bluuebunny/crossref_metadata_2025 huggingface dataset:
DEVELOPMENTAL ADVANCES OF THE PARIHS FRAMEWORK OVER THE LAST DECADE: A CRITICAL INTERPRETIVE SYNTHESIS
Authors: Berta Whitney , Duan Yinfei , Iaconi Alba , Wang Jing , Perez Janelle , Song Yuting , Chamberlain Stephanie , Estabrooks Carole
Published: December 2022

The original Promoting Action on Research Implementation in Health Services (PARiHS) and i-PARiHS frameworks contend that the successful implementation of evidence-based practices is a function of the core elements evidence, context, facilitation, and the capacity of intended recipients to apply research to practice. While applied widely, a number of theoretical and practical challenges associated with the framework’s application have been identified. Our critical interpretive synthesis examines how the last decade of research has advanced understanding of the conceptualizations of, relationships between, and dynamics amongst, PARiHS core elements. We find that work over the past decade affords more nuanced conceptualizations of context and facilitation; reveals myriad conceptualizations of implementation success, suggesting the need for a typology; demonstrates contradictory effects of context on facilitation that warrants more study; leads us to question the contextual primacy of leadership; and generally under-examines the interactions and dynamics amongst PARiHS core elements and their sub-elements.
UNDERSTANDING LEADERSHIP IN NURSING HOME CONTEXT THROUGH ADAPTIVE LEADERSHIP FRAMEWORK FOR CHRONIC ILLNESS
Authors: Wang Jing , Perez Janelle , Beeber Anna , Anderson Ruth , Berta Whitney , Lanham Holly , Estabrooks Carole
Published: December 2022

The case studies were conducted as an early component of a pan-Canada project entitled Translating Research in Elder Care (TREC). This sub-project provided insights into the challenges and leadership of facilitating care model changes, care quality improvement, and quality of work enhancement of three long-term care (LTC) facilities in Canada. Through the lens of Adaptive Leadership Framework for Chronic Illness (ALFCI), leadership emerged as a critical element of their organizational context. Staff reported that contextual factors of high intensity of work and inadequate staff were barriers that added to the complexity of challenges facing them. Data collectors observed that frontline staff exhibited leadership behaviors in knowledge transmission, information sharing, teamwork, and person-centered strategies to address challenges. However, top-down facilitation can lead to misunderstanding and a lack of motivation from the frontline staff to follow the facilitation. The findings also suggested tailored facilitation about including frontline staff in formal interactions.
ORGANIZATIONAL CONTEXT AND QUALITY INDICATORS IN NURSING HOMES: A MICROSYSTEM LOOK
Authors: Duan Yinfei , Iaconi Alba , Song Yuting , Hoben Matthias , Hayduk Leslie , Norton Peter , Estabrooks Carole
Published: December 2022

This cross-sectional quantitative sub-project assessed the association of organizational context (modifiable elements of work environments) with quality indicators (QIs) at the clinical microsystem (care unit) level. We used TREC data collected 09/2019-03/2020. The sample included 285 care units within 91 Western Canadian nursing homes. Outcomes included thirteen practice-sensitive QIs derived from the Minimum Data Set 2.0. Results from random-intercept logistic regression for each dichotomized QI showed that higher unit-aggregated scores on contextual elements as identified by the Alberta Context Tool, specifically care aide participation in decision-making (OR=3.7-8.4, p<.05), care aide perceived staffing (OR=2.6, p<.05) and time for completing tasks (OR=5.1-7.0, p<.05), and care aide rated unit-level leadership (OR=20.1, p<.05), were associated with a better unit-level performance on delirium symptoms, indwelling catheter use, behavioral symptoms, pain, and late-loss physical function. The findings suggest that targeting modifiable contextual elements is an important avenue for quality improvement interventions in nursing homes.
DONALD P. KENT AND ROBERT W. KLEEMEIER AWARD LECTURES
Authors: Lichtenberg Peter
Published: December 2022

The Donald P. Kent Award lecture will feature an address by the 2021 Kent Award recipient Luigi Ferrucci, MD, PhD, FGSA, of the National Institute on Aging. The Kent Award is given annually to a member of The Gerontological Society of America who best exemplifies the highest standards of professional leadership in gerontology through teaching, service, and interpretation of gerontology to the larger society. The Robert W. Kleemeier Award lecture will feature an address by the 2021 Kleemeier Award recipient Kenneth F. Ferraro, PhD, FGSA, of Purdue University. The Kleemeier Award is given annually to a member of The Gerontological Society of America in recognition for outstanding research in the field of gerontology.
SOCIAL RESOURCES AND STRATIFIED EXPERIENCES OF ICT USE AND LONELINESS DURING THE COVID-19 PANDEMIC
Authors: Hong Sungjae , Mejía Shannon
Published: December 2022

Limits to in-person social interaction increased the risk of loneliness during the Covid-19 pandemic. This study examines how gender and previous information communication technologies (ICT) experience could stratify how ICT-mediated social interactions related to loneliness during the COVID-19 pandemic. We employed National Health & Aging Trends Study data collected in 2018 and 2020-2021 (N=2,962; 27% age 85+; 57% women; 77% white) to examine how the email and video call use before and during the COVID-19 pandemic was associated with loneliness and how the degree of impact differed by gender and previous ICT experience. In total, 35% reported feeling lonely some days or more frequently during the COVID-19 pandemic. Preliminary analysis showed older adults using video calls during the COVID-19 pandemic were 1.24 times more likely to report loneliness. This association was stronger among men than women and those who did not use ICT preceding the pandemic than those who used.
REOPENING UNDER COVID-19: THE IMPACT OF REOPENING SOCIETY ON OLDER ASIAN AMERICAN’S DEPRESSIVE SYMPTOMS
Authors: Lou Yifan , Cheung Ethan Siu Leung , Liu Jinyu , Wu Bei
Published: December 2022

Background

The lockdown due to COVID-19 has influenced individuals’ lives in many aspects. Yet, the impact of reopening under an ongoing pandemic is understudied. This study aims to investigate the impact of reopening policy on older Asian Americans’ depressive symptoms and whether the impact varies by their sociodemographic characteristics.Method: We used interview data collected from 519 Chinese and Korean aged 60 and older in New York City between 5/23/2021 to 7/30/2021. Interrupted time series model was used to test whether there are significant level and slope changes in depressive symptoms (PHQ-9 scale) before and after the reopening on 7/1/2021 in NYC. We then ran the models in stratified sample by gender, education, income, self-reported health, and social connectedness through living arrangements, use of technology, and social interactions.

Results

Older Asians’ depression increased immediately following the reopening (ß=1.52, p< 0.05), and then slowly decreased then after (ß=-0.12, p< 0.001). A decrease in depression following reopening was significantly associated with the male gender, good health, higher income, living alone, having received or provided social support, daily texting, and no engagement in the discussions related to COVID-19 in social media. Discussions: While reopening may have long-term benefits on mental health, older Asians were anxious about their safety at the beginning of reopening under an ongoing pandemic. Older adults with worse health, lower SES, and limited social connectedness struggled to adjust to “back-to-normal” life. We discussed research, policy, and practice implications to support these disadvantaged older adults after reopening.
GEROFIT TELEHEALTH-DELIVERED GROUP EXERCISE IMPACTS SOCIAL SUPPORT AND HEALTH AMONG OLDER VETERANS
Authors: Abbate Lauren , Harris Rebekah , Jordan Sarah , Nearing Kathryn , Bettger Janet Prvu , Pearson Megan , Morey Miriam , Hall Katherine
Published: December 2022

Group exercise provides social support, which is especially important among older adults. Gerofit conducted a telephone survey with participants (n=258) from 15 sites to learn about Veterans’ experiences with transition to Gerofit-specific telehealth-delivered group exercise to guide continuous improvement of the program. One, open-ended question was asked at the end, inviting respondents to reflect on any other thoughts they had about the telehealth-delivered exercise sessions. This yielded robust qualitative responses which constitute the data analyzed in this qualitative descriptive study. Key themes that emerged from participant responses included: 1) telehealth-delivered group exercise provides structure, motivation, and accountability; and 2) transitioning from in-person to telehealth-delivered exercise has many beneficial impacts on health such as retaining strength and ability to recover from injury, weight management, and positive impacts on mental health and quality of life. Telehealth-delivered group exercise sessions provide social support and are associated with positive health impacts.
TRAINING RESEARCHERS TO CREATE RESEARCH ADVISORY BOARDS WITH OLDER ADULTS
Authors: Lessem Rachel , Berman Rebecca
Published: December 2022

The Sage Resource Project’s goal was to prepare researchers to use the Sage Resources to create Sage Model boards in order to continue to expand and amplify the voice of older adults in aging PCOR/CER research. Training researchers is essential to amplify the voice of older adults in research. This project culminated in the creation of a training manual as well as critical lessons learned for the advancement of engaged research with older adults receiving Long Term Services and Supports (LTSS). After developing a series of webinars for national dissemination, 5 research centers were identified as potential sites for intensive and tailored training on The Sage Model and, ultimately, two research centers completed the training with quite different approaches and results. This session will review the training that was developed as well as the lessons learned from training researchers on creating research advisory boards with older adults.
INNOVATIVE CARE ENVIRONMENTS FOR PEOPLE WITH DEMENTIA
Authors: Verbeek Hilde , de Boer Bram , Boltz Marie
Published: December 2022

As part of the ongoing culture movement within long-term care several innovative care concepts for people with dementia are developing. These concepts radically change their physical, social and/or organizational environment in order to align care services with needs and demands of people with dementia, and providing meaningful activities. The current symposium will discuss the effects and possible working mechanisms of innovative caring environments for people with dementia across three European countries and the US. The symposium will start with a presentation describing the Homestead care model in the Netherlands, which is a care model that was developed following a co-creation study focused on translating scientific knowledge on nursing home care environments into practice. This is followed by three presentations about the effects of three types of innovative care environments for people with dementia: (1) farm based day care in Norway, (2) shared housing arrangements in Germany, (3) green care farms providing 24-hour nursing care in the Netherlands. The three studies on the effects of innovative care environments present a variety of designs (case study, cluster randomized controlled multi-center intervention study, and a qualitative study with semi-structured interviews) to study the effects on various outcomes (activities, physical effort, social interaction, mood, the number of hospital admissions for people with dementia, quality of life, challenging behavior, risk of falls, stabilization of cognitive abilities, daily life). The symposium will conclude with a reflection on these innovative care concepts from a US perspective.
TRANSLATING SCIENCE INTO PRACTICE TO DEVELOP AN INNOVATIVE DEMENTIA CARE MODEL: THE HOMESTEAD CARE MODEL
Authors: de Boer Bram
Published: December 2022

This study reports on a participatory research approach to translate a scientific conceptual framework on innovative dementia care into practice. This led to the development of the Homestead care model. Results indicate that achieving positive outcomes for people with dementia, (in)formal caregivers, and the community is dependent on how well the physical, social and organizational environment are congruently designed. Physical aspects are related to interior design, outdoor areas, architecture and sensory elements. Social aspects include interactions with others in the environment, such as residents, staff, family, and the wider community (local entrepreneurs, societies, schools). Organizational aspects are related to the organizational culture and leadership of a care facility. These theoretical underpinnings of the conceptual model have been translated into three main pillars of the Homestead care model: activation, freedom, and relationships. The Homestead care model has a unique physical, social and organizational environment, which can affect daily life of residents.
LESSONS FROM CAPABLE: DRIVERS, IMPLEMENTATION EXPERIENCE, AND MARKET READINESS CONSIDERATIONS
Authors: Paone Deborah , Szanton Sarah
Published: December 2022

External, organizational, and individual factors which drive or restrain adoption, implementation, and scaling of CAPABLE provide lessons for other programs to move from research to practice and promote sustainability. Lessons are offered for policymakers, payers, consumers, and communities to support evidence-based programs that improve function and reduce disability for older adults. This symposium presents results from a 3-year study of implementation of CAPABLE by 40 organizations, an analysis of the drivers and restrainers of CAPABLE dissemination, and a 1-year pilot study on engaging unpaid care partners in CAPABLE. We will explore the lessons from each--finding synergy and unique insights. CAPABLE is a case example to guide efforts at the organizational, system, and societal levels.
MOVING, THINKING, AND SLEEPING: NOVEL INSIGHTS INTO PHYSICAL AND COGNITIVE HEALTH FROM ACCELEROMETRY DATA
Authors: Schrack Jennifer , Wanigatunga Amal
Published: December 2022

Physical activity and sleep are well-established predictors of health and longevity with aging. Wrist accelerometers, that produce high-frequency time series data, capture multiple aspects of daily physical activity and sleep 24-hours/day. Historically, the majority of accelerometry-based activity research has employed summary metrics to understand the associations of total daily physical activity and sleep with physical and cognitive health. Although these measures are important for understanding conformity with physical activity and sleep recommendations, they underutilize the potential of these data. Further, the summary metrics may differ by accelerometer type/brand, making it difficult to translate results across device types and studies. This symposium will examine the associations between accelerometry-derived physical activity and various aging-related health outcomes, and compare the measurement properties of two commonly used accelerometers for measuring sleep. Ms. Marino will discuss the association of physical activity volume and fragmentation with the presence of the Apolipoprotein-ε4 genotype in the Baltimore Longitudinal Study of Aging (BLSA), overall and by time of day. Dr. Wanigatunga will present evidence on the association of physical activity patterns with beta amyloid plaques in the BLSA. Dr. Schrack will present the association of physical activity fragmentation and diurnal patterns with peripheral artery disease in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Finally, Ms. Liu will compare measurement of sleep variables derived from two commonly used accelerometers. Collectively, these presentations highlight ways to utilize the richness of accelerometry data to illuminate more sensitive associations between movement and health outcomes to advance prevention science and promote health aging.
DIFFERENCES IN PHYSICAL ACTIVITY AMOUNT AND FRAGMENTATION OVER 24 HOURS BY B-AMYLOID STATUS AND AGE
Authors: Marino Francesca , Liu Fangyu , Simonsick Eleanor , Tian Qu , Deal Jennifer , Wanigatunga Amal , Resnick Susan , Schrack Jennifer
Published: December 2022

β-amyloid is a hallmark of Alzheimer’s disease and can be measured in vivo by PET imaging. Whether PiB+ (elevated β-amyloid) individuals exhibit distinct physical activity patterns throughout the day (i.e., activity amount or fragmentation) is unknown. Using data from 125 BLSA participants (56-95 years) with PET imaging and ≥3 days of wrist accelerometry, we examined associations between PiB status and activity patterns daily and during 6-hour time blocks using multivariable linear regression models. Modification by age was also examined. Daily total activity counts and activity fragmentation did not differ by PiB status (p=0.34 and p=0.70, respectively). Yet, per each additional year of age, PiB+ individuals were more active during early morning (p=0.04) and evening (p=0.029) but trended towards less active in mid-morning (p=0.069) than PiB- individuals. Though replication of findings is needed, older PiB+ participants appeared more active in the late evening/early morning, possibly reflecting altered sleep-time, agitation, or restlessness.
FACTORS ASSOCIATED WITH HIGH-RISK DISCHARGES FROM NURSING FACILITIES
Authors: Hughes Kelly , Feng Zhanlian , Oliveira Iara
Published: December 2022

Although some nursing facility discharges are appropriate or an individual’s choice, others may be facility-initiated discharges (FIDs) that are potentially inappropriate. Since FIDs cannot be observed directly in available data, this study focused on live discharges of residents with risk factors for FIDs from 2011-2017. We defined risk factors as characteristics identified in prior literature that were more prevalent among residents discharged live than residents not discharged in our analysis. We found the following risk factors: severe behavioral symptoms; impairments requiring more staff time; and transition to Medicaid eligibility. Psychiatric and mood disorders were not identified in prior literature but also associated with live discharge. Risk factors were consistent across years but varied by state and facility type. For-profit, chain, and government facilities were most likely to discharge residents with risk factors. Furthermore, the rates of post-discharge acute care use were highest among residents with risk factors.
PROGRAMS TO IMPROVE QUALITY OF LIFE AND HEALTH: WHAT DO OLDER ADULTS AND PRACTITIONERS THINK?
Authors: Ritter Ashley , Glicksman Allen , Stone Robyn
Published: December 2022

Numerous programs and services are designed to help older adults improve their health and quality of life. Impact evaluations typically focus on health outcomes. Often, less attention is paid to the opinions of professionals tasked with administering these efforts or the older persons and caregivers about the need for the program or the way the program is administered. This panel addresses the question with four presentations, each of which uses data collected from practitioners and/or older adults to gain their perspectives on programs to help maintain quality of life and health. Sweeny examines the experience of older LTBTQ adults as they navigate the care and social service systems. Dictus and colleagues will describe a community level effort to develop a master plan for aging in one county. The method for including the views of the older adults in the process can be a model for other communities. Corpora and colleagues report on efforts to ensure that staff are aware of important preferences of nursing home residents, with a focus on the predictors of successful implementation. Glicksman and colleagues examine the impact of migration on the attitudes and perceptions of older Spanish speaking migrants toward the formal long-term care system. Finally, Stone will address the question of how these types of data can be used to help shape policy and practice, using research to help older adults and professionals at all levels to support older persons in community and facility care.
ENGAGING OLDER ADULTS AND STAKEHOLDERS TO DEVELOP A COMMUNITY MASTER AGING PLAN: A CASE EXAMPLE
Authors: Dictus Cassandra , Allgood Sallie , Lavalley Ryan , Tyler Janice , Rosemond Cherie
Published: December 2022

As our population ages, communities are creating policies and programs to support older adults. Yet, there is a lack of input from older adults about which policies and programs meet their needs. This case example describes how one community in North Carolina (NC) engaged community stakeholders (older adults and organizational leaders) in all phases of their Master Aging Plan (MAP). Community stakeholders participated in a community assessment through surveys (n=860), focus groups (n=13, 63 participants), key stakeholder interviews (n=34), and two community-wide listening sessions. Organized by the WHO’s age-friendly framework domains, community stakeholders formed workgroups to create, implement, and track the MAP. An evaluation was completed using the tracking documents, ripple effect mapping, and workgroup leader interviews. Orange County, NC’s experience with collaborative community engagement can serve as a guide for other communities seeking to involve community stakeholders in the development and evaluation of their own MA
DIFFERENCES IN HEALTH AMONG LOW-INCOME OLDER IMMIGRANTS: DOES ETHNICALLY HOMOGENEOUS ENVIRONMENT MATTER?
Authors: Kim BoRin , Ryu ByeongJu , Baek Jihye , Park Sojung , Jeong Chung Hyeon , Park Jina
Published: December 2022

Older immigrants comprised 14% of the US older population, which is predicted to continue to rise. Despite the importance of ethnic attachment in older immigrants’ well-being, little is known how ethnically homogeneous housing environment affect older adults’ health. This study aims to fill the gaps in knowledge on low-income older immigrants living in subsidized senior housing and to explore the associations between immigrant status, senior housing environments, and self-rated health among this population. Our survey data was collected from 18 subsidized senior housing communities in IL, MO, and NH (N=459). Bilingual surveyors fluent in Chinese, Russian, and Korean were also available for the participants with limited English proficiency as the sampled housings were the multi-ethnicity properties. Hierarchical Linear Modeling was employed for our analysis to address our participants were clustered within senior housing.More than a half (56%) of our sample lived in ethnically homogeneous senior housing (either all immigrants or all non-immigrants). Immigrants consist of 53% of our sample, and 48% of them lived in ethnically homogeneous housing. Our finding showed that immigrants were more likely to report low level of self-rated health (OR=0.885, p< 0.01). However, ethnically homogeneous senior housing environments positively influence the association between immigrant status and self-rated health (OR=1.219, p<.05).This study highlights the importance of ethnically homogeneous living environment for low-income older immigrants in senior housing. Although ethnic diversity may be beneficial in broader society, concentration of ethnic minority older immigrants could play an important role in terms of social support and service delivery.
NEIGHBORHOOD CHARACTERISTICS AND QUALITY PERFORMANCE OF HOME HEALTH AGENCIES: A COHORT STUDY
Authors: Ma Chenjuan
Published: December 2022

Home health care (HHC) is a core source of home- and community-based services to older adults “aging in place’. This study examined variation in HHC quality by neighborhood characteristics in the US by using 5 years (2014-2019) of national Home Health Compare data linked to Providers of Services (POS) files and Area Health Resources Files (AHRF). HHC quality was measured by agency rates of timely initiation of care, hospitalization, and ED visits. We examined 7,487 HHC agencies (37,435 agency-years) in 1,760 counties. At baseline, the mean rates of timely initiation of care, hospitalization, and ED visit were 91.5%, 15.8%, and 12.5%. On average, county percentage of Blacks, Hispanic, individuals with college degree, unemployment, and being in poverty were 12.9% (range: 0.1% – 76.0%), 20.6% (0.4% - 95.8%), 30.4% (7.3% - 77.6%), 5.4% (2.1% - 24.0%), and 14.4% (3.1% - 38.0%) respectively in 2015. Estimates from multivariate regressions showed that neighborhoods with higher proportion of Blacks (β= -0.04, p=0.000) and Hispanics (β= -0.02, p=0.000), higher rate of unemployment (β= -0.07, p=0.035) were less likely to have HHC agencies providing timely initiated care; neighborhoods with higher proportions of Blacks (β= 0.01, p=0.000) and higher poverty rates (β= 0.02, p=0.027) were more likely to have HHC agencies with higher hospitalization rates; and neighborhoods with higher poverty rates (β= 0.04, p=0.000) were more likely to have HHC agencies with higher ED visit rates. Our findings indicate that racial/ethnic minorities in neighborhoods with low socioeconomic status were less highly to access high quality HHC.
ANIMAL MODELS AND THE EMERGENCE OF GEROSCIENCE
Authors: Austad Steven
Published: December 2022

Aging, meaning the generalized deterioration in physical and mental function with time, influences nearly all living species. Moreover, many underlying biological mechanisms of aging appear to be conserved. At the same time, there appear to be great differences in the rate at which different species age. Research using both traditional and nontraditional animal species, employing both laboratory and field studies has offered important insights into the discovery of underlying causes of aging. Also, a variety of studies using well-established animal models of aging have now identified both repurposed medications and new compounds and other approaches that appear to slow biological aging with potential improvements in lifespan and healthspan. It is these findings, when framed in the context of the emergence of multiple chronic diseases with aging, that have led to the Geroscience Hypothesis.
US RACIAL AND ETHNIC DISPARITIES IN DEMENTIA LIFE EXPECTANCY, RISK/PROTECTIVE FACTORS, AND CAREGIVING STRESSORS
Authors: Aranda Maria
Published: December 2022

The health, emotional, and economic impacts of dementia are far-reaching and impossible to fully calculate. Late-life dementia is not equitably distributed across population subgroups including older people and racial/ethnic minorities. Clear evidence underscores disparities in social/personal resources, environmental exposures, racism/discrimination, increased burden of caregiving, and uneven access to quality care especially for Blacks and Hispanics and caregivers. Each paper in this symposium addresses high-priority, disparity research areas highlighted in the recent NASEM Decadal Survey of Behavioral and Social Science Research on ADRD: characteristics of population groups that influence disease ascertainment and dementia life expectancy; quantification of mid- and late-life risk/protective factors; pesticide exposure and cognition, and caregiving stressors among racial/ethnic minorities. All presentations utilize nationally representative data on older people in the US. Garcia et al. utilize HRS data to create dementia life expectancy estimates using four competing algorithmic classifications of dementia status by race/ethnicity (Blacks, Whites), nativity status (US-, non-US-born Latinos), and gender. Applying the Lancet Commission Dementia Prevention framework to HRS data, Ferdows and Aranda examine risk/protective factors and quantify the relative contribution of individual variables in explaining racial/ethnic dementia disparities. Chanti-Ketterl et al. elucidate the association between organochlorines pesticides (total scores, specific type) and cognition based on NHANES data to ascertain racial/ethnic differences. Based on NHATS, Moon et al. explore differences in primary stressors by dementia care and race (Blacks, Whites) during COVID-19. Findings provide evidence of potential multi-level targets for interventions and public policies. All primary authors are early-career scholars dedicated to mitigating ADRD health disparities.
A NEW STEP TO PREVENT ELDER ABUSE IN JAPAN
Authors: Tsukada Noriko , Ikeda Naoki , Katsumata Asako
Published: December 2022

This paper first introduces major aspects of the Japanese Act on the Prevention of Elder Abuse, including trends in substantiated elder abuse cases in both institutional and domestic settings, definitions of elder abuse, and abusers and reporting systems. It then introduces the recent amendment of operational standards in institutional settings made by ministerial ordinance. The amendment includes a requirement to develop a committee to prevent occurrence and recurrence of elder abuse and to appoint a designated individual to establish guidelines and implement training. It is hoped to further prevent elder abuse in Japan.
DETECTION OF ELDER ABUSE IN JAPAN NOT COVERED BY THE ELDER ABUSE PREVENTION LAW IN COMPARISON WITH WHO DEFINITION
Authors: Wada Tadashi , Suda Hitoshi , Satoh Kana
Published: December 2022

The Elder Abuse Prevention Law mainly defines “elder abuse” inflicted by caregivers. Elder abuse by non-caregivers is therefore rarely covered by the law. We investigated domestic elder abuse reported in Matsudo City, Chiba, Japan, to determine the number of domestic elder abuse cases excluded from legal protection but constituting elder abuse defined by WHO. From April 2017 to March 2020, the municipal elder protection services agency received 525 reports of domestic elder abuse. We studied the effective records of 497 of these cases. 299 cases were confirmed elder abuse cases defined by the law, with 198 excluded. However, 176 out of the 198 excluded cases constitute elder abuse defined by WHO. In these 176 cases, abuse was perpetrated by non-caregivers. Due to the current formation of the law, this abuse went undetected and unprotected. We think amendment of the law is required to protect these excluded cases.
NEED FOR SUPPORT FOR PERSONS WITH DISABILITIES IN ELDER ABUSE
Authors: Suda Hitoshi , Wada Tadashi , Satoh Kana
Published: December 2022

Among the elder abuse cases reported to Matsudo City, Chiba Prefecture (population 487,091 as of April 1, 2017) from fiscal year (FY) 2017 to FY 2019. Of the 525 reported cases, 497 for which records could be judged to be accurate were included in the study. There were 119 cases (23.9%) in which the abusers were presumed to have a disability. Out of these 119 cases, the abusers of 86 (72.3%) cases were not involved with health and welfare policies for people with disabilities or such involvement had been suspended. If the abuser had received support in the field of health and welfare for the disabled or as a person in need at an early stage, the elder abuse might not have occurred. Support for people with disabilities and support for persons in financial need are required before they become abusers.
FOSTERING MULTIPARTNERSHIP IN DEVELOPING A DEMENTIA-FRIENDLY COMMUNITY WITH AN OPEN DEMENTIA DAY CENTER IN TAIWAN
Authors: Chang Ling-Hui , Pan Men-An , Wu Li-Xue , Lu Chi-pang , Sung Liwen , Huang Pai--Chuan
Published: December 2022

Introduction. Supporting persons with dementia without increasing the demands of formal care is an issue that many countries face today. Pingtung County proposed an innovative practice of an open dementia day center situated in a dementia-friendly community (DFC), where people with dementia in the center can freely go outside and enjoy community living. This presentation examines the experience of an university academic team in fostering a municipality-academic-community partnership as we tried to “flip” the care of a traditional dementia day center to adopt an “open” care model and concurrently to make the nearby community dementia-friendly. Method. A pragmatic research paradigm was adopted to address the socially situated situation in which we encountered when building a dementia-friendly community and the strategies we adopted to respond to the problem. Results/Discussion. Three themes: (1) Partnering with local government, e.g. to reduce the cognitive and physical barriers for outdoors activities and to increase the competence of local officials in DFC. (2) Partnering with local community and business: e.g. to increase the DFC awareness of community volunteers and to initiate a DFC business project, (3) building an academic team: e.g. to engage faculties who were motivated to pioneer an innovative practice, to fulfill their social responsibility, bridge the gap between theory, research, and practice. Conclusion. Significant changes were made in the community and the day center towards DFC. Community stigma towards dementia and community inertia was major obstacles. The allocation of city resources, personal drive towards DFC, and regular communication were key, despite the process was fraught with compromise, power dynamics, and conflicts of interests.
RACIAL/ETHNIC DISADVANTAGE IN PARENTAL DEATH ACROSS THE LIFE COURSE, SOCIAL ISOLATION, AND HEALTH IN LATER LIFE
Authors: Donnelly Rachel , Lin Zhiyong , Umberson Debra
Published: December 2022

Prior research has not considered how exposure to parental death across the life course may contribute to lasting social isolation and, in turn, poor health among aging adults. The present study uses longitudinal data from the Health and Retirement Study (HRS; 1998-2016) to consider linkages of parental death, social isolation, and health (self-rated health, functional limitations) for Black, Hispanic, and White older adults. Findings suggest that exposure to parental death before later life is associated with higher levels of isolation, greater odds of fair/poor self-rated health, and more functional limitations in later life. Moreover, social isolation partially explains associations between parental bereavement and later-life health. Racial disparities in bereavement are central to disadvantage: Black and Hispanic adults are more likely to experience parent death early in the life course and this differential exposure to bereavement has implications for racial and ethnic disparities in social isolation and health throughout life.
PERSONALITY TRAITS AND END-OF-LIFE ATTITUDES AND BEHAVIORS IN OLDER ADULTS: EVIDENCE FROM SHARE
Authors: Ryser Valerie-Anne , Vilpert Sarah , Borasio Gian Domenico , Maurer Jürgen
Published: December 2022

Personality traits (PTs) - Neuroticism, Extraversion, Openness to experience, Agreeableness, Conscientiousness - are related to decision-making styles, as well as to specific end-of-life (EOL) healthcare preferences. Building on this knowledge, our study aims to explore the association of PTs with attitudes and behaviours towards the EOL in general and EOL care planning in particular. Our analyses are based on a paper-and-pencil self-completion questionnaire (n=1’524) administered as part of wave 6 and 7 of SHARE in Switzerland. PTs are measured with the Big-Five inventory ten (BFI-10). Attitudes and behaviours related to EOL are: outlook −avoid thinking about death, think about and discuss EOL preferences−, administrative arrangements −testament, power of attorney−, approval and completion of advance care planning. Results show that older adults with higher scores on openness are more likely to think, plan and discuss EOL, as well as to have made arrangement in advance such as a testament, and a power of attorney. Higher scores on extraversion are linked with having a testament. Individuals who express higher scores on neuroticism more often think about their wishes for EOL, whereas those scoring higher on agreeableness are less likely to be in favour of advance care planning. To conclude, older adults in Switzerland remain unfamiliar with EOL topics, since only individuals with higher openness to experience are more prone to prepare for the EOL. PTs should be taken into account when educating and encouraging people to plan for their EOL.
WORKING MEMORY MODERATES DEPRESSIVE SYMPTOMS AFTER PARTNER MORTALITY: HEALTH AND RETIREMENT STUDY
Authors: Brush David , Paulson Daniel , Dvorak Robert
Published: December 2022

Grief is conceptualized as a process after which the individual becomes better adapted to changed living conditions after a loss. The Selection, Optimization, and Compensation with Emotion Regulation (SOC-ER) model posits that working memory may be necessary for mitigation and resolution of grief. This study examined the hypothesis that working memory facilitates successful grieving following the loss of an intimate partner. Participants include 3,599 respondents of the longitudinal Health and Retirement Study (HRS) who experienced spousal mortality between 1994 and 2014. Working memory was measured assessed using Serial 7’s, and depressive symptoms were assessed using the 8-question CES-D. Latent-growth models were used to estimate rate of change in depressive symptoms up to loss-of-spouse (baseline event), and then subsequent to that loss. Missing data were handled using full-information maximum likelihood. Sample participants had an average age 78.04 (SD = 7.32) at the time of their spouse’s death and were disproportionately female (69.10%), White/Caucasian (82.30%), non-Hispanic (92.37%), and completed an average of 11.61 (SD = 3.42) years of education. The hypothesized level 2 model fit the data very well: χ2(56)=61.323, p=.29 RMSEA=0.005 [0.000 0.012]; CFI=0.998, SRMR=0.028. Initial depressive symptom endorsement was significantly related to working memory ability. Working memory also moderated the relationship between depressive symptom endorsement and time, where individuals with better working memory tended to report lower depressive symptoms and demonstrated a lesser increase in depressive symptoms. In conclusion, working memory may be one determinant of successful bereavement. Findings support application of the SOC-ER model to the study of grief.
THE ASSOCIATION BETWEEN MEDITERRANEAN DIET ADHERENCE AND ALLOSTATIC LOAD IN OLDER ADULTS
Authors: Fiocco Alexandra , Obomsawin Anik , D'Amico Danielle
Published: December 2022

Allostatic load (AL) is a multisystemic index of biological wear and tear which is associated with poor health outcomes. In recent years, researchers have examined the association between dietary pattern intake and AL; however, no studies to date have examined the relationship between AL and consumption of a Mediterranean diet. Blood and urine samples were collected from 201 community-dwelling older adults who completed a Food Frequency Questionnaire (FFQ). A Mediterranean Diet Score (MDS) was calculated based on previous recommendations and a sex-based AL index was calculated using a count-based approach for 16 biomarkers associated with neuroendocrine, immune, cardiovascular, or metabolic function. It was hypothesized that a higher MDS would associate with lower AL, and that this association would be particularly robust for the immune and metabolic subcomponents of the AL index. In support of the study hypotheses, generalized linear models revealed a significant inverse relationship between MDS and AL (ß = -0.03, P = 0.037). Furthermore, higher MDS was significantly associated with lower immune (ß = -0.06, P = 0.38) and metabolic (ß = -0.05, P = 0.039) subsystem scores, but was not associated with cardiovascular or neuroendocrine subsystem scores. Exploratory analyses further showed that the association was more robust in male than female participants. The current findings are interpreted with caution given the study design and sample characteristics. However, these findings contribute to the literature supporting the Mediterranean diet as an important lifestyle behavior that may support healthy aging.
UNDERSTANDING AND RESPONDING TO THE NEEDS OF STUDENT CAREGIVERS THROUGH THE AGE-FRIENDLY UNIVERSITY LENS
Authors: Terhune Katherina , Graf Allyson , Wade Kate , Greer Faith
Published: December 2022

Caregiving has steadily increased over the years, with approximately 44 million individuals in the U.S. providing over 37 billion hours of unpaid, informal care for adult family members and friends with chronic illnesses or conditions that impact their functionality and daily activities. While much caregiving research has been completed over the years, research on student caregivers is scant, and less is known about the experiences and the needs of students in caregiving roles. This presentation examines data from a campus-wide survey to assess the prevalence and impact of unpaid caregiving on students. Utilizing the Age-Friendly University framework, this study aims to identify sources of unmet caregiving need, as well as community and campus connections to better support students in caregiving roles. Recommendations for assessing student caregiver needs and ways to generate and enhance caregiver support through the AFU lens will be highlighted.
OPPORTUNITIES AND OUTCOMES OF CENTERING OLDER ADULTS IN PATIENT-ORIENTED AND COMMUNITY-ENGAGED RESEARCH
Authors: Leach Carrie , Geary Carol
Published: December 2022

Community engagement is critical for achieving context-sensitive and culturally appropriate communication, implementation and research approaches that can lead to better public and patient health outcomes. Though patient and community-engaged approaches are increasingly utilized in social research, the inclusion of older adults remains limited, as are methodologies that will help inform adult-centric programs and interventions. To advance the science of community engagement and implementation, this symposium brings together methodological innovations to help researchers shift from involving older adults as participants in research, toward collaboratively engaging and partnering with older adults in the design and conduct of research. The first presentation centers on place-based health disparities by starting with a statewide survey to identify communities that researchers could engage. The second highlights how the involvement of older adults led to the development of tactics for connecting with the hardly-reached, people over the age of 75, with health enhancing services and support. The third discusses a model for greater involvement of older adults to draw out lessons for implementation science in long-term care. The final presentation demonstrates an innovative approach to pilot new solutions with multidisciplinary and community partners in clinical settings. This CEnR and PPER interest group collaborative symposium concludes by imagining ways to integrate the diverse perspectives to advance the science of engaged research and implementation in community and clinical settings. This symposium represents diverse perspectives on involving community stakeholders meaningfully and equitably with research, to bend the later life health equity arc toward greater inclusion and justice.
COMMUNITY PERSPECTIVES ON COMMUNICATION DISPARITIES IN LATE OLD AGE AND TACTICS TO CONNECT WITH THE HARDLY REACHED
Authors: Leach Carrie , Jankowski Thomas
Published: December 2022

Individuals who face the greatest health burdens often have the fewest communication resources to draw from to help them cope. Communication infrastructure theory provides a framework for understanding how communication resources and context constrain and enable connections to health enhancing information. Data collected from 1,609 older adults through in-depth interviews and a random sample survey in one midwestern county in Michigan as part of a multi-year, multi-level community engaged study and a statewide random digit dial telephone survey showed that age influenced integration in a communicative structure. Findings suggest that the dynamics of living into late old age result in communication disparities through diminishing interpersonal resources, activity, and opportunities to congregate. Actionable knowledge and strategies provided to community leaders on how to connect with the hardly reached, individuals age of 75 and older, are presented.
VALIDATION OF THE PITTSBURGH PERFORMANCE FATIGABILITY INDEX FROM USUAL-PACED 400 M WALK
Authors: Qiao Yujia (Susanna) , Harzelak Jaroslaw , Toto Pamela , Moored Kyle , Goodpaster Bret , Santanasto Adam , Nicklas Barbara , Glynn Nancy W
Published: December 2022

The Pittsburgh Performance Fatigability Index (PPFI, higher=greater fatigability), a novel accelerometer-based performance fatigability measure, was recently developed for adults aged ≥60 years. We validated PPFI during a usual-paced 400m walk in 429 individuals enrolled in the Study of Muscle, Mobility and Aging (age=76.9±5.3years, 57.6% women, gait speed=1.0±0.2 m/s from 4-meter walk). PPFI quantifies percent of performance decrement (i.e., slowing down) during 400m walk by comparing area under the observed cadence trajectories to the hypothetical area that reflects sustaining maximum cadence for the entire walk. PPFI scores (mean=2.1%±2.5%, range: 0-21.7%) demonstrated convergent validity with Short Physical Performance Battery (SPPB, Pearson correlation (r)=-0.32) and mobility (time to walk 400m, r=0.47). PPFI scores discriminated higher versus lower physical function (SPPB: 1.6% (≥10) vs. 2.9% (<10), p<.001), adjusted for age, sex, height, and weight. PPFI is the first validated accelerometer-based objective risk assessment tool for measuring performance fatigability, an established marker of functional decline.
DUAL ROLES OF FITNESS AND FATIGABILITY IN THE LIFE-SPACE MOBILITY OF OLDER ADULTS
Authors: Moored Kyle , Qiao Yujia (Susanna) , Rosso Andrea , Toledo Frederico , Cummings Steven R , Goodpaster Bret , Kritchevsky Stephen , Glynn Nancy W
Published: December 2022

Objective fitness and perceived fatigability may interact to limit mobility within the larger environment (life-space mobility). We assessed this cross-sectionally in SOMMA (N=371, mean age=76.4±5.0). Life Space Assessment scores (range: 0-120, 5-point difference=clinically relevant, e.g., going outside additional 1-3 days/week) incorporated level, frequency, and assistance used for life-space mobility (Mean=82.7±18.8). Fitness was measured as VO2peak (Mean=19.5±4.2 mL/kg/min) from a symptom-limited treadmill test. Higher fatigability was defined as a Borg Rating of Perceived Exertion (RPE, range: 6-20) ≥10 after a five-minute steady-state treadmill test. Each 1-SD higher VO2peak was associated with a 2.2-point higher life-space score (95% CI: 0.25-4.07, p=.027). After adjustment for demographic, lifestyle, and health confounders, the association between fitness and life-space mobility was significant only for those with higher fatigability (RPE≥10: B=5.70, 95% CI: 0.79-10.60, p-interaction=.008). Older adults with both lower fitness (objective capacity) and higher fatigability (perceived capacity) may be at greatest risk of reduced real-world mobility.
PERCEIVED FATIGABILITY AND MORTALITY IN MID-TO-LATE LIFE IN THE BALTIMORE LONGITUDINAL STUDY OF AGING
Authors: Wanigatunga Amal , Chen Xiaomeng , Marino Francesca , Simonsick Eleanor , Ferrucci Luigi , Schrack Jennifer
Published: December 2022

This study hypothesized that perceived fatigability, fatigue standardized to walking, would better discriminate mortality risk than general fatigue symptoms. We leveraged perceived fatigability, self-reported tiredness, self-reported low energy and mortality data from 1,112 participants aged ≥50 years. Hazard ratios (HRs) of all-cause mortality (198 [17.8%] events) by either z-scored fatigability, tiredness, and energy level were estimated using Cox proportional hazards models. Model discrimination was compared using Harrell’s C-statistics (C). After full covariate adjustment, 1 SD higher perceived fatigability, tiredness and low energy level were associated with higher mortality risk (HR=1.20, 95% confidence interval [CI]:1.05-1.37; HR=1.28, 95% CI:1.11-1.48; HR=1.26, 95% CI:1.10-1.45, respectively). The model for perceived fatigability (C=0.8039) had comparable discrimination to tiredness (C=0.8085,p=0.26) and low energy level (C=0.8067,p=0.41). While perceived fatigability was associated with higher mortality risk, it did not exhibit superior ability to discriminate mortality risk than self-reported fatigue symptoms among persons in mid-to-late life.