bluuebunny/crossref_metadata_2025 huggingface dataset:
PHYSICAL AND MENTAL HEALTH INFORMATION-SEEKING BEHAVIORS AMONG US-BASED LATINO ADULTS AGES 50–86
Authors: DuPont-Reyes Melissa , Villatoro Alice , Vasquez Elizabeth , Tang Lu
Published: December 2023

Introduction

As U.S.-based Latino populations disproportionately experience chronic disease and age earlier than their non-Latino white counterparts, attentiveness to knowledge gaps in health communication is critical to address health disparities among Latino older adults.

Methods

We conducted a cross-sectional survey among U.S.-based Latinos ages 50-86 (N=274; 2021) that measured physical and mental health information seeking across four sources—TV/radio/print-media, Internet/social-media, family/friends, and healthcare providers. Linear regression models examined patterns of personal, family, and mental health factors on each information seeking outcome.

Results

Foreign-born Latinos had lower odds of mental health info-seeking on Internet/social media (p< 0.05) than U.S.-born Latinos. Compared to higher educational attainment, low education reduced odds of physical/mental health info-seeking in all media sources (p< 0.05). Family mental health history vs none saw 3-5 times the odds of physical/mental health info-seeking to all sources (p< 0.01). Additionally, moderate/severe mental health vs mild/none was associated with 2-3 times the odds of physical/mental health info-seeking among family/friends and healthcare providers (p< 0.01). English media use increased odds of physical health info-seeking in TV/radio/print-media and family/friends (p< 0.05), while Spanish/English media use increased odds of mental health info-seeking to healthcare providers (p< 0.05).

Conclusions

Latino older adults report diverse yet unique patterns in health information acquisition. Those with self/familial mental illness especially seek health information more often than Latinos without a lived experience. Findings demonstrate the need to apply culturally appropriate health communication strategies to address the needs of older Latino adults, with special focus on families coping with mental illnesses.
ENGAGING COLLEGE STUDENTS AND LIFE-LONG LEARNERS WITH INTERGENERATIONAL JUSTICE ISSUES
Authors: Hasche Leslie , De Fries Carson , Taeckens-Seabaugh Ashley , Kohlbrenner Briana , Decker Hannah , Cutforth Asia
Published: December 2023

Generational conflict and equity issues are often hot topics in popular media that expand across issues of politics, government budgets, environment, community-planning, health care, and employment. While increasing media attention highlights the need to reframe the way we talk about these topics to combat ageism, explicit academic exploration of the ways theories of social justice that consider impacts across generations and time are also needed. With the aim to provide an overview of an innovative course on intergenerational justice, we will showcase how different theories and educational activities are used to engage both graduate students and life-long learners. For over nine years, versions of this course have been offered in graduate programs, in intergenerational learning courses, and in life-long learning trainings and public events for older adults. The course frames these contemporary issues (i.e., politics, ecological justice, health care) by exploring the issue of justice between age groups, which is called intergenerational justice. Additionally, the contemporary issues will also show how considerations for intragenerational justice (i.e., injustices experienced within age groups), need to be considered within the debates of generational equity and conflict. Examples of learning activities and strategies to integrate intergenerational learning opportunities to combat attitudes about aging will be shared from both instructor and former student perspectives. Thus, we hope to demonstrate how intergenerational course topics may be a fruitful focus of gerontological education efforts to engage students, to disrupt generational conflict and ageist narratives, and to offer opportunities for intergenerational connections for problem-solving on contemporary issues.
SLEEP MEDICATION USE AND FALLS IN OLDER ADULTS WITH OSTEOPOROSIS
Authors: Anderson Loretta , Ek Stina , Orwig Denise , Wennberg Alexandra
Published: December 2023

One third of older adults take sleep medications, but they are associated with fall risk. One in four older adults experiences a fall each year, costing the U.S. $50 billion dollars annually. Osteoporosis is linked to falls, but little research has examined sleep medication use and falls risk among older adults with osteoporosis. We examined the 2011 National Health and Aging Trends Study (NHATS). Outcomes were falls in the last month, falls in the last year, multiple falls in the last year, and fear of falling. Self-reported sleep medication use dichotomized for analysis (0= once/week or less; 1= 2 or more times/week) was the exposure of interest. Osteoporosis was self-reported (yes/no). Of 8,245 participants, 58% female, 68% white, and 20.5% had osteoporosis. Multivariable logistic regression showed, sleep medication users, compared to rare- or non-users, had higher odds of a fall in the last month (O.R. = 1.64, 95% CI: 1.10, 2.47), in the last 12 months (O.R. = 1.60, 95% CI: 1.20, 2.12), multiple falls in the last 12 months (O.R. = 1.64, 95% CI: 1.08, 2.50), and fear of falling (O.R. = 1.58, 95% CI: 1.18, 2.11). Osteoporotic sleep medication users show increased risk of falls, multiple falls per year, and fear of falling. As older adults with osteoporosis are at increased risk, reducing sleep medication use may decrease this risk, thus decreasing the need for costly medical care. This study contributes to clinicians’ efforts to reduce falls in vulnerable older adults and may reduce overall burden to Medicare.
THE STUDY OF MUSCLE, MOBILITY AND AGING (SOMMA): MITOCHONDRIAL ENERGETICS OF SKELETAL MUSCLE
Authors: Coen Paul , Hepple Russell , Goodpaster Bret
Published: December 2023

Aging leads to a decline in mitochondrial energetics of skeletal muscle. We hypothesize that worse mitochondrial energetics is associated with greater comorbidity burden and worse fatiguability. Furthermore, sex differences in mitochondrial decline with aging are poorly understood. Prior human muscle biopsy studies have tended to be small and did not account for confounding factors including physical activity and adiposity levels. The Study of Muscle, Mobility, and Aging (SOMMA) is an observational longitudinal cohort study of 879 older adults designed to discover the biological basis of mobility disability and to collect tissues and measurements for future studies of the biology of human aging. The multidisciplinary SOMMA team includes two clinical centers (University of Pittsburgh and Wake Forest University), a biorepository (Translational Research Institute at AdventHealth), and the San Francisco Coordinating Center (California Pacific Medical Center Research Institute). At baseline, SOMMA collected biospecimens (muscle and adipose tissue, blood, urine, fecal samples); a variety of questionnaires; physical and cognitive assessments; whole-body imaging (magnetic resonance and computed tomography); accelerometry; and cardiopulmonary exercise testing. Primary outcomes include change in walking speed and change in fitness (VO2 peak). In this symposium, we will present new findings from SOMMA baseline data that link skeletal muscle mitochondrial energetics to age-associated comorbidities, including diabetes, and performance fatiguability. We also highlight the critical role that sex differences in mitochondrial energetics plays in mobility limitation. SOMMA is supported by the National Institutes of Aging (R01AG059416).
CARDIORESPIRATORY FITNESS AND MITOCHONDRIAL ENERGETICS IN THE OLDEST OLD: THE STUDY OF MUSCLE, MOBILITY AND AGING
Authors: Distefano Giovanna , Noone John , Ramos Sofhia , Kramer Philip , Cawthon Peggy , Newman Anne , Marcinek David , Goodpaster Bret
Published: December 2023

Cardiorespiratory fitness (CRF) and mitochondrial energetics are known to decrease with aging, albeit with a great degree of heterogeneity. Studies reporting these declines typically include individuals younger than 85 years of age. We investigated CRF and mitochondrial energetics in a cohort of old (O: 70-84yrs.; n=698) and oldest old (OO: 85+yrs.; n=70) adults enrolled in SOMMA. Cardiorespiratory fitness (VO2peak) was measured by modified Balke treadmill protocol, and mitochondrial energetics was assessed by 31P Magnetic Resonance Spectroscopy (ATPmax) and high-resolution respirometry of myofibers (oxidative phosphorylation, OXPHOS). Bivariate associations and group differences were assessed using unadjusted and adjusted regression models with clinical site/technician, gender, race, body mass index and physical activity (steps per day) as covariates. Old and oldest old groups showed an association between VO2peak and OXPHOS (R2=0.282, p<0.001; R2=0279, p=0.0083; respectively, adjusted for site/technician), but only the old group showed associations between VO2peak and ATPmax (R2=0.201, p<0.001; R2=0.017, p=0.609; respectively, adjusted for site/technician). Group comparison adjusted for clinical site, gender, and race, showed lower VO2peak (p < 0.001), OXPHOS (p=0.026), and ATPmax (p=0.0014) in the OO compared to O group. However, no group differences in OXPHOS (p=0.08) and ATPmax (p=0.09) are observed when adjusting for body composition and physical activity, factors known to affect mitochondria. In conclusion, CRF associates with different measures of mitochondrial energetics in older adults, but only with mitochondrial respiration in oldest old. Additionally, we suggest that decreases in mitochondrial energetics observed in the oldest old are related to age, changes in body composition and physical activity.
ASSOCIATION OF DIABETES WITH BODY COMPOSITION, CARDIORESPIRATORY FITNESS, AND MITOCHONDRIAL ENERGETICS
Authors: Ramos Sofhia , Distefano Giovanna , Kramer Philip , Cawthon Peggy , Toledo Frederico , Cummings Steven , Goodpaster Bret , Coen Paul
Published: December 2023

We investigated the association of diabetes with cardiorespiratory fitness and skeletal muscle mitochondrial energetics in older adults (N=876, mean age ± SD: 76.3 ± 5.0 yrs.; 59% females) from the Study of Muscle, Mobility and Aging (SOMMA). Participants were grouped by self-reported diabetes status (N=131, with diabetes). Cardiorespiratory fitness (modified Balke protocol), mitochondrial energetics (31P magnetic resonance spectroscopy [31P-MRS] and high resolution respirometry from skeletal muscle biopsy), physical activity (wearable accelerometer) and body composition (magnetic resonance imaging) were measured. Generalized linear regression models were used to calculate means adjusted by age, race, gender, BMI, and co-morbidities. Thigh fat-free muscle volume (p=0.12) and abdominal subcutaneous adipose tissue depot (p=0.15) were similar between those with and without diabetes. However, visceral (18.84%, p>0.01) and intramuscular adipose tissue (6.57%, p=0.02) were higher in older adults with diabetes. VO2peak (-4.79%, p>0.01), and mitochondria energetics measured by ATPmax (-5.10%, p=0.04), maximum complex I+II carbohydrate (maxOXPHOSCHO) (-6.67%, p=0.02) and fatty acid (maxOXPHOSFAO) (-8.70%, p=0.01) stimulated respiration were lower in those with diabetes compared to those without. Following further adjustments for both physical activity and visceral adiposity, revealed that only VO2peak (-4.65%, p>0.01) and maxOXPHOSFAO (-7.38%, p=0.02) remained significantly lower in older adults with diabetes. Overall, our data suggests that cardiorespiratory fitness and skeletal muscle mitochondria energetics are reduced in older adults with diabetes, independent of visceral adiposity and physical activity.
AGE MATTERS IN FINANCIAL STRAIN AND SUBJECTIVE HEALTH AND WELL-BEING FOR PEOPLE WITH LTSS NEEDS IN CALIFORNIA
Authors: Chen Lei
Published: December 2023

Long-Term Services and Supports (LTSS) are a big concern for older adults and people with disabilities. It is important to reset aging and disability silos and create coordinated LTSS networks for people with disabilities of all ages, including those with cognitive impairments, difficulties performing activities of daily living (ADLs) and/or instrumental activities of daily living (IADLs). This study examined how age differentiates the associations among disability status, financial strain, and subjective health and well-being for people with LTSS needs in California. This study used the first cycle of data (2019-2020) from the California Long-Term Services and Supports (CA-LTSS) survey, merged with select data from the California Health Interview Survey (CHIS) (N = 2,030). Multivariate Regressions and Conditional Process Analysis (CPA) were applied to test the hypothesized relationships. Findings show that young and middle-aged participants with LTSS needs struggled to make financial ends meet. Middle-aged and older participants with LTSS needs reported worse self-rated health, and young participants with LTSS needs had severer psychological distress. Participants with difficulty in IADLs or more types of disability difficulties tended to have more financial strain, and these associations were significantly stronger for young participants than older participants. Similarly, participants with difficulty in IADLs or more types of disability difficulties tended to report severer psychological distress, and these associations were significantly stronger for young participants than older participants. The findings suggest the value of approaching younger people with disabilities and target policies and service programs to meet their financial and mental health needs.
DESIGNING FOR PROGRAM SUSTAINABILITY: AN EVALUATION OF BC’S PROVINCIAL BETTER AT HOME PROGRAM
Authors: Hannah Camille , Symes Bobbi , Lalji Kahir
Published: December 2023

Better at Home programs help older adults in communities across British Columbia with non-medical tasks such as light housekeeping, yard work, transportation to appointments, grocery and meal delivery, and friendly visiting, helping them to remain at home and stay connected to their communities. Better at Home is funded by the Province of British Columbia and managed by the United Way. An evaluation of 81 Better at Home programs took place over 2022/23 focusing on the delivery, design, and sustainability of programs. A multipronged evaluation approach was utilized, including site visits; document and administrative data review; interviews with program staff, older adults, and caregivers (n=87); and a survey of program stakeholders (n=399). Over 2021/22, a total of 244,875 services were provided through Better at Home. The most common services provided were light housekeeping, friendly visiting, prepared meal delivery, and grocery services. The evaluation identified design and delivery best practices (e.g., building trust and relationships), program opportunities (e.g., leveraging communities of practice), and lessons learned (e.g., increasing awareness of burnout, capacity, and duplication). Some challenges to program efficiency were also identified (e.g., increased demand for services and complexity of client needs, staff and volunteer turnover). Six program improvements were recommended to ensure the long-term sustainability of Better at Home programs: 1) Securing multi-year funding that accounts for inflation, 2) Ensuring sufficient human resources for service delivery, 3) Offering strategic training opportunities, 4) Continuing to invest in existing programs, 5) Growing partnerships and community networks, and 6) Providing comprehensive supports to program staff.
AN INTEGRATED TRANSITIONAL CARE INTERVENTION IMPROVES PATIENT-REPORTED OUTCOMES IN OLDER ADULTS WITH STROKE
Authors: Markle-Reid Maureen , Fisher Kathryn , Ganann Rebecca , Pollard Chris , Whitmore Carly
Published: December 2023

The transition between hospital and home is associated with significant challenges resulting in hospital readmissions and poor health outcomes. This study aimed to test, in real-world clinical practice, the effectiveness of a Transitional Care Stroke Intervention (TCSI) compared to usual care on patient-reported outcomes and health and social service use costs in older adults (> 55 years) with stroke and multimorbidity (> 2 chronic conditions). The TCSI was delivered virtually by an interprofessional (IP) team, and included care coordination/system navigation support, phone/video visits, monthly IP team conferences, and an online resource co-designed with patient partners to support self-management and system navigation. The primary outcome was risk of hospital readmission after six-months. Secondary outcomes included physical and mental functioning, stroke self-management, patient experience, and health and social service costs. Ninety participants were enrolled (44 intervention, 46 control); 11 (12%) participants were lost to follow-up, leaving 79 (39 intervention, 40 control). Differences favoring the intervention group were seen in physical functioning (SF-12 PCS mean difference: 5.10; 95% CI: 1.58-8.62, p=0.005), self-management (Southampton Stroke Self-Management Questionnaire mean difference: 6.00; 95% CI: 0.51—11.50, p=0.03), and patient experience (Person-Centred Coordinated Care Experiences Questionnaire mean difference: 2.64, 95% CI: 0.81, 4.47, p=0.005). No significant between-group differences were seen for baseline to six-month risk of hospital readmission or total health and social service costs. The TCSI produced greater gains in patient-reported physical health, self-management and experience compared with usual stroke care. These improvements were achieved without increasing total healthcare costs.
ELEVATED PREVALENCE AND RISK OF KIDNEY DISEASE AMONG SEXUAL MINORITY OLDER ADULTS IN THE US
Authors: Cahill Sean , Chandra Meghana , Hertel Mollie , Khanna Saumya , Mitra Shimontini , Mirabella Jack , Cropper Avareena
Published: December 2023

Pooled data from the Behavioral Risk Factor Surveillance System (2014–2019) were used for 22,114 lesbian, gay, bisexual adults and adults who said that their sexual orientation was “other” or “something else” aged 50 and over, and 748,963 heterosexual older adults. Logistic regressions were used to compare prevalence of self-reported kidney disease among older adults by sexual orientation. After adjusting for age, race and ethnicity, and BMI, GB+ men had increased odds of self-reported kidney disease (AOR 1.42; 95% CI, 1.21–1.68). LGB+ women also had higher odds of self-reported kidney disease (AOR 1.29; 95% CI, 1.09–1.52). After controlling for sociodemographic factors, health behaviors, access to healthcare, and self-reported coronary heart disease, HIV, and diabetes, older gay, bisexual and other men (GB+) men (AOR 1.3; 95% CI, 1.09-1.54) were more likely than their heterosexual counterparts to report kidney disease. LGB+ men and women also reported high incidences of known risk factors for CKD. For example, both GB+ men (OR 1.39; [95% CI], 1.26-1.54) and LGB+ women (OR 1.39; [95% CI], 1.25-1.55) were more likely to be smokers and have a higher incidence of activity limitations, adverse health outcomes, and limited access to health care, housing and employment. We did not find any statistically significant differences in kidney disease between transgender and cisgender respondents. There is an increased need for screening for CKD risk factors, for preventative education and culturally responsive and affirming care, and for interventions to address social drivers of marginalization and vulnerability in older LGBT+ adults.
PREVALENCE OF SINGLE AND MULTIPLE CHRONIC CONDITIONS AMONG RESETTLED BHUTANESE OLDER ADULTS IN OHIO
Authors: Karmacharya Isha , Shrestha Aman , Subedi Janardan , Ghimire Saruna
Published: December 2023

Background

Migrants and refugees are more prone to chronic health conditions, which can worsen with age and accumulated stressors. Bhutanese older adults with refugee backgrounds in the US have not been well-studied. This study aimed to assess the prevalence of chronic diseases (single and multiple conditions) and to identify factors associated with multimorbidity among resettled Bhutanese older adults in Ohio. Additionally, the study compared the prevalence of chronic diseases with state-level data for other racial/ethnic groups.

Methods

Structured interview was conducted among 276 resettled Bhutanese, aged 55 years and above, in four major Ohio cities (Columbus, Akron, Cleveland, and Cincinnati), selected through snowball sampling with local Bhutanese organizations. State-level data of people, aged 55 years and above in Ohio, from the 2021 Behavioral Risk Factor Surveillance System for Non-Hispanic White, Non-Hispanic Black, Hispanic, and Asian populations were used for comparison. Binary logistic regression was used to identify factors associated with multimorbidity.

Results

Only 14.1% of participants were free of chronic diseases, while 62.3% had multimorbidity. Depression (31.8%), diabetes (42.8%), and respiratory diseases (26.4%) in older Bhutanese were considerably higher than in other racial/ethnic groups. Hypertension prevalence (63.0%) was higher than all other race/ethnic groups, except Non-Hispanic Black individuals (72.3%). Poor self-reported health and the presence of depressive symptoms had higher odds of having multimorbidity. Study Implications: This study underscores valuable insight into the disease burden among resettled Bhutanese older adults and can inform stakeholders to develop targeted public health programs and practices to meet the needs of minority populations.
SUBJECTIVE COGNITIVE DECLINE PHENOTYPES, SOCIAL ENGAGEMENT, AND CARDIOVASCULAR HEALTH
Authors: Dowling Maritza , Theeke Laurie
Published: December 2023

Epidemiological studies report subjective cognitive decline (SCD) as a risk factor for incident dementia. The co-occurrence of SCD, chronic conditions, and loneliness may contribute to functional limitations and decline. SCD etiologies are multifaceted, suggesting possible underlying phenotypes defined by clustering factors that characterize decline. Using pooled data (2015-2021) from the Behavioral Risk Factor Surveillance System (BRFSS) we investigated SCD phenotypes based on the six-item self-reported Cognitive Decline Module that measured challenges in daily life due to memory loss and confusion over the prior twelve months. We hypothesized that SCD phenotypes would be associated with socio-demographic, cardiovascular health and social engagement variables. Mixture modeling was used to determine unobserved SCD phenotypes (latent classes) based on item response patterns. Latent class membership was predicted from socio-demographic variables using multinomial logistic regression. The resulting classes predicted a six-item cardiovascular risk index (CVRI) and a measure of aloneness. SCD symptoms were reported by 65,217 (45-80+ years old). Mixture models produced four-latent SCD classes labeled as mild (43%), mild-moderate (23%), moderate (24%), and severe (10%). Mean CVRI scores were significant across classes (p < 0.001) and highest in the severe subgroup (n=6,491) which was more likely to be non-Hispanic Blacks, female, younger (45-64), low-income, non-homeowners, and report depression, and poor/fair health status. Class membership also significantly predicted aloneness. Studies are needed to examine how SCD phenotypes may be used in the design and development of interventions that are more precise to the cluster of modifiable risk factors which could, subsequently, prevent or delay dementia pathogenesis.
FACTORS ASSOCIATED WITH HELP-SEEKING AMONG US CHINESE OLDER ADULTS WHO REPORTED ELDER MISTREATMENT
Authors: Chao Ying-Yu , Seo Jin Young , Chang Yu-Ping
Published: December 2023

Purpose

Elder mistreatment (EM) is an important public health issue. Guided by the Andersen’s Behavioral Model of Health Services Use, this study aimed to examine factors that impede or facilitate help-seeking intentions and behaviors among U.S. Chinese older adults who reported EM.

Methods

Data were from the Population Study of Chinese Elderly in Chicago (PINE). Different types of mistreatments, informal and formal help-seeking intentions and behaviors were assessed. Descriptive statistics, linear regression, and multinominal logistic regression were used.

Results

Among 450 participants who reported EM, 46.55% experienced psychological mistreatment, 29.91% had financial exploitation, 14.92% had caregiver neglect, 4.68% had physical mistreatment, 1.11% had sexual mistreatment, and 17.78% had multiple victimizations. Intentions of informal help-seeking was higher among victims who were female and married, and those who experienced financial exploitation and caregiver neglect. Formal help-seeking intentions were lower among victims who had a larger social network size. EM victims who were female, married, perceived more social support, experienced financial exploitation, and experienced caregiver neglect were more likely to seek help from informal resources. EM victims who had higher income, perceived more social support, and had multiple victimizations were more likely to seek formal resources. Conclusion/implication: Our findings suggest that the predisposing factors, enabling resources, and need factors that impacted seeking help from informal and formal resources among older Chinese Americans who reported mistreatment. Findings provided important insights for developing early screening programs and interventions, such as increasing help-seeking channels and improving access to care services.
SELF-PERCEPTION OF AGING AND THE SELF-REPORTED HEALTH/FRAILTY PARADOX
Authors: Buta Brian , Hladek Melissa , Alzahrani Mallak , Xue Qianli
Published: December 2023

We aimed to study the cross-sectional association between self-perception of aging (SPA) and frailty paradox, defined as self-reporting excellent/very good health despite being frail or fair/poor health despite being robust. The study sample included 2,950 participants from the Health and Retirement Study (2008 wave) who were 65 years and older, completed the Psychosocial and Lifestyle Questionnaire, and had no missing data on the variables included in the models. Frailty was measured by the physical frailty phenotype. Self-reported health (SRH) was rated as either excellent, very good, good, fair, or poor. SPA was measured using an 8-item questionnaire spanning subjective well-being, positive affect, and life satisfaction; respondents rated their agreement with statements such as “Things keep getting worse as I get older” and “So far, I am satisfied with the way I am aging.” Negative statements were reverse-coded and the average of all items was calculated; higher scores indicated more positive SPA. 181 (6%) participants met the criteria for the frailty paradox: 54 reported being in excellent/very good health despite being classified as frail, while 127 reported fair/poor health despite being classified as robust. After adjusting for potential confounding variables, including age, sex, race, education, and comorbidity burden, we found that individuals with higher SPA scores had greater odds of excellent/very good SRH despite frailty. Specifically, the odds nearly doubled for every one unit increase in SPA score (p-value< 0.01). Positive self-perception of aging may be a potential interventional buffer against negative impact of physical frailty on self-assessment of overall health status.
REDUCING HTN AMONG BLACK ELDERS THROUGH AN IMMERSIVE VIRTUAL FOREST
Authors: Mickus Maureen
Published: December 2023

Rates of uncontrolled hypertension (HTN) among Black individuals is higher than for any other racial or ethnic group in the U.S. The prevalence of HTN in this minority population, coupled with arterial aging, portend serious risks for cerebrovascular and cardiovascular diseases among Black elders. Past research has indicated that exposure to nature, specifically immersion within a forest setting, can be effective for reducing HTN. But deriving health benefits derived from time in a forest may be difficult for older persons from historically disadvantaged groups. This purpose of this study was to assess whether access to calm and immersive forest images delivered using virtual reality (VR) can modify HTN among community-dwelling Black elders. The study involved a quasi-experimental design and a sample of individuals ages 60-98 recruited from a senior center primarily serving minorities. Each of the 22 participants completed 4 biweekly VR trials using software with a soothing audiovisual simulation of a forest meadow including trees, birds, flowers, and wildlife. Results indicated an average decline of 10 mm HG (SD=7.0) in systolic blood pressure with Hedges g effect sizes ranging from .38 to .96 across sessions. The elders expressed a more relaxed mood and viewed VR as a pleasant distraction overall. Given that none of the participants reported any adverse effects from using this technology, further exploration of forest-based VR as a promising method for decreasing HTN in a high-risk population of older adults is warranted.
INTERPROFESSIONAL EDUCATION: STRATEGIES TO REACH RURAL STUDENTS THROUGH GERIATRIC EDUCATION
Authors: Jurkowski Elaine
Published: December 2023

Inter-professional collaboration across disciplines such as primary care medical practice, physician assistants, social workers, and nutritionists does not occur naturally, since educational programs are often taught independently of each other, but these disciplines are required to work collaboratively with each other. The objective was to promote communication across disciplines and help each discipline understand the roles played in promoting mental health and general health for older adults. Three specific strategies to address Interprofessional Education were devised and implemented within a rural context to address the goal of improving collaboration and communication. An educational seminar was conducted using cases and guide questions focused on identifying strategies for care. A second strategy was through “Student hot-spotting” where students worked with a high-need complex case over the course of a school year weekly, as a team-based approach. A third strategy made use of a weekly medical clinic for team-based patient care. The teams consisted of Medical Residents, Social Work students, Physician Assistant students, and nutrition students. Findings suggest professionals were surprised at what they learned from the other disciplines they were collaborating with. They also learned about community-based resources available as well as strategies to promote health outcomes. All participants felt that the opportunity to collaborate outside of their disciplines would strengthen their impact when working with older adults and their families. In conclusion, a problem-based learning approach coupled with the opportunity to collaborate with other disciplines through (IPE) improves overall collaboration among professionals. All strategies had positive learning outcomes.
MAKING AN IMPACT: AN INTEGRATED MODEL TO REDUCE AGEISM AND SUPPORT PROFESSIONAL IDENTITIES
Authors: Powell-Versteeg Amy , Perkins Rebekah , Ward R Scott , Edelman Linda , Supiano Katherine
Published: December 2023

Nearly one-million people in the U.S. are living with Parkinson’s disease (PD) and require skilled care. Despite this, only 20% of educational programs offer a geriatric rotation. Ageism is a major factor in healthcare students’ lack of clinical exposure, decreased self-confidence, and desire to specialize in geriatrics. Research shows positive exposure to older adults improves students’ knowledge, attitudes, and interest in this population. Yet, limited geriatric curriculum exists that integrates specialized knowledge combined with positive contact experiences to shape students’ professional identities as capable providers. This project combined two experience-based learning (ExBL) models to form the Intrinsically-Motivated learning, Professional identity, Awareness, Capacity, and Timing (IMPACT) model—to support specialized knowledge acquisition and positive, repeated contact experiences with older adults. Third-year Doctor of Physical Therapy (DPT) students who completed both didactic training and a 2-week PD Boot Camp were interviewed about their experiences in the program. Nine students participated in the PD Boot Camp and interviews. Qualitative thematic analysis revealed the following: 1) unexpected insights gained about clients’ unique abilities, 2) therapeutic alliances formed and mutually created functional goals, 3) improved decision-making through practice with mentorship, and 4) increased self-confidence to provide care to clients with complex conditions. The IMPACT model provided students specialized knowledge and practical skills to capably care for older adults with PD. This model can serve as a guiding educational framework to reduce ageism among healthcare students across a variety of settings, support students in developing their professional identities, and increase interest in caring for older adults.
THE AMBIVALENCE OF BACHELOR OF NURSING LECTURERS TOWARD MALNUTRITION EDUCATION: A QUALITATIVE STUDY
Authors: ten Cate Debbie , Van den Boomgaard Iris , Ziylan Canan
Published: December 2023

Malnutrition in older adults occurs multifactorially and should be prevented interdisciplinary. This requires an improvement in the competencies regarding the integral prevention of malnutrition in students of different Bachelor’s programs, such as dietetics, social work and nursing, who are the future professionals. A precondition is that this education is taught by lecturers who have a positive attitude toward malnutrition education. However, it is unknown what this attitude is. We started our exploration within Bachelor of Nursing lecturers. Therefore, the aim of this study was to gain insight into the attitude of these lecturers regarding malnutrition education. A qualitative study, where semi-structured, in-depth interviews were held with nine Bachelor of Nursing lecturers from four different educational institutes. The interviews were transcribed and thematically analyzed. Two main themes emerged from the data: (1) ‘malnutrition is important’, subdivided in three sub-themes: ‘personal experiences’, ‘nursing experiences’ and ‘theoretical knowledge’, and (2) ‘not acting consequently’, subdivided in four sub-themes: ‘unclear responsibilities’, ‘insecurity regarding own abilities’, ‘depending on experts’ and ‘problems with prioritization’. The results showed that lecturers have a positive perception regarding malnutrition education, but that there is a discrepancy between their attitude and actual behavior. This means that this may lead to difficulties in embedding and providing qualitative malnutrition education in the curriculum. It is advised that lecturers follow train-the-trainer courses to develop and enhance their competencies in providing malnutrition education. Also, an efficient integration of and interdisciplinary approach regarding malnutrition education is advised.
AGE-RELATED MICROAGGRESSIONS: A FOLLOW-UP DESCRIPTIVE STUDY
Authors: Lewis Hannah , Patt Stephanie , Gietzen Luke , Buchanan Jeffrey
Published: December 2023

Age-related microaggressions are forms of ageist discrimination that occur during day-to-day interactions. The aim of this study was to identify common types of age-related microaggressions as well as to determine how negative affect influences emotional reactions to microaggressions. Using an online survey, participants (n = 200) were asked if they had experienced any of the 20 most common examples of age-related microaggressions reported in previous research (Gietzen et al, 2022). Follow up questions inquired about the frequency, emotional reactions, and behavioral responses to these microaggressions. Participants also rated their physical health and completed the Positive and Negative Affect Scale (PANAS; Watson et al., 1988). The results indicated that participants were familiar with these microaggressions 53% of the time. Participants also reported having negative reactions to 43% of these microaggressions. The frequency of negative emotional responses to microaggressions was significantly correlated with scores on the negative affect subscale of the PANAS (r = .34, p < .001) and with ratings of perceived physical health (r = -.32, p = .002). Finally, an analysis of the 20 survey items revealed that two items were “highly impactful” microaggressions, defined as microaggressions that older adults reported experiencing often and reported having a negative emotional reaction to at least one-third of the time. The results of the study provide further insight into what age-related microaggressions look like, and how older adults experience these interactions.
THROUGH THE LOOKING-GLASS: THE FAMILY SHAME OF ELDER ABUSE
Authors: Hsieh Jessica , Mirza Raza
Published: December 2023

Elder abuse (EA) has been recognized as a serious public health concern. Recent studies have found that approximately 10% of community-dwelling, cognitively intact older adults experience some form of EA each year. Although EA research has made substantial progress, EA is often under-reported, with only an estimated 15% of cases being reported to formal support services. One of the main reasons for the under-reporting of EA is the victims’ feelings of shame, which have been shown to be exacerbated when the perpetrator is a family member and/or an individual with whom the older adults have close trusting relationships. Qualitative interviews conducted with 12 older adult (parent) and adult child caregiver dyads (n=24) revealed that older adults who experience EA by their adult children experience intense shame. Thematic analysis focused on what led to these feelings of shame, and this resulted in four main themes: (1) Failure in their role as a parent; (2) Adult children viewing them as powerless and unworthy; (3) Experiencing negative psychological effects; and (4) Self-blame. With a sense of responsibility to protect their family, older adults tend to keep ‘family shame’ to themselves, leading to a reluctance to disclose EA. As spouses and adult children, the two most common caregiving types, have also been reported to be the two most common groups of EA perpetrators, gaining a better understanding of the root causes of shame can help to support older adults in living safely in their homes and communities for as long as possible.
RELATING THE ORGANIZATIONAL CULTURE ASSESSMENT INSTRUMENT TO ADHERENCE IN A PRAGMATIC TRIAL OF A MUSIC INTERVENTION
Authors: Zhu Enya , McCreedy Ellen , Dionne Laura , Mor Vincent
Published: December 2023

Embedded pragmatic trials encourage the translation of evidence-based interventions to “real-world” settings. Most pragmatic trials of behavioral interventions for people with dementia suffer from low adherence. Understanding how organizational values and structure may increase adherence is important. We report findings from an embedded, pragmatic trial (ePCT) of a personalized music intervention for managing behaviors in residents with dementia, conducted in 54 nursing homes (NHs) from four corporations between June 2019 and February 2020. Before the trial began, the administrator and a nursing staff member from each NH completed the Organizational Culture Assessment Instrument (OCAI). Using the OCAI, respondents rated their organizational culture by allocating a total of 100 points across four competing domains: Clan, Adhocracy, Hierarchy, and Market. Results were aggregated to understand how differences in culture impacted corporate-level adoption of the intervention. All four corporations allocated the majority of their points to Clan culture, which is focused on collaboration and staff engagement. However, corporations differed in their scoring of the secondary culture type. The two corporations that rated Hierarchical culture, which prioritizes consistency and efficiency, highly were more likely to adhere to the intervention protocols. The corporation with Market highly rated had the lowest adherence to the protocols. After controlling for other corporate characteristics, including for-profit status, size, and overall quality, hierarchical culture was associated with greater numbers of exposed residents and a higher dose of the music, compared to other culture types. Understanding the role of organizational culture on pragmatic implementation is an understudied area for research.
THE ASSOCIATION BETWEEN COGNITION AND UPPER EXTREMITY MOTOR REACTION TIME IN OLDER ADULTS: A NARRATIVE REVIEW
Authors: Jones Alexandria , Weaver Natalie , So Mardon , Jaffri Abbis , Heckman Rosalind
Published: December 2023

Response timing is essential to optimal sensorimotor control across the lifespan. While it is broadly assumed that reaction time increases as cognition declines with age, it is unclear if this assumption is supported by the literature. The purpose of this narrative review was to determine the association between cognition and upper extremity reaction time in older adults. Cognitive domains of sensation and perception, motor construction, perceptual motor function, executive function, attention, learning and memory, and language were considered. We conducted a systematic search using Scopus database. The search strategy was designed to meet four inclusion criteria: 1) community-dwelling adults >60 years, 2) upper extremity motor task, 3) at least one cognitive assessment, 4) simple reaction time measure. 1154 articles were screened. Two articles met the full inclusion criteria, but the studies did not associate the cognitive assessment and simple reaction time measures. Nine articles that met three inclusion criteria were reviewed. We found that executive function and learning and memory have been associated with complex and choice reaction time measures. Language, perceptual motor function, and attention have been studied with mixed evidence for an association with reaction time; whereas, sensation and perception and motor construction have not been assessed. Overall, limited research has compared cognitive domain function and simple reaction time to determine if age-related changes are associated. While the complex interplay between cognition and motor function is of substantial interest, these measures are often interdependent and additional knowledge is needed to understand their influence on sensorimotor control with age.
ULTRAPROCESSED FOODS AND COGNITIVE FUNCTIONING IN OLDER ADULTS
Authors: Seago Elayna , Katz Benjamin
Published: December 2023

Consumption of ultra-processed foods (UPFs) is increasing globally. Previous research has explored the psychological effects of this dietary shift, including associations between diet and cognition. While this previous work shows that neuroprotective dietary patterns in general, and UPF consumption in particular, may have a deleterious effect on cognition, less research has explored the specific cognitive domains most closely associated with UPF consumption. The present study draws from the 2016 Harmonized Cognitive Assessment Protocol and the 2012 Health Care and Nutrition Study (HCNS) from the Health and Retirement Study to examine the relationship between UPF consumption and a wide a wide array of fluid and memory-based cognitive measures in older adults. Additionally, we used the food frequency questionnaire from the HCNS to categorize participants’ foods as ultra-processed using the NOVA system. Initial analyses using analysis of covariance with UPF bins, controlling for age, gender, and self-rated health, indicates that measures of processing speed, but not other fluid measures nor most measures of delayed recall, were most closely associated with UPF consumption. These initial findings provide more specific detail regarding the cognitive correlates of UPF-heavy diets and provide a pathway to future work that more closely examines the longitudinal effects and underlying physiological mechanisms of UPF consumption.
DEPRESSIVE COGNITIONS AND SYMPTOMS IN CAREGIVING GRANDMOTHERS: TESTING GROWTH CURVE MODEL STABILITY
Authors: Burant Christopher , Musil Carol , Zauszniewski Jaclene , Jeanblanc Alexandra
Published: December 2023

Grandmothers caring for grandchildren have elevated depressive symptoms levels compared to grandmothers who do not provide care. Depressive symptoms are state-like in nature and describe recent depressive symptoms. The Depressive Cognition Scale© captures changes in negative thinking patterns that often precede depressive symptoms. Depressive cognitions, according to Beck’s theory of depression, are the first depressive symptoms to appear and typically lead to more serious symptoms of depression. Previously diagnosed depression may also contribute to current levels of depressive cognitions and depressive symptoms. Data were collected on 342 participants in a longitudinal nationwide online research study of caregiving grandmothers. A latent growth curve model of how previously diagnosed depression and depressive cognitions impacted the trajectory of depressive symptoms at four time points (baseline, 2 weeks, 12 weeks, and 24 weeks) was tested. The model fit the data well (Chi Square=24.301.; df=12; p=.019; TLI=.977; CFI=.987; RMSEA=.055). This model was submitted to 6 separate multigroup nested model tests (levels of income, education, age, employment, number of children, and primary vs. multigeneration families) to provide evidence supporting generalizability of the model. All models fit the data well (TLI=.960-.991; CFI=.973-.992; RMSEA=.051-.025). Total invariance/stability, based on nonsignificant changes in chi square and CFI<.01, was supported in the multigroup analyses across all levels testing equality in measurement and regression weights and residual variances. This lack of change in the model across 6 different grandmother scenarios provides further evidence supporting the need for interventions to address diagnosed depression and depressive cognitions for reducing depressive symptoms in grandmother caregivers.
FACTORS AFFECTING SUICIDAL IDEATION IN COMMUNITY-DWELLING OLDER ADULTS WITH DEPRESSION
Authors: Smith Shelby , Barry Lisa , Steffens David , Fortinsky Richard
Published: December 2023

Suicidal ideation (SI) within the older adult population represents a continuing public health crisis. The previously published 5D Framework utilizes a set of five domains (depression, disability, disconnectedness, disease, and deadly means) to explain multifaceted influences on late-life suicide. This study explored factors associated with SI among community-dwelling older adults with depression by including measures of selected 5D Framework domains and additional factors potentially associated with SI in an explanatory analytic model. We utilized baseline data from an ongoing clinical trial to assemble a cohort of older adults (age 65+) who screened positive for depression via provider diagnosis or scoring ≥16 on the Center for Epidemiologic Studies Depression scale (CES-D). Individuals joining the clinical trial between May 2017-March 2020 completed baseline assessments evaluating levels of depression, cognitive impairment, psychological resilience, dispositional optimism, social engagement, level of financial strain, and educational attainment. Sl was defined as endorsement of Question 9 of the PHQ-9. In the study cohort (N=171), mean age was 73.5 [SD: 5.76], 67.3% female, 92.4% non-Hispanic White, and 18.1% endorsed SI. In a multivariate logistic regression analysis, increased severity of depression was positively associated with SI (AOR 1.18 [95% CI:1.06-1.31]) while higher level of optimism was inversely related with SI (AOR 0.913 [95% CI:0.84-0.96]). No statistical significance was noted for age, gender, education, financial strain, resilience, cognitive impairment, or social engagement. We conclude that optimism is a protective factor against SI, and reporting more severe depressive symptoms represent an important risk factor for SI, among older adults with depression.