bluuebunny/crossref_metadata_2025 huggingface dataset:
PILOT RESULTS OF A GAMIFIED TRAINING FOR CERTIFIED NURSING ASSISTANTS ON AGE-FRIENDLY HEALTHCARE
Authors: Wihry David , Wehry Susan , Hunt Angela , Metcalf Judith , Spofford Victoria
Published: January 2025

Certified Nursing Assistants (CNAs) are an integral part of supporting the health and wellbeing of older adults within long-term care (LTC) settings. As the Age-Friendly Healthcare movement expands to include LTC, it will be important to ensure effective and accessible training for CNAs on Age-Friendly Healthcare competencies. This poster will present the results of a pilot study examining the usability and satisfaction with an app-based training on the 4Ms of Age-Friendly Healthcare (What Matters, Medication, Mentation, Mobility). The modules are tailored to the practice needs of CNAs and use principles of gaming to increase uptake of the training. A post training survey was distributed to 127 CNAs from eight LTC communities who completed the curriculum, with a 79% response rate. 78% agreed they would prefer to learn this way versus alternative learning methods such as online learning, classroom learning, etc. (12% neither agreed nor disagreed, 10% disagreed). 85% agreed that they believe gamification is a successful delivery method for learning (8% neither agreed nor disagreed, 7% disagreed). 80% agreed that they would recommend the training program to their co-workers (13% neither agreed nor disagreed, 7% disagreed). The number of participants stating that they had a “very good” level of knowledge of Age-Friendly Healthcare increased from 25% to 39% using a retrospective pre-post rating. Qualitative feedback highlighted interactivity, brevity, and ability to engage the individual as key themes about the value of the training modules. Implications for use of gamification in Age-Friendly Healthcare training will be presented.
PREDICTING ALL-CAUSE MORTALITY USING THE SARCOPENIA PHENOTYPE: EVIDENCE FROM THE KFACS
Authors: Kim Miji , Shin Hyung Eun , Lee Daehyun , Jung Heeeun , Jang Jae Young , Cho Hyunjin , Lim Nahyun , Won Chang Won
Published: January 2025

The Global Leadership Initiative on Sarcopenia (GLIS) has sought to establish a consensus on sarcopenia diagnosis, which involves reduced muscle mass and strength. We investigated the association between sarcopenia phenotypes (low muscle mass, muscle strength, and physical performance) and all-cause mortality. We conducted a prospective 6-year follow-up analysis of 2,400 older adults (52.8% women; mean age 76.0±3.9 years) enrolled in the Korean Frailty and Aging Cohort Study. Participants were included if they had undergone dual-energy X-ray absorptiometry, handgrip strength testing, and physical performance assessments at baseline (2016–2017). Discrete-time Cox proportional hazards models evaluated the association between sarcopenia and all-cause mortality. According to the GLIS criteria, the prevalence of sarcopenia was 15.4% in men and 7.5% in women. Totally, 203 deaths occurred, with 6-year mortality rates of 2.1 (95% confidence interval [CI]: 1.9–2.5) per 100 person-years in individuals without sarcopenia, and 4.8 per 100 person-years (95% CI: 3.6–6.3) in those with sarcopenia. After adjusting for potential confounders, reduced muscle mass and muscle strength were significantly associated with an increased risk of all-cause mortality (hazard ratio [HR]: 1.56, 95% CI: 1.09–2.24). Moreover, the presence of all three criteria of sarcopenia was associated with an increased risk of all-cause mortality (HR: 1.87, 95% CI: 1.27–2.67), while reduced muscle mass and physical performance were not significantly associated with mortality (p=0.06). In conclusion, the conceptual definition of sarcopenia outlined by the GLIS, which includes both reduced muscle mass and muscle strength, is associated with premature mortality among community-dwelling older adults.
PREVENTION OF SEVERE EVENTS IN OLDER PEOPLE IN SWEDEN – POSSIBILITIES AND CHALLENGES
Authors: Bravell Marie Ernsth , Johansson Linda , Finkel Deborah
Published: January 2025

Older adults are at high risk of malnutrition, falls, pressure ulcers and poor oral health. In Sweden the quality register Senior Alert is trying to improve the preventive work among older people. This study used data from Senior Alert to understand how the preventive work process functions in different care settings. Data included 2957 persons that were assessed in Senior Alert: 864 in nursing homes, 226 in home care and 1829 in hospital. Descriptive and comparative analyses were performed to understand how many were assessed as having risk, and then the actions planned and follow-ups. The results demonstrated that people who were assessed in hospital had risks of some kind in almost half of the cases (46%), in comparison to nursing homes (29%) and home care (8%). Planned actions differed between the settings: in nursing homes, actions were more often planned to prevent poor oral health (29%) whereas hospital staff more often planned actions to prevent falls (73%), malnutrition (71%) and pressure ulcers (57%). Planned actions were significantly less in home care. Follow-ups follow the same patterns, where follow-up in home care were significantly smaller than in nursing homes and hospitals in all areas. Home care provides good opportunities to provide preventive care, as it is more continuous than, for example, hospital care. Additional analyses identified particular actions planned and performed, for a fine-grained investigation of preventive care in Sweden.
REACTANCE/HEIGHT AS A POTENTIAL BIOIMPEDANCE INDICATOR OF FRAILTY AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Lafontant Kworweinski , Zamarripa Estefania , Tice Abigail , Blount Amber , Suarez Jethro Raphael , Kim Dahee , Stout Jeffrey , Thiamwong Ladda
Published: January 2025

Frailty is prevalent among older adults and is characterized by reductions in physical function and muscle quality. Despite the emerging clinical utility of bioelectrical impedance analysis (BIA), little is known about how bioimpedance indices, such as phase angle (PhA), Levi’s Muscle Index (LMI), reactance/height (Xc/Height), and resistance/height (R/Height), relate to physical function (i.e., handgrip strength, postural sway, Timed-Up-and-Go, Sit-to-Stand, Short Physical Performance Battery) and frailty. This study aimed to investigate these relationships in community-dwelling older adults. We cross-sectionally compared physical function measures and bioimpedance indices between frail, pre-frail, and robust categories as determined by the FRAIL questionnaire in 150 community-dwelling older adults (female, n = 137; age = 73.9 ± 6.9 years; BMI = 30.5 ± 6.4 kg/m2) using Kruskal-Wallis H and one-way ANOVA tests. Spearman rho (ρ) and Pearson r correlation coefficients were used to assess relationships between variables. PhA (r = -0.15, p = 0.07) and LMI (ρ = 0.05, p = 0.57) were not significantly associated with FRAIL scores, unlike Xc/Height (r = -0.29, p < 0.001) and R/Height (r = -0.20, p = 0.02). Among the bioimpedance indices, only Xc/Height differed significantly between frailty categories (F(2,147) = 6.55, p = 0.002) while all physical function assessments except postural sway differed between the categories (p < 0.05). These results suggest that only Xc/Height may be indicative of frailty among older adults. However, these conclusions may be limited by the use of the FRAIL questionnaire; future research should compare LMI and PhA using multiple frailty assessments.
RELIABILITY OF REMOTE SELF-ADMINISTRATED DIGITAL COGNITIVE ASSESSMENTS
Authors: Huynh Duong , Patterson Mary , Huang Bin
Published: January 2025

Early diagnosis of cognitive impairment and dementia relies on comprehensive, evidence-based cognitive assessment, which currently requires a clinic visit and access to skilled healthcare providers. This poses a challenge for people who live in areas with inadequate primary care services and those who have economic, insurance, or other transient hardships (transportation, time, etc.) that limit their access to healthcare services. Digital cognitive assessments (DCAs) with remote testing capabilities have emerged as an efficient and cost-effective solution. The aim of this study was to validate the reliability of BrainCheck, a platform for DCAs, when self-administered remotely. A total of 46 participants (60.9% female; age range 52-76) remotely completed a battery of eight BrainCheck cognitive assessments twice on the same device (iPad=8, iPhone=5, laptop=33): the participants self-administered in one session and were administered by a research coordinator (examiner) in the other session. The inter-session interval (ISI) varied across participants, from within the same day to 21 days apart. Testing outcomes, including the duration of time needed to complete the battery, the raw score from each assessment, and the raw overall score, were compared between the two sessions. We found moderate or good agreement between self- and examiner-administered performance, with intraclass correlation ranging from 0.59 to 0.83. Results from mixed-effects modeling further confirm the non-significant difference between self- vs. examiner-administered testing performance, which is independent of other factors including testing order, ISI, device, and participants’ demographic characteristics. These results demonstrate the feasibility of remote self-administration using BrainCheck.
RESILIENCE COMPONENTS, POSTOPERATIVE COMPLICATIONS, AND QUALITY OF LIFE DETERIORATION AFTER PANCREATECTOMY
Authors: Choi Jung-Yeon , Kim Kwang-il
Published: January 2025

Background

Resilience, the ability to adapt positively to adversity, remains a multisystemic process with no standardized objective measurement methods. The aim of this study was to identify the association between resilience components and frailty, postoperative complications, and quality of life changes after pancreatectomy in older patients.

Methods

This study evaluated older patients (aged ≥ 65) scheduled for pancreatectomy between August 2020 and December 2023. Patients who underwent a Comprehensive Geriatric Assessment and signed informed consent were included. Frailty was determined by multidimensional frailty score more than 5. Neurohumoral resilience was measured using the ACTH stimulation test, cardiovascular autonomic function using orthostatic blood pressure measurement, and cognitive-motor function using dual-task gait tests. The primary outcome was postoperative complications, and the secondary outcome was the deterioration in quality of life one year after pancreatectomy.

Results

A total of 57 patients were included in the analysis. Among them, 17 (29.8%) were classified as frail, 10 patients (17.5%) experienced postoperative complications, and 12 patients (24.5%) had worsened quality of life after one year. Low blood pressure and slow usual gait speed was associated with frailty. Diminished cortisol responsiveness correlated with frailty and postoperative complications. Quality of life deterioration was associated with differences between dual-task (serial 7) gait speed and fast gait speed.

Conclusion

This study highlights the potential association between multidomain resilience components, frailty, and clinical outcomes in older patients undergoing pancreatectomy. Future research should focus on developing robust, objective, and reliable resilience metrics for clinical use.
SAFETY AND EFFECTS OF HEAT-INACTIVATED LACTOBACILLUS PARACASEI D3.5 (LPD3.5) ON MENTAL WELLBEING IN OLDER ADULTS
Authors: Lloyd Amanda , Warren-Walker Alina , Holt Nigel , Lynch Doug , Kay Denis , Stephens Kevin , Jain Shalini , Yadav Hariom
Published: January 2025

A healthy gastrointestinal (GI) tract and its microbiome are crucial for maintaining overall health, while microbiome abnormalities can lead to various health issues including brain health and impact quality of life (QOL). These issues are often linked to dysregulation of the gut-brain axis. Although probiotics and prebiotics are common strategies to improve gut and brain health, they have limitations. Postbiotics, offering stable and predictable exposure, present an attractive alternative. In this open-label pilot study, we tested PoZibio®, a postbiotic containing heat-inactivated Lactobacillus paracasei D3.5 (LpD3.5), in 13 healthy older adults (≥50 years) over 30 days to assess its safety, tolerability, and impact on GI function and QOL. Participants consumed four LpD3.5/PoZibio capsules daily and completed the SF-36 and GSRS surveys before and after the study. PoZibio was found to be safe and well-tolerated, with notable improvements in emotional well-being and gastrointestinal symptoms. However, due to the study’s open-label design, small sample size, and short duration, these findings should be interpreted cautiously. Larger, placebo-controlled trials are needed to confirm PoZibio’s potential benefits for the gut-brain axis and overall health.
SELF-REPORTED FALL RISK AND FEAR OF FALLING OF OLDER ADULTS: THE MEDIATING AND MODERATING IMPACT OF HEALTH LITERACY
Authors: Kim Dahee , Thiamwong Ladda , Emrich Christopher , Li Yingru , Xie Rui
Published: January 2025

Objectives: Older adults who perceive more fall risks in their daily lives may have a higher fear of falling (FOF). Despite, as a human agency, health literacy of older adults may improve their health and well-being outcomes, but the role of health literacy in fall risk-FOF association has been less highlighted. This study investigated mediating and moderating impacts of their health literacy on the fall risk-FOF association. Methods. This study used data from 176 community-dwelling older adults (MeanAge = 74.49, SDAge = 7.16). Self-reported fall risk was measured using the CDC STEADI fall risk checklist. FOF was assessed using the Short Falls Efficacy Scale International. Health literacy was reported as the level of confidence in filling out a medical form by oneself. This study employed the SPSS PROCESS Macro to test the mediation and moderation models. Results. Older adults’ health literacy moderated their self-reported fall risk-FOF association. The more fall risks older adults perceive, the higher FOF the Low health literacy group showed, whereas the lower FOF the High health literacy group reported. This indicates that health literacy would buffer the impact of fall risk in daily life on FOF in late adulthood. However, we found no indirect impact of self-reported fall risk on FOF via health literacy. Conclusion. These findings highlight the role of health literacy in mitigating the impact of self-reported fall risk on FOF of older adults. This study suggests health literacy as an agency that enhances health and well-being in older adults’ remaining lives.
SENSOR-BASED MONITORING OF PHYSICAL ACTIVITY IN OLDER ADULTS SIX MONTHS POST-FALL: MODERATING FACTORS
Authors: Schmidt Laura , Stuckenschneider Tim , Kwiecien Robert , Zieschang Tania
Published: January 2025

Older individuals who have experienced a fall often experience concerns about falling, impaired activities of daily living, and reduced physical activity (PA). Changes in PA following a fall are often influenced by moderators such as age or fall history; however, these moderators remain understudied. Therefore, this project investigates the association between moderators and changes in PA in older adults after a fall. Participants aged ≥60 years were recruited if they presented to the emergency department following a fall without hospital admission. Moderators were collected through a home-based geriatric assessment conducted within four weeks after the fall. PA was measured within four weeks and six months after the fall using an accelerometer (activPAL4, PAL Technologies Ltd., UK). Associations between moderators and changes in PA were calculated fitting Linear Mixed Model (LMM) in R (R Core Team, 2023 Version 4.3.2 (2023-10-31). A total of 178 valid datasets were analyzed. LMM analysis revealed a significant average increase in step count over time (p=0.006). Notably, female participants showed a significant larger increase in steps per day (+1,777.9, 95% CI: 292.2 – 3263.7, p=0.019) than male participants. In women, fall history (95% CI: -1009.5 – (-207.4), p=0.003) and age (95% CI: -315.8 – (-82.5), p< 0.01) were negatively associated with step counts. Given the healthcare challenges associated with falls in older adults, our findings underscore the importance of early identification of moderators in emergency department settings. Identifying these factors may enable targeted interventions for individuals at risk of functional decline post-fall, potentially preventing further functional decline.
SEX DIFFERENCES IN THE ASSOCIATION BETWEEN COMORBIDITIES AND COGNITIVE STATUS IN OLDER BLACK AMERICANS
Authors: Nyarko Albert Junior , Esiaka Darlingtina
Published: January 2025

The decline in cognitive status among aging populations is a growing concern, particularly for Black Americans who experience a higher burden of chronic conditions that are known precursors of cognitive impairment. Despite the known disparities in brain health outcomes among aging Black Americans, limited research has explored how sex interacts with comorbid conditions to impact cognitive status in this population. We investigated sex differences in the association between comorbidities (stroke, diabetes, hypertension, sleep apnea, PTSD, active depression, cancer, asthma, and brain tumors) and cognitive status (presence of abnormal cognitive status) among older Black Americans. We analyzed data from participants (N= 448, 330 females; Mage = 75.79, SDage = 7.40; mean years of education = 15.89) who are a part of the University of Kentucky ADRC cohort. Our analysis showed significant sex differences in the association between comorbidities and cognitive status. Having a higher number of comorbidities was associated with greater presence of abnormal cognitive status in Black American males (b =.016, p =.131) than females (b =.002, p =.580). Further analysis showed that hypertension was significantly associated with a greater presence of abnormal cognitive status in Black American males (b =.295, p =.007). The presence of comorbidities, especially hypertension, may impact cognition more in older Black American males than females. Our findings highlight the complexity of comorbidities’ impact on cognition and underscore the importance of considering sex differences in research on aging and brain health in Black Americans.
SOCIAL SUPPORT USING SOCIAL NETWORKING SERVICES FOR OLDER ADULTS WITH MCI
Authors: Yoon Seolah , Choi Jeongeun , Park Min Kyung , Hong Dahye , Kang Bada
Published: January 2025

Older adults with mild cognitive impairment (MCI) are more likely to experience negative health-related outcomes. Social support is an important strategy for preventing adverse outcomes. While social support interventions using social networking services (SNSs) have potential benefits for social relationships and health, their impact on older adults with MCI, along with usability challenges and strategies, has not been comprehensively synthesized. The aim of this scoping review was to map the use of social support interventions using SNSs for health and social care of older adults with MCI and examine the usability challenges and strategies of SNS platforms. Following the Joanna Briggs Institute methodology, eight studies published between January 2005 and June 2024 were selected from such databases as PubMed, CINAHL, Web of Science, EMBASE, PsycINFO, SCOPUS, and Google Scholar. Social support interventions were categorized into five types: social networking, informational, esteem, emotional, and tangible support. Positive outcomes of the interventions included enhanced social interaction, increased physical activity, and improved memory and alertness. Usability challenges, such as technical skill deficits and privacy concerns, were identified, and strategies, such as weekly email checklists, training sessions, and simplified design features, have been proposed to address them. This review highlights the potential of social support interventions using SNSs to positively impact the physical, cognitive, and social outcomes of older adults with MCI. We discuss gaps in social support interventions attributed to SNSs and implications for future interventions aimed at improving the health and social well-being of older adults with MCI.
THE CONTRIBUTION OF COMMUNITY/NEIGHBORHOOD TO COMMON PREDICTORS OF NON-COMMUNICABLE AGING RELATED DISEASE
Authors: DeLouize Alicia , Kowal Paul , Naidoo Nirmala , Chhim Srean , Sopheab Heng , Snodgrass Josh , Chin Savuth
Published: January 2025

Non-communicable diseases (NCDs) are now the leading causes of death globally. Their increasing rates have been associated with market integration and they tend to cluster in certain neighborhoods and communities, yet research has mostly focused on individual level causes. The aim of this research was to identify neighborhood/community level associations with NCDs that are often attributed to individual lifestyle factors. The World Health Survey Plus (WHS+) was conducted in Cambodia in 2023 and is among the first studies to collect nationally representative point-of-care biomarker data along with anthropometric, performance test, and survey data (N = 5,275). Multi-level models were run, with 98 regions and 276 communities as random intercepts, predicting rates of diabetes, hypercholesterolemia, hyperlipidemia, hypertension, arthritis, angina, stroke, and frailty level. Between 22% to 77% of the variance usually attributed to fixed effect independent variables (education, log of household income, salt, alcohol, tobacco, waist-to-stature-ratio (WSR), anxiety, stress, and sedentary behavior) was attributed to group-level fixed effects. Alcohol, sedentary behavior, stress, anxiety, WSR, and education were group-level variables that were conflated at the individual level for at least one NCD. Prevention and treatment of non-communicable diseases have mostly centered around individual lifestyle changes, yet there are likely ecological causes that can be targeted.
THE IMPACT OF INDIVIDUAL AND NEIGHBORHOOD SES ON A SMOKING CESSATION INTERVENTION IN A LUNG CANCER SCREENING SETTING
Authors: Avila Jaqueline , Flores Efren , Su Yan-Jhu , Haas Jennifer , Park Elyse , Rigotti Nancy
Published: January 2025

Lung cancer screening (LCS) offers a teachable moment for smoking cessation, but socioeconomic status (SES) may affect treatment success. This study assesses whether educational level or neighborhood SES are associated with smoking abstinence and completion of a smoking cessation intervention offered in the LCS context. This is a secondary analysis of a clinical trial (NCT03611881) testing the effectiveness of smoking cessation treatment for older smokers scheduled for LCS (N=615). Outcomes were self-reported 7-day smoking abstinence and study follow-up completion at 6-months. Independent variables were educational level (high school graduation or less [low] vs. post-high school education [high]); neighborhood SES (Area Deprivation Index [ADI], ranging 1 [low SES] to 100 [high SES] categorized as: highest 15% vs. remaining 85% scores), and a combination of both measures. Logistic regression models tested the association between outcomes and SES measures, adjusted for covariates. 32.7% of the sample had low educational level, and the mean sample ADI was 19.9 (SD: 12.8). Smoking cessation was higher among those with higher vs. lower neighborhood SES (15.7% vs. 7.4%, p-value=0.03). Study completion was lower among those with lower vs. higher educational level (78.1% vs. 84.5%, p=0.05). In multivariable models, these associations were not significant but individuals with high educational level and low neighborhood SES were more likely to complete the study than those with both low educational level and low neighborhood SES (OR: 6.04, 95%CI: 1.47-24.7). Smoking cessation in the LCS context might be improved by targeting community factors that affect neighborhood SES and educational level.
THE PREDICTORS OF SEDENTARY BEHAVIOR AMONG OLDER ADULTS WITH POOR MOBILITY
Authors: Okrah Albert , Nelson-Twakor Elizabeth , Fulzele Sadanand , Landwehr Samantha , Zhao Karrie , Hsieh Katherine , Jehu Deborah
Published: January 2025

Older adults with poor mobility are typically more sedentary, which poses increased risk for disability. Identifying the predictors of objectively measured sedentary behavior may affect targeted treatment strategies. This study aimed to identify the predictors of sedentary behavior in older adults with poor mobility. We recruited 18 older adults with self-reported poor mobility (78.3±8.6 years, 44.4% female) from the community and residential care facilities. Participants reported demographic information (years of education, age, sex, fall history) and completed a battery of assessments, including cognition (Rey Auditory Verbal Learning Test), depression (Geriatric Depression Scale), and gait (gait speed). Participants wore an activity monitor on their non-dominant ankle for 7 days (ActiGraph, Pensacola, FL). We used a minimum wear time of ≥4 days, including 2 weekend days in the analysis. We conducted a linear regression with sedentary behavior percentage as the dependent variable, with moderate-to-vigorous physical activity (MVPA), fall history, depression, memory, and gait speed as variables of interest, and we controlled for age, sex, and education,. All variables were correlated at r≤±0.3. The overall model was significant (R2=0.93, p=0.004). The predictors of high sedentary behavior were: greater depression [β=0.59, CI=0.04,1.14], lower MVPA [β=-0.16, CI=-0.2,-0.13], male sex [β=2.71, CI=0.03,5.39], and better memory [β=1.02, 0.29,1.74]. Our results suggest that older adults with poor mobility who are male, more depressed, less physically active, and have better memory are more at risk for being sedentary. Targeted interventions to reduce sedentary behavior and increase exercise, especially those most at-risk for a sedentary lifestyle, may improve health outcomes.
THE VALUE OF IN-PERSON VA MEDICAL FOSTER HOME NATIONAL CONFERENCE FOR RURAL PROGRAM COORDINATORS
Authors: Manheim Chelsea , Fix Rachel , Haverhals Leah
Published: January 2025

The Department of Veterans Affairs (VA) Medical Foster Home (MFH) program provides long-term care for nursing home eligible Veterans who desire to reside in home-like environments. In MFHs, Veterans are matched with non-VA caregivers to live in caregivers’ homes as part of their family, with caregivers providing around-the-clock care for up to three patients. MFH coordinators are responsible for full program implementation including recruiting, screening, and monitoring caregivers; recruiting Veterans; and partnering with VA’s Home Based Primary Care teams who provide Veterans’ healthcare in MFHs. Balancing these many duties, the MFH coordinator position can prove isolating. In 2024, the VA Office of Geriatrics and Extended Care (GEC) sponsored two, two-day, conferences for MFH staff to encourage goal setting, cross-site collaboration, and foster support. The first conference hosted 83 attendees from east coast programs in Orlando, Florida in March, and the second hosted 98 attendees from Midwest and western programs in Chicago, Illinois in May. Conferences coincided with VA efforts to expand MFH programs to all VA Medical Centers (VAMCs) by 2026. Additionally, the VA Office of Rural Health (ORH) currently funds expansion of four rural MFH programs. To assess experiences of MFH coordinators from the four rural expansion programs, we conducted interviews with them in June 2024. Coordinators reported making strong connections with more seasoned coordinators in nearby areas, developed innovative marketing ideas and created action plans, and improved motivation to serve in rural areas. Interviews showed that in-person conferences provide needed boosts to coordinators working in solitary positions.
A LIFE COURSE PERSPECTIVE ON FACTORS UNDERLYING NURSING HOME STAFF RETENTION
Authors: Ahmad Waqar , Morgan Jennifer , Burgess Elisabeth , Wright Eric
Published: January 2025

Nursing homes continue to experience persistent challenges in retaining nursing home staff. Understanding the life course context of nursing home staff has the potential to shed needed light on this persistent issue. The life course perspective emphasizes understanding the dynamic interplay of personal, social, organizational, and historical factors and how this dynamism influence lives. Using cross-sectional survey data from 678 nursing home staff working in 23 nursing homes, we use ordinal logit regression to estimate a predictive model consisting of demographic, job quality and life course factors predicting employment intentions. Life course-relevant findings include: intergroup differences in employment intentions by life course markers and identities with career stage, benefits status, and breadwinner status demonstrating significant impact on intent to stay. Further, we find evidence that cumulative disadvantage, emotional burnout and other care roles have additional significant impacts on intent to stay. This study has practical implications for nursing home leadership and policy makers. Nursing home leaders need to amend their conventional strategies of retaining the LTC workforce by creating tailored supports for workers while simultaneously addressing job quality deficits. Access to mental health services, increased leave for caregiving and respite, improved access to high-quality health insurance and benefits that assist this workforce to deal with contingency factors and career mobility (e.g. small grants, tuition remission) have the potential to alleviate some of the instability in this often-vulnerable workforce.
A SPECTRUM OF AGING: INTRODUCTION OF A REFLECTED EXPERIENCE MODEL OF AGING WELL
Authors: Chilton Patricia Davis , Magrath Priscilla , Grilli Matthew , Pfeifer Valeria , Sullivan Daniel , Mehl Matthias
Published: January 2025

Current methods to study aging lack a personalized approach in investigating the question of what it means to age well - the narrated, lived experience of those doing the aging. The current study collected narratives from 92 individuals between the ages of 62 and 95. Participants were interviewed via Zoom Health and provided four minutes of spontaneous (i.e. unprepared) answers to the question, “In your own words, what does aging well mean to you?”. The responses were recorded, transcribed using speech-to-text, deidentified, and checked for accuracy by trained research assistants. The responses were analyzed qualitatively using an interpretivist approach, inductively identifying recurring ideas from the narratives, and extracting themes that represent a broad spectrum of aging well experiences and meaning. The main themes that emerged were: Lifestyles/Health/Wellness, Compensation/Adaptation, Social Connection, Social Contribution, Existential, and Time Awareness. A thematic map was created representing the main themes and their 24 subthemes. Using MAXQDA software, a descriptive analysis of the coded themes indicated that out of 1,618 coded segments, 28% represented Lifestyle/Health/Wellness themes (e.g. physical/cognitive health, travel, finances), 25% reflected Existential themes (e.g. purpose/meaning, emotional wellbeing, spirituality, openness/growth), 15% represented Social Connection, 10% were Compensation/Adaptation (e.g. interdependence, technology, adjusting environment/mindset), while 6% represented both social contribution (e.g. volunteerism) and time awareness. These analyses constitute a first step towards a reflected experience model of aging and can facilitate a richer understanding of the diversity and lived experience of aging well.
ADVERSE CHILDHOOD EXPERIENCES AND DEPRESSION: AGING PERCEPTIONS’ MEDIATING ROLE IN OLDER KOREAN IMMIGRANTS
Authors: Lee Hajin , Park Juyoung , Jang Yuri
Published: January 2025

In response to the sustained mental health impact of Adverse Childhood Experiences (ACEs) in later life and the heightened vulnerability of older adults in socially disadvantaged positions, we examined how early life adversities shape self-perceptions of aging and mental health among low-income older Korean immigrants. We conceptualized self-perceptions of aging as a mediator and hypothesized that the impact of ACEs on depressive symptoms would be mitigated by negatively internalized perceptions of aging. Using data from 315 older Korean residents in subsidized housing in the Los Angeles area (Mean age = 79.4), we found supportive evidence for our hypotheses. In addition to the direct effects of ACEs (B [SE] =.80 [.18], p <.001) and self-perceptions of aging (B [SE] = −.68 [.16], p <.001) on depressive symptoms, the indirect effect of ACEs on depressive symptoms through self-perceptions of aging was found to be significant (B [SE] =.12 [.05], bias-corrected 95% bootstrap confidence interval = 0.02, 0.22). Those with greater ACE exposures were more likely to hold negative perceptions of aging, which in turn led to greater symptoms of depression. Our findings elucidate a potential mechanism through which early life adversities manifest the impact on the current mental health state of low-income older Korean immigrants and highlight the importance of culturally sensitive community-based interventions to foster resilience and positive views on aging for the protection and promotion of community mental health.
AGE AND RACE PATTERNS IN TWO TYPES OF OBJECTIFICATION OF WOMEN
Authors: Sherman Aurora
Published: January 2025

Objectification of women can take several forms, including denial of autonomy, sexualization, and self-objectification. Objectification is a dehumanizing experience with significant negative psychological and physical health consequences which has largely been studied in majority White and younger samples of women. This study surveyed 349 women aged 50 and older, who are Latina (n= 107), African American (n= 125), or White (n= 117). Objectification was measured by the Self-Objectification Beliefs and Behaviors Scale (SOBBS, Lindner & Tanleff-Dunn, 2017) and by the Invisibility subscale from the Self-Objectification Scale (SOS-I, Talmon & Ginsburg, 2016). The web-based survey was administered by Qualtrics Panel Services. Results indicate that the scales are reliable for all three groups and across mid-life and older women. Further, ANCOVAs with self-rated health as a covariate revealed no significant differences in either objectification measure based on race or ethnic group, suggesting that objectification is a shared experience for women from these three backgrounds. Finally, the ANCOVA also showed a significant age-group difference in the SOBBS scores (F(1, 324) = 5.18, p <.03) but not in Invisibility scores (F(1, 325) = 2.06, ns). Mid-life women reported higher self-objectification experiences (EMM = 42.62, SE = 1.33) compared to women older than 65 (EMM = 38.32, SE = 1.33). There were no significant interactions of race group with age group for either measure. Results are discussed in the context of Objectification and Life Course Theories.
AGE DIFFERENCES IN SOCIOCULTURAL DETERMINANTS OF INDIGENOUS HEALTH
Authors: Goldtooth Amanda , Livingston Raechel , Cerino Eric
Published: January 2025

Healthy aging frameworks often lack a culturally-informed theoretical approach to investigate how sociocultural resources advance health equity, particularly for Indigenous adults. Our work addressed this gap by empirically testing Yellow Bird and colleagues’ (2023) Cultural Determinants of Healthy Indigenous Aging model. Specifically, we examined age differences in associations between sociocultural resources and health. In a sample of 85 Native American or Alaska Native adults from the Midlife in the United States study (average age=54.25 years, SD=12.86, 52% female), respondents completed surveys on sociocultural resources (spirituality, neighborhood quality, purpose) and self-reported health outcomes (physical health, negative affect, positive affect). We regressed each health outcome on the sociocultural resources and adjusted for age, sex, and education. We also examined whether age moderated these associations. People with higher purpose reported better self-rated physical health (Est.=0.06, SE=0.01, p<.001), lower negative affect (Est.=-0.05, SE=0.01, p<.001), and higher positive affect (Est.=0.04, SE=0.01, p<.001). Age moderated the relationship between spirituality and positive affect (Est.=0.01, SE=0.002, p<.01) such that higher spirituality related to higher positive affect among comparatively older adults (Est.=0.14, SE=0.04, p<.01). People with better neighborhood quality reported better self-rated physical health (Est.=0.61, SE=0.20, p<.01). Age moderated the relationship between neighborhood quality and positive affect (Est.=0.02, SE=0.01, p<.05) such that better neighborhood quality related to higher positive affect among comparatively older adults (Est.=0.48, SE=0.19, p<.05). Consistent with Yellow Bird and colleague’s (2023) culturally-informed framework, results suggest that purpose, neighborhood quality, and spirituality may serve as sociocultural pathways to promote healthy Indigenous aging and advance health equity.
AGEISM AND PERSONALITY AS UNIQUE PREDICTORS OF OLDER ADULT WELLBEING
Authors: Wininger Claire , Wolk Megan , Beatty Jennifer , Kwak Judy , Hill Patrick
Published: January 2025

Ageism is a primary risk factor for poorer psychological wellbeing in older adulthood. However, the pernicious effects of ageism prove complicated to alleviate given they move beyond whether one experiences discrimination due to age, as older adults often internalize the negative stereotypes associated with these discriminatory acts. The current study evaluated whether certain personality traits may exacerbate or mitigate the wellbeing concerns associated with ageism. Participants (n = 250, ages: 60-80) completed measures of ageist discrimination, internalized ageism, the Big Five personality traits, and psychological wellbeing. Results indicated that older adults who reported greater ageist discrimination and internalized ageism reported worse psychological wellbeing, as did adults who scored lower on extraversion but higher on neuroticism. Multiple regression tests of moderation though found that the Big Five personality traits failed to moderate ageism-wellbeing associations. Put differently, personality traits and ageism were independent predictors of wellbeing. Moreover, the current study found that experiences of ageist discrimination and internalized ageism were positively correlated, and both held unique negative associations with psychological wellbeing. These findings clearly demonstrate that both forms of ageism hold independent pernicious effects for older adults largely regardless of their personality.
AN OPEN PILOT STUDY OF A COMMUNITY-ENGAGED BRAIN HEALTH EDUCATION PROGRAM FOR CHINESE AMERICANS AGED 50 OR ABOVE
Authors: Wang Kaipeng , De Fries Carson , Li Xiaoyouxiang , Sun Fei , Zhu Jie
Published: January 2025

Chinese Americans, the largest Asian American subgroup in the U.S., face linguistic, cultural, and socio-economic barriers to dementia prevention. To promote brain health in this population, a community-engaged approach is essential. This study evaluates a community-engaged education program for Chinese Americans aged 50 or older, designed to enhance brain health knowledge and motivate lifestyle changes to prevent dementia. The program is structured into four phases. First, we assessed participants’ interests in brain health topics, availability, and preferred modes of delivery. Next, experts in the identified topics developed educational content and outcome assessments. The third phase involved implementing a six-session program over three months, offered in Mandarin both virtually and in-person. The sessions covered general knowledge about Alzheimer’s disease and related dementias, diet, sleep, physical exercise, health checks, and mindfulness. Finally, we evaluated the program’s feasibility and effectiveness using mixed methods, including pre-post surveys, session feedback questionnaires, and focus groups. Seventy-seven participants completed the pretest survey, and 47 (61%) attended at least four sessions and completed the post-test survey. The results of paired t-tests showed statistically significant improvements in knowledge of brain health, diet, exercise, and health checks, as well as increased motivation for lifestyle changes. While supporting these results, qualitative findings further revealed the applicability, understandability, comprehensiveness, cultural relevance, elder friendliness of the sessions, and participants’ motivation for attending and self-improvement. Findings highlight feasibility and effectiveness of a community-engaged education approach in brain health promotion and lifestyle change and underscore the need for continued community outreach among Chinese Americans.
ASSESSING HEALTH BEHAVIORS AND WELLBEING OF NON-SPOUSAL LGBTQIA+ CAREGIVERS OF PEOPLE WITH AD/ADRD
Authors: Caldwell Clover , Schwartz Heather , Slowey A J , Werner Nicole , Pickett Andrew
Published: January 2025

Informal caregivers of people living with Alzheimer’s Disease (AD) or AD-Related Dementias (AD/ADRD) face high levels of burden and stress, while LGBTQIA+ identifying individuals often experience stigmatization and discrimination. Young adults are increasingly involved in caregiving for older adult relatives. To date, there is limited research related to the experiences LGBTQIA+ dementia caregivers, particularly those who are not spousal partners of care recipients. We conducted an online survey of LGBTQIA+, non-spousal caregivers, recruited through the Prolific platform. Participants (n=116) responded to items about health-behaviors (e.g., physical activity, sleep hygiene, alcohol use) and caregiving experiences (e.g., burden). Participants most commonly identified as white (n=63, 53.4%), women (n=64, 54.2%), and bisexual (n=71, 60.2%). The average age was 37.64 (SD=12.44) years and participants reported 25.54 (SD=25.17) average weekly hours caring for parents (n=56, 48.3%), grandparents (n=40, 34.5%), or others (n=24, 20.7%). Participants most commonly were ‘moderately active’ (n=70, 60.3%), had poor sleep quality (M=2.32 / 4, SD=.87), moderate alcohol use (n=52, 50.5% reported 3-6 drinks per session) and caregiver burden (M=13.54, SD=7.19). Participants reported feelings of loneliness (M=5.39/ 9, SD=2.04) and depressive symptoms (M=9.32, SD= 7.22), both of which were predicted by caregiver burden (Loneliness: F=2.73, p<.001, Adj. R2=.30; Depressive Symptoms: F=2.92, p<.001, Adj. R2=.32). Non-spousal LGBTQIA+ dementia caregivers reported suboptimal health behaviors, partially associated with time and other constraints related to caregiving. Further, caregiver burden was associated with both loneliness and depressive symptoms. Additional research and interventions are needed to promote health and reduce burden among this population.
ATTACHMENT SECURITY AND COPING SKILLS IN INTERACTIONS BETWEEN DAUGHTERS AND THEIR MOTHERS WITH COGNITIVE CHANGE
Authors: Gad Dustin , Monin Joan , Wells Jenna
Published: January 2025

The caregiving literature shows that daughters with secure attachment to their mothers with cognitive change report decreased stress and caregiver burden. However, the behavioral patterns that underlie this link remain undiscovered. In the present study, we examined the associations between daughters’ apparent security, an observational attachment code developed by Brooke Feeney and colleagues indicating comfortability and openness, in interactions with their mothers and their tendency to use various coping strategies. Daughter-mother dyads (N = 69) engaged in video-recorded discussions about their concerns regarding their mothers’ memory loss. Apparent security was rated by trained coders. Daughters completed questionnaires about their use of coping styles. Results showed that daughters’ greater apparent security was associated with less use of self-distraction (B = -.470, p =.047), denial (B = -.471, p =.005), and behavioral disengagement (B = -.422, p =.010). Daughter’s greater apparent security was also associated with greater displays of positive affect (r =.487, p <.001), emotional disclosure (r =.352, p =.003), descriptive disclosure (r =.293, p =.015), open discussion (r =.496, p <.001), confidence (r =.262, p =.030), and receptiveness to mothers’ support attempts (r =.476, p <.001). These results suggest that interventions and targeted efforts to make daughters feel more open and accepting with their mothers during discussions about memory loss may increase their ability to cope in the context of their mother’s dementia.
ATTRIBUTED DIGNITY ACROSS THE LIFESPAN: COMPARING DIGNITY IN OLDER ADULTS AND COLLEGE-AGE INDIVIDUALS
Authors: Adawudu Emefa , Chen Chunfang , Choi Jeungok , Jacelon Cynthia
Published: January 2025

Attributed Dignity is a core value in human interaction. Researchers have shown that the perception of dignity changes across the lifespan. To understand attributed dignity across the lifespan, we compared the factor structure of the Jacelon Attributed Dignity Scale (JADS) between samples of older adults and college-aged individuals. The theory of attributed dignity guided this study. Data was collected from 289 older adults from senior centers in New England and 380 college students at a large public university in New England using JADS, social desirability scale (SDS), and Rosenberg Self Esteem Scale (SES). SDS and SES were used to determine construct validity. Exploratory Factor Analysis (EFA), construct validity, and reliability of the scale were analyzed. EFA resulted in an 18-item scale with four factors including ‘self-value’, ‘perceived value from others’, ‘behavior with respect towards others’, and ‘self in relation to others’ for both older adults and college-age individuals. Older adults rated ‘behavior with respect towards others’ as the most important factor, while ‘self-value’ was considered the most important attribute of dignity in college-age individuals. Correlations between the JADS, SDS, and SES indicate attributed dignity is a unique concept. Findings indicate that the perception of attributed dignity varies across the lifespan. Consistent with a developmental perspective, older adults value their behavior most highly, while college-aged individuals are more focused on their own self-value. Understanding how the emphasis among factors of attributed dignity changes across the lifespan can provide direction for interventions to effectively enhance attributed dignity.
AWARENESS OF PERSONAL GAINS, MINDFULNESS, AND PSYCHOLOGICAL WELLBEING AMONG DEMENTIA CAREGIVERS
Authors: Simon Darby , Plys Evan , Allen Elizabeth , Seward Morgan , Vranceanu Ana-Maria
Published: January 2025

The current study tested if increased awareness of personal gains from caregiving and mindfulness skills each independently related to psychological well-being among caregivers of people living with dementia, beyond caregiver role-related factors. We conducted a secondary analysis of baseline data from 92 stressed caregivers, aged 22 to 83 years old (M=53.90, SD= 14.53), who participated in a clinical trial. Three separate multiple regression models tested the relationship between awareness of personal gains (Caregiver Reaction Scale- Personal Gain subscale), mindfulness (Applied Mindfulness Process Scale), and outcomes of depression (Hospital Anxiety and Depression Scale [HADS]-Depression), stress (Perceived Stress Scale-10), and anxiety (HADS-Anxiety), while controlling for role overload, caregiving competence, and hours of providing direct care per week. Results revealed that, in the full model, higher awareness of personal gains (β = -.31, p <.001) was significantly related to lower levels of depression. Higher awareness of personal gains (β = -.23, p <.05) and higher levels of mindfulness (β = -.18, p <.05) were significantly related to lower levels of stress. Neither awareness of personal gains nor mindfulness predicted caregivers’ anxiety. These findings provide evidence that awareness of personal gains and mindfulness uniquely predict aspects of dementia caregivers’ psychological well-being, even after controlling for well-established predictors. Psychological interventions may target caregivers’ awareness of their personal gains and mindfulness to improve their caregiving experience and psychological health. Anxiety may require different treatment approaches.