AGen2023 Virtual Poster Presentations

Aging and Gerontology

66876 | An Analysis of the Impacts of the Long-term Care Reward Revision in Japan―Impacts on Labor Supply and Labor Demand of Short-time Visiting Care Workers

Xinfang Zhang, Tohoku University, Japan

As Japan's population ages rapidly, the need for nursing care is increasing. On the other hand, the nursing care labor market is experiencing a severe shortage of caregivers. Therefore, the purpose of this study is to clarify the effects of the impacts of the 2009 long-term care fees revision by focusing on the impacts on labor supply and demand of part-time visiting caregivers. This study was conducted by the difference-in-differences (DID) model using individual data from the ""Survey on Nursing Care Labor Conditions"". The analysis was performed using the 23 wards of Tokyo as the treatment group. The control group consisted of establishments in Tokyo, Saitama, Chiba, Kanagawa, Aichi, Kyoto, Osaka, Hyogo, and Fukuoka prefectures other than the 23 wards. The subjects of the analysis were non-regular part-time home care workers, and relative real wages, number of workers, and number of hours worked were explained variables. The results of the estimation are as follows. Firstly, there was a significant increase in relative real wages after the revision of the nursing care fee increase. Positive and significant growth was obtained for the number of workers, indicating that the increase in nursing care fees increased the number of short-time workers for home care workers at nursing care facilities in special wards. On the other hand, no significant change was estimated for working hours. This suggests that the policy effect may have been offset by workers’ suppression of working hours by workers affected by the so-called ""1.03-million-yen and 1.3-million-yen barriers.

67182 | Predictors of 1-year Mortality From a Subacute Geriatric Ward in Singapore

Bernard Kok Chong Yap, Changi General Hospital, Singapore

Kiat Sern Goh, Changi General Hospital, Singapore

Thulasi Chandran, Saint Andrew’s Community Hospital, Singapore

Pei Ting Tan, Changi General Hospital, Singapore

Vivian Cantiller Barrera, Changi General Hospital, Singapore

Christine Yuanxin Chen, Changi General Hospital, Singapore

Older patients have multiple comorbidities that result in adverse health outcomes. However, factors predicting mortality in subacute geriatric population is lacking. The study aims to identify factors and develop a scoring system to predict 1 year all-cause mortality of older patients in subacute geriatric unit. This was a prospective study carried out from June 2018 to June 2019. 290 consecutive patients admitted to the subacute unit in a Singapore community hospital were recruited. Patient data collected included demographics, laboratory markers, length of stay in acute and subacute unit, readmissions rates, medications, geriatric survey instruments. Logistic regression was performed to identify factors associated with 1 year allcause mortality. Risk score was calculated for each identified factor and a scoring system that stratified patient into 3 risk groups with corresponding mortality percentages was developed. Our study showed a 1 year all-cause mortality of 15.8% post subacute unit discharge. Predictors of mortality included eGFR <60ml/ min/1.73m2 (OR 6.30; 95% CI 2.34, 16.92), 1 year readmission (OR 4.58; 95% CI 1.28, 16.38), hypoalbuminemia <35mmol/L (OR 4.10; 95% CI 1.68, 10.01), dysnatremia (145 mmol/L) (OR 3.49; 95% CI 1.07, 11.44) and MMSE <24 (OR 2.66; 95% CI 0.55, 12.90). Our scoring system stratified patients into 3 groups with the following 1 year mortality risk: Low: 3.2%, Moderate: 7.7%, and High: 45.2%. Readmission within 1 year, dysnatremia, low eGFR, hypoalbuminemia and lower MMSE scores were significant predictors of 1 year mortality post discharge from a subacute unit.

67523 | Alcohol Use and Cardiovascular Risk in a Prospective Cohort Study of Older Latino Adults: The Mediating Effect of Inflammation

Sandra Arevalo, California State University, United States

Katherine L. Tucker, University of Massachusetts at Lowell, United States

Background: Moderate alcohol consumption has been associated with a reduced risk of cardiovascular disease (CVD), which may be due to the anti-inflammatory effects of moderate alcohol use. However, most studies examining the alcohol-CVD association have focused on healthy, non-Hispanic white populations using cross-sectional designs. Methods and Results: To examine alcohol intake and CVD risk (measured by the 10-year Framingham risk score, FRS-10y) in an ethnic minority population, we drew from the Boston Puerto Rican Health Study, a prospective, population-based cohort of 866 older Puerto Ricans (aged 45-75 years) with a high prevalence of obesity, type 2 diabetes, and metabolic syndrome. We also evaluated the inflammatory marker C-reactive protein (CRP) as a mediator. In prospective multivariable models, moderate alcohol use had a significant indirect and protective effect on FRS-10y through CRP (β=-0.16; bias-corrected 95% CI: -0.35 to -0.05) after adjusting for age, sex, education, smoking, body mass index, physical activity level, dietary quality, language acculturation, and white blood cell concentration. Conclusions: Results from this large longitudinal study of Puerto Ricans are in line with findings suggesting that the link between moderate alcohol consumption and cardiovascular health may be primarily through an anti-inflammatory effect. We add to the alcohol-CVD literature by longitudinally demonstrating the relationships between alcohol consumption, anti-inflammatory effects, and reduced CVD risk in Puerto Rican adults, a group at high CVD risk.

68946 | The Effect of Conscious Movement Processing on Gaze Behaviour and Gait Pattern in Older Adults at Risk of Falling: A Preliminary Analysis

Wai Lung Thomson Wong, The Hong Kong Polytechnic University, China

Toby C. T. Mak, The Hong Kong Polytechnic University, China

Polly P. Y. Chan, The Hong Kong Polytechnic University, China

Candy W. Y. Chan, The Hong Kong Polytechnic University, China

Carman K. M. Leung, The Hong Kong Polytechnic University, China

Shamay S. M. Ng, The Hong Kong Polytechnic University, China agen.iafor.org/agen2023-virtual-presentations

Conscious movement processing has been suggested to compromise movements by interfering with automatic movement control. This study aims to compare gaze behaviour and gait pattern between individuals with high and low conscious movement processing propensity in older adults at risk of falling during adaptive locomotion. Twenty-one older adults (mean age=72.8±5.2) were included in this preliminary analysis. Participants were divided into two groups, either the Low Reinvestor Group (LRG;n=10) or the High Reinvestor Group (HRG;n=11), by a median split of the Chinese version of Movement Specific Reinvestment Scale (MSRS-C), which assessed conscious movement processing propensity. Each participant performed five trials, where they were instructed to circumvent an obstacle while walking along a pathway at a self-selected pace. Spatial and temporal gait parameters were used to indicate gait pattern. The location of fixations, number of fixations, and percentage of fixation duration were used to indicate gaze behaviour. We observed a significant main effect of group for percentage of fixation duration on destination (F[1, 19]=5.202, p=0.03). LRG spent significantly more time directing their gaze towards the destination than HRG. There was a trend of a main effect of group for double support time (F[1, 19]=4.043, p=0.06). LRG appeared to exhibit less double support time than HRG. Our preliminary analysis discovered a potentially different gaze behaviour (and altered gait pattern) between older adults with different conscious movement processing propensities during adaptive locomotion.