ISSN 2399-5300 | ONLINE Vol. 3 | No. S1 • November 2019

INNOVATIONIN AGING INNOVATION IN AGING®Downloaded from https://academic.oup.com/innovateage/article-abstract/3/Supplement_1/NP/5615048 by guest on 19 November 2019 An Open Access Journal of

VOLUME 3/NUMBER S1/ NOVEMBER 2019 The Gerontological Society of America

Program Abstracts from the GSA 2019 Annual Scientific Meeting “Strength in Age—Harnessing the Power of Networks” INNOVATION IN AGING An Open Access Journal of The Gerontological Society of America

Laura P. Sands, PhD, FGSA Karen Jung, MSW Editor-in-Chief Managing Editor Virginia Tech The Gerontological Society of America 230 Grove Lane (0555) 1220 L Street, NW, Suite 901 Blacksburg, VA 24061 Washington, DC 20005 E-mail: [email protected] E-mail: [email protected]

Steven M. Albert, PhD, FGSA J. Jill Suitor, PhD, FGSA Deputy Editor-in-Chief Deputy Editor-in-Chief University of Pittsburgh Purdue University Christine E. Bishop, PhD, FGSA Associate Editor, Economics of Aging Jennifer Tehan Stanley, PhD Downloaded from https://academic.oup.com/innovateage/article-abstract/3/Supplement_1/NP/5615048 by guest on 19 November 2019 Associate Editor, Psychological Sciences University of Akron Howard B. Degenholtz, PhD, FGSA Associate Editor, Long-Term Services and Supports Roland J. Thorpe, Jr., PhD, FGSA University of Pittsburgh Associate Editor, Minority Health/Health Disparities Johns Hopkins Bloomberg School of Public Health Min-Ah Lee, PhD Associate Editor, Relationships & Well-Being Michael Weiner, MD, MPH Chung-Ang University, South Korea Associate Editor, Health Outcomes Research and Informatics Indiana University, Regenstrief Institute, Inc., and U.S. Department of Richard Pak, PhD Veterans Affairs Associate Editor, Technology Clemson University​ Elaine C. Wiersma, PhD Deputy Associate Editor, Qualitative Research Alison Phinney, PhD, RN Lakehead University, Canada Associate Editor, Qualitative Research University of British Columbia, Canada

J. Tina Savla, PhD, FGSA Associate Editor, Methodology Virginia Tech

ADVISORY BOARD

Jacqueline L. Angel, PhD, FGSA Karl Pillemer, PhD, FGSA The University of Texas at Austin

Toni C. Antonucci, PhD, FGSA Wendy A. Rogers, PhD, FGSA University of Michigan University of Illinois Urbana-Champaign

Kenneth Covinsky, MD Richard Schulz, PhD, FGSA University of California, San Francisco University of Pittsburgh

Kenneth F. Ferraro, PhD, FGSA Purdue University

PUBLICATIONS COMMITTEE

Margie E. Lachman, PhD, FGSA, Chair Brandeis University Panayiotis D. Tsitouras, MD, FGSA, Past Chair University of Oklahoma

Rozalyn M. Anderson, PhD, FGSA Judith L. Howe, PhD, DSW, FGSA Suzanne Meeks, PhD, FGSA University of Wisconsin-Madison Mount Sinai School of Medicine University of Louisville Debra Bakerjian, PhD, APRN, FAAN, Derek M. Isaacowitz, PhD, FGSA Anne B. Newman, MD, MPH, FGSA FAANP, FGSA Northeastern University University of Pittsburgh University of California, Davis Brian P. Kaskie, PhD Kushang V. Patel, PhD, MPH, FGSA Elizabeth J. Bergman, PhD University of Iowa University of Washington Ithaca College Catheryn Koss, JD, PhD Miriam S. Rose, M.Ed. Lisa K. Borrero, PhD California State University, Sacramento Benjamin Rose Institute on Aging University of Indianapolis David G. Le Couteur, FRACP, PhD Laura P. Sands, PhD, FGSA J. Scott Brown, PhD, FGSA The University of Sydney Virginia Tech Miami University Skye N. Leedahl, PhD Amber Watts, PhD Deborah Carr, PhD, FGSA University of Rhode Island The University of Kansas Robert T. Mankowski, PhD Rong Yuan, MD, PhD Tamas Fulop, MD, PhD, FGSA University of Florida SIU School of Medicine Université de Sherbrooke

Fellow of The Gerontological Society of America (FGSA) OUP PRODUCTION DEPARTMENT

Katie Ostrowka, Journal Manager - Production THEINNOVATION GERONTOLOGIST IN AGING AnA Open Journal Access of TheJournal Gerontological of The Gerontological Society Society of America of America

EDITORIAL BOARD

Steven M. Albert, PhD KathleenJoseph Abrahamson, E. Gaugler, RN, PhDPhD, FGSA Loretta Pecchioni, PhD University of Pittsburgh UniversityPurdue of University Minnesota Louisiana State University Tamara A. Baker, PhD, FGSA Rebecca S. Allen, PhD LauraUniversity N. Gitlin, of Kansas PhD Nancy J. Petersen, PhD The University of Alabama JohnsScott R.Hopkins Beach, PhD,University FGSA Department of Veterans Affairs Medical Jacqueline L. Angel, PhD KathyUniversity E. Green, of Pittsburgh PhD Center, Houston The University of Texas at Austin SaraUniversity J. Czaja, of PhD, Denver FGSA Downloaded from https://academic.oup.com/innovateage/article-abstract/3/Supplement_1/NP/5615048 by guest on 19 November 2019 University of Miami Carl F. Pieper, DrPH Tamara A. Baker, PhD R.Adam Turner Davey, Goins, PhD, FGSAPhD Duke University Medical Center University of Delaware, Newark University of South Florida West Virginia University Larry Polivka, PhD Nancy R. Gee, PhD Daniel Béland VirginiaLeslie K. Commonwealth Hasche, PhD, University MSW Claude Pepper Center University of Denver Johnson-Shoyama Graduate School of Public Policy Megan Gilligan, PhD Thomas R. Prohaska, PhD Iowa State University William E. Haley, PhD University of Illinois at Chicago Jennifer Bellot, PhD, RN, MHSA Mary Ann Johnson, PhD Thomas Jefferson University University of South Florida University of Nebraska Lincoln Jill Quadagno, PhD JonYoshinori Hendricks, Kamo, PhD The Florida State University Mercedes Bern-Klug, PhD, MSW Louisiana State University The University of Iowa Oregon State University Giyeon Kim, PhD, FGSA Anna Rahman, PhD Richard Birkel, PhD Chung-AngPamela University, Herd, SouthPhD Korea University of Southern California National Council on Aging UniversityHui Liu, ofPhD, Wisconsin FGSA ​Michigan State University Ruth E. Ray, PhD Christine E. Bishop, PhD MarianaRobert López-Ortega, B. Hudson, PhD, PhD MPP Wayne State University Brandeis University National Institute of Geriatrics,Boston NationalUniversity Institutes of Health, Mexico Anne Collins McLaughlin, PhD Virginia E. Richardson, PhD, MSW Jamila Bookwala, PhD NorthKathryn Carolina Hyer, State PhD, University MPP The State University Lafayette College UniversityDavid A. Nace,of South MD, Florida MPH Sara E. Rix, PhD MarshallUniversity B. Kapp, of Pittsburgh JD, MPH Hayden Bosworth, PhD Marcia Ory, PhD, FGSA AARP Public Policy Institute Durham VA Medical Center and FloridaTexas State A&MUniversity Karen A. Roberto, PhD Duke University Medical Center KarenBrian A. Roberto, Kaskie, PhD, PhD FGSA Virginia Tech Virginia Polytechnic Institute and State University Barbara J. Bowers, PhD, RN, FAAN University of Iowa Miles G. Taylor, PhD, FGSA Miriam S. Rose, MEd University of Wisconsin-Madison NancyFlorida Kelley-Gillespie, State University PhD Benjamin Rose Institute on Aging Margaret P. Calkins, PhD UniversityRobert Joseph of Nebraska Taylor, MSW,at Omaha PhD University of Michigan IDEAS Consulting Inc. Mary Ann Kluge, PhD Michael J. Rovine, PhD Noah J. Webster, PhD Pennsylvania State University Francis Caro, PhD University Universityof Colorado, of Michigan Colorado Springs University of Massachusetts Boston Peter A. RichardLichtenberg, Winett, PhDPhD, ABPP Laura P. Sands, PhD Virginia Tech Wayne State University Purdue University Nicholas G. Castle, PhD Jeremy B. Yorgason, PhD University of Pittsburgh PhoebeBrigham S.Young Liebig, University PhD Andrew Scharlach, PhD UniversityAnna Zajacova, of Southern PhD, California FGSA University of California- Berkeley Barbara B. Cochrane, PhD, RN, FAAN Western University, Canada University of Washington Rebecca G. Logsdon, PhD Rick J. Scheidt, PhD University of Washington Kansas State University ConstanceFellow of L. The Coogle, Gerontological PhD Society of America (FGSA) Virginia Commonwealth University Ronald J. Manheimer, PhD Richard Schulz, PhD The Manheimer Group University of Pittsbugh Teresa Cooney, PhD University of Missouri Graham J. McDougall Jr., PhD, Debra Sheets, PhD, MSN, RN RN, FAAN, FGSA University of Victoria Katrina Cubit, PhD The University of Texas at Austin Australian Nursing & Midwifery A. Lynn Snow, PhD Lisa C. McGuire, PhD Accreditation Council University of Alabama Center for Disease Control and Sara J. Czaja PhD Prevention Avron Spiro, PhD University of Miami Miller School of Medicine VA Boston Healthcare System and Kate de Medeiros, PhD Boston University Medical Center Jeanette M. Daly, RN, PhD Miami University Maximiliane E. Szinovacz, PhD The University of Iowa Suzanne Meeks, PhD University of Massachusetts-Boston Kara Bottiggi Dassel, PhD University of Louisville Arizona Association of AAAs Claudia Meyer, MPH Jeanne A. Teresi, EdD, PhD National Ageing Research Institute Columbia University and Research Division, Adam Davey, PhD Hebrew Home, Riverdale Temple University Edward Alan Miller, PhD, MPA University of Massachusetts Boston Jennifer L. Troyer, PhD Howard B. Degenholtz, PhD University of North Carolina at Charlotte University of Pittsburgh Nancy Morrow-Howell, PhD, MSW, ACSW Washington University in St. Louis Jim Vanden Bosch, MA David J. Ekerdt, PhD Terra Nova Films University of Kansas Naoko Muramatsu, PhD, MHSA University of Illinois at Chicago Hans-Werner Wahl, PhD Connie Evashwick, PhD, ScD, FACHE Linda S. Noelker, PhD University of Heidelberg Saint Louis University Benjamin Rose Institute on Aging Dana Beth Weinberg, PhD Richard H. Fortinsky, PhD Frank Oswald, PhD Queens College and The Graduate Center - City University of Connecticut Health Center Goethe University Frankfurt University of New York Lisa Fredman, PhD Patricia A. Parmelee, PhD Maureen Wilson-Genderson, PhD Boston University The University of Alabama Virginia Commonwealth University Helene H. Fung, PhD Julie Hicks Patrick, PhD Jacqueline S. Zinn, PhD Chinese University of Hong Kong West Virginia University Temple University 690 Innovation in Aging, 2019, Vol. 3, No. S1 satisfaction with aging ((β: -0.23 95%CI: -0.36- (-0.10)) 2016 wave of Health and Retirement Study. Health status and satisfaction with life (β: -0.27 95%CI: -0.44- (-0.11)). was indicated by chronic condition and ADL and IADL Frailty syndrome is highly prevalent and having a better functional limitations. Logistic regression model was used understanding of its influence on health outcomes at inter- to examine how the completions of LW and PA are asso- mediate pre-frail states could provide insight into reducing ciated with health and education variables respectively. manifestations in later life. Interaction terms were created to test the moderating ef- fects of race and age. Results: The analysis results show that MULTIDIMENSIONALLY HETEROGENEOUS HEALTH older adults with higher IADL functional limitation and LATENT CLASSES AND HEALTHCARE UTILIZATION more education were more likely to complete completing PA FOR OLDER CHINESE or LW. Being white and higher age will increase the prob- Downloaded from https://academic.oup.com/innovateage/article-abstract/3/Supplement_1/NP/5615048 by guest on 19 November 2019 Linglong Ye,1 Jiecheng Luo,1 Ben-Chang Shia,2 and ability for an older adult to complete PA, whereas the older Ya Fang1, 1. School of Public Health, Xiamen University, adults with heart problem were more likely to complete LW. Xiamen, China, 2. School of Management, Taipei Medical The association between IADL/ADL and PA was stronger in University, Taipei, Taiwan white than other racial groups, and the association between Objectives: Based on a multidimensional perspective, this IADL and LW was stronger in young-old than the oldest- study aimed to assess the heterogeneous health latent classes old. Conclusion: The findings highlight the importance of of older Chinese, and further examined the effects of health examining the completions of two advance directive docu- latent classes and associated factors on healthcare utilization. ments respectively and indicate the necessity of developing Methods: Data came from the Chinese Longitudinal Healthy distinct and concrete strategies to promote the completions Longevity Survey in 2014. Latent class analysis was adopted of PA and LW. to identify heterogeneous health latent classes by health in- dicators of physical, psychological, and social dimensions. ELDER VOICES NETWORK: PARTNERING WITH Two-part models were used to evaluate the impact of health OLDER PEOPLE AND THEIR CAREGIVERS TO AVOID latent classes and socio-demographic factors on outpatient MEDICAL HARM and inpatient utilization. Results: Among 2,981 partici- Molly Ranahan,1 Mary Brennan-Taylor,1 Michael Richbart,1 pants aged 65 and over without missing health indictors, Collin Clark,1 Ryan Gadzo,2 Ranjit Singh,1 and four health latent classes were identified and labeled as Robert Wahler1, 1. University at Buffalo, Buffalo, New “Lacking Socialization” (10.4%), “High Comorbidity” York, , 2. Erie County Department of Senior (16.7%), “Frail Group” (7.7%), and “Relatively Healthy” Services, Buffalo, New York, United States (65.1%). Among 1,974 participants with complete informa- Team Alice, named after an older adult in our commu- tion, compared with the Relatively Healthy group, those in nity who died as a result of medication harm, is an inter- the Lacking Socialization group costed more inpatient ex- disciplinary team of prescribers, pharmacists, educators, penditure (p-value =0.02). Those in the High Comorbidity advocates, and researchers with a mission to protect older and Frail groups tended to use healthcare services and costed people from medication-related harm across the continuum more outpatient expenditure (all p-value <0.01). After con- of care. In 2019, Team Alice partnered with the Erie County trolling for health latent classes, the effects of age, gender, Department of Senior Services, older people, and caregivers marital status, education, residence area, occupation, and to form the Elder Voices Network (EVN) as a vehicle for health insurance on healthcare utilization were significant. patient-driven deprescribing in the Western New York re- Conclusions: Four heterogeneous health latent classes were gion. The objective of this presentation is to detail the plan- identified by multidimensional health, and had significant ef- ning and implementation of critical components of EVN’s fects on healthcare utilization. After controlling for health formation, including outreach and engagement, funding de- latent classes, different effects of socio-demographic factors velopment, community partnerships, roles and communica- on healthcare utilization were found. It enhances our under- tion, and decision-making. Case study results demonstrate standing of heterogeneous health and complex healthcare the capacity of community-based participatory research demands in older Chinese, and is valuable for improving (CBPR) to empower older people and caregivers with know- healthcare resource allocation targeted for healthy aging. ledge, skills, and tools to promote self-advocacy across the system. Presenters will also discuss recommendations useful WHAT MATTERS FOR COMPLETION OF ADVANCE for future patient engagement initiatives. DIRECTIVES AMONG AMERICAN OLDER ADULTS? Yifan Lou,1 and Jinyu Liu2, 1. Columbia University, New CHANGES IN THE MEDICARE HOME HEALTH CARE York, New York, United States, 2. Columbia University, MARKET: THE IMPACT OF ACA REIMBURSEMENT New York City, New York, United States POLICY Background: Most previous studies consider advance Jamila M. Torain,1 Joan Davitt,2 Charlotte L. Bright,3 directives as one single outcome, which conceals possible Nancy Miller,4 Sarah Chard,5 and Denise Orwig1, variations of individuals’ decisions on two different advance 1. University of Maryland, Baltimore School of Medicine, directives documents–living will (LW) and durable power of Baltimore, Maryland, United States, 2. University of attorney for healthcare (PA). To advance the knowledge on Maryland, Baltimore, Maryland, United States, advance planning among older adults in the US, this study 3. University of Maryland, Baltimore, Baltimore, Maryland, examined how health status and education are associated United States, 4. The University of Maryland Baltimore with completions of LW and PA and whether such associ- County, Baltimore, Maryland, United States, 5. UMBC, ations vary by age and race. Methods: Data are from the Baltimore, Maryland, United States GSA 2019 Annual Scientific Meeting