Journal of Applied Gerontology最新文献

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.

Despite the benefits of the widespread adoption of mobile technologies, older adults continue to face significant security and privacy challenges in their use of mobile devices, due to several factors. This often results in the avoidance of certain security and privacy mechanisms, leaving many older adults vulnerable to digital security challenges and privacy risks. This paper examines 41 peer-reviewed studies to investigate how older adults view and control mobile security and privacy mechanisms, risks, and challenges. We examine the perceptions around mobile security and privacy mechanisms and educational and support strategies. Our findings highlight how closely security and privacy concerns relate to system design and support, and user knowledge. It also emphasizes promising methods such as embedded social learning, tailored training, and policy recommendations to address highlighted issues, allowing developers and policymakers to more effectively instill confidence and facilitate better digital inclusion and mobile security and privacy of older adults.

BackgroundInpatient falls among older adults remain a relentless problem.ObjectiveTo use a multivariable regression model to assess the degree to which perceived balance problem, balance confidence, fear of falling (FOF), and falls history are associated with fall prevention behavior among hospitalized older adults.MethodA cross-sectional analysis was conducted using survey data collected among 70 rurally hospitalized older adults (F = 57.1%, Mage = 77.8; SD = 8.7).ResultsFifty-one participants (72.9%) responded yes to having a balance problem, and only 18 participants (25.7%) responded yes to being at fall risk. The regression analysis found that older adults who indicated a balance problem reported greater fall prevention behavior (b = .38; SE = .17; p = .030; r_semi-partial = .22). No other variable in the model was independently associated with fall prevention behavior.

In our study, we investigated the relationship between caregivers' perceptions of their caregiving experience and their sleep quality among those caring for individuals with dementia. Using 2017 National Study of Caregiving (NSOC) and the 2017 National Health and Aging Trends Study (NHATS) Round 7 data from 784 caregivers, we conducted a multiple logistic regression analysis. Our sample included 62% female caregivers; 45% reported excellent or very good sleep, with 80% stating their sleep was rarely or never interrupted by the care recipient. We found that better perceived relationship quality was associated with an 8% higher likelihood of reporting good sleep. Interestingly, perceived caregiving benefit did not significantly impact sleep quality. Greater perceived caregiving burden was linked to a 9% lower likelihood of good sleep. These findings suggest that interventions aimed at reducing perceived caregiving burden and improving relationship quality could positively affect sleep and health outcomes for caregivers.

Digital exclusion is characterized as a complex, multidimensional issue that involves multiple influencing factors. There is currently no consensus on the concept of digital exclusion due to inconsistencies and lack of conceptual clarification across the literature. This study aimed to clarify the conceptual definition of digital exclusion among older adults through a scoping review and concept analysis. The review followed Walker and Avant's concept analysis methodology and Arksey and O'Malley's five-stage framework, and used thematic analysis to synthesize three key attributes, antecedents and consequences of digital exclusion across individual, intermediary, and societal dimensions, respectively. Based on these findings, a conceptual definition of digital exclusion was developed. Such exclusion restricts their digital participation and consequently exacerbates existing health and social inequities. In the future, structural reforms including equitable infrastructure allocation and age-inclusive policy frameworks are necessary to prevent digital exclusion of older adults.

ObjectiveOur study examined the association between educational attainment and hypertension among older Black and White adults.MethodsA sample of older Black and White adults (N = 3,212) from the National Health & Aging Trends Study (NHATS). The predictor variable, educational attainment, was measured with three education categories (less than high school, high school or equivalent, and greater than high school). The dependent variable, hypertension, was measured by asking respondents if their doctor diagnosed them with hypertension. Covariates included demographics and health-related variables. We conducted logistic regressions to identify the association between educational attainment and hypertension.ResultsAdjusted stratified models showed that older Black adults with beyond high school educational attainment had 20% higher odds of having hypertension, compared to older Black adults with an educational attainment of high school and lower. Adjusted stratified models showed that older White adults had 8% lower odds of having hypertension, compared to older White adults with an educational attainment of high school and lower.ConclusionThere are notable differences in hypertension among older Black and White adults which are associated with higher levels of educational attainment.