Journal of Applied Gerontology最新文献

Amidst global migration, aging immigrant communities face cultural-language barriers posing significant risks for social isolation, decreased quality of life, and equitable access to care. Language translation apps hold promise in addressing these barriers.MethodsA scoping review was conducted on cultural-language translation apps in older adult care. We present our findings, while offering methodological insights related to the integration of a critical equity lens.ResultsThere is a notable gap in the literature on the use of cultural-language translation apps with older adults. The use of translation apps and devices holds potential for enhanced relationships and communication. There are concerns about the accuracy of translation, limited availability of languages, and appropriateness of use beyond day-to-day conversations.ConclusionTechnological adoption offers prospects for reducing language barriers and redressing health inequities experienced by racialized immigrant older adults. However, based on this vast gap in research on the topic, future research is indicated.

Financial exploitation (FE) of older adults is associated with adverse mental health outcomes. However, little is known about factors that buffer or exacerbate these effects. This study examined whether income level and health behaviors moderate the relationship between FE and psychological distress in later life. Community-dwelling adults aged 50 and older (N = 277) completed measures of psychological distress, health behaviors, income, and perceived FE. Hierarchical linear regression analyses were conducted, controlling for background characteristics and number of medical conditions. FE, lower income, and worse health behaviors were each linked to increased distress. A significant three-way interaction was found: among participants with low health behavior engagement, the relationship between FE and distress was strongest in lower-income individuals. Conversely, among participants with high health behavior engagement, the relationship was strongest in higher-income individuals. These findings suggest that both income and adaptive health behaviors may not uniformly protect against the emotional toll of FE.

Volunteering in later life has been widely recognized as a pathway to support healthy aging. However, economically marginalized older adults often face barriers to participating in formal or organizational volunteering. We aimed to identify the associated factors and outcomes of formal volunteering among older adults with low income or wealth in the U.S. Following PRISMA guidelines, we systematically searched five databases for peer-reviewed empirical studies published since 2005. Guided by the ecological framework of the antecedents and consequences of productive engagement in later life, we summarized factors and outcomes associated with formal volunteering at the individual, community, and societal levels. Older adults with lower economic status often experience disproportionately greater benefits from volunteering but face barriers to participation. Addressing these barriers could promote equitable access, enhance volunteer inclusion, and foster broader societal benefits.

Objectives: To examine whether personality traits and health behaviors predict falls in community-dwelling older adults. Methods: Longitudinal data from the Canadian Longitudinal Study on Aging (CLSA) at baseline (2011-2015) and follow-up two (2018-2021) were analyzed using logistic regression for 5270 adults aged 65 and older, with an alpha level of 0.05. Results: At baseline, participants' mean age was 72 years, with 51.1% female. Most identified as White (96.7%) and had education beyond secondary (81.5%). Increased physical activity (OR: 1.012, 95% CI: 1.01-1.014), decreased alcohol consumption (OR: 1.634, 95% CI: 1.419-1.883), and smoking cessation (OR: 2.8, 95% CI: 2.198-3.568) increased fall risk, while conscientiousness (OR: 0.832, 95% CI: 0.792-0.874) and openness (OR: 0.959, 95% CI: 0.922-0.998) were protective at follow-up two. Personality changes significantly influence falls. Discussion: Findings highlight the complex interplay between personality traits, health behaviors, and falls, suggesting a one-size-fits-all approach to fall prevention may be insufficient.

Long-term care is a priority for public policy in Spain, especially after COVID-19. The InCARE Project (Supporting INclusive development of community-based long-term CARE services through multi-stakeholder participatory approaches) promoted participatory policy and service development, using a Theory of Change (ToC) approach. The Theory of Change describes a causal pathway for making strategic changes in the long-term care system over the next decade, aiming to achieve the desired impacts. A two-day workshop was held with 32 stakeholders, including policymakers, professionals, family carers, and people who use care services. A national ToC and a specific pilot project ToC outlined the steps required to improve the long-term care system to fulfill the needs and preferences of people in situations of dependency. The Theory of Change approach can be highly valuable for policy design, and it provides an integrated action map to guide the changes and inform political and management actions in the coming years.

Severe staff shortages, sustained stress, low compassion satisfaction, high compassion fatigue, and serious levels of burnout among healthcare workers were frequently reported during COVID-19. In this cross-sectional study with 760 care aides working in 28 LTC homes in Alberta, Canada, we used a two-level multilevel regression model to examine how working environments were associated with compassion fatigue, burnout, and compassion satisfaction measured with the Professional Quality of Life (ProQOL-9) scale. Our findings showed that higher compassion satisfaction and lower burnout were observed when care aides perceived a more supportive working culture. Care aides reported higher compassion fatigue when there was a lack of structural or staffing resources. We also found that perceptions of not having enough staff or enough time to complete tasks were significantly associated with higher levels of burnout. These findings suggest which elements of the working environment may be promising targets for improvement efforts.

Age-related hearing loss affects 65% of older adults, and untreated hearing loss is associated with multiple adverse outcomes, including social isolation and loneliness. Thus, it is imperative to target age-related hearing loss. This scoping review assesses whether the use of hearing aids may increase social connectivity and reduce loneliness in adults ages 50 and older living with age-related hearing loss. We identified six qualifying studies across three databases and found that hearing aid adherence improves social connectivity among older adults. Of six studies, one study showed that non-hearing aid use mediated the link between hearing loss and cognitive decline with social isolation acting as a mediating factor, while another found that increased usage improved social participation. Given that hearing aid use is an effective treatment for age-related hearing loss, there is a substantiated need for policy and governmental involvement to improve access and affordability.

This study examined associations of COVID-19 mortality rates, staffing, and resident behavior with changes in antidementia and psychotropic medication initiation among nursing home (NH) residents with dementia. A nationally representative survey of Directors of Nursing was analyzed to assess changes in medication initiation at the peak of the pandemic. NHs with higher COVID-19 mortality rates were less likely to report increases in antidementia medication initiation. COVID-19 mortality rates were not associated with significant increases or decreases in psychotropic initiation. NH's that reported increased resident behavioral problems during the pandemic had higher odds of psychotropic initiation. In summary, NHs most affected by COVID-19 deaths were less likely than NHs with a milder pandemic experience to increase initiation of antidementia medications. Increased behavioral symptoms, possibly due to consequences of COVID-19, were associated with more psychotropic drug use. More research is needed to understand factors influencing prescribing practices during public health emergencies.

Core cultural values, along with commonly held beliefs about dementia, influence the caregiving roles assumed by Hispanic/Latino caregivers. Further, cultural values inform the utilization of available supportive programs and may influence participation in community-based dementia-support interventions. This paper discusses attitudes and perspectives on participating in community-based dementia-support interventions using a focus group methodology of Hispanic/Latino staff (n = 5). Findings from longitudinal focus groups (n = 3) with Hispanic/Latino staff, serving predominantly Hispanic/Latino populations, are presented. Findings highlight the value of research funding to support immediate care-related needs over future-focused research. They also emphasize the importance of culturally appropriate terminology and the centrality of cultural values that align with dementia-support research to effectively engage Hispanic/Latino populations. As supportive interventions for dementia caregivers are developed and implemented in real-world settings, including and aligning with cultural elements (i.e., family-oriented, family relationships) may encourage greater participation of Hispanic/Latino caregivers in research.

One-third of home health care (HHC) patients have dementia. Despite the critical role of caregivers for this population, little is known regarding prevalence or risk factors for unmet caregiving needs during HHC. We examined 426,608 older (65+) HHC patients with dementia in 2018. Unmet caregiving needs were determined from HHC clinician reports indicating that (1) no caregiver was present (lack of availability) or (2) the caregiver needed training (lack of capacity). Most (83%) HHC patients with dementia experienced an unmet need for caregiving. Medicaid enrollment and depression were associated with lack of caregiver availability; greater clinical severity and being post-acute were associated with lack of caregiver capacity. Patients with high (compared to low) cognitive symptom severity had higher odds of unmet needs due to lack of caregiver capacity (aOR:1.80; 95% CI: 1.70-1.90). Findings illustrate the gap between dementia caregiving needs and capacity, highlighting the importance of supportive resources such as training.