Journal of Aging and Health最新文献

Objectives: Findings on the effect of network size and support on functional health are mixed. We examine whether network types, that simultaneously incorporate multiple network characteristics, are associated with functional health in late life.

Methods: Data are from the National Social Life, Health, and Aging Project (N = 3005). We estimated the longitudinal effect of membership in five multidimensional network types on disability in six activities of daily living using negative binomial regression, and on mobility (assessed using a timed walk test) using a generalized linear mixed model.

Results: Compared to those in the large without strain network, older adults in the small, restricted, high contact network had fewer disabilities but worse mobility, while those in the large network with strain also had worse mobility.

Discussion: Care plans focusing on function and mobility should consider multiple aspects of older adults' social networks including network size, diversity, and relationship strain.

This study explores the role that place of birth and place of residence have in variation in cognition in adulthood in the UK. We take advantage of both the large sample size and number of cognitive domains in the UK Biobank to estimate the effect of place of birth and place of residence on adulthood cognition using multilevel modeling. We find, consistent with studies in the US, that place effects at both time points contribute modest variation (<3% of the variation) across all measured cognitive domains, suggesting a relative lack of contribution of shared environments in explaining future Alzheimer's Disease and Related Dementias. Moreover, the geographical contribution to cognitive function in adulthood was slightly larger for females than for males. This study is among the first to explore the impact of both the independent and joint associations of place of birth and place of residence with different cognitive domains.

Objectives: To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus.

Methods: Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes.

Results: Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus.

Discussion: There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.

Background: The ability to age healthily is highly dependent on individual characteristics that include gender, social class, a range of biological and contextual factors, and migrant background. Indeed, immigration has changed the demographic composition and social structure of many European countries, generating an increasing interest in how societies, and immigrants in particular, are aging. Research Design: This paper compares the age-related trajectories of health decline in three health measures (activity limitation indicator, self-perceived health, and chronic conditions) among 7,429 immigrants and 81,424 native-born populations aged 50 years old and over using longitudinal data from seven waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) (2004-2020). Analysis: We use descriptive and multivariate models (random-effects regression models) to analyze the association between migration status and each health outcome. We are particularly interested in determining the age-related trajectory of this association across three levels of education, exploring at the same time the effect of the interaction between immigration status and age on health. Results: Our results highlight potential gaps in health between immigrants and native-born people that are particularly large for the low-educated group. In other words, the health decline is more marked for low-educated immigrants compared to native-born populations in particular for activity limitation indicator and self-perceived health, while it is less pronounced with the accumulation of chronic conditions. Conclusions: Our findings should serve to enhance the design of the provision of social services and support and the promotion of equal opportunities.

Objective: Determine how preventable causes of death contribute to the life expectancy gap between Mexico and Spain.

Methods: We used a linear integral decomposition to analyze the impact of preventable mortality on life expectancy between ages 30-75 (temporary life expectancy) between Mexico and Spain in 2018. Additionally, we computed cause-deleted life tables to estimate potential gains in temporary life expectancy. Analyses were stratified by educational attainment, sex, and age.

Results: Low-educated Mexicans showed the largest gains in temporary life expectancy from removing preventable deaths (3.4 years for males, 1.6 for females), partially explaining the gap with Spain. Removing these deaths would close the gap almost entirely due to a higher relative decrease for middle- and high-educated individuals.

Discussion: While access to adequate healthcare is crucial for improving population health, appropriate non-medical public policies can significantly reduce mortality disparities between Mexico and Spain, especially for individuals from higher educational backgrounds.

Objectives: Nearly 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).

Methods: Data 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.

Results: Among 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).

Discussion: In 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.

Objective: To ascertain the barriers and facilitators to physical activity (PA) for older adults in Residential Aged Care Facilities (RACFs), from the perspective of residents, staff, and family.

Methods: A mixed-methods systematic review, underpinned by the Social Ecological Model (SEM). Five databases were searched from inception to May 2024. Data synthesis followed a convergent integrated approach, with relevant quantitative data 'qualitised' and synthesised with qualitative data using thematic synthesis.

Results: This review included 67 studies (40 qualitative, 16 mixed-methods, and 11 quantitative). Thematic synthesis identified 51 key themes (27 facilitators and 24 barriers), spanning all levels of the SEM. Intrapersonal factors (e.g. poor general health) were the most commonly cited barriers (n = 53 studies), and interpersonal factors (e.g. social support) the most commonly reported facilitators (n = 55 studies) to PA in RACFs.

Discussion: An interplay of multi-level factors must be addressed in the development and implementation of strategies to promote PA in RACFs.

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.