Journal of Applied Gerontology最新文献

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.

The age of the United States is steadily increasing while the number of practicing and upcoming primary care physicians trained to provide geriatric care is limited. The US population is incredibly diverse, with minority ethnic groups anticipated to reach 50% of the US population over the next few decades. It is unclear how culture considerations are being integrated within primary care best practices, identifying a clear gap in our understanding and the literature. The current scoping review identified relevant publications regarding primary care best practices and the consideration of culture. Following Arksey and O'Malley's (2005) guidelines, two researchers completed two searches across databases for articles discussing best practices/culture considerations in primary care targeting geriatric populations. Seven articles were included for consideration in this review. Our findings indicate limited research has empirically investigated best practices or cultural considerations within geriatric primary care. Recommendations and future research are discussed.

Research on Community-based Adult Day Services (ADS) primarily focuses on individual-level outcomes, often neglecting broader organizational factors that impact service quality and accessibility. In this study, we aim to develop a structured tool to assess the dynamic capabilities of ADS to meet the needs of a diversifying aging population. Utilizing a mixed-method approach, including literature review, expert consultations, online surveys, and interviews, we formulated a theory-driven set of measures. Preliminary analysis assessed the scale's performance and validity. The findings from this study provide valuable insights to further refine and validate the measure, which may serve as a useful tool for researchers and ADS providers in assessing and enhancing the dynamic capabilities of this vital community-based service.

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.