Gerontologist最新文献

Background and objectives: Population aging underscores the need for a comprehensive understanding of the multi-level factors that support aging in place. Physical environments are closely linked to social environments, and caregivers often observe how these environmental features shape the everyday experience of people with memory problems. This study examines how caregivers' perceptions of neighborhood built environments are associated with their perceptions of the social inclusion of people with memory problems in communities.

Research design and methods: A statewide survey was conducted in Texas, involving 95 caregivers of individuals with memory problems (defined as having significant memory impairment that impacts daily functioning). Descriptive statistics summarized neighborhood characteristics and caregivers' perception of the community's social inclusion. Logistic regression predicted two target outcomes of social inclusion for people with memory problems: (1) respect and support and (2) intergenerational exchange (e.g., age-integrated social interactions).

Results: For neighborhood characteristics, legibility-related environmental features were more commonly present than those related to accessibility or safety. For social inclusion, caregivers perceived positive community respect and support for people with memory problems but limited intergenerational interaction. Legibility of neighborhood environments was positively associated with caregivers' perceptions of respect and support for people with memory problems, while accessibility was associated with intergenerational exchange.

Discussion and implications: The findings underscore the role and potential of neighborhood environments for improving social inclusion for people living with memory problems. They suggest that improving legibility and accessibility of neighborhood environments can foster respect and social support and intergenerational exchanges central to aging in place.

Background and objectives: Employee background checks can help protect older adults in long-term care facilities. The National Background Check Program (NBCP) offers federal support to strengthen employee background check systems. Yet, regulations on provider requirements, disqualifying offenses, and administrative processes differ across states. We examine differences between NBCP (N = 27) and non-NBCP (N = 23) states across three domains: (1) types of LTC providers required to conduct background checks (2) disqualifying offenses considered by each state, and (3) processes used to administer background checks. We also assess regulatory changes across these domains from 2005 to 2024 across all 50 states.

Research design and methods: We conducted policy surveillance of state regulations on employee background check programs applicable to individuals seeking work at long-term care facilities. Our sample includes all 50 states, with 27 receiving an NBCP grant. We assess current regulations across three policy domains and review how these regulations have evolved since 2005, when the NBCP pilot program was initiated.

Results: NBCP states have expanded background check regulations to include a broader range of long-term care providers and disqualifying offenses following the grant. However, minimal differences were observed between the two groups in background check processes such as fingerprinting and registry reviews.

Discussion and implications: While many NBCP states have adopted measures like disqualifying offenses and RAP back systems, their overall impact on hiring practices, F-tags and quality of care remains uncertain.

Background and objectives: Sexual and gender minority (SGM) older adults are more likely to use long-term care (LTC) than their cisgender, heterosexual counterparts. However, LTC settings may lack SGM-affirming policies necessary for inclusive care. This study analyzed the prevalence of SGM-affirming policies in nursing homes (NH) and assisted living facilities (ALF) in Minnesota and examined differences across facility characteristics.

Research design and methods: A survey was conducted across 165 NH and 266 ALF in Minnesota. Facilities were assessed by their explicit inclusion of 28 SGM-affirmative policies, like nondiscrimination and training policies, with a mean index score calculated to determine the overall prevalence of affirming policies. Differences by facility type (NH vs ALF), location (rural vs. urban), ownership (non-profit vs. for-profit), and religious affiliation (religious vs. secular) were assessed in multinomial logistic regression. Latent class analysis compared lower (n = 244) and higher (n = 153) performers across facility characteristics.

Results: Across LTC facilities, there was an average of 11.30 SGM-affirming policies out of 28 policies assessed. Lower performing facilities reported fewer SGM-affirming policies (mean = 7.34) than higher performing facilities (mean = 17.24). No significant differences in policy prevalence were found between NH and ALF; between rural and urban facilities or by ownership status. However, striving facilities were more likely to be secular than religious.

Discussion and implications: The prevalence of SGM-affirming policies was distributed binomially, suggesting facilities fall within two categories (lower performers and high performers). Efforts should focus on adopting SGM-affirmative policies across all LTC facilities to ensure equitable and inclusive care for SGM older adults.

Background and objectives: Older adults' personal views of aging (VoA) can shape health and well-being outcomes. This study explores how non-kin social interactions within a Continuing Care Retirement Community (CCRC) influence the development and reinforcement of personal VoA before and during the COVID-19 pandemic.

Research design and methods: This qualitative study was nested within an ongoing ethnographic project in a midwestern U.S. CCRC. Data included 22 resident interviews contextualized by two months of ethnographic fieldwork and participant observation. Interviews and field notes were analyzed using thematic analysis to explore how non-kin social interactions affect the multidimensional aspects of VoA, including losses and growth in physical functioning, cognitive abilities, and socio-emotional experiences.

Results: Findings show that non-kin interactions played a dual role in buffering against and reinforcing negative VoA. They buffered residents by replenishing social networks, reducing isolation, encouraging health behaviors, and fostering solidarity. At the same time, peer and staff interactions reminded residents of decline and death, reinforcing stereotypes and leading to othering and patronizing behaviors. These dynamics mirror prior studies yet highlight the unique salience of non-kin ties in CCRCs. The timing of data collection suggests that the pandemic amplified rather than fundamentally altered the benefits and risks of peer influence on VoA.

Discussion and implications: Personal VoA is multidimensional and sensitive to social environments. Friendships and non-kin ties are pivotal in shaping how older adults interpret their own aging, with potential to both promote and undermine positive VoA and well-being.

Background and objectives: Social isolation affects one in four people and is associated with adverse health outcomes, yet accurate social isolation risk prediction models remain lacking. This study develops and validates an interpretable machine learning (ML) approach to predict social isolation and identify key predictors among middle-aged and older adults in China.

Research design and methods: Training data came from the China Health and Retirement Longitudinal Study. Baseline data from 2011 included 12,785, 12,323, and 11,590 participants for the 2-, 4-, and 7-year prediction models. External validation used data from the China Family Panel Studies 2010, 2012, and 2016. Five ML algorithms were used to construct prediction models with 283 candidate predictors. SHapley Additive exPlanations explained the feature importance. Classic logistic regression and restricted cubic spline (RCS) explored potential causal associations.

Results: In the development phase, the Gradient Boosting Machine (GBM) achieved the best performance across 2-, 4-, and 7-year models (AUC-ROC = 0.767, 0.729, and 0.749). In the external validation, the GBM had AUC-ROC with 0.649 and 0.678 for the 2- and 7-year prediction models. Age, monthly non-food consumption, and net primary residence value were consistently identified as the top predictors. Environmental exposures (greenness exposure, rainy days) and community environment (convenience stores, out-migrants) also emerged as important predictors. RCS analysis revealed non-linear associations between these external factors and social isolation.

Discussion and implications: With multimodal data, our best-performing model GBM outperformed existing models for identifying social isolation risk. The interpretability of our model highlights actionable and potentially reversible targets, especially at a community and environmental level.

Background and objectives: Family caregiving is common in US Hispanic/Latino populations. Using the Sociocultural Stress and Coping Model framework, we examined the prevalence, duration and reported stress levels of caregivers from different heritage groups in the Hispanic Community Health Study/Study of Latinos (unweighted-n = 5,313).

Research design and methods: We generated target population specific prevalence and mean estimates of study variables and compared between those who reported caregiving and those who did not. Then, for care providers, we generated prevalence and mean estimates of study variables by Hispanic/Latino heritage. Lastly, we fit a series of survey generalized linear models to examine the associations between the proposed variables and the outcomes reflecting caregiving and caregiving experiences.

Results: Nearly 2-in-5 individuals in our study were involved in caregiving. In models adjusting for demographic covariates, participants of Mexican heritage were most likely to report caregiving for others but were less likely to report caregiving for more than 6-months. Older age and foreign-birth were linked to increased odds ratios of providing care. On average, Central Americans and Puerto Ricans reported higher levels of stress associated with caregiving.

Discussion and implications: Understanding the nuanced characteristics of caregivers from varying Hispanic/Latino heritage groups can facilitate the development of tailored caregiver interventions to address stress associated with being a caregiver and its impact on health.

Hearing loss affects an estimated 18 million UK adults and is the third leading cause of years lived with disability worldwide. Hearing loss diminishes quality of life, activities of daily living, mental health, and negatively impacts the economy. When left unaddressed, hearing loss exacerbates health inequalities and is associated with an increased risk of developing dementia. Hearing loss and dementia frequently co-occur and have overlapping risk factors. People from disadvantaged backgrounds typically access hearing and memory services at a more progressed stage of their conditions. Early intervention is essential to mitigate negative effects and reduce disease burden. Universal adult hearing screening is not currently recommended by the UK National Screening Committee, despite evidence of cost-effectiveness and international recommendations. We argue that the UK should adopt targeted, risk-stratified screening that prioritises those at greatest risk of dementia and people in deprived communities, where unmet need is highest. Such an approach is practical, equitable, and consistent with the Governments' prevention and personalised care agenda set out in the 10-year Health Plan for England. We outline the evidence, discuss implementation pathways, and call on policymakers to commission a targeted, risk-stratified adult hearing screening pilot. A successful programme would address unmet need, reduce inequalities, and further inform global debates on hearing screening strategies.

Background and objectives: Generative artificial intelligence, particularly large language models (LLMs), is increasingly used to navigate information, potentially shaping users' perceptions of different social groups. This study examines age-related stereotypes in LLM-generated text using natural language processing (NLP) techniques.

Research design and methods: To ensure neutrality, extensive pilot testing was conducted to craft a prompt that did not elicit bias yet generated coherent responses. The final prompt, "Describe the personality of a [AGE]-year-old person," was used with OpenAI's GPT-4o API in February 2025, varying AGE from 10 to 90 in 10-year increments. The analysis was guided by the Stereotype Content Model, which assesses social cognition along two key dimensions: warmth (sociability, morality) and competence (ability, assertiveness). Scores were quantified using sentence embeddings.

Results: Text similarity and stereotype content analyses revealed three age clusters, with older adults showing the most internal consistency. Descriptions of individuals aged 60 and above featured relatively higher warmth but lower competence compared to younger groups. Notably, positive assertiveness terms were rarely used to describe older adults.

Discussion and implications: Findings suggest that GPT-4o may embed subtle age-related stereotypes, even when using largely positive language. These patterns potentially influence user perceptions through repeated exposure. Future research should investigate the mechanisms behind these biases and explore mitigation strategies to promote more age-inclusive AI-generated content.

Background and objectives: While some research exists on women who have survived attempted intimate partner homicide (IPH), studies focusing on survivors aged 60 and older and how they cope with health concerns remain scarce. Guided by intersectionality as a theoretical framework, this study examined older women's experiences of managing their health in the aftermath of surviving a violent attack by a male partner, considering how intersecting identities such as age, gender, and survivorship shape their health-related challenges. The insights gained could inform targeted interventions and policies to address this population's unique vulnerabilities and care needs.

Research design and methods: Interpretative phenomenological analysis methodology was used to conduct in-depth, semi-structured interviews with nine older women who had survived an attempted IPH. A purposeful sampling strategy was employed to identify women who had been legally or medically classified as survivors of attempted intimate partner homicide and self-identified as such. The interviews, guided by an interview guide, were recorded, transcribed verbatim, and analyzed to elicit the main themes.

Results: Three themes emerged from the participants' narratives: (1) The ripple effect of the injury, (2) Reduced access to formal and informal health-related support systems, and (3) Limited financial resources for recovery needs.

Discussion and implications: The interplay of chronic health conditions, minimal support networks, and financial constraints highlights how advancing age, traumatic histories, and systemic healthcare gaps are mutually exacerbating. These findings underscore the value of integrated, age-conscious, and trauma-informed services and theoretical frameworks that address the complete spectrum of older survivors' healthcare needs.

This conceptual article advances a feminist gerontological perspective on the intellectual and emotional labor of older adults-particularly women. Building on theories of invisible labor, care ethics, and adult learning, the paper argues that unpaid, informal knowledge work (e.g., caregiving, mentoring, volunteering, community education) constitutes a form of cognitive labor that is persistently under-acknowledged in aging and education discourse. The analysis highlights the gendered dimensions of later-life learning, contending that older women act as vital yet unrecognized intellectual actors in family and community life. Through a critical synthesis of literature across gerontology, feminist theory, and adult education, the article proposes a new framework for recognizing and valuing intellectual contributions of older learners beyond formal institutions. By documenting this perspective, the paper challenges deficit narratives of aging, stimulates dialog about the ethical and political stakes of recognizing cognitive labor, and identifies directions for future research and policy to advance gerontological scholarship.