Journal of Applied Gerontology最新文献

ObjectivesPurposeful design of physical settings, including sensorial elements, may enhance participant engagement in psychosocial interventions. Yet, consideration of these settings remains limited. This review mapped evidence on whether and how purposeful physical settings are reported in protocols for group-based psychosocial interventions for older adults.MethodsUsing Arksey and O'Malley's framework, we searched four databases for protocols of group-based psychosocial interventions for older adults involving in-person sessions.ResultsOf the seventy-five included protocols, only six (8%) explicitly reported physical settings. Author consultation identified an additional 16 protocols, totaling 22 (29%) considering settings such as layout, acoustics, lighting, and thermal comfort. Physical activity interventions in community settings with smaller groups were more likely to report these elements.DiscussionUnderreporting and limited detail on physical settings highlight room for improvement. Intentionally integrating and thoroughly reporting these settings could enhance intervention designs, potentially improving outcomes and replicability of psychosocial interventions for older adults.

BackgroundPopulation aging and associated cognitive decline presents major public health challenges. Tai Chi and Qigong (TCQ) have gained attention as potential non-pharmacological approaches to improve brain health.ObjectiveTo evaluate the effects of TCQ on neuropsychological performance among community-dwelling older adults, considering cognitive level and dose-response.MethodsFollowing Cochrane and PRISMA guidelines, six databases were searched from inception to February 2024. Thirty-one randomized trials involving 3,766 participants were analyzed using random-effects meta-analysis.ResultsTCQ significantly improved overall neuropsychological performance (SMD = 0.66, 95% CI: 0.42-0.89) and specific domains, with standardized mean differences ranging from 0.64 for global cognition to 2.25 for attention, among older adults with or without cognitive impairments. No dose-response relationship was observed, suggesting that the benefits of TCQ were consistent across varying intervention durations, frequencies, and control group types.ConclusionFindings support TCQ as a feasible non-pharmacological intervention for cognitive enhancement in community-dwelling older adults.

Rural older adults, particularly those with Chronic Obstructive Pulmonary Disease (COPD), face significant risks to medical care during power outages caused by natural disasters. This cross-sectional study surveyed 222 Iowan adults aged 45-80 between March and May 2024 to assess disaster preparedness for power outages. Nearly nine in 10 participants experienced recent outages, yet 42% maintained a specific medical care plan for such events. Those with COPD exhibited moderately greater levels of preparedness, including higher rates of saving extra medication and establishing emergency communication plans. They were also twice as likely to have a care plan or emergency medication. Despite these gains, comprehensive preparedness remained low. The study highlights that recurrent disasters, such as windstorms and wildfire smoke, expose critical gaps in medical and emergency planning in rural communities. These results underscore the urgent need for tailored, disease-specific strategies and educational interventions to strengthen disaster resilience among rural populations.

Homebound status increasingly emerges as a critical social and health concern among older adults. Recognized as a "hard-to-reach" group, there is a need to better understand how to define and identify homebound older adults. Using the Arksey and O'Malley framework (2005), we searched eight databases with a librarian-guided strategy. Two authors independently screened titles, abstracts, and full texts, and extracted data based on set criteria. We included 19 studies that define homebound status through factors such as the duration and frequency of confinement; consequences of physical, social, or cognitive impairments; and those needing assistance. Researchers identify homebound individuals through health records, outpatient clinics, reports from family, neighbors, or community agencies like Meals on Wheels. Challenges include over-reliance on convenience and snowball sampling, as well as time constraints that limit the ability of researchers and clinicians to systematically identify those missing clinical appointments. A framework is needed to guide a formal identification.

The need for evidence-based services that help older adults thrive in the community aligns with the economic need to lower costs while achieving better outcomes. Some hospitals with global budgets have started paying for community-based care to decrease hospitalizations. We evaluated health, utilization, and cost outcomes associated with CAPABLE, a time-limited intervention to improve daily function, among 205 participants. The Johns Hopkins Hospital has paid for CAPABLE because it may decrease avoidable hospitalizations while improving outcomes. We used a difference-in-difference approach to compare outcomes for participants and non-participants. Avoidable charges were significantly less for CAPABLE participants compared to non-participants (p = 0.02) between 2016 and 2022. While not achieving statistical significance, participants experienced fewer avoidable hospitals stays and readmissions. Participants had significant improvements in functional outcomes and decreased depression scores. Implementing CAPABLE has potential to yield cost-saving and health improving benefits for hospitals with global budgets and insurers by reducing preventable hospitalizations.

Ensuring healthy aging and extending health span is critical, particularly in aging societies. This study analyzed patterns of risk for long-term care (LTC) certification within 3 years in rapidly aging areas of Japan using the Kihon Checklist (KCL) and machine learning models. Data from adults aged 65 years or older in Iiyama City (aging rate 37.0%) were analyzed using Exhaustive Chi-squared Automatic Interaction Detector decision trees. The dependent variable was LTC certification, and independent variables included age, sex, and six KCL domains: physical strength, nutrition, oral function, isolation, memory, and mood. Three risk patterns demonstrated consistent results across training and evaluation datasets. Age was the strongest determinant of LTC certification. Among those aged 80 years or older, low cognitive function and depression were key risk factors, while younger groups showed stronger associations with physical weakness. Results suggest age-specific segmentation of populations is crucial for designing effective interventions to prevent LTC certification.

This study aims to investigate the impact of Home and Community Based Care and Services (HCBCS) on intergenerational support from offspring, specifically examining whether HCBCS acts as a substitute or supplement. Using four waves of data from the China Health and Retirement Longitudinal Study (CHARLS), we employ the difference-in-differences (DID) method, along with Logit, Oprobit, and OLS models. The findings show that HCBCS boosts economic support from offspring to older adults but reduces emotional and caregiving support, indicating HCBCS has both supplementary and substitutive effects. Also, the results emphasize that the effects of HCBCS are more prominent in households with multiple offspring and urban areas. These findings have important implications for HCBCS program design, providing insights into how such services can better complement and substitute family-based intergenerational support and offering valuable evidence for policymakers to assess and enhance the effectiveness of public elderly care services.

Although the theory of relational ageism describes how ageism is reinforced through interpersonal interactions, it remains unknown whether peer support programs may help reduce ageism and enhance older adults' well-being. We conducted a pilot and feasibility study of a manualized anti-ageism peer support program facilitated by trained older adults called "Aging Together." Key components include peer support, education about ageism and health, and "tell your story of aging." Six small groups of five-to-eight participants (N = 48 total) met for ten, weekly, in-person (60-90 minute) sessions in a U.S. Midwest city. Results indicate the program was feasible and acceptable overall (attendance rate = 88.91%, attrition rate = 6.25%, M acceptability score = 4.23/5). Wilcoxon signed rank tests (N = 28) indicated a significant decrease in relational ageism (M = 2.73/6 to 2.19/6; p ≤ .01) and depressive symptoms (M = 8.61/30 to 6.57/30; p ≤ .01). Future research should scale this program across diverse, geographical settings and explore potential mediating relationships between internalized/relational ageism and psychosocial well-being.

To develop strategies to better meet palliative needs for older adults, it is critical to understand what factors influence the implementation and sustainability of palliative care (PC) in the outpatient setting. This study explored provider perceptions about multi-level factors impacting implementation of outpatient PC. Applying an implementation science framework, barriers and facilitators were identified for key implementation and sustainability concepts within the provider, organizational context, and external levels. Provider perceptions were explored using semi-structured group interviews (n = 11) with 9 outpatient specialty PC teams. Participants (n = 26) included outpatient PC team members and team leaders. Key considerations for health systems seeking to implement or expand outpatient PC include addressing misperceptions, co-location with referring clinical teams, and building the PC workforce to support interdisciplinary PC teams. To address challenges communicating benefits of PC, improved performance measures are needed to document and incentivize appropriate referral and use of PC throughout the continuum of care.

With the growing global older population and the impact of loneliness and social isolation in this group, it is imperative to study resources to improve social connectedness. Artificial Intelligence (AI)-powered platforms are an emerging technology being utilized for this purpose. This systematic review investigated the impact of AI interventions on loneliness and social isolation in older adults. Eighteen studies were included in this systematic review. Conversational AI technology played a role in improving numerous areas that are known to increase social connectedness. Those areas included self and shared identity, social integration, usability and usefulness, social support, self-efficacy, and health outcomes. While some participants enjoyed the AI interaction, sensed relationships developed, and felt the AI was useful, others would like conversational AIs and AI chatbots to be more human-like and conversations to have more depth and provide help and information gathering more targeted to their needs.