Lessons Learned in the Delivery of Live Remote Group Weight Loss and Physical Activity Interventions for Older Adults

Abstract Social connection lies at the root of lasting health behavior change, and as such most effective interventions are built around social tools. Group leaders and peers provide education, and act as models of successful change and collaborators in addressing common barriers to behavioral adoption and maintenance. Unfortunately, many older adults do not have access to high quality group programs due to factors such as limited transport options, lack of local availability, or worries over personal safety. Importantly, developing effective, synchronous remote group programming is not as simple as delivering an in-person session via teleconference software. Instead, careful consideration must be paid to technology selection, fostering effective group communication, and developing confidence for use of remote intervention tools. This symposium provides key lessons learned from three group-based activity and weight loss interventions for older adults that focused on live, remote interaction. Jason Fanning will share lessons from the MORPH study, which paired remote group-mediated behavioral counseling with dietary weight loss and the accumulation of aerobic activity across the day. Christina Hugenschmidt will share her experiences adapting a group program involving improvisational dance or social gaming for remote delivery. Kushang Patel will present results from a mixed-methods study on the feasibility and acceptability of a remotely-delivered exercise program for older adults with knee osteoarthritis. Finally, Barbara Nicklas will place these experiences in the context of the development of exercise interventions for older adults over time, and highlighting vital next steps for ensuring more older adults have access to this important behavioral medicine.

group meetings generally in home via WebEx and used an mHealth self-monitoring app as they attempted to move more often and reduce caloric intake.Relative to a control condition, the program produced improvements in physical function (η^2=.08),pain intensity (η^2=.12),sedentary time (η^2=.07),and weight loss (η^2=.21).Key findings related to effective remote group intervention delivery included: (1) the importance of a self-efficacy-enhancing technology orientation; (2) the value of small group bonding activities to seed communication; and (3) the impact of software choice on interpersonal communication.We will discuss the value of these findings for future remote intervention design.

THE VIRTUALIZATION OF A MOVEMENT AND SOCIAL GROUP-ACTIVITY INTERVENTION FOR OLDER ADULTS AND THEIR CAREGIVERS
Christina Hugenschmidt, 1 Deepthi Thumuluri, 2 Christina Soriano, 3 Rebecca Barnstaple, 4 Jason Fanning, 5 Jessie Laurita-Spanglet, 6 and Edward Ip, 1 1.Wake Forest School of Medicine, North Carolina,United States,2. Wake Forest School of Medicine,North Carolina,United States,3. Wake Forest University,North Carolina,United States,4. York University,Toronto,Ontario,Canada,5. Wake Forest University,Winston Salem,North Carolina,United States,6.University of Southern Maine, Portland, Maine, United States COVID-related safety concerns mandated suspension of our ongoing trial testing the effects of movement and social engagement in older adults with early-stage dementia and their caregivers (dyads).Participant vulnerability and the requirement for group social interaction complicated intervention resumption.We present results from a successful pilot to rapidly and iteratively optimize study interventions for remote delivery targeting intervention mediators (social connection, movement) based on participant feedback.Three-dyad groups (n=6 individuals) completed cycles of intervention via Zoom immediately followed by an interview with openended and quantitative feedback.Cycles were repeated until no new information was solicited, then repeated with new participants.Optimization revealed needs for technological support, more intensive movement, and social connection.Specifically, the inability to make eye contact, see others' full body, and technology-associated timing asynchronies impeded social connection in the movement group.We will present practical tips for crafting remote group interventions for caregiver/person living with dementia dyads.

FEASIBILITY AND ACCEPTABILITY OF TELE-ENHANCE FITNESS IN OLDER ADULTS WITH KNEE OSTEOARTHRITIS
Kushang Patel, 1 Elise Hoffman, 1 Neta Simon, 1 and Nancy Gell, 2 1.University of Washington, Seattle, Washington, United States, 2. University of Vermont, Burlington, Vermont, United States Enhance Fitness (EF) is an evidence-based, group exercise program for older adults.When COVID-19 halted in-person EF classes nationally, we adapted EF for remote delivery (tele-EF) by engaging key stakeholders.To determine feasibility and acceptability of tele-EF, we conducted a mixed methods study among 42 older adults (≥65 years) with knee osteoarthritis.Participants attended EF classes for 1-hour, 3 days/week for 4-5 months (1-3 months in-person EF and 2-4 months in tele-EF).Attendance for in-person EF was 80.0% versus 91.0% for tele-EF.Nearly all participants (95.2%) reported that they were satisfied or very satisfied with tele-EF.Qualitative exit interview data mapped well onto Social Cognitive Theory constructs.With tele-EF, participants found that livestream classes facilitated accountability and self-efficacy to participate in exercise and that interactive instruction provided encouragement and support to exercise.Thus, tele-EF is a viable remotely-delivered exercise program for older adults that retains many features of in-person EF.Relationship status is thought to be associated with cognitive health in older adults, with married persons performing better on memory assessments than unmarried-cohabitating, single, divorced, and widowed persons.However, questions remain about whether relationship termination causes cognitive decline, is a result of it, or whether they share a cause; and the mechanisms by which such a relationship might operate.To address this gap in the literature, we hypothesized that relationship termination could affect cognition via the following five pathways: (1) post-termination depression; (2) loss of distributed-cognition partner; (3) cognitive depletion from caring for partner in declining and ultimately terminal health; (4) divorce to preserve assets to qualify for Medicaid to cover healthcare for cognitive decline; and (5) posttermination changes in neuropsychiatric symptoms alongside a pre-existing neurodegenerative condition that also causes cognitive decline.Using data from the 2000-2016 waves of the Health and Retirement Study (HRS; N = 23,393), we found that relationship termination, whether due to divorce or widowhood, was associated with cognitive decline.Using mixed-effects regression we found that the rate of cognitive decline increased after relationship termination (widowhood: □ = -0.587,p <0.001; divorce: □ = -0.221,p <0.001), supporting mechanism (5).Using HRS data for respondents and their spouses' mental and physical health, health insurance, and activities of daily living, we also find support for mechanisms (1) and (3).Relationship termination is a critical juncture in a person's life course that has multiple implications and may, ultimately, worsen patients' conditions.

PERCEPTIONS OF PARTNER AFFECT MEDIATE AFFECT CONTAGION IN OLDER COUPLES' DAILY LIFE: AN EXPERIENCE-SAMPLING STUDY
Elisa Weber, 1 and Gizem Hueluer, 2 1.University of Zurich, University of Zurich, Zurich, Switzerland, 2. University of Bonn (Germany) Intimate relationship partners dynamically covary in their affective states.One mechanism through which intimate relationship partners experience and shape each other's affective states is affect contagion, i.e., the spread of affective states from one person to another.The degree to which socialcognitive processes are involved in affect contagion in daily life remains unclear.The majority of older adults live together with a spouse/partner, and intimate relationships are one of the most important social contexts in their daily lives.Expanding on previous research, we focused on contagion of positive and negative affect between older relationship partners, and examined whether processes of affect contagion were mediated by perceptions of partner affect, i.e., how individuals thought their partners felt at previous moments.We used data from an experience sampling study with 152 older heterosexual couples (304 participants; 65+ years old) who reported on their positive and negative affect, perceptions of their partner's positive and negative affect, and presence or absence of partners 6 times a day for 14 days.Dyadic multilevel mediation models were used to evaluate our hypotheses.We observed strong evidence that processes of positive affect contagion between partners were mediated by perceptions of partner's affective states.Negative affect contagion was directed from men to women, but not vice versa, and mediated by perceptions of partner's affective states.Partner presence was unrelated to processes of affect contagion.Our findings help identify underlying mechanisms of affect contagion and support the notion that perceptions of close others' emotions might shape our own feelings.

ROMANTIC ATTACHMENT, STRESS, AND COGNITIVE FUNCTIONING IN A LARGE SAMPLE OF MIDDLE-AGED AND OLDER COUPLES
Rebekka Weidmann, and William Chopik, Michigan State University, East Lansing, Michigan, United States Romantic relationships are a key factor contributing to health across the lifespan.Within this research line, attachment theory has been a useful framework to understand how relationships impact health.One primary health concern in late adulthood is reduced cognitive functioning: Alzheimer's disease and related neurodegenerative disorders become increasingly prevalent with age affecting millions of people.Even though much research has identified various sociodemographic, medical, and behavioral risk factors, little knowledge exists on romantic attachment's psychosocial role for cognitive decline.The purpose of this study was to examine the link between insecure attachment, stress, and cognitive functioning in a large sample of middle-aged and older couples.In particular, we wanted to investigate how insecure attachment is linked to both partners' cognitive functioning and whether stress mediates these associations.To that aim, we used data of 1,043 romantic couples (Mage = 64.7 years; 38.5% same-sex couples) who reported on their attachment anxiety and avoidance, their stress levels, their cognitive decline, and their and their partners' dementia symptoms.Couple members also participated in a memory performance task.The results suggest that anxiety is linked to participants' cognitive decline, while avoidance was linked to partners' cognitive decline and poorer memory performance.We also detected significant mediational effects for stress in the association between insecure attachment and cognitive functioning.We conclude that potentially malleable

Session 3070 (Paper) Love, Romance, and Aging DOES RELATIONSHIP END PRECEDE COGNITIVE DECLINE? AN ANALYSIS OF THE HEALTH AND RETIREMENT STUDY Douglas
Hanes, 1 and Sean Clouston, 2 1. Stony Brook University, Stony Brook, New York, United States, 2. Renaissance School of Medicine, Stony Brook University, Renaissance School of Medicine, Stony Brook University, New York, United States