Journal of Applied Gerontology最新文献

Objective: To assess the effectiveness of randomized clinical trials that utilized dance and yoga as interventions for individuals with Parkinson's disease in relation to anxiety, self-esteem, cognition, depressive symptoms, and fecal and urinary incontinence. Method: Five databases (Embase, PubMed, ScienceDirect, Scopus, and Web of Science) were consulted following PRISMA guidelines and registered in PROSPERO. Results: Seven studies were included in the meta-analysis, showing low risk of bias and high heterogeneity (I2 = 91%; p < .001). Yoga was effective for anxiety (I2 = 97%; p < .001) and dance showed positive effects on cognition, albeit with high variability (I2 = 90%; p < .001). Both interventions were beneficial for depressive symptoms (I2 = 75%; p < .001). Conclusion: Dance and yoga are promising interventions for anxiety and depressive symptoms in Parkinson's disease patients. Record: Prospero CRD42024533561.

Distress behaviors are common in residential care settings and contribute to staff burnout and poor quality of life for older adults. While nonpharmacologic interventions reduce distress behaviors, implementation in routine care remains challenging. Our study applies a narrative reanalysis of interventions to 34 studies identified in a prior systematic review to describe the setting, focus, core components, and complexity of interventions identified. Most interventions occurred in post-acute settings, followed by transitions between care settings and inpatient mental health settings. Identified interventions were highly complex and heterogeneous regarding the components assessed and the details reported. Intervention components focused on patients, healthcare workers, environmental, and multiple levels. Common patient-level components included individualized care plans, distress behavior detection, medical management, and symptom monitoring. Common staff-level components included education and healthcare team workflow. Current evidence does not provide sufficient detail to replicate these interventions. We provide a template for standardized intervention testing and reporting implementation.

Older adults are disproportionately exposed to increased harm and adverse outcomes in abusive contexts. This systematic review aimed to explore and evaluate current literature on the role of paramedics responding to older adults in abusive contexts, with a specific focus on the vulnerability-reducing and protective potential of paramedics. A systematic review of the literature was undertaken using the Joanna Briggs Institute Systematic Review Guidelines. From an initial yield of 584 results, 18 sources of evidence met the criteria for inclusion and subsequent data extraction. Predominantly North-American literature indicated that older adults experience nuanced, disproportionate and complex vulnerability in abusive contexts, and that paramedics have a poorly defined and inconsistently applied duty of care. Consequently, this systematic review provides key recommendations for enhancing the capacity of paramedics to respond to the unmet needs and vulnerabilities of older adults either experiencing or at risk of abuse or neglect.

Osteoarthritis elevates the risk of falling among older adults due to joint pain and stiffness, especially among women, yet sex influences in these associations remain understudied. This study investigated factors associated with falls by sex. A sample of community-dwelling older adults with osteoarthritis from the 2016 Health and Retirement Study (2624 females; 1271 males) was analyzed using survey-weighted logistic regression, controlling for sociodemographic characteristics such as geographic residence and health-related issues. For women with osteoarthritis, higher risk of falling was associated with being White compared to Black, living in rural areas compared to urban areas, in addition to opioid use. Among men with osteoarthritis, having heart problems and better distal vision increased the risk of falling. Sex-specific fall prevention strategies, such as rural programs, opioid education for women, and increasing awareness and fall education for men with heart problems, are encouraged to promote active living among older adults with osteoarthritis.

"Filial piety" is deeply embedded value in Asian culture, whereby younger individuals are expected to provide support to the older generation. Nevertheless, financial support is frequently prioritized to the detriment of companionship. Employing data on about 50,000 households from the China Family Panel Studies (CFPS) survey (2016-2022), this study demonstrates a notable substitution between the provision of financial support to their older parents and the allocation of greater time to interact with them. The results additionally indicate that such substitution is more pronounced among males, individuals of working age, and those in the middle class. However, this issue could be addressed through the implementation of legislation that explicitly requires adult children to regularly visit and communicate with their older parents. In light of these findings, it is evident that there is an opportunity for policymakers to devise innovative strategies that will enhance family solidarity and support for older people.

Several interventions for care partners of persons living with dementia target the negative effects of behavioral symptoms. Evidence suggests that actively engaging care partners improves outcomes. However, there is little information on the best approaches to optimize active engagement. Enhancing Active Caregiver Training (EnACT) is an arts-based intervention designed to help care partners address the behavioral symptoms of dementia. The purpose of this study is to describe the process of partnering with care partners of persons living with dementia (n = 9) to refine EnACT. We conducted a series of three iterative focus groups to (1) identify video vignettes, (2) test intervention activities, and (3) gather feedback. Focus groups were analyzed in three cycles using structural, descriptive, and pattern coding. Intervention revisions focused on narrowing vignette topics, removing confusing components, enhancing accessibility, and adding facilitator training. Partnering with care partners improved intervention feasibility in preparation for future testing.

This study investigates how internet use moderates cognitive health disparities between rural and urban older adults in Brazil. It uses data from 9,257 adults aged 50 and above from the second wave of the Brazilian Longitudinal Study of Aging (2019-2021) and conducts multivariable linear regression analyses. Findings indicate that urban residents had better general cognitive health outcomes than rural residents. A significant interaction effect between internet use and rural-urban residency was observed for general cognitive health. Internet use attenuated rural-urban differences in cognitive functioning. These results suggest that interventions that enable and promote internet use among underserved older adults, particularly those in rural areas, could have significant value in Brazil.

Code Status Discussions (CSDs), CPR understanding, and health literacy is understudied in traumatically injured older adults. We hypothesized that traumatically injured older adults and their families would have limited understanding of CPR and code status, and that lower health literacy would be associated with reduced advance care planning knowledge. We surveyed injured adults ≥65 or their surrogates to assess baseline code status, health literacy, and CPR discussions. Univariate and multivariable analyses were conducted. Among 201 respondents 55% had low health literacy. Only 38% had discussions about CPR, and 21% were asked about code status during admission. Surrogates similarly overestimated CPR success and were unaware of code status when compared to patients (p > 0.05). Lower health literacy was associated with decreased odds of seeking additional CPR information and less confidence in CPR effectiveness knowledge (p < 0.05). Older adults admitted after injury and surrogates for those incapacitated had an overall poor understanding of code status, CPR, and had low health literacy.

Alongside increases in life expectancy, grandparenting has become a common social role; however, its implications for cognitive, social, and physical functioning remain understudied. Participants (N = 1,002) aged 66-79 in the St Louis Personality and Intergenerational Network (SPIN) study completed questionnaires about physical health, health practices, loneliness, and subjective memory and indicated whether they were grandparents. Grandparents (n = 533) also answered questions about involvement with their grandchildren. There were minimal differences in the well-being of grandparents and non-grandparents. Among grandparents, however, those who were relatively more engaged socially and emotionally with their grandchildren reported lower levels of loneliness, more engagement in healthful behaviors, and better subjective memory. Grandparents who reported providing relatively high levels of both instrumental support and socioemotional engagement reported better overall physical health-related quality of life. Findings provide preliminary evidence that social and emotional ties to grandchildren are associated with better physical and cognitive health among grandparents.

This study examined differences in access to information on health and social activities by socioeconomic position (SEP) among community-dwelling older adults in Japan. A mail survey was conducted with 4,101 adults aged ≥65 years without functional disabilities. Information-gathering frequency and sources (television, newspapers/magazines, the internet, social interactions) were assessed. Educational attainment and subjective economic status were classified into three levels. Poisson regression models with robust variance and linear regression models were used to analyse associations between SEP and information access. Older adults with higher SEP were more likely to gather information regularly, particularly through newspapers/magazines and the internet, while television and social interactions were common across all SEP levels. Those with higher education tended to use multiple information sources. These associations were more pronounced for educational attainment than for economic status. Television and social interactions may be effective channels for reaching those with lower SEP.