Journal of Aging and Health最新文献

Although research has linked ageism and pain to increased stress in older adults, their influence on stress within the context of pandemics has not been adequately examined. Our objective was to investigate relationships among pain, ageism, and pandemic-related stress in older adults using structural equation modeling (SEM) and mediation analysis. We hypothesized that pain would exert a direct and/or indirect influence on pandemic-related stress, and ageism a direct influence. Data were collected from 486 North American older adults in January 2024. Participants completed measures of pain, ageism, and pandemic-related stress. SEM and mediation analyses yielded evidence suggesting ageism and pain influence pandemic-related stress, although ageism mediated pain's impact on pandemic-related stress. This study underscores how pain and ageism can impact older adults' psychological well-being during pandemics. Findings highlight a potential need for public health interventions to address ageism and pain during future waves of COVID-19 or other global health crises.

BackgroundThis study examined whether patterns of relationship quality between parents and adult children were associated with the onset of ADL disability in later life.Research Design and MethodsUsing data from the Health and Retirement Study (N = 8,101), we studied whether support, strain, and patterns of relationships between parents and adult children were related to age of onset of ADL disability among parents.ResultsGreater support from adult children (based on parental report) was associated with later onset of ADL disability, and greater social strain was associated with earlier onset of disability. Compared to high-quality relationships, adverse, indifferent, and ambivalent relationships were associated with an earlier onset of ADL disability over time.DiscussionIt is important to acknowledge the complexity of relationships between parents and their adult children to understand how patterns of quality within these relationships influence ADL functioning in later life among parents.

We investigated the changes in home care clients' vision and hearing over 18 months and examined the role of sensory impairments in maintaining their functioning. We used data from the Finnish Resident Assessment Instrument (RAI) database (n = 7013). Sensory impairment status was categorized by type (single or dual) and severity (mild or moderate/severe). The association between sensory impairment and functioning over 18 months was examined using binary logistic regression analysis with generalized estimating equations. Of 7013 home care clients, 48% had sensory impairment at baseline. Over 18 months, sensory impairment improved in 7% (n = 482) and worsened in 23% (n = 1605) of the clients. Sensory impairments were associated with impaired physical, cognitive, and psychosocial functioning at baseline. Especially moderate to severe dual impairment was associated with increased impairment in cognitive and physical functioning over time. Sensory impairments should be considered as an integral part of maintaining home care clients' overall health and well-being.

ObjectiveAccelerated biological aging is a plausible and modifiable determinant of dementia burden facing minoritized communities but is not well-studied in these historically underrepresented populations. Our objective was to preliminarily characterize relationships between telomere length and cognitive health among American Indian/Alaska Native (AI/AN) and Black/African American (B/AA) middle-aged and older adults.MethodsThis study included data on telomere length and neuropsychological test performance from 187 participants, enrolled in one of two community-based cognitive aging cohorts and who identified their primary race as AI/AN or B/AA.ResultsNested multivariable regression models revealed preliminary evidence for associations between telomere length and cognitive performance, and these associations were partially independent of chronological age.DiscussionSmall sample size limited estimate precision; however, findings suggest future work on telomere length and cognitive health in underrepresented populations at high risk for dementia is feasible and valuable as a foundation for social and behavioral intervention research.

ObjectivesThis study aims to examine the relationship between social connectedness and health-related quality of life (HRQoL) among older adults, focusing on the impact of technology accessibility and geographic context (urban vs. rural).MethodsData from the 2021 National Health and Aging Trends Study (NHATS) with 2303 participants aged 65 and older were used. Confirmatory factor analysis validated measures of social connectedness and HRQoL, followed by regression analysis to explore their relationship, including the moderating roles of technology accessibility and geographic context.ResultsThe findings indicate a significant positive relationship between social connectedness and HRQoL. However, technology accessibility moderates this relationship only in rural areas, where lower technology access enhances the positive effects of social connectedness on HRQoL.DiscussionThe results suggest that interventions to improve HRQoL among older adults should consider different geographical locations. Notably, promoting in-person interactions is crucial for enhancing the HRQoL of rural older adults.

ObjectivesFew studies have investigated health outcomes associated with arthritis in low-middle-income countries. Our objective was to examine the association between arthritis and all-cause hospitalization and mortality among middle-aged and older adults in Mexico.MethodsOur sample included 12,106 participants aged >50 years from the 2012, 2015, and 2018 waves of the Mexican Health and Aging Study. Logistic regression was used for the associations between arthritis and hospitalization. Kaplan-Meier and Cox proportional hazard models were used for the association between arthritis and mortality.ResultsArthritis was associated with higher odds of hospitalization (OR = 1.23; 95% CI = 1.09-1.38), but not mortality. Arthritis with physical limitations had the highest odds of hospitalization (OR = 1.48; 95% CI = 1.27-1.73). Arthritis with joint pain (OR = 1.24; 95% CI = 1.10-1.41) and medication use (OR = 1.28; 95% CI = 1.11-1.48) had higher odds of hospitalization.ConclusionAmong middle-aged and older adults in Mexico, arthritis was associated with a high risk of hospitalization.

BackgroundAccurate classification of cognitive impairment in population studies is challenging.ObjectiveTo compare the performance of a diagnostic algorithm with a clinical consensus panel.SampleIn 2016, the Health and Retirement Study (HRS) implemented the Harmonized Cognitive Assessment Protocol Project (HRS-HCAP) to streamline cognitive assessments for select HRS participants.MethodsThe Manly-Jones HCAP diagnostic classification was used to classify cognitive status as normal, mild cognitive impairment (MCI), or dementia. For this analysis, a consensus panel of five clinicians reviewed 50 cases with high diagnostic uncertainty, each reviewing 30 cases, blinded to the algorithm's classifications.AnalysisDiagnostic concordance was assessed using unweighted and weighted Cohen's kappa (κ).ResultsUnweighted concordance was 70% (35/50), with discordance mostly among MCI cases. Weighted concordance was 84%. Unweighted κ was 0.56 (95% CI 0.30-0.81) and weighted κ was 0.75 (95% CI 0.49-0.91), indicating moderate to substantial agreement between the two methods.

ObjectiveWe compared pain prevalence and intensity between caregivers and non-caregivers, as well as between different types of caregivers.MethodUsing two rounds of data from the National Social Life, Health, and Aging Project, we used regression models to analyze differences in pain prevalence and intensity between caregivers and non-caregivers at baseline (2010-2011) and follow-up (2015-2016). The sample consisted of 2332 participants aged 62 and older (352 caregivers and 1980 non-caregivers).ResultsCross-sectionally, caregivers were more likely than non-caregivers to report pain. Longitudinally, caregivers with pain at baseline were more likely to report the presence of pain and greater pain intensity five years later compared to non-caregivers who also reported pain at baseline. More hours of care per week was associated with greater pain intensity at baseline and follow-up among caregivers with pain.DiscussionCaregivers' pain is a public health concern, with efforts to mitigate the effects of caregiving on pain needed.

ObjectivesThere is growing recognition that social participation may help attenuate cognitive decline in older ages. Unfortunately, previous research often relies on participation index measures, which may obfuscate associations among cognition, specific activities, and the frequency of partaking in those activities.MethodsData are from six waves of the Health and Retirement Study (N = 20,696). Regression models test how associations between social participation and cognition vary by social activity and by multiple specifications of activity frequency.ResultsUsing a participation index, any new activity or increase in activity frequency was positively associated with cognition. When segregating activities, only three activities had positive associations: meeting friends, volunteering, and being a part of community organizations. We find limited evidence that activity frequency is an important moderator.DiscussionSocial activities likely have heterogeneous associations with older adult cognition. The frequency threshold linking social participation to cognition may be "any" regular participation in select activities.

ObjectiveThe aim of this study is to conduct a systematic review of published literature to examine factors associated with Length of Stay (LOS) and Readmission Rates for older Hospital in the Home (HITH) patients.MethodIn accordance with PRISMA guidelines, seven databases were searched for peer-reviewed articles relating to HITH, older patients, LOS and readmissions.ResultsTwenty-nine studies met the inclusion criteria. Risk factors associated with increased readmissions and LOS were age, prior hospitalisations, illness severity, geriatric-related complications, and cognitive impairment. Most studies found that patients participating in HITH had a shorter initial acute hospitalisation LOS than patients transferred to a subacute hospital or rehabilitation ward. However, LOS and readmissions, comparing HITH to traditional in-hospital care, were inconsistent.ConclusionsOverall, LOS and readmission rates (comparing home-based care to hospital care) were inconsistent but appear related to patient demographics and disease profile and require further study.