The South East Texas Geriatric Workforce Enhancement Program: Reach, Teach, Innovate

Abstract Through collaboration between academic and community partners, the South East Texas Geriatric Workforce Enhancement Program (SETx GWEP) aims to promulgate the 4Ms framework via a range of educational initiatives. The faculty and audience is interprofessional and diverse, representing the residents of South East Texas. Specific initiatives focus on Alzheimer’s disease and related dementias, elder abuse, geriatric mental health, patient priorities, transitions of care, and geriatric dental care. Training modalities include online modules, Project ECHO sessions, webinars, discussion forums, and simulation. During the COVID19 pandemic the SETx GWEP adapted to meet the needs of its stakeholders, including increasing the number of online activities, hosting town hall meetings, and developing training to address the impact of COVID19 on the older adult population. The SETxGWEP trained over 1000 people in 2020. To address healthcare disparities among older adults, SETx GWEP developed training on the practice of cultural humility in older adult care.

in the workshop, which included 3.5 days of expert-led seminars followed by completion of an individualized learning plan over six months. Results from our evaluation indicated significant improvements in four of five geropsychology domains on the Pikes Peak Geropsychology Knowledge and Skill Assessment Tool. Our findings demonstrate continued enhancement of geropsychology competencies through advanced coursework is feasible and improves depth of training, particularly when combined with individualized learning plans.

VIRTUAL GERIATRIC MENTAL HEALTH CARE OFFERED WHERE NEEDED MOST: AN EVALUATION OF A TELEHEALTH CONSULTATION MODEL
Julie Filips, 1 Chalise Carlson, 2 Ana Alfaro, 2 Ranak Trevedi, 3 Anita Savell, 4 and Christine Gould, 2 1. VAMC,Minneapolis,MN,Minnesota,United States,2. VA Palo Alto Health Care System,Palo Alto,California,United States,3. VA Palo Alto Center for Innovation to Implementation,Menlo Park,California,United States,4. CRH Operations for VISN 23,Minneapolis,Minnesota,United States Many VA facilities serving large rural populations do not have geriatric mental health specialists available to assist with managing the aging Veteran population's complex medical and behavioral comorbidities. We applied mixed-methods to evaluate an innovative model utilizing a geriatric psychiatrist who provides cross-facility consultation in a 5-state region. During a 3-month period, the consultant completed 135 consults and 20 e-consults to settings ranging from outpatient to long-term care. Leadership stakeholder and provider interviews highlight the importance of the availability of the consultant, collaboration with local care teams, staff education, person-centered approach, and work ethic/passion. The core challenges that the consultant helps manage include complex comorbidities, medication questions, and dementia with behavioral disturbance. Initial provider survey responses (n = 11) show high satisfaction with services (100%) and strong agreement (80%) that providers could follow through with recommendations. Next steps include replication of this model in other VA facilities. Through collaboration between academic and community partners, the South East Texas Geriatric Workforce Enhancement Program (SETx GWEP) aims to promulgate the 4Ms framework via a range of educational initiatives. The faculty and audience is interprofessional and diverse, representing the residents of South East Texas. Specific initiatives focus on Alzheimer's disease and related dementias, elder abuse, geriatric mental health, patient priorities, transitions of care, and geriatric dental care. Training modalities include online modules, Project ECHO sessions, webinars, discussion forums, and simulation. During the COVID19 pandemic the SETx GWEP adapted to meet the needs of its stakeholders, including increasing the number of online activities, hosting town hall meetings, and developing training to address the impact of COVID19 on the older adult population. The SETxGWEP trained over 1000 people in 2020. To address healthcare disparities among older adults, SETx GWEP developed training on the practice of cultural humility in older adult care.

ORAL HEALTH AND DENTAL CARE AMONG OLDER ADULTS IN CHINA: WHAT ARE THE RISK AND PROTECTIVE FACTORS?
Chair: Weiyu Mao Co-Chair: Yaolin Pei Discussant: Huabin Luo Oral health is a global public health concern. The four papers in this symposium capture various understudied risk and protective factors in oral health and dental care among older adults in China. The first paper examined the relationship between social isolation, loneliness, and tooth loss among Chinese older adults, using the Chinese Longitudinal Healthy Longevity Survey. The findings suggest that higher levels of social isolation, rather than loneliness, were associated with fewer remaining teeth and accelerated tooth loss over time. The second paper investigated urban-rural disparities in dental care utilization among Chinese adults aged 18 to 65 years old, using the 2019 New Era and Living Conditions in Megacities Survey. The findings demonstrate urban residents were more likely to visit dentists than rural residents. Besides socioeconomic status, health attitudes/behaviors, and oral health needs, health insurance coverage was considered an important enabling factor to promote dental care use in this population. The third paper examined the relationship between denture use and cognitive decline among Chinese older adults, using data from the Chinese Longitudinal Healthy Longevity Survey. The findings indicate that denture use is protective against cognitive decline over time in later life. The fourth paper examined the prevalence of self-reported orofacial pain symptoms and their correlates at the last year of life among Chinese older adults. Low socioeconomic status, smoking, chronic conditions, oral hygiene practice, and natural teeth condition were associated with such symptoms. This symposium offers valuable insights to improve oral health and dental care in older adults in China.

SOCIAL ISOLATION AND ACCELERATED TOOTH LOSS AMONG CHINESE OLDER ADULTS
Xiang Qi, 1 Yaolin Pei, 2 Katherine Wang, 3 Shuyu Han, 4 and Bei Wu, 2 1. Rory Meyers College of nursing, New York,New York,United States,2. New York University,New York,New York,United States,3. Duke University,Durham,North Carolina,United States,4. Fudan University,Shanghai,Shanghai,China (People's Republic) Social isolation and loneliness in older adults are major global public health concerns. Tooth loss is also a common problem in this population. This study examined the effects of social isolation and loneliness on the number of remaining teeth and the rate of tooth loss among Chinese older adults. We included 4,268 older adults age 65+ from three waves of the Chinese Longitudinal Healthy Longevity Survey (2011/2012, 2014, 2018). Linear mixed-effect models showed higher levels of social isolation were associated with fewer remaining teeth (β = -1.59, P < 0.05) and accelerated tooth loss (β=-0.10, P<0.05) controlled for sociodemographic, lifestyle, oral hygiene behavior, and health status. Loneliness was neither associated with the number of remaining teeth (β=0.64, P>0.05) nor with the rate of tooth loss (β=-0.09, P>0.05) before and after controlling for covariates. These findings expand our knowledge regarding the correlation between social connection and tooth loss in non-Western populations.  New York,New York,United States,3. New York University,New York,New York,United States Using data from the '2019 New Era and Living Conditions in Megacities Survey' that included 4,049 residents aged 18-65, we examined the urban-rural disparities in dental visits among adults living in China's 10 megacities. All of China's megacities are metropolitan regions that include urban, periurban and rural land, and all have rural populations within the city boundaries. The results show that 43.3% (n=595) rural and 23.8% urban (n=637) residents had never visited dentists. Urban residents were more likely to visit dentists than rural residents after controlling for covariates (OR=1.57, 95%CI=1.30 to 1.91). The rates of visits were similar across age groups. Higher socioeconomic status, having urban insurances, having positive attitudes towards healthy diets and visited physicians regularly, and having poorer oral health was associated with higher odds of visiting dentists (P<0.05). These findings can help develop policies to increase dental care access to underserved populations in Chinese megacities.

DENTURE USE AND COGNITIVE DECLINE IN CHINESE OLDER ADULTS: A PROPENSITY SCORE ANALYSIS
Bei Wu, 1 and Xiang Qi, 2 1. New York University,New York,New York,United States,2. Rory Meyers College of nursing,New York,New York,United States Using data from the Chinese Longitudinal Healthy Longevity Survey (2011 to 2018), we examined the effect of denture use on cognitive decline (assessed by the Mini-Mental State Examination [MMSE]) among 1,316 cognitively normal older adults with severe tooth loss (≤9 remaining teeth) at baseline. We generated propensity scores for weighted and matched analyses using 18 covariates, classified as socio-demographics, health-related behaviors, health status, and oral health conditions. The results show that non-denture users had worse cognitive decline than denture users. In the kernel-based matched data, the difference in the declined score of cognitive function between denture and non-denture users was 2.25 (95%CI=1.37 to 3.13). In the weighted data, the difference in cognitive function score was 2.14 (95% CI=1.35 to 2.94). Using dentures is beneficial for cognitive health in older adults with severe tooth loss, suggesting that prosthodontic rehabilitation with dentures might have benefits beyond restoring oral functioning.