bluuebunny/crossref_metadata_2025 huggingface dataset:
HEALTHCARE LITERACY AMONG INFORMAL CAREGIVERS: THE ROLE OF SOCIAL SUPPORT SYSTEM AND BURNOUT
Authors: Medcalf Robyn , Dayrit Jessika , Salom-Bail Shirley , Islaya Cesz , Foutz-Lowe Shelly , Alladi Renuka
Published: December 2022

Informal caregivers are integral components in the lives of individuals with health problems. However, little is known if the number of hours of informal care correlates with healthcare literacy levels. Thus, using the Center for Disease Control (CDC) Behavioral Risk Factor Surveillance (BRFSS) 2016 public dataset, the aim of this study examines the association between informal caregivers’ hours of care and their health literacy level, by controlling their social/emotional support, type of care they provide, and socioeconomic level. Data was weighted for complex sampling design and logistic regression to examine the data (Nf3,249). The study’s results show that being full-time or part-time caregiver has no association to healthcare literacy in verbal (OR=0.99, 95% CI=0.57–1.71) and written (OR=1.21, 95% CI=0.78–1.85) comprehensions. Further, caregiver’s type of care does not correlate to healthcare literacy level in verbal (OR=0.87, 95% CI=0.58–1.32; OR=0.93, 95% CI=0.59–1.45) and written (OR=0.91, 95% CI=0.66–1.27; OR=0.81, 95% CI=0.57–1.16) comprehensions. However, caregivers who rarely-to-never receive social/emotional support are four times more likely to have difficulties understanding verbal health information than those who have always-to-usually receive social/emotional support (OR=4.02, 95% CI=2.45–6.61). Caregivers who rarely-to-never receive social/emotional support are two times more likely to have difficulties understanding written health information compared to those that have always-to-usually receive social/emotional support (OR=2.30, 95% CI=1.51–3.51). Caregivers with lower socioeconomic backgrounds are at higher probability of low healthcare literacy level. Our study suggests further longitudinal and qualitative research, to understand healthcare literacy level among informal caregivers, and how social support systems correlates to healthcare literacy level.
USING ASSISTIVE TECHNOLOGIES AS A MEASURE TO SUPPORT WELL-BEING IN LATE-LIFE DISABILITIES
Authors: Su Tai-Te , Mejía Shannon
Published: December 2022

In the United States, the trends of disabilities among older adults have been largely stable over the past decade. However, the impact of disabilities on health and quality of life remains substantial and requires continued research. Along with a set of compensatory strategies, assistive technologies play a promising role in augmenting individuals’ capacity and reducing environmental demands in daily activities. Using data from the five survey rounds of the National Health and Aging Trends Study (2015‒2019), we aimed to investigate the longitudinal associations between disabilities, assistive technologies, and subjective well-being among older adults. A multi-class hierarchical spectrum was constructed to capture the state of disability and assistive technology use. Overall, results showed that subjective well-being decreased progressively along the spectrum. Additionally, assistive technologies were found to differentiate the associations between disabilities and well-being outcomes. Discussions focused on the insights and implications for successful accommodation to disabilities in later life.
EXERGAME INTERVENTION TO PROMOTE FAMILY CAREGIVERS’ SOCIAL SUPPORT, PHYSICAL ACTIVITY, AND WELL-BEING
Authors: Lin Xin Yao , Lachman Margie
Published: December 2022

Family caregivers often experience high stress, social isolation, poor mental and physical health, and have a sedentary lifestyle. The current study was a randomized trial (Nf76) comparing the effectiveness of Go&Grow (social vs non-social exergame app) to promote well-being through increased social support and physical activity for family caregivers over a 6-week intervention. Both groups received daily reminders to use the app. Findings showed the treatment group increased significantly more than the control group in well-being (management of distress) and social support (satisfaction with contact quality). There was an indirect effect of change in social support in which the treatment group increased more than the control group in satisfaction with contact quality, which in turn led to more positive affect and less loneliness. The increase in steps ranged from 3% to 12% across conditions. Social support moderated the relationship between condition and step changes, such that those in the treatment group who increased more in overall social support and knowing others’ experiences increased steps more than those with less support, while change in steps for the control group was not related to support level. In the treatment group, those who used the social features of the app more frequently had a greater increase in steps compared to those who used the social features less often. These findings can offer new insights into implementing behavior change mechanisms using exergames for sedentary and socially isolated family caregivers to improve their health with modifiable behavioral factors such as physical activity and social support.
POSITIVE AGEING AND DEATH OR DYING: A SCOPING REVIEW
Authors: Otto Robin , Fields Noelle , Anderson Keith , Bennett Michael
Published: December 2022

Ageing world populations and increases in life expectancy have facilitated an interest in developing ageing models that promote inclusivity and positive perceptions of ageing. This scoping review examines how and to what extent research that utilizes successful, active, productive, and healthy ageing framework(s) include death or dying. The study followed Joanna Briggs Institute’s methodological standard for scoping reviews and PRISMA guidelines and conformed to Arskey and O’Malley’s five-stage framework. A thematic analysis was used to identify how research utilizes the concepts of death and dying in the context of positive ageing models. The analysis identified five core themes: (a) the critique that death and dying dimensions in positive ageing models are absent; (b) older adults’ outlooks on death and dying while ageing well; (c) religious and spiritual dimensions of ageing well; (d) negative consequences of positive ageing models without death and dying dimensions; and (e) the future of death and dying in positive ageing models. The results bolster support for a paradigm shift that redefines what it means to age successfully without denying death. Incorporating the topics of death and dying into ageing conversations encourages individuals to ponder their end-of-life preferences and proactively participate in their advanced care plans. Death and dying conversations help care providers support people to live and die in a manner that is meaningful to them and inspire those receiving care to live fully and deeply and to think about the legacy that they want to leave.
EXPANDING WORLDS: ASSESSING STRATEGIES TO IMPLEMENTING A VIRTUAL REALITY PROGRAM IN RESPITE CARE
Authors: Quinones-Visot Emily , Bakk Louanne , Allen Katy , Milnamow Mary , Dauenhauer Jason
Published: December 2022

Virtual reality (VR) is an immersive experience that simulates real or imagined environments and provides an innovative solution to social isolation and loneliness. Implementation science was used to identify barriers and facilitators to implementing a novel VR intervention as part of a community-based participatory research project at Lifespan of Rochester within their Partners in Care (PIC) volunteer respite program. The VR intervention will be facilitated by PIC staff and volunteers with caregivers of community-dwelling persons living with dementia (PLwD) receiving respite services. A mixed-methods design was used to identify perceived barriers and facilitators to implementation. Focus groups and self-administered surveys were completed by PIC staff (Nf10) to assess their thoughts and concerns related to program implementation. Surveys included validated measures to assess self-rated ability to perform VR functional components, attitudes toward VR, beliefs on the acceptability, appropriateness, and feasibility of the VR program, effectiveness of improving comfort, confidence, and preparedness of facilitators. Identified barriers included lack of VR knowledge, skills, and confidence in capabilities; concerns related to safety, confusion, and triggers for PLwD; and the need to strengthen buy-in from staff. Implementation strategies were selected from the Expert Recommendations for Change project and tailored to support effective uptake and behavior change among PIC staff and volunteers. Identified evidence-based strategies included training and shadowing opportunities, identifying champions, and developing a trauma-informed approach manual. These findings illustrate the need to carefully examine organizational factors that can impede the implementation. The benefits of this approach and the lessons learned will be discussed.
DEVELOPING AN INTERPROFESSIONAL GRADUATE CERTIFICATE IN LONG-TERM SERVICES AND SUPPORTS
Authors: Towsley Gail , Elrod Leigh , Cox Nicholas , Varela Alberto , Edelman Linda
Published: December 2022

The demand for long-term services and supports (LTSS) is increasing and the capacity and competencies of the interprofessional LTSS workforce need to be expanded to provide value-based, person-centered care. The purpose of this presentation is to describe the process of developing an interprofessional LTSS graduate certificate in Gerontology. We broadened an existing nursing graduate certificate to encompass content related to skilled nursing facilities, assisted living and home health and hospice agencies. We will discuss: 1) how we engaged faculty from seven graduate programs: Pharmacy, Physical Therapy, Occupational Therapy, Dentistry, Social Work, Nursing and Physician Assistant to co-create the certificate; 2) challenges and benefits to developing a certificate; and 3) the 15-credit hour certificate components. Our faculty partners were committed to offering a LTSS focused graduate certificate which includes didactic courses and clinical hours. Four students have enrolled in the LTSS graduate certificate in Gerontology since implementation in Spring 2021.
ADOPTION OF SNFISTS BY US NURSING HOMES DID NOT REDUCE REHOSPITALIZATION RATES AMONG POST–ACUTE CARE PATIENTS
Authors: Jung Hye-Young , Kim Seiyoun , Ryskina Kira
Published: December 2022

SNFists, physicians and advanced practitioners who focus their practice in nursing homes, have grown in prevalence in recent years. In this retrospective cohort study, we measured the role of nursing home adoption of SNFists in rehospitalization rates. We used 100% Medicare facility and professional claims for hospitalized fee-for-service beneficiaries discharged to nursing homes in 2012-2019. We defined SNFists as generalist physicians and nurse practitioners with at least 80% of their Medicare Part B claims for nursing home care. All nursing homes that did not have a SNFist in 2012 were followed through 2019. We used an event study approach with staggered SNFist adoption to estimate the effect of a nursing home adopting at least one SNFist on the facility’s unplanned 30-day rehospitalization rate, adjusted for patient case mix, facility and market characteristics. Models included facility and year fixed effects. Standard errors were clustered at the facility level. Of the 6,616 nursing homes in the sample, 77% adopted SNFists by 2019. Nursing homes that adopted SNFists did not experience a statistically significant change in rehospitalization rate compared to those that did not adopt: rehospitalization rates decreased by 0.02 percentage points (95% CI -0.35 to 0.32; p=0.93) one year after SNFist adoption and by 0.15 percentage points (95% CI -1.01 to 0.70; p=0.73) six years after adoption, compared to the baseline difference between the groups in the year before adoption. In sum, despite the wide adoption of SNFists by US nursing homes, we did not observe an associated decrease in rehospitalization rates.
EXPLORING THE IMPLEMENTATION OF FOUR TRANSITIONAL CARE INTERVENTIONS FOR OLDER ADULTS: A COLLECTIVE CASE STUDY
Authors: Fakha Amal , Leithaus Merel , de Boer Bram , van Achterberg Theo , Hamers Jan , Verbeek Hilde
Published: December 2022

Four transitional care interventions, aiming to improve transitions between hospital and home settings for older adults, were implemented in Belgium. These interventions are complex in nature and their implementation in practice is often challenging. This study explores the implementation of these interventions from the perspectives of healthcare professionals involved in the process, and by investigating three implementation aspects: influencing factors, strategies used, and outcomes. A retrospective qualitative collective case study was conducted using semi-structured interviews with thirteen healthcare professionals. Thematic analysis was used, and the Consolidated Framework for Implementation Research guided the final data interpretation. Key findings indicated that implementation barriers were mostly at the organizational level (i.e., resources, structure, networks & communication), while facilitators were at the individual level (i.e., personal attributes, champions). The prominent strategy used to implement these interventions was engagement and additional strategies were suggested for the future sustainability of the interventions (i.e., building strategic partnerships, developing policies to support transitional care). The overall implementation was perceived as favorable with high adoption as a key outcome. This study highlights the crucial role of healthcare professionals, being motivated and committed to fostering the implementation of interventions in transitional care. It is important to use implementation strategies targeting factors at both the individual level as well as the organizational level for implementing transitional care interventions in the future.
GERIATRICIAN CO-MANAGEMENT AND EDUCATION OF JUNIOR DOCTORS IMPROVE THE CARE OF HOSPITALIZED OLDER SURGICAL PATIENTS
Authors: Thillainadesan Janani , Aitken Sarah , Monaro Sue , Cullen John , Kerdic Richard , Hilmer Sarah , Naganathan Vasi
Published: December 2022

We evaluated changes in processes of care after the introduction of a novel model of care for older vascular surgery inpatients. This model, called Geriatrics Co-management of older vascular surgery patients (GeriCO-V) embedded a geriatrician into the vascular surgery team who provided proactive geriatrics assessment of patients and education for junior surgical doctors. A pre-post study of the GeriCO-V model comparing prospectively recruited pre-intervention (n=150) and post-intervention (n=152) cohorts of consecutively admitted vascular surgery patients aged ≥65 years at an acute care academic hospital. Education of junior surgical doctors was embedded in the new model of care and included role modelling, provision of delirium and frailty screening lanyards and mobile Apps for ‘just-in-time’ learning, and a Wiki page of tips on assessing older patients. We measured processes of care by review of medical charts. After implementing the novel geriatrician and education embedded model of care, there was a significant increase in several processes of care by the junior surgical doctor: screening for cognition (8% vs 76%, p<.001) and delirium (2% vs 69%, p<.001), documentation of functional history (34% vs 76%, p<.001), medications (53% vs 74%, p<.001) and treatment preferences (5% vs 46%, p<.001) and prescribing of pharmacological venous thromboprophylaxis (93% vs 99%, p=.03) and co-prescription of laxative with opioid (60% vs 81%, p=.002). A collaborative model of care that embeds proactive geriatrician care and education of junior surgical doctors improves the quality of care for older vascular surgical patients.
CHANGING THE NARRATIVE ON NURSING HOME CARE
Authors: D’Antonio Patricia
Published: December 2022

Redesigning our nursing home care system will require substantial policy change, and we know that policy change needs an effective framing strategy. This panel will include speakers who have been studying public mindsets and opinions about nursing home care and its implications for advocacy communications. We will also talk about the implications of this research for the larger reframing aging initiative.
KEY PREDICTORS OF COGNITIVE AGING
Authors: Turiano Nicholas , Boron Julie Blaskewicz
Published: December 2022

Understanding who will experience cognitive dysfunction and dementia is as important as identifying methods to combat such deterioration. This symposium seeks to highlight new advances in understanding cognitive deterioration and promote resilience in adulthood. Odd and colleagues utilized a national sample (2,643 adults aged 34-85) to show that 9-year decreases in executive function and episodic memory predicted increased risk of dying. Use of a brief cognitive assessment administered via telephone was unique – a method that may assist clinicians administering cognitive screenings to older adults in isolated areas. Graham and colleagues utilized a daily diary approach in 116 older adults (aged 60-90) to show that greater daily fluctuations in mindfulness were associated with higher episodic memory and executive functioning. Further, mediational evidence suggested that on days when mindfulness was greater, individuals perceived a younger subjective age. Willroth and colleagues provide evidence that higher scores on eudaimonic well-being in older adults (n=349) predicted greater cognitive resilience. Specifically, even though some participants had neuropathological burden (e.g., increased beta-amyloid, neurofibrillary tangles), they did not exhibit pronounced cognitive declines. Using data from 14 longitudinal studies, Yoneda and colleagues examined the impact of physical activity on cognitive impairment and death. Multi-state survival analyses demonstrated engagement in more physical activity reduced risk of cognitive impairment and death. This symposium suggests that examining changes in cognition, incorporating subjective and objective indices of cognitive impairment, utilizing long-term longitudinal and daily diary designs, and testing key modifiable behaviors is crucial to understanding and promoting optimal cognitive functioning in adulthood.
WELL-BEING AND RESILIENCE TO DEMENTIA-RELATED NEUROPATHOLOGY
Authors: Willroth Emily , James Bryan , Graham Eileen , Kapasi Alifiya , Bennett David , Mroczek Daniel
Published: December 2022

Not all older adults with dementia-related neuropathology in their brains experience cognitive decline or impairment. Instead, some people maintain relatively normal cognitive functioning despite neuropathologic burden, a phenomenon called cognitive resilience. Using a longitudinal, epidemiological, clinical-pathologic cohort study (N=349), the present research investigated associations between well-being and cognitive resilience. Consistent with pre-registered hypotheses, higher eudaimonic well-being (i.e., Ryff Psychological Well-being Scale) and higher hedonic well-being (i.e., Satisfaction with Life Scale) were associated with better-than-expected cognitive functioning and less-than-expected cognitive decline relative to one’s neuropathological burden (i.e., beta-amyloid, neurofibrillary tangles, Lewy bodies, vascular pathologies, hippocampal sclerosis, and TDP-43). The association of eudaimonic well-being in particular was present above and beyond known cognitive resilience factors (i.e., socioeconomic status, education, cognitive activity, low neuroticism, low depression) and dementia risk factors (i.e., ApoE genotype, medical comorbidities). This research highlights the importance of considering eudaimonic well-being in efforts to prevent dementia.
PHYSICAL ACTIVITY, COGNITIVE HEALTH, AND LONGEVITY IN OLDER ADULTHOOD
Authors: Yoneda Tomiko , Piccinin Andrea , Lewis Nathan , Knight Jamie , Hyun Jinshil , Kleineidam Luca , Hofer Scott , Terrera Graciela Muniz
Published: December 2022

Research suggests that physical activity (PA) protects against cognitive impairment in older adulthood; however, the extent to which PA engagement throughout older adulthood influences the simultaneous risk of transitioning to cognitively impaired states and death is unclear. Applying coordinated data analysis across 14 studies, multi-state survival models (MSM) were independently fit to data from fourteen longitudinal studies (NTotal=52,039). PA was synthesized across studies using the metabolic equivalent of task approach. Adjusting for demographics and chronic conditions, meta-analytic results indicated that engaging in more PA was associated with a reduced risk of transitioning from no cognitive impairment to mildly impaired cognitive functioning (HR=0.94, 95%CI’s=0.89,0.99) and death (HR=0.72, 95%CI’s=0.65,0.80). Based on MSM estimates, multinomial regression models computed total life expectancy stratified by national PA recommendations. Meta-analytic results indicate a positive linear effect of PA, such that more PA is associated with longevity. This presentation will include discussion of knowledge translation efforts.
DIETARY INTERVENTIONS FOR HEALTHY AGING
Authors: Das Sai Krupa , Redman Leanne
Published: December 2022

Aging is associated with a host of cellular and molecular changes that cumulatively result in a progressive decline in metabolic and physical function, development of chronic disease, and increased risk of mortality. Dietary interventions targeting these age-related changes have been shown to attenuate the aging process and improve healthspan, i.e., the length of time individuals are disease- and disability-free. Calorie restriction (CR) is one such intervention that has been shown to be effective in reducing disease risk and improving multiple markers of biological aging. The biological mechanisms mediating the observed benefits of CR are not fully understood but possibly involve changes in energy metabolism, oxidative damage, insulin sensitivity, inflammation, and function of both the neuroendocrine and sympathetic nervous systems. Despite the benefits of CR, sustained adherence remains a challenge. An alternative dietary approach with potential for impact on markers of aging and disease risk is intermittent fasting (IF), which represents a broad class of meal-timing interventions that involve alternating periods of eating and extended fasting. One novel form of IF called time-restricted eating (TRE) involves eating within a 10-hour period and fasting for the rest of the day. TRE appears to improve adherence to IF and especially improve cardiometabolic health in humans. Studies in rodents and pilot studies in humans have found that TRE reduces body weight and hunger, improves insulin sensitivity, lowers blood pressure, reduces inflammation and oxidative stress, improves circadian rhythms, and, in rodents only, extends lifespan. With feasibility data demonstrating reasonably high adherence rates, TRE is a promising strategy to improve markers of healthspan.
TEAMS AND TOOLS: ADDRESSING POLYPHARMACY USING THE ARMOR TOOL IN A RURAL NURSING CARE FACILITY
Authors: Zell Angela , Haque Raza
Published: December 2022

Federal guidelines by the Centers for Medicare and Medicaid Services around the use of an interdisciplinary team (IDT) approach have been in place for years. However, use of evidence-based tools to address polypharmacy have not been specified. A study was conducted to evaluate the implementation of the ARMOR (Assess, Review, Minimize, Optimize, Reassess) tool to address polypharmacy in a rural nursing care facility. The tool provided a stepwise approach to a standardized process for the IDT to discuss individual resident care plans including psychotropic medications, psychosocial concerns, falls, quality of life, functional status and other factors in their weekly meetings. Surveys and a focus group were used to measure attitudes and skills of the IDT in relation to the use of the evidence-based tool in the IDT process. Data collected presents an overall positive attitude for and improvement in skills in the IDT with the use of the ARMOR tool.
THE EFFECTS OF COVID-19 ON THE MIGRATION OF HOME HEALTHCARE WORKER
Authors: Monaghan-Geernaert Pamela
Published: December 2022

Home health caregivers provide a vital role in allowing people to age in place. Women, and in particular immigrant women, have become the largest provider of home health care in Western Industrialized Countries. Global push-pull factors affecting caregivers were greatly disrupted with the emergence of the global pandemic – COVID-19. The pandemic highlighted how fragile the system is and how the easily the ‘grey economy’ can be compromised. This research looks at border access, immigration restrictions and other factors which impeded the migration of caregivers. Poor countries suffered greatly with restrictions on exporting women who use cross national moves as a means to generate income for families in their homeland, and rich countries faced extreme shortages. The results were devastating for all parties – caregivers and care recipients alike.
FAMILY PREPAREDNESS AT HOSPITAL DISCHARGE OF THE PERSON LIVING WITH DEMENTIA
Authors: Boltz Marie , Best Irene , Kuzmik Ashley
Published: December 2022

Family care partners face increased and more complex caregiving demands at the time of hospital discharge for persons living with dementia. This study examined family care partners’ needs for preparation and factors associated with the degree of preparation for caregiving. Care partners who were younger (t=3.26, p=.001), demonstrated anxiety (t= 2.6, p=.010) and depression (t =4.6, p <.001), and were caring for a person in pain (t=2.3, p=.023) had lower scores on the Preparation for Caregiving Scale. Care partners described the least preparation to care for the patients’ emotional needs (M= 2.8, SD=1.2) and deal with the stress of caregiving (M= 2.7, SD=1.2). Content analysis of nurses’ transitional care notes converged with these findings, while also describing a lack of preparation to advocate for information from medical providers. Findings suggest the need to attend to the psychological and informational needs of care partners, while considering patient well-being and comfort.
GENDER DIFFERENCES IN INTERACTIONS AND WELL-BEING AMONG HOSPITALIZED PATIENTS LIVING WITH DEMENTIA
Authors: Paudel Anju , Boltz Marie , Resnick Barbara
Published: December 2022

While the incidence of dementia is generally higher in women compared to men, gender differences in interactions and well-being in dementia is still unclear. This study examined gender differences in interactions and well-being among hospitalized patients living with dementia. A total of 140 hospitalized patients (53% female and 47% male) were included in the analysis. On average, the participants were 81.43 years old (SD= 8.29), had positive interactions with staff based on higher scores on Quality of Interaction Schedule, QUIS (5.81, SD= 1.36), and fair emotional well-being based on lower scores on Cornell Scale for Depression in Dementia, CSDD (7.79, SD= 5.59). Although men seemed to have more positive interactions (male=6.07, SD=1.13; female=5.59, SD=1.51) and greater wellbeing (male=7.52, SD=4.77; female=8.03, SD=6.25) than women, there were no statistically significant gender differences observed in linear models with appropriate covariates. Future work should continue to explore gender differences in interactions and well-being.
PREDICTORS OF THE DESIRE TO INSTITUTIONALIZE IN CARE PARTNERS OF HOSPITALIZED PERSONS WITH DEMENTIA AT DISCHARGE
Authors: Kuzmik Ashley
Published: December 2022

Hospitalized persons with dementia are more likely to be discharged to long-term nursing home care as compared to persons without dementia. The desire to seek this care is due in large part to the inability of family care partners to continue to provide care at home. This study aimed to identify predictors of desire to institutionalize (DTI) in care partners of persons with dementia at hospital discharge. A stepwise multiple linear regression was done to examine the dyad factors among 434 patient and care partners associated with DTI . Lower preparedness for caregiving (p < .001), higher caregiver strain (p = .039), cohabitation (p < .001) and care partner race (White; p = .016) were associated with DTI. Findings underscore the need to assess family preparedness for caregiving, strain, and living situation upon admission, and suggest the need to examine racial differences in the desire to seek nursing home care.
SUPPLEMENTING GLYNAC IN AGING IMPROVES GLUTATHIONE, MITOCHONDRIA, AND AGING HALLMARKS: A RANDOMIZED CLINICAL TRIAL
Authors: Sekhar Rajagopal , Kumar Premranjan , Liu Chun , Suliburk James , Hsu Jean , Jahoor Farook , Minard Charles , Taffet George
Published: December 2022

Oxidative stress (OxS), mitochondrial dysfunction and aging hallmarks are important contributors to aging, but effective solutions to correct these defects in older adults (OA) are lacking. Via earlier translational studies we discovered that supplementation of GlyNAC (combination of glycine and N-acetylcysteine) improves/corrects these defects. We conducted a double-blind, placebo-controlled (RCT) in 24 OA (mean age 71y) to definitively determine the effects of supplementing GlyNAC vs. isonitrogenous placebo (alanine) for 16-weeks on intracellular glutathione (GSH), OxS mitochondrial function, inflammation, insulin-resistance, endothelial function, physical function, body composition and multiple aging hallmarks. 12 YA (mean age 25y) served as young controls and received GlyNAC for 2-weeks. Subjects were studied before receiving supplementation study, and after receiving supplementation for 2-weeks (OA, YA) and 16-weeks (OA). The RCT found that compared to YA, the OA had severe GSH deficiency (red-cells, muscle), mitochondrial dysfunction, OxS (TBARS, F2-isoprostanes), diminished physical function (gait-speed, muscle strength, exercise capacity), elevated waist-circumference and systolic blood pressure, and multiple hallmarks defects of aging (affecting mitochondrial function, mitophagy, nutrient sensing, inflammation, insulin-resistance, genotoxicity, stem-cells and cellular senescence). GlyNAC supplementation for 2-weeks rapidly improved several defects, and further improved/corrected multiple defects after 16-weeks. No improvements were seen in YA receiving GlyNAC, or in OA receiving the alanine placebo, suggesting that protein supplementation per se in OA does not improve defects. The results of this RCT provides proof-of-concept that GlyNAC supplementation improves/reverses GSH deficiency, mitochondrial dysfunction, OxS, inflammation, physical function/strength and multiple aging hallmarks. GlyNAC could be a novel, simple and safe nutritional supplement to improve/reverse age-associated defects and promote health in aging humans.
CIRCULATING BIOMARKERS OF CELL SENESCENCE IN A RANDOMIZED TRIAL OF CALORIC RESTRICTION WEIGHT LOSS
Authors: Justice Jamie , Leng Iris , LeBrasseur Nathan , Mitin Natalia , Kritchevsky Stephen , Nicklas Barbara , Ding Jingzhong
Published: December 2022

There are no circulating markers exclusive to cell senescence for clinical trials in middle-aged/older adults. In this study we evaluated T-cell expression of tumor suppressor protein p16INK4a and plasma senescence associated secretory proteins (SASP)-factors in the context of an 18-week randomized trial of caloric restriction (CR) compared to a weight stable Control. The analysis includes 55 middle-aged/older adults (75%Women; 33%African American; 57.6±5.8 years) with obesity and prediabetes. We measured mRNA expression of select senescence and apoptosis gene transcripts (p16INK4a, p21, BCL2L, BAK1) in peripheral blood CD3+ T-cells (quantitative-RT-PCR) and a panel of 27 plasma SASP proteins (Luminex/multiplex; ELISA). Weight loss in those randomized to CR was -10.8±0.9 kg compared to +0.5±0.9 kg in Control. Using mixed models, T-cell expression of senescence-biomarkers p16INK4a, p21, BCL-2L, and apoptosis-marker BAK1 were not different between CR and control at 18 weeks (time × treatment adjusted for age, race, and sex, all p>0.05). We explored associations between biomarkers with weight loss; moderate spearman correlations (rs=0.28 to 0.64) were observed between weight loss and change in plasma SASP-factors (Activin A, I-CAM, MMP1, PAI-1, TNF-RI, TNF-RII, VEGF, uPAR, p< 0.05 all), but not T-cell biomarker expression. We evaluated associations between biomarkers and found change in T-cell p16INK4a was associated with change in plasma SASP-factors, Fas (rs=0.51), osteopontin (rs=0.34), myeloperoxidase (rs=0.39), and MMP2 (rs=0.40) (CR+Control combined). Among middle-aged/older persons with obesity undergoing 18-weeks CR, changes in T cell p16INK4a expression were correlated with reductions in key SASP factors, and weight loss was associated with lower pro-inflammatory SASP profile.
THE CANNABIS AND OLDER PERSONS STUDY: EXPANDING OUR MINDS THROUGH INTERDISCIPLINARY RESEARCH
Authors: Kaskie Brian , Han Benjamin
Published: December 2022

The Cannabis and Older Persons Study has examined the increasing use of cannabis among Americans over 60 years old since 2016. This year’s symposium presents varied methodological approaches researchers have used to better understand the harms and benefits associated with cannabis use among older Americans. Divya Bhagianadh examines the association between cannabis legalization policies across the Untied States and corresponding use of end of life programs and services. Julie Bobitt analyzes interviews provided by older adults in Illinois and defines how attitudes held by medical doctors and other clinical care providers are critical to shaping cannabis use among older adults. Brian Kaskie considers the role of cannabis policy clusters. Jacobo Mintzer reviews findings from a controlled trial providing two cannabinoids to treat agitation among persons with Alzheimers in hospice. Thorsten Rudroff examines cannabis use among a sample of older persons at risk for falls. These studies reflect how cannabis use among older persons continues to grow and diversify, and how researchers have use different approaches to advance scientific understanding of determinants and outcomes, both desirable and undesirable, associated with cannabis use among older adults. This symposium offers policy makers and health care leaders a balanced perspective. On one side, we discuss how prevention and treatment efforts for substance use disorder, including cannabis use disorder, must increase proportionally to the increasing number of older cannabis users. On the other side, we consider how more than 5 million older Americans, especially those with pain, find some benefit in using cannabis.
EXPERIENCES AND RECOMMENDATIONS FOR STARTING A UNIVERSITY GERONTOLOGY RESEARCH LABORATORY
Authors: Howell Britteny , Peterson Jennifer
Published: December 2022

Although founding and directing an independent research laboratory is often expected of faculty at American universities, there are several barriers to successful completion of this important task. There is little guidance in the literature regarding exactly how to go about starting a research laboratory. The guidance that does exist for faculty often focuses on running research labs in the “hard sciences,” such as biomedical science and engineering, leaving social and behavioral scientists out of such considerations. Additionally, smaller or teaching-focused universities often have little infrastructure or support for starting a research lab, so faculty at these institutions may not know where to begin. These barriers are significant concerns for junior faculty, who are often unprepared for the realities and challenges of starting a successful research lab while obtaining other milestones required of promotion and tenure. We present two examples of recently-formed gerontology research laboratories begun by junior faculty, one in the psychology department of a research university and one in public health at a teaching-focused university. Our case studies present the audience with specific examples, lessons learned, and guidance for starting their own gerontology research laboratory in higher education, as well as recommendations on maintaining its functioning during a global pandemic (COVID-19).
TEACHING THE INTERSECTION OF AGING AND DISABILITY FOR FIRST-YEAR STUDENTS
Authors: Mulhorn Kristine
Published: December 2022

The honors college at Drexel included their Freshmen Seminar in a recent effort to offer various courses on the theme of aging across the campus. Usually, the themed courses are for juniors and seniors who can choose electives. This year, the theme of aging was interwoven into two freshmen seminars with a maximum of 20 students. The purpose of this course was to examine the complexity of these two concepts and recognize possible avenues for study, research, and careers based these perspectives. Disability is not only a way of describing how someone lives with biological or physical difference, but disability can be a social identity, and a group recognized in recent civil rights legislation. Aging is not only at the individual level, but an ongoing demographic change that is happening throughout the world. Students reflected on online quizzes on ableism and ageism to gain insights about their own biases and the biases within their chosen career fields. Through class discussions and reflections, students achieved course objectives: 1) describe how society can better prepare individuals to fully participate in society throughout life; 2) recognize key factors affecting those with disability and aging with disability as they navigate education, health services, housing and work; 3) synthesize literature on aging and disability to make recommendations for improving social participation for those either aging with disability or aging into disability; and 4) describe public policy challenges for those over 50 and those who identify as disabled.
A MULTIPRONGED APPROACH TO MODELING DYADIC SIMILARITY AMONG MIDDLE-AGED AND OLDER ADULTS
Authors: Purol Mariah , Weidmann Rebekka , Hickman Louis , Oh Jeewon , Chopik William
Published: December 2022

One surprising finding in the field of dyadic influence is the minimal influence that couple personality similarity has for life and relational well-being. Most research has focused on pairing of symmetric psychological characteristics on a broad, trait level (i.e., one person’s extraversion with their partner’s extraversion) across romantic partners. However, many more cross-trait combinations are possible, and facet-level traits may provide additional information that is traditionally lost. Among 1,366 middle-age and older couples, we examined similarity effects of personality facets on health, life, and relational well-being using difference scores, response surface analyses, and machine learning approaches. Across analytic and operational approaches, partner and similarity effects were relatively small in magnitude, although additional variance was explained for some outcomes (e.g., relationship satisfaction) than others (e.g., memory, chronic illnesses). Our findings constitute one of the more comprehensive examinations to date and suggest even the modest effects of personality similarity may be overstated.
A PILOT RANDOMIZED CLINICAL TRIAL TO PROMOTE POSITIVE AFFECT IN PATIENTS WITH FIBROMYALGIA
Authors: Reid Cary , Ong Anthony , Moskowitz Judy , Sanni Mubarak , Kim Patricia , Wethington Elaine , Addington Elizabeth , Sluys Erica
Published: December 2022

Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition characterized by widespread pain, impaired physical functioning, and deficits in positive affect (PA). Standard behavioral therapies for FMS focus on reducing negative affect (NA) and yield only modest benefits. We examined the feasibility, acceptability and preliminary efficacy of a 6-week, online, PA-enhancing intervention, entitled: Lessons in Affect Regulation to Keep Stress and Pain UndeR control (LARKSPUR). We enrolled participants from one large health system in New York City and ResearchMatch. Ninety-five FMS patients were randomized to LARKSPUR or a neutral emotion reporting arm. Results to date indicate that LARKSPUR is feasible: recruitment (82%), retention (93%); and acceptable: mean satisfaction score on 1-10 scale (9.4, SD=1.2). Planned efficacy analyses will evaluate treatment effects on pain intensity and interference, depressive symptoms, and stress appraisals. If effective, LARKSPUR will lay the foundation for understanding how behavioral treatments for FMS can be optimized through PA enhancement.
DO INTERNALIZED AGE STEREOTYPES MEDIATE THE RELATIONSHIP BETWEEN VOLUNTEERING AND SELF-EFFICACY AMONG ADULTS 50+?
Authors: Steward Andrew , Hasche Leslie
Published: December 2022

Volunteering is associated with increased self-efficacy among older adults, and self-efficacy has been shown to mediate the relationship between ageism and health. A growing, compelling body of literature based in stereotype embodiment theory identifies significant, negative public health impacts of internalized age stereotypes. Yet, little research explores whether volunteering may both reduce internalized ageism and enhance self-efficacy as people age. This cross-sectional study examined whether internalized age stereotypes mediate the relationship between volunteering and self-efficacy for adults 50+. A convenience sample of volunteers (n = 165) 50+ years of age residing in the U.S. Mountain West was recruited. A 15-minute, online survey was utilized. The independent variable was number of volunteer hours per week (mean = 6.45, SD = 5.38). The dependent variable was self-efficacy measured by five items from the five-point, Likert-type general self-efficacy scale (α = .83; mean = 4.81, SD = 1.08). Drawing from the self-stereotypes of aging scale, the indirect effects of five internalized positive (e.g., “wise” and “capable”) and five negative (e.g., “grumpy” and “helpless”) age stereotypes were tested. Results indicate that increased internalized positive, but not negative, age stereotypes partially mediated the relationship between volunteer hours and self-efficacy while holding constant age, gender, race, self-rated health, functional limitation, education, employment, and previous volunteer experience. Although positive age stereotypes have long been considered a form of ageism, the results of this study suggest that internalized positive age stereotypes may function as a form of esteem to promote enhanced psychosocial health as people age.
HOW TO PUBLISH: GUIDANCE FROM GSA’S JOURNAL EDITORS
Authors: Meeks Suzanne , Anderson Rozalyn , Albert Steven , Isaacowitz Derek , Jung Karen
Published: December 2022

Each year the GSA publications team sponsors a symposium to assist authors who wish to publish in GSA’s high impact and influential journals. The first part of the session will include five brief presentations from the editors of The Gerontologist, Innovation in Aging, and the Journals of Gerontology Series A and B plus journal managing editors. We will integrate practical tips with principles of publication ethics and scholarly integrity. The topics will be as follows: (1) Preparing your manuscript: strong and ethical scholarly writing for multidisciplinary audiences, (2) common problems that affect peer review, (3) addressing translational significance and fit to journal expectations, (4) transparency, documentation, and Open Science; and (5) working with Scholar One. Following these presentations, we will hold round table discussions with editors from the GSA journals portfolio. At these round tables, editors will answer questions related to the podium presentations and other questions specific to each journal. Intended audiences include emerging and international scholars, and authors interested in learning more about best practices and tips for getting their scholarly work published.
COMMON PROBLEMS THAT IMPACT PEER REVIEW
Authors: Anderson Rozalyn
Published: December 2022

This presentation will review the most common issues that affect how reviewers see a manuscript submission. These include clarity, use of figures, and attention to existing research, especially establishing the significance and novelty of the work, and how to frame a narrative. I will also address responding to peer review. The focus will be on the biological science perspective (Journals of Gerontology Series A), but these issues are relevant to all submissions to GSA journals.
DEFINING TRANSLATIONAL SIGNIFICANCE IN GERONTOLOGY
Authors: Albert Steven
Published: December 2022

Innovation in Aging requires a statement from authors on translational significance. This requirement forces authors to consider the implications of their research for changing some component of aging. How does the research address a challenge posed by aging bodies, minds, relationships, or societies? The editorial board has developed criteria for assessing translational significance. Translational research must meet at least one of three criteria. It (i) must predict or explain a health or behavioral outcome, (ii) be advanced enough in deployment or development to assess these effects, and (iii) have a clear pathway to large-scale program delivery or change in clinical practice. The criteria rule out some kinds of submissions, such as scale development, single-case studies, or reviews of literature. We use these criteria to structure each article’s required translational significance statement. Rethinking translation may help focus research across the full set of GSA journals.
MAKING CLASSROOMS MORE AGE-FRIENDLY: STRATEGIES FOR INTERGENERATIONAL EXCHANGE
Authors: Montepare Joann , Farah Kimberly , Borrero Lisa
Published: December 2022

Aging populations are reshaping how we think about teaching and learning in higher education. As a result, educational opportunities for intergenerational exchange are on the rise with the growth of the Age-Friendly University (AFU) initiative. Endorsed by GSA’s Academy for Gerontology in Higher Education, the AFU principles call for promoting intergenerational exchange to facilitate the reciprocal sharing of expertise between learners of all ages. Age diverse classrooms and learning spaces have distinctive needs and dynamics that instructors, and students, will need to learn how to navigate. This collaborative symposium, that brings together members of the Age-Friendly University (AFU) and Intergenerational Learning, Research, and Community Engagement (ILRCE) Interest Groups, will explore evidenced-based practices that contribute to successful experiences in and beyond the classroom. Montepare and Farah will provide an overview of the AFU initiative and intergenerational classroom issues. Jarrott and colleagues will address how technology and other strategies can prepare individuals for intergenerational learning experiences, including when circumstances limit in-person opportunities, such as during COVID. Dauenhauer and Heffernan will share insights from faculty about ways to develop and sustain a lifelong learning program that incorporates intergenerational interactions in the classroom experience. Leedahl will discuss strategies for developing age-friendly intergenerational internship experiences with community partners. Borrero, co-convener of the ILRCE Interest Group, will serve as the discussant.