A Home Hazard Removal Program to Reduce Falls in Community-Dwelling Older Adults

Abstract The majority of falls experienced by older adults occur in the home with home hazards associated with an increased risk of falling. Low-income older adults, who have more disability and live in substandard housing, need feasible interventions to help them safely age in place. The Home Hazard Removal Program (HARP) is a new home hazard removal and fall risk self-management program delivered in the home by occupational therapists to prevent falls. To evaluate the program, a randomized control trial was conducted with 310 community-dwelling older adults receiving aging services in the community. HARP had high acceptability with older adults and was feasible to deliver in the community. Adjusted for fall risk, individuals in the HARP group fell 1.4 times versus 2.2 times in the control group over 12 months. This low-cost home hazard removal program demonstrated acceptability, feasibility, and a significant reduction in falls for at-risk community-dwelling older adults.


JAPAN'S NEW FRAMEWORK ON DEMENTIA CARE Kenji Toba, Tokyo University, Tokyo Metropolitan Institute for Gerontology, Tokyo, Japan
The number of people with dementia in Japan is everincreasing. In 2020, 6 million people lived with dementia. The number is expected to increase to 9 million in 2040. This means that a person with dementia will be supported by three working people. To prepare for the big wave of dementia, Japan released the New Orange Plan in January 2015. In 2019, the Framework for Promoting Dementia Care was issued by the Japanese cabinet in which prevention and the opportunity for persons with dementia to age in place were set as the main goals. This framework requires all ministries to promote people's awareness about individuals with cognitive impairment. The educational targets include taxi drivers, retail shop clerks, bankers, police, and people working in the criminal justice system. I will discuss the New Framework which has potential to assist the country in supporting people living with dementia. The Terrie Fox Wetle Rising Star Award in health Services and Aging Research is an award named in honor of Fox Wetle, PhD, who is internationally recognized for her contributions to aging, public health, and health care research. The award recognizes health services researchers in early or middle-career phases who have made significant contributions that embody the value of multidisciplinary health services science and are likely to have a sustained, high impact on practice and research. This aware lecture will be presented by the 2021 Award Recipient, Andrea Gilmore-Bykovskyi, PhD, RN, and will highlight emergent findings and foci in her dementia-focused health services research program. In particular, the award lecture will discuss progress in investigating social and behavioral communication patterns among individuals with moderate to advanced dementia; and the role of temporally situated observational measures and inclusion of persons with dementia and their caregivers in this line of research. The lecture will conclude with a discussion of next steps for this area of investigation surrounding assessment of episodes of lucidity in advanced dementia; and considerations for strengthening progress in outcome evaluation among persons living with dementia through multidisciplinary and community-informed health services research.

IRVING S. WRIGHT AWARD: CELLULAR RECYCLING IN AGING AND DISEASE: THE IMPORTANCE OF TAKING OUT THE TRASH Malene Hansen, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, United States
Aging is greatly influenced by quality-control processes that keep the materials inside our cells in proper shape and function. One of these processes is called autophagy, which means "self-eating". This cellular recycling process can digest damaged components to provide new and better parts for the cell. Autophagy plays important roles in many age-related diseases and has been directly linked to aging. In our laboratory, we use the microscopic soil-dwelling round worm C. elegans to understand how autophagy is linked to aging and disease. In this Wright Award seminar, I will discuss our progress on understanding how autophagy is regulated during normal aging and how it may promote a long and healthy lifespan.

TERRIE FOX WETLE AWARD (2020): THE ROLE OF HOME-DELIVERED MEALS PROGRAMS IN IMPROVING HEALTH AND PROMOTING COMMUNITY INDEPENDENCE FOR OLDER ADULTS Kali Thomas, School of Public Health, Providence, Rhode Island, United States
Dr. Terrie "Fox" Wetle is internationally recognized as a leader who conducts and advocates for multi-disciplinary and multi-method investigations centered on aging, public health and health care with direct implications for shaping policy and practice. This award lecture, given in Dr. Wetle's name, will be presented by the 2020 award recipient, Kali Thomas, PhD. Dr. Thomas will present a line of multi-disciplinary and multi-method research focused on the impact of home-delivered meals as it relates to the health outcomes of homebound, food insecure older adults. Findings will include results from observational and intervention studies conducted at both the local and national levels. Examples of how this evidence has influenced policy and practice, including greater integration with healthcare, will be provided. The lecture will conclude with discussion about future opportunities for collaboration with community partners to measure and understand the impact of these vital social services on the lives of older adults.

VINCENT CRISTOFALO "RISING STAR"AWARD: DNA METHYLATION LANDSCAPES IN AGING Morgan Levine, Yale University, New Haven, Connecticut, United States
The epigenetic code can be thought of as the operating system of the cell. It controls the most basic and critical cellular processes including differentiation, replication, metabolism, and signaling. Yet, with age, the epigenetic landscape is remodeled, bringing about widespread consequences for cellular and tissue identity, integrity, and functioning. But, what if like computer programmers, we could discover how to recode or restore the original program? The revolutionary discoveries by Yamanaka and Takahashi suggests this may be possible. While early experiments showed that Yamanaka factors could be used to convert somatic cells into induced pluripotent stem cells, more recent work by us and others have shown that signatures of epigenetic aging are also wiped clean during this process. What's more, epigenetic age reversal appears to take place early in the process and thus can be achieved without the cell _needing to dedifferentiate. Building off of this discovery, our lab is combining novel experiments and advanced bioinformatic techniques to decipher the epigenetic code and determine how it is remodeled during aging, development, and reprogramming. In our recent work, we have made advancements in mapping the epigenetic alterations observed in aging and linking them to both cellular processes and disease etiology. We have identified specific age changes in mouse and human cells that reflect mitotic history, cellular senescence, oxidative damage, and mitochondrial dysfunction. We have also demonstrated that these changes inform differences in organismal lifespan and/or disease etiology at the tissue level. Overall, this work has sweeping implications for our basic understanding of epigenetic aging and reprogramming, and will help provide the foundation for potent therapeutics that extend healthspan and lifespan.

ADVANCING AGE INCLUSIVITY IN A PANDEMIC: AGE-FRIENDLY UNIVERSITY (AFU) CAMPUSES TAKE ACTION
Chair: Joann Montepare Co-Chair: Kimberly Farah The COVID-19 pandemic presented extraordinary challenges for professionals in the aging field across campuses and communities, calling for rethinking and redesigning how their work was structured, their programs were delivered, and their connections were sustained. The pandemic also made clear the value of being an age-friendly institution of higher education, especially as we experience historic changes in age demographics. This symposium features campus leaders representing institutional partners of the Age-Friendly University (AFU) global initiative (endorsed by GSA's Academy for Gerontology in Higher Education) who will discuss how their age-friendly programs were adapted during the pandemic to continue to advance age inclusivity. These diverse responses exemplify the vast potential of age-friendly opportunities. June and Andreoletti (Central Connecticut State University) will discuss how the Scholars for Life! program supported the engagement of older learners in the neighboring community through the engagement of faculty. Elfenbein (University of North Georgia) will describe how learning experiences for older learners and intergenerational exchange were created beyond the classroom through the Personal Enrichment, Action and Knowledge (PEAK) program. Terhune (Northern Kentucky University) will describe how student support practices and services were adapted to provide working adult students with guidance for navigating their educational needs during the pandemic. Kheirbek (University of Maryland, Baltimore) will describe how age-friendly collaborations with the institution's medical school leveraged