Generations-Journal of the American Society on Aging最新文献

To achieve optimal, equitable health outcomes for all older adults, the United States desperately needs equity in access to, quality of, and cost of aging care. To illustrate these needs, we discuss the current inequitable state of frailty care. Frailty disproportionately affects marginalized populations, yet these populations struggle to access high-quality geriatrics care and long-term care services and supports (LTSS) that mitigate frailty, leading to accelerated frailty trajectories. Health services research can provide the data needed to document, elucidate, and address health inequities in frailty care, including early identification and referral of frail adults to specialized care and financing LTSS.

The IMPACT Collaboratory is a national infrastructure and resource dedicated to transforming dementia care in real-world environments for millions of Americans and their care partners, using embedded pragmatic clinical trials. This new approach of applied clinical research holds the promise of accelerating the science of dementia care, improving relevancy of interventions to real-world partners, promoting health equity, and closing the gaps between research, everyday clinical practice, and lived experiences of people living with dementia and their care partners.

Alzheimer's disease and related dementias place an enormous burden on individuals, families, health and long-term care systems, and governmental budgets. As the burden escalates with rising prevalence, attention has increasingly focused on how the risk of developing dementia can be reduced. Evidence indicates there are ways, from a population perspective, to reduce the risk of cognitive decline and possibly dementia, including through healthier lifestyles. It is imperative that the public health community lead the effort to address modifiable risk factors and social determinants of health for dementia and promote healthy aging through public health action.

Older women living with HIV are an especially vulnerable population due to their experience of multiple stigmas resulting from intersectional identities. Using an intersectional convoy model to conceptualize social relations, we consider how HIV-related stigma, age, gender, race/ethnicity, and socioeconomic position shape access to support resources through personal networks. We briefly review existing research on how intersecting identities and structural inequities might influence the structure, composition, and function of support networks among older people with HIV. Potential applications of the intersectional convoy model and implications for research and practice are discussed.

This article profiles a program in Detroit, MI, funded by the National Institute on Aging, called the Michigan Center for African American Aging Research and its key offshoot the Healthier Black Elders Center (HBEC). Board members of its Community Advisory Board weigh in on key programming and offer perspectives and recommendations on health and social issues. The HBEC Consulting Program is a blend of formal volunteering and paid work through consulting fees. The article also outlines next steps for HBEC.

Indigenous older adults are a diverse and growing population that is not equitably included in gerontological research and continues to experience disparate health outcomes in later life. Resolving structural inequities endured by Indigenous peoples across the lifespan using existing policy mechanisms will only be possible if we better develop our theoretical frameworks to include Indigenous perspectives and develop research agendas that center minoritized aging populations. We illustrate this approach by proposing modifications to Title VI of the Older Americans Act and the Indian Healthcare Improvement Act.

Elder mistreatment is an important public health problem that can be prevented. By investing in upstream prevention and taking a multigenerational approach, the U.S. can help create communities where older adults are safe, thriving, and living out the remainder of their lives free from abuse and exploitation. The need to do so has never been more pressing as the U.S. is on the precipice of historic population changes that could place a substantial burden on families, communities, and systems of care and protection for older adults. This article describes these changes and how public health efforts can make a difference.

This article draws on investigations by its authors, and from American and Italian interventions to provide recommendations for decreasing social isolation in older adults for policy makers, researchers, and other professionals committed to supporting the improved social integration of older adults. The article argues that to mitigate social isolation it is critical to foster a sense of belonging (personal involvement in a system or environment so people feel they are an integral part of that system or environment). Suggestions are provided on how to leverage systematic interventions to foster isolated older adults' sense of belonging to their communities.

The opioid crisis directly connects to elder abuse: grandparents may be caring for grandchildren of parents addicted to opioids; and family members, caregivers, and older adults may misuse opioids. The Elder Justice Act, the Older Americans Act, the Omnibus Reconciliation Act of 1981, and the Elder Abuse Prevention and Prosecution Act dictate responses to such opioid misuse. The Administration for Community Living, the Administration on Aging, the Office of Community Services, and the Department of Justice administer these laws. This article describes the laws, their status, and programs these agencies authorize.

The Veterans Health Administration's Medical Foster Home (MFH) program is a long-term-care model in which veterans requiring personalized nursing home-level care live in the homes of private caregivers, who are recruited and screened by a VA MFH program coordinator. Often, these caregivers are older adults who are nearer to or older than retirement age. Seven years of research into the program has shown benefits in building community and improving quality of life for veterans, caregivers, and family members of veterans living in MFHs across the United States.