Research on Aging最新文献

This study investigated differences in cognitive risk and objective cognitive performance between lesbian, gay, and bisexual (LGB; n = 309) and heterosexual (n = 16,207) older adults using baseline data (2011-2015) from the Comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA). Cognitive risk was assessed using the Australian National University - Alzheimer's Disease Risk Index (ANU-ADRI). Cognitive performance was measured using a composite score based on performance on six cognitive tests. The analytic strategy included a combination of t-tests, chi-square tests, and linear regression models. Contrary to expectations, LGB participants exhibited lower cognitive risk scores (M = -1.08, SD = 8.85) in comparison to heterosexual participants (M = 0.61, SD = 10.62). On subcomponents of the ANU-ADRI score, LGB participants reported higher rates of depression and smoking, and lower social engagement. In terms of cognitive performance, LGB participants scored significantly higher (M = 104.58, SD = 14.72) in comparison to heterosexual participants (M = 100.12, SD = 15.05). This difference remained even after controlling for ANU-ADRI score, race, and income. Our findings highlight the importance of incorporating sociodemographic characteristics into cognitive risk assessments.

Rising life expectancy, declining fertility, and changing partnership patterns are disrupting traditional families and may increase the importance of friendship in later life. Older adults without partners or children (e.g., unpartnered, childless, and "kinless") might rely more on friendships for support. Yet, friendship remains understudied in aging research, especially across diverse global contexts. This study uses data from the World Values Survey and United Nations (64,277 adults aged 45+ across 87 countries) to examine how family structure, region, and development level influence the value placed on friendship. The results reveal regional variation in friendship emphasis, high value placed on friendship among those who have never had a partner or child regardless of global context, and high emphasis on friendship among those with disrupted partnerships specifically in highly developed countries. Findings highlight the need to prioritize friendship in research and policy, especially with accelerating demographic shifts occurring globally.

Research on LGBTQ+ rural aging is sparse-thus limiting understanding on how best to support this population. Building on equitable aging theory, this community-engaged qualitative study incorporated data from 4 focus groups with 31 LGBTQ+ older adults in rural communities in California to examine challenges, thriving and surviving strategies, and recommendations for policy and practice. Data analysis identified six interrelated domains reflecting challenges and strengths regarding health, housing, technology, transportation, caregiving, and community for LGBTQ+ older adults in rural communities. We identified three themes to illustrate how these domains intersected across levels (micro, mezzo, macro) to explain equitable aging for LGBTQ+ older adults in rural communities: fractured culturally responsive health care and family fortifications, social connections and space, and affordable and accessible housing. Findings around health, housing, technology, transportation, caregiving, and community were interwoven throughout these themes and provide a blueprint for policymakers and practitioners to better support this population.

Automated vehicles (AVs) have the potential to improve road safety and improve transportation access, particularly for older adults. As a cutting-edge technology where few have personal experience, individuals' initial perceptions of the safety of AVs will likely stem from communications originating from various stakeholders. A survey instrument was developed to both implicitly and explicitly estimate how personal perceptions of AV safety are influenced by safety messages from different sources. The implicit measure revealed that younger adults were particularly influenced by positive safety-related information provided by average AV crash rates and official statements from AV companies. When measured explicitly, older adults reported a larger preference for safety-related messages from safety advocacy groups and a decreased preference for information from average crash rates and AV companies. Results are discussed in terms of how safety related messages from various stakeholders might be utilized to affect perceptions of AVs across adulthood.

Research on end-of-life (EOL) planning has largely focused on heterosexual couples, overlooking the experiences of sexual minority spouses. Using dyadic data from the Health and Relationships Project, this study applies a minority stress framework and dyadic perspective (i.e., considering both partner's views) to examine how gay, lesbian, and heterosexual couples engage in informal (e.g., discussions) and formal (e.g., legal arrangements) planning. Multilevel logistic regressions assess how both spouses' health, dementia concerns, social relationships, and experiences of discrimination shape planning behaviors. Results show that gay and lesbian couples are significantly more likely than different-sex couples to engage in both forms of planning. While marital quality, health, friendships, and discrimination are important predictors, they do not explain the observed group differences. This may suggest that same-sex couples are more motivated to plan ahead due to other unmeasured factors, including concerns about legal recognition, potential discrimination in healthcare, legal literacy, or community support.

As chronic conditions dominate mortality trends, the place of death has emerged as a key marker of end-of-life (EoL) care quality. Although many older adults wish to die at home, structural barriers often lead to institutional deaths, especially among socioeconomically disadvantaged groups. This study investigates how housing types, defined by economic status, affordability, and congregate features, affect place of death in older adults. Drawing on National Health and Aging Trends Study data (N = 3,145), we examine links between housing type, EoL resource access, unmet needs, and death location. Residents of Subsidized Senior Housing (SSH) report more formal support yet still face unmet functional assistance needs, while traditional home residents depend on informal caregivers. SSH residents more often die in nursing homes or hospitals, whereas higher-income peers more frequently die at home. These findings indicate housing environments shape EoL resource availability, underscoring the need for targeted policy to reduce housing-related EoL disparities.

Friendship is an understudied social context in research on advance care planning (ACP). Using data from the Health and Retirement Study (2018-2020), we examine the associations between the quality and quantity of friendships and older adults' engagement in advance directives (AD) and end-of-life (EOL) discussions. Multivariable logistic regressions show that having any friends is associated with greater odds of AD and EOL discussions. Number of close friends and emotional support are positively associated with AD only. Marital status and gender, both independently and jointly, moderate the associations between friendship predictors and ACP. The positive association between emotional support from friends and EOL discussions is more pronounced among never married men, compared to both married individuals and never married women. These findings highlight friendship as a salient social context associated with ACP engagement, particularly among never married men.

Unmet needs are common among people living with cognitive impairment (PLwCI) and are linked to adverse outcomes. While caregiving networks (CGNs) are crucial in supporting care, little is known regarding how CGNs relate to unmet needs for PLwCI across racial and ethnic groups. Using data from the 2023 National Health and Aging Trends Study, we adapted the latent profiles of CGN sizes and composition among Black, Latinx, and White PLwCI and assessed their associations with unmet care needs. Zero-inflated negative binomial models showed that White PLwCI in "Spousal CGNs" had more unmet needs than those in "Spouse and other CGNs." Black PLwCI who relied on "Children and Others CGNs" experienced fewer unmet needs. Among Latinx CGNs, "Friends and others CGNs" CGNs showed fewer unmet needs. These findings underscore the importance of addressing within-group variation in CGNs to inform equitable, culturally responsive caregiving policies.

We used latent class analysis to identify profiles of midlife and older Chinese adults' preferences regarding involvement in three dimensions of end-of-life care: information exchange, deliberation, and decisional control. Data are from 548 urban and rural Shanghai residents aged 50+. We used multinomial logistic regression to evaluate associations between individual- and family-oriented beliefs and latent class membership. We identified four profiles. Lead decision-makers (49%) prefer to take charge of information exchange and final decisions, while valuing collaborative discussions. Autonomous decision-makers (19%) prefer making decisions without others' input. Delegating decision-makers (16%) prefer that family or doctors decide. Acquiescent decision-makers (15%) prefer to follow their family's wishes if discrepant preferences exist. Among family-oriented values, only strong extended familism beliefs were associated with delegating decision-making. Individuals' desire for a "good death" was strongly linked to independent decision-making. Practitioners should assess, understand, and develop practices to ensure decision-making preferences are met in Chinese families.

Home- and community-based services (HCBS) complement informal family care and support healthy aging. While HCBS benefits are well documented, how informal family care moderates the association between HCBS and the subjective well-being (SWB) of older adults with disabilities and mediation mechanisms remain underexplored. Using 2018 China Health and Retirement Longitudinal Survey data (n = 1,812), we find that HCBS utilization is positively associated with SWB (measured by life satisfaction), with unmet care needs-reflecting person-environment incongruence-serving as a mediator. Informal family care moderates the HCBS-SWB association. The positive HCBS-SWB association is stronger among older adults with disabilities who were childless, lived alone, and had fewer family caregivers, primarily due to a greater mediation effect of unmet care needs. These findings highlight the importance of considering the structure and capacity of family care when promoting HCBS, ensuring HCBS more effectively complements family support and addresses older adults' needs.