Journal of Aging and Health最新文献

PurposeTo 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 FindingsExtracted 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%.ConclusionsIADL 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.

ObjectivesNearly half of older adults experience somnolence, but the link between medications with somnolence as an adverse effect and somnolence is unclear. This study investigated the association between polypharmacy and somnolence symptoms (excessive sleepiness or long sleep duration).MethodsData from the National Social Life, Health, and Aging Project (NSHAP) 2010-2011 was used to examine the concurrent use of medications with potential somnolence as an adverse effect and the prevalence of somnolence symptoms.ResultsAmong the 2638 older adults (mean, 71 years), 49.0% used medications with potential somnolence adverse effects. The adjusted prevalence of somnolence symptoms was significantly higher among those using three or more medications (58%) than those not using such medications (31.2%) (difference, 20.4%; 95% CI 12.5, 28.4).DiscussionIn this cross-sectional study, medications with somnolence as a potential adverse effect were commonly used, and the findings suggest a link between polypharmacy and the increased risk of somnolence symptoms.

ObjectivesThis 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.MethodsSix 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.ResultsA 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.DiscussionFuture 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.

ObjectivesThe 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.MethodsUsing 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.ResultsOlder 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.DiscussionMigrant 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.

ObjectiveMost 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.MethodsWe 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.ResultsWe 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.DiscussionMobility is associated with relocation to housing that is more accessible and may be an indicator of greater need for supports to age in place.

ObjectiveThis study aimed to investigate the relationship between falls and cognitive and balance problems in patients.MethodsThis 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.ResultsDuring 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].ConclusionCombined MMSE and SIDE assessment at ward admission facilitated the easy identification of individuals at high fall risk.

BackgroundWhile life expectancy has increased globally, chronic disease burdens remain high. Cancer, despite improved survival, remains a major cause of disability and the second leading cause of death. Though behavioral risks such as smoking, poor diet, and physical inactivity are linked to cancer, few studies examine their impact on cancer-free life expectancy and gender disparities.MethodsUsing U.S. Health and Retirement Study data (2004-2020) and a multistate model approach, we estimated cancer-free life expectancy and life expectancy in individuals with cancer at age 50+, examining gender differences and their associations with smoking, poor diet, and physical inactivity.ResultsAt age 50, women live 2.7 more years cancer-free than men (27.3 vs. 24.6 years). Risky behaviors reduce cancer-free life expectancy in both sexes, but women lose more years than men.ConclusionsGender-sensitive public health strategies targeting healthy behaviors could extend cancer-free life expectancy and reduce gender gaps in aging populations.

ObjectivesTo examine whether the association between vision and cognitive difficulties varies by age group.MethodsWe analyzed pooled data from the 2021-2023 National Health Interview Survey, including 52,582 U.S. adults aged 45 and older. Vision and cognitive difficulties were based on self-reports. Logistic regression with interaction terms assessed age-related differences.ResultsVision difficulty was reported by 22.7% of respondents. It was associated with over twice the odds of cognitive difficulty among adults aged 65-84 (adjusted odds ratio (aOR) = 2.2, p < 0.001), stronger in midlife (ages 45-64; interaction aOR = 1.2, p = 0.002), and weaker among those 85+ (interaction aOR = 0.7, p = <0.001). The predicted probabilities show that adults with vision difficulty were consistently more likely to report cognitive difficulty across all age groups, with the relative difference decreasing with age.DiscussionVision difficulty is linked to higher odds of cognitive difficulty, especially in midlife. Early screening and intervention may support cognitive health across the life course.

ObjectiveTo study the associations between midlife physical activity and later-life mobility limitation and falls in monozygotic and dizygotic twin pairs.MethodsMidlife physical activity data from 1975, 1981, and 1990 questionnaires were drawn from the Older Finnish Twin Cohort. In the third survey, the participants were aged 46-50 years. Mobility limitations (none, some or severe) and falls (no falls, single fall or recurrent falls) were self-reported 2014-2016. Data (n = 641) were analyzed using multinomial logistic regression models.ResultsIn individual-level analysis a low level of physical activity in midlife was associated with severe mobility limitations. In within-twin pair analyses physical activity in midlife was associated with single falls among all pairs.DiscussionLower levels of self-reported physical activity during midlife were associated with severe mobility limitations over two decades later. However, this association was attenuated when controlled for genetic factors.