Journal of Applied Gerontology最新文献

This study examined how access to Information and Communication Technology (ICT) devices, prior online experience, and ICT training (with or without assistance) influenced eHealth use among homebound Medicare beneficiaries in the U.S. during COVID-19. Data were obtained from the National Health and Aging Trends Study, and participants (N = 653) were categorized as non-users, patient portal users, video telehealth users, or dual users. Multinomial logistic regression models showed that access to ICT devices was initially associated with eHealth engagement. However, this association became non-significant after accounting for prior online experience and ICT training. Prior online experience significantly predicted patient portal use, while ICT training, particularly when provided with assistance, significantly predicted video telehealth use and dual usage. The study highlights that providing ICT devices alone may be insufficient to reduce eHealth disparities among homebound older adults. Educational programs promoting digital engagement and targeted training are essential to ensure equitable healthcare access.

Studies have shown links between nutrition in older adults and marital status. Few studies explore the interaction of gender and marital status with a healthy diet in the US for older adults. Using a sample of oldest olds living in an independent, retirement community dwelling in Florida, we found a statistically significant difference in healthful diet between women and men, controlling for marital status, health status, social isolation, loneliness, and other covariates. We also found a significant negative relationship between healthful diet and widowhood (b = -3.85, p < .000). Likewise, older adults who were divorced or never married had lower healthful diet scores than those who were married or remarried (b = -7.31, p < .000), disability was associated with a lower healthful diet (b = -.30, p < .01), and loneliness was negatively associated with healthful diet. The results have important implications for medical advisers and those involved in providing support to these older adults.

Limited evidence describes how practicing dementia caregiving specialists (DCS) facilitate caregiver mastery of dementia-related challenges. This qualitative study was designed to characterize perceptions of a national sample of DCS about the caregiver support they provide and strategies they use to promote caregivers' adaptation to dementia caregiving challenges. Qualitative analysis of interviews with 27 DCS from 11 states indicates the scope of DCS practice ranged from one-to-one and group-based consultation to community education and advocacy. DCS reported providing care at inflection points such as care transitions. DCS supportive strategies to facilitate caregiver adaptation were classified into six themes, such as identifying immediate caregiving challenges, experimenting with adaptive solutions, and sustaining new solutions over time. Findings provide a framework to develop DCS training resources, design intervention models, and examine the impact of DCS support on patient and caregiver outcomes, such as outcomes during care transitions.

Smartphone use among older adults has become increasingly important, shaping social inclusion and daily life. This study examined public discussions on X (formerly Twitter) regarding smartphone use in older adults, comparing Persian-speaking and English-language communities. Tweets in English and Persian were collected from June 1 to June 30, 2024, and analyzed using Braun and Clarke's thematic analysis approach. Six themes emerged in the English-language dataset, including digital exclusion, learning and adaptation, usability challenges, preference for simplicity, vulnerability to digital risks, and intergenerational support. Persian tweets revealed five main themes, overlapping with those identified in the English-language data, but highlighting stronger emotional and cultural dimensions, such as sentimental value in digital interactions. Overall, discussions reflected experiences ranging from empowerment to exclusion, underscoring the importance of inclusive technology design, culturally sensitive digital literacy programs, and policies addressing accessibility barriers for older users.

This study examined the reciprocal relationships between digital engagement and successful aging among 4,319 Chinese older adults aged 60 to 75, using four waves (2016-2023) of the China Longitudinal Aging Social Survey. Cross-lagged panel models showed that digital engagement positively predicted successful aging in earlier waves (β = 0.144-0.158, p < .001), but the effect weakened and reversed in later waves (β = -0.028, p < .05). Successful aging consistently predicted higher levels of digital engagement (β = 0.046-0.082, p < .001). These reciprocal associations were stronger among women and urban residents. The full model accounted for 45.5% of the variance in successful aging and 49.9% in digital engagement. Findings suggest that moderate digital engagement supports aging outcomes, whereas excessive or prolonged engagement may reduce its benefits. Interventions should encourage balanced digital participation and address gender and urban-rural disparities to promote successful aging.

Contact with blue spaces appears to benefit older adults' health and well-being, but evidence on its relationship with frailty is scarce. This cross-sectional study investigated associations between exposure to blue spaces and multidimensional frailty in 189 community-dwelling people aged ≥65 years (Portugal). Measurements included the Tilburg Frailty Indicator, questionnaire regarding exposure, and Geographic Information System data for proximity. Purposeful visits once or twice a month were associated with lower physical frailty, as were visits with pets, engaging in physical activity, and spending 1-2 hours or >2 hours in these environments. Visiting with others was associated with lower social frailty. Incidental exposure-passing by visible blue spaces during daily commutes-was linked to lower total and physical frailty. Walking travel times <20 minutes were associated with lower total, physical, and social frailty, with different distances within this range showing domain-specific associations. Results suggest blue spaces may promote healthy aging.

Supportive environmental features (SEFs) are attributes of homes that help people overcome activity limitations. Evidence suggests that SEFs may facilitate aging in place. However, real-life SEF implementation patterns are not fully understood. This study examined associations between SEFs and disability/mortality status. We analyzed the first cohort of the National Health and Aging Trends Study using multinomial logistic regression. SEFs were operationalized using indicators of home accessibility, including bathroom home modifications (BHMs) and supportive housing features (SHFs). Basic activities of daily living (ADL) and instrumental ADLs (IADL) were used to quantify disability status. Changed SEF status and disability status, combined with mortality, served as dependent variables. At baseline, BHM/SHF did not predict changes in disability. Disability burden predicted lower likelihood of SEF addition. Greater baseline SEF predicted future additions of SEFs. Raising awareness of SEF in the context of increasing ADL/IADL limitations is key to promoting SEF implementation among older adults.

ObjectivesExamine longitudinal mediation of sleep duration between adverse childhood experiences (ACEs) and depressive symptoms in middle-aged and older adults.MethodsWe analyzed data from six waves (2011, 2013, 2014, 2015, 2018, and 2020) of the China Health and Retirement Longitudinal Study (CHARLS) using parallel process Latent Growth Curve modeling.ResultsHigher ACEs were associated with shorter initial sleep (β_iSD = -0.064), and higher initial depressive symptoms (β_iDEP = 0.111). Mediation analysis revealed that shorter initial sleep duration indirectly linked higher ACEs to both a higher initial level of depressive symptoms (β = 0.027) and a faster increase in depressive symptoms over time (β = -0.017). Mediation via initial sleep was stronger for deprivation-related ACEs (28.0%) than threat-related (16.4%).ConclusionsACEs are linked to shorter initial sleep duration and a higher risk of depressive symptoms. Initial sleep partially mediates these associations. Increasing sleep may alleviate depressive symptoms in ACEs-exposed individuals.

Appearance concerns are rarely studied in very old adults. We tested whether directing attention to the self (mirror) versus others (poster) differentially affects appearance self-evaluations among community-dwelling older adults (N = 76; age 62-98, M = 81.41; 62% women). Participants completed questionnaires while seated facing a mirror (self-focus) or a poster depicting younger and older faces (other-focus). A 2 × 2 ANCOVA (Focus × Gender), controlling for age, education, relationship status, and self-rated health, showed a significant interaction. Men rated their appearance more positively in the mirror condition than in the poster condition. In contrast, women did not differ across conditions but rated their appearance lower than men under self-focus and higher than men under other-focus. These gendered patterns suggest that environmental cues in aging-service settings may shape how the oldest-old perceive their appearance and interact with staff. We discuss how to optimize environments to minimize gendered threats to self-image.

Background and ObjectivesFalls are a critical health concern, with fear of falling and cognitive function recognized as key factors in the complex network of causes leading to falls. Yet, their mediating roles in urban settings of low- and middle-income countries remain underexplored.Research Design and MethodsThis study was conducted among 9,117 women aged ≥60 years in Iran (Dec 2024-Jan 2025), using stratified sampling across eleven municipal zones. Validated tools assessed fear of falling, cognitive function, loneliness, anxiety, depression, and frailty. Analyses included logistic regression, mediation, and survival models, adjusting for age, education, and assistive device use.ResultsHigher fear of falling increased the odds of falling (OR = 1.04, p < .001). In contrast, better cognitive function reduced fall risk by about 1% per unit increase (OR = 0.99, p < .001). The oldest-old reported greater fear and loneliness (p < .05). Mediation analysis showed cognitive function partially explained the pathway from frailty to fear of falling (z = -6.6, p < .001). Survival analysis indicated that less lonely participants had lower fall risk (HR = 0.99, p <.001).Discussion and ImplicationsStronger cognitive ability and reduced fear of falling are protective against falls. Interventions targeting these domains can enhance safety and resilience, offering guidance for policymakers and urban planners.