BACKGROUND AND OBJECTIVES:Loneliness is a serious public health concern among the aging population. Not only is loneliness an unpleasant emotional experience but it is also associated with worse health, well-being, and even mortality. This is a particularly important issue among the population aging with intellectual and developmental disabilities, who are more likely to experience loneliness across the life course, and who-particularly if living in an intermediate care facility (ICF) or nursing facility-may lack social connections. RESEARCH DESIGN AND METHODS:We analyzed data from the 2012-2013 to 2021-2022 waves of the National Core Indicators-Intellectual and Developmental Disabilities In-Person Survey (NCI-IPS; 8 waves total), a national survey of adults with intellectual and developmental disabilities receiving state services (N = 101,374 observations drawn from 49 states). Multilevel logistic regression models examined whether loneliness varied according to living situation. RESULTS:Indicated that (a) adults aging with intellectual and developmental disabilities in ICF and nursing facilities reported significantly greater loneliness than those living in the community, (b) having friends was associated with reduced loneliness overall, yet (c) having friends was associated with reduced loneliness among those living in the community, but not for those living in ICF or nursing facilities. DISCUSSION AND IMPLICATIONS:These results indicate not only that adults with intellectual and developmental disabilities living in institutionalized settings are at higher risk of experiencing loneliness and its detrimental effects but also that specialized interventions are required to meet their unique needs and reduce their loneliness in mid and later life.
Individuals with intellectual and developmental disabilities (IDD) face several barriers to healthcare, making them less likely to receive numerous routine preventive health screenings. Preventive healthcare is a critical aspect to maintaining health and wellness, particularly for people with complex health needs. This study examines individual- and state-level factors associated with mammogram and colonoscopy screenings in mid- and later-life foradults with IDD receiving state services. Multilevel logistic regression models analyzed data from the 2012-2013 and 2018-2019 waves of the National Core Indicators In-Person Survey (NCI-IPS). Results indicated that factors such as age, living situation, transportation access, and community involvement were associated with completion of both preventive screenings. Medicaid expansion was associated with a significantly greater likelihood of completing a colonoscopy screening only among younger persons in the sample (i.e., in their 50s). These findings may have implications for completion of preventive health screenings for adults with IDD.
Abstract Adults with intellectual and developmental disabilities (IDD) are living longer than ever before, a testament to advancements in healthcare. However, adults with IDD face a number of challenges accessing healthcare, and particularly preventative healthcare targeted towards midlife and older adults, which have previously been far less utilized by adults aging with IDD. This study uses longitudinal data from the National Core Indicators In-Person Survey (NCI-IPS) to examine factors associated with adults with IDD’s utilization of two preventative healthcare measures specific to mid- and later life: mammograms and colonoscopies. Both mammogram and colonoscopy utilization exhibited curvilinear age trajectories, with usage increasing through ages 60 and 65 respectively, before decline at older ages. For both mammogram and colonoscopy utilization, living with family was associated with a 50% lower likelihood of utilization, while poor health, access to transportation, and community inclusion were associated with increased usage. For mammograms, participating in a community activity was also associated with increased utilization. Women with IDD were also about 25% less likely to receive a colonoscopy than men. Interestingly, the likelihood of receiving a mammogram dropped significantly in 2018-2019 compared to a decade prior, whereas the likelihood of receiving a colonoscopy increased over time. No racial/ethnic differences were found. Results highlight a number of factors associated with preventative healthcare use among the population of adults aging with IDD. These were similar for mammogram and colonoscopy utilization, and highlight the importance of living situation, transportation, and community engagement for adults with IDD’s access to preventive medicine.
Abstract Adults and older adults with intellectual and developmental disabilities (I/DD) often experience medical complexity, accelerated aging, and shortened life expectancy. This project explores health service utilization (HSU) of adults with I/DD receiving state services in the U.S. over the adult lifespan before and after the implementation of the Affordable Care Act (ACA). Three waves of cross-sectional data (2008–2019) from the National Core Indicators-In Person Survey were analyzed using multilevel mixed effects logistic regression (n=46,284). Older adults with I/DD were more likely to receive a physical exam, flu vaccine, eye exam, hearing test, and a dental exam compared to younger individuals, although these differences were small. Compared to non-Hispanic whites, non-Hispanic blacks were less likely to receive physical exams, flu vaccines, and dental exams; non-Hispanic other were less likely to receive eye exams and dental exams; and Hispanic persons were less likely to receive eye exams, flu vaccines, and dental exams. Individuals with I/DD living in states that expanded Medicaid were at 68% greater odds of receiving a physical exam than those who did not. Our research indicates that overall adults with I/DD are not yet reaching HSU of pre-ACA times, perhaps due to the oversaturation of existing providers. National and state policies, along with individual case management each play a role in ensuring healthy aging of individuals with I/DD. A call to action to better understand and integrate these three entities may help improve the potential for healthy aging of this group.
This study explores factors associated with participation in moderate physical activity and muscle strengthening activity in adults with autism receiving state services (age: 18–78 years). Researchers analyzed the National Core Indicators-In Person Survey (2017–2018) data using multilevel mixed effects logistic regression. Older adults on the autism spectrum engaged in both moderate physical activity and muscle strengthening activity less often than younger adults on the autism spectrum (OR 0.99; p < 0.05; OR 0.98; p < 0.001). Individuals reportedly in fair/poor health had 50
Abstract Are you an ESPO member curious about what the “new normal” means for your future career in the field of aging? Or are you a GSA member interested in hearing from your colleagues about their experiences over the past year? Welcome to the ESPO Presidential Symposium! During this session, speakers will share honest and candid insights about their careers in the field of aging amidst the pandemic, racial discrimination/social unrest, and economic insecurity. Speakers in the ESPO Presidential symposium include: Dr. Thomas K.M Cudjoe, Dr. Candace S. Brown, and Dr. Marnin J. Heisel. Dr. Cudjoe, a physician, will discuss his clinical experience treating older adults with COVID-19, the shift to tele-health, and his research on the impact of social isolation on older adults. Dr. Brown, an academician, will discuss how the new attention to the longstanding issues of social injustice in the U.S. shaped her teaching pedagogy, research, student mentorship, and provide critical context regarding the impact of COVID-19 on Black and Indigenous People of Color (BIPOC) professors. Dr. Heisel, a clinical psychologist, will share how his intervention research on resiliency and well-being in older adulthood shifted amidst the “new normal,” as well as how older adults in his clinical practice encountered and coped with difficulties over this past year. As our society confronts social injustice, tackles health implications of COVID-19, and adjusts to a new way of life, we must consider how these factors, together, inform the interdisciplinary stories of struggle and resilience in the field of aging.
The population aging on the Autism Spectrum (AS) faces disproportionate physical and mental health comorbidities. This research describes self-care practices, including physical activity (PA), nutrition, and spirituality, and the impact of these practices on the health and well-being of older adults on the AS. Researchers conducted semi-structured interviews (N = 30) with older adults (age 50+ years) on the AS on the following topics: health, employment, relationships, and services/supports. Data were analyzed using Dedoose software and a constant comparative method. Participants described self-reported health benefits of their PA. Participants who engaged with organizations reported receiving instrumental support and fulfillment. Several themes emerged regarding socialization and routines in self-care in older adults on the AS, which may inform interventions.
Abstract Adults with Autism Spectrum Disorder (ASD) participate in physical activity (PA) infrequently compared to adults in the general population. This is problematic as individuals with ASD suffer from disproportionate physical and mental health co-morbidities as well as diminished life expectancy, but do not reap the physical and mental health benefits of PA. This study used data from the National Core Indicators-In Person Consumer Survey (n=4,370; age: 18-78) to analyze factors associated with both aerobic PA and muscle strengthening (MS) activity in adults with ASD receiving state Developmental Disability Services. This research used multilevel logistic regression modeling, with mediation and moderation analyses to explore personal and environmental factors associated with PA/MS in this population. Findings indicated the following significant associations between community engagement and PA and MS: community contact (OR=1.17; p<0.001; OR=1.07; p<0.001), community group participation (OR=1.83; p<0.001; OR=1.91; p<0.001), and employment/day program participation (OR=1.32; p<0.05; OR=1.32; p<0.001). Additionally, at older ages, participants were less likely to engage in PA and MS three or more times a week (OR=0.99; p<0.05; OR=0.99; p<0.05). These findings indicate that increasing age is associated with decreased PA and MS activity in this group, while community engagement may facilitate their PA and MS activity. While much remains unknown about the population aging with ASD, it is evident that they suffer from poorer health than the general population and have experienced lifelong difficulties with socialization and communication. Greater access to community engagement opportunities may promote this population’s healthy aging, as well as support their unique social needs.
Abstract The 2020 ESPO Presidential Symposium features interdisciplinary perspectives and recent scientific advances made by early career researchers from each of the GSA scientific sections. They provide examples of how their work is addressing ways age matters. The first paper by Justice (Biological Sciences) will present the latest geroscience research. The second presentation will explore how age influences end-of-life care (Health Sciences, Starr). The third presentation will focus on age as a predictor of kidney function decline (Behavioral and Social Sciences, Surachman). The fourth presentation will explore how age shapes older adults’ resilience (Academy for Gerontology in Higher Education, Bouchard). The fifth presentation will examine opioid use in older adults (Social Research, Policy, and Practice, Jansen). Additionally, early career scholars will share information about their research trajectories and future directions within their disciplines. Given the diverse nature of these presentations, attendees will be exposed to varying strategies, methodologies, and tools that are employed across disciplines. The symposium concludes with a discussion on ways to identify synergies across different fields and promote strategies for successful cross-disciplinary collaboration.
Abstract Social isolation is associated with poor health and well-being in older adults. Little is known about isolation in persons aging on the Autism Spectrum (AS), a group with varied physical and mental health comorbidities. The purpose of this study was to explore social networks of adults aging on the AS. We conducted in-depth interviews (N=30) with adults on the AS (age 50+) and analyzed findings using a constant comparative method. Findings suggest that older adults on the AS struggle to build and maintain social networks over the life course, in large part, because of challenges with communication and trust. Implications of isolation include challenges with community supports and employment. We propose several social convoy models and intervention mechanisms to support this population--as their social networks narrow over time, and they face aging-related challenges without the buffer of strong social relations.
Abstract This proposed symposium will bring together a diverse panel of emerging and established academics, as well as, industry leaders to speak about the power of collaboration. As the delivery of health care in the field of gerontology becomes increasingly complex – researchers and practitioners will have to find new ways to address these challenges. One potential solution is to become more interdisciplinary and collaborative in our approach. This symposium will bring together academic and industry leaders from the National Science Foundation’s Centers for Health Organization Transformation (CHOT) to share with our membership an industry-academic partnership model that has benefited industry-focused research across more than 50 disciplines. As the ESPO representatives for the SRPP division, we believe that our membership would benefit from a symposium of this nature. This symposium would also reflect this year’s conference is “Harnessing the Power of Networks.” The SRPP section has the strongest commitment to practice and research on practice such as ways to improve the delivery of services to an increasingly diverse older population. A model of industry partnership holds tremendous value for all those involved; however, it is incredibly valuable for junior researchers who are just beginning their careers. The CHOT model provides opportunities and funding for researchers to develop collaborative relationships; engage in research; access new sources of data; disseminate findings directly to a broader audience, and have the ability to address some of health care’s wicked problems.