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Prevention, with widespread lifestyle risk reduction at the community-level, is currently considered an effective method to decrease Alzheimer’s disease (AD). As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Core, diverse older adults (60+) living in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, motivations, self-efficacy, and referral services for AD lifestyle risk. The study sample (n=40, mean age 68 years (range: 60-77 years) was 88% African American/Black (n=35), 100% Non-Hispanic, and 45% males (n=18)). Thirty-nine (95%) of subjects successfully participated in coaching sessions; on average 91.9% (11) sessions/subject were completed. Participants provided positive anecdotal feedback and the need for continued health coaching during COVID. N=30 (75%) of the original sample consented for continued health coaching during the Covid pandemic, 63% female, 88% African American/Black, 60-77 age range (mean age 69 years), and 47% reporting memory problems. Baseline Covid interviews indicated poorer health status associated with reporting memory problems for poor physical health days (F=7.03;p=.01); poor mental health days (F=6.88;p=.01); total mental/physical health poor days (F=2.76;p=.11); sad days (F=15.52;p=.001); worried days (F=6.27;p=.02); tired days (F=9.77;p=.004); feelings of emptiness (F=10.09;p=.004); feelings of rejection (F=3.382;p=.08); feelings of failure (F=7.58;p=.01); little interest/pleasure (F=7.84;p=.009); and feeling down (F=6.75;p=.02). In conclusion, this preliminary work creates the impetus for future large-scale AD prevention investigations to improve the lives of AD-risk, low-income, diverse older adults reporting memory problems. This research indicates the subjective reporting of memory problems requires health intervention.

The COVID-19 pandemic is a public health crisis the world has not seen in a century, with older adults faced with unique impacts due to their increased vulnerability and need to social distance. This research examines changes in physical and mental health and quality of life among older adults in the upper Midwest during the COVID-19 pandemic. Seventy older adults aged 70-97 participated in three phone interviews (April [Time 1], June [Time 2], and October [Time 3] 2020) focusing on experiences coping with the pandemic and understanding overall changes in well-being. Participants rated their quality of life, physical health, and mental health on a scale from 1 to 5 with 1 being “Poor” and 5 being “Excellent.” Self-reported quality of life, mental health, and physical health initially declined between retrospective pre-COVID and Time 1 scores, with gradual increases seen across all three variables for Time 2 and Time 3 scores. Thematic analysis of qualitative responses for each interview wave identified salient themes of: 1) reduced quality of life, 2) distraction and routine, 3) loss and uncertainty, and 4) resilience and adaptation. The significance and meaning of these themes shifted across each time point. For example, the reduced quality of life theme initially encompassed loss of activities, later shifted to concerns about struggles to maintain relationships, and finally focused on hope for the future. Findings will be discussed in light of the significance of change over time as well as policy and practice implications for older adults.

Background: The onset of the COVID-19 pandemic has dramatically influenced the health and well-being of older adults. Changes in lifestyle patterns has required reframing communication habits and learning new skills to maintain social connections and access healthcare. Objectives: To assess 1) well-being measured prior to and during the COVID-19 era; and 2) use and comfort level of technology for social interactions and telehealth visits during this time. Methods: A mailed survey to a randomly selected national sample (>65) during the summers of 2018, 2019, and 2020. Measures included mental and physical well-being and various psychosocial measures. For 2020, questions related to COVID-19 and the use of technology were included. Results: A total of 4,696 (2018), 3,976 (2019) and 2,726 (2020) responded to these surveys (response rate ~27%). Overall, most constructs remained stable despite the ongoing pandemic. Most respondents reported average or high resilience (90%), high purpose (48%), stable social networks (76%), and low stress (55%). However, loneliness increased during 2020 (57%). Respondents who used technology were more likely to connect with family and friends. Only 43% reported high comfort with using technology, with older age (>75) less comfortable. At the time of the survey 37% had not seen a healthcare provider through telehealth services, and 15% felt their healthcare needs were not met by a telehealth experience. Conclusion: Results demonstrate that respondents were doing well during COVID-19. Yet increases in loneliness and greater technology needs to stay socially connected and to access healthcare may result in negative long-term health outcomes.

The COVID-19 pandemic may have adverse health implications, particularly among older adults with chronic conditions who are at increased risk of severe illness. This cross-sectional study examined the early health impacts of the pandemic among adults aged 50 and older with chronic conditions. Participants included 700 adults (M = 64.60 years, SD = 8.85, range = 50 – 94) from Michigan (82.4%) and 33 other U.S. states who reported at least one chronic condition and completed an anonymous online survey between May 14 and July 9, 2020. Of these, 488 also provided open-ended responses. Individuals reported lower illness self-efficacy, less consumption of fruits, vegetables, and fried foods, and lower physical activity, along with greater alcohol use since the pandemic. About half (42.7%) reported worsened sleep. One in five (20.1%) reported at least some difficulty obtaining medications and over half (60.4%) reported at least some difficulty receiving routine care. Almost two-thirds (63.9%) had delayed preventative care and one in five (19.3%) had delayed essential medical treatment. Nearly half (42.6%) avoided contacting care providers about a physical health concern and one in eight (12.9%) avoided reporting mental health concerns. Qualitative data revealed that the pandemic has influenced how participants cared for their physical health through following guidelines related to COVID-19; coping with daily routine changes; greater awareness of self-care; mental health impacts; and health care disruptions. Older adults with chronic conditions report distinct pandemic-related challenges for self-care and health care that should be addressed in interventions to maintain their health and functioning.

Risk of severe COVID-19 illness increases with age, and older adults are more likely to be hospitalized and die from COVID-19 and related complications as compared to their younger counterparts. This reality, combined with pandemic-related lockdown and social distancing policies, has increased in-home isolation for older adults. This includes cancelling in-person healthcare appointments and conducting many appointments via tele-health. As older adults have had to quickly pivot to learning new technologies, little is known about their experiences with navigating virtual healthcare during the pandemic. Therefore, this qualitative study aims to address that gap. One-on-one interviews (N=29) were conducted with older adults (Mean age=71.5; 86% female) via phone/Zoom. Participants were asked about their healthcare experiences during the pandemic and the role technology played. Interviews were transcribed and thematically analyzed using Nvivo12 software. Findings demonstrate that participants used technology to schedule medical appointments, engage in virtual visits with their providers, set reminders to take medications, and undertake their daily exercise routine. Post-lockdown, some participants preferred in-person visits due to the nature of their diagnosis, personal preference, or unfamiliarity with the needed technology. Older adults encountered challenges including cancelled appointments, miscommunication with providers, and lack of skill to use technologies. Cancellation of appointments and postponement of treatments affected the health of some of the participants. Implications of this research can inform tele-health approaches with older patients, as well as provider communication and coordination of care. Leveraging technology for preventative health approaches can also assist older adults in ongoing health maintenance and promote well-being.