Journal of Aging and Health最新文献

ObjectiveTo identify predictors of the number of complementary and alternative medicine (CAM) modalities used among older U.S. adults and examine how sociodemographic, health, and healthcare access factors influence CAM use diversity.MethodWe analyzed 2017 National Health Interview Survey data from 5,804 adults aged ≥65, using negative binomial regression to assess sociodemographic, health, cultural, and access-related predictors of the number of CAM modalities used.ResultsRespondents used an average of 0.31 different CAM modalities. Greater CAM use diversity was linked to younger age, female gender, higher income and education, residence in the Western U.S., psychological distress, financial barriers to medication, valuing culturally sensitive care, and conditions such as cancer and arthritis. Lower diversity was associated with older age, larger households, diabetes, and hypertension.DiscussionFindings indicate that CAM engagement reflects both proactive wellness orientations and responses to unmet needs, underscoring the importance of culturally sensitive, integrated geriatric care.

Purpose of the ResearchUsing longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we examined whether childhood book environment is associated with higher cognitive functioning and better cognitive maintenance later in life, especially among individuals with lower education.Major FindingsAmong 86,619 adults aged 60+ (226,515 person-wave observations from Waves 4-8, with retrospective childhood circumstances from Waves 3 and 7), even modest childhood access to 11-25 books is associated with higher overall cognition levels, independent of education and other covariates, with greater benefits observed in less-educated adults. Book-rich environments are also associated with a more favorable cognitive trajectory over time, particularly for more educated adults, given the potential for steeper late-life decline.ConclusionsFindings support a critical period model of higher cognitive functioning and a cumulative advantage model of longitudinal change, which also align with reserve-depletion patterns.

ObjectivesOlder U.S. military veterans with cardiovascular disease (CVD) are at elevated risk for functional decline. This study examined sociodemographic, health, and psychosocial correlates of overall and domain-specific functioning in this population.MethodsData were drawn from 757 veterans aged ≥60 years with CVD who participated in the National Health and Resilience in Veterans Study. Bivariate, multivariable, and relative importance analyses were used to identify key correlates of functioning.ResultsPoorer overall functioning was most strongly associated with major depressive disorder (MDD), somatic, and posttraumatic stress disorder (PTSD) symptoms, and medical comorbidities, whereas greater resilience and positive expectations about aging were associated with better functioning. Domain-specific analyses revealed distinct correlates. Relative importance analyses indicated that MDD, somatic, and PTSD symptoms, resilience, and medical comorbidities accounted for most of the explained variance in overall functioning.ConclusionsFindings underscore the importance of integrated care to preserve functioning among older veterans with CVD.

ObjectivesCognitive function is shaped by social network characteristics, but the geographic dispersion of social network ties remains understudied. We examine whether having a greater proportion of network ties residing outside of one's local area ("network extralocality") may benefit cognitive function among U.S. older adults.MethodsWe analyzed nationally representative data from the 2015-2016 National Social Life, Health, and Aging Project (N = 4,557) in multivariable regression models to examine associations between network extralocality and Montreal Cognitive Assessment (MoCA) scores among adults aged 50 and older.ResultsA full-range difference in network extralocality was significantly associated with a .48-point higher MoCA score after adjusting for covariates. A significant interaction between age and network extralocality revealed stronger associations at older ages.DiscussionSocial tie proximity may be an overlooked dimension of social life with cognitive implications. Place-based interventions may support independent aging-in-place by facilitating opportunities to form and maintain extralocal ties.

ObjectivesNeighborhood environments influence falls in later life, but the role of functional limitations in this relationship is unclear. Guided by environmental gerontology theories, we examined whether functional limitations (none/mild/severe) moderated the association between neighborhood social cohesion and physical disorder and subsequent falls.MethodsWe pooled adults aged ≥65 (n = 5,075) from the 2014-2016 Health and Retirement Study and assessed falls 2 years later (2016-2018). Survey-weighted logistic regressions estimated associations at each limitation level, adjusting for sociodemographic and health covariates.ResultsHigher social cohesion and physical disorder were associated with greater odds of falls. Among those with mild limitations, both associations were attenuated, while among those with severe limitations, higher physical disorder was associated with lower odds of falls.DiscussionFindings highlight the need to address both environmental and individual factors in fall prevention and suggest that lower risk among limited adults reflects self-restriction, underscoring supervised indoor exercise and accessible transportation.

BackgroundEducational disparities in disability are substantial, but the contribution of pain remains underexplored.Research DesignUsing 2002-2018 National Health Interview Survey data, we examined the role of site-specific pain-joint, low back, neck, headache/migraine, and facial/jaw-in educational disparities in physical, cognitive, work, and social limitations, as well as activities of daily living (ADLs) and instrumental ADLs (IADLs). Karlson-Holm-Breen decomposition estimated the proportion of disparities mediated by pain, and Oaxaca-Blinder decomposition assessed whether differences reflected pain prevalence or differential impacts of pain across education levels.ResultsPain explained 18-34% of the disability gap between adults with less than a high school education and those with a bachelor's degree or higher, largely attributable to higher pain prevalence among the less educated. Contributions were greater in midlife than older age, while sex differences were negligible.ConclusionsThese findings identify chronic pain as a key, understudied pathway through which education shapes disability inequalities across later adulthood.

ObjectiveDifferences in cognitive outcomes for two home-based 16-week interventions after usual rehabilitative care post-hip fracture were examined.MethodsCommunity Ambulation Project randomized controlled trial included 210 hip fracture participants. Interventions: Specific multi-component (PUSH) included strength-, balance-, function-, and endurance-based exercises; non-specific active control (PULSE) included seated range-of-motion exercises and sensory transcutaneous electrical neurostimulation. Cognitive measures: Modified Mini-Mental State Examination, plus Hooper Visual Organization Test and Trails A/B in an ancillary study (CAP-MP, n = 40), assessed pre-randomization and 16 and 40 weeks post-randomization.ResultsOver 16 weeks, PUSH-assigned participants became faster on Trails A (Δ = -6.3, 95% CI: -16.7, 4.2); those in PULSE became slower (Δ = 9.3, 95% CI: -1.7, 20.3, p = .04). At 40 weeks, PUSH-assigned participants became faster on Trails B (Δ = -21.5, 95% CI: -46.2, 3.3) while those in PULSE became slower (Δ = 15.2, 95% CI: -11.9, 42.3, p = .04). No other significant differences were found.DiscussionResults suggest that multi-component exercise interventions like PUSH may prevent/delay decline or improve attention and psychomotor speed in patients with recent hip fracture.

PurposePain and depression are linked to higher mortality risk and lower subjective survival probabilities (SSPs). We examine if SSPs for individuals with pain and depression match their actual lifespans.MethodsUsing data on 12,745 Health and Retirement Study respondents aged 57-89 in 2000 with follow-up through 2018, we assessed whether respondents' SSPs were "correct," "underestimated," or "overestimated" relative to their lifespans. Adjusted multinomial logistic regressions predicted SSP accuracy based on pain interference, depression, and their interaction.ResultsSevere or interfering pain (i.e., high impact pain) was associated with a 25% higher risk of underestimating SSPs (RRR = 1.25, p = .04), and depression increased the risk by 49% (RRR = 1.49, p < .001). High impact pain and depression also corresponded with lower average SSPs and higher mortality risk.ConclusionHigh impact pain and depression increase the risk of underestimating longevity. Future research should explore the impact on health and financial decisions in older adults.

ObjectivesThis study investigated the association between functional limitations and depressive symptoms among older adults in South Korea, focusing on gender differences in the moderating roles of relationship satisfaction with family, friends, and neighbors.MethodsFixed-effect models were applied to five waves of data from the Korean Retirement and Income Study, encompassing 19,180 observations.ResultsIncreases in functional limitations were associated with higher levels of depressive symptoms, regardless of gender. However, the moderating effects of relationship satisfaction differed by gender: For older women, satisfaction with family moderated the association, whereas for older men, satisfaction with friends played a moderating role.DiscussionThe findings suggest tailoring interventions to improve family relationships for women and friendships for men in mitigating depressive symptoms among functionally vulnerable older adults in Korea, where rapid population aging poses significant challenges to protect functional and mental health among older adults.

This study aimed to document the typology of social participation and network among older Canadians and examine their associations with health. Using 2011-2015 cross-sectional data from the Canadian Longitudinal Study on Aging, a latent profile analysis was conducted to identify patterns of social participation and network, and multinomial logistic regressions examined associations with self-rated health. Four types of social participation and networks characterized older Canadians: diverse (74.0%), childless (12.1%), restricted (9.7%), and very socially active (4.3%). Compared to the diverse group and excellent/very good health, belonging to the restricted group was associated with higher probabilities of reporting fair or poor health, both general (1.95; p < .001) and mental (2.18; p < .001). Still comparing to the diverse group and excellent/very good health, the very socially active group presented lower likelihood of reporting good general health (0.82; p = .03). These results suggest that the social participation and network are associated with health inequalities in older Canadians. Future studies should look at the role of virtual interactions in the health of older adults.