bluuebunny/crossref_metadata_2025 huggingface dataset:
IS THERE A RELATIONSHIP BETWEEN PAIN AND FEAR OF FALLING IN OLDER ADULTS LIVING IN LONG-TERM CARE FACILITIES?
Authors: Vieira Edgar R , Tavares Diego , Nobrega Particia , Maciel Alvaro
Published: November 2019

Fear of falling is common in older adults and it is associated with multiple factors such as gait and balance issues, difficulties in activities of daily living, visual impairment, and frailty. Unfortunately, fear of falls increases the risk of falls as opposed to protect from falls. Pain can impair mobility, affects activities of daily living, and may also be associated with fear of falling but no studies have evaluated this potential association. The objectives of this study were to evaluate if there was an association between pain and fear of falling in older adults living in long-term care facilities. One hundred and eight older adults living in long-term care facilities participated in the study. The mean age was 79±7 years, and 65% of the participants were women. The participants completed the Geriatric Pain Measure (GPM) questionnaire for multidimensional pain assessment (scores range from 0 to 42), and the Falls Efficacy Scale International (FES-I) for fear of falling assessment (scores range from 16 to 64). The data was analyzed using multiple linear regression. Forty-five percent of the participants had chronic pain (≥3 months) and 18% had acute pain (<3 months). Pain scores were 29±31. Pain was associated with an increase of 3 to 7 points (out of 64 max) in the FES-I. The prevalence of pain in long-term care residents was high, and pain was associated with increased fear of falling.
DON’T JUST GO THROUGH LIFE, GROW THROUGH LIFE: RESILIENCE AND ITS EFFECT ON SUCCESSFUL AGING
Authors: Nuccio Alexandria G , Stripling Ashely M
Published: November 2019

Resilience is commonly recognized as a protective factor that increases an individual’s ability to adapt positively to adversity or change. Given the rates of change, which occur in mid and late life, understanding resilience within this population is of particular importance. Yet to date, the direct mechanisms through which resiliency functions remains underexplored in this population. As such, the current investigation seeks to examine the mechanism through which lifelong resiliency may affect the lives of older adults in order to promote successful aging. Data including assessments of lifelong resiliency (measured by an individual’s opinion that life has been a continuous process of learning/changing/growing), environmental mastery (Ryff, 1989), instrumental activities of daily living (IADLs), mood (e.g. depression and self-rated emotional health), and subjective physical health were derived from the Survey of Midlife in the US Database (MIDUS 3). Participants were primarily White/Caucasian (88.7%) and female (54.9%); with a mean age of 63.64 years (SD=11.35). A series of hierarchical multiple linear regressions revealed that resiliency predicted better physical (F=43.448,p<0.001) and emotional health (emotional health (F=46.515,p<0.001), depression (F=17.665,p<0.011)), as well as increased environmental control (IADLs (F=109.992,p<0.001), and Environmental Mastery (F=64.686,p<0.001)) in models adjusted for known correlates (i.e. age, sex, race, marital status, education). The present findings suggest that high levels of resilience increase not only perceptions of the world (subjective environmental mastery, physical and mental health) but also direct outcomes (IADLs). Implications of the current finding include elucidation of the concept of resiliency, as well as, recommendations for increasing resiliency in late life.
RESILIENT AGING ROUNDTABLE: AN EVALUATION OF A BRIEF COMMUNITY PSYCHOEDUCATION DISCUSSION GROUP
Authors: June Andrea , Marty Meghan
Published: November 2019

Increased aging resilience levels are associated with many positive outcomes for older adults including improved quality of life, increased coping and adaptation, and decreased depressive symptoms (Earvolino-Ramirez, 2007; Fullen & Gorby, 2016; Hicks & Conner, 2014; (Sharpley, Bitsika, Wootten, & Christie, 2014). However, very few resilience promotion programs are described in the literature. The purpose of the present study was to evaluate a brief, community-based psychoeducation group designed to enhance aging resilience. Participants were recruited through a private mental health practice focused on serving older adults in the Pacific Northwest. Nine participants (M age = 71; 78% female, 100% non-Hispanic white; 100% with some college) completed the pre- and post-assessment measures: An adapted 9 item version of the Communicative Ecology Model of Successful Aging (CEMSA; Fowler, Gasiorek, & Giles, 2015) and the Groningen Ageing Resilience Inventory (GARI; van Abbema et al., 2015). The discussion group consisted of six 90-minute meetings every-other-week, facilitated by a licensed clinical psychologist. Each meeting focused on a different topic related to psycho-social aspects of aging and included understanding ageism, embracing change, creating meaning, normal and “successful” aging, and strengthening social ties. Although not statistically significant, initial results showed lower post-assessment mean scores on the CEMSA indicating lower levels of aging uncertainty, negative attributions, and pessimism as well as higher post-assessment mean scores on the GARI indicating higher perceived resilience. Moreover, 77.7 % of the group agreed or strongly agreed that they had learned a lot from the group. Future directions will be discussed.
RACIAL DISPARITIES IN RURAL-URBAN MORTALITY GAP IN THE UNITED STATES: A 24-YEAR LONGITUDINAL STUDY
Authors: Ferdows Nasim , Ferdows Soroosh Baghban , Kumar Amit
Published: November 2019

Although overall life expectancy in the US has improved rapidly over the course of the 20th century and the racial gap in all-cause mortality has declined in recent decades, geographical disparities in mortality have increased in the last three decades. This research aims to study racial and geographical disparities by comparing the race and sex-specific mortality trends of the US rural and urban populations. We created a longitudinal county level analytic file of the US population 65 years and older, over the period of 1968 to 2015 obtained from CDC-WONDER and Area Health Resources Files. First, we used an OLS regression of age-adjusted mortality rate onto year indicators interaction with race and gender to depict the race and sex-specific trend in age-adjusted mortality rates. We also estimated the change in in mortality rate over time, for each race and gender, relative to values in 1968. Finally, we estimated race and sex specific trend in rural-urban mortality gap using state fixed effects regression. Our results indicate that racial gap in mortality rates has only declined in urban areas. Mortality rates of the whites in rural areas declined more rapidly than their Black counterparts, resulting in a gap that has been widening in the last three decades. The racial gap has increased considerably for males residing in rural counties not adjacent to an urban county. Thus, racial disparity in mortality has increased in rural areas, with a considerable widening between white and black male population living in the more remote rural areas.
WHAT ARE THE PATHWAYS TO RETIREMENT: DO HEALTH AND COHORT MATTER?
Authors: Huang Fang-Yi , Li Min
Published: November 2019

Studies about retirement often neglect ethnic identity. Yet, racial and ethnic inequality plays an important role in retirement decisions. For instance, minorities are less likely to continue working in old age beyond the normal retirement age because of some individual factors such as poor or fair health, cognitive impairment, functional limitation (Green, 2005; Ghilarducci & Moore, 2015; Mudrazija, 2010), physical limitations (Radl, 2014; Solem et al., 2016; Pienta & Hayward, 2002), retirement benefit and eligibility of pension (Radl, 2014; Honig, 1996). This research examined the influence of ethnicity on whether working for people aged above 60 in Taiwan. In addition to testing the pathways to retirement, we scrutinized how occupational sector mediates the likelihood of ethnic effect on retirement. After comparing two cohorts from the dataset “Taiwan Longitudinal Study in Aging”, we found that working in public sector, white-collar workers, being a Mainlander, being non-married, higher education, self-reported bad health and functional limitation are all associated with the higher likelihood of retirement. Finding suggested that the incentive structure of the public pension for public sector workers, who are mostly Mainlanders, could contribute to the higher likelihood of retirement. However, the magnitude of mediator is much larger for the older cohort than the younger cohort. The study not only could benefit cumulative advantage approach by analyzing East Asia data but also bring policy implication, that retirement policy makers should reduce public pension incentive for public sector workers to delay the retirement age.
ENVIRONMENTALLY SUSTAINABLE DIET AND RECYCLING THERAPY FOR OLDER ADULTS’ WELL-BEING AND HEALTHCARE EXPENDITURES
Authors: Hsiao Hsinyi , Hagedorn Aaron
Published: November 2019

Due to the rapid climate change in recent years, global communities have seen an increased frequency of large-scale natural and man-made disasters. Acknowledging extravagant lifestyles and wasteful consumption of natural resources as prominent factors leading to intensified stress placed on the biosphere and ecosystems, many older adults with chronic medical conditions or disabilities in Taiwan have promoted environmental sustainability through two ways: 1) participating a recycling program in their local communities by collecting, sorting, and reclaiming reusable resources that are regenerated into eco-friendly blankets for disaster survivors and 2) practicing plant-based diet to promote healthy lifestyle and mitigate climate change. These older participants of environmentally sustainable initiatives believe the interconnectedness among humanity, the environment, and sustainable lifestyles. To understand association between the recycling therapy and older adults’ well-being a quasi-experimental design with 72 people age 60 and older (recycling group vs. non-recycling group) and photovoice were used to examine longitudinal effects of the recycling therapy on physical and mental health. To examine the effects of plant-based diet on dementia and health care cost ten-year data from Taiwan’s National Health Insurance Database were used by two studies to compare risk of dementia and medical expenditure between vegetarian and non-vegetarian groups among older adults in Taiwan. Four presentations in the symposium will discuss positive outcomes of environmental volunteering on older adults’ physical and mental wellness and longitudinal effects of a cohort with environmental-friendly diet on dementia risk and lower actual health care expenditures.
DNA METHYLATION AT THE CROSSROADS OF PHYSIOLOGICAL RESPONSE TO STRESS AND PATHOLOGICAL BIOLOGY
Authors: Salimi Shabnam
Published: November 2019

It is likely that the dimension and the scope of stress perception are different in different body systems conditioning their specific rates of aging. Moreover, in addition to between-individual variabilities in body response to stress, there is inter-organs variability in adaptations resulting in pleiotropy of phenotypes evolved with aging. Epigenetic measures may be considered possible readouts of the extent and proxy of the adaptive response to intrinsic and/or extrinsic stress in body organs. It is thus important to disentangle the epigenetic basis of stress, adaptation, and pathology. In this symposium we discuss a combination of the specific DNA methylation patterns relate to the diseases as an intrinsic stressor and adaptation responses imposed to bodily systems, and also accelerated body organ morbidities. We explain the static and dynamic DNA methylation differentiation over time as the “epigenetic code” of accelerated pathology across various age using longitudinal data.
POLICY SERIES: NEW FAMILY CAREGIVING RESEARCH TO SUPPORT POLICY AND PRACTICE CHANGE
Authors: Accius Jean C , Young Heather
Published: November 2019

Families are the most important source of support to older adults. Today, there is growing recognition of the escalating complexity of family caregiving. Family caregivers are increasingly carrying out health-related tasks with little training or preparation, as well as continuing to provide the majority of long-term services and supports (LTSS) at home. Providing care in the context of rapidly changing health care and LTSS systems can have a significant impact on the family members who provide care and take a significant toll, emotionally, physically, and financially. Studies commonly show that family caregivers report learning complex tasks by trial and error and worry about making a mistake. This symposium highlights new caregiving research from the AARP Public Policy Institute. The first paper will present new research on the increasing complexity of the challenges facing family caregivers, such as managing multiple medications, wound care, and interaction with the health care system. The second paper will present new data on the economic value of the unpaid contributions of family caregivers in the United States. The third paper will examine the growing importance of family caregiving on the public policy agenda, and describe recent policy developments that recognize and explicitly support caregiving families. Recommendations for policy and practice change to address caregiving needs will be examined in all papers. Our discussant will identify key implications from this research for policymakers and practitioners, and potential drivers for developing a better system of family support at the federal and state levels.
ARE POLICY AND PRACTICE CHANGE TO SUPPORT FAMILY CAREGIVERS ON THE RISE?
Authors: Feinberg Lynn F
Published: November 2019

The challenges and pressures of family caregiving for older relatives or friends are a reality of daily life. Better recognition of and support for family caregivers has emerged as a national health, economic and social priority that can no longer be ignored. Unlike previous generations, most (60%) family caregivers work at a paying job today in addition to caring for older relatives with a serious health condition or disability. Building a better system of care for older adults means changes in workplaces as well as health care and LTSS settings. This paper presents an analysis of the key challenges that family caregivers face, and highlights policy developments and practice change at the federal and state levels since 2015. The presentation addresses the importance of person- and family-centered care in everyday practice, and discusses the road ahead to change the culture of care.
THE NIH PATHWAYS TO PREVENTION PROGRAM
Authors: Shropshire Keisha L
Published: November 2019

The National Institutes of Health Office of Disease Prevention (ODP) Pathways to Prevention (P2P) Program identifies research gaps, methodological and scientific weaknesses in selected scientific areas; suggests research needs; and moves the field forward through an unbiased, evidence-based assessment of a complex public health issue. P2P workshops are designed for topics that have incomplete or underdeveloped research and that have a need for a synthesis and critical assessment of the published literature. This talk will explain the purpose of this P2P workshop on use of drug therapies for osteoporotic fracture prevention within the larger context of NIH efforts to promote prevention research.
ECONOMIC INEQUALITY AND FUTURE THOUGHT AMONG OLDER ADULTS
Authors: Adamson Erin M , Ekerdt David J , Adamson Erin M
Published: November 2019

Cumulative advantage theory sees inequality extending into later life. Does inequality also extend to the imagination of one’s future and desires for life yet to come? We draw from semi-structured interviews with 55 individuals residing in Midwest cities to explore differences in talk about finances and expectations for longevity, fulfillment, and “active” pursuits. Addressing personal futures, participants’ desires for longevity varied. Lower SES individuals discussed not having expected to live to their current age (or much beyond it) and not wanting to live a long time. Higher SES individuals, by contrast, expressed confidence that they could afford care no matter how long they lived. Higher SES participants often described future leisure goals whereas lower SES participants tended not to name leisure goals, or they named activities they desired but could not afford. For low SES individuals, active pursuits also were limited by diseases disproportionately affecting poor Americans, such as diabetes.
SOCIAL NETWORKS, HEALTH, AND WELL-BEING AMONG PEOPLE LIVING WITH DEMENTIA
Authors: McConnell Eleanor S , Corazzini Kirsten , Konrad T Robert
Published: November 2019

Although the impact of dementia on the health and well-being of those living with Alzheimer’s Disease and related Disorders (ADRD) and their care partners has been widely studied, less attention has been paid to how the disease impacts individuals within the context of their larger social networks. This symposium presents findings from a series of integrated studies aimed at strengthening measurement of health and well-being among older adults with living with dementia and well-being among members of their social networks. Findings will be presented from five studies: (1) a scoping review of social network measurement in older adults in chronic illness, including dementia, that emphasizes the use of technology in measuring older adults’ social networks; (2) a simulation study to evaluate the feasibility and reliability of sensor technology to measure social interaction among a person living with dementia and others in their immediate surroundings; (3) development of a web-based application that allows older adults to map and activate their social networks; (4) a qualitative analysis of interviews from persons living with dementia, their unpaid caregivers, and paid caregivers from an adult day health program concerning well-being focused outcomes; and (5) a mixed methods analysis of the feasibility of using both traditional and novel measures of health and well-being deployed among networks of people living with dementia. Emerging technologies for measuring social networks health and well-being hold promise for advancing the study of the relationship-based nature of care for people living with dementia.
THE METHODOLOGICAL RELEVANCE OF MASS OBSERVATION DATA
Authors: Eost-Telling Charlotte L , Kingston Paul , Taylor Louise , Bailey Jan
Published: November 2019

The Mass Observation Project, established in 1937, documents the lives of ordinary people living in the UK, and explores a wide range of social issues. The Project distributes a set of written questions (“Directives”) to a panel of 500 members of the British public (“Observers”) three times each year; “Observers” respond in writing. From the initial commissioning of a “Directive” to data becoming available for analysis takes between four to six months. This approach offers researchers an opportunity to capture in-depth qualitative data from individuals with a range of demographic backgrounds who live across the UK. As there are no word limits on “Observers’” responses and they remain anonymous, a “Directive” often yields rich, high-quality data. Additionally, compared with alternative methods of collecting large volumes of qualitative data from a heterogeneous population, commissioning a “Directive” is cost-effective in terms of time and resource.
THE HEALTH IMPACT OF SCAMS
Authors: Bailey Jan , Kingston Paul , Taylor Louise , Eost-Telling Louise
Published: November 2019

This presentation will offer new and alternate insights into ‘scams’ and the health effects of fraud on older people. It reports data captured from a Mass Observation Project “Directive” focusing on scams and their impact on individuals. Eighty “Observers’” aged 50 and over responded to the “Directive”. Responses indicate that falling victim to a scam may have negative impacts on individuals’ mental wellbeing, self-esteem and relationships with others. Data analysis also identified that fear of victimisation can also affect individuals, resulting in worry, anxiety and maladaptive coping strategies. Offering a sociology of health perspective, we will focus is on these health impacts of scams and the legitimisation of the issue as a socio-political problem. We will also highlight additional important areas for consideration, such as the absence of a common understanding of the concept and nomenclature of ‘scam’, and the ‘vagaries of scams’ by presenting a typology of scams.
UTILIZING EFFECTIVE MENTORING STRATEGIES FOR RESEARCH SUCCESS: NYU SUMMER SCHOLARS PROGRAM
Authors: Rowe Meredeth , Yap Tracey , Wu Bei
Published: November 2019

Since 1998 the Hartford Institute for Geriatric Nursing has offered a summer program designed to accelerate the development of research projects and trajectories for young scientists. This interprofessional program brings faculty and scholars together from across the globe representing all healthcare disciplines. In the week long program, scholars benefit from expert presentations and daily mentoring sessions with experts in gerontological research. In this symposium, scholars will discuss strategies they have used to successfully move from ideas for research, to development of proposals, conduct of research projects and planning career trajectories. We will present differing mentoring strategies and available mentoring opportunities for gerontological-focused scientists. Each scholar will present their work with topics including optimal medication management to sustain home placement: use of adaptive dance to improve mood and function in persons with Alzheimer’s disease; facilitating positive attitudes toward older adults in nursing students; the use of mindfulness to reduce symptoms of urinary incontinence; and, a novel intervention to reduce pressure ulcers in the nursing home.
IMPACT OF ADAPTED DANCE ON MOOD AND PHYSICAL FUNCTION AMONG ALZHEIMER’S DISEASE ASSISTED LIVING RESIDENTS
Authors: Bennett Crystal
Published: November 2019

Neuropsychiatric secondary symptoms and altered physical function are prevalent among persons with Alzheimer’s Disease and related dementia disorders (ADRD) which increase healthcare costs and caregiver burden. Adapted dance is a promising intervention that may improve these symptoms and physical function. The purpose of this study is to test whether 12 weeks of adapted dance (60 min 2x/week) improves agitation, physical function, and reduces caregiver burden. An experimental crossover design will be used. ADRD residents with a Montreal Cognitive Assessment score between 6-26, Timed up and go of <20 seconds, Cohen-Mansfield Agitation Inventory Score (CMAI) of >15, and do not use oxygen or assistive device will be eligible to participate. Outcomes will be assessed at baseline and every 4 weeks during each study arm for 24 weeks. Measures include CMAI and the Neuropsychiatric Inventory-Clinician Scale for agitation; Short Physical Performance Battery for physical function; and Zarit Burden Interview for caregiver burden.
A TELEWELLNESS APPROACH TO REDUCE BARRIERS TO GROUP EXERCISE FOR ADULTS AGING WITH MOBILITY DISABILITY
Authors: Mitzner Tracy L , Remillard Elena T
Published: November 2019

Group exercise classes have the potential to provide physical, cognitive, and emotional health benefits, through the physical activity performed as well as the social interaction among class participants. Substantial barriers exist for adults aging with lower-body mobility disabilities to engage in group exercise classes, including lack of transportation to classes, inaccessible buildings where classes are held, and lack of appropriate modifications offered for this population of older adults. Just as telehealth interventions have reduced barriers to healthcare, telewellness interventions can reduce barriers to engaging in wellness activities, such as group exercise classes. We will discuss a research study employing teleconferencing software to translate an evidence-based group tai chi class for adults aging with lower-body mobility disabilities. We will present the adaptation requirements identified to test the efficacy of a telewellness intervention for improving increasing social interaction and positive health behaviors (i.e., physical exercise frequency) for adults aging with disabilities.
SUPPORTING AGING IN PLACE WITH THE INTERNET OF THINGS: MEETING CHALLENGES OF USE THROUGH AUGMENTED REALITY TOOLS
Authors: Levy Laura , Gandy Maribeth
Published: November 2019

Internet of Things (IoT) devices (including smart thermostats, lightbulbs, and door locks) have the potential to greatly enhance independence and promote aging-in-place among older adults with mobility disabilities. However, these devices require extensive information technology expertise to select, configure, use, and adapt to meet one’s needs and this creates considerable barriers to their adoption, acceptance, and utilization. Meanwhile, increasingly available consumer augmented reality (AR) technologies can enable individuals to experience how IoT function and are used within the context of one’s own abilities and home. This may provide potential users an effective means of overcoming barriers to adoption, acceptance, and utilization of IoT to support aging in place. We present preliminary results from a participatory design study of older adults with mobility disabilities on the use of AR on a smart phone device to support IoT understanding.
DECONSTRUCTING THE MODEL-MINORITY MYTH OF U.S. ASIANS: DETERMINANTS AND CONSEQUENCES OF ELDER MISTREATMENT
Authors: Dong XinQi , Simon Melissa
Published: November 2019

Elder mistreatment (EM) is increasingly recognized as a global health concern. Among U.S. minority and immigrant populations, the social contexts and psychological consequences associated with EM remain poorly understood. Further population-based epidemiological studies using standard EM measures are required to advance the field. To address this gap and to challenge prior assumptions regarding Asian populations, this purpose of this symposium is to improve our understanding of EM epidemiology in an older minority population. Data were drawn from the Population-based Study of Chinese Elderly in Chicago (PINE), a longitudinal, representative, population-based study of 3,157 community-dwelling Chinese older adults in the greater Chicago area. Session 1 will examine the transmission between child mistreatment, intimate partner violence, and EM. Session 2 will take a typology approach to capture the multifaceted family relationships, and will further examine which family typologies were associated with greater likelihood of EM, while which typologies were protective against EM. Session 3 will explore the positive and negative aspects of social support from spouse, family, and friends in relationship to EM subtypes, including psychological, physical, financial and sexual mistreatment, and caregiver neglect. Session 4 will examine the relationship between broad, moderate, and strict definitions of EM and likelihood of experiencing anxiety. Last, Session 5 will explore the differential relationships between EM subtypes and depressive symptoms. In summation, this symposium challenges popular conceptions of the “model minority myth” and aims to increase the practical and clinical relevance of EM epidemiology in community, research, healthcare, and policy settings.
ELDER MISTREATMENT AND DEPRESSIVE SYMPTOMS AMONG OLDER CHINESE AMERICANS
Authors: Chao Ying-Yu , Chang Yu-Ping , Dong XinQi
Published: November 2019

This study aimed to examine the association between different types of elder mistreatment and depressive symptoms among U.S. Chinese older adults. Data were from the Population Study of Chinese Elderly in Chicago (PINE). Participants were 3,157 Chinese older adults who were 60 years and over (mean age = 72.8). Logistic regression analyses were performed. The results showed that participants with overall mistreatment (OR, 2.11; 95% CI, 1.83-2.43), psychological mistreatment (OR, 2.12; 95% CI, 1.78-2.51), physical mistreatment (OR, 1.82; 95% CI, 1.10-2.99), and financial exploitation (OR, 1.33; 95% CI, 1.11 – 1.60) were more likely to report more depressive symptoms. There was no significant association between sexual mistreatment and depressive symptoms (p = 0.07). Longitudinal studies are needed to obtain a more comprehensive understanding of the pathways between elder mistreatment and depressive symptoms.
INTERPROFESSIONAL SKILLS AND CULTURAL AWARENESS OF STUDENTS CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS
Authors: Daniel Kathryn M , Bond Mary Lou
Published: November 2019

Based on rapidly increasing numbers of older adults and growing populations of culturally diverse citizens, we developed and provided an interprofessional education program for graduate nursing and social work students that focused on the delivery of care to older adults and veterans with multiple chronic conditions. The students participated in multiple activities together over a year long period. Activities included an introductory IPE day with all students together and simulated patient cases that had required roles for the students’ specialties. Knowledge and skills of interprofessional collaborative practice were measured with the Interprofessional Self Assessment Competencies (IPEC) and Assessment of Interprofessional Team Collaboration Scale (AITCS). We also measured attitudes toward cultural differences using the Cultural Awareness Scale (CAS). The entire project was repeated a second year with a second cohort of students. Overall, our students were better able to understand and work collaboratively with other health care professionals after participating in this program. Regarding cultural awareness, both NP and SW students were more aware of and comfortable with cultural differences after participating in the program. After one year of experience, we wanted to know more about our students’ skills and attitudes. Focus groups were added to the design to dive deeper into the students’ perceptions about which activities were most impactful and recommendations for future IPE activities. This paper will describe these data and implications for future planning of more effective interprofessional and cultural programming for students caring for older adults and veterans.
OLDER WOMEN WITH HIV: STRATEGIES FOR HEALTHY AGING
Authors: Brennan-Ing Mark , Seidel Liz , Erenrich Rebecca , Karpiak Stephen E , Freeman Ryann N , Shen Megan Johnson , Burchett Chelsie O , Siegler Eugenia L
Published: November 2019

Women over 50 represent one-quarter of U.S. older adults with HIV, but we know little about how these women face the challenges of aging. As part of a larger study, we conducted two focus groups with racially diverse older women with HIV in New York City (n = 9) and Oakland, CA (n=11). Discussions concerned strategies for healthy aging. Transcripts were analyzed using inductive thematic methods. Women in both groups shared that they had close connections to family members and the importance of family support for motivating them to take care of their health. Some took proactive steps to stay healthy through nutrition and exercise, although the cost of gym memberships was a barrier. Many were lonely and needed socialization opportunities. Some suggested exercise classes could help to both maintain health and bolster social connections. Implications of these findings for developing programs for older women with HIV will be discussed.
AN EVALUATION OF THE VA RURAL INTERDISCIPLINARY TEAM TRAINING PROGRAM: OUTCOMES AND IMPLICATIONS
Authors: Howe Judith L , Kramer Josea , Weintraub Nancy , Gottesman Eve , Richter Regina , Bean Andrew
Published: November 2019

The rural interdisciplinary team training (RITT) program has provided in-person training for almost 2000 VA providers and staff at 125 rural clinics since 2011. The multi-modal workshop, accredited for 6.5 hours for a number of disciplines, focuses on the recognition of common issues facing older Veterans, red flags prompting further assessment, how to administer screening instruments and team-based approaches for improving patient outcomes. Participants develop an improvement action plan improvement project based on common challenges faced by clinic patients. A program evaluation found an increase in geriatrics knowledge and a modest improvement in teamwork after the education program. It also found that participants self-identified an enhanced ability on average to use red flags after the 6.5 hour training in areas such as polypharmacy, falls and caregiver stress. The action plans were often not implemented at follow-up. The evaluation results will be discussed, as well as challenges, limitations, and implications.
DAYS AND NIGHTS OF DYADS: EXAMINING BEHAVIORAL INTERDEPENDENCE IN CO-RESIDING COUPLES USING ACTIGRAPHY
Authors: Miller Lyndsey M , Beattie Zachary , Mattek Nora , Sharma Nicole , Wild Katherine , Kaye Jeffrey
Published: November 2019

Physical activity and sleep are behaviors that contribute to overall health, and are notoriously challenging to improve. For individuals co-residing as a couple, there is growing recognition of the importance of the interdependence between individuals’ behaviors (e.g. the physical activity and sleep habits of one’s partner has an influence on one’s own sleep and physical activity). Yet, studies examining this phenomenon have primarily been conducted among young adults and have either used self-report or episodic measures. The purpose of this study was to examine physical activity and sleep as interdependent behaviors within older adult couples. Using intensive longitudinal data (continuously collected over 35 days) from actigraph watches worn by 54 dyads (mean age in years 72.4 ± 7.1), we examined daily step counts and nightly sleep duration (total of 3780 observations) as a dyadic daily process. Results from multilevel process models for distinguishable dyads (Mplus version 8.2: Muthén & Muthén, 1998-2018) indicated that step count and sleep duration were interdependent processes at the within-dyad level (ps < 0.001). At the between-dyad level, on days with a typical number of steps, on average dyad members’ sleep duration was 7.55 hours [95% CI 4.27 - 10.79 hours], and across dyads, partners’ sleep duration and step counts were also interdependent processes (ps < 0.05). In order to improve the physical activity and sleep of older adults who co-reside with a partner, these results suggest that targeting the dyad, rather than the individual, may be necessary.
MENTAL AND PHYSICAL HEALTH EFFECTS OF EVERYDAY DISCRIMINATION TRAJECTORIES
Authors: Mueller Collin , Tavares Carlos
Published: November 2019

How do perceived discrimination trajectories impact health of Black, Latinx, and White adults ages 50 and older? Few researchers have sought to discern between the health effects of perceived discrimination measured cross-sectionally versus longitudinally. We aim to address this gap by leveraging newly available 3-wave panel data. We analyze 3 waves of data from the Health and Retirement Study (HRS) (n=2830 individuals ranging in age from 50 to 84, observed from 2008-2016). We first estimate group-based trajectories of everyday discrimination using finite mixture models. Second, we use multinomial logistic regression to estimate the likelihood of group membership in one of the identified trajectories of everyday discrimination based on psychosocial and demographic covariates. Third, we estimate the effects of group membership in one of these trajectories on four health outcomes: functional mobility, self-rated health, a count of chronic health conditions, and depressive symptoms. We identify three latent group-based trajectories of perceived discrimination. Black Americans are more likely than Latinx or White Americans to be members of latent trajectories characterized by higher levels of perceived discrimination over time. Membership in higher-discrimination groups over time is associated with worse physical and mental health profiles. Including measures of trajectory membership fully mediates the relationship between cross-sectional perceived discrimination and chronic conditions. Levels of discrimination decline across cohorts, suggesting that younger individuals perceive higher levels of everyday discrimination than their older counterparts.
SEX-DIMORPHISM IN THE GENOMIC REGULATION OF AGING
Authors: Benayoun Bérénice A , Lu Ryan A , Sampathkumar Nirmal K
Published: November 2019

The current cohort of human supercentenarians reveals a surprising predictor for achieving such an exceptional longevity: being female. Indeed, out of 34 living supercentenarians, 33 are women. We obtained samples from 4 and 20 months old female and male mice. Our data indicates that cytokine levels are differentially regulated with age in males vs. females, with pro-inflammatory cytokines specifically upregulated in the serum of old males, but not females. Because of the central role of macrophages in inflammation and their infiltration in tissues with age, we have generated RNA-seq from purified macrophages of aging animals. Female macrophages displayed ~7-20-fold more transcriptional remodeling with aging than males. Pathways specifically downregulated in females with aging included lysosome, inflammation and phagolysosome. Consistently, our data shows that aged female, but not male macrophages, display decreased phagocytic efficiency. Our results support the notion that there are differences in aging trajectories in female vs. male mice.
IT’S NOT OK TO FALL: CHALLENGES AND SUCCESSES OF A NURSING HOME FALL PREVENTION PROJECT
Authors: Sturdevant Diana L , Carlson Barbara , Round Teri
Published: November 2019

This study pilot-tested a 12-week, comprehensive, resident-centered fall prevention program aimed to lower falls in nursing home residents in Oklahoma. Staff from 52 nursing homes received a training on evidence-based fall prevention strategies and fall-risk assessment. Content was present using motivational scenarios that encouraged situational problems solving. Rate of falls, including falls with major injury) were collected for 3 months before (roll-in), during (treatment), and following (sustainability). Nursing homes completing the project (n=29) showed significant decline in falls, including falls with major injury. Staff acceptance and project implementation varied across nursing homes and was related to organizational policies that did not adapt care based on residents needs on any given day. Adaptability, not just knowledge, is important for ensuring the safety of residents. Future work will focus on the role of leadership in promoting more open systems for delivering care.
CHANGING NURSING HOME CULTURE: LONG-TERM CARE LEADERSHIP ACADEMY
Authors: Round Teri , Sturdevant Diana
Published: November 2019

Nursing homes that fostered open communication and teamwork were more likely to change their practices and adopt the “It’s Not OK to Fall” program. This pilot study evaluated the feasibility and acceptance of a team-building approach for developing leadership skills to three groups of coworkers: Administrators/Directors of Nursing, charge nurses, and certified nursing assistants (CNA) employed by nursing homes in Oklahoma. Each coworker group received one day of job specific leadership training, with another one half-day session where all levels engaged in team-building exercises. Participant satisfaction with course content ranged from agree-to-strongly agree. All stated that they could apply the leadership strategies at their facility. Administrators/Directors of Nursing found tools for tracking turnover/retention and strategies for improving staff communication helpful. Charge nurses and certified nursing assistants seldom viewed themselves as leaders, found coworker group communication very fragmented, and felt least knowledgeable about nursing home care best practices.
PARTICIPATION IN THE COMMUNITY AMONG PEOPLE WITH AND WITHOUT DEMENTIA: DESTINATIONS AND PERCEPTIONS OF CHALLENGES
Authors: Chaudhury Habib , Mahal Tanveer , Seetharaman Kishore
Published: November 2019

Older adults with dementia face challenges in their outdoor mobility and there are concerns of their not being able to continue going outside for everyday activities and social participation. The focus of this study was to identify patterns of visits to community destinations and activities, and perceptions of risks. Interviews were conducted with 59 adults (aged 54-84) with (n=29) and without (n=30) dementia using the Participation in ACTivities and Places OUTside the Home (ACT-OUT) questionnaire in Vancouver, Canada. Findings indicate that participants with dementia had abandoned visiting a few places over time (e.g., bank, cemetery, buildings of worship), whereas there were no change in participation in taking transit to destinations such as supermarkets, entertainment and cultural places. However, in some cases, companions or partners of persons with dementia indicated that they were prone to getting anxious when left alone in public places and were at high risk of getting lost.
EVERYDAY MARKERS OF PERSONALITY IN ADULTHOOD
Authors: Scott Stacey B , Neubauer Andreas , Smyth Joshua , Sliwinski Martin
Published: November 2019

Personality should manifest everyday as behaviors, affective states, and thoughts. Trait personality measures require retrospection and appraisal, processes affected by cognitive changes. Ecological momentary assessments (EMA), however, may identify sensitive everyday personality markers. We analyzed data from 178 individuals aged 20-79 who completed 3 EMA measurement bursts. Each burst, participants rated positive affect (PA), negative affect (NA), negative thoughts (URT), total social interactions, and interaction pleasantness up to 5x daily for 7 days. We tested for measurement invariance across bursts in a confirmatory factor analysis using 4 indicators of Neuroticism (N; a trait measure of N from BFI and 3 EMA-based indicators: mean NA, standard deviation NA, mean URT) and 4 indicators of Extraversion (E; trait E from BFI and mean PA, mean interactions, mean pleasantness). Strict measurement invariance held, indicating that the association among these indicators remained stable across the 18 month observation period.
PSYCHOLOGICAL AND SOCIAL FACTORS ASSOCIATED WITH SLEEP HEALTH ACROSS ADULTHOOD
Authors: Lee Soomi , Buxton Orfeu M
Published: November 2019

Sleep is associated with all-cause mortality, cardiovascular disease, cognitive impairment, as well as daily social interactions and productivity. Studies often have focused on sleep duration only, lacking the ability to comprehensively understand the importance of age-related changes in varied facets of sleep health. Moreover, psychological and social factors that may be associated with sleep health in adulthood are still poorly understood. This symposium showcases contemporary endeavors towards understanding how diverse indicators of sleep health relate to psychological and social factors across adulthood. Paper 1 uses perceived job discrimination as a social stressor to test associations between perceived job discrimination and sleep health (difficulty falling/staying asleep, excessive daytime sleepiness, sleep duration) among working women. Paper 2 examines the relationship between personality traits and self-reported and actigraphy-measured sleep health (sleep duration, sleep quality, sleep latency, insomnia symptoms, wake-after-sleep-onset). Paper 3 uses daily diary data to examine the link between pain and sleep health (sleep disturbances, napping) in older adults’ everyday lives and test moderating effect of social support. Paper 4 examines sleep health (sleep latency, feeling unrested) as a mechanism linking physical activity and cognitive function. These papers use different project datasets that include diverse populations of middle-aged and older adults, such as the Sister Study, Midlife in the United States Study, and Daily Experiences and Well-being Study. At the end of these presentations, Dr. Buxton will discuss their theoretical and methodological contributions, and consider challenges and opportunities for future research.
RACIAL DISPARITIES IN NURSING HOME RESIDENTS: QUALITY OF LIFE: DOES THE GAP PERSIST OVER TIME?
Authors: Shippee Tetyana P , Ng Weiwen , Bowblis John , Duan Yinfei , Akosionu Odichinma , Woodhouse Mark
Published: November 2019

The proportion of racial/ethnic minorities in nursing homes (NHs) has increased steadily in recent years. This study longitudinally examines minority NH residents’ quality of life (QoL); a key measure of overall well-being. We used unique data from Minnesota annual QoL interviews (2011-2015), merged with resident and facility characteristics to model QoL. Mixed models with various resident and facility level controls, facility random effects, and both fixed and random effects for year were fit to estimate the effect of being a minority and living in a high-proportion minority facility on QoL. While white residents’ unadjusted QoL scores remained stable over time, scores for minority residents declined. In full models, white residents in low-minority facilities consistently had the highest QoL scores while minority residents in high-minority facilities had the lowest scores. More policy attention is needed to address these persistent and possibly widening racial disparities, with targeted attention needed for high-minority facilities.
THE NATIONAL COLLABORATORY TO ADDRESS ELDER MISTREATMENT: COORDINATING NETWORKS OF CARE
Authors: Lees-Haggerty Kristin , Rosen Tony , Fulmer Terry
Published: November 2019

Elder mistreatment is a devastating and pervasive issue affecting an estimated one in ten older adults in the US. To effectively address elder mistreatment, it is essential for researchers, health care providers and communities to coordinate efforts and leverage each other’s strengths. The National Collaboratory to Address Elder Mistreatment (NCAEM), funded by The John A. Hartford Foundation and Gordon and Betty Moore Foundation, is a group of elder mistreatment experts from across the country taking a collective impact approach to alleviating the burden of elder mistreatment on survivors, families, communities, and systems. NCAEM’s goals are to provide hospital emergency departments with training and tools to address elder mistreatment and to develop networks of experts, health care, and community-based providers in a coordinated response to this complex problem. This symposium will include four presentations describing the NCAEM’s collective impact approach, intersection with related work, and applicability to other initiatives. We will present our strategy for creating a team, moving beyond typical collaborative efforts through the development of a central infrastructure and streamlined processes to support experts from across the country as we work together toward common goals and shared measurement for addressing elder mistreatment. Following an overview of our approach, presentations will include specific examples of how the NCAEM worked with clinical partners to refine an elder mistreatment screening and response tool, case examples from NCAEM clinical test sites describing efforts to bridge hospital and community-based services, and learnings from NCAEM’s strategic alignment with complimentary initiatives (the Geri-ED Accreditation and Collaborative).