Gerontologist最新文献

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: 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: The scarcity of resources and available caregiving services in rural areas in the United States has been well documented. However, less research has compared unmet service needs between caregivers of people with Alzheimer's disease and related dementias (ADRD) in rural versus urban areas.

Research design and methods: Using semistructured interviews guided by theories of health service use and dependent care, we interviewed 20 family caregivers residing in rural areas of Western North Carolina and 18 caregivers within the urban setting of Houston, Texas, and compared their unmet service needs and contextual factors that facilitate their service use.

Results: Thematic analyses revealed similar unmet service needs among rural and urban caregivers; however, the ways they approached and solved their challenges differed. Caregivers in rural areas wished for more information and caregiver support whereas urban caregivers looked for information they needed until they found the answers. Rural caregivers expressed guilt about using services because they felt they were limited and zero-sum whereas urban caregivers shared available resources so that other caregivers could use them as well. Unmet service needs for urban caregivers included more racially and ethnically specific services for people with ADRD in their ethnic-specific languages and foods while rural caregivers' cultural needs were not racially and ethnically specific but for more place-specific services.

Discussion and implications: Recommendations for rural caregivers included utilizing online and virtual opportunities and expanding their reach across the United States. For urban caregivers, increasing culturally tailored service options would likely increase access and use.

Background and objectives: Two exploratory 6-month pilots of triadic walking with culturally celebratory social reminiscence in gentrifying neighborhoods tested feasibility and health impact among normal and mildly cognitively impaired (MCI) older Black adults.

Research design and methods: Fourteen triads walked 1-mile 3×/week, using a navigational application with image-based reminiscence prompts. Focus groups evaluated perceived health impact and experience. Primary outcome measures were program evaluations (feasibility), pre-post self-report health, Montreal Cognitive Assessment, blood pressure, and weight. Analysis used mean rank scores for program evaluations, pre-post paired t-tests for health outcomes, and thematic coding for 30 focus groups.

Results: Feasibility: Retention was 74% and 86% for pilots, and 100% and 92%, respectively, were "extremely likely" to recommend to friends/family. Mean rank scores indicated appropriate pace and dose, effective conversational prompts, and program readiness with minor changes. Health impact: Self-rated health, mood, activity levels, and energy improved, days feeling downhearted decreased, and days feeling calm/peaceful were maintained or improved. Among Cohort 2, cognitive assessment scores were maintained or improved for 67%; for MCI, 76% had mean improvement of 2.4 (p = .045). Blood pressure and weight decreased for 78% and 44%, respectively. Focus groups: Perceived impact of triadic walking included increased physical and social activity outside the program, increased awareness of cognitive decline risk and personal agency, and deep-seated sense of community connection.

Discussion and implications: Triadic walking provides structure, accountability, connection, and purpose, motivating sustained engagement. Walking programs that center socialization, particularly within culturally meaningful contexts, may be more effective among older Black adults.

Clinical trial registration number: NCT05906654; NCT05906667.

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.

Background and objectives: Few people who are ages 80+ meet the criteria of successful aging (SA) proposed by Rowe and Kahn. Going beyond the individual-level conceptualization, we argue that SA always operates in multiple contexts and that context may become most critical in advanced old age. However, we are not aware of any previous study providing an empirical test of how contexts for SA unfold across persons 80 years and older, including those living in institutions.

Research design and methods: We estimated and compared prevalences of successful aging based on a classic versus context-enriched understanding of SA in multiple large surveys of older adults, i.e., the D80+ study (N = 3.233) and the NRW80+ study (N [baseline] = 1.863). In addition to replication across independent samples, we investigated the stability of context-related SA across time.

Results: Prevalences of SA according to Rowe and Kahn were 9.1% in adults aged 80-84 and 0.7% in persons 90 years or older. However, prevalence rates for those with good contexts at their disposal even if not fulfilling Rowe and Kahn's criteria were much higher across all age groups (80-84 years: 54.9%, 90 years and older: 44.4%). Greater two-year stability was observed for contextual compared to individual criteria. Notably, positive effects of context on SA were stronger at onset compared to late fourth age.

Discussion and implications: Our findings support a contextualized understanding of SA and inform policy that furthering SA in the fourth age requires the optimization of multiple contexts at the community level.

Background and objectives: Although prior research has identified racial/ethnic and gender differences in successful aging (SA), heterogeneity within groups has been little examined. We consequently explore the variety of aging experiences among older Black women.

Research design and methods: We used the 2010/2012 U.S. Health and Retirement Study, limiting analyses to Black women who completed the Psychosocial Leave-Behind Questionnaire (N = 1,186). We conducted latent class analysis (LCA) using indicators of physical health, psychological well-being, social support/strain, and social engagement.

Results: Six SA latent classes were identified and labeled according to their distinctive characteristics: infirm, isolated, taxed, independent, vivacious, and robust. The infirm class had uniformly poor health, while the isolated class was in poor physical health but also lacked social relations. Although both had average physical health and psychological well-being, the taxed class experienced high levels of social support and social strain compared to the high support (and unpartnered) independent class. The vivacious and robust classes exhibited high physical health and psychological well-being, high social support/low social strain, and high social engagement, but vivacious women (23% of respondents) were unpartnered and robust women (16% of respondents) were partnered. The robust class had the highest physical and psychological well-being, and best social relations across all classes.

Discussion and implications: Using nationally representative data, we reveal significant heterogeneity in Black women's aging experiences. Although many face difficult aging experiences, 39% of older Black women fit the SA framework well. Future work should recognize that Black women's aging experiences are not homogenous.

Background and objectives: The aging experiences of military veterans provide critical insights into what successful aging is and means for later life contexts constrained by distinct health and social needs. Can veterans 'successfully' age when they are exposed to so many stressors with serious health and social consequences for later life? Veterans can offer valuable lessons for developing comprehensive approaches to refining successful aging, ensuring inclusivity of different older populations. Building on Rowe and Kahn's idea of successful aging, we utilize the complementary concept of 'active aging' to explore if there are unique factors, characteristics, and interventions that support active aging in veterans, compared to non-veteran populations.

Research design and methods: A rapid review and evidence synthesis was conducted across 9 databases in medicine, psychology, anthropology, sociology, and public health to search for peer-reviewed articles and research reports.

Results: Findings suggest that programs linking health and social dimensions can support the active aging of veterans, namely interventions promoting active physical and cognitive lifestyle as well as social connectedness and engagement. Such programs and interventions help prevent and combat mental and physical health decline and increase quality of life and well-being.

Discussion and implications: Findings have implications for veteran and non-veteran populations more broadly, as people can actively age even when they have unique health and social needs.