bluuebunny/crossref_metadata_2025 huggingface dataset:
PREVALENCE OF POSSIBLE SARCOPENIA AND ASSOCIATED FACTORS AMONG OLDER HOMELESS ADULTS IN HOME FOR DESTITUTE
Authors: Whaikid Phatcharaphon , Piaseu Noppawan , Srisuk Wasana
Published: January 2025

Sarcopenia is a significant problem leading to increased morbidity and mortality risk, particularly in older homeless adults in home for destitute as they are vulnerable and are experiencing premature degeneration. The Asian Working Group for Sarcopenia (AWGS) 2019 introduces possible sarcopenia for early prevention of sarcopenia. Therefore, this study aimed to describe the prevalence and risk factors of possible sarcopenia among older homeless adults. This cross-sectional study included 163 older homeless adults aged 50 and above in homes for destitute in Thailand. The participants completed a questionnaire on personal and health-related factors, and assessments according to AWGS 2019 criteria. Data were analyzed using descriptive statistics and multinomial logistic regression. Results revealed that the prevalence of case finding, and possible sarcopenia was 74.9% and 71.2%, respectively. Among participants aged 50-59, the prevalence rates were 60.8% and 55.1%, while those aged 60 years and over showed a significantly higher prevalence of 90.8% and 89.5%, respectively. Multinomial logistic regression analysis revealed four risk factors significantly associated with possible sarcopenia, including age, gender, BMI, and number of comorbidities (odds ratio (OR) = 1.253, 95% confidence interval (CI) = 1.117-1.405, OR =.222, 95% CI =.056-.874, OR =.584, 95% CI =.458-.745, and OR =.308, 95% CI =.109-.868, respectively). This study confirmed that possible sarcopenia can begin as early as age 50, aligning with indications of premature degeneration in this population. Therefore, it is recommended to start screening earlier than usual to ensure proper management and delay the progression of sarcopenia.
PRIMARY LANGUAGE’S ROLE IN SOCIAL INTEGRATION AND FUNCTIONAL INDEPENDENCE AFTER TRAUMATIC BRAIN INJURY
Authors: Jung Wonkyung , Taylor Janiece
Published: January 2025

Social integration is an ultimate goal of neurorehabilitation and linked to better functional outcomes. However, older immigrants whose primary language is not English may have difficulties reintegrating into society after their injuries. This study investigated the moderating role of primary language in the relationship between social integration and functional independence following traumatic brain injury (TBI) among older adults at the first-year post-injury. Data were obtained from the Traumatic Brain Injury Model System National Database (TBIMS-NDB). Using Hayes’s PROCESS macro-Model 1, data were analyzed to assess the impact of social integration and primary language on functional independence. We finally had 1442 older adults aged between 65 and 88 years at the time of TBI. The results revealed that social integration significantly influenced functional independence (β = 11.399, p < 0.001), while primary language had an insignificant impact (β = -3.735, p = 0.051). Additionally, a significant interaction effect was found between social integration and language (β = 6.912, p = 0.006), indicating that the relationship between social integration and functional independence was moderated by primary language. The model explained a substantial proportion of the variance in functional independence (R-Square = 0.328). Further analysis showed that the effect of social integration on functional independence varied based on language proficiency, with a stronger association observed among non-native English speakers (β = 25.224) compared to native English speakers (β = 18.311). These findings highlight the need to consider primary language in interventions to improve social integration and functional outcomes for older adults with TBI.
QUANTIFYING NURSING HOME CARE QUALITY FOR OLDER HIV AND SEXUAL AND GENDER MINORITY POPULATIONS: A SCOPING REVIEW
Authors: Moriarty Haley , Wong Chelsea , Olivieri-Mui Brianne
Published: January 2025

Standardized quantitative measures of nursing home (NH) care quality for older people with human immunodeficiency virus (HIV) or sexual and gender minority (SGM) populations are sparce. This scoping review identified the current literature empirically measuring quality of care in NHs for people with HIV (PWH) and SGM populations including, but not limited to, validated measures endorsed by national organizations. The initial librarian-assisted search strategy across four databases resulted in 764 articles. Literature that quantified care quality for HIV (8 studies) or SGM (1 study, 1 report) populations in the NH setting were included. No studies examined the overlap of HIV and SGM populations nor were there studies of general clinical care for either population. The lowest quality was seen with measures of ART prescriptions (n=4/8 studies) and CD4/viral load monitoring (n=2/8 studies). NHs tended to have lower overall care quality (e.g. antipsychotic prescribing, star rating, rehospitalizations) for PWH v people without HIV unless PWH were the majority patient population (n=4/8). One study and one report measured staff/clinicians’ levels of discrimination toward SGM populations finding low willingness to provide care and high rates of refusal to admit SGM patients, respectively. There is insufficient empirical data measuring clinical care quality for SGM using NHs. In conclusion, HIV care quality in NHs has been measured but general clinical care quality for PWH using NHs has not. The growth of the aging HIV and SGM populations demands more research empirically evaluating NH care quality beyond HIV care and including intersecting HIV and SGM identities.
RESULTS OF A STEPPED EXERCISE PROGRAM AMONG VETERANS WITH KNEE OSTEOARTHRITIS AND CO-OCCURRING BACK PAIN
Authors: Burrows Brett , Woolson Sandra , Coffman Cynthia , Allen Kelli
Published: January 2025

Co-occurring back pain can exacerbate an already high risk of disability among patients with knee osteoarthritis (OA). We described the effect of a stepped exercise program for patients with knee OA (STEP-KOA) versus arthritis education (AE) on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for participants with and without co-occurring back pain. Veterans with knee OA (n= 345) were randomized 2:1 to STEP-KOA or AE control group that received mailed materials. STEP-KOA began with 3 months of internet-supported home exercise (Step 1), followed by 3 months of bi-weekly physical activity coaching (Step 2), then 3 months of physical therapy (Step 3) if participants did not make clinically relevant improvement in pain or function with the prior step. WOMAC, which assesses lower-extremity pain, stiffness and function was the primary outcome at 9 months. Self-reported back pain was reported at baseline. Differences in mean WOMAC scores at 9-months were compared between arms in those with and without back pain using t-tests. Overall, 72.4% (n=250) reported having co-occurring back pain. Among participants with co-occurring back pain (n= 176), 9-month mean WOMAC score was 10.1 points lower (95% CI -15.5, -4.7; p< 0.001) in STEP-KOA vs. AE. Among participants without co-occurring back pain (n= 79), 9-month mean WOMAC score did not differ between arms (Mean Difference= 4.3; 95% CI -5.3, 13.9; p=0.37). In conclusion, among participants with co-occurring back pain, the STEP-KOA intervention resulted in a significant reduction in mean WOMAC score at 9-months compared to AE alone.
SINGLE AND DUAL-TASK SPATIOTEMPORAL GAIT ANALYSIS OF OLDER ATHLETES PARTICIPATING IN THE NATIONAL SENIOR GAMES
Authors: Leach Susan , Doerfler Deborah , Schilz Jodi , Vallejo Rose , Jordre Becca , Jones Beth Moody
Published: January 2025

One purpose of this study was to gather normative spatiotemporal gait parameters in older athletes and determine differences under three walking conditions: Forward Usual Single Task, Forward Usual Dual Task, and Forward Fast Single Task. Post hoc analyses were explored to determine a) the impact of a cognitive dual task during usual speed on gait parameters b) to determine the impact of a change in gait speed from usual to fast on gait parameters. A secondary purpose was to determine if Open, Closed or Continuous sport category influenced gait parameters. It was hypothesized that gait parameters would change with the addition of a dual task, with increased speed, and sport category. Regarding methodology, participants included 335 athletes 50 years or older in this single center cross-sectional, quasi-experimental study. Spatiotemporal gait parameters were quantified using ProtoKinetics’ Zeno Walkway system. A multivariate analysis of variance compared gait parameters under three walking conditions. Post-hoc analyses determined the impact of a cognitive dual task during usual walking speed, and a change in gait speed from usual to fast. Results indicated a significant effect of walking condition on all spatiotemporal gait parameters. From single to dual task, all gait parameters were significant with the exception of stride width coefficient of variation. From usual to fast speed, select gait parameters were significant. Sport category also demonstrated changes in select gait parameters. To conclude, normative spatiotemporal gait parameters were established for older athletes in three walking conditions and differences identified.
SMARTPHONE OVERUSE AMONG OLDER ADULTS: A SCOPING REVIEW
Authors: Choi Jeongeun , Lee Hyangkyu , Yoon Seolah , Cho Hyeonmi
Published: January 2025

The rapid advancement of technology and widespread adoption of smartphones have led to increased smartphone usage among older adults. While smartphones offer many benefits, excessive use can lead to health issues, especially for older adults who may experience reduced social interactions and higher levels of anxiety or depressive symptoms. However, most existing research has focused primarily on adolescents and younger adults. This scoping review aimed to investigate the terms and definitions, factors associated with smartphone overuse, and its outcomes in older adults. We searched seven databases, including PubMed, PsycINFO, Embase, Cochrane Library, Web of Science, Scopus, and CINAHL, covering studies published from 2007 to 2024. We followed the Joanna Briggs Institute scoping review methodology, and sixteen studies were selected. Smartphone overuse was characterized by various terms and definitions, including ‘smartphone overdependence’, ‘smartphone addiction’, and ‘problematic smartphone usage’. According to the biopsychosocial model, factors related to smartphone overuse were classified into biological, behavioral, psychological, and social categories. Most commonly reported factors included biological aspects such as age, sex, and BMI; behavioral factors like types of smartphone activities; psychological factors including loneliness, anxiety, and depressive symptoms; and social factors such as income and educational level. Smartphone overuse can negatively affect physical, psychological, and social health, resulting in pain in the musculoskeletal system, sleep disturbances, anxiety, depressive symptoms, and loneliness. Future research should focus on developing standardized definitions and exploring effective interventions to mitigate the negative effects of smartphone overuse in older adults.
SOCIAL CONNECTIONS AND FALLS AMONG OLDER WOMEN WITH AND WITHOUT HIV IN THE UNITED STATE
Authors: Quach Lien , Lloyd Patricia , Erlandson Kristine M , Wilson Tracey , Rubtsova Anna , Sharma Anjali , Burr Jeffrey , Siedner Mark
Published: January 2025

Falls affect one in four older adults annually and are linked to biological and environmental risk factors. Women with HIV (WWH) may be particularly vulnerable due to lower social support and higher loneliness but their relationship with falls is not well understood. We analyzed data from 1,068 women aged 50 and older in the 2017 Women’s Interagency HIV Study (WIHS). Social connections were evaluated using the Multidimensional Social Support Scale, which queries respondents about issues such as support for sharing private worries and help with medical appointments. Loneliness was defined as a score of 6-9 on the UCLA Loneliness Scale (range 0-9). Logistic regression models estimated associations between social connections and loneliness with falls, adjusting for age, education, alcohol use, smoking, and total of comorbidities. Falls were reported by 31.5% of participants, with similar rates between WWH and women without HIV (WWoH) (adjusted odds ratio [aOR]=1.08; 95%CI 0.79,1.49). Loneliness was associated with a higher likelihood of falls (aOR=1.28; 95%CI 1.04,1.82). Some social connection aspects, such as having someone with whom to provide information or share worries (aOR=0.90; 95%CI 0.81, 0.996), or to receive assistance with medical appointments (aOR=0.89; 95%CI 0.80, 0.989), was associated with a lower odd of falls. WWH experience falls at rates similar to WWoH. However, loneliness and lack of social connections are key contributors to falls in older women in the US. Future research should explore whether interventions to mitigate loneliness and enhance social connections impact falls in older women in the US.
SOCIOECONOMIC INEQUALITIES IN HEALTHY AGING OF OLDER KOREAN ADULTS: AN AGE-PERIOD-COHORT ANALYSIS
Authors: Lee Yunhwan , Kim Eunsaem , Kim Jinhee , Kim Sukyung , Shin YooGyung , Han Jimin
Published: January 2025

As South Korea’s healthy life expectancy continues to increase, reaching 73 years in 2021 and ranking third in the world, there is growing interest in assessing functional ability as well as its disparity across various older population segments. The study aimed to investigate healthy aging trends by socioeconomic status in the recent decade among Koreans aged 65 years or older and to analyze the age, period, and cohort effects. Data were from the four waves, about 10,000 people in each wave, of the National Survey of Older Koreans conducted every three years from 2011 to 2020. The physiological, physical, cognitive, psychological, and social dimensions were combined to create the healthy aging index (HAI), with higher scores indicating a healthier state. Socioeconomic status included education, household income, and wealth. A multilevel analysis with a cross-classified random effects model was performed. An overall trend of healthy aging in the past decade was evident, but the gap between the highest and lowest levels of education has widened. The 1935-1944 birth cohort showed a significant decrease in HAI, suggesting a long-lasting negative effect of early life adversity in the latter years of colonial rule. There was a strong age effect, demonstrating a quadratic decline in HAI over the life course. Even though the last ten years have shown a general trend toward healthy aging, socioeconomic disparity persists. The study’s findings underscore the need for policies on healthy aging to consider the life-long vulnerability of certain aging population segments characterized by adverse early life experiences.
THE IMPACT OF PARTICIPATION IN AN IMMERSIVE VIRTUAL REALITY TAI CHI PROGRAM ON THE BALANCE OF OLDER ADULTS
Authors: Kim Jaehyun , Lobos Marcos Ardon , Park Serim , Oh Seungjun , Kim Jay , Kim Junhyoung
Published: January 2025

Falls are the leading cause of injury-related mortality in older adults aged over 65 years, with ~36 million older adults suffering from falls each year that result in more than 34,000 deaths. Tai Chi, an ancient Chinese martial art, is shown to reduce the risk of falls by improving physical functioning (e.g., balance, flexibility, muscle strength). Despite the well-recognized health benefits of Tai Chi instruction, older adults often encounter barriers including limited access to programs, a lack of instructors, and environmental distractions. To address these barriers, this study examined the impact of an immersive virtual reality Tai Chi intervention (IVTC) on the balance of older adults. Eighteen older adults from senior centers in North Carolina participated in eight 15-minute IVTC sessions over a month and completed the Berg Balance (BB) test before and after the IVTC intervention program. The results showed significant improvement in BB scale scores after the IVTC sessions (p <.001) with a large effect size (d = -2.75). Holden’s System Usability Scale indicated that participants were very favorable towards using the program. Our findings suggest that the IVTC program is a very usable intervention that could effectively improve the balance of older adults, highlighting its potential as an innovative intervention to reduce fall risks for older adults.
THE RELATIONSHIP BETWEEN CREATININE-TO-CYSTATIN C RATIO AND FRAILTY: THE MEDIATING ROLE OF MUSCLE STRENGTH
Authors: Jia Shuli , Ge Mei-Ling , Xue Qian-Li , Dong Bigrong
Published: January 2025

Background

The creatinine to cystatin C ratio (CCR) has recently been suggested as a predictor for many adverse clinical outcomes. This study aimed to investigate the association between CCR and frailty, as well as the mediating role of muscle strength.

Methods

Cross-sectional and longitudinal analyses with 4-year follow-up of community-dwelling adults aged ≥60 years were conducted. Frailty was assessed using the physical frailty phenotype, which includes five binary criteria (weakness, slowness, exhaustion, low activity level and weight loss). Participants with three or more criteria were defined as frail. Muscle strength was measured by the maximum handgrip strength (HGS) of two hands. Logistic regression was used to analyze the associations between baseline CCR and prevalent and incident frailty. Mediation analyses were performed to examine the mediating role of HGS in the relationship between baseline CCR and incident frailty.

Results

Higher CCR was associated with lower risk of frailty (OR 0.41(0.18,0.92), p=0.030) in cross-sectional analysis, but this relationship was not significant when adding HGS in the regression model. After excluding participants who were frail at baseline and during the mid-follow-up, and those met the criteria for weakness at baseline, a total of 2428 participants were included in the longitudinal analysis. The association between baseline CCR and incident frailty was partially mediated by the mid-follow-up HGS (mediation proportion: 14%, p < 0.001). Conclusions: HGS partially mediated the associations between CCR and frailty in Chinese populations. The findings reveal a novel biomarker for frailty, which may also facilitate the identification of frailty subtypes.
TIME-OF-DAY MOVEMENT AMOUNT AND VARIABILITY BY COGNITIVE STATUS IN A SAMPLE OF BLACK OLDER ADULTS
Authors: Wanigatunga Amal , Marino Francesca , Liu Fangyu , Shen Nicola , Karas Marta , Parker Lauren , Albert Marilyn , Schrack Jennifer
Published: January 2025

Reduced daily movement, particularly in the mornings, is linked with elevated Alzheimer’s disease risk, yet prior studies have consisted of primarily non-Hispanic White participants. Whether this association exists in Black older adults, who often are underrepresented in research and experience delays in cognitive impairment diagnosis, remains unexplored. Wrist-worn accelerometry was analyzed from 21 Black participants (median age: 73 years, 83% women) referred from the Johns Hopkins Alzheimer’s Disease Research Center who evaluate each participant for mild cognitive impairment (MCI). Separate age and sex adjusted linear regression models estimated movement differences by MCI status in mean: 1) total physical activity amount or variability (counts/d) over 24-hrs and 2) amount or variability of activity (counts/d) from 12am-6am, 6am-12pm, 12pm-6pm, and 6pm-12am. Variability measures were calculated as the SD of minute-level activity during each time period. Thirteen participants (62%) were identified with MCI. Participants with MCI averaged 1,700,927 (SD=721,021.9) counts/d compared to cognitively unimpaired participants who averaged 1,727,588 (SD=841,627.9) counts/d. Amount of activity counts/d did not differ between those living with and without MCI overall or by time-of-day (p for all>0.56). However, there was a significant difference in physical activity variability between 6am-12pm, where variability was higher among those with MCI by 66,451 (95% CI: 883, 132,020) counts/d. Our findings warrant further investigation into whether variability, rather than amount, in everyday movement occurring during early morning hours could serve as a digital biomarker to enhance cognitive impairment screening for Black older adults living independently.
“IT’S NOT THE AGE, IT’S THE APTITUDE: FACTORS INFLUENCING ADOPTION OF DIGITAL HEALTH APP AMONG OLDER ADULTS”
Authors: Birati Yosefa , Orkibi Hod , Kolpina Lola , Zisberg Anna
Published: January 2025

The rapid growth of digital health services has established mobile health (mHealth) apps as a key communication channel between healthcare providers and patients in primary care. These apps offer features such as appointment scheduling, access to medical records, and administrative task management. This study examines how digital health literacy, perceived ease of use, and perceived usefulness of mHealth apps explain mHealth apps and online services usage among older adults. Our study involved 179 community-dwelling older adults (mean age 73.5±5.05). The sample was relatively well-educated, with 33.2% holding a bachelor’s degree and 31.5% having a master’s or higher degree. Notably, 80% of participants reported high to very high confidence in using mHealth apps. Multiple regression analysis showed that age and health status alone explained only 4% of the variance in mHealth app use. However, when accounting for digital health literacy (β =.228, p <.001), ease of use (β =.369, p <.001), and usefulness (β =.283, p <.001) the model accounted for 58.7% of the variance (ΔR² =.493, p <.001). These findings underscore the critical importance of addressing digital health literacy and usability challenges among older adults. By focusing on these factors over age alone, we can enhance the design and personalization of mHealth apps and facilitate independent engagement with digital health services among the older adult population.
ACCEPTABILITY AMONG DEMENTIA CAREGIVERS OF THE ONLINE SELF-GUIDED ACT FOR CAREGIVERS PROGRAM
Authors: Green Gavin , Batura Josey , Kelley Heather , Gossner Jacob , Aller Ty , Levin Michael , Fauth Elizabeth
Published: January 2025

Acceptance and Commitment Therapy (ACT) is an effective therapeutic intervention for stress and mental health concerns across various populations. Our study evaluates the acceptability of an online self-guided ACT program tailored specifically for dementia caregivers via a longitudinal mixed-method design. The study was advertised to community programs (e.g. Area Agencies on Aging, Alzheimer’s Association), and N = 83 caregivers completed the post-intervention survey (Mean age = 62.6; 82% female; 89% White, 57% spouse caregivers). The system usability scale averaged 86.1/100, indicating high acceptability, with the majority of participants reporting they would like to use the program again (76%), that the information was helpful (86%), and that they would refer the program to other caregivers (85%). We used a team-based approach to thematic analysis of in-depth interviews from 28 participants at both post-intervention and follow-up. Qualitative data supported the quantitative findings as participants expressed a high level of satisfaction with the program’s online asynchronous structure and content. Participants emphasized the practical skill-building exercises and emotional education as particularly helpful. Further, many participants reported continued engagement with the program by revisiting notes, reviewing session summaries, and reflecting on specific analogies or information. Those who maintained engagement away from the program reported increased motivation to apply skills taught in the program in their daily lives. The online self-guided ACT for Caregivers program demonstrates the potential for broader implementation of ACT in community and healthcare settings through its mobile and cost-effective nature.
ACTIVITY ENGAGEMENT FOR OLDER ADULTS WITH COGNITIVE IMPAIRMENT: UNDERSTANDING NEEDS AND SUPPORTS
Authors: Lydon Elizabeth , Keeler Carlyn Ellison , Mudar Raksha , Czaja Sara , Boot Walter , Charness Neil , Rogers Wendy
Published: January 2025

Understanding the daily challenges experienced by older adults living with cognitive impairment is essential for developing strategies to support their health and quality of life. These impairments involve cognitive changes that can pose barriers to daily activities, especially complex tasks such as managing medications. However, the specific difficulties faced by this population are not well understood. The Everyday Needs Assessment for Cognitive Tasks (ENACT) Study examines these challenges in community-dwelling older adults with probable cognitive impairment determined by reporting recent changes in their cognition and scoring as mildly impaired on global cognitive screening. Participants were aged 60 and older (N = 91). We used a mixed methods needs assessment approach to identify difficulties across five activity domains: Health, Social Engagement, Transportation, Domestic Life, and Leisure and Recreation. Participants rated the level of difficulty they experienced with activities within these domains using a Likert scale and then participated in in-depth interviews to explore the underlying causes, focusing on memory, planning, organizing, and communication challenges. We examined participants’ response strategies to challenges, such as using visual reminders, technology, personal habits, and seeking assistance from others. Difficulties related to memory and executive functioning were key contributors to the participants’ challenges. Details from the interview data provide insights about the context of the challenges. Their most common response strategy was utilizing support from others. Interventions and technology solutions designed to support this population should prioritize features that aid memory recall and task organization and facilitate functional independence.
AGE AND EMOTION: AGE MODERATES THE RELATIONSHIP BETWEEN MIXED EMOTIONAL EXPERIENCES AND PSYCHOLOGICAL WELL-BEING
Authors: Whitman Kathrine , Chen Enna , Stephenson Jane , Carstensen Laura
Published: January 2025

Aging is associated with higher levels of emotional well-being, with older adults experiencing more positive emotions, fewer negative emotions, and more mixed emotions in daily life. Mixed emotional experiences (reporting more than one type of emotion during the same period) may indicate more emotional complexity and adaptive functioning. Alternatively, it may indicate degraded emotional experience. Here, we examined the relationship between everyday positive, negative, and mixed emotional experiences with life satisfaction, trait-level positive emotion, psychological well-being, and depression. Participants in an experience sampling study (n =180, aged 18 to 93, M = 56.9) reported their emotions at five randomly selected times each day for seven days. As expected, reports of positive emotions were associated with life satisfaction and trait-level positive emotion, while negative emotions were associated with depression and inversely correlated with psychological well-being. Interestingly, the association of negative emotions with depression was weaker in older participants, suggesting that older people may be more resistant to clinical depression even in the face of negative emotions. Most interestingly, we found that mixed emotional states were associated with increased psychological well-being among older adults but decreased psychological well-being in younger adults. Older adults’ increased psychological well-being in relation to mixed emotions and their resilience to the effects of negative emotion are consistent with adaptive, age-related changes in emotional experience and well-being. These findings highlight the differential effects of experiential positive, negative, and mixed emotions on various measures of well-being, with younger and older adults experiencing key differences in emotional drivers of well-being.
AGE DIFFERENCES IN DECISION SUPPORT NETWORK SIZE: A STUDY OF TOTAL JOINT REPLACEMENT CANDIDATES
Authors: Wild Tess , Riffin Catherine , Löckenhoff Corinna
Published: January 2025

Arthritis, which affects tens of millions of middle-aged and older adults, is one of the most common causes of activity limitation, disability, and chronic pain. Despite evidence that total joint replacement (TJR) can improve quality of life and physical functioning in arthritis patients, many eligible TJR candidates hesitate to pursue surgical intervention, and this reluctance is higher among older patients. Research shows that willingness to undergo TJR is influenced by a variety of psychosocial factors. Social relationships in particular can be an important source of support and information for patients when considering surgery. It is well documented that people’s social networks tend to be smaller and more close-knit as they age, and recent research suggests that decision support networks for hypothetical healthcare decisions show the same trend. The present study examined whether this pattern extends to realistic decisions about TJR. Using a name-elicitation approach, we collected information on the size of patients’ decision support networks (Msize = 3.30; rangesize = 0-8) in a sample of potential TJR candidates (N = 98; Mage = 67.88; rangeage = 40-93 years). As predicted, linear regression revealed that, compared to younger potential TJR candidates, older potential TJR candidates identified fewer members in their decision support networks (B= -0.033; p =.048). Additional analyses examined the role of potential covariates including demographics (e.g., gender, marital status), health (e.g., pain, functional status), and psychosocial variables (e.g., personality, health literacy). Theoretical implications and ramifications for clinical practice are discussed.
AGING AND RADICAL ENVIRONMENTAL CHANGE: “WHY DON’T THEY JUST LEAVE?”
Authors: Friis Marlene , Gustat Jeanette , Cherry Katie , Cronin James , Bertrand William
Published: January 2025

Coastal Louisiana has experienced extensive land loss due to oil and gas extraction, flood protection measures, and repeated exposure to hurricanes, flooding, and other severe weather events. Radical socioeconomic changes further negatively impact older residents. Projected relative sea-level rise, increased intensity of weather events, and large infrastructure projects may further alter the ecosystem, leaving residents with the option to either adapt or retreat. Governmental agencies are working towards reducing population vulnerability through risk reduction measures, disincentivizing further population growth, or promoting outmigration to higher ground. Critically, older adults may be uniquely vulnerable to the hazards associated with coastal living as they are both overrepresented in population statistics yet may also be less sensitive to policies designed to move people out of harm’s way. Regarding migration decisions, older adults are often deeply embedded in the socioecological systems of historic communities and typically value the benefits of continuity over disruption. Using the Environmental Distress Scale on a sample of geographically vulnerable adult residents in lower Plaquemines Parish, Louisiana (n=161) and in-depth interviews with older adults (n=45), results indicate that Place Attachment, Solastalgia, Threat Perception, Felt Impact, and Action may undergird decisions to stay put in the face of radical environmental change. Results show that most adults ages 55 and over (75%) intend to stay in the area. Although some older adult may qualify as trapped (involuntarily immobile), this research supports older adults’ agency in choosing to be voluntarily immobile in the face of slow-onset environmental changes. This distinction has policy implications.
ASSOCIATIONS BETWEEN LIFE COURSE ADVERSITIES AND SUBJECTIVE VIEWS ON AGING
Authors: Nakagawa Takeshi , Ito Daisuke , Yasumoto Saori
Published: January 2025

Recent research indicates that how individuals perceive their own aging may be influenced by negative life events or adversities in early life, such as war (Korniek et al., 2024). However, little is known about whether and when the impacts of adversities become salient across the lifespan. This study examined the associations between life course adversities and subjective views on aging. Data was derived from a nationally representative survey of Japanese older adults aged 60 years and above. Life course adversities (including occurrence and age at first occurrence) were measured retrospectively in 2006. Subjective views on aging and covariates (including sociodemographic, social, and health-related factors) were measured in 1996. A total of 782 participants (60-84 years at baseline; female 54.2%) completed the two surveys. Of these participants, 88.9% experienced at least one adversity in their lifetime. We conducted multiple linear regression analysis to examine the associations of life course adversities, classified as childhood (ages 0-12), adolescence (ages 13-19), young adulthood (ages 20-34), midlife (ages 35-54), and older adulthood (ages 55+), with subjective views on aging. We found that, while individuals who experienced more adversities in older adulthood perceived their own aging as more negative (Beta = -.076, p = 0.035), those who experienced more adversities in childhood perceived their own aging as more positive (Beta =.095, p = 0.009). Results suggest that adversities at different ages may have differential effects on subjective experiences in late life. Further examinations are required to better understand the resilience and vulnerability of older adults.
BIOMARKERS OF HEALTH AND AGING IN A COHORT OF VIETNAMESE ADULTS AGED 60 AND OLDER
Authors: Tennyson Robert , Martin Melanie , Pan Tiffany , Korinek Kim , Zimmer Zachary , Cohen Alan A , Tran Toan
Published: January 2025

War and traumatic events have negative health impacts across the life course, and most wars are situated in lower- and middle-income countries, where many survivors are now or will soon be entering old age. To date, however, most aging research has focused on health effects in high-income countries, neglecting the burdens of war exposure for the broader global population. The Vietnam Health and Aging Study (VHAS), a longitudinal study of 2,447 individuals aged 60+, investigates how stress and trauma experienced during the American War impacts health and aging of Vietnamese survivors. Using biomarker and anthropometric data collected in 2021-2022, we examined associations of recruitment characteristics (age, sex, district, military participation) with select cardiometabolic and inflammatory biomarkers (e.g., C-reactive protein [CRP], Interleukin-6 [IL-6]). Preliminary analyses revealed variation in associations of key demographic and outcome measures. Hypertensive risks were significantly higher for males, and overweight/obesity (OW/OB) risk significantly higher for females, whereas age was positively associated with hypertensive risk and inversely associated with OW/OB risk. Hypertensive risk was lower for those with formal military experience, while proinflammatory markers (i.e., CRP, IL-6) increased with age but did not vary by sex or military participation. District residence, which reflects differences in bombing intensity during the war, showed varied associations with inflammatory and cardiometabolic biomarkers. These findings suggest inflammatory and cardiometabolic risks are not uniformly coupled across participants in this study, underscoring the complexities of how prior war trauma interacts with other factors to influence health and well-being during aging.
CAN NUDGES REDUCE THE SHARING OF MISINFORMATION ONLINE? EXPERIMENTAL EVIDENCE ACROSS THE LIFESPAN
Authors: Moore Ryan , Chu Li , Hancock Jeffrey , Carstensen Laura
Published: January 2025

Observational data on online behavior indicates that older adults are more likely to share misinformation than younger adults. Thus, identifying scalable strategies to reduce older adults’ sharing of misinformation is imperative. This study investigates the potential for 1-sentence text-based nudges appearing alongside online news to reduce intentions to share misinformation. A lifespan sample of American adults (aged 18-99, M=49.1, SD=20.8) was shown online news headlines fact-checked as true or false by professional fact-checkers and asked about their intentions to share each headline. Alongside each headline, participants saw nudges that varied in two ways: (1) whether they were emotionally meaningful or not and (2) whether they were presented in a novel manner or not. Drawing on socioemotional selectivity theory, which posits that as people’s time horizons shrink they prioritize emotional meaning, we expected that emotionally meaningful nudges would be more likely to reduce older adults’ sharing of misinformation. Interestingly, in contrast to studies based on online behavioral data, we found that in a survey context older adults were less likely to report intentions to share misinformation online than younger adults, even after controlling for baseline sharing tendencies and other covariates. We found that novel nudges were more effective than non-novel nudges at reducing intentions to share misinformation across all ages, and that novel nudges were more effective than accuracy nudges, another popular intervention (Pennycook et al. 2021). Emotionally meaningful nudges were not more effective for older adults. This study draws implications for designing effective interventions against misinformation sharing across the lifespan.
CARING FOR ONE, TWO, OR THREE GENERATIONS? PREVALENCE OF VARIOUS CAREGIVING ROLES AND CAREGIVER CHARACTERISTICS
Authors: Zan Hua , Yancura Loriena , Barnett Melissa
Published: January 2025

With increasing diversification in household composition and living arrangements over recent decades, the roles of family caregivers have become more complex, sometimes requiring individuals to assume multiple caregiving responsibilities such as caring for both grandchildren and older parents. While caregiving can be a rewarding experience, it can negatively affect caregiver well-being, especially for those providing high-intensity care. Given that family caregivers are the backbone of our care system, it is crucial to understand who these caregivers are and their health and wellbeing. This study provides a profile of U.S. intergenerational caregivers using data from 2018 RAND Health and Retirement Study (HRS) family files and HRS core public files. We estimate the prevalence of four different caregiver types (i.e., caring for older parents only, spouses only, grandchildren only, and those filling more than one caregiving role) overall and by socio-demographic characteristics. We also compare the socio-demographic characteristics and health outcomes (e.g., self-reported health and depression) of different caregiver types to non-caregivers. Our results showed that one in three adults age 50 or older were caregivers, the majority of which only cared for one generation: grandchildren, spouses, or older adults. Approximately 14% of caregivers cared for multiple types of family members. Caregiver profiles and health outcomes vary by caregiver type. For example, spousal caregivers had the highest depression score compared to individuals only caring for grandchildren or older parents and those filling more than one caregiving role. This knowledge is essential for establishing a foundation for targeted interventions to support caregivers.
CHALLENGES AND INSIGHTS: EVALUATING LIFE STORY WORK’S ROLE IN DEMENTIA CARE POST-PANDEMIC
Authors: DiFranco Lacey , Orsulic-Jeras Silvia , Powers Sara , Sanders Lisbeth
Published: January 2025

Decades of research have demonstrated that life story work can be an invaluable tool for residential care staff and individuals living with dementia. This study examines outcomes from 53 residential care staff (Mage=46.2 years, 92.5% female) implementing LifeBio Memory™ – an application that utilizes voice recorded interviews and artificial intelligence to automate production of resident story books and resources. In a pre-and post-intervention analysis utilizing resident proxy and staff evaluations, we observed an interesting distinction between the importance of person-centered care at the individual versus organizational level. We found a significant increase from baseline to follow-up among staff reporting they knew the resident’s life story [t(105) = -10.24, p <.001] and care preferences [t(106) = -8.91, p <.001] better after implementing the intervention. However, when asked about their feelings about and ability to provide person-centered care at their organization, staff reported a significant decrease from baseline (M = 39.70, SD = 5.54) to follow-up (M = 37.96, SD = 6.99) [t(52) = -1.42, p = 0.033]. More importantly, staff that reported higher agreeance to providing personalized care, also reported stronger organizational support at baseline (r = 0.427, p =.001) and follow-up (r = 0.606, p <.001). Additional feedback revealed organizational culture and direction for utilizing materials varied, and care facilities prioritized personal care over socialization and engagement when short-staffed. Discussion will focus on the role of organizational support for sustaining the use of life story materials in the provision of person-centered care within residential care settings.
DAILY VARIABILITY OF MULTI-DIMENSIONAL SUBJECTIVE AGE ACROSS THE ADULT LIFE-COURSE: IMPACT OF SCORING METHODS
Authors: Zhou Shally , Brady Brooke , Zheng Lidan , Anstey Kaarin
Published: January 2025

Subjective age (SA), measured as how old you feel, is associated with positive health and developmental outcomes. Despite the increased use of multi-dimensional items, there is great heterogeneity in how it is implemented. SA measures often use different scoring methods which may impact subsequent analyses and interpretations. To understand the daily fluctuations of multi-dimensional SA and evaluate the impact of scoring differences, 210 participants aged 18 to 84 (M = 54.50, SD = 18.03, 60.95% female) reported six SAs over two week-long bursts of daily surveys. Common SA scoring methods including raw, discrepancy, proportional and composite average scores were compared. Multi-level models demonstrate chronological age is a significant predictor for all scoring methods across all SA dimensions. Examining raw and discrepancy scores, younger participants felt older than their chronological age, but this difference decreased and reversed with increasing age leading to older participants feeling younger. Proportional scores reveal the percentage difference between felt SA and chronological age reduced 0.17% every year, indicating felt discrepancies were largest at both extremes of the sample. Furthermore, intercepts and significant associations varied across scoring methods and SA dimensions for sex, expectations regarding aging, self-perceptions of aging, daily stress, and daily positive and negative affect. Exploring multi-dimensional SA provides deeper insights into life-course variability, and a more nuanced understanding of ageing. Scoring approaches led to somewhat different interpretations in a life-course sample. Future studies are encouraged to consider the study’s design and main research question when determining the most appropriate questions and scoring method.
DAY-TO-DAY CHANGES IN A SIMPLIFIED MEDITERRANEAN DIET: IMPLICATIONS FOR NEXT DAY COGNITIVE FUNCTION
Authors: Parker Kelly , Hamm Jeremy
Published: January 2025

Although individual differences in Mediterranean diet (MD) have been linked to better cognitive functioning over extended periods of time, little is known about day-to-day fluctuations in MD adherence and how it may influence daily cognitive functioning. This daily diary study examined a simplified Mediterranean diet (sMD) and its impact on cognitive functioning the following day over the course of one week. Participants (N=217, Mage = 54±15, 65% female) completed daily surveys and cognitive tasks over one week to measure their daily adherence to the sMD and their daily cognitive function. Lagged multilevel models assessed the impact of (within-person centered) daily sMD on next day cognitive functions that included episodic memory, executive functioning, and processing speed. Age, sex, income, education, and race were controlled in all models. Results showed that on days following higher than usual adherence to the sMD, participants had faster processing speed (b = -45.10, p < 0.01) and greater letter fluency (b = 0.49, p = 0.04) than on days after lower than usual sMD adherence. These findings show that day-to-day shifts in sMD adherence have implications for lagged changes in cognition for middle-aged and older adults, suggesting even small changes in sMD add up and could contribute to improved cognitive aging over time. Small, but simple changes such as increasing fruit, vegetable, and fish intake and reducing sugar-sweetened beverage consumption may thus result in improved cognitive functioning even over very brief time periods.
DECISION TO SCREEN: CAREGIVERS VOICES IN MAMMOGRAPHY DECISION-MAKING WITH DEMENTIA
Authors: Crouch Adele , Fowler Nicole
Published: January 2025

The USPSTF recommends mammograms through 74 years old and data suggest that individuals should have a life expectancy of 10 years for a mortality benefit. Mammography beyond 75 may increase burden and risk of overdiagnosis and overtreatment; dementia may exacerbate this burden. Despite guidelines and changing risks and benefits, many over 75 who have life limiting illnesses receive mammograms; it’s unclear what motivates these decisions. Therefore, this descriptive qualitative analysis explored dementia caregivers descriptions about the decision to undergo or not undergo mammography screening for their relatives with dementia. Sixty dyads from an IRB-approved study on mammography decision-making completed interviews. Regarding the decision to screen, a main theme emerged: unconscious choice. Sub-themes included: 1) automatic reoccurring event; 2) healthcare provider recommended; 3) hospital/healthcare organization recommended, 4) family history. Some identified it as an automatic reoccurring event (“It was needed for general health, and it’s something that we do in our household religiously.”). In consultation with a healthcare provider some decided to proceed with mammograms (“Her doctor said it was time for her annual mammogram and he would schedule it”). Numerous were prompted to receive a mammogram by a hospital/healthcare organization (“We received a reminder in the mail that it was time for me, and it was time for her, and I just made the appointment. There was no discussion.”). Lastly, participants identified that their family history of cancer prompted them. Overall, many participants may not have recognized mammography as a choice.