Journal of Aging & Social Policy最新文献

The growing prevalence of dementia is a significant public health concern in the context of dramatic population aging worldwide. Nutrition is related to cognitive outcomes over the life course and dementia risk. This study examines the cognitive consequences of perceived food deprivation in the United States and India. A novel harmonized data set was developed to evaluate differences in the cognitive consequences of perceived food deprivation using data drawn from the U.S. Health and Retirement Study (HRS) and the Longitudinal Aging Study in India (LASI). OLS regression was used to evaluate the association between three domains of cognitive function and perceived food deprivation and to examine whether these effects are dependent on country context. Results show significant cognitive consequences across all three cognitive domains in association with perceived food deprivation, but based on moderation analyses, these effects are significant only among food-deprived individuals in the United States who have approximately one-third of a standard deviation lower cognitive function than their non-food-deprived counterparts (p < .001). Future research is needed to identify mechanisms of these effects and identify specific food policies that could reduce cognitive risks related to perceived food deprivation in the United States.

Throughout the COVID-19 pandemic, the Centers for Medicare and Medicaid Services and state health agencies implemented numerous regulations for nursing homes addressing infection control and data reporting. This study explores interviews (n = 156) with administrators of 40 nursing homes across the U.S. between July 2020 and December 2021 to better understand their experiences with governmental agencies amid shifting regulatory standards, frequent inspections, and possible enforcement actions. Administrators highlighted confusion due to the evolving and sometimes conflicting guidance between state and federal agencies, although some states offered valuable COVID-19-specific assistance. They also described challenges in understanding and implementing new, frequently changing requirements, resulting in potential inspection deficiencies. Although enforcement actions, including financial penalties, are intended to deter noncompliance, administrators expressed concerns about added resource strain. Recommendations included increasing collaboration and data collection between regulatory agencies; reducing administrative burden during outbreaks and incorporating feedback from centers during regulatory changes; and increasing reimbursement to support compliance. Continued changes to oversight, including increased penalization and risk-based survey prioritization, should be evaluated to determine differential impacts on nursing home operations and resident care.

Nursing homes are under immense pressure to improve quality. The purpose of this study was to determine if there is a relationship between registered nurse (RN) skill mix (proportion of RN hours among all nursing staff hours) and higher quality measure (QM) star ratings. Data sets from 2021-2022 were utilized from the American Community Survey, Centers for Medicare and Medicaid Services (CMS), Medicare Cost Reports, Payroll-Based Journal, and Care Compare. The final analytic sample was 14,556 unique nursing homes. Ordered logistic regression was used to examine the relationship between RN skill mix (independent variable) and QM star ratings (dependent variable). The study found that RN skill mix is positively associated with QM star ratings. For a 1% increase in RN proportion, the odds of being in a higher QM star rating category increase by 4% (OR = 1.04, p < .001). This study fills two significant gaps in prior literature by relying on more accurate nurse labor hours through electronic payroll records vs. self-reported data, and by using the government standard of 15 quality measures vs. a few selected metrics. The results have implications for policymakers to incentivize improved quality, and for nursing home administrators to improve QM star ratings.

House, land and asset ownership are crucial indicators of economic security in old age. Food security recognized as a robust social determinant of health and well-being among the older population, ranks highly in the UN's Sustainable Development Goals. This study aimed to examine the association between house, land, and asset ownership, and food insecurity among middle-aged and older adults in India. Data came from a nationally representative survey, the Longitudinal Aging Study in India (LASI) - (2017-18) wave 1. Bivariate and multivariate logistic regression models were used to examine the associations of housing and land and asset ownership with food insecurity. Further, to assess the endogeneity, we used instrumental variable probit model. Housing, land and asset ownership were significantly associated with food. Older adults residing in a rental house were more likely to report food insecurity, particularly the association was stronger in urban areas (aOR = 1.92, 95%CI 1.27, 2.90, p < .001. Also, participants in rural households who did not have agricultural land and farm property were more likely to report food insecurity. Public policy must consider the role of housing, land and asset ownership in reducing food insecurity and improving the overall well-being of the growing older population in India.

The dementia population has higher rates of mortality during hospital stays than those without dementia. The aim of this study is to examine the relationship between ownership status (i.e. for-profit vs. not-for-profit) and nursing resources (i.e. nurse work environment, nurse-to-patient staffing, and nurse education) on 30-day mortality among post-surgical older adults with dementia. A cross-sectional analysis of linked American Hospital Association, Medicare claims, and nurse survey data was conducted using multi-level logistic regression models. We examined these models to assess the relationship between ownership status and 30-day mortality after adjusting patient and hospital characteristics. We also analyzed the relationship between the hospital ownership status and the 30-day mortality, after considering the three nursing resources. Older adults with dementia who received care in hospitals with not-for-profit status were less likely to die within 30 days of admission following surgery compared to those treated in hospitals with for-profit hospital status (i.e. odds ratio 0.82, 95% confidence interval 0.73-0.92, p = <.001). In addition, the odds ratios estimating the association between ownership and mortality were similar across the different models of the three nursing resources with and without those controls (i.e. 0.88 vs. 0.83 vs. 0.82). Surgical patients with dementia had better outcomes when cared for in not-for-profit hospitals, particularly with greater levels of nurse education and nurse staffing. The relationship between profit status and mortality was partly explained by the lower levels of nurse staffing and education in for-profit vs. not-for-profit hospitals.

Recent research has challenged the notion that dementia is an inevitable outcome of age-related cognitive decline, highlighting the possibility of preventing or delaying onset by addressing specific risk factors. This paradigm shift suggests that prevention through lifestyle modifications and early interventions is possible, potentially averting millions of cases worldwide. This study explores the translation of scientific evidence on dementia prevention into public health policy in Switzerland. Combining the analysis of official policy documents and qualitative interviews with stakeholders, the study explores potential barriers and challenges to implementing preventive intervenions or programs, as well as opportunities for improvement. Results indicate a significant gap in incorporating emerging scientific evidence on dementia prevention into health policies and disseminating information to the public in Switzerland. This study underscores the need for a collaborative and coordinated approach to address these barriers and effectively translate scientific findings into preventive policies and campaigns. These insights can inform policy and targeted programs in Switzerland both at the federal and the cantonal level, eventually serving as a model for other countries seeking to translate evidence-based dementia prevention strategies into public health policies. By bridging the gap between research and policy, significant progress can be made in preventing or delaying the onset of dementia, providing significant benefits to individuals, families, and society.

Despite rapid population aging, the situation of older adults in Ethiopia has received limited attention from policymakers, leaving older adults with little to no social protection. To understand the impact of the lack of a basic income benefit, this study explored the perspectives of retired pensioners on late life precarity in Addis Ababa. An exploratory descriptive study using interviews and focus group discussions was conducted with 31 retirees age 60 + . Data were analyzed thematically. The findings highlight five major life challenges of retirees leading to precarious lives in Ethiopia: unattended health issues and unaffordable health care; absence of recreational places; lack of respect and feeling disengaged; vulnerable livelihoods; and overlooked value and contribution of older adults. The findings underscore the need to employ intersectional perspectives in future studies for better understanding of inequality and inequity in aging in resource-poor contexts. Furthermore, the findings underline the need for national policies aimed at improving the well-being and quality of life of both retirees and all older adults. By implementing a social protection policy, creating elder-focused community centers, and implementing sustainable income-generating initiatives, Ethiopia can ensure that older citizens receive the necessary support needed to thrive and enjoy a fulfilling late life.

India's urban population is rapidly aging. By 2050, nearly 25% of India's population will be aged 60 and above, forcing cities to adapt their infrastructures and policies. This study examines how older citizens' healthcare, social security, and employment policy preferences differ between Kolkata, a city with rich historical significance and evolving infrastructure, and Chennai, a rapidly urbanizing city with expanding public services. Data from 914 respondents were analyzed using hierarchical modeling, indicating that older adults in Chennai support welfare and healthcare policies more than their counterparts in Kolkata. These findings provide actionable insights for policymakers to tailor city-specific interventions for aging populations in India.

Living arrangements of older people significantly impact their lives and well-being, but no studies to date have examined future changes among older adults in living arrangements in Middle Eastern Asia. This study employs the ProFamy method to project future changes in the living arrangements among older adults aged 65 years and older in Iran during 2016-2051. The results reveal substantial shifts in the living arrangements of older adults. Older households are expected to triple by 2051, especially among those aged 80 years and older. Moreover, over three million older adults are projected to live alone, including about 1.2 million aged 80+. Households comprising older couples with no co-residing kids are projected to triple as well. These trends call for proactive planning and policymaking in Iran, emphasizing the importance of developing a robust medical system, suitable housing, long-term care provision, family caregiver support, and public initiatives promoting active aging.