Gerontologist最新文献

{"title":"Caregiving Challenges from Persistent Pain Among Family Caregivers to People with Dementia.","authors":"Shelbie G Turner, Irina Mindlis, M Carrington Reid, Karl A Pillemer","doi":"10.1093/geront/gnae164","DOIUrl":"https://doi.org/10.1093/geront/gnae164","url":null,"abstract":"<p><strong>Background and objectives: </strong>Many family caregivers to people with dementia experience persistent physical pain. Though caregivers' pain is associated with poor caregiving outcomes, there is little research on how pain challenges caregiving to yield poor outcomes. This study developed a typology of caregiving challenges from pain among family caregivers to people with dementia.</p><p><strong>Research design and methods: </strong>We conducted semi-structured, in-depth interviews with 25 family caregivers living with persistent pain and caring for people with dementia. We inductively analyzed data via a thematic analysis approach, wherein we identified and categorized caregiving challenges stemming from caregivers' pain. We then analyzed how challenges were related to one another and their consequences for caregiving outcomes.</p><p><strong>Results: </strong>Analysis revealed three interrelated categories of caregiving challenges from living with pain: 1) physical (e.g., difficulty lifting care recipient), 2) psychological/emotional (e.g., worry about future care if their pain condition worsens), and 3) familial/relational (e.g., resentment towards family without pain for not helping with care). Caregivers reported that these challenges compounded one another in ways that made both caregiving and pain management more difficult. Moreover, challenges led to caregivers delaying or skipping care tasks. The nature of challenges and their connection to caregiving outcomes were dependent on various supporting factors, such as whether caregivers reported benefits from their own pain (e.g., greater empathy).</p><p><strong>Discussion and implications: </strong>The resulting typology informs a conceptual model to guide future translational research on caregivers' pain, including illuminating promising intervention targets of pain self-management programs for family caregivers to people with dementia.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584829","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":"Usability Testing of the PACE-App to Support Family Caregivers in Managing Pain for People with Dementia.","authors":"Nai-Ching Chi, Kristy Nguyen, Angela Shanahan, Ibrahim Demir, Ying-Kai Fu, Chih-Lin Chi, Yelena Perkhounkova, Maria Hein, Kathleen Buckwalter, Michael Wolf, Kristine Williams, Keela Herr","doi":"10.1093/geront/gnae163","DOIUrl":"https://doi.org/10.1093/geront/gnae163","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pain management is often suboptimal in individuals with dementia, and their family caregivers are tasked with supporting pain management despite limited preparation. The web-based PACE-app (PAin Control Enhancement) was designed to assist caregivers in managing pain for individuals with dementia. This study aimed to evaluate the usability of the PACE-app.</p><p><strong>Research design and methods: </strong>A convergent parallel mixed-methods design was used to evaluate the PACE-app's usability with 16 family caregivers and 6 healthcare professionals. Quantitative data were collected using the Post-Study System Usability Questionnaire (PSSUQ), while qualitative data were gathered through guided app reviews and semi-structured interviews. Quantitative data were analyzed descriptively, and qualitative data were thematically coded.</p><p><strong>Results: </strong>The PSSUQ results indicated that both family caregivers and healthcare professionals had a highly positive experience with the PACE-app: overall scores (2.01 vs. 1.68), system usefulness (1.76 vs. 1.68), information quality (1.98 vs. 1.80), interface quality (2.30 vs. 1.60), and satisfaction (2.00 vs. 1.60) were rated on a 1-7 scale (with lower scores indicating better usability). Qualitative findings supported these results, with participants endorsing the PACE-app's usefulness, ease of use, learnability, effective information presentation, aesthetics, clear layout, and overall satisfaction. Participants also provided valuable feedback for improving information quality (enhancing clarity) and interface quality (real-time coaching on pain management).</p><p><strong>Discussion and implications: </strong>The study demonstrated favorable usability and strong satisfaction among family caregivers and healthcare professionals using the PACE-app. Incorporating participants' suggestions will guide enhancements to the app's information and interface, ensuring it better meets users' needs.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584843","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":"The Evolution in Dementia Caregiving Research: NIA's Catalyst Role.","authors":"Marcia G Ory, Alan B Stevens","doi":"10.1093/geront/gnae161","DOIUrl":"https://doi.org/10.1093/geront/gnae161","url":null,"abstract":"<p><p>This article celebrates the National Institute of Aging (NIA)'s successes over the past fifty years in advancing the science base informing the need for and response to dementia caregiving. In parallel with other public and private efforts, insightful NIA leadership supported by funding initiatives established the field of dementia caregiving research. In support of the health and well-being of family caregivers, NIA was a catalyst of innovation that led to numerous evidence-based caregiving interventions informed by basic research on care tasks and consequences. As evidence of the impending burden of dementia care on US families mounted, NIA-funded multidisciplinary collaboratives of researchers generated comprehensive models of family caregiving across diverse populations. Today, the dementia caregiving evidence base is shaping public policy and making possible dementia caregiving support services in health systems and community-based organizations. NIA continues to support the scientific study of dementia caregiving with a collaboratory of leading scientists and by making available state-of-the-art datasets and encouraging standardized research methodologies. NIA's leadership in the field of dementia caregiving research has never been more significant as the number of persons living with dementia in the US approaches 7 million, and the value of family caregiving is estimated to be $350 billion.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569213","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":"Digital Contact as Strain or Support: How Does Type of Contact Shape the Association between Mother-child Interactions and Adult Children's Depressive Symptoms in Later-life Families?","authors":"Ranran He, J Jill Suitor, Megan Gilligan","doi":"10.1093/geront/gnae158","DOIUrl":"https://doi.org/10.1093/geront/gnae158","url":null,"abstract":"<p><strong>Background and objectives: </strong>This paper aims to extend research on the association between mother-child contact and adult children's psychological well-being in later-life families by differentiating between in-person, virtual, and written digital contact, examining the moderating role of children's gender, and exploring the processes that underlie these associations.</p><p><strong>Research design and methods: </strong>Mixed-methods data were collected from 250 adult children nested within 131 families as part of the third wave of the Within-Family Differences Study. On average, adult children were 59 and mothers were 88 years of age.</p><p><strong>Results: </strong>Multilevel analyses revealed that interacting with mothers through written digital media was associated with higher depressive symptoms among adult children, whereas mother-child in-person and virtual digital contact was not associated with children's depressive symptoms. When stratifying the sample by children's gender, we found that mother-child written digital contact was associated with higher depressive symptoms among daughters, but not sons. Qualitative analyses suggested that adult daughters' psychological well-being was negatively associated with written digital contact with their mothers because this medium of interaction typically fell short of daughters' expectations for emotionally enriching exchanges.</p><p><strong>Discussion: </strong>This study revealed differences in how virtual and written digital contact are associated with psychological well-being among adult daughters, but not sons, suggesting that it is important to consider type of contact, gender of interactants, and content of exchanges when studying the associations between digital communication and relational and psychological well-being and designing intervention programs and digital communication technologies.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565170","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":"Celebrating the National Institute on Aging's 50th Anniversary: The Gerontologist Special Collection.","authors":"Joseph E Gaugler","doi":"10.1093/geront/gnae159","DOIUrl":"https://doi.org/10.1093/geront/gnae159","url":null,"abstract":"","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565166","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":"Late-Life Homelessness: A Definition to Spark Action and Change.","authors":"Amanda Grenier, Tamara Sussman","doi":"10.1093/geront/gnae123","DOIUrl":"10.1093/geront/gnae123","url":null,"abstract":"<p><strong>Background and objectives: </strong>Comprehensive definitions of social issues and populations can set the stage for the development of responsive policies and practices. Yet despite the rise of late-life homelessness, the phenomenon remains narrowly understood and ill-defined.</p><p><strong>Research design and methods: </strong>This article and the definition that ensued are based on the reconceptualization of interview data derived from a critical ethnography conducted in Montreal, Canada, with older homeless persons (N = 40) and service providers (N = 20).</p><p><strong>Results: </strong>Our analysis suggests that definitions of late-life homelessness must include 4 intersecting components: (1) age, eligibility, and access to services; (2) disadvantage over the life course and across time; (3) social and spatial processes of exclusion that necessitate aging in \"undesirable\" places; and (4) unmet needs that result from policy inaction and nonresponse.</p><p><strong>Discussion and implications: </strong>The new definition derived from these structural and relational components captures how the service gaps and complex needs identified in earlier works are shaped by delivery systems and practices whose effect is compounded over time. It provides an empirically grounded and conceptually solid foundation for the development of better responses to address homelessness in late life.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of Acculturation on Depressive Symptoms and Activities of Daily Living of U.S. Older Chinese Immigrants.","authors":"Yanping Jiang, Mengting Li, Soonhyung Kwon, Yuyang Zhu, Bei Wu, Fengyan Tang","doi":"10.1093/geront/gnae124","DOIUrl":"10.1093/geront/gnae124","url":null,"abstract":"<p><strong>Background and objectives: </strong>Acculturation is a critical aspect of social experience for immigrants, including Asian immigrants. Existing literature has shown mixed findings on the health impacts of acculturation and largely relied on cross-sectional studies, preventing drawing definitive conclusions. This study aimed to examine the long-term effects of acculturation on depressive symptoms and activities of daily living (ADL) limitations in a large sample of older Chinese immigrants in the United States.</p><p><strong>Research design and methods: </strong>Data were drawn from 2,811 older Chinese immigrants from the Population Study of Chinese Elderly in Chicago. Acculturation was assessed at baseline, and questionnaires on depressive symptoms and ADL limitations were completed at 4 assessments.</p><p><strong>Results: </strong>Overall, results showed that acculturation was not associated with depressive symptoms at baseline but was associated with a faster decline in depressive symptoms over time. No associations were found between acculturation and ADL limitations. Stratified analyses showed that the significant relationship between acculturation and a faster decline in depressive symptoms was only evident among female participants. Also, acculturation was associated with a lower risk of reporting ADL limitations at baseline in female participants but a higher risk of reporting ADL limitations in male participants.</p><p><strong>Discussion and implications: </strong>This study indicates the long-term benefits of acculturation on mental health among older Chinese immigrants in the United States, particularly among females. Initiatives supporting the acculturation process need to consider sex disparities and individual preferences, aiming to foster sustained benefits for healthy aging in this population.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The National Institute on Aging's Resource Centers for Minority Aging Research: Development, Evolution, and Impact.","authors":"Sidney M Stahl, Peter A Lichtenberg, Lisa L Barnes, Naoko Muramatsu, Spero M Manson","doi":"10.1093/geront/gnae160","DOIUrl":"https://doi.org/10.1093/geront/gnae160","url":null,"abstract":"<p><p>Spanning nearly 30 of the 50 years in which the National Institute on Aging (NIA) has existed, the Resource Centers for Minority Aging Research (RCMAR) program represents one of the most successful initiatives for advancing minority aging research and diversifying the scientific workforce within the Institute and across the National Institutes of Health. This article celebrates the genesis of the RCMAR program, beginning with the need to enhance this work, ranging from theories underlying the then-nascent field of health disparities research to study design, measurement, and analytic procedures. It describes the companion focus on preparing, expanding, and diversifying generations of future scholars/scientists to carry forward these advances. RCMAR's emphasis on promoting a comprehensive approach to research career development and building supportive learning communities heralded a more holistic approach to training than was previously the case. The discussion describes the evolution of the structure and emphases of the RCMAR program as it has responded to the frequently changing political, funding, and research environments. The article concludes by highlighting the major successes of this initiative, the challenges it faces, and opportunities afforded future growth as individual centers, the program at large, and NIA as a whole continue to innovate as they collectively address the original goals which remain relevant today and in the near future.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562501","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":"Older Adults in Administrative Quagmire: A Scoping Review of Policy and Program Coordination Across Six Marginalized Older Adult Populations.","authors":"Patrik Marier, Meghan Joy, Sandra Smele, Rym Zakaria, Julie Beauchamp, Valérie Bourgeois-Guérin, Pierre-Luc Lupien, Tamara Sussman","doi":"10.1093/geront/gnae120","DOIUrl":"10.1093/geront/gnae120","url":null,"abstract":"<p><strong>Background and objectives: </strong>Coordination of governmental action is crowded with policies and programs that are highly interdependent, sometimes operating in silos if not contradicting each other. These dilemmas, or administrative quagmires, are heightened for older adults in general, but they are particularly problematic for marginalized older adults because these groups often require public assistance and support. This scoping review studies the coordination of governmental action on aging published in social science journals, focusing on 6 groups of marginalized older adults: those with histories of immigration, individuals with severe mental health problems, those who have had experiences of homelessness, formerly incarcerated individuals, members of the LGBT (lesbian, gay, bisexual, and transgender) community, and individuals living in a rural area.</p><p><strong>Research design and methods: </strong>A 5-stage scoping review methodology was followed, and 53 articles (published between 2000 and 2022) from 5 social science databases were analyzed.</p><p><strong>Results: </strong>The analysis revealed a limited number of contributions with coordination as a primary focus. Understandings of coordination varied but tended to examine structure, organization, and relationships between sectors. When coordination was the primary object of a study, it was often analyzed in 1 specific policy area or within a clinical setting along the lines of facilitating care coordination.</p><p><strong>Discussion and implications: </strong>This scoping review reveals a mutual neglect on the part of public administration and policy scholars toward marginalized older adults and a lack of public administration considerations on the part of scholars studying long-term care and social service programs for these marginalized older adults.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Dental Care Use Following Marital Status Change in the Health and Retirement Study.","authors":"Shaw Hubbard, Portia Y Cornell","doi":"10.1093/geront/gnae151","DOIUrl":"https://doi.org/10.1093/geront/gnae151","url":null,"abstract":"<p><strong>Background and objectives: </strong>Previous studies have indicated that married people are generally healthier than unmarried people, with lower mortality rates. Most work in this area has employed cross-sectional data, and few studies have examined change in marital status from married to unmarried as a potential social ecological determinant of dental health behavior. Here we used longitudinal data to examine change in dental behavior over time following marital status change, and to explore whether self-reported gender may play a modifying role in any behavioral change.</p><p><strong>Research design and methods: </strong>Employing panel data from the Healthy Retirement Study (1996-2018) to follow all individuals who entered the study in married/partnered status, and using both two-way fixed effects and group-time average difference-in-difference models, we analyzed the association between any change in marital status and dental care use, compared to individuals who remained married. All analyses were stratified by gender.</p><p><strong>Results: </strong>Both types of difference-in-difference analyses indicated that both widowhood and divorce were associated with a decrease in dental care use in both genders. Divorced men saw the greatest decrease in dental care use. We found gender had a moderating effect on strength of association in all analyses.</p><p><strong>Discussion and implications: </strong>This research suggests that any change in marital status from married to unmarried has a detrimental effect on dental health behavior for both genders. Future research might investigate other potential barriers to dental care access these populations might face, in order to develop effective interventions.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548793","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}