Gerontologist最新文献

Background and objectives: Acculturation is a critical aspect of social experience for immigrants, including Asian immigrants. Existing literature has shown mixed findings on the health impacts of acculturation and largely relied on cross-sectional studies, preventing drawing definitive conclusions. This study aimed to examine the long-term effects of acculturation on depressive symptoms and activities of daily living (ADL) limitations in a large sample of older Chinese immigrants in the United States.

Research design and methods: Data were drawn from 2,811 older Chinese immigrants from the Population Study of Chinese Elderly in Chicago. Acculturation was assessed at baseline, and questionnaires on depressive symptoms and ADL limitations were completed at four assessments.

Results: Overall, results showed that acculturation was not associated with depressive symptoms at baseline but was associated with a faster decline in depressive symptoms over time. No associations were found between acculturation and ADL limitations. Stratified analyses showed that the significant relationship between acculturation and a faster decline in depressive symptoms was only evident among female participants. Also, acculturation was associated with a lower risk of reporting ADL limitations at baseline in female participants but a higher risk of reporting ADL limitations in male participants.

Discussion and implications: This study indicates the long-term benefits of acculturation on mental health among older Chinese immigrants in the U.S., particularly among females. Initiatives supporting the acculturation process need to consider sex disparities and individual preferences, aiming to foster sustained benefits for healthy aging in this population.

This paper draws on wisdom and lifespan development research to propose a conception of "wise aging", which may become particularly relevant in very old age as people's capacities for successful aging decline. We propose that three types of balance distinguish wise aging from successful aging. First, wisdom balances one's own interest with a greater good, emphasizing self-transcendence and compassion. Second, wisdom balances control striving with acceptance of uncontrollability. Wise aging involves a realistic awareness of one's decreasing levels of control and one's interconnectedness to and dependence on other people. Third, wisdom acknowledges, regulates, and balances positive and negative affect. Wise aging involves the ability to appreciate and relish the joys of life, but also to accept and embrace more negative emotions and fully support others going through different times.

Background and objectives: Physical capability, social support, loneliness, depression, and anxiety predict life satisfaction in older adults. Currently, no systematic review and meta-analysis has been conducted to investigate the strength of these associations globally. Therefore, this study quantified the strength of these associations.

Research design and methods: A systematic literature search was conducted using MEDLINE, EMBASE, APA PsycINFO, Web of Science, and Scopus. We included observational studies assessing the association between physical capability, social support, loneliness, depression, and anxiety with life satisfaction in adults aged 65+.

Results: 10,552 articles were identified, of which 78 studies in 164,478 participants were included in systematic review and 57 were included in the meta-analysis. Greater life satisfaction was significantly associated with greater physical capabilities (OR=2.64; 95% CI 2.01-3.45; p<0.001, k=35, n=33,732), higher social support (OR=3.27; 95% CI 2.59-4.13, k=20 studies, n=13,228), and reduced loneliness (OR=3.30; 95% CI 2.53-4.30, k=11, n=33,638), depression (OR=4.76; 95% CI 3.10 - 7.32, k=24, n=64,097), and anxiety (OR=5.10; 95% CI 2.21-11.78, k=5, n=43,368). The strength of associations did not vary between Western and Eastern countries, year of publication, or quality. Gender was a moderator: loneliness was more strongly associated with life satisfaction in females. Age was also a moderator, the association between social support and life satisfaction weakened with increasing age.

Discussion and implications: Improving the physical capabilities of older individuals, fostering social support, and alleviating feelings of loneliness, depression, and anxiety may help build life satisfaction in older individuals, which policymakers and healthcare professionals should prioritise when implementing strategies.

Background and objectives: Although the model of successful aging is already well discussed and has received considerable critical responses, its intersection with the growing enthusiasm for creative engagement among older adults needs further exploration. This article contributes to the growing literature on later-life creativity by examining its relationship with the discourse of successful aging.

Research design and methods: The study employs critical humanities-based perspectives and the literature on later-life to address creativity in older age within contemporary neoliberal imperatives.

Results: While successful aging is as an antithesis to the narrative of decline, it often fails to capture alternative meanings of aging and the creative engagement in later life. The commercialization and commodification of creativity often function to discipline individuals towards a culture of productivity, optimization, and innovation. However, many older individuals challenge these notions as they create their own models of aging well and authentically that do not align with the ideals of successful aging.

Discussion and implications: Reductionist, individualistic, and capital-driven understandings of later-life creativity can be broadened by employing critical interdisciplinary approaches, which also help rethink the current meanings of old age and aging. The article will be of interest to scholars, policymakers, artists, and practitioners in gerontological scholarship and the humanities.

Background and objectives: The number of people with memory problems who desire or are forced to age in place has been growing rapidly. COVID-19 has brought significant challenges to the ability of those with memory problems to stay active and age in place. This study investigated the roles of neighborhood environments in helping community-dwelling people with memory problems maintain physical activity during the COVID-19 pandemic.

Research design and methods: We used retrospective online survey data from 75 caregivers who responded on behalf of their care recipients with memory problems living in Texas communities. We used difference-in-difference (DID) estimations based on zero-inflated negative binomial regression models to examine the changes in recreational walking and moderate-to-strenuous exercise before and during the COVID-19 pandemic and whether such changes vary by diversity of walkable neighborhood destinations.

Results: In the total sample, there was a significant reduction in both recreational walking (Δ change=-45.16 min/week, p<0.001) and exercise (Δ change=-36.28 min/week, p=0.03) after the COVID-19 outbreak. The pandemic's impact on exercise varied by diversity of neighborhood destinations (DID=0.81, p=0.03). Those living in neighborhoods with diverse walkable destinations experienced less decline in physical activity compared to those living in areas with limited destinations.

Discussion and implications: These findings suggest that the impact of the COVID-19 pandemic on physical activity among people with memory problems may be partially explained by neighborhood land use characteristics. Destination-rich, mixed-use neighborhood environments can help people with memory problems stay active even during pandemics such as COVID-19 in the U.S. and potentially elsewhere.

Background and objectives: Comprehensive definitions of social issues and populations can set the stage for the development of responsive policies and practices. Yet despite the rise of late- life homelessness, the phenomenon remains narrowly understood and ill-defined.

Research design and methods: This paper and the definition that ensued is based on the reconceptualization of interview data derived from a critical ethnography conducted in Montreal, Canada with older homeless persons (N=40) and service providers (N=20).

Results: Our analysis suggests that definitions of late life homelessness must include four intersecting components: 1) age, eligibility, and access to services ; 2) disadvantage over the life course and across time; 3) social and spatial processes of exclusion that necessitate aging in 'undesirable' places; and 4) unmet needs that result from policy inaction and non-response.

Discussion and implications: The new definition derived from these structural and relational components captures how the service gaps and complex needs identified in earlier works are shaped by delivery systems and practices whose effect is compounded over time. It provides an empirically grounded and conceptually solid foundation for the development of better responses to address homelessness in late life.

Background and objectives: The Individualized Positive Psychosocial Interaction (IPPI) Program is an adaptable, evidence-based intervention. IPPI trains nursing home care partners to engage residents living with moderate to severe dementia in preference-based, one-to-one interactions using emotion-focused communication. We sought to understand provider-driven adaptations made to the IPPI Program and whether the adaptations made were fidelity-consistent.

Research design and methods: Data were collected from n=78 interviews with n=23 nursing home provider champions who led a quality improvement project (QIP) to implement the IPPI with 3 to 5 residents per care community. Using content analysis, we report quantitative data on the adaptation characteristics according to the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) core modules and participant quotes to illustrate adaptations.

Results: Champions reported 34 adaptations, with an average of 2.6 adaptations per nursing home. The majority of IPPI adaptations pertained to implementation (65%; n=22), while 17% (n=6) were content and 17% (n=6) were context. Motivation for adaptations ranged from organizational (e.g., time constraints) to recipient (e.g., cognitive capacity). Most adaptations made to the IPPI protocol by care partners were fidelity-consistent (92%; n=33).

Discussion and implications: Care partners' adaptations to the IPPI made the intervention more resident-centric. Future healthcare intervention providers must consider the user perspective and encourage adaptations that further tailor to the user, as long as the adaptations are fidelity-consistent.

Background and objectives: Thus far, successful aging has been conceptualized and operationalized as a relatively static construct. Investigating daily successful aging provides a dynamic approach highlighting how successful aging can be achieved through everyday actions, giving older adults a stronger sense of control over their lives.

Research design and methods: We used 8-day diary data from MIDUS 2's US national sample of older adults (N=716, Mage[SD]=68.80[6.45]). Participants reported daily physical symptoms, functioning, and engagement in life (collectively, successful aging indicators), alongside daily stressors and positive events. We also correlated personal mean and standard deviation of the indicators with one-time measures of health and well-being.

Results: Intra-class correlation revealed substantial within-person variability in successful aging indicators. These indicators were associated with daily stressors and positive events. One-time health and well-being indicators were positively associated with personal mean levels of successful aging, although their correlations with personal standard deviations were less consistent.

Discussion and implications: Intra-individual variations in successful aging as everyday symptoms, functioning, and engagement with life are observable among a national sample of older adults, challenging the static view of successful aging and, instead, emphasizing the need to understand "micro-level" contributors of successful aging.

Background and objectives: Historically, aging research has focused primarily on health deterioration and negative aspects associated with aging. This has limited the scope of our understanding of the experience of aging and the relationships between aging and well-being from an integrative biopsychosocial perspective. In the same vein, there is a lack of reliable and valid assessments of aging that capture the positive aspects that characterize and improve the subjective experience of this period of life, particularly one that focuses on psychosocial well-being, including meaningful experiences and activities, group memberships, and general abilities. This study presents the development and validation of the Positive Aging Scale (PAS), a novel self-report assessment.

Research design and methods: This was an online cross-sectional study conducted on 501 UK residents aged ≥60 years. A number of self-reported items and measures of positive aging, general health, well-being, and cognitive functioning were administered to the sample. We used exploratory and confirmatory factor analyses and assessed the dimensionality, reliability, and concurrent criterion-related validity of the PAS.

Results: The results suggested that a unidimensional solution represents the data well, with the positive aging factor adequately loading on 8 items, and the solution showing factorial invariance between young-old and old participants (i.e., ≥75 years). Total PAS scores positively correlate with general health, well-being, and cognitive functioning.

Discussion and implications: The PAS demonstrated strong psychometric properties and the findings highlight correlations between the PAS and key outcomes of positive aging, including general health. Implications for research and interventions are discussed.

Background and objectives: This study examined day-to-day variation in care-resistant behaviors (CRBs) exhibited by persons living with dementia during mouth healthcare and the potential influence of time of day on CRB trajectories.

Research design and methods: A secondary analysis was conducted on a sample of 75 nursing home-dwelling persons living with dementia who exhibited CRBs during mouth care activities. Over 21 days, CRBs were measured using the revised Resistiveness to Care scale (RTC-r) during morning and afternoon mouth care sessions. Group-based trajectory modeling was used to identify trajectory patterns and assess differences between morning and afternoon CRB patterns.

Results: Three trajectory patterns were identified: morning CRB trajectory patterns showed 50.6% of persons living with dementia had consistently low RTC-r scores, 37.5% of persons living with dementia exhibited fluctuating, moderate RTC-r scores, and 11.9% exhibited RTC-r scores that started high and then decreased over time. Similarly, CRB trajectory patterns during afternoon mouth care showed a consistently low RTC-r score for 54.5% and a fluctuating moderate RTC-r score for 38.6% of persons living with dementia. However, the third CRB trajectory group followed a high-increasing trajectory, with RTC-r scores starting high and continuing to increase for 6.9% of persons living with dementia.

Discussion and implications: CRBs are dynamic and vary within days and over time; however, the time of the day is often not considered in interventions to manage CRBs. Thus, it is important to consider the timing of providing mouth care for persons living with dementia. Based on the characteristics of the trajectories, we suggest that morning mouth activities may be more efficient.