Journal of Applied Gerontology最新文献

{"title":"Factors Related to Social Disconnectedness Among Older Veterans: A Scoping Review.","authors":"Melissa R Cruz, Aanand D Naik, Jack Tsai, Vanessa Schick, Jason Burnett","doi":"10.1177/07334648261481220","DOIUrl":"https://doi.org/10.1177/07334648261481220","url":null,"abstract":"<p><p>BackgroundOlder U.S. veterans (≥65) experience disproportionately high rates of social isolation and loneliness, yet veteran-specific risk and protective factors remain underexamined.ObjectiveTo synthesize research on social isolation and loneliness among community-dwelling US veterans aged 65+, using the Social Connection Framework to identify structural, functional, and quality-based factors with implications for clinical practice and applied gerontology research.MethodsGuided by PRISMA-ScR, the review searched three databases (2004-2025), screened 6,835 articles, and peer-reviewed studies assessed social isolation or loneliness among veterans aged ≥65. Thirty-two studies met the inclusion criteria.ResultsMost studies examined a single domain: structural (38%), functional (34%), or quality (19%). Structural indicators reflected limited engagement and smaller networks. Functional factors emphasized perceived support and emotional trust. Quality factors aligned with wellbeing. Depression, anxiety, and PTSD were more common with low integration, whereas resilience aligned with emotional ties and perceived inclusion.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"7334648261481220"},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital-Use Discontinuation as a Follow-Up Marker of Cognitive and Depressive Vulnerability in Later Life: A Multicohort Longitudinal Study.","authors":"Yang Liu, Yi Wei, Shengde Wu","doi":"10.1177/07334648261486071","DOIUrl":"https://doi.org/10.1177/07334648261486071","url":null,"abstract":"<p><p>BackgroundDigital inclusion in later life is often measured as static user/non-user status, although older adults may enter, remain in, remain outside, or leave digital environments.ObjectiveTo examine whether digital-use transitions, particularly discontinuation, mark cognitive and depressive vulnerability.MethodsWe analyzed harmonized longitudinal data from CHARLS, ELSA, HRS, and SHARE. Adjacent-wave internet-use transitions were classified as persistent non-use, adoption, persistent use, or discontinuation. Cohort-specific forward, reverse, pre-transition, and marker analyses were pooled with random-effects methods where appropriate.ResultsAcross 250,379 transition intervals, discontinuation was preceded by lower cognition and more depressive symptoms, and was associated with lower subsequent cognition (β = -0.145) and higher depressive symptoms (β = 0.094) than sustained use. Adoption was associated with higher cognition and, on average, fewer depressive symptoms than persistent non-use. Baseline vulnerability predicted lower adoption and higher discontinuation. Adding discontinuation to baseline risk models produced only small gains in discrimination.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"7334648261486071"},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver Burden and Associated Factors Among Family Caregivers of People With Dementia in Rural and Remote Areas: A Systematic Review and Meta-Analysis.","authors":"Changxing Xie, Qihang Chang, Haoning Bu, Qiang Guo, Jiaxin Yu, Fei Jiang","doi":"10.1177/07334648261483301","DOIUrl":"https://doi.org/10.1177/07334648261483301","url":null,"abstract":"<p><p>BackgroundEvidence on family caregivers of people with dementia in rural and remote areas remains limited, and burden levels and associated factors lack systematic quantitative synthesis.ObjectiveTo synthesize burden and associated factors.MethodsNine databases were searched through November 2025 following PRISMA. Quality was appraised with the Joanna Briggs Institute checklist. Comparable data were meta-analyzed; others were narratively synthesized.ResultsTwelve studies involving 1,416 caregivers were included. Pooled mean scores were 45.19 for the 22-item Zarit Burden Interview (95% CI 29.49-60.89) and 19.90 for the 12-item version (95% CI 12.98-26.82). Burden was associated with behavioral and psychological symptoms of dementia (<i>r</i> = 0.44, 95% CI 0.16-0.65), poorer caregiver mental health (<i>r</i> = 0.48, 95% CI 0.38-0.56), and longer dementia or caregiving duration (<i>r</i> = 0.29, 95% CI 0.13-0.43). Narrative synthesis implicated functional impairment, greater caregiving demands, lower self-efficacy, and economic disadvantage. Despite low-to-very-low certainty, findings indicate substantial, multifactorial burden and prioritize caregiver support.PROSPEROCRD420261277658.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"7334648261483301"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Golden Age: A Cross-Lagged Study of Self-Leadership and Morale Among Older Adults.","authors":"Zhouyan Hu, Nur Hairani Abd Rahman, Kai Zhao, Nurul Liyana Mohd Kamil","doi":"10.1177/07334648251389737","DOIUrl":"10.1177/07334648251389737","url":null,"abstract":"<p><p>Exploring the mental health of older adults offers key insights for promoting active aging, and studies on psychological mechanisms inform effective interventions. However, the link between self-leadership and morale in older adults remains underexplored. Self-leadership is a positive psychological trait that is beneficial for improving mental health through internal strategies. This study investigates the relationship between self-leadership and morale, with a focus on the mediating role of resilience. Using a longitudinal design, data were collected via questionnaires from 330 older adults in urban Shanghai, and a latent variant-based cross-lagged panel model (CLPM) was applied. Results revealed that (1) resilience mediated the positive predictive effect of self-leadership on morale over time and (2) resilience and morale exhibited an inter-temporal interaction. This study concludes that self-leadership positively influences older adults' morale with resilience serving as a key internal mechanism, offering valuable guidance for home care aides and practitioners, and contributes new perspectives to aging policy development.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"1822-1832"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polypharmacy Thresholds that Best Predict Emergency Room Visits and Mortality in Older Adults: A Population-Based Study in Québec, Canada.","authors":"Alexandre Campeau Calfat, Justin P Turner, Marc Simard, Marjolaine Dubé, Caroline Sirois","doi":"10.1177/07334648251391524","DOIUrl":"10.1177/07334648251391524","url":null,"abstract":"<p><p>BackgroundPolypharmacy is prevalent among older adults. Identifying informative medication thresholds could enhance clinical decision-making and healthcare planning.ObjectivesTo measure the predictive capacity of medication count and polypharmacy thresholds on (1) frequent emergency visits and (2) mortality, in community-dwelling older adults in Quebec, Canada; To measure the predictive capacity of inappropriateness criteria (potentially inappropriate medications, anticholinergic burden level, and drug-drug interactions) on these same outcomes.MethodsWe conducted a population-based study using the Quebec Integrated Chronic Disease Surveillance System. Using multivariable logistic regression models, we assessed the predictive capacity [area under the curve (AUC)] of medication use (medication count, polypharmacy thresholds, number of inappropriateness criteria) on frequent emergency visits (≥3) and mortality from April 2, 2022, to March 31, 2023. Findings were interpreted from two perspectives: clinical (with models including individuals' clinical characteristics, such as chronic diseases) and public health (with models excluding clinical characteristics to mimic polypharmacy measures usually used in surveillance).ResultsMedication count remained the most informative predictor in the clinical perspective analyses, with AUC = 0.739 for frequent emergency visits and AUC = 0.804 for one-year mortality, while medication thresholds lacked discrimination. Public health perspective analyses resulted in a bell-shaped predictive pattern peaking at eight medications for both frequent emergency visits (AUC = 0.690) and one-year mortality (AUC = 0.764). Inappropriateness criteria did not outperform medication count or polypharmacy thresholds.ConclusionFrom a clinical perspective, medication count is more informative than polypharmacy thresholds. From a public health perspective, a threshold of eight medications may serve as a useful polypharmacy measure.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"1809-1821"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379378","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":"Mechanisms Linking the Number of Chronic Diseases to Health-Related Quality of Life in Older Adults: The Roles of Disability, Depressive Symptoms, and Social Support.","authors":"Chao-Nan Chen, Xiao-Yun Liang","doi":"10.1177/07334648251390014","DOIUrl":"10.1177/07334648251390014","url":null,"abstract":"<p><p>This study used longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS; <i>n</i> = 7,900, aged ≥60) to examine the mechanisms linking the number of chronic diseases with health-related quality of life (HRQoL) in older Chinese adults. Chronic diseases were significantly associated with reduced HRQoL (<i>β</i>_total = -0.01, 95% <i>CI</i>: -0.011, -0.009). Disability and depressive symptoms jointly mediated 69% of this effect through independent (<i>β</i>_disability = -0.0027, 95% <i>CI</i>: -0.0031, -0.0022; <i>β</i>_depressive = -0.0034, 95% <i>CI</i>: -0.0039, -0.003) and chain mediation (<i>β</i>_{disability-depressive} = -0.0008, 95% <i>CI</i>: -0.0009, -0.0006). Notably, informal social support moderated this negative relationship (<i>β</i> = 0.002, 95% <i>CI</i>: 0.001, 0.003), while formal social support had no significant impact (<i>β</i> = -0.0002, 95% <i>CI</i>: -0.001, 0.002). This study highlighted the need for interventions targeting management of disability and depressive symptoms, while leveraging informal care networks to mitigate HRQoL decline in the elderly.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"1788-1796"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Well-Being in Older Adults: A Machine Learning Analysis of 47 Potential Predictors.","authors":"Mohsen Joshanloo","doi":"10.1177/07334648251386155","DOIUrl":"10.1177/07334648251386155","url":null,"abstract":"<p><p>This study examined potential predictors of financial well-being in older adults. Data were drawn from the Health and Retirement Study, focusing on psychosocial, demographic, and lifestyle variables. Random Forest analysis was performed to assess the relative importance of 47 potential predictors, offering a data-driven evaluation of which factors are most strongly associated with subjective financial well-being. Results showed that psychological variables (particularly chronic stress, life satisfaction, perceived control, and optimism) were stronger predictors than demographic indicators. Among demographic variables, education was the most important. The results suggest that financial well-being reflects individuals' ability to maintain a sense of satisfaction, optimism, and agency in the face of life challenges, rather than being determined solely by economic or demographic conditions.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"1797-1808"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood Deprivation and Symptom Burden Among Older Adults After Hospitalization for COVID-19.","authors":"Jason R Falvey, Denise Acampora, Katy Araujo, Mary Geda, Thomas M Gill, Gail McAvay, Terrence E Murphy, Alexandra Hajduk, Andrew B Cohen, Lauren E Ferrante","doi":"10.1177/07334648251391521","DOIUrl":"10.1177/07334648251391521","url":null,"abstract":"<p><p>Persistent symptoms following COVID-19 disproportionately affect older adults and may be exacerbated by neighborhood socioeconomic deprivation. We evaluated the association between neighborhood deprivation and symptom burden after COVID-19 hospitalization among 298 older adults from five Connecticut hospitals (June 2020-June 2021). Symptom burden was measured using the Edmonton Symptom Assessment System at baseline and 1, 3, and 6 months post-discharge, while neighborhood deprivation was assessed with the Area Deprivation Index. Using Bayesian linear mixed models adjusted for demographic and clinical factors, we found that residing in high-deprivation neighborhoods (ADI > 9/10; <i>n</i> = 28) was associated with higher symptom burden over the 6-month follow-up period. Adjusted analyses estimated a 2.2-point greater mean symptom burden (95% CI: 0.1-4.2). These findings suggest that neighborhood socioeconomic factors may significantly contribute to the persistence of COVID-19 symptoms in older adults, underscoring the need for targeted post-discharge care strategies.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"1743-1748"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379307","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":"Changes in Social Network Size and Older Adults' Health During the COVID-19 Pandemic.","authors":"Molly Copeland, Gerald Nowak, Hui Liu","doi":"10.1177/07334648251389285","DOIUrl":"10.1177/07334648251389285","url":null,"abstract":"<p><p>Structural characteristics of older adults' social networks, including network size, affect mental and physical health, while health conditions can also spur changes in network size. Understanding these patterns is particularly important during a global pandemic that disrupted many older adults' social connections and health. Using nationally representative survey data from the National Health and Aging Trends Study (<i>n</i> = 2869), models examine (1) pre-pandemic depressive symptoms, chronic conditions, and self-rated health predicting personal network size stability, growth, and contraction over the early pandemic and (2) how changes in network size predict health. Results indicate that greater pre-pandemic chronic conditions and worse self-rated health predict network contraction during the pandemic, while greater pre-pandemic depressive symptoms predict network growth. Network contraction predicts higher depressive levels. Results speak to older adults' poor physical health increasing risks to social resources, while network contraction presents risks to mental health during a global health crisis.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"1732-1742"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Insights From Care Professionals on Non-dementia Mental Distress in Nursing Home Residents.","authors":"Jana Čížková, Iva Holmerová, Michaela Honelová","doi":"10.1177/07334648251387384","DOIUrl":"10.1177/07334648251387384","url":null,"abstract":"<p><p>ObjectivesIn Czechia and Slovakia, nursing homes provide care for older adults with reduced independence due to aging. While specialized facilities exist for individuals with Alzheimer's and dementia, those with other forms of mental distress lack adequate support. This study aims to explore the experiences of caregivers in nursing homes, focusing on their strategies for recognizing, managing, and addressing mental distress among older adults.DesignA qualitative design study, adhering to the COREQ checklist, was conducted. Semi-structured interviews were performed with professional caregivers from nursing homes in Czechia and Slovakia.Setting and ParticipantsThe study involved 11 professional caregivers working in nursing homes located in Czechia and Slovakia.MethodsThematic analysis was applied to data obtained through semi-structured interviews to identify key themes related to the research question: \"What is the experience of professionals in nursing homes when caring for older adults with mental distress other than dementia?\".ResultsThree main themes and nine sub-themes were identified. The first theme focused on how caregivers recognize mental distress, either through subjective assessments or information provided by other sources, such as relatives or medical records. The second theme addressed the challenges posed by behavioral symptoms, categorized into four sub-themes: never satisfied; greediness for contact; suspicion, accusation, and mistrust; and making conflicts. The third theme examined the strategies used by caregivers to manage these behaviors, including advocacy, empathetic listening, and seeking support from colleagues or mental health professionals.Conclusions and ImplicationsSystemic challenges, including under-diagnosis and stigmatization of mental health conditions, hinder the quality of care for clients with mental distress in nursing homes in Czechia and Slovakia. Recommendations include integrating psychologists into nursing homes, centralizing medical records, improving training programs, and using behavioral symptoms as diagnostic cues. Implementing these measures could enhance care quality and outcomes for both caregivers and clients.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"1780-1787"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423258","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}