Awareness of Balance as an Intraindividual Dynamic of Objective and Subjective Experiences of Fall Risk in Daily Life

Abstract Falls are life-changing events in older adulthood. With an accurate understanding of balance, older adults can adapt to age-related changes in physical ability without prematurely restricting physical activity. The Daily Balance Project examines the implications of older adults’ awareness of fall risk in daily life. For 30-consecutive days, following a fall-risk assessment, 40 older adults used a smartphone to report balance confidence and then perform four balance assessment and a 30-second sit-to-stand task to measure postural sway and fall-risk. Measures of postural sway showed greater intraindividual variability than balance confidence and fall risk. Multilevel models showed that awareness of balance fluctuated during the study and varied across individual differences in baseline fall-risk. Baseline fall risk also differentiated how balance confidence and postural sway were linked to subsequent momentary fall risk assessments. The findings are discussed within the framework of action-perspectives of adult development and awareness of aging.

Previous research establishes that hurricanes adversely affect nursing home (NH) resident health but specific causal pathways are still unclear. We combined power outage data with Medicare claims to determine the effects of power loss from Hurricane Irma(2017) among NH residents in Florida. Out of 580 facilities, 289 reported power loss. These facilities had higher star ratings; higher beds counts, and were preferentially in the Southeast region of Florida compared to facilities without outages. There were 27,767 residents living in a NH without power. They were comparable in characteristics to residents that did not lose power (N=26,383). We ran adjusted generalized linear models with robust standard errors, clustering for NH. We found power loss was associated with a trend towards increased odds of mortality within 7-days (OR:1.12, 95% CI:0.96, 1.30) and 30-days (OR:1.10, 95% CI:1.00, 1.21) post-storm, but not with hospitalization. Future research should investigate the time-specific effects of power outages.

NEW DEVELOPMENTS IN VIEWS ON AGING RESEARCH: VARIABILITY, INNOVATIVE CONCEPTS, AND CONTEXTUAL PERSPECTIVES
Chair: Anna Kornadt Co-Chair: Hans-Werner Wahl Discussant: Susanne Wurm Views on aging (VoA) such as attitudes toward own aging, awareness of aging or subjective age, have a large impact on outcomes related to positive development in later life. Recent research in this domain has focused on complex research designs and inter-systemic linkages at different levels. Indicators of short-term variability of VoA have increasingly been investigated, linking the respective findings with performance indicators, biomarkers, and trait-like data. In addition, bidirectional relationships of VoA and outcomes over time as well as data contextualizing VoA across historical time may offer new insights on the plasticity of VoA seen in bio-cultural co-construction. The symposium will showcase these recent trends with studies from the U.S. and Germany. We examined daily fluctuations in future time perspective within the daily stress and awareness of aging processes. Awareness of age-related change (AARC) focuses on everyday experiences that highlight changes in behavior and functioning as a result of growing older. We integrated individual differences in control beliefs because those with higher control tend to be more resilient to stressors. We conducted a daily diary study of 112 older adults (aged 60-90) who completed measures of control beliefs at baseline and then daily measures of stressor exposure, appraisal (e.g., threats to future plans), and AARC for eight consecutive days. Increases in threats to future plans were associated with increases in AARC losses, and those with low control were especially vulnerable to increases in threats to future plans. With a constricted future time perspective, any threats to future plans may be especially harmful for older adults who are low in control beliefs. We examined short-term fluctuations of subjective age with data obtained from 123 young-old (Mage = 67.19 years) and 47 old-old adults (Mage = 86.59 years) who reported their momentary subjective age six times a day over seven consecutive days as they were going about their everyday lives. Participants felt younger on a large majority of occasions, and 25% of the total variability in subjective age could be attributed to within-person variation. Those with younger trait subjective ages exhibited larger moment-to-moment variation, while chronological age did not impact variability. Furthermore, we investigated relationships between within-day fluctuations of subjective age and daily cortisol fluctuations. Our findings extend the literature on subjective age by showing that how old people feel can vary on a momentary basis, that state and trait components of subjective age are related, and that fluctuations in subjective age are related to biomarkers of stress.

AWARENESS OF BALANCE AS AN INTRAINDIVIDUAL DYNAMIC OF OBJECTIVE AND SUBJECTIVE EXPERIENCES OF FALL RISK IN DAILY LIFE
Shannon Meija, 1 Tai-Te Su, 2 Aileen Griffin, 3 Faith Washington, 1 Jason Fanning, 4 and Jacob Sosnoff, 5 Innovation in Aging, 2021, Vol. 5, No. S1  Falls are life-changing events in older adulthood. With an accurate understanding of balance, older adults can adapt to age-related changes in physical ability without prematurely restricting physical activity. The Daily Balance Project examines the implications of older adults' awareness of fall risk in daily life. For 30-consecutive days, following a fall-risk assessment, 40 older adults used a smartphone to report balance confidence and then perform four balance assessment and a 30-second sit-to-stand task to measure postural sway and fall-risk. Measures of postural sway showed greater intraindividual variability than balance confidence and fall risk. Multilevel models showed that awareness of balance fluctuated during the study and varied across individual differences in baseline fall-risk. Baseline fall risk also differentiated how balance confidence and postural sway were linked to subsequent momentary fall risk assessments. The findings are discussed within the framework of actionperspectives of adult development and awareness of aging. We investigated the reciprocal longitudinal relation between perceived stress and three established domains of views on aging (VoA): (1) subjective age; (2) attitude toward own aging [ATOA]; and (3) aging-related cognitions including social loss, physical decline, and continuous growth. We also examined the potentially moderating role of chronological age. Data of the German Ageing Survey, comprising two measurement occasions (2014 and 2017) and a sample of 4,588 individuals aged between 40 and 95 years, were analyzed. Controlling for socio-demographic and health-related indicators, cross-lagged models indicated mutual longitudinal relations between VoA and stress. Whether the pathway from stress to VoA or the opposite pathway was stronger varied depending on the VoA considered. With increasing age, most VoA domains were less strongly associated with subsequent perceived stress. Our findings suggest that less favorable VoA predict higher perceived subsequent stress, but they are also preceded and predicted by higher levels of perceived stress.

NO HISTORICAL CHANGE IN VIEWS ON AGING AND THEIR CORRELATES: EMERGING EVIDENCE FROM GERMANY AND THE UNITED STATES
Hans-Werner Wahl, 1 Johanna Drewelies, 2 Sandra Duezel, 3 Margie Lachman, 4 Jacqui Smith, 5 Nilam Ram, 6 Ulman Lindenberger, 3 and Denis Gerstorf, 7 1. Heidelberg University, Heidelberg, Baden-Wurttemberg, Germany,2. Humboldt University,Berlin,Berlin,Germany,Berlin,Berlin,Germany,4. Brandeis University,Brandeis University,Massachusetts,United States,5. University of Michigan,University of Michigan,Michigan,United States,6. Stanford University,Stanford,California,United States,7. Humboldt University of Berlin,Humboldt University of Berlin,Brandenburg,Germany To examine historical changes in views on aging, we compared matched cohorts of older adults within two independent studies that assessed differences across a two-decade interval, the Berlin Aging Studies (BASE, 1990/93 vs. 2017 and the Midlife in the United States Study (MIDUS, 1995/96 vs. 2013. Consistent across four different dimensions of individuals' subjective views on aging (age felt, age appeared, desired age, attitudes towards own aging) in the Berlin Aging Studies and corroborated with subjective age felt in the MIDUS, there was no evidence whatsoever that older adults of today have more favorable views on how they age than older adults did two decades ago. We discuss reasons for our findings, including the possibility that individual age views may have become increasingly decoupled from societal age views.

OLDER ADULT SUBSTANCE USE, SUPPORT, HEALTH, AND WELL-BEING: UNDERSTANDING A COMPLEX PICTURE
Chair: Bethany Bareham Co-Chair: Verena Cimarolli Discussant: Alexis Kuerbis Substance Use Disorders (SUDs), particularly hazardous alcohol use and Opioid Use Disorder (OUD), are increasingly common in older populations. Both are associated with poor mental and physical wellbeing. Alcohol use can also contribute positively to older people's social and emotional wellbeing, and may be used by older people in managing pain. Health concerns can make older people more aware of the impact of their lifestyle, including substance use, for their health. The relationship between substance use, health and wellbeing in old age is complex, raising questions for how older people with SUDs are best supported. We aim to give insight into this complexity, drawing on five recent studies. Our first presentation examines the impact of health concerns in old age on alcohol use. Our second presentation explores the complicated relationship between experiences of pain, and alcohol use with age. Our third presentation considers wellbeing in older people with OUD, and the impact of Adverse Childhood Experiences, psychosocial, health and sociodemographic factors; and what this means for how wellbeing is promoted in this population. Our fourth presentation explores how those supporting people with dementia navigate alcohol use amongst older residents, in a care context where autonomy is prioritised, but health risk behaviours must be managed. Our final presentation considers alcohol use in 'the new normal'; examining the impact of the COVID-19 pandemic on older people's alcohol use, and motivations to engage in healthier/unhealthy use. We consider implications of these complex considerations around addressing substance use amongst older people for practice.