Gerontologist最新文献

Background and objectives: Despite interest in using real-time location systems (RTLS) to improve quality and efficiency of care and to collect data for the development of clinical algorithms, research on their implementation and use in long-term care homes is scarce. This study examines RTLS implementation in one long-term care home identifying failure points, ethical tensions, and sociotechnical misalignments that led to abandonment.

Research design and methods: Semistructured interviews were conducted with 47 participants (residents, care partners, direct care staff, managers, administrators) across two time points; all also completed a demographic survey. Thematic analysis of the data was guided by the Non-Adoption, Abandonment, Scale-up, Spread and Sustainability framework, and Sociotechnical Systems theory.

Results: Initial enthusiasm for RTLS stemmed from safety and efficiency expectations, but misaligned functionalities, limited staff engagement, and ethical tensions undermined adoption. Stakeholders anticipated real-time monitoring and fall detection, neither of which were provided. Residents frequently removed the wearables, citing discomfort and privacy, while staff encountered barriers due to the limited integration of the RTLS into workflows. Ethical tensions emerged as residents' autonomy and preferences were overridden by care partners.

Discussion and implications: These failures underscore the need for iterative and participatory approaches to implementation, transparent communication, and stakeholder alignment. The findings highlight the sociotechnical complexities of implementing surveillance technologies in long-term care. Ethical concerns surrounding resident autonomy, workforce surveillance, and data governance, must be addressed in future implementations to ensure that RTLS supports rather than compromises the dignity and rights of residents and staff.

This article explores an innovative new framework that addresses system-level complexity in long-term care research through the lens of culture change. We first discuss the current findings and gaps in culture change research and explore how a lack of system-level research may have slowed culture change adoption. After a review of potential system-level theories, we identify a conceptual framework that integrates the theoretical constructs of the Consolidated Framework for Implementation Research (CFIR) and Complex Adaptive Systems (CAS) for a more advanced conceptual modeling of culture change implementation. To illustrate the integration of CFIR and CAS as a conceptual framework to research culture change at a system-level, we create a crosswalk using two prominent implementation tools that support culture change: The Preferences for Everyday Living Inventory and the Artifacts of Culture Change 2.0. We argue for the value of this novel conceptual framework in highlighting the complexity of systems in long-term care research.

Dementia is a prevalent and growing concern among Indigenous communities. Research on the lived experience, culture, and context of the dementia journey has improved our understanding of Indigenous Peoples' experiences. This research study elucidates the deep understanding of healthy brain aging from interviews with seven Anishinaabe/Ojibwe Traditional Knowledge Sharers from Manitoulin Island in Ontario, Canada. Using a community-based participatory research (CBPR) approach and Indigenous methodologies, researchers worked with a Community Advisory Council (CAC) to develop the study. Interviews with Traditional Knowledge Sharers were recorded, transcribed, and shared with a local Anishinaabe/Ojibwe artist for his interpretation and artistic representation of the key healthy brain aging teaching that arose from the interview. The artist developed six paintings based on these teachings for Anishinaabe/Ojibwe people, titled: Perseverance, Anishinaabe Cognition, Presence, Healing Step, Benevolence, and Linkages. A seventh painting was also developed, with the shared teaching of Bebaminojmat-one who goes around and shares their healing gifts. We describe these teachings and the cross-cutting themes that arose from the post-analysis. This study contributes to the field of aging by revealing cultural and philosophical concepts related to healthy brain aging specifically for Anishinaabe/Ojibwe people. The findings can be used to guide healthcare providers in supporting healthy brain aging in culturally meaningful ways and developing culturally safe health education interventions. Artistic analysis and representation proved to be an effective vehicle for exploring cultural values central to the development of programs and education aimed at addressing existing brain health disparities.

Background and objectives: AI-driven lifestyle monitoring systems collect data from ambient, motion, contact, light, and physiological sensors placed in the home, enabling AI algorithms to identify daily routines and detect deviations to support older adults "aging in place." Despite its potential to support several challenges in long-term care for older adults, implementation remains limited. This study explored the facilitators and barriers to implementing AI-driven lifestyle monitoring in long-term care for older adults, as perceived by formal and informal caregivers, as well as management, in both an adopting and nonadopting healthcare organization.

Research design and methods: A qualitative interview study using semi-structured interviews was conducted with 22 participants (5 informal caregivers, 10 formal caregivers, and 7 participants in a management position) from two long-term care organizations. Reflexive thematic analysis, guided by the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework, structured findings into facilitators and barriers.

Results: In all, 12 facilitators and 16 barriers were identified, highlighting AI-driven lifestyle monitoring as a valuable, patient-centered, and unobtrusive tool enhancing care efficiency and caregiver reassurance. However, barriers such as privacy concerns, notification overload, training needs, and organizational alignment must be addressed. Contextual factors, including regulations, partnerships, and financial considerations, further influence implementation.

Discussion and implications: This study showed that to optimize implementation of AI-driven lifestyle monitoring, organizations should address privacy concerns, provide training, engage in system (re)design, and create a shared vision. A comprehensive multi-level approach across all levels is essential for successful AI integration in long-term care for older adults.

Background and objectives: Family caregivers of community-dwelling frail older adults often experience substantial stress and poor mental health. This study aimed to examine whether and how a Stress Process Model (SPM)-based mHealth multicomponent supportive program (Hi-Care) promoted adult children caregivers' mental well-being.

Research design and methods: A 3-month randomized controlled trial (n = 136) was conducted among the Hi-Care intervention group versus usual care. Caregivers' mental outcomes (depressive symptoms and anxiety symptoms), potential mediators (mastery and competence), and moderators (reciprocal filial piety, social support, and coping) were evaluated at baseline (T0), postintervention (T1), and 1-month postintervention (T2).

Results: Caregivers were primarily female (62.5%), with a mean age of 48.4 ± 9.4. The intervention group improved more than the control group in mastery (T1, T2), social support (overall and three types of objective support, subjective support, and support utilization) (T1, T2), negative coping (T2), depressive symptoms (T1, T2), and anxiety symptoms (T2), but not competence, reciprocal filial piety, or positive coping. Mastery mediated the intervention effectiveness on depressive and anxiety symptoms. Overall social support modulated the effects of mastery and intervention on psychological outcomes. Specifically, objective support enhanced mastery's role in reducing depressive or anxiety symptoms, while subjective support impeded intervention impacts but strengthened mastery's effect on anxiety management. Support utilization boosted intervention or mastery in decreasing depressive symptoms. Negative coping weakened the intervention's protective effect against anxiety.

Discussion and implications: Mastery, social support, and negative coping served as mechanisms of mental improvement, informing more targeted interventions to promote caregivers' mental well-being.

Clinical trial registration number: ChiCTR2400089142.

Background and objectives: Augmented reality filters have enabled real-time alterations of one's appearance, including filters that allow users to explore how younger or older versions of them might look. This can be entertainment, but can also confront users with an unexpected contrast in appearance. Users sharing their reactions to these filters on social media, allow a view into the effects such filters have. We aim to better understand what these effects are and how such filters support user's engagement with aging and their past.

Research design and methods: We searched TikTok for videos on age filter use, centered on those associated with the #teenfilter hashtag. From the initial dataset of 624 we retain 434 videos for a further analysis. We combine a quantitative analysis of the video descriptions and who features in the videos with a thematic analysis of the video content.

Results: We identified eight themes around how users reacted to age filters. These span from positive reactions, such as appreciation and amusement, to negative ones, such as shock and disagreement. Nostalgia and reminiscence were common reactions, with users reflecting on their own lives, but also using the opportunity to draw connections between themselves and their parents or kids.

Discussion and implications: Our findings describe the broad range of reactions stemming from the use of augmented reality age filters. We find that these filters can help users reminisce and connect across generations. Filters have been shown to affect self-perception and support self-expression and this extends to age and aging.

Background and objectives: Racial discrimination against migrants is pervasive and harmful, with long-lasting consequences for people's health and well-being as they age. Societal narratives, however, often position migrants who experience difficulties as undeserving and culpable, and therefore, responsible for their experiences of discrimination. This article interrogates how older Chinese migrants in Aotearoa New Zealand reproduce these societal narratives as they make sense of lifetime experiences of racism and racial discrimination.

Research design and methods: We analyzed interviews with eight ethnic Chinese people who had migrated to Aotearoa New Zealand as adults about their life course experiences. Transcripts were analyzed using narrative inquiry with a specific focus on participants' talk related to lifetime experiences of racism and discrimination.

Results: Two narratives were used to story experiences of racial discrimination: "discrimination is inevitable" and the "grateful migrant." These two narratives were used to explain how people should adjust their behavior to reduce experiences of discrimination, despite the ultimate inevitability of discriminatory experiences. Participants also used the "grateful migrant" narrative to reinforce their appreciation of the benefits of living in Aotearoa New Zealand.

Discussion and implications: Older migrants used these narratives to explain experiences of racial discrimination and to conclude that such experiences were part of what it meant to be a good migrant. Rather than seeing discrimination as a barrier to migration success, they storied difficulties as part of the journey to achieve a good old age in their adopted country.

Background and objectives: Aging is associated with functional decline and multimorbidity, highlighting the need for holistic biomarkers to monitor healthy aging. The aim of this study was to validate intrinsic capacity age (IC-age) as a biomarker of aging and to examine its association with multimorbidity and geroprotective agents.

Research design and methods: A cross-sectional study was conducted with data from 48,068 participants aged ≥60 years from the 9th wave of the Survey of Health, Ageing and Retirement in Europe (2021-2022). Random forest regression was used to train a model predicting IC-age based on biomarkers (cognitive, psychological, sensory, vitality, locomotion) and demographic factors.

Results: IC-age showed a prediction error of 5.3 years (r = 0.55). Biomarkers for vitality (handgrip strength), cognitive (verbal fluency and memory), and sensory (hearing aid use) domains were important contributors. General linear models assessed associations with multimorbidity, physical activity, and smoking. Intrinsic capacity age was significantly higher in individuals with multimorbidity and smokers compared with healthy individuals. Physical activity exhibited a protective effect on IC-age, with vigorous activity showing a particularly pronounced benefit in women.

Discussion and implications: This model demonstrates that IC domains can estimate biological age and distinguish individuals based on their comorbidities. It also underscores the role of physical activity as a key geroprotective factor, with vigorous physical activity in females with comorbidities showing the most pronounced protective effect on IC-age. These results validate the concept of IC-age as a comprehensive measure of aging and highlight its potential to inform personalized interventions and public health strategies.

Background and objectives: With China's rapidly aging population, the need for innovative care models that support both longevity and quality of life has become increasingly urgent. This study examines the interplay between "aging in place" and "aging well" within the context of retirement communities in China, focusing on two pioneering examples: Taikang Home · Chu Garden and Xianghe · Da'ai City.

Research design and methods: Adopting a qualitative approach, this research employs semi-structured interviews with residents, service team members, and management team members to explore how these retirement communities facilitate aging in place and contribute to the aging well of their residents.

Results: The findings reveal that these communities are well-equipped to address both the physical and emotional needs of older adults, offering comprehensive medical care, age-friendly facilities, and a supportive social environment. The key to this success is the integration of healthcare services within living facilities, the use of smart technologies for safety and convenience, and a strong emphasis on community and social engagement. The study also identifies challenges, such as ensuring sufficient personal companionship and managing diverse resident lifestyles, suggesting areas for further policy and practice improvement.

Discussion and implications: This research contributes to the literature on aging by integrating the concepts of aging in place and aging well, offering insights into how physical and social environments can support older adults and suggesting novel concepts that could be replicated elsewhere.

Background and objectives: As populations age and diversify, understanding older adults' sense of community becomes critical for promoting their well-being. This study aimed to validate the Brief Sense of Community Scale (BSCS) among community-dwelling older adults of native Dutch and migrant backgrounds living in Rotterdam, the Netherlands.

Research design and methods: A representative sample of 862 individuals aged 65 years and older completed the BSCS. The sample included 300 (34.8%) native Dutch, 211 (24.5%) Turkish-Dutch, 200 (23.2%) Surinamese-Dutch, and 151 (17.5%) Moroccan-Dutch participants. Psychometric properties were assessed through analyses of internal consistency, factorial validity, and measurement invariance across gender and ethnicity, based on established theoretical frameworks of sense of community.

Results: Confirmatory factor analyses supported both the first-order and second-order four-factor models of the BSCS, with good model fit indices. For the second-order four-factor model, these were CFI = 0.97, RMSEA = 0.06, and SRMR = 0.027. The full scale showed strong internal consistency (Cronbach's α = 0.88), with subscale reliabilities ranging from 0.64 to 0.88. Measurement invariance testing confirmed configural, metric, scalar, and (for gender) strict invariance, indicating that the BSCS functions equivalently across gender and the four largest ethnic groups in the Netherlands. These findings support the scale's structural validity and cross-group comparability in diverse older adult populations.

Discussion and implications: The BSCS is a reliable and valid measure of sense of community for both native and migrant older adults. It offers valuable insights for research, policy, and initiatives aiming to improve social connectedness and well-being in multicultural urban settings.