CAREGIVER DEPRESSIVE SYMPTOM SEVERITY AMONG OLDER ADULTS WITH COGNITIVE VULNERABILITY

Abstract While caregivers of older adults with dementia often report considerable levels of depressive symptoms, much less is known about depressive symptoms among family members of older adults with depression or recent delirium. As part of an ongoing randomized clinical trial testing an in-home multidisciplinary team intervention for older adults with cognitive vulnerability due to dementia, depression, and/or delirium (care recipients, or CR) and their caregivers, in this presentation we report baseline data from the first 211 dyads enrolled in the trial to determine how caregiver depressive symptom severity is related to: CR diagnoses; CR cognitive impairment severity; and CR depressive symptom severity. CR diagnostic groups: Depression Only (n=49); Dementia Only (n=61); Depression and Dementia Only (n=47); Delirium Plus (n=54). Depressive symptom severity was measured using the Center for Epidemiologic Studies Depression Scale; CR cognitive symptom severity was measured using the Telephone Interview for Cognitive Status. Among CR, 57% were female, mean/sd age=77/6.9, 93% White; among caregivers, 64% were female, mean/sd age=66/13.7, 91% White, 55% spouses, 25% daughters, 9% sons. In multivariate linear regression models, which included covariates caregiver gender, relationship to CR, and number of hours/week providing care, we found that caregiver depressive symptom severity was less severe among caregivers of CR with Dementia Only compared to CR with Depression Only (b=-3.32; p=0.06); not associated with CR cognitive symptom severity; and significantly associated with CR depressive symptom severity (b=0.14; p<0.01). We conclude that family members of older adults with depression deserve greater attention to address their own depressive symptoms.


ATTITUDES TOWARD OWN AGING AND PERSONALITY IN LATER LIFE: EXAMINATION OF BIDIRECTIONALITY OVER 20 YEARS
Anna E. Kornadt, 1 Jelena S. Siebert, 2 and Hans-Werner Wahl 2 , 1. Bielefeld University, Bielefeld, Nordrhein-Westfalen, Germany, 2. Heidelberg University, Heidelberg, Baden-Wurttemberg, Germany Big Five personality traits are assumed to be linked with attitudes toward own aging (ATOA).Both constructs have central importance for the aging process, it is thus important to comprehensively address their mutual connection over time.We used data from the ILSE study, a longitudinal study with four measurement occasions, spanning 20 years and including two participant cohorts (n = 501; born 1950-52 and n = 500; born 1930-32).Dual latent change score models showed that personality was longitudinally related to change in ATOA: Lower Neuroticism, higher Conscientiousness, and higher Openness predicted more positive attitudes; the effect for Extraversion varied by time.Furthermore, the role of personality seems to be confined to certain sensitive periods in midlife and early old age.ATOA had only marginal longitudinal impact on personality.Our results shed light on the developmental co-dynamics of personality and subjective perceptions of aging across the second half of life.

COGNITIVE PERFORMANCE AND COGNITIVE COMPLAINTS WITH ATTITUDES TOWARD AGING IN MIDLIFE AND OLD AGE
Jelena Siebert, 1 Jelena S. Siebert, 2 Tina Braun, 3 and Hans-Werner Wahl 2 , 1. Heidelberg University, Heidelberg,Germany,2. Heidelberg University,Heidelberg,Germany,3. Universität der Bundeswehr,Neubibberg,Bayern,Germany.Converging longitudinal research suggests that more negative views on aging go along with higher cognitive impairment.In some contrast, although conceptually suggested, possible reciprocal relationships remain less clear empirically.Using 20-year data from the Interdisciplinary Longitudinal Study of Adult Development (ILSE), we aim to better understand developmental co-dynamics between cognitive factors and attitude toward own aging (ATOA).Drawing on 1002 baseline participants (445 at T4) from two age cohorts (midlife: 40 years at baseline; old age: 60 years), longitudinal trajectories between ATOA, performance-based cognitive measures and subjective cognitive complaints are examined.Findings based on multi-group latent growth curve models (a) reveal substantial associations between ATOA and subjective complaints as well as objective cognition in both age groups; (b) confirm previous findings that ATOA predicts cognitive change over 20 years; and (c) find cognitive complaints but not cognitive performance able to predict change in ATOA in later life.

AGE-RELATED ATTRIBUTIONS OF CHANGE: DETERMINANTS AND CONSEQUENCES
Klaus Rothermund 1 and Clara de Paula Couto 2 , 1. FSU Jena,Jena,Thuringen,Germany,2. FSU Jena,Dept. of Psychology,Jena,Thuringen,Germany Diehl and colleagues recently introduced the concept of "Awareness of Age-related Change" (AARC; Diehl & Wahl, 2010), emphasizing the need to investigate the subjective experience of one's own aging.In the Aging-as-Future project (n=1,300 participants, age range 35-85), we separately assessed the experience of changes and attributions of these changes to age.Attributions of changes were driven by a correspondence between the direction of change (gain vs. loss) and negative vs. positive age stereotypes.Importantly, our data also support the assumption that changes interact with age-related attributions in predicting life satisfaction.Specifically, age-related attributions were shown to exacerbate negative effects of losses on well-being.While caregivers of older adults with dementia often report considerable levels of depressive symptoms, much less is known about depressive symptoms among family members of older adults with depression or recent delirium.As part of an ongoing randomized clinical trial testing an in-home multidisciplinary team intervention for older adults with cognitive vulnerability due to dementia, depression, and/or delirium (care recipients, or CR) and their caregivers, in this presentation we report baseline data from the first 211 dyads enrolled in the trial to determine how caregiver depressive symptom severity is related to: CR diagnoses; CR cognitive impairment severity; and CR depressive symptom severity.CR diagnostic groups: Depression Only (n=49); Dementia Only (n=61); Depression and Dementia Only (n=47); Delirium Plus (n=54).Depressive symptom severity was measured using the Center for Epidemiologic Studies Depression Scale; CR cognitive symptom severity was measured using the Telephone Interview for Cognitive Status.Among CR, 57% were female, mean/sd age=77/6.9,93% White; among caregivers, 64% were female, mean/sd age=66/13.7,91% White, 55% spouses, 25% daughters, 9% sons.In multivariate linear regression models, which included covariates caregiver gender, relationship to CR, and number of hours/week providing care, we found that caregiver depressive symptom severity was less severe among caregivers of CR with Dementia Only compared to CR with Depression Only (b=-3.32;p=0.06); not associated with CR cognitive symptom severity; and significantly associated with CR depressive symptom severity (b=0.14;p<0.01).We conclude that family members of older adults with depression deserve greater attention to address their own depressive symptoms.

FACTORS ASSOCIATED WITH UNMET NEED AMONG FAMILY CAREGIVERS
Joanne R. Campione 1 and Katarzyna Zebrak 2 , 1. Westat,Durham,North Carolina,United States,2. Westat,Rockville,Maryland,United States This study investigates the relationship between caregiver demographics, caregiving intensity, caregiver support use, and aspects of the caregiving situation with perceived unmet need.The data source was survey response data from 1,558 informal caregivers caring for older adults (age 60+) or caring for any adult with Alzheimer's disease or related dementia (ADRD).Participants were randomly recruited through U.S. Area Agencies on Aging client lists of any service and interviewed in December 2016.Caregivers were asked, "Are you receiving all the help you need?" Twenty-two percent (n=345) said "Definitely No" and were classified as having unmet need.We placed caregivers in tertiles based on their Zarit burden score; unmet need was 14% among low burden, 20% among medium, and 34% among high.The mean age of the care recipient (CR) was 81 years.Caregivers were 70% non-Hispanic White, 52% caring for CR with ADRD, and 43% spouse of CR.A multivariable logistic regression found two predictive factors (odds ratio p-value < 0.01) that increased the likelihood of reporting unmet need: daily intensity of caregiving and not feeling appreciated by CR.Usage of caregiver education, counseling or support group services in the past 6 months decreased the likelihood of reporting unmet need.In the high burden subgroup, Black caregivers were more likely to report unmet need than White caregivers.Understanding the relationship between caregiver demographics, self-reported burden level, service use, and the caregiver's need for more help can assist caregiver support programs in assessing, measuring, and addressing the ongoing needs of caregivers.

MOVING TOWARD BEST PRACTICES IN STATE APPROACHES TO SUPPORTING FAMILY CAREGIVERS OF OLDER ADULTS
Julia Burgdorf, 1 Jennifer Aufill, 2 and Jennifer L. Wolff 3 , 1. Johns Hopkins Bloomberg School of Public Health, Baltimore,Maryland,United States,2. Johns Hopkins University Bloomberg School of Public Health,Baltimore,Maryland,United States,3. Johns Hopkins University,Maryland,United States In January 2018, Congress passed the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act to establish a national strategy to acknowledge and assist family caregivers.The success of such an effort will be contingent on knowledge and dissemination of best practices.We conducted a policy project funded by the Milbank Memorial Fund that profiles five geographically and politically diverse states that have pursued novel approaches to supporting family and unpaid caregivers of older adults.We discuss findings from national and state reports, state aging plans, and interviews with 26 key informants.We find that each state (Hawaii, Maine, Minnesota, Tennessee, Washington) sought to strengthen supports for family caregivers as an element of broader community-based long-term services and supports strategies.Supports for family caregivers included financial support for working caregivers, caregiver assessment and care planning, and expanded access to respite care: several states included these services within programs targeted to persons at high risk of institutionalization or Medicaid-entry.Key informants noted the importance of tailoring programs to suit each state's unique demographic, geographic, and service delivery context, and reported that individual stories, advocacy, and data were critical to placing family caregiving on legislative policy agendas.State leaders highlighted the pivotal role of state aging networks in efforts to supporting caregivers, given these entities' deep knowledge of local community needs and challenges and established relationships with local service providers.Meaningful change often required a long-term commitment and sustained incrementalism, typically by innovating on a smaller scale before expanding statewide.

NOTHING FOR ME WITHOUT ME: CAREGIVER TRAINING NEEDS
Jeananne Elkins, 1 and Phillip Rustin 1 , 1. Brenau University, Gainesville, Georgia, United States Over 34 million informal caregivers provide care to an adult aged 50 or older with over 15 million caregivers caring for a person with dementia.People often become caregivers unexpectedly.For most caregivers little training is available, and most skills are learned "on the job".The objective of this study is to determine the training needs of caregivers.An anonymous survey was conducted at two caregiver conferences.Caregivers were asked to name up to 5 training needs.For this abstract we report the percent of responses by caregivers.Seventy-nine caregivers completed the survey.Seventy-seven percent (77%) of the caregivers cared for a person over age 50.Increased knowledge of health issues (17%) and resources (17%) were the highest responses.Training in physical caregiving skills i.e. bathing (10%), transfers (8%) and diaper changes (4%) were voiced as important.Training for improving personal interactions with the care recipient was important (9%) as well as how to practice patience, kindness and compassion (7%).Two areas where training is available but perhaps not accessible -caregiver support (9%) and care recipient behaviors (8%) were all important to caregivers.Healthy eating (9%) and stopping or limiting driving by