bluuebunny/crossref_metadata_2025 huggingface dataset:
DEVELOPMENT AND IMPLEMENTATION OF THE COGDRISK DEMENTIA RISK ASSESSMENT TOOL AND INTERACTIVE WEBSITE
Authors: Kootar Scherazad , Peters Ruth , Huque Md Hamidul , Eramudugolla Ranmalee , Anstey Kaarin
Published: December 2022

We developed a comprehensive risk assessment tool for dementia – Cognitive Health and Dementia Risk Assessment (CogDrisk) and a version specifically for Alzheimer’s disease called CogDrisk-AD that could be applicable in low and high-resource settings. This tool incorporates risk and protective factors identified through systematic synthesis of observational studies that report risk ratios. Risk and protective factors included in the tool were selected on the strength of evidence as well as the availability of measures that are practicable in a range of clinical and research contexts. Seventeen risk/protective factors were identified for inclusion in the dementia algorithm to estimate the risk of dementia while sixteen factors were identified for the AD model, with an overlap in the majority of the factors. CogDrisk and the CogDrisk-AD were predictive of dementia and AD when validated across four high-quality international cohort studies. To enable the CogDrisk tool to be implemented in practice our team has developed an interactive website where individuals 18 years and above can complete the CogDrisk questionnaire, obtain a personalised risk profile, and receive feedback on their risk profile. The website was developed with the capacity to collect and store data. We anticipate that the tool can be used by members of the public, in clinical settings and as a screening or outcome measure for clinical trials.
ANTICIPATED SUICIDAL AND DEATH IDEATION IN RESPONSE TO AN IMAGINED DEMENTIA DIAGNOSIS
Authors: Maxfield Molly , Peckham Allie , James Dara , Lathrop Laura , Fiske Amy
Published: December 2022

Alzheimer’s disease and related dementias are prevalent, incurable, and highly impactful diagnoses. Dementias are therefore feared diagnoses. Dementia-related anxiety (DRA) is anxiety about a current or future diagnosis of dementia and the associated complex symptoms. In a mixed methods study, semi-structured interviews were conducted to identify causes of DRA and revealed that numerous adults anticipated suicidal or death ideation if diagnosed with dementia. Fifty cognitively healthy, community-dwelling adults aged 58 to 89 (M = 70.92, SD = 6.08; 64% female) were recruited from a university participant registry and Memory Clinic. Among participants endorsing anticipated suicidal or death ideation, responses ranged from active plans, including interest in physician-assisted suicide, to more passive wishes to hasten death rather than continue to live with dementia. Within reports of both anticipated suicidal and death ideation, subthemes emerged, including the concern about becoming a burden to others in more advanced stages of dementia, the devaluation of life or the self with dementia, and the desire for (and anticipated thwarting of) control and independence. Statements of anticipated suicidal and death ideation were contingent on a future dementia diagnosis and may reflect errors in affective forecasting. Nevertheless, given the prevalence of dementias and older adults’ elevated rates of suicide, the intersection of these two public health issues warrants greater attention and further investigation.
TRANSLATION AND CULTURAL ADAPTATION OF THE PREFERENCES FOR EVERYDAY LIVING INVENTORY INTO KOREAN
Authors: Kwon Jenny , Shin So Young
Published: December 2022

Valid and reliable measures are necessary to provide person-centered care tailored to the individual. However, there are no such measures in Korean nursing home settings. Therefore, the purpose of this study was to translate and culturally adapt the Preferences for Everyday Living Inventory (PELI); test face validity; and finalize a Korean version of PELI (PELI-K). The translation and cultural adaptation were done according to guidelines of the International Society for Pharmacoeconomics and Outcomes. After translating, cognitively capable Korean older adults (n=10) reviewed the PELI items and completed a questionnaire. Face validity was assessed by three questions regarding grammar and wording, understandability, and cultural relevance using a 4-point Likert scale: 1 (strongly disagree) to 4 (strongly agree). Higher scores indicate better validity. The mean (±SD) age of participants was 67 (±2.50) years. The mean score of appropriateness for grammar and wording was 2.70 (±.82); understandability was 3.70 (±.48); and cultural relevance was 3.70 (±.67). Participants found the Korean version of PELI easy to understand and interpret, and culturally relevant. However, some translations have room for improvement in rephrasing sentences and using alternative wording. Based on cognitive debriefing results and several suggestions from participants, necessary changes were made before creating a final version of PELI-K. These findings suggest that PELI was successfully translated and culturally adapted to Korean. Implementing PELI-K in Korean nursing home settings will help with eliciting individual preferences and incorporating them into care delivery. Next steps can evaluate care quality improvement and increased residents’ satisfaction.
THE EFFECTS OF A HAND-BASED HOME-TRAINING PROGRAM ON FINE FORCE PERCEPTION IN OLDER ADULTS
Authors: Cook Rachel Logue , Kern Kathy , Brown Susan
Published: December 2022

The ability to use and manipulate the hands is essential for completing daily activities such as dressing, food preparation, and medication adherence, but declines with age. Assessments of hand function typically include measures of maximum strength despite our recent findings that fine force control may be more indicative of function than strength. The purpose of this study was to determine the effectiveness of a hand-based intervention on improving various aspects of hand function in older adults. Eleven older adults (mean age: 77±6.8y, 7 females) completed a 6-week home-based training program consisting of a series of sensorimotor tasks. Hand assessments included tactile sensation, dexterity, maximum grip and pinch strength, and fine force control using a pinch force matching paradigm. In the fine force task, participants were given a reference force (25% MVC) and were instructed to match the force without visual feedback using either the same (ipsilateral) or opposite (contralateral) hand as the reference force. After the training program, older adults displayed a 35% reduction (p < 0.01) in matching error during the contralateral fine force control task. Additionally, both tactile sensation and dexterity showed improvements in the dominant hand (p < 0.05). No differences were observed in maximum pinch or grip strength. We observed improvements in fine force control, tactile sensibility, and dexterity, all of which contribute to hand function needed for daily activities, as a result of the home-based intervention. These results underscore the importance of measuring different aspects of hand function and the need for additional hand-based interventions in the aging population.
VARIATION IN STATE ENFORCEMENT REGULATIONS REGARDING FINANCIAL PENALTIES AGAINST ASSISTED LIVING FACILITIES
Authors: Weems Jacy , Thomas Kali
Published: December 2022

Provider behavior is known to be driven by market forces, including costs. Financial penalties are the primary enforcement remedy available to state agencies in deterring substandard practices in assisted living (AL) communities. States develop licensing and enforcement requirements for AL communities, and regulations vary by license. Using state regulations and statutes sourced for AL license types from Nexis Uni, we used key phrases to extract information from all 50 states and D.C. to characterize how state agencies calculate and assess financial penalties for licensed AL community violations. Fines are assessed for each day of substandard behavior or as a one-time amount; within the nursing home sector, per-day fines tend to be higher than per-instance fines as they accumulate. We found that of the states analyzed so far (n=25), ten states (40%) may impose either per-day or per-instance fines, nine (36%) can impose per-instance fines only, three (12%) may impose per-day fines only, and three (12%) incorporated facility size in assessing fine amounts. One state had no policies concerning AL fine enforcement. The median per-instance maximum fine amount is $2,000 [IQR $500-$5,000], while the median maximum per-day fine is $500 per day [IQR $150-$2,000]. Eleven states (44%) utilize tiered amount categories based on violation scope and severity. Agencies also consider characteristics such as community size and past performance when assessing fine amounts. Inconsistent penalties across states illuminate the need to assess the impact of current regulations, identify best enforcement practices to improve overall compliance, and share best practices between enforcement agencies.
LONELINESS AND PSYCHOLOGICAL DISTRESS AMONG AFRICAN AMERICAN ASSISTED LIVING RESIDENTS APPROACHING END OF LIFE
Authors: Arthur Christopher , Bender Alexis , Perkins Molly
Published: December 2022

Social isolation and loneliness are common at end of life and important contributors to psychological distress, particularly among older adults. Despite evidence that isolation and loneliness are generally prevalent in assisted living (AL), little research has examined these states within the context of end of life (EOL). This study uses secondary data from an EOL study in assisted living to qualitatively characterize the experience of isolation and loneliness in African American AL residents with varying levels of psychological distress. We performed a thematic analysis using ethnographic and interview data collected from 25 residents (64% female) in a large (90+ bed) all-African American AL community in metropolitan Atlanta. We assessed psychological distress using the PHQ-4 and used this measure in qualitative analysis to explore varying patterns of social isolation and loneliness across residents. Findings showed high variability in psychological distress based on PHQ-4 scores (range 0–12, mean = 3.5, SD = 3.75). Across themes of social isolation and loneliness, we compared experiences of residents with low and high psychological distress. The maintenance of agency in the face of isolation and loneliness was the predominant pattern among the low-distress group, while passive withdrawal was consistently identified among the high-distress group. We classified these themes in terms of individual interpersonal relationships characterized by self-isolation and negotiation of family connections, as well as AL community-level relationships characterized by the liminality of the lived AL experience. Results have important implications for multilevel interventions designed to reduce social isolation, loneliness, and psychological distress among this population.
THE EFFECTS OF TBI SEVERITY AND PTSD ON SUBJECTIVE COGNITIVE DECLINE IN OLDER VETERANS
Authors: Alshaheri Alin , Ly Monica , Thomas Kelsey , Delano-Wood Lisa
Published: December 2022

Both post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) have been linked to subjective cognitive complaints; however, less is known about the unique relationships of PTSD symptoms and TBI severity with domain-specific subjective cognitive declines in older Veterans. The current study included 215 Vietnam-Era Veterans from the Department of Defense-Alzheimer’s Disease Neuroimaging Initiative (age M=69.62 years, SD=4.30). General linear models, adjusting for age, education, apolipoprotein E ε4 status, self-reported health, MMSE score, and depressive symptoms, examined the unique effects of PTSD symptoms (measured using the Clinician-Administered PTSD Scale) and TBI severity (none, mild, moderate/severe) on subjective cognitive decline measured using the Everyday Cognition (ECog) measure. Greater current PTSD symptoms were associated with greater subjective cognitive declines on the ECog total score (t=.198, p=.009) as well as memory (t=.197, p=.008), language (t=.228, p=.004), and visuospatial (t=.216, p=.007) subscales. Compared with participants with no TBI, mild TBI was associated with greater subjective cognitive decline on the ECog total score (t=.329, p=.026) as well as the language (t=.334, p=.030) and divided attention (t=.411, p=.007) subscales, while moderate-to-severe TBI was associated with greater subjective declines in planning (t=.291, p=.049) and divided attention (t=.320, p=.032). There was no interaction between PTSD and TBI severity on ECog scores. Results suggest that PTSD symptoms and mild versus moderate/severe TBI differentially impact specific domains of subjective cognitive decline. Future work should investigate how repetitive TBI may modify these relationships, and whether PTSD and TBI severity are associated with objective cognition and quality of life in older Veterans.
LIVING IN HISTORICALLY REDLINED NEIGHBORHOODS AND ACCELERATED BIOLOGICAL AGING AMONG OLDER ADULTS
Authors: Ailshire Jennifer , Fisk Calley , Jones Chelsey
Published: December 2022

Various neighborhood factors, including greenspace availability and neighborhood socioeconomic disadvantage, are associated with accelerated biological age (aging faster than expected based on chronological age) among older adults. Neighborhoods, however, evolve overtime and historical neighborhood conditions may be influential in the aging process of older residents. In the United States, many neighborhoods were impacted by historical redlining (a federally sponsored, discriminatory program targeting communities of color throughout the 1930s), wherein neighborhoods received grades based on demographics and quality of infrastructure. Overwhelmingly, neighborhoods with more residents of color were considered less desirable or “redlined” and prior research links living in historically redlined neighborhoods to poor health across the life course and worse neighborhood conditions. We link data on redlining of U.S. census tracts from the National Community Reinvestment Coalition (NCRC) to the 2016 Health and Retirement Study Venous Blood Study (HRS-VBS) to assess whether living in historically redlined neighborhoods is associated with advanced biological aging among adults aged 55 and older. Our indicator of expanded biological age is a summary measure of 22 biomarkers associated with cardiovascular, immune, and metabolic functioning. Using multivariate linear regression models controlling for an individual’s age, sex, and race/ethnicity, we found that individuals living in neighborhoods historically designated as “declining” or “hazardous” were about 2 years older biologically than individuals living in neighborhoods designated as “best/desirable”. These findings suggest that residing in neighborhoods differentially shaped by historical forces impacts rates of accelerated aging. Identifying these historical neighborhood conditions may help target interventions addressing disparities in aging.
TRANSFER TRAUMA AND MAJOR EVENTS AMONG NURSING HOME RESIDENTS BEFORE AND DURING THE COVID-19 PANDEMIC
Authors: Montoya Ana , Park Pil , Chang Chiang-Hua , Bynum Julie
Published: December 2022

The negative consequences of transfers are known as transfer trauma. Nursing home (NH)-to-NH transfers place long-term NH residents at risk for developing transfer trauma and this risk may have increased during the COVID-19 pandemic in the setting of a state policy that increased the number of residents who transferred between NHs. The objective of this cross-sectional cohort analysis was to assess the incidence of transfer trauma and major events (hospitalization/death/discharges) among long-term NH residents who transferred from one NH to another before and during the COVID-19 pandemic using a composite measure of transfer trauma based on validated scales from Minimum Data Set (MDS) assessments. A total of 750 residents transferred in the pre-COVID cohort and 795 in the COVID cohort were eligible for assessment of transfer trauma and major events. After adjusting for demographic characteristics, residents in the COVID cohort were almost twice more likely to die and almost three times more likely to discharge within 90 days compared to those in the pre-COVID cohort (AOR=1.94, 95%CI [1.15, 3.26] and AOR= 2.86, 95%CI [2.30, 3.56], respectively). Residents in the COVID cohort were less likely to experience transfer trauma compared to those in the pre-COVID cohort. In the during-COVID cohort, 26% of residents had a COVID-19 diagnosis and they were less likely to experience transfer trauma compared to residents without a COVID-19 diagnosis (AOR=0.34, 95%CI [0.23, 0.50]). It is important to note that some residents may have not stayed in the nursing home long enough to assess them for transfer trauma.
DIFFERENCES AND SIMILARITIES OF ELDERLY PERSONS IN SWEDEN WITH A DIAGNOSIS OF PSYCHOSIS OR NON-PSYCHOSIS (SMI)
Authors: Bülow Per , Bülow Pia H , Finkel Deborah
Published: December 2022

Psychiatric care in Sweden is jointly organized by psychiatric practice and municipal social services. To determine who is entitled to support from the municipalities, the concept of “psychiatric disability” was created in connection with psychiatric reform in 1995. Psychiatric disability is a poorly identified concept and in Sweden, a person has severe mental illness (SMI) if they have difficulties in carrying out activities in crucial areas of life, these difficulties are caused by a mental disorder, and they are prolonged. Internationally, SMI is often synonymous with psychosis, but in Sweden other severe psychiatric conditions are included, but not dementia. Both practically and ethically, the unclear definition of SMI is a problem because it determines whether a person is granted interventions and what forms the interventions take. We investigated similarities and differences in people defined as SMI, divided into two groups, psychosis (Nf222) and non-psychosis (Nf253). Adults with SMI aged 65 or over (in 2016) have been assessed using data from four surveys carried out between 1996 and 2011, as well data available from national registers. People with psychosis had worse functional levels on the Global Assessment of Functioning and more unmet needs, according to Camberwell Assessment of Needs. However, differences between psychosis and non-psychosis groups varied across measures (e.g., education, income, living situation) and results differed depending on age at onset, year of first admission to a mental hospital, and length of institutionalization. These variables had a greater impact on the similarities and differences between measures than the diagnosis itself.
ESTABLISHING A SPANISH FOCUSED ADVANCED CARE PLANNING EDUCATIONAL SESSION FOR LATINA BREAST CANCER SURVIVORS
Authors: Cajavilca Moroni Fernandez , Dassel Kara , Portugal Gabriela , Utz Rebecca , Supiano Katherine
Published: December 2022

In this exploratory, qualitative study, a focus group was conducted with Latina breast cancer survivors and patients to explore their feedback on how a culturally, sensitive educational session looks like, and whether a Spanish-speaking advanced care planning (ACP) educational session might be able to identify barriers for promoting awareness and discussion of ACP. First, the educational session informed participants on ACP, specifically an advanced directive (AD) and barriers that contribute to decreased rates in ACP among Latino populations. Second, a group interview was facilitated by the project lead using a semi structured interview guide. Eight Latina cancer survivors or patients participated in the educational session. Thematic analysis revealed four themes: 1) Familial Involvement 2) Need for Advanced Care Planning Education 3) Addressing Language and Cultural Barriers and 4) Culturally Sensitive and Informative Resources. A Spanish focused educational session may reduce current barriers that hinder ACP conversations, and may lead to increased rates of participants engaging in AD documentation.
THE EFFECTS OF TYPE 2 DIABETES MELLITUS ON POSTURAL ADAPTATION DURING A VISUAL SEARCH TASK IN OLDER ADULTS
Authors: Wolfe Alexander , You Tongjian , Leveille Suzanne , Manor Brad , Jor’dan Azizah
Published: December 2022

Type II diabetes mellitus (T2DM) is associated with a reduction in sensory integration capacity that often results in cognition and postural control deficits. The effects of T2DM on the ability to adapt one’s postural sway while standing and performing a visual search task (VST) are unknown. Twenty-three healthy older adults (HOA) (70–90 years) and 20 older adults with T2DM (67–93 years) performed multiple trials of quiet standing with and without a VST (i.e., counting 1 target letter in a grid of random letters). Postural sway acceleration measures were jerk, velocity, range, and pathlength in the anterior-posterior (AP) and medial-lateral (ML) direction, as well as elliptical area. Postural adaptation to the VST was defined as the absolute change between conditions. VST accuracy (%) was defined as the percentage of participant-reported target letters compared to total target letters. In general, for both groups, performing the VST resulted in an average reduction in sway jerk, velocity, pathlength, and range when performing the VST, compared to control (T2DM & HOA, p < 0.04). VST accuracy and the magnitude of postural adaptation to the VST were similar between groups (p>0.15). Within the T2DM group, those who performed worse on the VST exhibited less adaptation (i.e., smaller decrease) in ML velocity (r=0.47, p=0.04). No other differences or associations were observed. Compared to healthy older adults, those with T2DM demonstrated a similar capacity to adapt their postural control in response to a VST. However, this group exhibited different characteristic changes in sway which were linked to task performance.
TESTING A NEW MODEL OF REABLEMENT-FOCUSED INTEGRATED CARE IN ADULT DAY SERVICE USERS IN TAIWAN: A PRELIMINARY STUDY
Authors: Chang Yu-Ting , Yu Hsiao-Wei , Lin Pay-Shin
Published: December 2022

There is a growing consensus that implementing personal-centered therapeutic activities at adult day services (ADS) leads to functional improvement in care recipients and reduces the burden on caregivers. Taiwan has introduced reablement-focused integrated care (RFIC) model for ADS users, the effects of this new model merit investigation. This study aimed to examine whether the RFIC model promotes physical and mental function in care recipients and improves caregiver satisfaction. We recruited ADS-care recipients and their family caregivers (N = 14 dyads) through purposive sampling for a quasiexperimental study. Six dyads were assigned to the RFIC intervention group and eight dyads to the control group. The RFIC intervention consisted of ten one-hour sessions over two months. The functional abilities of care recipients and the care satisfaction of caregivers were assessed at baseline and after the intervention. The RFIC group, compared to the control group, showed an improvement in care satisfaction score, and the group difference was significant (RFIC group: mean (SD) change score = 1.17 (2.64); control group: mean (SD) change score = −3.38 (2.20); p < 0.01). There were no differences in physical and mental function between the RFIC and control groups. These preliminary results suggest that when reablement is used as a means of personal-centered therapeutic training for ADS users, it can help caregivers cope with care problems and improve how they appraise their mastery and satisfaction as regards care. However, the effects of RFIC on the physical and mental function of care recipients require further investigation.
SEX DIFFERENCES IN SKELETAL MUSCLE ENERGETICS AMONG OLDER ADULTS
Authors: Kramer Philip , Distefano Giovanna , Ramos Sofhia , Goodpaster Bret , Coen Paul , Marcinek David , Cawthon Peggy , Molina Anthony
Published: December 2022

Mobility impairment is the most common disability among older adults, with an earlier presentation, higher prevalence, and greater severity in women compared to men. A decline in skeletal muscle metabolism contributes to the loss of mobility with age. However, it is unknown if sex-specific differences in muscle energetics can explain the disparity in mobility impairment among men and women. In the Study of Muscle, Mobility, and Aging (SOMMA), muscle energetics was characterized using in vivo Phosphorus Magnetic Resonance Spectroscopy and High-Resolution Respirometry of permeabilized fiber bundles from muscle biopsies. In this analysis of 773 participants aged 70–94 years, 519 were women, of which 16% were deemed lower extremity mobility impaired based on a Short Physical Performance Battery (SPPB) score
RURAL/URBAN DIFFERENCES IN LIFETIME OCCUPATION AND ALL-CAUSE MORTALITY AMONG MEXICAN ADULTS
Authors: Gutierrez Mariela , Wong Rebeca , Kuo Yong-Fang
Published: December 2022

Mortality is affected by occupation dimensions, such as physical and mental demands, environmental exposures, and access to resources. Few studies have examined the relationship between occupation and mortality in countries with shifting occupation profiles, such as Mexico. We used 2001–2018 data from the Mexican Health and Aging Study to investigate the association between lifetime occupation type and all-cause mortality among participants aged 50 and older. We grouped participants’ longest-held occupations into five categories: (1) no main job; (2) agriculture; (3) domestic, service; (4) administrative, professionals, sales; and (5) production, industrial, transportation. We used Cox Proportional Hazard regression to study death risk associated with occupation, adjusting models for baseline demographic, health, and job characteristics. We stratified analysis by rural and urban to account for differences in occupation composition. Our sample included 10,482 participants, with 4,147 deaths occurring during follow-up. The percentage of participants in administrative, professional or sales was higher in urban areas than rural areas (60.7% vs. 20.5%). The percentage of participants in agriculture was higher in rural areas than urban areas (81.8% vs. 18.2%). Compared to professionals, participants in agriculture, industry, or transportation had a slightly higher risk of death (HR=1.65, 95% CI 1.59 to 1.77). Agriculture workers in rural areas had a higher risk of death than non-agriculture workers in rural areas. Considering rural/urban differences in occupations and their effect on mortality can inform policy aimed at improving the working environment for Mexican adults. Understanding rural/urban differences in mortality associated with occupation can elucidate socioeconomic inequalities in mortality.
ASSOCIATION BETWEEN LIMITED ENGLISH PROFICIENCY AND MEDICARE ENROLLMENT CHOICE
Authors: Estenson Lilly , Jacobson Mireille
Published: December 2022

Choosing between traditional Medicare and Medicare Advantage (MA) is an important health and financial decision that can be especially complicated for Medicare beneficiaries who have limited proficiency speaking or reading English (LEP). In this study, we used data from the 2016–2018 Medicare Current Beneficiary Survey and ordinary least squares regression to examine the association between LEP and MA enrollment. Among the 19,621 respondents (32,912 person-year observations) who answered LEP questions, 9.2% self-reported having LEP and 38% were enrolled in MA. Limited proficiency reading English was significantly associated with enrollment choice; respondents who reported reading English “not well” or “not at all” were 6.7 percentage points less likely to enroll in MA than respondents who reported reading English “well” or “very well” (SE=0.025; p < 0.01). However, when we stratified respondents by language spoken at home, we discovered considerable variation in this association among language subgroups (English: -6.5 percentage points, SE=0.029, p < 0.05; Spanish: -1.5 percentage points, SE=0.051, p=NS; other: -11.2 percentage points, SE=0.065, p < 0.10). Additionally, respondents with limited proficiency reading English were 8.0 percentage points less likely to positively rate their Medicare knowledge (SE=0.022, p < 0.01) and 6.4 percentage points less likely to review their Medicare options annually (SE=0.023, p < 0.01) than respondents with English reading proficiency. Limited proficiency speaking English was not significantly associated with MA enrollment, Medicare knowledge, or annual options review. These findings suggest that English literacy rather than speaking proficiency may be a crucial determinant of enrollment choices. Language access around health insurance information is critical for equitable Medicare enrollment.
BEFORE IT WAS COOL: THE AGING NETWORK’S ROLE IN ADDRESSING SOCIAL NEEDS AND REDUCING DISPARITIES
Authors: Wilson Traci , Kunkel Suzanne
Published: December 2022

Decades before social determinants of health (SDOH) became such a focus of attention across health and social care, Area Agencies on Aging (AAAs), Title VI Native American Aging Programs, and their Aging Network partners had developed local systems of coordinated services and supports to assess and address health-related social needs. Every service and program provided by an AAA or Title VI program addresses a need related to SDOH risks. The Older Americans Act mandates that funded services such as congregate and home-delivered meals, support for caregivers, transportation, and housing supports are targeted to older adults with the greatest economic or social need. Using the foundational study on “ACL’s Impact on the Social Determinants of Health” as a framework, this symposium will demonstrate how OAA-funded programs map to SDOH pathways. Presenters will describe specific programs and new practices within the Aging Network that identify and address social needs of older adults from historically marginalized and underserved communities. These initiatives, many of which were born through COVID response, include analyses and partnerships to advance health equity and care integration. Presenters will describe how Aging Network practices and partnerships have altered community environments to make community living accessible to older adults who have been traditionally underserved, and current workforce challenges that threaten continued progress. The session will conclude with an interactive discussion about gaps, strategies, and next steps to reinforce, articulate and demonstrate the value of Aging Network services in addressing SDOH risks and needs.
ROBUST LONGEVITY EFFECTS OF NOVEL COMPOUNDS TESTED BY THE CAENORHABDITIS INTERVENTION TESTING PROGRAM
Authors: Driscoll Monica , Onken Brian , Sedore Christine , Coleman-Hulbert Anna , Hall David , Lithgow Gordon , Phillips Patrick , Montes Viviana Perez
Published: December 2022

Many efficacious interventions that promote mouse longevity (sirtuins, TOR, insulin signaling) have identification roots in invertebrate genetics. The Caenorhabditis Intervention Testing Program (CITP) was charged by the NIA to evaluate pharmacological interventions that promote healthy aging in a robust and reproducible manner across diverse genetic backgrounds of natural variant Caenorhabditis strains. The central premise of the CITP effort is that compounds that have strong effects across diverse genetic backgrounds have enhanced probability of translatability into pre-clinical research. Indeed, some CITP-verified compounds have been shown to promote healthspan and longevity in mouse models, in support of this fundamental premise. One example that supports the Geroscience hypothesis (anti-aging compounds will promote systemic health) is our finding that when HBX, the counterpart of one of the strongest C. elegans longevity interventions (ThioT), was tested in a comprehensive multi-laboratory collaboration (Buck Institute), a remarkable increase in bone health in aging mice emerged (PMID 33778327). Our current effort includes pursuing compound submissions from the larger scientific aging community, as well as identification of candidates via high-throughput screening of chemical libraries and data mining of peer-reviewed publications. We now evaluate whole-organism RNA sequence data to estimate the mode of action for successful interventions, and conduct mortality analysis from a generalized family of distributions on high-resolution automated lifespan data to determine whether a given intervention changes the rate or onset of aging. Our recent lifespan-altering discoveries include a small molecule, a proprietary compound, an isothiocyanate and a vitamin derivative. We will present on the breaking compound successes.
EVALUATING INSTRUMENTS FOR ASSESSING HEALTHSPAN: A MULTI-CENTER CROSS-SECTIONAL STUDY IN THE COMPANION DOG
Authors: Chen Frances , Ullal Tarini , Graves Jessica , Ratcliff Ellen , Naka Alexander , McKenzie Brennen , Carttar Tennery , LaCroix-Fralish Michael
Published: December 2022

The companion dog is an emerging model in translational geroscience and offers novel opportunities to investigate aging biology and potential gerotherapeutics. However, there is a scarcity of validated tools and clinical outcome measures to characterize and understand the impact of aging in this translational species. Here we report on a multi-center, cross sectional veterinary clinical study, where we evaluated a clinical questionnaire (Canine Frailty Index; CFI; Banzato et al., 2019) to assess frailty and an owner assessment tool (VetMetrica HRQL) to evaluate HRQL in 451 adult companion dogs. Results support evidence of validity for the tools by confirming expectations that frailty and HRQL deteriorate with age. CFI scores were significantly higher (higher frailty) and HRQL scores significantly lower (worse HRQL) in old dogs (≥ 7 years of age) compared to young dogs (≥ 2 and < 6 years of age). Body size (small < 25lbs or large > 50lbs) was not associated with CFI or total HRQL score. However, older, larger dogs showed faster age-related decline in HRQL scores specific to owner-reported activity and comfort. Findings suggest that the clinician-assessed CFI and owner-reported VetMetrica HRQL may be useful tools to evaluate two determinants of healthspan in dogs: the accumulation of frailty and the progressive decline in quality of life. Establishing validated tools that operationalize the assessment of canine healthspan is critical for the linking pathophysiological mechanisms to aging phenotypes in the companion dog and for accelerating the development of gerotherapeutics that benefit both human and veterinary medicine.
USING SOCIAL MEDIA TO UNDERSTAND FAMILY CAREGIVER PERSPECTIVES ON ASSISTIVE TECHNOLOGY FOR PERSONS WITH ALS
Authors: Choi Yong K , Alomairi Salhah
Published: December 2022

ALS Forum (alsforums.com) is an online support group for those who have motor neuron disease or amyotrophic lateral sclerosis (ALS). It provides information, advice, connection, care, and assistance to persons living with ALS and their family caregivers. This study aimed to analyze the online discussion posts by caregivers of persons with ALS and assess their perceptions, experiences, and challenges of using assistive technologies (AT). Posts were extracted from the ALS caregiver discussion forum via web scraping using Python in March 2022. The extracted posts are dated between June 2005 and January 2022. The total number of posts and replies generated during this period was 52,292 by 2,397 unique users. Additional searches were conducted using assistive technology-related keywords to create the text dataset. A total of 263 posts by 137 unique users were identified. After the initial review, 186 posts were included in the final analysis. Thematic analysis revealed six major themes: (1) Uses of AT (automation/control, communication, mobility); 2) Barriers and Facilitators (cost, effort to learn new technology, rejection, interoperability, customer service); 3) Usability (hardware and software-related); 4) Sharing Experience on AT; 5) Giving Advice; 6) Seeking Information on AT. The findings are consistent with previous literature that online health discussion forums provide access to rich data that contains lived experiences of patients and caregivers. The findings may inform the design of future assistive technology that incorporates the patients’ and caregivers’ perspectives to increase the adoption and long-term sustainability of the technology for people living with ALS and their caregivers.
OLDER AMERICANS ACT PROVISIONS AND SOCIAL DETERMINANTS OF HEALTH: INTERSECTIONS AND IMPACTS
Authors: Griffin Shannon , Skinner Robbie , Kunkel Suzanne , Blair Elizabeth , Simon Lois , Graham Robert , Wilson Traci , Hudgins Kristen
Published: December 2022

Older Americans Act (OAA) programs and services are strongly linked to social determinants of health (SDOH) and integral to addressing social needs among older adults and individuals with disabilities and their families. Supported by the Administration for Community Living, researchers examined the intersection of OAA-funded programs and services under Titles III, VI, and VII and their impacts on SDOH. This study used an integration of extant literature; secondary data; and interviews with ACL office leadership, AAAs, Title VI program staff, and other local service providers to examine existing social needs among older adults, equity prioritization within OAA-funded program development, and impacts of OAA-funded programs and services. Study findings highlighted relationships between ACL and Aging Network entities, best practices for and process challenges of transforming grant funding into recipient services, and OAA-funded program areas for possible future development.
RACE AND DETERMINANTS OF HEALTH MODERATE ASSOCIATIONS BETWEEN COGNITIVE DECLINE AND DRIVING MOBILITY OVER 10 YEARS
Authors: Wheeler Katie , Pope Caitlin , Bell Tyler , Carroll Brooke , Ross Lesley , Ball Karlene
Published: December 2022

The ability to drive a vehicle is an everyday function that helps older adults maintain independence. Few observational studies have examined the relationship between cognitive decline and driving mobility and in context of racial differences and social determinants of health (SDOH). To address this empirical gap, this study aimed to characterize how cognitive functioning is longitudinally associated with driving mobility (driving space, driving exposure, and driving difficulty) in older age, and how it may vary by race and SDOH. Using the control arm of the Advanced Cognitive Training in Vital Elderly study (n=581, 24.5% Black), multilevel models examined longitudinal associations between processing speed, visual attention, memory, and reasoning with driving mobility outcomes. Race and SDOH moderations were explored. Only declines in reasoning and processing speed related to driving mobility, moderated by race and SDOH. Reasoning decline related to increased driving space in White (β=-.21,p=.006) but not Black older adults (p=.286). Processing speed decline related to greater driving exposure in Black older adults (β=-.15,p < .001) but less driving exposure in White older adults (β=.13,p=.006). Processing speed decline related to reduced driving exposure (β=-.06,p=.001) and increased driving difficulty (β=-.35,p < .001), but only in people living in poorer neighborhood and built environment and poorer social community contexts, respectively. Overall, findings emphasize that relationships between cognitive decline and driving mobility are dependent on race and SDOH. Consideration of such factors may help target those in greatest need to sustain safe driving mobility and functional independence.
FINANCIAL HARDSHIPS AND MEDICATION ADHERENCE DURING THE COVID-19 PANDEMIC
Authors: Lytle Megan , Carr Dawn , Homan Patricia
Published: December 2022

Medication nonadherence is associated with numerous negative health outcomes among older adults, including myocardial infarction, stroke, preventable hospitalizations, and increased risk of decline in self-reported health status. Maintaining continuous use and access to needed medications in later life has important implications for quality and length of life. A primary barrier shown to interfere with medication adherence in older adults is an inability to pay for medication. Relative to their younger counterparts, older adults have more financial protections that increase access to needed prescription medication through health insurance coverage. Despite these added protections, older adults are more likely to experience financial insecurity, with some evidence suggesting that COVID-19 accentuated existing vulnerabilities. Data are derived from the Health and Retirement Study (HRS), leveraging data drawn from the 2016, 2018, and 2020 study waves (n=3,185). Logistic models were used to evaluate the association between five COVID-19 related financial setbacks (i.e., inability to pay mortgage/rent, credit card bills, utility or insurance bills, medical bills, and inadequate money for food), and medication nonadherence among adults 60+. Results show that net of pre-COVID financial vulnerabilities and socioeconomic status, individuals who reported being unable to pay medical bills and those unable to pay rent/mortgage after the start of the pandemic reported higher odds (19% higher and 230% higher odds, respectively) of not taking/filling their prescription medication due to cost. Results suggest that greater financial protections for housing and medical bills among financially vulnerable older adults will increase medication adherence.
COVID-19 VACCINATIONS AMONG COMMUNITY-DWELLING PERSONS LIVING WITH DEMENTIA AND THEIR CAREGIVERS
Authors: McCann Brandy Renee , Savla Jyoti , Roberto Karen , Blieszner Rosemary
Published: December 2022

There is a paucity of information regarding the uptake of the COVID-19 vaccine among community-dwelling persons living with dementia and their family caregivers. We examined factors influencing COVID-19 vaccine acceptance and hesitancy among community-dwelling persons living with dementia and their family caregivers during the early months of the vaccine rollout (February-March, 2021). Data came from three waves of telephone interviews (Mtime = 38.33 minutes) with 26 family caregivers living in rural Appalachian Virginia (96% White, 81% Female, Mage= 63±12 years, 42% Spouse Caregivers). We conducted a four-stage trajectory-based thematic content analysis and used the health belief model to interpret the data. Whereas all family caregivers and their relative living with dementia were eligible for the vaccine at Wave 3, only 10 dyads received it, while 10 dyads did not. In two families, the caregivers received the vaccine but not the person living with dementia; in four families, the caregiver had not received the vaccine, but their relative did. COVID vaccination acceptance was influenced by perceived direct and indirect health risks, cues from trusted allies, and ability to overcome vaccination barriers. Homebound people living with dementia faced unique barriers including transportation to vaccine sites and providers’ inability to deliver the vaccine to the home. Caregivers who refused or delayed vaccinations for themselves or their relatives discussed confusion about eligibility, low perceived risk of COVID, vaccine fear, and personal choice beliefs. Findings inform direct care delivery for interdependent family members who live in remote locations facing a public health crisis.
PSYCHOMETRICS IN THE DEVELOPING OF LONGITUDINAL MEASURES OF FRAILTY
Authors: Voll Stacey , Terrera Graciela Muniz , Hofer Scott
Published: December 2022

Frailty has become an increasingly important aspect in the field of health research in studies of vulnerability to adverse events and individuals functioning due to accumulated health deficits. Yet, there is no agreement on how to measure frailty or identify adults as frail, resulting in high heterogeneity between estimates of frailty and identification of frail individuals. The purpose of this poster is to provide a summary of the process in the development of a frailty index with robust psychometric properties to be used in research using longitudinal health study sets.
DEVELOPMENT OF PREDICTIVE MODELS FOR INCIDENT FRAILTY IN OLDER ADULTS: MACHINE LEARNING APPROACHES
Authors: Jung Heeeun , Kim Miji , Park Mina , Ryu Jinhyung , Mun Kyung-Ryoul , Won Chang Won
Published: December 2022

Frailty is not only a clinical symptom accompanying adverse health outcomes but also a syndrome that involves a dynamic transition between varying phases. This study aimed to develop machine learning (ML) models for predicting incident frailty over a 2-year follow-up period among Korean community-dwelling adults aged 70 years and older. We conducted prospective analyses (n=2,408) among participants who underwent measurement of frailty status at baseline and 2-year follow-up from the Korean Frailty and Aging Cohort Study. Frailty was defined as the presence of three or more of five components using the Fried frailty phenotype. A total of 2,250 participants classified as non-frail at baseline and 116 (5.2%) with incident frailty during the 2-year follow-up. 32 variables selected by stepwise analysis were used as inputs among 77 variables composed of sociodemographic and clinical characteristics. The different ML models such as Logistic Regression(LR), K-Nearest Neighbor(KNN), Gaussian Naïve Base(NB), Support Vector Machine(SVM), and Random Forest(RF) with the 10-fold cross validation were compared. A feature selection, grid search, and data resampling methods were applied to find the best inputs and models. The best performing inputs of 16 variables were found and Gaussian NB achieved the highest accuracy of 0.82 and F1-score of 0.79 in predicting frailty incidence after 2-years with selected 16 inputs, followed by RF (accuracy 0.82, F1-score 0.76) and LR (accuracy 0.80, F1-score 0.76). We developed ML models for predicting frailty and is expected to contribute to the early prediction of frail older adults and timely intervention in clinical and community settings.
WHAT I KNOW NOW THAT I WISH I HAD KNOWN WHEN I WAS YOUNGER: OLDER WOMEN’S RELATIONSHIP ADVICE AS SKINNY POETRY
Authors: Watson Wendy , Faulkner Sandra , Stelle Charlie
Published: December 2022

Research has demonstrated that relationships are important in the lives of older women. Eighteen women between the ages of 64–84 participated in interviews about their lives and relationships across the life course. As a final question, the women were asked, “What do you know now about relationships that you wish you’d known when you were young?” Responses to that question were examined using a skinny poem. The Skinny poem is a short poetry form that portrays a vivid image in 11 “skinny” lines. It is a type of lyric poem that uses condensed images, expressions of personal feelings, and demonstrations of emotional context in musical lines. Skinnys were written by one author and analyzed by a second author. This poster will present the 18 skinny poems and the analysis of the poems. In these skinnys, one can see the relationship experiences the women had throughout their lives. There is a connection to wisdom, a recognition that they have grown and learned about relationships over time and have advice they wished their younger selves had known. Emotions range from anger and anxiety to trepidation and regret. Most of the women reflect on things they would have done differently, from how they treated others to how they felt about themselves. They recognize that relationships take work and that as older women, they still do not know everything about relationships. They also learned about themselves as individuals and wished they had not searched for their identity and self-worth in their connection to others.