Innovation in Aging最新文献

Background and objectives: Despite the rapid growth of older Asian American populations, little is known about their retention and its associated factors in longitudinal aging studies, partially due to the limited longitudinal studies among this population. This study addresses this critical gap by examining key predictors of attrition in this understudied population.

Research design and methods: Using data from the Population Study of Chinese Elderly in Chicago (PINE), a large longitudinal epidemiological study of older Chinese immigrants in the United States (US), we analyzed the effect of sociodemographic, immigration, health, and psychosocial characteristics on attrition status and various attrition patterns.

Results: High levels of acculturation and longer length of stay in the US were associated with a higher likelihood of attrition. Also, participants with higher levels of educational attainment and loneliness were more likely to drop out of the study earlier. In addition, participants with lower income were more likely to remain in the study.

Discussion and implications: These results show unique attrition dynamics in older Asian immigrants, where acculturation and education paradoxically increase attrition risk. These findings highlight the need for tailored retention strategies to enhance continued participation in longitudinal aging studies among older Asian American immigrants.

Background and objectives: Population aging affects health and social care needs. Although its effects on healthcare needs have been widely discussed, less has been said about its implications on social care needs, even though the consequences of living with chronic conditions are related to functional decline, disability, dependency, and mobility limitation. This study aims to identify trajectories of healthcare and social care needs after the onset of chronic conditions, as well as to explore through cross-country comparisons how demographic, socioeconomic, living arrangements, and health-related dimensions explain individuals' trajectories.

Research design and methods: Using data from the Survey of Health, Ageing and Retirement in Europe, we analyzed trajectories of 16,718 individuals aged 50 and above from 10 European countries through sequence analysis. Multinomial regression models were fitted to understand the factors that explained these trajectories.

Results: This study identified four trajectories after the onset of chronic conditions: (a) "Persistent multimorbidity and social care needs," (b) "Persistent multimorbidity without social care needs," (c) "One chronic condition and social care needs," and (d) "One chronic condition without social care needs and some recoveries." The models present divergences in individuals' characteristics, including demographic and socioeconomic aspects, as well as differences by country, related to each trajectory.

Discussion and implications: By acknowledging trajectories within health and social care needs, we showed the challenges posed by aging processes, which require tailored-made and person-centered services oriented towards preventing and postponing the onset of chronic conditions as well as dealing with their consequences on individuals' daily lives.

Background and objectives: In recognition of the aging population and aged care workforce shortages, calls have been made for responsive and effective strategies for this workforce group. This study aimed to investigate the feasibility, acceptability, and preliminary efficacy of an online mentoring program for aged care support workers serving older adults in New Zealand residential care facilities.

Research design and methods: This mixed-methods study consisted of (1) a nonrandomized single-arm intervention study, with outcome measurement at baseline, 3- and 6-month (Satisfaction with Life Scale, Generic Job Satisfaction, Perceived Stress Scale, and General Self-Efficacy Scale) and (2) a post-intervention qualitative descriptive study exploring perceived acceptability and feasibility aspects of the proposed intervention. Participants met once a month, for 30-60 min. They followed a program manual to work on self-identified goals.

Results: Thirty-eight support workers enrolled, and 22 of them took part and completed the 6-month program. The recruitment target was reached within the proposed 3-month timeframe. Data collection procedures were considered practical and convenient. Participants (13 mentees and 9 mentors) reported that the program was appealing and relevant, its duration and intensity appropriate, and the online delivery acceptable. Participants proposed refinements to improve their experience further. Exploratory outcomes analysis found all measures trended in the expected direction.

Discussion and implications: The WeCare Mentoring Program was found to be a feasible and acceptable intervention. Participants reported several improvements in their well-being and their caregiving-related skills. The next step is to test the intervention's effectiveness in a definitive controlled trial or quasi-experimental study. If future efficacy trials prove successful, this program can offer a much-needed support to the aged care workforce, and lead to better outcomes for them and the people they care for.

Background and objectives: Social engagement is widely recognized as a protective factor for mental health in later life, yet most studies treat it as a static condition and overlook potential asymmetries in the effects of becoming socially engaged and disengaged. This study examines (1) whether the mental health effects of entering and exiting social engagement are asymmetric, (2) whether these effects differ by the type of engagement (informal vs formal), and (3) whether gender moderates these associations.

Research design and methods: Using 7 waves of data from the Korean Longitudinal Study of Aging, we analyzed 6,762 older adults aged 65 and older. Asymmetric fixed effects models were employed to estimate within-person changes in depressive symptoms associated with entry into and exit from social engagement. Gender-stratified models and interaction terms were used to examine differential effects by gender.

Results: Transitions into and out of social engagement were significantly associated with changes in depressive symptoms, but no statistically significant asymmetries were found for either informal or formal engagement in the full sample. However, gender-stratified analyses revealed asymmetric effects for formal social engagement: women benefited more from entering engagement, whereas men were more negatively affected by exiting it. No gender differences or asymmetries were observed for informal social engagement.

Discussion and implications: These findings underscore the importance of distinguishing between types of social engagement and considering gender differences when designing interventions. Policies that support both prevention and re-engagement-particularly those that are gender-sensitive and address formal social roles-may be most effective in promoting mental health among older adults.

Background and objectives: Frailty is a dynamic syndrome increasing older adults' vulnerability to adverse outcomes. Longitudinal data on frailty transitions and their influencing factors remain limited. We aimed to examine bidirectional frailty transitions among middle-aged and older adults using a multi-state Markov (MSM) model.

Research design and methods: Data were obtained from four waves (2011-2018) of the China Health and Retirement Longitudinal Study (CHARLS), including 15 763 participants aged ≥45 years. Frailty was assessed using a 32-item frailty index. MSM models estimated transition probabilities, mean sojourn times, and covariate effects. Additional analyses examined age- and gender-specific patterns and included an age × gender interaction term.

Results: Baseline prevalence of robust, pre-frail, and frail states was 44.3%, 39.4%, and 16.3%, respectively. Within one year, pre-frail participants had probabilities of 18.0% reverting to robust and 19.7% progressing to frail states. At five years, these probabilities were 23.4% and 33.4%, respectively, with mortality increasing to 19.7%. Older age increased frailty progression and mortality risks but reduced recovery likelihood. Notably, significant age × gender interactions were observed for transitions from pre-frail to robust and from frail to death. Men showed higher recovery rates but greater frailty-related mortality than women. Urban residency, higher education, and marriage were protective, while smoking and alcohol increased frailty risk.

Discussion and implications: Frailty among middle-aged and older Chinese adults demonstrates substantial bidirectional transitions, indicating notable opportunities for intervention and prevention. Age, gender, socioeconomic status, and lifestyle behaviors are key modifiable determinants influencing frailty progression and recovery. Public health strategies prioritizing targeted screening and preventive interventions-particularly among vulnerable groups-could effectively mitigate frailty progression, promote recovery, and improve overall population health outcomes.

Background and objectives: The growth in older adults living with disabilities and the decline in the workforce call for technology-driven nursing services to alleviate the burden. Functional assistive robots have emerged as a promising solution; however, their acceptance and attitude toward them remain underexplored. Therefore, this study aimed to investigate the attitudes and requirements of older adults living with disabilities regarding functional assistive robots.

Research design and methods: A mixed-methods study was conducted between November 2023 and January 2024, comprising a cross-sectional survey of 85 older adults with varying levels of disability and semi-structured interviews with 10 participants. Quantitative data were analyzed descriptively, and qualitative data were thematically analyzed to enrich and contextualize the findings.

Results: Fifty-three percent of participants expressed willingness to use a functional assistive robot, with safety, affordability, ease of use, and multifunctionality identified as the most influential factors. Walking assistance and toilet transfer were the most desired functions across all disability levels. Qualitative findings reinforced the quantitative findings, revealing dissatisfaction with current aids due to their limited stability and maneuverability, alongside a strong desire for increased independence and reduced strain on family caregivers. Attitudes toward robots ranged from enthusiasm to skepticism, influenced by perceived usefulness, disability level, and care context. Participants emphasized the need for compact, stable designs with simple interfaces, and some expressed interest in light social features, provided they did not compromise core functionality.

Discussion and implications: This study highlights the demand for functional assistive robots that address critical mobility-related tasks. Functional assistive robots are viewed as promising, but adoption hinges on improving safety, usability, and affordability. Multifunctional, user-friendly designs are essential for practical use. The findings offer guidance for nurses, caregivers, and developers by clarifying core functional needs and concerns, supporting the creation of acceptable technologies that enhance autonomy and quality of life.

Background and objectives: Cardiometabolic syndrome (CMS) poses a significant public health challenge due to its rising prevalence in aging and significant healthcare costs. Recent studies have suggested telomere length (TL), a marker of cellular aging, may be impacted by CMS among women, but comprehensive evidence remains limited. This study aimed to examine the association between CMS risk factors (increased waist circumference [WC], elevated blood pressure, impaired fasting blood glucose, elevated triglycerides, decreased high-density lipoproteins) and TL in women, with consideration of age and race or ethnicity.

Research design and methods: A systematic review was conducted following PRISMA guidelines, with searches across five databases. Thirteen relevant studies published between 2007 and 2022 were included. A narrative synthesis was performed to evaluate associations between CMS risk factors and TL.

Results: Findings revealed individual CMS risk factors did not demonstrate relationships with TL; however, a link was identified between collective CMS risk factors and decreased TL. The influence of CMS on TL varied by mean sample age, where increased WC was associated with decreased TL for middle adulthood women. Findings based on race or ethnicity were inconclusive due to limited analyses, but examination by continent revealed a relationship between increased WC and decreased TL in Asia and North America.

Discussion and implications: There was high heterogeneity among diagnostic criteria for CMS risk factors across studies, potentially limiting findings. This review highlights the need for further research to clarify the complex associations between CMS and TL in women throughout the lifespan. Future large cohort studies using standardized CMS diagnostic criteria should examine variations by age and race or ethnicity to enhance understanding of these relationships.

Background and objectives: Multimorbidity is increasingly prevalent among the middle-aged population, yet it is largely often overlooked. We aimed to explore and compare the differences in multimorbidity patterns by sex and age among middle-aged inpatients from China and the United Kingdom.

Research design and methods: We analyzed 184 133 hospitalization records from Shaanxi, China, and 180 497 from the UK Biobank for -middle-aged populations. Using network analysis, we examined multimorbidity patterns by sex, age groups (40-44, 45-49, 50-54, and 55-59 years), and countries. We also identified hub diseases in both sex-specific and sex-age-specific networks and their corresponding roles in forming multimorbidity patterns.

Results: In both China and the United Kingdom, males exhibited higher multimorbidity prevalence (China: 58.51% vs 55.33%, 1.06×; United Kingdom: 31.15% vs 29.79%, 1.05×) and greater complexity of multimorbidity patterns (China: 1179 patterns vs 990 patterns, 1.19×; United Kingdom: 438 patterns vs 377 patterns, 1.16×) than females. In sex-specific networks, males in both countries demonstrated the specificity of circulatory, genitourinary, and endocrine/nutritional/metabolic-associated multimorbidity patterns, while females demonstrated specific genitourinary and neoplasm-associated multimorbidity patterns. Hub diseases in these networks are distributed in similar disease categories. In sex-age-specific networks, dominant multimorbidity patterns and hub diseases shifted by age. In males, both countries showed stable but dominating circulatory, endocrine/nutritional/metabolic and digestive-associated multimorbidity patterns with aging. In comparison, Chinese females demonstrated an increase in nervous system-associated multimorbidity patterns and a decrease in genitourinary-associated multimorbidity patterns with ageing; British females demonstrated an increase in mental/behavioral-associated multimorbidity patterns and a stable but dominating -genitourinary-associated multimorbidity patterns.

Discussion and implications: In both China and the United Kingdom, males demonstrated more complex multimorbidity than females. With ageing, multimorbidity patterns are stable in males, while females in China and the United Kingdom each develop different and specific multimorbidity patterns. These findings may inform targeted interventions for middle-aged inpatients with multimorbidity by sex and age.

[This corrects the article DOI: 10.1093/geroni/igae071.].