Journal of Applied Gerontology最新文献

This study aims to examine the trajectory of older adults' cognitive function over time and identify its predictors. Based on the model of neuroplasticity and cognitive reserve, participants' general characteristics as well as their physical, mental, and social factors were included as predictors of cognitive function. A latent growth model analysis was used to examine the trajectory of cognitive function and its predictors. The analysis of the unconditional model revealed that older adults' cognitive function significantly decreased over time. The rate of cognitive decline was significantly related with age, current smoking status, depression scores, number of social activities, time spent in group cognitive activities, and number of individual cognitive activities. The findings identified predictors affecting initial cognitive function and the rate of cognitive decline in older adults. The rate of cognitive decline varies widely among individuals. Identifying these differences is essential for effectively tailoring interventions that address individual needs.

The COVID-19 pandemic exacerbated the challenges of home- and community-based service (HCBS) providers in recruiting and retaining direct care workers (DCWs). One of the largest and fastest-growing occupations in the U.S., DCWs are essential to the growing population of persons in need of long-term services who wish to remain in their homes. We surveyed all Connecticut Medicaid HCBS providers about their pandemic-era recruitment and retention challenges, strategies employed to overcome them, recommendations for regulatory and policy changes, and use of American Rescue Plan Act (ARPA) funding. Respondents (n = 447) noted the continuing key roles played by compensation and working conditions, emphasized unintended consequences of government unemployment policies, provided creative suggestions for professionalization of DCW work, and suggested best practices for consideration, including the success of word-of-mouth and employee referral bonuses in recruiting and the importance of organizational culture in retention.

This study investigated the relationship between different intensities of leisure-time physical activity (LTPA) (i.e., vigorous LTPA vs. leisure walking) and life satisfaction, and the moderating effect of dementia diagnosis on this association in a representative sample of U.S. older adults derived from the 2022 National Health Interview Survey (n = 8,779). Multivariable regression analysis revealed significant associations between both LTPA intensity and life satisfaction. Moderation analysis revealed that dementia diagnosis significantly influenced the relationship between vigorous LTPA and life satisfaction in older adults, while no significant dementia diagnosis moderating effect was found to affect the relationship between leisure walking and life satisfaction. These findings suggest that vigorous LTPA was particularly beneficial for enhancing the life satisfaction of people living with dementia (PLWD), while leisure walking universally enhances life satisfaction in older adults regardless of their dementia status. Practical suggestions and implications are provided for designing LTPA programs tailored to the specific needs of PLWD.

We examined the associations between physical activity (PA)-measured through self-reported walking and vigorous activities-and pain occurrence (self-reported bothersome pain or frequent pain medication use), and persistent pain (pain occurring for two consecutive years). This analysis used a large, nationally representative sample of 2279 older adults from the National Health and Aging Trends Study of 2015-2018, and applied generalized estimating equation regression with propensity score weighting. Approximately 70% and 50% of the participants reported walking and vigorous activities respectively at baseline. The cumulative incidence over the 3-year follow-up time was approximately 60%, and was similar across PA groups. The risk of pain occurrence or persistent pain did not differ by walking or by vigorous activity status (relative risks ranged from 0.97 to 1.20, and the 95% CIs included one). While pain occurrence was common among older adults, our analysis did not find it to be associated with PA.

How negative self-perceptions of aging relate to physical activity (PA) in older adults with arthritis is unclear. We examined whether general health mediated the relationship between Awareness of Age-Related change (AARC) losses and PA. We analyzed baseline data from a randomized controlled trial of a PA intervention for adults ≥60 years who self-reported PA, AARC, general health, pain, and social support. We evaluated point-biserial correlations between PA and other factors in participants with self-reported arthritis and developed a mediation model incorporating AARC losses, general health, and PA. We observed significant correlations between PA and general health, social support, and AARC losses in this physically active sample. General health mediated the effect of AARC losses on PA. While negative self-perceptions of aging were associated with less PA in older adults with arthritis, their impact was attenuated by general health. PA interventions for this population may benefit by targeting perceived general health.

Social technology in older adults can improve self-rated health; however, there can also be difficulties using it. Our study aimed to evaluate the feasibility and acceptance of virtual assistant device (VAD) use in cognitively impaired homebound older adults. 52 newly referred Meals on Wheels clients aged 60 and older were recruited for a three-phase study: 6 weeks of meals alone (control), followed by 6 weeks of meals+Alexa Echo Show 8 (AES8) basic usage, and lastly 6 weeks of meals+AES8 advanced usage. Technology acceptance with the AES8 was significantly higher by the end of the study and participants anecdotally enjoyed playing music, setting reminders, and accessing spiritual content. There were also associations with improvements in memory, depression, and gait speed, despite no specific health programming. Thus, we believe use of VADs for cognitively impaired homebound older adults have future potential to benefit their cognitive and physical health. ClinicalTrials.gov ID: NCT04581317. Impact Statement: We certify that this work is novel because we were able to highlight improvements in the feasibility of use of a voice-activated virtual assistant device, technology acceptance, and some health indicators for underserved, cognitively impaired homebound older adults.

This scoping review, following Levac et al.'s methodology, examines the implementation and impact of relationship-centered care (RCC) in long-term care (LTC) settings for older adults. Peer-reviewed articles from AgeLine, CINAHL Complete, MEDLINE, PsycINFO, and Web of Science were included if published after 2000, involved older adults in LTC homes, focused on RCC, and conducted in Australia, Europe, New Zealand, or North America. Key findings were organized using inductive content analysis, and 41 empirical studies with qualitative, quantitative, and mixed-methods designs were included. Three categories emerged: (1) Core Practices of RCC-relationship building and reciprocal exchange; (2) Transformative Impacts of RCC-improved care quality and collaboration; and (3) Pathways and Roadblocks to RCC-individual and organizational factors. By understanding the key elements, facilitators, and barriers of RCC, policymakers and practitioners can develop targeted strategies to improve care experiences and outcomes for residents, families, staff, and all others involved in LTC.

This study aimed to examine the associations between the different constructs of daytime sleepiness and subjective well-being (SWB), and to investigate whether physical disability moderated these associations in community-dwelling older adults. We examined daytime sleepiness using the Epworth Sleepiness Scale (ESS) and SWB was evaluated in terms of self-rated health and happiness. Exploratory factor analysis (EFA) was used to determine latent constructs of ESS, yielding two primary factors, which were designated as active and passive factors. The active factor was positively correlated with self-rated health and self-rated happiness. By contrast, the passive factor was negatively correlated with self-rated health but not with self-rated happiness. Physical disability was evaluated using the Groningen Activity Restriction Scale (GARS). By examining the interaction terms between the ESS factors and GARS, we demonstrated that the physical disability moderated the associations of active and passive factors with self-rated health.

In the United States, spouses provide 17% of in-home care for people living with dementia. Negative impacts of dementia care on spouses/partners are well-documented, but we lack information about the holistic experience for spouses/partners. We conducted a secondary thematic analysis of data from two observational studies about everyday music engagement and dementia care at home. In this paper, we report on experiences of dementia care from the perspectives of spouses/partners. Participants included 15 people living with dementia (20% women, 20% people of color); 15 spouses/partners (73% women, 27% people of color). Individual experiences varied, but underlying patterns emerged: 1) Caregiving approaches were grounded in loyalty and commitment 2) Spouses/partners struggled to accept changes occurring with dementia progression, and 3) As verbal skills diminished, spouses/partners found meaning in small gestures. Spousal/partner dementia care poses unique challenges and rewards. Identifying underlying motivations and sources of strength can support the caregiving experience.

This umbrella review aims to describe caregiver interventions tested across populations of informal caregivers of older adults and to examine the effect of caregiver interventions on depression, burden, and quality of life across intervention types and care-recipient populations. PubMed, Scopus, APA PsycInfo, ABIM, Sociological Abstracts, PAIS, and EconLit databases were systematically searched. Forty systematic reviews were identified as meeting inclusion criteria. Most commonly, interventions focused on improving outcomes for caregivers of older adults with dementia. Among the included reviews, caregiver depression was most likely to be reduced by caregiver interventions, and cognitive behavioral therapy (CBT) and mindfulness-based interventions (MBI) were most effective. The use of information and communication technologies to deliver caregiver interventions is increasingly common. Standardization of intervention classifications and transparent reports of intervention delivery details will strengthen research in this field.