Digital Commons Network^™

Home, Neighborhood, And Community Environments And Social Isolation In Later Life: Joint Associations And Their Moderation By Life-Course Socioeconomic Mobility, Jeein Law

Graduate Doctoral Dissertations

Social isolation is a major public health concern among older adults, yet less is known about how multilevel residential environments shape isolation among those aging in place. Guided by the Socio-Ecological Model, Person–Environment Fit, and a life-course perspective, this dissertation examined whether micro-level home hazards, meso-level neighborhood social cohesion and physical disorder, and macro-level census-tract structural conditions were associated with social isolation. It also examined whether life-course socioeconomic mobility moderated the associations between home and neighborhood environments and social isolation.

This dissertation used two nationally representative longitudinal studies of U.S. older adults. Aims 1 and 2 used the National Health …

The Effect Of State Policy On Individuals With Mental Illness In Nursing Homes: A Multilevel Analysis, Adrita Barooah

Graduate Doctoral Dissertations

ABSTRACT

THE EFFECT OF STATE POLICY ON INDIVIDUALS WITH MENTAL ILLNESS IN NURSING HOMES: A MULTILEVEL ANALYSIS

August 2026

Adrita Barooah, B.Sc., University of Delhi, India

M.S., University of Massachusetts Boston

Ph.D., University of Massachusetts Boston

Directed by Professor Pamela Nadash

The proportion of individuals living with a mental illness in U.S. nursing homes has grown substantially over the past few decades (Fashaw et al., 2020), raising serious concerns about care quality, resource adequacy, and costs to both nursing homes and government payers. The lack of adequate resources and knowledge has resulted in sub-par mental health care (O'Connor et al., …

From Structure To Experiences: How Facility Capacity And Staffing Shape The Adoption And Impact Of Lgbt-Affirming Policies In Long-Term Care, Andrew Alberth

Graduate Doctoral Dissertations

Long-term care (LTC) settings – including nursing homes (NHs) and assisted living facilities (ALFs) – provide necessary care for individuals with extreme health and functioning limitations. Sexual and gender minority (LGBT) older adults report challenges receiving effective, person-centered care LTC. Some LGBT older adults may hide their sexual orientation and gender identity when entering LTC settings or delay seeking needed LTC fearing discrimination from staff and other residents. Furthermore, staff in LTC settings indicate little awareness of LGBT-residents and possess inadequate LGBT-cultural competency necessary for providing person-centered care. Therefore, LGBT-residents LTC experiences remain underexplored in the broader research. Adopting LGBT-affirming …

How Far Does Social Security Go? Comparing Benefits To Elder Index 2025: Infographic, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston

Center for Social and Demographic Research on Aging Publications

Social Security remains the foundation of retirement income, but for millions of older adults it does not fully cover the cost of basic necessities such as housing, health care, food, and transportation.

Empowering Lifelong Choice: Supporting Older Individuals With Idd To Thrive At Work, Transition To Retirement With Dignity, And Maintain Community Connections, Leslie Quarles

Critical and Creative Thinking Capstones Collection

This synthesis addresses the need to support older individuals with intellectual and developmental disabilities in their engagement in continued work. The project traces the journey from an initial focus on supporting older individuals with intellectual and developmental disabilities to work as long as they wish to an eventual shift toward a phased retirement approach. It considers issues such as a reimagined visualization of the support team structure, integration of tailored job supports and Community Life Engagement (CLE). The author's familial history sparked a sense of injustice that would not stay buried, shaping a career path in disability services and access. …

Economic Security & Older Adults In Massachusetts: Infographic, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston

Center for Social and Demographic Research on Aging Publications

The Elder Index measures the income older adults need to meet their daily living costs while staying in their own homes. This fact sheet presents overview data of economic security of Older Adults in Massachusetts based on the 2025 Elder Index data.

Economic Security & Older Adults In The United States: Infographic, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston

Center for Social and Demographic Research on Aging Publications

The Elder Index measures the income older adults need to meet their daily living costs while staying in their own homes. This fact sheet presents overview data of economic security of Older Adults in the United States based on the 2025 Elder Index data.

The Elder Economic Security Standard™ Index: Methodology Overview, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston, Jan Mutchler, Nidya Velasco Roldan, Michelle Ward, Ceara Somerville, Caitlin E. Coyle

Center for Social and Demographic Research on Aging Publications

The Elder Index illustrates how living costs vary geographically (specifically, by county, metropolitan area, and state), and based on the characteristics of households. Costs are calculated based on household size (one person age 65 or older, two persons age 65 or older), housing tenure (owner with no mortgage, renter, owner with a mortgage), and health status (excellent, good, poor). The expenses included in the Elder Index cover basic needs of older households, including shelter, medical care, food, and transportation; the costs reflect average market costs and do not take into account any needs-based subsidies. The Elder Index helps answer important …

2025 Elder Indextm For Boston: Fact Sheet, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston

Center for Social and Demographic Research on Aging Publications

The Elder Index^_TM measures of the cost of living independently for older adults aged 65 or older. The Elder Index allows us to identify older people with incomes “in the gap” between the Federal Poverty Guideline (FPL) and what it takes to live with security. Older adults living “in the gap” have incomes too high to qualify for many means-tested public benefits programs, yet too low to achieve intermediate- or long-term economic stability. This fact sheet presents 2025 Elder Index for older adults living in Boston, Massachusetts.

Living Between The Lines: Economic Insecurity And Older Americans: Insecurity In The Massachusetts, 2025, Caitlin E. Coyle, Michelle Ward, Nidya Velasco Roldan, Ceara Somerville, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

New estimates from the 2025 Elder Index^TM demonstrate that the cost of living in Massachusetts has increased substantially in recent years for older adults, especially for renters. The Elder Index measures the necessary costs faced by households made up of one or two older adults, calculated county by county for the entire United States. Estimated costs are higher in Massachusetts than in any other state in the nation. Within the Commonwealth, the Elder Index is lowest in Western Massachusetts, and highest in Metro Boston, Martha’s Vineyard and Nantucket, with differences in the Elder Index across locations accounted for largely …

Living Between The Lines: Economic Insecurity And Older Americans, Caitlin E. Coyle, Michelle Ward, Nidya Velasco Roldán, Ceara Somerville, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

New estimates from the 2025 Elder Index(TM) suggest that over half of older adults living alone, and about one out of four older couples, lack the financial resources required to pay for basic needs. We compared household incomes for adults age 65 and above living in one- and two-person households to the 2025 Elder Index for each state to calculate Economic Insecurity Rates (EIRs), the percentage of independent adults age 65 or older with annual incomes that do not support economic security. National averages suggest that 53% of older adults living alone and 25% of older couples have annual incomes …

Frailty, Home Accessibility, And Falls In Later Life, Bonnie Albright

Graduate Doctoral Dissertations

As more people remain in their homes as they age, the risk of living at home with frailty and reduced function increases, which may also increase the risk for falls in the home. The scientific literature shows that frail people are more likely to experience falls, which leads to many negative outcomes, such as hospitalization, placement in a skilled nursing facility, and even death. The preference to age-in-place (AIP) is more likely to be met if older people live in accessible housing. Accessible homes may mitigate the risk for falls and promote AIP, especially among frail older people.

While there …

Assessing Community Needs: Human Services For Adults In Millis And Medway, Caitlin E. Coyle, Michelle Ward, Ceara Somerville

Center for Social and Demographic Research on Aging Publications

This report presents the results of a comprehensive evaluation of issues relating to aging in Millis and Medway. A needs assessment was undertaken in order to support planning on the part of the Towns of Millis and Medway, the Councils on Aging (COAs), and the communities as a whole. Results presented here focus on the characteristics and needs of Millis and Medway residents who are age 60 and older. While the primary goal of this report is to support COA planning, a secondary goal is to present information that will be useful to other Millis and Medway offices and organizations …

Wellesley Council On Aging: Planning For The Future, Caitlin E. Coyle, Beth Rouleau

Center for Social and Demographic Research on Aging Publications

Taking a community-engaged approach, this assessment sought to capture the voices, experiences, and aspirations of older adults living in our community. It is designed to support the COA in fulfilling its mission: acting as the community resource for older adults, their families, and caregivers; advocating for their interests; and offering social, educational, physical activity, transportation, and nutrition programs that promote health, independence, and meaningful engagement.

Specifically, this needs assessment aimed to: 1. Describe the demographic and social trends shaping Wellesley’s older adult population. 2. Identify older residents’ priorities, challenges, and unmet needs—spanning health and wellness, housing and mobility, social connection, …

Belmont Council On Aging: Planning For The Future, Caitlin E. Coyle, Nancy Mazonson, Ceara Somerville

Center for Social and Demographic Research on Aging Publications

This report presents the results of a comprehensive needs assessment of Belmont’s older adult population. The study was conducted to support planning by the Belmont Council on Aging and Beech Street Senior Center, and it also provides valuable information for other town departments, community organizations, and residents. Specifically, this report aims to: *Describe Belmont’s current older adult population and their needs. *Assess the services and resources currently available. *Identify gaps and opportunities for improvement. *Provide recommendations to ensure Belmont remains a supportive, age-friendly community for years to come.

As the number of older residents grows, so too will the need …

Age & Dementia Friendly Bellingham: Assessment Of Community Needs And Ideas For Action, Caitlin E. Coyle, Katherine Burnes, Ceara Somerville

Center for Social and Demographic Research on Aging Publications

In 2022 a steering committee of three Bellingham residents involved in the COA/Senior Center served as a catalyst in helping Bellingham attain the designation of Age and Dementia Friendly. A Task Force including an impressive mix of individuals from town government, schools, local organizations and older residents was formed to help Bellingham set and implement annual goals of activities designed to make Bellingham a good place to grow older for all residents.

This report describes research undertaken by the Center for Social and Demographic Research on Aging within the Gerontology Institute at the University of Massachusetts Boston on behalf of …

The Gendered Role Of Friendships For Advanced Care Planning And Health In Later Life, Zee Kee Emily Lim

Graduate Doctoral Dissertations

Friendship is becoming more pertinent to older adults because they are increasingly living with fewer family ties in later life due to changing social and demographic trends (Fiori et al., 2020; Verdery et al., 2019). However, friendships are not as extensively studied as compared to family relationships (Blieszner et al., 2019). Thus, additional research is needed to better understand the influence of friendships on health and health behaviors in later life.

This dissertation includes three studies that focus on the association between friendship and loneliness, advanced care planning, and cognitive function, examining the role of gender in these three studies, …

Aging In Harwich: A Community Needs Assessment, Claire E. Wickersham, Caitlin E. Coyle

Center for Social and Demographic Research on Aging Publications

At a time of such significant population aging, the Harwich Council on Aging commissioned a community-wide needs assessment with support from the Friends of the Harwich Council on Aging. The specific goal of this report is to support the strategic planning of the Harwich Council on Aging. An additional goal is to present information useful to other Harwich departments and organizations interacting with older residents planning for the future of Harwich. This report presents the results of a comprehensive examination of issues relating to aging in Harwich. Results presented here focus on the characteristics and needs of Harwich residents aged …

Investigating The Associations Of Cognitive Health, Health Behaviors, And Personality In Older Community-Dwelling Adults, Yan-Jhu Su

Graduate Doctoral Dissertations

Cognitive decline poses a significant public health challenge, with profound implications for aging populations. This dissertation investigates the associations between health behaviors, leisure activities, personality traits, and cognitive function in older U.S. adults, using data from the Health and Retirement Study (HRS) and the Consumption and Activities Mail Survey (CAMS). This work comprises three studies that explore both cross-sectional and longitudinal perspectives on cognitive aging.

Study 1 examines the complex interactions between personality traits, education, health behaviors, and cognitive function. The study is divided into two parts: Study 1a explores the role of health behaviors—smoking, alcohol use, and physical activity—as …

Living In Essex: A Community Needs Assessment, Sue Berger, Ceara Somerville, Caitlin E. Coyle

Center for Social and Demographic Research on Aging Publications

This report describes research undertaken by the Center for Social & Demographic Research on Aging (CSDRA) within the Gerontology Institute at the University of Massachusetts Boston, on behalf of the Town of Essex. The goals of this project were to investigate the needs, interests, preferences, and opinions of Essex residents age 18 or older by engaging the community regarding their experiences and needs relevant to the Council on Aging’s (COA’s) objective to identify and serve the needs of all Essex citizens 60 and older.

Aging In Somerville: A Community Needs Assessment, Ceara Somerville, Caitlin E. Coyle

Center for Social and Demographic Research on Aging Publications

This report describes research undertaken by the Center for Social & Demographic Research on Aging (CSDRA) within the Gerontology Institute at the University of Massachusetts Boston, on behalf of the City of Somerville. The goals of this project were to investigate the needs, interests, preferences, and opinions of Somerville residents age 60 or older by engaging the community regarding their experiences and needs relevant to the Council on Aging’s (COA’s) objective to identify and serve the needs of all Somerville citizens 60 and older.

Enhancing Transportation Options For Older Adults: Served By Councils On Aging With Support From The Montachusett Area Regional Transit Authority (Mart): A Program Validation Study, Caitlin E. Coyle, Nina M. Silverstein, Taylor Jansen, Shayna Gleason

Center for Social and Demographic Research on Aging Publications

This study follows a 2022 evaluation report UMass Boston researchers conducted for MART of a pilot program whose measurable aims were to demonstrate (pre/post) an increase in ridership, destinations, trips provided, and shared rides coordinated across the participating COAs. The pilot with four participating COAs was ambitious and while the results indicated some early successes (rider satisfaction), more areas for improvement were noted (software and transition to the use of digital technology). (Silverstein et. al., 2022) Since then, MART has adopted a new software program and collaboration with My Senior Center, a senior 4 center management and reporting system. MART …

Assessing The Need For Supportive Day Programming In Andover, Adriana Hernandez, Setarreh Massihzadegan, Caitlin E. Coyle

Center for Social and Demographic Research on Aging Publications

Supportive and social day programs (SSDPs) provide opportunities for socialization and engagement in physical activity, cognitive exercises and emotional support in small group settings, These programs are beneficial for older adults who may experience physical or cognitive heath changes that make it difficult to participate independently. As well, those who do not drive or who are socially isolated may also benefit from participation in an SSDP. These programs also help families who may need breaks from caregiving tasks and to connect families to vital resources and support networks. An SSDP is designed to promote and enhance the social, physical, and …

Up-Island Council On Aging: Planning For The Future, Ceara Somerville, Caitlin E. Coyle

Center for Social and Demographic Research on Aging Publications

This report describes research undertaken by the Center for Social & Demographic Research on Aging (CSDRA) within the Gerontology Institute at the University of Massachusetts Boston, on behalf of the Up-Island Council on Aging (UICOA). The goals of this project were to investigate the needs, interests, preferences, and opinions of Aquinnah, Chilmark, and West Tisbury residents age 50 or older by engaging the community regarding their experiences and needs relevant to the Council on Aging’s (UICOA’s) objective to identify and serve the needs of older residents of Up-island.

Aging In Uxbridge: A Community Needs Assessment, Caitlin E. Coyle, Katherine Burnes, Ceara Somerville

Center for Social and Demographic Research on Aging Publications

This report describes research undertaken by the Center for Social & Demographic Research on Aging (CSDRA) within the Gerontology Institute at the University of Massachusetts Boston, on behalf of the Town of Uxbridge. The goals of this project were to investigate the interests, preferences, and opinions of Uxbridge’s residents aged 55 or older by engaging the community regarding their experiences and needs relevant to the Council on Aging’s (COA’s) and Senior Center objective to identify and serve the needs of all Uxbridge citizens 55 and older. The contents of this report are meant to inform the Town of Uxbridge, the …

A Study Of Human Services In The Town Of Natick, Caitlin E. Coyle, Mary Krebs, Morgan Clark, Matt Frye

Center for Social and Demographic Research on Aging Publications

The Town of Natick has committed to engaging the community to guide efforts to update and modernize municipal policies, procedures, and programs such that they appropriately reflect the needs and interests of the community.

Between 2021 and 2022, the Community Services Department underwent some organizational restructuring, which included staffing changes and the inclusion of Recreation & Parks and the Sassamon Trace Golf Course as divisions within the department, which already included the Council on Aging & Human Services, Veterans Services, and the Natick Community Organic Farm4. The Community Services Department is “charged with responding to the needs, interests and quality …

Livable Marshfield: Age And Dementia Friendly Action Plan: Improving Livability For All Ages And Abilities, Caitlin E. Coyle, Beth Rouleau, Ceara Somerville

Center for Social and Demographic Research on Aging Publications

The Town of Marshfield’s Age and Dementia Friendly action plan signifies a milestone and reflects many years of dedication to creating environments within Marshfield that are supportive of residents of all ages and abilities. Guided by the Council on Aging (COA), the Town of Marshfield is dedicated to understanding and responding to the needs and interests of older adults in the community. Over the years, the share of residents over age 60 has steadily grown. According to 2019-2023 estimates from the American Community Survey, an estimated 28% of Marshfield residents are age 60 or older (approximately 7,200 residents). Projections suggest …

Planning For The Future Of The Easthampton Council On Aging, Caitlin E. Coyle, Sue Berger

Center for Social and Demographic Research on Aging Publications

This report describes an assessment undertaken by the Center for Social & Demographic Research on Aging (CSDRA) within the Gerontology Institute at the University of Massachusetts Boston, on behalf of the ad hoc Senior Center Building Committee. The goals of this project were to document the features of other communities building processes, engage residents in preliminary conversation about their needs and preferences as they consider aging in Easthampton. Results of that work are described in this report and recommendations to the ad hoc building committee are provided. These recommendations are meant to provide an objective description of this preliminary community …

The Provision Of Healthcare For Older Adults In A Massachusetts Jail/House Of Correction: Perspectives From Providers, Laura Driscoll

Graduate Doctoral Dissertations

THE PROVISION OF HEALTHCARE FOR OLDER ADULTS IN A MASSACHUSETTS JAIL/HOUSE OF CORRECTION: PERSPECTIVES FROM PROVIDERS November 2024 Laura C. Driscoll, B.S., Boston University M.S.P.T., Boston University DPT, MGH Institute of Health Professions M.S., University of Massachusetts Boston Ph.D., University of Massachusetts Boston Directed by Professor Jan Mutchler The aging population in U.S. jails is growing rapidly presenting significant challenges for healthcare provision within carceral settings. Older adults in these facilities often experience complex health conditions, including chronic diseases and age-related impairments, that require specialized care. Despite this, limited research has explored the experiences of healthcare providers tasked with caring …

Democratizing The Early Identification Of Alzheimer's Disease And Access To Care: The Role Of Psychologists In Brief Assessment, Jacqueline S. Hogan

Graduate Doctoral Dissertations

As Alzheimer’s disease (AD) presents a growing public health challenge, accessible early detection tools are urgently needed. This study used data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (N = 1,536) to evaluate the ability of machine learning models to predict a conversion from normal cognition or mild cognitive impairment (MCI) to AD. A brief neuropsychological battery, including the Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS13), Mini-Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT), and Functional Activities Questionnaire (FAQ), was employed. The Gradient Boosted Trees model demonstrated superior performance, achieving an F1 score of 0.88, recall of 0.93, precision …