Journal of Applied Gerontology最新文献

This study evaluated the health-promoting effects of assistive technology(AT) from a holistic health perspective with the data from the rapid Assistive Technology Assessment (rATA) survey conducted by the World Health Organization (WHO) in China in 2021. Through a generalized ordered logit regression, we found that AT mainly aids in the reduction of "severe impairment" in basic activities of daily living (BADL) and facilitates the attainment of "minimal impairment" in instrumental activities of daily living (IADL), indicating that AT at the current stage not only serves as a tool to maintain basic survival, but also plays a crucial role in promoting overall health. Further research ascertained that the effects of assistive technology on BADL and IADL bear resemblances between two age groups but differ between urban and rural residents. Consequently, efforts must be made to enhance the supply system of AT, thereby improving social well-being for all.

Despite evidence that specialized care for seriously ill nursing home (NH) residents is needed, barriers to accessing palliative care (PC) remain. A significant issue is the complexity of the referral process that inhibits timely and equitable access to care. This qualitative descriptive study explored the PC referral process in NHs. Using rapid qualitative analysis with semi-structured interview data from NH staff, primary care, and specialty PC providers (N = 17) in six states, this study outlines a multistep referral process along with barriers and proposed solutions. Key recommendations include comprehensive PC education program development, implementation of an evidence-based PC screening tool, and the holistic integration of PC services in NHs.

People living with dementia have high rates of hospitalizations. Identifying factors that influence hospitalization is important. This study examines the influence of physical activity levels on risk of hospitalization and emergency department (ED) use among older people living with mild cognitive impairment (MCI) or dementia followed in our primary care practice in Rochester, Minnesota, United States. We included those age 55 years and older, who had a clinic visit between June 1, 2019 and June 30, 2021 and completed a social determinants of health questionnaire about physical activity levels (n = 3090). Physical activity was classified as sufficiently active, insufficiently active, or physically inactive. Risk of hospitalization and ED visits by physical activity levels were examined. People who were physically inactive were at higher risk of hospitalization and ED visits (p < .001) compared with those who were sufficiently active. This highlights an area for health promotion in people living with MCI and dementia.

The importance of giving a voice to groups considered hard-to-reach for research purposes is becoming increasingly apparent, with insights into their experience having the potential to improve research participation. Fall-prone older adults are a cohort underrepresented in research, often excluded in large-scale research and considered difficult to recruit. This study aims to explore older fallers' experiences of being fall-prone and participating in research. Seven older fallers (4 males, aged 69-88) participated in semi-structured telephone interviews following participation in an experimental research project. Interviews explored participants' personal experience of being fall-prone and participating in research. The resulting data was analyzed using thematic analysis. Three primary themes emerged: "Research through the eyes of older fallers", "Living with falls", and "It's all in the mind is it?". Our study gives voice to older fallers who have recently participated in experimental research to learn of their personal views on research participation.

This study explores whether living situation modifies longitudinal associations between depressive symptoms and changes in cognitive status across ten years in generally healthy, community-dwelling older adults. Participants (N = 687, M_age = 73.92 years) from the no-contact control condition of a multisite longitudinal study completed the Mini-Mental State Examination, Center for Epidemiological Studies Depression scale, and self-reported living situation. Multilevel models revealed that for older adults living alone, having clinically meaningful depressive symptoms was associated with greater decline in MMSE over ten years. However, reporting clinically meaningful depressive symptoms was not associated with decline in MMSE for adults who were living with others. These results suggest that living situation may be a modifying factor of cognitive change over time for older adults with clinically meaningful depressive symptoms. This highlights the need for targeted interventions for adults who may be at a greater risk of cognitive decline across older adulthood.

A comprehensive understanding of the patterns of psychosocial characteristics in older adults with pain is needed. Our objectives were to (1) identify psychosocial phenotypes (comprising depression, anxiety, affect, self-realization, resilience, and social participation) among older adults with pain and (2) compare pain characteristics, physical health, and cognition among the identified phenotypes. Using cross-sectional 2021 data from the National Health and Aging Trends Study, we performed latent class analysis to identify four psychosocial phenotypes of older adults with pain (N = 1903): Favorable (best psychosocial characteristics, 67.7%), Adverse (worst psychosocial characteristics, 4.9%), Intermediate (moderate scores on psychosocial variables, 12.6%), and Compensated (moderate scores with relatively high self-realization and resilience, 14.9%). Phenotypes with less psychosocial adversity had generally better clinical outcomes. Future research should explore precision pain management interventions in older adults based on their psychosocial phenotypes, longitudinal trajectories of phenotypes, and technology-based, point-of-care clinical insights for pain management.

Limited access to support services due to language and cultural barriers often results in a belief that family alone is the only option during times of need among Arab Americans. We test whether participation in a culturally adapted version of the Alzheimer's Association "Living with Alzheimer's" educational program is associated with positive outcomes for Arab-American care partners (N = 58). We present a single group design using paired t-tests that demonstrate reduced care burden and increased care satisfaction from pre- to post-participation. Family conflict trended downward after program participation. Findings provide preliminary data to illustrate culturally adapted Alzheimer's disease and related dementia (ADRD) educational programs hold promise to help family members caring for a person living with ADRD, even when such programs are not generally accepted by cultural norms.

Older adults who cease driving are more likely to experience psychosomatic decline than those who continue driving. This mixed-methods study was intended to examine differences in psychosomatic functions depending on driving status and lifestyle activities, and factors affecting engagement in additional lifestyle activities after driving cessation. The quantitative analysis included individuals aged 60 and above. Driving status, lifestyle activities, and psychosomatic functions were assessed. For qualitative analysis, semi-structured interviews were conducted with the driving-cessation group to determine the factors affecting involvement in various lifestyle activities after driving cessation. Analysis of covariance was used for quantitative data, while text mining and qualitative inductive analysis were used for qualitative data. Older adults who engaged in more lifestyle activities walked faster than those who engaged in fewer lifestyle activities, even after driving cessation. Actively using local and personal resources may increase engagement in lifestyle activities after driving cessation.

This study was designed to investigate the implications of perceived social support from adult children (SSAC) on the incidence of later-life depression (LLD) among rural older adults in China. A total of 1762 participants without depressive symptoms and aged ≥60 years at baseline were recruited from three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study (CHARLS) and followed up until 2018. After following-up for 2-7 years (average 4.6 years), a total of 746 participants (43.2%) were identified with LLD and the overall incidence of LLD was 128.5 per 1000 person-years. Univariate and multiple Cox regression analysis consistently indicated that receiving living care support was the sole form of SSAC that may significantly reduce the risk of LLD in rural older adults in China (HR: 0.81, 95% CI: 0.70-0.95, p = .008). These results may be of assistance in comprehensively understanding the role of SSAC in the mental health of older adults.

As the United States' population ages, it is also becoming more diverse. The country's Older Americans Act requires county-level offices on aging to be both service and information providers. But it is unclear to what extent offices on aging can identify gaps within the aging services information they provide and improve efforts to meet the information needs of diverse older adults. Utilizing an action research methodology, this study describes a partnership with an office on aging which ultimately resulted in the development and deployment of a diversity audit which is used to increase diverse representation in the aging services information their organization provides. The results reinforce the importance of designing resources with diversity in mind. By implementing the diversity audit and its recommendations, other aging services providers worldwide can ensure they are prepared to serve all older adults who may benefit from the services and information they have to offer.