Journal of Aging & Social Policy最新文献

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.

How public policies convey dementia is an important source of the public's understanding of dementia, and newspapers are critical to depicting and disseminating this information to the public. The present study used topic modeling strategies to analyze Chinese newspaper portrayals of dementia from 2005 to 2020 to trace changes in key areas of dementia knowledge in relevant policies. Using WiseNews, the largest Chinese media database, we chose 45 newspapers from mainland China and identified 12,719 articles related to dementia. Using latent Dirichlet allocation (LDA), we performed a topic modeling analysis and identified the six most prevalent topics on dementia across articles: lifestyle recommendations, neighborhood life, foundational scientific research, celebrity and media portrayals, dementia caregiving, and pharmaceutical innovations - all related to the dementia knowledge scale's four dimensions. Findings suggest a steady increase in the number of articles on dementia caregiving and a decline in lifestyle recommendations from 2005 to 2020. However, newspapers continued to stigmatize aging by regularly co-depicting dementia and old age and by using biased terminology. Among the first to investigate dementia's portrayals in mainland Chinese newspapers, this study illuminates the need for expanding mass media campaigns to raise the country's dementia knowledge to foster a dementia-inclusive society.

The demand for home-based eldercare, especially for those with dementia, has been growing as societies age; in this context, the acute shortage of local care labor has resulted in the use of migrant workers in many countries. Taiwan, Singapore, and Austria, all emphasizing the family's responsibility for eldercare, have long histories of recruiting migrant workers for home-based eldercare. However, cases of mistreatment of migrant caregivers and care recipients have aroused public concern regarding migrant workers' care capabilities and working conditions. Migrant caregivers have also reported that their lack of care skills and sufficient rest hamper their work with care recipients who have dementia. This commentary provides a critical review of the laws and policies pertaining to live-in migrant care workers' care capabilities and working conditions; the effects of such legal frameworks; and recent changes in Taiwan, Singapore, and Austria. This article enhances our cross-country understanding of the advantages and disadvantages of using foreign labor for eldercare in private homes. Governments should enact legislation that supports live-in migrant care workers' care capabilities and welfare, thereby also improving the well-being of care recipients and their families.

In November 2020 an outbreak of ethnically and politically motivated armed conflict started in Tigray and expanded to the Amhara and Afar regions of Ethiopia, bringing a devastating impact upon civilians and disadvantaged groups. Persons living in those areas, including older adults, were forced to flee and seek refuge at internal displacement centers. Given the lack of scholarship on aging and humanitarian contexts, this study investigated the challenges faced by older individuals fleeing the war zone and settling in internal displacement centers during Ethiopia's armed conflict. A qualitative descriptive study was used in this cross-sectional investigation. Data from the in-depth interviews with 13 older adults were supplemented with key informant interviews and observations. Interview data was analyzed using thematic analysis. Findings revealed that the older adults escaping their homes and staying in the displacement center faced food shortages; inadequate shelter, clothing and bedding; lack of sanitation and hygiene supplies; inaccessible health services; social network destabilization; family disintegration; lack of care and support; and psychological stress, all of which negatively impacted their physical and psychosocial well-being. The findings call attention to the need for practical access to social and economic integration of older adults in the aftermath of the war as well as ongoing psychosocial intervention.

The need to optimize supports of Alzheimer's disease and related dementias (ADRD) care partners through policy innovation is high. This study sought to frame the care and support needs of multiple historically underrepresented populations who may be underserved and/or have difficulty accessing culturally specific services and determine specific policies that may reduce ADRD care partner burden and improve wellbeing. Qualitative data were gathered through interviews (N = 24) with leaders of organizations that support people living with ADRD and focus groups (N = 5) with dementia care partners from four communities historically underserved in the United States (Asian, Black, Indigenous, and Latinx). Organizational leaders also participated in a modified Delphi process to identify priorities for supporting care partners. Multiple themes were identified including: information resources; navigation and coordination within and across systems; access to clinicians, care teams, health/personal records; legal and financial issues; in-home and respite care; psychological and physical health support for care partners; and flexibility of schedules. Policy-related priorities for supporting care partners informed development of specific policy recommendations related to financing, supports, and respite. State and national policies can be enhanced to address these priorities across populations in ADRD care partner supports, especially for historically underserved groups.

Lower socioeconomic status (SES) is linked to earlier nursing home admission, but it is unclear if this remains true after accounting for health needs. This study examines SES-related inequalities in nursing home admission, controlling for health needs in an area of Switzerland with universal home-based care for older adults. Data were from the Lausanne Cohort 65+ study, including 3650 participants. SES was measured by education level, occupational class, and receiving means-tested benefits (a proxy for low income). Health needs were assessed with a set of physical and mental health variables. Cox proportional hazard models are controlled for demographics and health needs. Over 6 years, 115 (3.2%) participants were admitted to a nursing home. Lower education and receiving means-tested benefits were linked to earlier nursing home admission. However, after adjusting for all SES variables and health needs, associations between socioeconomic inequalities and nursing home admission did not remain significant. Lower SES is initially associated with earlier nursing home admission, but this is substantially explained by functional and cognitive impairment. The study suggests that access to long-term care in Switzerland is horizontally equitable but emphasizes the importance of preventing functional and cognitive decline in lower SES groups.

Little is known about the effect of implementing a long-term care insurance (LTCI) program on long-term institutional care admissions. This study employs a quasi-experimental design to examine the impact of China's LTCI pilot program on institutional care admissions among older adults. Using four waves (2013, 2015, 2018, and 2020) of the China Health and Retirement Longitudinal Study with 8,005 observations, difference-in-differences was applied to compare institutional care utilization between pilot and non-pilot cities before and after the 2016 policy implementation. Results demonstrate that LTCI significantly increases institutional care admission probability by 0.5%, indicating a profound behavioral impact despite modest absolute changes. The magnitude and direction of effect varies considerably across population subgroups. Age emerges as a key moderating factor, with older individuals showing stronger policy responsiveness. Functional disability presents a more complex pattern: while insurance coverage facilitates access for those with moderate care needs, the effect diminishes among severely disabled individuals for whom institutional care represents an unavoidable necessity. Metropolitan areas demonstrate substantially greater policy effectiveness compared to rural regions. The findings provide crucial evidence on how enabling factors in healthcare utilization operate within different demographic and geographic contexts, offering insights for policymakers designing LTCI systems in aging societies.