Journal of Applied Gerontology最新文献

BackgroundAge-related cognitive decline and mild cognitive impairment (MCI) are major public health concerns, while pharmacological treatments offer limited benefit. Mind-body and expressive therapies have emerged as scalable non-pharmacological alternatives, yet their comparative cognitive effects remain unclear.ObjectiveTo evaluate and compare the effects of mind-body and expressive interventions on global cognition and domain-specific outcomes in adults aged 60 years and older.MethodsFollowing PRISMA 2020 guidelines, randomized controlled trials were identified from seven databases from inception to April 2025. Random-effects meta-analyses were conducted across 71 trials (6,754 participants). Certainty of evidence was assessed using the GRADE framework.ResultsInterventions produced a moderate improvement in global cognition (d = 0.61), with strongest effects in individuals with MCI. Smaller benefits were observed for cognitive flexibility and processing speed, while language and working memory effects were inconsistent. Evidence certainty was moderate for global cognition and lower for domain-specific outcomes.PROSPERO registrationCRD420251110463.

ObjectiveTo evaluate the specific contribution of the real-time postural feedback component during training on balance and mobility in individuals with Parkinson's disease (PD).MethodFive databases were searched in June 2025. Studies comparing the same basic balance and gait training with versus without feedback were included. Meta-analysis was conducted and the quality of evidence was assessed.ResultEleven studies were included. Narrative analysis indicated that additional feedback may immediately improve dynamic balance and modulate gait speed but not static balance. Meta-Analysis Showed providing feedback significantly augmented post-training improvement in standing balance (SMD = 0.880, 95% CI = 0.345∼1.416, moderate-quality), but not on walking stability (SMD = 0.516, 95% CI = -0.025∼1.058, moderate-quality), Berg Balance Scale (MD = -0.079, 95% CI = -2.159∼2.000, very-low-quality), Timed-Up-and-Go (MD = 0.939, 95% CI = -1.414∼3.293, low-quality), and walking speed (MD = 0.002, 95% CI = -0.057∼0.062, low-quality).ConclusionProviding real-time postural feedback may have immediate effects on dynamic balance and walking speed and a post-training effect on standing balance in PD.RegistrationCRD42024522330.

PurposeThis study examined whether different types of help received influence subsequent levels of functional ability in older adults.MethodsLongitudinal data were drawn from the US Health and Retirement Study (HRS), the Survey of Health, Aging and Retirement in Europe (SHARE), and the China Health and Retirement Longitudinal Study (CHARLS). A total of 4,395 adults aged 50+ were followed for 10 years on average. Mixed-effects models tested whether help status (no help, informal help only, formal help only, or both) predicted subsequent (Instrumental) Activities of Daily Living ((I)ADL) Difficulties Scores.ResultsIndividuals who had received formal help or combined formal and informal help in the previous wave showed higher subsequent (I)ADL Difficulties Scores than those who received no help.ConclusionHelp type was associated with later difficulty levels but did not alter age-related functional patterns. Further research may examine whether characteristics of the help provided can modify functional outcomes.

ObjectiveTo explore ADRD prevalence by nativity, comparing U.S.-born and non-U.S.-born Black individuals to uncover risk factor differences and inform targeted interventions.MethodsWe conducted a retrospective cohort study with 77,069 Black individuals from the All of Us Research Program. We analyzed two cohorts, U.S.-born and non-U.S.-born Black individuals with ADRD, using 1:1 propensity score matching to balance key factors. Analyses were performed in R and Python with significance set at α = 0.05.ResultsOf 72,311 U.S.-born and 4,758 non-U.S.-born Black individuals, 1:1 propensity score matching resulted in 4,758 matched participants per group. ADRD prevalence was 3.76% in U.S.-born and 4.12% in non-U.S.-born Blacks, with rates increasing with age and being higher among retirees and the unemployed.ConclusionNon-U.S.-born Black individuals have a higher ADRD risk than U.S.-born Blacks due to SDOH and demographic factors, supporting the need for targeted interventions and further research to address health inequities.

BackgroundAlthough physical activity has wide ranging benefits, most older adults do not meet recommended physical activity guidelines.ObjectivesThis study evaluated the feasibility, acceptability, and efficacy of a digital exercise program, the Fittle Senior System (FSS), designed to provide behavior-change programs to increase engagement in physical activity and foster social interaction.MethodsThe sample included 181 adults aged 60-95 years, with an average age of 70.1 years. Participants were randomized into the FSS intervention condition or a Tablet Education (TE) control condition. Measures include measures of usability, health and psychosocial outcomes, and use of the FSS system. Assessments occurred at baseline and 3- and 6- month post-randomization.ResultsParticipants in both conditions experienced increased physical activity, exercise self-efficacy, health-related quality of life, decreased social isolation, and loneliness.ConclusionsDigital exercise programs are feasible for older adults and can result in improvements in health and psychosocial outcomes.

The ward round is an essential part of a hospital stay; however, there are no practical recommendations aimed at optimizing geriatric patient participation. The aim of our study was to describe such rounds in detail, assess patient satisfaction, quantify interruptions, and increase patient activity. Ward rounds were observed over a period of 2 months, with data being collected from 97 patients across 366 individual visits, and 58 patients being given a pad and pen to make notes in preparation. The average duration of each patient visit was 4 minutes 8 seconds, and 70.4% of them were disrupted in some way. Physicians addressed five topics per visit, while patients mentioned two on average, and 17.2% of the patients used a pad and pen. Our findings suggest that disruptions can be easily reduced. Pads and pens, however, are hardly used.

Falls are a leading cause of injury and disability among older adults. This study examined longitudinal patterns of fall occurrence and their associations with demographic, health-related, and psychological factors among Mexican American older adults. Data were drawn from six waves (2004-2021) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly. The analytic sample included 1,742 interviews at baseline (Wave 5) and 4,002 person-wave observations across six waves. Generalized Estimating Equations were used to estimate population-averaged associations while accounting for repeated observations over time. Fall occurrence during the prior 12 months was self-reported. Cognitive function, depressive symptoms, and functional limitations were assessed using validated measures. Overall, 36.3% of person-wave observations reported at least one fall. Fall occurrence was more frequent with older age, female sex, urinary incontinence, diabetes, vision problems, stroke or heart attack history, depressive symptoms, fear of falling, and difficulty with instrumental activities of daily living.

This study aimed to identify the determinants of resistance exercise participation among older adults, focusing on differences between young-old (65-74 years) and old-old (≥75 years) adults. Data from the Korean National Health and Nutrition Examination Survey, including 1,590 older adults, were used. Resistance exercise participation was assessed based on adherence to the World Health Organization's guideline of at least two weekly sessions. Multiple logistic regression analyses identified factors associated with resistance exercise participation. For young-old adults, being female and living in rural areas posed significant barriers. For old-old adults, being female, widowed, and in other marital categories hindered resistance exercise participation, whereas health literacy and living alone were positively linked with engagement. Age-specific interventions are crucial to promote older adults' resistance exercise participation. Healthcare providers must understand the unique characteristics and differences across age groups to develop tailored approaches. Resistance exercise interventions for old-old adults should consider their health literacy.

This study examined associations between fear of falling and sleep outcomes in spousal care dyads affected by dementia. This was a cross-sectional secondary analysis of the 2017 National Health and Aging Trends Study and National Study of Caregiving, focusing on 126 community-dwelling spousal dyads in which the care recipient had possible or probably dementia. Insomnia severity was assessed for dyads. Bivariate and multiple regression analyses were performed. Care recipients with fear of falling reported significantly higher insomnia severity, as did their caregivers. However, in adjusted models, fear of falling was no longer significant. Positive emotion and sleep medication use were associated with sleep in care recipients, while psychological distress was associated with sleep in caregivers. Findings suggest the importance of assessment of fear of falling and psychological distress in dementia care. Longitudinal studies are needed to clarify causal pathways and inform interventions.

Civic engagement in later life is shaped not only by individual characteristics but also by neighborhood and societal contexts, though these levels are rarely examined together. Guided by a socio-ecological framework, this study investigates how neighborhood conditions and country-level indicators, specifically the Human Development Index (HDI) and income inequality (Gini), are associated with civic engagement in later life. The data included responses from 9,468 individuals aged 65+ across 33 European countries. Four dimensions of civic engagement were examined: formal volunteering, informal caregiving, associational engagement, and political engagement. Binary two-level regression models showed that more accessible neighborhood amenities were positively associated with all forms of engagement, while neighborhood problems had negative effects. HDI was linked to higher engagement overall and amplified the enabling effects of neighborhood amenities on associational and political engagement, highlighting the interactive nature of national and local contexts in shaping civic engagement.