Gerontology and Geriatric Medicine最新文献

Nursing assistants (NAs) are critical professionals across the long-term care continuum. Despite the demands of NAs, these frontline personnel experience workplace challenges and turnover at a disproportionate rate compared to other professionals. Much research has explored the experiences of nursing assistants using federal survey data and national datasets. Guided by a socio-ecological model and the job-demands resource model, this study utilized a sequential mixed-methods approach to uncover a more nuanced understanding of NA workplace experience. Results from this combined qualitative (N = 17) and quantitative (N = 354) study found that there are several workplace aspects, such as organizational culture and supervisor relationships, that contribute to NA experiences across system levels. Further exploration of direct care tasks directly from nursing assistants is necessary to understand full intentions.

This study investigated how elderly individuals' exercise satisfaction in snowy areas relates to their health indicators and future care needs. Survey data were collected from individuals aged ≥65 years who lived in snowy-cold regions. Participants completed measures of exercise satisfaction, frailty, quality of life (QOL), and cardiovascular health study during the winter and spring of 2019, with a follow-up measure in 2022 to assess care needs. Findings revealed an association between exercise satisfaction, QOL, and frailty indicators, irrespective of the season. Notably, winter exercise satisfaction showed a stronger correlation with future care needs compared to spring exercise satisfaction. Those expressing low winter exercise satisfaction were significantly more likely to require increased care 3 years later than those reporting no inactivity. Although physical activity was not measured directly, the findings underscore that perceptions of exercise satisfaction during snowy seasons can predict future care needs in older adults. The influence of seasonal variations and subjective exercise satisfaction on long-term care requirements is vital for tailored interventions and improved healthcare strategies for older adults in cold regions.

Objectives: Common age-related health conditions can lead to poor mental health outcomes and deteriorate cognition. Additionally, commonly prescribed medications for various mental/physical health conditions may cause adverse reactions, especially among older adults. Psychedelic therapy has shown positive impacts on cognition and has been successful in treating various mental health problems without long-lasting adversities. The current study examines the association between psychedelic drug usage and cognitive functions in middle-aged and older adults. Methods: Data were from wave 3 (2013-2014) of the Midlife in the United States (MIDUS) study. We used multiple linear regression models examining associations between psychedelic usage and cognitive functions, controlling for covariates of sociodemographic and health factors. Results: We included 2,503 individuals (M_age = 64 ± 11). After controlling for covariates, the finding revealed that psychedelic usage was independently associated with more favorable changes in executive function (β = .102, SE = 0.047, p = .031) and less depressive symptoms (β = -.090, SE = 0.021, p < .001). The same effect was not found for episodic memory (β = .039, SE = 0.066, p = .553). Discussion: Addressing the mental health implications of physical health conditions in older adults are vital for preventing neurocognitive deterioration, prolonging independence, and improving the quality of life. More longitudinal research is essential utilizing psychedelics as an alternative therapy examining late-life cognitive benefits.

Background and Purpose: Patients with COPD-induced malnutrition and muscle wasting are often frail. Consequently, traditional rehabilitation may be even counterproductive due to energy costs and there is a need for specialized rehabilitation programs, which are lacking for these patients. We developed such a program, which includes resistance training, following Nonlinear Periodized Exercise principles and physical energy management, in combination with a restriction of physical activities. The purpose of the study was to investigate the feasibility and the potential effects of this program. Methods: Patients who are eligible for the program are those with COPD gold III/IV and a fat free mass index below standard. We conducted a qualitative feasibility study and interviewed both patients and healthcare professionals (HCPs), using a deductive approach. The open interviews were qualitatively analyzed focussing on six areas of Bowens' feasibility model: acceptability, demand, implementation, practicality, limited efficacy, and integration. Results and discussions: Seven patients and seven HCPs were interviewed. For patients, key factors that helped to adhere to the program were knowledge about energy management, alternative skills to cope with COPD, and social support. They found the program beneficial. However, several patients considered a limitation of walking and ADL activities challenging. HCPs considered the program feasible and beneficial especially for those patients who accept they need a behavior change and who adhere to the program. For HCPs, key factors were the consistent approach and coaching skills of the multidisciplinary team members, and the monitoring role of the nurses. The limitation of physical activity and endurance training deviates from existing geriatric rehabilitation programs which propagate functional activity and training. Still, evidence from the current study suggests that our tailored approach for these patients might be more appropriate and also potentially effective without harm for physical function. Conclusions: Our novel, multidisciplinary rehabilitation program is considered feasible and clinically relevant by both patients and healthcare professionals. The next step is to explore its effects on muscle strength, physical functioning, and quality of life.

In today's world, it is unavoidable for older adults to use technology, which causes some challenges for them. In this qualitative study, we used grounded theory to evaluate information and communication technology (ICT) adoption strategies among Iranian older adults. The participants included 18 older adults, five experts, and five family members of older adults. The data collection method included conducting semi-structured interviews, taking field notes, and observation. The data were analyzed using the Corbin and Strauss approach. Three main themes were extracted as follows: support from others, effort for learning, and smart choice. The subthemes of support from others included creativity in educating older adults; having access to an educational supporter; and receiving informational, emotional, and financial support. The subthemes of effort for learning included utilizing aids, adaptive measures, shortcut techniques, and self-learning. The subthemes of smart choice included physical characteristics, technical features, price sensitivity, and availability of an active sales representative. Accordingly, it is essential to teach older adults to increase their ICT adoption rate and continued use of technology. In this respect, developing a standard ICT manual for older adults can be beneficial.

Background: Perturbation-based balance training (PBT) is a promising fall risk reduction method that involves inducing unexpected perturbations to balance to train participants reactive balance control. Due to the unpredictable nature of PBT, its acceptability to older adults could present a barrier to the implementation of PBT in the community. Aim/Purpose: The purpose of this study was to assess the perceived acceptability of a community-based PBT program to both older adults and healthcare professionals (HCPs). Methods: Nineteen older adults (aged 69.6 ± 6.6 years, 17 women, 2 men) and three HCPs participated in the qualitative study. Participants completed four PBT sessions facilitated in conjunction with HCPs. Interviews, based on the theoretical framework of acceptability, were conducted before and after PBT and analyzed using template analysis. Results: PBT was perceived as effective by older adults and HCPs. However, HCPs perceived the equipment cost as a substantial barrier to feasibility in the community.

Background: There is little evidence for statins for primary cardiovascular prevention in older adults. Consequently, it is important to assess patient attitudes toward the use of statins, which might differ from attitudes toward other medications. We aimed to describe older patient attitudes toward deprescribing statins versus general medications. Methods: We conducted a survey using the revised Patients' Attitudes Toward Deprescribing questionnaire in its original version and adapted to statin use in adults ≥65 years taking a statin for primary prevention. Results: Among the 47 participants (mean age 74.6 years), 42 (89%) were satisfied with their current therapy, but still willing to stop ≥1 of their medications upon their doctor's advice. About 68% (N = 32) were satisfied with their statin therapy, while 83% (N = 39) would accept to consider deprescribing. Twenty-six (55%) participants were concerned about missing future benefits when stopping their general medications and 17 (36%) when stopping their statin. Eight (17%) participants believed they were experiencing side effects of statins and twice as many for general medication (38%, N = 18). Conclusion: Our study provides insight about differences and similarities in patient attitudes toward deprescribing general medications and statins in primary prevention. This information could support patient-centered conversations and shared-decision making about deprescribing.

Background: This study examined the relationship between hospital-based electronic health information exchange (HIE) and the likelihood of having a preventable emergency department (ED) visit during the COVID-19 pandemic for US patients with Alzheimer's Disease and Related Dementias (ADRD). Methods: We used multi-level data from six states. The linked data sets included the 2020 State Emergency Department Databases (SEDD), the Area Health Resources File, the American Hospital Association (AHA) Annual Survey, and the AHA Information Technology Supplement to study 85,261 hospital discharges from patients with ADRD. Logistic regression models were produced to determine the odds of having a preventable ED visit among patients with ADRD. Results: Our final sample included 85,261 hospital discharges from patients with ADRD. Patients treated in hospitals that received more types of clinical information for treating patients with COVID-19 from outside providers (OR = 0.961, p < .05) and/or hospitals that received COVID-19 test results from more outside entities were significantly less likely to encounter preventable EDs (OR = 0.964, p < .05), especially among patients who also had multiple chronic conditions (MCC) (OR = 0.89, p = .001; OR = 0.856, p < .001). Conclusion: Our results suggest that electronic HIE may be useful for reducing preventable ED visits during the COVID-19 pandemic for people with ADRD and ADRD alongside MCC.

Background: The Alanya region on Turkey's southern coast has become an important destination for German retirement migration. Objective: Identify research studies on German retirement migration to Turkey which deal with the life situation, the motives, the handling of critical life situations in the context of retirement migration, and the reasons for return migration. Methods: The researcher conducted a qualitative systematic literature review from January 2021 to May 2021 in MEDLINE, CINAHL Complete, and APA PsychInfo. Results: Eleven studies on German and European retirement migration to Turkey were included after a critical assessment based on defined inclusion and exclusion criteria. Motives for retirement migration are climatic, scenic, cultural advantages and the lower cost of living in Turkey. Conclusion: It has been found that most of the studies are thematically narrowly defined, detailed studies deal with and describe the development of retirement migration in a more general way.

In this study, based on the 2022 National Health and Aging Trend Study (N = 5,593, age 65+), we examined direct associations between moderate and vigorous physical exercise (PE) and depressive/anxiety symptoms as well as bothersome pain and sleep problems. We then examined if the association between PE and depressive/anxiety symptoms would be partially mediated by the effects of PE on bothersome pain and sleep problems. Results from a path model showed that controlling for sociodemographic and health statuses, PE was negatively associated with depressive/anxiety symptoms and bothersome pain, but it was not significantly associated with sleep problems. The mediation analysis showed that 10% of the total effects of PE on depressive/anxiety symptoms was indirect effects of PE on bothersome pain. This study is important as it examined the associations among PE, pain, sleep, and depression/anxiety in community-dwelling older adults in their natural environments. Healthcare and social service providers for older adults need to emphasize the importance and benefits of PE for older adults' physical and mental health. Easy access to venues for PE is also important.