Pub Date : 2023-12-01DOI: 10.1093/geroni/igad104.0598
Sarah Holmes
Abstract Low-income older adults may qualify to live in subsidized housing via the Housing and Urban Development (HUD) Section 202 program. Established in 1959, Section 202 is the only HUD program that provides housing exclusively for older adults. More than 1.8 million older adults receive this type of federal housing assistance. Older adults living in low-income senior housing communities are mostly people of color, socioeconomically disadvantaged, and at risk for poor physical and mental health and adverse health outcomes. Additionally, they have limited access to healthcare services and other resources such as internet use, healthy food options, opportunities for physical activity, and safe indoor and outdoor physical environments. Further they are at increased risk of high emergency room utilization and transfer to nursing home settings. The purpose of this project was to develop Interdisciplinary Wellness Clinics for older adults living in low-income senior housing communities and provide direct services including such things as blood pressure monitoring, medication management, hearing evaluation and cerumen removal, foot and nail care, pain management, management of acute medical problems, immunizations, and Medicare Annual Wellness Visits. Interdisciplinary Wellness Clinics are provided monthly to four low-income senior housing communities and serve approximately 500 residents living in these communities. This symposium will provide a review of residents seen and services provided with a focus on findings identified and interventions implemented; a description of the Medicare Annual Wellness services; and a review of approaches used to engage residents in using these services.
{"title":"INTERDISCIPLINARY WELLNESS CLINICS IN LOW-INCOME SENIOR HOUSING COMMUNITIES","authors":"Sarah Holmes","doi":"10.1093/geroni/igad104.0598","DOIUrl":"https://doi.org/10.1093/geroni/igad104.0598","url":null,"abstract":"Abstract Low-income older adults may qualify to live in subsidized housing via the Housing and Urban Development (HUD) Section 202 program. Established in 1959, Section 202 is the only HUD program that provides housing exclusively for older adults. More than 1.8 million older adults receive this type of federal housing assistance. Older adults living in low-income senior housing communities are mostly people of color, socioeconomically disadvantaged, and at risk for poor physical and mental health and adverse health outcomes. Additionally, they have limited access to healthcare services and other resources such as internet use, healthy food options, opportunities for physical activity, and safe indoor and outdoor physical environments. Further they are at increased risk of high emergency room utilization and transfer to nursing home settings. The purpose of this project was to develop Interdisciplinary Wellness Clinics for older adults living in low-income senior housing communities and provide direct services including such things as blood pressure monitoring, medication management, hearing evaluation and cerumen removal, foot and nail care, pain management, management of acute medical problems, immunizations, and Medicare Annual Wellness Visits. Interdisciplinary Wellness Clinics are provided monthly to four low-income senior housing communities and serve approximately 500 residents living in these communities. This symposium will provide a review of residents seen and services provided with a focus on findings identified and interventions implemented; a description of the Medicare Annual Wellness services; and a review of approaches used to engage residents in using these services.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"58 1","pages":"181 - 181"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986015","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/igad104.1174
Justine Sefcik, Harleah Buck
Abstract This symposium presents a series of cases where gerontological researchers identified fraudulent participants and bots engaging in their studies. These presentations describe the complex nature of participants misrepresenting themselves and being creative to enroll in studies for financial incentives. Dr. Sefcik shares how a snowball sample led to participants enrolling in a study and misrepresenting themselves during virtual qualitative interviews. Dr. Boon illuminates how Facebook recruitment led to bot responses and steps taken to identify if participants were real. Dr. Frechman reveals how recruitment on social media platforms and email distribution lists led to bot attacks of the study survey. Dr. Carpenter explains a study involving a multi-methods approach in which a bot completed several surveys and an interviewee gave nonsensical responses. Dr. Wallace explains two types of fraudulent activity occurring, the first with bots completing an online survey and the second with deception during interviews. All presenters discuss their experiences of suspecting fraudulent research participation, approaches on how they verified participants, action steps to address misrepresentation, processes put in place to uphold the integrity of their studies, and tips to mitigate future fraud. This is a Nursing Care of Older Adults Interest Group Sponsored Symposium.
{"title":"RESEARCHERS BEWARE: CAUTIONARY TALES OF FRAUDULENT RESEARCH PARTICIPANTS AND WHAT TO DO ABOUT THEM","authors":"Justine Sefcik, Harleah Buck","doi":"10.1093/geroni/igad104.1174","DOIUrl":"https://doi.org/10.1093/geroni/igad104.1174","url":null,"abstract":"Abstract This symposium presents a series of cases where gerontological researchers identified fraudulent participants and bots engaging in their studies. These presentations describe the complex nature of participants misrepresenting themselves and being creative to enroll in studies for financial incentives. Dr. Sefcik shares how a snowball sample led to participants enrolling in a study and misrepresenting themselves during virtual qualitative interviews. Dr. Boon illuminates how Facebook recruitment led to bot responses and steps taken to identify if participants were real. Dr. Frechman reveals how recruitment on social media platforms and email distribution lists led to bot attacks of the study survey. Dr. Carpenter explains a study involving a multi-methods approach in which a bot completed several surveys and an interviewee gave nonsensical responses. Dr. Wallace explains two types of fraudulent activity occurring, the first with bots completing an online survey and the second with deception during interviews. All presenters discuss their experiences of suspecting fraudulent research participation, approaches on how they verified participants, action steps to address misrepresentation, processes put in place to uphold the integrity of their studies, and tips to mitigate future fraud. This is a Nursing Care of Older Adults Interest Group Sponsored Symposium.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"345 2","pages":"353 - 353"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986026","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 Falls are a significant public health problem; one third of individuals aged 65 years or older fall each year. Strength and balance exercises reduce fall risk, but most older adults are inactive. Individuals at risk of falls need clear guidance to ensure exercises performed at home are safe and provide adequate challenge. The aim of this qualitative study was to investigate the experiences and perceptions of older adults with increased fall risk enrolled in a 3-month digitally delivered home-based fall prevention exercise program (DFP). Semi-structured interviews were conducted by an interview specialist on a sample of 16 participants (81% female, age 77.3±5.8 years). Interviews were transcribed, imported, and coded into Dedoose, a tool for qualitative analysis. Codes were refined with each interview and themes were generated from the final codes. Three themes were identified: adherence to a home-based digitally delivered fall prevention exercise program, impact of fall prevention exercises on activities of daily living (ADL), and benefits of home-balance exercises. Participants attributed adherence to the home exercise program with minimal in-person visits. Participants reported fear of falling increased as they aged; upon completion, participants felt reduced fear of falling in their ADL. Balance exercises were the most appealing due to the level of difficulty and motivation to improve balance. Participants recommended changes to improve the DFP exercise program, with majority wanting to continue the program. This qualitative analysis provides guidance to health professionals about the acceptability and recommended changes for a digitally delivered home fall prevention exercise program.
{"title":"A QUALITATIVE ANALYSIS OF A DIGITAL FALL PREVENTION EXERCISE PROGRAM FOR OLDER ADULTS WITH INCREASED FALL RISK","authors":"Shannon Farrell, Nicole Bajdek, Mary Dishaw, Pamela Garabedian, Alisha Williams, Naomi Hachen, Kieran Reid, Nancy Latham","doi":"10.1093/geroni/igad104.3146","DOIUrl":"https://doi.org/10.1093/geroni/igad104.3146","url":null,"abstract":"Abstract Falls are a significant public health problem; one third of individuals aged 65 years or older fall each year. Strength and balance exercises reduce fall risk, but most older adults are inactive. Individuals at risk of falls need clear guidance to ensure exercises performed at home are safe and provide adequate challenge. The aim of this qualitative study was to investigate the experiences and perceptions of older adults with increased fall risk enrolled in a 3-month digitally delivered home-based fall prevention exercise program (DFP). Semi-structured interviews were conducted by an interview specialist on a sample of 16 participants (81% female, age 77.3±5.8 years). Interviews were transcribed, imported, and coded into Dedoose, a tool for qualitative analysis. Codes were refined with each interview and themes were generated from the final codes. Three themes were identified: adherence to a home-based digitally delivered fall prevention exercise program, impact of fall prevention exercises on activities of daily living (ADL), and benefits of home-balance exercises. Participants attributed adherence to the home exercise program with minimal in-person visits. Participants reported fear of falling increased as they aged; upon completion, participants felt reduced fear of falling in their ADL. Balance exercises were the most appealing due to the level of difficulty and motivation to improve balance. Participants recommended changes to improve the DFP exercise program, with majority wanting to continue the program. This qualitative analysis provides guidance to health professionals about the acceptability and recommended changes for a digitally delivered home fall prevention exercise program.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"93 7","pages":"979 - 979"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986419","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/igad104.2245
Lance Pflieger, Kengo Watanabe, Max Robinson, Gustavo Glusman, J. Lapidus, Oliver Fiehn, Robert Moritz, N. Rappaport
Abstract Serum based biomarkers of longevity have long been sought to explain the mechanisms of healthy aging and longevity. Using a 1:3 case cohort design, the Longevity Consortium has produced untargeted mass spectrometry based proteomic and metabolomic datasets from serum of four cohorts with longevity status, defined as those that reached the age corresponding to the 98th percentile of survival using sex specific and birth cohort specific survival percentiles. The cohorts are the Osteoporotic Fractures in Men study, the Study of Osteoporotic Fractures, the Health, Aging, and Body Composition Study, and the Cardiovascular Health Study. In this study, we integrate metabolomics and proteomics using machine learning and system biology approaches to construct multi-omic signatures predictive of longevity and healthy aging. We identify networks enriched for biomarkers previously shown to be associated with longevity such as apolipoproteins, along with novel associations, and we further compare with our findings in a mouse omics LC dataset of molecular changes induced by life-extending interventions. We show substantial differences between male and female longevity networks. The study highlights the effectiveness of using integrative systems biology methods to capture the heterogeneity of underlying molecular aging phenotypes, in order to generate a robust signature of longevity. The identified biomarker signatures may have significant implications for the development of personalized interventions aimed at promoting healthy aging and preventing age-related diseases.
{"title":"PROSPECTIVE MULTI-OMIC ANALYSIS OF HUMAN LONGEVITY COHORTS IDENTIFIES ANALYTE NETWORKS ASSOCIATED WITH LONGEVITY","authors":"Lance Pflieger, Kengo Watanabe, Max Robinson, Gustavo Glusman, J. Lapidus, Oliver Fiehn, Robert Moritz, N. Rappaport","doi":"10.1093/geroni/igad104.2245","DOIUrl":"https://doi.org/10.1093/geroni/igad104.2245","url":null,"abstract":"Abstract Serum based biomarkers of longevity have long been sought to explain the mechanisms of healthy aging and longevity. Using a 1:3 case cohort design, the Longevity Consortium has produced untargeted mass spectrometry based proteomic and metabolomic datasets from serum of four cohorts with longevity status, defined as those that reached the age corresponding to the 98th percentile of survival using sex specific and birth cohort specific survival percentiles. The cohorts are the Osteoporotic Fractures in Men study, the Study of Osteoporotic Fractures, the Health, Aging, and Body Composition Study, and the Cardiovascular Health Study. In this study, we integrate metabolomics and proteomics using machine learning and system biology approaches to construct multi-omic signatures predictive of longevity and healthy aging. We identify networks enriched for biomarkers previously shown to be associated with longevity such as apolipoproteins, along with novel associations, and we further compare with our findings in a mouse omics LC dataset of molecular changes induced by life-extending interventions. We show substantial differences between male and female longevity networks. The study highlights the effectiveness of using integrative systems biology methods to capture the heterogeneity of underlying molecular aging phenotypes, in order to generate a robust signature of longevity. The identified biomarker signatures may have significant implications for the development of personalized interventions aimed at promoting healthy aging and preventing age-related diseases.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"254 ","pages":"691 - 692"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986476","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/igad104.0206
Anthony C Traver, Holly Dabelko-Schoeny
Abstract This qualitative study aims to understand how the living environments occupied by older adults before, during, and after an episode of homelessness inform their access to a healthy, stable, and dignified life. Indicators of accommodation, quality, and service integration are explored using the Aging in the Right Place conceptual framework. Through partnerships with a homeless shelter, a meal site, and a mental health outreach team in Columbus, OH, demographic questionnaires and semi-structured interviews were completed with 22 older adults with an episode of late-life homelessness. Nine direct service providers were also interviewed. Interviews were analyzed using the team-based flexible coding method in Nvivo 1.6.1. Results indicated that low or no income in late life forced older adults to occupy a continuum of precarious and low-quality living environments that include shared housing, doubling up, emergency shelters, institutional settings, and living on the land. AIRP indicators are discussed for each. Conflict, death of a support person, mental and behavioral challenges, unit deterioration, rental price increases, and social isolation forced OA down the housing continuum and into homelessness. Sub-optimal conditions interacted with age to exacerbate health conditions, create social isolation, and expose OA to harm. Informal and formal relationships, emergency shelter services, vouchers, and specific behaviors and attitudes were identified as critical for securing affordable and accommodating housing in which to age. Understanding the experiences of OPEH who are striving to occupy their subjective right place to age can help service providers and policymakers meet the unique needs of precariously housed OA.
摘要 本定性研究旨在了解老年人在无家可归之前、期间和之后所居住的生活环境如何影响他们获得健康、稳定和有尊严的生活。研究采用 "在合适的地方养老 "概念框架，探讨了住宿、质量和服务整合的指标。通过与俄亥俄州哥伦布市的一个无家可归者收容所、一个供餐点和一个心理健康外展团队合作，对 22 名晚年无家可归的老年人进行了人口调查问卷和半结构化访谈。此外，还采访了九名直接服务提供者。访谈采用 Nvivo 1.6.1 中基于团队的灵活编码方法进行分析。结果表明，晚年低收入或无收入迫使老年人在一系列不稳定和低质量的生活环境中生活，这些环境包括合租房、双人间、紧急避难所、机构环境和在土地上生活。AIRP 指标将逐一讨论。冲突、赡养人死亡、精神和行为挑战、单元破损、租金价格上涨以及社会孤立迫使 OA 在住房连续体中走下坡路，沦为无家可归者。不理想的条件与年龄相互作用，加剧了健康状况，造成社会隔离，并使 OA 面临伤害。非正式和正式的关系、紧急庇护所服务、优惠券以及特定的行为和态度被认为是获得可负担和可容纳的住房以安度晚年的关键。了解 OPEH 努力占据其主观上适合养老的地方的经历，有助于服务提供者和政策制定者满足居住不稳定的 OA 的独特需求。
{"title":"PRECARIOUS HOUSING BEFORE, DURING, AND AFTER AN EPISODE OF LATE-LIFE HOMELESSNESS","authors":"Anthony C Traver, Holly Dabelko-Schoeny","doi":"10.1093/geroni/igad104.0206","DOIUrl":"https://doi.org/10.1093/geroni/igad104.0206","url":null,"abstract":"Abstract This qualitative study aims to understand how the living environments occupied by older adults before, during, and after an episode of homelessness inform their access to a healthy, stable, and dignified life. Indicators of accommodation, quality, and service integration are explored using the Aging in the Right Place conceptual framework. Through partnerships with a homeless shelter, a meal site, and a mental health outreach team in Columbus, OH, demographic questionnaires and semi-structured interviews were completed with 22 older adults with an episode of late-life homelessness. Nine direct service providers were also interviewed. Interviews were analyzed using the team-based flexible coding method in Nvivo 1.6.1. Results indicated that low or no income in late life forced older adults to occupy a continuum of precarious and low-quality living environments that include shared housing, doubling up, emergency shelters, institutional settings, and living on the land. AIRP indicators are discussed for each. Conflict, death of a support person, mental and behavioral challenges, unit deterioration, rental price increases, and social isolation forced OA down the housing continuum and into homelessness. Sub-optimal conditions interacted with age to exacerbate health conditions, create social isolation, and expose OA to harm. Informal and formal relationships, emergency shelter services, vouchers, and specific behaviors and attitudes were identified as critical for securing affordable and accommodating housing in which to age. Understanding the experiences of OPEH who are striving to occupy their subjective right place to age can help service providers and policymakers meet the unique needs of precariously housed OA.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"89 8","pages":"64 - 64"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986482","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/igad104.2461
Debbie Ten Cate, Marieke Schuurmans, Lisette Schoonhoven, R. Ettema
Abstract Nurses have a key role in providing nutritional care to older adults to prevent and treat malnutrition, and stimulate health and well-being. However, evidence for nursing activities regarding nutritional care is often lacking. Therefore, intervention development is necessary. From earlier studies, an evidence-based nutritional intervention carried out by nurses appeared the best solution. The aim of this study was to outline the steps taken to develop a complex nursing intervention to prevent and treat malnutrition in older adults and the challenges faced during this stage. Following the phase of intervention development of the Medical Research Council (MRC) Framework, a systematic review, a questionnaire survey, semi-structured interviews, focus groups and participant observation were carried out. The purpose was to gather information about current nursing practice and context, the needs of future users and providers, and gain insight into the problem. The studies showed that nurses had moderate knowledge of (mal)nutrition. They gave nutritional care low prioritization during daily nursing activities. These results provided insight that the intended nursing nutritional intervention would most likely lead to a misfit with the context. To fit the intervention properly into nursing practice, it was decided to develop an educational intervention targeting nurses instead of a nutritional intervention carried out by nurses. Building proofs in context leads to challenges but is essential to prevent a misfit between complex nursing interventions and nursing practice. As an element of rigorous intervention development following systematic steps, it increases the chance of successful implementation.
{"title":"FROM MISFIT TO FIT: THE IMPACT OF NURSING PRACTICE ON COMPLEX NURSING INTERVENTION DEVELOPMENT","authors":"Debbie Ten Cate, Marieke Schuurmans, Lisette Schoonhoven, R. Ettema","doi":"10.1093/geroni/igad104.2461","DOIUrl":"https://doi.org/10.1093/geroni/igad104.2461","url":null,"abstract":"Abstract Nurses have a key role in providing nutritional care to older adults to prevent and treat malnutrition, and stimulate health and well-being. However, evidence for nursing activities regarding nutritional care is often lacking. Therefore, intervention development is necessary. From earlier studies, an evidence-based nutritional intervention carried out by nurses appeared the best solution. The aim of this study was to outline the steps taken to develop a complex nursing intervention to prevent and treat malnutrition in older adults and the challenges faced during this stage. Following the phase of intervention development of the Medical Research Council (MRC) Framework, a systematic review, a questionnaire survey, semi-structured interviews, focus groups and participant observation were carried out. The purpose was to gather information about current nursing practice and context, the needs of future users and providers, and gain insight into the problem. The studies showed that nurses had moderate knowledge of (mal)nutrition. They gave nutritional care low prioritization during daily nursing activities. These results provided insight that the intended nursing nutritional intervention would most likely lead to a misfit with the context. To fit the intervention properly into nursing practice, it was decided to develop an educational intervention targeting nurses instead of a nutritional intervention carried out by nurses. Building proofs in context leads to challenges but is essential to prevent a misfit between complex nursing interventions and nursing practice. As an element of rigorous intervention development following systematic steps, it increases the chance of successful implementation.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"86 5","pages":"761 - 761"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986514","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/igad104.1297
Diefei Chen, Alden L. Gross, Sherry Willis, George W. Rebok
Abstract Cognitive ability and cognitive decline have been linked with mortality in older adults. However, little was understood about the role of cognitive interventions on mortality outcomes in this population. Using twenty-year follow-up data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, we examined the association between cognitive change and mortality risk, and the effect of ACTIVE cognitive training (memory, reasoning, and speed of processing) on mortality risk. Mortality was ascertained through linkage to the National Death Index database. To model time to death as a function of cognitive change and training effect, we used shared growth-survival models with simultaneously estimated latent intercepts and slopes as predictors. Among the 2802 participants, 2021 died on or before the year 2019 (72.1%). Both higher baseline level and slower decline in global cognition were associated with lower hazards of all-cause mortality after adjusting for covariates (HR = 0.68, 95% CI 0.58, 0.79; HR = 0.42, 95% CI 0.40, 0.44, respectively). We did not observe any significant effects of ACTIVE cognitive training in memory, reasoning, or speed of processing on all-cause mortality. Our findings demonstrated the association between the trajectory of cognitive change and mortality among older adults, independent of cognitive training interventions. More work is needed to identify relevant timing as well as modalities of non-pharmaceutical interventions that can promote healthy longevity.
摘要 认知能力和认知能力下降与老年人的死亡率有关。然而，人们对认知干预对这一人群死亡率结果的作用知之甚少。我们利用 "独立和活力老年人高级认知训练（ACTIVE）"试验的 20 年随访数据，研究了认知变化与死亡风险之间的关系，以及 ACTIVE 认知训练（记忆、推理和处理速度）对死亡风险的影响。死亡率是通过与国家死亡指数数据库的链接确定的。为了将死亡时间作为认知变化和训练效果的函数来建模，我们使用了共享的成长-生存模型，并将同时估算的潜在截距和斜率作为预测因子。在2802名参与者中，有2021人在2019年或之前死亡（占72.1%）。在调整协变量后，较高的基线水平和较慢的全球认知下降速度都与较低的全因死亡率相关（HR = 0.68，95% CI 0.58，0.79；HR = 0.42，95% CI 0.40，0.44）。我们没有观察到 ACTIVE 认知训练在记忆、推理或处理速度方面对全因死亡率有任何明显影响。我们的研究结果表明，认知变化轨迹与老年人死亡率之间存在关联，与认知训练干预措施无关。我们还需要做更多的工作，以确定可促进健康长寿的非药物干预的相关时机和方式。
{"title":"THE RELATIONSHIP BETWEEN 10-YEAR CHANGES IN COGNITIVE ABILITY AND SUBSEQUENT MORTALITY: FINDINGS FROM THE ACTIVE","authors":"Diefei Chen, Alden L. Gross, Sherry Willis, George W. Rebok","doi":"10.1093/geroni/igad104.1297","DOIUrl":"https://doi.org/10.1093/geroni/igad104.1297","url":null,"abstract":"Abstract Cognitive ability and cognitive decline have been linked with mortality in older adults. However, little was understood about the role of cognitive interventions on mortality outcomes in this population. Using twenty-year follow-up data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, we examined the association between cognitive change and mortality risk, and the effect of ACTIVE cognitive training (memory, reasoning, and speed of processing) on mortality risk. Mortality was ascertained through linkage to the National Death Index database. To model time to death as a function of cognitive change and training effect, we used shared growth-survival models with simultaneously estimated latent intercepts and slopes as predictors. Among the 2802 participants, 2021 died on or before the year 2019 (72.1%). Both higher baseline level and slower decline in global cognition were associated with lower hazards of all-cause mortality after adjusting for covariates (HR = 0.68, 95% CI 0.58, 0.79; HR = 0.42, 95% CI 0.40, 0.44, respectively). We did not observe any significant effects of ACTIVE cognitive training in memory, reasoning, or speed of processing on all-cause mortality. Our findings demonstrated the association between the trajectory of cognitive change and mortality among older adults, independent of cognitive training interventions. More work is needed to identify relevant timing as well as modalities of non-pharmaceutical interventions that can promote healthy longevity.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"190 ","pages":"392 - 392"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138987167","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/igad104.1799
Ryan Mace, A. Vranceanu, Nathaniel R. Choukas, Elizabeth A Rochon, Katherine McDermott, Julia E Hooker, Christine Ritchie
Abstract Despite facing greater risks for poorer health, low-income White and BIPOC older adults underutilize mental health services even when they have indicated need. Increasing the repertoire for depression care that is community-based and uses paraprofessionals has potential to increase access and engagement. We are testing the effectiveness of a peer support intervention called Peer Enhanced Depression Care (PEERS) which is an 8-week community-based intervention that uses trained peer mentors to deliver emotional, appraisal and informational support in addition to encouraging self-care skills to depressed low-income white and BIPOC older adults. Enrolled participants are randomized to either the peer support intervention (PEERS) or to the social interaction control and followed for 12 months. The primary outcome is depression and secondary outcomes include engagement, mental health service use, and social, emotional, and physical functioning. Challenges related to the onset of the COVID-19 pandemic and social isolation required a shift from recruitment initially focused on the health care system to community-based organizations serving older adults. Required contactless recruitment strategies eg. flyers and newspaper ads, led to self-referral of community-dwelling older adults to the study. Challenges to participant enrollment included barriers related to communication, stigma related to help-seeking, distrust and unfamiliarity with research. Recruitment of peer mentors was facilitated by a robust infrastructure supporting the employment of the peer support workforce. Continued PM supervision after initial training, review of skills and evaluation of performance were important in maintaining quality and fidelity to the intervention.
{"title":"INCREASING THE REPERTOIRE FOR DEPRESSION CARE: PEER SUPPORT AS DEPRESSION CARE FOR VULNERABLE OLDER ADULTS","authors":"Ryan Mace, A. Vranceanu, Nathaniel R. Choukas, Elizabeth A Rochon, Katherine McDermott, Julia E Hooker, Christine Ritchie","doi":"10.1093/geroni/igad104.1799","DOIUrl":"https://doi.org/10.1093/geroni/igad104.1799","url":null,"abstract":"Abstract Despite facing greater risks for poorer health, low-income White and BIPOC older adults underutilize mental health services even when they have indicated need. Increasing the repertoire for depression care that is community-based and uses paraprofessionals has potential to increase access and engagement. We are testing the effectiveness of a peer support intervention called Peer Enhanced Depression Care (PEERS) which is an 8-week community-based intervention that uses trained peer mentors to deliver emotional, appraisal and informational support in addition to encouraging self-care skills to depressed low-income white and BIPOC older adults. Enrolled participants are randomized to either the peer support intervention (PEERS) or to the social interaction control and followed for 12 months. The primary outcome is depression and secondary outcomes include engagement, mental health service use, and social, emotional, and physical functioning. Challenges related to the onset of the COVID-19 pandemic and social isolation required a shift from recruitment initially focused on the health care system to community-based organizations serving older adults. Required contactless recruitment strategies eg. flyers and newspaper ads, led to self-referral of community-dwelling older adults to the study. Challenges to participant enrollment included barriers related to communication, stigma related to help-seeking, distrust and unfamiliarity with research. Recruitment of peer mentors was facilitated by a robust infrastructure supporting the employment of the peer support workforce. Continued PM supervision after initial training, review of skills and evaluation of performance were important in maintaining quality and fidelity to the intervention.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"84 ","pages":"548 - 549"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138987256","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/igad104.0520
Juyoung Park, Lisa Ann Wiese, Janet Holt
Abstract We conducted a randomized control pilot trial in an underserved, racially/ethnically diverse community, to examine the efficacy of (1) computer literacy training provided by high school students meeting rural older adults in their homes, followed by 2) telehealth-based online chair yoga (OCY) or computer brain games (CBG). First, high school students engaged in a “train the trainer” computer skills course using a previously-tested curriculum designed for the target population. Students mentored the older adults in learning computer skills and to access either the OCY (n = 15) or CBG (n=15), which were randomly assigned. Outcomes measured at pre, post, and three months following the 12-week intervention included computer proficiency, cognitive function, pain levels, and psychosocial well-being. In a linear mixed growth model with random intercepts, there was a significant linear trend in computer-based competency, t(50, 19) = 2.56, p = .013. Computer proficiency (computer basics, Internet and email use, communication, and calendaring) increased significantly in both the OCY and CBG groups. Importantly, there was a significant linear change in pain by group, controlling for age and living alone, F(1, 14) = 6.64, p = .022, η2 = .32 (large effect size). Chronic pain in the OCY group decreased significantly from baseline to 3-month follow-up (18.89 to 11.35) but increased in the CBG group (14.27 to 17.28). Increases in cognitive function increased pre/post t(29) = -2.98, p = .003 (one-tailed). These results are promising for older adults with limited exercise opportunities, who also face cognitive risk exacerbated by elevated pain levels.
{"title":"MAINTAINING BRAIN HEALTH VIA TELEHEALTH-BASED CHAIR YOGA FOR RURAL UNDERSERVED OLDER ADULTS","authors":"Juyoung Park, Lisa Ann Wiese, Janet Holt","doi":"10.1093/geroni/igad104.0520","DOIUrl":"https://doi.org/10.1093/geroni/igad104.0520","url":null,"abstract":"Abstract We conducted a randomized control pilot trial in an underserved, racially/ethnically diverse community, to examine the efficacy of (1) computer literacy training provided by high school students meeting rural older adults in their homes, followed by 2) telehealth-based online chair yoga (OCY) or computer brain games (CBG). First, high school students engaged in a “train the trainer” computer skills course using a previously-tested curriculum designed for the target population. Students mentored the older adults in learning computer skills and to access either the OCY (n = 15) or CBG (n=15), which were randomly assigned. Outcomes measured at pre, post, and three months following the 12-week intervention included computer proficiency, cognitive function, pain levels, and psychosocial well-being. In a linear mixed growth model with random intercepts, there was a significant linear trend in computer-based competency, t(50, 19) = 2.56, p = .013. Computer proficiency (computer basics, Internet and email use, communication, and calendaring) increased significantly in both the OCY and CBG groups. Importantly, there was a significant linear change in pain by group, controlling for age and living alone, F(1, 14) = 6.64, p = .022, η2 = .32 (large effect size). Chronic pain in the OCY group decreased significantly from baseline to 3-month follow-up (18.89 to 11.35) but increased in the CBG group (14.27 to 17.28). Increases in cognitive function increased pre/post t(29) = -2.98, p = .003 (one-tailed). These results are promising for older adults with limited exercise opportunities, who also face cognitive risk exacerbated by elevated pain levels.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"122 ","pages":"158 - 159"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138988183","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/igad104.1460
Vanessa Young, Luis Serrano-Rubio, Carlos Gaona, Floyd Jones, Sudra Seshadri, J. Kaye, Zach Beattie, Mitzi Gonzales
Abstract In-home digital technology affords the opportunity for more precise and ecologically valid assessments of daily activity engagement. However, concerns about loss of privacy can hinder recruitment, especially within communities already underrepresented in research. Literature on effective, culturally tailored recruitment strategies is limited. Herein, we describe strategies employed for an in-home digital technology study with 100% Mexican American representation. Hispanic participants were recruited from the greater San Antonio area. Direct recruitment strategies conducted in both English and Spanish included community outreach events, a participant repository, cross-enrollment with other research studies, and by word of mouth. Mass recruitment strategies included flyer dissemination, newsletters, and digital announcements through community organizations (i.e., Salud America!) and national (i.e., Research Match) and institutional websites. Between September 2022 and February 2023, 31 participants were enrolled out of 154 individuals who were contacted. Of these, 29% were recruited from community events, 22.6% from word of mouth, 19.4% from cross-enrollment, 12.9% from the research repositories, and 16.1% from mass recruitment strategies. The most common reasons for non-enrollment included lack of interest (n=49), screen failure (n=29), and privacy concerns (n=12).Direct recruitment efforts achieved higher rates of enrollment, while mass media campaigns yielded lower responses and resulted in more unsuccessful contact attempts. Understanding the relationship between social networks and research beliefs may be particularly relevant given the Hispanic culture’s collectivist and family-oriented nature. Hence, social network theories, combined with a diffusion of innovation framework, may be advantageous for increasing trust and may consequently improve representation of diverse groups in research.
{"title":"CONECTAR: A MINDSET TO INCREASE HISPANIC ENGAGEMENT IN DIGITAL TECHNOLOGY RESEARCH","authors":"Vanessa Young, Luis Serrano-Rubio, Carlos Gaona, Floyd Jones, Sudra Seshadri, J. Kaye, Zach Beattie, Mitzi Gonzales","doi":"10.1093/geroni/igad104.1460","DOIUrl":"https://doi.org/10.1093/geroni/igad104.1460","url":null,"abstract":"Abstract In-home digital technology affords the opportunity for more precise and ecologically valid assessments of daily activity engagement. However, concerns about loss of privacy can hinder recruitment, especially within communities already underrepresented in research. Literature on effective, culturally tailored recruitment strategies is limited. Herein, we describe strategies employed for an in-home digital technology study with 100% Mexican American representation. Hispanic participants were recruited from the greater San Antonio area. Direct recruitment strategies conducted in both English and Spanish included community outreach events, a participant repository, cross-enrollment with other research studies, and by word of mouth. Mass recruitment strategies included flyer dissemination, newsletters, and digital announcements through community organizations (i.e., Salud America!) and national (i.e., Research Match) and institutional websites. Between September 2022 and February 2023, 31 participants were enrolled out of 154 individuals who were contacted. Of these, 29% were recruited from community events, 22.6% from word of mouth, 19.4% from cross-enrollment, 12.9% from the research repositories, and 16.1% from mass recruitment strategies. The most common reasons for non-enrollment included lack of interest (n=49), screen failure (n=29), and privacy concerns (n=12).Direct recruitment efforts achieved higher rates of enrollment, while mass media campaigns yielded lower responses and resulted in more unsuccessful contact attempts. Understanding the relationship between social networks and research beliefs may be particularly relevant given the Hispanic culture’s collectivist and family-oriented nature. Hence, social network theories, combined with a diffusion of innovation framework, may be advantageous for increasing trust and may consequently improve representation of diverse groups in research.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"26 1","pages":"443 - 444"},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138988271","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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