Journal of Aging and Health最新文献

Objective: This study aimed to investigate the relationship between falls and cognitive and balance problems in patients.

Methods: This retrospective observational study analyzed the medical records of 1010 older patients admitted to a convalescent rehabilitation ward. The primary endpoint was fall occurrence during ward stays. The main outcomes were the Mini-Mental State Examination (MMSE) and Standing Test for Imbalance and Disequilibrium (SIDE), with patients divided into groups of MMSE ≥28 and <28 and SIDE ≥2b and <2b.

Results: During ward stays, 220 patients (22%) fell. Estimating the fall risk of the MMSE ≥28 + SIDE ≥2b group compared to that of other groups revealed that only the MMSE <28 + SIDE <2b group had a significantly higher fall risk, with a hazard ratio [95% confidence interval] of 3.13 [1.51-6.46].

Conclusion: Combined MMSE and SIDE assessment at ward admission facilitated the easy identification of individuals at high fall risk.

Objectives: This scoping review aimed to synthesize research on the health experiences of LGBTQ+ people living with dementia (PLWD) and their caregivers, and the impact of health policies on this population.

Methods: Six databases were searched for research studies and policy literature. Titles, abstracts, and full texts were reviewed by a three-member team. Data was extracted and thematically analyzed. Feedback from 7 LGBTQ+ adults was collected through a community consultation session.

Results: A total of 9257 unique research and 945 policy citations were identified, of which 60 research and 19 policy papers were reviewed. Nine research studies and ten policy papers met eligibility criteria. Themes emerged through the analysis of research findings, the community listening session, and policy findings.

Discussion: Future work needs to disentangle the impact of policies on the health experiences of this population. Dementia-specific and LGBTQ+ inclusive services and policies are needed to address growing health disparities.

Purpose: To examine the factor structure and predictive utility of four instrumental activities of daily living (IADL) measures to identify cognitive status changes among older adults enrolled in the ACTIVE Trial.

Major findings: Extracted factors represented IADL instruments. Baseline performance on the Everyday Problems Test (EPT) predicted 5-year MMSE scores (est. = .08, p < .001), adjusting for demographic and health covariates, baseline MMSE, self-reported IADL function, and the performance-based Observed Tasks of Daily Living and Timed Instrumental Activities of Daily Living assessments. For each 1-point increase in baseline EPT financial performance, the odds of cognitive impairment decreased by 26%.

Conclusions: IADL functional domains were not interchangeable across instruments. The EPT demonstrated better predictive utility compared to other instruments for detecting subsequent cognitive decline/impairment. This is a useful step in developing effective tools to detect early functional deficits indicating subsequent clinical impairment. Advanced Cognitive Training for Independent and Vital Elderly Trial (ACTIVE), NCT00298558, https://clinicaltrials.gov/study/NCT00298558.

Objective: Most older adults in the United States (U.S.) prefer to remain in their current housing as they age, but difficulty with mobility (e.g., walking) may make this more challenging. We estimated the association between difficulty with mobility (mobility) and residential relocation in the following year.

Methods: We included adults aged ≥65 participating in ≥2 rounds (years 2011-2019) of the National Health and Aging Trends Study. Mobility was self-reported and change in permanent address was captured by study staff. We used a prospective cohort design and logistic regression with a clustering correction to estimate adjusted associations.

Results: We did not find evidence that mobility was associated with relocation versus no relocation in our sample of 26,444 observations from 5699 older adults. However, mobility was positively associated with moves to housing with fewer environmental barriers.

Discussion: Mobility is associated with relocation to housing that is more accessible and may be an indicator of greater need for supports to age in place.

Objectives: The study investigated the health status of older migrants relative to their New Zealand-born peers. We adopted a holistic view of health (physical, mental, and social) and a structural approach to health disparities based on migrant status and socioeconomic position.

Methods: Using case-control matching based on age, gender, and education, the health status of 357 older migrants and 357 New Zealand-born older adults was compared.

Results: Older migrants reported significantly poorer social health. Health inequities were patterned by socioeconomic status. Working class older migrants had significantly poorer physical, mental, and social health than their New Zealand-born peers. Inequities in social wellbeing persisted even at the upper end of the social gradient.

Discussion: Migrant background is an important social determinant of health in older age. The reduced social wellbeing of economically advantaged migrants highlights vulnerabilities regardless of socioeconomic position and the need for targeted social policies.

Objectives: Death anxiety is feelings of worry and fear regarding death. This study explored the effect of number of chronic conditions on death anxiety in older adults and the moderating effect of age. Methods: This study used the fifth, sixth, seventh, and eighth waves of longitudinal data (2012-2021) collected in Anhui, China (5014 person-year observations). A mixed linear model was used to examine the effect of number of chronic conditions on death anxiety and the moderating effect of age. Results: The number of chronic conditions showed an inverted U-shaped relationship with death anxiety, with death anxiety being lower in older adults with older age. As age increased, the U-shaped curve became flatter, and the extremes shifted to the right. Discussion: Particular attention should be given to younger older adults with chronic conditions to help them recover earlier from the negative impact by providing information and counseling about their chronic conditions.

This special issue is the result of the Michigan Center for Contextual Factors in Alzheimer's Disease (MCCFAD) third Summer Data Immersion (SDI) program held on May 23-26, 2022. Thirty-seven researchers from 17 universities participated in the program, which emphasized racial/ethnic and other contextual factors in the study of Alzheimer's disease and related dementias (ADRD) costs using a team science approach. During the program, data from the Health and Retirement Study were used to investigate multiple topics related to both financial and non-financial costs of ADRD including: (1) life course socioeconomic factors, (2) costs of preclinical ADRD, (3) COVID-19, (4) family members' employment outcomes, (5) geographic contexts, (6) monetary value of unpaid ADRD care, and (7) spousal relations for couples living with ADRD.

ObjectivesThis study examined the magnitude, changes, and racial/ethnic disparities in the economic costs of the 16-year preclinical phase of dementia-a period of cognitive decline without significant impact on daily activities. Methods: The study utilized two dementia algorithms to classify individuals with incident dementia in the Health and Retirement Study. These cases were compared to matched controls in terms of poverty status, labor force participation, and unsecured debts. Results: Older adults classified with dementia were more likely to drop out of the labor force and become poor than similar older adults without dementia. Racial/ethnic disparities in poverty persisted during the preclinical period, with non-Hispanic Black older adults more likely to leave the labor force and Hispanic older adults more likely to have unsecured debt. Discussion: Findings highlight the economic costs during prodromal phase of dementia, emphasizing need for early interventions to reduce financial strain across diverse older adults.

Objective: To examine racial and ethnic differences in costs of informal caregiving among older adults with dementia in the United States.

Methods: We used data from the 2002 to 2018 Health and Retirement Survey to estimate annual informal care hours for adults with dementia (n = 10,015). We used regression models to examine racial and ethnic differences in hours of informal care for activities of daily living (ADL) and instrumental ADL, controlling for demographic characteristics, education, and level of disability.

Results: Our sample was 70% non-Hispanic White, 19% non-Hispanic Black, and 11% Hispanic. Hispanics received, on average, 35.8 hours of informal care each week, compared to 30.1 for Blacks and 20.1 for Whites. Racial and ethnic differences persisted when controlling for covariates.

Discussion: Informal care is a greater cost to racial and ethnic minoritized families. Informal care was valued at a replacement cost of $44,656 for Hispanics, $37,508 for Blacks, and $25,121 for Whites.

Objectives: Guided by a life course perspective and fundamental cause theory, this study aims to visualize co-trajectories of health between partners and examine how changes in one spouse's cognitive status can cohesively impact the health of the other spouse along three dimensions (functional, mental, and cognitive).

Methods: Drawing longitudinal data from the Health and Retirement Study 2000-2016 (N = 3582), we measure women's health profiles by functional limitation (physical health), depression (mental health), and cognitive function (cognitive health). We use multivariate linear mixed models to summarize these paths in the same visual representation.

Results: The approach provides a visualization tool that depicts data and model in the same spatial representation allowing assessment of model fit and comparison. This study advances the traditional life course studies by representing underlying processes as a multidimensional time vector of health outcomes.

Discussion: The described approach provides a blueprint for studying complex health profiles or trajectories.