Gerontologist最新文献

Background and objectives: Mobility limitations have been linked to cognition. However, little is known about the relationship between mobility decline and cognitive decline. This study investigated the effect of mobility limitations and decline on cognitive decline in a population-based cohort of older adults.

Research design and methods: A population-based cohort of 9,695 cognitively intact participants (mean age = 65.4 years, standard deviation [SD] = 10.4) was assessed. Mobility limitation scores ranging from 0 to 10 were assessed at baseline (Wave 4) by using self-reporting difficulty in a set of 10 activities, and a higher score indicated worse mobility. A subset of 9,250 participants underwent 2 mobility assessments at Waves 3 and 4, and were categorized into normal mobility or mobility decline (defined as Wave 4 - Wave 3 > 1 SD of Wave 3). Linear mixed models were used to assess the longitudinal contribution of mobility limitations and decline to cognitive decline.

Results: During a median follow-up period of 9.4 years (SD 1.8), the participants in the highest quartile of mobility scores displayed an accelerated cognitive decline (-0.191 SD/year, 95% confidence interval [CI] = -0.223, -0.159) compared with those in the lowest quartile. Notably, individuals experiencing mobility decline exhibited a marked cognitive decline (-0.179 SD/year, 95% CI = -0.220, -0.139), potentially influenced by factors such as physical activity and depression.

Discussion and implications: Mobility limitations and decline significantly correlate with cognitive decline in older adults, highlighting that mobility focused interventions in healthcare strategies preserve cognition.

This article celebrates the National Institute on Aging (NIA)'s successes over the past 50 years in advancing the science base and informing the need for and response to dementia caregiving. In parallel with other public and private efforts, insightful NIA leadership supported by funding initiatives established the field of dementia caregiving research. In support of the health and well-being of family caregivers, NIA was a catalyst of innovation that led to numerous evidence-based caregiving interventions informed by basic research on care tasks and consequences. As evidence of the impending burden of dementia care on US families mounted, NIA-funded multidisciplinary collaboratives of researchers generated comprehensive models of family caregiving across diverse populations. Today, the dementia caregiving evidence base is shaping public policy and making possible dementia caregiving support services in health systems and community-based organizations. NIA continues to support the scientific study of dementia caregiving with a collaboration of leading scientists and by making available state-of-the-art datasets and encouraging standardized research methodologies. NIA's leadership in the field of dementia caregiving research has never been more significant, as the number of persons living with dementia in the United States approaches 7 million and the value of family caregiving is estimated to be $350 billion.

Background and objectives: End-of-life (EOL) doulas (EOLD) are an emerging role providing nonmedical support and advocacy for the dying and their families. Research about EOLD is new and currently highlights a need for more clarity in role definition and application. This review aims to comprehensively analyze existing knowledge regarding EOLD and their role in EOL care.

Research design and methods: A systematic and comprehensive search of 9 bibliographic databases identified all published academic articles related to EOLD (as named, self-identified, and/or trained) research from inception to June 2023. This review utilized an integrative approach and textual narrative synthesis to summarize the existing body of research findings related to EOLD.

Results: 25 articles were identified, representing multiple disciplines including health and medicine, public health, social/behavioral sciences, and humanities. Research on EOLD has rapidly increased in recent years and is showing signs of maturation. The review focuses specifically on summarizing the breadth and depth of identified research on EOLD and critically analyzes emergent themes from the review: Application, Perception, Identity, and Future Research Directions.

Discussion and implications: This review provides the most comprehensive review of the research literature on EOLD to date. Thematic findings for future research directions have provided the basis of a redirected research agenda to guide the field going forward. There is still a need to clarify who EOLD are and how they are being conceptualized by multiple stakeholders. Future research must address these missing voices to fully grasp the value and unique role that EOLD contribute to EOL care.

For 50 years, the National Institute on Aging (NIA) has supported and promoted research on religious involvement among older adult populations. This article discusses the ways that NIA funding has 1) broadened our understanding of how religious involvement is conceptualized and measured; 2) explored the important role of social networks and interactions within religious communities in relation to congregants' health; 3) supported research on national samples of the U.S. population to explore demographic variability in religious practices and beliefs, as well as their social correlates; and 4) examined health-relevant frameworks and topics in relation to religion's association with physical and mental health and well-being. The article focuses on research on African Americans and Mexican Americans as well as work that compares these populations to non-Latino Whites and Black Caribbeans. In this article, we provide an overview of selected research topics in the area of religion and aging, including Conceptualization and Measurement of Religious Participation; Religion and Mental Health; Religion and Physical Health; Church-Based Informal Support; Church Support and Mental and Physical Health; Religious Coping, and the Use of Clergy for Serious Problems. Scholarship and research supported by the NIA have fundamentally contributed to a deepening understanding of why and how religion matters for the health and social well-being of African American, Black Caribbean, and Mexican American older adults.

Background and objectives: Alzheimer's disease and related dementias (ADRD) remain a pressing concern in the US, which also has one of the highest incarceration rates worldwide. Existing research has analyzed dementia risk and care among currently incarcerated and homeless populations; this paper fills a gap by examining later-life cognitive disparities facing formerly incarcerated and/or homeless individuals.

Research design and methods: Using Health and Retirement Study data (HRS; 1998-2018), we tested whether formerly homeless and/or incarcerated people had earlier onset of cognitive decline, and whether they were more likely to have modifiable risk factors for ADRD than those without such experiences. We estimated prevalence of mild cognitive impairment (MCI), dementia, and self-reported ADRD diagnosis. We also used repeated observations of cognitive functioning coupled with nested nonlinear regression to examine the onset of accelerated cognitive decline.

Results: Adjusting for demographic variables, formerly homeless and/or incarcerated participants have increased odds of having risk factors for dementia, including smoking, drinking alcohol, depression, mental illness, and discrimination from healthcare providers and police. Diagnosis of MCI and ADRD were more common among participants reporting a history of incarceration or homelessness. Nested nonlinear regression revealed that previous experiences of incarceration or homelessness-alone or together-are associated with earlier onset of accelerated cognitive decline compared to those who experienced neither.

Discussion and implications: This study suggests that, even if they occur earlier in life, homelessness and incarceration experiences may increase risk of poorer cognitive health in late life. Future work is warranted to understand the lifelong consequences linked to this adversity.

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 article and the definition that ensued are 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 4 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 nonresponse.

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: 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 4 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 United States, 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.

Background and objectives: Physical capability, social support, loneliness, depression, and anxiety predict life satisfaction in older adults. Currently, no systematic review and meta-analysis have 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: In total, 10,552 articles were identified, of which 78 studies in 164,478 participants were included in the systematic review and 57 were included in the meta-analysis. Greater life satisfaction was significantly associated with greater physical capabilities (odds ratio [OR] = 2.64; 95% confidence interval [CI]: 2.01-3.45; p < .001, k = 35, n = 33,732), higher social support (OR = 3.27; 95% CI: 2.59-4.13, k = 20 studies, n = 13,228), 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 policy-makers and healthcare professionals should prioritize when implementing strategies.

Background and objectives: Coordination of governmental action is crowded with policies and programs that are highly interdependent, sometimes operating in silos if not contradicting each other. These dilemmas, or administrative quagmires, are heightened for older adults in general, but they are particularly problematic for marginalized older adults because these groups often require public assistance and support. This scoping review studies the coordination of governmental action on aging published in social science journals, focusing on 6 groups of marginalized older adults: those with histories of immigration, individuals with severe mental health problems, those who have had experiences of homelessness, formerly incarcerated individuals, members of the LGBT (lesbian, gay, bisexual, and transgender) community, and individuals living in a rural area.

Research design and methods: A 5-stage scoping review methodology was followed, and 53 articles (published between 2000 and 2022) from 5 social science databases were analyzed.

Results: The analysis revealed a limited number of contributions with coordination as a primary focus. Understandings of coordination varied but tended to examine structure, organization, and relationships between sectors. When coordination was the primary object of a study, it was often analyzed in 1 specific policy area or within a clinical setting along the lines of facilitating care coordination.

Discussion and implications: This scoping review reveals a mutual neglect on the part of public administration and policy scholars toward marginalized older adults and a lack of public administration considerations on the part of scholars studying long-term care and social service programs for these marginalized older adults.

Background and objectives: An ageing population worldwide has highlighted the need for improved care in long term aged care homes. In Australia, such homes are called Residential Aged Care homes, and reform is underway to improve the quality and safety of aged care. A key enabler of quality improvement is increasing evidence-based practice through creating a system to support research translation. Collaborative multi-stakeholder research networks offer a potential solution by bringing together stakeholders to identify evidence-to-practice gaps, co-design research and translate knowledge into practice. The aim of this scoping review was to understand the current evidence on the creation and maintenance of multi-stakeholder aged care research networks internationally, reported facilitators and barriers, and outcomes.

Research design and methods: An academic literature search in five databases to identify existing multi-stakeholder aged care research networks. A grey literature search was conducted using Google, Google Scholar, grey literature databases and a manual search of targeted websites.

Results: 10 papers and 19 web-based resources were identified, reporting on six multi-stakeholder research networks internationally. Enabling factors of successful networks included flexibility in structure, good governance, leveraging pre-existing research relationships, consistent and open communication, staff with dual roles in research and practice, and a focus on building long term partnerships independent of research projects.

Discussion and implications: Collaborative multi-stakeholder research networks offer promise for improving research translation in aged care. Advancing the development of impactful multi-stakeholder aged care research networks requires internationally agreed terminology for network models, clear reporting and evaluation guidelines and dedicated infrastructure resources.