Journal of Applied Gerontology最新文献

Smartwatches have potential to provide support for prospective memory (PM), the ability to remember and carry out an intention in the future. How older adults (OAs), particularly those with cognitive impairment (CI), might interact with smartwatches is undetermined. This study aimed to understand the usability of smartwatches among cognitively diverse OAs and the potential for smartwatches to serve as reminder aids for this population. Participants were 58 OAs (age 60+) with and without CI. After using a smartwatch as a reminder aid for 10 days, participants gave low usability ratings overall, and the smartwatches did not aid performance of a daily PM task. Perceived usefulness of the smartwatches was associated with subjective memory, suggesting that perceived memory challenges may play an important role in smartwatch adoption. Results can inform the development of future efficacy tests and interventions involving smartwatches.

This study aims to understand the influence of friendship ties on the cognitive function in older Chinese population aged 60+ and the moderating role of gender. Three waves of the Chinese Longitudinal Aging Social Survey (CLASS) (2014, 2016, and 2018) data were adopted (n = 2145). A latent class growth modelling (LCGM) was conducted to examine friendship trajectories from 2014 to 2018. Four friendship trajectories were identified: (1) stable and strong, (2) steady decline, (3) recovery after decline, and (4) decline after growth. After controlling the cognitive function at baseline, compared to the "stable and strong" group, the "steady decline" group reported significantly lower cognitive function in 2018 (B = -0.79, β = -0.27, 95% CI [-0.42, -0.11]). Recovering friendship ties after decline is associated with a higher increase in cognitive function among males than females. This study highlights the protective effects of friendship on later-life cognitive function.

We report results of a workforce initiative to increase functional screenings for older adults with lived experiences of homelessness. Thirty-four healthcare practitioners screened 253 patients ages 50 years + using a battery of screening tools aligned with the 4 Ms. Using secondary analyses, we describe practitioners' participation in the workforce initiative, patients' functional scores, and a qualitative analysis of "what matters" to patients. Many practitioners did not complete all screenings. Among patient respondents, 6% reported moderate to severe ADL impairment; 24% scored positive cognitive impairment; 32% reported being unable to walk 250 feet; 46% reported moderate to severe pain. Resilience strategies developed during homelessness "matter." Few participants reported impaired ADL performance, which may reflect levels of independence needed to survive homelessness or to maintain services while homelessness. Findings suggest a need for additional workforce training to increase functional screenings for older adults in this population.

This study explores the link between the time older adults spend on lifelong learning and volunteering, examining how this association varies by socioeconomic status (SES) in South Korea. Employing fixed-effects regression models, we analyze six waves (2008-2018) of panel data from the Korean Longitudinal Study of Aging (KLoSA). Findings reveal an inverse U-shaped relationship between the time spent in lifelong learning and volunteering, with the high SES group showing a sharper increase and quicker decline in the association compared to the low SES group. This study emphasizes the importance of educational programs in encouraging volunteering among older adults. Additionally, the findings suggest a necessity for support systems to be established to assist older adults, especially those with lower SES, who may encounter difficulties in volunteering despite their willingness to engage in such activities.

This cross-sectional study explores the reliability and validity of a newly developed 15-item Medicare proficiency questionnaire (MPQ) across a mixed group of participants enrolled and unenrolled in Medicare. The MPQ was designed to assess beneficiary knowledge across a variety of Medicare topics and was developed by combining questions selected from the 2003 Medicare Current Beneficiary Survey and updating it with researcher-generated Medicare Part D questions. During the month of February in 2024, participants enrolled and unenrolled in Medicare, which were recruited on Prolific, completed online surveys which included the MPQ and demographic questions. We found that the MPQ has adequate internal consistency reliability with Cronbach's alpha = .73 across participants enrolled and unenrolled in Medicare as well as adequate validity, as demonstrated by positive relationships of MPQ scores to education level and to enrollment status (enrollees scoring higher).

This study explored associations between hospital-older adult center (or senior centers) partnerships, healthcare utilization, and Medicare costs among community-dwelling older adults with dementia. Using a novel statewide dataset in Massachusetts (U.S.), we estimated multilevel mixed-effects generalized linear models, with individuals nested in the geographic catchment areas of older adult centers that did or did not report partnerships with hospitals. Individuals with dementia living in communities where older adult centers engaged in partnerships with hospitals had fewer hospital stays, on average. This association and those for other outcomes (e.g., readmissions, total costs) were especially robust for older adults with multiple chronic conditions and those dually eligible for health services through Medicare and Medicaid. Our findings indicate the importance of continued research, policy, and practice on the interfaces across health and social care settings to improve environments for people aging in place with dementia.

Symptoms of dementia can impact the nutritional status and quality of life of people with dementia, but there is limited research exploring the dietitian's role in post-diagnostic care. This study aims to explore the role of a dietitian in a multidisciplinary dementia program for people living in the community. Participants in a twelve-week multicomponent, multidisciplinary post-diagnostic intervention for people with dementia and care partners were offered three consultations with a dietitian to receive dietary assessment, education and advice. Key clinical findings from dietetics case notes of 40 people with dementia were analyzed using a composite case series approach. Of these, 39 required ongoing nutrition support and intervention. Common issues identified include insufficient energy and/or nutrient intake, unintentional weight loss, poor management of comorbidities and difficulties with coordination of care. Dietitians are an integral part of a multicomponent intervention for dementia. Future work is needed to optimize dietetic care models. Running headline. Dietetics in an early intervention for dementia.

Falls are a common public health problem; one-third of individuals 65-years or older fall annually. A digitally delivered home exercise program could be an effective way to deliver fall prevention interventions to at-risk older adults. The aim of this study was to explore the experiences and perceptions of at-risk older adults enrolled in a 12-week digitally delivered home-based fall prevention exercise program. Semi-structured interviews (N = 16) were conducted by a user-experience specialist (75% female, age 77.3 years). Participants reported that the program increased exercise intensity and introduced new exercises, such as balance training. Participants highlighted the exercise physiologist motivational coach as a fundamental element of the program to support motivation and adherence. Recommendations for the exercise program included more variety of exercises, individualization of the exercise program, and live virtual interactions. This qualitative analysis provides insight into the acceptability of a digital fall prevention exercise intervention through participant feedback and perception.

This observational cohort study examined the association between Alzheimer's disease and related dementias (ADRD) and hospital and skilled nursing facility (SNF) utilization among community-dwelling older adults aged 65 and older. Using four waves of longitudinal survey data from the 2016-2022 Health and Retirement Study conducted by the University of Michigan and multivariate, individual-level regressions, we found that the cognitive impairment but no dementia (CIND) and ADRD groups exhibited similar patterns in hospitalizations, hospital visits, and total hospital days compared to the normal cognition group. However, CIND was significantly associated with increased odds of SNF stays (odds ratio [OR], 1.22) and a higher number of SNF visits (incidence rate ratio [IRR], 1.45) than the normal cognition group. Higher odds of any SNF stay (OR, 1.26) and number of SNF visits (IRR, 1.45) were also observed for ADRD compared to normal cognition. These findings suggest that CIND or ADRD was not associated with hospital use but was significantly associated with increased SNF use.

We evaluate the feasibility, acceptability, and potential effect of an acceptance and commitment therapy (ACT) tele-counselling program offered by a non-profit organization for care partners of persons with dementia (PWD) in a bilingual rural province. Thirty participants enrolled and one withdrew. Intervention group participants (n = 14) received 6-8 individual counselling sessions via telephone, videoconference, or text. Control group participants (n = 15) received two general support telephone calls from Alzheimer Society staff. Results indicated limited recruitment and adherence (completion) feasibility, although acceptability and usability were high. Significant within-group reductions in anxiety and stress symptoms (DASS-21) and burden (ZBI-12) in the intervention group were demonstrated, although the groups were not significantly different post-intervention. ACT tele-counselling may increase care partner access to mental health services, improve symptoms, and alleviate strain on Alzheimer Society staff, though a larger trial is needed with a longer duration, multiple ACT therapists, and additional recruitment efforts. Protocol registered at https://clinicaltrials.gov/study/NCT05385458.