Journal of Women & Aging最新文献

Aging Veterans face complex needs across multiple domains. However, the needs of older female Veterans and the degree to which unmet needs differ by sex are unknown. We analyzed responses to the HERO CARE survey from 7,955 Veterans aged 55 years and older (weighted N = 490,148), 93.9% males and 6.1% females. We evaluated needs and unmet needs across the following domains: activities of daily living (ADLs), instrumental ADLs (IADLs), health management, and social. We calculated weighted estimates and compared sex differences using age-adjusted prevalence ratios. On average, female Veterans were younger, more were Non-Hispanic Black and unmarried. Females and males reported a similar prevalence of problems across all domains. However, compared to males, female Veterans had a lesser prevalence of missed appointments due to transportation (aPR 0.49; 95% CI: 0.26-0.92), housework unmet needs (aPR: 0.44; 95% CI: 0.20-0.97), and medication management unmet needs (aPR: 0.33; 95% CI: 0.11-0.95) but a higher prevalence of healthcare communication unmet needs (aPR: 2.40; 95% CI: 1.13-5.05) and monitoring health conditions unmet needs (aPR: 2.13, 95% CI: 1.08-4.20). Female Veterans' common experience of unmet needs in communicating with their healthcare teams could result in care that is less aligned with their preferences or needs. As the number of older female Veterans grows, these data and additional work to understand sex-specific unmet needs and ways to address them are essential to providing high-quality care for female Veterans.

Veterans frequently need assistance because of injuries and chronic conditions, but also serve as caregivers to family and friends. Our aim was to describe the prevalence of characteristics and experiences of women veterans who serve as caregivers and compare them with non-veteran women. We measured caregiving prevalence caregiving among women veterans (N = 4,179) and women non-veterans (n = 160,307) using population-based data from 48 jurisdictions in the Behavioral Risk Factor Surveillance System from 2021 to 2022. We calculated weighted prevalence estimates and adjusted prevalence ratios [PR] for the association between veteran status and three health outcomes adjusted for age, race and ethnicity, and caregiving activities. Similar proportions (∼23%) of women veterans (n = 1,000) and non-veterans (n = 36,929) were caregivers. Among women caregivers, veterans were more likely than non-veterans to have had a chronic health condition (63 vs. 57%), disability (39 vs. 35%), and current frequent mental distress (27 vs. 22%), although all were quite prevalent in both groups. In adjusted models, the only significant difference was in current frequent mental distress among women veterans compared with non-veteran women caregivers age 18-44 (PR = 1.49, 95%CI: 1.20 - 1.85). Women veterans provide similar care as non-veteran women. However, younger women veteran caregivers more frequently experience mental distress, suggesting the importance of routine assessment of caregiving status to initiate support. This may be a result of military experiences (e.g., combat, trauma) and related comorbidities (e.g., traumatic brain injury, PTSD) that could enhance caregiving burden, making caregiver support, chronic disease self-management programs, and mental health services priorities for women veteran caregivers.

Physical activity (PA) and exercise are central to maintaining health, however research has shown steep declines in PA and exercise among women Veterans as they age. Though motivation may be an important contributor to initiating and sustaining exercise that may change across the lifespan, little is known about exercise motivation and its relation to age and exercise behavior among women Veterans. This cross-sectional study sought to describe exercise motivations, examine relationships among exercise motivations and age, and explore the degree to which age and motivation predict self-reported exercise behavior among women Veterans. We conducted a secondary data analysis from a regional mail survey of 197 women Veterans (mean age = 51; SD = 10.5) enrolled in Veterans Health Administration primary care in a northeastern region (N = 180 in analysis). Measures included demographics (age, body mass index), self-reported exercise motivation, and an estimate of average weekly exercise. Participants endorsed multiple motivators for exercise, most prominently fitness and health management. Age was significantly negatively related to amount of exercise and with socializing as an exercise motivation. After accounting for body mass index, age was a significant predictor of exercise behavior, and exercise motivations accounted for an additional 7.3% of variance in self-reported weekly exercise. Our results suggest that although motivation is a potentially important predictor of exercise, factors beyond motivation may better predict exercise in women Veterans. Further research is needed on personal and practical facilitators and barriers to exercise in this population.

In this study, we examined rates of insomnia and co-occurring unhealthy alcohol use in a national sample of women Veterans age 50 years and older. We further explored associations between sociodemographic measures, insomnia-related clinical characteristics, and unhealthy alcohol use, and analyzed whether women with insomnia were more likely to report unhealthy alcohol use. Study aims were evaluated using national Veterans Health Administration (VA) electronic health records data from VA's Corporate Data Warehouse. Data were extracted for women Veterans ≥50 years old with ≥1 VA primary care visit in each study year (2018: 3/11/18-3/10/19; 2020: 3/11/20-3/10/21; 2022: 3/11/22-3/10/23). Cases of insomnia were identified via diagnostic codes and prescription medications for insomnia. Unhealthy alcohol use was identified via Alcohol Use Disorders Identification Test-Consumption screening scores indicating unhealthy alcohol use. Annual sample sizes ranged from 240,420-302,047. Over the study timeframe, insomnia rates (diagnosis or medication) among women ≥50 years old ranged from 18.11-19.29%; co-occurring insomnia and unhealthy alcohol use rates ranged from 2.02-2.52%. Insomnia and unhealthy alcohol use rates were highest among women aged 50-59 years old. Depression and physical health comorbidities were consistently associated with insomnia; associations by race and ethnicity were less consistent. Compared to women without insomnia, women Veterans with either concurrent or unremitting insomnia were more likely to endorse unhealthy alcohol use. Findings signal a potential need for assessment and preventative efforts aimed at addressing insomnia and unhealthy alcohol use among women Veterans.

Women Veterans constitute a distinctive cohort whose exposure to military service can contribute to development of bladder conditions, such as urinary incontinence (UI), as they age. Behavioral therapies are recommended as first-line treatment for incontinence, yet many VA Medical Centers do not have staff trained to administer them. The purpose of this research study was to conduct a qualitative program evaluation of MyHealtheBladder, a mobile telehealth version of an evidence-based eight-week behavioral treatment program designed for women Veterans with incontinence. MyHealtheBladder uses mobile telehealth technology to teach pelvic floor muscle exercises, bladder control strategies, fluid management, risk factor reduction, and self-monitoring. Eighteen women Veterans who completed a pilot study of MyHealtheBladder participated in semi-structured telephone interviews exploring their experience with the program. A directed content analysis was conducted of the transcribed interview data. Participants described ease of accessing MyHealtheBladder using smart phones and other mobile devices, emphasizing the flexibility of using the program at home, work, or while traveling. Most participants described program content as understandable, relevant, and easy to follow. They discussed how the program increased knowledge of UI, promoted consistency in practicing behavioral therapy, strengthened pelvic floor muscles, reduced urine leakage, and improved psychosocial wellbeing. Suggestions for improvement included more interaction with staff, more individualized tailoring of content to UI type, incorporating in-person clinic visits, and including supplementary material. Participants uniformly endorsed the program and recommended it for other women Veterans, as well as for those in active duty to prevent or treat UI earlier in the life course.

Objective: To evaluate the impact of sociodemographic and clinical sex/gender-associated factors on dementia severity at the time of diagnosis.

Methods: Retrospective, cross-sectional study using 2007-2020 data from the Registry of Dementia of Girona (ReDeGi), collecting information from new dementia diagnoses in the seven hospitals of the Health Region of Girona (Northeast region of Catalonia, Spain). Sociodemographic and clinical variables were compared by sex and dementia severity at diagnosis. A multivariate analysis stratified by sex evaluated the risk of having a moderate/severe dementia diagnosis.

Results: Of 9614 new dementia cases, 6040 (62.8%) were women, and 3574 (37.2%) were men. Women and men aged 75-85 years had 27.9% (p = .003) and 43.1% (p < .001) less risk of moderate/severe diagnosis, respectively, than those >85. Being institutionalized increased the risk of moderate/severe diagnosis more in women (159.9%; p < .001) than in men (114.8%; p = .030). Being single and having a higher education increased the risk of moderate/severe diagnosis by 76.2% (p = .039) and 69.8% (p = .021), respectively, only in women.

Conclusions: Age, education level, marital status, and place of residence were differentially associated with moderate/severe dementia at the time of diagnosis in women and men, indicating sex/gender differences in dementia severity at diagnosis, with an increased impact on women.

In rural Bangladesh, older adults generally enjoy their role as grandparents and spend their leisure and inactive periods (non-involvement in income-generating activities) with their grandchildren. The life satisfaction of the older adults partly lies in their role-playing as grandparents. The aim of this study was to examine the impact of caring for grandchildren on the life satisfaction of the older adults in rural areas. A survey method was used to conduct the study, and the age of the participants was 60 years and above. Four Mohollas of Kalia Upazilla of Narail district were selected purposively, and 253 older adults (123 male & 130 female) were chosen by using a purposive sampling technique. An interview schedule (containing both open and close-ended questions) was used to collect data in the months of November and December 2018. The findings showed that activities with grandchildren and caregiving roles depended on the age structure, and families with more household income were found to enhance the life satisfaction with grandparenting. There was a significant association between the life satisfaction of older adults and their grandparenting role. By identifying some dimensions of family involvement and socio-demographic conditions, this research aims to provide a deeper understanding of the dynamics of how grandparenting impacts the life satisfaction of older adults in rural areas of Bangladesh. The results might help to minimize the shortfalls of policy regarding the well-being of the older adults by focusing on their social and psychological needs. This will ensure aging is in place for everyone.

A dearth of research has focused on the diverse experiences of aging sexual minority populations and, in particular, older sexual minority women. Studies that have disaggregated the population of lesbian, gay, bisexual, transgender, questioning, queer, intersex and two-spirit (LGBTQIS+) older adults reveal that due to minority stress and a lifetime of disadvantage. Lesbians experience higher rates of chronic health conditions and mental health problems (including loneliness) than heterosexual women and greater financial inequalities compared to gay men or heterosexual women. Despite this, limited inquiry has explored the everyday lives of older queer women and fewer still draws upon women's commentary on their own lived experiences or centers older women as authoritative agents and experts on their own lives. In response to this knowledge deficit, this research traverses the aging experiences of female-identified members of a gay square dance (GSD) club in Toronto, Canada. We apply queer theory to explicate the unique ways in which a GSD club queers the aging process for 14 older women dancers. Findings of the inquiry highlight the ways in which these dancers confront and reject heteronormativity, while illuminating pathways to successful aging for older sexual diverse women. The older women dancers in this study perform gender in ways that challenged heteronormativity and gender binaries, enhanced belongingness and acceptance, embodied joy, and fostered wellness. These concepts have been identified as critical factors in successful aging and highlight what queering aging might look like for this resilient population who have overcome a lifetime of disadvantage.