bluuebunny/crossref_metadata_2025 huggingface dataset:
Computer-mediated Focus Groups to Advance Aging Research: Challenges and Opportunities.
Authors: Coon David , Gomez-Morales Abigail , Carll phil , Cordova Lourdes , Glinka allison , Gonzalez-Piles Socorro
Published: December 2021

When compared to in-person offerings, fewer focus groups to date have been conducted with user-friendly technologies to help reach diverse communities of older adults with chronic health conditions (e.g., Alzheimer’s disease, Type II diabetes, Parkinson’s) and the family caregivers and professional providers who assist them. The current project describes the adaptations needed to deliver successful computer-mediated focus groups via videoconference, thereby providing solutions to barriers faced by participants who often cannot attend in-person because they are housebound due to transportation or financial barriers, live in rural areas or reside too far from focus group offerings, or work full or part-time and face scheduling conflicts. During the pandemic, we successfully recruited diverse groups of family caregivers, care recipients, and professional providers into computer-mediated focus groups. Caregivers (83%) and care recipients (17%) between 34 to 90 years old (N=47) took part in the series of focus groups facilitated in English and Spanish (25.5%). Over 40% of participants self-identified as Hispanic or Latinx, Native American, or African American with roughly 15% attending from rural areas. Similarly, professional providers age 18 to 80 (N=25) attended separate groups in either English or Spanish (48%). Our results suggest that computer-mediated focus groups offer a unique opportunity to reach diverse samples of older adults, family caregivers, and their providers. These computer-mediated focus groups also offer the chance to learn novel ways to break barriers to health access by providing virtual reach capabilities for those facing health, transportation, work, or geographic barriers.
Feasibility and Barriers of an Olfactory Training Intervention
Authors: Yoneda Tomiko , Cid Natalia López-Bago , Lewis Nathan , Willden Michael , Nelson Anna , Semenoff Nadia , Piccinin Andrea , Knight Jamie
Published: December 2021

Olfactory dysfunction is a common issue in late-life and can be an early indicator for neurodegenerative diseases. Further, olfactory interventions not only improve olfaction but have shown promise for the delay and treatment of dementia. This study aimed to better understand the feasibility and barriers of implementing an olfactory intervention. Participants (N=23) between the ages of 52-86 (mean=71) years were recruited from the community. A demographic questionnaire showed participants were all non-smokers and identified as women (70%), men (26%), and transgender (4%). The majority were married (61%), while some were separated or divorced (17%), widowed (13%), or single (9%). Four focus groups, guided by both structured and open-ended questions, were conducted and audio-recorded with 3-7 unique participants per group. Data were transcribed, thematically analyzed, and independently coded, which resulted in three overarching themes: (1) cognitive, genetic, and environmental factors of smell, (2) methods to reduce barriers and increase the feasibility of an intervention, and (3) flexibility with technology use. Findings suggest that implementing an olfactory intervention is feasible and of interest to older populations especially when provided with detailed training protocols that have flexibility in the amount of technology used within the study. Barriers included sensitivity to smells, allergies, and dexterity issues. Reducing these barriers will facilitate implementation and decrease the likelihood of attrition. Consulting the target population provides insights into barriers, participant interest, and can assist with the development of training and intervention programs.
SSDoH and Aging in Persons of African Ancestry
Authors: Balls-Berry Joyce
Published: December 2021

Persons of African Ancestry (Black) encompasses a broad spectrum of individuals across the African diaspora. The diversity of the Black community must be considered in the context of SSDoH especially as it relates to diseases of aging. Blacks report higher levels of discrimination as a barrier to Alzheimer’s Disease or related dementia (ADRD) care, are less likely to receive timely diagnoses of ADRD, and many do not trust that a future cure for ADRD will be shared equally and equitability with their community compared to their white counterparts. Once diagnosed, older Blacks, are twice as likely as their white counterparts to have ADRD. A key to addressing the Black community’s ADRD needs is speaking openly about the historical underpinnings related to social injustice and racism as a link to appropriate ADRD diagnoses. Ultimately, SSDoH impact treatment, healthcare policy, and the future of biomedical research for the Black community.
The Development of A Self-Appraisal Tool for the Level of Long-Term Care Service Integration.
Authors: Chang Yu-Chien , Chen Ya-Mei
Published: December 2021

Introduction Taiwan is the fastest aging countries in the world. In 2016, Taiwan implemented Long-Term Care Plan 2.0 (LTC Plan 2.0), aims to provide coordinated and integrated LTC services. However, how to assess the level of integration and which integration mechanisms are better applied are still unclear in the literature. This study intended to address a research question regarding “How can agencies measure their level of service integration?” and, therefore, aimed to develop an integration assessment tool—the Taiwanese Self-Assessment for LTC Systems Integration (TwSASI)- for LTC agencies to use to self-evaluate their current “level” of providing integrating LTC services. Methods 　　TwSASI was first developed base on Connie J. Evashwick’s (2005) framework and literature review, including four domains: inter-entity planning and management, care coordination, integrated information system, and integrated financing, and 11 dimensions with 51 items. Through the Delphi method, with two rounds of investigation and feedback from 26 experts, RAND/UCLA Appropriateness Method (RAM) was used to assess the consensus regarding the dimensions and items developed and refined the tool content accordingly. Results After two rounds of investigation, four domains remained with 10, 11, 4, and 5 items in each domain respectively. All items reached good experts' consensus with medians of the 30 items’ importance, feasibility, and appropriateness all over 8. The Scale Content Validity Index (SCVI) of the 4 dimensions all over than 0.9. Conclusion The TwSASI can be feasible for evaluating the level of LTC service integration in Taiwan. LTC agencies can improve their level of service integration accordingly.
Effectiveness Of Supervision On Work Engagement And Turnover Intention Of Care Managers in Japan
Authors: HATA Ryosuke
Published: December 2021

In Japan, care managers engage frail older adults to support their assisted living in long term care insurance system. However, due to the lack of some or all supervision, many care managers face problems such as low work engagement and high turnover rate. This study aims to examine what types of supervision have positive effects on work engagement and turnover intensions of care managers in Japan. The sample of 241 care managers were asked whether they have received individual supervision in the workplace (ISVW), individual supervision in the community (ISVC), group supervision in the workplace (GSVW), or group supervision in the community (GSVC). Independent samples t-tests and one-way ANOVAs were conducted to examine the effectiveness of each types of supervision on work engagement and turnover intension. T-tests showed that only GSVW was significantly related to work engagement (t=-2.06, p<0.05). Whereas, only ISVW had a significant effect on turnover intensions (t=2.37, p<0.05). One-way ANOVAs revealed that 28 care managers receiving GSV had significantly higher work engagement than 92 care managers who did not receive any SV (F=5.33, p<0.01). 40 care managers receiving both ISV and GSV showed significantly lower turnover intentions than 92 care managers who received neither ISV nor GSV (F=2.84, p<0.05). Since the results have implications for the importance of supervisions to enhance work engagement or to reduce turnover intension of care managers, a larger sample will need to confirm these effects.
Evidence-based Recommendations to Inform Best Practices for LGBTQ Older Adults in Long-term Care Settings
Authors: Fasullo Katherine , McIntosh Erik , W. Buchholz Susan , Ruppar Todd , Ailey Sarah
Published: December 2021

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults are more likely to live alone and have less familial support, which disproportionately contributes to a reliance on long-term care facilities as they age. Best-practice guidelines supported by scholarly literature to care for LGBTQ older adults in long-term care settings do not exist. This review synthesizes literature about LGBTQ older adults in long-term care facilities and provides recommendations for best practice guideline development. Four electronic databases were searched in June 2019 for studies conducted between 2000 – 2019 related to caring for LGBTQ older adults in long-term care settings. An integrative literature review was completed on the twenty eligible studies. Findings showed that LGBTQ participants fear discrimination in long-term care leading to the invisibility of their identities. They recognize a need for increased staff training and the importance of community networks and facility preferences. Long-term care staff have mixed experiences with inclusive practices and complex views of LGBTQ older adults. They experience training deficits and have a need for more expansive training modalities. The recommendations offered by both LGBTQ participants and long-term care staff are to revise policies and forms as well as provide widespread training and education. LGBTQ participants recommend that their unique identities be recognized within long-term care while long-term care staff recommend leadership involvement to change culture and practice. This review provides evidence-based recommendations to promote equitable healthcare to the LGBTQ older adult population and calls to attention the need for long-term care settings to uniformly follow best-practices.
Intergenerational Engagement in Residential Settings: A Scoping Review of the Literature
Authors: Gardiola Andrea , Mirza Raza , Bull Amanda , Klinger Christopher , Hsieh Jessica , Peck Samantha
Published: December 2021

Intergenerational engagement provides a rich environment for people of different ages to come together and exchange life stories, skills, and knowledge. Today, intergenerational interactions are decreasing, however, these exchanges can have positive implications for seniors in residential care homes (RCHs) and younger persons. A scoping review following Arksey and O’Malley’s five-step framework was conducted to investigate the impact of intergenerational engagement and programs (IGPs) on older adults in RCHs. A systematic search of ten electronic databases and hand search of references was carried out; thematic content analysis to established key themes. A total of 1,183 academic and grey literature sources were reviewed, with 66 full-text studies assessed for eligibility. Of these sources, 35 studies met inclusion criteria. Studies highlighted four main themes: 1. Types of IGPs, 2. Psycho-social benefits for older adults and improved status among elders with cognitive impairments, 3. Younger person benefits, suggesting reduced ageism and improved social and communication skills, and 4. Program recommendations, including the need for enthusiastic program facilitators, coordination between facilities, sensitivity training for younger persons, detailed advertisements, and appropriate activities for different age groups. Findings inform future practice and research, highlighting that IGPs are an effective strategy to alleviate negative health outcomes for seniors in RCHs. Future research is needed to evaluate long-term effects and further health outcomes. IGPs provide an opportunity to facilitate purposeful and reciprocal relationships between generations, fostering intergenerational understanding. By studying IGPs and intergenerational interactions, we can better determine practices that meaningfully engage elders in RCHs in Canada.
Burnout, Compassion Satisfaction, and Personality Among Nursing Assistants: Who is at Risk?
Authors: Richert Mallory
Published: December 2021

Nursing assistants often experience high rates of turnover and burnout, which may lead to poor resident care outcomes and quality of life, as well as continued staff shortages and increased workload for nursing assistants. This study examined personality correlates of burnout and compassion satisfaction among 100 nursing assistants employed as nursing assistants in long-term care (LTC) and hospitals throughout the United States. Participants completed the Professional Quality of Life Scale 5 (ProQOL 5) and the Big Five Inventory – 2 Short (BFI-2-S). There was a significant positive correlation between compassion satisfaction and agreeableness, and extraversion, and between burnout and neuroticism. Additionally, there were significant negative correlations between compassion satisfaction and neuroticism, and between burnout and agreeableness, and extraversion. These results indicate which nursing assistants may be more likely to experience burnout and may be at an increased risk of turnover. Specific interventions may be developed for such individuals to increase compassion satisfaction, reduce burnout, and reduce staff turnover. Furthermore, information regarding personality types of individuals at greater or lesser risk for burnout may be helpful for LTC administrators in the recruitment and hiring of nursing assistants, and thus may reduce rates of turnover. Resident care outcomes may also improve as nursing assistant hiring efforts are focused more on individuals who are less likely to experience burnout. Future researchers might investigate potential risk and protective factors for burnout and compassion satisfaction in nursing assistants.
Development of an Animal-Assisted Activity/Therapy Dog Checklist for Long-Term Care Facilities
Authors: Dunn Karen , Johnson Amy , Winkle Melissa
Published: December 2021

Animal-assisted activities (AAA) and therapy standards of practice have been published to protect the well-being of animals, animal handlers, and the special populations of patients that benefit from this mode of treatment. Inconsistencies among practice standards with concerns surrounding the topics of dog welfare, human well-being, and zoonotic transmission have been reported. The purpose of this qualitative research study was to review published AAA and therapy standards with older adult populations for best practices, conduct focus group sessions with caregivers from long-term care facilities that allow therapy dog visitation, and synthesize findings into an AAA checklist to be used by long-term care facility decision-makers when interviewing or bringing in therapy dog teams. Comparative analyses utilizing a systematic and sequential approach was used to analyze the data from the focus group sessions. Due to the COVID-19 pandemic, only two focus group sessions at one long-term care facility were conducted resulting in a total of 15 caregivers. Four themes emerged from the data: promotes positive mood, essential resident screenings, caregiver roles, and memory aides. Relevant themes and AAA and therapy standards and guidelines were then combined in the development of the AAA/Therapy Dog Checklist. Administrators may find having a user-friendly AAA/therapy dog checklist a useful tool that can be used when interviewing therapy dog teams to ensure future dog therapy experiences will be positive and safe. The safety and well-being of residents in long-term care facilities and animals are essential to promote positive health outcomes for both populations.
Learning best practices for educating a caregiving workforce
Authors: Tewary Sweta , Indorewala Yumna , Cook Nicole , Pandya Naushira , Damier Sashah , Twahir Assma
Published: December 2021

It is well established that the health professional workforce is not adequately prepared to meet the demands of an aging older population. Caregivers are often the backbone supplemental workforce for seniors, providing daily care with assistance with activities of daily living, with little training. Part of the mission of the South Florida Geriatric Workforce Enhancement Program (SFGWEP) is to support and empower caregivers through community based training programs. Between January 1 2020 to January 31, 2021 SFGWEP provided education to more than 340 caregivers on topics related to opioid use, effective communication with individuals with dementia and other topics. Attendees responded to a short evaluation survey, which included three multiple-choice questions on if attending was a good use of their time, if they gained knowledge and if they plan to apply material, and two open-ended questions to identify opportunities for improvement in future trainings. Responses were overwhelmingly positive (>98% for multiple-choice questions.) There were also three open-ended questions that were analyzed using a modified thematic approach. The three questions covered what attendees learned, what they wanted to learn more about and suggestions for improvement. Analysis suggests that attendees plan to be more mindful about communication (e.g. improve eye contact, listen more) and that they want more information on neurocognitive disorders and resent research, including psychological changes due to disease and medication side effects. In terms of improvement, attendees said the program should allow more time for questions and should use more engaging materials (polls, posters, flyers and case studies).
Best Practices for Working with Latinx Older Adults in Mental Healthcare
Authors: Weber Kendall , Stone Lisa
Published: December 2021

Background: The number of older adults in the United States is growing rapidly. The percentage of individuals from ethnic minority groups that make up this population is also rapidly increasing, with Latinx older adults comprising the fastest growing subgroup. However, Latinx older adults historically underutilize mental health services, in large part due to the lack of culturally sensitive and informed care provided by mental health professionals (de Guzman et al., 2015). However, to date, comprehensive, evidence-based best practices for mental healthcare for Latinx older adults do not exist. Method: A literature review was conducted of research on the developmental, social, cognitive, biological, and affective bases of behavior among Latinx older adults. Results: Taking an integrated, evidence-based psychological approach with cultural considerations, we found that the literature could broadly be organized into six best practice guidelines. We propose assessing for and incorporating the following topics into mental health treatment of Latinx older adults: immigration status, acculturation, attitudes towards mental health, physical and cognitive health disparities, discrimination, and unique preferences for care structure in later life. Discussion: These guidelines are intended to represent basic principles to incorporate into practice and do not represent an exhaustive list of factors to consider for a heterogenous group of older adults. Instead, the six, empirically-based guidelines proposed in this study can serve as a starting point for increasing mental health providers’ awareness of the unique experiences of Latinx older adults, with the aim of improving the experience of this historically underserved population in mental healthcare treatment.
Depressive and Anxiety Disorders in Alcohol Use and Related Problems among Older African Americans
Authors: Arnold Tomorrow
Published: December 2021

The older African American (AA) population is expected to triple by 2050; however, research on depression, anxiety, and alcohol use among older AAs is lacking. Current mental health and substance use studies involving older AAs often focus on between-race differences, frequently comparing AAs to Whites, without addressing within-group variation in the former. As such, little is known about the associations between depression, anxiety, alcohol use and related disorders in this population. The present study used data from 2016-2017 Midlife in the United States (MIDUS) Milwaukee 2 to examine whether depressive and anxiety symptoms and disorders are associated with alcohol use and alcohol problems among 274 African Americans aged 50 to 93 (62.8% women). Of the sample, 9.5%, 3.6%, and 6.6% met criteria for depression, generalized anxiety (GAD), and panic disorders, respectively. About 8.1% had drank heavily and 18.5% binge drank in the past month with 10.2% reporting alcohol problems in the past year. Those with depression and those with panic disorder were more likely to be heavy drinkers; while only those with panic disorder were more likely to be binge drinkers. Meeting criteria for depression or panic disorder but not GAD disorder were both more likely to have had alcohol-related problems than those not meeting criteria. Only panic disorder was associated with increased likelihood of drinking more than intended in the past year. Preliminary exploratory findings suggest that the associations between depressive symptoms, type of anxiety disorder, alcohol use, and problems varied by gender.
Mobile Intervention Outcomes Compared Pre and Post-Shelter-in-Place for Middle Aged and Older Adults
Authors: Carlson Chalise , Alfaro Ana , Chick Christina , Bruce Martha , Hoffman Valerie Forman , Gould Christine
Published: December 2021

The Meru Health Program (MHP), a mobile app-based intervention targeting depressive symptoms, teaches mindfulness and cognitive behavioral skills through video lessons and practices. MHP includes integrated asynchronous therapist and peer support. Our aim was to examine whether using the MHP reduced loneliness and improved mental health quality of life (QoL) in middle-aged and older adults with depressive symptoms (Patient Health Questionairre-9 [PHQ-9] ≥ 7). The timing of this study partially overlapped with the emergence of the SARS-CoV-2 (COVID-19) pandemic resulting in California’s shelter-in-place (SIP) orders. Fifty participants (42 enrolled prior to SIP) completed baseline assessments with a mean age of 57.06 (SD = 11.26; Range: 40-81 years) exhibiting mild to moderate depression symptoms (PHQ-9: M = 12.28, SD = 5.47). Participants enrolled pre-SIP exhibited significant improvements in QoL, F(1,38) = 12.61, p = .001, η2 = .25, and significant declines in loneliness, F(1,38) = 5.42, p = .03, η2 = .13. Improvements in QoL were found for post-SIP participants as well, F(1,44) = 6.02, p = .02, η2 = .12. In contrast, loneliness did not improve for the post-SIP cohort, perhaps alluding to the increased impact of social isolation during SIP. Our findings indicate MHP can improve QoL symptoms before and during SIP. It is possible that middle-aged and older individuals may require more individualized support during SIP to help alleviate loneliness when social connection is severely restricted. MHP remains a promising and scalable solution for those middle-aged and older adults struggling with mental health symptoms.
The Illness Experience of Veterans With Dementia: Perceived Measures Related to Depressive Symptoms
Authors: MacNeil Amanda , Judge Katherine , McCarthy Kate , Bass David
Published: December 2021

Recent work has examined how individuals with dementia (IWDs) experience their illness, although few studies have looked at IWDs who report heightened depressive symptoms, a key well-being outcome. Stressing the ability of IWDs to self-report and guided by the Stress Process Model for Individuals with Dementia, this study examined the relationships between depressive symptoms and various aspects of the illness experience including objective cognition, perceived memory difficulty, perceived functional difficulty, and dyadic relationship strain. The sample includes IWDs with mild to severe dementia who are veterans (N=69). Significant positive correlations emerged between depressive symptoms and several measures of the illness experience: perceived cognition (r=.48, p<.001), perceived function (r =.43, p<.001), and dyadic relationship strain (r=.32, p=.01). In contrast, objective cognition, measured by a modified version of the Blessed Orientation Memory Concentration test, was not significant (r =-.06, p=.63). A multiple regression found the total variance explained by all independent variables was 32% (R2=.32, F(4,68)=7.58, p<.001), with perceived memory difficulty (B=.26, p<.01) and dyadic relationship strain (B=.25, p=.04) accounting for unique and significant variance in depressive symptoms. A mediation analysis indicated perceived memory difficulty fully mediated the relationship between perceived functional difficulty and depressive symptoms. Findings highlight the importance of IWDs perceptions of their illness experience for psychosocial well-being outcomes, such as depressive symptoms. Findings add to the literature by showing the importance of IWDs perceptions of their illness and their impact on well-being outcomes. Results also demonstrate the utility and feasibility of including self-reported data from IWDs in research studies.
Minimally Adequate Mental Health Treatment and Mortality in Primary Care Older Adults With Depression and Anxiety
Authors: Vasiliadis Helen-Maria , Lamoureux-Lamarche Catherine , Grenier Sébastien , Roberge Pasquale
Published: December 2021

Receipt of quality mental health (MH) care can influence mortality. Given the scarce literature on the topic, the aim was to assess the 3-year risk of mortality in older adults (OA) associated with receiving adequate MH treatment for depression/anxiety in an epidemiologic context. The study sample included 358 OA with depression/anxiety recruited in primary care practices and followed prospectively for 3 years. Mortality was assessed from vital statistics data. Adequate care was based on receipt of pharmacotherapy, follow-up care and psychotherapy. Propensity score analysis was carried out where the inverse probability (IPW) of receiving adequate treatment was calculated. Time to event analyses with IPW was used to assess the effect of receipt of adequate MH treatment on the risk of mortality controlling for individual and health system factors. The results showed that receipt of adequate MH treatment reduced the risk of mortality (HR0.44; 95% CI: 0.22 – 0.99). Individual factors that increased mortality were male sex, being single, reduced functional status and cognitive functioning, # physical disorders, current smoking; while exercise reduced risk. Health system factors such as past # of hospitalizations increased the risk; while # of emergency department visits and continuity of care reduced mortality. Finally, treating depression/anxiety with minimal follow-up care and pharmacotherapy or psychotherapy has a significant impact on reducing mortality in OA. Primary care physicians should recognize the important potential impact of years of lives saved when providing quality MH care to OA.
Cumulative COVID-19 Disparities in Nursing Home: Focusing on Geographical Factors and Racial Components
Authors: Hong Sungjae , Meija Shannon
Published: December 2021

The impact of COVID-19 has been greatest in vulnerable US populations. This study examines the cumulative geographical and racial disparities of COVID-19 cases in nursing homes. Analysis of COVID-19 Nursing Home Data from Centers for Medicare & Medicaid Services was limited to weekly reports from the nursing homes that reported the ratio of black residents, from 2020-05-31 to 2021-01-17 (N=268,222 from 8,026 nursing homes). The outcomes were weekly COVID-19 cases and death per 1,000 occupied beds. Nursing homes were categorized by a geographic (rural vs. urban) and racial composition (>50% of residents are black vs. else). Elapsed time and county-level weekly COVID-19 cases and deaths/1,000 people were the key covariates. Multilevel zero-inflated negative binomial regression revealed evidence of cumulative COVID-19 disparity between rural and urban nursing homes. At the earliest time, COVID-19 incidence was lower in rural nursing homes than in urban nursing homes (IRR=0.406 for cases, 0.034 for death). The significant interaction with time implied that, over and above evolving disease prevalence, rural nursing homes became more likely than urban nursing homes to experience COVID-19 over time (IRR=1.057 for cases, 1.193 for death). Nursing homes, with >50% black residents, were more likely to experience COVID-19 than their counterparts at the earliest time (IRR=1.339 for cases, 5.630 for death), but independent of local disease prevalence, this disparity decreased over time (IRR=0.973 for cases, 0.972 for death). Our findings suggest that racial and geographic factors contribute to the cumulation of disadvantage during the COVID-19 crisis at the second half of 2020.
Health Literacy and Health Conditions at the Intersections of Gender and Race in Later Life
Authors: Yamashita Takashi , Liu Darren , Burston Betty , Keene Jennifer
Published: December 2021

The benefits of health literacy are well-documented. Health literacy is a set of skills to locate, understand, and use health-related information to make optimal health decisions. However, relatively less is known about the long-term relationship between health literacy and overall health conditions among older adults. Additionally, health literacy and health at the intersection of gender and race/ethnicity, rather than gender and race separately, are yet to be investigated. This study analyzed sub-samples (n = 1,260 adults age 50+) of the 2010 Health and Retirement Study (HRS) health literacy module data, and the 2012, 2014, and 2016 HRS data to examine the trajectories of health based on eight physical and mental conditions (0-8 points: better-worse) among older adults. Latent growth curve mixture models were used to investigate the changes in health and six groups defined by gender (women and men) and race/ethnicity (White, Black, and Hispanic). Results showed that overall health deteriorated over time (latent-slope = 0.19, p < 0.001) but the trajectories were diverse (latent-slope variance = 0.06, p < 0.001). Greater health literacy (0-5 points: worse-best scaling), which was measured with a validated scale, was associated with better overall health only among White women and men. Notably, White women received the baseline health benefits (b = -0.20, p < 0.05) from health literacy whereas Black women (b = 0.09, p > 0.05) did not [Δb = 0.09 -(-0.20) = 0.29, p < 0.05]. Other detailed comparisons, theoretical explanations, and public health policy implications for diverse older populations were evaluated.
Intersections of Gender and Race among Older Workers during the COVID-19 Pandemic
Authors: Yamashita Takashi , Punksungka Wonmai , Van Vleet Samuel , Helsinger Abigail , Cummins Phyllis
Published: December 2021

The novel coronavirus/COVID-19 pandemic in 2020 has impacted the aging workforce. In addition to local data and case studies that are rapidly increasing, baseline national-level inquiries are needed for investigating relevant social inequalities. Also, the intersections of gender and race/ethnicity among older adults are critical yet understudied areas. For example, older minority women’s experience in the pandemic, compared to older men, are yet to be investigated. We analyzed the nationally representative 2020 Health and Retirement Study (HRS) COVID-19 module data. Based on the sample of 2,086 adults aged 50 years and older, employment during the pandemic as well as psychosocial measures, including social support and attitudes toward work, are examined. We used survey-weighted binary logistic regression models. Results showed that older Black women (Odds-ratio = 0.52, p = 0.02 < 0.05) were less likely to work for pay compared to White women during the pandemic. Also, older Hispanic men (Odds-ratio = 2.82, p = 0.03 < 0.05) were more likely to work for pay than older White men. Older Hispanic women (Odds-ratio = 2.41, p = 0.03 < 0.05) were more likely to worry about getting social support during the pandemic than White women. However, there was no significant differences in the changes in attitudes toward work across gender and racial/ethnic groups during the pandemic. Based on the baseline national data analysis, we discussed possible policy changes and interventions that consider the intersections of gender and race/ethnicity to help older adults re-adjust to post-pandemic work environments and labor markets.
Manifestations of Racial Trauma in Bereaved Middle to Older Aged Black Adults
Authors: McDuffie Danielle
Published: December 2021

Black adults have a higher likelihood of experiencing bereavement and increased negative implications of systemic racism compared to other groups. The effects of racism have also been suggested to have an impact on how bereaved Black individuals conceptualize their loss and the deceased. However, there is limited literature on how direct and indirect childhood experiences with racial violence and viewing racially violent deaths impact bereaved Black adults later in the lifespan. The current study seeks to explore the impacts childhood engagement with racial violence might have on bereaved middle to older Black adults. 103 middle to older aged Black adults (M=44.72, SD=5.48, 67% male) from a larger online grief study were probed about factors including somatization, depression, affect, grief, and the prevalence and intensity of exposure to race-based violence during their childhoods. Linear regressions and bivariate correlations were used for data analysis. Childhood racial violence significantly predicted grief (F=6.348, p=.013). Additionally, experiencing childhood racial violence was significantly associated with somatization (r=.197, p=.047), depression (r=.198, p=.045), and negative affect (r=.256, p=.010). Endorsed intensity of racial violence was significantly associated with depression and negative affect (r=.464, p=.000; r=.440, p=.000, respectively). Bereaved Black middle to older adults seem greatly impacted by childhood experiences of racial violence. It is important to consider the role outside cultural influences such as racial trauma might have on other deleterious mental health experiences such as bereavement. Furthermore, in the assessment of ACEs among Black and other people of color, it could be important to include childhood racial violence.
Daily Emotional Dynamics of Custodial Grandfamilies: Cross-Dyad Correlations of Affect Means and Variability
Authors: Castro Saul , Infurna Frank , Webster Britney , Smith Gregory , Crowley Max , Dolbin-MacNab Megan , Musil Carol
Published: December 2021

Evidence indicates that daily emotional dynamics are associated with mental and physical health. However, these processes have not been examined among custodial grandmothers taking care of adolescent grandchildren. This daily diary study examined correlations between grandmothers and adolescents’ mean levels and variability in negative (NA) and positive affect (PA). Custodial dyads (M = 214) across the nation completed two weeks of daily surveys. For both grandmothers and adolescents, their own PA means were negatively correlated with NA means, PA variability, and NA variability; NA means were positively correlated with variability in PA and NA (ps <.01). Across dyads, grandmothers’ PA means were positively correlated with adolescents’ PA means and negatively correlated with adolescents’ NA means, PA variability and NA variability. Grandmothers’ NA means were positively correlated with adolescents’ variability in PA and NA (ps <.01). Our findings demonstrate how daily emotional dynamics are correlated within and between family members.
Differential Influence of COVID-19 pandemic on Life-Space Mobility of older adults
Authors: Zisberg Anna , Shulyaev Ksenya , Gur-Yaish Nurit , Shadmi Efrat
Published: December 2021

Life-space mobility (LSM) is critical to aging successfully since it is essential to maintain independence, affecting the health and quality of life of older adults. During the COVID-19 pandemic older adults, who are at high-risk of serious illness and complications, are restricted by stay-at-home orders, limiting their outdoor activities. This study evaluated differences in LSM before and during the pandemic and factors related to limited pre-hospitalization mobility. We used a natural experiment design comparing LSM one month prior to hospitalization and its related factors on two subsamples of hospitalized older adults: recruited before and after February 2020 (pandemic outbreak). No significant differences were observed in LSM between pre-pandemic (N=141, M(SD)=54.9(33,5)) and during-pandemic (N=186, M(SD)=55.3(32.9)) samples, even after adjustment for cognitive, functional, and demographic characteristics (F=2.281, p=0.13). Of those who participated during the pandemic, a total of 94 (50.5%) declared that their mobility was strongly affected by the pandemic and had significantly lower LSM (F=4.626, p<0.01) comparing both to those who declared not being affected (N=92) and to the pre-pandemic group, controlling for potential cofounders. In the "during-pandemic" group older adults with higher basic physical functioning, higher economic status, and those with lower levels of education were more likely to indicate that their pre-hospital mobility was affected by the pandemic. These results show that the pandemic period has a differential effect on life-space mobility of older adults. Functional, socio-economic, and educational factors need to be considered in planning how to maintain older adults’ mobility during the ongoing pandemic.
Eye and Visual Health in New England: Findings from the Healthy Aging Data Reports
Authors: Xu Shu , Jansen Taylor , Lee Chae Man , Karakida Maki , Porell Frank , Dugan Elizabeth , Silverstein Nina
Published: December 2021

Eye and visual health issues in older adults are prevalent, often undetected and untreated, but can contribute to poor physical and mental health issues, and higher mortality rates. The study describes state and local community rates of eye and visual health indicators (cataract, glaucoma, self-reported vision difficulty, and clinical diagnosis of blindness or visual impairment) of older adults 65+ in MA, NH, RI, and CT. Data sources used to calculate rates were: the American Community Survey (2014-2018 RI, 2012-2016 MA and NH, 2014-2018 CT) and the Medicare Current Beneficiary Summary File (2016-2017 RI, 2015 MA and NH, 2016-2017 CT). Small area estimation techniques were used to calculate age-sex adjusted community rates for more than 150 health indicators (https://healthyagingdatareports.org/). Disparities in rates were examined for 4 eye and visual health indicators: cataract, glaucoma, self-reported vision difficulty, and clinical diagnosis of blindness or visual impairment. Results showed variability in rates across states. MA had the highest rates of self-reported vision difficulty (5.8%) and blindness or visual impairment (1.5%), and the greatest differences in rates of self-reported vision difficulty (0.00-40.91%). CT had the highest rates of glaucoma (28.3%), and the greatest differences in rates of glaucoma (19.51-41.91%) and blindness or visual impairment (0.44-4.39%). RI had the highest rates of cataract (67.5%). Understanding the distribution of community rates makes disparities evident, and may help practitioners and policymakers to allocate resources to areas of highest need.
Mobilizing Elders: An Interprofessional Effort
Authors: Lynch David , de la Paz Andrew , Lau Carissa , Mournighan Kimberly , Young Kimberly , Dale Maureen , Hanson Laura , Batsis John
Published: December 2021

Older adults often experience functional decline during hospitalization as a result of immobility. Such decline has associated adverse outcomes, including gait instability, falls, pressure injuries, delirium, and new nursing home admissions. Our objective was to create an effective and sustainable in-hospital mobility program through enhanced interdisciplinary cooperation in an Acute Care of the Elderly (ACE) unit. An interdisciplinary team at UNC’s 25-bed ACE unit planned and delivered enhanced patient mobility beginning in July 2020. We used an input-process-output model to design and analyze an intervention based on enhanced collaboration. Inputs included a mobility taskforce which was comprised of physicians, nurses, physical and occupational therapists, and quality improvement specialists. Through regular meetings, each taskforce member contributed to the study design and were empowered to identify barriers to implementation. Outputs included stakeholder engagement and mobility rates. Early results show a doubling in mobility rates over a 6-month period with consistent and enthusiastic stakeholder engagement. Observations of such benefits include: a) stakeholder inclusion from each discipline ensured implementation that was pragmatic and easily incorporated into the daily workflow; b) mobility champions regularly disseminated information to their respective disciplines, leading to changes using a quality improvement process; and c) barriers to implementation were rapidly identified, and mobility champions were motivated to find solutions, allowing cohesive incorporation of a broad spectrum of priorities. An interprofessional team model is effective to mobilize hospitalized older adults, potentially reducing adverse hospital outcomes. Successful implementation of such programs is dependent on interprofessional collaboration.
Persistent Disability Six Months after Initial Disability Less Likely in Older Women
Authors: Shah Raj , Webb Katherine , Ryan Joanne , Wolfe Rory , Ernst Michael , Espinoza Sara , Woods Robyn
Published: December 2021

Many community-dwelling older adults develop activity of daily living (ADL) disability and subsequently regain function. Using data from the ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial, we examined the relationship of gender, incident disability, and persistent disability 6 months after the incident disability. Walking, bathing, dressing, transferring, toileting, and eating were assessed as ADLs, at bi-annual interviews. ADL disability was defined as requiring help with or inability to do or severe difficulty with ≥1 ADL; persistent disability was an ADL loss at 6 months after a first (incident) ADL disability. Discrete time, multivariable Cox proportional hazards regression was utilized to estimate associations with developing incident ADL disability described as cause-specific hazard ratios, with death as a competing outcome. For persons with incident ADL disability, odds of developing persistent disability at 6 months as compared to recovery was determined using multivariable logistic regression. These analyses included 18,414 (51.6% women) ASPREE participants in the United States and Australia aged 70+ years (65+ years if U.S. ethnic minority) without ADL disability at trial entry. During a median follow-up of 4.7 years, 1,485 participants (63.2% women) developed an incident ADL disability, and, of those, 272 (57.0% women) met criteria for persistent disability at 6 months. Women had an increased risk (HR=1.17, 95% CI=1.05 to 1.32) of developing incident ADL disability; however, women were less likely to have persistent disability versus recovery 6 months later (OR=0.66, 95% CI=0.49 to 0.89). Why persistent disability development is lower in older women needs further exploration.
Nursing Home Factors and Their Impact on COVID-19 Cases: A Study of Wisconsin State
Authors: Abahussain Mohammed , Nambisan Priya , Galambos Colleen , Zhang Bo , Bukowy Elizabeth
Published: December 2021

COVID-19 has been devastating for Nursing Homes (NHs). The concentration of older adults with underlying chronic conditions inevitably made the setting highly vulnerable leading to high rates of mortality for residents. However, some nursing homes fared better than others. This study examines several quality measures and organizational factors to understand whether these factors are associated with COVID-19 cases in Wisconsin. We combined three datasets from Centers for Medicare & Medicaid Services (CMS) – the Star Rating dataset, Provider Information dataset and COVID-19 Nursing Home dataset. Data used is from the period of Jan 1 – Oct 25, 2020 for the state of Wisconsin. The analysis includes 331 free-standing NHs with no missing values from the data sets. The variables used were self-reported information on nursing home ratings, staff shortage, staff reported hours, occupancy rate, number of beds and ownership. Of the 331 NHs examined, shortages were reported of 25.4%, 31.1%, 3.2% and 15.6% of licensed nurse staff (25.4%), nurse aides (31.1%), clinical staff, (3.2%) and other staff (15.6%) Additionally, there was a significant (p<.05) positive correlation between number of beds and COVID-19 cases, and there was no statistically significant association between occupancy rate and COVID-19 cases. NHs with better star ratings were also found to have less COVID-19 cases. Interestingly, private NHs had significantly higher COVID-19 cases than for-profit and government owned NHs, a finding that is congruent with other studies in this area. Recommendations for practice will be discussed.
"It is the scourge of God" Misconceptions of COVID 19 Pandemic Among Older Market Traders In Ibadan, Nigeria
Authors: Omobowale Olubukola , Fowotade Adeola
Published: December 2021

Abstract Background: Community perception on COVID-19 can influence the development of the right attitude towards mitigating the spread of the Sars CoV 2 virus. Older adults are at risk of severe infections and mortality is high among them. Objectives: This study was conducted to document the knowledge, perceptions and misconceptions of COVID-19 among older market traders in Ibadan, Oyo State, Nigeria. Methods: A cross-sectional study conducted in two densely populated markets in Ibadan. An interviewer-administered semi-structured questionnaire was used to collect data on the knowledge and perception of COVID-19. Data were analyzed using SPSS version 23. Level of significance was set at p<0.05. Results: A total of 321 respondents were sampled. All participants were aware, source was mainly through radio (93.5%), and 65.8% believed COVID-19 was as a scourge from God for punishments of sins. Only 41.1% had good knowledge of spread with personal contact (95.3%) mostly reported. On knowledge of symptoms and preventive measures, dry cough (84.7%) and frequent hand washing (95.6%) were mostly reported. Knowledge of cause was significantly associated with age (p=0.04) and marital status (p=0.001), while level of education (p=0.012) was significantly associated with knowledge of spread. Conclusion: Misconceptions about the knowledge of the cause and spread of COVID-19 were prevalent among the study population. The implication of this finding among older adults and the significant effect of some sociodemographic factors on the knowledge of the cause and spread of COVID-19 calls for urgent health-promoting interventions that would dispel the misconceptions.