Journal of Applied Gerontology最新文献

Perturbation-based training (PBT) is a balance training method that uses externally applied mechanical perturbations to trigger rapid reactions for regaining postural stability in a controlled environment. However, there is a lack of comprehensive reviews on PBT's efficacy in older adults. Therefore, this study investigated the impact of PBT on older adults. Primary sources were gathered from SCOPUS, PubMed, CENTRAL, and Web of Science, covering data up to January 23, 2025. The analysis included 17 studies with 1,006 participants. Results indicated that PBT significantly reduced fall incidence (SMD: 4.82, 95% CI: 3.10-6.55, p = 0.001) and improved balance control (SMD: 0.47, p = 0.001), Timed Up and Go (SMD: 0.64, p = 0.02), fear of falling (SMD: 0.62, p = 0.004), reactive balance control (SMD: 0.72, p = 0.002), gait speed (SMD: 0.50, p = 0.01), and postural stability (SMD: 0.38, p = 0.001). The findings revealed that PBT improved mobility, postural control, and fear of falling while decreasing the fall incidence of older adults.

To enhance caregivers' wellbeing during the post-caregiving transition, we developed a culturally tailored peer mentoring program (PMP) that trains former family caregivers of individuals with dementia to serve as volunteer mentors for current dementia caregivers in the Chinese American community. Using a mixed-method design, we evaluated the feasibility and preliminary effects of the PMP, which included 8 former caregivers and 38 current caregivers in New York City. The program demonstrated strong feasibility, reflected in high retention, fidelity, and positive feedback from former caregivers. Although quantitative data did not show significant improvements in former caregivers' mental health, qualitative data indicated an enhanced sense of purpose, personal growth, and social connections. These results underscore the need to refine the intervention manual and examine its effectiveness in a larger-scale study.

This prospective cross-sectional study examined whether a beneficial social network can buffer the negative association between frailty/pre-frailty and self-rated health among older adults in three less privileged urban neighborhoods. The final sample of 561 Berlin residents aged ≥65 (mean age 75.56 ± 6.66 years, 62.4% female) was assessed using the Frailty Phenotype and the Lubben Social Network Scale. Confounder-adjusted linear regression analyses were performed. The analyses showed that a strong social network is associated with better subjective health for non-frail and pre-frail older adults, but this buffering effect was not observed among frail individuals. We conclude that strengthening social networks may be beneficial for the subjective health of non-frail and pre-frail older adults. This buffering effect may diminish with advanced physiological limitations.

The shortage of psychologists trained to work competently with older adult clients highlights the need to identify modifiable factors such as knowledge of aging, ageist attitudes, and aging anxiety that may bias therapeutic expectations. Among 212 doctoral psychology trainees, knowledge of aging was low (52% accurate); biological knowledge was more accurate than psychological or social knowledge. More biological and less psychological and social knowledge related to more ageist attitudes and aging anxiety. Knowledge, aging anxiety, and ageist attitudes did not differ based on having aging-related coursework. Trainees with coursework covering ageism had better expectations regarding appropriateness of the client for therapy and their competence and comfort treating the client. Less knowledge, more ageist attitudes, and greater aging anxiety related to poorer therapeutic expectations. Aging-related training should target increasing knowledge about aging and reducing ageist attitudes and aging anxiety as potential ways to ameliorate biases in therapeutic expectations for older clients.

Rural and urban areas differ in terms of age structure, health outcomes, and access to resources, but there is limited research on rural-urban differences in elder mistreatment. This study addresses that gap. We used data from Round 3 of the National Social Life, Health & Aging Project (NSHAP) survey (n = 2,333) to examine rural-urban differences in rates of 11 indicators of elder mistreatment, overall and by individual indicators. We conducted logistic regression models and generated predicted probabilities adjusting for sociodemographic and social well-being characteristics. Elder mistreatment was less common among rural than urban older adults (adjusted predicted probability 41.5% vs. 49.5%, P < 0.01). Rates were also higher for urban older adults for nearly every individual indicator of mistreatment. Rates of elder mistreatment were high (>40%) for both rural and urban older adults, but urban older adults faced a greater risk, requiring attention to urban risk and rural resilience.

The study investigated the direct and indirect effects of social isolation and loneliness on cognitive function in older adults, with systemic inflammation and sleep disturbance as mediators and diabetes as a moderator. Data were drawn from 5,722 older adults who participated in the 10th and 12th waves of the Health and Retirement Study. Social isolation directly affected cognitive function, whereas loneliness did not. Sleep disturbance mediated the effects of both social isolation and loneliness on cognitive function. Systemic inflammation did not mediate the effects of social isolation or loneliness on cognitive function. Multigroup path analysis revealed no significant differences in the pathways linking social isolation, loneliness, physiological mediators, and cognitive function between the diabetes and non-diabetes groups. These findings suggest that sleep disturbance may serve as a pivotal target for interventions aimed at mitigating the pathways through which social isolation and loneliness detrimentally affect cognitive function.

Most older adults in the US live with multiple chronic conditions, and over one-third experience chronic pain. Risks associated with polypharmacy have led to growing interest in "deprescribing," or reducing potentially harmful medications, in favor of non-pharmacological pain management. This qualitative study explored the views toward deprescribing among community-dwelling older adults (aged 65+) in Alabama with chronic pain, multimorbidity, and polypharmacy. Thirty-four participants completed in-depth telephone interviews. Thematic analysis identified facilitators to deprescribing: interest in holistic care, concerns about long-term side effects, and a desire for better quality of life; barriers: fear of worsening pain, reluctance to change established regimens, and limited provider support; and needs for credible information and social support. Findings highlight the role of education, provider engagement, and access to resources in supporting informed decisions. Tailoring these strategies to underserved settings such as the Deep South may reduce medication-related harms and improve pain management for older adults.

Climate change poses a significant threat to public health. While existing studies document its detrimental effects, the impact on functional disability and how to mitigate the effects remain underexplored. Using data from the China Health and Retirement Longitudinal Study (CHARLS) during 2011-2018, this study finds that higher temperatures correlate with higher levels of functional difficulty measured by activities of daily living (ADL) scores among China's middle-aged and older adults. Subgroup analyses indicate that males and those of greater age experience larger adverse effects. However, individual- and community-level adaptations help mitigate the adverse effects of higher temperatures on ADL difficulty, with access to air conditioning and healthcare facilities serving as key protective factors. These findings underscore the need for targeted climate adaptation policies, including promoting air conditioning accessibility and enhancing community infrastructure, to safeguard the well-being of aging populations facing climate change.

Nursing home residents commonly experience depression. This study examined the relationship between contextual isolation (having a socially salient characteristic in a nursing home where few other residents share that characteristic) and diagnosed depression. Using a cross-sectional design, we identified 1,033,485 long-stay nursing home residents from the 2010-2019 national Minimum Data Set 3.0 (a resident-centered assessment) 1 year from admission. Sixteen percent were contextually isolated on multiple characteristics. Males who were multiply contextually isolated had diagnosed depression more than males without contextual isolation (adjusted prevalence ratio: 1.09; 95% Confidence interval: 1.08-1.10). Resident groups defined by racial group who were contextually isolated on multiple characteristics had a higher prevalence of diagnosed depression than those without contextual isolation. Interventions targeting the impact of contextual isolation may reduce the prevalence of diagnosed depression among long-stay nursing home residents.

Post-traumatic symptomatology (PTS) in older adults is associated with reduced psychological well-being. Based on the Anxiety Buffer Disruption Theory (ABDT), we examined the death anxiety-PTS association, as well as the moderating role of resilience on this association in older adults living in southern Israel who had been exposed to continuous missile threats/attacks before the onset of the 2023 Israel-Hamas War. 205 older Israeli adults (M = 73.97, SD = 6.49) who live near the Gaza strip completed a questionnaire regarding these variables. Lower resilience and higher death anxiety were associated with increased PTS. There was also a moderating effect of resilience on the death anxiety-PTS link, as this link was significant for individuals reporting high/median levels of resilience, but was nullified for those reporting low resilience levels. Our findings suggest that resilience is a crucial factor for older adults experiencing constant terror threat, and are discussed in light of ABDT.