Gerontologist最新文献

Background and objectives: This review focuses on tools used in dementia diagnostic disclosure, particularly from family caregivers' perspectives. With dementia affecting millions globally, caregivers face challenges needing clear information and assistance. The review aims to: (a) identify tools used, (b) assess caregivers' preferences and challenges, and (c) highlight gaps to enhance communication strategies in dementia care.

Research design and methods: This systematic review, adhering to the PRISMA guidelines and registered with PROSPERO (CRD42024557806), synthesized evidence from nine studies on tools for dementia disclosure, with a focus on family caregiver perspectives. A comprehensive search of eight databases up to September 16, 2025, combined LLM-assisted screening and human review to identify qualitative, quantitative, and mixed-methods studies. Thematic synthesis analyzed caregiver preferences, tool effectiveness, and practice gaps.

Results: Across five countries (UK, Australia, USA, Denmark, Netherlands), written materials were universally valued (e.g., 80-95% satisfaction), with visual aids and brain images less common but effective when used. Caregivers preferred direct, comprehensive information (e.g., 98% sought details about behavior and psychological symptoms of dementia) delivered face-to-face, with written backups, although retention challenges (e.g., 61% recall) and inconsistent tool provision persisted. Gaps included limited visual aid adoption and poor post-diagnostic support, highlighting unmet needs.

Discussion and implications: This review highlights the importance of tools in supporting caregivers during dementia disclosure and calls for the development of a standardized Dementia Disclosure Evaluation Tool. Despite limitations (e.g., small sample sizes, urban bias), the findings lay the groundwork for improving caregiver support and guiding future research in diverse contexts.

Background and objectives: CONFIDNECE is a culturally tailored intervention to reduce caregiver financial strain, which disproportionately impacts Latino family caregivers to persons living with dementia. CONFIDENCE demonstrated preliminary efficacy at lowering financial strain in a feasibility study, yet attendance in group videoconference sessions was low (62%). CONFIDENCE was revised to integrate the NeuViCare™ application (app) that leveraged an interactive artificial intelligence (AI) assistant and text message reminders to engage participants between sessions. This study examined whether app registration was associated with attendance, as well as overall utilization of app features.

Research design and methods: CONFIDENCE was delivered in a community-based organization, where registration for the NeuViCare™ app was offered at no cost to complement the 4-week facilitated group-based intervention. Investigators tracked caregiver attendance in sessions, app registration, and uptake of app features. Bivariate statistics were used to assess the relationship between app registration and attendance.

Results: Fifty-five (55) caregivers completed the CONFIDENCE intervention, among whom 50.9% (28) registered for the NeuViCare™ app. App users attended an average of 2.9 (72%) sessions, compared to 2.0 (50%) of non-users (p=.002). Interactive features of the app (e.g., messaging an AI digital assistant) were infrequently used by participants.

Discussion and implications: Findings support further investigation into technology-enhanced psychoeducation for family caregivers of persons living with dementia to promote intervention adherence, particularly Latino caregivers who face greater caregiving burden and limited access to supportive resources despite higher dementia prevalence. These findings contribute to the emerging literature on technology adoption, including interactive AI, in service contexts.

Background and objectives: As the prevalence of Alzheimer's disease and related dementias (ADRD) continues to rise worldwide, so does the demand for home care workers who provide essential personal care that enables individuals living with ADRD to age in place. However, there is limited knowledge about dementia-specific training programs for home care workers. This scoping review aims to examine existing dementia training programs available for home care workers and evaluate their outcomes.

Research design and methods: We searched five databases, including PubMed, Web of Science, CINAHL, Sociological Abstracts, and Scopus. We used the PRISMA Extension for Scoping Reviews (PRISMAScR) and Arksey and O'Malley's (2005) five-step scoping review framework. Eligibility criteria included relevant study population (paid home care workers), dementia education or training programs, original evaluations, and published in English.

Results: Of the 903 articles identified through the five databases, 17 articles met eligibility criteria and 12 were included in the final analytic sample. The results are presented in three sections: 1) training details, 2) methods and measures, and 3) training outcomes.

Discussion and implications: This scoping review has implications for three groups of stakeholders, including researchers, governments and policymakers, and home care workers. This work underscores the importance of further implementation and evaluation of dementia training programs for home care workers.

Background and objectives: We explored the use of machine learning models for predicting safety accident subtypes among individuals with dementia using in-home sensors and to identify key predictors.

Research design and methods: An observational study was conducted using 966 days of in-home sensor data, sleep data from wearable Actiwatch devices, caregiver-completed structured safety accident diary data, and individual data collected in South Korea. Five machine learning classification models were developed to predict physical injury, nighttime behaviors/wandering, and risky behaviors. Model performance was compared, and the most important predictive features were extracted.

Results: The Gradient Boosting Model showed the best performance in predicting physical injury and nighttime behaviors, while CatBoost performed best for risky behaviors. Activity patterns recorded using in-home sensors emerged as essential features for predicting different safety accident subgroups, particularly for nighttime behaviors and wandering.

Discussion and implications: These findings highlight the potential of these technologies to identify high-risk individuals with dementia. Further research is recommended to integrate these methods for daily safety monitoring of this population.

Background and objectives: Sleep quality is a critical component of health and recovery for hospitalized older adults, yet current monitoring practices often lack the precision and detail required for effective intervention. This qualitative study aimed to evaluate the feasibility and acceptance of implementing the artificial intelligence-powered Sleepsense bed sensor for sleep monitoring in a geriatric inpatient hospital setting.

Research design and methods: This qualitative study involved interviews with 22 patients and focus groups with 33 interdisciplinary staff members. Data were analyzed using an interpretive description approach, guided by the technology acceptance model and unified theory of acceptance and use of technology, to explore the feasibility and acceptance of Sleepsense bed sensors in a geriatric inpatient setting.

Results: Key findings from thematic analysis emerged in three main themes representing the feasibility and acceptance of Sleepsense bed sensors among hospitalized older adults: user acceptance, integration with somnolog into clinical practice, and implementation barriers and practical challenges. Staff reported high acceptance of Sleepsense technology due to its nonintrusiveness and ability to reduce disruptive nighttime checks. However, challenges such as the need for consent, data interpretation, and occasional inaccuracies were also identified. Integrating Sleepsense with existing care practices was recommended to enhance patient care while maintaining staff confidence.

Discussion and implications: This study underscores the potential of advanced sleep monitoring technologies in subacute care settings and highlights the importance of addressing implementation barriers for effective adoption.

Background and objectives: This study examined whether transitions in living arrangements (ie, changes in cohabitation status or household composition are associated with life satisfaction in later life and whether these relationships differ by race/ethnicity.

Research design and methods: Data from the 2014-2020 waves of the Health and Retirement Study (HRS; N = 8,389) were analyzed. The 2014 baseline was chosen to ensure harmonization of the study variables across waves, specifically accounting for changes in psychosocial indicators. Linear regression models assessed associations between living arrangement types, living arrangement transitions and changes in life satisfaction, using a two-wave before/after design.

Results: Older adults who lived alone at baseline experienced lower life satisfaction during the observation period. Additionally, older adults who lived alone at both time points, transitioned to living alone, or transitioned to living with others, experienced declines in life satisfaction. Non-Hispanic Black older adults experienced greater declines to life satisfaction than non-Hispanic White older adults experiencing the same transitions, including living with others at both time points, transitioning to living with others, or transitioning to living alone.

Discussion and implications: Findings from this study demonstrated a negative association between living alone and life satisfaction, irrespective of whether we focused on baseline living arrangement status or transition to living alone. The moderating role of race/ethnicity reflects both cultural norms, such as stronger family support among non-Hispanic Black older adults, and structural inequalities affecting living arrangement choices. These findings underscore the importance of generating policies and programs that promote social connection, financial stability, and culturally responsive support for older adults living alone.

Artificial intelligence (AI) models and applications are proliferating rapidly throughout gerontological research and education. Machine learning has catapulted gerontological research in diagnosing and treating age-related health conditions. Students and educators have new tools for customized learning and innovation. Yet many of these developments come with persistent challenges, including bias, inaccuracy, and data security. As in other fields, engagement with AI models in gerontology is often siloed within disciplines. Exploring common opportunities and challenges in this space requires collaboration and conversations across disciplines. To fill this gap, the Gerontological Society of America (GSA)'s Public Policy Advisory Panel convened a multidisciplinary panel discussion of experts from the six GSA member groups and three advisory panels in November 2024 to discuss how AI is shaping various disciplines, and what ethical issues exist within or across disciplines. Several common themes emerged across disciplines: (1) human interaction remains critical to offset AI limitations in human experience, abstract reasoning, creativity, and bias; (2) AI provides opportunities for customized support across disciplines for older adults, care partners, practitioners, researchers, and students; (3) ongoing training is essential to navigate this rapidly evolving landscape; and (4) cross-disciplinary collaboration is needed to address overlapping challenges, limitations, and risks concerning AI.

Background and objectives: Older African American women have excess rates of stress-associated chronic diseases. Yet, limited research exists that explores within-group differences in their stress exposures and coping responses. Specifically, limited research has investigated stress and coping among college-educated African American women in later life, and this study sought to fill this gap in the literature.

Research design and methods: Constructivist grounded theory methods informed this study. Sixteen semi-structured interviews were conducted with older (aged 65+ years) African American women holding a bachelor's degree or higher. Purposive and snowball sampling was used to reach population of interest, including posting flyers in areas that might serve older African American women (local libraries, parks). Interviews focused on questions that elicited the women's perceived stressors and identified coping strategies used to buffer stress and protect well-being. Data analysis procedures involved open and focused coding, analytical memo writing, and the constant comparative approach. Several strategies, including member-check interviews, were used to achieve rigor and minimize threats to trustworthiness.

Results: A spirit of survival emerged as the core category that underpins how women experience and respond to stress. Four primary stressors were reported, which included gendered racism, losing independence, romantic relationships, and financial strain. Women described diverse coping strategies, including friendships, religion and spirituality, community care, self-care, and self-numbing strategies.

Discussion and implications: Findings provide evidence that can support the development of holistic stress-reduction interventions that integrate and center the unique stressors impacting well-educated older African American women and the coping strategies they use.

Background and objectives: Few doctoral psychology trainees choose to specialize in geropsychology, despite the rising need for trained professionals in this area. Guided by the theory of planned behavior, we aimed to identify modifiable factors that relate to trainees having stronger intentions to work with older adult clients.

Research design and methods: A sample of 188 doctoral trainees in clinical and counseling psychology programs in the United States completed survey measures online. Structural equation modeling was used to test hypothesized relations of ageist attitudes, aging-specific preparation, perceived competence, social approval, and attitudes about work with older adults, and intention to work with older adult clients.

Results: Perceiving greater social approval for working with older adults directly related to a stronger intention to do this work. Ageist attitudes indirectly influenced intention through perceived competence for and attitudes about work with older adults. Receiving more training in aging also indirectly related to intention through greater perceived competence for work with older adult clients.

Discussion and implications: These findings supported the theory of planned behavior as a conceptual framework for understanding psychology trainees' intentions to work with older adults and suggested ageist attitudes and aging-specific training as modifiable factors that influence trainees' interest in clinical work with older adults. Doctoral psychology training programs could encourage additional interest in clinical work with older adults by making an explicit statement of support for this work, by working to reduce their trainees' ageist biases, and by providing more aging-specific training and education.

Background and objectives: This scoping review explored caregiving experiences and relationships among migrant home care workers, older adult care recipients and employer families, with the aim of analyzing the nature and extent of these relationships and understanding the factors that influence caregiving dynamics.

Research design and methods: The review was conducted in accordance with Arksey and O'Malley's scoping review framework. We searched WoS Core Collection, Scopus, Pubmed, EBSCOhost: Psychology and Behavioral Sciences, EBSCOhost: PsycArticles, EBSCOhost: PsycInfo databases, and Google Scholar. Inclusion criteria were (a) articles reporting a research study; (b) articles focusing on triadic or dyadic caregiving relationships and experiences involving the migrant home care worker and/or the older care recipient and/or the employer family; (c) articles focusing on transnational migrant care workers; (d) articles published since 2013; and (e) articles written in English or Spanish. We screened a total of 637 records, and 38 articles met the inclusion criteria.

Results: These studies represented a number of countries and used various quantitative, qualitative and mixed-method study designs. The findings revealed that caregiving dynamics among the three parties are strongly influenced by cultural, structural, and interpersonal factors. Positive relationships improve the well-being of all parties involved; however, challenges such as abuse, exploitation, and poor working conditions persist, especially for live-in care workers.

Discussion and implications: Strengthening triadic caregiving relationships through cultural training, improved legal and institutional protections and psychosocial and language support are critical for enhancing quality of care and the well-being of all those involved in the caregiving process.