'They Don't Want to Label It': Insights from Communities Not Enrolled in the Network of Age-Friendly States and Communities.

More than 800 municipalities and 11 states and territories in the United States have joined the Network of Age-Friendly States and Communities (NAFSC); however, to our knowledge, no studies have examined the many communities that have not joined. The present study explored the factors that inhibit communities from joining the NAFSC. Data were drawn from semi-structured interviews conducted with 12 community leaders in Massachusetts and Maine. Results indicated variation in perceptions and attitudes, with some participants seeing benefits to joining but encountering barriers to doing so, while others did not see sufficient benefit to joining to make the effort worthwhile. Key themes included lack of human and financial capacity, concerns over aspects of the NAFSC model, and desire to maintain local control over the process and components of age-friendly efforts. Participants voiced a need for funding and technical assistance in order to expand their age-friendly work.

Dementia-focused programs in older adult centers and health care use among individuals with dementia.

There is growing attention to community-based services for preventing adverse health care outcomes among people aging with dementia. We explored whether the availability of dementia-centered programming within older adult centers (ie, senior centers)-specifically, adult day services (ADS), social adult day centers (SADCs), memory cafes, and caregiver support-is associated with reduced hospitalization, emergency room use, and total Medicare costs for community-dwelling individuals ages 75 and older with Alzheimer's disease and related dementias (ADRD), and whether associations differ by the relative size of the local jurisdiction. We used a novel dataset that links Medicare claims data with data from an organizational census of municipally based Massachusetts older adult centers. Living in a community with an older adult center that facilitates access to ADS and/or SADCs was associated with reduced hospital utilization and costs among residents in smaller jurisdictions. We found no evidence for associations concerning memory cafes or support groups. These findings underscore the potential of older adult centers in curbing health care costs and acute care usage among individuals with ADRD, particularly in smaller communities with centers that provide access to ADS.

Organizational Characteristics of Senior Centers and Engagement in Dementia-Friendly Communities.

Background and Objectives: Dementia-friendly communities (DFCs) are systematic and collaborative efforts to make local communities more supportive and inclusive of persons living with dementia and their care partners. This study explores how the organizational characteristics of senior centers influence their engagement in DFCs. Research Design and Methods: We used a partially mixed, concurrent, equal status design, drawing on qualitative interviews with staff from 13 senior centers leading DFC initiatives as part of a statewide dementia-friendly network in Massachusetts, as well as quantitative data from 342 senior centers collected as part of a statewide survey. Results: The qualitative results demonstrated ways in which human, social, tangible, and programmatic capital facilitate senior centers' DFC engagement. In particular, the results illuminated the importance of social capital with organizations and groups outside of the senior center, spanning the municipal, regional, and state levels. Findings from multivariate analyses further indicated robust and strong associations between higher levels of social capital, as well as more dementia-focused programming and greater variety of funding sources, with greater likelihood of engagement in DFC work. Discussion and Implications: Results indicate the importance of policy and practice to foster both organizational capacity and multilevel systems conditions to enable and motivate senior centers' involvement in DFC initiatives.