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Occupational licensing in later life: changing older workers' work and retirement pathways before and after the COVID-19 pandemic. 老年生活中的职业许可:在COVID-19大流行前后改变老年工人的工作和退休途径。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf247
Yun Taek Oh

Background and objectives: Occupational licensing is the fastest-growing labor market institution, and a significant portion of newly licensed individuals are older workers. This study introduces occupational licensing as an influential factor of later-life work and retirement by investigating the sociodemographic and economic characteristics of older workers newly attaining licenses and the choices of work adjustments after attaining licenses, as well as measuring the changes in these trends before and after the COVID-19 pandemic.

Research design and methods: I use the sample of workers aged between 50 and 60 from the IPUMS-CPS 2017-2019 (n = 3,831) and 2023-2025 (n = 2,674). I use propensity score matching to investigate the sociodemographic and economic characteristics of older workers newly attaining licenses, multinomial logistic regression with two-stage residual inclusion to examine the choice of work adjustments after newly attaining licenses, and linear regression to predict the reasons for newly attaining licenses.

Results: Older workers with more resources, from historically underrepresented groups, and self-employed are more likely to newly attain licenses, yet there is no statistical difference in license attainment before and after the pandemic. Attaining licenses increases the likelihood of moving to different employers before and after the pandemic, yet the reason for moving cannot be determined: career development or bridge employment.

Discussion and implications: Prolonging the labor force participation of older workers is a growing interest. Subsidizing older workers' license attainment will contribute to prolonging their labor force participation by providing financial, psychological, and social benefits throughout their remaining work life-course.

背景和目标:职业许可是增长最快的劳动力市场制度,新获得许可的个人中有很大一部分是老年工人。本研究通过调查新获得职业执照的老年工作者的社会人口特征和经济特征以及获得职业执照后的工作调整选择,将职业执照作为晚年工作和退休的影响因素,并衡量这些趋势在COVID-19大流行前后的变化。研究设计和方法:我使用了IPUMS-CPS 2017-2019 (n = 3,831)和2023-2025 (n = 2,674)中年龄在50至60岁之间的工人样本。我使用倾向得分匹配来调查新获得许可证的老年工人的社会人口和经济特征,使用两阶段残差包含的多项逻辑回归来检查新获得许可证后工作调整的选择,并使用线性回归来预测新获得许可证的原因。结果:拥有更多资源的老年工人,来自历史上代表性不足的群体,以及自雇人士更有可能获得新执照,但在大流行前后获得执照的情况没有统计学差异。获得执照增加了在大流行前后跳槽到不同雇主的可能性,但搬家的原因无法确定:职业发展还是过渡性就业。讨论与启示:延长老年工人的劳动参与率是一个日益增长的兴趣。补贴老年工人获得执照将有助于延长他们的劳动力参与率,在他们剩余的工作生涯中提供经济、心理和社会福利。
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引用次数: 0
Gerontologists combating fraudulent research participants: recommendations from design to dissemination. 老年学家打击欺诈性研究参与者:从设计到传播的建议。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf206
Justine S Sefcik, Jeffrey T Boon, Harleah G Buck, Erica Frechman, Cara L Wallace, Joan G Carpenter

This article provides comprehensive guidance for gerontological researchers on preventing and identifying fraudulent research participants-from study design through dissemination. Drawing from our own experiences with identified fraudulent participants, we highlight the complex and often financially motivated nature of participant misrepresentation. These experiences inform our broad recommendations for researchers, funding bodies, and academic institutions, emphasizing protocol design focused on early detection of fraudulent participants including verification processes and proactive measures to uphold study integrity. Key recommendations include requiring a fraudulent participant detection plan in grant applications, training peer reviewers and research teams, and implementing regular data checks. We also discuss the importance of collaboration with Institutional Review Board representatives, funders, universities, and professional organizations who uphold scientific integrity of research accompanied by the dissemination of experiences to educate the scientific community. By normalizing the expectation of fraud and addressing it at multiple levels, we aim to enhance the reliability and trustworthiness of gerontological research. This article serves as a valuable resource for researchers to safeguard their studies against fraudulent activities and maintain the credibility of their data.

本文为老年学研究人员提供了从研究设计到传播预防和识别欺诈研究参与者的综合指导。根据我们自己与已确定的欺诈参与者的经验,我们强调了参与者虚假陈述的复杂性和往往是出于经济动机的性质。这些经验为研究人员、资助机构和学术机构提供了广泛的建议,强调方案设计的重点是早期发现欺诈参与者,包括验证过程和积极措施,以维护研究的完整性。主要建议包括要求在资助申请中制定欺诈参与者检测计划,培训同行评议人和研究团队,以及实施定期数据检查。我们还讨论了与机构审查委员会代表、资助者、大学和专业组织合作的重要性,这些组织维护研究的科学完整性,同时传播经验以教育科学界。通过规范欺诈预期并在多个层面解决欺诈问题,我们的目标是提高老年学研究的可靠性和可信度。本文为研究人员提供了宝贵的资源,以保护他们的研究免受欺诈活动的影响,并保持他们的数据的可信度。
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引用次数: 0
The effectiveness of a hybrid mindfulness-based intervention in reducing stress among informal caregivers of people with dementia: a randomized controlled trial. 基于正念的混合干预在减少痴呆症患者非正式照护者压力中的有效性:一项随机对照试验。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf281
Patrick Pui Kin Kor, Alex Pak Lik Tsang, Daniel Lok Lam Lai, Justina Yat Wa Liu

Background and objectives: Informal caregivers of people with dementia experience significant caregiving stress. Mindfulness-based interventions are effective approaches for alleviating caregiving stress. However, traditional mindfulness training is intensive and challenging to attend due to the substantial caregiving responsibilities of this population, leading to issues with program attrition and adherence. To address this limitation, a novel Mindfulness-Based Dementia Care Program (MBDCP) was developed by simplifying traditional mindfulness training and utilizing a hybrid delivery model tailored to the needs of dementia caregivers. This study aimed to evaluate the effectiveness of the MBDCP in reducing caregiving stress compared with a brief education program.

Research design and methods: A single-blinded, parallel-group randomized controlled trial was conducted with 127 dementia caregivers (MBDCP: n = 64; Control: n = 63) recruited from three community care centers in Hong Kong. The MBDCP included six weekly 90-min sessions delivered through face-to-face and online formats. Outcomes were assessed at baseline, postintervention, and 6-month follow-up. The primary outcome was perceived stress, whereas secondary outcomes included heart rate variability, mindfulness, depressive symptoms, caregiving burden, dyadic relationships, and neuropsychiatric symptoms of care recipients.

Results: MBDCP significantly improved perceived stress, depressive symptoms, trait mindfulness, and heart rate variability compared with the control group. No significant effects were observed on caregiving burden, dyadic relationships, positive caregiving aspects, or neuropsychiatric symptoms.

Discussion and implications: The MBDCP effectively reduced stress and improved psychophysiological outcomes in dementia caregivers. These findings highlight the potential of simplified, hybrid mindfulness training to enhance accessibility and effectiveness for this population.

背景和目的:痴呆症患者的非正式照护者承受着巨大的照护压力。正念干预是缓解照顾压力的有效方法。然而,传统的正念训练是密集的,具有挑战性的,因为这群人有大量的照顾责任,导致计划的损耗和坚持问题。为了解决这一限制,一种新的基于正念的痴呆症护理计划(MBDCP)通过简化传统的正念训练和利用适合痴呆症护理人员需求的混合交付模式而开发。本研究旨在评估MBDCP在减少照顾压力方面的效果,并与简短的教育计划进行比较。研究设计与方法:采用单盲、平行组随机对照试验,从香港三家社区护理中心招募127名痴呆护理人员(MBDCP: n = 64; Control: n = 63)。MBDCP包括每周6次90分钟的面对面和在线课程。在基线、干预后和6个月随访时评估结果。主要结局是感知压力,次要结局包括心率变异性、正念、抑郁症状、照顾负担、二元关系和受照顾者的神经精神症状。结果:与对照组相比,MBDCP显著改善了感知压力、抑郁症状、特质正念和心率变异性。在照顾负担、二元关系、积极照顾方面或神经精神症状方面未观察到显著影响。讨论和启示:MBDCP有效地减轻了痴呆症护理人员的压力,改善了心理生理结果。这些发现强调了简化、混合正念训练的潜力,以提高这一人群的可及性和有效性。
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引用次数: 0
Differences in retirement knowledge and financial preparedness between Hispanic and non-Hispanic White older adults in the United States. 美国西班牙裔和非西班牙裔白人老年人退休知识和财务准备的差异。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf266
Luisa R Blanco, Anna Choi, Ron D Hays

Background and objectives: We assess differences in retirement knowledge between older Hispanic and non-Hispanic White adults, and the extent to which individual, household, and neighborhood characteristics account for these differences. We also evaluate whether the relationships of retirement knowledge with financial outcomes (i.e., wealth) and health differ between Hispanic and non-Hispanic White older adults.

Research design and methods: We analyzed the Retirement Knowledge Scale (RKS) included in the 2020 Health and Retirement Study (N = 1,350). We use a regression approach with a Blinder-Oaxaca decomposition analysis.

Results: The average RKS was significantly lower among Hispanic than among White older adults. The top three factors explaining differences in retirement knowledge between Hispanic and White older adults were educational attainment, financial literacy, and neighborhood socioeconomic characteristics. RKS was significantly (p < .05) and positively associated with financial account balances and the likelihood of reporting very good or excellent health. We find that the association of RKS with wealth is of smaller magnitude for Hispanic than for White older adults. However, the relationship between retirement knowledge and health did not differ across racial/ethnic groups. Finally, differences between Hispanic and White older adults on the RKS were larger for men than for women.

Discussion and implications: The results suggest that reducing gaps in financial literacy and education, and acknowledging the role of neighborhood characteristics, can be helpful channels for reducing differences in retirement preparedness among Hispanic and White older adults. It is also significant that retirement knowledge is more strongly linked to wealth among White older adults.

背景和目的:我们评估西班牙裔和非西班牙裔白人老年人退休知识的差异,以及个人、家庭和社区特征对这些差异的影响程度。我们还评估了退休知识与财务结果(即财富)和健康之间的关系在西班牙裔和非西班牙裔白人老年人之间是否存在差异。研究设计和方法:我们在2020年健康与退休研究(N = 1,350)中使用退休知识量表(RKS)。我们使用回归方法与Blinder-Oaxaca分解分析。结果:西班牙裔老年人的平均RKS明显低于白人老年人。解释西班牙裔和白人老年人退休知识差异的前三个因素是教育程度、金融知识和社区社会经济特征。讨论和启示:结果表明,缩小金融知识和教育的差距,并承认社区特征的作用,可以帮助减少西班牙裔和白人老年人在退休准备方面的差异。同样重要的是,在白人老年人中,退休知识与财富的联系更为紧密。
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引用次数: 0
When and how is age mentioned? The role of age references in narratives of adults aged 65 and over. 何时以及如何提到年龄?年龄参照在65岁及以上成人叙事中的作用。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf276
Veronika Gocieková, Anna Ševčíková, Gabriela Gore-Gorszewska, Martina Rašticová, Andrea Lambert South

Background and objectives: Both societal and personal beliefs about aging shape how older adults experience and respond to age-related changes. This study explores how adults aged 65 years and above internalize or resist aging stereotypes and beliefs through age-related references embedded in daily experiences.

Research design and methods: Data were drawn from three research projects on relationships, sexuality, and employment in later life, each with a minimum age requirement of 50 years. For the secondary data analysis within this study, we selected 50 participants aged 65+ years from a total pool of 189 in-depth interviews. Thematic analysis methods were used to derive themes related to the context and function of age references.

Results: Results highlight four key contexts in which participants referred to age: (1) seeking balance between autonomy and limitations, (2) navigating societal versus personal expectations, (3) legitimizing end-of-life reflections, and (4) reframing hassles as unnecessary. In these contexts, references to age served two primary functions: (1) providing relief and (2) navigating decline. (3) Avoiding mentioning age constituted a unique third function. Participants employed these references to manage experiences of decline and seek relief from the discomfort associated with aging.

Discussion and implications: Findings from the present study suggest that age references-including some rooted in ageist stereotypes-play a key role in how older adults navigate the aging process. These references help normalize limitations, express discomfort, or avoid confronting declines, thereby supporting adaptation and emotional balance. Recognizing their function may guide interventions that enhance adaptive uses while reducing risks of internalizing harmful stereotypes.

背景和目的:关于老龄化的社会和个人信念决定了老年人如何经历和应对与年龄相关的变化。这项研究探讨了65岁以上的成年人如何通过日常经历中嵌入的与年龄相关的参考来内化或抵制衰老的刻板印象和信念。研究设计和方法:数据来自三个研究项目,分别涉及人际关系、性行为和晚年就业,每个项目的最低年龄要求为50岁。对于本研究的二次数据分析,我们从189个深度访谈中选择了50名年龄在65岁以上的参与者。运用主位分析方法推导出与时代指称的语境和功能相关的主位。结果:结果强调了参与者提到年龄的四个关键背景:(1)在自主和限制之间寻求平衡;(2)在社会与个人期望之间进行导航;(3)使临终反思合法化;(4)重新定义不必要的麻烦。在这些语境中,提及年龄有两个主要功能:(1)提供安慰;(2)引导衰退。(3)避免提及年龄构成了独特的第三个功能。参与者使用这些参考来管理衰退的经历,并寻求与衰老相关的不适的缓解。讨论和启示:本研究的发现表明,年龄参考——包括一些植根于年龄歧视的刻板印象——在老年人如何应对衰老过程中起着关键作用。这些引用有助于使限制正常化,表达不适,或避免面对衰退,从而支持适应和情感平衡。认识到它们的功能可以指导干预措施,加强适应性使用,同时减少有害刻板印象内化的风险。
{"title":"When and how is age mentioned? The role of age references in narratives of adults aged 65 and over.","authors":"Veronika Gocieková, Anna Ševčíková, Gabriela Gore-Gorszewska, Martina Rašticová, Andrea Lambert South","doi":"10.1093/geront/gnaf276","DOIUrl":"10.1093/geront/gnaf276","url":null,"abstract":"<p><strong>Background and objectives: </strong>Both societal and personal beliefs about aging shape how older adults experience and respond to age-related changes. This study explores how adults aged 65 years and above internalize or resist aging stereotypes and beliefs through age-related references embedded in daily experiences.</p><p><strong>Research design and methods: </strong>Data were drawn from three research projects on relationships, sexuality, and employment in later life, each with a minimum age requirement of 50 years. For the secondary data analysis within this study, we selected 50 participants aged 65+ years from a total pool of 189 in-depth interviews. Thematic analysis methods were used to derive themes related to the context and function of age references.</p><p><strong>Results: </strong>Results highlight four key contexts in which participants referred to age: (1) seeking balance between autonomy and limitations, (2) navigating societal versus personal expectations, (3) legitimizing end-of-life reflections, and (4) reframing hassles as unnecessary. In these contexts, references to age served two primary functions: (1) providing relief and (2) navigating decline. (3) Avoiding mentioning age constituted a unique third function. Participants employed these references to manage experiences of decline and seek relief from the discomfort associated with aging.</p><p><strong>Discussion and implications: </strong>Findings from the present study suggest that age references-including some rooted in ageist stereotypes-play a key role in how older adults navigate the aging process. These references help normalize limitations, express discomfort, or avoid confronting declines, thereby supporting adaptation and emotional balance. Recognizing their function may guide interventions that enhance adaptive uses while reducing risks of internalizing harmful stereotypes.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12718111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The AI-aging-enterprise: a political economy of aging and artificial intelligence. 人工智能老龄化企业:老龄化和人工智能的政治经济学。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf262
Vera Gallistl, Clara Berridge, Muneeb Ul Lateef Banday, Justyna Stypinska, Anita Ho, Robin N Brewer, Alisa Grigorovich, Alexander Peine, Anna Wanka

The current discourse on artificial intelligence (AI) in gerontology remains mostly on an interventionist level and focused on solving problems faced by individuals, leaving the wider social conditions that shape the relationship between aging and AI out of view. The considerable accumulation of power, particularly for technology development companies, in the development and implementation of AI, however, calls for a deeper and more complex analysis of the relationships between AI, older adults and the "aging enterprise." Building on the classical political economy of aging, and expanding it with concepts from material gerontology, we propose a "political economy of aging and AI" as a conceptual tool to analyze the relationships between (older) individuals, social and political structures, and (technological) materialities. We exemplify how such a political economy perspective enables a more complex consideration of the current discourse on (a) AI solutions, (b) AI ethics, and (c) AI policies. We close by summarizing our understanding of a political economy of aging and AI that centers materialities as the critical-gerontological focus of analysis and by outlining calls for action toward strengthening the power of older adults in the emerging AI-aging-enterprise.

目前关于老年学中人工智能的讨论仍主要停留在干预主义层面,并专注于解决个人面临的问题,而忽略了影响老龄化与人工智能之间关系的更广泛的社会条件。然而,在人工智能的开发和实施过程中,权力的大量积累,特别是技术开发公司的权力积累,要求对人工智能、老年人和“老龄化企业”之间的关系进行更深入、更复杂的分析(Estes, 1979)。在经典老龄化政治经济学的基础上,用物质老年学的概念对其进行扩展,我们提出了一个“老龄化和人工智能的政治经济学”,作为分析(老年人)个体、社会和政治结构以及(技术)物质之间关系的概念工具。我们举例说明了这种政治经济学视角如何能够更复杂地考虑当前关于a)人工智能解决方案,b)人工智能伦理和c)人工智能政策的论述。最后,我们总结了我们对老龄化和人工智能的政治经济学的理解,将物质作为关键老年学分析的重点,并概述了在新兴的人工智能老龄化企业中加强老年人力量的行动呼吁。
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引用次数: 0
The validity of Blue Zones demography: a response to critiques. 蓝区人口统计的有效性:对批评的回应。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf246
Steven N Austad, Giovanni M Pes

Blue Zones are geographically and temporally defined areas with a history of disproportionately high concentrations of nonagenarians and centenarians. Nearly two decades ago, these zones gained international attention when the Blue Zone term was introduced in seminal articles published in Experimental Gerontology and National Geographic. Since then, numerous scientific papers have extracted valuable insights into human health from investigating the long-lived people who live there. However recently, validity of the ages of people living in the Blue Zones has been questioned. Here, we address these concerns by describing in detail the age validation process undertaken in Blue Zones and comparing it to the prevailing standards in gerontological demography. As discovered a century and a half ago, most self-reported claims of exceptional longevity are false. However, using methods developed by gerontological demographers over the past decades, the true age of people claiming exceptional longevity can be determined by cross-checking multiple independent documentary sources. This procedure minimizes, and usually eliminates, errors due to fraud, honest mistakes, poor memory, or identity switches, especially between homonymous siblings. All Blue Zones described herein have been extensively validated based on thoroughly cross-checked data from multiple independent sources plus state-of-the-art demographic methods. Consequently, age data from these Blue Zones are valid and reliable.

蓝区是地理上和时间上确定的区域,历史上90多岁和百岁老人的集中度过高。近20年前,当《实验老年学》(Experimental Gerontology)和《国家地理》(National Geographic)杂志发表的开创性文章中引入“蓝区”一词时,这些区域获得了国际关注。从那时起,许多科学论文通过调查居住在那里的长寿人士,获得了有关人类健康的宝贵见解。然而最近,居住在蓝区居民年龄的有效性受到了质疑。在这里,我们通过详细描述在蓝区进行的年龄验证过程,并将其与老年人口统计学的现行标准进行比较,来解决这些问题。正如一个半世纪前发现的那样,大多数自称特别长寿的人都是假的。然而,使用过去几十年来老年人口统计学家开发的方法,可以通过交叉检查多个独立的文献来源来确定声称特别长寿的人的真实年龄。这一过程最大限度地减少并通常消除了由于欺诈、诚实错误、记忆力差或身份转换而导致的错误,特别是在同名兄弟姐妹之间。本文中描述的所有蓝色区域都经过了广泛的验证,这些验证基于来自多个独立来源的彻底交叉核对数据以及最先进的人口统计方法。因此,来自这些蓝色区域的年龄数据是有效和可靠的。
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引用次数: 0
A mixed-methods study on spousal caregivers' burden in young-onset dementia in China: a joint display of qualitative and quantitative data. 中国年轻痴呆患者配偶照顾者负担的混合方法研究:定性和定量数据的联合展示。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf255
Xiaoyan Cui, Junqiao Wang, Xueting Tang, Ding Ding, Bei Wu, Qianhua Zhao, Jing Wang

Background and objectives: Becoming spousal caregivers for persons with young-onset dementia (YOD) is an unexpected event that deviates from the normal life course trajectory, creating unique and profound challenges. Understanding their burden, its primary sources, and their coping resources is essential for developing tailored support.

Research design and methods: We employed a mixed-methods approach to comprehensively understand the caregiving burden experienced by 11 community-dwelling spousal caregivers of YOD. We used the Zarit Burden Interview to quantify caregiving burden and conducted semi-structured qualitative interviews to explore the caregiving experience in depth. A joint display method was used to integrate and present the converging findings from quantitative and qualitative data, offering a holistic perspective on the caregiving burden.

Results: All participants experienced varying degrees of burden, with the average burden level being moderate. Four themes emerged regarding their caregiving burden experiences: diverse sources of caregiving burden, unexpected changes in personal and interpersonal interactions, complex emotional experiences, and inadequate social support and resources. Quantitative and qualitative results converged and supported each other. The burden was mainly driven by care recipients' excessive dependence and dynamic care needs. Spousal caregivers faced significant challenges in maintaining their personal identity and social life. Caregiving reshaped family dynamics. The inadequate support resources and overwhelming responsibilities imposed substantial psychological stress on them.

Discussion and implications: There is an urgent need to develop family-centered community support services and respite care to provide younger spousal caregivers with the time and space to manage their personal lives and alleviate their burden.

背景与目的:成为年轻性痴呆患者的配偶照护者是一件偏离正常生活轨迹的意外事件,带来了独特而深刻的挑战。了解他们的负担、负担的主要来源和应对资源,对于制定有针对性的支持至关重要。研究设计与方法:采用混合方法对11名社区老年配偶照顾者的照顾负担进行综合分析。我们使用Zarit负担访谈来量化照顾负担,并进行半结构化的定性访谈来深入探讨照顾经验。采用联合展示的方法,整合并呈现定量和定性数据的趋同结果,提供了一个整体的视角来看待护理负担。结果:所有参与者都经历了不同程度的负担,平均负担水平为中等。关于他们的照顾负担经历,出现了四个主题:照顾负担的各种来源;个人和人际交往中的意外变化;复杂的情感体验;社会支持和资源不足。定量和定性结果相互融合,相互支持。受照护者的过度依赖和动态照护需求是造成负担的主要原因。配偶照顾者在维持其个人身份和社会生活方面面临重大挑战。看护重塑了家庭动态。支助资源不足和繁重的责任给他们造成了巨大的心理压力。讨论与启示:迫切需要发展以家庭为中心的社区支持服务和临时护理,为年轻的配偶照顾者提供时间和空间来管理他们的个人生活并减轻他们的负担。
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引用次数: 0
A novel tool to assess the capacity of people with dementia to designate a surrogate. 一种评估痴呆症患者指定代理能力的新工具。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf259
Devan Stahl, Jason Adam Wasserman, Lauren Barron, Sally P Weaver

Background and objectives: As their cognitive function declines, people with dementia often lose decision-making capacity (DMC) for choosing certain medical treatments, but some retain the capacity to designate a surrogate (CDS) decision maker. There is currently no tool for assessing the CDS. The purpose of this study is to validate a novel capacity assessment tool for evaluating CDS for people with a clinical diagnosis of dementia.

Research design and methods: A concurrent mixed-methods design was used to evaluate 52 participants' ability to (a) consistently name a surrogate, (b) understand the role of the surrogate, and (c) provide a rationale for why they chose their surrogate. A basic difference of means was used to test differences in CDS scores between participants who had and did not have DMC. Thematic analysis was applied to the narrative data on reasons for the participants' choice of surrogate.

Results: The CDS instrument demonstrated high interrater reliability and evidence of validity. On every dimension, the CDS tool identified participants who otherwise lacked DMC who nonetheless had full understanding of the need, process, and role of a surrogate. Thematic analysis revealed 33 unique reasons participants chose their surrogate, which were then grouped into three overarching themes.

Discussion and implications: The CDS tool shows that there are patients who may otherwise lack DMC but who can validly designate a surrogate. The CDS tool may be a highly useful instrument to promote patient-centered care among vulnerable patients deemed to lack capacity for treatment decisions.

背景与目的:随着认知功能的下降,痴呆症患者往往失去选择某些药物治疗的决策能力(DMC),但有些人保留了指定替代决策者的能力。目前还没有评估指定代理(CDS)能力的工具。本研究的目的是验证一种新的能力评估工具,用于评估临床诊断为痴呆的人的CDS。研究设计和方法:采用并行混合方法设计来评估52名参与者的能力(1)一致地命名代理,(2)理解代理的角色,(3)提供他们选择代理的理由。使用基本均数差异来测试患有和未患有DMC的参与者之间CDS评分的差异。对被试选择替代因素的叙事数据进行主题分析。结果:本仪器具有较高的判读信度和证据效度。在每个维度上,CDS工具确定了缺乏DMC的参与者,尽管他们完全理解代理的需求、过程和角色。主题分析揭示了参与者选择代孕的33个独特原因,然后将其分为三个主要主题。讨论和意义:CDS工具显示,有些患者可能缺乏DMC,但可以有效地指定代理。CDS工具可能是一种非常有用的工具,可以在被认为缺乏治疗决策能力的弱势患者中促进以患者为中心的护理。
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引用次数: 0
Expanding the social pathways linking self-perceptions of aging to health: the role of friendships. 扩展将衰老自我认知与健康联系起来的社会途径:友谊的作用。
IF 3.2 2区 医学 Q1 GERONTOLOGY Pub Date : 2025-11-10 DOI: 10.1093/geront/gnaf270
Rita X Hu, Meng Huo

Background and objectives: This study investigates how friendships serve as a social pathway underlying the health effects of self-perceptions of aging (SPA). We adopt a conceptual framework integrating stereotype embodiment theory and the differential investment of resources (DIRe) model.

Research design and methods: This study used longitudinal data from the Health and Retirement Study (HRS), which tracks a nationally representative sample of 9,098 participants aged 50 and older over 8 years (Time 1: 2008/10, Time 2: 2012/14, Time 3: 2016/18). We examined the direct and indirect effects of both positive and negative SPA on physical, mental, and cognitive health through friendships. Positive and negative SPA were assessed separately. Friendships were measured through the number of close Friends, frequency of contact with friends, and positive and negative friendship quality. Health outcomes were measured across three domains: physical (functional disabilities), mental (depressive symptoms), and cognitive (cognitive functioning). Structural equation modeling was employed to examine the direct and indirect effects.

Results: Positive SPA was associated with more friends and more frequent contact. Negative SPA was associated with lower positive and higher negative friendship quality. Contact frequency with friends mediated the associations between positive SPA and physical, mental, and cognitive health. Positive and negative friendship quality mediated the associations between negative SPA with physical and mental health.

Discussion and implications: These findings identify friendships as critical pathways linking SPA to health. Interventions and community programs that promote positive aging beliefs and support friendship-building may be effective strategies to enhance later-life health and well-being.

背景与目的:本研究探讨了友谊如何作为一种社会途径,在衰老自我认知(SPA)对健康的影响下发挥作用。本文采用刻板印象体现理论和资源差异投资模型相结合的概念框架。研究设计和方法:本研究使用了健康与退休研究(HRS)的纵向数据,该研究追踪了全国代表性的9,098名50岁及以上的参与者,时间为8年(时间1:2008 /10,时间2,2012 /14,时间3,2016 /18)。我们研究了积极和消极的SPA通过友谊对身体、心理和认知健康的直接和间接影响。SPA阳性和阴性分别进行评估。友谊是通过亲密朋友的数量、与朋友联系的频率以及积极和消极的友谊质量来衡量的。健康结果通过三个领域进行测量:身体(功能性残疾)、精神(抑郁症状)和认知(认知功能)。采用结构方程模型(SEM)分析了直接效应和间接效应。结果:积极的SPA与更多的朋友和更频繁的联系有关。消极的SPA与较低的积极友谊质量和较高的消极友谊质量相关。与朋友的接触频率介导了积极的SPA与身体、心理和认知健康之间的关联。积极和消极友谊质量在消极SPA与身心健康的关系中起中介作用。讨论和启示:这些发现确定友谊是连接SPA和健康的关键途径。促进积极的老龄化信念和支持友谊建立的干预措施和社区项目可能是提高晚年健康和福祉的有效策略。
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