Journal of Applied Gerontology最新文献

This study constitutes both a scoping review and a concept analysis, as it systematically examines digital literacy across settings (home, assisted living facilities, and other long-term care facilities) in the context of persons with dementia and their caregivers. We performed a scoping review of 22 empirical studies to examine how the literature has defined digital literacy in dementia care, followed by a concept analysis to conceptualize digital literacy's antecedents, attributes, and consequences. Our analysis revealed three antecedents of digital literacy: technology-enhanced support systems, individual characteristics, and sociodemographic characteristics, which collectively impact persons with dementia and their caregivers' abilities to utilize digital resources effectively. We identified two critical attributes-technological skills and critical thinking skills-to evaluate digital health information. Our findings revealed that digital literacy is tied to several important consequences: technology acceptance, impacts on psychosocial factors, and the promotion of digital equity. These findings provide a foundation for future research that can incorporate the core components of digital literacy when designing technology-mediated interventions. While our findings conceptualized digital literacy among persons living with dementia and their caregivers, more research is needed to promote standardized terminology and consider the digital literacy level of end-users in developing technology-mediated interventions in the future.

This study compared potentially inappropriate medications (PIMs) using three criteria (BEERS 2019, STOPP v2, and FORTA 2021) in hospitalized older adults in Southern India. In this cross-sectional study of 597 patients (mean age: 72.80 ± 7.41 years), PIM prevalence was remarkably high across all criteria: BEERS (99.33%), STOPP (99.16%), and FORTA (99.83%). The mean PIMs per patient were: BEERS (3.89 ± 1.84), STOPP (3.77 ± 1.92), and FORTA (7.94 ± 3.22). Cohen's kappa showed fair agreement between BEERS and STOPP criteria (κ = 0.252, p < .001), but poor agreement with FORTA. Bland-Altman analysis indicated acceptable agreement between each tool and mean standardized PIM value. The number of medications during hospitalization was the only significant predictor of PIM use in both BEERS (OR = 2.504, p = .008) and STOPP criteria (OR = 1.685, p = .008). Results highlight the need for systematic medication review.

There is no consensus on the optimal self-rated successful aging (SRSA) cut-off point for determining whether aging is successful. The present study aims to address this gap by identifying reliable SRSA cut-off points through a comparison based on Rowe and Kahn's (1997) successful aging model. A sample of 478 older adult residents of municipal centers and nursing homes aged ≥50 years (M = 72.11, SD = 10.43) were subjected to the single-item SRSA evaluation, as well as scale sets measuring Rowe and Kahn's (1997) criteria. A receiver-operating characteristic analysis was then used to determine a range of potential SRSA cut-off points to discriminate between successful and not successful agers. The application of Rowe and Kahn's (1997) successful aging criteria revealed an optimum cut-off point of ≥7, having the best balance of sensitivity (86.7 or 74.9%) and specificity (46.9 or 55.3%).

Everyday technologies, like smartphones, might improve care of persons living with Alzheimer's disease and related dementias (PLWADRD) and reduce burden among care partners. However, care partners often report inadequate technical skills for using technology-based strategies. To address this need, we developed a manualized behavioral intervention called Technology Assistance in Dementia (Tech-AiD). We gathered feedback on the intervention concept from invested partners (10 care partners and 10 healthcare professionals) in a multimethod study. Quantitative results suggested very high intervention acceptability (4.55/5), appropriateness (4.36/5), and feasibility (4.11/5). Qualitative responses indicated a willingness to participate in Tech-AiD if available, described the program as a good fit for the needs of persons living with ADRD and care partners, and suggested that Tech-AiD's delivery format was convenient. Qualitative responses also included specific suggestions to improve Tech-AiD (e.g., creation of a technology helpline, booster sessions). Results provide evidence of Tech-AiD's readiness for a pilot trial.

Meaningful moments are brief, non-pharmacological person-centered interactions or activities that evoke positive emotions in hospitalized patients living with dementia and connect them to their history, identity, or surroundings. The aim of the study was to (a) identify key elements of an innovation primarily designed for long-term care that would be suitable for facilitating meaningful moments for people with dementia in a hospital environment, (b) determine the preferred way of introducing these key elements into practice, and (c) map out determinants, implementation strategies, mechanisms, and outcomes using the Implementation Research Logic Model. Successful implementation required an approach focused on knowing the person, sharing meaningful moments, and incorporating those approaches into everyday care routines. Factors for success included an iterative feedback loop, persuasive education, clear roles, and effective leadership.

The widespread adoption of Electronic Health Records (EHR) in the United States offers a transformative opportunity to enhance patient-provider interactions, yet the impact on the quality of care for older adults remains unclear. This study delves into how EHR use influences quality of care and whether Patient-Centered Communication (PCC) mediates this relationship, considering age and gender differences among adults 65 and older. Using data from the 2018-2020 HINTS survey, path analysis showed a significant indirect effect through PCC in the full sample (a*b = 0.12, p < .05). In addition, there were significant effects of PCC on quality of care in the full sample and all age and gender strata (p < .05). Remarkably, PCC mediates this relationship more strongly among individuals over 70 (a*b = 0.14, p < .05). These results highlight the demographic differences in how EHRs and PCC contribute to healthcare experiences in older adults, underscoring the need for tailored EHR design and communication strategies.

While older adults are increasingly using a variety of information and communication technologies (ICTs), keeping them online and using these ICTs may be challenging when technology difficulties arise. Using data from an online survey of U.S. older adults, 65 years and older (N = 1173), we investigate the sources of technical support older adults draw upon when technical problems arise and the factors that influence which sources are used for technical support. Most reported fixing technical issue themselves (71%) or getting help from family (65%) at least some of the time. Higher online self-efficacy was positively associated with fixing technical issues themselves, finding answers online, and using more sources of technical support. Older adults with lower online self-efficacy were more likely to receive help from family. Those with more social support were more likely to get help from family and less likely to use customer support or fix technical issues themselves.

Anxiety in older adults can negatively impact driving behaviors due to the associated symptoms and medications used to treat them. We aimed to investigate the effect of anxiety and anxiolytics on driving behaviors in older adults using data from participants enrolled in the multi-site AAA Longitudinal Research on Aging Drivers Study. A total of 2,832 participants met the eligibility criteria. Using generalized linear models, compared to participants without anxiety or anxiolytic use, those with anxiety alone (-540 miles/year, 95% CI = -1,002 to -78) and those with both anxiety and anxiolytic use (-1,777 miles/year, 95% CI = -2,910 to -644) drove fewer miles. Additionally, participants with anxiety (1.19, 95% CI = 1.08-1.32) and those with both anxiety and anxiolytic use (1.32, 95% CI = 1.02-1.67) experienced a higher rate of hard braking events. Older adults with anxiety conditions and taking anxiolytics should use caution when driving.

This study examined the relationship between the behavioral activation system (BAS) and fall risk awareness among Korean older adults, focusing on the mediating roles of optimistic bias and risk-taking. Data from 280 participants aged 60-84 were collected via an online survey. Using PROCESS Macro 3.5 Model 6, results showed that BAS positively correlated with optimistic bias, risk-taking, and fall risk awareness. However, optimistic bias and risk-taking were not directly correlated with fall risk awareness. A double mediation effect was observed, where optimistic bias and risk-taking sequentially mediated the BAS-fall risk awareness link. While BAS generally increased fall risk awareness, its influence became negative when mediated through optimistic bias and risk-taking. These findings suggest BAS affects fall risk awareness in complex ways, sometimes leading to lower awareness due to overconfidence and risk-taking behaviors.

Despite their considerable potential to address health and cognitive challenges, mobile and wearable health devices remain underutilized by older adults compared to other smart products, suggesting skeptical attitudes toward these health devices in older adults. Using an online scenario-based survey describing hypothetical individuals with health vulnerabilities, we examined the attitudes of middle-aged and older adults (N = 737) toward mobile and wearable devices for (1) predicting cognitive decline, (2) suggesting health behaviors, and (3) diagnosing diseases. Our results showed that the presence of health vulnerability was associated with higher perceived usefulness, lower privacy concerns, and greater intention to adopt these devices. Additionally, technological readiness, experiences, and various demographic factors influence attitudes, highlighting the complex structure shaping attitudinal barriers against adoption of these devices. These results emphasize the need for more tailored market segmentation and strategies to enhance the adoption of health-related gerotechnologies while addressing privacy concerns.