Journal of Applied Gerontology最新文献

Older people living alone are particularly vulnerable to loneliness. To contribute to the understanding of this issue in the Global South, we estimated the prevalence of loneliness and analyzed the association between sociodemographic characteristics, digital social isolation, and loneliness in older adults living alone, during the COVID-19 lockdown in Mexico. Data were drawn from the National Health and Nutrition Survey (ENSANUT) Continua COVID-19 conducted in 2020. The prevalence of loneliness was 49.8% (95% confidence interval [CI] 44.7-54.8); while the prevalence of digital social isolation was 45.3% (95% CI 40.5-50.2). A multivariate logistic regression model demonstrated that lack of education (odds ratio [OR] = 2.40, 95% CI 1.23-4.69; p = .011) and widowhood (OR = 2.51, 95% CI 1.54-4.10; p < .001) were significantly associated with loneliness. Identifying the sociodemographic characteristics of older adults living alone who are most likely to feel lonely can inform the designing of targeted interventions and policies to address loneliness in this vulnerable group.

Previous research has reported both positive and negative associations between retirement and depressive symptoms; however, little is known about the actual situation in Chinese society, as well as potential mediators in this association. Drawing from the 2020 China Longitudinal Aging Social Survey data (CLASS) (N = 9,883), we employed OLS regression models and the bootstrap approach to assess the association between retirement and depressive symptoms and the mediating effect of engagement in leisure activities. Results showed that retirement is associated with reduced depressive symptoms among older adults in China. Besides, engagement in leisure activities including group and individual activities partially mediated the average association between retirement and depressive symptoms, and individual activities exert stronger mediating effects than group activities. China should take small steps to raise the retirement age and implement its flexibility. A promising strategy to prevent depressive symptoms entails encouraging retirees to engage more in leisure activities, especially individual activities.

Improving caregivers' quality of life begins with conducting research that aims to understand caregiver's needs. However, caregivers may be reluctant to participate in research studies, adding to the importance of developing, tracking, and evaluating recruitment strategies. Here, we review the nationwide community outreach practices we implemented as our lab embarked on a program of research to develop an online intervention tailored for those caring for a spouse with Alzheimer's Disease or a Related Dementia (ADRD). We made hundreds of "cold" calls and e-mails to organizations across the US who may have access to caregivers, but whom we had no prior relationship with. It took 36.5 contact attempts to possible recruitment sites for every 1 enrolled caregiver. While time consuming, this low-cost recruitment method may offer a route for research teams to recruit caregivers into research studies without access to a medical center or collaborating physician(s).

Among older adults, chronic insomnia is a risk factor for cognitive decline. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the initial treatment. We conducted a retrospective cohort study of 84,739 Veterans, using national Veterans Health Administration data, to evaluate the association between CBT-I completion and incident cognitive impairment among older Veterans. Veterans were classified as administration of Any CBT-I versus Referral only using electronic documented notes. Incident cognitive impairment was defined by dementia-related diagnosis codes or an associated medication prescription. Among Veterans not using sedative-hypnotics, there was a decreased incidence of cognitive impairment for Veterans completing Any CBT-I compared to Referral only, RR= 0.87 (95% CI: 0.80-0.98). Yet, for Veterans taking sedative-hypnotic medications, there was an increased incidence of cognitive impairment between groups, RR= 1.18 (95% CI: 1.07-1.30). CBT-I may offer a protective effect from incident cognitive impairment; however, the presence of sedative-hypnotics reverses this trend.

Older adults are disproportionately exposed to increased harm and adverse outcomes in abusive contexts. This systematic review aimed to explore and evaluate current literature on the role of paramedics responding to older adults in abusive contexts, with a specific focus on the vulnerability-reducing and protective potential of paramedics. A systematic review of the literature was undertaken using the Joanna Briggs Institute Systematic Review Guidelines. From an initial yield of 584 results, 18 sources of evidence met the criteria for inclusion and subsequent data extraction. Predominantly North-American literature indicated that older adults experience nuanced, disproportionate and complex vulnerability in abusive contexts, and that paramedics have a poorly defined and inconsistently applied duty of care. Consequently, this systematic review provides key recommendations for enhancing the capacity of paramedics to respond to the unmet needs and vulnerabilities of older adults either experiencing or at risk of abuse or neglect.

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.

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.

Marital quality is linked to the well-being of older adults. Social networks tend to shrink in later life, and older adults often rely on their spouses for social support. A better understanding of subpopulations with distinctive sociocultural characteristics, such as older Hispanic adults, is warranted. Hispanic cultural values represented as familismo-the value placed on family relationships-make marital relationships even more critical. The present study investigated the correlates of positive and negative marital quality constructs among older Hispanic adults aged 51 years and older. Regression analysis of the 2016/2018 Health and Retirement Study (HRS) data (n = 1012) showed that women (b = -0.25, p < .05) reported lower positive marital quality than men. Also, depressive symptoms (b = -0.14, p < .05) were associated with greater negative marital quality. The present study evaluated marital quality correlates among unique and understudied older Hispanic populations and explored possible theoretical explanations.

This study investigates disparities between older adults based on urbanicity in the United States. We analyzed data from 8259 participants aged 65+ from the 2018 Health and Retirement Study. The mean age was 74 (SD 8). Low-urbanicity participants (29%) were more likely white (88% vs. 77%, p < .001), and had lower education (20% vs. 16%, p-value = .017), higher rates of hypertension (69% vs. 66.3%, p = .035), lung disease (15% vs. 11%, p=<.001), and cognitive impairment (24% vs. 19%, p < .001). After adjustment for demographics, they were less physically active (60% vs. 55%, p = .021) and more dependent on IADLs (19% vs. 16%, p = .018). Urbanicity significantly affects physical abilities (i.e., jogging, climbing stairs, and handling objects) more in younger participants (65-75) than older ones (75+) (p for interaction = .003, .007, and .012, respectively). Significant urbanicity-based disparities in older adults' physical and functional abilities must be addressed to tailor interventions that improve their quality of life.