1,720,974 research outputs found
Subjective Memory Decline Predicts Incident Cognitive Impairment Among White—But Not Black or Hispanic—Older Adults
No full textBackground and objectives: This study investigates whether subjective memory decline in a racially diverse sample of older adults without cognitive impairment at baseline is associated with incident cognitive impairment during a 12-year follow-up period.
Research design and methods: With panel data from a national sample (N=9,244) of cognitively-intact Black, White, and Hispanic Americans 65 years or older in 2004, we examine if subjective memory decline is associated with the loss of normal cognition by 2016. Cognitive status was assessed every two years with a modified version of the Telephone Interview for Cognitive Status to identify the transition from normal cognition to cognitive impairment.
Results: Estimates from Weibull accelerated failure-time models reveal that subjective memory decline is associated with earlier incident cognitive impairment (time ratio = 0.96, p<.05). In subsequent models stratified by race-ethnicity, this association was evident among White respondents (time ratio = 0.95, p<.01) but not among Black, US-born Hispanic, or foreign-born Hispanic respondents.
Discussion and implications: Given that the prognostic validity of subjective memory decline differs by race and ethnicity, caution is warranted when using it as a screening or clinical tool in diverse populations.Accepted versio
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Nativity, Neighborhoods, and Body Composition in the Sacramento Area Latino Study on Aging
Full text linkBACKGROUND AND OBJECTIVES: Globally, obesity influences the risk of many major chronic diseases. Our study examines the association between individual nativity and neighborhood level concentration of immigrants with 10-year changes in weight, body mass index (BMI), and waist circumference (WC) among older Latinos. RESEARCH DESIGN AND METHODS: The Sacramento Area Latino Study on Aging (SALSA) is a population-based prospective study of community-dwelling older adults of Mexican origin (baseline ages 58-101 years). The primary outcome was repeated measures of weight over a 10-year period for 1,628 respondents. Nativity was defined by participants' reported place of birth (US-born or Latin American foreign born). Neighborhood immigrant concentration was measured as the percentage of foreign born at census tract level (2000 US Census). We used linear mixed models with repeated measures of weight, height, BMI, and WC as dependent variables (level 1), clustered within individuals (level 2) and neighborhood migrant concentration (level 3). RESULTS: Foreign born (FB) respondents had lower baseline weight than the US-born (mean, 160 vs. 171 lbs, p < .0001). Over time, weight differences between the FB and the US-born decreased by 1.7 lbs/5 years as US-born weight decreased more rapidly. We observed a significant interaction between individual nativity and neighborhood immigrant concentration (p = .012). We found similar patterns for BMI, but did not find statistically significant differences in WC trajectories. DISCUSSION AND IMPLICATIONS: Our study observed significant differences by foreign born vs. US nativity in baseline weight/BMI and in their trajectories over time. Additionally, we found weight/BMI differences in neighborhood immigrant concentration for the FB, but not for the US-born
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Medical Care Delivery in U.S. Nursing Homes: Current and Future Practice.
Full text linkThe delivery of medical care services in U.S. nursing homes (NHs) is dependent on a workforce that comprises physicians, nurse practitioners, and physician assistants. Each of these disciplines operates under a unique regulatory framework while adhering to common standards of care. NH provider characteristics and their roles in NH care can illuminate potential links to clinical outcomes and overall quality of care with important policy and cost implications. This perspective provides an overview of what is currently known about medical provider practice in NH and organizational models of practice. Links to quality, both conceptual and established, are presented as is a research and policy agenda that addresses the gaps in the evidence base within the context of our ever-changing health care landscape
Out-of-Pocket Health Expenditures and Health Care Services Use Among Older Americans With Cognitive Impairment: Results From the 2008–2016 Health and Retirement Study
Full text linkBACKGROUND AND OBJECTIVES: The evidence base on health services use and cost burdens associated with transition to severe cognitive impairment (SCI) and dementia is underdeveloped. We examine how the change in cognitive impairment status influences nursing home use, hospitalizations, and out-of-pocket (OOP) expenditures. RESEARCH DESIGN AND METHODS: We use prospective data from the Health and Retirement Study (2007/2008–2015/2016) on adults 70 years and older meeting research criteria for cognitive impairment not dementia (CIND) at baseline (unweighted n = 1,692) to fit 2-part models testing how reversion to normal cognition, stability (CIND maintenance), and transition into SCI/dementia influence change in yearly nursing home use, hospitalizations, and OOP expenditures. RESULTS: Over 8 years, 5.9% reverted, 15.9% remained CIND, 14.9% transitioned to SCI/dementia, and 63.3% died. We observed substantial increases in the propensity of any nursing home use which were particularly pronounced among those who transitioned or died during follow-up and similar but less pronounced differences in patterns of inpatient hospitalizations. Average baseline OOP spending was similar among reverters (1,145 [993–1,296]), and transitioners (2,529 (2,101–2,957). By the eighth year of follow-up, spending among reverters increased to 2,188 (1,402–2,974) and 7,719 (4,345–11,094). Estimates were only partly attenuated through adjustment to covariables. DISCUSSION AND IMPLICATIONS: A better understanding of variations in health services use and cost burdens among individuals with mild cognitive impairment can help guide targeted care and financial planning
Television Viewing, Physical Activity, and Loneliness in Late Life
Full text linkBACKGROUND AND OBJECTIVES: Television viewing is the most common leisure activity in late life and may ease loneliness but encourage sedentary behavior. These associations may be particularly evident among older adults who live alone and who may lack other forms of companionship throughout the day. RESEARCH DESIGN AND METHODS: Adults aged 65+ (N = 257) participated, of whom 34% lived alone. Participants completed an initial interview followed by a 5- to 6-day data collection involving multimethods: (a) Electronically Activated Recorders (30 s every 7 min) provided audio recordings of television viewing, (b) Actical accelerometers objectively measured physical activity, and (c) ecological momentary assessments every 3 hr assessed social interactions. RESULTS: On average, older adults spent approximately 37% of their waking time (6.4 hr a day) watching television. Multilevel models revealed that television viewing occurred when participants were alone or with a spouse and was associated with a greater proportion of time sedentary, lower activity, and higher ratings of loneliness compared to when not watching television. Older adults who lived alone reported greater loneliness during 3-hr intervals when viewing television, but older adults who lived with others spent a greater proportion of time sedentary when viewing television. DISCUSSION AND IMPLICATIONS: Findings are discussed with regard to different rationales and ways of watching television—as compensation for social isolation or as a passive leisure activity with a social partner. We discuss ideas for research on additional aspects of television viewing and screen time in late life
Theorizing ‘place’ in aging in place: The need for territorial and relational perspectives
Full text linkThis paper argues for a greater theorization of ‘place’ within aging in place research. It extends calls for a relational conceptualization of place by demonstrating the need for aging in place researchers to also pay greater attention to territorial aspects of place. This complementary understanding will help establish a new spatial grammar within aging in place research, that not only would improve conceptual clarity to aging in place, but it would also support a more critical engagement of aging in place in questions of inequality. The paper demonstrates this through a discussion of two forms of inequality pertinent to older people: the uneven capacity of places to support older people and experiences of social exclusion in relation to place attachment for older people from marginalized groups
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Elder Mediation Services among Diverse Older Adult Communities in Australia: Practitioner Perspectives on Accessibility
Full text linkBackground and Objectives: Elder abuse is a complex problem, and barriers to reporting and help-seeking include shame and fear of loss of relationships with key family members. Elder mediation has been identified as one promising method of alternative dispute resolution. This study aimed to investigate the accessibility of elder mediation services among diverse groups of older adults, from the perspective of practitioners in a large Australian jurisdiction. Research Design and Methods: The study employed a sequential mixed-methods approach, comprising a thematic analysis of semistructured interviews (N = 17) and an online survey of practitioners (N = 49) involved in referral to, or provision of, elder mediation services. Accessibility was conceptualized using existing theoretical frameworks, spanning practical (logistics-related), and normative (justice- and culture-related) dimensions. Results: Factors limiting accessibility of elder mediation services included lack of community and practitioner awareness of elder abuse and elder mediation, discomfort with the mediation process, financial costs, lack of services in regional and remote areas, and complex service systems for older people. Within the mediation process, difficulties in assessing and accommodating cognitive and other impairments, managing power imbalances, and determining the appropriateness of the dispute for mediation were influential. Discussion and Implications: This study showed that mediation can be a promising and effective approach to resolving disputes involving older people. The emergent perceptive dimension (community and practitioner awareness) emphasizes the importance of awareness-raising efforts surrounding both elder abuse and the potential of mediation as a viable pathway, the training of elder-mediators as well as resourcing elder mediation services, especially in rural and remote locations
Emotion Recognition and Reactivity in Persons With Neurodegenerative Disease Are Differentially Associated With Caregiver Health
Full text linkBACKGROUND AND OBJECTIVES: Motivated by the high rates of health problems found among caregivers of persons with neurodegenerative disease, we examined associations between deficits in two aspects of care recipients' socioemotional functioning and their caregivers' health.
RESEARCH DESIGN AND METHODS: In 2 studies with independent samples (N = 171 and 73 dyads), caregivers reported on care recipients' emotion recognition and emotional reactivity. Caregiver health was assessed using both self-report measures (Studies 1 and 2) and autonomic nervous system indices (Study 2).
RESULTS: Lower emotion recognition in care recipients was linearly associated with worse self-reported health, faster resting heart rate, and greater physiological reactivity to an acoustic startle stimulus in caregivers. These effects held after accounting for a variety of risk factors for poor caregiver health, including care recipients' neuropsychiatric symptoms. Emotional reactivity showed a quadratic association with health, such that the lowest and highest levels of emotional reactivity in care recipients were associated with lower self-reported health in caregivers.
DISCUSSION AND IMPLICATIONS: Results shed light on the unique associations between two aspects of care recipients' emotional functioning and caregivers' health. Findings suggest potential ways to identify and help caregivers at heightened risk for adverse health outcomes
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