bluuebunny/crossref_metadata_2025 huggingface dataset:
A Step Backward and Forward in an Age-Friendly University Initiative: Adapting a Campus Learning Partnership
Authors: Gautam Ramraj , Melillo Karen Devereaux , McDonough Carol
Published: December 2021

The 5-campus UMass system received designation as an Age-Friendly University (AFU) in 2019. AFU Principle 1 highlights the importance of involving older adults in University activities. UMass Lowell’s Center for Gerontology Research and Partnerships collaborated with the Learning in Retirement Association (LIRA) in Spring 2020 to offer aging-related courses around healthy aging. However, due to COVID-19, these were canceled and are re-scheduled for Spring 2021 via Zoom. The paper will describe the process of selecting course offerings with LIRA and the subsequent cancellation/rescheduling process and adaptation needed. A course will focus on AFU initiative and the opportunities and challenges at UMass Lowell. Likewise, the other course will offer a session on technology and aging where age-based digital divide and strategies for reducing it will be discussed. This paper will reflect on how the collaboration with LIRA and course selection process relates to the AFU principles 1, 5 and 9.
Policy Series: COVID-19: How It Shaped Nursing Home Care and Elder Justice
Authors: Lindberg Brian
Published: December 2021

This session will provide updates on how the pandemic led to horrific situations in long-term care facilities and how the pandemic influenced major federal efforts to address elder abuse, neglect, and exploitation.
Designing Participatory Aging Research on Exclusion From Social Relations: A Citizen Science Project
Authors: Urbaniak Anna
Published: December 2021

Many policies and initiatives aim at enhancing the social participation of older adults. Despite this growing interest in increasing social inclusion and combating social exclusion in older age, the voices of socially-excluded older adults and their experiences remain underrepresented in research. Based on data from the Austrian research project “Socially Excluded Older Adults: Voices and Experiences” (SEVEN), I reflect on what it means to co-create research with the hard-to-reach populations of socially excluded older adults. Data discussed is derived By inviting this group to participate in each stage of the research, the project develops an innovative approach that, on the one hand, facilitates and advances ways for socially-excluded older adults to express their voices, thereby empowering them and their self-advocacy, and, on the other hand, creates research insights that are able to grasp the life worlds of older, socially excluded adults more accurately.
Daily Financial Thoughts and Indices of Mental and Physical Health: The Importance of Socioeconomic Status
Authors: Piazza Jennifer , Rush Jonathan , Cerino Eric , Mogle Jacqueline , Stawski Robert , Charles Susan , Almeida David
Published: December 2021

The current study examined the associations between daily financial thoughts, socioeconomic status (SES), and indices of emotional (positive and negative affect (PA/NA)) and physical health (physical symptoms and cortisol). Participants (N = 782) from the National Study of Daily Experiences, a subsample of the Midlife in the United States Refresher survey, completed daily diary interviews and provided saliva samples, from which cortisol was assayed. Participants who, on average, reported more daily financial thoughts also reported more NA, less PA, more physical symptoms, and had higher cortisol AUCg (all p’s < .05). These effects were more pronounced among people reporting lower SES. Daily fluctuations in financial thoughts also predicted daily fluctuations in NA, PA, and physical symptoms (all p’s <. 01). Again, these associations were more pronounced among people reporting lower SES. Results indicate that intrusive, daily financial thoughts may be one pathway explaining the link between SES and health outcomes.
Grandchild Caring and Late-Life Depression: A Comparative Longitudinal Study in China and Europe
Authors: Yang Yazhen
Published: December 2021

The impact of grandparenting on the grandparents’ health has been relatively under-studied, and international comparisons can provide useful lessons for grandparents and policymakers. This study examined country differences in the effects of grandchild care provision on the grandparents’ depression in Italy, Spain, China, Denmark and Sweden using the longitudinal Harmonised CHARLS and SHARE data collected between 2010-5. Controlling for the grandparents’ depression in 2011, grandparents providing non-intensive grandparental care in China, Sweden and Denmark in 2013 were less likely to report depression in 2015 compared to those who did not provide any care in 2013. Such effects were more pronounced among grandmothers compared to grandfathers. The results indicate that the effects of grandchild caring on the grandparents’ depression in China was comparable to Denmark and Sweden. Future research can focus on identifying the causal pathways between grandparenting and wellbeing, and the implications of such pathways for older persons’ wellbeing worldwide.
Critical Age-Friendly Research and Representational Ethics
Authors: Oswald Austin
Published: December 2021

As the efforts of the Global Age-friendly Cities and Communities movement mature and continue to grapple with society’s shifting dynamics, blind spots and knowledge gaps are exposed. This research applies critical discourse analysis to examine the evolution of Age-friendly NYC using an intersectional lens committed to an ethics of representation. Over 1,000 pages of public records were analyzed to trace the history of this movement in relation to age, race, sexuality, gender, ability, and class. Findings suggest that Age-friendly NYC is a global leader of the age-friendly movement, yet social identities are represented neither equally nor universally in its initiatives. Discussions of race, sexuality, and gender are subtle. They also overlook how these identities may intersect and shape the aging experience for differently positioned older adults. A comprehensive understanding of the aging experiences of those with multiple intersecting identities is needed to inform future age-friendly policies and programs.
A Critical Examination of Senior Housing: Promoting Equity Through Ensuring Safe Spaces
Authors: Perry Tam , Kilgore Zach , Appel Michael , Waktins Michele , Sanford Claudia , Archambault Dennis
Published: December 2021

As affordable senior housing communities aimed to address the health and well-being concerns of residents in the COVID-19 pandemic, special attention to safety during renovation had to be addressed. This paper offers case studies from members of a city-wide advocacy group, Senior Housing Preservation-Detroit. Eighty one percent of covid deaths in the City of Detroit are those 60 and above; 81.2% of deaths have been among African Americans (Detroit Health Department, 2021). With the grief and challenge in a city hit early on in the 2020 pandemic, these case studies will highlight how Covid-19 affected planned projects in senior buildings, how stakeholders such as developers, staff and residents responded and key considerations for future emergencies affecting senior housing communities. This paper offers critical perspectives applicable to many urban landscapes in order to raise awareness to policy makers, and practitioners.
Designing Socially Assistive Robots for People With Alzheimer’s and Related Dementia
Authors: Mitchell Kimberly , Zhao Xiaopeng , Yu Jinxiao , MacDougall Luke
Published: December 2021

Alzheimer’s disease (AD) is the most common form of dementia and is associated with memory loss and cognitive impairments that affect daily life. Approximately 5.8 million older adults in the U.S. are living with AD. People with AD often require high levels of care and assistance to maintain daily activities. The majority of care provided to a person living with AD or other forms of dementia is from a family caregiver, representing 18.6 billion hours of unpaid care valued at $244 billion. The long duration, time-intensive nature of caregiving imposes high burdens on caregivers. We designed a socially assistive robot to engage in conversation with people with AD, by engaging in conversation, helping them conduct simple daily tasks, and relieving caregivers of some of their responsibilities. Using design-thinking methodology, a prototype social robot has been created using 3-d printing technology and a single board computer based on raspberry Pi. Interaction between human and robot is implemented using the Mycroft open source voice assistant. The authors demonstrated that the robot is able to have natural conversations with human users. The overall cost of the robot is estimated to be less than $300, rendering it possible for wide distribution among the public. Future research includes further implementation of various cognitive assessment and cognitive training programs using the social robot to improve the quality of life for people living with AD.
Memory-Related Limitations and Care Needs of Gender Minority BIPOC Adults
Authors: Cicero Ethan , Lambrou Nickolas , Wharton Whitney , Flatt Jason
Published: December 2021

Limited research exists investigating cognitive impairment and Alzheimer’s disease and related dementias (ADRD) among gender minority (GM) adults (transgender/non-binary/, including examining memory-related challenges among GMs who also identify as Black, Indigenous, or People of Color (BIPOC). 2015-2019 Behavioral Risk Factor Surveillance System data were used to explore care needs of GM and cisgender (CG) adults with subjective cognitive decline (SCD, N=441), which may be the first clinical manifestations of ADRD. Regression models examined SCD-associated functional limitations and care needs among GM-BIPOC, GM-White, CG-BIPOC, and CG-White adults. GM-BIPOC and GM-White were 2-4x more likely to have SCD-related limitations, require assistance with daily tasks, be unable to do day-to-day or social activities when compared to CG-White. GM-BIPOC were 2-5x more likely to be uninsured and experience cost-related healthcare barriers compared to GM-White and CG-White/BIPOC. Additional research is needed to improve care and well-being for this understudied population.
Marital Quality and Heavy Alcohol Use Among Older Couples
Authors: Curl Angela , Bulanda Jennifer , Roberts Amy Restorick
Published: December 2021

Supportive marital relationships may reduce partners’ problematic health behaviors, whereas unhappy relationships may lack efficacious spousal monitoring of health and increase the likelihood of using maladaptive coping strategies, such as heavy alcohol use, to deal with relationship problems. We used pooled data from the 2014 and 2016 waves of the Health and Retirement Study to examine how both partners’ perceptions of marital quality were associated with heavy drinking. Our analytic sample included married couples in which both spouses were over age 50, completed the leave-behind psychosocial questionnaire, and provided non-missing data on marital quality and alcohol use (n=2,095 couples). Measures included both positive and negative dimensions of marital quality and controls for sociodemographic, economic, health, household and marital characteristics. Using Proc Glimmix, we estimated a dual-intercept Actor-Partner Interdependence Model (APIM), in which separate equations were computed simultaneously for husbands and wives. For husbands, higher negative marital quality was associated with an increase in the odds of their own heavy drinking (OR=1.27), but there was no significant association between wives’ marital quality and husbands’ heavy drinking behavior. For wives, marital quality was not significantly associated with their own heavy drinking, but husbands’ higher ratings of both negative and positive marital quality increased the risk of wives’ heavy drinking (OR=1.60 and OR=1.75, respectively). Results suggest that marital quality is associated with heavy drinking in later life: self-ratings of marital quality matter for men, whereas spousal perceptions of marital quality are more important for women.
Global Rise of Depression Prevalence Amid the COVID-19 Pandemic
Authors: Egbert Anna , Karpiak Stephen , Havlik Richard , Cankurtaran Sadiye , Ozturk Sirinnaz
Published: December 2021

The immense burden of depressive disorders is on the rise, with global prevalence estimates in 2017 ranging from 4% to 13%. The novel coronavirus SARS-CoV-2 is likely to impact the established risk factors for depressive disorders. Thus, a rapid increase in depression prevalence can be expected amid the COVID-19 pandemic. Using epidemiologic data (N=111,225) derived from an extant online survey “Measuring Worldwide COVID-19 Attitudes and Beliefs” (launched by Fetzer and colleagues, March-April 2020) in 178 countries, we examined age-dependent global prevalence of depression and assessed the impact of social factors caused by the COVID-19 pandemic on depressive symptomatology. Point prevalence of depression was measured using the PHQ8 standard cut-off score (i.e., ≥10). Correlates of depressive symptoms were analyzed with hierarchical regression modeling separately in three age groups, i.e., 18-34, 35-54 and 55+ years. We found that nearly 20% of individuals globally revealed significant symptoms of depression, including 27% of young, 15% middle-aged, 9% adults aged 55+. These data suggest that the prevalence of depression is 2-5 times higher than global estimates preceding the COVID-19 pandemic. Regression modeling explained approx. 50% variability in depressive symptoms across the three age groups. Increased risk of depression was found in females, single or divorced individuals, and those who presented poorer health and higher anxiety. Social restrictions amid the COVID-19 pandemic were marginal risks for depression. Together, this study highlights the impact of the COVID-19 pandemic on the mental health of people of different ages and urges the development of increased access to psychological interventions.
Social Connectivity in the Context of COVID-19 and Long-Term Care
Authors: Garnett Anna , Pollock Hannah , Floriancic Natalie , Donelle Lorie , Babenko-Mould Yolanda , Oudshoorn Abe , Hand Carri , Forchuk Cheryl
Published: December 2021

The COVID-19 pandemic has disproportionately impacted older adults, particularly those residing in long-term care homes (LTCHs), causing immense loss of life and resulting in overall health declines in LTCH residents. These vulnerable older adults have also experienced extreme loneliness, anxiety and depression. Social connectedness is an important contributor to well-being and quality of life of older adults in LTCHs and family members are an essential component to this. However, restrictions driven by policies to protect resident safety, have constrained family members’ access to long-term care homes and limited in-person contact between residents and their families. In their absence, health providers have been integral to supporting connections between residents and their families within LTCHs. This study aimed to understand the experiences of social connectedness between residents and family members who have been physically separated due to the current pandemic and, to examine LTCH health providers’ experiences and responses to support social connectedness. Using a qualitative descriptive design, in-depth semi-structured interviews were conducted with 21 family members and 11 healthcare providers. Emergent themes from qualitative content analysis are: (a) all-encompassing impacts of separation; (b) advocacy became my life; (c) the emotional toll of the unknown; 4) the burden of information translation; 5) precarious balance between safety and mistrust for the healthcare system; and (d) a formulaic approach impedes connectivity. A more comprehensive understanding of the experiences and support needs of LTCH residents and their family members within the context of a pandemic can inform practice approaches to support social connections going forwards.
Feasibility Pilot: Problem Adaptation Therapy for Emotion Regulation in Community-Dwelling Older Adults
Authors: Sheffler Julia , Meynadasy Melissa , Kiosses Dimitris , Sachs-Ericsson Natalie
Published: December 2021

Emotion regulation (ER) difficulties in older adults are associated with increased depression and decreased resiliency to stressful life events. In general, maladaptive ER is a transdiagnostic risk factor for a range of psychological and physical problems across the lifespan. Thus, interventions targeting ER may be valuable in reducing risk for a range of late-life pathologies. The present study evaluated and adapted an existing ER-focused treatment (i.e., Problem Adaptation Therapy (PATH)) for community older adults. We completed a small clinical pilot study to assess the feasibility of the adapted protocol and initial signals of effect of the intervention on ER, depression, and resiliency. Participants were recruited using an online survey, which was used to then identify participants scoring in the highest and lowest quartiles for ER. Individuals in the lowest ER quartile (N=27) were randomly assigned to the PATH condition or a physical health education (PHET) control condition. Of the 27 participants in the low ER group, four participants (3 PATH, 1 PHET) dropped out of the intervention. A paired samples t-tests revealed significant decreases in depressive symptoms, significant increases in self-reported ER skill, and improvements in resiliency (all ps<.05) for the PATH condition. For the PHET condition, only significant increases in self-reported ER skill (t(12) = -2.68, p = .020) were observed. In sum, the intervention protocol proved feasibility and demonstrated initial signals of effect in the expected directions. Future studies will examine mechanisms of action and the efficacy of the adapted PATH protocol.
Bats: Secrets of Extended Healthspan
Authors: Teeling Emma
Published: December 2021

Of all mammals, bat possess the most unique and peculiar adaptations that render them as excellent models to investigate the mechanisms of extended longevity and potentially halted senescence. Indeed, they are the longest-lived mammals relative to their body size, with the oldest bat caught being >41 years old, living approx. 8 times longer than expected. Bats defy the ‘rate-of-living’ theories that propose a positive correlation between body size and longevity as they use twice the energy as other species of considerable size, but live far longer. The mechanisms that bats use to avoid the negative physiological effects of their heightened metabolism and deal with an increased production of deleterious Reactive Oxygen Species (ROS) is not known, however it is suggested that they either prevent or repair ROS damage. Bats also appear to have resistance to many viral diseases such as rabies, SARS and Ebola and are the suspected reservoir species for a huge diversity of newly discovered viruses, including Sars-CoV-2 This suggests that their innate immunity is different to other mammals, perhaps playing a role in their unexpected longevity. Here the potential genomic basis for their rare immunity and exceptional longevity is explored across multiple bat genomes and divergent ageing and immune related markers (e.g. microbiome, telomeres, mitochondria, cellular dynamics, cytokine response) studied in wild bat populations. These findings provide a deeper understanding of the causal mechanisms of ageing and tolerant immunity, potentially uncovering the key molecular pathways that could be utilised to benefit society.
Feasibility of Routine Quality-of-Life Assessment in Long-Term Care Homes
Authors: Hoben Matthias , Banerjee Sube , Beeber Anna , Chamberlain Stephanie , Hughes Laura , O’Rourke Hannah , Stajduhar Kelli , Spiers Jude
Published: December 2021

Maximizing long-term care (LTC) residents' quality of life (QoL) is the primary goal of care. However, most residents have cognitive impairment and care staff time is severely limited, leading to various complexities in measuring QoL. This study developed and assessed the feasibility of an approach to routinely measuring QoL in LTC residents. We used the DEMQOL-CH, a practical, reliable, valid tool, developed in the UK to be completed by care aides to assess QoL in residents with moderate to severe dementia. We recruited 45 care aides in 10 LTC homes in Alberta, Canada who we surveyed on the QoL of 263 residents via video calls. We assessed time to complete; care aide and manager perceived feasibility of completing the DEMQOL-CH; internal consistency and inter-rater reliability of DEMQOL-CH scores; and we conducted cognitive interviews with 7 care aides to assess care aide comprehension of the tool. Time to complete was on average 4 minutes with little variation. Care aides and managers rated using the DEMQOL-CH as highly feasible and valuable. The internal consistency of the DEMQOL-CH score was 0.80. The DEMQOL-CH score inter-rater agreement was 0.73. Cognitive interviews suggested good comprehension overall with some comprehension problems especially in care aides who speak English as a second language. Asking care aides to complete the DEMQOL-CH is highly feasible, requires minor resources, and reliability is high. However, some items caused comprehension and reliability problems. Reasons and possible solutions will be subject to further investigations.
Oral Health in Late Life: Challenges and Solutions
Authors: Chen Xi , Wu Bei , Shuman Stephen
Published: December 2021

Older adults face a unique challenge in maintaining their oral health due to an increased disease burden, polypharmacy, functional impairment and other reasons. The five papers in this symposium describe the oral health issues in various groups of older adults and discuss different approaches to improve oral health for older adults. Using data from the Population Study of Chinese Elderly in Chicago, the first paper examined the relationship between self-reported discrimination and oral health related quality of life and investigated how resilience mediated such a relationship among foreign-born older Chinese Americans. The second paper described the oral health concerns and related treatment needs in older adults receiving palliative care using a mixed method design. The third paper demonstrated how to use behavior change techniques to improve oral self-care skills of individuals with mild dementia and support their family caregivers. The fourth paper described a project that integrates the age-friendly health system's principles into specialty dental care to address healthy aging and oral health. This initiative helped prevent and change the false belief that aging inevitably involves deterioration in oral health. The fifth paper described the impact of COVID-19 on the management of oral health problems and access to dental care in older adults. Transformative changes in care delivery and the impact of vaccination on access to care was also explored. This symposium helps better understand the oral health needs in older adults and provides new evidence to improve oral health for these individuals.
Adopting the 4Ms Framework and Age-Friendly Concepts Into Dental Care
Authors: Arany Szilvia , Medina-Walpole Annette , Caprio Thomas
Published: December 2021

We report on launching a dental initiative that addresses healthy aging and oral health, focusing on prevention and changing the false belief that aging inevitably involves deterioration in oral health. Our project integrates the age-friendly health system's principles into specialty dental care at Eastman Institute for Oral Health, URMC. We established an oral health-centered framework with project elements of the 4Ms - what matters, medication, mentation, and mobility. We developed pilot 4Ms templates integrated into dental charts to implement healthy-aging key oral health processes, including oral health assessment, treatment planning, and oral hygiene support. We engaged all members of the dental team through educational sessions for providing care for patients affected by Alzheimer’s disease and related dementias. We leveraged on locally available interdisciplinary resources and the collaboration reflecting undergoing efforts at the University of Rochester Division of Geriatrics and the Finger Lakes Geriatric Education Center, a Geriatric Workforce Enhancement.
Feasibility of a Generic FFC Intervention for Long-Term Care: Evidence From Interventions in Various Care Settings
Authors: Vluggen Stan , Metzelthin Silke , devan Ginkel Janneke de Man-van , de Waal Getty Huisman- , Zwakhalen Sandra
Published: December 2021

Function Focused Care (FFC) interventions support nurses to adapt their level of care to the capabilities of older people and to optimize their self-reliance. Recently, three FFC-interventions were implemented in various Dutch care settings. Lessons learned and implications were synthesized and an advanced FFC-program ‘SELF’ was developed for wide application. SELF comprises interactive and multidisciplinary sessions, is theoretically grounded, primarily focuses on behavior change in nurses, and is tailored to the team’s needs. It also includes policy and environment review, goal-setting, and coaching-on-the-job. SELF was tested in one Dutch psychogeriatric ward. Afterwards, focus groups were conducted with nurses, trainers, manager and coaches. The interactive content, mutual discussions, and practice-based working methods were highly valued. SELF increased awareness and willingness to practice FFC and was considered feasible in practice. Increased involvement and support of allied health professionals and the manager was preferred. A nationwide effectiveness trial is planned after refining SELF.
Community-Engaged Older Adult-Led Policy, Systems, and Environment Interventions in the MS High Obesity Program
Authors: Buys David , Smith Masey , Halfacre Katie , Holmes Megan
Published: December 2021

Older adults in rural areas are at unique risk for poor outcomes due to social isolation and limited access to resources. The Mississippi High Obesity Program (HOP) aims to enhance access to social connections and resources like community gardens, food pantries, and physical activity as part of its broader objective to prevent and reduce obesity. Through policy, systems and environment strategies, development of Memoranda of Understanding (MOUs) between aforementioned entities, and community based participatory research approaches, Mississippi HOP efforts enhance food systems improvement efforts; grow multi-sectoral collaboration; and evaluate the effectiveness of new policies, and specifically MOUs, in reaching these goals. Older adults represent more than 40% (n=27) of all coalition members and stakeholder leaders (n=61); they are essential for the success of these initiatives. This presentation will highlight the work done during the COVID-19 pandemic and the role of and benefits to older adults, especially ones in rural communities.
Shifting Issues of Support Exchange Under 20-Year Implementation of Japanese Long-Term Care Insurance Program
Authors: Wakui Tomoko
Published: December 2021

Japan has faced numerous issues in the last twenty years with its mandatory long-term care (LTC) insurance program. This LTC insurance program obviously affected older adults’ informal support exchanges, reducing support from family and the community, which became more valuable, subjectively. Furthermore, changes in support have impacted older adults’ subjective well-being and children’s perceived care motivation. Additionally, a mandatory uniform system challenges the issue of tolerance of diversity, meaning how non-traditional families’ opinions be involved LTC situations. This symposium discusses unexpected shifting issues in Japan in the implementation of a public LTC program with a focus on older adults’ support exchanges. The first paper examines the long-term impacts of formal and informal support by examining the effects of implementing formal services. The second paper assesses a community’s role in relation to family in the presence of a public LTC program. The third paper examines the subjective impacts of older parents, who provided support to adult children and their reciprocal expectations of receiving LTC. The fourth paper, on the other hand, articulates reciprocal impacts on sons’ care motivation, which has become more important, since the introduction of the LTC program reinforced men’s participation in LTC. Finally, the fifth paper clarifies how a public uniform program accommodates informal support from non-traditional families when the program premises the presence of family in advanced care planning. Our findings have long-term implications for aging societies in relation to formal and informal support exchanges.
Neighborhood Relationship Matters for Whom?: Interaction With Family Structure and Functional Conditions
Authors: Sugawara Ikuko , Kobayashi Erika
Published: December 2021

Living environment is considered to have unignorable effect on our health and well-being, especially when we face shrinkage of mobility as we age. Social interaction with neighbors constitutes our social environment, and it may affect our well-being by interacting with other social resources such as support from family and professional care providers. In this study we examined the effect of social environment in neighborhood on older people’s well-being, and how its effect is moderated by their family structure, functional conditions, and LTC service usage. Data was obtained from the survey conducted in 2012 with nationally representative sample of Japanese adults aged 60 years and older. The results showed that for people with functional limitation but were not certified as needing LTC, neighborhood social network was positively associated with well-being. These results suggest the unique function of neighbors for frail people to keep everyday life in the community.
Perceptions of Social Determinants of Successful Aging Among Older Men Living With HIV
Authors: Rubtsova Anna , Moore David , Jeste Dilip , Holstad Marcia
Published: December 2021

The overall purpose of this qualitative study was to examine barriers and facilitators of successful aging among older men living with HIV (OMLH). Participants were recruited through HIV Neurobehavioral Research Program at the University of California, San Diego. Our sample included 14 OMLH: average age - 62 years old (range: 53 to 72), 79% white, 43% living alone, 79% men who have sex with men, 57% having college education or higher. Semi-structured interviews lasted from 43 to 114 minutes and were fully transcribed. Several themes emerged related to perceived barriers to successful aging stemming from social institutions: i.e., age discrimination and ageism, sexual and HIV-related stigma, social isolation, lack of resources, and food insecurity. Perceived institutional solutions promoting successful aging included mixed-age/inter-generational support groups, computer literacy training, health education, information and resources related to healthy lifestyle on a limited budget, and increased transparency of resources available to older adults.
Barriers and Facilitators to Advance Care Panning Among Veterans Aging With HIV
Authors: Taylor Emily Pinto , Halpin Sean , Marconi Vincent , Justice Amy , II Theodore Johnson , McInnes D Keith , Perkins Molly
Published: December 2021

Advance care planning (ACP) and hospice services are underutilized by patients living with HIV (PWH). Little is known about how older PWH approach ACP; the purpose of this qualitative study was to understand barriers and facilitators to ACP within the context of the patient-clinician relationship. Data are from a larger multimethod study designed to understand social determinants of health (SDH) that shape the lives and healthcare experiences of veterans aging with HIV. The sample includes 25 veterans from the Veterans Aging Cohort Study (VACS) recruited from an urban VA medical center. Semi-structured interviews were performed and analyzed using thematic analysis. Less than half of participants reported engaging in ACP. Key barriers to ACP include: fragile social ties, distrust of the healthcare system, and fear of disclosure and discrimination. We offer several recommendations for clinicians to engage in these conversations successfully and highlight the importance of considering SDH when designing interventions.
Social Determinants of Health Among Those With and Without HIV Infection in NYC, the Epicenter of the U.S. Crisis
Authors: Taylor Tonya
Published: December 2021

The COVID-19 pandemic in NYC, the epicenter of the US crisis, revealed indisputable evidence that social determinants of health (SDoH, e.g., racism, crowded housing, employment risks) and disparities in comorbid health risk factors produce higher burdens of disease and death among racial and ethnic populations. We conducted a needs assessment of SDoH among 1400 patients in several ambulatory care clinics to explore the impact among older adults, across different clinical populations. Among older adults with HIV (OAH), we found lower rates of food and housing insecurity compared to older adults without HIV. Despite higher levels of COVID knowledge and prevention adherence, we also found significantly higher levels of isolation, loneliness, depressive symptoms, and anxiety among OAHs compared to those without HIV. Access to Ryan White entitlements did buffer some impacts but preexisting high burdens of mental health issues were exacerbated, perhaps due to heightened perceptions of increased vulnerability to COVID-19.
Walking It Off: More Stressors and Perceived Stressor Control Predict More Physical Activity in Daily Life
Authors: O'Brien Erica , Almeida David
Published: December 2021

Research shows that, while the experience of stress relates to lower levels of physical activity (PA), people who perceive a greater sense of control engage in higher levels of PA. This study explores whether a sense of control specifically over stressful situations moderates the negative association between stressor exposure and PA in daily life. We used 8-day diary data from up to 1,236 participants (Age: Range = 43-91, M = 62.47, SD = 10.20) in the National Study of Daily Experiences. Somewhat contrary to hypotheses, people reported spending more time on light PA (but not moderate-to-vigorous PA) on days when they also experienced more stressors than usual. Perceived stressor control appears to magnify this effect, with people reporting even more light PA on days when they feel greater control. Initial findings suggest that a physically active lifestyle may help middle-aged and older adults cope with daily stressors.
Exploring Use of Digital Home Assistants for Older Adults: A Demonstration Project
Authors: Kadylak Travis , Malecki Maya , Galoso Leonardo , Gowrishankar Saahithya , Brown Amy , Sreenivas Ramavarapu , Rogers Wendy
Published: December 2021

Emerging digital home assistant technology has potential to support older adults in their homes. Voice-activated assistants can be used for entertainment, environmental control, physical activities, health management, and social engagement. However, many older adults have limited experience with these devices, which are not designed with them in mind. We conducted a demonstration project to explore how seven older adult assisted and independent living residents interacted with digital assistants over four months. We conducted monthly semi-structured telephone interviews and pre/post questionnaires. Participants desired to use their devices to communicate with others, and for a range of health activities, including nutrition tracking, medication management, and health information searching. However, numerous usability barriers emerged. Some participants perceived their device as a social companion. These findings indicate that older adults are willing to use digital assistants for various activities that may enhance independence, although instructional and training materials are needed to support their use.
SmartBathroom Data Visualization Tool to Inform OT Clinical Reasoning
Authors: Sanford Jon , Basu Avinandan , Xu Yangyi
Published: December 2021

Traditionally, Occupational Therapy assessment of an older adult’s toilet transfer performance has been based on qualitative observation and client self-report. The purpose of this study was to evaluate the effectiveness of supplementing traditional clinical reasoning with quantitative transfer performance data about body and foot position, balance, hand placement and grasping forces on grab bars. Specifically, we conducted an online survey of occupational therapy practitioners and educators to assess the usefulness and usability of 2D and 3D graphic visualizations representing foot and hand position and forces exerted on the floor, toilet seat and grab bars. These data were captured by sensors located throughout GA Tech’s SmartBathroom laboratory during a study of transfer performance. Findings are being used to identify the most useful sensor data and the most effective ways to convey that data to improve training of occupational therapy students.
The Relationship Between Social Media Use and Well-Being: The Mediating Role of Social Support
Authors: Lin Xin Yao , Lachman Margie
Published: December 2021

Frequent social media usage can have negative effects on well-being, but the mechanisms involved are unclear. This study explored the mediating role of giving and receiving support. Using the Midlife in the United States Refresher eight-day daily diary study (N=782, age 25-75), multilevel structural equation modeling examined the hypothesized relationships at both the within- (intraindividual) and between-person (interindividual) levels. Results showed that at the within-person level, days with more social media use were associated with a larger proportion of time giving support and worse well-being (less positive affect and more stress, negative affect, and loneliness). At the between-person level, more social media use was associated with worse well-being. Giving support, but not receiving support, mediated the relationship between social media use and well-being at the within, but not the between-person level. Discussion focuses on ways to address the negative consequences of social media use related to social connections and well-being.
How the COVID-19 crisis affected diverse older adults: A mixed methods case series
Authors: Thiamwong Ladda
Published: December 2021

The coronavirus disease (COVID-19) pandemic has magnified inevitable physical, mental and social health consequences, especially in Hispanic older adults who experience health disparities and ageism. Even though physical distancing has been adopted as a key strategy to help reduce further spread of COVID-19, prolonged periods of physical distancing may worsen existing health problems. This study aims to explore how the COVID crisis affected diverse older adults. An explanatory sequential mixed methods design was utilized. Quantitative data were collected by questionnaires via Qualtrics survey and qualitative data were collected by individual phone interviews with four open-end questions. One in 4 older adults lives alone and one in 20 has no friend to call on. More than half of the participants were afraid of COVID and a fourth of them were afraid of losing their life to COVID. Participants identified keeping themselves busy as key to staying healthy during the pandemic.
Active Aging From Theory to Practice: National Experiences of Policy Making in Europe and Canada
Authors: Barbabella Francesco
Published: December 2021

Born in Europe as a concept aiming to counteract new demographic and societal challenges, active aging has progressively become a key pillar of an extended welfare state for aging populations in many high-income countries. Needs, interests, and preferences of new aging cohorts are changing, becoming more diverse and requiring a better understanding and greater attention by policy makers, beyond mere social welfare programmes for those with social, economic or health needs. Active aging policies aim at improving individuals’ quality of life by optimizing opportunities for health, participation, and security (WHO 2002), hence unlocking the potential of older people as active citizens in the community and the society. Since the focus is on a multidimensional concept of quality of life, active aging works at the intersection of labour, social, educational, family, infrastructure, and many other policy areas. However, there may be gaps and discrepancies between the concept in itself and its application at the policy level. The purpose of this symposium is to present and discuss how different post-industrial societies are advancing and implementing active aging policies, in the context of overarching societal challenges and competing needs. In this respect, the symposium focuses on four countries representing different traditional welfare state models: Canada, Italy, Poland, and the United Kingdom. These four case studies bring analyses of active aging policies at national and/or regional level, providing a picture of how such policies have been designed, how they evolved and what they have achieved in recent years.
Using Technology for Prescription and Adherence in an Alzheimer’s Prevention Program
Authors: Watts Amber , VanSciver Angela , Clutton Jon , Finley Katrina , Flores Erica , Szabo-Reed Amanda , Burns Jeffrey , Vacek James
Published: December 2021

Healthy lifestyle change is difficult to adopt and maintain without support. Often physicians recommend exercise to their patients, but have limited means to support this change. A major goal of our study is to provide physicians with a simple method of referring patients to a program that supports adoption and maintenance of exercise that meets recommended guidelines for older adults. The Lifestyle Empowerment for Alzheimer’s Prevention program (LEAP! Rx) is a yearlong intervention to support cognitively normal older adults in adoption and maintenance of moderate to vigorous exercise, a key prevention factor for Alzheimer’s disease. The program uses the electronic medical record and builds relationships with physicians to identify patients eligible to participate. It electronically communicates about patients’ progress back to referring physicians to facilitate ongoing physician-patient interaction. Participants receive exercise coaching to reach their weekly exercise goals and have access to online lifestyle education classes (e.g., nutrition, sleep, stress management). The study is currently enrolling (n= 121 enrolled; mean age 71.4; 12% non-white, 4% Hispanic/Latino, and 83% female). Physician referrals originate from five clinics represented by 48 physicians. The study design will actively compare the physician referral process to self-referrals from the community (n=20). We have adapted the protocol to the conditions of the pandemic including online exercise coaching and support. This presentation will discuss successes and lessons learned from this novel method of recruitment and adherence to exercise.
Aging With Intellectual and Developmental Disabilities: When Dementia Is Diagnosed or Suspected
Authors: Clark Phillip , Munly Kelly
Published: December 2021

Individuals with lifelong intellectual and developmental disabilities (IDD) have unique needs associated with aging that pose challenges for them and their families. In particular, an increased likelihood for early onset Alzheimer’s disease is a major concern that can place individuals at risk for a host of biomedical, psychological, and social challenges. Faced with providers not trained in how to properly screen for, diagnose, and treat conditions, individuals and families are often left with inadequate care, services, and support. To address these concerns, education for professionals is essential in providing accurate information based on clinical best practices. This symposium presents an innovative and interprofessional model developed by a partnership of geriatrics and IDD educational and service organizations based on Project ECHO (Extension for Community Healthcare Outcomes) methodology. A virtual community is created in which participants both teach and learn from each other through a combination of didactic and case presentations. The first paper describes the ECHO model, including the development of the hub and spoke structure, recruitment of providers, and collaborative and multidisciplinary process of curriculum development. The second paper explores educational experiences of participating spoke agencies in the program, including professionals’ and clients’ outcomes. The third paper presents the implications of creating a foundation based on interprofessional education and networking principles to bridge the gap between health and social care disciplines and parallel service systems. The final paper provides recommendations and implications for developing and refining methods to address the need for provider education in this rapidly expanding field.
Bridge Builders and Boundary Spanners: Intersectoral, Interorganizational, and Interprofessional Education
Authors: Clark Phillip
Published: December 2021

The needs of individuals aging with intellectual and developmental disabilities (IDD) and their families do not fall neatly within defined policies, programs, and professions. They comprise complex challenges based on medical, psychological, social, environmental, economic and familial dimensions. These needs pose a challenge for providers in developing solutions at three levels: (1) different policies and programs create barriers based on different funding sources, eligibility requirements, and administrative restrictions; (2) clinical and community-based programs embody the gap between healthcare and human service providers; and (3) different professions are trained in their own methods of assessment and care plan development that impede the design of integrated approaches to defining and solving problems. This paper proposes an intersectoral, interorganizational, and interprofessional framework for addressing these problems based on networking and collaborative practice principles embodying bridge-building, boundary-spanning, and team-working as a basis for provider education. Implications for expanded education in this field are explored.
Relationships Between Salivary Cortisol Slope and Neuropsychiatric Symptoms in Persons Living With Dementia
Authors: Hwang Yeji , Dong Fanghong , Perez G Adriana , Hodgson Nancy
Published: December 2021

While a flatter diurnal cortisol slope has been related to poor health outcomes in healthy populations, little is known about this relationship in persons living with dementia (PLWD). The purpose of this study was to examine the association between diurnalcortisol slope and neuropsychiatric symptoms in PLWD. Secondary data analysis was conducted using baseline data from the Healthy Patterns Study (N=168). Diurnal cortisol slope was calculated using the difference between changes in salivary cortisol from 30 minutes after awakening to bedtime. Spearman rho coefficients were used. Flatter cortisol slope was associated with the presence of symptoms of agitation (r=-0.191, p=0.013) and disinhibition (r=-0.168, p=0.03). Steeper cortisol slope was related to a more severe level of anxiety symptoms (r=0.36, p=0.009) and higher frequency of insomnia (r=0.292, p=0.011). We found that cortisol slope was associated with neuropsychiatric symptoms in PLWD. Future research is needed to examine the mechanisms underlying the relationships.