bluuebunny/crossref_metadata_2025 huggingface dataset:
THE TELLEGACY PROGRAM
Authors: Holloway Jeremy
Published: December 2022

Emerging research displays how social isolation and loneliness (SIAL) before and during the Coronavirus pandemic are linked to health issues caused by SIAL. These issues are estimated to increase the risk of early death by 26 percent, the equivalency of smoking 15 cigarettes a day. The program started soon after the pandemic as an intergenerational program created to combat SIAL among older adults. University students, known as Legacy Builders, connect through virtual or via phone conversations to communicate meaningfully with the older adult. Students are prepared with a curriculum on mindfulness, SMART goal-setting, growth mindset, visualization goal-setting exercises, and reminiscence therapy as well as the skill and art of listening. At the end of the encounters, a legacy book is given to the older adult with a description of the older adult’s life shared during their conversations with the Legacy Builder. The UCLA Loneliness Scale was utilized along with older adult self-reports. Sixteen residents in a memory care facility, ages 58 to 86, with multiple levels of dementia participated in the program of Summer 2021. The UCLA Loneliness Scale revealed that 13 of the 16 residents originally reported that they feel lonely or isolated. After 5 weeks of participation 7 out of the 16 residents report that they felt less lonely. Qualitative analysis showed improved perceptions of aging and an interest in Geriatrics among the student participants. These results also displayed positive older adult perceptions of the younger generation, and similar responses of the younger generation towards older adults.
STAKEHOLDER ENGAGEMENT IN THE DESIGN OF A FALL RISK PREDICTION SYSTEM FOR SOCIALLY VULNERABLE OLDER ADULTS
Authors: Demiris George , Hodgson Nancy , Richmond Therese , Skubic Marjorie , Harrison Sean , Sefcik Justine , Oh Sungho , Cho HanNah
Published: December 2022

Falls and fall-related injuries are significant public health issues for adults 65 years of age and older. Fall-related injuries are among the most expensive medical conditions. Mild cognitive impairment (MCI) and housing conditions are each independent risk factors for multiple falls among older adults and there is increasing evidence of the adverse effect of MCI on balance, stride, gait speed and increasing fall risk. We developed an innovative technology-supported intervention called Sense4Safety to 1) identify escalating risk for falls through real-time in-home passive sensor monitoring (using depth sensors); 2) employ machine learning to inform individualized alerts for fall risk; and 3) link ‘at risk’ socially vulnerable older adults with a tele-coach who guides them in implementing evidence-based individualized plans to reduce fall-risk. The purpose of this study was a) to examine preferences and attitudes of low-income older adults towards an in-home sensor-based system to inform fall prevention strategies; and b) solicit feedback from and validate the intervention protocols by clinical experts in fall prevention, fall risk assessment and geriatrics. We conducted one hour interview sessions with a total of 10 older adults and 10 clinical experts. Sessions were transcribed and analyzed. Findings included perceived benefits and challenges, recommendations for refinement of the intervention (including educational components and different visualization approaches for sensor data) and the role of family members or trusted others in addressing fall risk. We highlight clinical and ethical implications resulting from the use of passive monitoring for socially vulnerable older adults with MCI.
DIGITAL TECHNOLOGY USE AND INTERGENERATIONAL INTEGRATION: THE MEDIATING ROLE OF DIGITAL LITERACY
Authors: Park Hayoung , Choi Bomi , Joo Susanna , Kim Yoon-Myung , Kim Hyoun K
Published: December 2022

This study aimed to analyze the mediating effect of digital literacy on the association between digital technology use and intergenerational integration in later life. The sample included 315 older Korean adults aged 65 and above (M=68.83, SD=4.19, range=65-84) who participated in an online survey in December 2021. The participants’ use of digital technology was measured by the sum of thirteen questions about how often they used each digital technology in their daily lives. Intergenerational integration was measured by the sum of thirty questions concerning awareness of understanding and empathizing with characteristics and cultures between generations to live harmoniously in the times through communication and cooperation. The mediating variable, digital literacy, was measured by the sum of thirty-five questions from the New Media Literacy Scale, asking individuals’ ability to find, evaluate, and communicate information in a digital society. Age, gender, education level, household income, marital status, and living conditions were controlled for to reduce confounding effects. According to the mediation path analysis using SPSS PROCESS macro and bootstrapping, digital literacy significantly mediated the effects of digital technology use on intergenerational integration in later life; the higher the level of digital technology use, the higher the level of digital literacy, and this had a positive effect on the level of awareness of intergenerational integration among older adults. This study is significant in that it confirms the mechanism underlying the link between digital technology use and intergenerational integration and provides a new empirical model to promote intergenerational integration in terms of digital aging.
LEVERAGING VIDEO CONFERENCING TECHNOLOGY TO FACILITATE SOCIAL ENGAGEMENT IN OLDER ADULTS
Authors: Mois George , Lydon Elizabeth , Shende Shraddha , Khamzina Madina , Myers Dillon , Mudar Raksha , Rogers Wendy
Published: December 2022

Social engagement is critical for maintaining well-being and quality of life in older adults. However, typical age-related changes across bio-psychosocial dimensions as well as age-related conditions such as mild cognitive impairment (MCI), pose many challenges for older adults to remain socially connected. The development of technologies, specifically video conferencing, can be leveraged as a tool to facilitate the delivery of social engagement opportunities, both enhancing access and minimizing social isolation. For successful adoption of these tools, the needs and preferences of older adult users must be considered. We employed an iterative research process for designing and developing a social-engagement intervention using a platform called OneClick.chat. We provide community-dwelling older adults with opportunities to engage in casual conversations and reminisce with others on topics of shared interests (e.g., nature, food, hobbies). Our iterative design process involved an interdisciplinary team of engineers, human factors specialists, gerontologists, and neuropsychologists. We also evaluated the system with eight participants (aged 50-64) who provided their insights pertaining to the content, delivery, perceived ease of use, usefulness, and potential adoption of this video-conferencing platform. Based on the feedback received, we have optimized the intervention in preparation for a randomized controlled trial. Furthermore, we provide key insights related to the implementation of social engagement through video technologies with the aim of facilitating social connectivity. Our learnings can be used to guide future work involving video-technology-based interventions to facilitate social connectivity for older adults with varying cognitive abilities.
THE ASSOCIATION BETWEEN SUBJECTIVE AGE AND TECHNOLOGY USE AMONG OLDER ADULTS
Authors: Ikeuchi Tomoko , Wakui Tomoko , Itoh Sakiko , Miwa Hiroyasu , Watanabe Kentaro
Published: December 2022

Background

Subjective age (SA) (i.e., felt age) has been found to be a biopsychosocial marker of aging. This study examined the associations between SA and frequency of technology usage of older adults.

Methods

Data were collected via an online survey conducted in 2020. The study analyzed participants aged 65 to 89 (M = 71.9, SD = 3.91) years resided in Japan (N = 1855, 54.3% women). SA was indexed by asking participants to specify in years how old they felt. Proportional discrepancy scores (PDS) ((SA - chronological age) / chronological age) were calculated to indicate younger or older SAs and used as an independent variable. Participants were asked about the frequency of computer, smartphone, flip phone, and SNS use.

Results

Nearly 90% reported using computers for more than 2-3 days a week, 64.3% smartphones, 22.9% flip phones, and 36.6% SNS. Logistic regression analyses revealed that lower PDS (i.e., feeling younger) was associated with a significantly higher frequency of smartphone use (OR: 0.75; 95% CI: 0.59, 0.96) after adjusting for age, gender, education, and subjective health. No such association was found for computer, flip phone, and SNS use. Implications: Older adults who use smartphones daily may feel younger than those who do not. Since the present study was administered during the COVID-19 pandemic, the daily use of smartphones may have helped older adults stay in touch with friends and family members and obtain information they need. The use of smartphones possibly contributed to better mental health outcomes while practicing social distancing.
CAREGIVING STRESSORS AND MENTAL HEALTH AMONG OLDER DEMENTIA CAREGIVERS: THE MEDIATING ROLE OF LIFE DISRUPTION
Authors: Wang Fei , Irani Elliane
Published: December 2022

Providing care to a loved one with dementia can take a mental toll on older adult caregivers who struggle to balance their caregiving duties and self-care. However, few caregiving studies focus on older adults as caregivers. Further, the extant research mainly investigates stressors directly related to the demands of caregiving without accounting for the disruptions in different areas of life triggered by dementia caregiving. Guided by the Stress Process Model, we examined how life disruption mediates the association between caregiving stressors and caregiver mental health. A total of 360 older adult caregivers (age 65 or above) of individuals with dementia (age 65 or above) in the U.S. were selected from the 2017 National Study of Caregiving. An index of life disruption was created based on seven types of life challenges due to caregiving, such as constriction of social life and job-caregiving conflict. Results from a path analysis show that both objective and subjective caregiving stressors (i.e., care assistance and role overload) were positively associated with life disruption, which in turn, were positively associated with depressive symptoms and anxiety. Caregiver socio-demographics and self-rated health were included in the analysis as covariates. These findings inform a novel clinical assessment framework for practitioners to identify the unique challenges faced by older dementia caregivers in the U.S. Moreover, this study elucidated life disruption as a modifiable factor to mitigate mental health problems in this population. Future research should compare the effects of different types of life disruption on mental health among older dementia caregivers.
CAREGIVING FOR AN OLDER RELATIVE IN YOUNG ADULTHOOD
Authors: Fingerman Karen , Zhang Shiyang , Zhou Zexi , Ng Yee To , Birditt Kira , Zarit Steven
Published: December 2022

Caregivers are typically viewed as midlife or older individuals, but nearly 25% of self-identified caregivers are young adults (aged 18 to 29). We report findings from a small study of Hispanic/Latinx, African American, and Asian American young adult caregivers, using: quantitative and open-ended assessments and weekly diary surveys. We assessed caregiving tasks young adults provide, rewards, and detriments of providing care. In open-ended responses, young adults described their caregiving roles as emotional as well as hands on, and reported filling in for other caregivers who could not help. They reported goal disruptions (e.g., education, romantic ties) associated with caregiving, but felt they were repaying debts to their grandparents through caregiving. Diary data document vicissitudes in weekly caregiving experiences and well-being. Discussion focuses on the unique implications of caregiving ties between young adults and their grandparents when the grandparent incurs physical or cognitive health impairments.
SLEEP IS REQUIRED FOR ODOR EXPOSURE TO CONSOLIDATE MEMORY AND REMODEL OLFACTORY SYNAPSES
Authors: Chandra Rashmi , Farah Fatima , Muñoz-Lobato Fernando , Bokka Anirudh , Benedetti Kelli , Saifuddin Fatema , VanHoven Miri , L'Etoile Noelle
Published: December 2022

Olfactory dysfunction precedes dementia in several neurodegenerative disorders such as Alzheimer’s disease (AD) or Parkinson’s Disease (PD), and AD/PD are associated with progressive sleep abnormalities. However, how sleep affects cognitive performance remains unclear, perhaps due to the complexities of the human nervous system. Here we demonstrate that the transparent model organism C. elegans which has well defined neural connection sleeps after repeated odor trainings. This provides us with a platform to dissect how sleep affects memory at a synaptic resolution. We identified that sleep after training is required for the animal to retain a long-term memory of the odor. We found that if animals do not sleep in the first two hours after training, memory is not consolidated. After identifying the neurons that are required for the memory, we show that the sensory-interneuron connections within the circuit are downscaled after sleep. Therefore, we found a time-specific requirement of sleep that modulates synaptic downscaling to preserve memory. Conversely, lack of sleep post-training erases the long-term memory and destabilizes the synaptic downscaling, indicating that modulating the amount of sleep is sufficient to modulate memory. These results make C. elegans an excellent tool to ask what molecular mechanisms, cell biological processes and circuit level reorganizations are engaged during sleep to promote memory. This understanding will provide insights into the functions of sleep that affects cognitive performance in neurodegenerative diseases.
TRACING THE RELIGIOUS LIFE COURSE: INTER- AND INTRAGENERATIONAL SOURCES OF LATER-LIFE RELIGIOSITY IN BABY BOOMERS
Authors: Silverstein Merril , Yoon Joonsik , Harris RianSimone , Hwang Woosang
Published: December 2022

The development of religiosity in later life has its origins in earlier phases of the life course, yet few studies have investigated the contribution of early religious exposure to religious beliefs and behaviors in old age. This investigation uses multigenerational data from the Longitudinal Study of Generations taken from 385 baby boom children, 16-26 years of age, and their parents in 1971, and follows the children’s religious orientations into midlife and old age. Guided by intergenerational transmission and path dependency perspectives, we found that parents’ religious intensity in 1971 strengthened their children’s cognitive and behavioral religiosity in later life as mediated by children’s early and midlife religiosity. Our results demonstrate both intergenerational transmission followed by temporal stability in religious belief and practice. Evidence suggests that parental influence creates religious momentum in their children that carries from adolescence/young adulthood through the unfolding of their lives into old age.
MULTIMODAL AFFECTIVE ANALYSIS OF FACIAL AND VOCAL EXPRESSIVITY USING SMARTPHONE AND DEEP LEARNING ANALYSIS
Authors: Kim Heejung , Cho Youngshin , Lee Sunghee , Kang Chaehyeon
Published: December 2022

Limited expressivity of emotion is one of the most common symptoms of major depression, particularly in older adults. Although assessing facial and vocal expressivity is very important for accurate clinical evaluation of geriatric depression, research has rarely examined older adults via telehealth technology. This study aims to quantify facial and vocal expressivity via a multimodal affective system with deep learning. A total of 19 Korean adults aged over 65 years with severe depressive symptoms participated in this research. Using smartphone video recording, 1,429 facial and vocal data were collected between July and December 2020. Recorded videos were transmitted automatically to the cloud system. Basic facial movements were extracted using combined video frames and mel spectrogram images. Compared to the AI hub of Korean images from big data, mood status was classified into seven categories (anger, disgust, fear, happiness, neutrality, sadness, and surprise). Frequencies of each mood were coded into continuous variables for each participant in each recording. When comparing video and text prediction to determine “true labels,” the overall accuracy was 0.69, with F1 scores ranging from 0.57 to 0.79. In addition, the most common emotions were angry, happy, neutral, sad, and surprised. This study suggests that smartphone-recorded video could function as a useful tool for quantifying mood expressivity. This study established a preliminary method of affective assessment for older adults for telecare use based on socially assistive technology at a distance from the clinic.
COMMUNICATION WITH HEALTHCARE PROVIDERS DURING THE PANDEMIC: EXPERIENCES OF OLDER ADULTS
Authors: Sweeder Logan , Sillner Andrea , Boltz Marie , Van Haitsma Kimberly
Published: December 2022

The COVID-19 pandemic introduced many societal changes, including the need to use technology to communicate with healthcare providers. For many this was a new form of communication. This study examines (1) who older adults identified as healthcare providers and (2) reflected on how communications with formal healthcare providers changed during the pandemic. This data is a subset of a cross-sectional descriptive survey that was distributed electronically to a sample of community-dwelling older adults aged 65 years and older (N=323). Qualitative data was analyzed using thematic analysis. Quantitative data was analyzed using descriptive statistics. Participants averaged 72.7 years of age and 74.5% were retired. Just over ¼ of the sample identified nurses as part of their formal healthcare team; however, participants who identified nurses as formal healthcare providers had fewer negative themes regarding telehealth communication with healthcare providers compared to those who did not. They were also more likely to support in-person and technology driven communication models in the future. Telehealth remains an evolving form of primary healthcare that was utilized throughout the COVID-19 pandemic. Many older adults in our study considered it a resource that requires further optimization while others were staunch opponents to its continued employment in healthcare settings. Nurses are a vital part of our healthcare system and frequently interact with patients and families to coordinate care. Further research should examine how different scopes of nursing practice can support the implementation of telehealth to improve care delivery among community-dwelling older adults.
TURNING REAL-WORLD DATA INTO ACTIONABLE EVIDENCE FOR HEALTHCARE INTERVENTIONS IN NEURODEGENERATION
Authors: Poulsen Rachel , Chang Jun Ha , Bhatti Danish , Rizzo Matthew , Merickel Jennifer
Published: December 2022

Background

Age-related neurodegenerative disorders, including Alzheimer’s disease and Parkinson’s disease (PD), progressively reduce mobility and quality of life (QoL). Real-world mobility from actigraphy predicts PD disease severity. This pilot analysis assessed utility of actigraphy to screen early physical function-related QoL decline in PD. Method: Mobility was monitored for 4 weeks using wrist-worn ActiGraph recordings in 27 participants with idiopathic PD (age = 67.78 ± 5.64, 19 males). Days with >600 mins of wear time during non-sleep times were analyzed (µ = 29.78 days ± 3.78). Typical activity was quantified as average steps per hour. Participants completed demographic and health assessments. Disease severity and physical function QoL were measured using the clinically-validated Unified PD Rating Scale (MDS-UPDRS) and Short Form-36 (SF-36), respectively. Disease severity, QoL, and typical activity were compared using Spearman correlations.

Results

Lower typical activity from actigraphy was associated with more severe motor symptoms (MDS-UPDRS; r = -0.40, p = 0.04) and with increased impairment in physical function QoL (r = 0.50, p < 0.01). Daily activity from actigraphy did not predict symptom severity of non-motor and motor-related complications. Discussion: Pilot results show utility of actigraphic metrics for indexing real-world mobility and QoL declines in neurodegenerative disorders, in line with broader efforts to turn real-world data into actionable evidence for healthcare interventions. Ongoing discovery in larger populations should yield robust, clinically-relevant indices of daily activity in aging and neurodegenerative impairment.
RACIAL/ETHNIC DISPARITY IN 4M-BASED PRIMARY CARE DELIVERY VIA TELEHEALTH IN PROVIDER SHORTAGE AREA
Authors: Lee Rain , Kim Yi Hyun , Kim Laurie , Yoo Ji Won , Maxi Andrea , Hong Chelin
Published: December 2022

Background

Telehealth is a promising alternative to primary care delivery in provider shortage areas. The purpose of this study was to evaluate the implementation of the 4Ms (i.e., Medication, Mentation, Mobility, What Matters) framework in telehealth-based primary care in provider shortage areas by ethnic status.

Methods

This study was a retrospective analysis of 184 older adults (60+) representing 5% of the total sample at urban primary care in ethnically and racially diverse populations. Data were retrieved from July 2020 to September 2021. 14 trained primary care providers participated in this study and provided the 4Ms as following: 1) Medication (e.g., deprescribe or reduce high-risk Medication); 2) Mentation (e.g., depression and cognition assessment with brief counseling); 3) Mobility (e.g., mobility and home safety assessments); 4) What matters (e.g., advance care planning). The current study measured components of the 4Ms per telehealth visit by ethnic/race status (white vs. non-white).

Results

Overall, advance care planning (i.e., what matters) was the most discussed via telehealth (79%), followed by mobility (46.2%), Medication (16.8%), and Mentation (14.7%). To examine the disproportion of accessing telehealth by patients’ racial background, the independence test of chi-square showed that non-white populations were less likely to have access to telehealth than white patients (p = .02).

Conclusion

There was an ethnic and racial disparity in the 4M framework application via telehealth in an urban primary care clinic. To sustain telehealth for patients in a healthcare shortage, ethnically and culturally specific training is needed, and linguistically diverse curricula are recommended.
CROSS-NATIONAL DIFFERENCES IN ATTITUDES TOWARD FAMILY AND GOVERNMENTAL SUPPORT FOR ELDER AND CHILD CARE
Authors: Avni Elinore
Published: December 2022

Population aging in wealthy western nations has raised concerns about who will provide care to older adults. At the same time, the rise of single parenthood and dual-career families has heightened the need for childcare. As governments and families face challenges in meeting these dual needs, this study compares responses to the question of “who should primarily provide” eldercare and childcare across three countries: the US, Germany and Israel. Analysis of 2012 International Social Survey Programme data reveals that while persons in the US endorse family as care providers to both older adults and children, Israelis endorse government as eldercare providers yet family as the source of childcare provision. German respondents prefer both government and family as childcare providers, yet believe the government should provide eldercare. The paper discusses how cross-national differences in attitudes toward care are associated with cultural and socio-economic characteristics, and highlights implications for policy and practice.
CANCER CARE IN ELDERLY: CHALLENGES AND REQUIREMENTS OF INFORMAL CAREGIVERS
Authors: Chakravarty Esha , Chakravarty Indrani
Published: December 2022

The affect of Covid -19 and changes in healthcare has shifted most of cancer care of elderly to home settings. Calcutta Metropolitan Institute of Gerontology (CMIG), Regional Resource and Training Centre in Ageing studied the daily tasks, requirements and emotional burden of caregivers in West Bengal, India. Caregivers of lung cancer, liver cancer and colorectal cancer patients (n=500) completed questionnaires provided by CMIG. The mean age of cancer patients was 72.5 years. CMIG found that 47% of the caregivers were the spouses of elderly patients, 33% were their adult children and 20% were other family members. Forty six percent of the caregivers were found to care for patients with metastatic disease, 33% cared for co morbidities, 63% cared for those undergoing chemotherapy or radiotherapy. Ninety eight percent of the caregivers provided assistance with Activities of Daily Living, 75% in administering medicine, 47% helped in pain management, 39% helped in hospital visits or deciding to call doctor. Twenty one percent of the caregivers reported poor health and 16% were not confident of the quality of care they provided. Sixty six percent reported suffering from stress and perceived cancer as a family disease, 45% thought they lacked social support. Of the adult children who provided care, 78% resported they needed more training to provide quality cancer care and transitioning to formal care would improve results.This study will help influence State policies for allocation of resources for training for cancer caregivers, build support groups for stress management and create cancer care helplines.
POTENTIAL PREDICTORS OF HEALTH LITERACY IN OLDER ADULTS
Authors: Rubinstein Stephanie , Fennell Gillian , Zelinski Elizabeth
Published: December 2022

Objective

Being able to effectively communicate health care needs and understanding health-related information is particularly important as people grow older. In this study, we sought to identify the factors related to subjective health literacy among older adults.

Methods

We examined eight potential predictors of health literacy: subjective memory, cognition, objective health literacy, self-rated health, age, sex, race, education, depression. Our data was derived from a large sample (N=1,272) of participants aged 50 and older who took part in the Health and Retirement Study (HRS; 2008 wave and 2009 internet survey).

Results

Controlling for all other variables, subjective memory (b = .15, p = .02) was positively and self-rated health (b = -.09, p < 0.001) was negatively associated with subjective health literacy. Neither objective health literacy, cognition, nor age were significantly associated with subjective health literacy. Women reported better health literacy than did men (b = .09, p = 0.01). The predictors in this model explained 9% of variation in subjective health literacy. Discussion: These findings may be better understood as we take into consideration the interplay between health literacy, cognition, education, and subjective memory established in extant literature. We discuss the implications of our findings as they relate to healthcare decision-making as well as plans for future research.
LONGITUDINAL EFFECTS OF HYPERTENSION ON COGNITIVE PERFORMANCE IN OLDER ADULTS
Authors: Moll Allison , Woodard John L
Published: December 2022

Hypertension impacts many older adults, but it is still not clear whether it has a negative effect on cognitive performance in older adults. The purpose of this study was to assess the longitudinal effect of hypertension on cognition in older adults (Mage=75.6 years, SD=8.3). Participants came from the National Alzheimer’s Coordinating Center database. The cognitive assessment included the MoCA, Digit Span, Trail-Making Test A and B, WAIS-R Digit Symbol, Category Fluency, and Letter Fluency. Linear mixed effects modeling examined the random and fixed effects of clinician-assessed hypertension, months since first study visit, sex, age, and the interaction between hypertension and time since first visit on cognitive performance across five annual study visits. Results showed that hypertension had a significant main effect on Category Fluency, Trails B, Letter Fluency, and Digit Span–Forward and Backward. However, effect sizes were quite small (ηp2 range: 3.93x10-4 – 1.73x10-3). Main effects of age and months since first visit were significant predictors of all cognitive measures, such that older age was associated with worse cognitive performance and more months since the first visit was associated with better cognitive performance. This positive association is perhaps suggestive of practice effects across study visits. A significant interaction between hypertension and months since first visit for Category Fluency and Trails B showed that hypertensives and non-hypertensives performed differently at the initial visit but similarly by the last visit. However, effect sizes were small (ηp2 range: 3.86–9.64x10-4). These results suggest hypertension effects on cognition in older adults are minimal.
LIFE COURSE CONDITIONS AND COGNITION IN A NATIONALLY REPRESENTATIVE SURVEY OF OLDER ADULTS
Authors: Iveniuk James , Compernolle Ellen , Gupta Riddhi , Hanis Jen , Hawkley Louise
Published: December 2022

By the time people reach older adulthood, their cognitive function may be conserved, or in decline, in part due to their social experiences over their entire life course. Researchers have gained a greater understanding, over recent decades, of the importance of life-course events for cognition in later life. Nevertheless, our understanding of many of these factors, especially in childhood, remains limited. Drawing upon Round 2 of the National Social life, Health, and Aging Project (NSHAP; N=3,377), and data linked to the 2010 census, the 1940s census, and air pollution data, we undertake a whole-life-course approach to understanding the determinants of cognitive function in older adults. Building on the work of the Lancet Commission on risk factors for dementia, we considered health conditions, low education,incarceration, and brain injury (ever); poor health behaviors and low social contact (current); and air pollution (average over past five years). We also considered adverse childhood experiences,, and home conditions in 1940. Similar to other studies, we found that female gender, identifying as white, and being born in the US were significantly associated with better cognitive function. Higher depression and lower social contact were associated with worse cognition. There were no significant associations between cognition and early childhood factors - with the exception that growing up in an urban area was associated with better cognitive function. Experiencing jail time was also negatively associated with cognitive function. Findings point towards the need for a more expansive consideration of life course conditions, as they impact cognition in late life.
THE RELATIONSHIP BETWEEN SKIPPING BREAKFAST AND DEMENTIA: A RETROSPECTIVE COHORT STUDY IN OSAKA
Authors: Chikama Hitomi , Kanaya Reiko , Takeya Yasushi , Toki Hiroshi , Yamamoto Ryohei , Yamakawa Miyae
Published: December 2022

In Japan, annual medical checkups are carried out to prevent lifestyle diseases. Studies have found that skipping breakfast is a risk factor for diabetes, and potentially also dementia. This retrospective cohort study aimed to evaluate the relationship between skipping breakfast and dementia in people with diabetes. The eligible cohort was anyone on the National Health Insurance Database of Osaka who had a checkup in FY 2013 and had diabetes (N = 283,410). The cohort was divided into two groups, those who skipped breakfast more than three times a week (7.38%) and those who did not. The database does not allow individuals to be identified. People with diabetes were defined as those prescribed diabetes drugs in the year before the checkup or with HbA1c of 6.5% or higher at the checkup. People with dementia were defined as those prescribed anti-dementia drugs between April 2014 and December 2017. Data also included body mass index (BMI), smoking, sex , age, and prescription of hypolipidemic or blood pressure drugs. Logistic regression analysis was used, with odds ratio (OR) and 95％ confidence interval . Being male, younger, smoking, having lower BMI or HbA1c levels, and drug prescriptions were associated with skipping breakfast. Skipping breakfast was associated with dementia (OR 1.26, 1.14–1.41), as was lower BMI and being older. For people with diabetes, skipping breakfast is a risk factor for obesity and dyslipidemia, which are associated with dementia. This study therefore provides evidence for a health behavior approach to eating breakfast in people with diabetes.
ASSOCIATION OF SUBJECTIVE AND OBJECTIVE COGNITION WITH DISEASE AWARENESS: EVIDENCE FROM BLOOD BIOMARKERS DATA
Authors: Lin Zhuoer , Fu Mingqi , Chen Xi
Published: December 2022

Impaired cognitive ability and its misperception contribute to poor decision-making of older adults; yet their impact on health-related decisions is less known. We examined how self-perceived and actual cognition were associated with chronic disease awareness using a nationally representative sample of Chinese older adults. Blood biomarkers data were collected in 2015 to identify participants’ dyslipidemia and diabetes status. Among participants with identified dyslipidemia or diabetes, disease awareness was defined as self-reported diagnosis of the conditions as of 2018. Objective and subjective cognition were respectively assessed using the Mini-Mental State Examination and self-rated memory. The associations of subjective and objective cognition with chronic disease awareness were determined by weighted logistic regressions. Among 4,578 adults aged 60 and older with complete measurements, 1,442 and 759 individuals were identified having dyslipidemia and diabetes, with proportions of disease awareness being 38.0% and 58.1%, respectively. Individuals with mild (Odds Ratio [OR]=0.63; 95%CI: 0.45-0.89) or severe cognitive impairment (OR=0.46; 95%CI: 0.29-0.72) had lower odds of dyslipidemia awareness; and those with severe cognitive impairment had lower odds of diabetes awareness (OR=0.43; 95%CI: 0.23-0.79) than cognitively intact counterparts. However, adjusting for objective cognition, older adults with better subjective cognition had lower odds of dyslipidemia (OR=0.80; 95%CI: 0.63-1.02) and diabetes (OR=0.71; 95%CI: 0.55-0.92) awareness. Such associations were stronger for individuals with rural status, lower education, or living without children. Our findings highlight the great challenges deteriorated cognitive function and misperception may pose to chronic disease awareness, as well as the importance of targeted supports particularly for those more disadvantaged.
DETECTING NARCISSISM FROM DAILY LANGUAGE USE: A MACHINE LEARNING APPROACH
Authors: Zhang Shiyang , Gao Sibo , Fingerman Karen
Published: December 2022

High-quality social contacts are important for older adult’s emotional well-being whereas narcissism, characterized by self-centeredness, may undermine the quality of personal relationships. Narcissism may be associated with poorer quality relationships because narcissistic adults are more self-centered in their daily social interactions. The current study examined the associations between linguistic features of conversation throughout the day and narcissism using a machine learning approach. Older adults aged 65–89 (N = 281, Mage = 74.07) wore an unobtrusive electronically activated recorder (EAR) throughout the day for 4 to 6 days. The EAR was activated 30 seconds every 7 minutes to capture conversations occurring in a natural setting. The sound files that contained participant’s speech (N = 28,243) were transcribed verbatim. We used Linguistic Inquiry and Word Count (LIWC) to extract linguistic features from the transcriptions (nfeature = 81; e.g., function words, affective processes). Linguistic features were analyzed using random forest algorithm which is a supervised machine learning method that can evaluate features’ performances in predicting older adult’s narcissism. The model reached an accuracy of 62% and results showed that total word count, more auxiliary verbs (e.g., will), more swear words (e.g., damn), and less assent (e.g., agree) were the most powerful predictors of narcissism. Drawing on sound files collected from real-life interactions, findings indicate higher usage of aggressive and disagreeable words among more narcissistic individuals, which probably leads to poorer quality relationships with social partners. Interventions aiming to improve contact quality and emotional well-being may consider individuals’ word use in daily interactions.
CAN YOU HEAR ME? A MEDICAL STUDENT-LED QUALITY IMPROVEMENT INITIATIVE FOR HOSPITALIZED PATIENTS WITH HEARING LOSS
Authors: Rennke Stephanie , Warren Rachel , Sims Wynton , Menon Shreya , Binford Sasha , Rathfon Megan , Wallhagen Margaret
Published: December 2022

In acute care settings hearing loss (HL) is associated with impaired patient-provider communication, increased length of stay, and increased mortality. COVID-19 has exacerbated this problem with the widespread use of masks and eye shields which muffle speech and prevent lip reading. Our 800-bed tertiary care medical center lacked a standardized approach to identify patients with HL and address communication barriers. Three first year medical students spearheaded the initiative as part of a health systems improvement curriculum with support from a faculty coach and a faculty researcher. From September 2020 to October 2021, the students met with stakeholders, leadership and champions and unit staff, identified the current state and completed a gap analysis through interviews, surveys, and direct observation. The pilot in May 2021 included two week-long PDSA cycles on one hospital unit to: 1) screen patients aged 65 and older using the validated 10-item HHIE-S questionnaire, 2) implement an education and awareness campaign with bedside signage, posters, and conferences and 3) provide a personal amplifier (purchased in bulk by the medical center) with verbal and written instructions. A total of 29 patients screened positive and were given personal amplifiers. Post-pilot interviews reported increased provider awareness and knowledge around best communication practices. Patients and staff reported limited amplifier use due to poor sound quality, small dials, poorly fitting ear buds and a short battery life. Based on these results the team recommended discontinuing the personal amplifiers and identifying other communication tools including higher quality personal amplifiers and speech to text applications.
INVESTIGATING THE CONNECTION BETWEEN AGEISM AND ELDER ABUSE
Authors: Burnes David , Pillemer Karl , MacNeil Andie
Published: December 2022

Elder abuse is recognized as a pervasive public health problem with detrimental consequences for older adults and society. Although considerable research has examined elder abuse risk factors at the individual level, there is a growing call for the field to move beyond proximal causes and consider broader socio-cultural and structural factors that influence elder abuse. Illustrating this shift, organizations, advocacy groups and researchers have proposed a connection between ageism and elder abuse. However, despite the assertion that ageism is a causal factor for elder abuse, there is a scarcity of research to demonstrate this relationship, and a coherent theoretical framework linking ageism to elder abuse remains to be articulated. The purpose of the current study was to examine the conceptual pathways and limited empirical research connecting ageism and elder abuse, and to develop a conceptual model that links ageism and elder abuse. We conducted a comprehensive review and synthesis of the ageism/elder abuse literature, as well as research from other domains of interpersonal/family violence. Based on this synthesis, the proposed model includes plausible mediators (social isolation, devaluation, depersonalization, infantilization, powerlessness, blame) and moderators (intersection with socio-cultural identities, internalized ageism, policy/social norms) that could be targeted as mechanisms of change in interventions designed to address the issue. As such, it provides a framework for hypothesis-testing and future research on the topic. This study informs a research agenda to bring conceptual clarity and empirical evidence to the study of the connection between ageism and elder abuse.
THE ASSOCIATION BETWEEN FINANCIAL RESOURCES AND STRESSORS AND FINANCIAL EXPLOITATION
Authors: Hall LaToya , Moray Juno , Gross Evan , Lichtenberg Peter
Published: December 2022

The prevalence of financial exploitation (FE) experienced by older adults is increasing. Population-based survey estimates of FE in the older adult population range from 5% to 11%. Given the growing prevalence of FE victimization in older adult populations, understanding the population’s vulnerability to FE has increased in importance. This study investigates a conceptual framework in an attempt to understand how financial stressors and resources are associated with substantiated FE in a sample consisting largely of black older adults. The study uses a cross-sectional design to investigate group differences among a total sample of 142 community-dwelling older adult participants, 62 of whom sought services to address FE and 80 with no FE history FE. Older adults who sought services to address FE were more likely to be unmarried and had fewer years of education. Financial literacy had a protective effect on FE, whereas and perceived financial vulnerability increased FE risk. According to the findings sociodemographic and financial stress and resource measures have significant relationships with FE. These findings support the conceptual framework describing their relationship. This new conceptual framework provides a guiding factor in better understanding older adult's vulnerability to financial exploitation.
EXPOSING THE REALITIES OF THE WORKFORCE IN NURSING HOMES
Authors: Mueller Christine
Published: December 2022

For decades, staffing in nursing homes has been highlighted as being inadequate and directly affecting the quality of care received by residents. The COVID-19 pandemic, occurring during the committee’s deliberations, further highlighted and exacerbated the multiple workforce challenges in nursing homes. The committee’s recommendations related to the nursing home workforce will be presented. Dr. Christine Mueller, a professor at University of Minnesota and with expertise in staffing and quality of care, will discuss strengthening the workforce to meet complex and varied resident needs that align with the committee’s recommendations.
FRAMING CLIMATE-CHANGE INFORMATION TO PROMOTE ACTION IN OLDER ADULTS
Authors: Lemaster Philip
Published: December 2022

Climate change poses an existential global risk, and mitigation requires population-level behavioral change. Due to their shortened time horizon, older adults may not perceive climate change as a personal risk within their lifetime and may be less likely to take action to combat climate change. Socioemotional selectivity theory (SST; Carstensen, 2006) posits that, as people age and perceive a shorter time horizon ahead, they become more focused on maintaining emotional wellbeing. This study, rooted in SST, manipulated the emotional framing of climate-change information in a sample of U.S. older adults. Participants were given EPA climate-change information localized to their state of residence and were instructed that, by taking action, the impact of climate change could be reduced (instilling hope) or that, by not taking action, the impact of climate change could be exacerbated (instilling fear). Afterward, they completed measures assessing their willingness to engage in pro-environmental behaviors and support of macro-level legislation to combat climate change. Compared to older adults who received the "hope" frame, older adults who received the "fear" frame reported greater willingness to engage in pro-environmental behaviors (p = 0.007) and greater support of legislation to combat climate change (p = 0.038), perhaps an effect of older adults' motivation to reduce the negative affective state induced by the "fear" frame. Implications of these results for catalyzing older adults toward climate action are discussed.
THE AGE-FRIENDLY COMMUNITY ENVIRONMENT FACTORS CONTRIBUTING TO LIFE SATISFACTION OF OLDER ADULTS LIVING ALONE
Authors: Choi Mi Sun , Lee Hyunmin
Published: December 2022

Age-friendliness studies in Korea have investigated a few subsets of the local community environments for older adults’ well-being. Little is known about comprehensively understanding which aspects in community contexts can help older individuals living alone improve their life satisfaction. To address the knowledge gaps, this study utilized the raw data from the 2020 National Survey of Older Koreans, and responses of 3,112 older adult single-person households were investigated. From an ecological perspective, hierarchical regression analysis was performed by distinguishing the community environments into three categories of the World Health Organization’s age-friendly environments: physical, social, and service environments. The results showed that the perception of the physical environment (housing, living facilities, and space) was positively associated with life satisfaction. Second, the social environment (social involvement, neighbor interaction, respect for older individuals, and political activity) was positively related to life satisfaction. Third, perceived service environment (difficulty in utilizing service) was negatively related to life satisfaction. Based on the findings, we proposed political and practical recommendations. Specifically, as a physical environment aspect, effective budget allocation and policy attention should be required for the autonomy and independence of older adults living alone in their daily lives by ensuring that housing and circumstances are suitable for aging-in-place. As a societal component, initiatives must be established to promote participation in decision-making processes that result in a more favorable social perception through social inclusion. Finally, for the service environment, we must advocate for increased accessibility to community supportive services (mobility, health care, food delivery, communication, and information).
FACTORS IMPACTING EMERGENCY PREPAREDNESS AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Thompson Alisha , Little Kristina , Kim Youn Kyoung (Lily)
Published: December 2022

Natural and manmade emergencies have become more frequent over the past 20 years and will continue to pose serious risks to public health and safety. Older adults are more adversely affected by—and less prepared for—emergencies than younger adults. However, little is known about the risk factors impeding emergency preparedness among older adults. This study uses the ecological systems approach to explore factors associated with emergency preparedness and how those factors influence adults 60 and older. The study analyzed cross-sectional data taken from 690 community-dwelling older adults who participated in Wave 5 of the National Poll on Healthy Aging. The sample was broken down into the following two groups for comparison: individuals aged 60–69 (n = 383) and individuals 70 or above (n = 307). The self-reported measures of sociodemographic characteristics, physical health, mental health, and previous experience of a disaster were utilized via regression analysis to predict emergency preparedness. Emergency preparedness was assessed using X dichotomous questions (60-69: M = X; 70+: M = X). The results revealed that living alone and having a Hispanic background were negatively associated with emergency preparedness among those aged 60–69, while mental health status was positively associated with emergency preparedness among those aged 70+. Previous experience of a disaster positively impacted emergency preparedness among the sample. Implications for policy and practice focus on shifting the perspective of the disproportional risks for older adults around emergencies to one that values and supports older adults’ strengths and insights.