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Sustaining a healthy weight across the lifespan is an important aspect of disease prevention and quality of life in aging. Still, approximately 77% of US adults deviate from ideal weight recommendations, contributing to disease and disability. Improving lifestyles is critical to reducing this chronic disease burden. Self-perception of weight status (perceived-BMI) and its accuracy (versus actual-BMI) may influence behavior through goal setting and motivation; however, this relationship remains understudied in aging adults. Examining BMI dissonance and its broader context within the aging population may contribute to better understanding how self-perception shapes behavior and wellness. The current study contributes to this goal by assessing the field via scoping review. Electronic database searches were carried out in: PubMed, APA PsycInfo, Sports Medicine & Education Index. Peer reviewed white literature published in English from database inception to May 2024 were included in the search. Eligible research was related to aging adults’ body form and included primary measures for perceived- and actual-BMI. Populations were community-dwelling adults, aged 45+. The search revealed 4160 titles. After title, abstract, and full text screen, 13 articles were selected for inclusion. Evaluation of the selected studies showed that diverse aspects of perceived-BMI were described, including diagnostic accuracy and alignment with actual-BMI, association with health literacy, behavioral impacts, and correlations to lifestyle change strategies. These synthesized results may contribute to understanding how self-perception shapes behavior and wellness; discussion will include how this review can inform interventions to promote healthier lifestyles and reduce chronic disease burden across the adult lifespan.

Abstract 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 respondents overwhelmingly identified as CDECs. Results revealed that recent ,\"daily/often\" phone-based, video-based, and in-person communication were all, more-frequently reported in minority-ECs compared to the initial-EC sample. Phone-based communication was most-frequent in minority-IECs (61%,versus initial-IECs=49%), but was relatively ubiquitous among all (minority-CDECs=49%,initial-CDECs=43%). Initial-CDECs had the least video-based contact (17%); the remaining groups were relatively similar (minority-CDECs=36%,minority-IECs=33%,initial-IECs=32%). CDECs reported the most in-person communication (minority-CDECs=70%,versus initial-CDECs=49%); IECs reported the least (minority-IECs=44%, versus initial-IECs=14%,). Results suggest that this minority sub-set may communicate more, respectively. This may be influenced by population and data-collection-time differences. Still, CDECs may have maintained better access to in-person communication and relied less-heavily on distanced networks through the pandemic. Ultimately, individual characteristics (i.e., ethnicity) and experiences (i.e., COVID-19) may drive communication patterns and end-user needs; this could inform innovation. Future investigation into these topics is warranted.

Abstract 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.

Abstract 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.

Abstract COVID-19 has created communication and socialization challenges for many older adults (OAs) living in community or institutional settings (CECs, IECs respectively) and their essential contacts (ECs). An essential contact is someone who provides emotional, physical, and social support for an older adult. While social distancing measures have decreased the spread and infection rate, these measures have placed strain upon communication and socialization needed for wellbeing which may increase the risk of loneliness and subsequently depression, cognitive functioning, and mortality among OAs. This study compared how general, in-person, and distanced communication between CECs and IECs has changed due to COVID-19. Self-identified ECs to OAs (N=546) completed a Qualtrics questionnaire via Amazon Mechanical Turk. Respondents (Age Range: 19-77; Mean=44.3; SD=14.2) were generally female (54.8%), white (81.0%), and CECs (57.3%). Pearson chi-square was used to evaluate the association between EC and communication type. Phi and Cramer's V were used to measure effect size. IECs were significantly more likely than CECs to report much less general (41.6% vs. 10.7; medium effect) and in-person (60.0% vs. 22.4%; medium effect) social interaction due to COVID-19. IECs were significantly more likely to report much more distanced communication than CECs (42.8% vs 5.2%; small effect). Overall, this suggests community dwelling OAs' communication and socialization were less impacted by COVID-19 distancing than institutionalized OAs. Thus, institutionalized OAs may be at greater risk for negative effects of social distancing. Future efforts need to focus on prioritizing ways for institutionalized adults to communicate with their ECs if social distancing is needed.

Maintaining independence and quality of life (QOL) is a primary goal for adults. To support this goal, assistive and interactive technology (AIT) has been implemented to improve function and mitigate disease. To assess AIT effect on QOL in community-dwelling persons with dementia and mild cognitive impairment (MCI), a systematic review was performed, and articles were prepared for meta-analysis. Electronic database searches were carried out in PubMed, Cumulative Index for Nursing and Allied Health Literature, PsychINFO, and Web of Knowledge/Web of Science. Peer-reviewed journal articles published in English between January 2010 and February 2020 were included in the search. Studies investigated personal AIT use aimed at improving QOL (i.e. satisfaction/mood, functional ability, psychological/social function, independence). Technology was implemented in the home in everyday life. Studies were limited to those including community-dwelling participants aged 65+ with a diagnosis or report of MCI or dementia. Initial search resulted in 2624 total titles. After duplicate deletion, 1546 unique articles were identified. After title and abstract deletion, 60 articles were screened at full-text. After full-text screening, five usable articles remained. Usable studies presented: 1) a digital tablet companion, 2) a digital reminder calendar, 3) a medication-adherence bottle, 4) an automatic medication dispenser, and 5) a comprehensive tele-care computer system. These studies provide outcome measures focused on functional improvement and/or subjective QOL, informing future research in AIT implementation. Additionally, the severe paucity of applicable studies indicates a need for increased primary research on intersections between dementia and technology in the home environment.

Abstract COVID-19 risk-reduction efforts have protected high-risk individuals (including older adults) but have significantly altered life; persons now face reduced socialization. Advancing technologies (e.g., video-chat) may be useful in alleviating consequences of risk-reduction efforts, including loneliness, by improving access to alternative connection/communication across the lifespan. The purpose of this study was to investigate the relationships between technology use and individuals as this may contribute to well-being among older adults during COVID-19 and future isolating events. Participants (N=652) aged 19+ completed a questionnaire via Amazon Mechanical Turk; demographic, socialization, and technology-use data were collected. Respondents (MAge=45.15±15.81) were generally male (50.1%) and white (77.3%). In-person communication and video-chat were analyzed descriptively and with binary regressions. Results of a Wilcoxon Signed-Ranks Test indicated that video-chat (mean rank=228.45) was reported at higher frequency of use versus in-person conversations (mean-rank=202.48), Z=-4.8,p<.001). Additionally, being female positively predicted use of video chat (B=0.42,p<.05) while increasing age negatively predicted use (B=-0.01,p<.05). Regression results suggest that populations reporting higher video-chat communication (e.g., females, younger adults) may be motivated by maintaining social connectedness despite distancing and/or are committed to healthy behaviors, increasing aversion to in-person experiences. In contrast, it may be that persons reporting low video-chat use (e.g., males, older adults) may be less interested in distanced communication or may have lower technology comfort/access. Notably, sampling bias may influence results as data was collected online; future investigation is warranted. Ultimately, understanding interest in and barriers to using technology is vital to developing systems/services which support connection/communication when in-person contact is limited.

Abstract Older adults are at increased risk for loneliness/isolation, particularly with new COVID-19 recommendations; however, communication may help mitigate these negative perceptions. Reductions in loneliness/isolation may also significantly improve quality of life and well-being for vulnerable populations. Thus, the purpose of this study was to investigate the relationships between communication, individual characteristics, and time, to provide a clearer understanding of communication patterns in a longitudinal cohort. Participants (N=2351) with no missing data on any variables of interest (across time-points) were pulled from the Health and Retirement Study's Consumption and Activity's Mail Survey (waves collected: 2013, 2015, 2017). When last reported (2016/17), respondents were an average age of 70.14(SD=9.9), were generally female (63.0%) and white (75.7%). Analyses included longitudinal investigation, normality tests, and regression. Assumptions were violated in ANOVA; results of a Kruskal-Wallis test revealed that there were no significant changes in the distribution of in-person or distanced communication across the three waves. Individual responses were then averaged and standardized across waves (per participant for each outcome variable). In-person communication regression results reveal that being female positively predicted in-person conversation volume (B=0.23,p<.001) as did increasing number of years in school (B=0.03,p<.001), while being non-white negatively predicted in-person conversation (B=-0.301,p<.001). Distanced communication regression results reveal being female positively predicted volume of distanced communication (B=0.381,p<.001); however, being non-white and younger positively predicted increased volume of distanced communication (B=0.241,p<.001; B=0.005,p<.001, respectively). Given the varied communication patterns, future research should consider explanatory mechanisms in addition to investigating changes as a result of the ongoing pandemic.

Abstract Older adults are at increased risk for contracting COVID-19 and are more vulnerable to poor outcomes. Public health efforts to prevent spread of COVID-19 resulted in widespread social/physical distancing; this changed adults' regular communication with their essential contacts, warranting development of solutions for socialization to reduce loneliness, bolstering quality of life. Essential contacts provide social/emotional/physical care for community-dwelling or institutionalized adults. This study aimed to explore how essential contacts of older adults utilize technology to maintain social connection in response to COVID-19. Participants (N=156) aged 55+ completed a Qualtrics questionnaire via Amazon Mechanical Turk; demographic, social contact, and technology use data were collected. Respondents (M Age=62.2±4.9) were generally female (72.4%), white (89.7%), and a contact for an institutionalized adult (59%). Data were analyzed descriptively with binary regressions. Results revealed that volumes of general [X2(4,N=156)=37.69,p<.001], in-person [X2(4,N=156=37.84,p<.001], and distanced [X2(4, N=156)=27.69,p<.001] social interaction were significantly associated with the older adult's environment (community-dwelling vs. institutionalized). In-person conversation was significantly associated with environment [X2(1,N=156)=29.38,p=0.001], while other technology-based communications (e.g., video-chat) were not. In-person conversation was positively predicted by the contact being a physical caregiver (B=2.324,p<.001), while smartphone use was positively predicted by being a social contact (B=1.287,p<.05). Findings suggest that although technology was used by participants to communicate with their older adult contacts across groups, environment and caregiver/contact type significantly influenced communication. It may be that, throughout COVID-19, dyads have relied on familiar methods of socialization, or that there is lack of access to more sophisticated technologies for communication. This warrants future investigation.

When considering the various extrinsic variables that may affect disease vulnerability, it is valuable to study temporal ordering of factors to identify areas for disease intervention efforts. This study sought to inform improvement of networks for the purposes of education and health by attempting to better define the causal ordering of ethnicity, age, gender, education, disease burden, and dementia diagnosis with the Aging, Demographics, and Memory Study, a sub-study of the Health and Retirement Study. Participants and/or proxies self-reported total number of chronic conditions, subsequently regarded as disease burden. Assessments occurred over four waves; participants were not reassessed after dementia diagnosis. The current study categorized participants as demented (n=414), identified in any wave, or normal (n=117), identified in the final wave. Cognitively-impaired-not-demented and deceased participants were not considered due to lack of diagnosis. Cross-sectional weighting was used. A path model was developed; ethnicity, age, and gender were antecedent to education, and education was casually ordered before disease burden, which was antecedent to dementia diagnosis. A series of logistic and linear regression analyses were conducted. Results revealed that being non-white (Σβ=0.643, all p’s<.001), of older age (Σβ=0.250, all p’s<.001), female (Σβ=0.180, all p’s<.001), and having increased disease burden (Σβ=0.118, p<.001) all demonstrated a positive total effect on dementia diagnosis. Conversely, more years of education (Σβ=-0.245, p<.001) had a negative total effect on diagnosis. The education to disease burden pathway was non-significant. Ultimately, these results may indicate a need for dementia interventions that target those with low education or high disease burden.