bluuebunny/crossref_metadata_2025 huggingface dataset:
INSOMNIA SYMPTOM TRAJECTORIES OF SPOUSE CAREGIVERS OF OLDER ADULTS WITH FUNCTIONAL LIMITATIONS
Authors: Kong Dexia , Lu Peiyi
Published: December 2022

Background

Studies have suggested older spouse caregivers experience burden-related adverse health outcomes compared to non-caregivers. However, potential causal inferences remain unclear. This study examined the effect of caregiving on insomnia symptoms of spouse caregivers over time, compared to non-caregiver samples matched by propensity score (PS).

Methods

Longitudinal data from the Health and Retirement Study from 2006 to 2018 were used. Caregivers (Nf403) were respondents (aged 50+) who assisted their heterosexual spouses in performing (instrumental) activities of daily living at baseline. PS-matching was used to match non-caregivers based on sociodemographic, household, and health-related characteristics. Symptoms of insomnia were evaluated every four years for both groups. The link between caregiver status and number/severity of insomnia symptoms over time was assessed using a Poisson mixed-effects model.

Results

The propensity-matched sample achieved a satisfactory covariate balance. There was no statistically significant difference between caregivers and non-caregivers in the number of insomnia symptoms at baseline (β_caregiver=0.092, 95% CI = -0.017, 0.201). However, caregivers reported a slower increase in insomnia symptoms compared to non-caregivers (β_caregiver×time = -0.012, 95% CI = -0.021, -0.003). Results were cross-validated in modelling the severity of insomnia symptoms.

Conclusion

There is weak evidence that a spouse’s role as a caregiver may be beneficial for his/her sleep health over time. The negative effects of caring on older individuals’ sleep may vary depending on the caregiving context. The potential health benefits of informal spousal caring and their underlying mechanisms warrant further investigations.
PERSONAL STRATEGIES FOR MANAGING EVERYDAY ACTIVITY CHALLENGES AMONG ADULTS AGING WITH VISION LOSS
Authors: Mumma Kara , Remillard Elena , Rogers Wendy
Published: December 2022

An estimated 6% of adults in the United States ages 65 and older are living with vision loss and may experience other age-related declines and conditions co-morbidly (e.g., arthritis, hypertension, hearing loss). As such, they are likely to experience challenges in performing everyday activities, but little is known about their personal strategies or innovative solutions for managing activity challenges. The Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) study explored everyday activity challenges and strategies among older adults (Nf60; ages 60–79) with long-term vision loss (prior to age 50). The current analysis focused on understanding participants’ own methods for managing activity challenges, or things they have come up with, beyond traditional methods, such as getting help from other people (e.g., caregiver) or using assistive devices (e.g., white cane, screen reader). We coded response strategies among participants’ own methods, and the most frequently reported methods included: learning/familiarity/organization, planning ahead/prioritizing, and perseverance/patience/assertiveness. Response codes were classified using the Selection, Optimization, and Compensation model to better understand how these strategies are being used to adapt to losses. The most common strategies were classified as elective selection with optimization, which are strategies that entail continued performance of challenging activities through behavioral methods, without bringing in any new means to assist. Illustrative example quotes are featured to provide insight on the context of personal strategies. With greater understanding of solutions people aging with vision loss are employing to manage activity challenges, we can increase awareness about effective solutions and identify opportunities for supportive technology solutions.
LINKS BETWEEN LONELINESS AND SLEEP AMONG PARTNERED OLDER ADULTS: AFFECTIONATE TOUCH AS A MODERATOR
Authors: Lawrence Carly , Marini Christina
Published: December 2022

Sleep problems and loneliness both increase with age and undercut older adults’ health and well-being. Loneliness is a predictor of sleep problems, however, research in this area often fails to also consider the role of relationship quality. The current study therefore focuses on spousal relationship quality as it has been shown to have a proximal influence on sleep. We examined relative effects of physical and emotional facets of relationship quality–namely affectionate touch and emotional support (in addition to loneliness). We further examined the potential for relationship quality to buffer effects of loneliness on sleep. We utilized data from a nationally representative sample of older adults from the National Social Life Health and Aging Project (NSHAP). Participants were partnered (N = 559) and completed a novel sleep module that included subjective (i.e., insomnia symptoms) and objective (i.e., Wake After Sleep Onset; WASO) markers of sleep. Upon controlling for demographics and mental and physical health, a different pattern of findings emerged for each facet of sleep. For subjective sleep, older adults who were more lonely reported more insomnia symptoms, but only when spousal emotional support was low. For objective sleep, older adults who reported more affectionate touch experienced less WASO. These findings suggest that loneliness that occurs in the context of low emotional support from spouses is particularly damaging for older adults’ subjective sleep quality. Further, affectionate touch from spouses may represent an important intervention target for promoting felt security that helps older adults stay asleep throughout the night.
COPING AND LIFE SATISFACTION OF OLDER PEOPLE DURING THE COVID-19 PANDEMIC
Authors: Xu Dongjuan , Lalani Nasreen , Arling Gregory
Published: December 2022

Covid-19 put older individuals at high risk for increased morbidity and mortality, isolation, reduced coping and life satisfaction. Optimism, sense of mastery and closeness with family and friends can enhance coping and life satisfaction among older adults. No such studies were found during the pandemic. Our study examined the associations between optimism, sense of mastery, closeness with spouse, family, and friends, physical and psychological functioning and its effects on coping and life satisfaction. A national representative sample of 1,890 community dwelling older adults was obtained from the 2020 Health and Retirement Study COVID-19 data during March 2020-June 2021. A structural equation modeling approach used to test the associations and their direct and indirect effects on life satisfaction. Coping was seen as a mediator affecting these relationships and their effects on life satisfaction. Optimism (β = .318, p < .001), mastery (β = .195, p < .001) closeness with spouse/partner (β = .199, p < .001), closeness with children ((β = .075, p < .010), friends (β = .086, p < .001), had significant positive direct and indirect effects on life satisfaction. Frailty (β = -.137, p < .001), comorbidities (β = -.057, p < .050), and IADL limitations (β = -.118, p < .001) had negative direct effects on life satisfaction. Optimism, sense of mastery and closeness with family/friends promotes coping and life satisfaction whereas frailty and comorbidities negatively influence coping and life satisfaction of the older adults. Community interventions should target coping strategies that enhances optimism, mastery, and interpersonal closeness among older adults during pandemic.
A PILOT ASSESSMENT OF A TABLET-BASED INTERVENTION FOR HOMEBOUND OR SOCIALLY ISOLATED OLDER ADULTS WITH DEPRESSION
Authors: Galo Caroline , Benda Natalie , Rollandi Isabel Olivia , Czaja Sara , Ceruso Marco , Sirey Jo Anne
Published: December 2022

Older adults who are homebound or socially isolated have high rates of loneliness and depression with fewer opportunities for treatment. Our team extended an existing psychotherapy intervention (Engage & Connect) to improve access to mental health care for older adults who are homebound. We iteratively created a tablet-based application (Engage PRISM) leveraging a user-centered design approach to provide older adults, particularly those with limited technology experience, an easy-to-use application to support social reward. Engage PRISM connects clients with the psychotherapy intervention and additional features to increase social reward exposure virtually. All eligible participants received a K92 ZTE tablet, equipped with the Engage PRISM application, internet service, Zoom, and access to Selfhelp’s Virtual Senior Center. Participants were then enrolled in the 9-week Engage & Connect intervention delivered by a licensed mental health counselor via Zoom on the tablet each week. We evaluated feasibility of the intervention and preliminary effect on depressive symptoms through a weekly PHQ-9. Feasibility was assessed through participants’ ability to use the tablet to access mental health treatment. We provided tablets to eight participants ages 67 to 84; participants demonstrated 100% feasibility of use of the tablet intervention. We dropped two participants from the study due to a greater level of care needed. All participants were provided with referrals prior to ending the study. Preliminary evidence indicates that four of the six remaining participants had experienced a reduction in depressive symptoms (i.e., had lower PHQ-9 scores) three weeks into the study reporting over a 30% reduction on average.
IS THERE A CAUSAL RELATIONSHIP BETWEEN ONLINE HEALTH INFORMATION SEEKING AND ANXIETY AMONG OLDER ADULTS?
Authors: Cotten Shelia , Anarsky Reza Ghaiumy , Schuster Amy
Published: December 2022

The growth of the Internet has provided users unlimited access to an abundance of information, including health information. The Internet is typically the first source searched by U.S. adults (18 years and older) when seeking health information. Factors such as age and anxiety are associated with online health information seeking (OHIS). Older adults (65 years and older) are increasing their Internet use and OHIS, although OHIS decreases with age. Importantly, OHIS can lead to improved health outcomes for older adults. The relationship between OHIS and anxiety is less clear, with some studies finding individuals with higher anxiety are more likely to search for online health information while others find the reverse pattern. Anxiety affects up to 20% of older adults and is often unrecognized and untreated. Given the lack of research examining the relationship between OHIS and anxiety among older adults and the proportion of older adults who experience anxiety, we analyzed six waves (2015- 2020) of data from the National Health and Aging Trends Study to assess the causal relationship between anxiety and OHIS using a Random Intercept Cross-lagged Panel Model framework, a statistical approach to assess causal relationships. These results suggest that anxiety is leading to OHIS in the next wave, rather than the reverse; however, OHIS was not related to anxiety in the next wave. This suggests that OHIS is not capable of mitigating older adults’ anxiety. Practitioners working with older adults should be aware that older adults may need additional support to manage their anxiety.
HOW TO PROMOTE INTERGENERATIONAL INTEGRATION THROUGH ONLINE COMMUNICATION: A MODERATED MEDIATION MODEL
Authors: Lee Yeseul , Kang Miseon , Joo Susanna , Kim Hyoun K
Published: December 2022

The present study examined the extent to which online communication skills led to the degree of intergenerational integration mediated through loneliness, focusing on whether such a mediating path would be moderated by age groups. Intergenerational integration is a concept that emphasizes acceptance and flexibility to recognize diversity based on each other’s values across multiple generations or groups of varying ages. The older group included 315 Koreans aged 65 or above, and the younger group included 322 Koreans aged 19 to 29. Both groups completed an online survey conducted from December 2021 through January 2022. The results showed loneliness significantly mediated the association between online communication skills and the degree of intergenerational integration among both older and young adults; the higher the level of online communication skills, the lower the level of loneliness, leading to high levels of intergenerational integration. However, the mediation path was moderated by age; the association between online communication skills and loneliness was stronger for young adults compared to older adults. Additionally, the direct path was moderated by age: the association between online communication skills and intergenerational integration was stronger for older adults compared to young adults. The findings indicate that programs aimed at improving online communication skills (e.g., SNS or video calls) can reduce loneliness and thus promote intergenerational integration in both younger and older adults. This study highlights the importance of promoting online communication ability to increase intergenerational integration of both older and young adults.
BARRIERS AND FACILITATING FACTORS TO HEALTH MANAGEMENT TECH ADOPTION IN A RURAL MEALS ON WHEELS SAMPLE
Authors: Wihry David , Jain Jennifer , Crittenden Jennifer , Kaye Lenard , Caso Tabatha
Published: December 2022

Meals on Wheels clients served through the aging network represent a significant population of high need older adults who could benefit from health management technology. This poster presents the results of a study targeting Meals on Wheels clients in four rural U.S. counties on opportunities and barriers to adoption of technology-based health management interventions. Paper surveys were provided to 690 Meals on Wheels clients and 154 were returned (22.3% response rate). The mean age of respondents was 71.7 years and the sample was composed of 39% men and 61% women. When asked to select the most valuable features of home health management technology, 42% indicated vital signs monitoring, followed by remote access to classes and events at Area Agencies on Aging (21%), and video visits with medical providers (20%). When asked about current technology usage, 48% indicated never having engaged in a telehealth visit over a computer, smartphone or tablet. Top ranking barriers to health management technology utilization were affordability and privacy concerns. A majority (61%) of the sample disagreed or strongly disagreed that they have the money to afford a computer, smart phone, or tablet and 69% agreed or strongly agreed that they are concerned about privacy or scams when using the internet. Approximately four in ten (38%) are interested in using technology to manage their health. Additionally, 45% reported using a smartphone. The poster will also explore demographic differences in older consumer perceived barriers and opportunities and programmatic implications for expanding health management technology adoption.
USING DIGITAL TECHNOLOGIES TO IMPROVE READMISSION AND ADHERENCE AMONG OLDER ADULTS WITH HEART FAILURE
Authors: O’Connor Melissa , Wickramasinghe Nilmini , Gehlot Vijay , Sloane Elliot , Chalasani Suresh , Wallace Ramona , Wisk Patricia G , Gravenstein Stefan
Published: December 2022

Heart failure (HF) affects approximately 26 million people globally resulting in morbidity, mortality, and rehospitalization. With 30-day rehospitalization rates ranging from 19% to 25%, HF is burdensome for patients and challenging for clinicians to manage. HF costs in the U.S. exceeded $30 billion in 2012, projected to exceed $70 billion by 2030, and produce estimated social care costs of 12 billion in 2020. Therefore, reducing HF readmissions should be a global priority. A technology-based platform may assist in the goal of reducing readmissions. This platform may accomplish this goal by providing several digital tools that can assist the clinician in the care process, while simultaneously enabling patients with self-care through more effective communication in all care settings. Digital twins (DT) and the nursing Avatar (NA) are two such tools. The DT is a virtual, real-time digital representation of a physical object/process. It originated from NASA to improve physical model simulation of spacecraft in 2010 (Wickramasinghe et al., 2021). It is possible to achieve similar benefits in healthcare by developing suitable DT of patients in specific clinical contexts (Wickramasinghe et al., 2021; Lui et al., 2019). So to, the NA was studied by Bickmore, et al (2209) and found ultimately to be the preferred discharge communication method. As such, we proffer the development of digital twins and NA for HF patients to support better provider decision and patient communication. This will result in HF care being more precise, consistent, reproducible, and personalized resulting in improved diagnosis, treatment, and care outcomes.
SIMPLE SOLUTIONS TO A COMPLEX PROBLEM: LISTENING TO DIRECT CARE WORKERS’ PERCEPTIONS ABOUT RETENTION
Authors: Karmacharya Isha , Janssen Leah
Published: December 2022

Direct care workers (DCWs) play a crucial role in delivering long-term services in nursing homes, assisted living, and in-home care. The work is physically and emotionally demanding and generally low-paid, which makes retaining and managing the workforce extremely challenging and has resulted in an unending workforce crisis. This study provides data on retention-promoting factors from the perspective of DCWs working in high-performing facilities and home care agencies that were identified through national and state retention data and reviews from case management agencies. Qualitative interviews were conducted in the spring of 2022 with a purposive sample of DCWs (n=16). Interviews were transcribed, checked for accuracy, and coded via thematic analysis. Three overarching themes emerged: work culture, appreciation, and monetary benefits. Retention was supported by a work culture that emphasizes person-centered care, family atmosphere, relationship building, staff empowerment, coaching supervision, participative leadership, effective communication, and flexible working conditions. DCWs experienced appreciation from employers, supervisors, and clients, which they perceived to promote retention. This theme includes valuing, respecting, recognizing, and acknowledging the efforts of DCWs. Monetary benefits promoting retention were seen as regular wage raises, employee assistance funds, gift cards, bonuses, paid time off, health insurance benefits, and travel reimbursement. This study demonstrates that while worker retention is a crisis, there are modifiable aspects of the job that can promote workers’ retention. DCWs’ retention can be impacted by work culture and appreciation practices. Study findings have implications for facility policy and practice pertaining to DCW’s retention.
ENSURING A KNOWLEDGEABLE GERIATRIC WORKFORCE: INTERDISCIPLINARY EDUCATION IN LONG-TERM SERVICES AND SUPPORTS
Authors: Tucker-Roghi Gina , Towsley Gail , Edelman Linda
Published: December 2022

In this symposium, we describe five interdisciplinary educational programs to enhance the geriatric workforce in long-term services and supports (LTSS): Skilled nursing facilities (SNFs), assisted living, and home health and hospice. The interdisciplinary teams that came together to offer the programs leveraged technology to maximize access to experts in both the curriculum development process and the delivery of the educational programs for a wide range of target learners. The first program, an interdisciplinary telementoring series on dementia care for therapists in SNFs, was developed by a team of experts from occupational, physical and speech therapy. The program included asynchronous online didactic content and case-based learning relevant to therapists. The second program engaged faculty from seven graduate programs: Pharmacy, Physical Therapy, Occupational Therapy, Dentistry, Social Work, Nursing and Physician Assistant to co-create an interprofessional LTSS graduate certificate in Gerontology. The certificate encompasses asynchronous online courses to enable flexibility across programs and cover content specific to LTSS. In the third program, LTSS nurses completed an online educational course to better prepare them to care for complex older adults, improve leadership skills, become more resilient, and complete QAPI projects. The fourth program focused on utilizing interdisciplinary perspectives to educate LTSS direct care staff on the unique needs of LGBTQ older adults. The fifth program offered a virtual telehealth clinical experience to prepare physical therapy students for practice in a SNF setting. The curriculum included eight virtual modules and four telehealth patient encounters that exposed students to interdisciplinary teams in the SNF context.
INTERDISCIPLINARY TELEMENTORING FOR THERAPISTS IN SNFS TO IMPROVE DEMENTIA CARE KNOWLEDGE AND SKILLS
Authors: Tucker-Roghi Gina
Published: December 2022

Occupational, physical, and speech therapists possess knowledge and skills that have the potential to reduce the burden of care and improve the quality of life of skilled nursing facility (SNF) residents living with dementia. Despite this opportunity to impact the well-being of residents with dementia, many therapy practitioners lack specialized training on the management of dementia. Therapy practitioners (n=31) from 22 SNFs participated in eight weekly interdisciplinary educational sessions using the Project ECHO (Extension for Community Health Outcomes) tele-mentoring model. An interdisciplinary team of therapy experts collaborated on the development of the curriculum, which included didactic content on dementia-care best practices as well as case-based learning. This presentation describes the process of developing an interprofessional tele-mentoring therapy education program, challenges encountered during implementation, and strategies to retain learners. Evaluation data from participants will be shared and implications for future tele-mentoring interprofessional educational offerings for therapists will be discussed.
ALIGNMENT OF COMMUNICATION AND SUPPORT NEEDS BETWEEN LGBTQ+ FAMILY CAREGIVERS OF HOSPICE PATIENTS AND PROVIDERS
Authors: Cloyes Kristin , Reblin Maija , Hebdon Megan Thomas , Jones Miranda , Ellington Lee
Published: December 2022

Effective and equitable end-of-life care requires alignment between the support and communication needs of hospice family caregivers and the knowledge and competence of hospice care team members. We investigate alignment between LGBTQ+ caregivers and hospice providers in a secondary analysis of data collected in three studies: 1) Surveys identifying predictors of hospice providers’ (N=122) attitudes toward LGBTQ+ caregivers and patients; 2) focus groups assessing hospice interdisciplinary care team members’ (N=48) knowledge, training, and opinions regarding LGBTQ+ family caregiver and patient communication and care needs; and 3) in-depth interviews with LGBTQ+ hospice family caregivers (N=20). Synthesis of key findings show how alignment is impacted by lack of systematic, inclusive orientation and gender data, provider religiosity, expectations of disclosure, cisheteronormative assumptions about the universality of EOL experiences, and caregivers’ experiences of minority stress. We discuss implications for developing interventions to improve provider communication, empowering caregivers, and addressing hospice-specific sources of minority stress.
A COMMUNITY HEALTH WORKER–LED HOME VISIT INTERVENTION TO SUPPORT DIVERSE DEMENTIA FAMILY CAREGIVERS
Authors: Lee Jung-Ah , Ju Eunae , Sabino-Laughlin Eilleen , Gibbs Lisa , Nyamathi Adey
Published: December 2022

Diverse family caregivers of persons with dementia (PWD) are often faced with challenges in obtaining necessary resources due to limited English-proficiency, accessing available resources, and stigma. Diverse community health workers (CHWs) provided dementia family caregivers culturally and linguistically appropriate education, compassionate listening during a 3-month home-visit intervention. 25 participants were recruited from communities in California: Race/Ethnicity 32% Korean, 32% Vietnamese, 16% Latino, 20% White; 76% Female; 44% Spouse; Age=62.6 (28-83 years); 44% work; English proficiency=2.9 of 5. Recruitment is ongoing. The key themes from the exit interview with participants included (a) accepting the role of a caregiver, (b) better understanding and patience with the PWD, and (c) ongoing support from CHW. The overall satisfaction on the intervention was 4.7/5. The CHW-led home-visit intervention was well-received by ethnically diverse dementia family caregivers. Participants reported the usefulness of education, community resources, and compassionate support delivered in their homes over 3 months.
ALIVIADO HOME HEALTH AND HOSPICE AIDE DEMENTIA CARE EXPERT PROGRAM IMPROVES AIDE DEMENTIA KNOWLEDGE
Authors: Lin Shih-Yin , Durga Aditi , Ford Ariel , Ramos S Raquel , Crespo-Fierro Michele , Sadarangani Tina , Brody Abraham
Published: December 2022

Most persons living with dementia receive home health or hospice aide services during their hospice stay. To equip aides with essential knowledge and skills to effectively communicate with and care for persons living with dementia, we developed a 17-video dementia care expert program for aides, available in both English and Spanish. The objective of this presentation is two-fold: first, describe the development and refinement of the Aliviado aide dementia care expert program, including topic selection, usability testing, and cultural tailoring; and second, discuss aide knowledge improvement, along with special considerations for training aides during COVID-19. The Aliviado dementia care expert program for aides has been completed by 414 aides across 15 hospices as of February 2022; of which, 384 aides (93%) completed a dementia knowledge assessment both before and after the training and demonstrated significant knowledge gains with moderate-to-large effect sizes (p<0.0001; Cohen’s d=0.63).
GENDER DIFFERENCES IN CAREGIVING PRACTICES AND MARITAL RELATIONSHIPS OF SANDWICH GENERATION COUPLES IN MUMBAI
Authors: Hemalatha Sruthi Anilkumar , Sekher T V , Sarif Nawaj
Published: December 2022

Over the next few decades, the most important demographic trend for the Asia Pacific region will be population aging. The increasing aging population in India and the fact that the economic dependence of the older adults is high and the cost of education and child care is on the rise pose serious challenges to generations of individuals and couples who are expected to take care of both their children and their parents. This study's primary objective is to comprehensively understand the effects of giving care to their children and their parents on various aspects of the life of sandwich generation couples. The study uses primary data of 300 multigenerational households and 100 two-generation/one-generation households in Mumbai. Specifically, the study attempts to understand the effect of giving care to two generations on the marital relationship of the caregiving couples. Additionally, the study also explores gender differences in caregiving practices. Results from bivariate and multivariate analyses show that providing simultaneous care to two generations significantly impacts the marital relationship of the sandwiched couples as opposed to couples staying in one/two-generation households. Results also show considerable gender differences in caregiving roles and time spent on caregiving. Women spend more time assisting in household activities, while men are more likely to provide monetary support. Thus, extensive research on the sandwich generation in India is necessary to ensure the socio-economic well-being of the couples, the welfare of their children and parents, and the physical and psychosocial health of these couples.
FEASIBILITY OF A LONGITUDINAL AUDIOVISUAL OBSERVATION PROTOCOL TO CHARACTERIZE LUCIDITY IN ADVANCED AD/ADRD
Authors: Gilmore-Bykovskyi Andrea , Block Laura , Benson Clark , Fehland Jess , Botsch Meghan , Mueller Kimberly , Coulson Alison
Published: December 2022

Episodes of lucidity (EL) among individuals with advanced dementia, which are predominantly reported near end of life, are clinically and potentially epidemiologically significant events. Audiovisual observation offers a valuable approach to studying EL, providing opportunities to characterize verbal/non-verbal features of EL as well as their surrounding contexts. Approaches to capturing and characterizing audiovisual data and potential verbal/non-verbal indicators of EL near end of life are lacking. We determined the acceptability and feasibility of a multi-faceted observational study protocol among people with advanced dementia near end of life incorporating longitudinal audiovisual observation, informant field interviews/logs, and case review of high likelihood EL events. Five eligible individuals were enrolled, yielding a 100% enrollment/retention rate, 54 observations/140 hours of observation across participants. Task load and usability ratings indicate study procedures with iterative refinements were feasible; surveys and qualitative appraisal from participants and staff endorse high rates of acceptability and feasibility.
EXPLAINING THE RACIAL AND ETHNIC DIFFERENCES IN ADL DISABILITY AMONG OLDER ADULTS: A POLYSOCIAL SCORE APPROACH
Authors: Wu Chenkai , Tang Junhan
Published: December 2022

Disability in activities of daily life (ADL) is prevalent among older Americans. Racial and ethnic disparities in functional ability in old age continue to be a public health concern. We examined whether social environment, measured in a comprehensive way (polysocial score approach), could modify the racial and ethnic differences in ADL disability. Data are from the Health and Retirement Study; 5,925 older adults initially free of disability were included. Six ADLs were considered: bathing, eating, using the toilet, dressing, walking across the room, and getting in/out of bed. We included 24 social factors from five categories (economic stability, neighborhood environment, education, community/social context, and healthcare system) and used forward stepwise regression to screen for important ones. Polysocial score was created using 13 social factors and was classified as low (0-19), intermediate (20-30), and high (31+). We used the multivariable Poisson regression to estimate the risk of incident disability by three polysocial score categories and evaluate the interaction between race/ethnicity (non-Hispanic Whites and Others) and the polysocial score. A higher polysocial score is associated with a lower disability risk among non-Hispanic Whites and Others. We found an additive interaction between race/ethnicity and polysocial score categories. In the low polysocial score group, non-Hispanic Whites had a 4.7% lower risk of disability than the Others, while the difference significantly reduced to 2.4% and 2.6% in the intermediate and high polysocial score group, respectively. The polysocial score approach offers a new opportunity to explain the racial/ethnic disparities in functional capacity among older adults.
PRESIDENTIAL SYMPOSIUM: NUTRITION, METABOLISM, AND AGING
Authors: Anderson Rozalyn
Published: December 2022

Aging is associated with increased risk for a host of non-communicable diseases and disorders including diabetes, cardiovascular disease, cancer, and neurodegeneration. Although the underlying basis for this shared risk as a function of aging is not known, numerous diseases of aging have an established metabolic component. Data from preclinical and basic research indicate that the pace of aging is malleable, and studies in short-lived species have shown the ability of genetic and nutritional interventions to not only positively impact longevity but also to prolong health into older age. This symposium, “Nutrition, Metabolism, & Aging”, features internationally renowned aging research scientists whose work focuses on how nutrition and metabolism intersect with aging biology. We will hear from John Speakman from the University of Aberdeen who will present his research on “Metabolism and Extended Longevity”; Leanne Redman from the Pennington Biomedical Research Center whose work in humans will be described in her talk on “Dietary Interventions for Healthy Aging”; Holly Brown-Borg from University of North Dakota will discuss endocrine modulation of aging in her talk “Somatotropic Signaling in Health and Longevity”; and Valter Longo from the University of Southern California who will discuss the latest findings from his research in mice and humans in his talk “Periodic Fasting in Aging and Disease". Attendees will learn about nutrition and metabolism and how these cues are interwoven to regulate aging, impact health, and enhance longevity.
PERIODIC FASTING MIMICKING DIET, LONGEVITY, AND DISEASE
Authors: Longo Valter
Published: December 2022

Chronic dietary interventions have been known for decades to help prevent disease and extend longevity, yet most are difficult to adopt especially long-term. Brief periods of a diet that mimics fasting by regulating key starvation response genes including IGF-1, TOR-S6K and PKA lasting between 4 and 7 days and followed by long periods on a normal diet, are emerging as potentially effective pro-longevity interventions. These periodic fasting mimicking diets (FMD) provide low calories, sugars, and proteins and high levels of unsaturated fats. In mice, 4 day bi-monthly cycles of the FMD started at middle age extend longevity, reduce tumors by nearly 50%, reduce inflammatory diseases and increase cognitive performance at old ages. In humans, 3 monthly cycles of a 5 day FMD reduce markers or risk factors for aging, diabetes, cancer and cardiovascular disease including cholesterol, blood pressure, CRP, IGF-1, and fasting glucose, particularly in subjects with elevated levels of these markers at baseline. Here I will present our most recent mouse and clinical studies indicating that FMDs can help reverse insulin resistance, reduce risk factors/markers of aging and age-related diseases, and lower biological age.
MEASURING RESILIENCE ACROSS THE LIFE COURSE: FINDINGS FROM HRS AND ADD HEALTH
Authors: Taylor Miles , Bruefach Tyler , Carr Dawn
Published: December 2022

The study and measurement of psychological resilience (PR) is increasingly of interest to interdisciplinary audiences focused on successful aging across the life course. Though existing nationally representative datasets have not directly measured PR previously, recent advances have produced two novel measures showing promise among older and younger adults, respectively. We examine whether these measures capture similar internalized resources and if they effectively measure PR across race/ethnicity, gender, SES, and age. Analyses use two PR measures: the Simplified Resilience Scale (SRS) created in the 2006/8 Health and Retirement Study (N=14,064), and the Add Health Resilience Scale (AHRS) created in Wave 4 (2008) of the National Longitudinal Study of Adolescent to Adult Health (N=4,936). Both scales reflect Wagnild and Young’s (1993) conceptualization of PR as an internalized, multidimensional psychological resource that is protective for health and wellbeing. Confirmatory Factor Analyses suggest that both measures capture a single construct of PR well, on average (one-factor structure; CFI >.95, RMSEA <.06). These measures also perform similarly across social groups; we observed configural, metric, and at least partial scalar invariance across race/ethnicity, gender, education, and age. Assessing the validity of these measures across diverse US populations at various life stages is critical to understanding how PR shapes aging processes over the life course, and for promoting successful aging throughout mid and later life. Future research can advance understanding of PR and its measurement by leveraging intersectional combinations of social statuses including race/ethnicity, gender, education, and age.
RESILIENCE AND MULTIFACTORIAL STRESSORS AMONG OLDER ADULTS DURING THE COVID-19 PANDEMIC: A QUALITATIVE STUDY
Authors: Hladek Melissa , Wilson Deborah , Shofner Sabrina , Gross Alden , Bandeen-Roche Karen , Schoenborn Nancy
Published: December 2022

The COVID-19 pandemic represents a complex stressor that is experienced differently across individuals and age strata. The present study explored perceptions and experiences of older adults within the domains of health, social interactions, finances and care of existing chronic medical conditions; and strategies used to cope with these stressors. We recruited 30 people (mean age 81.4 years) stratified by frailty status to complete semi-structured interviews about what changes to the above domains had occurred and what coping strategies were utilized. Using inductive and deductive coding techniques, thematic analysis revealed three overarching themes. The first was Pandemic Experience, which was perceived as stressful, especially in the domains of social isolation from friends and family and concern for others’ well-being. The second domain was Resilience where participants reported highly adaptable and creative ways to connect with others and viewed the pandemic from a lens of lifetime experience, which acted as a stress buffer. The third theme was Silver Linings where participants reported unexpected renewal like reconnecting with family and friends in more meaningful ways and reconnecting with nature. We found no meaningful distinction in experience by frailty status and explore reasons for this. Policy implications including internet access and training and societal aging biases are discussed in the context of aging and coping theories.
RESILIENCY AMONG WHI WOMEN IN THE 80+ COHORT BY RACE AND NEIGHBORHOOD SOCIOECONOMIC STATUS
Authors: Krok-Schoen Jessica , Naughton Michelle , Cene Crystal , Shadyab Aladdin , Springfield Sparkle , Nolan Timiya , Felix Ashley , Jackson Rebecca
Published: December 2022

Resilience, an individual’s ability to successfully adapt to adversity, is a multifaceted outcome that may be affected by individual and community factors. A comprehensive examination of resilience by race and neighborhood socioeconomic status (NSES) among women aged 80+ is needed to better understand longevity in diverse populations. Women aged 80+ in 2011, in the Women’s Health Initiative (WHI) study were included. Resilience was measured using the 3-item Brief Resilience Scale, with higher scores indicating better resiliency. Descriptive statistics and multivariable linear regression examined the association of demographic, psychosocial, and health variables with resilience by race (White, Black, Asian) and NSES. The majority of participants (n=29,367, median age=84.0) were non-Hispanic White (91.4%), and had multimorbidities (66%). There were no significant differences by race on mean resiliency scores (p=0.06). Mean resilience was higher among women with higher NSES (low NSES=3.94±0.83, moderate NSES=3.95±0.82, high NSES=4.00±0.81; p< 0.001). Optimism (p< 0.001), social support (p< 0.01), and physical/mental symptom burden (p< 0.05) were significant correlates of resilience among Asian, Black, and White women. Self-rated health (p< 0.001), depressive symptoms (p< 0.001), optimism (p< 0.001), social support (p< 0.001), physical/mental symptom burden (p< 0.001), and body mass index (p< 0.001) were significant correlates of resilience across women with low, moderate, and high NSES. Age was significantly associated with resilience among women with moderate (β=-0.004, p=0.019) and high NSES (β=-0.005, p=0.045). This study found several common correlates of resilience across race and NSES among women aged 80+ in the WHI. Future research to enhance resilience, such as through psychosocial and behavioral interventions, is warranted.
ASSESSING THE IMPACT OF COVID-19 ON THE HEALTH AND WELLNESS OF THE LONG-TERM CARE WORKFORCE IN RURAL AND NORTHERN AREAS
Authors: Freeman Shannon , Banner Davina , Chew Hui Jun , Klassen-Ross Tammy , Jackson Piper
Published: December 2022

There is growing recognition that the mental health and wellbeing of the LTCF workforce have been disproportionately impacted by COVID-19. Therefore, we sought to describe the experiences and challenges LTCF employees faced during COVID-19 in rural and northern communities and highlight factors affecting their ability to be resilient and provide high quality care. We conducted 53 qualitative interviews using zoom with LTCF care providers (care aides, nurses, social workers), staff (food service workers, recreation providers), and management between November 2021 and February 2021. Data was transcribed and thematic analysis undertaken. We will describe participants experiences stratified by LTCF employee type and highlight similarities and differences in participants experiences across geography and facility type (freestanding vs. co-located in hospital) and describe factors affecting well-being, job satisfaction, and retention. We will share an inventory of programs and strategies participants found useful to mitigate negative effects on their mental health and well-being.
CANNABIS USE AND RISK OF FALLING IN OLDER ADULTS
Authors: Rudroff Thorsten
Published: December 2022

The prevalence of cannabis use has significantly increased among US adults ≥ 50 years. However, the effect of chronic cannabis use on fall risk in older adults is unclear. A series of investigations were conducted to examine the intersection between cannabis use and fall risk in older adults. The findings indicated that: 1) Older (≥ 50 years) chronic cannabis users have a higher fall risk and walking impairments, 2) cannabis users might have a discrepancy between perceptual and physiological fall risk, and 3) chronic use of Δ-9-tetrahydrocannabinol (THC) might have negative influences on inhibitory control and brain activity. Future mechanistic (e.g., neuroimaging) investigations of the short- and long-term effects a variety of cannabis products (e.g., THC/CBD ratios, routes of administration) on cognitive/motor function, and fall incidence in older adults are suggested.
CAREGIVER STRAIN AMONG AFRICAN AMERICAN AND HISPANIC MALE CAREGIVERS WITH CHRONIC CONDITIONS
Authors: Smith Matthew , Kew Chung Lin , Washington Tiffany , Bergeron Caroline , Merianos Ashley , Sherman Ledric , Goidel Kirby
Published: December 2022

Caregiving strain often stems from caregivers’ unmet needs and is a risk factor for physical and psychological ill-health. This study aims to identify factors associated with caregiver strain among middle-aged and older African American and Hispanic male caregivers living with one or more chronic conditions. Data were collected from 431 male caregivers using a web-based survey (55% African American, 45% Hispanic). Linear regression models were fitted to assess factors associated with caregiver strain, which was measured using caregiving difficulty items from Behavioral Risk Factor Surveillance System. On average, participants were age 54.9(±9.51) years, they self-reported chronic conditions were 3.74(±2.62), and their caregiver strain was 14.7(±7.30). Among African American caregivers, higher caregiver strain was positively associated with living with children below age 18 (β=0.14, P=0.045) and feelings of social disconnectedness (β=0.16, P=0.018) and depression (β=0.15, P=0.035). Conversely, caregiver strain was negatively associated with having insurance coverage (β=-1.34, P=0.028) and disease self-management efficacy (β=-2.26, P=< 0.001. Among Hispanic caregivers, higher caregiver strain was negatively associated with age (β=-0.28, P=< 0.001) and positively associated with feelings of social disconnectedness (β=0.16, P=0.041). Findings suggest African American and Hispanic males with chronic conditions have differing caregiving experiences. Compared to Hispanic men, contributors to caregiving strain among African American men were multifaceted and associated with financial resources, household dynamics, mental health, and the ability to self-manage their chronic conditions. While bolstering social connectedness may offset caregiver strain, tailored mental health and disease-management programming are needed to meet the specific needs of African American and Hispanic male caregivers.
EXPLORING THE ASSOCIATION BETWEEN FAMILY DYNAMICS AND PREPAREDNESS FOR FAMILY CAREGIVING AT THE END OF LIFE
Authors: Fox Aimee , Sharp Julia , Fruhauf Christine
Published: December 2022

The transition to providing end-of-life (EOL) care to a family member can be challenging for family caregivers as they face difficult decisions regarding medical course of treatment, increasing caregiving responsibilities, and anticipatory grief. Low preparedness for EOL caregiving is associated with higher levels of caregiver strain, increased levels of depression and anxiety, and complicated and prolonged grief after the death of the family member. Despite the breadth of caregiving research, little is known about how family relationships and interactions relate to caregiver preparedness for EOL caregiving. Thus, the purpose of this study was to explore the association between family caregivers’ family dynamics and their perceived preparedness for the transition to EOL caregiving. A sample of 173 family caregivers were recruited to complete an online, self-report survey. A structural equation model was used to analyze the association between family dynamics and caregiving preparedness. Most caregivers reported balanced family cohesion (75.1%) and family flexibility (75.7%), but low family communication and low family satisfaction. In addition, 20.2% of caregivers reported being not at all prepared for the transition to EOL caregiving. Although there was a lack of meaningful association between family dynamics and preparedness for EOL caregiving, it may be that family relationships and interactions grow more complex as families age and individuals take on new and different roles (such as family caregiving) within the family system. This study demonstrates the need for future research to develop new measures to explore how aging family dynamics relate to family caregiver experiences and outcomes.
FAMILY CAREGIVER SOCIAL CONNECTEDNESS: TECHNOLOGY USE ACROSS GENERATIONS DURING THE COVID-19 PANDEMIC
Authors: Pohl Janet , Kolodisner Jude , Coon David
Published: December 2022

During the COVID–19 pandemic, maintaining connectedness was difficult for caregivers. Family caregivers represent multiple generations whose experience with and use of social technology to maintain connectedness can vary and differentially impact critical health outcomes. The aims of this study were to examine caregiver connectedness and technology preferences across three generations of caregivers who provide care to older adults with chronic illnesses. The semi-structured focus-groups/interviews conducted in August of 2020 with family caregiver participants including Millennials (n=6), Generation X (n=5), and Boomer (n=8). Two researchers analyzed the transcribed content via thematic analysis. Similarities and differences across generations were assessed via comparative analysis. The themes that emerged from the data were: (1) Millennials (a) Altered stage of life, (b) Altered connectedness, (c) Need others to understand, (d) Stay away from social network sites; (2) Generation X (a) Altered connectedness, (b) Need others to understand, (c) Burden, (d) Fear-of-failure; and (3) Baby Boomer (a) Altered connectedness, (b) Technology builds connectedness, (c) Information seeking. All generations expressed alterations in connectedness with caregiver role. Millennials and Generation X caregivers emphasized need for others to understand that caregiving altered their lives with unique responsibilities. Technology use differed across the generations, with Millennial texting for confidential communications. Millennial and Generation X caregivers do not use social media due to envy of others’ fun. Baby Boomers expressed increased connectedness with the use of Zoom. Understanding the variation in the experience of caregiver connectedness and technology use by generation may identify targets for future caregiver connectedness intervention studies.