bluuebunny/crossref_metadata_2025 huggingface dataset:
HEALTH PROFESSIONS AND MEDICAL EDUCATION: HOW THE GSA STUDENT CHAPTER ENHANCES PROFESSIONALISM AND NETWORKING
Authors: Gugliucci Marilyn
Published: January 2025

The University of New England College of Osteopathic Medicine (UNE COM) has had a Geriatrics Club since 2003. This club then became recognized as an American Geriatrics Society (AGS) Student Chapter in 2006. In 2022, we also participated as a pilot GSA Student Chapter. The benefits of being a chapter of either one or two national organizations positions students for national student memberships, national resources, and networking opportunities. The AGS provides practice materials and skills information to the medical students. However, GSA provides opportunities beyond research presentations and publications, with approximately 1200 of GSA members connected to the Emerging Scholars and Professional Organization (ESPO). This applies to all health professions students and includes interprofessional opportunities. With a strong support system and mentoring system within ESPO, The GSA Student Chapter provides advancement in learning skills, attitudes and knowledge, along with an extensive network of fellow students and practitioners to support their undergraduate (pre-clinical and clinical) health professions education. This prepares students for their health professions careers by providing national organizational connections that they can rely on throughout their careers. Forming a GSA Student Chapter for health professions students, regardless of the type of health professions program will be shared and sample programs and events in palliative care, geriatrics and gerontology will be presented.
GSA STUDENT CHAPTER AS A GATEWAY TO UNDERGRADUATE STUDENT UNDERSTANDING OF PROFESSIONAL ORGANIZATION INVOLVEMENT
Authors: Bouchard Lauren
Published: January 2025

The Portland State University Student Chapter has created networking events for students across Oregon, and undergraduate students are especially important to the chapter. Due to the GSA annual meeting in Seattle, our chapter had the unique opportunity to educate students across the Pacific Northwest as to the importance of professional organization membership. In partnership with the Oregon Gerontological Association (OGA), Western Oregon University (WOU), and Portland Community College (PCC), our chapter created an educational event regarding the structure, events, and benefits of GSA. Undergraduate students may differ in their knowledge and understanding of opportunities they perceive to be beyond their educational level. For this reason, our Careers in Aging Month (CIAM) event focused on membership in the larger GSA organization with support from the Emerging Scholars Professional Organization (ESPO) section within GSA. We highlighted potential differences for undergraduate students, including the new change that allows these students to gain GSA membership for free. This presentation will explain chapter activities designed to encourage undergraduate student membership as well as provide suggestions to recruit and engage undergraduate student members.
HOUSING AND COMMUNITY FOR OLDER ADULTS AS AGING IN PLACE (AIP) ENABLER: AN INTERNATIONAL PERSPECTIVE
Authors: Park Sojung , Buffel Tine
Published: January 2025

This symposium discusses various approaches from five different countries that enable Aging in Place (AIP) through housing and community. The achievement of AIP depends on the institutional and cultural context. A study from New Zealand focuses on making new small homes accessible, and shows while accessible design is considered good design, not everyone understands it. User-centered accessible design is not commonly used, and trade-offs exist between accessibility, affordability, and size. A Korean study examines loneliness in older women living alone in a rural senior cohousing community. The findings show senior cohousing helps protect against loneliness by serving as a community hub for gathering, sharing, and caring. A Japanese study found “IBASHO” activities (i.e., place-based specific activities) help promote permanent community living in marginalized communities at higher risk of depopulation. Participating in such activities makes residents feel at ease in their community, even if they live alone or have poor health. A Canadian study discussed the development of a Naturally-Occurring Retirement Community (NORC) in Vancouver, formed by East Asian older adults who could not travel abroad due to border closures during the pandemic. The study explores the health-promoting nature of mutuality and its potential for population-level spillover effects on community well-being beyond the direct reach of formal programs. The last study from Hong Kong found significant improvements in perceived age-friendliness, with the greatest improvements among low-income older adults. The empirical knowledge from these studies offers valuable insights into a contextually rich understanding of a wide range of housing and communities.
MUTUALITY AMONG EAST ASIAN DIASPORA AT A NATURALLY OCCURRING RETIREMENT COMMUNITY IN METRO VANCOUVER
Authors: Gan Daniel , Wang Claire , O’Dea Eireann , Quay Lisa Cohen , Au Daisy
Published: January 2025

How did East Asians who were retiring abroad cope with the pandemic? This paper traces the development of a Naturally-Occurring Retirement Community (NORC) in Vancouver through the efforts of various community organizations. As borders closed during the pandemic, a group of community-dwelling East Asian older adults found themselves remaining in Metro Vancouver through the winter. They formed a group chat and began regular video chats. They shared virtual events, supermarket deals, and neighbourhood walks. A younger member stepped up to ask after members of the informal group whom were absent or unwell. Topics of discussions ranged from the wellbeing of members and their spouses, securing medical appointments, translating forms to be filled, friends back home, leisure activities, and the lives of their children or grandchildren. The group was formally served by facilitators of a seniors’ club at a non-profit. At the same time, they existed as an informal network marked by mutual care. We discuss the health-promoting nature of mutuality in this NORC as compared to other neighbourhoods to theorize the conditions needed for the emergence of Gemeinschaft NORC in urban areas. This paper sketches a theory of mutuality as the key which transforms dyadic peer support into community cohesion. We explore the implications of mutuality on formal programs in order to harness their potential to have population-level spillover effects for the wellbeing of community members just beyond their direct reach. We further speculate that mutuality is that which was lost in modernity, and is the reason culture is medicine.
ENCOURAGING NEW-BUILD, SMALL, AFFORDABLE, AND ACCESSIBLE HOMES IN AOTEAROA, NEW ZEALAND
Authors: James Bev
Published: January 2025

The growing need for mainstream housing to be accessible is an international issue, driven by ageing populations and ‘ageing-in-place’ policies. Alongside the impetus to improve housing accessibility, is interest in building smaller dwellings, potentially better suited to an ageing population. Internationally, some jurisdictions mandate accessible standards in new-build housing, while others adopt national voluntary accessibility standards. In Aotearoa New Zealand (NZ) there is no mandatory requirement and few incentives for new-build housing to be accessible. Only an estimated 2% of dwellings are accessible, while one in six people need modifications to live safely in their homes. Our study addresses the dearth of NZ research into achieving accessibility within a small footprint (50m2-75m2). Its focus on new-builds directly addresses a research gap in international literature, which is largely concerned with home modifications rather than new homes built to accessible standards. We report on findings from interviews with housing providers, architects/designers and builders/developers involved in the production of accessible, small homes. Key themes are: accessible design is perceived as good design; awareness, knowledge and understanding of accessible design and its implementation varies; user-centered accessible design is not well understood nor applied; and trade-offs are made between accessibility, affordability and size. Findings contribute to housing policies and practice by identifying levers to improve accessibility in new-build housing. Findings reinforce calls for a multi-pronged approach to achieve housing accessibility, and suggest that “explorative learning” about accessibility is emerging.
CHANGES IN OLDER ADULTS’ PERCEPTIONS OF AGE-FRIENDLINESS IN HONG KONG: A THREE-YEAR MIXED-METHODS STUDY
Authors: Lum Terry , Chui Hiu-kwan , Lu Shiyu , Chan On Fung , Guo Yingqi , Tang Jennifer , Liu Yuqi
Published: January 2025

Hong Kong is known for its high population density, high urbanization, and hilly terrain, making age-friendliness a challenge in the city. Yet, the city is aging rapidly; by 2041, one in three residents will be 65 and older. Although age-friendly city has become a significant public policy imperative in recent decades, there is a dearth of empirical evidence on how AFC initiatives can improve perceived age-friendliness among community-dwelling older adults and how such initiatives may affect older adults with different socioeconomic statuses differently. Drawing on a three-year citywide AFC initiative in Hong Kong, we conducted a trend study to evaluate changes in perceived age-friendliness in eight AFC domains with 2575 and 2697 community-dwelling older adults in 2015 and 2018 respectively, in addition to 36 focus groups involving 206 older adults. Participants were asked to share their views on changes in age-friendliness in their cities. Survey data were analyzed using linear regression, while focus group data were analyzed using thematic analysis. Significant improvements were found in perceived age-friendliness in all eight AFC domains. Low-income older adults saw the greatest improvements in age-friendliness. Thematic analysis revealed that despite improvements, shortcomings persist in housing, civic engagement, and employment domains. Nevertheless, our findings demonstrate that concerted efforts can improve a city’s overall age-friendliness and that such improvements appear most evident among low-income older adults.
EXPLORING THE NEIGHBORHOOD ENVIRONMENT’S ROLE IN OUTDOOR WALKING EXPERIENCES OF PEOPLE LIVING WITH DEMENTIA
Authors: Chaudhury Habib , Seetharaman Kishore , Wong Joey , Hung Lillian , Randa-Beaulieu Cari , Freeman Shannon , Groulx Mark
Published: January 2025

This presentation is based on a study that explores how people with dementia experience their neighborhood environment in the context of everyday outdoor walking. The experientially grounded approach explored ways in which people living with dementia can inform the process of dementia-friendly and inclusive planning and design. The focus on lived experience can also help planners and designers gain insights into the actions and strategies that people living with dementia adopt to cope with challenges in mobility and navigation in the neighborhood, thus gaining useful knowledge to generate contextually relevant design solutions. Four-part sequential sit-down and video-documented walk-along interviews were conducted with 32 participants living with mild to moderate dementia or mild cognitive impairment in British Columbia, Canada. Thematic analysis of interview transcripts and videos helped identify themes relevant to the ways in which the neighborhood environment shaped participants’ outdoor walking experiences. Findings underscored both supportive and constraining aspects of the neighborhood environment as it pertains to outdoor walking. Awareness of environmental barriers and stressors in the context of their physical and cognitive challenges informed participants’ planning and decision-making processes in relation to outdoor walks, as well as coping strategies to enhance familiarity, safety, comfort, and independence in the neighborhood environment. Planning and designing supportive built environments is key to facilitating the outdoor mobility of people living with dementia and should be a focus of research, policy, and practice related to building dementia-inclusive communities.
ENGAGING WITH MUNICIPAL PLANNERS WITH A DEMENTIA-INCLUSIVE PLANNING AND DESIGN GUIDE
Authors: Seetharaman Kishore , Chaudhury Habib
Published: January 2025

Dementia-friendly and inclusive community (DFC) action plans in British Columbian municipalities identify various planning and design strategies and actions to meet the goals of dementia-inclusivity. However, there is a lack of evidence-based design guidelines tailored to the context of British Columbia to support the implementation of these plans. To address this gap, a DFC planning and design guide was generated as part of the DemSCAPE study, consisting of planning and design principles and guidelines for wayfinding, safety, social interaction and access to amenities for people living with dementia. A series of knowledge mobilization (KM) activities will explore and augment the relevance, uptake, and implementation of this guide. Two focus groups (60-90 min; N = 5-7 per session) were conducted with municipal professionals working in two municipalities (i.e., City of Burnaby and City of Richmond) in Metro Vancouver. The existing municipal action plans emphasize the need for collaboration and dialogue across different departments of local government, e.g., social planners and seniors services coordinators (staff who are more closely connected with and help coordinate these plans) and planners, designers, and engineers. The focus groups are intended to trigger inter-departmental dialogue centered on DFC planning and design and examine DFC strategies and actions from various stakeholders’ perspectives within the scope of municipal planning. This KM project is expected to make meaningful contributions to the DFC initiatives of local government in BC by providing guidelines to municipal planners on how to apply a dementia-friendly and inclusive lens in planning and design.
FOSTERING DEMENTIA INCLUSIVE NEIGHBORHOODS: A GIS ANALYSIS OF NEIGHBORHOOD WALKABILITY FOR PERSONS WITH DEMENTIA
Authors: Freeman Shannon , Gourley Keone , Rossnagel Emma , Groulx Mark
Published: January 2025

Active engagement in the natural environment is an important aspect of health and wellbeing for persons with dementia. Neighborhoods with high walkability are critical for persons with dementia to access the outdoors and promote ageing in place, while allowing for persons with dementia to maintain social relationships, connect with nature, and foster a sense of freedom. Although persons living with dementia are affected by general walkability factors such as presence of sidewalks and the availability of destinations such as health services or recreational facilities, dementia-inclusive neighborhoods must also be distinctive and easy to navigate, as persons with dementia are more prone to become disoriented or lost. Therefore, the Dementia-Inclusive Streets and Community Access, Participation and Engagement (DemSCAPE) project sought to identify how persons living with dementia interact with their environment and how municipalities can implement change to make cities more walkable for PLWD. A GIS analysis was completed to assess current infrastructural barriers and facilitators for aging-in-place for persons living with dementia. This analysis, which included interviews with individuals living with dementia and their family caregivers, found that their neighborhoods were severely lacking the infrastructure needed to support walkability for persons living with dementia. From the absence of sidewalks to disorienting neighborhood patterns, the city of focus has a long way to go in supporting aging-in-place for persons living with dementia. This presentation will showcase how these findings can be used to influence protocols in municipalities to implement supportive infrastructure for persons living with dementia.
INTERDISCIPLINARY PERSPECTIVES ON CURRICULUM CONTENT FOR TRANSLATIONAL GEROSCIENCE EDUCATION
Authors: Al-Naggar Iman , Kuchel George , Newman John
Published: January 2025

Translational geroscience is a new field of study that aims to delay, prevent or alleviate several aging-related diseases simultaneously by targeting the so-called “biological hallmarks of aging,” a constellation of biological pathways at the root of natural aging and chronic conditions for which aging is the major risk factor (e.g., diabetes, cardiovascular disease, Alzheimer’s, cancer). Geroscience is a paradigm shift in healthcare because it aims to move away from single disease management to multi-disease prevention or alleviation and decrease the period of morbidity at the end of life. In order to train a workforce in conducting translational geroscience trials, the Geroscience Education and Training Network (NIH/NIA R25AG073119) is developing curricula towards a Certificate in Geroscience Research Program. This program is designed to train investigators in aspects specific to clinical trials of geroscience guided interventions (pharmaceutical or behavioral) in older adults. Evidence suggests that many factors often not considered in trial design play an important role in the outcomes of these trials; for example, social determinants of health contribute to accelerated aging and worse outcomes in minority populations, socially-disadvantaged persons, and other vulnerable populations, where chronic diseases arise at a much younger age. This symposium aims to begin a conversation between biological scientists, behavioral and social scientists and others to address the question “What knowledge from your specific field do translational geroscientists need to know to conduct meaningful and impactful geroscience clinical trials?” This insight is essential to help develop the curricula required to train a well-rounded workforce of translational geroscientists.
PEOPLE DO NOT AGE IN LABS: SOCIAL AND BEHAVIORAL CONSIDERATIONS WHEN DEVELOPING GEROSCIENCE INTERVENTIONS
Authors: Puterman Eli
Published: January 2025

Geroscience researchers are determined to identify the constellation of genetic, molecular, and cellular mechanisms of aging that, eventually, will be translated into anti-aging therapies and pills. It is argued, however, that without a consideration of social and behavioural determinants of health, geroscientists will miss the full potential to impact health and longevity of all humans, not just a select few. Social and behavioural determinants of health are the non-medical, non-biological factors influencing health and disease, and their underlying biological processes. Humans are complicated species, with a lifetime of exposures to stressful, adverse, and sometimes traumatic experiences and a lifetime of engaging in a mix of healthy and unhealthy behaviours. Together, social and behavioural factors shape biological aging through epigenetic embedding and wear and tear of biological systems, causing eventual accelerated biological aging and disease. By understanding what social and behavioural factors are, how they embed biologically and accelerate aging processes, geroscientists can develop a deeper understanding of the complicated nature of human experimental research. Social and behavioural factors impact recruitment, engagement, and adherence of participants in intervention trials, which can obscure significant treatment effects. Social and behavioural factors can also limit treatment effects, when considering how difficult it might be to reverse some of the long-term damage caused by life itself. It is important then, for geroscientists to learn about social and behavioural factors, and the best practices to engage as many people across the wide diversity of life circumstances, to impact the healthspan and lifespan of all.
JOURNAL OF GERONTOLOGY PSYCHOLOGICAL SCIENCES: FEATURED 2023 EDITOR’S CHOICE ARTICLES
Authors: Han Duke
Published: January 2025

The psychological sciences of the aging process are vast in scope and complexity. Methodological approaches that are interdisciplinary, innovative, and inclusive can make these enigmatic processes more tangible. This symposium showcases articles in the Journal of Gerontology Psychological Sciences that were selected as Editor’s Choice in 2023 because they exemplify these ideals. Smith et al. investigate cognitive ability differences by in-person versus telephone-based assessment methods. Jackson et al. explore associations between loneliness and cognitive resilience to brain neuropathology in older adults. Krok-Schoen et al. report on the resiliency of women aged 80 and older by race, ethnicity, and neighborhood socioeconomic status. Esiaka and Luth describe different interpretations of “honoring your parents” in the U.S., Ghana, and Nigeria. Lynch et al. link measures of loneliness, DNA methylation, and cognitive functioning.
SHIFTING OF COGNITIVE ASSESSMENTS BETWEEN FACE-TO-FACE AND TELEPHONE ADMINISTRATION: MEASUREMENT CONSIDERATION
Authors: Smith Jason
Published: January 2025

There is limited information concerning differences in cognitive performance attributable to assessment (telephone versus in-person) method instead of cognition. We evaluated mode effects on individual cognitive items and overall cognitive score in adults aged 65-79 in the 2014 Health and Retirement Study (n=6825). We assessed mode differences in test means and reliability, whether mode modifies associations of cognition with criterion variables, and formal measurement invariance testing by mode. People assessed by telephone tended to have higher scores for memory and calculation items (0.06-0.013 SDs) and lower scores for non-memory items (-0.09 to -0.01 SD). Cognition was differentially related to IADL score depending on assessment mode. Measurement invariance testing identified the largest mode differences in memory and attention items. Differences by telephone versus face-to-face mode of administration are apparent in cognitive measurement in older adults, and most pronounced for memory and attention tests that can be easier to answer via telephone.
ASSOCIATIONS BETWEEN LONELINESS AND COGNITIVE RESILIENCE TO NEUROPATHOLOGY IN OLDER ADULTS
Authors: Jackson Kathryn
Published: January 2025

Loneliness in the aging population is associated with decreased cognitive function and increased neuropathology; less is understood, however, about the association of loneliness and cognitive resilience (CR), defined as the discordance between a person’s actual and expected cognition given their neuropathology. For this study, data were combined from 2 longitudinal studies of older adults. CR proximate to death (CRlast_level) and across time (CRslope) were obtained by independently regressing global cognition and change in cognition onto multiple neuropathology indicators and extracting the resulting residuals. Using a series of linear regression models, we assessed the effect of loneliness level and change in loneliness on CR. Results show that higher and increasing loneliness was associated with lower CR in the face of neuropathology, suggesting that some individuals are less resilient to the accumulation of neuropathology than others, and experiencing high/increasing loneliness is a key factor putting some at risk.
EARLY LIFE INFLUENCES ON LATER LIFE ADRD RISK: THE ROLES OF ADOLESCENT COGNITIVE FUNCTION AND EDUCATION
Authors: Herd Pamela , Asthana Sanjay , Engelman Michal , Sicinski Kamil , Trane Ralph , Williams Victoria
Published: January 2025

By some estimates, each additional year of education reduces dementia risk by 7 percent. What remains unclear, however, is how early life cognitive function, which influences educational attainment, and is hypothesized to influence later life dementia risk, factors into the relationship between education and dementia risk. Existing research neither attends to the role that early life cognition may play in these relationships, nor does it separate out how these relationships might vary with AD versus non-AD dementias. We employ a unique dataset, the Wisconsin Longitudinal Study, which has been tracking participants over their full life course and is now assessing dementia in the population as they reach their mid 80s. The data include prospectives measures of early life cognition, other early life conditions, as well as detailed educational histories, in addition to dementia diagnoses that differentiate AD and non-AD types. We find that lower early life cognitive function increases the risk for AD dementia, and education does not mediate this relationship. Early life cognition, however, has no relationship with non-AD dementia, that is dementia caused by chronic disease, where instead education has a stronger relationship. We hypothesize that these differential relationships reflect variance in how early life biological and environmental factors affect risk and resilience for later life cognitive dysfunction.
DEMENTIA CARE PARTNER PREPAREDNESS AND DESIRE TO SEEK LONG-TERM CARE AT HOSPITAL DISCHARGE
Authors: Kuzmik Ashley
Published: January 2025

At hospital discharge, care partners of persons living with dementia encounter more complex caregiving demands and lack preparedness to manage the increased care needs, frequently resulting in the patient’s admission to long-term care. This study explored the mediating effects of patient clinical factors on the relationship between care partner preparedness and desire to seek long-term admission of persons with dementia at hospital discharge. The sample included 424 patient and care partner dyads from the Family centered Function-focused Care (Fam-FFC) trial. Using bootstrapping, we tested a multiple mediation model to examine the indirect effects of care partner preparedness on desire to seek long-term care admission through patient clinical factors (i.e., behavioral and psychological symptoms, comorbidities, delirium severity, physical function, and cognition). The results revealed that delirium severity (B=-.005; 95% bootstrap CI=-.015, -.001) and physical function (B=.004; 95% bootstrap CI=.002,.007) partially mediated the association between care partner preparedness and desire to seek long-term care admission. Findings highlight the importance of targeting delirium severity and physical function in clinical interventions for persons with dementia at hospital discharge to support care partner preparedness and minimize undesired long-term care admission.
ASSOCIATION OF BPSD AND CARE PARTNER OUTCOMES MEDIATED BY CARE PARTNER DISTRESS
Authors: Berish Diane
Published: January 2025

Behavioral and psychological symptoms of dementia (BPSD) include a range of symptoms that commonly occur during hospitalization and post-discharge. BPSD can be difficult to anticipate and can create challenges for family care partners which may lead to adverse care partner outcomes. Repeated measures data from the Fam-FFC study provides opportunity to examine the time-dependent relationship among BPSD, associated care partner distress, and care partner outcomes. Mediation models were used with Neuropsychiatric Inventory Questionnaire (NPI) scores at discharge from an acute care hospitalization, NPI scores of associated care partner distress at 2-months post discharge, and care partners outcomes at 6-months, including burden, strain, desire to institutionalize and level of preparedness for caregiving. Patient and care partner characteristics were included as covariates. Results showed that NPI severity had direct effects on desire to institutionalize (estimate=0.0754, p=0.0119) with no significant indirect effects. Care partner burden, NPI severity had statistically significant direct effects (estimate=0.3023, p=0.0038), with 53.4% (p<0.0001) mediational effect of associated care partner distress. Similarly, for care partner strain, NPI severity had statistically significant direct effects (estimate=0.21, p=0.003), with 48.8% (p<0.0001) mediational effect of associated care partner distress. There were no significant effects for the outcome of care partner preparedness. The repeated measures design study allows for the examination of these relationships over time and helps to build evidence for a mechanistic model. These results show the importance of assessment of BPSD presentation, particularly post-acute hospitalization, and providing support for care partners to reduce negative outcomes.
EVALUATING NURSING HOME-BASED INTERVENTIONS ON COMPETENCY LEVELS
Authors: Recker Amy , McCreedy Ellen , Baier Rosa , Smith Kate , George Regina , Geisser Sophia , Aguilar Vanessa , Snow A Lynn
Published: January 2025

The intervention at the heart of the 40WINKS sleep trial relies on a principle that can be applied to many other nursing home-based interventions: Progress through the intervention requires a gradual and consistent accumulation of skills that build upon one another. Without completing a fundamental level of the intervention (e.g., begin to hold staff huddles regularly), a nursing home’s team could not incorporate advanced concepts (e.g., engage in collaborative problem solving during huddles). With this in mind, the 40WINKS research team decided to evaluate the participating nursing homes based on progressive levels of competency. We evaluated levels of competency for each of the seven core elements of the intervention (leadership team functioning; huddles; problem solving; small action plans; individualized care; continuous metacognition; sleep and daytime activity information; connecting day and night staff; and spillover, spread, and integration), scoring each core element as not met, foundational, proficient, or advanced. We developed a matrix with the seven core elements and examples of the corresponding competency levels, which research team members complete weekly. We aggregate the competency matrices on a monthly basis and meet to code each nursing home into one of the four competency levels overall. This presentation will delve more in depth into this process, provide a roadmap for applying this approach to other interventions, and share preliminary results.
THE ASSOCIATION BETWEEN NEIGHBORHOOD PERCEPTIONS AND RISK OF FALLS
Authors: Le Qun , Chen Lingming , Procter-Gray Elizabeth , Zhang Meng , LoPilato Danielle , Aguirre Annabella , Li Wenjun
Published: January 2025

Fall is a leading cause of injury-related death among old adults. This study is to explore the associations between neighborhood environment perceptions and the risk of falls among old adults. The data was drawn from the Healthy Aging and Neighborhood Study in Central Massachusetts (2018-2024). Data were collected from 379 participants who aged over 65 years and live in rural, suburban, and urban communities. Neighborhood perception was measured using a self-administered questionnaire. Factor analysis was used to derive perception scores in five aspects including neighborhood utilitarian (NU) (range:0-7), sense of community (SEC) (range:0-5), safety of community (SAC) (range:0-8), friendly neighborhood (FN) (range:0-3), and aesthetics of community (AC) (range:0-5). A higher score indicates a more positive perception. The occurrences of falls were recorded using monthly falls calendars. Negative binomial regressions were used to assess the associations of neighborhood perceptions and fall rates adjusting for sociodemographic factors and follow-up time. The participants had high neighborhood perceptions (mean±SD: NU: 2.46±1.69, SEC: 3.34±0.92, SAC: 7.42±0.94, FN: 1.03±0.85, and AC: 3.55±0.86). Lower rates of indoor falls were associated with a higher score in SEC (IRR: 0.8, 95%CI: 0.6-0.9) and SAC (IRR: 0.7, 95%CI: 0.6-0.8). A one-unit higher AC score was associated with 20% lower rates of outdoor falls (IRR: 0.8, 95%CI: 0.6-1.0). Higher scores in the SEC (IRR: 0.8, 95%CI: 0.7-0.9), SAC (IRR: 0.8, 95%CI: 0.7-0.9), and AC (IRR: 0.8, 95%CI: 0.7-1.0) were significantly associated with lower rates of falls in any place. These results suggest the need of considering neighborhood perceptions in fall intervention.
A STORM IS COMING: A CLIMATE RESILIENCE FRAMEWORK FOR SENIOR HOUSING
Authors: Patskanick Taylor , Turner Grace , Coughlin Joseph
Published: January 2025

Older adults’ vulnerability to extreme weather events may vary especially based on geographic location and housing or residential situation. Emergency preparedness is a potentially modifiable protective factor influencing this vulnerability. Emergency preparedness, however, looks different for older adults living in senior housing communities compared to community-dwelling older adults. For example, the responsibility for emergency preparedness for extreme weather within the senior housing environment expands to include the housing operator and community-based emergency management services rather than this responsibility relying solely on the individual older adult. This paper examines a set of twenty interviews conducted with senior housing operators, owners, and community-based emergency services personnel located in five U.S. states exploring emergency preparedness for extreme weather events in senior housing. Interviews were analyzed using an inductive, team-based thematic analysis approach. Results from this study are presented in a three-phase modified Haddon Matrix (Haddon, 1968) to provide a comprehensive framework promoting age-friendly extreme weather preparedness for senior housing operators and local emergency services. The implications of this research offers a foundation for a standardized checklist of actions and processes for senior housing operators, their individual communities, and emergency services to use to build capacity for age-friendly climate resilience. Senior housing communities serving older adults must comprehensive and resilient emergency preparedness plans and programs able to respond to a changing climate in an ongoing, adaptive, and multi-phase way that accounts for all actors in the senior housing environment (e.g., staff, residents, resident families) and through every stage of an extreme weather event.
NEIGHBORHOOD ENVIRONMENT AND PHYSICAL ACTIVITY AMONG PERSONS WITH DEMENTIA
Authors: Choi Eunyoung , Choi Yeon Jin , Cha Hyungmin , Fisk Calley , Wilkie Rachel , Ailshire Jennifer
Published: January 2025

Physical activity plays an important role in delaying the progression of cognitive and functional decline among people with dementia (PWD). Neighborhood environments can provide key resources or function as critical barriers to promoting physical activity among PWD. However, the specific neighborhood factors that drive this relationship are yet to be determined. Our study examines how socioeconomic (i.e., area affluence and disadvantage), physical (i.e., annual average PM2.5, temperature, park area), and social (i.e., cohesion, disorder, and safety) aspects of neighborhood environment are associated with physical activity levels among PWD living in communities across the U.S. We used data from 2006 to 2018 of Health and Retirement Study for dementia status and neighborhood social environment, merged with census-tract level data from the Contextual Data Resource for socioeconomic and physical neighborhood factors. Specifically, we used the first wave of data where PWD were identified as having dementia (N=3,073). Physical activity was measured as a weighted sum of light, moderate, and vigorous activity (range: 0-31). We estimated linear regression models adjusting for individual-level sociodemographic covariates. Higher neighborhood socioeconomic affluence (B=0.45, 95% CI=0.07, 0.84) and social cohesion (B=0.70, 95% CI=0.32, 1.09) were associated with higher levels of physical activity. Conversely, any sign of neighborhood physical disorder (B=-1.23, 95%CI=-2.09, -0.38) was associated with reduced physical activity. No significant relationships were found from physical neighborhood environment factors. This study provides empirical evidence for the social-ecological model which posits the important role of broader environmental factors that influence PWD’s physical activity participation.
NOVEL AUTOMATED TOOLS TO IDENTIFY COGNITIVE DECLINE AND EMOTIONAL DISTRESS IN THE CONTEXT OF MCI AND AD/ADRDS
Authors: Bannon Sarah , Federman Alex
Published: January 2025

Alzheimer’s disease and related dementias (ADRDs) are rapidly increasing public health concerns with significant impact on individuals, families, and healthcare systems. Though recent technological advances have enabled earlier and more accurate diagnosis for some, the vast majority of individuals experience delays in diagnosis and unmet early support needs. Diagnostic delays and inadequate support exacerbate psychological distress for impacted individuals, which is important to address given 1) the impact of distress on long-term outcomes and 2) the difficulty of treating distress once it becomes chronic. Novel automated technologies have the potential to more effectively and efficiently identify changes in cognition and distress, and if leveraged could provide cost-effective avenues to improve ADRD care. This symposium describes novel methods of leveraging large-scale data and technology to enhance screening and identification of early decline and distress in the context of cognitive impairment and ADRDs. Ryan Mace, PhD will describe healthcare providers’ impressions of barriers to assessing subjective cognitive decline and gaps in current practice. Sarah Bannon, PhD will present findings from a secondary data analysis of electronic medical records examining structured data elements as indicators of psychological distress among individuals with recent ADRD diagnoses. Ayushi Divecha, MPH MPT will describe the use of random forest models to identify individuals at high risk for developing dementia from a harmonized database of 5 of the largest NIH-funded studies of aging across the US.
OVERCOMING BARRIERS IN DETECTING SUBJECTIVE COGNITIVE DECLINE: A QUALITATIVE STUDY WITH HEALTH CARE PROFESSIONALS
Authors: Mace Ryan , Cohen Joshua , Ritchie Christine , Okereke Olivia , Bartels Stephen , Hoeppner Bettina , Brewer Judson , Vranceanu Ana-Maria
Published: January 2025

Identifying older adults with subjective cognitive decline (SCD) is imperative for early interventions targeting modifiable risk factors for Alzheimer’s Disease and Related Dementias (ADRD). However, with fewer than half of older patients with SCD engaging in discussions about their concerns with healthcare professionals, a significant gap in current practice is evident. To address this gap, we engaged healthcare professionals (physicians and medical staff) in a qualitative study that aimed to: 1) understand barriers and facilitators to identifying SCD, and 2) develop strategies to guide the implementation of screening and assessment tools into routine care. We conducted live video focus groups with 26 healthcare professionals (Mean experience = 17 ± 13.6 years) from 5 clinics that treat older patients (e.g., psychiatry, neurology, integrative medicine, memory care). We analyzed the qualitative data using a hybrid deductive–inductive approach. We proposed concrete strategies for addressing barriers to SCD identification using the Expert Recommendations for Implementing Change (ERIC) framework. Four themes on barriers to SCD identification emerged: 1) the clinical heterogeneity of SCD, 2) variability in patients’ self-identification, 3) variability in clinical assessment practices, and 4) need for additional research and standardization. ERIC-informed strategies to address barriers included: education and training for providers, standardized diagnostic protocols, incorporating caregiver reports, and promoting de-stigmatizing language. Our study contributes to the symposium theme by delineating the intricacies of identifying SCD among older adults and by proposing ERIC framework-based strategies that align with the need for novel screening and assessment tools.
DO MINIMUM STAFFING LEVELS IMPROVE NURSING HOME QUALITY? EVIDENCE FROM CALIFORNIA’S MINIMUM STAFFING REGULATIONS
Authors: Bowblis John , Brunt Christopher
Published: January 2025

Nursing staff is a key component in providing high quality of care to nursing home (NH) residents, therefore, as of 2021, 39 states have minimum nursing staff regulations. In September of 2023, CMS announced a proposed rule for a first ever federal minimum nursing staff level, even though the effectiveness of these regulations at improving quality is unknown. In this paper, we utilized a difference-in-differences regression framework to understand how changes to minimum staffing regulations impact staffing and quality. In particular, we examine California’s 2018 change to staffing regulations that increased the minimum staffing level from 3.2 to 3.5 hours per resident day (HPRD) and implemented a new 2.4 HPRD minimum requirement for certified nurse aides (CNA). Comparing California to neighboring states that did not change staffing requirements, California NHs increased CNA staffing levels 0.15 HPRD (6.5% increase) and total nursing staff levels of 0.184 HPRD (4.8% increase) on average. Even with these increases, only about 70% of NHs met the new CNA requirement and 90% met the new 3.5 HPRD staffing requirements in 2019. While staffing levels increased, only 3 of the 13 quality measures examined were statistically significant at the 5% or 10% levels. At the 5% level, there was improvement in incontinence among long-stay residents. At the 10% level, there was improvement in pressure ulcers among long-stay residents and the short-stay rehospitalization rate. These results indicate that increasing staffing levels through mandated minimums had small to negligible impact on most aspect of NH quality.
ASSESSING THE INFLUENCE OF NURSING HOME SIZE AND CARE MODELS ON COVID-19: CASE AND MORTALITY RATES
Authors: Young Yuchi , Liu Yichun , Shayya Ashley , Chiu Wan-Yu , Hsu Wanhsiang , O’Grady Thomas
Published: January 2025

The COVID-19 pandemic disproportionately affected older adults in nursing homes, emphasizing the need for comparing various long-term care options. This study compares COVID-19 prevalence and mortality rates in traditional nursing homes, Green Houses (GHs), and nursing homes nested in Continuing Care Retirement Community (CCRC-NHs). CMS data and LTCFocus Data were utilized. COVID-19 case and mortality rates from June 1, 2020, to September 30, 2022, across traditional NHs, GHs, CCRC-NHs in 11 states were included. Poisson regression was utilized to compare risk among types of NHs while adjusting for covariates. The average age of residents of CCRC-NHs and GH was 84.4 and 83.1-years, respectively, higher than those in small (77.5-years) and large (77.6-years) traditional nursing homes (P<.0001). The proportion of female and White residents was significantly higher in CCRC-NHs and GHs than in traditional NH. Compared to GH residents, those in CCRC-NHs (RR 1.50, 95% CI 1.10-2.07), large NHs (RR 1.57, 95% CI 1.14-2.15), and small NHs (RR 1.80, 95% CI 1.32-2.47) had a higher risk of COVID-19 infection, with the highest risk observed in traditional small NHs. There were no statistically significant differences in COVID-19 mortality rates across different types of NHs. This study suggests that nursing home size and care models influence COVID-19 transmission, GHs, with their smaller, person-centered care settings, experienced lower infection rates, highlighting the potential advantages of such environments in pandemic management. Conversely, traditional NHs and CCRC-NH models, with more institutional layouts, may contribute to higher transmission rates suggesting a need for care model reevaluation.
ASSESSING THE IMPACT OF THE PATIENT-DRIVEN PAYMENT MODEL ON NURSING HOME CARE QUALITY: A STAFFING PERSPECTIVE
Authors: Orewa Gregory , Weech-Maldonado Robert , Davlyatov Ganisher , Lord Justin , Becker David , Feldman Sue
Published: January 2025

The Patient-Driven Payment Model (PDPM) launched on October 1, 2019, restructured Medicare payments to reflect resident needs over service quantity, aiming to improve quality and efficiency in nursing homes (NH). PDPM’s shift towards resident needs (rather than therapy minutes) may lead to greater nurse utilization, which may potentially improve the quality of care. This study draws on the resource-based view (RBV) theory to understand the association between the PDPM and NH quality of care mediated by nurse staffing intensity. Utilizing a longitudinal design (2017-2021), seven different datasets were merged (Cost reports, Payroll Base Journal (PBJ), Care Compare, Area Health Resource File (AHRF), HHS Provider Relief Fund, CDC NH COVID-19 public files, and CDC COVID-19 Data Tracker). Structural equation modeling (SEM) was used to assess the direct and indirect effects of PDPM on care quality, with nursing staffing intensity serving as a mediator. NH quality of care was operationalized using quality-measure five-star rating and staffing intensity by RN, LPN, and CNA hours per resident. We examined the direct effect of PDPM on quality of care and the indirect effect of PDPM on quality through nurse staffing. Control variables included organizational and market-level factors, and COVID-19-related variables. The result suggests an increase in RN staffing post-PDPM but a decrease in CNA hours (p< 0.001). PDPM had an indirect positive effect on quality through RNs while negative through CNAs. PDPM also showed a positive direct effect on quality. Policy implication highlights the complex interplay between different staffing roles and the impact on quality.
POLICY SERIES: ELECTION YEAR RESULTS: IMPLICATIONS FOR OUR FUTURE
Authors: Lindberg Brian , D’Antonio Patricia
Published: January 2025

Will Social Security be targeted? Will Obamacare be gutted? How will Medicare drug prices be affected? These and many other programs and policies will be influenced by who sits in the White House and the Congress starting in 2025. Join your colleagues and GSA’s own pundits for a discussion on what went down on November 5th and what will be coming up in aging policy.
PROVIDING STUDENTS WITH INSIGHTS ABOUT AGING AND TECHNOLOGY USING A COLLABORATIVE TEACHING APPROACH
Authors: Schoenfeld Elinor , Bruckenthal Patricia , Horwitz Shelley , Zadok Erez , Trimboli Tracy , Ye Fan
Published: January 2025

Novel and innovative methods are needed to introduce our youth to what roles they can play in supporting our aging population, whether it be in a professional or personal role. To engage college lowerclassmen in discussions about aging, a multidisciplinary team of faculty from the College of Engineering and Applied Sciences and the Schools of Medicine, Nursing, and Social Welfare developed a 10-week seminar entitled “Smart Aging – at the Intersection of Technology and Healthcare.” Students were introduced to community engagement, modern sensing, and analytics technologies for physiologic and physical data, concerns about data security and privacy issues related to technology use, and issues faced by older adults aging at home, including social isolation and social determinants of health. Students learned the process of developing vignettes/personas related to aging in place and how technology may help overcome an identified aging-in-place challenge. To learn about aging-in-place outside of class, students were asked to speak with family members or neighbors about aging. Each week students were asked to share and discuss what they have learned about aging in place from their explorations. At the end of the course, students presented their own vignettes/personas and graded the other students’ work. We are currently taking lessons learned to develop a similar multidisciplinary graduate-level course. During this presentation, we will share our experiences with teaching a cohort of freshman and sophomores about aging and share some of their vignettes/personas to highlight their perceptions about and insights into aging.