The M. Powell Lawton Award Lecture: The Person-Environment Fit Framework, Older Adults and Technology Interactions

Abstract M. Powell Lawton made significant contributions throughout his illustrious career to improve the quality of life of older adults. His landmark theory of person-environment fit (P-E Fit) recognized the importance of understanding the dynamic interactions between older adults and their physical and social environments and the subsequent impact of these interactions on independent living. In today’s living environments, technology is ubiquitous and can serve as both a barrier and facilitator to the ability of older people to live independently. This presentation will discuss how the P-F Fit Model can be used to clarify potential mismatches between technology systems and the characteristics, abilities, and preferences of older adult and how it can be used to guide design and training interventions to maximize the ability of aging adults to interact successfully with technology systems. Examples will be drawn from the Center for Research and Education on Aging and Technology Enhancement (CREATE) in the domains of social engagement, work, and health from technology design and intervention perspectives. The CREATE conceptual framework, consistent with the P-E Fit Model posits that users have varying needs, abilities, and attitudes; technology systems and tasks vary in demands; social, physical, and policy environments influence a person’s access to and support for technology transactions; and human-technology interactions are dynamic. A focus of the presentation will be on how a user-centered design approach is compatible with the P-E Fit model and can optimize the fit between older adults and technology systems.

During the COVID-19 pandemic Missouri Quality Initiative APRNs worked in 16 nursing homes (NHs) providing clinical expertise and support.To understand their influence on the NH COVID-19 response, we conducted four group interviews with APRNs from 13 of the 16 NHs.Using thematic analysis, we identified similarities and differences between NH groups and then compared groups by COVID-19 infection rates.Leaders from NHs with high COVID-19 rates were unwilling to report infections and were resistant to resident/staff testing.In contrast, leaders from NHs with low COVID-19 rates were strategic about acquiring supplies, held daily huddles, and initiated CDC recommendations almost immediately.All reported residents lost weight, and experienced mood and physical decline resulting from quarantine/isolation. APRNs worked with providers to identify potentially ill residents/staff, improve isolation/quarantine procedures, manage ill residents, and supported efforts to mitigate viral spread.We will discuss implications for broader infection prevention in NHs.Falls are common in nursing home (NH) residents and are the predominant reason for an emergency department (ED) transfer.Falls are responsible for 25% -87% of ED transfers, a proportion of which are potentially avoidable.INTERCARE -an implementation science study reducing unplanned hospitalizations (2018 -2020) -involved experts to identify potentially avoidable fall-related transfers.Focus group and stakeholder survey enabled identification of resources to safely manage some falls in NHs.25.9% of fall-related transfers were potentially avoidable based on using root-cause analysis and discharge reports.Avoidability was associated to ED visit, compared to hospitalizations.Appropriate resources identified by stakeholders included timely access to outpatient services for diagnostic imaging (e.g., X-Ray) and clinical skills' training in suturing and wound care for registered or specialist nurses.Although NHs are striving for a home-like environment, better access to basic diagnostic and treatment services within NHs should be possible.

Session 4480 (Symposium) THE M. POWELL LAWTON AWARD LECTURE: THE PERSON-ENVIRONMENT FIT FRAMEWORK, OLDER ADULTS, AND TECHNOLOGY INTERACTIONS Chair: Debra Dobbs
The lecture will be given by the 2020 recipient, Sara Czaja, PhD, FGSA of Weill Cornell Medicine.The 2021 M. Powell Lawton Award recipient is David Roth, Phd, FGSA, of Johns Hopkins University.The M. Powell Lawton Award is presented annually to an individual who has made outstanding contributions from applied research that has benefited older people and their care.The Lawton Award is generously funded by the Polisher Research Institute of Abramson Senior Care.

THE M. POWELL LAWTON AWARD LECTURE: THE PERSON-ENVIRONMENT FIT FRAMEWORK, OLDER ADULTS AND TECHNOLOGY INTERACTIONS
Sara Czaja, Weill Cornell Medicine/Center on Aging and Behavioral Research, New York, New York, United States M. Powell Lawton made significant contributions throughout his illustrious career to improve the quality of life of older adults.His landmark theory of person-environment fit (P-E Fit) recognized the importance of understanding the dynamic interactions between older adults and their physical and social environments and the subsequent impact of these interactions on independent living.In today's living environments, technology is ubiquitous and can serve as both a barrier and facilitator to the ability of older people to live independently.This presentation will discuss how the P-F Fit Model can be used to clarify potential mismatches between technology systems and the characteristics, abilities, and preferences of older adult and how it can be used to guide design and training interventions to maximize the ability of aging adults to interact successfully with technology systems.Examples will be drawn from the Center for Research and Education on Aging and Technology Enhancement (CREATE) in the domains of social engagement, work, and health from technology design and intervention perspectives.The CREATE conceptual framework, consistent with the P-E Fit Model posits that users have varying needs, abilities, and attitudes; technology systems and tasks vary in demands; social, physical, and policy environments influence a person's access to and support for technology transactions; and human-technology interactions are dynamic.A focus of the presentation will be on how a user-centered design approach is compatible with the P-E Fit model and can optimize the fit between older adults and technology systems.

IQ IN YOUNG ADULTHOOD AND DEPRESSIVE SYMPTOMS OVER THE RETIREMENT TRANSITION
Linn Elena Zulka, Valgeir Thorvaldsson, and Linda B. Hassing, University of Gothenburg, Gothenburg, Vastra Gotaland, Sweden Retirement can be a challenging life transition for mental health.Higher levels of IQ in young adulthood have been shown to be advantageous for different outcomes later in life such as quality of life and well-being.However, it remains unclear whether possessing higher cognitive abilities in early life also favors individuals' mental health when facing challenges related to the retirement transition.In this study, we therefore investigated the relationship between IQ in young adulthood and depressive symptoms over the retirement transition.We used data of six waves from the longitudinal population-based HEalth, Aging and Retirement in Sweden (HEARTS) study, as well as data on IQ in young adulthood from conscription.In a piecewise structural equation model, we modelled trajectories of depressive symptoms (measured by the CES-D scale) before and after retirement and in relation to young adulthood IQ (n = 1722 men).Results indicated an average decrease in depressive symptoms over the retirement transition for this sample of men.Higher childhood IQ was associated with further reduction in post-retirement depressive symptoms while controlling for education, retirement age, and memory ability and cardiovascular health at baseline.Our findings support the conclusion that higher IQ in young adulthood may act as a protective factor for mental health in the retirement transition.Individuals with higher IQ in young adulthood may have acquired coping strategies throughout their life-course, which they can apply when handling challenges related to retiring.

Netherlands Interdisciplinary Demographic Institute (NIDI), The Hague, Zuid-Holland, Netherlands
Background.Chronic health conditions (CHCs) pose stark detrimental effects on the health and abilities of older workers.The extent of these effects depend on the CHC, the time since its diagnosis and the type of health measure: a rarely explored combination of heterogeneities.Objective.This study examined how four existing and newly diagnosed CHCs influences older workers' vitality and worries about enduring physically and mentally until retirement age.Method.Data from two waves of the NIDI Pension Panel survey conducted in the Netherlands in 2015 and 2018 were used.We analyzed a sample of 1,894 older workers between the ages of 60-62 years at wave 1 using conditional change ordinal least square regression models.Results.Having a CHC at wave 1 was associated with lower levels of vitality and higher levels of worries at wave 2. These effects of CHCs on vitality and worries were much larger for older workers who were newly diagnosed with CHCs compared to those who experienced CHCs for longer.Intriguingly, the new diagnosis of physically disabling conditions increased worries about physical endurance at wave 2, while the new diagnosis of mentally disabling conditions increased worries about mental endurance at wave 2. Conclusion.By distinguishing the effects of four existing and newly diagnosed CHCs on vitality and worries, this study allows the identification of vulnerable groups of older workers.The findings may inform work accommodations and interventions which could improve both the quality and sustainability of work lives, while promoting healthy ageing of older workers.Clinically-relevant depressive symptoms were indexed by the Composite International Diagnostic Interview (CIDI).Expectation (probability) of working after age 62 was modeled continuously (range: 0 to 1).Multivariate mixed-effects logistic regression models of screening positive on the CIDI and passive suicide ideation were fit, separately, adjusting for demographics, household income and wealth, and health characteristics.Respondents working at baseline were less likely to screen positive on the CIDI longitudinally (OR: 0.36, 95% CI: 0.26 -0.51), and while expectations were inversely associated with screening positive on the CIDI this was not significant after accounting for work status (OR: 0.68, 95% CI: 0.43 -1.09, p=0.104).Longitudinally, higher expectations of working were inversely associated with passive suicidal ideation (OR: 0.54, 95% CI: 0.32 -0.92) even after accounting for working status.Future research will examine variation in these relationships by contextual factors like