Innovation in Aging最新文献

{"title":"Disparities in Chronic Stress Exposure and Appraisal and Later-Life Disability.","authors":"Madison R Sauerteig-Rolston","doi":"10.1093/geroni/igaf024","DOIUrl":"10.1093/geroni/igaf024","url":null,"abstract":"<p><strong>Background and objectives: </strong>Influenced by the stress process theory, this study investigated the relationship between chronic stress (measured by exposure and appraisal) and the onset of a disability in later life among White, Black, U.S.-born Hispanic, and foreign-born Hispanic adults.</p><p><strong>Research design and methods: </strong>Using nationally representative data from the Health and Retirement Study, I used Weibull accelerated failure time models to examine racial, ethnic, and nativity disparities in chronic stress exposure and appraisal and age of onset of disability during the following 8-10 years (i.e., incidence).</p><p><strong>Results: </strong>Over time, earlier onset of disability was associated with higher levels of stress exposure (β = -0.04) and negative appraisals (β = -0.07). Appraising stress as more upsetting had a detrimental influence on later-life disability for Black adults (occurring 11% earlier), but a protective effect for foreign-born Hispanic adults (occurring 20% later) compared with White adults.</p><p><strong>Discussion and implications: </strong>Overall, findings suggest it is important to acknowledge not just the exposure to chronic stressors, but how upsetting these chronic stressors make one feel to reduce racial, ethnic, and nativity disparities in disability.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf024"},"PeriodicalIF":4.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198983","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":"Sarcopenia, Obesity, or Both. What is the dominant Variable of the Associated Risks of Sarcopenic Obesity?","authors":"Alejandro Álvarez-Bustos, Jose A Carnicero, Walter Sepúlveda-Loyola, Begoña Molina-Baena, Francisco J Garcia-Garcia, Leocadio Rodríguez-Mañas","doi":"10.1093/geroni/igaf021","DOIUrl":"10.1093/geroni/igaf021","url":null,"abstract":"<p><strong>Background and objective: </strong>Sarcopenic obesity (SO), obesity, and sarcopenia have been related to adverse events in older adults, raising the question about the role of each component in the risk associated with SO. The objective of this manuscript is to evaluate the role of sarcopenia, obesity, and its interaction in the risks (frailty, disability, mortality) associated with sarcopenic obesity.</p><p><strong>Research design and methods: </strong>Data from the Toledo Study of Healthy Aging (TSHA) were used. This is a cohort-based study composed of community-dwelling adults ≥65 years. Obesity (Body Mass Index-BMI ≥30) and sarcopenia (the Foundation for the National Institutes of Health-FNIH criteria, standardized to our population) were assessed at baseline. Frailty, through the Frailty Phenotype (FP) and the Frailty Trait scale-5 (FTS5), and disability (Katz Index) were evaluated at baseline. Mortality, frailty, and disability were assessed at follow-up. Logistic (odds ratio, OR) and Cox (hazard ratio, HR) regression models were computed to assess the associations.</p><p><strong>Results: </strong>A total of 1 538 (74.73 years, 45.51% men) individuals were included. Cross-sectionally, SO, sarcopenia, and obesity were significantly associated with the risk of frailty and disability. Longitudinally, Sarcopenia was associated with all the adverse events (ORs/HRs ranged from 1.41 to 4.14, <i>p</i>-value < .05); whereas SO [FP, OR (95% confidence interval-CI): 4.27 (2.05, 8.93); FTS5, OR (95% CI): 6.14 (3.58, 10.51), <i>p</i>-value < .001] and obesity [FP, OR (95% CI): 3.10 (1.95, 4.94), <i>p</i>-value < 0.001; FTS5, OR (95% CI): 2.26 (1.17, 4.35), <i>p</i>-value 0.015] was only associated with incident frailty. Sarcopenia added risk to obesity for frailty (FP and FTS5) whereas obesity only did for frailty (FTS5) in sarcopenic individuals. The interaction between sarcopenia and obesity was not associated with any outcome.</p><p><strong>Discussion and implications: </strong>Sarcopenia and obesity provide each other an additive risk for frailty, but not a multiplicative (ie, interaction) one, in sarcopenic obesity. Sarcopenia is the mean factor accounting for the associated risk.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf021"},"PeriodicalIF":4.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093522","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 Mixed-Methods Scoping Review of Innovative Long-term Care Facility Design and Associated Outcomes.","authors":"Elizabeth Pywell, Katherine M Ottley, Azin Dolatabadi, Joshua Maza, Kayley Lawrenz, Jim Hutchinson, Heather Ward, Abigail Wickson-Griffiths, Paulette V Hunter","doi":"10.1093/geroni/igaf034","DOIUrl":"10.1093/geroni/igaf034","url":null,"abstract":"<p><strong>Background and objectives: </strong>As people live to late older adulthood, their reliance on disability supports and services increases. While these supports and services can often be provided at home, many people spend a period of their lives in long-term care, and the quality of long-term care environments is of great significance to those who make this transition and to those who support it. The objective of this study was to survey the range of design innovations in long-term care and to consider outcomes for residents, family caregivers, employees, and healthcare organizations.</p><p><strong>Research design and methods: </strong>To achieve these goals, we conducted a systematic scoping review and analyzed results using a convergent segregated mixed-methods approach. We summarized 75 articles on the topic of long-term care home building design by classifying structural design features and associated outcomes.</p><p><strong>Results: </strong>We identified 3 innovative design types (<i>small-scale homelike models</i>, <i>large-scale homelike models</i>, and <i>special small-scale approaches</i>). A wide range of potential positive outcomes were identified for residents, families, and staff. These outcomes included outcomes of central significance for long-term care, including improved quality of life, improved family satisfaction, and improved staff engagement in work.</p><p><strong>Discussion and implications: </strong>Based on these results, environmental design is a critical contributor to long-term care quality.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf034"},"PeriodicalIF":4.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198982","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":"Speed of Processing Training for Stress Adaptation in Caregivers of a Family Member With Dementia: A Randomized Controlled Trial.","authors":"Kathi L Heffner, Hugh F Crean, Autumn M Gallegos, Maria M Quiñones-Cordero, Miriam T Weber, Silvia Sörensen, Rose S Y Lin, Carol A Podgorski, Feng V Lin","doi":"10.1093/geroni/igaf033","DOIUrl":"10.1093/geroni/igaf033","url":null,"abstract":"<p><strong>Background and objectives: </strong>The chronic stress of caregiving for a family member with Alzheimer's disease and related dementias (ADRD) is associated with a host of health risks, including accelerated cognitive aging and poor emotional well-being. Despite known links between cognitive and emotion regulatory pathways, cognitive training has not been tested in ADRD caregivers as a means to strengthen cognitive capacity and concomitant emotion regulation, domains undergirding stress adaptation. This study aimed to identify effects of computerized cognitive training on cognitive and emotion indicators of caregivers' capacity for stress adaptation, a key mechanism for healthy aging.</p><p><strong>Research design and methods: </strong>ADRD family caregivers (<i>N</i> = 195; ages 55-85 years) enrolled in a 2-arm randomized controlled trial were assigned (1:1) to engage in a vision-based speed of processing and attention (VSOP/A) training or video education (VE). Processing speed and attention, working memory under stress, and emotion reactivity to laboratory and caregiving stressors were measured at baseline, following an 8-week intervention, and 6 months and 12 months postintervention. Intent-to-treat analyses using mixed models for repeated measures tested effects of VSOP/A training on these outcomes.</p><p><strong>Results: </strong>The VSOP/A group had significantly improved processing speed and attention performance compared to the VE group, and these differences persisted through 6 months postintervention. At 6 months postintervention only, working memory performance under stress was significantly better among the VSOP/A compared to VE group. At 12 months, caregivers in the VSOP/A group reported less negative emotion in response to ADRD-related behavioral symptoms of their care recipient. There were no group differences in acute emotion reactivity to the laboratory stressor at any time point.</p><p><strong>Discussion and implications: </strong>Findings from this study suggest that targeted cognitive training should be further developed as an efficacious strategy to strengthen ADRD family caregivers' stress adaptation capacity and healthy aging. <b>Clinical Trials Registration Number:</b> NCT03036423.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf033"},"PeriodicalIF":4.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198984","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":"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":"Tailoring Treatment for Substance Use Disorders in Older Adults: A Mixed-methods Study.","authors":"Megan O'Grady, Kristyn Zajac, Alexandra DePalma, Yang Liu, Lisa C Barry","doi":"10.1093/geroni/igaf027","DOIUrl":"10.1093/geroni/igaf027","url":null,"abstract":"<p><strong>Background and objectives: </strong>The number of persons in mid-to-late life with substance use disorders (SUDs) in the United States has tripled over the past 2 decades, with opioid use disorder largely accounting for this increase. Older individuals with SUDs have unique medical, psychological, and social needs. Despite these needs and growing demand for SUD treatment within this age group, little is known regarding availability of specialized SUD treatment programs for older persons and barriers or facilitators to implementing these services.</p><p><strong>Research design and methods: </strong>We conducted a mixed-methods study, first conducting qualitative interviews with counselors at outpatient SUD treatment facilities in Connecticut (<i>N</i> = 10). We then used these qualitative interview findings to guide analysis of quantitative data from SAMHSA's National Substance Use and Mental Health Services Survey (N-SUMHSS) and the National Survey of Substance Abuse Treatment Services (N-SSATS) survey.</p><p><strong>Results: </strong>Using the Behavioral Model of Health Services Utilization for Vulnerable Populations and Framework Analysis, we identified predisposing (eg, treatment attitudes), enabling (eg, transportation), need-based (eg, comorbidities; integrated care), and healthcare system-related (eg, insurance) characteristics affecting older adults' SUD treatment engagement. SUD treatment facilities offering \"a tailored program for seniors or older adults\" increased steadily in Connecticut, and the United States overall, between 2010 and 2022. Of the 74 (43%) Connecticut facilities offering tailored older adult services, social, structural, and mental health services were offered at high rates (64%-86%), but medical services were offered at lower rates (39%-52%).</p><p><strong>Discussion and implications: </strong>Our findings indicate a gap between the treatment needs of older adults with SUDs and available services. Greater attention to integrated medical services, screening for geriatric-specific syndromes that could impede treatment access (eg, cognitive impairment; mobility), and appropriate workforce training is needed to optimize treatment for older adults with SUD, especially considering the opioid use disorder epidemic in the United States.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 6","pages":"igaf027"},"PeriodicalIF":4.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496113","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":"Disparities Experienced by Racial Minorities Contribute to Treatment Gaps and Lack of Access to Resources and Supports for Substance Use Disorders.","authors":"Marissa K Mackiewicz, Jodi Winship, Patricia Slattum, Leland Waters","doi":"10.1093/geroni/igaf030","DOIUrl":"10.1093/geroni/igaf030","url":null,"abstract":"<p><strong>Background and objectives: </strong>Problematic substance use among older adults is rising. Although rates of substance use disorder (SUD) are higher among younger populations, the percentage of older adults with SUD had the highest increase between 2020 and 2021 of any age demographic. Disparities experienced by racial minorities contribute to treatment gaps and lack of access to SUD resources. This study explores the perspectives of low-income, urban-dwelling, primarily racial minority older adults on SUD treatment and recovery.</p><p><strong>Research design and methods: </strong>Adults aged 50 years and older residing in urban low-income apartment buildings in Richmond, VA who self-identified as having a history of substance use were recruited to participate in semistructured interviews about their beliefs on substance use and aging, perceptions of treatment options and barriers to SUD-related recovery supports, and views around peer support. Interviews were recorded and transcribed. Inductive qualitative thematic analysis of the interviews was conducted using the framework method of analysis.</p><p><strong>Results: </strong>Interviews were conducted with 16 individuals. The mean age was 65.6 years, 56% identified as male, 25% did not complete high school, 50% reported an annual income under $10,000, and 81.3% were Black. Nine themes were identified from the qualitative analysis: Causes of SUD, stigma and misconceptions about SUD, SUD treatments, SUD self-help, SUD and aging, barriers to treatment, defining recovery, lack of knowledge of current terminology, and the role of technology. They perceive that the reasons underlying SUD differ with age, with younger people more influenced by social pressure/environment and older people by social isolation or loneliness.</p><p><strong>Discussion and implications: </strong>This study highlights the perspectives of low-income, racial minority older adults providing insights into barriers to SUD treatment and recovery, opportunities for community education, and adaptation of current treatment strategies to meet the needs of this population.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 6","pages":"igaf030"},"PeriodicalIF":4.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496109","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":"Family Ties and Opioid Lies: Pathways to Elder Abuse in Rural Appalachia.","authors":"Karen A Roberto, Jyoti Savla, Pamela B Teaster, Brandy Renee McCann","doi":"10.1093/geroni/igaf029","DOIUrl":"10.1093/geroni/igaf029","url":null,"abstract":"<p><strong>Background and objectives: </strong>The opioid crisis has run rampant throughout America, with communities in rural Appalachia especially hard hit. While the direct effects of opioid use disorder on individuals, families, and communities are well documented, an unforeseen consequence of this crisis is the abuse of older adults by family members or paid caregivers with opioid addiction. The purpose of this study was to characterize cases of opioid-involved elder abuse compared to cases where opioids were not involved.</p><p><strong>Research design and methods: </strong>Guided by lifecourse and ecological perspectives, we analyzed quantitative case data and narrative notes for 220 substantiated incidences of abuse of persons aged 60+ that occurred between 2015 and 2017 in eastern Kentucky. Multinomial logistic regression analysis with robust standard errors was used to compare cases on key variables including the older adults' age, gender, income, activities of daily livings/instrumental activities of daily livings, and cognitive capacity. Composite narratives developed from thematic analysis of the case notes were used to contextualize opioid-involved elder abuse cases.</p><p><strong>Results: </strong>We found 25 opioid-involved cases of elder abuse and 15 cases in which the perpetrator used alcohol/other drugs. Compared to cases not involving substance abuse, women were more frequently victims of perpetrators who use opioids and alcohol/other drugs. Victims of opioid-involved abuse were more likely to experience material exploitation (stealing medication) than when perpetrators misused alcohol/other drugs or used no substances. A primary pathway to elder abuse was older adults taking in a family member due to various life circumstances. A second pathway to opioid-involved abuse was when older adults relied on the perpetrator for support and assistance.</p><p><strong>Discussion and implications: </strong>Opioid misuse by perpetrators heightened susceptibility to elder abuse. Older adults are often protective of their struggling families and may not recognize their own vulnerabilities. Interventions sensitive to cultural norms and close family relationships are needed to combat opioid-involved elder abuse.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 6","pages":"igaf029"},"PeriodicalIF":4.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496110","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}