Journal of Applied Gerontology最新文献

This study aimed to identify the determinants of resistance exercise participation among older adults, focusing on differences between young-old (65-74 years) and old-old (≥75 years) adults. Data from the Korean National Health and Nutrition Examination Survey, including 1,590 older adults, were used. Resistance exercise participation was assessed based on adherence to the World Health Organization's guideline of at least two weekly sessions. Multiple logistic regression analyses identified factors associated with resistance exercise participation. For young-old adults, being female and living in rural areas posed significant barriers. For old-old adults, being female, widowed, and in other marital categories hindered resistance exercise participation, whereas health literacy and living alone were positively linked with engagement. Age-specific interventions are crucial to promote older adults' resistance exercise participation. Healthcare providers must understand the unique characteristics and differences across age groups to develop tailored approaches. Resistance exercise interventions for old-old adults should consider their health literacy.

This study examined associations between fear of falling and sleep outcomes in spousal care dyads affected by dementia. This was a cross-sectional secondary analysis of the 2017 National Health and Aging Trends Study and National Study of Caregiving, focusing on 126 community-dwelling spousal dyads in which the care recipient had possible or probably dementia. Insomnia severity was assessed for dyads. Bivariate and multiple regression analyses were performed. Care recipients with fear of falling reported significantly higher insomnia severity, as did their caregivers. However, in adjusted models, fear of falling was no longer significant. Positive emotion and sleep medication use were associated with sleep in care recipients, while psychological distress was associated with sleep in caregivers. Findings suggest the importance of assessment of fear of falling and psychological distress in dementia care. Longitudinal studies are needed to clarify causal pathways and inform interventions.

Civic engagement in later life is shaped not only by individual characteristics but also by neighborhood and societal contexts, though these levels are rarely examined together. Guided by a socio-ecological framework, this study investigates how neighborhood conditions and country-level indicators, specifically the Human Development Index (HDI) and income inequality (Gini), are associated with civic engagement in later life. The data included responses from 9,468 individuals aged 65+ across 33 European countries. Four dimensions of civic engagement were examined: formal volunteering, informal caregiving, associational engagement, and political engagement. Binary two-level regression models showed that more accessible neighborhood amenities were positively associated with all forms of engagement, while neighborhood problems had negative effects. HDI was linked to higher engagement overall and amplified the enabling effects of neighborhood amenities on associational and political engagement, highlighting the interactive nature of national and local contexts in shaping civic engagement.

This study examined whether frailty mediates the relationship between sexual and gender minority (SGM) status and three types of outpatient healthcare utilization among adults aged 50 and older in the All of Us Research Program (2017-2022). We estimated controlled direct effects of SGM status across generalist, specialist, and mental health visits. Healthcare utilization and SGM status were self-reported, and frailty was measured using a survey-based deficit accumulation index. Both SGM status and frailty were independently associated with increased rates of all outpatient visit types. Regarding mediation, our results suggest that if all participants were robust, SGM adults would still have higher healthcare utilization compared to cisgender heterosexual older adults. This indicates that factors beyond frailty influence patterns of healthcare use in this population and highlights the importance of identifying additional determinants to ensure that older SGM adults receive appropriate and responsive care.

Although later-life learning is an important contributor to active ageing, research suggests that older adults with lower socio-economic status (SES) may participate less in learning. Simultaneously, we know little about whether the benefits of later-life learning, in terms of quality of life (QoL), vary by older adult SES. Hence, we investigated whether SES shapes older adults' participation in and benefits from learning. Using two waves of data (2016-17; 2019) from a nationally representative cohort of Singaporeans aged 60 to 95 years (n = 2,502), we find that older adults with higher education and occupational prestige had greater participation in both job- and nonjob-related learning. Moderation analyses showed that the beneficial effects of nonjob-related learning on QoL were only observed for lower-SES older adults. Our findings suggest that although lower-SES older adults benefit more from later-life learning, they are less likely to participate in it.

ObjectiveTo review the application of artificial intelligence (AI) in the care of older adults with disabilities, identifying intervention type, target populations, and effects.MethodsA literature search was performed in the PubMed, Cochrane Library, EBSCOhost, ScienceDirect, Web of Science, CNKI, SinoMed, and Wanfang. The search period is from the establishment of databases to November 2, 2024.ResultsA total of 15 studies (13 randomized controlled trials, 1 experimental study, and 1 quasi-experimental study) were included. AI applications in the care of older adults with disabilities were categorized into three domains: rehabilitation, companionship, and reduction of caregiver burden. The study focused on cognitive impairment or dementia, those with physical functional limitations, and those in need of long-term care. The main AI technologies involved human-computer interaction, web applications, data algorithms, and robotics.ConclusionAI shows promise in older adults with disabilities, though further development and support are needed for better integration.

This study investigated how informal caregiving moderates the relationship between leisure activity engagement and cognition using data from the Health and Retirement Study. Cognitive performance outcomes included total cognition and episodic memory. Leisure activity engagement was assessed by both the frequency and the diversity (variety) of activities. Caregivers (N = 6,275) were younger (M_caregivers = 66.65 years, SD = 10.0; M_{non-caregivers} = 70.32, SD = 9.9, p < .001), had a higher proportion of non-White individuals (31.62% vs. 14.82%), and females (63.06% vs. 57.76%) compared to non-caregivers (N = 4,271). Compared to non-caregivers, caregivers reported more frequent and more diverse activity engagement (p < .001), yet had lower total cognition (p < .001) and memory scores (p = 0.006). For both activity measures, higher scores were related to better total cognition and memory (p < .001). Moderation analyses indicated that higher activity frequency and diversity were related with better total cognition and memory, but the beneficial impact was attenuated among caregivers. Future work should investigate this relationship by considering caregiver-specific factors.

Telecare promises support for older adults aging in place and helps alleviate the burden on informal caregivers. However, research on informal caregivers' perceptions of telecare is limited, particularly in the context of unique challenges of dementia. This study addresses this gap by examining the differences between informal caregivers of older adults with and without dementia in terms of the care burden, acceptability of different telecare functionalities, and perceived psychosocial outcomes of telecare use. Conducted in Slovenia with 612 informal caregivers aged 40 and above, the study determined that dementia caregivers experienced higher care burden and perceived greater acceptability of mobility-related telecare devices. Both groups reported similar perceived psychosocial outcomes of telecare use, including reassurance and reduced anxiety. The findings highlight the need to tailor telecare functionalities to informal caregivers' specific circumstances, particularly in supporting people with dementia, to enhance telecare's effectiveness and the well-being of informal caregivers and care recipients.

Rapid population aging in Vietnam raises concerns about late-life depression. This study analyzed data from 4,457 adults aged 60+ in the 2018 Longitudinal Study of Aging and Health to identify predictors of depressive symptoms and assess whether digital inclusion mediates the effects of living arrangements. Weighted logistic regression examined associations, and generalized structural equation modeling assessed mediation, adjusting for demographic, health, and social factors. Living with non-spouse/non-child members, rural residence, disability, chronic disease, lower education, and limited social participation were linked to higher depression risk. In rural areas, device-only use reduced this risk. This digital pathway fully mediated the protective effects of "Living Alone" or "Living with Spouse Only" and partially offset the risks of "Living with Others." No mediation effects were found in urban areas. These findings underscore the need for tailored strategies that reflect contextual differences in digital inclusion and family-based support to improve later-life mental health.

Loneliness is negatively associated with cognition, especially in older adults, yet it is often examined as a unidimensional construct. This study examined how the heterogeneities of loneliness relate to dementia outcomes and whether sex moderates this relationship. Using data from 8802 older adults in the Health and Retirement Study, latent class analysis identified four loneliness classes: Less Lonely and Socially Connected (51.6%), Lonely, but Socially Connected (12.6%), Less Lonely but Socially Disconnected (18.0%), and Lonely and Socially Disconnected (17.8%). Lonely and Socially Disconnected group was more likely to meet criteria for prevalent and incident dementia at baseline (OR = 2.17, p < .001), Wave 2 (OR = 1.83, p < .001), and Wave 3 (OR = 1.75, p < .001), even after adjusting for covariates. Sex did not moderate these associations. Findings highlighted the importance of identifying loneliness subtypes to better inform targeted cognitive and social interventions in older adults.