Journal of Cross-Cultural Gerontology最新文献

This paper examines which leisure activities appear more attractive to older people, considering health status, disability and demographic-socio-economic and environmental variables. It employed data from Survei Penduduk Antar Sensus (SUPAS), the nationwide survey, conducted in 2015 by Indonesia's national statistical office. The sample selected 228,718 individuals aged 60 years old and above. Leisure activities were differentiated between active, sedentary, and no leisure activities. Health is measured with both health status and disability. Disability measures were adopted from Washington Group Short Set on Functioning-Enhanced (WG-SS Enhanced). Our multinomial regression models confirmed that health status was correlated with the choice of leisure activities in old age. Compared to older persons in good health, those reported in poor health without disruption to daily life were more likely to participate in sedentary or active leisure, but those with disruption to daily life were less likely to do so. Older persons with disability were disadvantaged in participating in either passive or active leisure. However, among all selected variables, employment and source of finance had the highest odds ratios and confounded the relationship between health and leisure activity.

The COVID-19 pandemic has underscored the growing importance of digital technologies for economic resilience, especially for vulnerable groups like older workers in the informal sector. However, barriers to access and digital literacy create challenges alongside potential opportunities, particularly in less developed countries such as Ghana. Using older adults over 50 years engaged in informal work in Kumasi's Central Business District in Ghana as a case, this paper explores older informal workers' use of digital technologies in Ghana during the pandemic. Findings suggest that older informal workers relied heavily on their mobile phones as the only critical technological tool to sustain their businesses during the COVID-19 pandemic. However, the findings also reveal critical gaps in skills, training, and support, alongside resourcefulness in leveraging digital tools for business continuity. Key policy implications include expanding mobile-centric digital literacy programs, addressing infrastructure divides, and integrating capacity building into social protection. The paper contributes insights on strengthening lifelong learning and extending the working lives of older persons in the informal sector in the post-COVID era.

Objective: Neuropsychological assessment among U.S. Arabic-speaking older adults is virtually non-existent due to lack of translated measures and normative data, as well as researchers' limited access to Middle Eastern/Arab Americans. The Montreal Cognitive Assessment (MoCA) is the only validated, widely-used dementia screen with Arabic language norms/cutoffs, yet, Arabic MoCA translations vary across countries and studies. We examined utility of a modified translation among Arabic-speaking immigrants in metro-Detroit.

Methods: The Arabic MoCA was modified to reflect consistency with the original English version while remaining meaningful in the Arabic language. The MoCA was then administered to 32 Arabic-speaking adults age 65 + living in metro-Detroit. Eight (25%) had an Alzheimer's disease or related dementia (ADRD) diagnosis. Each item was standardized and Cronbach's alpha assessed reliability. Ordinary least squares models examined whether an ADRD diagnosis predicts the total MoCA score and each item, adjusting for demographics.

Results: The mean age of the sample was 73 years old. The alpha was acceptably high at 0.87. Bivariate analyses show those with ADRD diagnosis scored lower overall on the MoCA. However, probability of diagnosis and age were confounded in the sample such that in multivariate analyses ADRD diagnosis did not explain additional variation beyond what is explained by age. Orientation, cube-copy test and serial 7s best distinguished those with ADRD.

Conclusion: The modified Arabic language MoCA shows promise distinguishing those with an ADRD diagnosis. This translation provides a resource for neuropsychologists looking for translated tests when working with Arabic-speaking patients in the U.S.

This study aims to develop and validate the content and response processes of a questionnaire intended for caregivers to screen for dysphagia in Brazilian older adults with dementia due to Alzheimer's disease and/or vascular dementia. The instrument items were developed in Brazilian Portuguese language based on the theoretical framework. A committee of speech-language-hearing therapists analyzed the relevance, objectivity, clarity, and understandability of the items with the Delphi method. The content validity index cutoff agreement score for experts' answers to validate each item in the questionnaire was 0.78; in the intraclass correlation coefficient, it was 0.75 for all items. For response process validity evidence, the questionnaire was applied to 30 caregivers of older adults with dementia, who judged the clarity and understandability of the items. Each item was validated when understood by at least 95% of participants. The first version of the instrument had 29 items. After two expert assessments, the last version had 24 items. The intraclass correlation coefficient was 0.85. Only one item needed semantic adjustments in the pre-test. The dysphagia screening instrument applied to caregivers of older adults with dementia was developed with adequate content and response process validity evidence, enabling adjustments in its construct. Future studies will analyze the remaining evidence of validity and reliability.

Life expectancy (LE) is a health indicator of a population's health and well-being. Modeling the trajectory of LE aligns with the objectives of Indonesia's Vision 2045 and Oman's Vision 2040. This study examines the influence of health status-resources (HSR), macroeconomic (ME), and sociodemographic (SD) factors on LE in Indonesia and Oman. These two nations navigate the challenges of the middle-income trap in the Organization of Islamic Cooperation. This study adopted a national-scale population-based approach that focuses on retrospective observations. We used partial least square structural equation models with World Bank data from 1980 to 2020 to analyze the relationship between the mentioned factors and the LE of Oman and Indonesia. For Indonesia's model, the results showed that ME has a total effect of β = 0.737 (p < 0.05) on LE, SD has a total effect of β = 0.675 (p < 0.05) on LE, and HSR has a total effect of β = 0.823 (p < 0.05) on LE. In Oman's model, ME has a total effect of β = 0.848 (p < 0.05) on LE, SD has a total effect of β = 0.755 (p < 0.05) on LE, and HSR has a total effect of β = 0.335 (p < 0.05) on LE. The findings underscore the need for policies that meld health and societal perspectives to improve public health in both nations. A shift in public health interventions and perceptions towards socioeconomic well-being and societal issues is pivotal for advancing LE growth, potentially steering these countries from the middle-income trap.

The Behavioral Risk Factor Surveillance System (BRFSS) is a randomized national U.S. telephone survey administered by state health departments. This study aimed to identify how Black/African Americans understand BRFSS caregiver and cognitive decline surveys and terminology to inform health messaging that centers the Black/African American experience. In focus groups, BRFSS surveys were administered to Black/African Americans (n = 30) aged ≥ 45 in Oregon. Participants were asked how they interpreted BRFSS terms 'memory loss' and 'confusion,' how these terms related to Alzheimer's and dementia, and about caregiving and cognitive decline experiences. The culturally responsive Africana Worldview guided interpretation, which centers the Black/African American experience and individuals within interdependent relationships and community identity when explaining behaviors of people from the African diaspora. BRFSS survey responses differed from focus group responses to the same questions. Two participants reported providing care in the past two years on the survey; in discussions, 21 participants reported providing care in the past two years. Interpretations of BRFSS terminology varied greatly. Differences between age-related cognitive changes, dementia and Alzheimer's disease were unclear. Cognitive decline was largely understood in terms of identity loss and relationship changes with the affected individual, and how that individual's relationship changed within community. Caution is advised when using BRFSS data to frame messaging because key cognitive health terms are not universally understood. Messaging that apply the Africana Worldview centralizes relationships and community rather than impact on individual's day-to-day activities, may be more effective for Black/African Americans and for other groups with different cultural and life experiences.

To clarify whether changes in frequency of going out due to the COVID-19 pandemic affect ikigai (sense of purpose in life) and mental health in Japanese middle-aged and older adults. In a questionnaire survey mailed to 16,866 adults aged > 40 years in Japan in September 2020, 7,973 responses were received (response rate, 47.3%) in October 2020. Following exclusions, data from 6,978 individuals (50.6% female, mean age 67.8 ± 12.2 years) were available for analysis. Respondents were categorized based on changes in frequency of going out, reflecting changes in social and/or physical activity, during the pandemic compared with before it: the previously active group went out often before but less often during the pandemic; the remained active group continued going out often; and the inactive group continued not going out often. Whether these changes affected the respondents' ikigai and mental health was investigated. The previously active group had a significantly higher proportion of individuals with decreased ikigai during the pandemic than the other groups. Mental health score decreased in all groups during the pandemic, but more so in the previously active group (-3.21), followed by the inactive and then the remained active groups (-1.45 and -1.28, respectively). Previously active individuals showed the greatest decline in ikigai and mental health among the three groups. These findings suggest that continuing to engage in appropriate physical and social activities, including going out, while following appropriate infection control measures, even under restrictions, can help people maintain ikigai and mental health.

Type 2 Diabetes (T2D) among older Asian American immigrants (AA) is a growing concern. Asian Americans represent 9% of diagnosed diabetes. Very little is known on how older Asian American immigrants with T2D navigate diabetes management, in particular the role of family support. This qualitative study examines Chinese and Filipino Americans, the two largest Asian subgroups in the US (4.2 million, and 3.6 million, respectively), and family support dynamics among adult children and their parents diagnosed with T2D. Ten dyads (n = 20) made up of adult children and aging parents participated in in-depth and dyadic interviews. Results indicate that family support occurs in a trajectory of stages. The following thematic patterns emerged in these dyads around support: independence, transitions, partnership, and stepping in. The findings point to various supportive stages that Asian American adult children and aging parents with T2D experience and the importance of developing supportive interventions for both adult children and aging parents at these various stages.

Traditionally, adult children have served as primary caretakers and providers for older Nepali adults. However, out-migration of adult children for employment and other opportunities is increasing. Health-related quality of life (HRQOL) in older Nepali adults in general and in the context of adult children's migration is poorly understood. This study aims to assess HRQOL of older Nepali adults and its relationship with adult children's migration. We used existing cross-sectional survey data on 260 older adults from Krishnapur municipality, which has witnessed a high rate of adult migration. HRQOL, quantified using the SF-12 scale, is expressed in terms of a physical (PCS) and mental (MCS) health component. A higher PCS and MCS score, each ranging from 0 to 100, indicates better physical and mental health, respectively. The correlates of HRQOL were assessed in simple and multiple linear regression. Participants had suboptimal HRQOL [mean (± SD): PCS = 40.4 ± 9.2 and MCS = 45.2 ± 7.7]. After adjusting for covariates, adult children's migration was associated with lower MCS scores (β: -2.33, 95%CI: -4.21, -0.44). Individuals with more than one child had higher MCS scores (β: 2.14, 95%CI: 0.19, 4.09). Females (β: -3.64, 95%CI: -7.21, -0.06) and those with a history of unemployment (β: -6.36, 95%CI: -10.57, -2.15) had lower PCS scores than their respective counterparts. The presence of chronic conditions was associated with significantly lower PCS and MCS scores. Our findings suggest that adult children's migration may negatively affect HRQOL among older Nepali adults, specifically their psychological well-being. Further research investigating potential moderating factors that may serve as important buffers is needed.

Predominantly Western-based biomedical models of successful aging have been used to research, understand, and explain successful aging among diverse populations. With an increasingly heterogeneous older adult population nationwide, scholars have been exploring Indigenous understandings of successful aging. To add to the accumulation of knowledge of diverse Alaska Native populations, this study involved semi-structured qualitative interviews with 20 Unangan Elders from the Aleutian and Pribilof Islands. This community-based participatory research study explores the aging experiences and conceptualization of successful aging of these Elders from this remote and culturally distinct region of Alaska. Thematic analysis was employed to identify themes related to successful aging within this specific region, which supported our previous four themes, or characteristics, of Alaska Native successful aging: physical health, social support and emotional well-being, generativity as a traditional way of life, and community engagement and Inidgenous cultural generativity. Each of these themes or characteristics of Eldership is intertwined and together support successful aging within two remote communities in the Bering Sea. The findings of this study illuminate how Alaska Native Elders can live in geographically diverse regions of the State, yet the values and teachings they possess on successful aging possess the same cultural values and teachings. This study highlighted two new emerging constructs that influence Alaska Native Elders' successful aging based on geographical location. Findings contribute to the thematic saturation of the four main successful aging domains while outlining the importance of future research to conduct deeper investigations into the role of environment and history on Elders' perceptions and understanding of aging.