bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes In Mental Health, Social Engagement, and Physical Activities During the COVID-19 Pandemic
Authors: Li Wenjun , Hou Su-I
Published: December 2021

The current COVID-19 pandemic has profoundly changed our behaviors and health, especially vulnerable community-dwelling older adults. This symposium includes three presentations that evaluated the pandemic’s impacts on mental health, social engagement and physical activity in healthy community-living older adults and those with dementia. Dr. Wenjun Li and his team examined the pandemic impact on mental health and social engagement among relatively healthy older adults residing in suburban and rural neighborhoods in Central Massachusetts, USA. The study reported significant variations in pandemic impacts by sex, age, race, income, living arrangement, and neighborhood housing density, suggesting the pandemic has had disproportionally negative impacts on socially and economically disadvantaged vulnerable older adults. Dr. W. Quin Yow and her team evaluated the impacts of government mandated social distancing and lockdowns on older adults with dementia and their caregivers in Singapore. The study found significant increases in irritability, aggression and hallucinations among older adults with dementia, and possible deterioration of health conditions and heightened moderate level of stress. The results suggest that social distancing may have resulted in negative outcomes in this vulnerable population with dementia and their caregivers. Dr. Ladda Thiamwong reported her team’s efforts on forming an international aging research collaborative to mitigate heath consequences of COVID-19 crisis from the international perspective. The team consists of ten scholars from five countries, including Hong Kong, Nepal, Singapore, Thailand, and the United States. They collect data using combinations of online and face-to-face surveys. Their important findings will be discussed in detail in this symposium.
Changes In Social Isolation, Anxiety and Depression Among Older Adults During The COVID-19 Pandemic
Authors: Li Wenjun , Churchill Linda , Siden Hannah , Aquirre Annabella , Procter-Gray Elizabeth
Published: December 2021

Social distancing and business lockdowns may have severe negative impact on daily living, mental and physical health of community-living older adults. Our Healthy Aging and Neighborhood Study surveyed 370 older adults in Central Massachusetts in 2020 and 2021. Participants were queried about pre-post pandemic changes in social and physical activities, mental and physical health, and lifestyle factors including food purchasing, diet and physical exercise; and attitude towards and receiving of vaccination. The study is ongoing and data are being accumulated. Preliminary analysis suggested that social distancing and lockdowns have negative impacted social engagement, communications with close friends, relatives and family members, food purchasing, frequency of outdoor exercises, especially group activities. The impact appeared to differ by sex, advancing age, and living arrangement. In summary, social distancing and business lockdowns may have negative impacts on most older adults while the impacts were more severe in those older and socioeconomically disadvantaged.
Comparative Analysis of Dementia Care Programs and Delivery Models
Authors: Peckham Allie , Saragosa Marianne , King Madeline , Roerig Monika , Marchildon Gregory
Published: December 2021

Dementia has significant social and economic impacts for those living with dementia and their caregivers. Despite an increase in prevalence of complex chronic conditions and dementia, long-term care services are continuously pushed out of institutional settings and into the home and community. The majority of people living with dementia in Canada and the United States (U.S.) live at home with support provided by family, friends, or other unpaid caregivers. Ten dementia care programs and service delivery models across five different North American jurisdictions in Canada and the U.S. are compared using a deductive analytical approach using a comparative policy framework developed by Richard Rose. The policy efforts included in this research attempt to improve health system flow and access for vulnerable populations. One common theme among all jurisdictions are long-standing institutional barriers that can make change difficult. These barriers can prevent the ability for systems to be flexible and adapt to meet the changing needs of populations. Incrementalism is often considered an appropriate approach to health system reform. Yet, incremental change efforts lead to policy layers and these layers can lead to tension between different policy mixes and unintended consequences. These programs were introduced in a manner that did not fully consider how to patch current structures and risk creating further system redundancies. One approach to reduce this risk is to combine evaluative efforts that assess ‘goodness of fit’. The degree to which these programs have embedded these efforts successfully is low, with the possible exception of DSRIP from NY.
The StrongerMemory Program: A Brain Health Intervention for Mild Cognitive Impairment
Authors: Tompkins Catherine , Ihara Emily , Liebreich Rob , Fredericksen Jessica , Bradley Lauren
Published: December 2021

The StrongerMemory program is a brain health intervention targeting older adults with mild cognitive impairment (MCI). Approximately 20% of individuals over 65 years old have MCI and 38% will potentially develop dementia after 5 years of MCI onset. Participants in the 16-week StrongerMemory program practice exercises involving math, writing, and reading aloud for 20-30 minutes a day, stimulating the prefrontal cortex of the brain, which governs the brain’s ability to retrieve memories. The current research exploring participants’ experiences with the StrongerMemory program was approved by the University’s Institutional Review Board. A semi-structured interview was implemented with each participant and the interviews took about 15 to 30 minutes to complete. There was a total of 24 respondents associated with a local continuing care retirement community, each providing their verbal consent to be interviewed and recorded over Zoom. The respondents were mostly female ranging in age from 65 to 90. Most respondents reported having advanced degrees and were participating in the program on their own, with a spouse or friend. Each interview transcript was coded by at least two members of the Mason research team. Participants reported being motivated to participate in the program due to fearing memory loss because of experiences of family members and friends and others wanted to remain “cognitively fit.” Codes and themes representing participants’ perceptions and reactions to exercises and their challenges and lessons learned from their participation will be discussed, including participants feelings of being “less foggy” and better able to remember information.
Innovations in Gerontology Education
Authors: Ellis Jennifer , McDonald Kimberly
Published: December 2021

This session examines innovative approaches to effectively address the aging services workforce needs in rural, Midwestern settings. Presenters will explore career pathways and transfer opportunities in gerontology education, as well as best practices for addressing the educational, professional and personal needs of diverse student populations.
Adult Learning and Employment Opportunities for Older Workers in Australia and the United States: Lessons for Adult Education
Authors: Cummins Phyllis , Taylor Philip , Yamashita Takashi , Janssen Leah
Published: December 2021

This study examined the role community colleges (U.S.) and Technical and Further Education (TAFE; Australia) institutes play in providing educational opportunities to older workers in the U.S. and Australia. Employment for adults of all ages has been impacted by job automation in recent decades. We analyzed national level data to estimate the impacts of job automation by age group. In both the U.S. and Australia, about 65% of older workers in sales occupations are at risk for job loss due to automation. Additionally, we reviewed occupational projection data and employment opportunities for workers who may be displaced by automation. Needs for health care support occupations, such as nursing assistants and occupational and physical therapy assistants are expected to grow rapidly. We will provide several recommendations based on the integration of our findings related to education/training programs and the aging workforce in the context of community colleges and TAFEs.
Health Risks, Perceptions, and Self-Care Patterns: A Comparative Study Between Older and Younger Filipinos
Authors: Soberano Julienne Ivan , Caciata Marysol , Flores Jo Leah , Leyva Erwin William , Hernandez Mary Abigail , Tuazon Josefina , Evangelista Lorraine
Published: December 2021

Worldwide trends in health risks, lifestyle behaviors, health perceptions, and health-seeking patterns suggest alarming disparities among individuals from low- and middle-income countries; particularly for older individuals (≥ 60 years). This study aims to compare health risks, perceptions, lifestyle behaviors, and health-seeking patterns between younger (< 60 years) and older (≥ 60 years) Filipinos from rural communities in the Philippines; and assess relationships between demographic, health risks and perceptions, and lifestyle behaviors to bolster health promotion efforts. A comparative cross-sectional study was employed with 863 younger and 427 older Filipinos. Results show that older participants were more likely to be single/widowed and had ≤ high school education. Older participants had higher rates of hypertension, dyslipidemia, diabetes, and depression but were more likely to report higher quality of life, ≥ 150 minutes of physical activity per week, ≥ 5 servings of fruits and vegetable per day, more difficulty falling asleep, report seeing a physician regularly, going to the community health center when sick, and attend stress management classes compared to their younger counterparts (all p’s < .001). There were no differences in rates of obesity, self-medication, and use of integrative health. Older age was associated with higher risks, improved health perceptions, healthier lifestyle behaviors, and better health-seeking patterns. Our data suggest that health risks are higher in older individuals but risky lifestyle behaviors were higher in younger individuals and suggest the need to design separate health promotion interventions that target the unique needs of older and younger Filipinos from rural communities.
Patient-Centered Digital Screener for Elder Abuse in the Emergency Department
Authors: Abujarad Fuad , Choo Esther , Dziura James , Edwards Chelsea , Pantalon Michael , Jubanyik Karen , D'Onofrio Gail , Gill Thomas
Published: December 2021

Elder abuse is a growing problem where many cases are left unidentified by professionals. For some older adults, the emergency department may be the sole point of care where they have an opportunity to be identified as victims of abuse. However, current methods of screening tend to miss less obvious forms of abuse and may deter older adults from self-reporting due to either a lack of understanding of abuse or fear of potential consequences. VOICES is an innovative, self-administrated, and automated tablet-based tool that combines screening, educational content, and brief motivational interviewing to enhance and improve identification of elder abuse cases. Combining an elder abuse screener and digital coach designed to guide the older adult through a customized pathway to encourage self-identification and self-reporting of abuse, VOICES is a robust tool engineered to place the screening process in the hands of the older adults, rather than the providers. We will discuss preliminary results of the ongoing feasibility study currently being conducted in the ED, which has successfully enrolled over 500 older adults. Current data indicate that 93% of patients find the tool to be satisfying, engaging, and easy to use. Preliminary findings also suggest that older adults who come in with “Little to none” knowledge of elder abuse increase knowledge of abuse after using the tool. In summary, VOICES appears to be a feasible tablet-based screening tool in the emergency department.
Feasibility of the ACTPlan Program for African American Dementia Caregivers: A Self-Directed Multimedia Delivery
Authors: Watkins Yashika , Collinge William , Hart Alysha , Tharpe Rita , Aggarwal Neelum , Bonner Gloria
Published: December 2021

African Americans (AA) are less likely than White Americans to complete advance care plans or end-of-life treatment documents. They face significantly greater risk of Alzheimer’s Disease, a silent epidemic for this population, and other dementias. The healthcare system’s lack of dementia support for AAs contributes to disparate care. A four-session caregiver group education program was conducted on advance care planning for AA dementia family providers. The program was based on Kolb’s Experiential Learning Model and initially found effective in an R01 study using in-person delivery by a professional. The present pilot assessed feasibility of delivering the program in a self-directed multimedia format without professional facilitation, using Session 1 on tube feeding decisions as the test session. Twenty-six AA dementia caregivers completed the session in groups of 5 to 8 at a church equipped with a large TV screen. On-screen prompts guided navigation through the program which included recorded lecture, slides, short videos on decision-making, and group discussions. Using quantitative and qualitative methods, pre-and post-survey instruments were administered and interviews conducted. Usability ratings averaged 84%. Knowledge and self-efficacy gains exceeded those of the R01, with a 35% increase in correct responses on knowledge items, versus 18% for the R01 subjects; and increase in perceived decisional self-efficacy of 31% versus 30% for the R01 subjects. Qualitative feedback was universally positive. These findings confirm the feasibility of the self-guided multimedia approach to delivery of the program. A large RCT is planned which, if successful, will support wide dissemination to AA caregivers in need.
State Adoption of Nursing Home Immunity From Legal Liability During the COVID-19 Pandemic
Authors: Nadash Pamela , Miller Edward , Simpson Elizabeth , Gusmano Michael , Beauregard Lisa
Published: December 2021

Twenty-eight states have provided nursing homes (NHs) with immunity from legal liability related to COVID-19. This study places these provisions in the context of prior actions protecting NHs from legal action and explores factors influencing the adoption of such immunity provisions across states. It uses cross-sectional data to examine patterns of policy adoption and to assess states’ likelihood of adopting immunity provisions using multivariate methods. Variables of interest include information on state political, socioeconomic, programmatic, and COVID-19-related characteristics as well as data on campaign contributions and lobbying activity at the state level. Factors significantly related to NH immunity provision adoption included measures of state fiscal health (unemployment), ideology (percent legislators Democrat), governing capacity (unified government), and NH characteristics (percent not-for-profit, hospital-based, and chain). Population density and Medicaid as a percentage of state general fund expenditures proved significant as well. Against these complex influences, organizations lobbying on behalf of NH residents and their families have found themselves ineffectual in creating avenues for accountability. Results indicate that enforcing accountability for NH deaths during the COVID-19 pandemic is a complex process, constrained by available policy tools and made more complicated by factors external to the NH environment that contributed to high death rates. Historically, the NH industry has been successful in avoiding consequences for poor quality care, a pattern that has persisted in that NHs have generally been successful in avoiding liability for negligence during the COVID-19 pandemic.
Predictors of Multimorbidity Among Korean Older Adults: Longitudinal Secondary Data Analysis
Authors: Kim Eunkyung , Lee TaeWha , Ji Yoonjung
Published: December 2021

Multimorbidity has become a global concern for an aging society. It has been reported to be associated with increased health service utilization, leading to poor health outcomes including quality of life. However, the incidence of multimorbidity and its related factors are poorly understood. The aim of this study was to determine the socioeconomic and health-related factors predicting the incidence of multimorbidity in Korean older adults using longitudinal secondary data from the Korean Longitudinal Study of Aging (KLoSA) dataset from 2008 to 2018. The KLoSA aimed to collect basic data to be used for developing socioeconomic policy for the aging society in Korea. The sample included 3,019 older adults aged 65 years and over who had 0-2 chronic diseases at baseline in 2008. Multimorbidity was measured with the incidence of co-existence of three or more chronic diseases using Cox’s proportional-hazards model. Among 3,019 respondents (female 57.6%, mean age 73.07±6.30 years), 586 (19.4%) incidents of multimorbidity were reported after 10 years of follow-up. Low participation in social activities, being overweight or obesity, more depressive symptoms, current or past drinkers, and lower life satisfaction were identified as significant predictors of multimorbidity among Korean older adults. This study identified high risk groups with overlapping senility and multimorbidity, who require more attention from health care providers in the course of chronic disease monitoring and management. This longitudinal approach will contribute to the development of preventive strategies to reduce the incidence of multimorbidity among older adults.
It’s Yet Another Thing: Barriers to and Recommendations for Physician Referrals to Home-Based Palliative Care
Authors: Kogan Alexis Coulourides , Cardenas Valeria , Zhu YuJun , Giulioni Jenna , Rahman Anna , Enguidanos Susan
Published: December 2021

To understand primary care providers’ (PCPs) experiences with referring patients to home-based palliative care (HBPC), we conducted individual, key-informant interviews with 31 PCPs. About half participants were male (54.8%), White (42.5%), US-born (58.1%), and were 57 years old (SD=9.17), on average. About one-third of participants (32.3%) indicated they refer 10+ patients annually to HBPC, while most (80.7%) reported “strong” comfort discussing palliative care with patients. Qualitative analysis revealed three prominent thematic categories, each related to barriers PCP experienced when referring patients to palliative care: (1) PCP-level (lack of knowledge and comfort); (2) perceived patient-level (culture, family disagreement, need, home-based aspect); and (3) HBPC program-level (need to close the loop with PCP, insurance coverage, program availability, and eligibility). PCP recommendations for overcoming identified barriers will be discussed. Findings hold important implications for timely patient-referrals to palliative care by PCPs and for sustaining palliative programs that rely on these referrals.
Effects of Age on Dual Task Walking Performance as Measured Using a Smartphone Application in Middle-Aged Adults
Authors: Zhou Junhong , Cattaneo Gabriele , Yu Wanting , Tormos Jose , Lipsitz Lewis , Bartres-Faz David , Pascual-Leone Alvaro , Manor Brad
Published: December 2021

After the age of 65, one’s ability to walk while performing an additional cognitive task (i.e., dual-tasking) is predictive of both future falls and cognitive decline. However, while it is well-known that older adults exhibit diminished dual-task performance, the time course of age-related dual-task decline has not been established. We thus conducted an analysis of data collected within the ongoing Barcelona Brain Health Initiative, a prospective population-based study characterizing the determinants of brain health maintenance in middle-aged adults. Cognitively-unimpaired participants (n=655) aged 40-65 years without neuro-psychiatric disease completed laboratory-based trials of walking normally (single-task) and walking while performing a verbalized serial subtraction task (dual-task). A smartphone-based gait assessment application was used to capture data and derive both the mean stride time (ST) and stride time variability (STV, defined as the coefficient of variation about the mean stride time) of each trial. The dual-task costs (DTC) to each gait metric were obtained by calculating the percent change from single- to dual-task conditions. We categorized participants into five groups according to age (e.g. Group 1: 40-45 years; Group 5: 60-65 years). Age group did not have an effect on single-task gait outcomes (p>0.51). However, the oldest age group, as compared to each of the other groups, exhibited greater DTC to both ST and STV (p<0.03). These results indicate that dual-task walking performance in particular may begin to diminish in late middle age even in the absence of detectable cognitive issues, DTC may offer a sensitive metric to age-related change in cognitive function.
Isolation and Loneliness: Implications for Health and Well-Being of Older Populations
Authors: Holt-Lunstad julianne
Published: December 2021

Evidence suggests social isolation and loneliness are prevalent within the population and may potentially be exacerbated due to the pandemic. Social connections have powerful influences on health and longevity, and lacking social connection qualifies as a risk factor for premature mortality. Evidence from the recent National Academy of Science consensus report on social isolation and loneliness among older adults will be summarized, providing the scope of the health effects, potential mechanisms and risk factors, as well as current gaps in the evidence. Importantly, this evidence points to several implications for solutions across sectors, including medical and healthcare practice and policy.
Research Applying Adaptive Leadership Framework for Chronic Illness Across Settings of Care
Authors: Bryant Ashley Leak , Beeber Anna , Wu Bei
Published: December 2021

The carepartner is an essential member of the team to facilitate and assist in maximizing the independence of the older adult. The four papers in this symposium applies The Adaptive Leadership Framework for Chronic Illness (ALFCI) at the point of design, as well as an analytic framework for literature synthesis, intervention design, and analysis of existing data. In the first paper, a qualitative metasummary of a scoping review synthesizes qualitative findings about fatigue adaptation and challenges for stroke survivors, care partners, and healthcare professionals. The second paper describes the use of the ALFCI in an intervention study to manage symptom challenges in older adults with acute myeloid leukemia. The third paper shares staff’s experiences of providing direct care for older residents with advanced dementia in long-term care facilities. The fourth paper describes use of the carepartner–assisted intervention to improve oral hygiene of older adults with cognitive impairment. The ALFCI is a useful framework for intervention design 1) this framework provides a comprehensive way to examine the context of symptoms/behaviors (not just the symptom/behavior in isolation), 2) the framework guides “collaborative work”, 3) analytically it can help guide development of shared meaning of communication and “collaborative work” of dyads (family caregivers, long-term care staff and older adults), and 4) helps understand process of staff utilizing their strengths and doing adaptive work to facilitate interactions and communication, managing older residents’ behavioral and psychological symptoms of dementia, and improving their care provision and work life.
Efforts by the Coalition to End Social Isolation and Loneliness
Authors: MacPherson Andrew
Published: December 2021

Established in the Fall 2018 and based in Washington, D.C., the Coalition to End Social Isolation & Loneliness brings together dozens of national organizations including consumer groups, community-based organizations, health plans, mental and behavioral health organizations, health care innovators, and many others to lead a multi-stakeholder dialogue to address the crisis of social isolation and loneliness in America. The Coalition focuses on three major areas to achieve this goal: Disseminating research findings, developing and advocating for federal and state legislative and regulatory policy interventions, and leading public awareness events in Washington, D.C. and across the nation. The COVID-19 pandemic has greatly accelerated efforts to engage Congress and the Executive Branch on a range of federal policy priorities, including leveraging and advancing social services and supports, supporting health care delivery to support those who are socially isolated and/or lonely, and advancing federally-funded research initiatives.
Caregiver Stress: Biomarkers Linked to Disease Risk and the Psychobiology of Stress Reduction
Authors: Beadle Janelle , Jain Felipe
Published: December 2021

Caregivers to older adults with chronic diseases frequently experience chronic stress which can negatively affect caregivers’ physical and mental health, and increase disease risk. This interdisciplinary symposium will highlight critical factors influencing caregiver stress, and the role of biomarkers in detecting caregiver disease risk. First, we will discuss the effects of stress and emotional experiences on risk for cardiovascular disease in caregivers of persons with dementia (PWD). In the first talk, Dr. Mausbach will examine relationships among perceived stress, blood glucose and risk of diabetes and cardiovascular disease in caregivers of PWD. Next, Dr. Losada-Baltar will discuss the degree to which caregivers’ ambivalent feelings towards providing care are associated with inflammatory markers of cardiovascular risk. Following this, two talks will investigate critical links between stress and caregiver emotional well-being. Dr. Liu will report relationships among the stress-related hormone cortisol, sleep, and anxiety in the context of adult day services. Dr. Beadle will examine the degree to which caregivers’ affiliative, empathetic interactions with others relate to their experience of stress through cortisol assessments and neuroimaging. The final talk by Dr. Jain will investigate the effects of a Mentalizing Imagery Therapy intervention for family PWD caregivers on stress, evidence for mindfulness as a causal mediator of stress reduction, and the relationship to brain networks associated with emotion regulation. Taken together, this symposium will identify relevant psychosocial and biological factors that contribute to caregiver stress, as well as discuss the psychobiology of amelioration of caregiver stress.
Resilience, Purpose in Life, Loneliness, and Associated Medical Costs in Older Adults
Authors: Barnes Timothy , Tkatch Rifky , Bhattarai Gandhi , Kraemer Sandra , Schaeffer James , Yeh Charlotte
Published: December 2021

Resilience, purpose in life (PIL), and loneliness have been linked, and used to characterize the health and well-being of older adults. Studies demonstrate that higher resilience, PIL, and minimal loneliness are associated with better late-life outcomes. However, research on how these constructs negatively impact medical costs is limited. Using survey and claims data from a large sample of older adults age 65+ (N=4,496), resilience, PIL, and loneliness were examined to determine associations with medical costs. Among study participants, 11% exhibited low resilience, 19% severe loneliness, and 35% low PIL. Low resilience was associated with 24% higher medical costs compared to participants with high resilience, severe loneliness with 20% higher costs compared to participants with no loneliness, and low PIL marginally associated with 12% higher costs compared to participants with high PIL. Interventions targeting resilience, PIL, and loneliness could be beneficial to promoting successful aging and lowering medical costs.
Validity of the Chinese Version of the Person-Environment Apathy Rating (PEAR-C) for Persons With Dementia
Authors: Jao Ying-Ling , Chao Ying-Yu , Liao Yo-Jen , Berish Diane , Yeh An-Yun , Chen Shang-Ti
Published: December 2021

Apathy is a prevalent neurobehavioral symptom in dementia. Despite that environmental stimulation plays a key role in apathy, it is often overlooked in assessment. The Person-Environment Apathy Rating (PEAR) scale is currently the only validated apathy scale for persons with dementia that addresses environmental stimulation and is only available in English. This project translated the PEAR scale into Mandarin Chinese and evaluated its content validity. The PEAR scale includes two subscales: PEAR-Environment and PEAR-Apathy. Each subscale includes six items. The PEAR scale translation and validation were conducted through a four-step process. First, the PEAR scale was translated from English into Chinese by two bilingual PhD-prepared researchers. Second, the two Chinese versions of PEAR (PEAR-C) were back-translated into English by another two bilingual PhD-prepared researchers. Third, three content experts reviewed the two translated scales and reconciled a final PEAR-C scale. Finally, these three experts individually rated the PEAR-C and evaluated its content validity item-by-item in two aspects: 1) content equivalence: appropriateness to use this scale in Chinese cultural setting, and 2) semantic equivalence: the scale remains the same meaning after translation. The content validity index (CVI) was calculated to sum the ratings across experts. The CVI of content equivalence for all items was 1.0 for both subscales. The CVI of semantic equivalence was 0.98 for the PEAR-Environment and 0.97 for the PEAR-Apathy. The PEAR-C shows substantial content validity. Its reliability and construct validity need further evaluation. This scale is promising to assess apathy for individuals with dementia in the Chinese-speaking community.
Caregiving Through the Pandemic: Exploring the Impacts of COVID-19 on Caregivers and Their Caregiving Experiences
Authors: Balmuth Alexa
Published: December 2021

In the midst of the COVID-19 pandemic, many caregivers have been tasked with a unique role; not only to keep themselves safe and healthy, but also to protect and find new ways to aid their care recipients, many of whom are older adults at relatively high risk for severe complications from COVID-19. These challenging circumstances have driven caregivers to quickly adapt as they continue to manage their personal lives and caregiving responsibilities. Utilizing three waves of survey data from the MIT AgeLab Caregiver Panel, this presentation will examine the attitudes, experiences and worries of family caregivers at several time points along the course of the COVID-19 pandemic, as well as caregivers’ preparations and coping behaviors along the way. Differences between caregiving situations will also be discussed.
Cannabis Use and Subjective Cognitive Decline Among Middle-Aged and Older Adults
Authors: Dowling Maritza
Published: December 2021

Cannabis is the most commonly-used drug in the US, with older adults being the fastest-growing group of users. National surveys among 50+ adults found poorer executive function among current or past cannabis users, but better performance with daily users. However, there is little evidence linking levels of cannabis use and subjective cognitive decline (SCD) among middle-age and older adults. This study sought to examine the association between levels of cannabis use in the past 30 days and SCD during the past 12 months using Behavioral Risk Factor Surveillance System (BRFSS) data (2016-2019) from 45+ individuals while controlling for demographics, chronic conditions, exercise, general and mental health. Logit models with SCD as outcome were estimated using complex survey weights. Multiple group analyses examined differences across age groups: 45-64 vs. 65+. Levels of cannabis use in the past 30 days were categorized as: no use, 1-4 days, 5-20 days; and 21-30 days. Adjusted results indicated that those who reported no cannabis use were from 35% to 47% less likely to report SCD compared to cannabis users at all levels: 1-4 days (OR=0.65, 95%CI=0.46, 0.92); 5-20 days (OR=0.53, 95%CI=0.36,0.78); 21-30 days (OR=.61, 95%CI=0.45,0.83). In multi-group analyses, levels of cannabis use effects on SCD remained statistically significant in the 45-64 age group, but not in the 65+ group. Further research targeting SCD is needed to design interventions particularly for middle-age cannabis users whose health has been compromised by disease or age-related vulnerabilities and are at greater risk for adverse cognitive outcomes from cannabis use.
COVID Vaccine Rollout for Older Adults in the United Kingdom
Authors: Jin Huajie
Published: December 2021

As of early March, at least 22 million adults had received one dose of a Covid vaccine in the UK, with 1.2 million of those fully vaccinated with two shots. Anybody aged 56 and over can book an appointment to get the Covid-19 vaccine. We will provide detailed information later. The symposium has experts from 8 countries. We will use an interview and dialog format, instead of presentations.
Discrimination, Stress, and Health Across the Life Course
Authors: Thorpe Roland , Hill Carl V
Published: December 2021

There is a paucity of research that seeks to understand why race disparities in health across the life course remain elusive. Two such explanations that have been garnering attention is stress and discrimination. This symposium contains papers seeking to address the impact of discrimination or stress on African American health or health disparities across the life course. Brown and colleagues examine the differential effects of chronic stress exposure by means of latent class analysis on mental and physical health in the HRS. Analysis revealed four subgroups, each demonstrated a typological response pattern with the most pronounced health consequences for high stress exposure, appraisal and few or no coping mechanisms. This suggests an alternative approach to examining the stress-health link by using a combined person- and variable-centered approach. Thomas Tobin and colleagues evaluate the life course processes through which early life racial discrimination (ELRD) and racial centrality shape adult allostatic load (AL) among older Blacks in the Nashville Stress and Health Study. Findings indicate that racial centrality is protective against adult high AL for those who experienced racial discrimination as children or adolescents. Cobb and colleagues examine how multiple attributed reasons for everyday discrimination relates to all-cause mortality risk among older Blacks in HRS. The authors report the 3 or more attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life. This collection of papers provides insights into how discrimination or stress impacts African American health or health disparities in middle to late life.
Number of Attributed Reasons for Everyday Discrimination and Mortality Among Older Blacks
Authors: Cobb Ryon
Published: December 2021

To date, little is known about the significance of the number of attributions for everyday discrimination on all-cause mortality risk among older Blacks. Data are from a subsample of older Black respondents in the Health and Retirement Study (HRS), a nationally representative panel study of adults above the age of 50 in the 2006/2008 HRS waves, respondents completed a battery of questions on experience with psychosocial stressors, which included the number of attributed reasons for everyday discrimination. Vital status was obtained from the National Death Index and reports from key household informants (spanning 2006–2016). Cox proportional hazard models were used to estimate the risk of mortality. During the 10-year observation period, 450 deaths occurred. A higher number of attributed reasons for everyday discrimination was associated with a higher likelihood of death after adjusting for demographic characteristics and remained significant after further adjustments for other psychosocial, health, behavioral, and economic covariates.
Return Migration as an Asset Maximization Strategy in Retirement
Authors: Sheftel Mara
Published: December 2021

Mexican immigrants make up an increasing proportion of the US population 65 and older. Estimating outcomes for this population is complicated by return migration. Due to data limitations, theoretical frameworks and empirical evidence fail to provide clear indication of the economic selection mechanism of return migration, especially at older ages making it difficult to estimate economic determinants of return. Here two waves of data from the US based Health and Retirement Study and the Mexican Health and Aging Study are combined to create a novel dataset that enables a comparison of assets at older ages for those who stay in the US, those who return before age 50 and those who return at 50 and older. Unadjusted results show no difference in total net wealth at older ages between the three groups, with higher business assets among returnees and higher concentration of wealth in home equity among stayers. With evidence of higher inequality among stayers, lower median wealth in Mexico, and asset advantages operating through citizenship, older age return can be interpreted as a means to acquire a higher standard of living in retirement for non-citizen immigrants. Comparing assets between 2000 and 2012 reveal the vulnerability of stayers during the US housing crisis. These findings are novel because they point to return migration as a retirement strategy and expose a source of vulnerability among those Mexican immigrants who remain in the US into older ages.
Racial and Age Group Disparities in the Effect of Social Distancing on Health Status
Authors: Lincoln Karen
Published: December 2021

African Americans are dying from COVID-19 at younger ages than Whites. Social distancing (SD) prevents the spread of the virus, but because of work demands, transportation needs, and living arrangements SD may be difficult for many African Americans, many of whom are experiencing higher unemployment, poverty, food insufficiency, and social isolation. This study will determine if the health of African Americans and Whites are differentially impacted by SD measures. SD rules can increase or decrease health disparities by: (a) directly impacting the symptoms and progression of chronic health conditions; (b) influencing availability of protective factors and exposure to risk factors; and (c) mitigating or exacerbating the effects of sources of disparities. These hypotheses will be tested using data from the Understanding America’s COVID Study. Findings can advance understanding of how public health requirements can reduce or increase health disparities and identify protective factors to facilitate adherence to public health guidelines.
Preparing Your Manuscript: Strong and Ethical Scholarly Writing for Multidisciplinary Audiences
Authors: Meeks Suzanne
Published: December 2021

This presentation will emphasize the importance of plain, good writing. Editors read 10 or more manuscripts per week with pressure to reject 80-90% of them. If the point and contribution are not clear in a quick scan of the paper, it will not be reviewed favorably. I will provide tips for writing that are commonly violated in submissions, provide references for additional writing support, cover expectations for language consistent with GSA’s Reframing Aging initiative, and discuss some common publication ethics issues that arise during the review process, including author contributions and embedding your scholarship in the context of prior work.
Common Problems That Impact Peer Review
Authors: Anderson Rozalyn
Published: December 2021

This presentation will review the most common issues that affect how reviewers see a manuscript submission. These include clarity, use of figures, and attention to existing research, especially establishing the significance and novelty of the work, and how to frame a narrative. I will also address responding to peer review. The focus will be on the biological science perspective (Journals of Gerontology Series A), but these issues are relevant to all submissions to GSA journals.
Formal and Informal Care Use Over the Course of Cognitive Deterioration Among Adults With a Disability
Authors: Choi HwaJung , Langa Kenneth , Norton Edward , Choi Tsai-Chin , Connell Cathleen
Published: December 2021

The dynamics between formal and informal care among persons with a disability may substantially differ over the course of their cognitive decline.

Based on a nationally representative study of older adults, the analysis sample included 3,685 individuals who had at least one activity of daily living (ADL) limitation. We estimated probabilities of using formal care and informal care in the years before and over the course of dementia after controlling for sociodemographic factors, survey mode, and proxy interview status.

The adjusted probability of receiving care from an informal helper increased before the onset of dementia: 36% in 4 years prior to the onset (T=-4); 46% at T=-2. In contrast, the increase in the probability of using formal care was pronounced primarily at the onset of dementia; for example, the probability of overnight nursing home stay was 12% at T=-2 vs. 31% at T=0, which continued to increase over the subsequent years (39% at T=6). The probability of using nursing home care at the onset was significantly greater for women vs. men (Adjusted risk ratio (ARR)=1.21; p=0.010); non-Hispanic white vs. Hispanic (ARR=1.62; p=0.004); those with low vs. high wealth (ARR=1.60; p < 0.001); those without a spouse vs. with a spouse prior to the onset (ARR=1.39; p < 0.001); and those with all adult children living far vs. at least one coresident adult child prior to the onset (ARR=1.51; p= < 0.001).

Public policies and interventions aimed at providing for the needs of people with dementia should consider disparities in care use across racial/ethnic and socioeconomic groups.
Group Telehealth Interventions Fostering Social Connection Among Older Veterans and Their Families
Authors: Weiskittle Rachel , Mlinac Michelle
Published: December 2021

During the early months of the COVID-19 pandemic, virtual and telephone visits rapidly replaced most in-person care within the Veterans Health Administration (VA) to reduce virus spread. To address the emerging mental health needs of older Veterans (e.g., isolation, loneliness), we developed an 8-week group treatment manual, deliverable over telephone or videoconference, to foster social connection and address pandemic anxieties. The manual was disseminated in March 2020 as a rapid response to emergent COVID-19 pandemic realities, during which many locations in the United States called for immediate self-quarantine measures for unknown durations. This talk will present the user-centered design of the manual, preliminary feasibility and acceptability findings from provider surveys, and introduce versions of the manual targeting specific populations (e.g., caregivers, Spanish speakers) currently in development or in pilot testing.
Effects of the Co-Occurrence of Diabetes and Tooth Loss on Cognitive Function
Authors: Luo Huabin , Tan Chenxin , Plassman Brenda , Sloan Frank , Schwartz Mark , Adhikari Samrachana , Qi Xiang , Wu Bei
Published: December 2021

Using data from the 2006, 2012, and 2018 waves of the Health and Retirement Study, we estimated effects of co-occurrence of diabetes mellitus (DM) and complete tooth loss (CTL), both self-reported, on cognitive function among 10,816 adults age 50+. Cognitive function was measured using a shortened version of the Telephone Interview for Cognitive Status. Results from the fixed effects linear regression model show that in comparison to those with neither condition, adults having both DM and CTL had the worst cognitive function (b = 1.49, p < 0.001), followed by having CTL alone (b = 0.78, p < 0.001), and having DM alone (b = 0.42, p < 0.001). Our study suggests that CTL is a stronger risk factor for lower cognitive function than DM, and the co-occurrence of DM and CTL poses additive risk. Further research is needed to investigate the pathway from DM and CTL to poor cognition.
Characterizing Perceived Control Over Daily Stress: Longitudinal Changes and Associations With Affect
Authors: Cerino Eric , Mogle Jacqueline , Stawski Robert , Rush Jonathan , Almeida David
Published: December 2021

Perceived control is an important psychosocial correlate of healthy aging. Using data from the National Study of Daily Experiences (N=1,047, M=55.82 years, SD=10.35, 57.27% Female), we examined cross-sectional age-related differences and longitudinal aging-related change in perceived control over daily stress across 10 years and explored the influence of stressor control on negative affect (NA) and positive affect (PA). Stressor control, NA, and PA were obtained from telephone interviews over 8 consecutive days in measurement bursts conducted in ~2008 and ~2017. Longitudinal analyses revealed significant declines in stressor control across 10 years (p<.001). Cross-sectional analyses revealed marginally lower stressor control among older individuals (p<.10). Within-person associations revealed lower NA and higher PA on days when stressor control was higher than usual (ps<.001). Results suggest that stressor control declines with age and holds promise as an important component of daily stress processes with relevance for health and well-being outcomes across the lifespan.
A Mismatch Between Theory and Practice in the Transition From Home to a Nursing Home: A Scoping Review
Authors: Groenvynck Lindsay , Fakha Amal , de Boer Bram , Hamers Jan , van Achterberg Matheus , van Rossum Erik , Verbeek Hilde
Published: December 2021

The transition from home to a nursing home is a complex process, existing of three transition phases (pre-, mid- and post-transition). It is often fragmented, leading to negative outcomes for older persons and informal caregivers. To prevent these negative outcomes, knowledge of existing transitional care interventions is paramount. Therefore, a scoping review was performed, summarizing current interventions aiming to improve transitional care. The review identified 17 studies, describing eight multi- and five single-component interventions. From the multi-component interventions, seven main components were identified: education, relationships/communication, improving emotional well-being, personalized care, continuity of care, support provision, and ad hoc counseling. This review identified a clear mismatch between theory on optimal transitional care and current transitional care interventions. All interventions focused on either a specific phase or target population throughout the transition process. This inhibits a continuous transition process in which a partnership between all stakeholders involved exists.