Journal of Applied Gerontology最新文献

With rising life expectancy at birth and declining mortality rates, analyzing demographic and epidemiological factors is key to understanding differing trends and identifying areas for improvement. This study examines age-specific contributions to life expectancy differences across the European region. Arriaga's life expectancy decomposition method is applied to country-specific abridged life tables for 53 countries to compare changes in life expectancy between two 20 year periods (1980-1999 vs. 2000-2019). This decomposition analysis reveals a shift in age-specific contributions-before 2000, gains were primarily driven by reductions in infant and child mortality, whereas after 2000, older age groups (70+) became the dominant contributors in over half of the countries. As population aging accelerates across Europe, a life-course approach is essential to not only extend life expectancy but also ensure those additional years are lived in good health, reducing inequalities and supporting demographic transitions.

As population aging accelerates, multimorbidity among older adults poses a growing public health challenge, highlighting the need to identify modifiable behavioral risk factors. Sleep, a core aspect of daily life, remains underexplored in the context of healthy aging. Utilizing five waves (2011-2020) of nationally representative longitudinal data from China (N = 10,065), this study employs individual fixed effects and instrumental variable methods to examine the impact of sleep duration on chronic disease risk. The findings indicate that longer nighttime sleep is associated with a lower likelihood of having chronic diseases, and this pattern remains consistent across multiple robustness checks. Mechanism analyses suggest that sleep promotes health by improving physiological function, psychological well-being, and behavioral vitality. Effects are particularly pronounced among the oldest-old, non-drinkers, and those not living with children. These results offer empirical support for incorporating sleep-focused strategies into interventions aimed at mitigating chronic disease risks in aging populations.

Visual impairment (VI) and cognitive impairment (CI) are growing public health challenges among older adults, particularly in low- and middle-income countries (LMICs) like India. This study examined the association between objectively measured near and distance VI and cognitive performance using data from 27,521 individuals aged 60 and above from the Longitudinal Aging Study in India (LASI) Wave I (2017-18). Cognitive function was assessed across five domains, and vision was evaluated using standardized visual acuity tests. Survey-weighted linear regression analyses revealed a significant, independent, and dose-response association between both near and distance VI and lower cognitive scores across all domains. These associations remained robust after adjusting for demographic, socioeconomic, and health-related factors. The findings highlight the potential of addressing vision impairment as a modifiable risk factor to mitigate cognitive decline and dementia among India's aging population.

Family caregivers play a key role in meeting the care needs of persons of all ages; the majority are employed. Caregiving can negatively affect employment and workplace productivity, but a lack of consensus regarding feasible, high-impact strategies to ameliorate such consequences exists. Our objective is to develop a consensus of the most important and feasible employer-based solutions to support working family caregivers. We used the e-Delphi method consisting of a literature review, 2 rounds of surveys, and 2 rounds of focus groups of caregivers, advocates, and employers. Respondents identified flexibility and financial support, paid leave, awareness campaigns, free/subsidized mental health counseling, free/subsidized legal consultations, and a trusted resource to help navigate Medicare and Medicaid as the most important and feasible supports for working caregivers. These consensus recommendations provide actionable guidance for employers and policymakers, aligning with the goals of the 2022 National Strategy to Support Family Caregivers.

We aimed to develop and test the psychometric properties of a new instrument to assess long-term care (LTC) home residents' social connection. We developed a conceptual model and then used literature review and qualitative interviews to identify candidate items for the Social Connection in Long-Term Care Residents (SONNET) scale, which we refined following pilot and field testing and with patient and public involvement. We evaluated the final instrument's feasibility, acceptability, reliability, and validity in 52 LTC resident-staff dyads in the UK and Canada. The 12-item SONNET scale comprises subdomains assessing social engagement and social connectedness, with versions to be rated by a resident or proxy (staff) informant. The SONNET scale is feasible and acceptable, and preliminary testing indicates its reliability and validity. It is available for use to examine social connection in LTC residents. Further testing in diverse samples and confirmation of psychometric properties is needed.

Camera-based active and assisted living (AAL) technologies offer a promising solution to the challenges of population ageing but are not widely accepted by older adults. One possible reason for this resistance is a lack of identification with one's future self, who is the primary beneficiary of such technologies. This study investigated the extent to which future self-continuity - the sense of psychological connectedness between present and future selves - influences older adults' acceptance of camera-based AAL technologies. Results from an online sample of older adults (n = 183) demonstrated that greater future self-continuity was associated with increased acceptance. This relationship was mediated by perceived usefulness: older adults with more vivid and positive views of their future selves exhibited stronger recognition of the technology's long-term benefits, which in turn increased acceptance. These findings highlight future self-continuity as a promising psychological target for interventions aimed at enhancing older adults' acceptance of camera-based AAL technologies.

IntroductionPeople most likely to be affected by Alzheimer's disease and related dementias (ADRD) are underrepresented in clinical research. Identifying and addressing factors which may influence their research participation is important to advance science and promote diversity. We examined the influence of social determinants of health (SDOH) on research participation among people living with ADRD.MethodsWe included those age 55 years and older living with ADRD, followed in our community practice in Rochester, Minnesota, who completed a questionnaire assessing SDOH and had at least one clinic visit between June 1, 2019 and June 1, 2020. Demographic and SDOH factors were examined by research participation.ResultsAmong 3273 people included, research participation was low overall (265/3273; 8.1%). People participating in research were more likely to be socially integrated and of higher educational attainment (p < 0.05).ConclusionPromoting social interaction is a potential area for focus to increase research participation in at risk populations.

The intensifying workforce crisis in nursing homes (NHs) has prompted state-level interventions such as CareGivers NC, a North Carolina (NC) initiative responding to widespread shortages of certified nursing assistants (CNAs). This study assesses whether participation in the CareGivers NC program resulted in measurable improvements in staffing hours and quality outcomes in NC NHs. Using a difference-in-differences approach with propensity score matching, we analyzed performance indicators from 2019 to Q2 2024. Compared to non-participating NHs, program participants showed a significant reduction in total and employee CNA hours, despite a slight increase in contracted hours. No consistent improvements were observed in CMS quality ratings, with a significant decline in staffing and quality measure ratings. These results highlight the limited effectiveness of workforce-only interventions in improving NH quality and emphasize the need for integrated reforms that couple staffing strategies with operational leadership, environmental assessment, policy reforms, and efforts to mitigate ageism.

Using a national survey of assisted living administrators (n = 2,084) and interviews with residents' bereaved next of kin (n = 30), we describe policies administrators reported complying with at the worst of the COVID-19 pandemic and explore relationships between COVID-19-related policies and bereaved next-of-kin's perceptions of end-of-life care quality, integrating findings to develop a comprehensive examination of end-of-life care in assisted living. During the pandemic, most administrators reported allowing compassionate care visits and hospice services. Next of kin described limited visitation and external care services and declines in residents' physical, mental, and social well-being, emphasizing the difficulty of missing precious time together. This study examines next-of-kin experiences of residents who died during the COVID-19 pandemic, providing evidence to inform future infection control policies.

BackgroundNurse practitioners (NPs) and physicians are essential to providing acute, episodic and palliative care in long-term care (LTC) homes and preventing unnecessary hospital transfers.ObjectivesTo explore the attributes of effective NP-physician collaboration in LTC and identify barriers to developing it.MethodsAn exploratory qualitative study was conducted using semi-structured interviews with 10 NPs and six physicians practicing in LTC homes in Ontario, Canada. Recruited individuals were not matched NP-physician dyads. Data were analyzed using inductive thematic analysis.ResultsTwo distinct NP-physician practice models emerged: one characterized by successful collaboration, and the other by failed partnership. Findings are presented in the form of vignettes illustrating key differences between the models. Successful collaboration featured resident-centered care, non-hierarchical relationships, and clearly defined roles. Barriers included lack of trust, high NP workload, and role ambiguity.ConclusionNP-physician collaboration can improve care for LTC residents. Successful implementation requires clear communication, role clarity, and leadership engagement to support NP integration and foster effective interprofessional relationships.