bluuebunny/crossref_metadata_2025 huggingface dataset:
PATIENT PRIORITIES CARE (PPC) IN HISPANIC PATIENTS WITH DEMENTIA
Authors: Mera Alejandra , Peel Emily , Naik Aanand , Samper-Ternent Rafael
Published: January 2025

Hispanics are the fastest growing underrepresented population in the U.S and have a higher risk of dementia compared to non-Hispanic whites. Lack of trust, limited health care access, and lack of culturally adapted interventions contribute to health disparities in this population group. Patient Priorities Care (PPC) is an evidenced-based approach that improves health outcomes in patients with multimorbidity. PPC guides patients, caregivers, and their providers to set realistic health care goals based on the patient’s values. Little is known about the benefits of PPC for Hispanics with multimorbidity and dementia. We designed and implemented a pilot feasibility study to adapt the PPC approach for Hispanics with multimorbidity and dementia (PPC-HD study). The PPC approach consists of a Priorities Setting Session with the patient, and caregiver, followed by a Care Alignment session with the patient’s clinician. In our sample of 20 Hispanics with dementia and multimorbidity, 85% of the participant care plans include patients’ preferences indicating the willingness of clinicians to use the PPC approach. Eighty-three percent of participants find PPC a rewarding experience with 67% reporting satisfaction in the availability of Spanish-speaking research staff, 61% reporting satisfaction in discussing healthcare preferences, and 56% reporting satisfaction with knowing patients’ preferences for future healthcare decisions. PPC is a feasible approach in this population group. Most clinicians used the patients’ preferences and included them in their care plans. Access to bilingual staff and delivery of the intervention in Spanish was highly valued by participants and caregivers. Participation in PPC was deemed very valuable.
SOCIAL WORKERS’ ROLE IN CULTIVATING ILLNESS UNDERSTANDING AND PROGNOSTIC AWARENESS: PERSPECTIVES FROM THE FIELD
Authors: ODonnell Arden , Gonyea Judith
Published: January 2025

For patients experiencing serious or life-limiting illnesses, informed decision-making depends on understanding prognosis and illness trajectory. Although physicians are viewed as the most appropriate group to share medical information, there is growing recognition that: a) cultivation of prognostic awareness occurs over time through a series of conversations in which patients continue to redefine medical treatments and broader life goals and b) other clinicians can contribute to these discussions. Using role theory, this qualitative study’s explores how the growing shift to a team approach is experienced by hospital-based physicians (MDs) and palliative social workers (PSWs),. Through semi-structured Zoom interviews with 17 matched MDs and PSWs across the U.S., we explored the degree of alignment or convergence of MDs’ and PSWs’ views on PSWs’ professional roles in prognostic conversations, including perceptions of role definitions, role sharing, role boundaries, and role conflicts. Interpretive description methodology, coupled with thematic analysis, revealed key insights into PSWs’ comfort levels in assuming roles and interventions in this prognostic awareness cultivation as well interprofessional convergence affirming PSWs’ role in a) assessing patients’ readiness for prognostic discussions, b) identifying gaps in patient understanding c) translating medical conditions into lived reality, and d) supporting emotional processing of patients and their families. Concerns about potential role conflicts emerged when PSWs were expected to either engage in or overstep into medically complex discussions. This study underscores the important role of social workers role in enhancing prognostic understanding and emphasizes the significance of role clarity, trust, and communication for effective interpersonal teams.
UNHOUSED OLDER ADULTS’ PREFERENCES FOR PROGNOSTIC COMMUNICATION AND ILLNESS-RELATED CARE
Authors: Latimer Abigail , Light Michael , Sasdi Olivia , Hossain Mohammad , Moser Debra , Pope Natalie
Published: January 2025

The number of older adults experiencing homelessness (OAEH) is growing. This vulnerable population is exposed to harsh conditions and fragmented healthcare, making even the most treatable health conditions life-threatening. Understanding seriously ill OAEH preferences for prognostic communication and illness-related care are needed research areas. This qualitative study was part of a larger project adapting Ariadne Labs’s Serious Illness Conversation Guide (SICG) for use with OAEH. We interviewed 11 unhoused older adults (≥ 50 years) with a serious illness - mostly men (n = 9) between age 53 and 72 (M = 61). Interview questions were developed corresponding to the model of prognostic communication (i.e., the SICG) with a particular interest in understanding older adults’ 1) communication preferences regarding their illness and prognosis and, 2) goals and values related to their illness and prognosis. We utilized reflexive thematic analysis which included coding and creating transcript summaries and data matrices to help the research team familiarize, condense, and observe patterns within the data. Findings reflect how 1) clinicians should deliver prognosis, 2) OAEH receive prognosis, and 3) OAEH treatment goals and values. Trust and authenticity emerged as essential components of prognostic delivery, both in what and how information is shared. Participants described past communication with healthcare professionals and the impact of these conversations. Illness-related priorities for OAEH included making practical plans for dying and death, leaving a legacy for their children, and maintaining independence. Study findings can inform clinical practice and intervention research to improve how this population receives serious illness communication.
CHRONIC PAIN, PAIN INTERFERENCES, AND COGNITION AMONG MIDDLE- AND OLD-AGED AMERICANS: A FIXED-EFFECTS ANALYSIS
Authors: Yu Chang , Barr Ashley , Yang Yulin , Grol-Prokopczyk Hanna
Published: January 2025

Objectives

The current study examines the relationship between chronic pain, chronic pain interference, and cognitive function in middle-aged and older Americans, focusing on how these associations may vary by educational background. Method: Data were obtained from the 2004-2006 and 2013-2017 waves of the Midlife in the United States Study (MIDUS 2 and MIDUS 3, N=6266 observations nested with 3965 individuals). We employed fixed-effects linear models to examine within-individual changes, specifically, the relationship between changes in chronic pain, pain interferences (with activity, mood, relations, sleep, and enjoyment) and their impact on cognitive function (specifically episodic memory and executive function). In addition, group differences in these fixed effects by education were examined via interaction terms.

Results

The results indicated that changes in pain negatively correlated with episodic memory, but this association was observed only for individuals without any college. Additionally, changes in pain interferences showed a negative correlation with both episodic memory and executive functioning across all levels of educational attainment.

Discussion

Findings highlight the importance of not only considering the role of persistent pain but also the effects of pain interferences on cognitive decline among aging population.
FUNCTIONAL LIMITATIONS, DEPRESSIVE SYMPTOMS, AND COGNITION ACROSS MID- AND LATE-LIFE: EVIDENCE FROM CHINA
Authors: Yu Chang , Barr Ashley , Grol-Prokopczyk Hanna
Published: January 2025

Objectives

This study examines the time-varying effects of functional limitations (IADLs and ADLs) and depressive symptoms on various cognitive functions, including mental status and memory among middle-aged and older Chinese individuals. It also assesses whether functional limitations and depression during middle age contribute to worse cognitive function in the later years independent of yearly shifts in depression and functional limitations. Method: Using longitudinal data from the China Health and Retirement Longitudinal Study (2011-2018), we conducted mixed-effects linear models to determine the intra- and inter- individual variation on the relationship between functional limitations, depression, and cognitive functioning (N = 22,039 observations nested within 10,054 individuals).

Results

Within-individual change in functional limitations and depression negatively predict cognitive functioning, with more functional limitations and depressive symptoms predicting a lower score in cognition, memory, and mental health, independent of age. Further, disabilities and depression in mid-life continue to predict worse cognitive functioning across the course of the study independent of any later changes in functional limitations and depressive symptoms and childhood conditions.

Discussion

From a life course perspective, adverse functionalities and mental health in midlife predicts worse cognitive function in later life independent of early life experiences.
MEMORY IN LATER LIFE: HOW NONAGENARIANS AVOID FORGETTING WHAT THEY WANT TO REMEMBER
Authors: Cherry Katie , Willis Matthew , Faucheux Gavin , Bernard Dominique , Barnes Mary , Reese-Melancon Celinda , Kim Sangkyu , Jazwinski S Michal
Published: January 2025

Subjective perceptions of memory play an important role in cognitive adaptability in later life. While self-reported memory is typically assessed using objective surveys, few studies have examined what older people have to say about their own experiences using memory in everyday life. The purpose of this study was to examine older adults’ memory management strategies and techniques that they use in everyday life to improve recall of information they do not want to forget. Participants consisted of 50 nonagenarians (90+ years of age) and two younger reference groups (60-74 and 75-89 years) who were enrolled in the Louisiana Healthy Aging Study (LHAS). All answered two open-ended questions regarding their preferred memory management strategies used in everyday life. Narrative responses were recorded, transcribed verbatim, and content analyzed for recurring concepts. Results yielded new evidence of environmental strategies, including object placement and non-electronic external memory aids (e.g., planners, calendars), and internal mnemonic techniques (e.g., rehearsal, association). When comparing internal mnemonic techniques specifically, nonagenarians were more likely to use association, whereas their younger counterparts were more likely to use imagery. These findings suggest that memory management techniques change very little in late adulthood. This research was supported grants from by the Louisiana Board of Regents through the Millennium Trust Health Excellence Fund [HEF(2001-06)-02] and the National Institute on Aging (P01 AG022064).
NEIGHBORHOOD SOCIAL CAPITAL IS ASSOCIATED WITH VARIABILITY IN AMBULATORY COGNITIVE PERFORMANCE
Authors: Hyun Jinshil , Cerino Eric , Katz Mindy , Lipton Richard , Sliwinski Martin
Published: January 2025

Prior studies suggested that within-person variability in cognitive task performance may be an early indicator of normative and pathologic cognitive aging. However, the influence of upstream social determinants of health (e.g. neighborhood) on cognitive variability is not well characterized. The aim of this study is to examine whether neighborhood social capital is associated with within-person variability in various cognitive domains and whether these associations are mediated by individual-level behavioral factors (i.e., physical activity, social interaction). The analysis sample included 316 individuals in Bronx, NY, enrolled in the Einstein Aging Study (mean age=77). Participants performed brief tests of processing speed, memory binding, and working memory on a smartphone up to six times daily over a two-week period. Neighborhood social capital was operationalized as a composite variable comprising economic connectedness, clustering, and volunteering rates, linked to participants’ address through zip code tabulation area. Results from heterogeneous variance multilevel models suggested that living in areas with lower levels of social capital was significantly associated with greater variability in processing speed and memory binding (ps<.001). Controlling for individual-level physical activity reduced the magnitude of the effects of neighborhood social capital, suggesting potential (and partial) mediating role of physical activity. In conclusion, living in areas with better community social capital may reduce the risks of cognitive impairment. It would be crucial to support upstream neighborhood-level interventions to prevent cognitive impairment among older adults. Future research should examine more precise behavioral mechanisms linked to neighborhood environments to better suggest effective intervention strategies to promote cognitive health.
SUBJECTIVE AGE, DEPRESSIVE SYMPTOMS, AND COGNITIVE FUNCTION: DOES CHRONOLOGICAL AGE MATTER?
Authors: Lee Juhyeong , Kim Giyeon
Published: January 2025

This study examined the mediating effect of depressive symptoms between subjective age and cognitive function among Korean older adults, with a focus on the moderating effects of chronological age. Using data from the 2020 National Survey of Older Koreans, a nationally representative sample of individuals aged 65 or older (N=9,836) was examined. Subjective age was calculated by subtracting perceived old age from chronological age, with higher values indicating an older subjective age. Depressive symptoms were measured using the Short Form of Geriatric Depression Scale (SGDS-K), and cognitive function was assessed using the Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS). A moderated mediation analysis was conducted by PROCESS (Model=59) for SPSS. Results showed that depressive symptoms significantly mediated the relationship between subjective age and cognitive function among Korean older adults. Particularly, an older subjective age was associated with lower depressive symptoms (B=-.0420, p<.001). Depressive symptoms were related to poor cognitive function (B=-.2372, p<.001). The direct effect of subjective age on cognitive function was also significant (B=-.1017, p<.001). Furthermore, chronological age moderated the indirect effects, demonstrating that subjective age was more strongly associated with lower depressive symptoms at younger chronological ages, whereas both subjective age and depressive symptoms were more strongly linked to poorer cognitive function at older chronological ages. The findings underscore the importance of considering both chronological and subjective age in understanding the interplay between depressive symptoms and cognitive function among Korean older adults.
EDUCATIONAL GRADIENTS IN HEALTH AND COGNITION: DOES THE TIMING OF EDUCATIONAL ATTAINMENT MATTER?
Authors: Bolz Fabio , Warren John , Grodsky Eric , Muller Chandra
Published: January 2025

Educational attainment is a strong predictor of later-life health and cognition. However, studies on the relationship between educational attainment and these outcomes usually do not consider the role of the timing of educational attainment. There is considerable heterogeneity in the timing of college degree attainment in the US and there are pronounced differences in timing by gender and race. Using nationally representative longitudinal data from High School and Beyond (HSB) we ask: (1) Does the impact of educational attainment on midlife health and cognition vary by age of degree attainment? (2) Does age at degree attainment moderate the effects of education differently across racial/ethnic and gender groups? We estimate OLS and logistic regression models for a variety of health and cognitive outcomes including: hypertension, diabetes, mental health conditions, general cognition, immediate recall, semantic fluency, phonemic fluency, delayed recall and working memory. We control for an extensive set of potentially confounding variables such as cognitive skills and non-cognitive traits in adolescence, academic performance in high school, and health in adolescence. Preliminary results suggest that bachelor’s degrees obtained later in life are associated with substantially lower levels of cognitive functioning at midlife than degrees obtained earlier in life; however, people who obtain college degrees after age 40 still display higher levels of cognitive functioning than individuals without a bachelor’s degree. Rates of hypertension and diabetes among those who obtained their college degree after age 30, in contrast, do not differ from rates for individuals without college degrees.
LIFE EXPECTANCY WITH UNMET AND MET CARE NEEDS FOR OLDER ADULTS
Authors: Castro Jose Cabrero , Bramajo Octavio , Mehta Neil , Downer Brian
Published: January 2025

Assessing unmet social care needs is crucial for understanding the challenges of an aging society like Mexico, where demographic changes have outpaced the development of formal care systems. This study examines the time lived with met and unmet care needs among Mexican adults aged 60 and over by estimating life expectancy according to limitations in instrumental (IADL) and basic activities of daily living (ADL) and receiving help. Analyzing 2012-2021 Mexican Health and Aging Study (MHAS) data (6,215 males; 8,156 females), we used multistate life table models to estimate life expectancy with no limitations, limitations but not receiving help (unmet care needs), and limitations but receiving help (met care needs). We stratified estimations by gender and living arrangement. Findings revealed significant gender differences. Women lived a greater proportion of their remaining life expectancy with ADL (+7%) and IADL (+9%) limitations than men. Men with ADL limitations lived a greater proportion of their life with unmet (8.5%) versus met (4.7%) care needs, a disparity less pronounced among women (12% unmet vs. 8.4% met care needs). Conversely, participants with IADL limitations lived a greater proportion of their life with met care needs (8% vs 1.9% for men; 16.3% vs 2.5% for women). Participants living with spouses or other adults experienced a greater proportion of life lived with met care needs than those living alone, for both ADL and IADL limitations. These results underscore the interplay between gender, living arrangements, and care needs, highlighting the need for targeted interventions to address care needs disparities.
MULTISTATE CHARACTERISTICS AMONG OLDER POPULATION IN CHINA (2024–2050): GLOBAL COMPARISON AND DYNAMIC SIMULATION
Authors: Li Yichao , Mi Hong
Published: January 2025

Global long-term care (LTC) issues become complex with diverse aging process. China’s population has entered deep and accelerated aging stage with multiple health status, which has heterogeneity among population with different features. However, overlooking the biases of multistate characteristics of aging due to lack of systematic methodology would affect LTC policies. Therefore, this study simulates the complex LTC demand by estimating life expectancy with disability and structure of disability population under different demographic scenarios, and compares China’s LTC demands with typical developed countries. In methods part, we used three-parameter lifetable model (DCMD model), Lee-Carter Coherent model and Bayesian multistate model to simulate the prevalence of mild, moderate and severe disability among older people. China Health and Retirement Longitudinal Study (CHARLS) 2020 was used for the initial dependency status. CHARLS 2011-2018 and Chinese Longitudinal Healthy Longevity Survey 2008-2014 was used as prior information. Death probabilities in Bayesian health transition matrixes were modified by estimated mortality patterns by sex, age and residential types (urban or rural areas). Healthy life expectancy in 2020 was also calculated by multistate lifetable model. Results showed that older people with moderate and severe disability in China had an increasing trend during 2023 to 2050 after simulating posterior distributions of health transition probabilities. China’s public long-term care expenditures will account for less than 0.7% of GDP in 2050, which is lower than developed countries. This study proposed an actuarial framework for estimating LTC demand with credible interval, which enables developing countries to dynamically adjust LTC policies.
TEACHING AGING WITH A GLOBAL CLASSROOM
Authors: Mulhorn Kristine
Published: January 2025

In a time of heightened interest in teaching about aging in undergraduate programs, Drexel launched a competitive effort to offer courses that would be of interest across a variety of majors and minors. As a scholar working in aging in Japan for several years, as well as a background in aging policy, I launched a course called “Aging, Aging Policy and Health in Asia”. The highlight was the global classroom—a three-week project between Drexel students and students at KAIST (Korean Advanced Institute of Science and Technology) on the topic of aging and technology. The focus of the effort to teach aging across the university was to assure that the AGHE competencies were included in these courses. We included competencies such as the bio-psycho-social model for healthy aging, the epidemiologic transition, and the ethics of caregiving. This course resulted in close collaboration related to a product or concept that had potential for direct application In the lives of older adults. For example, one project addressed the use of research and technology applied to aging policies of Korea and the US, and another looked closely at strategies that improve intergenerational interactions that improve the lives of older adults and children. This presentation will demonstrate the integration of AGHE competencies into the course, as well as the ways the students met the learning objectives within the course.
BIOLOGICAL AGING AS A MEDIATOR OF DEPRESSION AND MORTALITY
Authors: Wei Kai , Chen Xiaotong
Published: January 2025

Background

Depression has been linked to death from all-cause, cardiovascular disease and cancer; however, the underlying mechanisms remain unclear. We aimed to examine the mediating role of biological aging in the association of depression with mortality in a representative sample of the US population.

Methods

Longitudinal data were obtained from 33,434 participants aged ≥20 years in the 2005-2018 cycle of the National Health and Nutrition Examination Survey and their mortality data through 2019. The Patient Health Questionnaire (PHQ-9) was used to measure depressive symptoms, and major depression was defined as a PHQ-9 score ≥10. Three measures of aging, including phenotypic aging acceleration (PA-Accel), anthropometric aging acceleration (AA-Accel), and Klemera and Doubal method-based biological aging acceleration (KDBA-Accel), were calculated. Weighted multiple linear regression model, Cox proportional hazards model, and mediation analysis were performed.

Results

The major depression were positively associated with biological aging acceleration (PA-Accel β=1.34, KDBA-Accel β=0.88, AA-Accel β=0.36, all p < 0.0001). The mediation proportion of biological aging acceleration in associations of major depression with all-cause mortality were 21.53% (PA-Accel, p=0.0005), 14.63% (KDBA-Accel, p=0.0006), and 11.36% (AA-Accel, p=0.0004), respectively. Similar results were found in the Health and Retirement Study. Conclusions: Accelerated aging partially mediated the associations of major depression all-cause mortality in US populations.
CHANGES IN DEPRESSIVE SYMPTOMS ACROSS MIDDLE AND OLDER ADULTHOOD IN THE ORANJ BOWL LONGITUDINAL STUDY OF AGING
Authors: Yang Kaite , Ferri Christine , Girgus Joan
Published: January 2025

Life course fluctuations in depressive symptoms are important to document and understand. Previous research has suggested a U-shaped pattern in depressive symptoms across the lifespan, with more symptoms in younger and older adulthood compared to middle adulthood (Sutin et al., 2013). The present study used hierarchical linear modeling to examine changes in depressive symptoms in middle and older adulthood and the degree to which participants’ age at baseline affected symptom trajectories across 13 years. Participants were a representative sample of community-dwelling adults in New Jersey aged 50-74 (M=60.53) at baseline (ORANJ BOWL; Pruchno et al., 2010). N=4266 participants (64.3% female) who completed at least two waves of data collection from five timepoints were included in this study (T1: 2006-2008; T3: 2011; T4: 2013-2015; T5: 2015-2017; T6: 2017-2019). The trajectory of depressive symptoms (CESD-R-10) was best captured by a cubic model wherein symptoms peaked at T3, decreased, and then increased again after T4. There were significant intercept, linear, quadratic, and cubic terms for the effect of age as a continuous variable on depressive symptoms. Participants who were younger at the start of the study had more symptoms initially and then flatter trajectories compared to participants who were older. Participants who were older started with less symptoms but had a steeper increase in symptoms over time. These findings suggest that age-dependent fluctuations as well as impacts of and recovery from exogenous events like the Great Recession are reflected in depressive symptom trajectories in older adults (Pruchno et al., 2021).
DEPRESSION PREVALENCE IS HIGHER IN DISADVANTAGED NEIGHBORHOODS
Authors: Mitchell Jacob , Pfoh Elizabeth , Gunzler Douglas , Kenyhercz Michael , Mourany Lyla , Gunsalus Paul , Perzynski Adam , Dalton Jarrod
Published: January 2025

Depression is associated with premature morbidity and mortality. Knowing depression prevalence across diverse neighborhoods can inform healthy aging interventions. In this retrospective study, we analyzed electronic health data for mid-life adults (40-55 years) with ≥1 primary care appointment between 2010 and 2016 at two health systems in Cuyahoga County, Ohio. Patients were categorized as having depression if they had a diagnosis within 6 months of their first visit. Patient’s addresses were associated with the block group Ohio Area Deprivation Index (ADI), a measure of disadvantage. We used multivariable logistic regression to identify the predicted probability of depression across patients living in advantaged (ADI quintile 1) versus disadvantaged (ADI quintile 5) neighborhoods. We included race, given histories of neighborhood segregation in our location. We used a three-way interaction term between sex, race, and ADI quintile. Our sample included 150,710 patients, of which 14% had a diagnosis of depression. A higher percentage of patients with depression (versus not) were female (70% versus 54%), White (63% versus 56%), and lived in ADI quintile 5 (28% versus 25%). The predicted probability of depression was lower for patients living in ADI quintile 1 versus 5: White males (0.08, 95%CI: 0.08, 0,08 versus 0.16, 95%CI: 0.15, 0.17); White females (0.17, 95%CI: 0.16, 0.17 versus 0.25, 95%CI: 0.24, 0.26), Black males (0.05, 95%CI: 0.04, 0.07 versus 0.09, 95%CI: 0.09, 0,10) and Black females (0.14, 95%CI: 0.12, 0.16 versus 0.16, 95%CI: 0.15, 0.16). Place-based, mental health-promoting interventions may be needed to promote healthy aging among mid-life adults.
DEPRESSIVE SYMPTOMS ACROSS THE LIFESPAN: DIFFERENCES IN SYMPTOM CRITERIA ENDORSEMENT
Authors: Walker Teresa , Renn Brenna
Published: January 2025

Scientific literature and clinical wisdom often cite older adults as more likely to endorse somatic rather than mood symptoms of depression compared to younger people. However, this is based on older data and needs updating with demographic shifts. As many older adults with clinically significant symptoms of depression go undiagnosed and untreated, with deleterious effects on health outcomes and quality of life, identifying and treating depression is necessary to provide quality healthcare for older adults. Thus, the purpose of the current study was to investigate differences in endorsements of depressive symptoms across age groups with recent data from the National Health and Nutrition Examination Survey 2017-2020 Pre-Pandemic dataset. Participants (N = 8299) were categorized into young adults (18-24 years), middle adults (25-55 years), young-older adults (56-75 years), and older adults (76+ years). Responses to items on the Patient Health Questionnaire (PHQ-9) were dichotomized into meeting criteria for a depressive episode (vs. not). Chi-squared tests of independence revealed significant differences across some age groups for symptoms including sleep disturbance, feelings of worthlessness/guilt, and suicidal ideation. Young-older adults were the only age group to significantly differ from at least one other age group on all three of these items. Of particular note, older adults did not significantly differ from other age groups on any items, contradicting previous findings that older adults report more somatic symptoms than their younger counterparts. These findings contribute nuance to understanding depressive symptom presentation across the lifespan to guide clinical assessment of older adults.
DISCRIMINATION AND MENTAL HEALTH AMONG OLDER ADULTS: THE CONFOUNDING ROLE OF PERSONALITY
Authors: Stangl Morgan , Guo Man , Wang Yi
Published: January 2025

Existing literature shows that the perception of discrimination is related to poorer mental health. Personality may confound this association by shaping an individual’s coping style, social support seeking, and emotional regulation in the face of adversity. However, such a confounding role of personality hasn’t been well studied, and it’s unclear whether different personality traits have similar effects. Using data from middle-aged and older adults (aged 50+) in the 2018 Health and Retirement Study Psychosocial Leave-Behind Questionnaire (N = 5,529), this research delves deeper into the potential moderating role of two personality traits (neuroticism and extraversion) in the associations between perceived discrimination and mental health outcomes (depression and anxiety). Findings from regression analyses revealed that increased perceived discrimination was consistently associated with higher levels of anxiety and depression. While such associations did not vary based on individuals’ levels of neuroticism, the associations were weaker among individuals with a higher level of extraversion. This study revealed that the two personality traits, neuroticism and extraversion, have different effects on the relationship between perceived discrimination and mental health. Extroverted individuals may perceive and cope with discrimination differently with more adaptive coping mechanisms, such as seeking social support and engaging in problem-solving behaviors, which may buffer against the negative effects of discrimination on mental health. Further studies of the underlying mechanisms are needed. This can inform the customization of mental health interventions to align with individuals’ personality profiles for better-tailored and targeted support that effectively promotes their resilience in the face of discrimination.
GENDER DIFFERENCES IN THE IMPACT OF COVID-19’S HARDSHIP ON DEPRESSIVE SYMPTOMATOLOGY AMONG MEXICAN OLDER ADULTS
Authors: Gutierrez Sirena , Wong Rebeca , Milani Sadaf
Published: January 2025

Older women in Mexico report depressive symptoms more often than men. Amidst the COVID-19 pandemic, the exacerbation of mental health inequities among older adults remains unclear. We investigated whether the association between experiencing hardship and depressive symptoms varied by attributing these events to the pandemic. We used data from the Mexican Health and Aging Study (2018/2021) and included participants aged 50+ (n=13,046). Participants self-reported whether they experienced the following hardship events: child or spousal death, caregiving for a sick family member, worsened finances, or job loss. If they said yes, they could attribute the event to COVID-19, resulting in two binary measures of hardship events (0 vs. 1+), pandemic-related or non-pandemic. Our primary outcome was a 9-item depressive symptom score. We used generalized estimating equations models adjusting for sociodemographic covariates and a time fixed effect. Gender heterogeneity was examined with stratified models and multiplicative interaction terms. Participants averaged 63.7 years, and 56.3% were women. Both non-pandemic (b=0.38, 95% confidence interval [CI]: 0.30, 0.46) and pandemic-related (b=0.43, 95% CI: 0.31, 0.56) hardship were associated with greater depressive symptoms. The magnitude of the associations was stronger for women (b=0.44, 95% CI: 0.34, 0.55 vs. b=0.29, 95% CI: 0.18, 0.40 for non-pandemic hardship; b=0.49, 95% CI: 0.32, 0.66 vs. b=0.34, 95% CI: 0.15, 0.53 for pandemic-related hardship). However, the gender difference was only statistically significant for non-pandemic hardship (interaction p=0.042). Understanding mechanisms for gender differences in the impact of the pandemic on the mental health of older adults is essential for targeted interventions.
PREDICTORS OF ANXIETY SYMPTOMS AMONG OLDER ADULTS WITH COGNITIVE IMPAIRMENT BY THEIR COGNITIVE STATUS
Authors: Hwang Mina , Hwang Yeji
Published: January 2025

Anxiety is common neuropsychiatric symptoms of dementia. While various factors can trigger anxiety in individuals with cognitive impairment, there is limited information available regarding whether these factors vary based on one’s cognitive status. Therefore, this study aimed to examine predictors of anxiety in older adults with cognitive impairment by their cognitive status. Using data from the National Health and Aging Trends Study (NHATS) Round 12, 1,040 older adults with probable or possible dementia were analyzed. Participants were categorized into possible (n=508, 48.8%) and probable dementia (n=532, 51.2%) groups. For data analyses, descriptive analyses, chi square tests, and logistic regression analyses were conducted. In the group of possible dementia, when participants had pain (OR=3.48, p < 0.001) or depression (OR=6.55, p< 0.001), they were more likely to present anxiety. In the group of probable dementia, when participants had pain (OR=3.54, p < 0.001), depression (OR=7.84, p< 0.001), low community cohesion (OR=1.59, 0=0.044), or were dependent on activities of daily living (OR=2.42, p< 0.001), they were more likely to present anxiety. This study found that while pain and depression were related to anxiety in both probable and possible dementia groups, factors such as dependency on activities of daily living or community cohesion were only related to anxiety in probable dementia group. When persons living with cognitive impairment present anxiety, healthcare professionals and caregivers should consider those triggers to reduce their anxiety.
RUMINATION MEDIATES THE ASSOCIATION BETWEEN REGIONAL GRAY MATTER VOLUME AND SUBTHRESHOLD DEPRESSION IN OLDER WOMEN
Authors: Wu Dongmei
Published: January 2025

This study aimed to identify distinctive characteristics of gray matter volume alterations in older women with subthreshold depression and to explore the mediating role of rumination in the relationship between changes in brain structure and depressive symptoms. A total of 102 older women residing in the community were divided into two groups: those with depression symptoms (DS) (n=50) and a healthy control (HC) group (n=52). Whole-brain two-sample t-tests on voxelwise gray matter volumes in the brains were conducted to identify gray matter volume alterations in older women with subthreshold depression, and mediation analysis was performed to test whether rumination mediates the impact of gray matter volumes on depressive symptoms in older women. Even after controlling for age, education level, monthly income, Mini-Mental State Examination score, and total gray matter volume, we identified significant increases in local gray matter volume in the left dorsolateral prefrontal cortex and left fusiform gyrus in the DS group. Moreover, rumination was found to partially mediate the relationship between the gray matter volumes in both regions and depressive symptoms. These findings indicated that the volumes of the left dorsolateral prefrontal cortex and left fusiform gyrus serve as potential neurostructural markers for subthreshold depression in non-clinical older female adults. Additionally, an underlying mediation mechanism in which gray matter volume affected depressive symptoms through individual rumination tendencies was proposed.
RURAL OLDER ADULTS’ SOCIAL DISCONNECTION AND DEPRESSION DURING THE PANDEMIC
Authors: Jun Jung Sim , Lee Kyoung Hag
Published: January 2025

During the pandemic, 24% of older adults reported anxiety or depression, with higher rates among those with low socioeconomic status and poor health, particularly among female older adults (Koma et al., 2020). Older adults in rural communities face greater challenges due to underlying health conditions and limited resources (Henning-Smith, 2020; Pender et al., 2019). Therefore, this study aimed to examine the association between social isolation, social support, and mental health among this population. The research team recruited 103 rural-dwelling older adults using purposive sampling. Measurements included: the Geriatric Depression Scale-Short Form (Sheikh & Yesavage, 1986), Lubben Social Network Scale-6 (Lubben et al., 2006), and Multidimensional Scale of Perceived Social Support (Zimet et al., 1988). Six socio-demographic variables were used as control variables: age, gender, final education, annual household income, perceived health, and driving capacity. There was a positive association between social isolation and depressive symptoms (B = 0.24, SE = 0.07, p ≤.001; B = 0.20, SE = 0.08, p ≤.01) while social support from significant others was negatively associated with depressive symptoms (B = -0.35, SE = 0.11, p ≤.001). However, social support from family, from friends, and age were not significantly related to depressive symptoms. A lack of social resources is a risk factor for rural older adults, potentially leading to increased mental health issues. Social service workers should focus on improve social support systems among rural older adults to establish social networks and create social resources.
THE INFLUENCE OF ANXIETY AND PERCEIVED CONTROL OF ANXIETY ON OLDER VETERANS’ QUALITY OF LIFE
Authors: Davis Carter , Carlson Chalise , Beaudreau Sherry , Gould Christine
Published: January 2025

Anxiety disorders are prevalent among older military Veterans, and the presence of an anxiety disorder negatively impacts quality of life. Little is understood, however, about potential psychological processes that explain how quality of life is impacted by anxiety among older Veterans. One potential mechanism is anxiety control, or one’s perceived ability to manage their anxiety as it arises in various contexts. In this study, baseline data were analyzed from 62 older Veterans (M age = 71.2) who participated in a clinical trial of a guided anxiety management intervention. The most common diagnoses among participants were anxiety not otherwise specified (37.1%), and generalized anxiety disorder (22.6%). Linear regression models were created which tested anxiety symptom severity as a predictor of mental health-related quality of life, with anxiety control as a covariate. Lower anxiety severity (p <.001) and higher perceived control of anxiety (p =.013) were found to be significant predictors of quality of life. Anxiety control remained a significant predictor (p =.05) when anxiety diagnosis type was included as a covariate, but not when depression symptom severity and health comorbidity were included in the model (p =.19). These results indicate anxiety control as a potentially important target in interventions for older adult Veterans across anxiety disorder subtypes. However, larger samples are needed to clarify the path through which this effect operates and the influence of additional factors such as depression and comorbid health conditions, which could be examined through moderation and mediation analysis.
“WE’RE CAMPAIGN OBJECTS”: A QUALITATIVE LIVELIHOOD ANALYSIS OF THE VISUALLY IMPAIRED OLDER ADULT IN RURAL GHANA
Authors: Frimpong Eric , Gyimah Akwasi Adjei , Adjei Mathias
Published: January 2025

Background

In Ghana, a considerable proportion of the older adult population continue to face economic hardship due to the weakening of family structures and inadequate social support. This study aims to investigate the lived experiences of visually impaired older individuals residing in rural areas of the country.

Methods

For a deeper understanding of the experiences of respondents, the social model of disability informed the use of a qualitative approach to interviewing a total of 18 older adults residing in selected rural areas in Ghana. The data was analyzed through a thematic content analysis approach. Findings: Many older adults in Ghana living with visual impairment continued to experience economic hardship. They often rely on donations from family members and social groups, such as churches. However, these sources of support are inadequate to meet their needs. A major concern raised was access to government support programs. For those who were enrolled in such programs, they expressed dissatisfaction with the benefits received, citing their insufficiency in meeting their needs. Furthermore, many respondents expressed disillusionment with politicians who were perceived to have made empty promises during election campaigns in an attempt to implement programs that will enhance their livelihood.

Conclusion

These findings illustrate the pressing need for more effective support systems and interventions to address the economic challenges faced by visually impaired older people in rural Ghana. Policymakers must consider the unique needs and experiences of this population, and work towards implementing solutions that are both sustainable and effective.
COGNITIVE DISCREPANCY ON SOCIAL LIFE AND LIFE SATISFACTION AMONG OLD ADULTS WITH VISUAL DISABILITIES
Authors: Chang Ya-Han , Sörensen Silvia
Published: January 2025

Background and objectives

This study addresses the quality of life faced by individuals with vision impairment. Life satisfaction in the context of disability is co-determined by social life, loneliness feelings, future planning, and financial status. However, the role of cognitive discrepancy and social cognition congruence in shaping life satisfaction is rarely studied. This study uncovers the role, by investigating various factors, including social relationships, loneliness, and discussions of future care plans.

Research Design and Method

Baseline data from older adults with age-related macular degeneration (N=167, Mean age = 79.66), who were participants in a depression prevention trial, were analyzed to determine the relationship between future care planning to life satisfaction. Cognitive discrepancy, and moderation of this relationship by variable (1) loneliness and (2) quality of social relationship tested.

Results

The significant relationship between discussions about future care plans and older adults’ life satisfaction (p <.001) was moderated by the interaction of the quality of social relationships and loneliness as either cognitive discrepancy or congruence.

Discussion and Implication

The pivotal role of social cognitive congruence about loneliness and social relationships emerges as a critical factor in life satisfaction among old adults. We found the influence of cognitive discrepancy and care plan discussion on life satisfaction. Discussing plans with family members for elders with high cognition discrepancies is critically affecting their life satisfaction.
ASSOCIATION AND INTERACTION BETWEEN RESILIENCE AND PSYCHOLOGICAL DISTRESS IN DISABLED ELDERLY–CAREGIVER DYADS
Authors: Wang Anni
Published: January 2025

Objectives

The aim of this study was to explore the interaction between resilience and psychological distress in disabled elderly-caregiver.

Methods

A total of 246 homebound disabled elderly and their family caregivers from five provinces of China were investigated by convenience sampling using the Chinese version of the Resilience Scale and the Distress Thermometer and Problem List. Data analysis using the actor - partner interdependence model (APIM) modelling.

Results

The effect of resilience on psychological distress is a mixed pattern. With regard to the actor effect, the resilience of the disabled elderly and caregivers is negatively related to their own psychological distress, respectively. Regarding the partner effect, the resilience of the disabled elderly was negatively associated with caregiver psychological distress, and the resilience of the caregiver was negatively associated with psychological distress of the disabled elderly.

Conclusion

There is dyadic interaction between disabled elderly and their caregivers, suggesting that resilience can relieve not only one’s own psychological stress but also that of others to some extent. Families of disabled elderly need to focus on both the older person and the caregiver, taking advantage of resilience in a focused way to reduce psychological distress and improve the dyadic physical and mental health. Health professionals can design dyadic interventions which are focuses on resilience and its dyadic interaction, and effectively leverage the resilience advantages of the dyad based on the individual’s level of psychological distress, to improve the mental health of the elderly with disabilities and their caregivers.
NURSING HOME STAFF CARE APPROACHES ARE ASSOCIATED WITH MEALTIME DIFFICULTIES IN OLDER ADULTS WITH DEMENTIA
Authors: Lee Kyuri , Suh Heather , Liu Wen
Published: January 2025

Nonverbal mealtime care is critical for optimizing eating performance and mealtime behaviors of residents with dementia (RwD), especially for those with limited verbal communication abilities. Understanding the relationship between care staff’s nonverbal approaches and RwD’s mealtime behaviors help guide the development of evidence-based, effective mealtime interventions. This observational study characterized staff person-centered and task-centered care approaches and RwD mealtime difficulties and examined the associations between staff care approaches and RwD mealtime difficulties. Videotaped mealtime observations (N=185) involving 47 nursing home direct care staff (age mean ± SD = 45.6±11.8 years; 92.3% female; 80.8% white; 15.5±12.9 years worked as a caregiver, 12.3 ± 9.1 years in the current facility) and 12 RwDs (age 71.9±7.5 years; 91.7% male; 91.7% white, 41.7% married) were coded using the refined Cue Utilization and Engagement in Dementia (CUED) mealtime video coding scheme. Staff primarily used nonverbal person-centered care approaches, including modifications of resident abilities (62.4%), dyadic interactions (10.7%), and the dining environment (6.0%), followed by task-centered behaviors (9.6%). RwD’s mealtime difficulties score assessed by The Edinburgh Feeding Evaluation in Dementia (EdFED) was 5.91±3.59 (range 0-15). RwD’s mealtime difficulties was significantly associated with person-centered care approaches (b=0.04, p=.005) and task-centered care approaches (b=0.11, p=.042), controlling for staff age, years worked as a caregiver, and years worked in the current facility. Minimizing the use of task-centered care may alleviate residents’ mealtime difficulties. Person-centered care is highly recommended in dementia care, but needs to be multifaceted and tailored to the different contexts and needs of individual residents.