bluuebunny/crossref_metadata_2025 huggingface dataset:
IDENTIFYING GENDER-BASED DIFFERENCES IN CHARACTERISTICS OF OLDER ADULT CANNABIS USERS
Authors: Coromac-Medrano Juliamaria , Anquillare Elizabeth , Neiderman Adrianna , Thayer Rachel
Published: January 2025

As cannabis use continues to rise among older adults, understanding different patterns of cannabis use is essential for interpreting health outcomes and treatment expectations for this population. This study explored gender differences in age of onset, frequency of use, primary methods of cannabis ingestion, and scores on substance use disorder and cognitive questionnaires between male and female older adult cannabis users (OACU). This sample included 52 OACU ages 60+ (Mage=67.98, SD=5.77; 50%=female; 90%=White). Chi-square analyses and independent samples t-tests were performed to identify gender differences in patterns of cannabis use. The percentage of men who endorsed primarily inhalation methods (76%) was significantly greater than women (46%), and the percentage of women who endorsed primarily consuming edibles (54%) was significantly greater than men (24%), χ2(1, N=49)=4.69, p<.05. Men were more likely to use cannabis on more days of the previous week (M=5.42, SD=2.42) compared to women (M=3.88, SD=2.83), t(50)=2.11, p<.05. Men also generated significantly greater scores on the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) compared to women (Mscore=12.85, SD=6.75 and Mscore=8.96, SD=5.85, respectively), t(50)=2.22, p<.05. Women (Mscore=195.48, SD=46.88) reported significantly greater cognitive self-efficacy compared to men (Mscore=168.35, SD=44.54), t(49)=-2.18, p<.05. There was no difference regarding the age of first ever cannabis use between men (Mage=22) and women (Mage=26). These findings elucidate several differences in use patterns between male and female OACU. Future research can explore additional gender differences to better inform clinical teams about the individual characteristics of an older adult cannabis user.
BARRIERS TO SOCIAL ENGAGEMENT OF OLDER IMMIGRANTS IN THE UNITED STATES: A SYSTEMATIC REVIEW OF LITERATURE
Authors: Adeniji Dolapo , Miller Vivian , Tonui Betty , Barnhart Emma
Published: January 2025

Social engagement is crucial in older adulthood. Social engagement strengthens a sense of belonging, fosters meaningful participation in activities, enhances physical and mental health, alleviates stress and anxiety, and promotes a healthy lifestyle. However, older immigrants often face challenges in engaging socially due to acculturation stress and unfamiliar cultural norms. Using a systematic review of existing literature, this study seeks to identify existing literature that discusses older immigrants’ involvement and participation in community programming, synthesize findings on the accessibility of such programs, and present recommendations for modifications in programs and policies to serve this population best. Guided by the PICO framework and PRISMA guidelines, a systematic review of 11 university databases yielded (N=20) relevant peer-reviewed journal articles after completing a three-stage review process. These articles document social engagement practices identified among various ethnic backgrounds, including older Korean Americans, Chinese Americans, Mexican Americans, and Vietnamese, as well as immigrants and refugees originating from Africa and Asia. Findings suggest that ageism, social disintegration, and language barriers hinder the effectiveness of existing community programs, thus leading to social isolation and loneliness. While our study encompassed various ethnic groups, it is imperative to recognize the potential unique social engagement practices within each of these groups. This acknowledgment is essential in planning community programs to accommodate languages and cultural preferences that can help alleviate social isolation among aging immigrants. Future studies may benefit from a more targeted examination of social engagement practices within distinct ethnic groups to inform targeted interventions.
COMPARING HEALTH CARE WORKFORCE IN NURSING HOMES BETWEEN TAIWAN AND THE UNITED STATES: A PILOT STUDY
Authors: Shieu Bianca , Lee Ya-Wen , Harris John
Published: January 2025

Nursing homes (NHs) play a pivotal role in providing long-term care for elderly and chronically ill individuals. However, limited research has focused on understanding resident composition, staffing levels, and quality of care across different cultures. Therefore, this study aims to comprehensively compare the NH workforce between Taiwan and the United States, identifying improvement opportunities, enhancing staffing practices, and ultimately improving the lives of NH residents. This comparative analysis specifically examines two hospital-affiliated NHs in the US and three Christian-affiliated hospital-affiliated General-NHs in Taiwan. The first author conducted observations and interviews at two Hospital-affiliated NHs located in the Northeastern region of the United States, while the second author conducted observations and interviews at three Christian-based hospital-affiliated General NHs situated in Central Taiwan. Both authors spent several hours each day walking through the NHs, documenting their observations through field notes after each observation setting, conducting interviews with NH staff, and engaging with administrators to gather additional demographic information. We used Atlas.ti software for data analysis of our interviews. This study identified five distinct aspects warranting discussion due to their differences: ownership structure, NH resident demographics, medication administration protocols, staff training practices, and staffing shortages. In conclusion, the analysis of the healthcare workforce in NHs between Taiwan and the United States reveals critical insights into the challenges and opportunities faced by both nations. Additionally, this study contributes to a deeper understanding of NHs’ workforce dynamics, with implications for policy, practice, and resident well-being.
EXPLORING THE ASSOCIATION BETWEEN GOOGLE RATINGS AND NURSING HOME QUALITY
Authors: Dayama Neeraj , Gupta Shivani , Pradhan Rohit
Published: January 2025

Online review platforms such as Google ratings have become a resource for consumers seeking nursing home (NH) care for their loved ones. As these ratings reflect subjective experiences, it is important to explore how they may correlate with the more rigorous and systematic measures of NH quality. The primary purpose of this study was to explore the association of Google ratings with NH deficiencies. This study is structured as a cross-sectional analysis (2018) utilizing the following datasets: Brown University’s LTC Focus, Ohio nursing home Google rating data, and Area Health Resource File. The dependent variable was deficiencies which reflect a facility’s failure to meet specified resident care standards, known as federal participation requirements (FPRs). Examples of deficiencies include a facility’s failure to adhere to infection control protocols or improper medication management. The independent variable was consumer reported Google ratings for Ohio NHs. We used negative binomial linear regression, adjusting for NH organizational (size, occupancy, ownership, chain affiliation, payer mix) and market factors at the county level (per capita income, urban/rural location) to assess the relationship. Mean Google rating was 3.55 out of 5 and mean total deficiency count was 11.98. We found that Google ratings were negatively associated with deficiencies (Incidence Rate Ratio=0.93, p< 0.05) (as the number of deficiencies increased, Google ratings declined). From a policy perspective, our findings highlight the need for regulatory frameworks to incorporate consumer feedback mechanisms in evaluating and improving nursing home care quality.
TAKING CHARGE AND FLEXING PROTOCOLS: SNF NURSING STAFF’S UTI IDENTIFICATION
Authors: Delgado Kimberly , Roberson Donna
Published: January 2025

Skilled Nursing Facility (SNF) residents are at increased risk of adverse reactions, including death, due to inappropriate antibiotic use, which accounts for up to 75% of all SNF antibiotic prescriptions; the most common indication being urinary tract infection (UTI). The structure of SNFs create barriers to appropriate diagnosis and treatment of UTIs, with limited registered nurse availability and health care providers (HCP) being off-site. The purpose of this study was to describe SNF nursing staff experiences with residents whom they suspected were presenting with a UTI. A better understanding of what takes place prior to HCP contact can assist SNF leadership with improving nursing-led interventions. This qualitative descriptive study used a semi-stratified purposive sample, snowball sampling, and social media recruitment. Single, semi-structured interviews were completed using open-ended questions. Data analysis resulted in three themes: way out of the norm, taking ownership, and flexing protocols. Participants identified SNF residents’ behaviors that were ‘way out of the norm,’ as a key indicator of a UTI. Approaches to care included nursing staff taking ownership, or responsibility, and flexing protocols to prioritize the care and well-being of their residents. SNF nursing staff spend more time with their residents than the HCP, which results in them being heavily involved in the process of UTI identification. Inclusion of SNF nursing staff in future research is critical to the exploration of practices and improving outcomes. Research study recruitment barriers illustrate the tremendous need for education among SNF facility leadership to garner support and permission to access facilities.
RURAL DISPARITIES IN ELDERLY AMBULATORY CARE READMISSIONS: EVIDENCE FROM NATIONAL AMBULATORY MEDICAL CARE SURVEY
Authors: Kang Sunny , Miller Nancy , Zhang Ting
Published: January 2025

Objective

We examined factors associated with older patients’ readmission to ambulatory care within one week to two months’ discharge, and how this readmission pattern primarily varied by locality.

Methodology

We analyzed 7,619 older patients (age 50 and older) from the 2016 National Ambulatory Medical Care Survey. Logistic regression analyses were utilized to examine the risk factors for ambulatory readmission. Findings: Compared to the residence in Metropolitan Statistical Areas, the residence in rural areas (or micropolitan areas) will increase the odds of readmissions (OR=1.61, 95%CI[1.30, 1.99]), after controlling for other variables. Being Black was not statistically significant in predicting the likelihood of readmission, while black patients using Medicaid as the primary payment experienced higher risks of readmission (OR=2.09, 95%CI[1.02, 4.32]). The higher facility percentage (>50%) of Medicare beneficiaries was associated with smaller odds of readmission (OR=0.65, 95%CI[0.58, 0.73]). Nursing home visiting within the prior week or seeing a physicians’ assistant each increased the odds of readmission, whereas seeing a mental healthcare provider decreased the risks for readmissions (OR=0.40, 95%CI[0.19, 0.83]). Patients diagnosed with cardiovascular disease and Type II diabetes were associated with smaller odds of readmission. Policy Implications: Residence in rural areas (or micropolitan statistical areas) or being black Medicaid beneficiaries predicted greater odds of readmission to ambulatory care among older patients. Rural patients experienced lower likelihood of staff responsiveness after adjusting for other factors. Further research should explore the basis of these disparities. Mental health diagnoses in depressive and psychosis disorders also called upon additional studies regarding special care needs.
ACTIVITY RECORDING CAPILLARY FEEDER (ARC): A HIGH-THROUGHPUT BEHAVIORAL PHENOMIC ASSESSMENT IN DROSOPHILA
Authors: Wu Serena , Pham Vivian , Nguyen Tiffany , Jafari Mahtab
Published: January 2025

Drosophila melanogaster is not only a well-established model organism in aging research but it is also considered an emerging animal model to screen and evaluate potential anti-aging compounds. Our lab developed an algorithm to screen and identify natural products and botanical extracts with lifespan extension and healthspan-improving properties. Once a compound or extract was shown to increase lifespan, we performed various phenotypic assays to determine its impact on biomarkers of health in Drosophila. This work established Drosophila as a model system in pre-clinical aging research. However, traditional behavioral phenotypic assays such as geotaxis are laborious and time-consuming, hampering screening efficiency. To address this challenge in the emerging field of phenomics, we have utilized an automated system, originally developed by Ja Lab, University of Florida, called the Activity Recording Capillary feeder assay (ARC). This recording system leverages high-resolution machine vision to monitor Drosophila behaviors such as movement, sleep, and feeding dynamics. This innovative approach enables rapid and simultaneous assessment of multiple behavioral parameters, offering greater reproducibility and scalability than conventional methods. In this work, we present preliminary data on the feasibility of using ARC as a high-throughput phenomics screening modality to evaluate natural product induced changes in aging-related phenotypes such as locomotion. This work was supported by UCI Calit2.
ASSOCIATION OF NEIGHBORHOOD CHARACTERISTICS AND RACE ON HEALTH STATUS AND HEALTH CARE USE FOR OLDER ADULTS
Authors: Toseef Mohammad Usama
Published: January 2025

Research suggests that neighborhood characteristics are important social determinants of health. However, there is limited evidence that explores the interaction of race/ethnicity and neighborhood characteristics on healthcare use. We study this issue and specifically focus our analysis on how older Arab Americans use healthcare relative to their White counterparts. We conducted a retrospective study among patients 65 years and older (N = 112,056) who were tested for SARS-CoV-2 at the emergency departments of a large integrated midwestern healthcare system between March 1, 2020, and July 31, 2022. We used area deprivation index (ADI) quintiles that allows ranking of neighborhoods based on socioeconomic disadvantage. The outcomes for our analysis were infection with SARS-CoV-2, hospitalization, ED revisit 30 days and readmission 30 days. We estimated logistic regression models controlling for race/ethnicity, ADI and interaction of these two. We found that older Arab Americans in the 3rd and 4th quintiles were more likely than Whites to test positive for SARS-CoV-2. Arab Americans in the 4th quintile were more likely to be admitted as compared to Whites while no significant differences were observed in the other quintiles. Arab Americans in the 3rd quintile of ADI were more likely to have an ED revisit within 30 days and re-hospitalized within 30 days as compared to Whites. This shows how culture and perception of healthcare provision can play a role in the use of healthcare resource and policymakers and stakeholders may find it useful to focus on neighborhood characteristics as captured by ADI or similar measures.
EXPLORING EARLY BARRIERS TO KIDNEY TRANSPLANT: THE MORAL ECONOMIES OF DIALYSIS CLINICS
Authors: McDonnell Jenny , Idler Ellen , Wilk Adam
Published: January 2025

Kidney transplant conveys steep survival and quality of life benefits, yet only one-third of patients with kidney failure are referred for transplant evaluation. We explore the dialysis clinic as a site of inequities in transplant, wherein dialysis care professionals’ (DCPs’) early resource allocation decisions shape patients’ downstream access to transplant. Using a modified grounded theory approach, we conducted 39 in-depth interviews during summer 2022 with DCPs (e.g., nephrologists, social workers, nurses) about their processes leading to transplant referral or non-referral. Phone interviews were recorded and transcribed verbatim. Textual data were coded using MAXQDA software. Combining within- and across-case strategies for analysis, we uncovered tension between DCP’s reported referral philosophies and their tacit strategies for selectively allocating resources. While most DCPs reported that they “refer all patients”, in practice, they selectively direct limited resources (e.g., time, education, advocacy, empowerment) toward “ideal” patients. DCPs described “ideal” patients as compliant, activated, and motivated, compared to “risky” patients who “don’t do what they’re supposed to do”, struggle with self-management, and may “get less use out of a transplanted kidney” due to advanced age. We extend previous research by framing the dialysis clinic as a moral economy in which resources flow through a web of specific norms, meanings, and practices related to DCPs’ perceptions of patients’ deservingness and worth. Findings indicate that within this moral economy, DCPs direct limited resources toward “ideal” patients and away from “risky” patients most in need of DCPs’ time and advocacy. Calls for future research and policy implications are discussed.
HEALTH EQUITY APPROACH TO EXAMINE COGNITIVE DIFFICULTY WITH AND WITHOUT A MENA CHECKBOX IN THE US
Authors: Kindratt Tiffany , Tnesh Basma
Published: January 2025

Federal guidelines for collecting race/ethnicity in the US include White, Black, Hispanic/Latino, Asian, American Indian/Alaskan Native (AI/AN), and Native Hawaiian/Other Pacific Islander (NH/OPI) as minimum reporting categories. Middle Eastern and North African (MENA) Americans are included in the definition for the White race group, which includes other individuals of European ancestry. In 2023, the Office of Management and Budget proposed adding a separate checkbox for MENA individuals. Several studies have identified that MENA Americans have a higher burden of cognitive health concerns compared to Whites. Having a separate checkbox for MENA Americans may provide a truer assessment of health disparities for other racial/ethnic groups. We examined whether removing MENA Americans from the White race group altered comparisons of cognitive difficulty between racial/ethnic minoritized populations and Whites. Using national data from the American Community Survey (ages >=45 years; N=7,284,988), we identified 67,213 adults (ages 45+ years) with MENA ancestry/birthplace. Most self-reported as White (n=60,993) followed by some other race (n=3,699), Black (n=1,957), Asian (n=468), AI/AN (n=72), and NH/OPI (n=24). Cognitive difficulty was higher among Black, Asian, AI/AN, and NH/OPI compared to White adults before and after removing adults with a MENA ancestry or birthplace from the sample. Marginal changes were observed. For example, for Black adults, odds increased from 1.23 to 1.24. While we did not find a difference in cognitive difficulty when we removed MENA adults from the national sample, further research is needed to determine whether this finding differs in smaller samples (e.g., states) and for other health outcomes.
THE IMPACT OF CHILDHOOD ADVERSITIES ON INTERPERSONAL AND INSTITUTIONAL DISCRIMINATION IN MIDDLE AND LATE ADULTHOOD
Authors: Wei Wenxing
Published: January 2025

Introduction

Research on the impact of childhood adversities on later-life experiences of interpersonal and institutional discrimination is scarce. Drawing on the life course perspective, this study examines how childhood adversities influence interpersonal and institutional discrimination experienced in middle and late adulthood.

Methods

Utilizing the Health and Retirement Study (HRS), this study included a nationally representative sample of 14,268 adults aged 45 and older. Ordinary Least Squares (OLS) regressions were conducted to examine whether childhood adversities were associated with interpersonal and institutional discrimination, controlling for socio-demographic characteristics.

Results

Findings indicate a significant relationship between childhood adversities and both interpersonal and institutional discrimination in later life. Specifically, increased experiences of childhood adversities were associated with higher levels of reported discrimination, underscoring the persistent effects of early adversities on individuals’ later life experiences.

Discussion

This study contributes to the existing literature by focusing on the impact of childhood adversities on discrimination in an age group frequently neglected in studies. It underscores the importance of developing comprehensive prevention and intervention to mitigate the long-term effects of childhood adversities in middle and late adulthood. Additionally, the research identifies directions for future studies to delve into the mechanisms of these associations, to consider a wider range of childhood adversities (e.g., bullying), and to examine discrimination on broader levels (e.g., systemic). These explorations are crucial for the development of more effective support strategies and policy frameworks for individuals affected by childhood adversities and experiencing discrimination.
SELF-REPORTED WELL-BEING AMONG OLDER ADULTS WITH A PERSONAL OR FAMILY HISTORY OF INCARCERATION
Authors: Holaday Louisa , Stone Kimberly , Roy Brita , Williams Brie , Siu Albert , Wang Emily
Published: January 2025

The United States has one of the highest incarceration rates in the world. Prior work has demonstrated adverse health effects associated with personal or family history of incarceration, but none has focused on older adults. We conducted a cross-sectional study using data from the nationally representative Family History of Incarceration survey. Among the 1,114 adults aged 55 or older, we tested the association between personal incarceration and/or family member incarceration and overall; financial; social; physical; and mental wellbeing controlling for age; gender; race/ethnicity; income; education; employment; and marital status. We accounted for time since last incarceration, and duration of incarceration. Overall, 21% of respondents had been incarcerated (of whom 78% returned to the community over 10 years ago), and 64% had had an immediate family member incarcerated (of whom 30% were incarcerated 1 year or longer). “Thriving” overall wellbeing, which is associated with life expectancy, was less common among those with personal or family incarceration exposure (63.3% of those without incarceration exposure vs. 47.7-55.7% of those with incarceration exposure). In fully adjusted models, personal or family incarceration exposure was associated with lower odds of reporting “excellent” or “very good” physical health (OR: 0.50-0.55; all P< 0.05); and “thriving” social wellbeing (OR: 0.44-0.60; all P< 0.008). There existed a dose response relationship between longer durations of family member incarceration and lower wellbeing. Exposure to incarceration is independently associated with self-reported physical health and social wellbeing among older adults. Policy makers should consider methods to mitigate the harms associated with incarceration.
ASSOCIATION OF LIVING ALONE AND SOCIAL ISOLATION WITH ALL-CAUSE AND CARDIOVASCULAR MORTALITY: THE OTASSHA STUDY
Authors: Imamura Keigo , Kawai Hisashi , Ejiri Manami , Sasai Hiroyuki , Hirano Hirohiko , Fujiwara Yoshinori , Ihara Kazushige , Obuchi Shuichi
Published: January 2025

Living alone is considered a risk factor for all-cause and cardiovascular mortality, but this association may be confounded by social isolation status. This study examined how living alone while also being socially isolated affects older adults’ risk of all-cause and cardiovascular mortality. A total of 4,075 community-dwelling older adults (mean age: 72 years, male: 46%) who had participated in the 2012 or 2013 mail survey of the health checkup of the Otassha Study were included; the study period was October 2012 to November 2020. Social isolation was assessed by frequency of interaction with others, and less than once a week was defined as social isolation. Participants were classified into four groups: no social isolation – not living alone, no social isolation – living alone, social isolation – not living alone, and social isolation – living alone. A Cox proportional hazards model was used to analyze the association of combined living alone and social isolation with all-cause and cardiovascular mortality. A total of 203 (5.0%) of the participants were found to be living alone while being socially isolated. Social isolation was significantly associated with all-cause and cardiovascular mortality, regardless of whether the participants lived alone or not (p< 0.05). On the other hand, there was no association with mortality among those who lived alone but were not socially isolated. These results indicate that living alone is not necessarily a risk factor for all-cause or cardiovascular mortality. In conclusion, engaging in regular social interactions could help older adults reduce mortality.
DAILY EMOTION EXPRESSION, MODES OF SOCIAL CONTACT, AND WELL-BEING IN LATE LIFE
Authors: Zhang Shiyang , Richards Nicole , Gao Sibo , Fingerman Karen
Published: January 2025

Older adults engage in in-person and remote forms of contact (phone, text). In-person contact may provide opportunities for sharing emotions and promoting well-being in ways that other modes of contact do not. This study examined expressing positive and negative emotions during different modes of social contact (in-person, phone), and the association between emotion expression and well-being throughout the day. Community-dwelling older adults aged 65 - 90 (N = 286, Mage = 73.95) from the Daily Experiences and Well-being Study completed ecological momentary assessments (EMA) during which they indicated their social contact as well as positive and negative mood every 3 hours for 5 to 6 days. Participants also wore Electronically Activated Recorders (EAR) to unobtrusively capture ambient sounds. Sound snippets that contained participants’ speaking (N = 30,311) were transcribed verbatim and processed using the Linguistic Inquiry and Word Count (LIWC) to obtain linguistic features pertaining to emotion expression. Multilevel models revealed that in-person and phone contact were both associated with an increased use of positive words (e.g., love, sweet), yet only in-person contact was associated with more words expressing negative feelings (e.g., worried, sad). Using both positive and negative words was associated with a better mood in the same 3 hours. No associations were found between either positive or negative words and negative mood. Findings suggest that older adults may benefit emotionally from expressing both positive and negative feelings during in-person contact. Interventions for older adults’ emotional well-being may focus on fostering emotionally meaningful social ties and providing in-person contact.
ECONOMIC INSECURITY DURING THE COVID-19 PANDEMIC AMONG HEALTH CARE WORKERS BY EDUCATIONAL ATTAINMENT
Authors: Mroz Tracy , Dunlap Ben , Frogner Bianca
Published: January 2025

The COVID-19 pandemic had unprecedented impacts on healthcare workers. Prior to the pandemic, healthcare workers in lower skilled jobs (e.g., nursing assistants, home care aides) versus higher skilled jobs (e.g., physicians, nurses) were more likely to experience economic insecurity. We examined economic insecurity among healthcare workers between July 2021 and August 2023 via secondary analysis of Household Pulse Survey data. We used multivariable logistic regression to investigate the relationship between economic insecurity and educational attainment as a proxy for higher versus lower skilled workers, controlling for other sociodemographic characteristics. Of the 108,206 respondents who reported working in healthcare, representing a weighted sample of 10,656,917 healthcare workers, 49.5% had less than an associate degree, 10.0% had an associate degree, 21.7% had a bachelor’s degree, and 18.9% had a master’s degree or greater. Among workers with less than an associate degree, associate degree, bachelor’s degree, and master’s degree or higher: an estimated 78.7%, 69.9%, 56.1%, and 40.0% reported difficulty with usual expenses; 53.6%, 42.7%, 27.6%, and 17.4% reported food insufficiency; and 11.1%, 8.1%, 4.6%, and 2.8% reported being behind on their rent or mortgage payments, respectively. Lower educational attainment was significantly associated with greater economic insecurity across all measures. This relationship was attenuated, but still significant, after controlling for other sociodemographic characteristics. Lower skilled workers are critical to the healthcare workforce, especially in long-term care. Policies to promote economic security among these workers are needed to ensure a robust workforce is available to care for older adults.
THE IMPACT OF THE TEACHING NURSING HOME ON THE NURSING HOME WORKFORCE
Authors: Degenholtz Howard , Campbell Kenna , Treat Anny
Published: January 2025

The Teaching Nursing Home (TNH) is designed to improve the long-term care workforce and improve quality of care in nursing homes. The initiative has multiple components: enhanced clinical rotations for nursing students with partner schools of nursing, implementation of the Institute for Healthcare Improvement Age-Friendly Health System “4M” quality improvement model, and an online learning network. CMS Payroll Based Journal (PBJ) data were analyzed using a propensity weighted difference in difference model to determine if there was an effect on attrition or staffing levels. Staff satisfaction and burnout surveys were conducted at participating nursing homes in the winter of 2022 using a combination of web-based and in-person paper administration. Follow-up surveys were collected in 2023. Response rates ranged from 14% to 54%. A total of 190 surveys were available at baseline, and 183 at follow-up. All surveys were anonymous; cross-sectional analyses were conducted to identify trends. The findings for burnout were mixed. Emotional exhaustion decreased, but depersonalization increased and personal accomplishment was unchanged. Overall job satisfaction was unchanged but the management and leadership component of fob satisfaction declined. Attrition among registered nurses, licensed practical nurses and certified nurse assistants was lower than among matched facilities in the same market areas. After the first year of implementation, the TNH program is showing mixed benefits in terms of burnout and job satisfaction, but some benefit in terms of reducing turnover. As the Age-Friendly Nursing Home program is disseminated across the US, it is important to track the impact on the workforce.
DOES CAREGIVING HASTEN AGING? EXPLORING THE LINK BETWEEN TRIPLE-DUTY CAREGIVERS’ TRANSITIONS AND SUBJECTIVE AGE
Authors: Sun Xin , Hu Zhan
Published: January 2025

Perceptions of aging serve as crucial indicators for evaluating positive aging. This study examines the relationship between various caregiving transition types and subjective aging over time. Utilizing data from the 2018 and 2020 waves of the China Longitudinal Aging Study, we examine six transition types, incorporating both intra- and extra-familial caregiving behaviors, by constructing three subjective aging change patterns: “Consistent over time”, “Accelerated growth”, and “Relative decline”. The findings reveal that sustained caregiving is associated with a relative decline in subjective age, with a more pronounced effect observed in the reduction of ongoing extramural caregiving. Caregiver role transitions, such as exiting caregiving and transitioning between intra- and extra-familial caregiving, lead to an accelerated increase in subjective age, while entering caregiving aligns subjective age with the passage of time. In the context of caregiving role transitions, a positive self-perception of aging enhances the subjective age of female caregivers, whereas a positive general aging attitude reduces the subjective age of male caregivers. The study underscores the significance of caregiving experiences as crucial predictive factors for subjective aging. Establishing comprehensive family support policies throughout the caregiving lifecycle, promoting voluntary caregiving participation, can contribute to enhancing adaptive aging
PREVALENCE OF AMBIVALENT AGEISM AMONG AGING SERVICES PROVIDERS AND ASSOCIATION WITH STRESS
Authors: Kinkade Emily , Fuller Heather
Published: January 2025

Ageism is an ambivalent construct consisting of positive and negative attitudes towards older adults. It is well documented that ageism is harmful to the physical and mental well-being of both the holder and target of ageist beliefs and behaviors. However, most ageism research focuses on hostile ageism within specific contexts (e.g., the workplace and medical settings). Little to no research investigates the prevalence and implications of ambivalent ageism among other populations that provide important resources to older adults. This study investigates how common ambivalent ageism is among aging service providers, and whether ambivalent ageist beliefs are associated with their feelings of stress and burnout. A small sample of Midwestern aging service providers (n=40) was recruited. Ambivalent ageism was measured using the Ambivalent Ageism Scale, while service provider stress and burnout were measured with the Perceived Occupational Stress Scale and the Copenhagen Burnout Inventory, respectively. A paired-samples t-test found that benevolent ageism was significantly higher than hostile ageism among aging service providers. Multiple regression analyses indicated that among aging services providers, benevolent and hostile ageism were associated only with personal burnout, and not with perceived stress, perceived occupational stress, nor work-related burnout. Such findings suggest that benevolent ageism may be more common among service providers because it is less likely to be viewed as problematic, and thus is more normalized and unquestioned. Further, ambivalent ageist beliefs may be associated with personal burnout due to exacerbating stress-related conditions such as compassion fatigue.
THE ROLE OF SOCIAL NETWORKS ON THE RELATION BETWEEN AGE DISCRIMINATION EXPERIENCE AND DEPRESSION: A BUFFER OR A STRESS?
Authors: Park Junmin , Lee Yeonjung
Published: January 2025

A Confucian culture in Korea, which holds the older people in high esteem has been eroded due to the disruption of the traditional family structure since industrialization and modernization, resulting in the diminished respect for older adults. However, given these cultural background, experiences of age discrimination might be devastating especially for older adults. While social capital theory suggests that individuals obtain material, cultural, and human capital through their social networks, it is unclear whether social networks play a role as a buffer or a stress for the association between age discrimination experience and depression. Therefore, the objective of this study is to examine the moderating role of social networks (formal & informal) in the relationship between age discrimination experience and depression. Specifically, formal social networks are the frequency of participation in civic society, and informal social networks are the frequency of contact and interaction with family and non-family members. Andrew Hayes’ PROCESS macro analytical approach was applied using a selected sample who are aged 65 and older from the 2020 National Survey of Older Koreans (n=10,097). The results show that older adults who experienced age discrimination are likely to have more depressive symptoms. While formal social networks had no significant moderating effect, informal social networks had a significant moderating effect. Specifically, the association between age discrimination experience and depression is stronger at a high frequency of informal social network. Findings have implication that social networks might worsen the consequences of age discrimination for depression among Korean older adults.
UNDERMINING OLDER ADULTS’ AUTONOMY IN THE NAME OF HELP: NEGATIVE AGING ATTITUDES AND PHYSICAL HEALTH OUTCOMES
Authors: Chen Zizhuo , Zhang Xin
Published: January 2025

Older adults often face challenges in maintaining autonomy, such as having others make decisions for them and receiving paternalistic help. This research aimed to investigate whether such phenomena, although usually presented in the guise of benevolent help, reflect negative aging attitudes and threaten older adults’ physical health. Study 1 surveyed 89 younger adults on their preference for providing paternalistic (e.g., Developing strict meal plans) versus agentic help (e.g., Offering dietary recommendations with explanations) for different age groups. Results indicated that participants believed older adults (compared with younger adults) were more acceptable to paternalistic help and deemed it more effective than agentic help. Such inclination was positively associated with participants’ demeaning attitudes (i.e., disregarding ones’ advanced psychological needs) towards older adults and fixed essentialist beliefs about aging. Study 2 analyzed a 4-wave, 10-year, nationally representative dataset with 4288 cases to explore the impact of compromised autonomy (having others make decisions for them) on older adults’ physical health. Although cross-lagged model revealed a mutual positive prediction between older adults’ autonomy and their health status, further analysis using instrumental variables confirmed the causal relationship of autonomy on health, rather than the reverse. Moreover, older adults who were less able to make decision for themselves exhibited lower survival probabilities, even after controlling for other variables, including age, health status, ADL, etc. These findings underscored negative attitudes underlying some benevolent helping behaviors that undermined older adults’ autonomy and their detrimental physical outcomes, and shed light on the significance of protecting and promoting older adults’ autonomy.
ACCEPTABILITY AND FEASIBILITY OF WEARABLE SENSORS IN AN AGING INDIVIDUAL LIVING COMMUNITY
Authors: Koszalinski Rebecca , Tappen Ruth , Ghoraani Behnaz , Vieira Edgar , Furht Borko , Newman David , Jan Muhammad Tanveer
Published: January 2025

The use of health technology to detect and measure outcomes in aging individuals offers safe, efficient, and cost-effective detection of changes. There are numerous barriers to acceptability and engagement of technology including participant lack of knowledge, insufficient support, and challenging functionality. It is unclear if barriers of the use of smartwatches stem from participants’ unfamiliarity, inability to use technology, disinterest, or if bias contributes to inadequate engagement and testing with older adults. This team of researchers designed a pilot study to investigate the acceptability of smartwatches among aging individuals residing in adult living community in the Southeastern United States. Out of 27 participants who consented to the study, 7 (25.9%) were requested repeats and all (100%) wore the smartwatches for a period of 1 to 5 days. Engagement was high throughout the data collection period (May – December, 2023), with participants expressing interest in the smartwatches’ data output. Verbatim comments were predominantly positive (“like the look”; “like the technology”; “comfortable”). However, concerns were raised about smartwatch’s size (n = 2), weight (n = 1), and the necessity of maintaining the correct time on the device to facilitate independent time management (n = 5). This study contributes to the literature by highlighting the successful engagement and deliberate inclusion of aging individuals in health technology research, and the acceptability of technology (smartwatches) in this population. It suggests the importance of consulting aging individuals in the planning stages of deploying specific sensor technologies.
AS YOUNG AS YOU FEEL? TRACKING SUBJECTIVE AGE AND PHYSICAL WELL-BEING BEFORE A LUNG CANCER SCAN
Authors: Dunsmore Victoria , Neupert Shevaun
Published: January 2025

Research has not yet considered how cancer-related events trigger poor quality of life. Here, researchers examined whether the discrepancy between felt and chronological age was related to physical well-being, and if these fluctuated as patients with lung cancer approached a triggering event – repeated CT scans. 25 patients treated with curative intent treatment for lung cancer were recruited within 6 months of their upcoming CT scan. Patients were predominantly white (80%; Black: 12%), women (96%), between 43 and 78 years old (M = 62.33, SD = 8.10). Baseline surveys collected age, and repeated monthly surveys gathered physical well-being and felt age every 30 days until one’s scan. Following a monthly response rate of 100% (59 of 59 received), researchers calculated proportional discrepancy felt age scores by subtracting chronological age from felt age and dividing by chronological age. Using this score, researchers investigated the monthly relationship between age discrepancy and physical well-being. Results showed that on months when patients felt closer to, or older than, their chronological age they reported increases in physical well-being (γ10 = 1.75, t = 2.13, p =.04). The present model accounted for 33% of the within-person, and 39% of the between-person variance of physical well-being. In contrast to studies in non-clinical populations, results showed that feeling older was associated with better physical well-being in the months prior to a CT scan. Qualitative interviews could identify themes in coping with repeated scans that may mitigate the effects cancer treatment can have on physical well-being.
HOW DO OLDER ADULTS PRIORITIZE DIFFERENT ASPECTS OF THEIR PHYSICAL HEALTH?
Authors: Cook Rachel Logue , Brown Susan
Published: January 2025

Older adults often manage multiple health concerns and must decide which aspects of health to prioritize. While gerontologists and geriatricians are typically concerned about the development of cancer, cognitive and mobility impairments, and mental health disorders (Kotsani et al., 2021), little is known about which aspects of health are important to older adults. We developed an online survey that asked respondents to rank 10 health areas (arm and shoulder function, balance, bladder and bowel function, hand function, memory and cognition, mental health and mood, sleep, speech and communication, vision, walking) from most (#1) to least (#10) important in their daily life. Participants were also asked to explain why these rankings were selected in open-ended questions. Five hundred and ninety-five older adults (mean age 71.5 ± 5.5y) completed the survey. Health areas most often ranked as #1 were memory and cognition (36%), vision (19%), and mental health and mood (18%). Areas ranked as #10 were most commonly bladder and bowel function (22%), arm and shoulder function (21%), and sleep (21%). Open-ended responses indicated that health areas were given higher priority if respondents felt they impacted their ability to maintain independence, participate in valued activities, or they had experienced an impairment. Results from this study indicate that many older adults consider memory, vision, and mental health as important components of healthy aging. Further, these findings underscore the importance of understanding how and why older adults prioritize their health in order for healthcare providers to better serve the aging population.
THE MEDIATING ROLE OF PERCEIVED MASTERY ON THE RELATIONSHIP BETWEEN SELF-PERCEPTIONS OF AGING AND COGNITION
Authors: Apostolou Hannah , Buxton Michael , Luskey Valerie , Jacobs M Lindsey
Published: January 2025

Internalized ageism can be understood as a negative perception of one’s own aging experience. Negative perceptions of aging may lead to disengagement in daily tasks and exacerbate decreases in cognition. Positive self-perceptions of aging, however, may serve as a protective mechanism for cognition. Additionally, the relationship between self-perceptions of aging and cognition may be impacted by one’s sense of control in areas such as perceived mastery. Researchers used data from the 2020 Health and Retirement Study to examine the relationship between self-perceptions of aging on total cognition and the mediating influence of perceived mastery in a sample of older Americans (n=4369). Specific measures from the Psychosocial and Lifestyle Questionnaire and cognitive battery were selected to conduct the analyses in PROCESS for SPSS Version 4.2. The results showed that there was a significant total effect between self-perceptions of aging and total cognition (B=0.018, p< 0.001), and path a (i.e., self-perceptions of aging on perceived mastery) (B=0.004, p< 0.001) and path b (i.e., perceived mastery on total cognition) (B=0.795, p>0.001) were both significant. The direct effect (B=0.014, p< 0.001) was significant when adding perceived mastery to the relationship between self-perceptions of aging and total cognition. This suggests that more positively rated self-perceptions of aging are associated with higher total cognition scores independently, and this relationship may also operate via perceived mastery. Interventions aimed at increasing positive attitudes towards one’s own aging experience could lead to increased cognitive functioning. Further, skills training aimed at increasing one’s sense of control may further benefit cognitive outcomes.
THE RELATIONSHIP BETWEEN CAREGIVING TRANSITION AND SUBJECTIVE AGE: THE ROLE OF SENSE OF CONTROL
Authors: Choi Hyojin , Litzelman Kristin
Published: January 2025

Subjective age (SA) – how old one feels in relation to their chronological age – varies considerably in challenging situations. The strain and demands of family caregiving might therefore influence patterns of SA. Furthermore, psychological resources that enable family caregivers to deal with stressors, such as sense of control, may buffer these adverse effects. The purpose of this study was to examine the relationship between transitions in caregiving status and SA, and the moderation role of sense of control (perceived constraint and mastery) in this relationship. Using longitudinal data from the Health and Retirement Study (2006–2020), multilevel analyses were conducted to assess both within- and between-person relationships among caregiving transition, sense of control and subjective age. The sample consisted of married/partnered respondents (n=14,944 observations), and we categorized them into five caregiving transition groups: new caregivers, previous caregivers, long-term caregivers, potential caregivers, and non-caregivers based on caregiving status for their spouse/partner with limitations on daily living activities in consecutive waves. The findings show that caregiving transition interacted with perceived constraints and mastery to correlate with SA. Namely, among new caregivers, higher average levels of perceived constraints were associated with older SA (Beta=1.36, p=0.017). Among previous caregivers, higher within-person levels of perceived mastery were associated with younger SA (Beta=-2.66, p=0.001). These findings highlight the importance of developing and implementing interventions tailored to support spouses across the caregiving trajectory in having healthy levels of psychological resources, such as skills training programs and psychoeducation.