Homecare has increased its value as an alternative to nursing homes and adapted to evolving COVID... more Homecare has increased its value as an alternative to nursing homes and adapted to evolving COVID-19 challenges. However, little is known about how COVID-19 has impacted community-dwelling older adults who need assistance with daily activities, including dressing, cooking, and shopping. Guided by the stress process framework, this mixed-method study examined how older homecare recipients experienced the acute and chronic stress during the first eight months of the pandemic, focusing on the role of home care aides (HCAs) in the context of Medicaid-funded in-home services. Thirty-five dyads of care recipients and HCAs participated in a COVID telephone survey as part of a larger study. Care recipients were typically older minority (40% African American, 31% Latinx) women (77%). Their COVID-related anxiety level, assessed by a 6-item Spielberger State Anxiety Inventory (1 "not at all" to 4 "very much"), was 2.2 (SD=0.9). While COVID-19 drastically reduced contacts with family members and healthcare providers, HCAs continued to provide care in person. One care recipient said, "Fortunately, I still have my HCA come and that keeps me sane." HCAs showed resilience while facing their own family-and work-related stress: "I have followed the rules and just adapted. (COVID) did not affect the activities for my client." Some dyads, however, experienced care disruptions because of COVID infection or fear in one or both parties. COVID-19 has demonstrated homecare resilience at the person-, dyad-, and organization-levels, calling for equitable, sustainable home-based care for a growing number of older adults who desire to stay in the home.
Changes in cognition are a normative part of aging. Verbal fluency is widely used for assessing c... more Changes in cognition are a normative part of aging. Verbal fluency is widely used for assessing cognitive function, including predicting mild cognitive impairment. As people age, sleep duration and quality decrease. This has been associated with cognitive decline; individuals with low-quality sleep (fewer hours and difficulties with initiation or maintenance of sleep) are more likely to complain of poorer cognition. Lack of sleep is detrimental to verbal fluency (word production). Longer sleep has been linked to memory deficits and is a potential indicator of mild cognitive impairment. This study aimed to address the relationship between verbal fluency and cognitive function as mediated by sleep duration. Participants included 31 middle-aged adults (female, n=19;age=53.55±7.18yrs) and 24 older adults (female=14; age=70.33±3.69yrs). The MoCA assessed cognitive functioning. Verbal fluency (90 seconds each) was measured via category word (animals; semantic verbal fluency) and letter word (phonemic verbal fluency; F,A,S). Mediation models used Baron and Kenny’s (1986) approach for estimating mediation effects, controlling for age and education. Category results were non-significant. However, sleep duration partially mediated the relationship between letter fluency for each letter and cognitive function, respectively (F:F(2,52)=7.31, p=.002, R2=.22; A: F(2,52)=3.80, p=.029, R2=.18; S: F(2,52)=5.47, p=.007, R2=.17). Sleep hours were negatively associated with letter fluency, meaning fewer hours of sleep improved fluency performance, which in turn was positively associated with MOCA scores (F: b=-.378, 95%CI [-0.64, 0.02]; A: b=-.172, 95%CI [-0.42, 0.01]; S: b=-.24, 95%CI [-0.64, 0.02]. This coincides with the abovementioned literature and helps further understand how sleep and cognitive performance are related.
Social isolation may increase morbidity and mortality, particularly for aging adults. Research su... more Social isolation may increase morbidity and mortality, particularly for aging adults. Research suggests that COVID-19 has significantly disrupted social networks, exacerbating isolation and risk. However, the extent of disruption and its implications for older adults and their essential contacts (ECs) is unknown. ECs, those who provide support/engagement to older adults, play a significant role in networks and help shape communication patterns. Understanding the effects of COVID-19 on social connectedness between ECs and older adults is vital to promoting their well-being. The purpose of this study was to investigate ECs’ patterns of communication with adults aged 60+ during the COVID-19 pandemic , considering preferences, needs, and barriers. Self-identified ECs (N=546, Aged 19+, MAge=44.3±14.2) completed a Qualtrics survey via Amazon Mechanical Turk. Participants were ECs for community-dwelling (CDECs=57.3%) and institutionalized adults (IECs=42.7%). In addition to likert-style questions, the survey included free-response sections, examining communication quality, frequency, and method. Content analysis was conducted independently by two reviewers, using inductive coding. Qualitative results revealed distanced communication was widely utilized. Audiovisual/video communication was more frequently noted as desirable by IECs (32.8%) than CDECs (11.85%). Further, preference for audiovisual communication negatively correlated to expression of COVID-19-related barriers (IECs=12.5%, CDECs=7.7%, (r(546)= -.128, p=.01). Comparisons suggested that IECs reported absence of in-person contact with older adults more frequently than CDECs (recent contact=Never: 51% and 13.4% respectively). This may support the utility of video-communication to meaningfully supplement connectedness in the absence of in-person contact. The experiences described can reveal avenues for loneliness interventions and may guide future technology innovations.
Literature suggests aging adults are more likely to be socially isolated, particularly given the ... more Literature suggests aging adults are more likely to be socially isolated, particularly given the COVID-19 pandemic. This has been associated with diminished well-being and increased morbidity and mortality. Assistive and interactive technologies (AITs) may help reduce isolation by bolstering communication. However, rapid advancement of AITs can create new barriers, especially for marginalized/underserved communities. The purpose of this study was to explore isolation and AITs in a majority-non-white sample. Data collected were part of a larger survey. Participants (N=80: Non-White=92.5%, Black=36.5%, Hispanic=36.5%) completed a Qualtrics survey via Amazon Mechanical Turk. Respondents included younger (YA: N=34, ages:19-34, M=27.7±4.6), middle-aged (MA: N=27, ages:35-49, M=41.9±4.1), and older (OA: N=20, ages:50-70, M=57.6±6.5) adults. Surveys consisted of likert-style and free-response questions. Content analysis with inductive coding was performed independently by two reviewers. Qualitative results suggested most adults used AITs regularly. Phone-based functions (texting/calling, smartphone-use) were favored for communication between 2020-2021. These functions were the largest group reported for all ages, although YA reported them more frequently (65%) compared to MA (48%) and OA (59%). Data also suggested that people had more in-person interaction at the time of survey completion (majority September 2021), compared to one-year previous (46.4%). Increased distanced socialization negatively correlated with overall socialization (r(78)=-.231, p=.05). Results suggest that although AITs are widely used, they may not adequately reduce isolation, particularly for those relying on them for primary contact. This may be especially true for underrepresented adults. Future research should investigate if this trend is universal and if existing AITs are sub-optimal in specific populations.
alpha=.01 showed that depressive symptoms, measured by the CESD-10 (p<.001), and anxiety symptoms... more alpha=.01 showed that depressive symptoms, measured by the CESD-10 (p<.001), and anxiety symptoms, measured by the GAD-7 (p<.001), increased during the pandemic as did mental healthcare barriers related to transportation (p=.004) and beliefs that depression is a normal part of aging (p<.001). Only transportation concerns differed based on where older adults lived; those in rural (p<.001) and urban (p=.004) settings reported greater transportation barriers than those in suburban settings. No differences over time were found for barriers related to help-seeking (p=.403), stigma (p=.156), knowledge/ fear (p=.180), finding a therapist (p=.030), ageism (p=.302), psychotherapist qualifications (p=.265), physician referrals (p=.207), or finances (p=.818). These findings highlight the impact of COVID-19 on older adults' perceptions of changes in their psychological well-being as well as their experience navigating mental health services.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Companionship with close others are known to have a significant positive effect on our well-being... more Companionship with close others are known to have a significant positive effect on our well-being in later years of life. At the same time, it is known that the frequency of meeting and chatting with others, an indicator of companionship, declines as we age. In this study we explore the situation of companionship among older-old and oldest-old people. The focus of this study on understanding how the aging process affects the experience of companionship and how people adapt to the loss of companionship. Semi-structured, in-depth interviews with 43 people aged 75 and older living in urban communities in Kawasaki, Japan. Participants were asked about everyday interactions with close others and feelings they experienced at the time. Interviews were transcribed and analyzed qualitatively. Chatting, going out for lunch or dinner, and going shopping were examples of activities older Japanese enjoyed with close others. Almost all respondents mentioned the loss of their old friends and siblings. They also mentioned that the decline in their physical and cognitive health, as well as that of their companions hindered shared activities they used to enjoy. They cherished positive interactions with others, although the frequency declined. Some respondents intentionally made new companions in the physical proximity, but it was hard to compensate for the loss of old companions with new one. These findings suggest that the value of companionship remains or even increase as we age. It would be important to identify environmental or social factors that may prevent the loss of companionship among older adults.
Despite the prevalence of disability among older adults-approximately 30% of older adults between... more Despite the prevalence of disability among older adults-approximately 30% of older adults between age 65 and 75 and 48% of those over age 75 had limited physical functioning-only a handful of studies have explored the effect of physical functioning in the relationship between environments and older adults' well-being and investigated the needs of this sub-population. Therefore, this study aimed to investigate the moderating effect of physical functioning in the relationship between home and environments and older adults' health, global assessment of age-friendliness of community, and likelihood of aging-in-place, applying the press-competence model. This cross-sectional study utilized the 2015 AARP Age-Friendly Communities Survey, which includes 66 home and neighborhood features under the WHO's 8 domains of Age-Friendly Cities Guidelines. Twenty copies of datasets were created using multiple imputation, and hypotheses were tested using Hierarchical Linear Modeling to control the dependency among observations due to clustering. The effect of home and neighborhood environments on health is greater for those with physical limitations, while the effect on the likelihood of aging-in-place is greater for those with intact physical functioning. There was no difference in the relationship between home and neighborhood environments and global assessment of community. To further investigate the relationship, a three-way interaction term-environments × physical functioning × household income-was included and found each subgroup has different needs. Findings suggest that efforts to understand unique needs of diverse sub-populations and provide needed community features or services are essential to the well-being of older adults.
The current study explored whether the Brief Test of Adult Cognition via Telephone (BTACT) assess... more The current study explored whether the Brief Test of Adult Cognition via Telephone (BTACT) assessment could be used to predict longevity in a national sample of adults from the Midlife Development in the United States (MIDUS) study. Specifically, we examined whether 9-year changes in episodic memory (EM) and executive functioning (EF) predicted all-cause mortality risk (2004-2018). The sample included 2,643 participants (MAge=45.87; 92.23% white; 107 deceased) who completed the BTACT twice: between 2004-06 and between 2013-2017. Using change scores, decreases in EM (HR= 1.45 [1.09-1.93], p=.01) and EF (HR=1.585 [1.17-2.14], p&lt;.001) increased the hazard of dying (controlling for age, gender, race, education, and self-rated health). Results suggest the BTACT is sensitive enough to detect health-consequential decreases in EM/EF. Future research should consider the BTACT as a viable assessment tool for older adults who may not have easy access to cognitive screenings.
Fear of falling (FOF), defined as a psychological symptom, is related to increased fall risk, anx... more Fear of falling (FOF), defined as a psychological symptom, is related to increased fall risk, anxiety, and depressive symptoms. As physical function changes with age, FOF can appear beginning in midlife. FOF may result in avoiding physical activities, resulting in weakness of postural balance. Neuroticism is associated with anxiety and depression; thus, those high on neuroticism may have an increased FOF. This study aimed to address the relationships between FOF, neuroticism, and number of falls from external perturbations while standing. Participants included 45 participants (female: n=24; age range: 42-77yrs; age=62.44±9.25yrs). Five standing trials were completed on a force platform with perturbations. Hierarchical regression was used to investigate the impact of neuroticism (Big Five Inventory) and number of falls on FOF (The Falls Efficacy Scale International), accounting for age, anxiety (Geriatric Anxiety Scale), and depressive symptoms (Center for Epidemiological Studies Depression Scale). Anxiety was significantly associated with FOF (model 1; age, anxiety, depression), B=0.31, β=.55, t(41)=3.08, R2=.30, p=.004, 95% CI [0.11, 0.51]. Neuroticism was not significantly related to FOF (model 2; ΔR2=.05, ΔF=2.94, p=.094), nor was number of falls (model 3; ΔR2=.00, ΔF=0.01, p=.974). Results revealed that anxiety levels had the strongest relationship with FOF. This suggests that strategies to reduce daily anxiety may decrease FOF. Future research should examine how anxiety is related to history of falls, and how changes in physical functions (e.g., mobility, vision, proprioception) may impact FOF.
Understanding who will experience cognitive dysfunction and dementia is as important as identifyi... more Understanding who will experience cognitive dysfunction and dementia is as important as identifying methods to combat such deterioration. This symposium seeks to highlight new advances in understanding cognitive deterioration and promote resilience in adulthood. Odd and colleagues utilized a national sample (2,643 adults aged 34-85) to show that 9-year decreases in executive function and episodic memory predicted increased risk of dying. Use of a brief cognitive assessment administered via telephone was unique – a method that may assist clinicians administering cognitive screenings to older adults in isolated areas. Graham and colleagues utilized a daily diary approach in 116 older adults (aged 60-90) to show that greater daily fluctuations in mindfulness were associated with higher episodic memory and executive functioning. Further, mediational evidence suggested that on days when mindfulness was greater, individuals perceived a younger subjective age. Willroth and colleagues provide evidence that higher scores on eudaimonic well-being in older adults (n=349) predicted greater cognitive resilience. Specifically, even though some participants had neuropathological burden (e.g., increased beta-amyloid, neurofibrillary tangles), they did not exhibit pronounced cognitive declines. Using data from 14 longitudinal studies, Yoneda and colleagues examined the impact of physical activity on cognitive impairment and death. Multi-state survival analyses demonstrated engagement in more physical activity reduced risk of cognitive impairment and death. This symposium suggests that examining changes in cognition, incorporating subjective and objective indices of cognitive impairment, utilizing long-term longitudinal and daily diary designs, and testing key modifiable behaviors is crucial to understanding and promoting optimal cognitive functioning in adulthood.
Energy intake in the post-exercise state is highly variable and compensatory eating-i.e., (over-)... more Energy intake in the post-exercise state is highly variable and compensatory eating-i.e., (over-) compensation of the expended energy via increased postexercise energy intake-occurs in some individuals but not others. We aimed to identify predictors of post-exercise energy intake and compensation. In a randomized crossover design, 57 healthy participants (21.7 [SD=2.5] years; 23.7 [SD=2.3] kg/m 2 , 75% White, 54% female) completed two laboratory-based test-meals following (1) 45-min exercise and (2) 45-min rest (control). We assessed associations between biological (sex, body composition, appetite hormones) and behavioral (habitual exercise via prospective exercise log, appetitive traits) characteristics at baseline and total energy intake, compensatory energy intake (intake-exercise expenditure), and the difference between post-exercise and post-rest intake. We found a differential impact of biological and behavioral characteristics on total post-exercise energy intake in men and women. In men, only fasting (baseline) concentrations of appetite-regulating hormones (peptide YY [PYY, β=0.88, P<0.001] and adiponectin [β=0.66, P=0.005] predicted total post-exercise energy intake, while in women, only habitual exercise (β=−0.44, P=0.017) predicted total post-exercise energy intake. Predictors of compensatory intake (intake-exercise expenditure) were almost identical to those of total intake. The difference in energy intake between exercise and rest was associated with VO 2peak (β=−0.45, P=0.020), fasting PYY (β=0.53, P=0.036), and fasting adiponectin (β=0.57, P=0.021) in men but not women (all P>0.51). Our results show that biological and behavioral characteristics differentially affect total and compensatory post-exercise energy intake in men and women. This may help identify individuals who are more likely to compensate for the energy expended in exercise. Targeted countermeasures to prevent compensatory energy intake after exercise should take the demonstrated sex differences into account.
Essential contacts (ECs), people providing support/engagement to older adults, are vital to their... more Essential contacts (ECs), people providing support/engagement to older adults, are vital to their physical and socio-emotional well-being. Research suggests that COVID-19 has significantly affected the connectedness of aging populations and their ECs, limiting interaction and potentially weakening support networks. Assistive and interactive technologies (AITs) may be useful for mitigating disruptions by facilitating communication. The goal of this study was to explore AIT preferences and needs of ECs for connecting with adults aged 60+. Participants completed a Qualtrics survey via Amazon Mechanical Turk. An initial sample (N=580,MAge=44.3±14.3,White=81%) was collected (December 2020-February 2021). A minority sub-sample (N=79,MAge=38.9±11.6,Non-White=87.3%) was subsequently accrued (September-December 2021). Participants were initial/minority-ECs for community-dwelling (initial-CDECs=57%,minority-CDECs=89%) and institutionalized adults (initial-IECs=43%,minority-IECs=11%). Minority...
Homecare has increased its value as an alternative to nursing homes and adapted to evolving COVID... more Homecare has increased its value as an alternative to nursing homes and adapted to evolving COVID-19 challenges. However, little is known about how COVID-19 has impacted community-dwelling older adults who need assistance with daily activities, including dressing, cooking, and shopping. Guided by the stress process framework, this mixed-method study examined how older homecare recipients experienced the acute and chronic stress during the first eight months of the pandemic, focusing on the role of home care aides (HCAs) in the context of Medicaid-funded in-home services. Thirty-five dyads of care recipients and HCAs participated in a COVID telephone survey as part of a larger study. Care recipients were typically older minority (40% African American, 31% Latinx) women (77%). Their COVID-related anxiety level, assessed by a 6-item Spielberger State Anxiety Inventory (1 "not at all" to 4 "very much"), was 2.2 (SD=0.9). While COVID-19 drastically reduced contacts with family members and healthcare providers, HCAs continued to provide care in person. One care recipient said, "Fortunately, I still have my HCA come and that keeps me sane." HCAs showed resilience while facing their own family-and work-related stress: "I have followed the rules and just adapted. (COVID) did not affect the activities for my client." Some dyads, however, experienced care disruptions because of COVID infection or fear in one or both parties. COVID-19 has demonstrated homecare resilience at the person-, dyad-, and organization-levels, calling for equitable, sustainable home-based care for a growing number of older adults who desire to stay in the home.
Changes in cognition are a normative part of aging. Verbal fluency is widely used for assessing c... more Changes in cognition are a normative part of aging. Verbal fluency is widely used for assessing cognitive function, including predicting mild cognitive impairment. As people age, sleep duration and quality decrease. This has been associated with cognitive decline; individuals with low-quality sleep (fewer hours and difficulties with initiation or maintenance of sleep) are more likely to complain of poorer cognition. Lack of sleep is detrimental to verbal fluency (word production). Longer sleep has been linked to memory deficits and is a potential indicator of mild cognitive impairment. This study aimed to address the relationship between verbal fluency and cognitive function as mediated by sleep duration. Participants included 31 middle-aged adults (female, n=19;age=53.55±7.18yrs) and 24 older adults (female=14; age=70.33±3.69yrs). The MoCA assessed cognitive functioning. Verbal fluency (90 seconds each) was measured via category word (animals; semantic verbal fluency) and letter word (phonemic verbal fluency; F,A,S). Mediation models used Baron and Kenny’s (1986) approach for estimating mediation effects, controlling for age and education. Category results were non-significant. However, sleep duration partially mediated the relationship between letter fluency for each letter and cognitive function, respectively (F:F(2,52)=7.31, p=.002, R2=.22; A: F(2,52)=3.80, p=.029, R2=.18; S: F(2,52)=5.47, p=.007, R2=.17). Sleep hours were negatively associated with letter fluency, meaning fewer hours of sleep improved fluency performance, which in turn was positively associated with MOCA scores (F: b=-.378, 95%CI [-0.64, 0.02]; A: b=-.172, 95%CI [-0.42, 0.01]; S: b=-.24, 95%CI [-0.64, 0.02]. This coincides with the abovementioned literature and helps further understand how sleep and cognitive performance are related.
Social isolation may increase morbidity and mortality, particularly for aging adults. Research su... more Social isolation may increase morbidity and mortality, particularly for aging adults. Research suggests that COVID-19 has significantly disrupted social networks, exacerbating isolation and risk. However, the extent of disruption and its implications for older adults and their essential contacts (ECs) is unknown. ECs, those who provide support/engagement to older adults, play a significant role in networks and help shape communication patterns. Understanding the effects of COVID-19 on social connectedness between ECs and older adults is vital to promoting their well-being. The purpose of this study was to investigate ECs’ patterns of communication with adults aged 60+ during the COVID-19 pandemic , considering preferences, needs, and barriers. Self-identified ECs (N=546, Aged 19+, MAge=44.3±14.2) completed a Qualtrics survey via Amazon Mechanical Turk. Participants were ECs for community-dwelling (CDECs=57.3%) and institutionalized adults (IECs=42.7%). In addition to likert-style questions, the survey included free-response sections, examining communication quality, frequency, and method. Content analysis was conducted independently by two reviewers, using inductive coding. Qualitative results revealed distanced communication was widely utilized. Audiovisual/video communication was more frequently noted as desirable by IECs (32.8%) than CDECs (11.85%). Further, preference for audiovisual communication negatively correlated to expression of COVID-19-related barriers (IECs=12.5%, CDECs=7.7%, (r(546)= -.128, p=.01). Comparisons suggested that IECs reported absence of in-person contact with older adults more frequently than CDECs (recent contact=Never: 51% and 13.4% respectively). This may support the utility of video-communication to meaningfully supplement connectedness in the absence of in-person contact. The experiences described can reveal avenues for loneliness interventions and may guide future technology innovations.
Literature suggests aging adults are more likely to be socially isolated, particularly given the ... more Literature suggests aging adults are more likely to be socially isolated, particularly given the COVID-19 pandemic. This has been associated with diminished well-being and increased morbidity and mortality. Assistive and interactive technologies (AITs) may help reduce isolation by bolstering communication. However, rapid advancement of AITs can create new barriers, especially for marginalized/underserved communities. The purpose of this study was to explore isolation and AITs in a majority-non-white sample. Data collected were part of a larger survey. Participants (N=80: Non-White=92.5%, Black=36.5%, Hispanic=36.5%) completed a Qualtrics survey via Amazon Mechanical Turk. Respondents included younger (YA: N=34, ages:19-34, M=27.7±4.6), middle-aged (MA: N=27, ages:35-49, M=41.9±4.1), and older (OA: N=20, ages:50-70, M=57.6±6.5) adults. Surveys consisted of likert-style and free-response questions. Content analysis with inductive coding was performed independently by two reviewers. Qualitative results suggested most adults used AITs regularly. Phone-based functions (texting/calling, smartphone-use) were favored for communication between 2020-2021. These functions were the largest group reported for all ages, although YA reported them more frequently (65%) compared to MA (48%) and OA (59%). Data also suggested that people had more in-person interaction at the time of survey completion (majority September 2021), compared to one-year previous (46.4%). Increased distanced socialization negatively correlated with overall socialization (r(78)=-.231, p=.05). Results suggest that although AITs are widely used, they may not adequately reduce isolation, particularly for those relying on them for primary contact. This may be especially true for underrepresented adults. Future research should investigate if this trend is universal and if existing AITs are sub-optimal in specific populations.
alpha=.01 showed that depressive symptoms, measured by the CESD-10 (p<.001), and anxiety symptoms... more alpha=.01 showed that depressive symptoms, measured by the CESD-10 (p<.001), and anxiety symptoms, measured by the GAD-7 (p<.001), increased during the pandemic as did mental healthcare barriers related to transportation (p=.004) and beliefs that depression is a normal part of aging (p<.001). Only transportation concerns differed based on where older adults lived; those in rural (p<.001) and urban (p=.004) settings reported greater transportation barriers than those in suburban settings. No differences over time were found for barriers related to help-seeking (p=.403), stigma (p=.156), knowledge/ fear (p=.180), finding a therapist (p=.030), ageism (p=.302), psychotherapist qualifications (p=.265), physician referrals (p=.207), or finances (p=.818). These findings highlight the impact of COVID-19 on older adults' perceptions of changes in their psychological well-being as well as their experience navigating mental health services.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Companionship with close others are known to have a significant positive effect on our well-being... more Companionship with close others are known to have a significant positive effect on our well-being in later years of life. At the same time, it is known that the frequency of meeting and chatting with others, an indicator of companionship, declines as we age. In this study we explore the situation of companionship among older-old and oldest-old people. The focus of this study on understanding how the aging process affects the experience of companionship and how people adapt to the loss of companionship. Semi-structured, in-depth interviews with 43 people aged 75 and older living in urban communities in Kawasaki, Japan. Participants were asked about everyday interactions with close others and feelings they experienced at the time. Interviews were transcribed and analyzed qualitatively. Chatting, going out for lunch or dinner, and going shopping were examples of activities older Japanese enjoyed with close others. Almost all respondents mentioned the loss of their old friends and siblings. They also mentioned that the decline in their physical and cognitive health, as well as that of their companions hindered shared activities they used to enjoy. They cherished positive interactions with others, although the frequency declined. Some respondents intentionally made new companions in the physical proximity, but it was hard to compensate for the loss of old companions with new one. These findings suggest that the value of companionship remains or even increase as we age. It would be important to identify environmental or social factors that may prevent the loss of companionship among older adults.
Despite the prevalence of disability among older adults-approximately 30% of older adults between... more Despite the prevalence of disability among older adults-approximately 30% of older adults between age 65 and 75 and 48% of those over age 75 had limited physical functioning-only a handful of studies have explored the effect of physical functioning in the relationship between environments and older adults' well-being and investigated the needs of this sub-population. Therefore, this study aimed to investigate the moderating effect of physical functioning in the relationship between home and environments and older adults' health, global assessment of age-friendliness of community, and likelihood of aging-in-place, applying the press-competence model. This cross-sectional study utilized the 2015 AARP Age-Friendly Communities Survey, which includes 66 home and neighborhood features under the WHO's 8 domains of Age-Friendly Cities Guidelines. Twenty copies of datasets were created using multiple imputation, and hypotheses were tested using Hierarchical Linear Modeling to control the dependency among observations due to clustering. The effect of home and neighborhood environments on health is greater for those with physical limitations, while the effect on the likelihood of aging-in-place is greater for those with intact physical functioning. There was no difference in the relationship between home and neighborhood environments and global assessment of community. To further investigate the relationship, a three-way interaction term-environments × physical functioning × household income-was included and found each subgroup has different needs. Findings suggest that efforts to understand unique needs of diverse sub-populations and provide needed community features or services are essential to the well-being of older adults.
The current study explored whether the Brief Test of Adult Cognition via Telephone (BTACT) assess... more The current study explored whether the Brief Test of Adult Cognition via Telephone (BTACT) assessment could be used to predict longevity in a national sample of adults from the Midlife Development in the United States (MIDUS) study. Specifically, we examined whether 9-year changes in episodic memory (EM) and executive functioning (EF) predicted all-cause mortality risk (2004-2018). The sample included 2,643 participants (MAge=45.87; 92.23% white; 107 deceased) who completed the BTACT twice: between 2004-06 and between 2013-2017. Using change scores, decreases in EM (HR= 1.45 [1.09-1.93], p=.01) and EF (HR=1.585 [1.17-2.14], p&lt;.001) increased the hazard of dying (controlling for age, gender, race, education, and self-rated health). Results suggest the BTACT is sensitive enough to detect health-consequential decreases in EM/EF. Future research should consider the BTACT as a viable assessment tool for older adults who may not have easy access to cognitive screenings.
Fear of falling (FOF), defined as a psychological symptom, is related to increased fall risk, anx... more Fear of falling (FOF), defined as a psychological symptom, is related to increased fall risk, anxiety, and depressive symptoms. As physical function changes with age, FOF can appear beginning in midlife. FOF may result in avoiding physical activities, resulting in weakness of postural balance. Neuroticism is associated with anxiety and depression; thus, those high on neuroticism may have an increased FOF. This study aimed to address the relationships between FOF, neuroticism, and number of falls from external perturbations while standing. Participants included 45 participants (female: n=24; age range: 42-77yrs; age=62.44±9.25yrs). Five standing trials were completed on a force platform with perturbations. Hierarchical regression was used to investigate the impact of neuroticism (Big Five Inventory) and number of falls on FOF (The Falls Efficacy Scale International), accounting for age, anxiety (Geriatric Anxiety Scale), and depressive symptoms (Center for Epidemiological Studies Depression Scale). Anxiety was significantly associated with FOF (model 1; age, anxiety, depression), B=0.31, β=.55, t(41)=3.08, R2=.30, p=.004, 95% CI [0.11, 0.51]. Neuroticism was not significantly related to FOF (model 2; ΔR2=.05, ΔF=2.94, p=.094), nor was number of falls (model 3; ΔR2=.00, ΔF=0.01, p=.974). Results revealed that anxiety levels had the strongest relationship with FOF. This suggests that strategies to reduce daily anxiety may decrease FOF. Future research should examine how anxiety is related to history of falls, and how changes in physical functions (e.g., mobility, vision, proprioception) may impact FOF.
Understanding who will experience cognitive dysfunction and dementia is as important as identifyi... more Understanding who will experience cognitive dysfunction and dementia is as important as identifying methods to combat such deterioration. This symposium seeks to highlight new advances in understanding cognitive deterioration and promote resilience in adulthood. Odd and colleagues utilized a national sample (2,643 adults aged 34-85) to show that 9-year decreases in executive function and episodic memory predicted increased risk of dying. Use of a brief cognitive assessment administered via telephone was unique – a method that may assist clinicians administering cognitive screenings to older adults in isolated areas. Graham and colleagues utilized a daily diary approach in 116 older adults (aged 60-90) to show that greater daily fluctuations in mindfulness were associated with higher episodic memory and executive functioning. Further, mediational evidence suggested that on days when mindfulness was greater, individuals perceived a younger subjective age. Willroth and colleagues provide evidence that higher scores on eudaimonic well-being in older adults (n=349) predicted greater cognitive resilience. Specifically, even though some participants had neuropathological burden (e.g., increased beta-amyloid, neurofibrillary tangles), they did not exhibit pronounced cognitive declines. Using data from 14 longitudinal studies, Yoneda and colleagues examined the impact of physical activity on cognitive impairment and death. Multi-state survival analyses demonstrated engagement in more physical activity reduced risk of cognitive impairment and death. This symposium suggests that examining changes in cognition, incorporating subjective and objective indices of cognitive impairment, utilizing long-term longitudinal and daily diary designs, and testing key modifiable behaviors is crucial to understanding and promoting optimal cognitive functioning in adulthood.
Energy intake in the post-exercise state is highly variable and compensatory eating-i.e., (over-)... more Energy intake in the post-exercise state is highly variable and compensatory eating-i.e., (over-) compensation of the expended energy via increased postexercise energy intake-occurs in some individuals but not others. We aimed to identify predictors of post-exercise energy intake and compensation. In a randomized crossover design, 57 healthy participants (21.7 [SD=2.5] years; 23.7 [SD=2.3] kg/m 2 , 75% White, 54% female) completed two laboratory-based test-meals following (1) 45-min exercise and (2) 45-min rest (control). We assessed associations between biological (sex, body composition, appetite hormones) and behavioral (habitual exercise via prospective exercise log, appetitive traits) characteristics at baseline and total energy intake, compensatory energy intake (intake-exercise expenditure), and the difference between post-exercise and post-rest intake. We found a differential impact of biological and behavioral characteristics on total post-exercise energy intake in men and women. In men, only fasting (baseline) concentrations of appetite-regulating hormones (peptide YY [PYY, β=0.88, P<0.001] and adiponectin [β=0.66, P=0.005] predicted total post-exercise energy intake, while in women, only habitual exercise (β=−0.44, P=0.017) predicted total post-exercise energy intake. Predictors of compensatory intake (intake-exercise expenditure) were almost identical to those of total intake. The difference in energy intake between exercise and rest was associated with VO 2peak (β=−0.45, P=0.020), fasting PYY (β=0.53, P=0.036), and fasting adiponectin (β=0.57, P=0.021) in men but not women (all P>0.51). Our results show that biological and behavioral characteristics differentially affect total and compensatory post-exercise energy intake in men and women. This may help identify individuals who are more likely to compensate for the energy expended in exercise. Targeted countermeasures to prevent compensatory energy intake after exercise should take the demonstrated sex differences into account.
Essential contacts (ECs), people providing support/engagement to older adults, are vital to their... more Essential contacts (ECs), people providing support/engagement to older adults, are vital to their physical and socio-emotional well-being. Research suggests that COVID-19 has significantly affected the connectedness of aging populations and their ECs, limiting interaction and potentially weakening support networks. Assistive and interactive technologies (AITs) may be useful for mitigating disruptions by facilitating communication. The goal of this study was to explore AIT preferences and needs of ECs for connecting with adults aged 60+. Participants completed a Qualtrics survey via Amazon Mechanical Turk. An initial sample (N=580,MAge=44.3±14.3,White=81%) was collected (December 2020-February 2021). A minority sub-sample (N=79,MAge=38.9±11.6,Non-White=87.3%) was subsequently accrued (September-December 2021). Participants were initial/minority-ECs for community-dwelling (initial-CDECs=57%,minority-CDECs=89%) and institutionalized adults (initial-IECs=43%,minority-IECs=11%). Minority...
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Papers by Julie Boron