bluuebunny/crossref_metadata_2025 huggingface dataset:
Caregiving, Loneliness, and Stress: The Role of COVID-19
Authors: Syed Sumaiyah , Yang Iris , Wilson Stephanie
Published: December 2021

According to many prior studies, informal caregivers are at risk for heightened loneliness and distress. Moreover, the COVID-19 pandemic has introduced new challenges that may be accentuated among caregivers. This study examined caregiving frequency and its relation to loneliness, perceived stress, and negative affect during the COVID-19 pandemic. We then investigated the moderating roles of COVID-19 concerns and impacts, anticipating magnified effects among caregivers. Participants included respondents from the Health and Retirement Study (HRS) COVID-19 project sample (n=2108, mean age=69) who reported their caregiving frequency, general concern about COVID-19, related concerns about family members’ health, and social disruptions caused by the pandemic. Controlling for age, gender, and health status, daily caregivers reported significantly greater distress during COVID-19 compared to non-caregivers (p=.036). Higher levels of concern about family members’ health during COVID-19 was significantly associated with greater loneliness among daily caregivers (p = .009), but not among non-caregivers, such that daily caregivers with greater concerns had the highest levels of loneliness. On the other hand, unexpectedly, daily caregivers who experienced fewer social disruptions due to the pandemic reported higher levels of loneliness (p = .002); however, the association was null for non-caregivers. Findings suggest that daily caregivers may be particularly vulnerable to greater loneliness and stress during the COVID-19 pandemic. These experiences may exacerbate existing mental health disparities for those providing daily care.
Coping with the Subjective Impact of COVID-19 among Older Adults in Puerto Rico
Authors: Camacho David , Marti Yamile , Cho Sunghwan , Buckley Thomas , Vazquez Julia , Burnette Denise , Fabelo Humberto
Published: December 2021

The COVID-19 pandemic poses serious physical and mental health risks for older adults worldwide. To develop culturally and contextually congruent services to mitigate these risks requires understanding their stress and coping processes, which remain understudied in Latin America. This study examines qualitative data from 51 adults aged 60 and over who participated in an ongoing study of older Puerto Ricans’ knowledge, attitudes, and practices about COVID-19. Trained interviewers collected the data by telephone from January to August, 2021. Two-thirds of participants were female, 60% had less than high school education and 90% had poverty-level incomes. Drawing on Lazarus and Folkman’s Stress and Coping Theory, we conducted a thematic analysis of responses to open-ended questions about the nature and extent of COVID-related stressors, stress management, and meanings and guidance they had gleaned from their experience. Participants perceived the pandemic as an added threat to ongoing chronic stressors (e.g., Hurricane Maria, poverty, political instability); disruptions in daily routines, family cohesion, and grief and loss processes; and increased isolation and loneliness. They reported using cognitive, behavioral, socioemotional and spiritual coping, including positive thinking, keeping occupied, relaxation, religious practices and, in a few cases, social media. Participants highlighted a revitalized appreciation for emotional qualities of relationships, freedom and life in general. Consistent with our guiding theory, cultural, contextual, religious, and socio-political factors shaped their appraisals of stress and their coping strategies. Future research should examine how these practices relate to health outcomes and quality of life and how they can inform effective, appropriate interventions.
Cross-Validation of the Financial Exploitation Vulnerability Scale
Authors: Moray Juno , Lichtenberg Peter
Published: December 2021

Most of the available clinical tools that detect the experience of financial exploitation (FE) are not practical for use by the many professionals who work with older adults. The available measures are often time-consuming, require specialized training to administer, or focus exclusively on the cognitive aspects of financial decision-making. The need for a brief, standardized measure of contextual risk prompted the development of the Financial Exploitation Vulnerability Scale (FEVS; Lichtenberg et al., 2020). The purpose of this study was to cross-validate the FEVS as a psychometrically sound measure of contextual risk for FE. Participants were recruited from the community (n=95), and through a financial coaching service for older adults who had experienced a financial scam (n=21). A total of 114 older adults were recruited for the study, 33 who had experienced FE and 81 who had not. An independent samples t-test demonstrated that the FEVS total score successfully differentiated older adults based on the experience of financial exploitation. The FEVS total score was correlated with age, but no other demographic factors or collected neurocognitive measures. A ROC curve detecting FE analysis revealed an area under the curve of 0.68. Internal consistency of the FEVS was a=0.80. In a logistic regression model, only the FEVS and word-reading ability were related to FE. The results of this cross-validation study are very similar to the initial study, demonstrating that the FEVS is an accessible, theory-based tool that detects the experience of FE.
Falls among older adults in the Philippines and Vietnam: Results from nationally representative samples
Authors: Chen Tuo Yu , Cruz Grace , Vu Cong Nguyen , Saito Yasuhiko
Published: December 2021

Falls are a major public health issues globally. However, no study with nationally representative samples, previously, had been done to understand falls among older adults in the Philippines and Vietnam. Using a biopsychosocial perspective, this study investigated the prevalence of falls and their associated factors among community-dwelling older adults in these countries. Cross-sectional data were drawn from the Longitudinal Study of Ageing and Health in the Philippines (N = 4,606) and the Longitudinal Study of Ageing and Health in Vietnam (N = 4,378). The outcome variables were any falls in the past year. Independent variables included biophysical factors (vision/chronic conditions/functional impairments/pain locations/insomnia symptoms/sleep medications/grip strength/walking speed/postural control), psychological factors (depressive symptoms), and sociodemographic factors (age/sex/education/living in urban area/living alone/social network size). Descriptive analysis and logistic regression analysis were used to analyze data. The results showed that 17.7% of the Filipino older adults fell in the past year and it was 7.3% among Vietnamese older adults. Significant factors that increased the odds of any falls among Filipino older adults were having a higher level of education, living in urban area, living with others, experiencing more functional impairments, reporting one or more pain locations, and having poor grip strength. In Vietnam, having more chronic conditions, experiencing more functional impairments, and reporting two or more pain locations were found to increase the odds of any falls. Population in the Philippines and Vietnam are aging rapidly. Findings from this study are timely in identifying at-risk individuals and preparing for effective falls prevention strategies.
Thriving-in-Place: Examining the impact of intergenerational living in the Toronto HomeShare Program
Authors: Mirza Raza , Macri Melissa , Kelly-Adams Deirdre , Moore Carley , Austen Andrea , Tanner Jacalyn , Hsieh Jessica , Klinger Christopher
Published: December 2021

Most global cities, like Toronto, have rapidly aging populations who want to remain in homes and communities of their choice. Concurrently, seniors face vulnerabilities associated with low income, ageism, social isolation and loneliness. These vulnerabilities inhibit many seniors’ desires to age-in-place. The Toronto HomeShare Program, an intergenerational homesharing program facilitates aging-in-place by matching seniors with post-secondary students. The program, with an implementation focus and a research study, was developed to address and understand the needs of seniors seeking assistance, light supports and companionship at home, in exchange for reduced-rent housing for students. A mixed methods research design was employed. Seniors and students (n=22) completed a 167 question survey (n=22) and in-depth interviews (n=18). Quantitative data yielded descriptive statistics and qualitative data was subject to thematic content analysis. Participants agreed that homesharing programs could address risk for social isolation (95%), the need to move from their community (96%), and reduce risks of economic and social exclusion for young and old (97%). From the qualitative data, six benefits were apparent for all participants: (1) reduced social isolation and loneliness, (2) increased intergenerational exchange, (3) increase financial security, (4) household assistance, (5) increased general wellbeing; (6) enhanced companionship/safety. In 2020, Toronto HomeShare (now Canada HomeShare) was recognized by the World Health Organization as an age-friendly best practice, and has been scaled nationally in 16 cities. Intergenerational homesharing programs could be a catalyst for policy and cultural reform and to support older adults to not only remain in their communities, but to thrive-in-place.
Marketing and Psychology: An Interdisciplinary Partnership
Authors: Heinz Melinda , Elsinger Summer Zwanziger
Published: December 2021

Students enrolled in Psychology of Aging and Consumer Behavior combined efforts during an 8-week course to create marketing plans focused on proposing a product or service targeting older adults. The goal of the project was to 1) infuse aging content into the curriculum 2) increase awareness of older adult consumers and 3) decrease aging stereotypes. Student teams were engaged in this project one day each week over 8 weeks. Instructors created weekly tasks to break down components of the project and each student group was required to turn in evidence of their completed task. During the 2020-2021 academic year, participants used Microsoft Teams and recorded their tasks for instructors to grade. A rubric was used to facilitate grading of weekly team tasks and similar weights/points were used in both classes to create similar levels of student “buy in.” Suggested implementation tips for both face-to-face and online modalities will be discussed.
Subjective and Perseverative Cognition Mediate the Relationship Between Sleep and Work Impairment
Authors: Mu Christina , Small Brent , Lee Soomi
Published: December 2021

The study examined the mediating role of subjective and perseverative cognition on sleep and work impairment. Sixty nurses completed a background survey and 14-days of ecological momentary assessments (EMA) and sleep actigraphy. Each day, participants evaluated their subjective cognition (mental sharpness, memory, processing speed), perseverative cognition (rumination) and work impairment (how much did you cut back on normal paid work, how much did the quality of your work suffer). Multiple sleep characteristics were measured by EMA and actigraphy. Multilevel mediation models adjusted for sociodemographics and work shift. At the between-person and within-person levels, there were mediated associations of sleep quality and sufficiency (but not actigraphy-measured sleep) with work impairment through subjective and perseverative cognition. Better sleep quality or higher sleep sufficiency were associated with better subjective and perseverative cognition, which, in turn, were associated with less work impairment.
Opportunities to Impact Disability: Trends, Costs, and Evidence-Based Interventions
Authors: Szanton Sarah , Grabowski David
Published: December 2021

As healthcare shifts to a focus on social determinants and population health, and older adults increasingly seek to “age in community,” it is vital to understand the functional capabilities and related costs for older adults with disability. This symposium will present data on five major areas related to older adult disability. The 1st presenter will describe recent national disability trends. The 2nd will present Medicare costs by disability, dementia, and community-dwelling status in order to illustrate how these different demographic groups vary in Medicare expenditures over time. This information is critical to policymakers and health systems leaders to plan for these populations. They will then describe a 3rd project, which employs a novel longitudinal modeling approach, Group Based Trajectory Modeling, to identify and describe the distinct trajectories of Emergency Department use after incident disability. This work assesses the heterogeneity in health care use after disability, which may be shaped by available supports. The 4th presentation will describe a combined analysis of the 11 sites that have published data from implementations of the CAPABLE program. This program is a 10 session, home-based interprofessional program that provides an occupational therapist, a nurse, and a handyworker to addresses older adults’ self-identified functional goals by enhancing individual capacity and the home environment. Taken together, these presentations can inform interventions and policies that improve the health and quality of life of older adults with disabilities.
Trajectories of Emergency Department Use After Incident Functional Disability
Authors: Ornstein Katherine , Ankuda Claire
Published: December 2021

Emergency department (ED) visits for older adults with functional disability may represent unmet needs and are often burdensome to patients and families. While it is known that older adults with functional disability use the ED at high rates, this does not capture the heterogeneity of experience after the onset of disability. Using NHATS, we identified a cohort of older adults with incident disability, or who reported they began to receive help with self-care and/or mobility in the prior year. Using the month that they report first receiving help, we linked to Medicare data to assess quarterly patterns of ED use. We used Group Based Trajectory Modeling to assess the trajectories of ED use after disability. We identified three distinct trajectories of ED use: persistently high, declining, and persistently low. We describe the clinical, household, and sociodemographic characteristics associated with likely membership in each trajectory group.
Qualitative Evaluation: GRECC Connect as a Method of Delivering Health Care to Rural Older Veterans
Authors: Moo Lauren , Hung William , Dryden Eileen , Pimentel Camilla , Kernan Laura , Nearing Kathryn
Published: December 2021

The VA Office of Rural Health-funded GRECC Connect program uses telehealth modalities to provide geriatric specialty care to rural older veterans and education to clinicians in VA Community-based outpatient clinics (CBOCs). Qualitative evaluation of GRECC Connect has included interviews with three stakeholder groups: geriatrics specialty teams at 15 hub medical centers, rural CBOC staff, and patients/family caregivers. CBOC staff interviews included 50 individuals from 13 different CBOCs. Staff roles included clinic managers, social workers, psychologists, physicians, nurses, and telehealth technicians. Older veterans who had recently been involved in a GRECC Connect video visit were also invited to share their views on the visit. By including multiple perspectives on the program, we are better positioned to increase reach, access, and improve care for older rural veterans.
A Strategy Matching Tool for Boosting Implementation of Geriatric Telehealth Services in Rural CBOCs
Authors: Kernan Laura , Dryden Eileen , Pimentel Camilla , Nearing Kathryn , Moo Lauren
Published: December 2021

Fifteen Veterans Administration Medical Centers (VAMCs) offer geriatric specialty care telehealth services through a hub and spoke model to patients at affiliated community-based outpatient clinics (CBOCs). These services are not used to the extent they could be. Through interviews with 50 staff and providers at rural CBOCs we identified several implementation facilitators and barriers. CBOC-level barriers included space constraints, low staffing, internet connection issues, and limited knowledge of services available and referral processes. Patient-level barriers included discomfort with technology, cognitive decline, and inability to travel to the CBOC. We found that champions within the CBOC and iterative, targeted outreach from the hub helped facilitate uptake of services. We entered the identified barriers into the CFIR-ERIC (Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change) Implementation Strategy Matching Tool to help generate targeted strategies that will be used to refine each hub’s implementation approach.
Sleep Quality and Cognitive Decline: A Cross-Country Comparison Between England and China
Authors: Brocklebank Laura , Cadar Dorina , Yan Li , Zhao Yaohui , Steptoe Andrew
Published: December 2021

Too little or too much sleep is associated with accelerated cognitive decline in older adults. However, sleep duration does not capture other sleep problems prevalent in older adults, such as difficulties with falling or staying asleep. Less is known about the impact of sleep quality on cognitive ageing, and if this relationship differs between England and China. Therefore, the aim of this study is to examine the relationship of self-reported sleep quality with cognitive performance and rate of change over 6-7 years follow-up in two nationally-representative samples of English and Chinese older adults. The primary outcome was a memory score (range 0-20), which was assessed using immediate and delayed 10-word recall tests in both cohorts. The results of bivariate descriptive analyses at baseline suggest there may be an inverted U-shaped association between sleep quality and memory in English older adults, and a positive dose-response association in Chinese older adults.
Challenges for Children 65+ Caring for Parents 90+ With Dementia During COVID-19
Authors: Gallagher Elizabeth , Boerner Kathrin , Kim Yijung , Kim Kyungmin , Jopp Daniela
Published: December 2021

With the rise of the novel coronavirus, family caregivers of persons with dementia have been tasked with adapting to an entirely new caregiving landscape. Adult children caring for parents in the ‘oldest old’ age group bear an additional burden. Namely, children that are older adults themselves are navigating the joint vulnerability of both their own and their parents’ aging-related issues (e.g., health problems). The aim of this study was to explore the experiences of dementia caregivers during COVID-19 from the unique perspective of children aged 65 and older caring for parents aged 90 and older. Participants were 30 caregivers from the Boston Aging Together Study with whom we conducted in-depth interviews between March 2020 and February 2021. Thematic analysis revealed key challenges related to COVID-19. Children were worried about the prospect of their parent contracting the virus and took steps to minimize their parent’s exposure, such as discontinuing use of formal supports (e.g., home health aides) or assistance from other family and friends. Forgoing these supports often created greater responsibilities for caregivers as well as contributed to greater social isolation for both child and parent. In situations where parents resided in institutional settings, children were often unable to provide necessary help and support to parents due to restrictions. Caregivers also faced difficulties due to their parent not understanding or practicing COVID-19 regulations and in utilizing alternative means of communication with their parent (e.g., video conferencing). Supports and services should be designed in light of the unique challenges of this group.
Understanding and Explaining How Staff Promote Quality for Older People Living in Long-Term Care Facilities
Authors: Spilsbury Karen , Meyer Julienne , Haunch Kirsty , Thompson Carl
Published: December 2021

Little is known about how the workforce influences quality in long term care facilities for older people. Conceptually, quality is complex, often contested, and dynamic, has overlapping physical, social, psychological and emotional dimensions and can refer to both quality of life and quality of care. Assuming ‘more staff equates to better quality’ is intuitively appealing but research suggests that a more nuanced, non-linear, relationship exists. A programme of research in the UK is developing theoretical and empirical explanations of how staff promote quality for older people living in long-term care facilities. It shifts the debate from numbers of staff and their relationship to quality indicators toward recognising the ways in which staff more broadly influence quality. Our work will be useful for people and organisations making policy and delivering services on the best ways to deploy and support quality in long term care through the most valuable resource: its staff.
Structure, Process and Outcomes in Patient Engagement
Authors: Geary Carol , Eilers June , Jernigan Cheryl , Kimminau Kim
Published: December 2021

Although patient engagement in research is gaining acceptance by researchers and funding bodies, descriptions of implementation options and associated outcomes are limited. In this appreciative inquiry of the 12 institutions involved in the Great Plains Collaborative of the Patient-Centered Outcomes Research Network (PCORnet), we interviewed patient engagement officers and patient partners to enhance understanding of approaches to organizational structure, research engagement processes, and associated outcomes of the engaged research. Multiple structures have been identified including operational affiliations in both hospital and multiple university departments. Professional affiliations of patient engagement officers vary widely, including nurses, social workers, and public health professionals, among others. Patient engagement processes also vary, but with the majority using forms of advisory boards. All sites reported outcomes of their work including completed and/or ongoing research and co-authored publications.
Motivation for people living with dementia to engage in research advisory boards
Authors: Roes Martina , Gove Dianne , Diaz Ana
Published: December 2021

The importance of Public Involvement (PI) is increasingly being recognized in the field of dementia research. In 2012, Alzheimer Europe set up the European Working Group of People with Dementia (EWGPWD) which provides advice and input for all activities of the organization including several large European-funded research projects. The German Center for Neurodegenerative Diseases (DZNE) created a research advisory patient board in 2020 with the intention of supporting the board in strategic research decisions. Both groups are composed of people with dementia and act independently. With the aim of finding out whether PI in research is mutually rewarding and beneficial, members of both groups were asked about their motivation to be involved in PI research activities and the value this had for them. This was collected either through narrative interviews or during meetings. People with dementia described several reasons for being involved in PI activities in dementia research.
Emergency Department Utilization Patterns Among Physical Elder Abuse Victims in Comparison to Other Older Adults
Authors: Rosen Tony , Wen Katherine , Clark Sunday , Elman Alyssa , Jeng Philip , Zhang Yiye , Pillemer Karl , Bao Yuhua
Published: December 2021

Background: Physical elder abuse is common and has serious health consequences. Little is known, however, about the patterns of health care utilization among these victims, including whether opportunities may exist for earlier identification and intervention. Our goal was to describe Emergency Department (ED) utilization known physical elder abuse victims compared with non-victims. Methods: We used Medicare insurance claims to examine ED utilization patterns among a well-characterized cohort of 139 known physical elder abuse victims in the year before abuse was identified and compared this to control subjects matched on age, sex, race, and residential zip code. Results: Physical elder abuse victims were significantly more likely than control subjects to visit the ED (47.5% vs. 35.9%, p=0.01) during the year before identification and to have at least one visit for an injury-related complaint (14.4% vs. 8.3%, p=0.03). Victims were also more likely to have multiple visits (18.7% vs. 14.6%, p=0.24), visit multiple EDs (7.9% vs. 6.7%, p=0.63), or be high frequency utilizers (≥4 visits, 3.6% vs. 2.7%, p=0.58), but differences did not reach statistical significance. The most common diagnoses in ED visits among victims were: open wound of knee/ankle, exacerbation of chronic bronchitis, pneumonia, and chest pain. Conclusion: This work provides preliminary evidence that physical elder abuse victims use the ED more frequently and potentially have different patterns of utilization than other older adults. We plan to further characterize these different patterns to potentially to use them to develop tools for earlier identification.
Home-Visit Intervention to Reduce Stress of Underserved Family Caregivers for Persons With Dementia
Authors: Lee Jung-Ah , Aqajari Seyed Amir Hossein , Ju Eunae , Kehoe Priscilla , Gibbs Lisa , Rahmani Amir
Published: December 2021

Immigrant family caregivers for persons living with dementia (PWD) have constant stress due to the 24/7 responsibility. These family caregivers of PWD often have high morbidity and mortality. We provided a cultural and language specific home-visit intervention for these vulnerable family caregivers. There is a lack of an objective measure of stress for caregivers. We assessed caregivers’ stress by measuring heart rate variability (HRV), a physiological measure of stress, using a smartwatch for a one-month intervention. Weekly home visits for a month were provided to dementia family caregivers by trained community health workers with stress reduction techniques: mindful breathing and compassionate listening. Linear mixed-effect models were used to analyze the trends for the daily stress levels as measured by HRV from the smartwatch. We had 22 participants who completed the 4-week intervention (8 Latinos, 8 Koreans, 6 Vietnamese). The models showed a significant decrease in the stress level of all participants for 3 weeks (all Ps<0.01). At 28 days (4 weeks) all three groups showed a decrease in stress: Korean group (Beta= -0.405, P<0.001), Vietnamese group (Beta = -0.150, P=0.028), Latino group (Beta= -0.154, P=0.073) and all caregivers (Beta = -0.235, P< 0.001). The findings demonstrated a reduction of immigrant family caregiver stress with a home-visit weekly intervention for one month using mindful breathing and compassionate listening by culturally/linguistically appropriate community health workers. Large-scale studies to determine long-term outcomes of family dementia caregivers are necessary and should be carried out.
Recruitment and Measurement Challenges and Future Solutions
Authors: Van Haitsma Kimberly
Published: December 2021

Recruitment of residents in the EIT-4-BPSD study required that residents have evidence of at least one behavioral symptom noted by staff in the past month. Even with this inclusion criteria 25% of the sample had no behavioral symptoms at baseline based on the Cornell Scale for Depression in Dementia, the Cohen-Mansfield Agitation Inventory, the Resistance to Care Scale, Pain in Advanced Dementia Scale, and Quality of Life in Late-stage Dementia Scale. Further, settings had good quality of care. Challenges to recruitment included the lack of willingness of residents with significant behavioral symptoms to assent to participate and legally authorized representatives to consent. Challenges to measurement included recall by staff and assumptions that behavioral symptoms were normal, short observation periods, and resident inability to provide input. Future solutions include some revisions in measures that will be described, longer assessment periods, and elimination of requirements that make recruitment of this population difficult.
Patient, Caregiver, and Physician Barriers to Home-Based Palliative Care: Findings From a Terminated Study
Authors: Enguidanos Susan , Wladkowski Stephanie
Published: December 2021

Despite two decades of palliative care services, there remains numerous barriers to patient and caregiver use of palliative care. For many years, policymakers believed lack of funding for palliative care was the primary obstacle to accessing palliative care services. In 2017, we undertook a randomized controlled trial to test the effectiveness of a home-based palliative care (HBPC) program within accountable care organizations and in partnership with an insurance company that covered the cost of HBPC. After 20 months, we had recruited just 28 patients. This symposium will: (1) describe outcomes from various approaches undertaken to engage primary care physicians and recruit patients and their caregivers into this trial; (2) present barriers to HBPC referral identified from a qualitative study of primary care physicians; (3) present findings from a qualitative study of patient- and caregiver-identified barriers to HBPC; (4) describe physician and patient barriers to research participation; and (5) discuss implications of these findings for researchers and healthcare providers. Information presented in this symposium will inform researchers and policy makers about challenges and facilitators to recruiting patients, caregivers, and physicians to participate in research studies as well as inform healthcare practitioners of potential obstacles to increasing patient access to HBPC.
COVID Vaccine Rollout for Older People: East Meets West
Authors: Yao Nengliang , Cornwell Tom , Camillo Cheryl
Published: December 2021

Older adults should be one of the first groups to receive COVID-19 vaccines, because the risk of dying from COVID-19 increases with age. However, it takes time to distribute the vaccines to different countries, and the challenges in administering vaccines may differ by health system characteristics and local culture. This international symposium will discuss the vaccine rollout issues in eight countries (Isreal, Japan, South Korea, China, France, United Kingdom, Canada, and United States). We will use an interview and dialog format, instead of presentations. We will cover extensive topics including: Availability - What vaccines? Access, Acceptance, Caregivers – How are providers responding/handling caregivers wanting to be vaccinated?Cost/Financing Issues, Distribution Logistics/Transport/Safety, Lessons Learned, Mutations/Variants, Partnerships needed to vaccinate homebound patients (community partners; home health agencies, etc.), Who can/should provide vaccination? The situation with COVID-19 is still very fluid. Countries are at different stages of vaccinating older people. The chair didn't ask the speakers to write an abstract now, instead, the speakers will collect more information during the next few months and plan to have a prep meeting one month before the Annual Meeting.
COVID Vaccine Rollout for Older Adults in France
Authors: De Stampa Matthieu
Published: December 2021

Only about three million people in France have so far received at least one dose of a Covid-19 vaccine. Those aged over 75 are offered either Pfizer or Moderna vaccines in a vaccination center. Older people with pre-existing conditions can now get AstraZeneca's Covid-19 vaccine. We will provide detailed information later. The symposium has experts from 8 countries. We will use an interview and dialog format, instead of presentations (please refer to the program overview).
Using Documentary Short Film for Health Impact: An Example for Supporting Family Caregivers
Authors: Bell Janice , Zitter Jessica
Published: December 2021

Storytelling through film is a powerful tool with potential to improve understanding, spark discussion, shape perceptions of health and illness, and influence related behavior. We developed a film discussion guide for the documentary short film Caregiver: A Love Story. The 24-minute film follows the experience of a man who leaves his job to become the primary caregiver of his 59 year-old wife, who opts out of non-beneficial chemotherapy, choosing instead to remain at home with hospice support. The 2-hour program was facilitated by an experienced social worker and offered on five different days/times using Zoom video (n=60 total attendees; 9-15/ session). At each session, we showed the film, discussed self-care and caregiver resources, and fielded a survey to assess satisfaction, format acceptability and session impact (response rates 67-100%/session). Attendees liked the session format (90%); found the film relevant to their situations (80%); intended to look for new professional resources (79%); were motivated to do something different(71%); learned something new (64%); and intended to ask for more help from family or friends (64%). Many commented that they preferred the video meeting format over in-person meetings. The film viewing and discussion format is acceptable and accessible to family caregivers who may otherwise not be able to attend given competing demands. This format also has potential to improve support access to resources. Extensions to this work are planned to tailor the film discussion guide for health care providers and students working with family caregivers across inpatient, outpatient and hospice settings.
Action-Related Thoughts and Beliefs Regulate the Effect of Age Stereotypes on Aging Preparation
Authors: Kim-Knauss Yaeji , Lang Frieder , Fung Helene , Tse Dwight
Published: December 2021

Thinking about old age stereotypically affects one’s engagement in age-related behaviors and developmental regulation. We hypothesized that positive or negative aging stereotype (AS) would be associated with more or less aging preparation, while action-related thoughts and beliefs might exert influence thereon. We used the AAF online-study dataset consisting of 591 German, 348 Chinese, and 139 American adults (aged 18−93 and 55% female). Using a count measure of 15-preparatory-activities, we first explored the role of AS measured by a bipolar scale and how perceived utility and risk of aging preparation differentiate this association. Findings revealed that perceiving more utility buffered the impact of negative AS, which suggests that one’s action-related thoughts are more proximal and self-relevant predictor of aging preparation. Besides, Chinese and Americans were more susceptible to the presence of AS than Germans, implying that cultural background or societal conditions might also shape one’s belief system and thereby regulate behaviors.
Major Disasters’ Impacts on Long-Term Care Settings, Vulnerable Older Adults, and Care Providers
Authors: Haverhals Leah , Cherry Katie
Published: December 2021

The COVID-19 pandemic has disproportionately negatively affected older adults, and has specifically devasted older adults who are minorities and those who reside in long-term care (LTC) facilities. For professionals working in LTC facilities, major stressors and challenges due to the pandemic must be navigated, sometimes in parallel with the effect that major disasters like hurricanes can have on LTC facilities. This symposium will focus on the impact major disasters, including the COVID-19 pandemic and Hurricane Irma, had on LTC settings and those who live and work there, as well as older adults who are minorities and their communities. First, Dr. Roma Hanks will present findings from a study of community members and leaders in a majority African-American community in the United States (US) about their experiences with and challenges faced related to the pandemic. Second, Dr. Lisa Brown will share experiences and perceptions of mental health clinicians from across the US who worked in LTC settings before and during the pandemic. Third, Dr. Ella Cohn-Schwartz will describe how the pandemic impacted Holocaust survivors ages 75+ in Israel compared to older adults who did not experience the Holocaust. Fourth, Dr. Lindsay Peterson will present findings from interviews with nursing home and assisted living community representatives in the US regarding vulnerabilities LTC facilities experienced related to Hurricane Irma in 2017. As a whole, these presenters will provide insights into experiences of older adults, care providers, LTC facilities, and communities as they navigated challenges associated with the COVID-19 pandemic and a major hurricane.
Gender Differences in Avoiding Later-Life Disability: A Life Course Perspective
Authors: Morton Patricia
Published: December 2021

Identifying the early origins of adult health has underscored how experiences in the earliest stages of life can have lasting consequences. Whereas most research on the early origins of adult health has linked childhood conditions to worse health in adulthood, this study considered whether childhood conditions are associated with healthy aging. Guided by the World Health Organization’s emphasis on functional ability as a core component of healthy aging, the present study investigated the association between childhood social conditions and avoiding later-life limitations in basic and instrumental activities of daily living, referred to as disability-free status. This study also tested potential health-related and socioeconomic mediators and examined whether these life course antecedents of healthy aging vary by gender. Analyzing a sample of 9,376 adults over age 50 from the Health and Retirement Study over 10 years (2006-2016) revealed that childhood socioeconomic disadvantage reduced the odds of avoiding disability over time. For women, adult health lifestyles mediated this relationship whereas adult socioeconomic status (SES) mediated this relationship for men. Conditional indirect effects indicated that the mediational effects of body mass and education differed between men and women (i.e., moderated mediation). The direct effects of childhood and adult SES also varied by gender. These results demonstrate that the life course antecedents, especially SES, of healthy aging are distinct for men and women. Interventions should prioritize reducing early-life exposure to socioeconomic disadvantage, especially for women. Given the gendered differences in the mediating effects, midlife interventions can be tailored for men and women.
Activities of NEW Brain Aging
Authors: Conwell Yeates
Published: December 2021

The Network for Emotional Well-being and Brain Aging (NEW Brain Aging) was funded by NIA with the goal of forming a national, transdisciplinary collaborative that includes investigators with research expertise in emotional well-being (EWB), Alzheimer’s disease and related dementias (ADRD), human and animal neuroimaging, stress regulation, and computational/quantitative methods. Our objective is to stimulate mechanistic research identifying and testing mechanisms by which brain aging influences EWB and how EWB may impact risk for and progression of ADRD. This presentation will explain the structure and functions of the network that serve as a resource for investigators interested in EWB and aging research, and how to access them: a transdisciplinary community of scholars interested in brain, aging, and EWB research from both human and animal fields; webinars; workgroups to establish priorities for NEW Brain Aging activities; a resource repository; and pilot project funding opportunities to which network members can apply.
Overview of EWB and Aging
Authors: Kaplan Robert
Published: December 2021

The accumulation of scientific knowledge has been hampered by inconsistent usage of terms and categories. Ontology is the study of categories, their properties, and the relations between them. This presentation considers the definition and measurement of emotional well-being (EWB), a term that has been used inconsistently in research and clinical practice. The category contains eudaimonic and hedonic well-being that represent interrelated but conceptually distinct aspects of mental health. This presentation will review the definition and measurement of EWB and evidence for the validity of the construct. Evidence suggests EWB increases after age 50 and is important for maintenance of cognitive function in old age. Further, low in EWB may be a risk factor for incident ADRD, and is likely to impair cognitive functioning.
Novel Strategies to Reach and Engage Older Veterans During COVID-19
Authors: Peeples Amanda , Van Orden Kim
Published: December 2021

The COVID-19 pandemic and associated public health measures to prevent its spread have important implications for the health and wellbeing of older Veterans. Prior to the pandemic, social isolation was already recognized as a risk for older adults, contributing to increased risk of depression, physical inactivity, and mortality. Stay-at-home orders, social distancing, and transitions to new ways of delivering care have meant that many of the ways in which older Veterans connect with VA and others have changed. Older Veterans and Veterans with serious mental illness (SMI) are especially vulnerable to experience negative impacts from social isolation and loneliness. This symposium will present on four novel and adapted strategies for engaging with older Veterans during the COVID-19 pandemic and beyond: 1) VA Connection Plans, a whole health intervention to promote social connections for older Veterans with and without SMI (Peeples); 2) telehealth adaptations to PEER, an in-person, peer-delivered exercise intervention for older Veterans with SMI (Muralidharan); 3) VA Compassionate Contact Corps, a VA Voluntary Service program to connect older Veterans with friendly volunteers via telephone (Sullivan); and 4) group telehealth interventions to foster social connection among older Veterans and their families (Weiskittle). Kim Van Orden, geropsychologist and director of the Hope Lab (Helping Older People Engage) at the University of Rochester Medical Center, will serve as discussant.
Monitoring the Comparative Safety of SGLT2i vs GLP-1 RA in Older Adults With Type 2 Diabetes by Frailty Status
Authors: Kutz Alexander , Patorno Elisabetta , Gopalakrishnan Chandrasekar , Kim Dae
Published: December 2021

Using Medicare (4/2013-12/2017), we conducted 9 sequential analyses of patients with type 2 diabetes initiating SGLT2i vs. GLP1-RA mimicking the accrual of new data every 6 months to monitor SGLT2i safety with respect to diabetic ketoacidosis (DKA) since their U.S. approval. For each analysis, we estimated cumulative HRs (95% CIs) after 1:1 propensity score matching on >70 covariates comparing treatments within frail and non-frail patients. By analysis 1, SGLT2i were associated with a higher DKA rate vs. GLP-1RA in both frail and non-frail patients, but results were highly imprecise due to few events. With the accrual of more DKA events, precision of the estimates continued to improve through analysis 9 [HR=2.95 (95% CI, 1.19-7.31)] in frail patients; [HR=1.77 (1.15, 2.75)] in non-frail patients], with sufficiently precise estimates by analysis 6 in frail patients [HR=2.80 (95% CI, 1.03, 7.61)] and by analysis 7 in non-frail patients [HR=1.62 (95% CI, 1.01, 2.57)].
Information and Communication Technology Changes in Long-Term Care Due to COVID-19
Authors: Schuster Amy , Cotten Shelia
Published: December 2021

Residents of long-term care (LTC) facilities (e.g., nursing homes, assisted living facilities) have historically been vulnerable to feelings of loneliness and social isolation. Due to the COVID-19 pandemic, LTC facilities were required to restrict public access in March 2020. LTC communities were not prepared for the residents’ increased socioemotional needs which arose because of the mandated facility lockdown. This study investigated ICT use in LTC facilities and how ICTs are being used by residents since the onset of the COVID19 pandemic. Seventy LTC administrators in South Carolina (12 nursing homes and 58 assisted living facilities) completed an online survey exploring ICT access and use in LTC facilities and whether access and use changed as a result of COVID-19. Administrators from fifty-three percent of LTC facilities reported purchasing ICTs for their residents to use for communicating with family members and telehealth since the onset of COVID-19. LTC administrators reported that using the ICTs helped residents to socialize more frequently and feel more socially connected to their family members, friends and/or other residents. Barriers to ICT use included staff not having time to assist residents with technology, broken technology, and residents not wanting to share technology. LTC facilities were not adequately prepared to support the socioemotional needs of their residents in the event of a federally mandated facility lockdown. Future research should investigate the ICTs available for residents’ use in a national sample of LTC facilities and how LTC administrators adapted the ICTs available as a result of their experiences with COVID-19.
Older Adult Technology Use During a Global Pandemic: A Study of Mental Health, Social Supports, and Resiliency
Authors: Park Geunhye , Robinson Erin , Tefera Gashaye M
Published: December 2021

Older adults have been disproportionately impacted by the COVID-19 pandemic, which has led many to isolate during this time. Technology enables people to remain connected, however little is known about how older adults have used technology and the impact it has had on their mental health and connectedness. This study was to explore how the COVID-19 pandemic has influenced older adult mental health and social connectedness, with a particular emphasis on how technology has played a role. One-on-one interviews (N=29) were conducted with adults aged 65+ (Mean age=71.5; 86% female) via phone/Zoom. Participants were asked open-ended questions about the impact social distancing has had on their quality of life, health, and social connectedness as well as their technology use to remain connected. Findings highlight the mental health stressors experienced by older adults during the pandemic, as well as much resiliency and innovation. In speaking of the isolation and its effect on her mental health, one participant said, “I thought fighting cancer was bad, but this is worse.” Nearly all of the participants had used technology in some form to remain connected to others, which the most common being a smart phone to call, text, and video-interface. One participant commented, “You can’t beat an iPhone. How in the world could we ever live without an iPhone?” Many participants had learned a new technology during the pandemic, such as Zoom. Our findings raise the possibility that technology may be a good strategy for enhancing well-being of aging population amid the pandemic.