Virtual Testing of Seniors: The Feasibility of Research with Online Neuropsychological Tests (FRONT)

Abstract Synergic@Home is a feasibility study evaluating the effects of exercise and cognitive interventions for the prevention of dementia in at-risk individuals over age 60. The COVID-19 pandemic changed the study’s methods, with standardized neuropsychological tests needing to be administered virtually. Experience and research into the viability of neuropsychological assessments administered virtually is limited. After receiving permission to adapt the tests for virtual administration, a neuropsychologist, project managers, and research coordinators developed their approach. A PowerPoint presentation using text and visual stimuli from the tests was developed with on-screen instructions for the raters. An iterative development process involved feedback from the team in order to maximize the fidelity of these methods compared to in-person administration. Mock assessments supervised by a neuropsychologist further refined the methods and confirmed rater adherence to standardized procedures. A secure videoconferencing platform meeting privacy requirements was used. Dual monitors for the raters provided instructions on one monitor while stimuli for the participant was on the second monitor. The participant could only see the stimuli. This method of administering neuropsychological assessment, the Feasibility of Research with Online Neuropsychological Testing (FRONT), is being used to evaluate older adult participants in Synergic@Home. Results from this feasibility study may set the stage for new research methodologies and/or clinical evaluations in the future. This project is funded by the New Brunswick Healthy Seniors Pilot Project and the Canadian Consortium on Neurodegeneration in Aging (with grants from Public Health Agency of Canada and the Canadian Institutes of Health Research, with additional funding partners).

Results: Depression, self-reported poor health status, and physical inactivity are higher among isolated aging adults who have limitations with ADL/IADL.Specifically, those with difficulties concentrating/decision making (OR=3.62;CI=3.35-3.91)have higher chance of developing depression than those who do not have this limitation.Female are at risk for developing depression (OR=1.41-1.61;CI=1.51), yet they are likely to report for better health status (OR=1.54;CI=1.45-1.64)than males.Asian (OR=0.56;CI=0.39-0381),Black or African American (OR=0.54;CI=0.48-0.60)are less likely to be diagnosed with depressive disorder than White.Discussion/Recommendation: Physical and cognitive changes that come with aging can pose challenge, as functional capacity diminishes in home environment.Further research should be explored in longitudinal studies on mobility and improving quality of living among isolated aging population.

VIRTUAL TESTING OF SENIORS: THE FEASIBILITY OF RESEARCH WITH ONLINE NEUROPSYCHOLOGICAL TESTS (FRONT)
Chris Pauley, 1 Linda Yetman, 2 Jody-Lynn Lupo, 3 Penelope Slack, 4 Diane Jacobs, 5 Chris McGibbon, 6 Pamela Jarrett, 2 and Manuel Montero Odasso, 7 1.Horizon Health New Brunswick,Saint John,New Brunswick,Canada,2. Horizon Health Network,Horizon Health Network,New Brunswick,Canada,3 Columbia,Vancouver,British Columbia,Canada,5. University of California San Diego,La Jolla,California,United States,6. University of New Brunswick,Fredericton,New Brunswick,Canada,7. Lawson Research Institute,London,Ontario,Canada Synergic@Home is a feasibility study evaluating the effects of exercise and cognitive interventions for the prevention of dementia in at-risk individuals over age 60.The COVID-19 pandemic changed the study's methods, with standardized neuropsychological tests needing to be administered virtually.Experience and research into the viability of neuropsychological assessments administered virtually is limited.After receiving permission to adapt the tests for virtual administration, a neuropsychologist, project managers, and research coordinators developed their approach.A PowerPoint presentation using text and visual stimuli from the tests was developed with on-screen instructions for the raters.An iterative development process involved feedback from the team in order to maximize the fidelity of these methods compared to in-person administration.Mock assessments supervised by a neuropsychologist further refined the methods and confirmed rater adherence to standardized procedures.A secure videoconferencing platform meeting privacy requirements was used.Dual monitors for the raters provided instructions on one monitor while stimuli for the participant was on the second monitor.The participant could only see the stimuli.This method of administering neuropsychological assessment, the Feasibility of Research with Online Neuropsychological Testing (FRONT), is being used to evaluate older adult participants in Synergic@ Home.Census, 2018).With a longstanding reputation for being less "glamorous", social work with older adults will continue to experience deficits in the amount of those who commit to this field of practice unless more lasting change occurs (Cummings et al., p. 645, 2005).We must take a closer look at what takes place in the classroom at schools of social work to understand why social workers are not interested in working with older adults (Scharlach et al., 2000).Berkman et al. ( 2016) described in their work that a critical shortage of gerontology-focused social work faculty exists in schools of social work.Thus, we cannot expect more social workers to work with older adults unless they are exposed to this work in their educational programs.The purpose of this study is to report on the academic experience, research agenda, professional experiences (practice and teaching), and future goals of social work PhD/ DSW graduates.Ten social work doctoral graduates were interviewed in order to understand the impact their academic programs had on their commitment to older adults in their field and to learn their recommendations for schools of social work in an effort to sustain and grow the gerontological workforce.

A PLATFORM TO STUDY THE EFFECTS OF HOME ENVIRONMENT ON HEALTH AND WELLBEING OF OLDER ADULTS
Amir Baniassadi, 1 Brad Manor, 2 Wanting Yu, 3 Lewis Lipsitz, 3 and Alvaro Pascual-Leone, 4 1.Harvard Medical School, Hinda and Arthur Marcus Institute for Aging Research,Boston,Massachusetts,United States,2. Hinda and Arthur Marcus Institute for Aging Research,Harvard Medical School,Boston,Massachusetts,United States,3. Hebrew SeniorLife,Boston,Massachusetts,United States,4. Harvard Medical School,Boston,Massachusetts,United States While older adults' living environment is rarely welltuned to their specific needs, technological advances provide new opportunities to understand, and ultimately optimize, the relationship between the home environment and health outcomes.We aimed to establish proof-of-concept and feasibility of a platform enabling real-time, high-frequency, and simultaneous monitoring of environment, biological variables, and outcomes related to health and wellbeing in older adults.We recruited 7 participants (6 females, 1 male, aged 78-90, MoCA scores 14-28), installed environmental sensors measuring temperature, humidity, and CO2 inside their homes, provided them with wearables that measure sleep, activity, body temperature, and heart rhythms, and asked them to use a tablet to complete four sets of questionnaires and cognitive tests per day for three consecutive weeks.Environmental sensors collected data with no disruption or complaint from participants.Average compliance with the wearables was 81% (ring) and 60% (watch).All participants preferred the ring due to ease-of-use.Compliance was better in those with higher MoCA scores.Three participants were able to use the tablet successfully and completed 90% of prescribed questionnaires and cognitive tests.Cognitive and/or motor issues prevented the other participants from using the tablet.Exit interviews revealed that participants would prefer to complete a maximum of two sets of daily questionnaires and cognitive tests (five minutes each) in longer-term studies.These results suggest that it is feasible to study the impact of the environment on biological rhythms, cognition, and other outcomes in older adults and provide recommendations for ensuring long-term compliance with the protocol.

A SCOPING REVIEW OF PSYCHOLOGICAL SENSE OF COMMUNITY AMONG COMMUNITY DWELLING OLDER ADULTS
Thomas Buckley, University of Pittsburgh, Virginia Beach, Virginia, United States Psychological sense of community (PSOC) is an important construct for health and well-being outcomes for older adults.Drawing on the Ecological Theory of Aging and the Age-Friendly Cities (AFC) framework, this scoping review explored how PSOC has been used in research with community dwelling older adults.I followed Arksey and O'Malley's (2005) scoping review guidelines.Initial database searches yielded 860 articles.I included 33 in the final sample.I grouped articles based on study populations and conceptualization and operationalization of PSOC.I used thematic analysis to explore topic areas and main findings.The AFC framework guided development of themes and others emerged during analysis.Results show most studies used Asian or White samples and focused on geographic community or neighborhoods.Among the several measures of PSOC, the Brief Sense of Community Scale performed best with older adults.Topical research areas in the thematic analysis were built (1) built environment and neighborhoods, (2) social participation and connection, (3) civic participation, (4) PSOC as a protective factor, (5) health and well-being, (6) relocation, and (7) scale development.PSOC was a consistent predictor of health and well-being and served as a mediator to link neighborhood or environmental characteristics with health and well-being.Future research needs to examine PSOC in geographically and culturally diverse samples and conduct further psychometric testing of PSOC scales with older adults.PSOC is conceptually related to the AFC framework and serves as a mechanism that links AFC features and well-being outcomes.These results can inform practice and refine theory.
Results from this feasibility study may set the stage for new research methodologies and/or clinical evaluations in the future.This project is funded by the New Brunswick Healthy Seniors Pilot Project and the Canadian Consortium on Neurodegeneration in Aging (with grants from Public Health Agency of Canada and the Canadian Institutes of Health Research, with additional funding partners).In the next twenty years, it is estimated that Americans over the age of 65 will actually outnumber children under the age of 18 (US