bluuebunny/crossref_metadata_2025 huggingface dataset:
CANCER SURVIVORSHIP AND SUBJECTIVE COGNITIVE DECLINE IN THE US: RESULTS FROM A NATIONALLY REPRESENTATIVE SAMPLE
Authors: Brown Monique , Hucek Ally , Wei Jingkai , Anderson Loretta , Na Muzi
Published: December 2023

Cancer may be associated with objective cognitive decline. However, studies examining the link between cancer and subjective cognitive decline (SCD), which occurs earlier during cognitive trajectories, are lacking. In addition, research assessing risk factors for SCD among cancer survivors is scant. Therefore, this study aimed to examine the association between cancer and SCD in the past year, and assess the association between age of diagnosis, cancer treatment, and SCD among cancer survivors. Data were obtained from the 2021 Behavioral Risk Factor Surveillance System (N=15,447). Crude and adjusted logistic regression models, controlling for sociodemographic characteristics, were used to determine the association between cancer diagnosis, age at diagnosis, cancer treatment, and SCD. The association between ever having cancer and SCD in the past year was not statistically significant. However, disparities occurred among those who were cancer survivors. For example, those who were diagnosed with cancer in middle age (aged 35 to 44) had higher odds of SCD compared to being diagnosed at aged 45 and older (adjusted OR (aOR): 2.25; 95% CI: 1.10 – 4.58). Those who were currently undergoing treatment were more likely to have SCD compared to those who completed treatment (aOR: 1.86; 95% CI: 1.06 – 3.27). Respondents who had not started treatment and those who reported treatment was not necessary also had higher odds of SCD compared to those who completed treatment. Findings suggest that age and treatment disparities exist in SCD among cancer survivors. Future studies may include longitudinal observational studies examining cancer-related risks and SCD.
AGE DIFFERENCES IN SOCIAL NETWORK PREFERENCES: IMPLICATIONS FOR DECISION MAKING
Authors: Wild Tess , Löckenhoff Corinna
Published: December 2023

Many consequential decisions are made in the context of a social network, but it is not clear how lifespan developmental changes may influence the way people integrate others into their decision-making processes. Research shows that, compared to younger adults, older adults perform less exhaustive pre-decisional information searches, have smaller and more close-knit social networks, and place more value on harmonious relationships (e.g., Hess et al., 2015). Drawing on these findings, a pre-registered survey study examined age differences in the size, composition, and utilization of decision-related social networks as well as subjective goals and perceptions regarding joint decisions. An adult lifespan sample (N = 432; M age = 50.9375; SD age = 19.53267, range age = 18-96 years) considered hypothetical decisions involving specific (apartment, car, physician, and insurance plan) and generic (important vs. minor) scenarios. As predicted, linear regressions revealed that compared to younger respondents, older respondents reported that they would consult fewer people fewer times, and they were less likely to recruit distant social partners or professionals (ps<.05). Contrary to predictions, the tendency to prioritize relationship harmony over decision quality was negatively associated with age (p<.05). Further, there was no significant relationship between age and the perceived helpfulness of involving others. Findings remained robust when controlling for scenario type and demographic characteristics (gender, education level, race, income). This indicates that the size, composition, and utilization of decision-related social networks differs by age. Further research is needed to examine potential implications for decision quality and satisfaction.
NATIONAL POST–ACUTE AND LONG-TERM CARE STUDY: VARIATION IN OPERATING STATUS OF ADULT DAY CENTERS DUE TO COVID-19
Authors: Lendon Jessica , Singh Priyanka , Lu Zhaohui , Caffrey Christine , Sengupta Manisha
Published: December 2023

The 2020 and 2022 National Post-acute and Long-term Care Study (NPALS) captured nationally representative data on ADSCs’ operating statuses to mitigate COVID-19 among participants and staff. In 2020/2021, 35% of ADSCs were physically open and only served participants onsite, 32% were physically closed but serving participants at places of residence (i.e. virtually, meal delivery, home-visits), 20% served participants onsite and at places of residence, and 13% were temporarily closed and not serving participants. There was statistically significant variation in operating status by region, policy-relevant organizational and participant-level characteristics, and in the types of services provided. Discussion of results will highlight how NPALS data can be used to assess disparities in ADSC availability during the pandemic. Additional information from the forthcoming 2022 survey data will also be discussed, focusing on potential differences in operating status and ADSC characteristics between the two survey waves.
NURSING HOME SOCIAL WORK: CONFLICTING VALUES AND ETHICAL PRACTICE WITH RESIDENTS, FAMILIES, AND STAFF
Authors: Bern-Klug Mercedes , Gammonley Denise
Published: December 2023

People who live in nursing homes and those who spend weeks or months there recuperating from a hip replacement or stroke have a broad range of needs, many urgent and others enduring. Despite the high needs of residents—which have increased over the past decade as resident acuity has increased-- the settings are typically under-staffed both in terms of the number of direct care staff and the preparation of direct care staff (NASEM Report, 2022). Social workers and others in the social service role (i.e., those without a social work education) step into or are tapped to intervene when resident rights conflict with family wishes and/or staff rights and wishes. In this session using findings from both qualitative and quantitative studies, we will describe how and what type of conflicts social workers are involved with and the training they report they need to be better prepared to serve as a resource in this important role.
THE HEALTH CARE COSTS OF DEMENTIA FOR MEXICANS AND MEXICAN AMERICANS IN MÉXICO AND THE UNITED STATES
Authors: Anuarbe Mónika López , Gutierrez Angela
Published: December 2023

Dementia prevalence and costs affect subpopulations differently, generating healthcare and aging disparities. Most research on healthcare costs associated with dementia has overlooked cross-national comparisons among Hispanics in general and Mexicans in particular. This study utilizes the 2012-2018 Mexican Health and Aging Study (MHAS) and Health and Retirement Study (HRS) to assess: 1) relationships between geographic context and healthcare costs (hospitalization, medical, outpatient, prescription, dental); and 2) whether dementia status moderates the geographic context-healthcare costs relationship. We hypothesized that persons with dementia incurred higher healthcare costs in both countries, and that residents in less populated areas had lower healthcare costs than their counterparts. We used multivariable logistic regressions and generalized linear models, accounting for personal, healthcare access, and utilization factors. Results suggest that in 2012 (MHAS n = 15,723), persons with dementia in México had average healthcare costs that were 60.3% greater compared to those without dementia. Individuals with dementia also had a higher probability (11.9% p = 0.040) of incurring any healthcare costs in less densely populated areas (under 15,000 persons). In contrast, Hispanics participating in the HRS during that period (n=15,567), 58% of whom were of Mexican origin, did not have higher total healthcare costs if diagnosed with dementia, but incurred larger expenses in rural areas compared to their urban counterparts (p< 0.001). These results underscore how geographical context varies across countries and how dementia status can leave some individuals more financially vulnerable than others, affecting their access to healthcare services and overall health.
METHODS AND BASELINE CHARACTERISTICS FOR THE TECHSAGE TELE TAI CHI CLINICAL TRIAL
Authors: Mitzner Tracy , Mumma Kara , Remillard Elena
Published: December 2023

Individuals aging with long-term mobility disabilities encounter a range of significant barriers to participating in physical and social activities, from challenges with transportation, to lack of accessibility and access to appropriate instruction. We developed a Tai Chi telewellness intervention to facilitate both physical and social wellness through accessible, virtual group classes. The intervention translated an in-person, evidence-based tai chi program (Tai Chi for Health Institute’s Tai Chi for Arthritis) to be 1) a virtual experience (via Zoom) that includes a social component and 2) accessible and appropriate for those aging with mobility disabilities. We conducted the TechSAge Tele Tai Chi clinical trial to examine the effect of the intervention on physical activity and social connectedness (primary outcomes), as well as exercise self-efficacy, falls efficacy, depression, quality of life, and pain (secondary outcomes) for this population. The participant sample was community-dwelling adults (60-80 years of age) with a self-identified mobility disability (i.e., using a mobility aid or having serious difficulty walking or climbing stairs) for at least 10 years. The presentation will describe the rationale for the study, as well as the study design, methodology, and baseline data for the trial. We will also highlight the user-centered, iterative design approach we used in the design and evaluation of the intervention protocol.
TRAJECTORIES OF DISEASES, FUNCTIONAL LIMITATIONS, AND PSYCHOLOGICAL AND COGNITIVE HEALTH OF CENTENARIANS
Authors: Zhao Erfei , Ailshire Jennifer , Crimmins Eileen
Published: December 2023

Centenarians are recognized as providing a model of delayed aging. Centenarians are generally healthier throughout their 80s/90s than non-centenarians. However, the extent of the delay in morbidities experienced by centenarians remains unclear as it requires quantifying trajectories of health deterioration with age for both centenarians and their cohort counterparts who did not survive to 100-year-old. We use the Health and Retirement Study, a nationally representative sample, to assess the aging experience of centenarians and non-centenarians in the following domains: diseases, functional limitations, psychological and cognitive functioning. We include data from 1993 to 2018. We include 4,778 respondents born before 1918 as they had the potential to become centenarians during the study period - 201 reached at least 100-year-old and are categorized as centenarians; 4,577 of them died before 100. We use join point regression to determine 1) how many years centenarians were delayed in morbidities onset and 2) whether deterioration is accelerated starting at certain ages. On average, onset of any limitation in activities of daily living (ADL) among centenarians is delayed by about 10 years, instrumental ADLs by 9 years, and diseases by nearly 16 years (if hypertension is not considered). Rates of deterioration are slower, in general, for centenarians; however, starting at the age of 90, centenarians experience accelerated decline in ADL, IADL, functioning, and cognition. Centenarians do not appear to experience decline in psychological well-being whereas non-centenarians do. Our results suggest centenarians generally survive to older ages because they postpone aging; it is not avoidable indefinitely.
THEORIES OF CREATIVITY AND CRAFTS FOR OLDER PEOPLE
Authors: Adams-Price Carolyn
Published: December 2023

Although gerontologists have increased their discussions of the benefits of creative activities for older adults, some aspects of late life creativity have been discussed very little. Two aspects of late life creativity that have received little attention include 1) long-term participation in a particular creative domain, resulting in learning and the development of skills, and 2) the participation in culturally-meaningful crafts, especially those that connect people or result in a cultural legacy. Referring to examples from diverse cultures, we will discuss how theories of adult development and theories of creativity can be merged into a framework for studying the significance of participation in culturally-significant crafts for diverse older adults. Erikson’s theory of adult development and Glaveanu’s sociocultural theory of creativity will be used as a framework to explore the meaning and potential of participation in culturally-significant crafts for positive development in late life. We will discuss how practice leads to learning and mastery, how identity benefits from creating culturally-significant crafts, how creating in groups (or with an audience) leads to greater engagement, and how the creation of sharable products can lead to a meaningful legacy for some older creators. Examples from diverse cultures will be included, including from the two previous papers, and from older rural African American women who quilt.
CREATIVE ARTS INTERVENTION FOR ISOLATED LATINX OLDER ADULTS TO REDUCE TRAUMA SYMPTOMS
Authors: Alcantar Sandy
Published: December 2023

Creative arts is an important form of therapeutic psychotherapy to reduce trauma symptoms in migrant older adults by allowing them to explore what they once connected in their country of origin. This therapeutic modality helps to destigmatize mental health, promote health education, and feel accepted, include social connectiveness with individuals who have suffered similar trauma in their country of origin and have migrated to find a safer living environment. Interventions used have been tailored to Spanish Speaking Older adult immigrant clients that are at higher risk of mental health conditions, such as depression, anxiety, and posttraumatic stress disorder. These clients are often hiding in isolation and feel lonely. The main objective was to reduce anxiety due to re-traumatization of symptoms more importantly during pre/post COVID isolation and multiple stressors the country has been going through. For these individuals, their arts are their livelihoods due to their immigration status. It is imperative to encourage our elderly minority community to continue to focus on their crafts i.e., weaving, embroidery, sewing, crochet, cooking, pottery, or any creative arts they pr. This allows the person to have control, autonomy, feel useful and most importantly have a sense of belonging to their community, in a country that they feel displaced from. It is vital to use arts as an option to help our older adults process their life story to support development theories, in this case, Erik Erikson’s final stage of psychosocial development, integrity vs despair.
IDENTIFYING ACUTE PRECIPITANTS AND CONSEQUENCES OF RACIAL/ETHNIC CONFLICTS IN RESIDENT-TO-RESIDENT AGGRESSION
Authors: Chang E-Shien , Teresi Jeanne , Ramirez Mildred , Eimicke Joseph , Czaja Sara , Pillemer Karl , Lachs Mark , Rosen Tony
Published: December 2023

Resident-to-resident aggression (RRA) includes negative and aggressive physical, sexual, or verbal interactions between long-term care residents that in a community setting would likely be construed as unwelcome and have high potential to cause physical or psychological distress in the recipient. Though not explored in detail, previous research has shown that ethnic stereotyping may contribute to RRA. Our goal was to examine, for the first time, acute precipitants and consequences of RRA involving racial and ethnic conflicts. The parent study included comprehensive quantitative and qualitative information of 2,011 residents in 10 randomly-selected New York State nursing homes. Our qualitative analyses used an events perspective, focusing on how aggressive situations unfolded. We identified 51 single or repeated incidents of racial and ethnic conflicts during the study observation period. At the facility level, racial and ethnic conflicts were most commonly triggered by congested living spaces. At the relational level, racial and ethnic conflicts were frequently preceded by negative reactions to residents with cognitive impairment. At the individual level, racial and ethnic conflicts were found to be preceded by residents’ unmet or unrecognized needs. Unresolved racial and ethnic conflict commonly resulted in aggression escalation and spillover. Our results indicated racial and ethnic conflicts occurred commonly and repeatedly. Such behavior appeared tolerated and normalized, with limited institutional response. As the long-term care population becomes increasingly diverse, recognizing and addressing potential racial and ethnic conflicts becomes more pressing. Targeting racial and ethnic conflicts in RRA for intervention may also improve interactions between residents and frontline workers.
ENGAGING WITH NURSING HOME SOCIAL WORKERS TO DEVELOP AND IMPLEMENT CLINICAL INTERVENTION TRAINING
Authors: Supiano Katherine , Andersen Troy , Laura Bradbury , Gonzalez Kimberly Ponce
Published: December 2023

PreLoss Group Support (PLGS) is a 10-session multi-modal therapeutic group intervention for dementia family care partners administered by nursing home social workers (NHSWs) to facilitate healthy death preparedness and eventual bereavement. In prior work, we used empirically validated procedures for developing psychosocial interventions, created PLGS participant and facilitator manuals, and implemented and evaluated PLGS in three cohorts of nursing home family care partners using research team LCSWs as facilitators and NHSWs as co-facilitator-trainees. Our present pragmatic trial will determine if telehealth-delivered PLGS reduces risk of poor bereavement outcome in family care partners, when delivered by NHSWs trained in PLGS via telehealth. We systematically engaged with nursing home stakeholders; administrators and NHSWs in rural, urban, and Veteran nursing homes to identify their perceptions of family care partner needs with respect to end-of-life care in residents living with dementia.NHSWs collaborated with our team to develop a full-day clinical education program. We incorporated their suggestions of family “characters” to script into our video modules using professional actors, addressed potential concerns with telehealth delivery of the training and intervention, participant identification and recruitment procedures, and requests for didactic content and interactive case examples of treatment element application. Current NHSWs who attended the full day training completed a 7-item satisfaction scale yielding a satisfaction rate of 95% (highly valuable), with 100% indicating they would recommend training to SWs in other facilities. Sustained collaboration with NH stakeholders optimizes commitment of NHSWs to PLGS participants, intervention delivery and informs later implementation strategies for translation and dissemination.
LATER-ADULTHOOD TRAUMA RE-ENGAGEMENT AMONG VIETNAM VETERANS: A COORDINATED ANALYSIS
Authors: Spiro Avron , Kaiser Anica Pless , Smith Brian , Stellman Jeanne , Stellman Steven
Published: December 2023

Later-Adulthood Trauma Reengagement (LATR) is a framework for understanding the later-life emergence of trauma-related memories among aging veterans. LATR unfolds within the context of aging-related challenges such as retirement, physical decline, and bereavement. We developed a scale to assess LATR, the late-onset stress symptomatology short form (LOSS-SF). In this study, we compare the LOSS-SF scale across multiple samples of Vietnam veterans. Samples were surveyed between 2001 and 2020; all completed the LOSS-SF scale as well as measures of combat exposure and PTSD. We studied three male samples (256 repatriated US prisoners of war [RPW], 260 combat veterans [CV], and 507 deployed American Legion [AL] members) and one sample of 1956 women deployed to Vietnam, mostly nurses [WV]. Across samples, we examined three questions: 1) How prevalent is LATR? 2) Is LATR correlated with combat exposure and PTSD? 3) Using a regression framework, what factors (military characteristics, combat, PTSD) are related to LATR? Prevalence of LATR ranged from 5% to 38%. Mean LATR scores were higher among AL and CV samples than among the RPW and WV. LATR was modestly related to combat exposure (rs = .08 - .36) and moderately related to current PTSD symptoms (rs = .56 - .79). Regressions demonstrated the importance of PTSD to LATR across samples, and combat exposure was related to LATR only for WV. This study indicates that LATR varies across samples differing in gender and warzone experience and suggest further exploration of the overlap between PTSD and LATR among aging Vietnam veterans.
STRATEGIES FOR INVOLVING OLDER ADULTS AND INFORMAL CAREGIVERS IN HEALTH POLICY DEVELOPMENT: A SCOPING REVIEW
Authors: Kolade Opeyemi , Joshua Porat-Dahlerbruch , Makhmutov Rustem , van Achterberg Theo , Ellen Moriah
Published: December 2023

Encouraging the active involvement of older adults and informal caregivers in policymaking can lead to cost-effective health and long-term care interventions and enhance the creation of responsive policies. As part of the European Union TRANS-SENIOR program, a scoping review was conducted using the Joanna Briggs Institute’s methodology. Published and grey literature was searched. Studies were included if they described the use/evaluation of methods for engaging older adults (65 years and above) and informal caregivers in local, national, or regional health policy development. Analysis was guided by the Multidimensional Framework For Patient And Family Engagement In Health And Health Care. Thirteen engagement strategies were identified from 11 publications meeting the inclusion criteria. Adopting the World Bank’s categorization of citizen engagement methods, strategies were categorized as traditional, deliberative, and others. Older adults and informal caregivers are often consulted to elicit opinions for agenda/priority setting. However, their involvement in other stages of the policy cycle: health policy formulation, implementation, and evaluation, was unclear from the literature. The described engagement methods suggested that older adults and their informal caregivers do not often have shared equal power and shared responsibility in policymaking. Findings will guide policymakers in identifying and incorporating engagement strategies to support evidence-informed policymaking processes that can improve health outcomes for older adults/informal caregivers. Future research is needed on the evaluation of involvement methods.
DAILY ASSOCIATIONS OF SOCIAL INTERACTIONS WITH OBJECTIVE SLEEP MEASURES AMONG OLDER ADULTS
Authors: Kang Jee eun , Ji Linying , Buxton Orfeu , Sliwinski Martin
Published: December 2023

Disturbed sleep is a common problem and can have profound effects on older adults. Social relationships are known to be associated with quantity and quality of sleep. To extend prior research, we examined the associations of daily social interactions and sleep, using objective sleep measures and an ecological momentary assessments (EMA) approach. Participants in the Einstein Aging Study (n=285, Mage=77, range=70-90, 68% women, 46% White, 40% Black) reported their recent social interactions and physical contact four times a day for 16 days via EMA on mobile phones. Objective sleep measures (sleep timing, night sleep time, wake after sleep onset (WASO), sleep maintenance efficiency) were calculated from concurrent wrist actigraphy. Multilevel models controlled for demographics, living arrangement, Instrumental Activities of Daily Living, sleep-disordered breathing, and hypoxemia. Results showed that, on days when older adults had more day-time social interactions than their average, they had earlier sleep timing, shorter night sleep time, and less WASO, but no differences in sleep efficiency. On days when older adults had more physical contact than their average, they had earlier sleep timing and shorter night sleep time but no differences in WASO or sleep efficiency. These micro-longitudinal analyses among older adults suggest that daily social interactions are related to subsequent earlier sleep timing and shorter sleep at night, and can be beneficial for sleep quality. Physical contact seemed to be only associated with the timing and quantity of sleep but not sleep quality. Potential benefits of using an EMA approach in sleep research will be discussed.
REACTIONS TO PERPETRATORS OF BENEVOLENT AGEISM: WHAT INFLUENCES PERCEPTIONS?
Authors: Chasteen Alison , Saleem Zainab , Horhota Michelle
Published: December 2023

Ageism against older adults is a longstanding and pervasive problem. Benevolent ageism can be particularly difficult to address, given it is characterized by warmth and condescension. In two studies, we examined the impact of confronting prejudice on perceptions of a young adult perpetrator who expressed benevolent ageism. In both studies, the perpetrator initiated unwanted help to an older person who was either 62 or 82 years old, and the older adult either accepted or politely rejected the unwanted assistance. In both studies, participants felt that rejecting (i.e., confronting) the ageist behavior decreased the likelihood the perpetrator would repeat the behavior. Young adult participants used the age of the older target as a cue for interpreting the perpetrator’s intentions, such that they rated the perpetrator’s actions as less intending to offend if the older target was 82 than 62 years of age. Moreover, younger adults used the age of the older target to determine whether the perpetrator should be confronted, indicating that confrontation should occur when the target was 62 vs. 82 years old. Taken together, these studies demonstrate that participants of all ages feel that confronting benevolent ageism can be an effective tool for reducing biased behavior. As well, these findings show that the age of the older adult target might be used as a normative cue to interpret the perpetrator’s intentions and actions, thus providing a more nuanced picture of what might drive witnesses’ responses to ageist behavior.
AGEISM, JOB SATISFACTION, INTRINSIC MOTIVATION, AND RETIREMENT DECISIONS
Authors: Swift Hannah
Published: December 2023

This study examines experiences of ageism in the workplace and how they impact workers’ intentions to retire. Self-report data on experiences of ageism in the workplace, meta-perceptions of older workers, job satisfaction, motivation, and retirement intentions were collected in a sample of 125 UK employees aged 50 and older, alongside other relevant demographic information. In line with previous research, the analysis revealed that the positive relationship between ageism and intentions to retire is mediated by a reduction in job satisfaction. However, additional analysis confirmed that intrinsic motivation also partially mediates the relationship between job satisfaction and intentions to retire. A serial mediation model then established that experiences of ageism at work increased intentions to retire via reductions in job satisfaction, which in turn reduced intrinsic motivation to work. Separate models confirm these relationships remain when the experience of ageism is substituted for negative meta-perceptions of older workers. This research provides further evidence for the need to reduce ageism and negative age stereotypes in organizational settings but also highlights the role of intrinsic motivation as an important indirect pathway through which ageism increases retirement intentions. For the first time, the effects of negative meta-stereotypes on job satisfaction, intrinsic motivation, and intentions are also modelled.
BURSTING THE BUBBLE? CHANGES IN OLDER ADULTS’ LEISURE WITH OTHERS DURING THE PANDEMIC
Authors: Rauer Amy , Stewart Meagan , Fiori Katherine , Marini Christina , Kanter Jeremy
Published: December 2023

After months of social distancing, widespread vaccine availability gave hope to older adults that they could resume social activities. However, as new variants emerged, it was not always clear how safely older adults could connect with others. Thus, the current study examined how older adults’ leisure with others changed as they reintegrated using a sample of 136 older adults in the U.S. (Mage = 68, range: 50-91; 69% females; 93% White; 72% partnered; 61% retired; 88% living independently). Participants reported on leisure at three time points (Summer 2021; Fall 2021; Winter 2022) using a modified version of the Pittsburgh Enjoyable Activities Scale (Pressman et al., 2009). Repeated measures analyses revealed that although there were no differences in the total amount of leisure individuals engaged in over time, with whom they did these activities differed both across time and activities. Participants were most likely to do activities with romantic partners at all three waves, followed by activities alone. Leisure with friends and family was least likely. Although leisure alone and with friends remained stable over time, leisure with a romantic partner and with family declined from T2 to T3, when COVID-19 cases were peaking. Interestingly, declines were seen in both more traditionally social activities (e.g., taking trips, sports) and those usually considered more solitary (e.g., computer use, chores). Despite both rising COVID-19 rates and inconsistent rhetoric on social distancing, older adults were still able to do things they enjoyed, though their ability to do so with loved ones appeared to wane.
PREDICTORS OF HOSPICE AND END-OF-LIFE CARE: GEOGRAPHIC LOCATION, PATIENT PORTALS, NURSING HOME CARE, AND HOME HEALTH
Authors: Portz Jennifer , Washington Karla
Published: December 2023

Hospice is considered an indicator of high-quality care at end-of-life (EOL) often allowing patients to receive care aligned with their values, in their homes, surrounded by support and loved-ones. However, there is a need to address access barriers to hospice and enroll patients earlier in their disease trajectory. Understanding predictors of hospice use will help identify strategies for addressing hospice inequities, promoting longer hospice stays, and improving overall EOL outcomes. Focusing on research methodologies with large cohorts and national samples, this symposium examines the associations of health care services and inequalities on key EOL outcomes and hospice use. First, Autumn Decker will describe profiles of hospice use and EOL experience by geographic location and race from the National Health and Aging Trends Study. Next, Dr. Jennifer Portz will summarize the association between types of patient portal use and EOL outcomes including hospitalization, advance directives, and hospice use. Dr. Ellis Dillon will follow with a description of hospice use and short hospice length of enrollment for Conneticut’s Medicaid decedents, comparing decedents with nursing home stays to those without. Lastly, Dr. Olga Jarrin will present findings from her study of home health care use during the last 3 years of life as a predictor of death with hospice in a Medicare cohort. Our discussant, Dr. Karla Washington, will lead us in a conversation outlining the role of health care services, such as home health, nursing home care, and patient portals, for promoting access to hospice earlier and for all patients.
INTERGENERATIONAL CONTACT AND THE BENEFITS FOR OLDER ADULTS
Authors: Zhang Xin , Xi Wanyu , Weiss David
Published: December 2023

Intergenerational contact can be in a variety of forms, from day-to-day interaction between family members, such as filial piety expressed by the younger generation, to artificial contact in an on-line game context. No matter what form of intergenerational contact, it is believed that such contact should be beneficial for older adults for many reasons. For example, it can help to reduce feelings of loneliness, stress and provide a greater sense of purpose. It can also help to foster a greater appreciation for differences between generations and create stronger social connections with those of different ages. It can also boost mental health, physical health, and even reduce the risk of depression. In a group of 5 individual presentations, the authors showcased that intergenerational contact could promote life satisfaction in a 5-year-interval (Ayalon & Dikla), reduce ageist attitudes toward older adults in an on-line game context (Xi, Chang, Zhang, & Ayalon), foster positive self-perception of aging (Chang & Zhang; and Tse), as well as enhance health information-seeking behaviors (Zhao, Song, & Song). These results indicated that even from different cultural background (e.g., Chinese or Americans), a positive intergenerational contact, such as providing social support to aged parents, collaborating with partners from different age groups, and even offer kindness actions toward people of a different age group could indeed be beneficial. These studies provided theoretical insights for the intergenerational contact literature, and highlighted important practical implications for potential interventions to facilitate successful aging for older adults.
EMBRACING THE QUEER ART OF FAILURE IN GERONTOLOGICAL RESEARCH AND EDUCATION
Authors: Bybee Sara , Oswald Austin , Fabbre Vanessa
Published: December 2023

Halberstam describes the queer art of failure as a performance of dissidence in which lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) people willing reject traditional conceptualizations of success. Yet, dominant theoretical frameworks in gerontology are predicated upon notions of success and productivity which may be problematic for understanding the life trajectories of LGBTQ+ people. The use of such heteronormative frameworks has implications for gerontological research in two important ways: 1) Research methods and researchers themselves may be constrained by the normative expectations placed on LGBTQ+ people and 2) Heteronormative frameworks obscure the nuance of LGBTQ+ older adults’ lived experiences and may limit important contributions to gerontological knowledge. This symposium applies the queer art of failure to examine LGBTQ+ aging scholarship that deviates from traditional research and education. Speaker one shares experiences from LGBTQ+ individuals facing dementia, using concepts that counter framing dementia as pathology and decline. Speaker two discusses how participants’ preferences for receiving research results via found poetry may reflect LGBTQ+ participants’ natural inclination to question hegemonic norms. Speaker three describes collaborating with a coalition of LGBTQ+ older adults of color on a participatory action research study, detailing how epistemic tensions shaped the research in unexpected ways. Speaker four discusses how institutional failure led to enthusiasm for LGBTQ+ curriculum development, student mentoring, and knowledge production. These presentations suggest that the inclusion of diverse conceptualizations of success and productivity should inform future aging scholarship, as they may center the experiences of historically marginalized populations such as LGBTQ+ older adults.
DESIGN, RECRUITMENT, AND BASELINE CHARACTERISTICS OF THE AGING AND COGNITIVE HEALTH EVALUATION IN ELDERS TRIAL
Authors: Reed Nicholas
Published: December 2023

Hearing loss is highly prevalent among older adults and independently associated with cognitive decline. This presentation will describe the design and baseline characteristics of the first randomized controlled trial to test whether hearing treatment can reduce cognitive decline, the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial. This multicenter study was nested within the Atherosclerosis Risk in Communities (ARIC) observational cohort study. The primary outcome is 3-year change in a global cognitive function factor score derived from a comprehensive cognitive test battery. Other prespecified outcomes include loneliness, social network size, depressive symptomatology, health-related quality of life, hospitalization, falls, physical function, and accelerometry-measured physical activity. Cognitively intact, community-dwelling 70-84-year-old participants with adult-onset hearing loss were recruited from the parent ARIC study and de novo from the surrounding communities and randomized 1:1 to the best practices hearing intervention or successful aging health education control intervention. Over a 24-month period, 3004 telephone screenings resulted in 2344 in-person hearing, vision, and cognition screenings and 1294 comprehensive screenings. Among 1102 eligible, 977 were randomized into the trial (median age = 76.4; 53.5% female; 87.6% White; 53.3% held a bachelor’s degree or higher). Participants from the parent ARIC study were recruited much earlier in the process and were less likely to report hearing loss that interfered with their quality of life relative to de novo participants recruited from the community. Minor differences in baseline hearing or health characteristics were found by recruitment method (i.e., ARIC or de novo) or by study site.
CLINICAL FACTORS ASSOCIATED WITH THE QUALITY OF INTERACTIONS BETWEEN STAFF AND HOSPITALIZED PERSONS WITH DEMENTIA
Authors: Paudel Anju
Published: December 2023

The quality of care greatly depends on the quality of interactions between staff and hospitalized older adults with dementia which in turn can be influenced by many factors. This paper examines the clinical factors associated with the quality of interactions between staff and hospitalized older adults with dementia. Following the examination of bivariate associations, we conducted multiple linear regression in a sample of 140 hospitalized older patients with dementia who participated in the final cohort of Fam-FFC. On average, the participants (male = 46.1%, female = 52.9%) were 81.43 years old (SD = 8.29) and had positive interactions with staff. Accounting for 17.5% of the variance in the model, non-pharmacological interventions (b= 0.181; p<.001) and pain (b= -0.201; p<.01) were significantly associated with the quality of staff-patient interactions. To optimize care of hospitalized patients with dementia, staff should be encouraged to use non-pharmacological interventions and prioritize pain management in patients.
MARITAL TRANSITIONS IN MID AND LATE LIFE
Authors: Monin Joan , Newsom Jason
Published: December 2023

Marital transitions are common in mid and late life, yet little is known about what makes some middle aged and older adults thrive and others experience hardship through these transitions. This symposium will discuss antecedents, consequences, and moderators of adjustment to marital transitions in mid to late life. Monin and colleagues will address antecedents of divorce/separation, presenting results from a case control study showing that later stage dementia is associated with a lower likelihood of divorce/separation, and certain neuropsychiatric symptoms are associated with a greater likelihood of divorce/separation. In terms of consequences of relationship dissolution, Bourassa and colleagues will present findings from a study across a 20-year period of adulthood, showing that people with more breakups in adulthood have more advanced biological age in midlife. Two studies will discuss moderators of associations between relationship transitions and well-being. Carr and Choi will discuss the experiences of childless older adults who become widowed or divorced, and whether they suffer poorer mental health than their peers with children. They will show that childless widowed men and divorced men who lost a child to death have dramatically higher levels of social loneliness, relative to other men. Finally, Scheffer and colleagues will talk about the transition out of dementia spousal caregiving. They will present findings indicating that although caregivers’ emotional well-being and energy improves from moving from being an active caregiver to moving out of the caregiving role, those with lower household income had worse outcomes after caregiving ended.
MARITAL BIOGRAPHY AND ACCELERATED AGING: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: Choi Won , Lee Haena , Crimmins Eileen
Published: December 2023

It is well-established that marriage promotes health and longevity. While a large body of research has examined marital status differences in health, no studies have focused on how marital status is linked to biological age. Moreover, the association between marital biography – transitions in and out of marriage across the life course – and biological aging also remains to be explored. Biological age, which refers to the “physiological functioning relative to the average physiological state at a specific chronological age,” has been steadily gaining attention as a measure indicative of an individual’s health status. In this study, we advance the literature on marital status and health by examining how marital status and marital transitions are associated with biological aging among a representative sample of U.S. older adults. We use an expanded measure of biological age that incorporates 22 biological indicators, more than half of which were not used in previous studies, to better assess how marital experiences shape accelerated aging. Using data from the 2016 Health and Retirement Study, we find that the pace of aging of those who have experienced one disruption is not statistically different from those continuously married. However, for both currently and previously married individuals, the experience of multiple marital disruptions is associated with accelerated aging. Health behaviors account for the association between multiple marital disruptions and accelerated aging for previously married older adults but not for currently married older adults. Psychosocial resources did not mediate the influence of marital biography on accelerated aging.
NOVEL MOLECULAR MECHANISMS UNDERLYING THE ASSOCIATION BETWEEN PLCG2, ALZHEIMER’S DISEASE, AND LONGEVITY
Authors: Palavicini Juan , Garcia Rogers Juliet , Miller Henry , Weintraub Susan , Hopp Sarah
Published: December 2023

Phospholipase C-gamma-2 (PLCγ2) catalyzes the hydrolysis of the membrane phosphatidylinositol-4,5-bisphosphate (PIP2) to form diacylglycerol (DAG) and inositol trisphosphate (IP3), which subsequently feed into numerous downstream signaling pathways. PLCG2 rare coding variants are associated with both reduced (P522R) and increased (M28L) risk of Alzheimer’s disease (AD) and with longevity (P522R). In the brain, PLCG2 is primarily expressed by microglia, where it is proposed to regulate phagocytosis, secretion of cytokines and chemokines, cell survival and proliferation. We analyzed the brains of 3-month-old PLCγ2 knockout (KO), heterozygous (HET), and wild-type (WT) mice using multi-omic and histological approaches. Lipidomic analyses revealed sex-specific changes in total brain PIP2 and DAG content in KOs. Surprisingly, we found that PLCγ2 depletion led to significant decreases in myelin-enriched lipids including cerebrosides, sulfatides and phosphatidylethanolamine plasmalogens. Consistent with our lipidomics results, gene expression profiling revealed sex-specific changes in myelin-related genes. Further, in line with the available literature, gene expression profiling revealed PLCγ2 depletion led to subtle changes on microglia phenotype, suggestive of reduced microglia reactivity. Immunofluorescence confirmed subtle differences in density of microglia and oligodendrocytes in KOs. Exploratory proteomic pathway analyses revealed changes in KO and HET females compared to WTs, with over-abundant proteins pointing to mTOR signaling, and under-abundant proteins pointing to oligodendrocytes. Furthermore, a PLCG2 M28L knockin mouse model displayed phenotypes of accelerated aging, including exacerbated thymic atrophy, increased frailty scores, and impaired spatial memory. In summary, our study unraveled novel putative mechanisms underlying the association between PLCγ2, AD, and longevity (mTOR signaling and myelin homeostasis).
MASON CARES RANDOMIZED STUDY: EFFECTS OF A NINE-WEEK STRESS MANAGEMENT PROGRAM INTERVENTION ON CAREGIVER BURDEN SCORES
Authors: Gimm Gilbert , Layman Shannon , Ihara Emily , Inoue Megumi , Tompkins Catherine
Published: December 2023

OBJECTIVE

The Mason CARES study examines the impact of a virtual stress management program (Phase 1) and music intervention (Phase 2) on the stress of family caregivers of older adults with dementia. This study presents Phase 1 findings on 99 participants enrolled in 2022.

METHODS

Using primary data from 99 participants, we analyzed caregiver stress levels before and immediately after implementation of a 9-week stress management program using Zoom videoconference calls. Caregiver stress was measured using the Zarit Burden Interview (ZBI) score with a range from 0 to 48 (Bédard, 2001). Higher values (ZBI >=17.0) are associated with higher levels of stress.

RESULTS

Among the 99 caregivers, 49.4% were spouses and 50.6% were non-spouses (e.g., adult children). Mean ZBI scores before and after the 9-week stress busting program intervention across the full sample decreased by 14.7% (from 23.7 to 20.2). Spouses experienced a greater decrease (17.9% from 23.5 to 19.3) in caregiver stress compared to non-spouses (12.1% from 23.9 to 21.0). Reductions in stress levels also occurred for caregivers of older adults with mild cognitive impairment (13.9% from 21.0 to 18.0), moderate dementia (16.5% from 24.1 to 20.1), and advanced dementia (9.7% from 27.7 to 25.0).

CONCLUSION

Findings show that caregivers had high stress levels at baseline (ZBI score of 17 or more). Spouses reported greater stress improvement compared to non-spouses after the 9-week stress busting program. Also, caregivers of older adults with moderate dementia had greater improvement in stress compared to the mild or advanced dementia sub-groups.
TIME HELP FROM ADULT CHILDREN DURING THE COVID-19 PANDEMIC: VARIATION BY PARENTS’ COGNITIVE FUNCTIONING
Authors: Lin I-Fen , Wiemers Emily , Chin Janecca , Strauss Anna Wiersma
Published: December 2023

Many older adults in the U.S. do not live with adult children but have at least one adult child living nearby. Help from adult children is vital for supporting the health and well-being of older adults. During the COVID-19 pandemic, the need to maintain physical distancing and the fear of infection may cause disruptions in older adults’ activities of daily living but the extent to which nonresident adult children provide help with household tasks is largely unknown. This paper uses data from the 2018 and 2020 Health and Retirement Study (HRS) to assess whether adult children responded to their parents’ pandemic-specific needs by helping them with shopping for groceries, errands, rides, or chores (i.e., time help). Preliminary analysis shows that parents who had trouble buying food (even with the money) were more likely to receive time help from their nonresident adult children. Not only was time help much more common among older adults with children living nearby than older adults without any child living nearby but adult children living nearby also were more responsive to parents’ pandemic-specific needs than children who lived farther away. Additional analysis indicates an overall increase in time help from adult children in response to functional limitations between 2018 and 2020, suggesting that the pandemic may have increased family care more broadly. Because older adults with cognitive limitations may be particularly vulnerable during the pandemic, we will further examine whether pandemic-specific needs and time help from nonresident adult children differed depending on older adults’ cognitive functioning.