URBAN AGING RESIDENTS COALITION (UARC): A HYBRID MODEL TO BRIDGE THE TECHNOLOGY GAP

Abstract The COVID-19 pandemic spotlighted technology barriers for urban Black/African American older adults that lead to chronic stress, social isolation, and inability to fully engage with the world. In partnership with an African American older adult community leader, the Urban Aging Residents Coalition was founded in May 2020 to address engaging older adults with technology. A primary goal of UARC is to prevent social isolation and promote mental wellness through education. Using a hybrid model of videoconferencing and socially-distanced meetings, volunteer health professionals and community members (e.g., Information Technology Technician, Psychologist, and Nurse) delivered education to older adults. Participants also met for computer training to build confidence by sharing technology accomplishments with others (e.g., online bill paying). UARC has 75 active members and conducted over 12 videoconferences and in-person programming. The UARC project serves as a model for community/academic partnerships to support mental wellness and technology use in urban older adults.


INTERRATER RELIABILITY OF AN ADVANCED NONCONTACT WOUND MEASUREMENT SYSTEM USING ARTIFICIAL INTELLIGENCE
Venous leg ulcers (VLU) are recurring, disabling wounds that develop primarily in older adults with comorbidities. In an ongoing clinical trial testing a nutritional intervention researchers use advanced technology (Swift Skin and Wound) to measure VLU healing over time. This noncontact wound measurement system uses artificial intelligence to automatically calculate wound measurements and track healing progress. However, a subjective component of the Swift system involves delineating wound perimeters on photographs captured with a tablet or smartphone. To evaluate interrater reliability of the system in the current study, measurements of 11 wounds by two independent raters were assessed using an intraclass correlation coefficient (ICC). ICC estimates and their 95% confidence intervals were calculated using SPSS statistical package version 27 based on a mean-rating (k = 2), consistency, 2-way mixed-effects model. For area measures, ICC = 0.99 with 95% confidence interval = 0.998-1.0, indicating the Swift measurement system has excellent interrater reliability. Family caregivers for persons with dementia often times experience stress and burden while caregiving. The COVID-19 pandemic has worsened this situation with increased physical and social isolation, further resulting in health risks in this population. Technology-based interventions have become more commonplace in today's world to address ongoing caregiver needs although gaps in technological literacy and usage still exist among many users. This case study aims to report on the implementation of an ongoing Smarthealth technology intervention for two older adult family caregivers of persons with dementia and to explore their experiences with this system. Data were collected through acoustic monitoring, survey administration, and semi-structured interviews. Intervention effects on changes in emotional states will be discussed. Study findings showed the intervention improved self-awareness of emotional care and reactions to care recipients. Findings in this study highlight the importance and challenges of real-time technology-based intervention implementation in older adult caregiving populations. The COVID-19 pandemic spotlighted technology barriers for urban Black/African American older adults that lead to chronic stress, social isolation, and inability to fully engage with the world. In partnership with an African American older adult community leader, the Urban Aging Residents Coalition was founded in May 2020 to address engaging older adults with technology. A primary goal of UARC is to prevent social isolation and promote mental wellness through education. Using a hybrid model of videoconferencing and socially-distanced meetings, volunteer health professionals and community members (e.g., Information Technology Technician, Psychologist, and Nurse) delivered education to older adults. Participants also met for computer training to build confidence by sharing technology accomplishments with others (e.g., online bill paying). UARC has 75 active members and conducted over 12 videoconferences and in-person programming. The UARC project serves as a model for community/academic partnerships to support mental wellness and technology use in urban older adults. We conducted participatory design research for long term care (LTC) socially assistive robotic activities comprised of social, cognitive and physical components and enhanced human-robot (HRI) and human-human interactions (HHI). Repeated sessions were conducted with 10 geriatric experts (physicians, activity directors, nurses, occupational therapist) and 12 LTC residents (ages 70-92). Two robots, animal and humanoid, were used in combination with virtual reality. Four collaborative activities for paired older adults were designed and evaluated: playing drums to music, completing paintings, a fishing game, and training a dog with simple commands. Within each activity, three levels of difficulty were designed. Stakeholder feedback was obtained through observations and interviews. Numerous modifications were made following each session that addressed hardware, software and activity issues. Modifications were necessary both for the HRI and HHI aspects of the activity. Our experience demonstrates the necessity for participatory design in the deployment of technology for LTC settings. The availability and utility of patient-centered communication technologies in acute-critical care settings have evolved slowly over the past 30 years with wide variability, little standardization, and few randomized controlled clinical trials (RCT). The COVID-19 pandemic forced rapid expansion and use of communication technologies, particularly between patients and remote family caregivers. To capture changes responsive to the pandemic, this paper reviews current literature (< 5 years) on communication technologies in acute-critical care settings focusing on the user experience among older adult patients. We supplement these findings with case-based evidence from a pilot RCT of an electronic tablet communication application provisioned to mechanically ventilated ICU patients, and efforts toward hospital-wide implementation. Recent literature on patient communication technology consists primarily of qualitative, descriptive accounts of video communication (i.e., ICU visits) or provision of augmentative and alternative communication.

CURRENT APPLICATIONS OF PATIENT COMMUNICATION TECHNOLOGIES IN GERIATRIC CRITICAL CARE
Recommendations for required skills, standardization, and research regarding patient communication technology are provided.

PROTEOSTASIS: NOVEL INSIGHTS AND TECHNOLOGIES
Chair: Andrew Pickering

GENETIC AND PHARMACOLOGIC PROTEASOME AUGMENTATION AMELIORATES ALZHEIMER'S-LIKE PATHOLOGY IN MICE AND FLIES Andrew Pickering, University of Alabama at Birmingham, Birmingham, Alabama, United States
The proteasome has key roles in neuronal proteostasis, including removal of misfolded and oxidized proteins, presynaptic protein turnover, as well as synaptic efficacy and plasticity. Proteasome dysfunction is a prominent feature of Alzheimer's disease (AD) (1-3). Artificial impairment of proteasome function can mimic many neurodegenerative phenotypes (4, 5). We report impaired proteasome function to represent an early-stage marker of AD preceding many other markers of the disease. Significantly, we show that prevention of proteasome dysfunction by genetic manipulation in fly and cell culture models of AD delays mortality, cell death, and cognitive deficits. We developed a transgenic mouse with neuronal-specific proteasome overexpression which, when crossed with a mouse model of AD showed reduced mortality and cognitive deficits. To establish translational relevance, we developed a set of novel TAT-based proteasome-activating peptidomimetics. These agonists stably penetrate the blood-brain-barrier and enhance 20S as well as 26S proteasome activity. We show that treatment with these agonists protects against cell death in a cell culture model of AD as well as both cognitive decline and mortality in fly and mouse models of AD. The protective effects observed from proteasome overexpression in our models appear to be driven at least in part by increased turnover of the amyloid precursor protein (APP) by the proteasome. We conclude that the proteasome plays an important role in AD progression. Furthermore, augmentation of proteasome function is protective against AD-like pathogenesis in diverse models of the disease, representing a new therapeutic target for treatment of AD.

PROTEOSTASIS: NOVEL INSIGHTS AND TECHNOLOGIES Constanza Cortes, University of Alabama at Birmingham, Birmingham, Alabama, United States
Skeletal muscle has recently arisen as a novel regulators of Central Nervous System (CNS) function and Innovation in Aging, 2022, Vol. 6, No. S1