Engagement Of Older Adults Research Articles

Using Voice-activated Technologies to Enhance Well-being of Older Adults in Long-term Care Homes

Abstract Background and Objectives Information communication technologies (ICTs) can enhance older adults’ health and wellbeing. Most research on the use of voice-activated ICTs by older adults has focused on the experiences of individuals living in the community, excluding those who live in long-term care homes. Given evidence of the potential benefits of such technologies to mitigate social isolation and loneliness, more research is needed about their impacts in long-term care home settings. With this in mind, we evaluated impacts and engagement of older adults with voice- and touchscreen activated ICTs in one long-term care home in Canada. Research Design and Methods Interviews were conducted with older adults who were provided with a Google Nest Hub Max and with staff as part of a larger implementation study. Participants completed semi-structured interviews before the technology was implemented, and again at 6 and 12 months. The interviews were recorded, transcribed, and analyzed using thematic analysis techniques. Results We found that residents primarily used the technologies to engage in self-directed digital leisure and to engage with others both in and outside the home, and that this in turn enhanced their comfort, pleasure, and social connectedness. We also identified ongoing barriers to their engagement with the technology, including both personal and structural factors. Discussion and Implications Our findings suggest that implementation of voice-activated ICTs can bring added value to broader efforts to improve well-being and quality of life in long-term care by enhancing choice, self-determination, and meaningful relationships.

Use of an electronic wellness instrument in the integrated health and social care of older adults: a group concept mapping study

BackgroundHealth system fragmentation directly contributes to poor health and social outcomes for older adults with multiple chronic conditions and their care partners. Older adults often require support from primary care, multiple specialists, home care, community support services, and other health-care sectors and communication between these providers is unstructured and not standardized. Integrated and interprofessional team-based models of care are a recommended strategy to improve health service delivery to older adults with complex needs. Standardized assessment instruments deployed on digital platforms are considered a necessary component of integrated care. The aim of this study was to develop strategies to leverage an electronic wellness instrument, interRAI Check Up Self Report, to support integrated health and social care for older adults and their care partners in a community in Southern Ontario, Canada.MethodsGroup concept mapping, a participatory mixed-methods approach, was conducted. Participants included older adults, care partners, and representatives from: home care, community support services, specialized geriatric services, primary care, and health informatics. In a series of virtual meetings, participants generated ideas to implement the interRAI Check Up and rated the relative importance of these ideas. Hierarchical cluster analysis was used to map the ideas into clusters of similar statements. Participants reviewed the map to co-create an action plan.ResultsForty-one participants contributed to a cluster map of ten action areas (e.g., engagement of older adults and care partners, instrument’s ease of use, accessibility of the assessment process, person-centred process, training and education for providers, provider coordination, health information integration, health system decision support and quality improvement, and privacy and confidentiality). The health system decision support cluster was rated as the lowest relative importance and the health information integration was cluster rated as the highest relative importance.ConclusionsMany person-, provider-, and system-level factors need to be considered when implementing and using an electronic wellness instrument across health- and social-care providers. These factors are highly relevant to the integration of other standardized instruments into interprofessional team care to ensure a compassionate care approach as technology is introduced.

Engage! a pilot study of a brief behavioural activation program to promote engagement and well-being in older adults.

Previous research has indicated the suitability of behavioural activation (BA) as an intervention for reducing depression in older adults. However, little research has investigated the potential of BA to increase active engagement and well-being in older adults. The current pilot study sought to investigate the usefulness and acceptability of BA to promote well-being in a group of non-clinical older adults. Participants (N = 18) aged between 65 and 86 (M = 77.82, SD = 5.59) who were retired and living independently in the community were provided a 6-week BA program predominantly delivered online. Treatment retention, self-ratings, and participants' compliance to treatment principles indicate preliminary feasibility for the use of BA as an approach for increasing active engagement in older adult populations. Participants also provided feedback on their experiences with the program post-intervention via individual structured interviews. Thematic analysis of these data revealed that participants found the program to be beneficial in terms of increased self-awareness and social engagement, and provided several recommendations for improving acceptability of the program and workbook. The unexpected events relating to the first wave of the novel coronavirus (COVID-19) led to necessary adaptations to delivery modalities, and provided the researchers with an opportunity to investigate the use of a structured well-being program on a high-risk population during a pandemic. Our findings support the proposition that BA is a suitable intervention for increasing engagement and well-being in older adults, provide insight into adapting programs for older adults, and suggest next steps for testing intervention efficacy.

Ageing in Place: Older People Identify Barriers to Remaining in Low-Density Areas

AbstractStudies involving older people as co-investigators are limited in Portugal. The main objectives of this article are: (I) Analyze the barriers identified by older people living in low-density territories that pose a challenge to ageing in place. (ii) Understand the co-research methodology as an appropriate instrument for increasing the participatory capacity of older people and improving the conditions for ageing in place. (iii) Assess the role of social networks and community support in providing informal assistance to older people in low-density territories. The study involved 14 co-researchers, who had a balanced gender representation and an average age of 64.5 years. All the co-researchers were residents of the study location and volunteered for the research. They were provided training in interview techniques and active listening, prior to the study. A total of three interviews and 23 photographs were analyzed and discussed in five focus group meetings. The participants agreed upon four types of unmet needs and developed proposals to increase their negotiating power, thereby mitigating barriers to their permanence. The co-researchers presented their proposals at two public meetings with decision-makers, managers, and members of the municipal council. The findings were a significant addition to the promotion of the co-research approach and the engagement of older adults in detecting the obstacles that hinder their secure and independent aging in their living environment.

Four-Step Co-Designing of the Reablement Strategies Targeting Sarcopenia (ReStart-S): An Exercise-Based Multicomponent Program for Older Adults Residing in Long-Term Care Settings.

The prevalence of sarcopenia is concerningly high in long-term care settings (LTCS); yet, no exercise programs specifically targeting older adults living in residential care are available. The goal of the present study was to co-design and validate a program named Reablement Strategies targeting Sarcopenia (ReStart-S) for older long-term care residents. Cross-sectional study with an exploratory phase. LTCS in Udupi, Karnataka, India. Sarcopenic older adults diagnosed using Asian Working Group for Sarcopenia 2019 criteria. The program was designed using a four-step intervention mapping technique involving systematic progression after completing each step. The steps included 1) identifying the appropriate exercise-based intervention for sarcopenia, 2) determining objectives and expected outcomes, 3) seeking expert views through a Delphi consensus approach, and 4) assessing the feasibility of ReStart-S program among older adults living in LTCS. A comprehensive literature review appraised existing exercise programs for managing sarcopenia. A workshop held with six older adults and one caretaker, decided on morning exercise sessions, recommended 2-7 days/week. The results of the review and workshop were compiled for the Delphi process that had seven experts from 5 countries, achieving a 71% response rate after four rounds. In the last step, a pilot study on eight LTCS residents, two males and six females with a mean age of 78.3 ± 8.3 years, was conducted and the program was found to be feasible. The ReStart-S program for managing sarcopenia among older adults residing in LTCS incorporates evidence from the literature and the engagement of older adults, caregivers, and experts, making it a contextually appropriate intervention. Our study also provides researchers and healthcare professionals insight into co-designing an intervention program for vulnerable older adults. Finally, the program evaluation indicates that a full-scale trial testing the efficacy of the ReStart-S program is feasible.

Health behavior outcomes in stroke survivors prescribed wearables for atrial fibrillation detection stratified by age.

Smartwatches have become readily accessible tools for detecting atrial fibrillation (AF). There remains limited data on how they affect psychosocial outcomes and engagement in older adults. We examine the health behavior outcomes of stroke survivors prescribed smartwatches for AF detection stratified by age. We analyzed data from the Pulsewatch study, a randomized controlled trial that enrolled patients (≥ 50 years) with a history of stroke or transient ischemic attack and CHA2DS2-VASc ≥ 2. Intervention participants were equipped with a cardiac patch monitor and a smartwatch-app dyad, while control participants wore the cardiac patch monitor for up to 44 days. We evaluated health behavior parameters using standardized tools, including the Consumer Health Activation Index, the Generalized Anxiety Disorder questionnaire, the 12-Item Short Form Health Survey, and wear time of participants categorized into three age groups: Group 1 (ages 50-60), Group 2 (ages 61-69), and Group 3 (ages 70-87). We performed statistical analysis using a mixed-effects repeated measures linear regression model to examine differences amongst age groups. Comparative analysis between Groups 1, 2 and 3 revealed no significant differences in anxiety, patient activation, perception of physical health and wear time. The use of smartwatch technology was associated with a decrease in perception of mental health for Group 2 compared to Group 1 (β = -3.29, P = 0.046). Stroke survivors demonstrated a willingness to use smartwatches for AF monitoring. Importantly, among these study participants, the majority did not experience negative health behavior outcomes or decreased engagement as age increased.

COMMUNITY ENGAGEMENT IN OLDER ADULTS WITH COGNITIVE DECLINE: THE USAGE OF INFORMATION COMMUNICATION TECHNOLOGY

Abstract Background Cognitive decline is typical among older adults, affecting their activities of daily living and community participation. However, the advent of cognitive function support information technologies may improve their community engagement, perhaps more than memory training alone. This study examined information communication technology usage as a mediator of associations of cognitive decline and community engagement in older adults. Methods We sampled older adult cases from Round 11 of the National Health and Aging Trends Study data set (N=3817) with cognitive decline in community dwelling (mean age =81.38, SD=6.266), male (n= 1313) and female (n=1771). We utilized multi-level Structural Equation Model (SEM) to examine the mediation of cognitive decline and community connection through the ICTs, as well as direct relationships among memory, orientation, and executive function. Results From SEM analysis, an increase of ICTs usage has statistically significantly effects on older adults’ cognitive ability overall (Estimate = 0.103, S.E. = 0.023, C.R. = 4.438, p < 0.001). Cognitive function has a direct impact on the activity orientation function (Estimate=1, p < 0.0011.000). The greater usage of ICTs by older adults is associated with higher levels of community engagement (Estimate = 1.230, S.E. = 0.284, C.R. = 4.338, P < 0.001). Conclusion This finding highlights the potential role of ICTs in fostering older adults’ cognitive function for their social interactions and community involvement. Digital age older adults may have greater cognitive function than previous cohort, reducing demand for care services their community participation.

Reorganization of functional brain networks in healthy aging and mild cognitive impairment during the visual motion discrimination task

AbstractBackgroundPreviously, we reported that there was significant decrease in spectral power for eyes‐closed resting state EEG (rsEEG) immediately following a visual motion discrimination task as compared to before task engagement in older adults – the so‐called Task Aftereffect (TA). Further, we have also shown that rsEEG TA differentiated between older adults with mild cognitive impairment (MCI) and healthy controls (HC), with the MCI participants showing more integrated topology in post‐ as compared to pre‐cognitive task rsEEG. We now report EEG topological changes during task performance with regards to: changes in functional network organization from the beginning to the end of the task and evidence for significant differences in topology between MCI patients and HC.MethodWe studied a sample of community dwelling African American older participants over age 60 years, with consensus‐based diagnosis for 51 HC and 39 MCI. EEG epochs extracted for analysis were two‐second epochs before the motion onset of each stimulus at the beginning, middle, and end of the full task. Functional connectivity between channels was assessed by the phase lag index. Minimum spanning tree (MST) was used to characterize network topology.ResultTime effect was confirmed, as network organization in all participants significantly improved with task progression. On average, brain topology became more integrated with higher leaf fraction and smaller average eccentricity. Moreover, our results show differences between groups in MST parameters over the whole task. Most differences were observed at the earliest timepoint at lower frequency range (theta and lower alpha) where average eccentricity was significantly decreased. Leaf fraction and maximal betweenness centrality were significantly increased in the MCI group as compared to HC.ConclusionThe change in network organization suggests that MCI require greater network integration across brain areas before repeated motion onset presentations. This could reflect compensatory brain mechanisms, especially as both groups did not show significant differences in task performance. These findings enhance our understanding of the functional brain network organization immediately prior to repeated responses in a visual perceptual task in MCI compared to HC. This emphasizes the potential for using graph‐theoretic measures as a valid tool for the early detection of cognitive impairment.

Multimodal Neuromarkers Predict Successful Physical Activity Engagement in Older Adults with Vascular Disease

AbstractBackgroundPhysical inactivity is a significant risk factor for cognitive decline, particularly in vulnerable populations including those with cardiovascular risk‐factors1. To better understand the mechanisms that support positive physical activity engagement, the current study aimed to evaluate whether neuromarkers can predict future change in physical activity among older adults with a newly diagnosed cardiovascular risk‐factor.MethodWe analyzed baseline resting‐state functional and structural magnetic resonance imaging (MRI) data from the UK‐Biobank, a large population longitudinal cohort (n = 365; mean age = 62.10 years ± 6.5; cognitively normal). Brain imaging was obtained at baseline, and physical activity data was obtained at baseline and follow‐up after 5 years. Inclusion criteria were a new diagnosis of a cardiovascular risk factor (hypertension, type‐II diabetes‐mellitus, dyslipidemia, cardiac angina or myocardial infarction) between baseline and follow‐up; and did not meet the World Health Organization recommended 150 minutes/week of moderate or 75 minutes/week of vigorous physical activity at baseline. Demographic variables including age, sex, and education were included as covariates of non‐interest.To assess whether baseline resting‐state brain imaging predicts future change in physical activity behaviour, we performed a kernel‐ridge‐regression model with 5‐fold nested‐cross‐validation. Preprocessed neuroimaging data was used as input for the analysis, and the machine‐learning pipeline included feature reduction using grid‐search, hyperparameter selection, and model‐building: the model predicts whether test subject successfully increased physical activity engagement at follow up (reported above 150 min/week moderate or 75 min/week vigorous physical activity). Permutation‐testing (100 times) was performed before evaluating prediction metrics using accuracy and Receiver Operating Characteristic curves.ResultOur prediction model delivered an accurate performance with average accuracy of 0.861 ± 3.8, and 0.883 ± 4.2 area under the curve (AUC) in predicting future behaviour change from physically inactive at baseline to physically active in follow up.ConclusionThese results show baseline brain imaging can accurately predict physical activity behavior change in older adults with new cardiovascular disease. Leveraging machine‐learning methods to predict future lifestyle engagement will help characterize the neural mechanisms that support successful lifestyle change after a new cardiovascular diagnosis.1. Gallen et al. Trends in Cog Sci. 2019

Effect of 8 weeks badminton session on cardiovascular and neuromuscular functions among older adults in United Arab Emirates: a quasi-experimental study.

Older adults (40-70 years) are the most susceptible age group for developing cardiovascular, and neuromuscular disorders due to a lack of physical activities. The engagement of older adults in physical activities such as badminton can improve their neuromuscular function. Thus, this study aimed to analyze the effects of badminton on cardiovascular & neuromuscular function among older adults with and without non-communicable diseases in the United Arab Emirates. A total of 120 participants were recruited and divided into three groups: Two interventional groups which consisted of participants with non-communicable disease (WCN, N=40), and participants without the non-communicable disease (WICN, n=40), and one non-interventional group (NIC) as healthy control participants. Groups with and without non-communicable diseases engaged in badminton (45-60 minutes per session, thrice a week for two months) as per the specific inclusion and exclusion criteria. The findings of the study indicated that there was a significant improvement in cardiovascular and many neuromuscular variables within and between the groups (p≤0.05) with maximum changes in participants with non-communicable diseases. Engagement in sports like badminton can help to overcome the non-communicable disease burden. The immediate impact can be seen with the introduction of such interventional sports activities on a larger scale. Since the improvement was seen to be much better in the participants with non- communicable diseases, it could help to reduce the burden of non-communicable diseases. REF/2022/02/051455 (08/02/2022).

59 An Examination of the Moderating Effect of Self-Efficacy on the Association Between Health Literacy and Healthy Activity Engagement in Older Adults

Objective:Engagement in activities that promote overall brain health and well-being is often a key step in reducing risks to cognitive health in older adults. Given that higher health literacy has been found to be associated with healthier lifestyles, it is unsurprising that it has been the focus of many studies and programs aimed at improving the health outcomes of older adults. An equally important factor to consider when it comes to such efforts is the role of moderating variables in the relationship between health literacy and engagement in healthy behaviors. The present study examined the moderating effect of self-efficacy, a variable that has been shown to be positively associated with both health literacy and health behaviors. We hypothesized that increased self-efficacy will strengthen the relationship between health literacy and healthy activity engagement in a sample of community-living older adults.Participants and Methods:Forty-nine older adults (age: M = 64.35, SD = 8.00; education: M = 16.39, SD = 2.37; 87.76% female) completed a health literacy measure (Newest Vital Sign; NVS), a self-efficacy questionnaire (General Self-Efficacy Scale; GSE), and a lifestyle behaviors questionnaire (Healthy Aging Activity Engagement Scale; HAAE). The NVS is a performance-based measure in which participants are asked to interpret the verbal and numerical information of a nutrition label to make health-related decisions. The GSE is a self-report measure that evaluates one’s belief in their ability to handle challenges, solve problems, and accomplish goals. The HAAE is a self-report measure that assesses one’s engagement in healthy activities across multiple health domains.Results:To examine whether self-efficacy moderates the relationship between health literacy and healthy activity engagement, a moderation analysis was conducted using Hayes’ PROCESS macro for SPSS with age and education included in the model as covariates. The results revealed no significant interaction between health literacy and self-efficacy, b = 0.23, p = .59, 95% CI [-0.60 to 1.05].Conclusions:Contrary to expectations, in the present sample, the degree of self-efficacy was not a condition under which level of health literacy exerted its influence on healthy activity engagement in older adults. Future studies with larger and more nationally representative samples are needed to explore self-efficacy and other potential moderating factors in order to identify individual characteristics that support older adults’ adoption and engagement in health-promoting behaviors.

Marital Satisfaction, Gender, and Active Social Engagement in Older Adults: Longitudinal Evidence From South Korea.

This study investigated the longitudinal association between marital satisfaction and active social engagement among older adults, while also considering potential gender differences in these associations. Seven waves of data from the Korean Longitudinal Study of Aging from 2006 to 2019 were utilized (N = 2,568, aged 65 or older). Fixed-effects Poisson regression models were employed to account for unobserved individual-level confounders. To capture active social engagement comprehensively, multiple activity types including social interaction, physical activity, travel activity, and volunteer activity were considered. An interaction model was used to examine potential gender differences. The results of this study suggested that an individual's marital satisfaction is associated with an increase in their active social engagement. A one-standard deviation increase in marital satisfaction was associated with a 1.9%, 2.9%, 5.8%, and 18.1% higher incidence rate of engagement in social interaction, physical activity, travel activity, and volunteer activity, respectively, after accounting for individual-specific factors. The associations for social interaction and travel activity were largely driven by older men. In contrast, the associations for physical activity and volunteer activity were similar for older men and older women. Marital satisfaction plays a crucial role in fostering active social engagement among older adults. Interventions designed to address social and financial obstacles within marital relationships among older adults could effectively improve their health and well-being by promoting various types of activities. The impact of these interventions may differ based on gender and the specific types of activities involved.

The Role of Leisure Engagement in Older Adults Adapting to New Residences and Experiencing Other Transitions during a Pandemic

Older adults experience a transition when moving, and moving during a pandemic creates additional challenges. Leisure activities are linked to providing life satisfaction and maintaining identity among older adults experiencing life transitions such as moving to assisted living, widowhood, and caregiving responsibilities. Despite this link, there is a paucity of literature describing leisure’s role in adapting to new homes. A modified ethnographic approach was used to explore leisure’s role in older adults adapting to moving and other transitions during COVID-19. The analysis revealed that participants used leisure activities to maintain identity and to maintain and establish social circles after moving. We suggest that identity is essential to adaptation and should be added to current conceptualizations. This research has implications for practitioners and policy makers working in the community to address issues older adults may be facing by developing policies and programming that support older adults moving to new neighborhoods.

Participatory and Receptive Arts Engagement in Older Adults: Associations with Cognition Over a Seven-Year Period

ABSTRACT There is growing evidence for the impact of arts engagement on later life cognition. However, confounding by socioeconomic factors may have led to an overestimation of this association. We analyzed data from 4,344 older adults in the Wisconsin Longitudinal Study. We measured participatory (e.g. painting, making music, crafts) and receptive (e.g. concert, play, museum) arts engagement separately. Participants completed six neurocognitive tests measuring two distinct domains of cognitive function (episodic/working memory and executive function/language) concurrently and seven years later. We used inverse probability of treatment weighting (IPTW) to remove confounding by a range of demographic and socioeconomic factors. Engaging in participatory or receptive arts for up to one hour per week (but not more frequently) was associated with better subsequent executive function/language. Similarly, engaging in receptive arts activities for up to three hours per week (but not more frequently) was associated with better subsequent episodic/working memory. These effects were of similar sizes to doing vigorous physical activity for up to one hour per week. However, our findings also highlight key methodological issues when exploring the relationship between arts engagement and cognition that should be considered in future studies, including measurement bias, life-course stage, length of follow-up, variation in outcomes, attrition, and missing data.

Determinants of physical activity engagement in older adults.

In order to increase engagement in physical activity, it is important to determine which factors contribute to physical activity engagement in older adults. The current study examined the relative predictive ability of several potential determinants, in terms of both the concurrent level as well as longitudinal trajectories. Clinically normal adults aged 61-92 completed the Physical Activity Scale for the Elderly (n = 189 for cross-sectional models; n = 214 for longitudinal models). Potential determinants included age, gender, education, physical health, sensory health, mood, cardiovascular health, cognitive status, and biomarkers of Alzheimer disease (AD). We observed a novel finding that both concurrent physical health (p < 0.001) and change in physical health (p < 0.001) were significant predictors above and beyond other determinants. Concurrent mood predicted levels of physical activity (p = 0.035), particularly in females. These findings suggest that poor physical health and low mood might be important to consider as potential barriers to physical activity engagement in older adults.

Positive Self-perceptions of Aging Increase Physical Resilience to Facilitate Social Re-engagement of Older Adults Who Fall: Analysis Based on Health and Retirement Study Data

ObjectiveTo determine whether self-perceptions of aging (SPAs) predict physical resilience after a fall and whether SPA and physical resilience affect subsequent social engagement in older adults with a fall. DesignProspective cohort study. SettingGeneral community. ParticipantsOlder adults who reported a fall within 2 years after baseline data collection (N=1707, mean age 72.9 years, 60.9% women). Main Outcome MeasurePhysical resilience indicates the ability to resist or recover from functional decline from a stressor. The change in frailty status from directly after the fall to up to 2 years of follow-up was used to generate 4 physical resilience phenotypes. Social engagement was dichotomized based on the presence at 1 of the 5 social activities at least once a month. The 8-item Attitudes Toward Own Aging Scale was used to assess SPA at baseline. Multinomial logistic regression and nonlinear mediation analysis were used. ResultsPositive prefall SPA predicted more resilient phenotypes after a fall. Both positive SPA and physical resilience affected subsequent social engagement. Physical resilience partially mediated the association between SPA and social re-engagement (mediated percentage of 14.5%, P=.004). This mediation effect was fully driven by those with previous falls. ConclusionPositive SPA promotes physical resilience in older adults with a fall, both of which affect subsequent social engagement. Physical resilience partially mediated the effect of SPA on social engagement but only for previous fallers. Multidimensional recovery incorporating psychological, physiological, and social aspects should be stressed in the rehabilitation of older adults who fall.

Preliminary Data on Barriers to Treatment Engagement in Older Adults with Hoarding Disorder in Rural Mississippi

Preliminary Data on Barriers to Treatment Engagement in Older Adults with Hoarding Disorder in Rural Mississippi

CHARACTERISTICS OF OLDER ADULTS' LEISURE ACTIVITIES: A DAILY DIARY INVESTIGATION

Abstract Leisure activity engagement in older adults’ daily lives is well-documented, however, relatively few studies include participant-reported activities using prospective daily diary methods. The goal of the study was to examine the proportion of three types of reported leisure activities and how physical health moderated such activities. Two weeks of self-reported leisure activities examined among healthy sedentary community-dwelling adults from the Cognitive and Physical Exercise Study (N=33, 65-81 years, 442 unique data points). Each day, participants listed leisure activities performed, estimated time spent on each activity, and labeled the activities as cognitive, physical, and/or social. Physical health was assessed by the SF-12 at baseline. Across 14 days, 25.14% of reported activities were labeled as cognitive activities, 26.61% were labeled as social activities, and 22.97% were labeled as physical activities. Multilevel models indicated participants’ engagement in different domains of activities were not influenced by physical health and did not change over time.

PSYCHOMETRIC EVALUATION OF CARS: A BRIEF SCREENING INSTRUMENT FOR DRIVING SAFETY

Abstract Driving is critical to mobility, autonomy, freedom of choice, and engagement for older adults, but many eventually stop driving. While poor health often eventually leads to driving cessation, some drivers do not realize that their driving is impaired. The 4-item CARS instrument of driving safety has been created to serve as a screening tool by health professionals during assessments and routine appointments (Curl, 2014). To assess the construct validity of CARS, data were collected in 2015-2016 by The Knight Alzheimer’s Disease Research Center from cognitively impaired (N=42) and cognitively healthy participants (N=229), as well as “collateral sources” who answered the CARS items about the respondents’ driving. Vision problems and cognitive impairment, both known predictors for driving problems, were correlated with CARS scores. Results indicate that worse eyesight in the right eye is correlated with higher CARS scores (Spearman rho = -.17, p&amp;lt;.01), but not the left eye. Poor eyesight (i.e., less than 20/40 vision) was correlated with higher CARS scores (Spearman rho = .12, p&amp;lt;.05). However, cognitive impairment (very mild/mild dementia vs. healthy cognitive functioning) was not statistically significant. Total CARS scores were moderately correlated for respondents and their collateral sources, r = .32, p&amp;lt;.01. Results indicate that this instrument may be more useful as a tool for initiating difficult conversations about driving safety than for identifying older adults who are at higher risk for negative driving outcomes. Future research is needed to identify additional/alternative items with greater psychometric support.

Nutritional Status, Dietary Habits, and Physical Activity in Older Adults from Manta, Manabí.

The aim of this study was to evaluate dietary habits, nutritional status, and physical activity engagement in older adults living in the city of Manta, Manabí. An observational, descriptive, and cross-sectional study of 130 older adults was conducted to determine nutritional status via anthropometry, self-reported frequency of the consumption of foodstuffs, calculation of the healthy eating index (IAS), and physical activity patterns. Average age was 71.62 ± 4.34 years, whilst 83.07% of participants were at nutritional risk due to being overweight or obese. Dietary habits in males were characterized by the consumption of three meals a day, as well as greater intake of cereals, roots, tubers, and milk and its derivatives, whilst females consumed more fruits and vegetables. Meat was widely consumed, although females consumed more fish and seafood than males. Eggs were hugely popular foods, in contrast to legumes. Pasta was a dietary staple in females. Visible fats and luncheon meats were consumed little. IAS values reflected the "need to change", whilst physical activity engagement was found to be low. The nutritional status of the present study population was characterized by a tendency toward increasing overweight, particularly amongst females, with the predominance of class 1 obesity, low physical activity, and a healthy eating index requiring change toward more healthy habits.