bluuebunny/crossref_metadata_2025 huggingface dataset:
PARTNERS IN DEMENTIA – NORTHWEST: NEW APPROACHES IN MEDICAL STUDENT SERVICE LEARNING
Authors: Wang Mengru , Rosenbloom Michael , Becker Marigrace , Adaniya Stephanie
Published: January 2025

Partners in Dementia – Northwest is the first service-learning program at the University of Washington School of Medicine focused on older adults and persons living with memory loss, established in 2023. First year medical student volunteers, “mentees”, were paired with older adults living with memory loss, “mentors”, recruited from a memory disorders clinic based at the University of Washington. In its pilot year, 10 students were paired with 10 older adults and their caregivers, for bimonthly to monthly visits at the Memory Hub, a community space affiliated with the University that provides education, support, and wellness services. Students participate in mentor visits and group activities at the Memory Hub and accompany mentors to medical appointments to experience the health care system from the perspective of a person living with memory loss. The goals of the program are to provide medical students with early clinical exposure to memory disorders, reduce stigma surrounding aging and memory loss, and inspire students to pursue underserved specialties in dementia care. Pre-implementation surveys of students found that reasons for participation in the program included interest in learning more about the dementia disease process, building communication skills, recognizing signs of memory loss to enhance clinic skills, and learning how to maximize quality of life for persons with memory loss. Initial challenges identified by students include difficulties in engaging mentors when a caregiver is not present, navigating conversations, and transportation barriers.
SUSTAINABILITY OF OLDER ADULT VOLUNTEERS IN A MEDICAL EDUCATION PROGRAM
Authors: Christensen Keri , Knebl Janice , Severance Jennifer
Published: January 2025

Returning to pre-COVID learning expectations in a post-COIVD learning environment has presented new challenges in medical education. One is the sustainability of older adult volunteers, who are the center piece of a medical education program. Creating a sustainable volunteer program through engagement opportunities provides a space for volunteers to build community. UNTHSC has developed educational opportunities for older adult volunteers to learn about geriatrics as well as to create a space to connect with other volunteers. In the Seniors Assisting in Geriatric Education (SAGE) Program, teams of interprofessional health professions students are paired with volunteer older adults in the community, called Senior Mentors. The students visit their Senior Mentor at home, providing health screenings, safety assessments, community resources, and health education. With the onset of COVID-19 and the transition to virtual meetings with students, volunteers’ attrition was a challenge to administering the program. In response, the SAGE mentors were polled about events they would be interested in attending to increase volunteer engagement. A total of 166 surveys were administered and 78 volunteers responded. Results indicated that the majority (81%) would be willing to attend events and that events would be primarily educational health topics related to older adults. The results of that survey were then used to develop education events held twice a year to give the SAGE volunteers the opportunity to connect to other mentors, to expand their knowledge in caring and advocating for themselves, and to build personal relationships with the team involved with SAGE itself.
MEDICAL STUDENT OBSERVATIONS AND REFLECTIONS FROM A MEMORY DISORDERS BUDDY PROGRAM
Authors: Roy Mishy , Rosenbloom Michael
Published: January 2025

Alzheimer’s disease (AD) impacts 5.4 million individuals with an estimated cost of $215 billion annually in the United States, yet cognitive impairment goes unrecognized in half of affected patients. Potential barriers to diagnosis include physician lack of comfort as well as fear of delivering a devastating diagnosis. Although most medical schools offer training related to AD pathophysiology, few curriculums provide experiential learning that may shape student attitudes toward dementia. Employing the buddy program model, the Partners in Dementia (PND) program paired 20 mild AD patients from the HealthPartners dementia clinic with first year medical students from the University of Minnesota. Students were required to spend four hours/month interacting with their patient families and submit monthly journal reflections of their experiences. A qualitative text analysis of journal entries for 2 cohorts over 2 years was done using line by line text coding, and identified the following major themes: support systems, social-occupational decline, mentor/caregiver’s emotional challenges, activities, self-reflections, and objective/clinical narratives. The primary observations across both years were emotional challenges to living with AD and self-reflections on how to become better and more humanistic physicians. 100% of the families thought this was a valuable exercise and 94% of the students said it changed the way they think about people living with dementia. We concluded that educational models like PND provide medical students with opportunities to make reflections that may shape their future clinical approach to dementia. In turn, these programs may facilitate better identification and management of AD in the community.
INTERGENERATIONAL SERVICE: EXTENDING AGE INCLUSIVITY IN AND BEYOND THE CLASSROOM
Authors: Montepare Joann , Andreoletti Carrie
Published: January 2025

Higher education is becoming more age-inclusive on several fronts and age-friendly teaching and learning strategies are being used in new and novel ways to support a variety of educational outcomes. In this AIHE-ILRCE Interest Group collaborative symposium, presenters will discuss the diverse ways in which intergenerational service activities extend learning beyond the classroom and can enhance age inclusivity in higher education. To begin, Montepare and Baldizar (Lasell University) will provide an overview of contemporary age-inclusive campus initiatives in higher education (Age-Friendly University/AFU, Age Inclusivity Domains of Higher Education/AIDHE) and discuss The Empty Bowls project in which students and older adult community members work together to craft bowls to raise money to support the local Food Pantry. Brothers (Colorado State University) will describe the student-supported Market Days for Older Adults project, a farmer’s market-based program that aspires to address food insecurity and social isolation in older adults. Wei and colleagues (Stockton University) will discuss an intergenerational service project in which students organize technology training sessions aimed at educating older adult community members about various technology-related topics such as using smartphones for chronic disease management, personalized medicine, and more. Kwong (Connecticut College) will describe an interdisciplinary class, Intergenerational Play and Learning, which connects young children, college students, and older adult volunteers to promote learning through storytelling and engaging in play and group activities to strengthen social ties across generations and explore local history. AGHE Fellow and intergenerational scholar, Carrie Andreoletti (Central Connecticut State University), will serve as discussant. Intergenerational Learning, Research, and Community Engagement Interest Group Sponsored Symposium
INTERGENERATIONAL WORKSHOP TO EMPOWER OLDER ADULTS IN SMART TECHNOLOGIES
Authors: Wei Duo , Morales Joseph , Burdick David
Published: January 2025

Intergenerational programming, as outlined by the National Council on the Aging, involves those “activities or programs that increase cooperation, interaction, or exchange between any two generations. It involves the sharing of skills, knowledge or experience between old and young.” The overall goal of the intergenerational service learning project of the Medical Informatics class is to promote learning between university students and older adults in the community, and to put the concept of lifelong learning into practice. In the Medical Informatics class, students collaborate in multiple groups to organize technology training workshops. These workshops are tailored to educate older adult community members on a range of technology-related subjects, including utilizing smartphones and AI technologies for social engagement, entertainment, and health management, with the aim of enhancing health outcomes. The training sessions have been held at various venues across the South Jersey region, including AtlantiCare, Center for Family Services, Hammonton Canoe Club, Capital Health Medical Center, Four Seasons Clubhouse at Smithville, and others. The effectiveness of the intergenerational programming has been assessed through student feedback, surveys of the older participants, student faculty/course evaluations, and media coverage. Results indicate that this service learning initiative is a valuable approach in fostering a culture of learning among university students and community partners alike. University students act as mentors to older adults, while also benefiting from the diverse perspectives shared by the older generation, thus enriching their learning experience. Moreover, this collaborative effort nurtures stronger bonds between communities and the university, promoting mutual understanding and support.
INTERGENERATIONAL PLAY AND LEARNING: OPPORTUNITIES FOR ENGAGING PRESCHOOLERS, COLLEGE STUDENTS, AND OLDER ADULTS
Authors: Kwong Katherine , Franzone Monica
Published: January 2025

The U.S. Census notes that the population age demographic is rapidly changing, with approximately 10,000 individuals a day crossing the age threshold of 65, the mismatch between the number of individuals over the age of 65 and those under the age of 65 will have lasting implications in the coming decades. So, how can we take advantage of this resource? How can we benefit multiple generations? Intergenerational Play & Learning was a new course offered at Connecticut College during the Spring 2024 semester that introduced students to the intergenerational (IG) studies field and engaged them in experiential learning activities with older adults and preschool children. These students studied the changing relationships between young children and older adults through readings, videos, and personal observations. Through journals, interviews, and observation, students gained insights into the benefits of intergenerational learning (IL) and how IL can challenge discrimination. Course participants designed activities to promote social ties across age groups. The main goals for the course were: (1) provide a venue for young children, young adults, and older adults in the New London area to learn from and engage with each other; (2) encourage young and older adult participants to reevaluate stereotypes and discover how generations different from one’s own can provide an opportunity for learning; (3) evaluate the importance of family and community ties; and (4) develop a model for future intergenerational programming.
INTERSECTION OF AGE, SEX, AND FRAILTY: CONSIDERATIONS FOR TRANSLATIONAL GEROSCIENCE, GERIATRICS, AND FORTITUDE
Authors: Hilmer Sarah , Mach John , Howlett Susan
Published: January 2025

Understanding aging, optimising care of older adults and facilitating fortitude, must consider the intersection of chronological age, sex and frailty. While existing initiatives consider these factors separately, they occur together in old age and have complex interactions. This symposium brings together basic and clinical scientists, at differing career stages, from three countries, who have explored these issues in their research. Dr Alice Kane will discuss work from her laboratory in the Institute for Systems Biology, USA, on important sex differences in translational biomarkers for ageing and frailty. Dr John Mach will describe insights from a pre-clinical model of chronic drug therapy and polypharmacy, developed at the Kolling Institute, Australia, on the impact of age, sex and frailty on drug effects. Prof Sarah Hilmer, Australia, will discuss key considerations in age, sex and frailty for development of drugs for older adults, drawing on a recent position statement from the Geriatric Committee of the International Union of Basic and Clinical Pharmacologists that she chairs. Prof Heather Allore, Yale, USA, will share her expertise in biostatistics in aging research, to demonstrate design and analysis techniques that can untangle the relationship between age, sex and frailty, applicable to biological and health sciences research. Prof Paula Rochon, University of Toronto, Canada, will highlight the importance of disaggregated data on sex, age and frailty to inform research, health care and policy for older adults. Finally, Prof Susan Howlett, Dalhousie, Canada, who pioneered research in the intersection of age, sex and frailty, will lead the discussion. Women’s Issues Interest Group Sponsored Symposium
RICH HISTORY OF GERONTOLOGY AND GSA
Authors: Zarit Steven
Published: January 2025

In this presentation, Dr. Steven H. Zarit will lead a panel discussion exploring the historical underpinnings of gerontology and the Gerontological Society of America (GSA), drawing from his distinguished career and vast contributions to the field. Dr. Zarit, celebrated for his groundbreaking research on caregiver burden and stress, as well as family relationships across the lifespan, will delve into the evolution of gerontology and its profound impact on his work. Acknowledging his accolades, including prestigious awards from the GSA and the American Psychological Association, Dr. Zarit will reflect on his journey into gerontology and its intersection with seminal figures like Drs. Powell Lawton, James Birren, and Bernice Neugarten. The panel discussion will feature additional insights, drawing on personal experiences and perspectives. Through a series of questions posed by the moderator, the panelists will delve into their personal motivations, the transformative developments within gerontology, and the enduring influence of key figures in the field. Following the moderated discussion, the audience will have the opportunity to engage in an interactive question-and-answer session, fostering a dynamic exchange of ideas and insights. By drawing on the lessons of the past, this presentation aims to inspire visionary approaches to the future of gerontology informed by a panel who collectively have 145 years in the field.
SUSTAINING VALUES AND CHARTING FUTURES
Authors: Wilber Kathleen
Published: January 2025

In this presentation, Dr. Kathleen Wilber will lead a panel discussion exploring enduring values and evolving challenges within the field of gerontology, aiming to guide the trajectory of the discipline into the future. Dr. Wilber’s research is dedicated to enhancing health outcomes and quality of life for vulnerable older adults through systemic improvements in healthcare delivery. Her expertise in collaborative care models has contributed to understanding cost-effectiveness and optimizing service delivery structures. Recognized for her leadership in gerontology, Dr. Wilber was honored with the prestigious Donald P. Kent Award from the Gerontological Society of America (GSA) in 2023. In her presentation, she will share insights on timeless values that continue to shape the field and propose strategies for addressing persistent challenges. Dr. Wilber will also offer valuable advice for emerging scholars based on her personal journey, reflecting on lessons learned and potential areas for improvement. The panel discussion will further explore visions and directions for advancing the society. Following the moderated discussion, the audience will engage in an interactive question-and-answer session, fostering collaborative dialogue and actionable insights. By deliberating on enduring values, emerging challenges, and future directions, this presentation aims to catalyze concrete action plans to propel the society forward.
THE ASSOCIATION BETWEEN DIGITAL ENGAGEMENT OF OLDER ADULTS AND DISPLACEMENT DURING ARMED-CONFLICT CIRCUMSTANCES
Authors: Mannheim Ittay , Lifshitz Rinat , Bachner Yaacov , Cohn-Schwartz Ella
Published: January 2025

Digital engagement is perceived as having the potential to improve the well-being of older adults. This study tests this notion in extreme circumstances, such as an ongoing military conflict. The association of digital engagement with the well-being of older adults was examined within the context of forced displacement and imminent threat (e.g., rocket attacks) due to the ongoing war in Israel. Ninety-three older persons that were evacuated from their homes, and 150 that were not evacuated responded to an online or paper survey. The survey measured their digital engagement before the war and in the weeks after it began, perceptions towards aging and technology, and well-being (depressive symptoms, loneliness, subjective health, and control). Evacuees were found to be lonelier, with lower subjective health and a lower sense of control compared to non-evacuees. Baseline digital engagement retrospectively reported from before the war was the same between groups. However, following the war, those evacuated reported using a lower number of devices, had different patterns of uses, and perceived higher limitations in using technology. Importantly, a stepwise regression analysis identified that digital engagement was a stronger predictor than displacement on higher loneliness and lower subjective health. Whereas rocket threat was the strongest predictor for depressive symptoms and displacement for sense of control. Negative perceptions towards aging and technology were also predictors of higher depressive symptoms. This study discusses the importance of digital engagement for the well-being of the older population in a world with ever-growing prevalence of extreme circumstances such as armed conflicts.
LONELINESS AMONG ADULTS AGING WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES: THE ROLE OF LIVING SITUATION
Authors: Stokes Jeffrey , Waldron Danielle , Stam Elisabeth
Published: January 2025

Background and Objectives

Loneliness is a serious public health concern among the aging population. Not only is loneliness an unpleasant emotional experience, it is also associated with worse health, well-being, and even mortality. This is a particularly important issue among the population aging with intellectual and developmental disabilities (I/DD), who are more likely to experience loneliness across the life course, and who – particularly if living in an intermediate care facility (ICF) or nursing facility – may lack social connections.

Research Design and Methods

We analyzed panel data from the 2013-2014 through 2021-2022 waves of the National Core Indicators In-Person Survey (NCI-IPS; 8 waves total), a national survey of adults with I/DD receiving state services (N = 101,374 observations drawn from 49 states). Multilevel logistic regression models examined whether loneliness varied according to living situation.

Results

Results indicated that (1) adults aging with I/DD in ICF and nursing facilities reported significantly greater loneliness than those living in the community, and especially those living with family; (2) having friends was associated with reduced loneliness overall, yet (3) significant moderation analysis revealed that having friends was associated with reduced loneliness among those living in the community, but not for those living in ICF or nursing facilities.

Discussion

These results indicate not only that adults with I/DD living in institutionalized settings are at higher risk of experiencing loneliness and its detrimental effects, but that specialized interventions are required to meet their unique needs and reduce their loneliness in mid and later life.
LONELINESS AND SOCIAL ISOLATION IN THE COVID ERA
Authors: Cunningham Solveig , Hale Jo
Published: January 2025

Social isolation and loneliness diminish health and wellbeing and may have been exacerbated during the Covid-19 lockdown. We examined the relationship between social isolation and loneliness among U.S. older adults during the Covid-19 pandemic, when social isolation was high due to transmission reduction measures. Data are from the National Health and Aging Trends Survey (NHATS), representative of the age 70+ Medicare beneficiary population in the United States. Prior to the pandemic, one third of older adults experienced loneliness at least on some days. One in 5 older adults (22.5%; 95% CI: 20.0, 25.0) report an increase in loneliness during the pandemic. Those who were severely socially isolated had double the odds of feeling lonely. However, while unadjusted models suggest an increasingly positive correlation between social isolation and loneliness among older adults, associations in the fully adjusted model have weak and directionally variable correlations, suggesting that the relationship can be largely explained by other social and demographic characteristics. This may also explain why existing literature is divided on the relationship between social isolation and loneliness. During the pandemic, those who felt lonely were also more likely to strictly follow social isolation measures. The frequency of loneliness prior to the pandemic is a strong predictor of loneliness during COVID. Still, loneliness and isolation were only weakly correlated, even during this period of widespread increases in social isolation. The implications of social isolation and of loneliness for older adults’ wellbeing should be considered both jointly and independently, as they are not fully overlapping.
WHAT IS MEMORY CARE IN ASSISTED LIVING?
Authors: Smith Lindsey , Jutkowitz Eric , Thomas Kali
Published: January 2025

Memory care is the most common type of specialized care provided in assisted living (AL) settings. This specialized care caters to people living with dementia and other forms of cognitive impairment. However, what constitutes specialized memory care varies according to who and how the setting is defined. We use the lenses of the state, industry, and consumers to describe the prevalence of ALs with memory care across the US. We created a national directory of ALs and their state licenses to identify those ALs designated as providing specialized memory care by the licensing agency, classified according to whether the state holds these ALs to additional standards or simply requires disclosure. To identify AL communities considered memory care by industry professionals, we relied on a dataset of AL organizations from the National Investment Center (NIC), a nonprofit organization focused on providing data, analytics, and connections to the senior housing and care industries. Finally, to view AL communities through the lens of (potential) residents and their families, we used business advertisement descriptions from Data Axle, a business advertising database. We found that 28% of the 13,715 large (greater than 25 beds) AL communities in our national AL directory were identified as memory care by state licensing agencies, 60% by NIC, and 26% by Data Axle. Our findings raise questions regarding how the care provided in these settings may vary based on who defines memory care.
DEPRESSION AMONG MIDDLE-AGED AND OLDER INFORMAL CAREGIVERS IN 19 COUNTRIES: A CROSS-NATIONALLY HARMONISED STUDY
Authors: Jiang Nan , Pagan Jose , Wu Bei , Li Yan
Published: January 2025

The health of the caregivers is crucial to sustain informal care provision, while depression is an important health risk concept. In this study we aim to conduct multi-country, population-based studies on caregivers’ depression and examine the association of caregiving with depression in 19 countries. We included 142,741 adults aged ≥ 45 years in our sample. Depression was measured using established cut points in shortened Center for Epidemiologic Studies Depression (CES-D) or EURO-D scales. We conducted multivariable logistic regression analyses to explore the association of the past 12-month caregiving with depression. Over 30% of participants in our sample were engaged in caregiving with particularly high rates observed in Denmark, China, France, and Sweden. After controlling for potential confounders, caregivers had a significantly higher risk of having depression (OR = 1.13, 95% CI = 1.02-1.25) compared to non-caregivers. The associations were stronger in China, India, South Korea, Spain, and the United Kingdom than in other countries. Our findings suggest that urgent attention must be given to developing strategies that address the unique challenges faced by caregivers, fostering their well-being while maintaining high-quality care standards. Future interventions and policies need to aim at mitigating the mental health burden experienced by caregivers and ensuring sustainable and effective care support.
OLDER MIGRANTS IN THEIR SOCIAL CONTEXTS
Authors: Ritter Ashley , Glicksman Allen , Diederich Freya
Published: January 2025

It is recognized that a comprehensive understanding of the experiences and circumstances of older adults necessitates an examination of the broader social, institutional, and political frameworks within which they reside. The migration of older individuals entails a transformation in their relationships with family members, social networks, service providers, and governmental institutions. Lawton’s Environmental Press model, which posits that the influence of environmental factors on health and well-being intensifies as individuals age and become more fragile, can be extended to older migrants. Such individuals may find themselves relying more heavily on familial support, social networks, formal caregiving services, and governmental assistance to maintain their health compared to their native environments. The four papers presented in this panel explore the challenges confronting older migrants within these expansive contexts, probing the ways in which these contexts can either positively or negatively impact the well-being of older adults. The papers progress from an examination of familial dynamics (Reyes) to the broader societal milieu (Torres), followed by an analysis of formal care systems (Glicksman et al.), and concluding with an investigation of governmental policies at the national level (Kilkey). Collectively, these papers underscore the significance of social, institutional, and governmental frameworks in shaping the health and well-being outcomes of older migrants. Moreover, the papers underscore the necessity of employing diverse research methodologies, including surveys, qualitative inquiries, secondary data analyses, and literature reviews, to address the multifaceted nature of these issues and to cater to the specific inquiries at hand. International Aging and Migration Interest Group Sponsored Symposium
PLACE OF ORIGIN AND USE OF FORMAL HEALTH SERVICES
Authors: Glicksman Allen , Albert Steven , Davey Adam , Friedman Ari , Lai Philip , Rodriguez Misha , Schrauf Robert , Liebman Michael
Published: January 2025

The point of contact between older immigrants and the formal health system is an area of concern for providers, policy makers and researchers. The challenges that often appear in any interaction between older adults and formal providers are exacerbated when the older person is an immigrant because of language and cultural differences, challenges in a family where migration has taken place, and lack of familiarity with the local system for providing care. Attempts to understand these interactions require attention to two sources of diversity – on the one hand the place of origin of the older migrant and all the social, cultural and policy differences in the places of origin on the one hand and the diversity of types of encounters (ambulatory, emergency department, in-patient hospital) with the formal system and the related issues of insurance status on the other. Our study, using data on encounters between persons speaking Chinese, Spanish or Russian to examine use of the three types of encounters to examine patterns of service use for persons with similar health insurance and primary diagnoses. We will focus on the Chinese speakers and their distinctive pattern of use of formal health service compared to the other groups (Including white and Black English speakers). This is especially true in the lower rate of using emergency departments compared to the other groups. We will also address the challenges to studying immigrant experience in health settings when only language of interaction and not place of birth are collected by health providers.
FOSTERING AGE-FRIENDLY INITIATIVES IN SMALL UNIVERSITIES: A CASE STUDY OF SOUTHERN OREGON UNIVERSITY
Authors: Toyokawa Noriko
Published: January 2025

Compared to their larger counterparts, small U.S. higher education institutions face distinct challenges in implementing Age-Friendly University (AFU) initiatives. This presentation spotlights the AFU initiatives that Southern Oregon University (SOU) implemented as the case of such a higher education institution. Despite its resource constraints, such as the lack of aging-centered academic programs and an on-campus aging institute, SOU exemplifies AFU principles by its faculty’s developing courses to involve retired individuals through community partnerships and cultivate meaningful intergenerational interactions. While discussions on lifespan development topics provided in those courses have produced positive learning outcomes, they have also unveiled areas for improvement. Older adults desire more direct involvement to share their wisdom and expertise with students. In response, incorporating age diversity as a valuable resource, SOU strategically plants to enhance existing academic programs by infusing innovation into courses and promoting mutual learning between generations. For instance, a course in Adult Development and Aging is being re-designed so that collaborative groups of students and older adults will utilize electronic design tools and artificial intelligence to craft a book conveying older adults’ messages for the next generation. This addresses the needs of older adults and enhances technology skills for both groups. After examining the university’s current effort in the AFU initiative, this presentation will delve into small institutions’ unique challenges in promoting AFU initiatives. Recommendations will be explored, emphasizing the vital role of adapting existing courses to foster sustainable lifelong learning across generations.
DEMENTIA PROGRAMS FOR PERSONS WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES (IDD) AND THEIR CARE PARTNERS
Authors: Barton Kelli
Published: January 2025

There are limited evidence-based dementia programs for individuals with intellectual or developmental disabilities (IDD) and their care partners. Alzheimer’s Disease Programs Initiative grants through the Administration for Community Living provide an opportunity to expand evidence-based dementia programs to serve the IDD population. This presentation will discuss outcomes and lessons learned from the implementation of two dementia programs, Reducing Disability in Alzheimer’s Disease (RDAD) and Care Ecosystem, with the IDD population and their care partners through three funded projects. We employed a mixed-method approach to explore program impact and identify lessons learned that can inform dementia programming for the IDD population. Feedback from semi-structured partner interviews and regular meetings revealed several common themes. Partners identified the opportunity to provide dementia and IDD education to staff and to the community as a significant benefit and as crucial to establishing a foundation for program implementation. Further, while many care partners were formal caregivers, whose relationship and experience with the person with dementia typically differ from informal caregivers, results from the RDAD implementation showed promising trends in outcomes for both individuals and care partners. For example, behavioral symptom-related severity among individuals with IDD and behavioral symptom-related distress among care partners both decreased (p=0.07 and p=0.14, respectively), as measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q). Evidence-based dementia programs have much to offer the IDD population and their care partners; however, protocol modifications are needed to ensure physical and cognitive accessibility for individuals with IDD and to meet the needs of informal caregivers.
ADRD RISK REDUCTION HEALTH COACHING
Authors: Zanjani Faika , Hawks Cate , O’Donnell Kennedy , Berman Brian , Sargent Lana
Published: January 2025

Objectives

The development of the Richmond Brain Health Initiative (RBHI) was guided by the need to address local brain health service gaps to improve Alzheimer’s/Dementia (ADRD) health disparities in racially diverse communities. This paper focuses on the ADRD Risk Reduction Health Coaching program component.

Methods

The program is currently in implementation, focused on recruiting diverse older adults living in the Richmond, VA metro area, with the following risk factors: diabetes, hypertension, cardiovascular disease, or subjective cognitive decline. Weekly lifestyle telephone health coaching for 12 weeks was offered, followed by a monthly (6-month) maintenance stage. Health coaching calls last an average of 15-30 minutes per session. The intervention protocol target lifestyle risk via education, learning objectives, personal risk assessment, attitudes, and lifestyle behavioral change goal setting.

Results

The current study sample (n=49) is 96% 60+ years old (n=38), 38% African American/Black (n=18), 6% Hispanic (n=3), 70% female (n=33), 11% military veterans (n=5), 53% live alone (n=25). Preliminary mean differences indicate improvement in ADRD knowledge: baseline mean = 25.8, 12-week = 28.6; Physical Activity: baseline mean = 1.50 hours/week, 12-week = 3.00 hours/week; Social Activity: baseline mean = 2.07 hours/week, 12-week = 2.57 hours/week; Cigarettes: baseline mean = 0.62/day, 12-week = 0.30/day; Alcoholic Drinks: baseline mean = 1.50/week, 12-week = 1.10/week; and Medication adherence: baseline = 86%, 12-week = 100% adherence. CONCLUSIONS: This study showcases a model for reducing ADRD risk and promoting brain health in racially diverse communities by improving access to ADRD community services.
IMPLEMENTING REACH COMMUNITY IN AN INTEGRATED HEALTH SYSTEM: IMPACT AND LESSONS LEARNED
Authors: Herrick Tamara
Published: January 2025

This project examined the implementation of the Resources for Enhancing Alzheimer’s Caregiver Health (REACH) Community program within primary care and geriatrics settings, facilitated by Licensed Clinical Social Workers (LCSWs). The integration of LCSWs into the healthcare system offers a unique opportunity to provide comprehensive care by addressing both medical and psychosocial aspects of dementia caregiving. Their expertise in psychosocial assessment and intervention enables holistic care that addresses the multifaceted needs of care partners and their families. REACH Community is an evidence-based intervention for care partners of individuals living with dementia that focuses on safety, care partner health and emotional well-being, and behavior management. The intervention consists of four core sessions one-on-one with care partners, with additional sessions as an option if needed. Sessions can be delivered face-to-face, by telephone, or telehealth. With the emergence of COVID-19, all sessions transitioned to remote delivery via telehealth Zoom platform or telephone. Pretest posttest design assessed program impact. Key outcome measures included: Caregiver Frustration, caregiver well-being (Zarit Burden Inventory), and mood (PH-Q4). Pre-posttest results indicated that participants had an improvement in well-being, mood, and caregiver frustration following participation in the REACH Community program. The evaluation contributed valuable insights into the feasibility and effectiveness of integrating the REACH Community program into primary care and geriatrics settings utilizing LCSWs. We continue to offer the program in primary care and geriatrics center settings and REACH Community is part of our growing toolbox of evidence-based programs providing support to care partners of people living with dementia.
TRENDS IN RECEIPT OF PAID FAMILY CARE AMONG OLDER ADULTS WITH FUNCTIONAL IMPAIRMENT IN THE UNITED STATES, 2011–2022
Authors: Reckrey Jennifer , Liu Yifan , Qian Yiqing , Ornstein Katherine
Published: January 2025

While caregiving is frequently conceptualized as either paid care (e.g., home health aides, home care workers) or family care (e.g., spouses, children), family members may also receive payment to provide care (i.e., paid family care) through state-level Medicaid-waiver programs or through private arrangements within families. This study examines trends in paid family care prevalence over time and identifies factors associated with receipt of paid family care among older adults with functional impairment using the National Health and Aging Trends Study. Prevalence of paid family care increased slightly over time, with 7.0%, 5.9%, and 8.1% of the sample receiving paid family caregiving in 2011, 2015, and 2022 respectively. In 2022, 27.8% of those with any form of paid help received paid family care; 27.1% was funded privately and 72.9% was funded by other payers like Medicaid. As compared to those with a non-family paid helper, older adults with paid family care were more likely to be female (78.1% vs. 55.6%, p=0.028), Black/non-Hispanic (29.2% vs. 11.5%, p<0.001), and receive Medicaid (62.5% vs. 33.1%, p<0.001). They reported more chronic conditions (4.1 vs 3.2, p=0.012), impairment in more self-care tasks (3.18 vs 2.44, p=0.043), and more total weekly hours of care (20.0 vs 11.2, p<0.001). Paid family care makes a meaningful contribution to total care, particularly among those with high care needs. Future work examining paid family care both within and outside of the Medicaid system should explore the impact of paid family care on older adults and their larger family unit.
TOGETHER IN CARE: ELEVATING THE IMPORTANCE OF FAMILY AND PAID CAREGIVERS
Authors: King Jessica , Scales Kezia , Robins Amy , Gingerelli Toni
Published: January 2025

In 2023, PHI and the National Alliance for Caregiving (NAC) launched “Together In Care: The Direct Care Worker and Family Caregiver Initiative” with funding from the John A. Hartford Foundation. The goal of the initiative is to promote policy changes that address the interrelated needs of family caregivers and paid caregivers in the context of long-term care for older adults and people with disabilities, and particularly in home and community-based services (HCBS). Priority topics for the initiative include improving care team integration for family members and paid caregivers; advancing self-direction options and supports; and securing funding for new research on the underexplored nexus of paid and unpaid care. This presentation will begin by describing the conceptual rationale for focusing on the interconnection and overlap between paid and family caregivers, referencing the limited extant literature on this topic. We will then discuss the methodology and evaluation of our efforts to develop a shared caregiving policy agenda across diverse partners — who include federal and state officials, national experts and movement leaders, and long-term care providers — highlighting successes and lessons learned. The presentation will underscore the importance of using evaluation research methods to inform and assess the implementation and impact of complex policy advocacy interventions; share practical approaches and methods; and end with a discussion of the extensive research gaps and opportunities that have been identified through this innovative initiative.
AN EXAMINATION OF RELATIONAL COORDINATION AMONG PAID AND FAMILY CAREGIVERS IN THE ARIC COHORT
Authors: Ornstein Katherine , Reckrey Jennifer , Ballew Shoshana , Coresh Josef , Wolff Jennifer
Published: January 2025

The oldest-old (ages 85+) are disproportionately at risk for impaired function and reliant on support from caregivers. However, studies of caregiving typically fail to comprehensively enumerate and assess the capacity of both family and paid caregivers, shared care networks, and change over time. In this session we will describe the conceptualization and development of ARIC Cares, a caregiving study that will be embedded within the Atherosclerosis Risk in Communities Study (ARIC), a multisite prospective cohort of ~4,000 individuals ages 81-101 that has been characterized for >30 years. Existing studies of how caregiver factors relate to outcomes for older adults generally evaluate a limited set of measures specific to family caregivers (e.g., relationship to older adult). The role that paid caregivers play in meeting care needs in the community is consistently undervalued and less well studied. ARIC Cares will simultaneously assess family and paid caregivers and utilize the theory of relational coordination for understanding the dynamics of caregiving teams. ARIC Cares, which will focus on the end-of-life period and examine outcomes for older adults and their caregivers, will enumerate older adults’ care networks at 6-month intervals, in 4 diverse communities. Rigorous evidence regarding the caregiving experience, particularly focused on how teams of family and paid caregivers work together, could inform initiatives to improve quality of life among older adults and their caregivers. An understanding of these networks is critical as serious illness care, including complex dementia care, increasingly shifts to community settings where coordination between family and paid caregivers is vital.
RIGHTSIZING: A COLLABORATION BETWEEN PSYCHOLOGY AND EXTENSION TO HELP OLDER ADULTS DEAL WITH SENTIMENTAL CLUTTER
Authors: Dozier Mary , Krafft Jennifer , Turner Pamela , Bales Diane , Moore Susan , Smith Laura , Harris-Speight Jasmine , Buys David
Published: January 2025

Excessive clutter can create a barrier for older adults to maintain functional lives in their homes; however, interventions for hoarding are lengthy, expensive, and often unavailable, particularly for rural-dwelling older adults. Using the Rightsizing Program as an example, this presentation will highlight the synergy between Extension and academic faculty to promote aging in place across diverse states. The Rightsizing Program is a collaboration between Extension specialists at Mississippi State University (MSU) and University of Georgia (UGA) and psychology faculty at MSU with specific expertise in hoarding disorder. The program focuses on sentimental clutter, which can be particularly difficult for older adults to discard. The psychology faculty were able to integrate both their research and clinical expertise to inform program development. For example, there was an added emphasis on decreasing sense of guilt around clutter (e.g., explicitly stating that it is “okay to let go of items.”) that has been clinically observed to occur when older adults are reticent to let go of aspects of their past selves (e.g., clothes that no longer fit). The Rightsizing Program has been presented to 238 individuals and has increased access to both psychoeducation about hoarding and clutter as well as had the additional benefit of facilitating recruitment for psychological studies on hoarding on MSU campus. Partnership between Extension specialists and mental health researchers allows for a rapid dissemination of research findings, while also promoting ongoing research efforts.
CREATING AND SUSTAINING EXTENSION PARTNERSHIPS TO REACH RURAL OLDER ADULTS: THE STAY STRONG STAY HEALTHY PROGRAM
Authors: Miller Kristin , Weitzel Kelsey , Meinertz Naomi
Published: January 2025

Due to out-migration of family members and a lack of transportation and access to resources, rural-dwelling older adults often experience greater social isolation, which is linked to worse health outcomes and a loss of independence. Gerontological researchers have identified that increased participation in social activities can lead to increased social connections among rural-dwelling older adults. Through educational programs, the Cooperative Extension (Extension) system connects older adults with opportunities to engage in community programs to reduce social isolation and support older adults living independently longer. Despite the widespread success of Extension programs, the implementation and collaborative efforts that contribute to the success of these programs are unrecorded in empirical literature. In this presentation, we address this gap by presenting on the Stay Strong Stay Healthy (SSSH) program. SSSH is as an example of the successful implementation of a multi-state Extension program that improves psychosocial and physical health outcomes for both rural and urban older adults. Using the SSSH program as a model, we outline the community-based research principles that inform the collaborations between Extension campus researchers, Extension agents, and stakeholders to reach rural-dwelling older adults. We will draw on a current example of adapting the SSSH program for less ambulatory older adults in rural areas guided by a community advisory committee. By leveraging the resources and expertise of Extension, researchers can enhance the real-world impact of their work and contribute to the reduction of social isolation and increased ability to live independent for rural-dwelling older adults.
LISTENING TO COMMUNITY VOICES FOR COLLECTIVE ACTION: THE OBESITY BILL OF RIGHTS ORIGINS
Authors: Vafiadis Dorothea
Published: January 2025

Four town hall meetings were convened by the National Council on Aging and National Consumers League in senior centers and faith-based organizations during the summer of 2023. These venues were in four different states representing diverse cultural communities and socioeconomic backgrounds. Over 250 older adults, community leaders, and clinicians participated in discussions on the complex social and institutional barriers to obtaining appropriate management of overweight/management. These discussions yielded themes that were translated into the 8 core principles of the Obesity Bill of Rights (OBOR) which address issues such as ageism, weight bias, and aspects of the healthcare system that preclude adequate obesity care, coverage, and reimbursement. Obesity experts and stakeholders reviewed and validated the OBOR in the fall of 2023. On January 31, 2024, the OBOR was officially launched as a framework for health equity and self-advocacy. To date, nearly 50 health organizations and medical societies have endorsed the OBOR.
FROM FEAR TO FORTITUDE AND EMPOWERMENT: A PATIENT’S JOURNEY
Authors: Nece Patricia
Published: January 2025

Many older adults aged 65 and over with overweight and obesity struggle with navigating a health care system that is not inherently equipped to deliver quality obesity care. In the face of ageism and weight stigma, initiating conversations with providers who lack time, education, training, or even empathy can test the “fortitude factor” of even the most resilient of patients. Patricia Nece, J.D. will share her own personal experiences of such challenges and how the Obesity Bill of Rights can empower other patients facing similar situations to advocate for themselves—especially when it comes to making decisions about their own health care.
CREATING AN OBESITY BILL OF RIGHTS–INFORMED CLINICAL PRACTICE: A GERIATRICIAN’S PERSPECTIVE
Authors: Batsis John
Published: January 2025

The Obesity Bill of Rights (OBOR) sheds light on many challenges and opportunities for clinicians to implement in their respective practices. Dr. Batsis will share themes and insights that emerged from recent obesity roundtable discussions hosted by the National Council on Aging and leading up to the creation of the OBOR, including special considerations for obesity prevention and care for older adults aged 65 and over from a clinical standpoint. Barriers to obesity treatment; health care access; and access to trustworthy information for older adults—including those that intersect with issues of diversity, equity, and inclusion—will be explored. Examples of steps Dr. Batsis has taken to align his own delivery of care with the OBOR will be highlighted, as well as recommendations to facilitate open and responsive dialogue built on trust between patients and providers.