Wen Zhang, Tianyin Liu, D. Leung, Stephen Chan, Gloria Wong, Terry Lum
Depression and cognitive impairment are common and often coexist in older adults. The network theory of mental disorders provides a novel approach to understanding the pathways between depressive symptoms and cognitive domains and the potential “bridge” that links and perpetuates both conditions. This study aimed to identify pathways and bridge symptoms between depressive symptoms and cognitive domains in older adults. Data were derived from 2792 older adults aged 60 years and older with mild and more severe depressive symptoms from the community in Hong Kong. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9) and cognition using the Montreal Cognitive Assessment 5-min protocol (MoCA-5min). Summary descriptive statistics were calculated, followed by network estimation using graphical LASSO, community detection, centrality analysis using bridge expected influence (BEI), and network stability analyses to assess the structure of the PHQ-9 and MoCA-5min items network, the pathways and the bridge symptoms. Participants (mean age=77.3 years, SD=8.5) scored 8.2 (SD=3.4) on PHQ-9 and 20.3 (SD=5.4) on MoCA-5min. Three independent communities were identified in PHQ-9 and MoCA-5min items, suggesting that depression is not a uniform entity (two communities) and has differential connections with cognition. The network estimation results suggested that the two most prominent connections between depressive symptoms and cognitive domains were: (1) anhedonia with executive functions/language and (2) sad mood with memory. Among all depressive symptoms, sad mood had the highest BEI, bridging depressive symptoms and cognitive domains. Sad mood seems to be the pathway between depression and cognition in this sample of older Chinese. This finding highlights the importance of sad mood as a potential mechanism for the co-occurrence of depression and cognitive impairment, implying that intervention targeting sad mood might have rippling effects on cognitive health.
{"title":"Sad Mood Bridges Depressive Symptoms and Cognitive Performance in Community-dwelling Older Adults: A Network Approach","authors":"Wen Zhang, Tianyin Liu, D. Leung, Stephen Chan, Gloria Wong, Terry Lum","doi":"10.1093/geroni/igad139","DOIUrl":"https://doi.org/10.1093/geroni/igad139","url":null,"abstract":"Depression and cognitive impairment are common and often coexist in older adults. The network theory of mental disorders provides a novel approach to understanding the pathways between depressive symptoms and cognitive domains and the potential “bridge” that links and perpetuates both conditions. This study aimed to identify pathways and bridge symptoms between depressive symptoms and cognitive domains in older adults. Data were derived from 2792 older adults aged 60 years and older with mild and more severe depressive symptoms from the community in Hong Kong. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9) and cognition using the Montreal Cognitive Assessment 5-min protocol (MoCA-5min). Summary descriptive statistics were calculated, followed by network estimation using graphical LASSO, community detection, centrality analysis using bridge expected influence (BEI), and network stability analyses to assess the structure of the PHQ-9 and MoCA-5min items network, the pathways and the bridge symptoms. Participants (mean age=77.3 years, SD=8.5) scored 8.2 (SD=3.4) on PHQ-9 and 20.3 (SD=5.4) on MoCA-5min. Three independent communities were identified in PHQ-9 and MoCA-5min items, suggesting that depression is not a uniform entity (two communities) and has differential connections with cognition. The network estimation results suggested that the two most prominent connections between depressive symptoms and cognitive domains were: (1) anhedonia with executive functions/language and (2) sad mood with memory. Among all depressive symptoms, sad mood had the highest BEI, bridging depressive symptoms and cognitive domains. Sad mood seems to be the pathway between depression and cognition in this sample of older Chinese. This finding highlights the importance of sad mood as a potential mechanism for the co-occurrence of depression and cognitive impairment, implying that intervention targeting sad mood might have rippling effects on cognitive health.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"35 2","pages":""},"PeriodicalIF":7.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139146731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samuel M Mwangi, Lucy W. Maina, Gloria Chepngeno-Langat
Policy and program interventions for older adults 60 years or older in Africa have consistently been undermined by a lack of vital data as they are usually excluded from nationally representative population surveys. The Health and Wellbeing of Older Persons in Kenya (HWOPs-1) study developed a standardized assessment questionnaire that can be used for periodic data generation. This paper presents how the questionnaire was developed and examines its internal consistency and psychometric properties of the health module. The development and validation of the HWOPs-1 questionnaire was a three-step process. Step one was a review of 19 panel studies and two national level surveys followed by a wide consultation with key experts and stakeholders on aging. The third step was validation of the questionnaire with a crosssection of a representative sample to test its applicability and adaptability in a mix of rural and semi-urban settings. The internal consistency and psychometric properties of the three subscales: functionality, disability, and quality of life were assessed using Cronbach’s (α) alpha and exploratory factor analysis, respectively. Three subscales of functionality, disability, and quality of life showed high internal consistency with α=0.94, 0.97, and 0.87, respectively. There were also consistent factor loadings above 0.3 across all the factors. Gender differences across the three scales from the results of t-test were observed. Finally, weak but statistically significant correlations between the measures of well-being and risk factors for noncommunicable diseases were also observed from the analyses. The indicators assessed have been used in settings outside Africa to measure health and well-being of older adults are adaptable and reliable enabling comparability across space and across studies. The questionnaire provides a framework for examining disease and disability burden and their determinants among older adults in Kenya or similar settings.
{"title":"Developing a Standardized Questionnaire for Measuring Older Adult’s Health and Well-Being in Kenya","authors":"Samuel M Mwangi, Lucy W. Maina, Gloria Chepngeno-Langat","doi":"10.1093/geroni/igad137","DOIUrl":"https://doi.org/10.1093/geroni/igad137","url":null,"abstract":"Policy and program interventions for older adults 60 years or older in Africa have consistently been undermined by a lack of vital data as they are usually excluded from nationally representative population surveys. The Health and Wellbeing of Older Persons in Kenya (HWOPs-1) study developed a standardized assessment questionnaire that can be used for periodic data generation. This paper presents how the questionnaire was developed and examines its internal consistency and psychometric properties of the health module. The development and validation of the HWOPs-1 questionnaire was a three-step process. Step one was a review of 19 panel studies and two national level surveys followed by a wide consultation with key experts and stakeholders on aging. The third step was validation of the questionnaire with a crosssection of a representative sample to test its applicability and adaptability in a mix of rural and semi-urban settings. The internal consistency and psychometric properties of the three subscales: functionality, disability, and quality of life were assessed using Cronbach’s (α) alpha and exploratory factor analysis, respectively. Three subscales of functionality, disability, and quality of life showed high internal consistency with α=0.94, 0.97, and 0.87, respectively. There were also consistent factor loadings above 0.3 across all the factors. Gender differences across the three scales from the results of t-test were observed. Finally, weak but statistically significant correlations between the measures of well-being and risk factors for noncommunicable diseases were also observed from the analyses. The indicators assessed have been used in settings outside Africa to measure health and well-being of older adults are adaptable and reliable enabling comparability across space and across studies. The questionnaire provides a framework for examining disease and disability burden and their determinants among older adults in Kenya or similar settings.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"149 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139163177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kate Perepezko, Pamela Toto, Mary Hitchcock, Beth Fields
Evidence demonstrates that goal setting and care partner support help aging adults improve their health. Less is known about how aging adults and care partners collaboratively participate in goal setting, revealing a potential gap in care delivery processes. The current review describes the scope of the literature on this topic. A search was conducted in several relevant databases and 1,231 articles were screened for the following inclusion criteria: 1) Participants included aging adults (50+ years) and care partners, 2) Goal setting was conducted, and 3) Articles were in English. Common goals reported by aging adults were independence, improving or maintaining functioning, addressing symptoms, and remaining socially active. Care partners listed similar goals but also identified accessing services and supports as important. The level of care partner involvement varied across articles, with some care partners serving in a supportive role, some setting goals concurrently with the aging adult, and others setting goals on behalf of the aging adult. This review revealed concordant and discordant prioritization of goals within dyads. These findings illustrate the importance and potential complexity of including care partners in the goal setting process. We also found that collaborative goal setting and care partner directed goals are scarce, indicating the need for additional work in this area. Collaborative goal setting aligns with person and family-centered care approaches and can contribute to better care plans that meet the needs of aging adults and their care partners.
{"title":"Goal Setting for Aging Adults and Care Partners: A Scoping Review","authors":"Kate Perepezko, Pamela Toto, Mary Hitchcock, Beth Fields","doi":"10.1093/geroni/igad135","DOIUrl":"https://doi.org/10.1093/geroni/igad135","url":null,"abstract":"\u0000 \u0000 \u0000 Evidence demonstrates that goal setting and care partner support help aging adults improve their health. Less is known about how aging adults and care partners collaboratively participate in goal setting, revealing a potential gap in care delivery processes. The current review describes the scope of the literature on this topic.\u0000 \u0000 \u0000 \u0000 A search was conducted in several relevant databases and 1,231 articles were screened for the following inclusion criteria: 1) Participants included aging adults (50+ years) and care partners, 2) Goal setting was conducted, and 3) Articles were in English.\u0000 \u0000 \u0000 \u0000 Common goals reported by aging adults were independence, improving or maintaining functioning, addressing symptoms, and remaining socially active. Care partners listed similar goals but also identified accessing services and supports as important. The level of care partner involvement varied across articles, with some care partners serving in a supportive role, some setting goals concurrently with the aging adult, and others setting goals on behalf of the aging adult.\u0000 \u0000 \u0000 \u0000 This review revealed concordant and discordant prioritization of goals within dyads. These findings illustrate the importance and potential complexity of including care partners in the goal setting process. We also found that collaborative goal setting and care partner directed goals are scarce, indicating the need for additional work in this area. Collaborative goal setting aligns with person and family-centered care approaches and can contribute to better care plans that meet the needs of aging adults and their care partners.\u0000","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"36 25","pages":""},"PeriodicalIF":7.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghana’s older adult population is growing rapidly and projected to double by 2050. It is well-documented that social, health, and housing factors influence segmented aging trajectories that lead to disparate rates of disability. However, little is known how the intersection of place (i.e., urban; rural) and gender (i.e., woman; man) inform rates of disability among older Ghanaians. We seek to examine this gap in the literature through an intersectional approach. Using logistic regression with Wave 1 (2007/08) data from the World Health Organization’s Study on global AGEing and adult health (SAGE) Ghana, we investigate the prevalence of reporting activities of daily living (ADL) disability among respondents ages 50+ (n=4,106). To document gender differences by place, we compute separate adjusted odds ratio models among urban and rural respondents. We also control for health, social, and housing factors that might explain gender differences. Compared to urban men, urban women’s ADL disability disadvantage was explained by marital status, particularly widowhood. In contrast, rural women consistently reported an ADL disability disadvantage when compared to rural men. Additionally, we found that the morbidity profiles of those who reported ADL disability differed by place and that certain ADL difficulties (i.e., bed transferring; toileting) were especially common among women respondents. Women, regardless of urban or rural residence, were especially vulnerable to ADL disability. Marital status, particularly widows, explained the difference in disability risk between urban men and urban women. This finding suggests that urban women’s risk of ADL disability is attenuated during partnership. Also, we speculate that varied morbidity associations with ADL disability are due to different stressors in urban versus rural environments. These findings also generate further interest about rural women’s disability disadvantage.
{"title":"Exploring the intersectionality of place and gender among older adults in Ghana: An examination of women’s disability disadvantage","authors":"Shane D Burns, Latrica E. Best, Solomon Amoatey","doi":"10.1093/geroni/igad134","DOIUrl":"https://doi.org/10.1093/geroni/igad134","url":null,"abstract":"\u0000 \u0000 \u0000 Ghana’s older adult population is growing rapidly and projected to double by 2050. It is well-documented that social, health, and housing factors influence segmented aging trajectories that lead to disparate rates of disability. However, little is known how the intersection of place (i.e., urban; rural) and gender (i.e., woman; man) inform rates of disability among older Ghanaians. We seek to examine this gap in the literature through an intersectional approach.\u0000 \u0000 \u0000 \u0000 Using logistic regression with Wave 1 (2007/08) data from the World Health Organization’s Study on global AGEing and adult health (SAGE) Ghana, we investigate the prevalence of reporting activities of daily living (ADL) disability among respondents ages 50+ (n=4,106). To document gender differences by place, we compute separate adjusted odds ratio models among urban and rural respondents. We also control for health, social, and housing factors that might explain gender differences.\u0000 \u0000 \u0000 \u0000 Compared to urban men, urban women’s ADL disability disadvantage was explained by marital status, particularly widowhood. In contrast, rural women consistently reported an ADL disability disadvantage when compared to rural men. Additionally, we found that the morbidity profiles of those who reported ADL disability differed by place and that certain ADL difficulties (i.e., bed transferring; toileting) were especially common among women respondents.\u0000 \u0000 \u0000 \u0000 Women, regardless of urban or rural residence, were especially vulnerable to ADL disability. Marital status, particularly widows, explained the difference in disability risk between urban men and urban women. This finding suggests that urban women’s risk of ADL disability is attenuated during partnership. Also, we speculate that varied morbidity associations with ADL disability are due to different stressors in urban versus rural environments. These findings also generate further interest about rural women’s disability disadvantage.\u0000","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":" 4","pages":""},"PeriodicalIF":7.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138962789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-12eCollection Date: 2023-01-01DOI: 10.1093/geroni/igad119
M Cary Reid, Karl Pillemer
{"title":"Introduction to Special Issue: Translational Research on Pain and Pain Management in Later Life.","authors":"M Cary Reid, Karl Pillemer","doi":"10.1093/geroni/igad119","DOIUrl":"10.1093/geroni/igad119","url":null,"abstract":"","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"7 10","pages":"igad119"},"PeriodicalIF":4.9,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10714899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-08eCollection Date: 2024-01-01DOI: 10.1093/geroni/igad132
Nancy A Hodgson, Miranda V McPhillips, Darina V Petrovsky, Adriana Perez, Sonia Talwar, Nalaka Gooneratne, Barbara Riegel, Subhash Aryal, Laura N Gitlin
Background and objectives: Sleep disturbances occur in >60% of persons living with cognitive impairment, affecting their quality of life (QOL). Regulating the sleep-wake cycle through engaging cognitive, physical, and sensory-based activities delivered at strategic times may reduce sleep disturbances and be a feasible nonpharmacological treatment for sleep problems. The objective of this trial was to test the efficacy of a timed-activity intervention in improving QOL and sleep disturbances in persons living with cognitive impairment.
Research design and method: Randomized 2-group parallel design involving 209 dyads of community-residing persons living with cognitive impairment and care partners. Dyads were randomly assigned (1:1) to 1-hr home activity sessions administered weekly in the morning, afternoon, or evening over 4 weeks (the Healthy Patterns Sleep Program), or to an attention-control condition consisting of sleep hygiene training plus education on home safety and health promotion. QOL, objective and subjective sleep quality, and neuropsychiatric symptoms were assessed at baseline and 4 weeks later.
Results: QOL was significantly improved in the intervention group compared to control (p = .0491). There were no significant effects on objective or subjective sleep or neuropsychiatric symptoms. In a subgroup analysis, subjective sleep as measured by the PROMIS (Patient Reported Outcomes Measurement Information System) Sleep-Related Impairment survey was significantly improved in the intervention group compared to the control group for individuals with symptoms of depression (p = .015) or poor observed sleep at baseline (p = .005).
Discussion and implications: The Healthy Patterns Intervention may benefit QOL for persons living with cognitive impairment and those with poor subjective sleep. A longer dose may be necessary to elicit improvement in actigraphically measured sleep-wake activity.
{"title":"Timed Activity to Minimize Sleep Disturbance in People With Cognitive Impairment.","authors":"Nancy A Hodgson, Miranda V McPhillips, Darina V Petrovsky, Adriana Perez, Sonia Talwar, Nalaka Gooneratne, Barbara Riegel, Subhash Aryal, Laura N Gitlin","doi":"10.1093/geroni/igad132","DOIUrl":"10.1093/geroni/igad132","url":null,"abstract":"<p><strong>Background and objectives: </strong>Sleep disturbances occur in >60% of persons living with cognitive impairment, affecting their quality of life (QOL). Regulating the sleep-wake cycle through engaging cognitive, physical, and sensory-based activities delivered at strategic times may reduce sleep disturbances and be a feasible nonpharmacological treatment for sleep problems. The objective of this trial was to test the efficacy of a timed-activity intervention in improving QOL and sleep disturbances in persons living with cognitive impairment.</p><p><strong>Research design and method: </strong>Randomized 2-group parallel design involving 209 dyads of community-residing persons living with cognitive impairment and care partners. Dyads were randomly assigned (1:1) to 1-hr home activity sessions administered weekly in the morning, afternoon, or evening over 4 weeks (the Healthy Patterns Sleep Program), or to an attention-control condition consisting of sleep hygiene training plus education on home safety and health promotion. QOL, objective and subjective sleep quality, and neuropsychiatric symptoms were assessed at baseline and 4 weeks later.</p><p><strong>Results: </strong>QOL was significantly improved in the intervention group compared to control (<i>p</i> = .0491). There were no significant effects on objective or subjective sleep or neuropsychiatric symptoms. In a subgroup analysis, subjective sleep as measured by the PROMIS (Patient Reported Outcomes Measurement Information System) Sleep-Related Impairment survey was significantly improved in the intervention group compared to the control group for individuals with symptoms of depression (<i>p</i> = .015) or poor observed sleep at baseline (<i>p</i> = .005).</p><p><strong>Discussion and implications: </strong>The Healthy Patterns Intervention may benefit QOL for persons living with cognitive impairment and those with poor subjective sleep. A longer dose may be necessary to elicit improvement in actigraphically measured sleep-wake activity.</p><p><strong>Clinical trial registration number: </strong>NCT0368218 5.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"8 1","pages":"igad132"},"PeriodicalIF":7.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139484458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1093/geroni/igad104.2083
Y. Qiao, Adam J Santanasto, Peggy Cawthon, D. Forman, S. Kritchevsky, Barb Nicklas, A. Newman, Nancy Glynn
Abstract Performance fatigability manifests as insufficient energy to complete daily physical tasks and worsens with aging, exacerbating vulnerability to disability. Skeletal muscle energetics also declines with aging. Thus, we hypothesized muscle energetics may be an important contributor to performance fatigability. In the Study of Muscle, Mobility and Aging (SOMMA), participants completed a usual-paced 400m walk while wearing a wrist-worn ActiGraph, from which raw data were used to derive the Pittsburgh Performance Fatigability Index (PPFI, higher=more severe fatigability) that quantifies percent decline in the entire individual cadence-versus-time trajectory. Maximal oxidative phosphorylation (maxOXPHOS) in skeletal muscle mitochondria was quantified in vitro using high-resolution respirometry in permeabilized fiber bundles from vastus lateralis muscle biopsies. Maximal adenosine triphosphate production (ATPmax) was assessed in vivo by 31P magnetic resonance spectroscopy. We conducted separate tobit regressions to examine associations of maxOXPHOS and ATPmax with PPFI, adjusting for technician/site, age, sex, race, height, weight, and mins/day moderate-to-vigorous physical activity measured by ActiGraph in free-living, in N=795 participants with complete PPFI scores and >1 energetics measure (70-94 yrs, 58% women). Median PPFI scores were 1.4% [IQR: 0-2.9%]. After adjustment, each SD (18.4 pmol/(s*mg)) lower maxOXPHOS was associated with 0.55% (95% CI: 0.26, 0.85) higher PPFI scores, while each SD (0.2 mM/sec) lower ATPmax was associated with 0.54% (95% CI: 0.27, 0.81) higher PPFI scores. Our results indicate that lower skeletal muscle energetics were associated with more severe performance fatigability. This suggests that therapeutics targeting muscle energetics may thereby potentially mitigate fatigability and lessen susceptibility to disability among older adults.
{"title":"SKELETAL MUSCLE ENERGETICS ARE ASSOCIATED WITH PERFORMANCE FATIGABILITY","authors":"Y. Qiao, Adam J Santanasto, Peggy Cawthon, D. Forman, S. Kritchevsky, Barb Nicklas, A. Newman, Nancy Glynn","doi":"10.1093/geroni/igad104.2083","DOIUrl":"https://doi.org/10.1093/geroni/igad104.2083","url":null,"abstract":"Abstract Performance fatigability manifests as insufficient energy to complete daily physical tasks and worsens with aging, exacerbating vulnerability to disability. Skeletal muscle energetics also declines with aging. Thus, we hypothesized muscle energetics may be an important contributor to performance fatigability. In the Study of Muscle, Mobility and Aging (SOMMA), participants completed a usual-paced 400m walk while wearing a wrist-worn ActiGraph, from which raw data were used to derive the Pittsburgh Performance Fatigability Index (PPFI, higher=more severe fatigability) that quantifies percent decline in the entire individual cadence-versus-time trajectory. Maximal oxidative phosphorylation (maxOXPHOS) in skeletal muscle mitochondria was quantified in vitro using high-resolution respirometry in permeabilized fiber bundles from vastus lateralis muscle biopsies. Maximal adenosine triphosphate production (ATPmax) was assessed in vivo by 31P magnetic resonance spectroscopy. We conducted separate tobit regressions to examine associations of maxOXPHOS and ATPmax with PPFI, adjusting for technician/site, age, sex, race, height, weight, and mins/day moderate-to-vigorous physical activity measured by ActiGraph in free-living, in N=795 participants with complete PPFI scores and >1 energetics measure (70-94 yrs, 58% women). Median PPFI scores were 1.4% [IQR: 0-2.9%]. After adjustment, each SD (18.4 pmol/(s*mg)) lower maxOXPHOS was associated with 0.55% (95% CI: 0.26, 0.85) higher PPFI scores, while each SD (0.2 mM/sec) lower ATPmax was associated with 0.54% (95% CI: 0.27, 0.81) higher PPFI scores. Our results indicate that lower skeletal muscle energetics were associated with more severe performance fatigability. This suggests that therapeutics targeting muscle energetics may thereby potentially mitigate fatigability and lessen susceptibility to disability among older adults.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"307 1","pages":"639 - 640"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138985863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1093/geroni/igad104.0292
A. A. Korat, Kyla Shea, Paul Jacques, Paola Sebastiani, Molin Wang, Walter Willett, Qi Sun, Jean Mayer, Harvard T.H. Chan, Gail Rogers, Kathryn Barger, Jennifer Lee, Kerry Wellenstein, Gregory Matuszek
Abstract The COVID-19 pandemic required Older Americans Act (OAA) congregate nutrition programs to shut down in-person dining but continue serving meals in innovative ways. Re-opening provided a unique opportunity for congregate nutrition programs to continue these innovative changes and/or reinvent how they serve meals. These changes will be crucial for OAA nutrition programs to maintain their relevance, as all adults over age 60 qualify for OAA meals, yet fewer than that attend. To identify successful practices that could be adopted nationally and describe continuing challenges, we conducted surveys, focus groups, and interviews of congregate nutrition programs. Overall, 523 completed the entire survey, nine participated in focus groups, and three were interviewed. Responses came from across 47 states with most (94%) reporting permanently adopting service delivery methods implemented during the COVID-19 pandemic. Overall, nutrition programs described grab-and-go meals having attracted new participants during the pandemic and programs pairing other services with meals to appeal to and retain a wide range of participants. These include medically tailored meals, culturally relevant meals, partnerships with other organizations, and entertainment. These results can be used to strengthen congregate nutrition programs.
{"title":"POSTPANDEMIC SUCCESSES AND CHALLENGES IN REOPENING OLDER AMERICANS ACT CONGREGATE MEALS","authors":"A. A. Korat, Kyla Shea, Paul Jacques, Paola Sebastiani, Molin Wang, Walter Willett, Qi Sun, Jean Mayer, Harvard T.H. Chan, Gail Rogers, Kathryn Barger, Jennifer Lee, Kerry Wellenstein, Gregory Matuszek","doi":"10.1093/geroni/igad104.0292","DOIUrl":"https://doi.org/10.1093/geroni/igad104.0292","url":null,"abstract":"Abstract The COVID-19 pandemic required Older Americans Act (OAA) congregate nutrition programs to shut down in-person dining but continue serving meals in innovative ways. Re-opening provided a unique opportunity for congregate nutrition programs to continue these innovative changes and/or reinvent how they serve meals. These changes will be crucial for OAA nutrition programs to maintain their relevance, as all adults over age 60 qualify for OAA meals, yet fewer than that attend. To identify successful practices that could be adopted nationally and describe continuing challenges, we conducted surveys, focus groups, and interviews of congregate nutrition programs. Overall, 523 completed the entire survey, nine participated in focus groups, and three were interviewed. Responses came from across 47 states with most (94%) reporting permanently adopting service delivery methods implemented during the COVID-19 pandemic. Overall, nutrition programs described grab-and-go meals having attracted new participants during the pandemic and programs pairing other services with meals to appeal to and retain a wide range of participants. These include medically tailored meals, culturally relevant meals, partnerships with other organizations, and entertainment. These results can be used to strengthen congregate nutrition programs.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"59 21","pages":"90 - 90"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138985960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1093/geroni/igad104.1152
D. Burnes, Karl Pillemer
Abstract Knowledge of effective interventions for elder abuse and self-neglect (EASN) is limited. Adult Protective Services (APS) represents the primary agency responsible for receiving reports and investigating suspected cases of EASN in the US. However, APS lacks a distinct, conceptually informed intervention phase to support EASN cases. Based on theory, research, and consultations with stakeholders, RISE was designed to address this intervention gap within overall EASN response systems. Informed by ecological-systems, relational, and client-centered perspectives, RISE is a community-based EASN intervention that integrates core modalities (motivational interviewing, restorative justice, teaming, supported decision making) demonstrating evidence and/or promising results in EASN and other domains. The intervention operates at Relational, Individual, Social, and Environmental levels of ecological influence. Specifically, RISE works with both older adult victims and others, including alleged harmers, their relationships, and strengthens the social supports surrounding them. RISE began as a pilot in two Maine counties, was expanded to the entire state, has been used in over 450 cases, was written into Maine’s 2023 budget, is now being implemented and tested in New Hampshire and Toronto, Canada, and is being expanded to the criminal justice system. This symposium will describe RISE’s development and conceptual underpinnings (presentation 1), findings on implementing “teaming” (social support), an intervention modality (presentation 2), a qualitative evaluation of RISE from the perspective of APS caseworkers (presentation 3), evidence of RISE reducing EASN recidivism (presentation 4), and case studies of implementing RISE (and its restorative justice modality) in the criminal justice diversion context (presentation 5). This is an Abuse, Neglect and Exploitation of Older Persons Interest Group Sponsored Symposium.
{"title":"RISE: A COMMUNITY-BASED ELDER ABUSE AND SELF-NEGLECT RESPONSE INTERVENTION ADDRESSING A CRITICAL SYSTEMS GAP","authors":"D. Burnes, Karl Pillemer","doi":"10.1093/geroni/igad104.1152","DOIUrl":"https://doi.org/10.1093/geroni/igad104.1152","url":null,"abstract":"Abstract Knowledge of effective interventions for elder abuse and self-neglect (EASN) is limited. Adult Protective Services (APS) represents the primary agency responsible for receiving reports and investigating suspected cases of EASN in the US. However, APS lacks a distinct, conceptually informed intervention phase to support EASN cases. Based on theory, research, and consultations with stakeholders, RISE was designed to address this intervention gap within overall EASN response systems. Informed by ecological-systems, relational, and client-centered perspectives, RISE is a community-based EASN intervention that integrates core modalities (motivational interviewing, restorative justice, teaming, supported decision making) demonstrating evidence and/or promising results in EASN and other domains. The intervention operates at Relational, Individual, Social, and Environmental levels of ecological influence. Specifically, RISE works with both older adult victims and others, including alleged harmers, their relationships, and strengthens the social supports surrounding them. RISE began as a pilot in two Maine counties, was expanded to the entire state, has been used in over 450 cases, was written into Maine’s 2023 budget, is now being implemented and tested in New Hampshire and Toronto, Canada, and is being expanded to the criminal justice system. This symposium will describe RISE’s development and conceptual underpinnings (presentation 1), findings on implementing “teaming” (social support), an intervention modality (presentation 2), a qualitative evaluation of RISE from the perspective of APS caseworkers (presentation 3), evidence of RISE reducing EASN recidivism (presentation 4), and case studies of implementing RISE (and its restorative justice modality) in the criminal justice diversion context (presentation 5). This is an Abuse, Neglect and Exploitation of Older Persons Interest Group Sponsored Symposium.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"364 1","pages":"346 - 346"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background StrongerMemory is a brain health program centered on spending 30 minutes per day on handwritten journaling, reading aloud, and arithmetic exercises as a method to enhance cognition in older adults. The StrongerMemory research protocol is a 12-week program that includes a weekly meeting. After 104 participants completed the StrongerMemory research protocol, they were invited to participate in a focus group to share their experiences. Six focus groups were conducted by members of the StrongerMemory research team yielding 30 participants. Methods Focus groups were conducted virtually, with a set of pre-determined, open-ended questions centering around participant experiences and attitudes towards the StrongerMemory program. Participants were also asked to reflect on differences in their memory, cognition and well-being before and after StrongerMemory participation. Two researchers independently coded the focus group transcripts, and utilized the grounded theory analysis techniques of memoing and constant comparative analysis to explore the data. Common themes were then discussed. Results Five overarching themes emerged: Motivating, appreciating, challenging, committing, and enhancing. Conceptualizations of these themes focused on participants’ experiences and suggestions for strengthening the program. “Fostering community” was an outcome of the program often discussed. Conclusion The participant experience in StrongerMemory revealed unique perspectives on their motivation for participation and provided the researchers with new insights into the program such as fostering community within older adult groups. Further research includes exploring cognitive and social benefits of group participation in the StrongerMemory program.
{"title":"THE STRONGERMEMORY PROGRAM: EXPLORING COGNITIVE BENEFITS AND FOSTERING COMMUNITY","authors":"Catherine Tompkins, Emily Ihara, Francesca Keesee, Mckenzie Lauber, Catherine Magee, Jessica Fredericksen, Rob Liebreich","doi":"10.1093/geroni/igad104.2882","DOIUrl":"https://doi.org/10.1093/geroni/igad104.2882","url":null,"abstract":"Abstract Background StrongerMemory is a brain health program centered on spending 30 minutes per day on handwritten journaling, reading aloud, and arithmetic exercises as a method to enhance cognition in older adults. The StrongerMemory research protocol is a 12-week program that includes a weekly meeting. After 104 participants completed the StrongerMemory research protocol, they were invited to participate in a focus group to share their experiences. Six focus groups were conducted by members of the StrongerMemory research team yielding 30 participants. Methods Focus groups were conducted virtually, with a set of pre-determined, open-ended questions centering around participant experiences and attitudes towards the StrongerMemory program. Participants were also asked to reflect on differences in their memory, cognition and well-being before and after StrongerMemory participation. Two researchers independently coded the focus group transcripts, and utilized the grounded theory analysis techniques of memoing and constant comparative analysis to explore the data. Common themes were then discussed. Results Five overarching themes emerged: Motivating, appreciating, challenging, committing, and enhancing. Conceptualizations of these themes focused on participants’ experiences and suggestions for strengthening the program. “Fostering community” was an outcome of the program often discussed. Conclusion The participant experience in StrongerMemory revealed unique perspectives on their motivation for participation and provided the researchers with new insights into the program such as fostering community within older adult groups. Further research includes exploring cognitive and social benefits of group participation in the StrongerMemory program.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"359 1","pages":"896 - 896"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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