Journal of Applied Gerontology最新文献

Dementia's progressive nature requires care, often by unpaid family members, leading to significant caregiver burden (CB). Dementia worry (DW)-the anxiety about developing dementia-has been linked to exposure to people with dementia, but its relationship with CB remains unclear. This study investigates the role of DW in CB among Greek family caregivers, using Pearlin's Stress Process Model. A cross-sectional survey of 285 caregivers assessed CB, DW, social support, coping strategies, and perceptions of the care recipient's cognitive and behavioral symptoms. Findings revealed that caregivers' DW significantly mediated the relationship between their perceptions of the care recipient's symptoms and their own CB. Maladaptive coping strategies were directly associated with higher CB, while adaptive strategies and social support were not. These results support the inclusion of DW as a secondary intrapsychic stressor in Pearlin's model and suggest that addressing DW in interventions may help reduce CB and improve caregiver well-being.

Prevention of health impairments among older adults is crucial. We investigated the relationship between the number, type, and frequency of social participation and frailty onset in older adults. We conducted a retrospective longitudinal study involving community-dwelling older adults aged ≥65 years. At baseline, four categories of social participation were assessed: volunteer, hobby, sports, and learning groups. Participants (n = 18,023) were followed up after 3 years to determine frailty onset. Hazard ratios for the occurrence of frailty were significant for one, two, and three or more types. Participating in sports groups at least once per month and hobby groups at least once per month impacted frailty onset. Involvement in multiple types of groups was associated with reduced onset of frailty. Specifically, participation in sports or hobby groups was related to a lower incidence of frailty, even after excluding other influencing factors.

This study examined, in Europeans aged 50 and over, 4-year associations between trajectories of non-cancer, incident cancer, and continued cancer with changes in depression levels and grip strength (GS). A longitudinal analysis was conducted with 17,048 participants from 17 European countries using data from waves 6 (2015) and 8 (2019) of the SHARE project. Cancer diagnosis was self-reported, GS was assessed with a hand-held dynamometer, and depression were evaluated with the 12-item EURO-D scale. Participants were classified into three cancer trajectories: non-cancer, incident cancer, and continued cancer. Over 4 years, men showed significant increases in depression across all trajectories, whereas women presented stable or reduced depression levels, especially the continued cancer group. In this group, women exhibited a 1.7% decline in GS and a 10.5% reduction in depression, while men showed a 7.9% decline in GS and a 12.3% increase in depression.

BackgroundOlder adults may spend their later years living either in their own homes or in institutional care settings such as nursing homes. However, uncertainties persist regarding how different living arrangements are experienced and perceived by older adults. Addressing these uncertainties and ensuring that older adults are provided with environments that meet their needs requires careful consideration of their subjective perceptions and lived experiences within their current living contexts.ObjectiveThis study aims to explore and compare the daily life experiences and attitudes toward nursing homes among older adults in Türkiye-where the older population has been rapidly increasing in recent years-who live alone at home, live with a spouse, or reside in a nursing home.MethodsA qualitative design employing thematic analysis was used. 30 participants aged 65 and older (10 from each group) were recruited through purposive sampling. Semi-structured interviews were analyzed following a six-step thematic framework, with themes refined through peer debriefing and triangulation.ResultsFour main themes emerged: gratitude and adaptation beyond place, diversity of daily activities, challenging prejudices about institutional living, and the importance of autonomy. Participants' daily experiences appeared to be shaped more by perceived autonomy and social connection than by location. Misconceptions about institutional care were evident in participants' accounts, highlighting the need for public education and supportive policies.

Adult day services (ADSs) are key providers of community-based care for persons with dementia (PWD) and their family caregivers. In this study, the researchers focused on one state, Mississippi, to evaluate the availability of ADS centers for PWD. Using R software, the researchers mapped the locations of all known ADS centers in the state (N = 48) along with estimates of the number of PWD by county and then overlaid these maps with US Census data. Findings revealed that ADS centers were primarily located in counties with high concentrations of PWD, Black residents, and lower-income residents; however, there was a shortage of availability across every county in the state. While ADS centers were generally located in areas of greatest need, PWD and family caregivers across Mississippi are underserved and lack access to ADS. Policymakers and funding agencies should use data-driven strategies to expand ADS, particularly in high-need, underserved areas.

This study investigates the association between early-life hunger and the willingness for institutional care using data from the China Longitudinal Aging Social Survey (CLASS). The empirical results indicate that early-life hunger is significantly associated with a lower willingness among older adults to enter care institutions. Heterogeneity analyses reveal that this negative association is particularly pronounced among low- and middle-income groups, individuals with sons, and the cohort exposed to famine during childhood. Furthermore, by incorporating traditional cultural factors into the analytical framework, the study finds that the intensity of regional Confucian culture acts as a moderator, reinforcing the negative relationship between early-life hunger and the willingness for institutional care. These findings enrich the literature on the long-term correlates of early-life adversity and suggest that policymakers should focus on improving the service quality of care institutions while simultaneously strengthening family support functions.

BackgroundLoneliness and subjective age in later life have been examined extensively as separate constructs, yet surprisingly little research has explored how they are linked.ObjectiveTo examine: (1) the cross-sectional relationship between loneliness and subjective age, with depressive/anxiety symptoms as a potential mediator; and (2) the association between changes in loneliness and subjective age.MethodsData came from the 2023 (T1) and 2024 (T2) National Health and Aging Trends Study. We used descriptive statistics and path and logistic regression models.Results & ConclusionsHigher scores in loneliness were associated with feeling less young or feeling older than actual age, with depressive/anxiety symptoms as a significant mediator. Increased loneliness from T1 to T2 and depressive/anxiety symptoms were associated with feeling less younger or older at T2, whereas physical health variables were not associated with changes in the subjective-chronological age difference. The findings underscore that self-perceived age reflects psychosocial well-being more than physical health.

Alzheimer's disease presents a public health challenge, with disparities in dementia literacy and resource access, particularly in rural communities. This study examines Extension professionals' perceptions of the adequacy, availability, and awareness of clinical and non-clinical dementia resources, focusing on potential urban-rural and role-based differences. Using an existing dataset (N = 132), ordinal logistic regression assessed associations between resource ratings and county rurality as well as professional role. Results indicate professionals in rural counties reported significantly lower ratings for the adequacy (OR = 0.47, p < .05), availability (OR = 0.42, p < .05), and awareness (OR = 0.49, p < .05) of clinical dementia resources compared to urban counterparts. No significant differences emerged for non-clinical resources. Findings highlight geographic and professional disparities in clinical dementia resources.

The capability of people to engage in meaningful activities declines with the progression of major neurocognitive disorders. Cognitive strategies can help them pursue such activities, thus maintaining their dignity. They build on procedural memory and implicit retrieval, both preserves abilities, to automate the correct action sequences during learning, with repetition and while providing cues. However, few studies have implemented cognitive strategies especially in seniors' residences. Thus, the feasibility of their implementation remains unknown. This study aims to document the facilitators and barriers to the implementation of cognitive strategies with people living with neurocognitive disorders housed in a private seniors' residence. This participatory action research included training and coaching to allow care staff to integrate personalized cognitive strategies with nine residents. Qualitative interviews with 20 care staff and a focus group with 2 managers were conducted. Key facilitators identified included personalized approach rooted in life history, team awareness and engagement, alignment with organizational values, and a calm, home-like environment. Barriers included the rapid progression of neurocognitive disorder symptoms related to comorbidities, staff shortages and turnover, and disparities between organizational decisions and clinical practice. The results showed encouraging avenues to integrate cognitive strategies in long-term care settings when the care team is supported by adequate training and coaching.

ObjectivesWith an aging population and rural workforce shortages, family caregivers face growing demands. Caregivers' ability to continue providing care depends on their own underlying health and access to home- and community-based services (HCBS). This study examines rural caregiver needs within the Veterans Health Administration.MethodsWe conducted a qualitative study using data from family caregivers (N = 19). Content analysis was used to identify key themes.ResultsKey emergent themes included (1) Dyadic health: significant health concerns for both caregiver and Veteran; (2) Tension of pride vs. support needs as a caregiver; and (3) Patchwork of community supports: limited access to healthcare, respite, and transportation.DiscussionThis study highlights challenges in supporting rural family caregivers of older Veterans with complex health needs. Addressing transportation burdens, dual caregiver-care recipient needs require innovative, dyad-focused approaches. Future research using dyadic data can deepen understanding and guide community-based, caregiver-informed solutions.