Aging in place is a high priority for Floridians, yet nearly 40% of older adults have at least one disability, creating challenges for independent living. Mobility-related disabilities are among the most common types, including difficulties with walking, climbing stairs, or performing other physical tasks. Nearly one-third of community-dwelling adults aged 65 and older report difficulty with mobility tasks. Cognitive impairments also have a high incidence and prevalence which affects judgment and independent decision-making—with direct impact on independent medication management, ADL and IADL execution, ability to drive safely and use of community mobility. However, Florida ranks low in long-term services, support, and housing assistance for low-income adults with disabilities, highlighting the barriers that hinder aging in place with dignity and autonomy. Reducing these barriers is a moral imperative and a strategic investment in the well-being and prosperity of Florida.
Dr. Chiung-ju (CJ) Liu and Dr. Dorian K. Rose
Associate Professor Occupational Therapy; Research Professor Physical Therapy
Feasibility of hybrid task-oriented exercise for recent home health patients with cognitive impairment and mobility limitations
Key takeaways: Premature discharge from rehabilitation services due to insurance cost-saving measures can hinder patients from achieving optimal functional recovery, increasing the risk of hospital readmission and long-term care placement. This study will assess the feasibility of a hybrid, task-oriented exercise program that combines virtual and in-home visits for older people recently discharged from home health services who have cognitive impairment and mobility limitations.
Abstract: “East or West, Home is the Best.” Home health is the only post-acute care setting where patients receive skilled therapy to improve independence in the comfort of their own homes. To qualify for home health care, patients must be homebound. These patients are often older adults at an advanced age with multiple comorbidities, including cognitive impairment, and are at high risk for long-term care admission. While exercise is the best-known approach to improving older adults’ physical and cognitive capacity, high-risk older adults are often excluded from clinical trials. Additionally, most exercise interventions last three months or longer, making them impractical under the current Medicare payment model. Our team propose a hybrid, six-week task oriented exercise to improve mobility and cognition in high-risk older adults. The program is innovative because it applies a task-oriented approach from stroke rehabilitation to geriatric rehabilitation. Moreover, combining in-person and virtual delivery may reduce care costs. We will assess the feasibility of this program and estimate its preliminary effects on older adults recently discharged from home health who continue to experience cognitive impairment and mobility limitations. This will be done before using a more robust research design with active patients in a future larger trial.
Dr. Tracy Centanni
Associate Professor Speech, Language & Hearing Science
Improving speech in noise perception for individuals with age-related hearing loss
Key Takeaways: Hearing loss is a common age-related deficit that can impact an individual’s ability to follow and adhere to medical instructions, hear fire alarms, the doorbell, or the phone, and participate in daily activities like grocery shopping, which may accelerate their move into assistive living facilities. Our work will evaluate non-invasive vagus nerve stimulation as a portable, affordable, and promising new intervention for improving speech-in-noise perception beyond what is possible with hearing aids.
Abstract: Hearing loss, a common age-related deficit, affects multiple aspects of daily life, but one of the most disruptive symptoms is difficulty understanding speech in the presence of noise, which is commonly reported by those with hearing loss and leads older individuals to withdraw from social situations. Importantly, speech in noise perception continues to be problematic for many wearing hearing devices, even after incredible advancements in digital noise reduction technology. Reduced hearing sensitivity can make it difficult for older adults to continue living independently for many reasons. For example, individuals with hearing loss are at increased risk for falls due to increased cognitive load and reduced awareness of their environment. In addition, older adults with hearing loss may misunderstand medical recommendations or instructions, leading to poor compliance with their plan of care. While hearing aids help amplify sound and are useful in many situations, they can be ineffective in noisy contexts. Thus, to improve speech in noise perception, additional technological advancement is needed. One promising approach is transcutaneous auricular vagus nerve stimulation (taVNS), which is non-invasive, affordable, and portable. The proposed pilot study will evaluate taVNS for improving speech in noise perception in adults with age-related hearing loss.
Dr. Chien-Te Wu
Associate Professor Occupational Therapy
Tinker-FUN (Tinkering to Flex Ur braiN): A cognitive flexibility pilot program for community dwelling older adults
Key Takeaways: “The proposal aims to evaluate the feasibility of Tinker-FUN for community dwelling older adults in terms of acceptability, implementation, and adherence, as well as examine its preliminary intervention effect.”
Abstract: While cognitive training is a well-accepted approach to mitigating cognitive decline due to normal aging or neurodegenerative condition in older adults, no current practices target on cognitive flexibility that is critical for their adaptive aging in place. To address this, we have developed the cognitive flexibility intervention program, Tinker-FUN (Tinkering activities to Flex Ur braiN), and preliminarily examined its intervention effect. However, to pursue a larger scale clinical trial study and magnify its positive influence on adaptive aging in place, the current proposal aims to examine its feasibility in older adults from local communities in USA.
Dr. Hongwu Wang
Assistant Professor Occupational Therapy
Enhancing Aging-in-Place with AI-Personalized Recommendations and Hands-On Smart Home Technology Training
Key Takeaways: This project aims to enhance aging-in-place for older adults by developing an AI-driven tool that recommends personalized, affordable smart home devices and a hands-on training kit to boost safety and independence. It seeks to reduce preventable accidents like falls and medication errors by addressing usability and cost barriers.
Abstract: Every year, millions of older adults risk losing independence due to preventable home accidents. In Florida alone, falls cost $3.935 billion in medical expenses, while medication errors lead to 700,000 ER visits, 120,000 hospitalizations, and 7,000 deaths. Smart home devices, like voice-controlled lights or motion sensors, can prevent these issues but are often too expensive, confusing, or fail to adapt to the users’ changing needs. This project introduces two solutions: an intelligent tool for personalized, cost-effective device recommendations and hands-on training kits for confident use. The tool analyzes each person’s home layout, budget, and health risks to suggest devices like fall detectors or pill dispensers, updating recommendations as needs change (e.g., adding grab bars if mobility declines). Portable kits let users practice in realistic scenarios, such as responding to a simulated fall or power outage. To ensure equity, the prototypes will be tested with older adults in urban, rural, and resource-limited communities. This project aims to help older adults stay independent longer while reducing caregiver stress by simplifying and lowering the cost of technology. Results will guide a national effort to integrate smart home tools into care plans, supported by health insurers and tech companies for widespread access.
Dr. Elizabeth Tobener
Clinical Assistant Professor Speech, Language & Hearing Science
Unraveling the Impact of Age-Related Hearing Loss on Fall Risk
Key Takeaways: The goal of this project is to investigate the relationship between age-related hearing loss (ARHL) and fall risk by evaluating a sensitive, equipment-free balance screening measure. This study aims to improve fall risk assessment and prevention strategies for older adults with ARHL.
Abstract: The vestibular system plays a crucial role in maintaining balance and spatial orientation. Vestibular dysfunction significantly increases the risk of falls. The personal, societal, and economic impacts of falls are significant, yet identification and prevention strategies are limited. It has been well-established that the hearing and vestibular systems share similar anatomical features and degrade as an effect of aging. Given the connection between hearing loss and vestibular disorders, this research seeks to identify a measure of postural control that is sensitive to this connection. Specifically, the study will focus on two key objectives: (1) comparing video ocular counter roll measurements and (2) comparing single leg stance with and without lateral head tilt between adults with normal hearing and those with age- related hearing loss. The successful completion of this study will enhance understanding and improve the management of vestibular deficits in individuals with ARHL.
Dr. Jennifer Applebaum
Assistant Professor Environmental and Global Health
Risks and Benefits of Aging in Place with Pets among Older Adults with HIV
Key Takeaways: This study aims to assess the barriers and facilitators to aging in place with pets among people with HIV aged 50+, focusing on pets’ impacts on mental, physical, and social health, and economic stability. Through qualitative interviews with 20 pet-owning older people with HIV, the study will explore their perceptions of pets’ contributions to well-being and independence.
Abstract: As the population of people with HIV (PWH) in the U.S. ages, with 70% expected to be over 50 by 2030, understanding factors that support healthy aging becomes crucial. Aging in place, or living independently at home, is often challenged by age-related HIV co-morbidities, such as reduced cognition, reduced physical function, social isolation, and increased cardiovascular disease risk. Pets, owned by about 50% of PWH, offer mental and physical health benefits, such as stress reduction, alleviation of loneliness, and promotion of community participation and physical activity. However, pet caregiving can be resource-intensive and pose risks, such as falls and difficulty finding and maintaining pet-inclusive housing. This study aims to assess the barriers and facilitators to aging in place with pets among PWH aged 50+, focusing on pets’ impacts on mental, physical, and social health, and economic stability. Through qualitative interviews with 20 pet-owning older PWH, the study will explore their perceptions of pets’ contributions to well-being and independence. The findings will inform an NIH R01 submission to develop and test an adapted social needs intervention to enhance quality of life for older PWH, guiding healthcare providers and policymakers in creating supportive environments for aging in place with pets.