Gerontologist最新文献

{"title":"Diversity and 'successful ageing': exploring intersectional and existential dimensions to ageing well.","authors":"Susan Pickard, Victoria Cluley, Surinder Sharma, Upanish Oli, Gifty Thomas-Ekweh, Jay Banerjee, Chris Williams, Simon Conroy, Bram Vanhoutte, Alex Labeit","doi":"10.1093/geront/gnaf008","DOIUrl":"https://doi.org/10.1093/geront/gnaf008","url":null,"abstract":"<p><strong>Background and objectives: </strong>This paper aims to add to the literature on successful ageing in minoritized ethnic groups. Concurring with the critiques of 'successful ageing' for focusing on values and abilities more attainable by white middle-class older people, it explores alternative discourses according to which older people from minoritized groups consider themselves to be 'ageing well'.</p><p><strong>Research design and methods: </strong>The paper draws on original empirical material derived from a longitudinal research project focused on five minority ethnic groups living in a city (and surrounding areas) of the UK known for its diverse population. It draws on photovoice methods conducted with the participants and analyses the material through (i) a focus on intersectionality as a framing device that is dynamic over time and (ii) phenomenological approaches to old age as a distinct life stage existentially.</p><p><strong>Results: </strong>Although intersectionality is framed in the literature almost exclusively in terms of disadvantage, older participants made use of assets as well as deficits (which they often turned into assets) to construct a sense of meaning and purpose that enabled them to age well and flourish in often challenging circumstances.</p><p><strong>Discussion and implications: </strong>The images and narratives presented here challenge the normative depictions of a good or successful old age constructed from the perspective of white and middle-class older adults. They add a diverse range of alternative depictions of ageing well which will be of help for clinicians and others in supporting diverse older people to flourish in conditions of health as well as frailty.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of birthplace and age at migration on cognitive aging among Hispanic/Latino populations in the U.S.: Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA).","authors":"Mao-Mei Liu, Ariana M Stickel, Wassim Tarraf, Lehan Li, Krista M Perreira, Fernando Riosmena, Melissa Lamar, Fernando D Testai, Linda C Gallo, Tanya P Garcia, Jorge J Llibre-Guerra, Carmen R Isasi, Richard B Lipton, Martha Daviglus, William H Dow, Hector M González","doi":"10.1093/geront/gnaf009","DOIUrl":"https://doi.org/10.1093/geront/gnaf009","url":null,"abstract":"<p><strong>Background and objectives: </strong>While Hispanic/Latino populations in the U.S. are remarkably diverse in terms of birthplace and age at migration, we poorly understand how these factors are associated with cognitive aging. Our research seeks to operationalize a life course perspective of migration and health and contribute new understanding of Alzheimer's disease / Alzheimer's disease related dementias among U.S.-based Hispanic/Latino older adults.</p><p><strong>Research design and methods: </strong>Harnessing the Hispanic Community Health Study/Study of Latinos (n=16,415) and the Study of Latinos-Investigation of Neurocognitive Aging (n=6,377) data, we compare baseline cognition and 7-year cognitive change among U.S./mainland-born Hispanic/Latino adults relative to foreign/island-born immigrants by age of migration (four groups: born in mainland U.S., immigrated <16 years, 16-34 years, >34 years). Global cognition was calculated as a composite measure, and domain specific measures were considered in secondary analyses. We employed linear regressions, ANOVA contrasts and Blinder-Oaxaca decomposition techniques.</p><p><strong>Results: </strong>All Hispanic/Latino immigrant adults, regardless of age at migration, have a cognitive health disadvantage (at each visit and over time) relative to U.S./mainland-born Hispanic/Latino individuals. Differences did not endure the inclusion of covariates and were explained predominantly by first socio-economic and then acculturative factors, and far less by health and health behaviors. Acculturative factors are particularly important for individuals who migrated after childhood.</p><p><strong>Discussion and implications: </strong>Socio-economic and acculturation factors have outsized roles in explaining gaps in cognitive aging among U.S.-born and migrant Hispanic/Latino adults. It is then vital to examine whether disrupting socio-economic and acculturation inequalities closes such gaps in cognitive aging.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intergenerational Relationships and Family Support: Implications for Health and Wellbeing.","authors":"Merril Silverstein, Karen L Fingerman, J Jill Suitor","doi":"10.1093/geront/gnaf003","DOIUrl":"https://doi.org/10.1093/geront/gnaf003","url":null,"abstract":"<p><p>This review summarizes research projects supported by the National Institute on Aging (NIA) that have contributed scholarship on intergenerational relationships and support provided to older adults that frequently precedes, and is often complementary to, intensive caregiving. We review NIA-supported projects that have almost exclusively focused on intergenerational relationships and involved primary data collections, and others making use of omnibus aging and family studies that have allowed a variety of investigations on this topic. Where the former set of studies has generated deeply phenotypic analyses-comprehensive fine-grained analyses of relational data in specialized samples-the latter set has focused on analyses of secondary data, often from national samples which include information on intergenerational relationships. Early research funded by NIA addressed the factors underlying cohesion across generations, including the Longitudinal Study of Generations. Subsequent studies shed light on the dynamics of ties between siblings or across multiple generations in navigating support and affection. Studies have revealed important information about transfers of tangible and non-tangible resources, loss of parent or child, and diversity by race, ethnicity, and gender. NIA funding has made important inroads in understanding a relationship that is of primary importance in individuals' lives for their health and well-being.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and healthcare utilization among aging veterans in supported housing: A comparison with independently housed age-matched veterans.","authors":"Hind A Beydoun, Dorota Szymkowiak, Rebecca Kinney, Audrey L Jones, Jack Tsai","doi":"10.1093/geront/gnaf001","DOIUrl":"https://doi.org/10.1093/geront/gnaf001","url":null,"abstract":"<p><strong>Background and objectives: </strong>There is a large and growing population of older, formerly homeless adults living in permanent supportive housing, and there are concerns about how to address their healthcare needs. This study compared veterans aged 55 years and older residing in the Department of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program to an age-matched group of independently housed veterans receiving care through the U.S. Department of Veterans Affairs (VA) healthcare system on health and healthcare service use characteristics.</p><p><strong>Research design and methods: </strong>Cross-sectional analyses were performed on 1,436,537 (66,072 HUD-VASH vs. 1,370,465 housed) eligible veterans with index encounter dates between October 1, 2021, and July 31, 2022, using linked data from the VA's Homeless Operations Management and Evaluation System and the Corporate Data Warehouse. Propensity-score adjusted logistic regression models were constructed to compare aging HUD-VASH vs. housed veterans on outpatient and inpatient healthcare utilization.</p><p><strong>Results: </strong>HUD-VASH veterans were more likely to have physical and mental health morbidities, including substance use disorder than their independently housed counterparts. HUD-VASH veterans were less likely to utilize outpatient medical services, and more likely to use emergency and inpatient care services than independently housed veterans.</p><p><strong>Discussion and implications: </strong>Older veterans in the HUD-VASH program have greater healthcare needs and different patterns of healthcare utilization than their independently housed counterparts. Targeted interventions that better engage and reduce barriers to care among aging populations in supported housing are needed.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communications needs of family caregivers of geriatric unit residents at end-of-life.","authors":"Rinat Cohen, Gal Maydan, Shai Brill, Jiska Cohen-Mansfield","doi":"10.1093/geront/gnae174","DOIUrl":"https://doi.org/10.1093/geront/gnae174","url":null,"abstract":"<p><strong>Background and objective: </strong>There is a dearth of literature regarding the communication needs of family caregivers of institutionalized older adults and the degree to which these needs are fulfilled. This study aimed to clarify those needs regarding communication with staff in geriatric facilities during older non-communicative residents' end-of-life.</p><p><strong>Research design and methods: </strong>Personal interviews were conducted with 135 family caregivers from two geriatric medical centers and two nursing homes in Israel. Questions referred to quality of available communication and family caregivers' communication needs. We utilized inductive content analysis to identify these needs.</p><p><strong>Results: </strong>The first and last authors independently examined all the qualitative data regarding family caregivers' needs, and identified themes and categories based on similarities. These were further discussed and modified until agreement was reached. Family caregivers wished to have an available staff member to approach when needed, to be kept current on their older relatives' condition, to feel supported during a difficult time in their lives, and to overcome language and cultural barriers.</p><p><strong>Discussion and implications: </strong>This is the first study to examined family caregivers' communication needs using a broad perspective that relates to overall needs rather than specific ones, thus yielding a fuller understanding of family caregivers' emotional and practical needs, as well as language and cultural barriers. Translating these needs into practice by offering guidelines on how to fulfill them and developing tailored interventions and tools to assess them may improve not only communication, but also end-of-life care for residents of geriatric facilities.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking Action to Support Nursing Home Resident Wellbeing: Perspectives of U.S. Nursing Home Staff During COVID-19.","authors":"Denise D Quigley, Ashley M Chastain, Hsin S Ma, Monika Pogorzelska-Maziarz, Patricia W Stone","doi":"10.1093/geront/gnae184","DOIUrl":"https://doi.org/10.1093/geront/gnae184","url":null,"abstract":"<p><strong>Background and objectives: </strong>COVID-19 negatively influenced resident wellbeing in nursing homes (NHs). We examine perceptions and experiences of U.S. NH staff during the COVID-19 pandemic regarding resident wellbeing.</p><p><strong>Research design and methods: </strong>We sampled 68 NHs (out of 13,423) in strata defined by quality ratings, urban/rural location, and whether they served a resident population of <70% White. We enrolled 10 NHs and interviewed 11 nursing staff (8 certified nursing assistants/aides, 3 registered or licensed practical/vocational nurses), 12 managerial staff (4 administrators, 8 Directors of Nursing), and 5 infection preventionists. Thematic analysis identified themes related to challenges of quarantine/isolation, attempted solutions, and lessons learned concerning resident wellbeing.</p><p><strong>Results: </strong>NH managerial, infection prevention and nursing staff described how COVID-19 policies contributed to increased resident loneliness and declines in physical and cognitive wellbeing. Solutions/strategies employed across the U.S. and in low-and high-quality NHs included proactive mental health support, resident-centered family visitation, increased communication and care planning with families and efforts to maintain resident normalcy.</p><p><strong>Discussion and implications: </strong>Strategies to mitigate and alleviate concerns with resident wellbeing were both structural and made via staff choices. NH leadership needs to proactively plan how to adapt processes and structures that prioritize resident wellbeing along with resident care in times of crisis. Research is needed to outline the planning, implementation, and recommendations required to operationalize these strategies into practice. Determining the most effective ways to implement these structural changes within NH practices and workflows is critical to ensure that staff have sufficient time to spend with residents.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to improve research participation by older people with cognitive impairment: a systematic review.","authors":"Lucinda Swan, Slavica Kochovska, Nola Ries, Imelda Gilmore, Deborah Parker, Craig Sinclair, Caitlin Sheehan, Aileen Collier, Elizabeth Lobb, Linda Sheahan, Linda Brown, Michael Chapman, Wei Lee, Ingrid Amgarth-Duff, Timothy To, Meera R Agar, Annmarie Hosie","doi":"10.1093/geront/gnae188","DOIUrl":"https://doi.org/10.1093/geront/gnae188","url":null,"abstract":"<p><strong>Background and objectives: </strong>Older people with cognitive impairment are unrepresented in clinical research. Our objective was to review evidence for strategies to support their research inclusion and participation.</p><p><strong>Research design and methods: </strong>Systematic review of published reports of inclusion and participation strategies for older people with cognitive impairment in clinical research (PROSPERO CRD42020212092). Five databases were searched September 2020, March 2023 and April 2024. Screening, full text review and data extraction were independently performed. Risk of bias was assessed using Scottish Intercollegiate Guidelines Network Methodology Checklists. Outcomes were participant characteristics, recruitment and consent processes, retention, experience, involvement of others, adverse events, and other reported outcomes.</p><p><strong>Results: </strong>Of 4564 identified sources, 12 studies were included. Nine compared recruitment strategies; three examined consent processes. Of 4,208 participants (mean age 78.3 years), 61% were female. Median (interquartile range) monthly recruitment rate was 10.3 (5.6-14.8). Participants had mild cognitive impairment, dementia and/or delirium and two-thirds of studies involved proxies or study partners. Community outreach or population screening had higher recruitment compared to primary care referral and/or screening. Formal capacity and consent methods achieved lower rates of consent compared to informal. A memory and organisational aid increased participants' ability to provide informed consent compared to standard assessment. Few studies reported participants' or recruiters' subjective experience, and no studies reported participant retention or adverse events.</p><p><strong>Discussion and implications: </strong>Targeted, tailored and multi-pronged recruitment and consent strategies to support inclusion of older people with cognitive impairment appear promising. Higher quality studies are needed to confirm this finding.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"People with dementia disclosing their diagnosis to social networks: A systematic review and meta-synthesis.","authors":"Gianna Kohl, Mauricio Molinari Ulate, Jem Bhatt, Jennifer Lynch, Katrina Scior, Georgina Charlesworth","doi":"10.1093/geront/gnae186","DOIUrl":"https://doi.org/10.1093/geront/gnae186","url":null,"abstract":"<p><strong>Background and objectives: </strong>Given the stigma of dementia, individuals with the condition may be wary to disclose their diagnosis to other people, both in face-to-face and digital settings. While sharing one's dementia diagnosis with others is essential for accessing valuable support for social, cognitive, and physical well-being, this area of research has largely been neglected. In this meta-synthesis, we aimed to systematically review qualitative research on the factors associated with online and offline self-disclosure in people with dementia.</p><p><strong>Research design and methods: </strong>We conducted a systematic search in six electronic databases. Inclusion criteria comprised qualitative and mixed-methods studies describing experiences with self-disclosure in people with any type of dementia. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool. The meta-synthesis was conducted in NVivo using a thematic synthesis approach.</p><p><strong>Results: </strong>Twenty-eight studies were included. Three analytical themes were generated: 'Concealment', 'Stigma and fear', and 'Taking control', the latter two with subthemes. Findings from this review were corroborated with people with dementia and family carers as part of Patient and Public Involvement meetings. Our findings reveal that while stigma plays a pivotal role, people with dementia can take control of the meaning of their diagnosis through self-disclosure.</p><p><strong>Discussion and implications: </strong>Self-disclosure is complex and multifaceted. People with dementia, particularly those experiencing stigma, can benefit from post-diagnostic support that encompasses resources and interventions for self-disclosure. Further research is required to investigate people with dementia's disclosure decision-making process.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focusing on Caregiver Neglect: A Novel Strategy for Mistreatment of Older Adults Screening and Intervention.","authors":"Tony Rosen, Amy Shaw, Alyssa Elman, Daniel Baek, Elaine Gottesman, Sophie Park, Helena Costantini, Mariana Cury Hincapie, E-Shien Chang, David Hancock, Adrienne D Jaret, Kristin Lees Haggerty, David Burnes, Mark S Lachs, Karl Pillemer, Sara J Czaja","doi":"10.1093/geront/gnae185","DOIUrl":"https://doi.org/10.1093/geront/gnae185","url":null,"abstract":"<p><p>Mistreatment of older adults is common and has serious health consequences but is under-recognized and under-reported. Screening for mistreatment of older adults and initiation of intervention in primary care clinics may be helpful, but the value of existing tools is not supported by evidence. We argue that shifting the focus to individual sub-types of mistreatment of older adults can provide improved approaches to screening and ultimately to intervention. We focus on the example of caregiver neglect, the subtype associated with highest mortality. To develop caregiver neglect screening and intervention programs and to measure their effectiveness and impact, we assert that it is critical to: (1) define the phenomenon, (2) develop a conceptual model to explain why it occurs, (3) develop measurement strategies, and (4) systematically examine existing literature. We describe here the initial components of this development process.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting older people experiencing homelessness and memory problems in hostels: Learning from an ethnographic study.","authors":"Penny Rapaport, Gill Livingston, Jill Manthorpe, Caroline Shulman, Garrett Kidd, Ava Mason, Martin Knapp, Sophie Nadia Gaber","doi":"10.1093/geront/gnae187","DOIUrl":"https://doi.org/10.1093/geront/gnae187","url":null,"abstract":"<p><strong>Background and objectives: </strong>Older people with memory problems living in temporary hostel accommodation have longer stays and higher care needs than those without memory problems. In this ethnographic study, we aimed to elucidate how staff currently support older hostel residents with memory problems, what contextual factors determine support given and, what facilitates positive and meaningful outcomes for staff and residents.</p><p><strong>Research design and methods: </strong>We conducted interviews and participant observations with older people (≥50 years) experiencing memory problems and homelessness (interviews n=17, observations n=13), hostel staff and managers (interviews n=15, observations n=20) from seven residential facilities (six hostels and one care home), and health and social care practitioners (interviews n=17, observations n=7), from September 2021-December 2022 in London, England. We analyzed thematically from a critical realist position.</p><p><strong>Results: </strong>We identified four overarching themes: (1) Compensatory strategies and routines, (2) hostels are not homes, (3) meeting challenging interactions with compassion, and (4) facilitating opportunities for meaningful interactions. Social interactions for people with memory problems were restricted and, although sheltered by living in hostels, this did not equate to safety or provide opportunities for positive interactions.</p><p><strong>Discussion and implications: </strong>Staff worked hard to connect with older residents with memory problems, in resource and time-poor contexts, often left to provide care beyond their roles in contexts of unmet need. Our ethnographic account has informed co-design of a support intervention for hostel staff working with older people with memory problems, alongside recommendations for policy and practice.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}