bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Role of Communication Technology in Facilitating Social Connectivity and Addressing Loneliness
Authors: Mois George , Beer Jenay , Emerson Kerstin , Washington Tiffany
Published: December 2021

In the United States, two out of five adults report feelings of loneliness. The evolvement of communication technologies presents a promising potential in helping improve social connectivity and address the experience of loneliness. However, the sense of presence (embodiment) users are able to achieve through the technologies can vary depending on their abilities and functions. The present study identified user characteristics associated with an interest to adopt telepresence technologies (e.g., videoconferencing, smart displays, robots) across various levels of embodiment. The data for this study were collected using a Qualtrics survey which was distributed via Amazon Mechanical Turk. The participants recruited for this study were between the ages of 18-78 years old, constituting a total sample size of 384 participants. The data were analyzed using four logistics regression models. The dependent variables aimed to identify participants' interest to adopt telepresence technologies across varying embodiment levels. Across the lifespan older adults were significantly more likely to report lower rates of overall loneliness than young and middle-aged adults. Our findings indicate that those interested in adopting communication technologies with higher levels of embodiment had significantly higher odds of reporting being divorced or widowed (OR=4.12, p<.05), reside in a rural community (OR=2.20, p<.05), and report higher rates of emotional loneliness (OR=1.20, p<.05). Across the four models, there was no significant difference in participants' interest to adopt telepresence technologies. These results suggest that the sense of presence achieved across the various types of communication technologies may help address feelings of loneliness and support healthy aging.
A walk in the country: storying rural journeys of dementia care
Authors: Horne Jami , Aubrecht Katie
Published: December 2021

Dementia and dementia caregiving are increasingly recognized as significant public health issues. Dementia may be more prevalent in rural communities; in part due to higher rates of population aging. In Canada the Nova Scotia provincial dementia strategy Towards Understanding (2015) emphasizes the need to address the unique realities of rural dementia care as a priority issue; however, research remains limited on this demographic in the province, and Atlantic Canada more broadly. This presentation shares findings from the Royal Bank of Canada Foundation funded study, Rural Dementia Caregiving: A Community Life Story, conducted in 2021 to address this critical knowledge gap. The qualitative research design involved a narrative review, archival research and narrative analysis of interviews that yielded rich stories of family/friend dementia caregiving in rural Nova Scotia. Stories illustrate how history, culture and identity inform dementia caregiver realities, experiences and self-perceptions. Study results also suggest that rural dementia caregiving is characterized by factors that include strong community networks and deep-rooted connections to land, culture, and heritage, which can be experienced as supportive as well as constraining. The conditions of life in rural communities, including restricted access to internet, transportation, essential services and paid care providers, pose challenges to dementia caregiving. They also provide opportunities in which networks and connections become more visible and may even be strengthened. Findings demonstrate the lived realities of rural dementia caregivers and the people they care for are unique. Addressing their needs require a distinct approach that acknowledges and can appropriately respond to these differences.
ADRD Caregiving Experiences and Health by Race, Ethnicity and Care Recipient Geographic Context
Authors: Kindratt Tiffany , Sylvers Dominigue , Yoshikawa Aya , Anuarbe Mónika López , Webster Noah , Bouldin Erin
Published: December 2021

Few studies have examined how the intersectionality of geographic context and race/ethnicity influences Alzheimer’s disease and related dementia (ADRD) caregiving. Our aims were to determine whether 1) caregiver experiences and health differed across urban and rural areas; and 2) these links were moderated by caregiver race/ethnicity. We used data from the 2017 National Health and Aging Trends Study and National Study of Caregiving. The sample included caregivers (n=808) of care recipients ages 65+ with ‘probable’ ADRD (n=482). Geographic context was defined as care recipient’s residence in metro (urban) or non-metro (rural) counties. Outcomes included caregiving experiences (burden, gains, life impacts, service/resource use) and health (self-rated, anxiety, depression symptoms, chronic health conditions). Bivariate analyses indicated that non-metro ADRD caregivers were less racially/ethnically diverse (82.7% white) and more were spouses/partners (20.2%). Among racial/ethnic minority ADRD caregivers, non-metro context was associated with having more chronic conditions (p<.01), providing less care (p<.01), and not co-residing with care recipients (p<.001). Amid white ADRD caregivers, non-metro context was associated with not reporting caregiving was more than they could handle (p<.05) and finding financial assistance for caregiving (p<.05). Multivariate regression analyses demonstrated that non-metro minority ADRD caregivers had 3.09 times higher odds (95% CI=1,02-9.36) of reporting anxiety in comparison to metro minority ADRD caregivers. Geographic context shapes ADRD caregiving experiences and caregiver health differently across racial/ethnic groups. Despite higher rates of ADRD and ADRD-related mortality in non-metro areas, findings suggest both positive and negative aspects of caregiving among White, Black, and Hispanic ADRD caregivers.
Ageism in Hiring Decisions: Sense of Purpose as a Mitigating Strategy
Authors: Wilson Megan , Hill Patrick
Published: December 2021

Discrimination against older adults in the workplace is a pervasive issue that has important consequences for older adults, leading to lower well-being (Stokes & Moorman, 2020) and worse job outcomes (Macdonald & Levy, 2016). One area where discrimination manifests is in hiring practices, and thus research is needed to understand factors that impact willingness to hire older adults. One potential intervention target to reduce age discrimination in hiring is sense of purpose. Sense of purpose manipulations have previously been successful in increasing one’s comfort with diversity (Burrow & Hill, 2013), and thus may prove successful in combatting age discrimination in the workplace. Therefore, the current studies sought to understand whether sense of purpose was related to ageist attitudes and hiring decisions, and how a purpose manipulation might serve as a tool to combat discrimination in hiring. Across two studies (n = 594, MAge = 27.20), participants were shown the resumé of either an older adult applicant (62-years-old) or younger adult applicant (32-years-old), and were asked how hireable they would rate the applicant. The research found that the purpose manipulation did effectively increase individuals’ sense of purpose. In addition, the research found that sense of purpose was negatively related to ageist attitudes. However, the purpose manipulation was unsuccessful in reducing ageist attitudes, and had no effect on ageist discrimination in hiring. These results suggest that while sense of purpose is negatively related to ageist attitudes, manipulating purpose may not be an effective tool to reduce ageist attitudes or discrimination.
Association of First Employment Characteristics and Hospitalization in the Mayo Clinic Biobank
Authors: Takahashi Paul , Ryu Euijung , Larson Nicole , Jenkins Gregory , Christine Kirt , Yost Kathleen , Olson Janet
Published: December 2021

Work history is associated with long term health outcomes We hypothesize that characteristics of the first work experience, such as age at first job and length of work (hereafter job) are associated with future risk of hospitalization. We further hypothesize that the length of work will be associated with hospitalization. We conducted a survey of adults >60 years using a nested case-control approach within the Mayo Clinic Biobank. We collected job related variables including age at job start, reason for ending, and length of time. To test associations between each variable and hospitalization, we used age and gender adjusted logistic regression models. Our study included 4,024 subjects: 1,801 cases and 2223 controls. The mean age at time of match was 77.3 years (SD 7.2 years) with 49.2% males. Older age at the first full-time job was associated with lower chance of hospitalization later in life (OR=0.81 [0.67, 0.97] for those who started the job over 22 compared to those started at 18 or less). Cases were more likely to have stopped working because of illness (OR=2.04 [95% CI 1.29,3.27]). Cases were less likely to have stopped working because of retirement (OR=0.82 [95% CI: 0.72, 0.93]). We found cases were employed with a slightly shorter time (20.5 yrs. (SD 16.6)) compared to controls (21.8 yrs. (SD 16.3)) (p=0.005). Cases started work earlier and stopped work more frequently because of illness/disability compared to controls. This could reflect educational attainment in controls. This study highlights work history as potential predictor of future hospitalization.
Associations among Fall Risk Appraisal, Body Composition, and Physical Activity in Older Adults
Authors: Thiamwong Ladda , Xie Rui , Choudhury Renoa , Park Joon-Hyuk , Garcia Oscar , Rossler Aleatha , Stout Jeffrey
Published: December 2021

One-third of older adults have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between perceived fall risk or levels of fear of falling (FOF) and physiological fall risk (balance performance). We aimed to examine the associations among FRA, body composition, and physical activity (PA) using Assistive Health Technology, including the Bioelectrical Impedance Analysis, BTrackS Balance System, and activity monitoring devices. We evaluated 124 older adults with a mean age of 74.81 (SD=7.31, range 60 to 96), 77% were female, and 72% had no history of falls. The multinomial logistic regression was used to analyze the data. FRA was classified into 4 quadrants, and we found 47% of rational FRA (low FOF and normal balance), 19% of incongruent FRA (low FOF despite poor balance), 18% of irrational FRA (high FOF despite normal balance), and 16% congruent FRA (high FOF and poor balance). We found these following variables are associated with FRA: accelerometer-based moderate to vigorous physical activity (MVPA: mins), self-reported PA score (strength & flexibility), had difficulty walking up 10 steps without resting (resistance), had difficulty walking several city blocks (ambulation), left-hand average handgrip strength, CDC fall risk score, Senior Technology Acceptance (STA) score and body composition including Body Fat Mass (BFM), Percent Body Fat (PBF), Body Mass Index (BMI), Whole Body Phase Angle, Skeletal Muscle Mass (SMM) and Skeletal Muscle Index (SMI). Our results support the efficacy of using Assistive Health Technology on screening individuals with maladaptive FRA with targeted interventions to reduce fall risk.
Consequences of Genomic DNA Mono-Ribonucleotides for Chromosomal Stability
Authors: Roache Tavia
Published: December 2021

Mono-ribonucleotides are building blocks for polynucleotide RNA chains (e.g., messenger RNA), but if mis-incorporated into duplex DNA can cause mutagenesis and chromosomal instability. During DNA synthesis by Pol γ, remnants of unremoved RNA primers contribute to elevated mono-ribonucleotide triphosphates resulting in nucleotide pool imbalance, ultimately favoring mis-incorporated ribonucleotides during replication. Moreover, although polymerases generally replicate DNA with high fidelity, the steric gate occasionally allows a mis-incorporated ribonucleotide. Thus, a mono-ribonucleotide is one of the most abundant lesions in genomic DNA of eukaryotes. If unremoved from double-stranded DNA, the ribonucleotide exerts negative effects on replication, transcription, and genomic maintenance, with lasting effects on cellular homeostasis. Even a single ribonucleotide in telomeric DNA comprises shelterin binding and telomere capping causing vulnerability to spontaneous hydrolysis which potentiates telomere shortening. Consistent with this, a ribonucleotide positioned in double-helical DNA alters its structure by torsinally distorting the sugar-phosphate backbone. Fortunately, cellular response and repair pathways exist to help cells cope with mis-incorporated mono-ribonucleotides. The Ribonucleotide Excision Repair (RER) or a Topoisomerase 1 (Top1)-mediated pathway remove embedded ribonucleotides. For RER, RNase H2 incises 5’ of a mono-ribonucleotide, creating an access point for its removal. If cells are deficient in RNase H2, Top1 initiates removal of the ribonucleotide. However, Top1 is less accurate than RNase H2, which can lead to mutagenesis. Studying the mechanisms in which ribonucleotides are incorporated into DNA or further metabolized should provide insight to their negative consequences for chromosomal integrity, cancer, and auto-immune disease attributed to a genetic deficiency of RNase H2.
COVID-19 Related Media Consumption and Mental Health in Older Adults
Authors: Cenko Erta , Kaufmann Christopher , Manini Todd
Published: December 2021

At the beginning of the COVID-19 pandemic, consuming media was critical to identify precautionary behaviors to reduce the spread of the virus, particularly for older adults. Media consumption leads to heightened awareness, but may also negatively affect mental health. We examined whether non-social and social media consumption impacted anxiety and depression relative to pre-COVID-19 symptoms. We conducted an anonymous, cross-sectional survey in May and June 2020. Participants (n=1,168, 73.2 years, 56.8% women, 94.9% White), were asked to estimate their amount of time spent consuming pandemic-related media each day, and to report on anxiety and depressive symptoms both before and after the pandemic onset. We characterized change in anxiety and depression by subtracting scores on current anxiety and depressive symptoms from their recalled symptoms prior to the pandemic. Respondents with high pandemic-related media consumption (>3hrs) were more likely to have increased anxiety, compared to those with low (<1hr) media consumption (OR:1.57, 95%CI:1.09-2.23). Similarly, respondents with increased social media consumption during the pandemic were 64% more likely to have depression, compared to those who did not use social media. This association was bi-directional— those who reduced their social media use were 45% less likely to have depression and 26% less likely to have anxiety, compared to those who never used social media. Older adults consuming more pandemic-related media had increased anxiety. Increased social media consumption was associated with elevated depression symptoms. The potential benefits of media consumption about the COVID-19 pandemic may have unintended negative consequences on mental health.
Changes in Health and Well-Being in COVID-19 Clinically Vulnerable Older English People During the Pandemic
Authors: Gessa Giorgio Di , Price Debora
Published: December 2021

People with specific health profiles and diseases (such as diabetes, lung and heart conditions) have been classified as ‘clinically vulnerable’ (CV) to Covid-19, i.e. at higher risk of severe illness and mortality from Covid-19, and were targeted for shielding. However, there is as yet little evidence on how the pandemic and shielding impacted the health and social well-being of CV older people. Using data from Wave 9 (2018/19) and the first Covid-19 sub-study (June/July 2020) of the English Longitudinal Study of Ageing, we investigated changes in health and well-being during the pandemic by clinical vulnerability. We also explored the interactions between CV and age-group (50s, 60s, 70s, 80+), and between CV and shielding. Results suggest that CV older people (~39% of the sample) were more likely to report worse health and social well-being outcomes during the pandemic compared to non-CV participants, even considering pre-pandemic levels of health and well-being. However, changes in health were not uniform across age groups, with those in their 50s and 60s more likely to report greater deterioration in mental health than those in their 70s and over 80. Moreover, older adults who were shielding and were CV reported the most substantial rises in anxiety, depression, receipt of formal care as well as decreases in well-being and physical activity. While policies focussing on shielding CV older people reduce rates of hospitalisation and death from Covid-19, policymakers should address the wider needs of this group if their long-term health and social well-being are not to be compromised.
Effectiveness of home- and community-based services in decreasing health care service and expenditure in Taiwan
Authors: Chen Ya-Mei , Wu Shih-Cyuan , Chao Shiau-Fang , Chen Kuan-Ming , Hsiang Chen-Wei , Lin Ming-Jen , Hsieh Ji-Lung , Tseng Kuan-Ju
Published: December 2021

Background Whether long-term care service use decreases older adults’ health care service use and cost has been a strong interest among aging countries, including Taiwan. The current study examined the impact of continuous use of HCBS offered by Taiwan’s LTC plan 2.0 on older adults’ health service utilization and cost overtime. Methods This study used the LTC Plan 2.0 database and the National Health Insurance Plan claim dataset, and included 151,548 clients who had applied for and were evaluated for LTC services for the first time from 2017 through 2019 and continuously used any LTC Plan 2.0 services for six months. Outcome variables were users’ health service utilization and health care cost 12 months before and after starting to continuously use HCBS. Latent class analysis and generalized estimating equations were used to investigate the influences of different service use patterns on the changes in physical functions. Results Three subgroups of LTC recipients with different use patterns, including home-based personal care (home-based PC) services (n = 107324, 70.8%), professional care services (n = 30466, 20.1%), and community care services (n = 13794, 9.1%) were identified. When compared to care recipients in the community care group, those in the home-based PC group had more emergency room expenditures (1 point/month, p< 0.05) but less hospitalization expenditures (38 points/month, p<0.001), while the professional care group had less emergency room and hospitalization expenditures (3 and 138 points/month, p< 0.001). Conclusion Those receiving professional care and home care services spent less on health care service utilization.
Feasibility and Acceptability of the Technology-Based Fall Risk Assessments for Older Adults
Authors: Thiamwong Ladda , Garcia Oscar , Choudhury Renoa , Park Joon-Hyuk , Stout Jeffrey , Xie Rui
Published: December 2021

Promising technologies, which are simple, portable, quick, non-invasive, and inexpensive, may open new horizons on fall risk assessments and provide important information for older adults. We used a mixed-methods approach to examine the feasibility and acceptability of technology-based fall risk assessments, including the BTrackS Balance System, Bioelectrical Impedance Analysis, and activity monitoring devices among older adults. Data were collected via a Qualtrics survey and interviews. The acceptability was measured by the Senior Technology Acceptance (STA) and semi-structured interviews with 15 participants. The STA consists of four domains with 14 items, and the semi-structured interview includes three main questions related to experiences about balance performance tests, body composition, and activity monitoring. One hundred twenty-four community-dwelling older adults completed the online survey, and 15 older adults participated in the interviews. The majority of participants were female, and 72% had no history of falls. Race and ethnicity were 17% Hispanic, 7% African Americans, and 3% Asian Americans. About 7% had COVID-19 positive, 31% reported fear of COVID, and 14.5% were afraid of losing their life to COVID. The word-of-mouth strategy and key person approach were used and had an incredible impact on the recruitment process. None of the participants had ever had their fall risk and fear of falling assessed before agreeing to participate in this study. The technology-based fall risk assessments were feasible and acceptable. About 78% of participants liked the idea of using technology to assess falls risk, and 79% agreed that using technology would enhance their effectiveness in daily activities.
Health equity implications of COVID-19 on dementia care in community for people of African descent
Authors: Lukindo Mary , Hamilton-Hinch Barbara , Dryden OmiSoore , Aubrecht Katie
Published: December 2021

This presentation shares results from an analysis of interviews conducted to understand the health equity implications of COVID-19 responses on dementia care in the community for people of African descent in Nova Scotia, Canada. Interviews were embedded within a larger multi-method rapid research project that aimed to assess the impact of COVID-19 on dementia care for geographically and socially marginalized groups in the province. Data from the interviews was analyzed using a constructivist thematic analysis method, guided by an intersectional theoretical scaffold. Three themes were identified related to systemic barriers, mental health, system navigation and self-care, and collected under the overarching theme of ‘facing the unknown with dementia’. Results emphasized the value and notable absence of community driven, culturally specific dementia programs, resources and navigators for people living with dementia, family caregivers and care workers of African descent. Participants identified lack of health system and care provider knowledge and understanding of the cultures and histories of people of African descent as a barrier to quality care and to addressing dementia-related stigma. Conversations focused on the need for practical and accessible tools, strategies and perspectives responsive to the actually lived realities and needs of people in community, and for research that actually contributes to individual and collective life in tangible, timely and culturally meaningful ways. Recommendations focus on the importance of centering community in dementia care programs, policy, practice and research to improve services and supports for people of African descent.
Hospital-induced Delirium among Medical Older Adults: Evaluating the Veracity of Prognostic Models
Authors: Snigurska Urszula , Bjarnadottir Ragnhildur , Lucero Robert
Published: December 2021

Several prognostic models have been developed and validated for delirium prediction among older adults. However, model development and validation studies need to be evaluated for risk of bias to establish the veracity of the prognostic models. This is a critical step before they can be implemented in clinical practice. Multiple systematic reviews have evaluated prognostic models of hospital-induced delirium. However, none of the existing systematic reviews evaluated the validity of models for non-surgical, medical hospitalized older adults. We conducted a scoping review to evaluate the validity of existing prognostic models of hospital-induced delirium in medical older adults. CINAHL, PsycINFO, PubMed, and Web of Science were searched for original studies. The database search yielded 4,312 records. Five studies were included in the qualitative synthesis. All the studies claimed to have developed valid prognostic models. However, the risk of bias assessment revealed that existing prognostic models of hospital-induced delirium in medical older adults are at a high risk of bias. Collectively, the statistical analysis was the greatest source of bias. Notably, while we have seen a proliferation of prognostic models for use in the surgical older adult population, efforts at developing prognostic models in the medical older adult population seem to have declined since the early 1990s. Newer methods of data collection, such as data mining of electronic health records, and statistical analysis, such as machine learning, have shown promise in accurate prediction of hospital-induced delirium while overcoming many challenges associated with manual data collection and traditional statistical analyses.
Older Adults Performed Worse on Cognitive Assessment at Lonelier Moments: Using Ambulatory Assessment Approach
Authors: Kang Jee eun , Harrington Karra , Sliwinski Martin
Published: December 2021

This study focused on investigating the short-term effect of loneliness on older adults’ cognitive performances in daily life. Loneliness is suggested as a risk factor for cognitive health, but results in previous studies are inconsistent due to the lack of valid measures and limited research design. The attention-depletion hypothesis highlights that acute stress could immediately compromise cognitive ability by consuming attentional resources. Accordingly, this study examined whether loneliness, as one of the stressors related to one’s social relationship, was immediately associated with worse daily cognitive performances in older adults. Using an ecological momentary assessment approach, 311 community-dwelling older adults (Mage=77.5 (range=70-90), 67% female, 45% white) reported their level of loneliness as well as performed cognitive assessment five times a day for 16 days. Multilevel modeling showed that on occasion when participants reported a higher level of loneliness than normal, they performed worse in the processing speed test (p<.01) and the short-term memory binding test (p<.01) during those moments, controlling for age, gender, education, ethnicity, IADL, and retest-practice effect. Moreover, those momentary associations between loneliness and cognitive performances remained significant after controlling for the momentary level of feeling depressed. Unlike the concurrent effect, there was no lagged effect of loneliness on daily cognitive performances. These results suggest that transient but intense feelings of loneliness can function as acute stress and thus, compromise daily cognitive functioning short-term. Results will be discussed in terms of the potential benefit of momentary real-time interventions to lessen feelings of loneliness to maintain older adults’ cognitive functioning.
Representing Dutch Older Adults During COVID-19: What Can We Learn?
Authors: Lindenberg Jolanda , Verhage Miriam
Published: December 2021

From the very beginning of the COVID-19 pandemic older adults have been at the heart of public debate. Early articles argued that public representation of older persons displayed a a resurgence of ageist stereotypes and beliefs in (inter)national media (e.g. Ayalon et al. 2020, Fraser et al 2020, Lichtenstein 2020, Sotomayer et al. 2020). Yet studies confirming this are absent up to now. In this paper, we present findings on the representation of Dutch older adults during the first six months of the COVID-19 crisis in The Netherlands. We analysed 1141 articles about older adults of the five largest newspapers using quantitative content analyses and discourse analysis to systematically explore patterns, sentiments and meaning in the articles. We show that the majority of these articles were published in general news and that older adults were rarely (2%) cited in these articles. Most prominent adjectives were vulnerable and weak. Most prominent substantives were attention, long-term care facility and loneliness. The sentiment was largely negative. Additionally, we find three discursive frames predominate: ‘an older people’s disease’, ‘vulnerability’ and ‘solidarity’. This evidences that the Dutch reporting on older adults during COVID-19 reproduced a discourse of dependency highlighting and further emphasizing the sociopolitical context before COVID-19 while drawing out earlier ageist tendencies. On the basis of our findings and drawing on advisory experiences, we discuss implications for policy, education and practice and how we can reframe and differently address older adults specifically in terms of language and their more (un)conscious positioning in (public) debate.
Social Support and Social Strain as Predictors of Depressive Symptom Trajectories Following a Marital Transition
Authors: Denning Emily , O'Neill AnneMarie , Markwardt Sheila , Botoseneanu Anda , Allore Heather , Nagel Corey , Dorr David , Quiñones Ana
Published: December 2021

We investigated trajectories of depressive symptoms over 10 years following a marital transition (widowed or divorced) using data from the Health and Retirement Study (N = 377, mean age = 67.55 years; years 2006-2016). Piecewise growth curve models were estimated to investigate whether social support and strain from one’s spouse, measured prior to transition, predicted depressive symptom trajectories following the transition. Covariates included sex, age, education, race/ethnicity, wealth, and chronic conditions. Overall, trajectories of depressive symptoms after a marital transition were significantly negative, indicating a decrease in depressive symptoms over time. Findings did not differ significantly between participants who were widowed and those who were divorced. Spousal social support was associated with an increase in depressive symptoms and spousal social strain was associated with a decrease in depressive symptoms following a marital transition in separate models: support: b = .250, SE = .062, p <.001; strain: b = -.209, SE = .095, p <.05. However, social strain was not significant when examined jointly with social support. Depressive symptoms declined significantly for low (b = -.370, SE = .100, p <.001) and average levels of social support (b = -.113, SE = .037, p <.01), but not for high levels of spouse social support (b = .143, SE = .109, p = .188). These results suggest those with the highest levels of spousal support prior to the transition, whether divorced or widowed, experienced a more difficult recovery and may be targets for additional mental health support following a marital transition.
The Role of Relationship Quality for Solitude Experiences during the Pandemic
Authors: Choi Yoonseok , Pauly Theresa , Garza Elizabeth Zambrano , Broen Tiana , Gerstorf Denis , Hoppmann Christiane
Published: December 2021

As time spent at home has significantly increased during the pandemic, reports of household conflict has also risen among people living with others (Usher et al., 2020). One solution to alleviate the potential stress of increased time with others could be carving out time to oneself. The present study investigated how living conditions (e.g., with others vs. alone) are associated with everyday desire for solitude and whether daily solitude experience comes with improved daily emotional well-being in people living with others. Furthermore, it also explored whether relationship quality is associated with solitude experience in a similar manner as living conditions. To do so, we used repeated daily life assessments from a lifespan sample (N = 215; M age = 38.3 years, SD age = 17.5; 78 % female) collected during the early pandemic (April to August 2020). Findings indicate that neither living conditions nor relationship quality were directly associated with daily desire for solitude, but higher relationship well-being was related to low preference for solitude when measured as an individual trait. In addition, relationship quality significantly moderated everyday solitude–affect links: higher relationship quality was related to reduced negative affect during solitude, and conflict was related to increased positive and decreased negative affect on solitude as compared to non-solitude days. The results imply that it is the subjective experience of relationships rather than objective living conditions that shape daily affective quality during solitude.
Vaccine access shrinks disparities between long-term care and community rates of COVID-19 mortality.
Authors: Resciniti Nicholas , Kaplan Daniel , Sellner Joshua , Lohman Matthew
Published: December 2021

This longitudinal secondary data analysis examines differences in COVID-19 incidence and mortality among long-term care facility (LTCF) residents with those living in the community in South Carolina (SC) throughout the pandemic, including the time of vaccine availability. Data came from the SC Department of Health and Environmental Control (SCDHEC). Descriptive statistics and trends for cases of infections and deaths were calculated. Cox proportional hazards were used to compare COVID-19 mortality in LTC residents to community dwelling older adults, controlling for age, gender, race, and pre-existing chronic health conditions. Until early January of 2021, significantly greater incidence rates of infection (116.2 per 10,000 per month) and hazard of death after infection (HR=1.83, 95% CI: 1.70-1.98) were experienced among LTC residents as compared to older adults in the community even after statewide mask mandates and visitation guidance. Since vaccine availability, COVID incidence rates among LTC residents fell by half (59.5 per 10,000 per month after vaccines), and the relative hazard of death compared to older adults in the community was diminished (HR=1.44, 95% CI:1.29-1.61). Reducing the gap between LTCF and community-wide infection and mortality rates suggests that vaccination against COVID-19 is correlated with reduced disease spread in the greater community and in LTCF. Results indicate that policies and regulations addressing LTC resident and staff vaccination may effectively protect the most vulnerable older adults and the workforce providing their care while mask mandates and visitation guidance do not.
A Longitudinal Trajectory of Loneliness and the COVID-19 Pandemic Among the Oldest-Old Population
Authors: Cho Jinmyoung , Choi Shinae , Rahimighazikalayeh Gelareh , Martin Peter , Heinz Melinda , Ryou Yeon Ji
Published: December 2021

Loneliness is significantly associated with health and well-being among oldest-old adults. Due to the outbreak of the COVID-19, physical and social distancing policies might elevate loneliness among the oldest-old population. This study examined the trends and changes in the prevalence of feeling lonely using the 2020 HRS COVID-19 module merged to the 15 waves of the HRS RAND longitudinal datasets from 1992 to 2018. A total of 14,371 respondents, including 614 respondents aged 80 years and older were included. Generalized linear models compared age group differences within the 2020 module. Generalized estimating equations assessed the longitudinal change at the individual level and the trend of feeling loneliness among oldest-old adults from 1992 to 2020. Loneliness was assessed with one item of the CES-D scale (i.e., during the past week, felt lonely). After adjusting for demographic characteristics and health, the results showed that oldest-old adults were more likely to feel lonely compared to younger age groups (18% for 80’s vs. 14% for 50’s) during the early months of the pandemic. A longitudinal trajectory also showed that they feel lonelier than in prior years (19% in 2020 vs. 14% in 2018). However, compared to same-age groups from earlier years, a significantly lower prevalence of feeling lonely was observed (18% in 2020 vs. 27% in 1994). The results show that the outbreak of the COVID-19 may elevate feeling lonely, but the recent cohorts be less lonely than earlier cohorts. Future research should continue to explore protective factors for loneliness among oldest-old adults.
Advance Care Planning Among Healthcare Professionals During COVID-19
Authors: Hahne Jessica , Carpenter Brian
Published: December 2021

The COVID-19 pandemic is bringing healthcare professionals face to face with gravely ill patients in complex clinical situations. Caring for patients experiencing lengthy intubation, heavy sedation, rapid decline, and significant distress at the end of life has the potential to shift the perspectives of healthcare professionals regarding their own end-of-life care. This study explored advance care planning (ACP) among medical professionals and whether COVID-19 experiences altered their healthcare preferences and planning. Ninety-eight professionals (mean age = 45.6, 75% female) completed an online survey about ACP conversations, behavioral intentions to pursue ACP, openness to life-prolonging interventions, and ACP resource needs. ACP conversations were most extensive with spouse/partner (89% had talked about care preferences “some” or “a lot”) and to a lesser extent with parents (64%) and other healthcare providers (69%). Two-thirds (67%) of respondents had an ACP conversation since the start of COVID. Among respondents who had not completed ACP documents, 64% had taken some step toward ACP. When asked whether their preferences for life-prolonging medical interventions had changed, 70% reported no change, 16% reported being less open, and 14% reported being more open. A majority (60%) requested resources to help them pursue ACP on their own, although many (42%) were interested in assistance at their workplace. Given that only 37% of our sample had themselves completed an advance directive, our results suggest now may be a critical moment to engage professionals in ACP, considering how their experience during the pandemic has motivated ACP conversations and a reconsideration of preferences.
As Women Live Longer, What Do They Need Most?
Authors: Yahner Jennifer , Hussemann Jeanette
Published: December 2021

Women in the United States can live into their 80s, 90s, and even 100s—outliving men nearly five years on average. Over the next four decades, the number of women aged 85 years and older will nearly triple in size. Many will live alone and in poverty, with increasingly fewer supports on which to rely as they age. Although women can spend their lives caring for children, partners, and parents, often while working multiple jobs, as they grow older, many find their physical, emotional, and financial needs cannot be met. Using data recently collected for the Urban Institute’s EMPOWER: Building Late-Life Resilience study, with funding from the National Institute of Justice, we examine the needs of low-income women aged 85 years and older (N=35) living alone in Arizona communities. We explore issues of home safety perceptions and social isolation and study their relationship to women’s physical, emotional, and financial wellbeing.
Associations between PACS symptoms and risk factors among Long Haulers in the Rutgers Post-COVID Recovery Program
Authors: Dawson Alice , Hu William
Published: December 2021

At least 2/3 of people with mild to moderate COVID-19 infection will experience long-haul COVID symptoms that persist for weeks or months, however, risk factors that modify the likelihood that one develops these symptoms are unknown. Patients referred to the Post-COVID Recovery Program at Rutgers in New Brunswick (n= 108) through primary care referral or self-submitted online request and experiencing a wide variety of Post-Acute COVID-19 Syndrome (PACS) symptoms were stratified by those without self-reported cognitive complaints (n=54), those with self-reported cognitive complaints who scored well on cognitive testing (n=29), and those with self-reported cognitive complaints who scored poorly on cognitive testing (n=25). Comparisons between groups were made using ANOVAs and Chi Squared: for COVID-19 disease severity, COVID-19 disease treatment, comorbid COVID-19 symptoms during infection, comorbid PACS symptoms post-infection, pre-existing health conditions, levels of depression and anxiety, level of fatigue, and social determinants of health (access to healthcare, economic stability, housing stability). Preliminary analyses indicated that whereas people without complaints were normally distributed according to age (p>0.200 for Kolmogorov–Smirnov test), people with complaints and deficits were skewed towards the older age group (p<0.001 for K-S test) suggesting age to be a risk factor for cognitive impairment in PACS. Participants that reported cognitive complaints also reported increased symptoms of depression, anxiety, and fatigue, compared to participants without cognitive complaints. These data provide insight into associations between PACS symptoms and risk factors relevant in understanding this novel disease.
Associations of Adverse Childhood Experiences with Executive Function and Brain-Derived Neurotrophic Factor
Authors: Tsotsoros Cindy , Stout Madison , Hawkins Misty
Published: December 2021

Adverse childhood experiences (ACEs) may predict markers of neurocognitive performance (i.e., executive function; EF) and brain health/plasticity (i.e., brain-derived neurotropic factor; BDNF). This pilot examined the magnitude of effects between: 1) ACES and EF performance, 2) ACEs and BDNF levels, and 3) EF performance and BDNF levels. We hypothesize that higher ACEs will be associated with poorer EF scores and lower BNDF levels and that lower EF scores will be associated with lower BDNF levels. Given the pilot nature of the study, an emphasis is placed on effect size vs. significance. Participants were 36 middle-aged women enrolled in the NICE SPACES trial (age=31.4 years, BMI=34.2, racially minoritized=37.9%). ACES were quantified using the 10-item Adverse Childhood Experiences Scale. EF was measured using the fluid cognition composite from the NIH Toolbox – Cognition Battery. BDNF was estimated using proBDNF levels estimated from serum collected via venipuncture. Higher ACEs levels were not directly associated with EF scores (b = 0.03, p = .854); but did show a meaningful negative beta coefficient with BDNF levels (b = -0.34, p = .053). EF scores and BDNF showed a positive coefficient that did not reach significance (b = .26, p = .122). In a modest pilot of middle-age women, higher ACEs were associated with lower BDNF, indicating greater adversity in childhood is linked to lower neurotrophins levels in adulthood. The lower BDNF levels may help explain poorer performance on cognitive tasks. Larger follow-up studies in more powered samples are warranted given the size of detected coefficients.
Best Practices for Living Labs When Studying Older Adults Living in Rural Communities
Authors: Nakagawa Ashley , Freeman Shannon , Koopmans Alanna , Ross Chris , McAloney Richard
Published: December 2021

There are two core concepts that make living labs distinguishable: involvement of users as co-creators and evaluation in a real-world setting. Living labs increase the potential for product acceptance and adoption due to testing and tailoring with target users. Currently, there is a lack of a universally accepted guideline for best practices. The objective of this review is to identify the best practices of living labs that can be recognized by the scientific community and followed in future labs. A 5-stage scoping review, following Arksey and O’Malley’s (2005) framework, was used to map out the coverage of different aspects of living lab methodology. A systematic search for articles involving living lab framework and older adults published between 2016-2021, was conducted in seven databases. Nine articles were included after review, the majority of which were published in health journals and were from Italy and the United States. An overview of consistent user involvement in the innovation process, real-world testing vs. laboratory testing, and participant scope findings will be shared. Multiple rounds of user feedback, real-world testing, and a small but diverse participant group were the most successful in increasing positive sentiments about the products tested in a living lab environment. The lack of published articles on living lab frameworks studying older adults indicate a gap in the literature. Creating a universally accepted definition for living labs and guidelines for best practices will allow for scientific validity and comparisons of studies and may increase the use and popularity of living labs.
Delirium Duration Predicts 1-Month And 6-Month Mortality In Septic Patients From an Acute Geriatrics Unit
Authors: Mazzola Paolo , Zambon Antonella , Bellelli Giuseppe
Published: December 2021

Sepsis is highly prevalent in the older population compared to younger age groups. We showed that the SOFA score predicts the risk of death at 30 days in patients discharged from an acute geriatrics unit (AGU). We aim at comparing the ability of both delirium duration and SOFA to predict 1-month and 6-month mortality among septic patients. We performed an observational cohort study recruiting all patients consecutively admitted to San Gerardo hospital AGU (Italy) between March 2017 and January 2020, aged ≥70, who were diagnosed with sepsis according to 2016 Sepsis-3 criteria. All patients underwent a comprehensive geriatric assessment, including delirium twice a day with the 4AT. Outcomes were 1- and 6-month mortality rates. From 3,326 hospitalized patients, 235 were included in the study (median age 84 years, 42% females). Delirium accounted for 71.9% (169 patients, median duration 3 days). One-month and 6-month mortality rates were 32.3% and 55.3%, respectively. Age, albumin, hemoglobin, and PCR levels were associated with mortality and included as covariates in our Base Model. We performed pairwise comparison between c-indexes of the Base Model vs. Base+delirium duration (days) vs. Base+SOFA. The increment of predictive performance of model including delirium duration was statistically significant (c-index: 0.67 vs. 0.75 when considering 1-month mortality; 0.70 vs. 0.75 for 6-month mortality). Base+delirium duration performed better than Base+SOFA, but the difference not significant. Delirium duration performs as well as SOFA score in predicting 1- and 6-month mortality, with practical implications for the management of these patients in the continuum of care.
Disability & Sleep Quality of Custodial Grandparents During Fall 2020 of the COVID-19 Pandemic
Authors: Mayfield Kellie , Clark Karen , Anderson Raeda
Published: December 2021

Disability of custodial grandparents, grandparents who are the primary caretakers of their grandchildren often in parent absent households, are not frequently examined. One in four adults in the U.S. lives with a disability with the highest percentage of disabilities reported in the South. Quality sleep is integral for overall wellbeing and is altered with age. Sleep complaints of older adults are associated with multiple adverse health outcomes such as dementia, stroke and obesity. The objective of this study was to examine the relationship between disability and sleep quality amongst custodial grandparents during the COVID-19, Fall 2019 in Georgia. Thirty-four custodial grandparents were recruited from the Georgia Division of Aging Kinship Care Support Groups, ages 42 to 78, with most identifying as African American. Disability status and the Pittsburgh Sleep Quality Index were measured. Results showed a significant negative relationship for custodial grandparents’ disability status and sleep quality (χ2= 9.167, p=0.027; Γ=-0.683, p=0.002), sleep disturbance (χ2= 12.150, p=0.002; Γ=-0.897, p<.001), and use of sleeping medication (χ2= 9.645, p=0.022; Γ=-0.785, p<.001). Custodial grandparents with a disability had worse sleep quality, more sleep disturbances, and took more sleeping medication compared to custodial grandparents without a disability. Results have implications for kinship care providers and medical practitioners when engaging with custodial grandparents about their health, disability and impacts on their sleep quality.