bluuebunny/crossref_metadata_2025 huggingface dataset:
LEVERAGING A BEHEMOTH: TRANSLATING VA FAMILY CAREGIVER RESEARCH TO POLICY AND PRACTICE
Authors: Trivedi Ranak
Published: December 2023

The VA has been a pioneer in research, practice and policy that supports the needs of caregivers. The VA HSR&D funded Elizabeth Dole Center of Excellence in Veteran and Caregiver Research, of which Dr. Trivedi is a site PI and part of the core leadership, is a testament to this investment in research, as are several scientific projects. The VA also provides support for caregivers by providing an array of services (e.g., hotline; caregiver training programs; stipends) and has deployed 2000+ staff nationally to connect caregivers to VA and non-VA services. The VA has also invested in rigorous evaluations of existing practice and policy with the eye on refining and improving. Dr. Trivedi will provide an overview of her work within the VA that focuses on developing behavioral intervention to target the collective stress coping needs of Veteran-caregiver dyads. With the lens of implementation science, she will share her work identifying barriers and facilitators of accessing home and community-based services, and describe how these insights are being used to inform VA practice and policy.
BUILDING BRIDGES, CATALYZING RESEARCH, EMPOWERING ALL AGES: A CHAT WITH NIA SENIOR LEADERSHIP
Authors: Kelley Amy , Kelley Amy
Published: December 2023

The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, is the federally designated lead agency on aging research and supports research to understand the nature of aging and to extend the healthy, active years of life. Over the last decade, NIA’s budget has increased substantially. In keeping with NIA’s scientific mission, funding includes significant investments in Alzheimer’s disease (AD) and AD-related dementias research, as well as in non-AD research. This symposium will provide a forum for exploration of the implications of the NIA budget for the general research community. NIA’s senior staff will discuss research priorities and programs supported by the Institute. A question-and-answer session will follow these remarks on current funding and future priorities and research directions of NIA.
ASSOCIATION BETWEEN SUBJECTIVE SOCIAL STATUS AND PHYSICAL FRAILTY AMONG OLDER ADULTS IN INDIA
Authors: Muhammad T , Pai Manacy
Published: December 2023

Research on the association between subjective social status (SSS) and physical frailty is critical to crafting interventions that can combat functional decline, prolong physical vitality, and sustain quality of life. We assessed the association between SSS and physical frailty and the mediation of this association by perceived everyday discrimination and ill-treatment among older adults in India. Data come from the Longitudinal Aging Study in India with a sample of 31,464 older adults age 60 years and above. Physical frailty was assessed using an adapted version of the frailty phenotype developed by Fried and colleagues. SSS was assessed using the Macarthur scale. Multivariable logistic regression along with KHB (Karlson–Holm–Breen) method was employed to examine the associations and the mediation effects. The prevalence of physical frailty was 30.65% and those with lowest SSS had higher prevalence of physical frailty (42.06%). After adjusting for a number of confounders, odds of physical frailty were significantly lower among those with a high SSS in comparison to those with low SSS, and the variance explained by the SSS was higher than that explained by household consumption quintiles. The association between SSS and physical frailty was mediated by perceived everyday discrimination (percent mediated: 8.20) and experiences of ill-treatment (percent mediated: 9.32). The findings underscore that when examining the association between socioeconomic status and physical frailty, it is important to consider SSS given that perceptions of one’s social standing likely reflect the less apparent psychosocial components associated with it.
FINANCIAL EXPLOITATION OF OLDER ADULTS: INTERDISCIPLINARY PERSPECTIVES ON NEW DIRECTIONS
Authors: Miller Julie
Published: December 2023

Financial exploitation of older adults is a topic that has drawn increased public recognition in recent years. Despite advances in research, services, products, and policies working to prevent financial exploitation of older adults and support victims, interdisciplinary perspectives are needed to strengthen interventions. This symposium will bring together scholars and practitioners to address the issue of financial exploitation from a variety of disciplines, all united in their mission to detect and prevent financial exploitation of older adults and to support victims. The first two presentations in the symposium will highlight conceptual understandings of financial exploitation of older adults, including a revisionary model of financial exploitation of older adults that includes emerging cognitive, cultural, and other contextual factors (Presentation 1) and a study of financial vulnerability and mental health as they are associated with financial exploitation, particularly when perpetrated by trusted others (Presentation 2). The remaining presentations will describe research from cross-sector, cross-industry, interventions. Presentation 3 will describe study findings about a helpline for concerned persons of exploitation victims that dually offers services directed to primary victims of financial exploitation. Presentation 4 will highlight a study of case characteristics associated with a new adult protection law designed to protect older and vulnerable adults experiencing exploitation. Presentation 5 will describe a study of financial professionals’ experiences with, and attitudes toward, financial exploitation of aging clients. Findings from all five presentations will point to next steps for research and intervention across multiple disciplines, including social work, law and policy, healthcare, and financial services.
MANIPULATING THE ENDORSEMENT OF PRESCRIPTIVE VIEWS OF AGING—SPECIFICITY AND INTERNALIZATION
Authors: Wirth Maria , de Paula Couto M Clara P , Rothermund Klaus
Published: December 2023

Prescriptive views of aging are beliefs about how older adults should be and behave. The two most prominent views entail that older adults should remain active and contribute to society (active aging) and that they should withdraw from important positions (altruistic disengagement). Prescriptive views of aging set societal standards for age (in)appropriate behaviour and many older adults internalize these norms so much that they appear completely natural to them. This study investigated the malleability of endorsing prescriptive norms using social consensus information: 367 participants (50–87 years) were asked to indicate whether the general public agreed or disagreed with altruistic disengagement or active aging in the health or social domain. Subsequently, participants were presented with (fictitious) social consensus feedback which was either in line with participants’ estimation of social consensus or not (random assignment). Our results indicate that presenting social consensus feedback affected the endorsement of prescriptive views of aging. Learning that a majority of others supported (dis)agreement with a prescriptive age norm led to (lower) higher endorsement of this norm. This effect was specific to the norm and domain for which consensus feedback was presented. Thus, activation and disengagement are represented as separate norms in a domain-specific fashion. Endorsing prescriptions for older adults, in general, led participants to also more strongly endorse this norm for themselves. Our findings attest to the complexity and specificity of prescriptive views of aging and offer important insights for designing interventions.
ASSESSING THE PSYCHOMETRIC PROPERTIES OF THE GERIATRIC SUICIDE IDEATION SCALE IN MIDDLE-AGED AND OLDER MEN
Authors: Heisel Marnin , Flett Gordon
Published: December 2023

Middle-aged and older men have high rates of suicide, necessitating risk detection. We developed the Geriatric Suicide Ideation Scale (GSIS; Heisel & Flett, 2006) as an age-specific, multidimensional suicide risk assessment tool. The GSIS has shown strong psychometric properties in clinical, community, and residential samples (see Heisel & Flett, 2016), yet research has lagged investigating its utility with middle-aged and older men. The purpose of the present study was thus to assess the psychometric properties of the GSIS administered to 82 men, 55 years and older (M=63.3, SD=4.6 years), who participated in a meaning-centered psychological intervention group for those concerned about or struggling with the transition to retirement (Heisel et al., 2020). Psychometric analyses included investigation of participant response characteristics, internal consistency, and construct validity. Findings demonstrated acceptable internal consistency for GSIS totals (α =.88) and for its Suicide Ideation, Death Ideation, Loss of Personal and Social Worth, and Perceived Meaning in Life subscales (α =.62-.81). Positive associations between the GSIS and negative psychological factors (depression, anxiety, hopelessness, loneliness, perceived lack of mattering to others, and history of suicidal behavior; r =.30 to .51) and negative associations with positive factors (life satisfaction, psychological well-being, perceived support, and meaning in life; r = -.21 to -.51) supported its construct validity. These and other findings will be discussed in the broader context of upstream population level approaches to suicide risk detection and prevention. (Note: this abstract was accepted for the 2022 GSA meeting, but we had to withdraw due to family loss)
ADVANCES IN GLOBAL AGING RESEARCH FROM CROSS NATIONAL COMPARISONS
Authors: Nichols Emma , Ailshire Jennifer
Published: December 2023

Harmonized surveys on aging populations around the world provide an unprecedented opportunity to advance our understanding of the factors that promote healthy aging. The papers in this symposium use existing and newly available harmonized data from the NIA-funded Gateway to Global Aging to examine how patterns of physical and cognitive aging vary across countries and to identify potential modifiable risk factors for slowing aging-related decline. Jayakody et al. use data on 21 countries to identify risk factors for Motoric Cognitive Risk (MCR), a preclinical predictor of dementia, that are both country-specific and universal. Knapp et al. also investigate potential modifiable risk factors for poor cognitive health in 31 countries and identify the factors that are universally associated with higher risk across countries. These two studies provide novel insights into how we can harness studies across multiple countries to better understand which factors of aging are universal and which are context dependent. The next two studies examine patterns and risks through comparison of neighboring countries. Focusing on Mexico and Brazil, Gomes Goncalves et al., determine the extent to which rurality and education confer risk of cognitive impairment in the two largest countries in Latin America. Finally, Fermín-Martínez et al. develop a new measure to capture age-related functional decline that focuses on anthropometric information available in aging surveys, and they validate their measure in older adults in the United States and Mexico. The papers in this symposium show how cross-national comparisons are being used to advance our understanding of aging.
PUBLISHING WITH THE INTERNATIONAL JOURNAL OF AGING AND HUMAN DEVELOPMENT
Authors: Patrick Julie Hicks
Published: December 2023

For more than 50 years, under the leadership of four editors and two publishers, The International Journal of Aging and Human Development (IJAHD) has featured multidisciplinary scholarship related to aging processes and older adults. With the publication of eight issues a year and over 1000 pages of scientific content, the IJAHD places emphasis upon psychological and social studies of aging and the aged. However, the Journal also publishes research that integrates observations from other disciplines that illuminate the “human” side of gerontology. A more recent focus includes midlife development, as well. About half (47%) of the publications in the IJAHD are from international colleagues. IJAHD is delighted to support new investigators as they navigate dissemination. This presentation will discuss tips for both international and US-based scholars for ensuring timely reviews and positive decisions for manuscript submissions, including such areas as key words, suggesting unbiased reviewers, formatting, writing mechanics, clearly-articulated methods, and a sound theoretical basis.
BUILDING BRIDGES, CATALYZING RESEARCH, EMPOWERING ALL AGES: NIA SESSION FOR EARLY-CAREER RESEARCHERS
Authors: Kelley Amy , Kelley Amy
Published: December 2023

The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, supports biomedical and behavioral research with a lifespan focus. NIA research seeks to understand the basic processes of aging, improve prevention and treatment of diseases in later life, and improve the health of older persons, in addition to an emphasis on Alzheimer’s disease and related dementias. NIA supports a variety of training and career development opportunities for students, junior faculty, early-career investigators, and emerging scholars. In this session, we will provide an overview of NIA-funded research, followed by a presentation on funding mechanisms and strategies to consider when applying for extramural grants, particularly for early-career scientists at multiple career stages. Finally, attendees will be able to join any number of breakout group discussions (led by extramural NIA training staff and program officials) to discuss programs, initiatives, mechanisms, and/or policies specific to various career paths.
COLLABORATIVE RESEARCH WITH A MIXED-METHOD DATASET USING DECEDENT DATA
Authors: Melekis Kelly , Weisse Carol
Published: December 2023

This presentation will present opportunities and challenges in building and sharing a mixed method dataset of terminally ill hospice patients from residential homes for the dying (social model hospice). As nonprofit, community-based settings, residential homes for the dying document care decisions using paper files and handwritten notes, and files range in size based on length of stay (with some files being hundreds of pages in length). Through a multi-site community-university partnership, we have scanned over 500 patient records, extracted quantitative data, and de-identified data for qualitative analysis. We will share the challenges of data management and organization, extraction, and de-identification. We will also discuss ethical issues related to working with decedent data, community-engaged research, and multi-site collaboration. Based on our experiences with qualitative data analysis of resident files, we will share strategies for extracting qualitative data from decedent records, using qualitative data analysis software, and sharing data for collaborative research.
EXPLORING THE POTENTIAL OF CHATGPT FOR ASSESSING DELIRIUM SYMPTOMS IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Choi Yong Kyung , Lin Shih-Yin
Published: December 2023

Delirium is a common and serious geriatric syndrome, especially in older adults with cognitive impairment. Accurate caregiver assessment and reporting of delirium in community-dwelling older adults can help healthcare providers diagnose and treat delirium more effectively. Yet, caregivers often lack confidence in their ability to accurately assess and report delirium. An automated method to detect the presence and symptoms of delirium could potentially boost caregiver confidence and assist with more accurate delirium assessment and reporting. This study explored the use of ChatGPT, a generative AI based on the Large Language Model (LLM), to detect the presence and symptoms of delirium. We trained ChatGPT using a series of prompts specifically designed to enhance its understanding of the domain knowledge and the scoring mechanism of a caregiver-centered, seven-item delirium assessment, the Sour Seven. The trained ChatGPT model was asked to identify and score various delirium symptoms in five previously validated geriatric case vignettes using the Sour Seven scale. Each case was repeated three times to test for reliability. The ChatGPT assessment results were compared against those of human experts. The preliminary analysis showed that items 3, 6 and 7 were scored correctly in all cases, but mixed results were found on items 1, 2, 4, and 5, mostly because the AI applied a single symptom statement to multiple items. Overall, the results indicate that generative AI has the potential to accurately capture and represent complex delirium symptoms in natural language, which could assist caregivers in accurately identifying and reporting delirium symptoms.
FAMILY QUIZZING BEHAVIOR DURING IN-HOME DEMENTIA CARE: A SEQUENTIAL BEHAVIORAL ANALYSIS WITH VIDEO CASE STUDIES
Authors: Coleman Carissa , Wilson Paige , Williams Kristine
Published: December 2023

Quizzing is an understudied communication behavior used by care partners during in-home dementia care interactions. The aim of this study was to characterize and describe the behavior, identify types, characterize care situations, and determine how people living with dementia react to quizzing. Forty video observations of in-home interactions were coded to determine relationships between care partner quizzing and the person with dementia’s reactions and analyzed using sequential behavioral analysis. Ten case studies with high instances of quizzing were examined for interpersonal context. Quizzing was defined as a series of rapid questions by the care partner that most often appeared to test the memory or knowledge of the person with dementia. Instances of quizzing that included long-term and short-term memory checks were most likely to elicit a negative reaction from the person with dementia (resistiveness, distress, and apathy). Long-term memory check always preceded resistiveness and distress (CP=1.0) and apathy preceded long-term memory check short-term memory check (CP = 0.71, 0.21). Quizzing used for distraction or reminiscing appeared to elicit positive responses from the person with dementia. Distraction and mutual reminiscing always followed cooperation (CP=1.0). Case study results indicated the care partners seemed to be testing the abilities of the person with dementia; possibly to alleviate or reverse dementia symptoms. Additional research is warranted to understand the use of quizzing during in-home care. The use of behavioral coding, sequential analysis, and case study examination can provide evidence of communication best practices to develop communication training for dementia care dyads.
NIMHD INVESTMENTS IN RESEARCH ON OLDER ADULTS EXPERIENCING HEALTH DISPARITIES: 2018–2022
Authors: Ogletree Aaron , Doose Michelle , Oladeinde Yewande
Published: December 2023

The National Institute on Minority Health and Health Disparities (NIMHD) is the nation’s leading institute on the health of populations experiencing health disparities. These populations include individuals with low socioeconomic status (SES), those living in rural areas, sexual and gender minorities (SGM), and racial and ethnic minorities. Despite the need to advance research on these populations, particularly in old age when health disparities may be most salient, there has been no analysis of NIMHD funding on older adults to date. This portfolio analysis synthesized and described NIMHD’s investments in research on older adults using data from fiscal years 2018 through 2022. The Research, Condition, and Disease Categorization system was used to identify funded projects in the area of Aging; manual review confirmed project eligibility. In-depth project characteristics were extracted and topic areas evaluated. Findings demonstrate that NIMHD funded a total of 98 unique research projects focused on older adults. Of these, 47% focused on the etiology of health disparities, 38% on interventions, and 15% on methods and measurement. The most specified population was racial and ethnic minorities (91%), followed by individuals with low SES (21%), rural older adults (11%), and SGM older adults (8%). Projects focused on diagnostic or clinical care (16%), care coordination (6%), caregivers (6%), and shared decision-making (4%) were limited. Findings highlight opportunities for future research to advance health care and reduce health disparities for the growing proportion of older adults from populations experiencing health disparities.
ESTABLISHING THE EFFECTIVENESS OF THE ONLINE SAVVY FACILITATOR TRAINING PROGRAM
Authors: Sherman Carey Wexler , Hepburn Kenneth , Hobday John , Reed Lai
Published: December 2023

A total of 76 individuals took part in the revise training program we developed following prototype testing. These individuals were affiliated with 32 organizations in eight states. Each individual was scored on the observation/reflection provided at the end of each training session. Fifty-one percent of trainees received scores between 95-99% across all assessments; only 8.1% received summed scores less than 90%. In only 4 cases, was an individual required to repeat the observation/reflection exercise. Fifty-six trainees responded to a post-training evaluation survey that sought their Likert scale assessment (1=Strongly Disagree; 5=Strongly Agree) of their experience with elements of the online program and their sense of preparedness to lead SC program. The clarity and completeness of the program, overall, received a 4.40 rating, and the ratings for individual segments ranged from 4.40 to 4.5. Trainees gave the quizzes and assessments a 4.40 rating as learning aids. Trainees rated their overall preparedness to lead the SCP at 4.1. Trainees appreciated that the course was self- paced. They indicated particular benefit from the embedded videos, trainer manual, and the interactive materials and quizzes.
MOMENTARY ASSOCIATIONS BETWEEN PURPOSE IN LIFE AND COGNITIVE FUNCTION IN EVERYDAY LIFE
Authors: Sutin Angelina , Luchetti Martina , Gamaldo Alyssa , Mogle Jacqueline , Lovett Hephzibah , Brown Justin , Sliwinski Martin , Terracciano Antonio
Published: December 2023

Purpose in life has been associated consistently with healthier cognitive aging outcomes, including better cognitive function and lower risk of incident dementia. Most within-person research on purpose and cognition has focused on cognition measured over years, which has been essential to identify the long-term protective benefits of purpose. The present research shrinks the timescale to momentary assessments over days to address whether purpose operates in the moment to support healthier cognitive function in everyday life. Participants from the Couples Healthy Aging Project (N=303) completed smartphone-based momentary assessments of purpose and short cognitive tasks three times a day for eight days. In moments when participants felt more purpose driven than their average, they had faster processing speed (b=-1.240, SE=0.194; p<.001) and less variability in processing speed (b=-0.437, SE=0.135; p<.001). These associations were independent of person, temporal, and contextual factors and practice effects. Momentary purpose was unrelated to visual memory performance. Similar patterns were found for other purpose-related items (momentary engagement, motivation) but not for hedonic emotions (momentary positive affect). These results suggest that feeling more purpose-driven in the moment supports faster processing speed in daily life. This work demonstrates that the positive association between purpose in life and better cognitive function operates in daily life and may be one mechanism through which purpose is associated with better long-term cognitive outcomes.
OLDER ADULTS’ PERSPECTIVES ON ETHICAL ISSUES RELATED TO AGETECH
Authors: Bryanton Olive , Dragomir Gerry , Mann Jim , Moulton Marjorie
Published: December 2023

Most funding programs in the AgeTech sector emphasise the involvement of the end user in research and innovation activities in order to strengthen relevance, appropriateness and real-world impact. However, this engaged approach is still a work in progress and often remains a matter of tokenism with older adults. Involving older adults is seen as key when creating ethically appropriate and inclusive AgeTech for their age group. This paper based on the reflections from members of two AgeTech groups: AGE-WELL’s Older Adults and Caregivers Advisory Committee and the Research Group of Seniors 411 in Vancouver, BC. This paper highlights some ethical problems inherent in AgeTech, particularly how ageist assumptions can be built into technology-based healthcare, including the ongoing challenges of community participation, and presents a more radical agenda of older adults at the forefront of setting research priorities and shaping the development and implementation of AgeTech. Central to this is the building of community capacity; training to facilitate older adults’ engagement in the research process: mobilizing expertise within the community to address local needs; developing mechanisms for connecting older adults and researchers in an integrated knowledge mobilization process. The paper reflects on how this approach can have a significant impact on the lives of older people, and address the digital divide that marginalizes them. Remaining challenges include how to sustain older adults’ participation in innovation initiatives, and providing hard evidence to demonstrate that a more engaged approach has tangible benefits and impact in terms of developing new products and services.
EMOTION REGULATION THROUGH MUSIC AND MINDFULNESS ARE RELATED TO POSITIVE SOLITUDE
Authors: Bodner Ehud , Palgi Yuval , Bachman Noa
Published: December 2023

Mindfulness and emotion regulation through music listening are skills that share some attributes with the skill of positive solitude (PS; defined as an inner choice to dedicate time to a meaningful, enjoyable activity or experience managed by oneself, with or without the presence of others). Nevertheless, little is known about their relationship with PS in the second half of life. Hence, we recruited a convenience sample of community-dwelling adults in the second half of life (N = 123; M = 68.63, SD = 10.99), who completed self-report measures of demographics, emotion regulation through music, mindfulness, and PS. A hierarchical linear regression demonstrated significant positive associations between emotion regulation through music listening and PS, and between mindfulness and PS. Moreover, age moderated the relationship between mindfulness and PS. This relationship was found to be positive and significant only among older adults. These findings support the study’s hypotheses and emphasize the contribution of the current research to developmental research on PS in the second half of life.
CATALYZING CROSS-NATIONAL AGING RESEARCH: OPPORTUNITIES, CHALLENGES, AND STRATEGIES FOR EARLY CAREERISTS
Authors: Kobayashi Lindsay
Published: December 2023

Cross-national comparisons in aging research allow for the triangulation of evidence on health outcomes across diverse populations and contexts. They allow researchers to identify policy-relevant and context-specific modifiers of health risks faced by older adults. Catalyzing cross-national comparison studies is a challenge, as researchers need to carefully consider social, cultural, political, socioeconomic differences across populations and make sure that local partners are appropriately represented and involved. This presentation will describe experiences in building a research career focused on understanding healthy cognitive aging from a global perspective, using data from diverse high-, middle-, and low-income settings. Opportunities, challenges, and strategies for early career researchers interested in catalyzing cross-national aging research will be discussed. These include the importance of advocacy for research on aging in contexts outside of the United States, theoretical and methodological approaches to cross-national research, and building diverse interdisciplinary collaborations.
BUILDING BRIDGES TO CONDUCT RESEARCH WITH FAMILIES LIVING WITH COGNITIVE IMPAIRMENT IN THE US AND THE CARIBBEAN
Authors: Brewster Glenna
Published: December 2023

My program of research aims to tailor and/or develop individual or dyadic behavioral and/or psychoeducational interventions to improve sleep and quality of life for persons living with cognitive impairment and their care partners. In order to conduct this research, it has been important to collaborate with colleagues in other disciplines and work beyond the borders of the United States. During this presentation, I will reflect on my research experience thus far using that to share practical strategies I used to develop and maintain collaborative relationships with researchers and stakeholders, and lessons learned from working within research teams locally, nationally and internationally.
A COMPARATIVE STUDY OF GRIEF SUPPORT AND BURNOUT AMONG NURSING HOME STAFF
Authors: Hawes Frances , Wang Shuangshuang
Published: December 2023

A half-million older adults die in U.S. nursing homes (NHs) each year. However, only a few studies have been conducted on the experiences of the nursing home (NH) staff who provide this care. This study collected data from 555 NH workers in Fall 2022 and examined how their experiences with grief support affected burnout. Grief support was measured by the Grief Support Health Care Scale. Burnout was measured by the Maslach Burnout Inventory, which includes 3 subscales: exhaustion, depersonalization, and personal achievement. Findings indicate that 95% of sampled workers were exposed to at least one death at work; yet 31% percent of the sample never received any formal grief training. Examining the comparative dimensions of burnout, the highest percentage of workers with exhaustion and depersonalization ratings were RNs, nurse practitioners, and physicians, followed by CNAs. The lowest ratings of personal accomplishment were by direct support workers (maids/janitors housekeeping and laundry food service workers). Controlling for NH and individual characteristics, multivariate logistic regression showed that compared to workers who received low grief support, those who received high grief support were more likely to report high personal achievement and low feelings of depersonalization (i.e., impersonal response to residents). This research provides valuable information about the importance of grief support for nursing home workers to reduce feelings of burnout. In addition, findings indicate that there is a difference in grief support and burnout between different categories of nursing staff and there is a need to provide increased grief support to frontline workers.
ANALYSIS OF OHIO’S ASSISTED LIVING DIRECT CARE WORKFORCE
Authors: Kennedy Katherine , Hua Cassandra , Nelson Matt
Published: December 2023

Direct care workers (DCWs) in Ohio’s licensed residential care facilities (RCFs) provide the most assistance with activities of daily living to individuals with disabilities. DCWs include medication aides, personal care aides, and nurse aides. In 2017, 41% of Ohio AL administrators reported high DCW recruitment issues and 36% high DCW retention problems (8+ on 10-point scale). Understanding how RCFs with no or little recruitment/retention challenges compare to other RCFs on strategies used, training hours, wages, benefits, resident composition, and RCF characteristics can identify potential strategies to increase recruitment/retention. This study uses the 2019 Ohio Biennial Survey of Long-Term Care Facilities (n=540 RCFs) to compare RCF strategies to recruit and retain DCWs by measures of recruitment/retention problem-severity and their 3-year retention rates among full-time (FT) and part-time (PT) DCWs. In 2019, 65% of Ohio RCF administrators reported recruitment issues at the median or greater (8+). Similarly, 62% of RCFs experienced retention issues at the median or more (7+). On average, 37% of FT DCWs worked in the RCF for 3 years or more and 21% among PT DCWs (ranges: 0%-100%). 28.24% of RCFs reported high 3-year retention among FT DCWs (60-100%) and 26.51% reported high 3-year retention among their PT DCWs (30%-100%). RCFs with less serious recruitment challenges report providing more hours of training for newly employed DCWs before they provide resident care (34.54 vs. 29.60, t=-2.7, p<.01). Individual retention strategies did not show relationships with high retention. Results indicate pervasive challenges with DCW retention and recruitment that require new approaches.
VARIATION IN USE OF HOSPICE AIDES BY RESIDENTIAL SETTING
Authors: Reckrey Jennifer , Mckendrick Karen , Aldridge Melissa
Published: December 2023

Hospice care frequently includes visits from hospice aides, but need for hospice aide care may be different for those in the community compared to settings like assisted living or nursing homes where personal care is routinely provided. The objective of this longitudinal cohort study is to identify factors associated with hospice aide visits (any versus none) and frequency of hospice aide visits (proportion of routine hospice cays with an aide visit) in different residential settings (community, assisted living, and nursing home). We identified Medicare beneficiaries enrolled in the Medicare Current Beneficiary Survey (MCBS) who died between 2010-2019 (n=1,915). We used self-reported survey responses, Medicare claims data, and Medicare Provider of Service data to compare decedent hospice care experience across residential settings and estimated multivariable models to compare factors associated with hospice aide visits among residential settings. Hospice aide visits were least common in the community setting (64.4% vs 76.6% vs 72.6% with any hospice aide visits in community, assisted living, and nursing home respectively, p=0.002). In models adjusted for sociodemographic, clinical/functional, and hospice factors, neither hospice aide visits nor the proportion of routine hospice days with hospice aide visits varied significantly by residential settings. Future work to understand when and why hospice aides are utilized and how hospice aides collaborate with families and existing care teams in will help ensure that hospice care is appropriately tailored to individual care needs in all residential settings.
FUNCTION-FOCUSED CARE FOR ACUTE CARE USING THE EVIDENCE INTEGRATION TRIANGLE: IMPACT OF PATIENT CARE ACTIVITIES
Authors: Galik Elizabeth , Resnick Barbara , Boltz Marie
Published: December 2023

The benefits of physical activity during hospitalization are particularly relevant for older adults living with dementia, as these individuals are at the greatest risk for functional decline, delirium, behavioral symptoms associated with dementia, increased length of stay, adverse events increased readmissions and institutionalization post discharge. One effective way to engage these patients in physical activity is through implementation of a function focused philosophy of care. Function focused care helps nurses to evaluate patient’s underlying physical capability and motivate them to participate in all care activities. The Function Focused Care for Acute Care Using the Evidence Integration Triangle study is a randomized controlled theoretically based trial that includes four components include: (1) Development of a Stakeholder Team; (2) Education of Staff; (3) Development of a Function Focused Care careplan; and (4) Mentoring and Motivating of Staff and Patients. Those randomized to control were exposed to education about Function Focused Care only. To date a total of 10 hospitals and 365 patients living with dementia have participated in the study. The mean age is 82, and the majority are female (62%) and white (72%). Although not statistically significant, there is evidence of improvement in the number of care interactions in which patients participated in the treatment versus control group. Cognition, quality of care interactions, behavioral and psychological symptoms associated with dementia, comorbidities, physical resilience, tethers and pain were all indirectly associated with performance of function focused care through performance of activities of daily living and/or pain.
LYSOSOMAL SIGNALS IN LONGEVITY REGULATION ACROSS THE SCALE
Authors: Wang Meng
Published: December 2023

Lysosomes are key organelles in the cell that constitute an acidic subcellular environment and contain approximately 60 different types of hydrolytic enzymes. With the aid of these acidic hydrolytic enzymes, lysosomes are highly metabolically active and can digest various macromolecules delivered through endocytosis, phagocytosis, and autophagy. Moreover, lysosomes function as a “signaling hub” that integrates metabolic inputs, organelle interaction, and longevity control. Our studies discovered a pro-longevity lysosomal acidic lipase that activates a lysosome-to-nucleus retrograde lipid signaling pathway in Caenorhabditis elegans, and in turn revealed the critical role of this lysosomal lipid signaling in promoting oxidative stress tolerance and lipid catabolism through tuning mitochondrial activities. Furthermore, we discovered that this lysosomal lipase induces the release of lipid messengers from peripheral metabolic tissues, which act on neurons and lead to the up-regulation of the neuropeptide signaling pathway by activating a nuclear hormone receptor. More recently, lysosome-specific proteomic profiling has revealed that AMPK is specifically recruited to the lysosome upon lysosomal lipolysis and mediates the longevity effect, suggesting a previously unknown interaction between AMPK and lysosomal lipid signaling. Together, these findings highlight the crucial role of lysosomal signals in actively coordinating organelle crosstalk and tissue communication to improve longevity and promote healthy aging.
NURSING HOME CLOSURES DURING THE COVID-19 PANDEMIC
Authors: Hughes Kelly , Segelman Micah , Porter Kristie , Diaz Miranda , Oliveira Iara
Published: December 2023

Nursing homes experienced unprecedented financial challenges during the COVID-19 pandemic, raising concerns about closures. This study identified closures from 2020-2021 using certification surveys and examined characteristics associated with closures using multivariate analysis. We interviewed nursing home industry experts and providers about pandemic-related challenges and policies affecting closure. Closures did not increase in 2020 and 2021 relative to 2011-2019. However, nursing homes with more staff shortages and COVID-19 infections were more likely to close. Additional characteristics associated with closure include smaller size, lower occupancy rate, and fewer Medicare residents. Interviews noted the following financial challenges: costly contract staffing, increased PPE and COVID-19 testing costs, reduced occupancy rates, and increased internal resources needed to implement new infection guidance. Interviews suggested that strategies to mitigate staffing shortages and federal and state monetary assistance may have prevented closures in 2020 and 2021, but continuing attention to closures is needed in 2022 and 2023 as funding ends.
EFFECT OF RISE ON REPEAT ELDER ABUSE AND SELF-NEGLECT INVESTIGATIONS BY ADULT PROTECTIVE SERVICES
Authors: Lewis Stuart , MacNeil Andie , Connolly M T , Salvo Erin , Kimball Patricia , Rogers Geoff , Burnes David
Published: December 2023

Adult Protective Services (APS) is the primary agency responsible for investigating Elder Abuse and Self-Neglect (EASN) allegations in the US. The harms of EASN are well established; however, APS lacks a conceptually derived, evidenced-based intervention phase. RISE is a community-based EASN intervention designed to complement and augment APS that provides enhanced services and a longer intervention phase. The objective of this study was to test whether exposure to the APS/RISE collaboration reduced the case outcome of recurrence (repeat investigations) compared to usual APS only services. This study was based on a retrospective observational design (n = 1947) in two randomly selected counties of Maine where RISE was available to provide enhanced services to persons referred from APS. Analysis used an extended regression endogenous treatment Probit model using APS administrative data to predict case recurrence. Between 2019 and 2021, 154 cases participated in RISE and 1793 received usual APS only services. 49% of cases referred to RISE had a complex history with 2 or more prior substantiated allegations versus 6% for those receiving usual APS only services. After accounting for the non-random treatment assignment, RISE significantly lowered the likelihood of recurrence compared to persons receiving usual care provided by APS (probability of recurrence reduced by 0.55 for the Average Treatment Effect on the Treated and 0.26 for the Average Treatment Effect). A reduction in recurrence carries important implications for APS costs, resources, and workflow. It may also serve as a proxy indicating a reduction in re-victimization and harm for EASN victims.
SUCCESSFUL AGING AMONG OLDER PERSONS IN VIET NAM
Authors: Saito Yasuhiko , Vu Nguyen , Dang Linh
Published: December 2023

The present study aims to explore the prevalence and correlates of successful ageing among Vietnamese older persons. Data used for this study is from the baseline survey of the Longitudinal Study of Ageing and Health in Viet Nam (LSAHV). LSAHV is a nationally representative survey of older persons aged 60 and above in 2018-19 with 6,050 respondents. Face-to-face interviews were conducted using structured questionnaires and tablets. Rowe and Kahn’s definition was used to study successful ageing among older persons in Viet Nam. Study sample size was 4,370 older persons. Logistic regression was employed to examine the association of sociodemographic and lifestyle factors with successful aging among older persons. The prevalence of Vietnamese older persons meeting criteria of successful ageing was 16.2% at the time of baseline survey. The percentage of older persons reporting no major diseases, no disability, high cognitive function, high physical function, and engagement with life was 35.0%, 88.5%, 55.1%, 77.9%, and 79.7%, respectively. Logistic regression analysis showed that older persons who were younger, male, having higher education level, and often doing physical exercise were likely to be successful agers. The prevalence of successful ageing was quite low among Vietnamese older people. More health interventions, successful ageing guidelines, and health care services should be provided for older persons to improve successful ageing status. It is necessary to study successful ageing to improve well-being of older persons becaise Viet Nam is currently experiencing a rapid population ageing.
ESPO AND ACADEMY FOR GERONTOLOGY IN HIGHER EDUCATION SECTION SYMPOSIUM: UTILIZING TECHNOLOGY IN THE ADVANCEMENT OF OLDER ADULT EDUCATION
Authors: Su Yan-Jhu , Fassi Janelle , Fruhauf Christine
Published: December 2023

TThis symposium intends to echo one of the core values of the GSA 2023 Annual Scientific Meeting — empowering all ages. Online lifelong learning has become more common in the 21st century. The speed of technological development far exceeds people’s imagination. The speed at which technology develops is shown to create a widening gap between older and younger populations, known as the digital divide. Introducing technologies into intergenerational learning environments remains an important step to bridging the generational digital divide. In accordance with the AGHE gerontological education competencies, these authors will describe how older adults utilize technology. The first speaker will discuss the effectiveness of a virtual intergenerational program that addressed experiences of ageism for older and younger participants. The second speaker will introduce user-centered design principles and innovative tools that facilitate virtual Information Communications Technology (ICT) support and training for older people with limited abilities in using technology. The third speaker will illustrate concrete practice through international cases from different intergenerational technology integration projects. The fourth speaker will present key elements from the University of Rhode Island (URI) Engaging Generations Cyber-Seniors Program internship and describe student experiences enrolled in the program. The last speaker will discuss the benefits and challenges of technology use among older learners and state the experience of leading older learners using technology in Taiwan. This is a Geriatric Education Interest Group Sponsored Symposium.
APPLYING EVIDENCE-BASED PRACTICES TO INTERGENERATIONAL TECHNOLOGY-SUPPORTED LEARNING OPTIMIZES MUTUAL BENEFIT
Authors: Jarrott Shannon
Published: December 2023

Numerous intergenerational programs support varied goals using technology. Technological competence may be the desired outcome or the means for achieving outcomes in such programs. For example, Cyber Seniors operates in many settings with digital mentors providing technology training to more than 11,000 older adults. This and other technology-supported intergenerational programs have been delivered in-person and remotely with considerable success. Now that researchers have demonstrated feasibility and acceptability of intergenerational technology-supported learning, they may want to address the potential for such programs to be one sided. In the typical scenario, the youth bestows their technological expertise upon the older learner, but the pair can mentor each other to achieve additional goals. Application of evidence-based intergenerational strategies can optimize mutual benefit of technology-supported learning programs. In this paper, specific practices are illustrated with international examples from diverse intergenerational programs that incorporate technology. The author’s and others’ research linking practice with outcomes reveals that humanistic practice strategies (e.g., supporting equal group status in the contact setting) ensure that youth and older adults build relationships as well as technical skills while they learn from each other.
ASSOCIATIONS OF RELATIVE INTENSITY OF PHYSICAL ACTIVITY WITH INCIDENT CARDIOVASCULAR OUTCOMES AND MORTALITY
Authors: Schumacher Benjamin , LaMonte Michael , Di Chongzhi , Parada Jr. Humberto , Hooker Steven , Bellettiere John , Simonsick Eleanor , LaCroix Andrea
Published: December 2023

For an older individual, the energy expended (absolute intensity) during a specific activity (e.g., casual walk) may be closer to their maximal effort (higher relative effort) than for a younger individual. We compared the associations of relative and absolute intensity of physical activity (PA) with all-cause mortality and incident major cardiovascular disease (CVD). Accelerometer-measured PA in the Objective Physical Activity and Cardiovascular Health (OPACH) Study (mean age 78.5±6.7) was used to estimate daily hours of absolute light intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Accelerometer-estimated metabolic equivalents (METs) in each 15-second epoch were divided by two maximal MET capacity estimates. These percent maximal effort metrics were categorized and aggregated into daily hours of relative LPA and MVPA. Cox proportional hazards models estimated the associations of a one-hour daily increase in absolute and relative PA with the two outcomes. On each PA measurement scale, an increase in either intensity category reduced the risk of both outcomes. A one-hour increase in absolute LPA reduced the risks of both outcomes by 12%, and a one-hour increase in absolute MPVA reduced the risk of death and CVD by 45% and 27%, respectively. On the relative scale, LPA was more strongly associated with both outcomes than MVPA. Increasing absolute MVPA was more strongly associated with the outcomes than increasing relative MVPA. The PA intensity paradigm should keep shifting towards recommendation of more movement, regardless of intensity, and placing greater emphasis on relative light intensity activities to reduce the risks of death and incident major CVD.