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  • Oxford University Press (OUP)  (27)
  • 2020-2024  (27)
  • 1
    Online Resource
    Online Resource
    The Epidemiology of Social Isolation: National Health and Aging Trends Study
    Oxford University Press (OUP) ; 2020
    In:  The Journals of Gerontology: Series B Vol. 75, No. 1 ( 2020-01-01), p. 107-113
    Details
    In: The Journals of Gerontology: Series B, Oxford University Press (OUP), Vol. 75, No. 1 ( 2020-01-01), p. 107-113
    Abstract: Social isolation among older adults is an important but under-recognized risk for poor health outcomes. Methods are needed to identify subgroups of older adults at risk for social isolation. Methods We constructed a typology of social isolation using data from the National Health and Aging Trends Study (NHATS) and estimated the prevalence and correlates of social isolation among community-dwelling older adults. The typology was formed from four domains: living arrangement, core discussion network size, religious attendance, and social participation. Results In 2011, 24% of self-responding, community-dwelling older adults (65+ years), approximately 7.7 million people, were characterized as socially isolated, including 1.3 million (4%) who were characterized as severely socially isolated. Multinomial multivariable logistic regression indicated that being unmarried, male, having low education, and low income were all independently associated with social isolation. Black and Hispanic older adults had lower odds of social isolation compared with white older adults, after adjusting for covariates. Discussion Social isolation is an important and potentially modifiable risk that affects a significant proportion of the older adult population.
    Type of Medium: Online Resource
    ISSN: 1079-5014 , 1758-5368
    URL: Article
    DOI: 10.1093/geronb/gby037
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 2
    Online Resource
    Online Resource
    Family caregivers emphasise patience and personal growth: a qualitative analysis from the Caregiving Transitions Study
    Oxford University Press (OUP) ; 2022
    In:  Age and Ageing Vol. 51, No. 2 ( 2022-02-02)
    Details
    In: Age and Ageing, Oxford University Press (OUP), Vol. 51, No. 2 ( 2022-02-02)
    Abstract: informal caregiving for family and friends is becoming increasingly common due to the rising prevalence of chronic conditions and a shortage of affordable care options. While the impact of caregiving on caregivers’ health is well-documented, nuances in caregivers’ experiences may not be captured in quantitative studies. We aimed to better understand caregivers’ perception of their experiences through qualitative analysis. Methods participants were from the Caregiving Transitions Study (CTS), which is ancillary to the REasons for Geographic and Racial Differences in Stroke Study. We analysed responses from 150 caregivers to an open-ended question at the end of the CTS telephone interview concerning additional information about their caregiving experiences. We identified main themes and examined differences by sex, condition and relationship to the care recipient. Results four major themes were identified: cultural/family expectations; growth opportunities; and reciprocity; stressors and challenges and recommendations. Male caregivers more often indicated that their motivation for taking on this role was their sense of duty towards family, while female caregivers focused on the challenges and burden of caregiving that they experienced. Overall, caregivers highlighted the importance of patience and the positive impact of caregiving, such as opportunities for personal growth, acquiring new skills, and finding fulfillment and gratitude. Conclusions family caregivers shared both positive and challenging experiences as well as the impact that these experiences had on their lives. Understanding the full spectrum of the caregiving experience will help inform how the community and the health care system can best support caregivers in their roles.
    Type of Medium: Online Resource
    ISSN: 0002-0729 , 1468-2834
    URL: Article
    DOI: 10.1093/ageing/afab266
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2065766-3
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  • 3
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    Online Resource
    Corrigendum to: Stress, Burden, and Well-Being in Dementia and Nondementia Caregivers: Insights From the Caregiving Transitions Study
    Oxford University Press (OUP) ; 2021
    In:  The Gerontologist Vol. 61, No. 5 ( 2021-07-13), p. 804-804
    Details
    In: The Gerontologist, Oxford University Press (OUP), Vol. 61, No. 5 ( 2021-07-13), p. 804-804
    Type of Medium: Online Resource
    ISSN: 0016-9013 , 1758-5341
    URL: Article
    DOI: 10.1093/geront/gnaa209
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 4
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    Online Resource
    Stress, Burden, and Well-Being in Dementia and Nondementia Caregivers: Insights From the Caregiving Transitions Study
    Oxford University Press (OUP) ; 2021
    In:  The Gerontologist Vol. 61, No. 5 ( 2021-07-13), p. 670-679
    Details
    In: The Gerontologist, Oxford University Press (OUP), Vol. 61, No. 5 ( 2021-07-13), p. 670-679
    Abstract: Few population-based studies have directly compared caregivers of persons with dementia to caregivers of persons with other disabilities (nondementia caregivers). We enrolled dementia and nondementia caregivers who were providing substantial and sustained care and compared these groups on measures of caregiver stressors, appraisals of burden, and well-being. Research Design and Methods Caregivers (N = 251) who provided continuous care for at least 1 year and at least 5 h per week were recruited from the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Caregivers reported on dementia caregiving status, stressors, burden, and well-being. Results Forty-seven percent (n = 117) reported caring for a person with dementia. Dementia caregivers reported more stressors, providing more care for self-care and behavioral problems than nondementia caregivers. Dementia caregivers also reported higher appraisals of stress and burden, and more depressive symptoms, but did not differ from nondementia caregivers on mental and physical health quality of life. In multivariable-adjusted models, adjustment for the total number of care recipient problems attenuated differences between dementia and nondementia caregivers on burden and depression measures. Discussion and Implications Dementia and nondementia caregivers showed relatively few differences in indicators of overall well-being in this population-based sample, perhaps because both groups of caregivers in this study were providing substantial care. Dementia caregivers may require special assistance with dementia-specific problems such as behavioral problems. Clinical interventions and policy changes targeting highly burdened caregivers are needed to support them in allowing their care recipients to age in place at home.
    Type of Medium: Online Resource
    ISSN: 0016-9013 , 1758-5341
    URL: Article
    DOI: 10.1093/geront/gnaa108
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 5
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    Online Resource
    Caring for Older Adults With Vision Impairment and Dementia
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. 6 ( 2020-11-01)
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. 6 ( 2020-11-01)
    Abstract: Dementia and vision impairment (VI) are common among older adults but little is known about caregiving in this context. Research Design and Methods We used data from the 2011 National Health and Aging Trends Study, a nationally representative survey of Medicare beneficiaries, linked to their family/unpaid helpers from the National Study of Caregiving. Vision impairment was defined as self-reported blindness or difficulty with distance/near vision. Probable dementia was based on survey report, interviews, and cognitive tests. Our outcomes included hours of care provided, and number of valued activities (scored 0–4) affected by caregiving, per month. Results Among 1,776 caregivers, 898 (55.1%, weighted) assisted older adults without dementia or VI, 450 (21.9%) with dementia only, 224 (13.0%) with VI only, and 204 (10.0%) with dementia and VI. In fully adjusted negative binomial regression analyses, caregivers of individuals with dementia and VI spent 1.7 times as many hours (95% confidence interval [CI] = 1.4–2.2) providing care than caregivers of those without either impairment; however, caregivers of individuals with dementia only (95% CI = 1.1–1.6) and VI only (95% CI = 1.1–1.6) spent 1.3 times more hours. Additionally, caregivers of individuals with dementia and VI had 3.2 times as many valued activities affected (95% CI = 2.2–4.6), while caregivers of dementia only and VI only reported 1.9 times (95% CI = 1.4–2.6) and 1.3 times (95% CI = 0.9–1.8) more activities affected, respectively. Discussion and Implications Our results suggest that caring for older adults with VI involves similar time demands as caring for older adults with dementia, but that participation impacts are greater when caring for older adults with both dementia and VI.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igaa043
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 6
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    Objectively Measured Patterns of Daily Physical Activity and Phenotypic Frailty
    Oxford University Press (OUP) ; 2022
    In:  The Journals of Gerontology: Series A Vol. 77, No. 9 ( 2022-09-01), p. 1882-1889
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 77, No. 9 ( 2022-09-01), p. 1882-1889
    Abstract: Self-reported low physical activity is a defining feature of phenotypic frailty but does not adequately capture physical activity performed throughout the day. This study examined associations between accelerometer-derived patterns of routine daily physical activity and frailty. Methods Wrist accelerometer and frailty data from 638 participants (mean age 77 [SD = 5.5] years; 44% women) were used to derive 5 physical activity metrics: active minutes/day, sedentary minutes/day, total activity counts/day, activity fragmentation (reciprocal of the average active bout length), and sedentary fragmentation (reciprocal of the average sedentary bout length). Robust, prefrail, and frail statuses were identified using the physical frailty phenotype defined as having 0, 1–2, or ≥3 of the following criterion: weight loss, exhaustion, slowness, self-reported low activity, and weakness. Frailty was collapsed into not frail (robust and prefrail) and frail, and each frailty criteria was dichotomized. Multiple logistic regression was used to model each accelerometer metric. Separate frailty criteria and interactions with age and sex were also examined. Results With higher amounts and intensity of daily activity (more active minutes, fewer sedentary minutes, higher activity counts) and lower activity fragmentation, the odds of frailty were lower compared to robust/prefrail states (p & lt; .02 for all). For interactions, only an age by sedentary fragmentation interaction on the odds of frailty was observed (p = .01). For each separate criteria, accelerometer metrics were associated with odds of slowness, low activity, and weakness. Conclusion Less favorable patterns of objectively measured daily physical activity are associated with frailty and the components of slowness, low self-reported activity, and weakness.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glab278
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 7
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    Embedding Caregiver Support within Adult Day Services: Outcomes of a Multi-site Trial
    Oxford University Press (OUP) ; 2023
    In:  The Gerontologist ( 2023-08-07)
    Details
    In: The Gerontologist, Oxford University Press (OUP), ( 2023-08-07)
    Abstract: Adult day services (ADS) provide quality-of-life benefits to people with dementia , but few provide systematic caregiver support. We report outcomes of a multi-site, national trial testing a staff-delivered caregiver program, ADS Plus. Research Design and Methods Cluster randomized trial involving 34 ADS: 18 sites provided ADS (controls); 16 provided ADS and ADS Plus (intervention). Trained staff met with caregivers to provide dementia education, support/validation, referrals/linkages, and strategies for care challenges and self-care over 12-months. Main outcomes included depressive symptoms (CES-D) and well-being at 6-and 12-months, and client attendance over 12-months. Results Of 203 caregivers (Intervention=102; Control=101), 5.9% at 3-months, 12.8% at 6-months, and 22.7% at 12-months were lost-to-follow-up. Caregivers were predominantly female (80.3%), with 76.4% identifying as white/Caucasian, 14.8% Black/African American, and 12.3% Hispanic/Latino. Most (88.2%) had ≥college education and were 65.0 years old (SD=13.46). For those with 6-month data, 40.4% control and 40.2% ADS Plus caregivers had depressed symptoms (≥16 CES-D) at baseline. By 6-months, 43.6% control versus 34.2% ADS Plus caregivers had ≥16 scores (odds ratio=0.38, p=0.072). By 12-months, after covariate adjustments, ADS Plus caregivers reported reduced total depression scores versus controls (p=0.013) and lower depressed affect scores (p=0.015). Of 18 sites providing 12-month client attendance data, nine intervention sites reported 126.05 days attended versus 78.49 days for nine control sites (p=0.079). Discussion and Implications Compared to ADS alone, by 12-months ADS Plus improved caregiver mood and increased ADS utilization by 60.6%. Results support ADS staff delivering evidence-based caregiver support to enhance ADS benefits.
    Type of Medium: Online Resource
    ISSN: 0016-9013 , 1758-5341
    URL: Article
    DOI: 10.1093/geront/gnad107
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 8
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    Free-Living Gait Cadence Measured by Wearable Accelerometer: A Promising Alternative to Traditional Measures of Mobility for Assessing Fall Risk
    Oxford University Press (OUP) ; 2023
    In:  The Journals of Gerontology: Series A Vol. 78, No. 5 ( 2023-05-11), p. 802-810
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 78, No. 5 ( 2023-05-11), p. 802-810
    Abstract: Wearable devices have become widespread in research applications, yet evidence on whether they are superior to structured clinic-based assessments is sparse. In this manuscript, we compare traditional, laboratory-based metrics of mobility with a novel accelerometry-based measure of free-living gait cadence for predicting fall rates. Methods Using negative binomial regression, we compared traditional in-clinic measures of mobility (6-minute gait cadence, speed, and distance, and 4-m gait speed) with free-living gait cadence from wearable accelerometers in predicting fall rates. Accelerometry data were collected with wrist-worn Actigraphs (GT9X) over 7 days in 432 community-dwelling older adults (aged 77.29 ± 5.46 years, 59.1% men, 80.2% White) participating in the Study to Understand Fall Reduction and Vitamin D in You. Falls were ascertained using monthly calendars, quarterly contacts, and ad hoc telephone reports. Accelerometry-based free-living gait cadence was estimated with the Adaptive Empirical Pattern Transformation algorithm. Results Across all participants, free-living cadence was significantly related to fall rates; every 10 steps per minute higher cadence was associated with a 13.2% lower fall rate (p = .036). Clinic-based measures of mobility were not related to falls (p & gt; .05). Among higher-functioning participants (cadence ≥100 steps/minute), every 10 steps per minute higher free-living cadence was associated with a 27.7% lower fall rate (p = .01). In participants with slow baseline gait (gait speed & lt;0.8 m/s), all metrics were significantly associated with fall rates. Conclusion Data collected from biosensors in the free-living environment may provide a more sensitive indicator of fall risk than in-clinic tests, especially among higher-functioning older adults who may be more responsive to intervention. Clinical Trial Registration NCT02166333
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glac013
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2043927-1
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  • 9
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    Systematic Review and Meta-Analysis of Racial and Ethnic Differences in Dementia Caregivers’ Well-Being
    Oxford University Press (OUP) ; 2021
    In:  The Gerontologist Vol. 61, No. 5 ( 2021-07-13), p. e228-e243
    Details
    In: The Gerontologist, Oxford University Press (OUP), Vol. 61, No. 5 ( 2021-07-13), p. e228-e243
    Abstract: Studies comparing racial/ethnic differences on measures of psychological and physical well-being for dementia caregivers have reported differences between minority and white caregivers. Recruitment methods often differ for minority and white participants due to enrollment targets and may lead to biased comparisons, especially in convenience samples. We aimed to examine racial/ethnic differences in dementia caregiver outcomes and to determine whether differences vary between studies with population-based or convenience samples. Research Design and Methods We systematically reviewed articles with primary data from PubMed, Google Scholar, and PsycINFO. We included studies comparing African American or Hispanic/Latino to white dementia caregivers on measures of psychological well-being or physical well-being. Reviewers screened titles and abstracts, reviewed full texts and conducted risk-of-bias assessments. Meta-analyses were conducted to assess effects by race/ethnicity and study bias. Results A total of 159 effects were extracted from 38 studies, 2 of which were population based. Random-effects models revealed small but statistically significant effects with better psychological well-being in African American caregivers compared with white caregivers in both population-based (d = −0.22) and convenience sample studies (d = −0.21). Hispanics/Latino caregivers reported lower levels of physical well-being than white caregivers (d = 0.12), though these effects varied by level of rated study bias. Discussion and Implications Consistency across study methods raises confidence in the validity of previous reports of better psychological well-being in African American caregivers. Future studies should use population-based samples with subgroups of Hispanic/Latino, Asian American, and American Indian caregivers that are culturally distinct on factors such as country of origin and tribe.
    Type of Medium: Online Resource
    ISSN: 0016-9013 , 1758-5341
    URL: Article
    DOI: 10.1093/geront/gnaa028
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 10
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    Examining the Malleability of Negative Views of Aging, Self-Efficacy Beliefs, and Behavioral Intentions in Middle-Aged and Older Adults
    Oxford University Press (OUP) ; 2023
    In:  The Journals of Gerontology: Series B Vol. 78, No. 12 ( 2023-12-06), p. 2009-2020
    Details
    In: The Journals of Gerontology: Series B, Oxford University Press (OUP), Vol. 78, No. 12 ( 2023-12-06), p. 2009-2020
    Abstract: This study examined the malleability of a tripartite cluster of purported mechanistic variables targeted in a 4-week intervention program designed to improve adults’ engagement in physical activity. The targeted cluster of purported mechanisms consisted of negative views of aging (NVOA), self-efficacy beliefs, and behavioral intentions. Methods A randomized single-blind control group design was used to implement the AgingPLUS program in a sample of middle-aged and older adults (N = 335; Mage = 60.1 years; SDage = 8.3 years; age range 45–75 years). Results Using an intention-to-treat approach and analyses of covariance adjusting for participants’ baseline scores, findings showed significant improvements in the purported mechanistic variables both at the immediate (Week 4) and delayed posttest (Week 8) in the treatment group but not in the control group. These improvements were for the most part maintained until 8-month postrandomization, although to a smaller extent. Specifically, participants in the AgingPLUS group showed significant improvements in NVOA, self-efficacy beliefs, and behavioral intentions compared to the Health Education control group. Standardized effect sizes for statistically significant effects were variable and ranged from small (d = −0.23) to large (d = 0.80). Effect sizes showed some decay of the intervention at the 8-month posttest. Discussion Taken together, the findings supported the efficacy of the AgingPLUS program and showed that variables representing the purported mechanisms of the intervention were significantly moved in a positive direction. In doing so, the AgingPLUS program met a major requirement of the experimental medicine approach to behavior change interventions. Clinical Trials Registration Number NCT0329948
    Type of Medium: Online Resource
    ISSN: 1079-5014 , 1758-5368
    URL: Article
    DOI: 10.1093/geronb/gbad130
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2043945-3
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