bluuebunny/crossref_metadata_2025 huggingface dataset:
STRENGTH IN SEEKING SUPPORT: OLDER LATINOS’ ATTITUDES ABOUT CANCER
Authors: Carrion Iraida V , Estapé Tania , Neelamegam Malinee , Roberts Jane , Estapé Jorge
Published: November 2019

Given the growing Latino population 60 years and older, the current lack of relevant data, there is an urgent need to understand their attitudes about cancer to ensure effective prevention, intervention, and psycho-social care. A survey exploring attitudes about cancer was developed and administered in Spanish. Using convenience sampling (N = 168), univariate analysis was done to understand the study population’s characteristics. Frequencies were assessed to understand participants’ responses to questions on cancer-related attitudes. The effects of age, country of origin, length of stay in the U.S., and marital status were assessed using logistic regression. The participants had a mean age of 67.9 years, 65.5% were female, 56.5% were married or living with a partner, and 35.5% had tertiary education. Most respondents were from South America (46.7%), with a mean length of stay in the U.S. of 25.8 years. A high number (91.0%) indicated a preference to know if they had cancer, and 87.5% said that they would share their diagnosis with family and friends. Of the respondents, 80.4% felt that cancer patients should receive care from a psychologist and that cancer improves if a patient is lively and positive (82.6%). Compared to college-educated individuals, those with a high school education were less likely to choose to know about a cancer diagnosis (β=-1.92, p<0.01) or share it (β= 1.78, p<0.001). Attitudes about cancer vary depending on the educational level of older Latinos and may impact treatment decisions. These findings can enhance cancer information and education for older Latinos.
THE POWER OF CANCER KNOWLEDGE EXCHANGE AMONG OLDER LATINOS
Authors: Carrion Iraida V , Estapé Tania , Neelamegam Malinee , Roberts Jane , Estapé Jorge
Published: November 2019

Prior studies have indicated that older Latinos/as diagnosed with cancer experience social inequalities and other barriers due to their limited English language proficiency and access to health care (Fernández & Morales, 2007). In addition, for Latinos, a cancer diagnosis magnifies health disparities substantially (Gehlert & Colditz, 2011). Despite the impact of the cancer experience, Latinos manifest meaning-based beliefs and coping strategies in dealing with cancer diagnoses (Carrion, Nedjat-Haiem, Macip-Billbe, Black, 2017). However, little is known about older Latinos’ (60 years and older) transmission of knowledge, beliefs, and attitudes to family members and friends. Understanding older Latinos’ advice regarding cancer is essential, given their role in the transmission of knowledge. This study disseminates the latest qualitative findings on older Latinos/as and explores the perspectives shared with family members and friends by non-cancer participants. It explores the types of knowledge, beliefs, attitudes, and advice older Latinos provide to family members and friends about cancer. The data represent individuals without cancer (n=168) residing in the Greater Tampa Bay area. Latinos manifest meaning-based beliefs and coping strategies that assist in dealing with their cancer diagnoses and access to care. Recruitment occurred in community-based settings, with interviews conducted in Spanish and transcribed into English. Qualitative data were analyzed using a constant comparison method and coded in ATLAS.ti to identify emerging themes, including knowledge that a cancer diagnosis is beyond individual control and is in God’s hands, careful choice of a doctor to ensure proper prevention and treatment, and a positive attitude despite the cancer diagnosis.
MARKERS AND BIOMARKERS OF DEMENTIA BDNF GENOTYPE AND CHANGES IN WHITE MATTER HYPERINTENSITIES AND HIPPOCAMPAL MICROSTRUCTURE IN OLDER MEN AND WOMEN
Authors: Shaaban C Elizabeth , Metti Andrea , Barha Cindy , Yaffe Kristine , Rosano Caterina
Published: November 2019

Brain-derived neurotrophic factor (BDNF) may protect against cerebral gray and white matter impairments in older age. The val66met genetic polymorphism of BDNF is recently emerging as an early marker of brain structural integrity. However, evidence is sparse, cross-sectional, and mostly in men. In a longitudinal cohort study of community-dwelling older adults (N=139, mean age=81.6, 58% female, 58% white, mean follow-up=3.4 years), we estimated the overall and sex-stratified effects of BDNF val66met polymorphism on changes in cognition and gray and white matter macro- and micro-structure. Annualized percent change was computed for volume of white matter (WM) hyperintensities and gray matter (GM), fractional anisotropy of normal appearing WM, and mean diffusivity (MD) of GM in whole brain and memory and executive control function networks. Significant associations were adjusted for variables differing by genotype (race, APOE4, diabetes, triglycerides, smoking). Compared to met carriers, val homozygotes had slower annual whole brain WMH accrual (median (IQR) 31.4% (61.7) vs. 60.7% (92.4)), stronger in women. Met carriers had slower annual accrual of hippocampal MD (median (IQR) 1.26% (0.92) vs. 1.85% (1.09) for right hippocampus, stronger for women, and 1.45% (1.06) vs. 1.97% (1.22) for left hippocampus, stronger for men) compared to val homozygotes. Associations were robust to covariates’ adjustment. BDNF polymorphism was not associated with cognitive changes. BDNF polymorphism may help in early identification of those more likely to resist accrual of WMH and loss of hippocampal microstructural integrity, with effects varying by sex.
SURVIVAL OF PEOPLE WITH CLINICAL DIAGNOSIS OF DEMENTIA IN HONG KONG: A POPULATION-BASED STUDY
Authors: Luo Hao , Chai Yi , Tang Jennifer Y M , Wong Gloria H Y
Published: November 2019

Objectives: Studies on survival of people with clinical diagnosis of dementia can provide estimates of care outcomes of a health system and offer real-life insights on how to provide better support for the target population. This study aims to estimate survival from the point of recorded diagnosis of dementia, compared with people without dementia. Methods: This case-control study used data from Clinical Data Analysis and Reporting System (CDARS), a population-wide databased managed by Hong Kong Hospital Authority. All patients aged 60 years or over with a first-ever code for dementia from 2001 and 2010 (N=24,250) were matched with patients without dementia by sex and index date at a 1: 2 ratio. We adopted Cox proportional hazard model to estimate hazard ratios, with and without adjustment for age, sex, and comorbidities (diabetes, cardiovascular disease, hypertension, cerebrovascular disease, and high cholesterol). Results: A total of 5,847 patients have a diagnosis of Alzheimer’s disease (AD), and 7,729 have vascular dementia (VaD). The median survival time, calculated based on the Kaplan-Meier estimator, for patients with dementia of any kind, AD, and VaD were 1163, 2448, and 1268 days, respectively. Compared with the control group, the raw and adjusted hazard ratios for dementia were 2.78 (95% CI, 2.71-2.84) and 1.14 (1.13-1.17), respectively. Conclusions: Median survival times were much lower than figures reported by other regions and in screened populations. The high risk of death may be an indicator of late diagnosis and hence call for promoting early diagnosis to ensure timely intervention.
COLLEGE COMPLETION AS A PROTECTIVE FACTOR FOR LATER-LIFE COGNITION: ISSUES OF SELECTION
Authors: Greenfield Emily , Akincigil Ayse , Moorman Sara
Published: November 2019

Additional years of education is considered a modifiable protective factor against Alzheimer’s disease and related dementias. However, some empirical studies have suggested that linkages between educational attainment and later life cognition are largely a function of differential selection into higher education. Our study uses data from the Wisconsin Longitudinal Study, as one of the longest-running cohort studies in the U.S., to further probe how differential selection into higher education might influence associations between college completion and later life cognition. Using adjusted inverse probability weighting and with particular attention to adolescent IQ, we find evidence that college completion is associated with better language for both men and women at age 65, as well as with better memory for men. Examining heterogeneous treatment effects, we further find that associations between college completion and later life cognition are strongest for men who were least likely as adolescents to attend college.
CARING FOR OLDER INDIGENOUS PEOPLE WITH CO-MORBIDITIES AT END OF LIFE
Authors: Mason Kathleen R , Moeke-Maxwell Tess H , Gott Merryn
Published: November 2019

The number of deaths among older Māori, the indigenous people of New Zealand, are expected to increase by 48% by 2030. Colonization has had a varied impact on Māori ways of being and end-of-life care has become more difficult. Many have become disenfranchised from their families, peoples, lands and culture. Pae Herenga, a for-Māori by-Māori with-Māori qualitative research project, investigated the traditional Māori end-of-life care customs that Māori families used while caring for someone who was dying. An online education resource was developed to support Māori families, their communities and the palliative care sector. Interviews were conducted with 60 Māori participants including older many people (aged over 70). The findings found that families rich in cultural knowledge were proficient in caring for a loved one at end-of-life irrespective of their social or economic position. Cultural care values such as unconditional love, companionship, reciprocity, supportive relationships and collective decision making safeguarded care preferences of the dying. Access to traditional knowledge and traditional healing practices, and an understanding of spirituality helped to strengthen and prepare the dying person, and their families, on the end-of-life journey. The study also found that those families connected to communities’ rich in Māori cultural resources, such as knowledgeable older Māori people, were well supported by the community at end-of-life. This study highlights that Māori use of traditional care customs in all care settings can better support a ‘good death’ from a cultural perspective.
STYLE AND SUBSTANCE: A QUALITATIVE CHARACTERIZATION OF DEMENTIA CAREGIVING MANAGEMENT STYLES
Authors: Leggett Amanda N , Bugajski Benjamin , Webster Breanna , Broderick Brianna , Watkins Daphne , Gitlin Laura , Kales Helen C
Published: November 2019

Caring for a person living with dementia (PLWD) can take a physical and emotional toll, but understudied is the process of how family caregivers actually provide care (caregiver management styles). We interviewed 100 primary family caregivers regarding management of a recently experienced care challenge and values held which might impact care management decisions. Watkins’ (2017) rigorous and accelerated data reduction (RADaR) technique was used to analyze qualitative data through open/focused coding, determining commonalities of style components/themes, and finally defining caregiving management styles. Style for a given caregiver emerged from enacted care strategies, caregiver’s internal stances which informed their use of strategies, and broader engagement (or lack thereof) with the PLWD’s lived experience/reality. Styles emerging from the analysis will be described including the direct, rigid “Just do it” style, and the flexible, empathic “Teamwork” style. Individualizing caregiver interventions and supports based on caregiver management style is an important future direction.
TAKING A BREAK: DAILY RESPITE EFFECTS OF ADULT DAY SERVICE AS ACTUAL TIME AWAY FROM CAREGIVING
Authors: Wylie Molly J , Kim Kyungmin , Liu Yin , Zarit Steven H
Published: November 2019

Adult day service (ADS) can provide emotional and physical relief for caregivers of persons with dementia (PWD). Studies have examined differences between caregivers of service users and non-users; less known, however, is how actual hours away from caregiving responsibilities through using ADS impact caregivers’ daily outcomes. Using daily diary data from 173 family caregivers whose relatives are using ADS (day N = 1,359), this study investigated within-person differences in respite hours across 8 consecutive days and how daily respite hours are associated with daily well-being (i.e., mood and health symptoms). On average, caregivers reported 7.12 respite hours on ADS days and 1.74 respite hours on non-ADS days. Multilevel models revealed that having more respite hours is associated with better positive mood, but not with negative mood and health symptoms – after controlling for ADS use. Further, when caregivers perceived more break time from caregiving responsibilities, they showed better positive mood.
GROWING UP ON A FARM AND COGNITIVE FUNCTIONING IN LATER LIFE
Authors: Herd Pamela , Asthana Sanjay , Sicinski Kamil
Published: November 2019

There is growing interest in rural disadvantage and the implications for health and well-being in later life. We examine the relationship between living in rural areas in childhood and cognitive outcomes later in life using the Wisconsin Longitudinal Study. The WLS has prospective childhood measures of geographic status, adolescent IQ, and detailed measures of socioeconomic status, combined with later life measures of health and cognitive functioning. We find a robust relationship between rurality and lower levels of cognitive functioning, but it is explained by growing up on a farm.
THE POWER OF REVIEWS: HARNESSING RESEARCH ON COGNITIVE HEALTH
Authors: Quinn Kelly , Friedman Daniela B
Published: November 2019

Networks harness powerful resources to tackle complex challenges. This symposium leverages the power of one such network to advance research in cognitive health. Using literature reviews, we seek to aid in the translation of knowledge on cognitive aging and health into practice. By documenting research successes and identifying gaps, we highlight areas in which important lines of research can be propelled forward. The papers together focus on three dynamics of research practice: communication among researchers, commonly-used research tools, and the need to develop valid and reliable measures. The first paper examines nomenclature that scientists use to describe cognitive health in their research reporting, and makes recommendations for alignment of important concepts. The second and third papers explore commonly-used tools in intervention research: one on the use of psychosocial assessments typically employed with individuals with ADRD, such as for depression and quality of life, and the other on tools used by educational and intervention programs to evaluate caregiver knowledge of dementia. Each paper suggests that consistent measurement practices would enhance interpretation of findings across studies. The final paper considers a promising research area, walkable neighborhoods and cognitive health, and argues for the importance of developing valid and reliable measures in emerging research. Taken together, these papers provide critical reflection on current practices in cognitive aging research and suggest directions in which to build future investigation. In addition, this collection of papers fulfills the clarion call of The Healthy Brain Roadmap for finding ways to improve the cognitive health of all adults.
TERMS AND MEASURES OF COGNITIVE AGING AND COGNITIVE HEALTH: A SCOPING REVIEW
Authors: Miyawaki Christina E , Quinn Kelly , Croff Raina , Vogel Mia T , Belza Basia , Souza Anita M , Liu Minhui , Edwards Valerie J
Published: November 2019

The Healthy Brain Initiative: National Public Health Road Map to Maintaining Cognitive Health (2007) called on the research community to more widely disseminate its work on cognitive aging and cognitive health. However, communication beyond individual disciplines is complex. We identified terminology that social scientists use to describe cognitive aging and cognitive health among older adults, demonstrated how such terms are defined, and illustrated how these constructs are being measured. We searched terms such as Alzheimer* and dementia in studies between 2007 and 2018 (n=209). Geriatrics (n=95), neurology (n=81), psychiatry (n=65), and psychology (n=30) were most common disciplines; however, there was no consistency in how terms were used within and across disciplines. A detailed review of “cognitive impairment” and “mild cognitive impairment” demonstrated that formal definitions were provided infrequently and measurement of constructs ranged widely. The variability in terminology, definitions and measures reflects a need for greater specificity in research communication.
OUTCOMES MEASUREMENT IN EARLY-STAGE MEMORY LOSS INTERVENTIONS: A SCOPING REVIEW
Authors: Souza Anita Marie , Kim Boeun , Miyawaki Christina , Belza Basia , Lee Mee Kyung , Vogel Mia , Chu Frances , Su Yan
Published: November 2019

Psychosocial and psychoeducational groups are widely recommended for individuals with early stage Alzheimer’s disease and related dementias (ADRD). However, measurement challenges have hindered researchers’ efforts to demonstrate the efficacy of these groups. The purpose of this scoping review was to identify common measurement tools used in interventions for individuals with early stage ADRD and to develop suggestions for future investigations. CINAHL, Embase, PsycINFO, and PubMed were searched; 102 studies were reviewed. Inclusion criteria were set to capture intervention studies that utilized quantifiable measures with participants over age 50. Eleven articles met inclusion criteria. The majority of studies (73%) employed randomized controlled trial designs. Sample sizes ranged from N=20-236. Most commonly measured outcomes included depression, self-efficacy, self-esteem, and quality of life, but there was little consensus on how to best measure these outcomes. Standardization of psychosocial assessment tools are needed for future intervention studies with early stage ADRD.
USING HEALTH INFORMATION FROM AFFORDABLE WEARABLE DEVICES FOR PREDICTING IMPENDING TIPPING POINTS
Authors: Liu Jian , Heasley Beverly , Crist Janice D , Shea kimberly D , Plank Lorraine M Martin , Phillips Linda R , Peterson Rachel L
Published: November 2019

It is desirable to assess older adults’ health status from their routine activities, identify tipping points based on quantitative metrics, and evaluate the potential risks. Such assessments based on infrequently measured, traditional physical performance instruments fall short of sensitivity as well as reliability. In this research, we investigate multiple types of data collected continuously from older adults wearing fitness watches, which are equipped with various wearable wireless sensors. We develop a methodology to fuse the information from multivariate data streams and define a new synthesized metric to detect significant physiological transitions that lead to tipping points. Both sensitivity- and robustness-analysis are conducted to evaluate the risks of miss-detection and false alarm. The detection results are cross-validated by the self-reported data from daily diaries and questionnaires.
CREATING A PORTAL PLUS
Authors: Phillips Linda R , Heasley Beverly , Crist Janice , Lacasse Cheryl , Martin-Plank Lorraine , liu jian
Published: November 2019

Patient portals are popular health care tools. Few portals target caregiving families and few use predictive modeling to assist caregiving families make decisions about elder care options. Our goal is to incorporate the algorithms being developed for predicting tipping points in elder care to assist caregiving families visualize changes in older adults’ activity patterns, understand possible implications for continued in-home safety, and access educational information and consultation. While many patients use portals, use is restricted among persons in racial and ethnic minorities, with lower educational levels and poorer health literacy, and with fewer economic resources. The following strategies help us address these issues. Our portal archives data from affordable, wearable technology. Portal access uses similarly technology. Our educational materials use techniques known to be appealing and effective with older individuals in unique groups, e.g., results displays; fotonovelas. Input from community members/users helps maintain sensitivity to cultural appropriateness and health literacy.
THE SIGNIFICANCE OF IDENTIFYING A TIPPING POINT
Authors: Martin-Plank Lorraine , Martin-Plank Lori , Heasley Beverly , Lacasse Cheryl L , Phillips Linda R , Liu Jian
Published: November 2019

Defining a Tipping Point as seemingly abrupt, severe, and absolute vividly illustrates the end result of the consequence of not responding to impending events. Failure to detect an impending tipping point can result in unplanned consequences including falls, fractures, emergency care, a change in family caregiving situation, and a cascade of events leading to devastating permanent changes in chosen living arrangements or even death to the aging adult and the family caregiver. Proactive monitoring with a wearable device that can detect subtle changes in daily routines is a valuable tool, which caregiving families can use for decision support in accessing long term support services or planning for change in environment or level of care. Using this definition of tipping points and describing early changes can also be a valuable tool for clinicians when communicating potentially dangerous situations to the older adult and caregivers in the home or senior residential setting.
TURNING THE TIDE: PROMISING INITIATIVES IN GEROPSYCHOLOGY TRAINING AND RECRUITMENT
Authors: King Katherine
Published: November 2019

The field of geropsychology continues to attract insufficient numbers, and there is a growing sense of urgency among geropsychologists to turn the tide. As a result, a number of new research and programmatic initiatives have been started to better understand the problem and begin to generate solutions. This symposium will report on several such projects, including work from a number of early career geropsychologists. In this symposium, novel theoretical and pedagogical approaches to geropsychology training will be discussed. Graham explores how individuals develop an intention to work with older adults, and describes a new scale grounded in the theory of planned behavior. Dodson and Mlinac discuss bringing quality improvement into geropsychology training at all levels, while King, Rosowsky, and Jolson report on an experiential, intergenerational volunteer program used to demystify work with older adults and facilitate recruitment. Several presentations include the voices of students themselves. King, Rosowsky, and Jolson describe graduate student reactions to volunteering with older adults such as having previous negative beliefs about aging challenged. Bloom-Charette explores the experiences of geropsychology internship applicants, who tend to fare better than generalist applicants and feel well supported. Strong focuses on the problem of attracting individuals into academic geropsychology. In looking at participant responses to a recent webinar series on the topic, it is notable that a large number felt intimidated and overwhelmed by the prospect of entering academia. Taken together, projects in this symposium offer a variety of new directions for future geropsychology research, recruitment, and educational initiatives.
DEATH OF A GRANDPARENT IN ADULTHOOD: GENDER, GRIEF, AND THE ROLE OF MIDDLE-GENERATION PARENTS
Authors: Stokes Jeffrey E , Kim Kyungmin , Fingerman Karen L
Published: November 2019

Although the death of a grandparent in adulthood is often an expected or “on-time” life event, this loss may still result in grief for adult grandchildren. Structural aspects of relationships, including gender of the grandparent, adult grandchild, and/or middle-generation parent, may affect the response such a loss elicits from adult grandchildren. Further, adult grandchildren’s relationship quality and/or coresidence with middle-generation parents may also impact the effect of grandparent loss on adult grandchildren’s grief. Using data from Wave 2 of the Family Exchanges Study (2013), we found that (a) grandsons report less grief than granddaughters, irrespective of grandparents’ or middle-generation parents’ gender; (b) relationship quality with and worry about middle-generation parents matter most for granddaughters and those who lost a maternal grandparent; and (c) worry about middle-generation parents matters most for bereaved grandchildren who coreside with middle-generation parents. Results highlight the intersection of gender and relationship quality in a multigenerational context.
ETHNICITY, DEPRESSION, AND FUNCTIONAL OUTCOMES IN OLDER WOMEN
Authors: Germain Cassandra M
Published: November 2019

Women continue to have higher prevalence rates of functional impairment and depressive symptoms than men. In addition, women from certain ethnic groups experience disproportionately higher rates of ADL limitation, and are less likely to be screened for depression. The current study examines the association between race/ethnicity and depressive symptoms on functional limitations in Black, White and Hispanic women. We examined prevalence and adjusted odds of ADL limitations by race in n=9,846 women aged 50+ with low (CESD <4) and high (CESD =>4) depressive symptoms from the 2014 wave of the Health and Retirement Study. Overall, Black and Hispanic women had significantly higher rates of depression (p <.001) and ADL limitations (p<.001) than White women. Among those with high depressive symptoms, Black OR 1.98 [1.17, 3.34] and Hispanic OR 2.82 [1.42, 5.6] women have significantly higher rates of ADL limitations as compared to White women.
DISPARITIES OF DENTAL CARE UTILIZATION AMONG WHITE, BLACK, HISPANIC, AND ASIAN FROM 2002 TO 2016
Authors: Wu Yanyan , Zhang Wei , Wu Bei
Published: November 2019

Utilizing eight waves (2002-2016) of data from the Behavioral Risk Factor Surveillance System (BRFSS), this study examines the disparities and trend of dental care utilization among dentate adults aged 50 years or older in the U.S. Findings reveal that there was a significant increase of dental care utilization among Asians and Blacks in older adults. The rates increased from 73% (95%CI: 69%-78%) to 81% (95%CI: 79%-84%) and 54% (95%CI: 52%-56%) to 60% (95%CI: 69%-62%) for Asians and Blacks respectively in the 75-79 age-group. Early in 2002, there was a linear decreasing pattern of dental care utilization with age. However, the 65-69 age-group became a turning point in 2018 with a lower rate of dental care utilization before 65-69 years of age and higher rate in the older age groups. Overall, Hispanics and Blacks had much lower rates of dental care utilization than that of Whites and Asians.
ENHANCING ACCESS AND QUALITY OF RURAL VETERANS’ CARE THROUGH TELEMEDICINE IMPLEMENTATION
Authors: Seaman Aaron T , Solimeo Samantha , Bair Byron
Published: November 2019

Telemedicine, a promising approach for clinicians to provide care to patients who are unable to attend face-to-face encounters, has been embraced by the Veterans Health Administration to improve the delivery of specialty care to rural Veterans and their caregivers. Presenters in this symposium report on the potential and challenges of telemedicine in a variety of specialty care contexts. Stakeholder (Veteran, caregiver, and provider) perspectives are discussed. Hung et al.’s study examines the implementation of a teleconsultation intervention designed to connect geriatric teams with rural clinics, reporting on both patient outcomes and the challenges of implementation variability that teams encountered. Solimeo, et al.’s qualitative study of primary care providers’ experience of an osteoporosis telemedicine clinic’s outreach and care delivery demonstrates stakeholder acceptance as well as potential missed opportunities for patient and provider education. Findings from Nichols and Martindale-Adams’ mixed methods evaluation of a telephone intervention to assist caregivers of older, rural-dwelling Veterans demonstrate the impact the intervention has had on participants’ perceptions of and abilities to care for their family members and themselves. Hicken et al. present on the implementation of a videoconferencing intervention to provide in-home support to rural Veterans and their caregivers, reporting on both provider and patient/caregiver experiences of the intervention and its implementation. The four studies highlight the unique ways telemedicine can improve care and the necessity of including stakeholder perspectives across the implementation process.
ACCELERATED CHILDHOOD SKELETAL AGING IS PROTECTIVE OF DEVELOPMENT OF SARCOPENIA IN LATER LIFE
Authors: Peterson Matthew J , Froehle Andrew W
Published: November 2019

Sarcopenia is an age-related loss of muscle mass and strength that has a multitude of adverse sequelae. Similar to other aging-related phenomenon, sarcopenia is likely the product of inputs that begin in utero and continue throughout the lifespan. We hypothesized that patterns of childhood skeletal growth predict sarcopenia status later in life. Data are from N=202 lifelong participants of the Fels Longitudinal Study (median lifetime visits=33). At the sarcopenia measure visit, participants were aged 65.8 + 10.3 years, 54% female, with body mass index of 27.5 + 4.9. Sarcopenia was defined using published sex-specific cutpoints from dual energy x-ray absorptiometry quantified appendicular lean mass/height2. Childhood skeletal age was calculated from serial hand-wrist radiographs (FELS method). Residual skeletal aging (RSA) was calculated as skeletal age minus predicted chronological age at peak height growth velocity during adolescence. RSA variance was similar in both sexes, with a range of -2 (delayed skeletal aging) to +2 years (accelerated skeletal aging). In older age, 6% of males and 22% of females exhibited sarcopenia. In multivariate logistic regression models controlling for age, self-reported physical activity, and grip strength (all measured at sarcopenia visit), accelerated RSA was protective of sarcopenia (Adjusted OR=0.58; 95% CI: 0.35-0.94). This is the first study to link childhood skeletal maturation to sarcopenia later in life. Biological pathways that explain this association likely include physiological, environmental, and genetic factors that facilitate communication between bone and muscle, and span the life course. Determining their influence is the next important step in this work.
HOW DO MENTAL HEALTH TRANSITIONS SHAPE THE ROLE OF ADULT CHILDREN IN OLDER ADULTS’ SOCIAL NETWORKS?
Authors: Upenieks Laura
Published: November 2019

This study considers the role of adult children in the core networks of older adults undergoing mental health change. Taking a multidimensional perspective of the network system, I consider (a) presence of child(ren), (b) contact with children network members, and (c) embeddedness of children within the network using longitudinal data from the United States. Parameters were estimated with generalized estimating equations from the pooled panel data. There was no evidence that mental health transitions lead to systematic forms of child reshuffling or increased contact with child ties. Children that remained in networks, however, showed increased contact with other members of the network when the parent underwent depression onset, but became less embedded when their parents had chronically high levels of depression. These patterns may have far-reaching consequences for older people and their children, which could include increased feelings of loneliness and social isolation for parent and child alike.
GENOME-WIDE LINKAGE ANALYSIS IDENTIFIES A NOVEL LOCUS FOR LONGITUDINAL GAIT SPEED CHANGE WITH AGING
Authors: Santanasto Adam J , Wojczynski Mary K , Cvejkus Ryan K , Thyagarajan Bharat , Christensen Kaare , Schupf Nicole , An Ping , Zmuda Joseph M
Published: November 2019

Gait speed is an indicator of health and function with aging. The potential genetic contributions to gait speed and its decline with aging are not well characterized. We sought to better quantify the genetic contributions to and identify potential genes and genetic variants underlying change in gait speed among older adults. To accomplish these aims, we used data from 2379 individuals belonging to 509 families in the Long Life Family Study (mean age 64 ± 12, range 30–110 years; 45% men). Gait-speed was measured over 4 meters at baseline and after an average of 7±1.1 years. Quantitative trait linkage analyses were completed using pedigree-based maximum-likelihood methods with logarithm of the odds (LOD) scores > 3.3 indicating genome-wide significance. We also performed linkage analysis in the top 10% of families contributing to LOD scores to allow for heterogeneity among families (HLOD). Data were adjusted for age, sex, height and field center. At baseline, 26.9% of individuals had “low” gait-speed <1.0 m/s (mean: 1.1±0.2 m/s) and gait speed declined at a rate of -0.02±0.03 m/s per year (p<0.0001). Baseline and change in gait-speed were significantly heritable (h2 = 0.24-0.32, p<0.05). We did not find significant evidence for linkage for baseline gait speed; however, we identified a potentially novel locus for change in gait speed on chromosome 16p (LOD 4.2). A subset of 21 families contributed to this linkage peak (HLOD = 6.83). Sequence analysis of the chromosome 16 region may yield new insight on the biology of age-related mobility decline.
TWELVE-YEAR CLINICAL TRAJECTORIES OF MULTIMORBIDITY IN OLDER ADULTS: A POPULATION-BASED STUDY
Authors: Vetrano Davide Liborio , Roso-Llorach Albert , Fernández Sergio , Violán Concepción , Onder Graziano , Fratiglioni Laura , Calderon-Larranaga Amaia , Marengoni Alessandra
Published: November 2019

The scarce knowledge of multimorbidity development hampers the effectiveness of clinical interventions. We aimed to identify multimorbidity clusters, trace their evolution in a cohort of older adults, and detect the clinical trajectories of single individuals as they move among clusters over 12 years. Population-based study including 2931 persons 60+ with ≥2 diseases participating in the SNAC-K study. A fuzzy c-means cluster algorithm was used to group participants by disease patterns at baseline and follow-ups. Migration from one cluster to another was tracked over time, and the association between the clusters and mortality was tested. At baseline 52% of participants were classified into five clinically meaningful disease clusters: psychiatric and respiratory (5%), heart (9%), respiratory and musculoskeletal (16%), cognitive and sensory impairment (10%), and eye diseases and cancer (11%). The remaining 48% of participants (unspecified group) were grouped in any cluster at baseline but greatly contributed to the other clusters at follow-ups. Multimorbidity clusters that included cardiovascular and neuropsychiatric diseases presented a significantly higher mortality risk (odds ratios ranging 1.58–6.00) than the group not part of any clusters. Clusters characterized by cardiovascular and neuropsychiatric diseases included 25% of the study population at baseline and 28% of participants at six years, and they accounted for 51% of deaths at six years and 57% of deaths at twelve years. Multimorbidity clusters and clinical trajectories of older adults with multimorbidity show great dynamism over time. The multimorbidity clusters and trajectories identified in this study may help identifying groups with similar needs and prognosis.
RELATIONSHIP OF CARDIOPULMONARY EXERCISE TESTING AND FIELD WALKING TESTS IN MILD-MODERATE ALZHEIMER’S DEMENTIA
Authors: Salisbury Dereck L , Yu Fang
Published: November 2019

The purpose of this study was to investigate relationships among peak exercise parameters on 6-minute walk (6MWT) and shuttle walk tests (SWT), and laboratory-based cardiopulmonary exercise testing (CPET). These relationships have been established in cardiopulmonary patient populations, but not in community-dwelling older adults with mild-moderate Alzheimer’s dementia (AD). This study is a cross-sectional analysis of the baseline data of 6MWT, SWT, and CPET from the FIT-AD Trial (n=88: 49 males [76.6 {7.0} years and MMSE 21.5{3.5}] and 39 females [77.3 {6.5} years and MMSE 22.1 {3.4}]). Peak values for each test included heart rate (HR), systolic blood pressure (SBP), and rating of perceived exertion (RPE). Peak oxygen assumption (VO2) was measured in the CPET. Peak walking distance (PWD) was measured for the 6MWT and SWT. CPET produced significantly higher peak HR (118.7 [17.5] vs. 106 [22.8] vs. 106 [18.8] bpm), RPE (16 [2.1] vs. 12 [2.3] vs. 11 [2.1]) and SBP (182 [23.7] vs. 156 [18.9] vs. 150 [16.9] mmHg) compared to the SWT and 6MWT respectively. PWD on SWT (240.4 [128.1] m) and 6MWT (364.3 [108.5] m) significantly correlated with peak VO2 (17.0 [4.3]ml/kg/min) on CPET (r=.44 and r=.43) respectively. Correlations of peak VO2 and PWD on SWT in persons with AD are considerably lower than what is seen for persons with cardiopulmonary diseases. This lower correlation seen in our sample may be due to shorter PWD on walking tests. Future research should focus how mobility affects correlation of peak values on these tests.
SUPPORTING FAMILY CAREGIVERS THROUGH PATIENT TRANSITIONS FROM HOSPITAL TO HOME: THE CARE ACT AND BEYOND
Authors: Griffin Joan M , Holland Diane , Bangerter Lauren R , Ingram Cory , Wild Ellen , Taylor Erin , Gentes Rachel , Vanderboom Catherine
Published: November 2019

To date, nearly 40 U.S. states have passed the Caregiver Advise Record and Enable (CARE) Act to support family caregivers during transitions from hospital to home. These laws require hospitals to: 1) record designated family caregivers’ name in a patient medical records during a hospital stay; 2) inform the caregiver when the patient will be discharged; 3) provide education and instructions on care tasks needed for post-hospital discharge. Transitions from hospital to home are often fraught with adverse event risk and poor continuity of care, especially for rural patients with progressive life-limiting conditions. The CARE ACT has potential to address healthcare system factors that are sometimes attributable to poor transitions in care. Our presentation focuses on preliminary findings from an intervention that provides teaching, guidance, and counseling to caregivers caring for an individual receiving palliative care in the hospital and transitioning home to a rural setting. Findings suggest that the CARE ACT may be vital, but not fully sufficient, for successful transitions. Additional targets for caregiver interventions to improve transitions for this subset of very ill patients include: 1) attend to caregivers’ medical and non-medical needs which may impact their capacity to provide care; 2) advise clinical teams to communicate truthfully about prognosis and likely outcomes when creating post-hospital plans of care; 3) encourage caregivers to identify and engage services early in the transition; 4) urge caregivers to draw on multiple sources for social support. Findings can help optimize the CARE Act implementation, particularly in states with large rural populations.
ADDRESSING OLDER ADULT SOCIAL ISOLATION AND ABUSE THROUGH RURAL OUTREACH AND INTER-ORGANIZATIONAL COLLABORATION
Authors: Meinertz Naomi R , Gilligan Megan , Lee Jeongeun , Peitz Louise
Published: November 2019

Elder abuse is commonly linked with social isolation and in a rural state, such as Iowa, older adults may be at increased risk of social isolation and elder abuse. A community-based needs assessment aimed to record the first-hand perspectives of service providers regarding the needs of older adults in rural areas across the state of Iowa, covering 54 of the 99 counties. Through a survey (N=202) and focus groups (N=24), service providers, including direct care, Area Agencies on Aging, law enforcement, and attorneys, offered ways in which to address the gaps in service provision and prevention of elder abuse. Based on survey and focus groups, suggestions included ways to decrease social isolation among older adults by improving service outreach, provider training, and inter-organization communication. Discussion will outline gaps in service outreach and address future inter-organizational collaboration and strategies to prevent social isolation and elder abuse in rural communities.
THE TRANSFORMATION OF LATE-LIFE SINGLEHOOD: EMERGENCE OF THE SOCIETY OF DIVORCEES
Authors: Bildtgard Torbjorn , Öberg Peter
Published: November 2019

More than four decades ago Lopata coined the concept “society of widows” to describe the gendered reality of late life singlehood, where widowed women were excluded from coupled social life and had to depend on other widows for social integration. We have coined the concept “society of divorcees” to describe the changing reality of late life singlehood. Swedish, American and EU census data and a national survey to Swedes 60-90 years old (n=1225; response rate 42%). Results show that more people enter later life as divorcees or become divorced at a high age. Among Swedes 60+ divorcees outnumber widowed people, and the incidence of late life divorce has more than doubled since the millennium in what has been called the grey divorce revolution. Many other Western countries follow the same demographic trend, posing important questions about late life singlehood. Based on two Swedish studies we will show that the structure of the late life single community is becoming less gender skewed as a consequence of the emerging society of divorcees, and that in this society relationship careers are increasingly complex, attitudes to repartnering increasingly liberal and partner sanctification seldom an issue. We conclude by discussing the consequences of the emerging society of divorcees for late life support structures.
MULTIPLE FACTORS INFLUENCING SUCCESSFUL AGING
Authors: Fuller Heather
Published: November 2019

Empirically-based theories on successful aging have emphasized the multidimensional nature of aging well, including physical health and functioning, cognitive and emotional well-being, and social connectedness and engagement (e.g., Rowe & Kahn, 1987, Depp & Jeste, 2006). Yet, the field is still continuing to discover, deeply characterize, and better understand the biopsychosocial mechanisms through which varying social, physical, or cognitive activities may influence unique domains of successful aging. The current symposium builds on this growing body of research by addressing factors supporting successful aging across multiple dimensions of well-being and among a diversity of samples ranging from urban to rural, West Coast to Midwest, and community populations to professional athletes. Webster and Antonucci examine the links between social engagement and successful aging among affordable senior housing residents. They found that more frequent participation in social activities was associated with increases in life satisfaction over time. Toyama and Fuller examine how social engagement and health affect aging well, finding that older adults’ subjective health plays a more important role than objective health in maintaining social integration over time. Similarly, Turner describes the role of social networks and religiosity for health outcomes among aging NFL athletes. Finally, Casaletto and colleagues examined mechanisms underlying cognitive wellness as an aspect of successful aging. They found that engagement in both physical and cognitive activities independently support brain health and cognitive reserve in late-life. Taken together, these presentations provide a diverse and broad perspective on how varying factors influence the multiple dimensions of successful aging.
RELIGIOUS ATTENDANCE, SOCIAL SUPPORT, AND SELF-RATED HEALTH IN FORMER NATIONAL FOOTBALL LEAGUE ATHLETES
Authors: II Robert W Turner , Turner Robert , Sonnega Amanda , Cupery Tim , Bush Evelyn , Rosales Teri , Jackson James S
Published: November 2019

Concern exists about the health and well-being of football players, yet little research exists on the psychosocial risk and protective factors of NFL athletes’ well-being. This study assesses the role of religious attendance, social support, and self-rated health in former NFL athletes. Data comes from a stratified, random sample of 1,063 former NFL players. A set of nested linear regression models evaluated the relationship between self-rated health status and two indices of social support (family and friends) and attendance at religious services. Frequent attendance at religious services (β=0.19, p<.01), support from family (β=0.06, p<.05), and support from friends (β=0.06, p<.01) are positively and significantly related to better self-rated health. The ability to get out of the house did not affect these associations. However, the pain symptoms index fully accounted for any positive effect of family support and religious attendance in self-rated health.
PHYSICAL VERSUS COGNITIVE ACTIVITY FOR SUCCESSFUL AGING: BRAIN MAINTENANCE OR COGNITIVE RESERVE?
Authors: Casaletto Kaitlin , Casaletto Kaitlin B , Pa Judy , Tom Sarah , Arce-Renteria Miguel , Harrati Amal , Armstrong Nicole , Zahodne Laura
Published: November 2019

Mechanisms by which physical (PA) and cognitive (CA) activities promote healthy cognitive aging are unknown. We examined independent contributions of PA and CA to “brain maintenance” (MRI markers of brain integrity) versus “cognitive reserve” (better cognition than predicted by brain integrity) in two independent samples of non-demented older adults (UCSF n=344; UCD n=482). In UCSF, only PA was positively associated with white matter (WM) integrity, while CA attenuated the relationship between WM and cognition. This pattern suggests PA supports brain maintenance, while CA contributes to cognitive reserve. In UCD, CA was positively associated with total gray matter volume; PA was positively associated with age-related WM integrity, and attenuated the association between WM and cognition. This indicates that both PA and CA support brain maintenance, with PA more strongly related to cognitive reserve. There may be preferential, but overlapping pathways by which PA and CA maintain age-related brain and cognitive health.
MULTIMORBIDITY, MENTAL HEALTH, AND TERMINAL DECLINE IN LATER LIFE
Authors: Cadar Dorina , Stirland Lucy , Terrera Graciela Muniz
Published: November 2019

The close interlink between physical and mental health outcomes has long been recognised in gerontological research. Mental-physical comorbidities – the presence of at least one physical health long term condition, and at least one mental health-related long term condition are common in older age individuals. Numerous studies have shown a positive association between the prevalence of multimorbidity and age so, as the population of older individuals in developed nations continues to grow, multimorbidity is likely to become increasingly higher in ageing populations. A major goal in current gerontological neuropsychology and neuroepidemiological research is to better understand how interindividual differences in cognitive and mental health in old age emerge. Cognitive reserve (a marker of brain resilience) may come into play when facing stressors that affect cognitive decline and mental health, such as suffering from chronic diseases. We present data from three different longitudinal studies of ageing i) the Lothian Birth Cohort of 1921, ii) PREVENT and iii) the English Longitudinal Study of Ageing from the United Kingdom. These studies are ideally placed to address key research questions related to mental ageing, psychological health, terminal decline and their determinants. We explored the following objectives: 1) to investigate the association between an increasing number of chronic physical conditions, medication and mental disorders 2) to assess the role of childhood intelligence and education on the terminal decline in later life 3) to investigate the associations between different markers of cognitive reserve and dementia