Journal of ageing and longevity最新文献

Background/objective: This study examined whether a brief measure combining subjective cognitive concerns and financial interference, termed Subjective Cognitive Decline-Financial (SCD-F), is associated with excess spending behavior in older adults.

Methods: Community-dwelling older adults, some with early memory loss and some with no cognitive complaints (N = 150, M age = 72.6) provided 12 months of checking account statements and participated in interviews to clarify aspects of their personal financial behaviors. SCD-F was defined by asking if memory decline was interfering with financial decision making or transactions. A 3-point SCD-F measure was created. Excess spending was determined by whether checking account expenditures exceeded all sources of income. Nonparametric tests (Kruskal-Wallis and Mann-Whitney U) and multiple regression models assessed group differences and predictors.

Results: Group differences in excess spending were pronounced (H(2) = 15.75, p < .001). Those in the high SCD-F group had a significantly greater likelihood of excess spending (Z = -4.11; r = .43) and higher excess spending percentages (Z = -4.11; r = .43) compared to those with no memory loss. Regression analyses indicated that SCD-F was the strongest predictor of excessive spending (β = .40, t = 5.43, p < .001), even after controlling for age, gender, race, and education (R² = .235, F(5,144) = 8.86, p < .001).

Conclusions: A brief self-report measure, SCD-F, effectively identifies older adults at risk of financial mismanagement, even absent formal cognitive impairment. Monitoring subjective cognitive concerns together with financial interference could enable early intervention. This brief measure may be useful in clinical settings as a screening tool, and in large national surveys.

Older adults, aged 65 years and older, develop and experience frailty at different rates. Yet, this heterogeneity is not well understood, nor are the factors, such as geographical residence, that influence different frailty trajectories and subsequent healthcare outcomes. We aim to identify factors that impact older adult frailty trajectories, skilled nursing facility (SNF) placement, and death. Medicare beneficiaries ≥ 65 years from the National Health and Aging Trend Study (2011-2021) with complete data using Fried's frailty phenotype on ≥ 2 occasions (n = 6082) were included in the analysis. Rural/urban residence was defined using Office of Management and Budget criteria. Latent class growth analysis (LCGA) helped identify four frailty trajectories: improving, stable, mildly worsening, and drastically worsening. Cox proportional hazard analysis and logistic regression determined the association of social determinants of health (sex, race/ethnicity, education and income level, healthcare and transportation access, and social support) on death and SNF admission, respectively. The mean age was 75.12 years (SE 0.10); 56.4% female, 18.6% (n = 1133) rural residence. In the overall sample, 1094 (23.0%) older adults were classified as robust, 3242 (53.0%) as pre-frail, and 1746 (24.0%) as frail. Urban residence did not modify the relationship between frailty trajectories and SNF placement, nor did geographic residence on death. Higher income was associated with lower odds of a worse frailty trajectory, SNF admission, and a lower hazard of death, all reaching statistical significance. Future work should examine the factors that influence older adult participation in research and the impact of standardizing the definition of geographic rurality on older adult frailty and health outcomes.

The COVID-19 pandemic has illuminated and intensified pre-existing structural vulnerabilities among older adults living with HIV/AIDS in sub-Saharan Africa, particularly Nigeria. Within already overstretched healthcare infrastructures, these individuals faced heightened economic precarity, disrupted HIV care, and pronounced psychosocial distress. Exploring their lived experiences critically advances an understanding of resilience and informs contextually responsive interventions that can mitigate future health crises. This study employed a narrative qualitative approach to explore the lived experiences of older adults (aged 50 and above) attending the Infectious Diseases Institute (IDI) clinic in Ibadan, Nigeria, during the pandemic lockdown. Purposive sampling guided by maximum variation principles enabled the selection of 26 participants who provided detailed accounts through in-depth interviews. Reflective thematic analysis identified complex narratives illustrating intensified financial hardships, disrupted access to antiretroviral therapy (ART), and heightened psychological distress, including anxiety, depression, and profound isolation. Conversely, participants also articulated experiences of resilience, manifesting in improved medication adherence, strengthened family bonds, and introspective growth fostered by enforced isolation. These nuanced findings highlights the necessity of developing an adaptive, integrated healthcare interventions that addresses economic vulnerabilities, psychosocial wellbeing, and ART continuity, thereby better preparing resource-constrained health systems to support older adults with HIV/AIDS in future public health crises.

Background: We aimed to examine ACP in older adults in the U.S. across different sociodemographic characteristics and cognition levels (N = 17,698).

Methods: We utilized two legal documents from the Health and Retirement Study survey: a living will and durable power of attorney for healthcare (DPOAH). We established the baseline trends from 2014 to assess if trends in 2024 have improved upon future data availability. Logistic regression models were fitted with outcome variables (living will, DPOAH, and both) stratified by cognition levels (dementia/impaired cognition versus normal cognition).

Results: Age, ethnicity, race, education, and rurality were significant predictors of ACP (having a living will, DPOAH, and both the living will and DPOAH) across cognition levels. Participants who were younger, Hispanic, black, less educated, or resided in rural areas were less likely to complete ACP.

Conclusion: Examining ACP and its linkages to specific social determinants is crucial for understanding disparities and developing effective educational and interventional strategies to enhance ACP uptake among diverse population groups. Future studies are needed to assess whether disparities have improved over the last decade, particularly as 2024 data become available. Addressing ACP disparities is essential for healthcare professionals to advance research and promote effective practices in geriatric care and aging services.