bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual-Task Costs in Gait Speed Differs Across Age Groups
Authors: Paulson Sally , Gray Michelle , Gills Joshua , Campitelli Anthony , Jones Megan , Sanders Joohee , Madero Erica , Glenn Jordan
Published: December 2021

With age, there are simultaneous reductions in gait speed (GS). This decrease in GS has been associated with an increased fall risk and negatively impacts independence. Further, GS naturally declines with the addition of a secondary stimulus (i.e., cognitive requirements). Combined, these decrements can be additive in nature potentially leading to robust declines with advancing age. Therefore, the aim of this study was to examine age-related effects of dual-task cost (DTC) while walking. Adults (N = 145), over the age of 45 years, completed two walking trials for each GS condition: habitual (HAB) and fast (FST), with and without a DT (i.e., counting backwards by serials of three). Subjects were classified into four age groups: youngest-old (YG ≤ 64 years, n = 24), young-old (YO, 65-74 years, n = 46), middle-old (MO = 75-84 years, n = 54), and oldest-old (OO ≥ 85 years, n = 21). DTC was calculated and ANOVAs were used to assess differences between the groups. There was no difference in HAB DTC between the age groups (p=.61). However, there was a significant difference in FST DTC (p=.04) between the YO (M±SD: -14 ± -11%) and OO (M±SD: -24 ± -12%). These data indicate there was an age-related affect for fast dual-task cost, but not for habitual dual-task cost while walking. An increase in dual-task cost among the oldest-old may be associated with an inability to properly maintain a faster cadence while performing an arithmetic task which may be related to task prioritization.
Effect of High-Intensity Interval Training on Rheumatoid Arthritis CD4+ T Cell Oxidative Metabolism
Authors: Andonian Brian , Bartlett David , MacIver Nancie , Kraus William , Huffman Kim
Published: December 2021

Persons with rheumatoid arthritis (RA) have poor cardiorespiratory fitness and accelerated biological aging driven by systemic impairments in metabolism and inflammation. In this study of older RA participants, our goal was to identify the effects of a high-intensity interval training (HIIT) program on cardiorespiratory fitness and peripheral CD4+ T cell metabolism. We isolated CD4+ T cells from peripheral blood mononuclear cells in sedentary female RA participants (n=6; age=64.0+/-6.3 years) who underwent cardiopulmonary exercise testing and phlebotomy before and after 10 weeks of HIIT. HIIT improved RA cardiorespiratory fitness by 6.5+/-6.0% (pre-HIIT VO2 peak=25.1+/-5.1 ml/kg/min, post-HIIT VO2 peak=26.7+/-5.0; p=0.05). As measured by Seahorse XF Mito Stress Test, there were no significant mean changes in CD4+ T cell oxidative (oxygen consumption rate (OCR); pmol/min) or glycolytic (extracellular acidification rate (ECAR); mpH/min) metabolism, however there was large interindividual variability. RA peripheral CD4+ T cells preferred glycolytic metabolism (pre-HIIT mean basal OCR/ECAR ratio=0.78+/-0.13 pmol/mpH), while HIIT non-significantly shifted cellular preference toward oxidative metabolism (post-HIIT mean basal OCR/ECAR ratio=0.86+/-0.16; p=0.30). Increases in RA cardiorespiratory fitness following HIIT were significantly associated with increases in RA peripheral CD4+ T cell OCR/ECAR ratio (Spearman’s rho=1.0, p<0.001) and basal and maximal respiration (rho=0.89, p=0.02 for both). Additionally, increases in CD4+ T cell mitochondrial ATP-linked respiration were significantly associated with increased quantities of circulating naïve CD4+CCR7+CD45RA+ T cells (rho=0.89, p=0.02). Our findings suggest that targeting cardiorespiratory fitness may be key in modulating T cell specific oxidative metabolism and function to prevent immunosenescence in older patients with chronic inflammatory diseases.
Effect of Video assisted Home-Based exercise intervention on fall risk and gait parameters in older adults in India
Authors: Kulkarni Snehal , Nagarkar Aarti
Published: December 2021

Countries across the globe recommended isolation to protect older adults from COVID-19 infection. However, this led to decreased mobility and physical inactivity potentially increasing their risk of fall. The study was conducted in a group of 88 older adults between 60-74 years with known gait impairments and high fall risk. The participants were part of our cohort study on fall prevention program. Fall risk and gait impairments were measured using wearable sensors during the Timed-up and go test (TUG) at baseline. Using technology, a 16-week video assisted home based exercises intervention was delivered to reduce fall risk and improve gait parameters. The intervention consisted of flexibility, strengthening, balance and gait training exercises given progressively through one video session per week. The participants performed these exercises at home for the rest of the week. A home visit immediately after 16th week was arranged to collect post intervention parameters. Results showed an average 20% decrease in fall risk post intervention. An overall large effect size with Cohen’s d of 0.90 was reported for fall risk. Significant difference in TUG time (Z = -4.610, p< 0.000), stride velocity (Z= -5.035, p<0.000), stride length (Z = -5.867, p<0.000), time taken to stand (Z = -7.363, p<0.000) and time taken to turn (Z = -6.079, p<0.000) was observed in the post-test measurements as compared to pre-test measurements. Therefore, we conclude that video assisted exercise programs can be highly beneficial as alternatives to in person exercise intervention to prevent falls during COVID-19 isolation.
Physical Activity Impacts Walking Distances and Energy Consumption of Patients with Peripheral Artery Disease
Authors: Evans Nathaniel , Hassan Mahdi , Dinkel Danae , Johanning Jason , Pipinos Iraklis , Myers Sara
Published: December 2021

Lower extremity peripheral artery disease (PAD) is attributed to buildup of atherosclerotic plaques preventing adequate blood flow, leading to pain during walking, and ultimately physical inactivity. Normal day-to-day levels of physical activity may impact the distance a subject can walk before claudication pain onset, as well as their energy consumption capabilities. This study compared walking performance (initial claudication distance (ICD) and absolute claudication distance (ACD)), and energy consumption (EC) between active and inactive subjects with PAD. The distinction between groups was made using previous research that declared the average PAD patient walks 3586 steps/day. Ten subjects were classified as active (□3586 average steps/day) and sixteen participants as inactive (<3586 steps/day) based on a 7-day accelerometer measurement. The Gardner progressive treadmill test was used to asses ICD, ACD, and EC. EC was measured using a metabolic cart and calculated from the second minute of walking and the last minute prior to stopping due to claudication pain. The average ICD and ACD for the active group were 130.6±106.7 meters and 306.0±184.7 meters, respectively and 143.8±119.0 meters and 248.0±156.0 meters, respectively for the inactive group. The average EC for the second minute and last minute were 9.6±1.9 mlkg-1min-1 and 11.5±2.4 mlkg-1min-1 respectively for active group and 7.0±3.1 mlkg-1min-1 and 8.1±3.8 mlkg-1min-1 respectively for inactive group. The data suggests that the active group had better walking performance and greater energy consumption indicating increased efficiency of oxygen transport and extraction capability in the leg muscles.
Prescribing Personalized Exercise Programs Using Smartphone Sensors For Remote Fitness Assessment
Authors: Jacobs Jeremy , Yekutiel Ziv , Arnon Mical , Argov Esther , Karlinsky Keren Tchelet , Benmoha Eti , Netz yael
Published: December 2021

Guidelines for physical activity emphasize multiple fitness components among people aged >65. The age-related increase in variability of fitness components necessitates accurate individualized assessment prior to optimal prescription for personalized exercise program. Accordingly, we tested feasibility and effectiveness of a novel tool designed to remotely assess balance, flexibility, and strength using smartphone sensors (accelerometer/gyroscope), and subsequently remotely deliver personalized exercise programs via smartphone. This pilot study enrolled 52 healthy volunteers (34 females) aged 65+, with normal cognition and low fall-risk. Baseline preliminary data from smartphone fitness assessment were analyzed to generate 42 fitness digital-markers, used to generate personalized exercise programs (5 times/week for 6 weeks). Programs included graded exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, vestibular). Fitness was remotely assessed at baseline and after six weeks. Average age was 74.7±6.4 years; adherence was 3.6±1.7 exercise sessions/week. Significant improvement for pre/post testing was observed for 10/12 digital-markers of strength/flexibility for upper/lower body (sit-to-stand repetitions/duration; arm-lift duration; torso-rotation; arm-extension/flexion). Balance improved significantly for 6/10 measures of tandem-stance, with consistent (non-significant) trends observed across 20 balance digital-markers of tandem-walk and one leg-stance. Balance showed greatest improvement among the 37 participants exercising ≥3/week. These preliminary results serve as proof of concept among people aged >65: high adherence and improved fitness confirm the potential benefits and niche for remote fitness assessment used to generate personalized exercise programs. Future research is required to confirm the benefits among specific patient groups, such as those with frailty, deconditioning, cognitive and functional impairment.
Reliability of Grip Strength as a Predictor of Hand Limitation Among U.S. Older Adults: How Good is Grip Strength?
Authors: Logue Rachel , Brown Susan , Hasson Rebecca , Davis Matthew
Published: December 2021

Grip strength is commonly used to assess hand function in older adults and is associated with health outcomes including muscle strength, cognition, and mortality. However, the degree to which grip strength predicts an actual hand limitation is unknown. This study evaluated grip strength as a predictor of hand limitations associated with activities of daily living. Using the 2011-14 National Health and Nutrition Examination Survey (NHANES), we selected five self-reported hand-related functional limitations to classify older adults reporting one or more limitations versus those with no limitations. We identified 2,064 older adults (age≥65), 31% of whom reported a hand-related limitation. Odds ratios were used to assess the association between grip strength quartile and the likelihood of a hand limitation while controlling for sex, race/ethnicity, education level, income, and pain. Receiver operator curves were used to evaluate the degree to which grip strength discriminates between those with limitations versus those without. Older adults with very low grip strength (lowest quartile) were more likely to have at least one limitation (OR:6.1, 95% CI:3.2,11.8) than those with high grip strength (highest quartile). However, receiver operator curves suggested grip strength only modestly discriminated hand limitations (area under curve:0.71). While self-reported hand limitations were associated with lower grip strength, it was a relatively poor predictor of hand impairments among older adults. This study suggests grip strength may not predict hand function as well as previously thought. Better assessments are needed to adequately evaluate upper extremity impairments to help older adults maintain functional independence.
Sex differences in power decrement identified across the lifespan
Authors: Campitelli Anthony , Paulson Sally , Vincenzo Jennifer , Glenn Jordan , Jones Megan , Powers Melissa , Gills Joshua , Gray Michelle
Published: December 2021

Muscular power has been shown to be a significant predictor of physical function in older adults, but assessments of power have traditionally been performed in movements not specific to activities of daily living (ADLs). Recent research examined power in the context of ADL-specific movements, but it is unclear how ADL-specific lower-body power differs over lifespan in males and females. This investigation sought to describe ADL-specific power decline across the lifespan and analyze differences between the sexes. Adults (n = 557) aged 18-89 volunteered and were divided into age cohorts (18-30, 50-59, 60-69, 70-79, and 80-89 years). Participants performed a sit-to-stand (STS) task with as much velocity as possible while connected to a linear position transducer (LPT). The LPT calculated average and peak power. The average result of 5 individual STS trials was analyzed for each of the power variables. The first significant decrement in average STS power (p < .01) was observed at an earlier age cohort in males than females (60-69 in males vs. 70-79 in females). The per decade magnitude of power decrement after age 60 was larger in males than females in both absolute magnitude and percent decrease (11.74 vs. 10.09% decrease per decade). As power and physical function are correlated, this may have implications for the rate and age of functional decline in males. Additionally, understanding the differences in ADL-specific power decline between males and females gives clinicians and health professionals valuable information for developing preventative fitness paradigms specific to members of a given sex.
Texting Older Sisters to Step (TOSS) Using Fitbits to Promote Physical Activity: A Feasibility Study
Authors: Bowen Pamela , Opoku-Agyeman William , Mixon Veronica , Affuso Olivia , Clay Olivio
Published: December 2021

Black women are disproportionately diagnosed with obesity (BMI ≥ 30 kg/m2). Obesity is a preventable but complex, public health problem that is multifaceted, chronic, and approximately 58% of Black women 60 years and older are classified as obese, compared to 38% of their White counterparts. This 12 week, pre/post, 2-group study aimed to determine if a peer-informed physical activity (PA) intervention with peer support would be feasible among community- dwelling, obese, older Black women to promote regular PA. Forty-eight potential participants were screened, 24 categorized as obese were enrolled and completed the study. The mean age was 64 (SD 3.0) years. Steps were measured by a Fitbit-Inspire with data successfully collected on 98% of days with the treatment group averaging a daily increase of 700-steps more than the control. Evaluation of intervention’s acceptability revealed that 100% enjoyed the study and using the Fitbit device. Text message readability was 100% and 95% said the study was motivational. Additionally, 8.3% said daily prompts were too frequent, 12% indicated that future studies should include additional social support, and 88% did not comment on the Fitbit community option for support, suggesting that this feature was not practical. Findings demonstrated that this intervention meets the criteria of being scalable, low cost, feasible, and acceptable for the older Black women. Using self-monitoring techniques in combination with at least one other behavioral strategy, such as our TOSS messages (cues for motivation) as the delivery channel for health promotion messages are a promising approach to increase PA behaviors.
Does Closing the Donut Hole Reduce Financial Burdens Among Medicare Part D Beneficiaries?
Authors: Zhang Yalu , Liu Lan , Sun Jingjing , Zhang Xinhui , Sun Jiling , Song Xinming , Chen Gong
Published: December 2021

The Medicare Part D donut hole has been gradually closed since 2010. But it is still unclear how it has impacted the beneficiaries’ relative financial burdens, especially in the later stage of the closing plan. The measurement of catastrophic health expenditure induced by prescription drugs (CHE-Rx) reflects the relative financial burdens to beneficiaries’ household income, which bears more information than the measure of dollar-value expenses or the absolute poverty line used in prior studies. Using the Medical Expenditure Panel Survey 2008-2017 longitudinal national representative data and the method of difference-in-differences, this study found that the donut hole closing policy was associated with more usage of prescription drugs (b=2.84, p=0.023) and a higher likelihood of experiencing CHE-Rx (b=2.4%, p=0.011) among those who fell in the donut holes. Besides, the results show that the donut hole closing policy did not generate any immediate effects on prescription drug usage, CHE, and CHE-Rx. For the first time, this paper examined both the aggregated and marginal impact of the policy implementation, which had closed by an additional 35% between 2013 and 2017, on the relative financial burden among the beneficiaries.
Leadership among Directors of Social Work in Long Term Care Facilities
Authors: Abenojar John Paul
Published: December 2021

Long term care facilities (LTC) provide ongoing care for seniors and chronically ill. To maximize the quality of the care, LTC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies and interactions of facility administrators and nursing directors there is a substantial gap in the literature on the leadership styles and strategies employed by Directors of Social Work (DSW). The aim of this phenomenological study was to address this gap in research by exploring how DSW influenced leadership policies, prepared subordinates for crisis intervention and management, perceived that social workers influence decision making in patient care, and believed that communication amongst LTC staff about patient care could be improved.
Resilience among older adults with Type 2 Diabetes from the Look AHEAD trial
Authors: Olson KayLoni , Howard Marjorie , Mccaffery Jeanne , Dutton Gareth , Espeland Mark , Johnson Karen , Simpson Felicia , Wing Rena
Published: December 2021

There is growing interest in identifying factors protecting against aging-related decline. This cross-sectional study evaluated associations of self-reported resilience (ability to bounce back) with factors linked to aging-related decline among older adults with Type 2 diabetes (T2DM). Participants were 3,199 adults (72.2±6.2 years, 61% female, 61% white, BMI 34.2±8.2 kg/m2) enrolled in Look AHEAD (a multi-site RCT comparing weight loss to diabetes education among individuals with T2DM), who were followed observationally after the 10-year intervention was discontinued. The following items were assessed approximately 14.4yrs post-randomization: Brief Resilience Scale; overnight hospitalizations in past year; physical functioning measured objectively (gait speed, grip strength) and via self-report (Pepper Assessment Tool for Disability; Physical quality of life (QOL; SF-36)); a composite measure of phenotypic frailty based on having ≥3 of unintentional weight loss, low energy, slow gait, reduced grip strength, physical activity. Depressive symptoms (PHQ-9) and mental QOL (SF-36) were also measured. Logistic/linear regression was used to evaluate the association of these variables with resilience adjusted for age, race, and gender. Greater resilience was associated with lower BMI (p=.01), fewer hospitalizations (p=.02), better physical functioning (i.e., lower self-reported disability, better self-reported physical QOL, faster gait speed, greater grip strength and lower likelihood of meeting criteria for frailty; all p<.001), fewer depressive symptoms and greater mental QOL. Resilience is associated with better performance on indicators of overall functioning and risk for decline among older adults. Findings correspond with efforts to shift narrative on aging beyond ‘loss and decline’ to highlight opportunities to facilitate healthy aging.
The role of laughter for successful aging of Alaska Native Elders
Authors: Lewis Jordan
Published: December 2021

During a visit over tea and pilot bread, discussing successful aging and well-being, an Inupiat Elder shared that “It’s better to live a happier life, enjoy life all you can.” These wise words inspired the theme of this chapter which explores the role of laughter in the resilience and wellbeing of Alaska Native Elders. Based on a decade of research, this chapter introduces the concept of Alaska Native Eldership and provides an overview of the five strands of Alaska Native successful aging that contribute to their ability to remain resilient. Laughter is a universal emotional experience, and Alaska Native Elders have taught us that is has different functions that enable us to be resilient and age successfully. Laughter is woven throughout the strands of successful aging as a key to health and well-being and this chapter discusses the four types of laughter used to protect themselves, including redirecting conversations, practicing humility, taking away the power of stressful topics, as well as sharing happiness and laughter with others. This chapter concludes with reflections on how laughter contributes to our ability to find meaning and purpose in life and strengthening our relationships with family and community so we can remain resilient as we age.
Racial and Ethnic Differences in Retirement Satisfaction among Older US Adults
Authors: Van Vleet Samuel , McLaughlin Sara
Published: December 2021

Along with population aging, the diversity of the older US population is increasing. Research suggests that racial and ethnic minorities experience disadvantages over the life course that can negatively impact later life. Despite this, little research has examined racial and ethnic differences in satisfaction with retirement. Using data from the 2016 wave of the Health and Retirement Study, we compared retirement satisfaction among Black (n = 1,068), Hispanic (n = 674), Other (n=161), and White (n = 4,833) older adults (age 65+). Retirement satisfaction was measured with the following item: “All in all, would you say that your retirement has turned out to be very satisfying, moderately satisfying, or not at all satisfying?” Responses were categorized as very satisfied vs. all others. Approximately 43% of Black, 35% of Hispanic, 39% of Other, and 56% of White Americans reported being very satisfied with retirement (χ2(2.4)=58.9; p < .0001). In multivariate logistic models controlling for age, educational level, gender, household income, marital status, and functional limitations, the odds of being very satisfied with retirement were 32% lower for Hispanic (OR=0.68; 95% CI= 0.55, 0.85) and 37% lower for Other Americans (OR=0.63; 95% CI= 0.43,0.92) relative to their White counterparts. No significant difference was evident for Black and White Americans in adjusted analysis (OR=0.96; 95% CI=0.76,1.20). Our findings indicate that inequalities in the retirement experience exist by race and ethnicity in the United States. More research is needed to understand the factors responsible for lower retirement satisfaction among Hispanic and Other Americans.
Factors Associated With the Use of Telehealth in Middle-Aged and Older Adults During the COVID-19 Pandemic
Authors: Du Yan , Yang Rumei , Xu Qingwen , Xie Bo
Published: December 2021

The COVID-19 pandemic has promoted the adoption and use of telehealth, particularly in the early months of the pandemic. However, people with diverse characteristics may, or may not, be able to use telehealth, presenting digital divide in health care and potential health equity-related issues. This study aimed to assess the use of telehealth among middle-aged and older adults during COVID-19, and to explore factors associated with their telehealth utilization. We used publicly available data from the California Health Interview Survey collected during January 2019 and December 2020 (N=15, 279; mean age= 64.23±11.59; female: 52.7%). Approximately 11.0% of the sample used telehealth at least once. Bivariate and multivariate logistical regression analyses found that, compared with non-users, telehealth users were more likely to be having higher numbers of chronic conditions, with self-reported mental distress, living in urban areas, born in the US, with higher English proficiency, higher education, and having higher incomes. Age, race/ethnicity, and gender were not significantly correlated with telehealth usage. Logistic regression revealed that having mental distress (OR=1.48, 95% CI=1.29-1.71, p<0.01), more chronic conditions (OR=1.48, 95% CI=1.29-1.71, p<0.001) and living in an urban area (OR=1.93, 95% CI=1.36-2.74, p<0.001) were independently related to telehealth use. These findings suggest that telehealth, while being beneficial during the pandemic, might also introduce new challenges that exacerbate existing health inequity and disparities. Policy and community-based interventions are needed to promote the use of telehealth among middle-aged and older adults with diverse characteristics.
Cumulative Effect of Loneliness and Social Isolation on Health Outcomes among Older Adults
Authors: Barnes Timothy , MacLeod Stephanie , Tkatch Rifky , Ahuja Manik , Albright Laurie , Schaeffer James , Yeh Charlotte
Published: December 2021

Loneliness and social isolation are described similarly yet are distinct constructs. Numerous studies examine each construct separately; however, less research has been dedicated to exploring their impacts together. Using survey and claims data among adults age 65+ (N=6,994), the cumulative effects of loneliness and social isolation on late-life health outcomes were examined using Chi-square and multivariate regression models. Loneliness and social isolation were measured using the UCLA-3 Loneliness Scale and the Social Network Index. Participants were grouped into four categories of loneliness and social isolation based on overlap, including: lonely only (L), socially isolated only (SI), both lonely and socially isolated (LSI), or neither (N). Outcomes included quality of life and healthcare utilization and costs. Among participants, 9.8% were considered L, 20.6% SI, 9.1% LSI, and 60.5% N. Respondents were primarily female (55.0%) and 70-74 years of age (27.1%). Those considered LSI were more likely to be older, female, less healthy, depressed, with lower quality of life and greater healthcare utilization patterns. Participants who were L or LSI had higher rates of emergency room visits compared to the N group; LSI had the highest medical costs. Results demonstrate the cumulative effects of loneliness and social isolation among older adults. Findings not only fill a gap in research exploring the impacts of these constructs later in life, but also confirm the need for approaches targeting older adults who are both lonely and socially isolated. As the COVID-19 pandemic continues, this priority will continue to be urgent for older adults.
Marital Support Reciprocity and Life Satisfaction Among Older Koreans
Authors: Lee Hye Soo
Published: December 2021

The importance of reciprocity in social support for well-being has been shown, but few studies have investigated marital support reciprocity in older Korean samples. This study examined the associations between three types of marital support reciprocity and life satisfaction, stratified by age and gender. The sample consisted of 1,578 men and 1,464 women from the 2017 National Survey of Older Koreans, divided into young-old (65-74) and old-old (75+) groups (M age = 75.06, SD = 6.35). Participants self-reported emotional, instrumental, and physical support provided to and received from spouses, and life satisfaction (LS). Regression models controlling for covariates showed that results varied by age and gender. For young-old males, received emotional and provided instrumental support were positively associated with LS. For young-old females, both received and provided emotional support, and received instrumental support, were positively associated with LS, but provided physical support showed negative associations. For old-old males, providing emotional support was positively associated with LS; for old-old females, only received emotional support was significant. Using interaction terms to assess reciprocity, young-old females and old-old males showed reciprocity effects for instrumental support. When participants provided and received high levels of support, life satisfaction levels were high. However, when participants provided low levels of support, received support was not significant. Thus, the effects of receipt and provision of support on LS varied by age and gender among older Koreans, but reciprocity of instrumental support was only important for young-old women and old-old men.
Social Connectedness and Communication Technology Among Paid and Unpaid Caregivers of Middle-Aged and Older Adults
Authors: Lee Shinduk , Ory Marcia , Dahlke Deborah Vollmer , Smith Matthew
Published: December 2021

Objective: To examine differential relationships between communication technology use and social connectedness among paid and unpaid caregivers providing care for middle-aged and older adults. Methods: This nationwide study utilized a cross-sectional Qualtrics panel survey from caregivers, ages 50 years and older (n=504) of middle-aged and older adults. About 17% were paid (n=86) and 83% (n=418) were unpaid caregivers. Primary outcomes were caregivers’ sense of belonging to their local community and social bonds. The primary predictor of interest was caregivers’ use of communication technology (texting/communication applications). A multivariable regression analysis was performed to predict each outcome based on communication technology use, separately among paid and unpaid caregivers. Multivariable regression analyses were repeated after including the caregivers’ payment status (paid/unpaid) and the interaction term between the caregivers’ payment status and the use of communication technology. The models were adjusted for caregivers’ age, education, financial status, place of residence, and total weekly hours of caregiving. Results: Use of communication technology had a statistically-significant positive association with sense of belonging only among paid caregivers (b=25.8, p=.005). The relationship between use of communication technology and sense of belonging was significantly different between paid and unpaid caregivers (p=.005). Use of communication technology was significantly associated with social bonds only among unpaid caregivers (b=0.4, p<.001). There was no statistically-significant differential association between communication technology use and social bonds. Conclusion: Communication technology may play differential roles in linking paid and unpaid caregivers with their community and interpersonal groups. Additional efforts should examine mechanisms that provide meaningful caregiver support.
Nursing Students Visiting People with Dementia Online during COVID-19: A Qualitative Study
Authors: Kimzey Michelle , Patterson Jodi , Mastel-Smith Beth
Published: December 2021

The coronavirus disease 2019 (COVID-19) crisis has impacted the daily routines of students, people living with dementia, and their care partners. Social distancing results in fewer interpersonal interactions and enjoyable activities which makes life more challenging for those living with dementia. The purposes of this multiple case study were to understand how nursing students, people with dementia, and care partners (a) describe online visits between nursing students and people with dementia during stay-at-home directives in response to COVID-19 and (b) the perceived visit benefits. Nursing students participated in online visits to socially engage with their mentor (person living with dementia). During the visits it was anticipated that care partners would enjoy a brief respite. After 12 visits, investigators completed one-to-one online interviews with students (n = 10), care partners (n = 8) and mentors (n = 8). All cases reported a positive experience, perceptions of the conversations, improved social connection and meaning and purpose, mentor’s enhanced cognition and planned future connections. Relationships were formed between students, people with dementia, and care partners during online visits, an activity that might be implemented outside of a crisis to prevent social isolation across generations. Future efforts to engage people with dementia in residential facilities should be formally integrated into the care plan and staff dedicated to help with technology assigned.
Older Adult’s Marital Status, Support Exchanges and Psychological Well-being in Everyday Life
Authors: Ng Yee To , Fingerman Karen
Published: December 2021

Social support exchanges are an integral part of older adults’ well-being. Yet, we know little about how older adults' marital status may influence their support exchanges with different social partners in everyday life, and whether the effect of support exchanges on daily well-being vary by marital status. Adults aged 65+ (N = 278) completed an initial interview about their background and close social networks; then, participants reported whether they provided or received support from their close social partners and rated their psychological well-being for 5 to 6 days. Multilevel logistic models revealed that married older adults were more likely to provide or receive daily support from their close partners than widowed or divorced older adults. However, with respect to specific non-spousal ties, married older adults were less likely to provide support to siblings, friends or others (acquaintances, neighbors) compared to divorced older adults. Although married older adults were more likely to receive support from children than divorced older adults, they were less likely to receive support from siblings and friends compared to widowed or divorced older adults. Furthermore, receiving support from other familial ties (grandchild, other relatives) was associated with reduced daily well-being for widowed older adults whereas married older adults were able to maintain their daily well-being in such situation. Findings highlight the central role siblings and friends play in unmarried older adults' daily support networks and suggest that receiving support could have differential impact on daily well-being depending on older adults’ marital status.
Can Working Together Buffer Depression Among Older, Religious African American Couples?
Authors: Skipper Antonius , Rose Andrew , Jones Ethan , Reeves Alex , Joiner Jhazzmyn
Published: December 2021

Depression is a growing concern among older African Americans, as many within this group hesitate to seek professional help from psychiatrists or counselors. Instead, existing literature notes that older African Americans frequently utilize informal social support networks (e.g., church leaders) to respond to stress and buffer the negative effects of depression and depressive symptoms. Yet, little is known about the shared coping practices of older African American couples in relation to depression. Given the commonly noted high levels of religiosity among African Americans, this study examined communal coping as a mediator between sanctification and depression for older African American couples. This study utilized the dyadic data of 194 (146 married and 48 cohabiting) African American couples between the ages of 50 and 86 years. Capturing data with the Revised Sanctification of Marriage scale, the Communal Coping scale, and the Major Depression Inventory, bias-corrected bootstrap analysis revealed that men’s relationship sanctification and women’s depression was partially mediated by men’s, as well as the sum of men’s and women’s, communal coping in married couples. Further, men’s relationship sanctification and men’s depression was partially mediated by men’s, as well as the sum of men’s and women’s, communal coping. In addition, women’s sanctification was positively associated with men’s depression, directly. These findings are valuable in understanding the complex buffers, and contributors, to depression among older African American couples who may identify closely with religion but prefer the support of a partner over professional care.
Relational Sanctity as a Contributor to Forgiveness: Dyadic Data From Older African American Couples
Authors: Skipper Antonius , Rose Andrew , Reeves Alex , Joiner Jhazzmyn , Jones Ethan
Published: December 2021

Although research finds that healthy romantic relationships can provide several benefits in older adulthood, few studies examine the relational characteristics of older African American couples. Further, despite positive associations between religiosity and age, particularly among African Americans, a dearth of dyadic data consider the importance of religious constructs within the relationships of older African Americans. To address this gap, this study utilized dyadic data from the Strong African American Couples Project to examine the interconnection between relational sanctity and forgiveness among married and cohabiting older African American couples. A total of 194 African American couples (146 married and 48 cohabiting) aged 50 to 86 years were included in the analysis, and Actor Partner Independence Models were used to test the relational effects of sanctity and forgiveness. Findings revealed that no significant effects existed when women’s relational sanctity was the predictor variable. However, men’s relational sanctity had a significant positive association with both his own forgiveness of his partner and his perception of his partner’s forgiveness. These findings have valuable implications for professionals engaging older African American couples. First, this study helps to counter the often deficit-focused literature on African American couples by highlighting the potentially stabilizing influence of viewing one’s relationship as sacred. Second, this study offers a rare glimpse into the aspects of men’s religiosity that may be more consequential than women’s. Both practitioners and clergy could use this information to inform counseling efforts that seek to build on the strengths of married and cohabiting older African American couples.
Religiosity and Perceived Social Support Enhance Older Adults’ Resilience after the 2016 Flood
Authors: Cherry Katie , Calamia Matthew , Elliott Emily , Cantelli Angelina
Published: December 2021

In 2016, catastrophic flooding destroyed homes and property across south Louisiana. This study is part of a larger program of research that addresses the role of prior hurricane and flood experiences on current health and well-being in later life. Participants were predominately middle-aged and older adults who varied in current and prior severe weather experiences (M age=49.6 years, age range 18-88 years). All were tested during the immediate aftermath of the 2016 flood (Wave 1; N=223) and most participated in a follow-up assessment 9 (+/- 3) months later (Wave 2; N=202). Cherry et al. (2021) reported that greater flood stressors at Wave 1, such as displacement, flood-related losses, and damage to homes and property, were associated with more symptoms of post-traumatic stress disorder (PTSD). In this study, we tested the hypothesis that age, religiosity, and perceived social support would be positively associated with post-flood resilience at the Wave 2 follow-up. Results indicated that age was positively associated with religiosity and resilience, and negatively correlated with symptoms of PTSD. Additionally, faith community involvement, non-organizational religiosity, and religious beliefs and practices were all significantly correlated with post-flood resilience. Perceived social support was positively associated with resilience, and inversely correlated with PTSD symptoms. These data suggest that religiosity and perceived social support are valuable resources that foster post-disaster resilience among middle aged and older adults. Implications of these data for current views on age-related strengths and vulnerabilities after severe weather events are discussed.
Changing Family Relationships During the COVID-19 Pandemic: The Case of Elder Abuse
Authors: Yan Elsie , Lai Daniel , Lee Vincent
Published: December 2021

Since the first confirmed case being identified in January 2020, authorities in Hong Kong have implemented various measures in an attempt to control the spread of the disease. These measures include compulsory quarantining of infected persons and those suspected of exposure, temporary closure of high-risk premises, and suspension of public activities and services, encouraging work-from-home arrangement etc. These measures, however, may exacerbate the impact of known risk factors and create new avenues for elder mistreatment. Life stress, financial strains and work-from-home arrangements increase chances of family conflicts, cessation of public services increases burden in the already stressed caregivers. This study examines the changing intergenerational family relations in the midst of the pandemic. A total of 1200 community dwelling senior citizens participated through responding to a telephone survey. Information was collected on participants’ demographic characteristics, perceived disruptions brought about by COVID-19, family relations, physical and mental health, etc. Family conflicts and abuse were commonly reported: 27.8% reported family conflicts, 14.5% psychological abuse, 3.1% physical abuse, 3.9% financial abuse. A large proportion of participants (41.8%), however, also reported improved family relations during the pandemic. Results of logistic regression indicate that advanced age, female gender, poor financial situation were significant predictors for family conflicts and abuse. Contrary to our expectations, pandemic related disruptions in daily lives and perceived safety in the community were not associated in family conflicts and abuse in the present sample.
The Impact of Health Literacy and Religiosity on Attitudes Towards Physician-Assisted Death
Authors: Albright Amy , Tutek Joshua , Allen Rebecca
Published: December 2021

The aim of the current study was to examine the relationship between functional health literacy and religiosity regarding attitudes towards physician-assisted death (PAD). Of participants, the majority were female (62.6%) and non-Hispanic White (79.6%), and ages ranged from 19 to 83 (M = 37.81, SD = 12.55). As measured by the Newest Vital Sign, 82.6% (n = 219) of individuals within the current sample had adequate functional health literacy, while 10.6% (n = 28) scored within the “possibly limited” range, and 6.8% (n = 18) scored within the “highly limited” range. There was a positive association between religiosity and age (r = .21, p < .001), and older participants were more likely to endorse religious beliefs and/or activities. There was a significant association between greater acceptance of attitudes towards PAD and functional health literacy (r = .17, p < .01), indicating that those with higher health literacy have more positive attitudes towards PAD. There was no significant association between attitudes towards PAD and age (r = -.02, p > .05) or education (r = -.05, p > .05). Similarly, attitudes did not differ by gender (t (256) = -.66, p > .05) or by race/ethnicity, (F(5, 253) = .73, p > .05). Of note, functional health literacy may be particularly important to monitor in this context, as several studies (i.e., Kobayashi et al., 2015) have shown that health literacy may decrease with mild cognitive impairment and may therefore provide important information regarding older adults with this condition.
Effect of the SARS-CoV-2 Pandemic on Technology Use: In-Person versus Video-Chat Communication
Authors: Hubner Sarah , Swanson Alex , Chataut Akankshya , Kotopka Stephen , Manley Natalie , Shade Marcia , Boron Julie Blaskewicz
Published: December 2021

COVID-19 risk-reduction efforts have protected high-risk individuals (including older adults) but have significantly altered life; persons now face reduced socialization. Advancing technologies (e.g., video-chat) may be useful in alleviating consequences of risk-reduction efforts, including loneliness, by improving access to alternative connection/communication across the lifespan. The purpose of this study was to investigate the relationships between technology use and individuals as this may contribute to well-being among older adults during COVID-19 and future isolating events. Participants (N=652) aged 19+ completed a questionnaire via Amazon Mechanical Turk; demographic, socialization, and technology-use data were collected. Respondents (MAge=45.15±15.81) were generally male (50.1%) and white (77.3%). In-person communication and video-chat were analyzed descriptively and with binary regressions. Results of a Wilcoxon Signed-Ranks Test indicated that video-chat (mean rank=228.45) was reported at higher frequency of use versus in-person conversations (mean-rank=202.48), Z=-4.8,p<.001). Additionally, being female positively predicted use of video chat (B=0.42,p<.05) while increasing age negatively predicted use (B=-0.01,p<.05). Regression results suggest that populations reporting higher video-chat communication (e.g., females, younger adults) may be motivated by maintaining social connectedness despite distancing and/or are committed to healthy behaviors, increasing aversion to in-person experiences. In contrast, it may be that persons reporting low video-chat use (e.g., males, older adults) may be less interested in distanced communication or may have lower technology comfort/access. Notably, sampling bias may influence results as data was collected online; future investigation is warranted. Ultimately, understanding interest in and barriers to using technology is vital to developing systems/services which support connection/communication when in-person contact is limited.
The Association between the Types of Exercise Motivation and Social Presence about Gerontechnology
Authors: Song Si Young , Jung Inhye , Kang Miseon , Kim Kwang Joon , Kim DaeEun , Jun Hey Jung
Published: December 2021

The purpose of this study was to identify the types of exercise motivation and examine the association between the types of exercise motivation and social presence about exercise-related gerontechnology among Korean young-olds. In this study, social presence about gerontechnology implies the degree of perception of a robot that helps exercise functions as human-like socially interacting entities (Heerink, 2010). Online survey data collected from the Korean older adults over the age of 65 in February 2021 was used, and the subjects of this study were 154 young-olds aged 65 to 74 who exercise regularly. Latent class analysis (LCA) was conducted to classify the types of exercise motivation, followed by multiple regression analysis. As a result of LCA, the types of exercise motivation was classified with two groups. These groups were named ‘for pleasure and leisure (PL, 77.2%)’ and ‘for maintenance of health (MH, 22.8%)’, respectively. The result of multiple regression showed that compared to the second group (MH), the social presence about gerontechnology was high for the first group (PL) after controlling age, gender, education level, marital status, household income and chronic disease. These results indicate the Korean young-olds’ exercise motivation may vary and expectations for social presence toward exercise-related gerontechnology differ depending on the exercise motivation. To date, the importance of social presence in gerontechnology has tended to be emphasized mainly in the care field. This study suggests that exercise-related gerontechnology devices also need to consider the aspect of social presence especially for young-olds who exercise for pleasure and leisure.