"I'm Part of Something That Matters": Exploring What Older Adults Value Through Their Engagement in Age-Friendly Community Initiatives.

Older adults' engagement in age-friendly community (AFC) initiatives is considered an essential element of community transformation. However, research on older adults' experiences of engaging in AFC initiatives remains nascent. Based on qualitative interviews with 23 older adult participants from 15 AFC initiatives across four states in the United States (U.S.), our reflexive thematic analysisidentified three themes regarding what participants value from their engagement: (a) social contribution; (b) social connectedness and integration; and (c) staying active and personal growth. Exploring older adults' interest in contributing to, connecting with, and growing in their community can inform recruitment and retention in AFC initiatives.

Disparate benefits of higher childhood socioeconomic status on cognition in young adulthood by intersectional social positions.

OBJECTIVES: Emerging evidence supports the protective effects of higher childhood socioeconomic status (cSES) on cognition over the life course. However, less understood is if higher cSES confers benefits equally across intersecting social positions. Guided by a situational intersectionality perspective and the theory of Minority Diminished Returns (MDR), this study examined the extent to which associations between cSES and cognition in young adulthood are jointly moderated by racialized identity and region of childhood residence. METHODS: Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we used multilevel modeling to test associations between cSES and delayed recall and working memory 14 years later when participants were ages 25-34. Further, we examined the influence of racialized identity and region of childhood residence on these associations. RESULTS: Higher cSES was associated with higher delayed recall and working memory scores across social positions. However, the strength of the association between higher cSES and working memory differed across racialized subgroups and region of childhood residence. We found a statistically significant three-way interaction between cSES, race and region of childhood residence. Of particular important, a small yet statistically robust association was found in all groups, but was especially strong among White Southerners and especially weak among Black participants from the South. CONCLUSIONS: This study contributes to a growing body of research indicating that the protective effects of higher cSES on cognition are not universal across subgroups of intersecting social positions, consistent with the theory of MDR. These findings provide evidence for the importance of considering the role of systemic racism across geographic contexts as part of initiatives to promote equity in life course cognitive aging and brain health.

Statewide Age-Friendly Virtual Fair as a Tactic for Social Change Across the Aging Ecosystem.

Prior research has demonstrated ways in which community events help to establish age-friendly community initiatives and strengthen their impact. We extend these insights by discussing how the design and implementation of a statewide event - the New Jersey Age-Friendly Virtual Fair - exemplifies this practice theory and extends its applicability beyond local community development toward broader state-level age-friendly ecosystems. We describe how events that are deliberately multi-organizational, multi-sectoral, and multi-level can help to further propel the Age-Friendly Movement toward systems change for aging in community.

Early life adversity, race, and childhood socioeconomic status: intersecting drivers of later life cognition.

OBJECTIVES: Research on associations between early life adversity (ELA) and later life cognition has yielded mixed results and generally have not considered how broader societal systems of stratification potentially influence associations. The current study addresses this gap by exploring if racialized identity and childhood socioeconomic status (cSES) moderate associations between ELA exposure and later life cognition. METHODS: Using data from the Health and Retirement Study (Waves 2010-2018), we used growth curve modeling to examine if the confluence of ELA, cSES, and racialized identity is associated with cognition. RESULTS: Among White participants, greater exposure to ELA was associated with poorer baseline cognitive functioning, and higher cSES buffered against this association. Among Black participants, exposure to ELA was not associated with baseline cognitive functioning, regardless of cSES. We did not find evidence of any associations between main predictors nor their interactions with change in cognition over time. CONCLUSIONS: This study provides evidence that associations between ELA and later life cognition is contingent upon multiple social positions in the United States. These findings support the importance of integrating insights on intersecting social positions within life-course-oriented efforts to reduce racialized cognitive disparities.

Diminished Returns of Higher Parental Education on Cognition for Black Adults in Middle and Later Life.

OBJECTIVES: Mounting evidence suggests that the protective effects of one's own higher socioeconomic status (SES) on health are diminished among minoritized racial/ethnic groups in the United States. This study extends this area of research to childhood SES and cognition in middle and later life, focusing on the protective effects of higher parental education among non-Hispanic Black and White adults. METHODS: Harmonizing data from individuals ages 50 and older across the Health and Retirement Study, the Study of Midlife in the United States, and the National Social Life, Health, and Aging Project, we examine whether associations between parental education and two measures of cognition (episodic memory and global cognition) are moderated by racialized identity (non-Hispanic White or Black) using a random-effects individual participant data meta-analysis approach. RESULTS: Findings indicated a small, but robust, protective effect of higher parental education on both episodic memory and global cognition among adults identified as White. Among adults identified as Black, there was no association between parental education and either cognitive outcome. DISCUSSION: This study provides evidence that the protective effect of higher parental education on cognition is not the same across racialized populations, consistent with the theory of Minority Diminished Returns. As scholars continue calls for life-course-oriented efforts to reduce racialized cognitive disparities, it is important to consider early-life risk and protective factors in the context of racism.

Participatory Research Approaches in Alzheimer's Disease and Related Dementias Literature: A Scoping Review.

Background and Objectives: Given the increase in methodological pluralism in research on brain health, cognitive aging, and neurodegenerative diseases, this scoping review aims to provide a descriptive overview and qualitative content analysis of studies stating the use of participatory research approaches within Alzheimer's disease and related dementias (ADRD) literature globally. Research Design and Methods: We conducted a systematic search across four multidisciplinary databases (CINAHL, SCOPUS, PsycInfo, PubMed) for peer-reviewed, English-language studies addressing ADRD that explicitly described their use of a participatory research approach. We employed a systematic process for selecting articles that yielded a final sample of 163 studies. Data from articles were analyzed to chart trends from 1990 to 2022 in terminology, descriptions, application of participatory approaches, and the extent and nature of partnerships with nonacademics. Results: Results demonstrated geographic differences in the use of stated approaches between North America-where community-based participatory research predominates-and Europe, where Action Research is most common. We further found that only 73% of papers in this systematic review had identifiable definitions or descriptions of the participatory approach used. Findings also showed that 14% of articles demonstrated no evidence of engaged partnership beyond activities typical of research participants, while 23% of articles identified partnering with people with dementia, and an additional 16% reported partnerships with members from Indigenous, Black, Asian, or Latinx communities. Discussion and Implications: This scoping review identifies three areas in need of greater attention in ADRD literature using participatory research approaches. First, findings indicate the importance of strengthening the use, transparency, and rigor of participatory methods. Second, results suggest the need for greater inclusion of historically marginalized groups who are most affected by ADRD as research partners. Finally, the findings highlight the need for integrating social justice values of participatory approaches into research project designs.

Organizational Characteristics of Senior Centers and Engagement in Dementia-Friendly Communities.

Background and Objectives: Dementia-friendly communities (DFCs) are systematic and collaborative efforts to make local communities more supportive and inclusive of persons living with dementia and their care partners. This study explores how the organizational characteristics of senior centers influence their engagement in DFCs. Research Design and Methods: We used a partially mixed, concurrent, equal status design, drawing on qualitative interviews with staff from 13 senior centers leading DFC initiatives as part of a statewide dementia-friendly network in Massachusetts, as well as quantitative data from 342 senior centers collected as part of a statewide survey. Results: The qualitative results demonstrated ways in which human, social, tangible, and programmatic capital facilitate senior centers' DFC engagement. In particular, the results illuminated the importance of social capital with organizations and groups outside of the senior center, spanning the municipal, regional, and state levels. Findings from multivariate analyses further indicated robust and strong associations between higher levels of social capital, as well as more dementia-focused programming and greater variety of funding sources, with greater likelihood of engagement in DFC work. Discussion and Implications: Results indicate the importance of policy and practice to foster both organizational capacity and multilevel systems conditions to enable and motivate senior centers' involvement in DFC initiatives.

Variation in Implementing Dementia-Friendly Community Initiatives: Advancing Theory for Social Change.

Dementia-friendly communities (DFC) have emerged as a global movement to make communities more supportive and inclusive of people living with dementia (PLWD) and their care partners. This study contributes to a nascent body of research on DFC initiatives by building theory on their local implementation. Based on an analysis of data from semi-structured interviews with 23 leaders of initiatives in Massachusetts (United States), we aimed to identify key dimensions of variation in the implementation of DFC initiatives. We found that all initiatives engaged in a common set of activities, such as the facilitation of training about dementia and improving services for PLWD. Although initiatives mostly engaged in these activities in ways that targeted the community at large, in some instances, they concentrated their efforts on enhancing the dementia-friendliness of their own organizations. We describe ways in which financial, social, and human capital operate as key factors that influence the initiatives' primary focus (i.e., the community at large or their own organization). Our findings suggest the importance of helping DFC initiative leaders more explicitly specify the focal ecological level of their efforts throughout the trajectory of their work, especially in the context of resource considerations. Results also indicate ways in which DFC initiative efforts at one systems level can support those at other levels over time.

Municipal Ethnic Composition and Disparities in COVID-19 Infections in New Jersey: A Blinder-Oaxaca Decomposition Analysis.

COVID-19 has disproportionally impacted Latinx and Black communities in the US. Our study aimed to extend the understanding of ethnic disparities in COVID-19 case rates by using a unique dataset of municipal case rates across New Jersey (NJ) during the first 17 months of the pandemic. We examined the extent to which there were municipal-level ethnic disparities in COVID-19 infection rates during three distinct spikes in case rates over this period. Furthermore, we used the Blinder-Oaxaca decomposition analysis to identify municipal-level exposure and vulnerability factors that contributed to ethnic disparities and how the contributions of these factors changed across the three initial waves of infection. Two clear results emerged. First, in NJ, the COVID-19 infection risk disproportionally affected Latinx communities across all three waves during the first 17 months of the pandemic. Second, the exposure and vulnerability factors that most strongly contributed to higher rates of infection in Latinx and Black communities changed over time as the virus, alongside medical and societal responses to it, also changed. These findings suggest that understanding and addressing ethnicity-based COVID-19 disparities will require sustained attention to the systemic and structural factors that disproportionately place historically marginalized ethnic communities at greater risk of contracting COVID-19.

Race, Childhood Socioeconomic Status, and Region of Childhood Residence as Intersectional Life-Course Predictors of Cognitive Aging in the United States.

Background and Objectives: Race, childhood socioeconomic status (cSES), and region of childhood residence are each associated with later-life cognition, but no studies have examined how the confluence of these factors influences later-life cognitive performance. Guided by intersectionality theory, we examined individuals' social positionality across these dimensions as a predictor of cognitive performance in later life among non-Hispanic White (NHW) and non-Hispanic Black (NHB) older adults. Research Design and Methods: We used data from the 2010-2016 waves of the Health and Retirement Study with participants aged 65 and older in 2010. We employed growth curve modeling to estimate associations among race, cSES, and region of childhood residence, as well as their interactions, and cognitive performance at baseline and over time. Results: Identifying as NHB, residing in the South, and having lower cSES each were associated with poorer later-life cognition at baseline. Childhood residence in the South was an especially strong risk factor for poorer cognition among NHBs. Among NHWs, higher cSES was associated with better baseline cognitive performance, especially among those from the South. NHBs from the South demonstrated a small advantage of higher cSES, but regardless of cSES, NHBs from the South had lower levels of baseline cognitive scores compared to all other subgroups. We observed steeper declines in cognitive performance over the 6-year study period among participants who lived in the South as children. Discussion and Implications: Our findings suggest that intersectional social positions across race, cSES, and region of childhood residence primarily influence baseline cognition in later life. Results implicate the importance of attention to multiple life-course social positions in the context of racism within social policies and other initiatives to promote equity in later-life brain health.

Responding to Local Needs by Mobilizing Community Assets: Age-Friendly Community Initiatives During the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVES: Age-friendly community initiatives (AFCIs) strive to make localities better for long and healthy lives by fostering improvements across social, physical, and service environments. Despite the heightened need for community supports during the coronavirus disease 2019 pandemic, very little research has addressed the work of AFCIs in the context of this crisis. We aimed to develop theory on how AFCI core teams have contributed to community responses during the pandemic, as well as what contexts have influenced the initiatives' ability to contribute. RESEARCH DESIGN AND METHODS: As part of a multiyear, community-partnered study on the development of philanthropically supported initiatives in northern New Jersey, we conducted qualitative interviews with 8 AFCI core teams during the winter of 2020-2021. The interviews focused on the leaders' efforts at that time, with probing questions concerning enabling factors for their community responses. We analyzed the data using an inductive coding process encompassing open, axial, and subcoding. RESULTS: The analysis indicated four distinct roles of AFC core groups: good community partner, creator, advocate, and communications broker. We further found that AFC leaders primarily drew on three types of capital-human, social, and tangible-to enact these roles, oftentimes in cumulative ways. DISCUSSION AND IMPLICATIONS: We interpret our study's findings and their implications by integrating insights from theories of social impact. We further highlight the importance of continued research on community-centered approaches to promote aging in community during times of societal crisis, and otherwise.

Age-Friendly Cities and Communities: Research to Strengthen Policy and Practice.

Since the early 2000s, a global age-friendly movement has emerged with aspirations to make environments and systems within localities more supportive of long and healthy lives. Despite growth in the social movement over the past decade, research on how to work toward community change, especially in systematic and comprehensive ways across diverse geo-political and sociocultural contexts, has been relatively slower to develop. This special issue of the Journal of Aging & Social Policy aims to accelerate this area. It features articles that advance knowledge on processes and contexts toward enhancing the age-friendliness of cities and communities. In this introductory essay, we provide background on the age-friendly cities and communities movement - including its accomplishments alongside key challenges. We then discuss the importance of research at the intersection of policy and practice to strengthen the movement into the 21st century. Next, we introduce the articles in this special issue, organized under four themes: implementation and sustainability processes; partnerships and multisectoral collaboration; theory-based program design; and policy and practice diffusion. A final article provides an overview of the career contributions of Dr. Frank Caro, an age-friendly champion and gerontologist to whom this special issue is dedicated.

Life course linkages between enriching early-life activities and later life cognition: Evidence from the Wisconsin Longitudinal Study.

Prior research suggests that participation in enriching early-life activities (EELAs) has long-term benefits for cognitive health and aging. This study aims to examine the life course processes underlying these associations by drawing on theoretical models from life course epidemiology. Specifically, we tested sensitive-period effects, social pathways, and selection effects as potential explanations for linkages between greater participation in EELAs and better later life cognition. We drew on data from the Wisconsin Longitudinal Study (WLS), which is among the longest-running cohort studies in the U.S. that has followed graduates (all identified as non-Hispanic White) from Wisconsin high schools since 1957. We used prospective measures of key variables, including information from high school yearbooks, with assessments of cognitive performance at ages 65 and 72. Results from multilevel modeling indicated that greater participation in cognitively oriented extracurricular activities (but not physically nor socially oriented activities) was associated with both better language/executive functioning and memory at age 65. Although the size of these associations was reduced when accounting for other cognitive resources in adolescence (childhood socioeconomic status and adolescent cognitive ability) and in midlife (adult socioeconomic status and formal group participation), there remained small, yet statistically robust, associations. We did not find robust associations between greater EELA engagement and slower rates of decline in cognition between ages 65 and 72, nor did we find evidence of gender differences. Results suggest that for this cohort of older adults, EELA participation is part of life course "protective chains," whereby exposures to assets at one point in the life course increase the likelihood of subsequent exposures, each sequentially and in their own right, toward better later life cognition. We discuss how results support the importance of policies and practices to promote healthy cognitive development among youth for the long-term cognitive health of a rapidly aging U.S. population.

Giving, Receiving, and Doing Together: Interorganizational Interactions in Age-Friendly Community Initiatives.

Multi-sectoral collaboration is widely considered essential for age-friendly community change; however, there has been little empirical research to describe the ways in which organizations interact as part of age-friendly community initiatives (AFCIs). We conducted a qualitative descriptive study using data from multiple waves of semi-structured interviews with core teams of eight grant-funded AFCIs in the north-eastern U.S. We employed iterative, inductive coding to systematically describe ways in which AFCI core teams described working with other organizational entities. Findings indicated two overarching themes: (a) helping each other (giving and receiving linking, informational, and instrumental assistance), and (b) doing something together (organizing community events, planning collaborative projects, participating in meetings). We discuss the implications of this characterization for guiding research, evaluation, and policy to optimize AFCI implementation and impact across diverse settings.

Theories of Community Collaboration to Advance Age-Friendly Community Change.

The age-friendly communities movement has grown rapidly in global prominence over the past 2 decades. However, theories to guide multisectoral action toward age-friendly community change have been slower to develop. We demonstrate the value of drawing on theories of community collaboration to inform age-friendly community efforts across engagement, planning, implementation, and measurement. We introduce 3 theories-Asset-Based Community Development, Strategic Doing, and Collective Impact-each with principles and strategies for guiding multisectoral group processes toward long-term and systematic community change. While distinct from each other, these theories collectively suggest the importance of incorporating a more explicit community-building approach within the age-friendly communities movement. We describe the implications of this integrative theory development for bolstering sustainable and comprehensive practices and policies to improve environments for aging across diverse communities.

New Jersey COVID-19 municipal dataset.

Although data about COVID-19 cases and deaths in the United States are readily available at the county-level, datasets on smaller geographic areas are limited. County-level data have been used to identify geospatial patterns of COVID-19 spread and, in conjunction with sociodemographic variables, have helped identify population health disparities concerning COVID-19 in the US. Municipality-level data are essential for advancing more targeted and nuanced understanding of geographic-based risk and resilience associated with COVID-19. We created a dataset that tracks COVID-19 cases and deaths by municipalities in the state of New Jersey (NJ), US, from April 22, 2020 to December 31, 2020. Data were drawn primarily from official county and municipality websites. The dataset is a spreadsheet containing cumulative case counts and case rates in each municipaly on three target dates, representing the peak of the first wave, the summer trough after the first wave, and the outbreak of the second wave in NJ. This dataset is valuable for four main reasons. First, the dataset is unique, because New Jersey's Health Department does not release COVID-19 data for the 77% (433/565) of municipalities with populations smaller than 20,000 individuals. Second, especially when combined with other data sources, such as publicly available sociodemographic data, this dataset can be used to advance epidemiological research on geographic differences in COVID-19, as well as to inform decision-making concerning the allocation of resources in response to the pandemic (e.g., strategies for targeted vaccine outreach campaigns). Third, county-level data mask important variations across municipalities, so municipality-level data permit a more nuanced exploration of health disparities related to local demographics, socioeconomic conditions, and access to resources and services. New Jersey is a good state to explore these patterns, because it is the most densely-populated and racially/ethnically diverse state in the US. Fourth, New Jersey was one of the few locations in the US with a high prevalence of COVID-19 during the first wave of the pandemic in the US. Thus, this dataset permits exploration of whether sociodemographic variables predicted COVID-19 differently as time progressed. To summarize, this unique municipality-level dataset in a diverse state with high COVID-19 cases is valuable for scholars and policy analysts to explore social and environmental factors related to the prevalence and transmission of COVID-19 in the US.

Using Mixture Modeling to Construct Subgroups of Cognitive Aging in the Wisconsin Longitudinal Study.

OBJECTIVES: Longitudinal surveys of older adults increasingly incorporate assessments of cognitive performance. However, very few studies have used mixture modeling techniques to describe cognitive aging, identifying subgroups of people who display similar patterns of performance across discrete cognitive functions. We employ this approach to advance empirical evidence concerning interindividual variability and intraindividual change in patterns of cognitive aging. METHOD: We drew upon data from 3,713 participants in the Wisconsin Longitudinal Study (WLS). We used latent class analysis to generate subgroups of cognitive aging based on assessments of verbal fluency and episodic memory at ages 65 and 72. We also employed latent transition analysis to identify how individual participants moved between subgroups over the 7-year period. RESULTS: There were 4 subgroups at each point in time. Approximately 3 quarters of the sample demonstrated continuity in the qualitative type of profile between ages 65 and 72, with 17.9% of the sample in a profile with sustained overall low performance at both ages 65 and 72. An additional 18.7% of participants made subgroup transitions indicating marked decline in episodic memory. DISCUSSION: Results demonstrate the utility of using mixture modeling to identify qualitatively and quantitatively distinct subgroups of cognitive aging among older adults. We discuss the implications of these results for the continued use of population health data to advance research on cognitive aging.

Life Course Pathways From Childhood Socioeconomic Status to Later-Life Cognition: Evidence From the Wisconsin Longitudinal Study.

OBJECTIVES: A growing body of research indicates that older adults are at greater risk for poorer cognition if they experienced low socioeconomic status (SES) as children. Guided by life course epidemiology, this study aimed to advance understanding of processes through which childhood SES influences cognition decades later, with attention to the role of scholastic performance in adolescence and SES in midlife. METHOD: We used data from the Wisconsin Longitudinal Study (WLS), which has followed a cohort of high school graduates since they were 18 years old in 1957. Childhood SES was measured prospectively in adolescence, and measures of memory and language/executive functioning were based on neurocognitive assessments at age 72. We used participants' scores on a statewide standardized test in high school as an indicator of scholastic performance in adolescence. The measure of SES in midlife included years of postsecondary education, income, and occupation status at age 53. RESULTS: Findings from structural equation models indicated that scholastic performance in adolescence and midlife status attainment together fully mediated associations between childhood SES and both memory and language/executive functioning at age 72. Adolescent scholastic performance was directly associated with later-life cognition, as well as indirectly through midlife status attainment. DISCUSSION: Findings provide support for both latency and social pathway processes when considering how SES in childhood influences later-life cognition. Results contribute to growing calls for social policies and programs to support optimal brain health at multiple phases throughout the life course, especially among individuals with lower SES as children.

Designing Retrospective Measures on Childhood for Older African American Adults.

A growing body of research addresses the long-term implications of early-life circumstances for adult health and aging by drawing on retrospective reports on childhood. There has been little scholarly discourse on considerations for the design of such questions for members of racial/ethnic minority groups specifically. This article aims to encourage greater attention to this area by presenting insights from the process of designing a childhood history questionnaire within an ongoing study of cognition, health, and aging among older African American adults in greater Newark, New Jersey. The article presents on three overarching themes, including the importance of (a) adopting a resilience orientation with attention to protective factors, (b) being sensitive to concerns about questions on adverse childhood experiences, and (c) orienting to ethnoracially embedded cohort influences. The article concludes by describing the particular importance of cultural humility-with attention to intersectional social positions-among researchers who are engaged in studies on childhood with older adults from underrepresented racial/ethnic groups.

Perceived Hearing Loss, Social Disengagement, and Declines in Memory.

A growing body of evidence suggests that age-related hearing loss is related to changes in older adults' memory. We test the hypothesis that the association is due to social disengagement following the onset of perceived hearing loss. At ages 65 (2004) and 72 years (2011), 3,986 participants from the Wisconsin Longitudinal Study (WLS) self-reported on hearing problems and several types of social engagement and completed three tests of memory. We estimated fixed effects regression models. Perceived hearing loss was related to significant decline in memory. Declines in frequency of in-person social contact were also associated with declining memory, but there was no evidence of a mechanism wherein reductions in social engagement explained the association between perceived hearing loss and memory decline. We conclude that self-reported hearing loss and social disengagement are likely independent risk factors for memory loss among older adults.