Innovation in Aging最新文献

{"title":"Entering and Exiting the Vehicle: Day-to-Day Activity, or High-Risk Endeavor Among Older Adults.","authors":"Xingyu Zhang, Yang Wang, Julie Faieta","doi":"10.1093/geroni/igaf032","DOIUrl":"10.1093/geroni/igaf032","url":null,"abstract":"<p><strong>Background and objectives: </strong>A primary concern of many older adults as they age is whether they will be able to remain in the community setting. This is impacted by their ability to commute to their surroundings as needed to attend occupational-, leisure-, or health care-related appointments in the community setting. Whether an older adult is able to independently drive or relies on rides from others, the first step to safe community transportation is boarding into and alighting out of a vehicle. This study aimed to determine the prevalence of boarding and alighting injuries across age demographics and describe demographic factors that may impact the prevalence of injury.</p><p><strong>Research design and methods: </strong>This study was a retrospective, cross-sectional analysis. National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) data from 2017 to 2021 was analyzed through descriptive statistics and multivariable logistic regression.</p><p><strong>Results: </strong>Findings indicate that the annualized estimate of injury is 209,797 across age groups. Older adults were found to have a higher rate of injury and hospitalization following injury.</p><p><strong>Discussion and implications: </strong>This study replicates earlier reporting on non-crash vehicle injuries occurring during boarding and alighting from 2001 to 2003. Continued research is needed to investigate methods of boarding and alighting injury risk reduction for vulnerable populations.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf032"},"PeriodicalIF":4.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Data Collection Strategies in Research on Alzheimer's Disease and Related Dementias (ADRD).","authors":"Jeong Eun Kim, Melissa Knox, Joshua D Grill, Megan Witbracht, Yuchen Zhang, Hector Salazar, Marita Garrett, Eunji Russ, Melany Medina, Jennifer H Lingler","doi":"10.1093/geroni/igaf026","DOIUrl":"10.1093/geroni/igaf026","url":null,"abstract":"<p><strong>Background and objectives: </strong>Remote data collection emerged as a valuable method for engaging vulnerable populations, such as individuals participating in Alzheimer's disease and related dementias (ADRD) research. Despite challenges like technology readiness and privacy concerns, remote methods have the potential to enhance participation among diverse groups by offering flexibility while addressing accessibility barriers such as geographic distance. This study shares experiences with virtual data collection and the strategies employed to enhance ADRD research involving individuals with and at risk of cognitive impairment.</p><p><strong>Research design and methods: </strong>Experiences are drawn from RIDE (<i>Recruitment Innovations for Diversity Enhancement</i>), an online survey study to assess interest in ADRD research participation among presumably unimpaired adults identifying as Black or African American; and PARADE (<i>Patient and Family Member Reactions to Biomarker-Informed ADRD Diagnoses</i>), an observational, longitudinal cohort study of individuals receiving a biomarker-informed diagnosis for cognitive impairment and their care partners. We detail approaches employed across recruitment, data collection, to retention stages.</p><p><strong>Results: </strong>Virtual data collection was highly feasible in both studies, successfully engaging participants in ADRD research, including those from underrepresented racial and ethnic groups. In RIDE, although project staff occasionally needed to troubleshoot technical challenges (e.g., broken survey links, video issues), the study successfully recruited 500 adults identifying as Black/African American. PARADE showed that synchronous interviews minimized missing data, with care partners providing essential technical and logistical support. Despite occasional difficulties with video conferencing and participant payments, most participants remained fully engaged, highlighting the effectiveness of virtual methods and the need for continuous support to ensure successful participation.</p><p><strong>Discussion and implications: </strong>Virtual data collection offers opportunities to promote inclusion in ADRD research, as demonstrated by the successful enrollment of diverse participant samples in both studies. Successful implementation requires careful planning to address challenges such as digital literacy, educational disparities, and technical support.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf026"},"PeriodicalIF":4.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Disparities in Cognitive Impairment: The Role of Neighborhood Social Cohesion.","authors":"Yeonwoo Kim, Soeun Jang","doi":"10.1093/geroni/igaf031","DOIUrl":"10.1093/geroni/igaf031","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cognitive impairment is a significant public health challenge, particularly as the aging population continues to grow. Individuals from lower socioeconomic backgrounds are at greater risk for cognitive decline, contributing to persistent socioeconomic disparities. While research has predominantly focused on individual-level factors influencing cognitive health, the role of favorable residential environments in mitigating these disparities remains less studied. This study investigates the longitudinal association between time-variant neighborhood social cohesion and cognitive impairments over 6 years, and its moderating effect on the relationship between socioeconomic status and cognitive impairment, exploring its potential to reduce socioeconomic disparities in cognitive decline.</p><p><strong>Research design and methods: </strong>We analyzed data from the Health and Retirement Study collected in 2012, 2014, 2016, 2018, and 2020. Our sample included respondents aged 50 and older who were not cognitively impaired at baseline, allowing us to identify those who developed cognitive impairment after 2012 (<i>N</i> = 11 026).</p><p><strong>Results: </strong>Multilevel logistic regression models showed that higher levels of perceived neighborhood social cohesion were associated with a lower likelihood of cognitive impairment (OR = 0.96, 95% CI = 0.95, 0.97, <i>p</i> < .001). Additionally, greater educational attainment and higher family income were associated with lower risks of cognitive impairment. Interaction tests showed that the protective role of neighborhood social cohesion was particularly stronger for individuals from lower socioeconomic backgrounds.</p><p><strong>Discussion and implications: </strong>These findings highlight the importance of promoting neighborhood social cohesion as a part of multilevel public health strategies to mitigate cognitive decline and address health disparities in older adults. Further research is warranted to explore the mechanisms underlying these associations and to identify effective approaches for enhancing neighborhood social cohesion in communities with low-socioeconomic individuals, ultimately informing multilevel public health interventions.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 6","pages":"igaf031"},"PeriodicalIF":4.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Social Robot in Home Care: Acceptability and Utility Among Community-Dwelling Older Adults.","authors":"Ivy Yan Zhao, Angela Yee Man Leung, Yaqi Huang, Yaqian Liu","doi":"10.1093/geroni/igaf019","DOIUrl":"10.1093/geroni/igaf019","url":null,"abstract":"<p><strong>Background and objectives: </strong>Social robots show great potential for delivering home-based aged care and supporting aging-in-place. This study aims to assess the acceptability of social robots in delivering home care to older adults across 7 domains: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy.</p><p><strong>Research design and methods: </strong>This is a mixed-methods study. Thirty community-dwelling older adults, aged 51-88, engaged with a social robot, equipped with artificial intelligence and designed to interact with humans in a socially acceptable manner. The robot was operated 24/7 in participants' homes for 6 weeks. Descriptive analysis, latent growth mixture modeling, and thematic analysis were conducted for data analysis.</p><p><strong>Results: </strong>Home-based robotic care was very well received. The average frequency of the use of different features of the robot was 23.4 times/person/day. Three trajectory groups of engagement in human-robot interactions were identified: those who are living alone or with an older spouse, with fair health and financial status were the most interactive group. Participants perceived the robot as user-friendly, manageable, and seamlessly integrated into their daily routine, such as reminding meal intake. The robot also reduced the stress of caregivers. It served as a companion and \"good listener,\" ameliorating the feelings of loneliness, calming depressive emotions, and keeping participants informed about the outside world. Interestingly, participants believed that interacting with the robot enabled them to engage with contemporary technologies, acquire new skills, and showcase their fashion sense in front of friends.</p><p><strong>Discussion and implications: </strong>Home-based robots are acceptable and manageable by older adults. Future studies should examine the effectiveness of home-based robotic care on enhancing the health-related outcomes of older adults. <b>Clinical Trial Registration Number</b>: NCT06487611.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf019"},"PeriodicalIF":4.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tying the Knot for Parents: How Adult Children's Marital Choices Impact Parental Depression in China.","authors":"Xiaowei Dong, Nawi Ng, Lars Jacobsson, Ailiana Santosa","doi":"10.1093/geroni/igaf022","DOIUrl":"10.1093/geroni/igaf022","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aims to examine the causal effect of adult children's marital status on parental depressive symptoms in the Chinese context, and whether parents' demographic characteristics play a role in the association.</p><p><strong>Research design and methods: </strong>We utilized the 5 waves of China Health and Retirement Longitudinal Study spanning over 9 years. The participants were categorized into 3 distinct groups: (1) the individuals with at least 1 divorced adult child; (2) those with at least 1 unmarried child aged 30 or older; and(3) a reference group consisting of those not meeting criteria for the first 2 categories. We employed marginal structural models to estimate the causal effect of adult children's marital status and parental depressive symptoms.</p><p><strong>Results: </strong>In total, 13,077 participants were included in the analysis. Parents with divorced adult children (β = 1.55, 95% confidence interval [CI]: 1.28-1.82) and those with marriage-delayed children (β = 0.83, 95% CI: 0.53-1.13) had an increased risk of depressive symptoms when compared to the reference group. When the number of divorced or marriage-delayed adult children was included, the coefficient for parental depressive symptoms was 1.10 (95% CI: 0.92-1.28).</p><p><strong>Discussion and implications: </strong>This study provides evidence that adult children's divorce and delayed marriage are associated with parental depressive symptoms in the Chinese context. This research helps uncover culturally significant risk factors for late-life depression, necessitating enhanced psychological support and preventive strategies to address the needs of vulnerable groups.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf022"},"PeriodicalIF":4.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Later-Life Learning on Trajectories of Cognitive Function Among U.S. Older Adults.","authors":"Nan Wang, Hanzhang Xu, Radha Dhingra, Ying Xian, Eleanor S McConnell, Bei Wu, Matthew E Dupre","doi":"10.1093/geroni/igaf023","DOIUrl":"10.1093/geroni/igaf023","url":null,"abstract":"<p><strong>Background and objectives: </strong>Low education in early life is a major risk factor for dementia. However, little is known about how education in later life is related to cognitive function in older adults. We assessed whether later-life learning was associated with better cognitive function over time and whether the associations differed by sex, race/ethnicity, and prior education.</p><p><strong>Research design and methods: </strong>We used data from the 2008-2018 Health and Retirement Study, including participants aged 65+ without baseline dementia and followed for up to 6 years. Global cognition was measured using a summary score. Later-life learning was measured at every wave at least once a month or more, not in the last month, or never.</p><p><strong>Results: </strong>Of 12 099 participants, 10.2% attended an educational or training course \"at least once a month or more,\" 45.5% reported \"not in the last month,\" and 43.3% reported \"never\" at each wave of the study. Results from adjusted mixed-effects models showed that engaging in any later-life learning, either at least once a month (0.56 points higher, 95% confidence interval [CI] = 0.40-0.73) or not in the last month (0.55 points higher, 95% CI = 0.45-0.65) was associated with better cognitive function compared to never engaging in these activities. The association remained consistent as people aged. The benefits of later-life learning on cognitive function were greater in women than in men-at least once a month versus never was 0.30 points greater in women than men (95% CI = -0.03 to 0.63, <i>p</i> = .0760); not in the last month versus never was 0.24 points greater in women than men (95% CI = 0.04-0.43, <i>p</i> = .016). There were no significant differences by race/ethnicity or prior education.</p><p><strong>Discussion and implications: </strong>Later-life learning was associated with better cognitive function over time. These findings underscore the importance of continued learning among older adults.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf023"},"PeriodicalIF":4.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Types of Social Group Participation and Long-Term Cognitive Preservation in Older Ages.","authors":"MinJia Hsieh, TienYu Owen Yang, TzuYi Li, Chi Chiao, TeTien Ting, YenLing Chiu, YiFang Chuang","doi":"10.1093/geroni/igaf009","DOIUrl":"https://doi.org/10.1093/geroni/igaf009","url":null,"abstract":"<p><strong>Background and objectives: </strong>Participating in social groups predicts better cognitive preservation in older adults in the short term (<5 years). Long-term evidence with direct comparison between specific types of social groups is needed.</p><p><strong>Research design and methods: </strong>In the Taiwan Longitudinal Study of Aging (<i>n</i> = 4,009, mean age 64 years), 1,479 individuals reported participation in at least 1 of the 4 common types of social groups at baseline in 2003, including socializing, volunteering, religious, and networking groups. Cognitive function was measured by a modified Short Portable Mental Status Questionnaire at years 0 (baseline), 4, 8, and 12. Linear mixed-effects models were used to estimate relative cognitive preservation (in %) compared with individuals who did not participate in social groups at baseline or compared with individuals who participated in different social groups at baseline.</p><p><strong>Results: </strong>We found volunteering group participation was associated with most consistent cognitive preservation at year 4 (35%, 95% CI: +10% to +60%), 8 (+64%, +44% to +84%), and 12 (+57%, +24% to +89%) compared with the individuals who did not participate in social groups, and at year 12 compared with participants of other social groups (+65%, +16% to +114%).</p><p><strong>Discussion and implications: </strong>Our findings support a long-term prediction of better cognitive preservation among volunteering group participants.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 4","pages":"igaf009"},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Door Decals for Wayfinding and Redirection: A Quality Improvement Project Involving the Use of Clinical Real-Time Location Systems for Evaluation of Environmental Design Changes.","authors":"Leia C Shum, Twinkle Arora, Yasser Karam, Amy Cockburn, Shehroz S Khan, Andrea Iaboni","doi":"10.1093/geroni/igaf020","DOIUrl":"10.1093/geroni/igaf020","url":null,"abstract":"<p><strong>Background and objectives: </strong>Environmental design modifications are important non-pharmacological interventions for people with dementia in older adult residential care, but their effects are difficult to measure objectively. In this paper, we present the assessment of the impact of door decals installed on patient rooms, offices, and exit doors on patient movements as an example of the uses of location data in evaluating environmental design interventions.</p><p><strong>Research design and methods: </strong>We undertook a quality improvement project in an inpatient specialized dementia unit using de-identified data from a clinical location monitoring system from 79 individuals with dementia admitted over time to 15 patient rooms to measure patient movements. In the first phase, decals were applied to 1 office and 6 patient room doors, and doors with and without decals were compared. In the second phase, patient movements were compared before and after a decal was applied to the remaining exit, office, and 9 patient doors. Main outcomes of interest were the number of daily approaches to concealed doors and daily approaches and entrances to patients' own and others' rooms.</p><p><strong>Results: </strong>Using location data, we identified a significant reduction in the number of approaches to and dwell time at office doors and exits. No differences were found in patient movements in relation to their own or others' rooms in either phase, although patients assigned a room with a decal tended to approach others' rooms with decals less often than those with a plain door.</p><p><strong>Discussion and implications: </strong>Door decals successfully reduced patient contact with staff-only doors and exits but did not have a large impact on patient movement with respect to wayfinding. Location tracking systems provide an important opportunity to evaluate the impact of design interventions in situ in specific older adult care contexts.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf020"},"PeriodicalIF":4.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reported Visual Difficulty and Mortality Risk Among Older Adults: The Mediating Role of Recurrent Falls.","authors":"Shu Xu, Jeffrey A Burr, Qian Song, Joshua R Ehrlich","doi":"10.1093/geroni/igaf016","DOIUrl":"10.1093/geroni/igaf016","url":null,"abstract":"<p><strong>Background and objectives: </strong>Visual difficulty is associated with an increased risk of mortality, however the mechanisms accounting for the link between visual difficulty and mortality have not been described. This study examined the association between visual difficulty, recurrent falls, and mortality risk among Americans aged 65 and older.</p><p><strong>Research design and methods: </strong>This longitudinal study employed data from the <i>2015-2020 waves of the National Health and Aging Trends Study</i> (<i>N</i> = 7,039). Visual difficulty was assessed by questions regarding self-reported near and distance vision and the use of visual aids. Recurrent falls were defined as experiencing a fall more than one time within the last year. Discrete-time survival models with a structural equation modeling-based approach were estimated for the associations between visual difficulty, recurrent falls, and all-cause mortality.</p><p><strong>Results: </strong>Among the respondents, 8.1% reported visual difficulty at baseline. Compared to those without visual difficulty, older adults with visual difficulty were more likely to experience recurrent falls. Having visual difficulty at baseline was associated with experiencing recurrent falls in the following wave (β (log-hazard odds) = 0.12, <i>p</i> < .001) and with mortality in subsequent waves (β = 0.39, <i>p</i> < .001). The association of visual difficulty with mortality was mediated by recurrent falls (β = 0.05, <i>p</i> < .001).</p><p><strong>Discussion and implications: </strong>Compared to those with normal vision, older adults with visual difficulty are more likely to experience recurrent falls, which may in turn increase the risk of mortality. Future research should investigate other potential pathways to gain a more complete understanding of the relationship between visual difficulty and mortality risk.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf016"},"PeriodicalIF":4.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Work During Skilled Home Healthcare: Prevalence and Determinants.","authors":"Julia G Burgdorf, Adrianne Smiley, Yolanda Barron, Jeri Goodman, Margaret V McDonald","doi":"10.1093/geroni/igaf018","DOIUrl":"10.1093/geroni/igaf018","url":null,"abstract":"<p><strong>Background and objectives: </strong>Medicare-funded home health (HH) delivers skilled care via visits to patients' homes. Social work (SW) services are included within the HH benefit and may positively affect outcomes for HH patients with complex needs. However, no prior work has quantitatively assessed SW provision during HH.</p><p><strong>Research design and methods: </strong>We examined 2018 linked HH claims, assessment, and HH agency data for a national sample of 1 372 570 Medicare HH patients. We described the prevalence, number, and timing of SW visits, compared characteristics of those who did versus did not receive SW, and modeled odds of receiving SW using a multilevel logistic model clustering at the HH agency level and adjusting for patient sociodemographic characteristics and clinical status and HH agency characteristics.</p><p><strong>Results: </strong>Just 11.3% of HH patients received SW. On average, those who received SW had a single SW visit (mean = 1.3; standard deviation [<i>SD</i>] = 0.6) occurring about a week (mean = 8.8 days; <i>SD</i> = 6.6) after HH admission. The patient-level factors most significantly associated with receiving SW included being non-Hispanic Black compared to non-Hispanic White (adjusted odds ratio [aOR]: 1.70; 95% confidence interval [CI]: 1.66-1.74), being Medicaid-enrolled (aOR: 1.26; 95% CI: 1.24-1.28), living alone (aOR: 1.31; 95% CI: 1.28-1.33), having high cognitive impairment (aOR: 2.12; 95% CI: 2.07-2.18), and exhibiting depressive symptoms (aOR: 2.17; 95% CI: 2.10-2.23). Patients also had greater odds of a SW visit if receiving care from an HH agency that was nonprofit (aOR: 1.31; 1.19-1.45) and lower odds if the HH agency had a rural service area (aOR: 0.67; 95% CI: 0.61-0.74).</p><p><strong>Discussion and implications: </strong>Findings indicate that SW access remains rare during HH and is driven by both demand-side (ie, patient needs) and supply-side (ie, agency characteristics) factors. There is a need to identify patient profiles most likely to benefit from SW services during HH and to develop strategies to mitigate agency-level barriers to access.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf018"},"PeriodicalIF":4.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}