Gerontologist最新文献

{"title":"Building a Public Health Infrastructure to Support Family Caregivers of People with Dementia.","authors":"Joseph E Gaugler, Elma Johnson, Gary Epstein-Lubow, Lauren Parker, Fayron Epps, Ashley Millenbah","doi":"10.1093/geront/gnaf223","DOIUrl":"https://doi.org/10.1093/geront/gnaf223","url":null,"abstract":"<p><p>The Centers for Disease Control and Prevention-funded Building Our Largest Dementia (BOLD) Infrastructure's Public Health Center of Excellence on Dementia Caregiving (PHCOE-DC) is one of three national centers designed to help public health departments strengthen and grow their Alzheimer's disease and related dementia initiatives. The PHCOE-DC specializes in disseminating tools and resources to help public health agencies develop programming and partnerships that support family caregivers of individuals with dementia. Through its reach and dissemination efforts, the PHCOE-DC has helped to elevate dementia caregiving as a priority for public health departments. Since 2020, the PHCOE-DC has increased visibility for the role of public health in strengthening the support infrastructure for family caregivers of individuals with dementia and has established a network of national leaders in dementia caregiving. This article summarizes PHCOE-DC's past work and potential future activities as the Center continues to elevate dementia caregiving as a priority for public health.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201922","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":"Advancing Inclusive Brain Health and Dementia Care for People with Intellectual and Developmental Disabilities: A Public Health Framework.","authors":"Beth Marks, Jasmina Sisirak, Matthew P Janicki, Kathryn P Service, Karen Watchman","doi":"10.1093/geront/gnaf222","DOIUrl":"https://doi.org/10.1093/geront/gnaf222","url":null,"abstract":"<p><p>Adults with intellectual and developmental disabilities (IDD) face disproportionately high rates of chronic conditions, including an elevated risk for dementia. Yet access to appropriate brain health promotion and dementia care remains limited due to stigma, underdiagnosis, misdiagnosis, and systemic barriers. This article presents the Healthy Brain Initiative for People with Intellectual and Developmental Disabilities (HBI-PwIDD), which aims to: 1) raise awareness of brain health and support health-promoting approaches for people with IDD experiencing Alzheimer's disease and related dementias; 2) build interprofessional partnerships to develop an inclusive, competent workforce; and, 3) strengthen engagement of people with IDD and their supporters in accessing quality healthcare and improving outcomes. Applying a disability intersectionality lens, we integrate brain health promotion with dementia-capable services, emphasizing the critical role of disability-inclusive public health planning. We highlight person-centered approaches grounded in legal and human rights principles that provide access to brain health care and community-based supports. Finally, we discuss how tailored public health messaging and evidence-based workforce strategies can advance national and state brain health and dementia plans and improve equity in care for individuals with IDD. This paper illustrates how integrating disability-inclusive practices within public health systems can promote inclusive aging, improve dementia-related outcomes, and guide gerontologists in building inclusive, life course-oriented models of care.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201632","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":"Promoting Risk Reduction: Increasing Public Health Capacity to Address Dementia.","authors":"Shelby Sutton Roberts, Mickal Lewis, Catherine Woodall Colcombe, Chelsea Kline, Jeanine Menczywor Donnelly, Benjamin Denno, Heather M Snyder, Matthew Baumgart","doi":"10.1093/geront/gnaf227","DOIUrl":"https://doi.org/10.1093/geront/gnaf227","url":null,"abstract":"<p><p>The Alzheimer's Association Building Our Largest Dementia (BOLD) Public Health Center of Excellence on Dementia Risk Reduction (Center), established in 2020, was created to assist public health agencies translate this science into action and build health department capacity to address dementia risk reduction. Through partnerships with the academic community and public health agencies, the Center provides tools, training, and data to support the integration of dementia risk reduction into existing chronic disease prevention and healthy aging efforts. This article outlines the Center's approach, highlights key initiatives and outcomes, and identifies opportunities for future research to strengthen public health infrastructure to reduce dementia risk across the lifespan. Despite the strong evidence, dementia risk reduction remains underutilized in public health practice. By equipping the workforce with accessible training and resources and fostering collaboration across sectors, the Center creates a bi-directional bridge between research, public health practice and implementation.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201905","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":"Advancing Early and Equitable Detection of Dementia: Key Learnings/Challenges, Recent Innovations, and Future Directions.","authors":"Joshua Chodosh, Soo Borson, Alexandra Nordyke, Simona C Kwon, Karyn Marsh, Alok Vedvyas, Matthew Lee","doi":"10.1093/geront/gnaf221","DOIUrl":"https://doi.org/10.1093/geront/gnaf221","url":null,"abstract":"<p><p>Worldwide, over half of all individuals with dementia are undiagnosed. In the United States, racial, ethnic, and economic inequities mirror global findings, with higher rates of missed and delayed diagnosis and poorer diagnostic quality among minoritized and disadvantaged groups. For example, delayed diagnosis is more prevalent among people identifying as non-Hispanic Black or Latino than non-Hispanic white. Systematic efforts to improve detection can increase diagnosis rates; there is broad consensus that earlier detection and initiation of focused care and support services benefit both affected individuals and their loved ones. Systemic under-detection and its contributions to persistent population-level suffering underscore the importance of early detection of dementia as a key public health issue. Improving early detection calls for comprehensive, coordinated responses from local, regional, and national public health systems in partnership with health care delivery systems and community-based organizations. The Public Health Center of Excellence on Early Detection of Dementia (PHCOE on EDD), funded by the Centers for Disease Control and Prevention (CDC), is a national resource to promote understanding and implementation of evidence-based and evidence-informed public health strategy for early detection of dementia. We, together with the PHCOEs on Dementia Risk Reduction and Dementia Caregiving, and nearly four dozen state and local initiatives, seek to operationalize the priorities of the Building Our Largest Dementia Infrastructure for Alzheimer's Act and National Healthy Brain Initiative, established by federal legislation in 2018 and 2024. Our efforts support the CDC's mandate to build a national public health infrastructure for brain health and dementia.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201612","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":"Building States' Capacity to Address Dementia.","authors":"John Shean, Kina White, Kristen Felten, Victoria O'Connor, Elma Johnson, Meghan Fadel","doi":"10.1093/geront/gnaf226","DOIUrl":"https://doi.org/10.1093/geront/gnaf226","url":null,"abstract":"<p><p>One of the principal objectives of the Building Our Largest Dementia Infrastructure (BOLD) program is to elevate dementia as a public health priority in state, local, territorial, and tribal health departments across the U.S. Since 2020, the BOLD program, through the stewardship of the Centers of Disease Control and Prevention, has supported 45 state and other health departments throughout the U.S. to refine and implement strategic public health action plans to address dementia that focus on risk reduction, early detection, and caregiving using the framework of the Healthy Brain Initiative Road Map Series. Following an overview and description of the extent of BOLD's reach, we will highlight several exemplars from individual states' work in advancing dementia as a public health priority, including efforts to engage local Geriatric Workforce Enhancement Programs to facilitate age-friendly local healthcare systems; working with diverse faith-based communities to disseminate risk reduction strategies; and supporting and training county staff to better meet the needs of dementia caregivers in their respective communities, among others. The resources, opportunities, and challenges to initiate key public health actions to address dementia vary widely across state, local, territorial, and tribal communities, and the current paper will demonstrate how CDC's BOLD Program has begun to address this rich diversity throughout the U.S.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201928","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":"Wired for Companionship: A Meta-Analysis on Social Robots Filling the Void of Loneliness in Later Life.","authors":"Fahimeh Mehrabi, Akram Ghezelbash","doi":"10.1093/geront/gnaf219","DOIUrl":"https://doi.org/10.1093/geront/gnaf219","url":null,"abstract":"<p><strong>Background and objectives: </strong>Loneliness is a significant public health concern affecting over a quarter of older adults worldwide. Emerging research suggests that artificial intelligence (AI)-enabled social robots may offer a viable alternative for providing a new form of social support and reducing loneliness. This meta-analysis evaluates the effectiveness of AI-enabled social robots in reducing loneliness among older adults and examines the conditions under which these interventions are most effective.</p><p><strong>Research design and methods: </strong>A systematic search was conducted through October 2024. Effect sizes from 19 studies (N = 1,083) were synthesized using robust variance estimation (RVE) in meta-regression. Moderation analyses examined how social robots' effectiveness differs by contextual factors such as participants' backgrounds and studies' characteristics.</p><p><strong>Results: </strong>Our findings indicated that social robots significantly reduced loneliness among older adults. However, studies with control groups indicate a higher effect size. Moreover, greater reductions in loneliness are observed among individuals in institutional settings compared to those living independently. In addition, stronger intervention effects reported in Japan and Turkey than in the United States. However, age, cognitive status, robot type, duration of intervention, and year of publication did not significantly influence intervention effectiveness.</p><p><strong>Discussion and implications: </strong>Findings underscore the potential of social robots as an effective and scalable approach for addressing loneliness among older adults, particularly within institutional care environments. Policymakers, gerontologists, and care providers should consider integrating AI-enabled social robots into existing care frameworks, emphasizing culturally sensitive and inclusive implementation strategies.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193802","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":"An Account of Personal Autonomy for People Living with Dementia.","authors":"Andrew Douglas Heslop Stumpf, Erin McKenzie, Avery Beavers","doi":"10.1093/geront/gnaf210","DOIUrl":"https://doi.org/10.1093/geront/gnaf210","url":null,"abstract":"<p><strong>Background and objectives: </strong>People living with dementia see autonomy as central to their well-being, and loss of autonomy is one of the things people diagnosed with dementia fear most. Effective support of autonomy requires us to understand carefully what autonomy is, and to structure care plans and health policy in accordance with that understanding. Many recent social scientific studies of autonomy in people with dementia do not carefully operationalize the term \"autonomy.\" This is problematic because autonomy is a highly ambiguous term that points to a complex reality. We distill from the relevant philosophical and empirical literatures a conceptually clear and empirically informed account that is relevant to the experience of people living with dementia.</p><p><strong>Research design and methods: </strong>We present a general account of the concept of personal autonomy, drawing on existing philosophical literature. We then test the relevance of this account via a scoping review of empirical research reporting on the experience of personal autonomy in persons living with dementia.</p><p><strong>Results: </strong>With the assumption that adequate relational supports are in place, all aspects of our philosophically informed account of personal autonomy (decisional autonomy, authenticity and executional autonomy) are compatible with the experience of persons living with dementia.</p><p><strong>Discussion and implications: </strong>With adequate relational support, personal autonomy remains an achievable goal even in contexts of moderate to severe dementia. A conception of personal autonomy that is both theoretically and empirically informed can help guide efforts to study and support personal autonomy in persons living with dementia.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193832","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":"Engaging in the Life-planning in Early Alzheimer's and other Dementias advance care planning intervention is associated with perceived advance care planning concordance and interpersonal connectedness.","authors":"Sara G Bybee, Jordana L Clayton, Nancy Aruscavage, Rebecca Utz, Sharon E Bigger, Eli Iacob, Kara Dassel","doi":"10.1093/geront/gnaf179","DOIUrl":"10.1093/geront/gnaf179","url":null,"abstract":"<p><strong>Background and objectives: </strong>Persons living with dementia often rely upon a care partner as their surrogate medical decision maker, yet little is known about how dementia care dyads achieve advance care planning (ACP) concordance: when a care partner fully understands a care recipient's values and preferences as best they can. Examining data from a pilot study of the online Life-planning in Early Alzheimer's and other Dementias (LEAD) intervention to better understand how dyads achieve perceived ACP concordance, we hypothesized that: (1) engaging in ACP was associated with perceived ACP concordance, (2) perceived ACP concordance was associated with interpersonal connectedness, and (3) engaging in ACP was associated with interpersonal connectedness.</p><p><strong>Research design and methods: </strong>Dyads completed the LEAD intervention and answered open-ended survey questions. After aggregating data supporting and or not supporting each hypothesis, process codes and subcodes were used to identify the elements involved in each supported hypothesis (Cohen's Kappa .65-.82).</p><p><strong>Results: </strong>N = 48 community-based dyads completed the LEAD intervention, with N = 43 answering open-ended questions. Care recipients averaged 65.1 years of age (SD =14.8); care partners averaged 54.9 years (SD = 14.6) and were primarily spouses (n = 32, 66.7%) or children (n = 12, 25.0%). Engaging in ACP was associated with higher interpersonal connectedness and with perceived ACP concordance. Perceived ACP concordance was not associated with higher interpersonal connectedness.</p><p><strong>Discussion and implications: </strong>These findings suggest that clinicians should focus on facilitating ACP discussions with dyads, as these conversations appear crucial for fostering understanding and agreement between dyad members, ultimately leading to perceived ACP concordance.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838557","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":"Toward an intragroup approach to alleviate ageism in the second half of life.","authors":"Liat Ayalon","doi":"10.1093/geront/gnaf169","DOIUrl":"10.1093/geront/gnaf169","url":null,"abstract":"<p><p>Ageism, defined as stereotypes, prejudices, and discrimination based on age, is highly prevalent and has negative health and mental health impacts. Although interventions to reduce ageism directed by younger agents of ageism toward older persons exist, there is scarcity of knowledge concerning interventions to alleviate ageism directed by older persons toward other older persons or toward themselves. The proposed intragroup approach to ageism challenges the traditional view of older persons solely as victims of ageism, highlighting their role as both agents or targeters and targets of ageism-thus, exhibiting self-directed and other-directed ageism, pointed toward themselves and toward other older persons, respectively. The intragroup approach emphasizes the complexity of ageism in the second half of life, when bias and conflict occur within the group of older persons rather than between groups, thus requiring a nuanced understanding of one's subjective social group identification. The proposed theoretical framework identifies needed steps to transition toward personalized interventions of ageism, which affect change by matching interventions to the characteristics of the individual and the context in which ageism operates. This includes attention to the relationships between self-and other-directed ageism, as determined by subjective social group identification, the multidimensional nature of ageism, as composed of stereotypes, prejudices, and discrimination including an implicit component, and the possible impact of contextual factors, related to the prominence of ageism in society.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735201","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":"Ageism during the 2024 U.S. Presidential Election: thematic analysis of tweets.","authors":"Juanita-Dawne R Bacsu, Ali Akbar Jamali, Alixe Ménard, Dylan Fiske, Megan E O'Connell, Megan Funk, Shirin Vellani, Melba Sheila D'Souza, Florriann Fehr, Jasmine C Mah, Sarah Anne Fraser, Alison L Chasteen, Melissa K Andrew, Shoshana Green, Sepideh Mansourigovari, Raymond J Spiteri","doi":"10.1093/geront/gnaf166","DOIUrl":"10.1093/geront/gnaf166","url":null,"abstract":"<p><strong>Background and objectives: </strong>When the 2024 U.S. Presidential election was announced, Joe Biden and Donald Trump were two of the oldest candidates in election history. This circumstance created sentiments of ageist political discourse and arguments for presidential age limits. Despite clear ageist discourse during the U.S. election, there is a notable lack of research examining this issue. This study used posts from X (formerly Twitter) to understand ageism on social media during the 2024 U.S. Presidential Election, particularly focusing on the campaign period when the race was between Biden and Trump.</p><p><strong>Research design and methods: </strong>Posts were collected from X during the American presidential election campaign from February 11-25, 2024. After filtering out non-English, incomplete, and unrelated posts, 1,254 relevant posts were coded line-by-line and then thematically analyzed. Rigor was established by using multiple strategies ranging from a strong audit trail to using interrater reliability during thematic analysis.</p><p><strong>Results: </strong>Four main themes were identified: (1) old age as an inherent weakness: \"they're both too old,\" (2) dementia-related stigma, (3) dehumanization of older adults: \"ancient fossils are running for office,\" and (4) fear of perceived incompetence.</p><p><strong>Discussion and implications: </strong>Our study's findings shed light on how ageist discourse on social media threatens the credibility of older political leaders by shifting the focus from policies to stereotypical age-based attacks. Further research is needed to examine the impact of ageist discourse on electoral campaigns.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719059","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}