bluuebunny/crossref_metadata_2025_split huggingface dataset:
Older Adult Substance Use, Support, Health, and Well-Being: Understanding a Complex Picture
Authors: Bareham Bethany , Cimarolli Verena , Kuerbis Alexis 
Published: December 2021

Abstract
Substance Use Disorders (SUDs), particularly hazardous alcohol use and Opioid Use Disorder (OUD), are increasingly common in older populations. Both are associated with poor mental and physical wellbeing. Alcohol use can also contribute positively to older people’s social and emotional wellbeing, and may be used by older people in managing pain. Health concerns can make older people more aware of the impact of their lifestyle, including substance use, for their health. The relationship between substance use, health and wellbeing in old age is complex, raising questions for how older people with SUDs are best supported. We aim to give insight into this complexity, drawing on five recent studies. Our first presentation examines the impact of health concerns in old age on alcohol use. Our second presentation explores the complicated relationship between experiences of pain, and alcohol use with age. Our third presentation considers wellbeing in older people with OUD, and the impact of Adverse Childhood Experiences, psychosocial, health and sociodemographic factors; and what this means for how wellbeing is promoted in this population. Our fourth presentation explores how those supporting people with dementia navigate alcohol use amongst older residents, in a care context where autonomy is prioritised, but health risk behaviours must be managed. Our final presentation considers alcohol use in ‘the new normal’; examining the impact of the COVID-19 pandemic on older people’s alcohol use, and motivations to engage in healthier/unhealthy use. We consider implications of these complex considerations around addressing substance use amongst older people for practice.
Age Effect on the Bidirectional Relations Between Alcohol Consumption and Pain
Authors: Yeung Ellen , Lee Matthew , Sher Kenneth 
Published: December 2021

Abstract
Alcohol consumption reduces but pain rises over the life course. Thus, we hypothesized that developmental variability in the bidirectional association between alcohol consumption and pain would vary as a function of age. This hypothesis was tested across three age groups – younger (&lt;29), middle (29-65), and older (&gt;65) using NESARC wave 1 and 2 data (N=34,653). The effect of pain interference at baseline on alcohol consumption at follow-up was non-significant across the age groups, indicating that self-medication theory was unsupported. The effect of alcohol consumption at baseline on pain interference at follow-up was significant among the middle (Estimate -.007, p=.002) and older (Estimate -.019, p&lt;.001) groups, but non-significant among the younger group. This latter effect differed significantly between the younger and older groups (p =.005) and the middle and older groups (p=.041). Results show that alcohol consumption reduces pain interference, especially later in life.
Dementia Care: Addressing Pain and Maximizing Comfort
Authors: Vinoo Deepa 
Published: December 2021

Abstract
Pain is common in older people who have Dementia, and is associated with a number of chronic and acute conditions. There is evidence that as many as 83% of nursing home residents experience pain that often goes unrecognized or inappropriately treated. Pain has a powerful effect on mood, sleep quality, functional ability, and overall quality of life. Rejecting care due to pain is very common among patients with Dementia. An association between pain and increased agitation has been noted, Significant reduction of agitation and psychotropic usage have been demonstrated by pain treatment in patients with moderate to severe dementia. This project was conducted in six memory care units with 150 residents at 815 bedded long-term geriatric care facility. All residents in memory care units from May 2018 to December 2019 were individually assessed for pain management, rejection of care, usage of psychotropics, falls and physical altercations. Trained interdisciplinary staff to evaluate pain by using PAIN AD. Educated interdisciplinary team on pharmacological and non-pharmacological pain management, and Pain management has improved from 40% to 90%, Rejection of care reduced from 80% to 30%. Usage of antipsychotics reduced by 12%. Falls reduced from 12% to 2%. Physical altercations reduced to zero. Staff call out due to work related injury significantly reduced. Staff verbalized improved job satisfaction and increased morale.
Evaluating Spaces for Older Adults Experiencing Homelessness: Findings From an Environmental Audit
Authors: Brais Hannah , Cormier Émilie , Serrano Diandra , Mahmood Atiya , Sussman Tamara , Bourgeois-Guerin Valérie 
Published: December 2021

Abstract
Homeless populations require spaces and services that take into account their life trajectories. The Aging in the Right Place - Environmental Checklist (AIRP-ENV) is an environmental audit tool developed by our team to evaluate the accessibility and overall design features of housing targeted for aging individuals experiencing homelessness. Researchers in Vancouver, Calgary and Montreal employed this tool in 2021 to evaluate environmental features in selected promising practices to identify built environment factors that promote aging in the right place. Preliminary findings reveal the following themes across sites: access to communal and recreational spaces encourage social inclusion and meaningful recreation opportunities; barrier-free built environment features foster independence and safety; and access to services and amenities encourage community mobility. Findings demonstrate a need to employ a broader evaluative lens that incorporates psycho-social factors to gain a nuanced understanding of aging in the right place for older adults who have experienced homelessness.
Temporary Housing for Older People: Addressing Housing Insecurity to Promote Aging in the Right Place
Authors: Gurung Shreemouna , Elkes Shelby , Mahmood Atiya , Lemme Holly , Modara Gelareh , Lam Emily , Mora Maria Juanita , Canham Sarah , Weldrick Rachel 
Published: December 2021

Abstract
The Aging in the Right Place (AIRP) project is a multi-year, multi-city partnership grant on aging, housing insecurity and homelessness. This paper presents findings from provider/staff interviews (N=5) at a Temporary Housing Program (THP) serving older people experiencing (or at risk of) homelessness (OPEH) in Vancouver, Canada. The researchers sought to understand the strengths and weaknesses of the program, scale-up (i.e., policies) and/or scale out impacts (i.e., on people and communities), as well as how the program promotes housing security and stability for OPEH. Narrative data reveals the program provided housing stability to OPEH by offering increased access to resources (food, pharmaceutical, transportation, social support and engagement). Additionally, through the promotion of client autonomy, privacy and security in their housing unit, the organization and staff work to support and foster AIRP among their clients and help to transform a temporary housing space into a secure home-type setting.
The STEP-HI Trial: Pragmatic Challenges and Design Issues
Authors: Binder Ellen 
Published: December 2021

Abstract
Multi-modal interventions present many implementation challenges, especially for studies of frail older adults. The STEP-HI study is an ongoing multi-center, randomized, controlled, double-blinded clinical trial that is evaluating whether six months of topical testosterone therapy combined with a supervised center-based exercise-training program can improve mobility, functional performance, and quality of life after hip fracture, compared to exercise training alone or Enhanced Usual Care. Female hip fracture patients ≥ 65 yrs. old who are living in the community or assisted living are being randomized within 26 weeks of surgical repair for the fracture, and re-evaluated 24 weeks later. This presentation discusses the rationale and study design, and modifications to the protocol in response to challenges, including the COVID-19 pandemic.
Implementation of a Remote Fidelity Oversight Program for a Multi-Site Exercise Intervention
Authors: Stevens-Lapsley Jennifer 
Published: December 2021

Abstract
The STEP-HI exercise protocol is a supervised, 2 phase, multimodal, high-intensity exercise program that emphasizes resistance training. Exercise sessions are conducted at an exercise facility and occur on two non-consecutive days/week for 6 months. During specified exercises, the exercise interventionist targets the participant’s eight-repetition maximum (8-RM), defined as the greatest resistance that can be moved 8 times through full range of motion with good form. A rigorous, remote fidelity monitoring program maximizes consistency of the intervention across sites. This fidelity oversight program is a model for future exercise studies because of its unique remote, hierarchical structure. All exercise interventionists are initially certified by written examination and direct observations. Some exercise sessions are also video recorded and reviewed using fidelity checklists. After initial certification, repeated direct observation and video-based verification of fidelity are repeated at prescribed intervals for each interventionist to ensure sustained consistency of implementation across sites.
A Dyadic Latent Profile Analysis of Older Couples’ Psychological, Relational, and Physical Health
Authors: Novak Josh , Ermer Ashley , Wilson Stephanie 
Published: December 2021

Abstract
The present study explored the heterogeneity of older couples’ psychological, relational, and physical health using a sample of 535 couples above the age of 62. A dyadic latent profile analysis was conducted to identify and predict unique clusters of couples’ relative psychological (depressive symptoms and daily hassles), relational (problematic affective communication and marital satisfaction), and physical health (number of health problems and self-reported health satisfaction). Predictors of class membership included relationship length, age, income, and hours worked outside the home. Results revealed 4 distinct classes: Happy & Healthy Together (63.5%), Individually & Relationally Strained (14.7%), Relationally Happy with Strained Wives (12.3%), and Relationally Happy with Strained Husbands (9.3%). Typology descriptions and predictors of class membership will be discussed. These findings highlight that health promotion efforts should be tailored to the specific psychological, relational, and physical health concerns of both partners rather than a one-size-fits-all approach.
Effects of Own and Partner Pain on Spousal Caregivers’ Marital Quality
Authors: Nah Suyoung , Martire Lynn 
Published: December 2021

Abstract
Little is known about whether care recipients’ and their spousal caregivers’ own pain influence the marital quality perceived by caregivers. Considering that experiencing and witnessing pain may be related to marital distress, we hypothesized that care recipient and caregiver pain would be associated with caregivers’ greater increases in marital conflict over time. We focused on 264 spousal caregivers of older adults with chronic illnesses or disability from the 2015 and 2017 National Study of Caregiving. Sixty-nine percent of care recipients and 54% of caregivers in this study were bothered by pain at baseline. Findings revealed that caregiver (b = 0.25, p = .02) and care recipient pain (b = 0.34, p &lt; .01) at baseline were both associated with caregivers’ higher marital conflict at follow-up. These findings suggest the importance of accounting for not only care recipients’ pain but also spousal caregivers’ own pain when examining caregivers’ marital quality.
Challenges of Implementing the PRISM 2.0 Trial for Supporting Social Connectivity Through Technology
Authors: Boot Walter , Czaja Sara , Plude Dana 
Published: December 2021

Abstract
Following the success of the Personal Reminder Information and Social Management (PRISM) trial, which found that a specially designed computer system for older adults can enhance social connectivity and reduce loneliness among older adults at risk for social isolation, the PRISM 2.0 trial sought to replicate and extend these results to a new technology platform (tablet rather than desktop) with expanded social features and diverse populations of older adults, including older adults living in rural areas, assisted living communities, and senior housing. This symposium discusses the aims of the trial conducted by the Center for Research and Education on Aging and Technology Enhancement (CREATE), challenges encountered (including challenges related to the COVID-19 pandemic), and solutions to those challenges. S. Czaja will begin with an overview of the PRISM 2.0 system and the trial. J. Sharit will discuss challenges encountered working within the context of assisted living facilities and with impaired participants. This will be followed by a discussion of technical challenges encountered during the course of the trial presented by N. Charness. W. Rogers will present training issues involved (both with respect to participants and assessors). Finally, W. Boot will describe challenges encountered with measuring and quantifying technology use during the trial. Lessons learned are applicable to many types of technology interventions administered in diverse contexts. D. Plude, Deputy Director in the Division of Behavioral and Social Research of NIA, will serve as discussant.
PRISM 2.0: A Technology System to Support Resource Access and Social and Cognitive Engagement
Authors: Czaja Sara , Boot Walter , Charness Neil , Rogers Wendy , Sharit Joseph 
Published: December 2021

Abstract
Social isolation and lack of engagement are common among older adults and present a risk for emotional, physical and cognitive decline. Technology offers the potential of remediating these risks and enhancing opportunities for connectivity. In this paper we present an overview of the PRISM 2.0 multi-site RCT, which evaluated a simple to use Personalized Reminder Information and Social Management System (PRISM) among a sample of two hundred and forty-eight adults age 65+ in diverse contexts (Rural Locations, Assisted Living Communities and Senior Housing). PRISM 2.0 is a tablet-based system, intended to provide support for access to resources and information, new learning, social and cognitive engagement, and memory. We describe the goals and content of PRISM, the user-centered design process, and measurement strategies. We also discuss the challenges of conducting the trial during the COVID-19 pandemic and the strategies used to adapt the trial protocol within the three contexts.
Challenges of Quantifying PRISM 2.0 and Tablet Use
Authors: Boot Walter , Charness Neil , Moxley Jerad 
Published: December 2021

Abstract
As with the PRISM 1.0 trial, an important outcome of the PRISM 2.0 trial is use of the PRISM system and use of the PRISM system compared to the control condition (a standard tablet without the PRISM software). Frequent use over time is an important measure of system success. Further, use data provide key measures of system usefulness and usability. What features do participants use most and how often? Within those features, what activities do they engage in? What are the patterns of use throughout the trial, and how does PRISM system use compare to the control condition? However, quantifying use is not an easy task. This talk presents the challenges of quantifying use of a complex, multi-faceted system, and of making meaningful comparisons in use between two very different systems. Analysis approaches and solutions are discussed.
Cognition-Mortality Associations Are Stronger When Estimated Jointly in Longitudinal and Time-to-Event Models
Authors: Aichele Stephen , Cekic Sezen , Rabbitt Patrick , Ghisletta Paolo 
Published: December 2021

Abstract
Objectives: With aging populations worldwide, there is growing interest in links between cognitive decline and elevated mortality risk—and, by extension, analytic approaches to further clarify these associations. Toward this end, some researchers have compared cognitive trajectories of survivors vs. decedents while others have examined longitudinal changes in cognition as predictive of mortality risk. A two-stage modeling framework is typically used in this latter approach; however, several recent studies have used joint longitudinal-survival modeling (i.e., estimating longitudinal change in cognition conditionally on mortality risk, and vice versa). Methodological differences inherent to these approaches may influence estimates of cognitive decline and cognition-mortality associations. These effects may vary across cognitive domains insofar as changes in broad fluid and crystallized abilities are differentially sensitive to aging and mortality risk. Methods: We applied each of the above analytic approaches to data from a large-sample repeated-measures study of older adults (N = 5,954, of whom 4,453 deceased; ages 50–87 years at assessment). Results: Cognitive trajectories indicated worse performance in decedents and when estimated jointly with mortality risk, but this was attenuated after adjustment for health-related covariates. Better cognitive performance predicted lower mortality risk, and, importantly, cognition-mortality associations were stronger when estimated in joint models. Associations between mortality risk and crystallized abilities only emerged under joint estimation, confirming the greater power of this statistical approach. Discussion: These results suggest that joint estimation of cognition-mortality associations may be beneficial for research in cognitive epidemiology and cognitive reserve in adult development.
Conducting Research in Persons With Dementia During the COVID-19 Pandemic: Challenges and Strategies
Authors: Jao Ying-Ling , Berish Diane , Kolanowski Ann 
Published: December 2021

Abstract
The COVID-19 pandemic has caused a health crisis for vulnerable older adults, physically and psychologically. Despite the urgent demand for clinical research for people with dementia, research activities are restricted due to the pandemic. This symposium will share the experiences of researchers conducting studies with older persons with dementia during the COVID-19 pandemic. The presenters share their strategies to overcome challenges at different stages of the study process during the pandemic. The research projects include work conducted in acute care, assisted living, nursing homes, and the community. The presentations include perspectives from different geographic areas and across countries in North America. The first presenter reports the challenges in continuing an ongoing research project, and shares strategies to engage stakeholders and plan a new protocol for recruitment and in-person data collection with residents with dementia in nursing homes. The second presenter reports on the barriers and facilitators of conducting an ongoing clinical trial with older adults with dementia across hospital and community settings and discusses strategies to meet project goals which include modifications to the protocol and analytic plan. The third presenter describes adaptations made to a study intervention designed to promote quality resident-staff interactions in assisted living and alterations to stakeholder engagement. The fourth presenter describes challenges and strategies to engage older adults with dementia via technology. The discussant will synthesize the findings across studies and highlight policy and research implications for the COVID-19 pandemic as well as other emergency situations.
Clinical Research in the Hospital During the Pandemic: What’s Worked and Not Worked?
Authors: Boltz Marie , Kuzmik Ashley , Best Irene , Mogle Jacqueline 
Published: December 2021

Abstract
Under normal conditions, the hospital setting presents multiple challenges to research with persons with dementia and their care partners. This presentation describes the additional barriers posed by the COVID-19 pandemic, as well as the strategies to meet those challenges, in a cluster randomized controlled trial that examines the efficacy of a nurse-family partnership to promote functional recovery of persons with dementia. In response to research restrictions, the research team altered their plan for recruitment, implementation of the intervention, data collection, and analytic approach. This presentation describes these alterations and discusses the plan to meet the aims of the project while meeting the requirements of the Institutional Review Board, accountability to the funder, and university regulations. Modifications in staffing patterns, staff training, and procedures will also be discussed, as well as the study timeline. Finally, strategies to maintain a positive attitude and productivity within the team will be discussed.
Supporting Patient Engagement in Dementia Research via Technology During the COVID-19 Pandemic
Authors: Hung Lillian , Yang Sophie , Gregorio Mario , Phinney Alison 
Published: December 2021

Abstract
The COVID-19 pandemic brings challenges to patient partnerships in research. In-person research meetings with patient partners were prohibited. In this presentation, we outline specific issues we encountered in a patient-led dementia research project, which involved a literature review study and gathering community stakeholders to identify the top 10 local priorities in the development of a dementia-friendly community. We will describe how we found shared solutions to complete the project. In response to COVID, computers and training were provided for patient partners to maintain team connection, plan project activities, conduct team analysis, and host a community workshop in the lockdown time. The drastic shift to virtual research methods created barriers and opportunities for co-research with older people with dementia. Virtual meetings can generate inequities for those who do not have a computer and knowledge in videoconferencing. Practical strategies to overcome barriers to using virtual technologies will be explored.
Aging in Place Since the COVID-19 Pandemic Onset: A Qualitative Study of Neighborhood Engagement
Authors: Finlay Jessica , Kobayashi Lindsay , Cannon Melissa , Meltzer Gabriella 
Published: December 2021

Abstract
The COVID-19 pandemic may fundamentally change neighborhood environments and ways of aging in place. This research aimed to investigate perceptions of and engagement in neighborhoods since the pandemic onset among online survey respondents of the COVID-19 Coping Study. We analyzed a random stratified sample of 500 open-ended responses collected July-September 2020 with quotas for age, gender, race/ethnicity, and education to match the US population aged 55+. Qualitative thematic analysis identified both increased and decreased local activity and varying levels of social interaction, support, and civic engagement. Community characteristics including age structure, socioeconomic diversity, density, housing patterns, weather, and social infrastructure were related to neighborhood perceptions. These interacted with personal characteristics such as duration of residence, living arrangements, family closeness, health status, and preferred lifestyle. Results highlight coping strategies among aging adults and their neighbors, sources of individual and community vulnerability, and opportunities to strengthen social infrastructure and resiliency within neighborhoods.