Medicine and Health Sciences Commons^™

Area Agencies On Aging Provide Crucial Support For Older New Yorkers During Covid-19, Claire Pendergrast

Population Health Research Brief Series

This research brief discusses how Area Agencies on Aging are providing crucial support for older NewYorkers during COVID-19.

Evaluation Of The Livewell Method: Final Report, Paula Carder, Serena Hasworth, Diana Cater

Institute on Aging Publications

The LiveWell Method uses a practice-based framework to improve the quality of life for people living and working in long-term care settings, including assisted living and memory care. It is designed to improve teamwork, communication, and morale by helping staff organize, track, measure, and improve daily operations. This evaluation is informed by the LiveWell Method’s “bottom-up and top enabled” approach, which engages and empowers direct care staff and administrators to create a more democratic and transparent workplace. In addition, the evaluation included questions to assess LiveWell’s core values, such as creating care innovations, nurturing dignity, creating community, and honoring elders, …

Post-Acquisition Processing Confounds In Brain Volumetric Quantification Of White Matter Hyperintensities, Ahmed A. Bahrani, Omar M. Al-Janabi, Erin L. Abner, Shoshana H. Bardach, Richard J. Kryscio, Donna M. Wilcock, Charles D. Smith, Gregory A. Jicha

Neurology Faculty Publications

BACKGROUND: Disparate research sites using identical or near-identical magnetic resonance imaging (MRI) acquisition techniques often produce results that demonstrate significant variability regarding volumetric quantification of white matter hyperintensities (WMH) in the aging population. The sources of such variability have not previously been fully explored.

NEW METHOD: 3D FLAIR sequences from a group of randomly selected aged subjects were analyzed to identify sources-of-variability in post-acquisition processing that can be problematic when comparing WMH volumetric data across disparate sites. The methods developed focused on standardizing post-acquisition protocol processing methods to develop a protocol with less than 0.5% inter-rater variance.

RESULTS: A series …

Age Drives Distortion Of Brain Metabolic, Vascular And Cognitive Functions, And The Gut Microbiome, Jared D. Hoffman, Ishita Parikh, Stefan J. Green, George Chlipala, Robert P. Mohney, Mignon Keaton, Bjoern Bauer, Anika M. S. Hartz, Ai-Ling Lin

Sanders-Brown Center on Aging Faculty Publications

Advancing age is the top risk factor for the development of neurodegenerative disorders, including Alzheimer’s disease (AD). However, the contribution of aging processes to AD etiology remains unclear. Emerging evidence shows that reduced brain metabolic and vascular functions occur decades before the onset of cognitive impairments, and these reductions are highly associated with low-grade, chronic inflammation developed in the brain over time. Interestingly, recent findings suggest that the gut microbiota may also play a critical role in modulating immune responses in the brain via the brain-gut axis. In this study, our goal was to identify associations between deleterious changes in …

Pro-Angiogenesis Therapy And Aging: A Mini-Review, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Apart from major illnesses and chronic afflictions, the elderly experience lesser ailments, such as muscle weakness, cold intolerance, and transient memory lapses. Physical signs in the aged include wrinkled skin and the slow healing of skin abrasions. These ailments and signs are grouped together because they may be due in part to an age-linked, waning microcirculation. A reduced capillary density (CD) throughout the body of aged people and animals has been reported in over 40 papers. The reduced CD is due in turn to declining levels of angiogenic growth factors (AGFs) throughout the body during old age, as documented in …

Social Isolation And Loneliness In Older People: A Closer Look At Definitions, Mary Lou Ciolfi, Frances Jimenez Ba

Disability & Aging

Social isolation and loneliness are related and the terms are often used interchangeably, but they are distinct concepts with different definitions, health impacts, and interventions. Our population is aging and older people are at increased risk for both social isolation and loneliness and the associated negative health consequences. Understanding the important differences between social isolation and loneliness will help us recognize them earlier in vulnerable populations, engage in more meaningful conversations with older adults about their own risks, and will inform the development and delivery of more individualized, meaningful, and cost-effective interventions.

Csf Protein Changes Associated With Hippocampal Sclerosis Risk Gene Variants Highlight Impact Of Grn/Pgrn, David W. Fardo, Yuriko Katsumata, John S. K. Kauwe, Yuetiva Deming, Oscar Harari, Carlos Cruchaga, Alzheimer’S Disease Neuroimaging Initiative, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

Objective—Hippocampal sclerosis of aging (HS-Aging) is a common cause of dementia in older adults. We tested the variability in cerebrospinal fluid (CSF) proteins associated with previously identified HS-Aging risk single nucleotide polymorphisms (SNPs).

Methods—Alzheimer’s Disease Neuroimaging Initiative cohort (ADNI; n=237) data, combining both multiplexed proteomics CSF and genotype data, were used to assess the association between CSF analytes and risk SNPs in four genes (SNPs): GRN (rs5848), TMEM106B (rs1990622), ABCC9 (rs704180), and KCNMB2 (rs9637454). For controls, non-HS-Aging SNPs in APOE (rs429358/rs7412) and MAPT (rs8070723) were also analyzed against Aβ1-42 and total tau CSF analytes.

Results—The GRN risk …

Development, Validation And Application Of A New Fornix Template For Studies Of Aging And Preclinical Alzheimer's Disease, Christopher A. Brown, Nathan F. Johnson, Amelia J. Anderson-Mooney, Gregory A. Jicha, Leslie M. Shaw, John Q. Trojanowski, Linda J. Van Eldik, Frederick A. Schmitt, Charles D. Smith, Brian T. Gold

Physical Therapy Faculty Publications

We developed a merged younger-older adult template of the fornix and demonstrated its utility for studies of aging and preclinical Alzheimer's disease (AD). In Experiment 1, probabilistic tractography was used to reconstruct the fornix in younger and older adults and successful streamlines were then averaged to create a merged template in standard space. The new template includes the majority of the fornix from the hippocampal formation to the subcallosal region and the thalamus/hypothalamus. In Experiment 2, the merged template was validated as an appropriate measure for studies of aging, with comparisons against manual tracing measures indicating identical spatial coverage in …

In The Information Age, Do Dementia Caregivers Get The Information They Need? Semi-Structured Interviews To Determine Informal Caregivers’ Education Needs, Barriers, And Preferences, Kendra Peterson, Howard Hahn, Amber J. Lee, Catherine A. Madison, Alireza Atri

Dartmouth Scholarship

Most patients with dementia or cognitive impairment receive care from family members, often untrained for this challenging role. Caregivers may not access publicly available caregiving information, and caregiver education programs are not widely implemented clinically. Prior large surveys yielded broad quantitative understanding of caregiver information needs, but do not illuminate the in-depth, rich, and nuanced caregiver perspectives that can be gleaned using qualitative methodology. We aimed to understand perspectives about information sources, barriers and preferences, through semi-structured interviews with 27 caregivers. Content analysis identified important themes

Piscataquis Thriving In Place Collaborative Year 1 Evaluation Report, University Of Maine Center On Aging

Maine Center on Aging Education and Training

The Piscataquis Thriving in Place Collaboration's mission is to improve regional services and supports that help adults with chronic health conditions remain in their homes avoid unnecessary hospitalization. The following report presents evaluation results from Year 1 of the Piscataquis Thriving in Place Collaborative gained through survey work and Ripple Effects Mapping. sessions conducted with project workgroups. Project outcomes during the first year were diverse, but can be roughly categorized into the areas of increased knowledge of community needs among collaborative members, increased knowledge of available resources to support thriving in place, and expansion of services and supports in response …

Disaggregating Activities Of Daily Living Limitations For Predicting Nursing Home Admission, Joelle H. Y. Fong, Olivia S. Mitchell, Benedict S. K. Koh

Research Collection Lee Kong Chian School Of Business

Objective: To examine whether disaggregated activities of daily living (ADL) limitations better predict the risk of nursing home admission compared to conventionally used ADL disability counts. Data Sources: We used panel data from the Health and Retirement Study (HRS) for years 1998–2010. The HRS is a nationally representative survey of adults older than 50 years (n = 18,801). Study Design: We fitted Cox regressions in a continuous time survival model with age at first nursing home admission as the outcome. Time-varying ADL disability types were the key explanatory variables. Principal Findings: Of the six ADL limitations, bathing difficulty emerged as …

Worlds Of Connection: A Hermeneutic Formulation Of The Interdisciplinary Relational Model Of Care, Susana Lauraine Mccune

Antioch University Dissertations & Theses

Despite a general agreement across health care disciplines that Advanced Care Planning (ACP) and Advanced Directives (ADs) add important elements to a patient's end-of-life care desires, and can inform their loved ones and advocates, help create ease of mind, and enhance quality of care, they continue to remain significantly underused. More than half of Americans transition to chronic and terminal illness without having completed them. The aim of this study was to increase the frequency and enhance the quality of communication about Advance Directives and Advance Care Planning within the clinical relationship. The resulting Interdisciplinary Relational Model of Care (IRMOC) …

The Role Of Self-Transcendence : A Missing Variable In The Pursuit Of Successful Aging?, Valerie Lander Mccarthy, Jiying Ling, Robert M. Carini

Faculty Scholarship

While successful aging is often defined as the absence of disease and disability or as life satisfaction, self-transcendence may also play an important role. The objective of this research was to test a nursing theory of successful aging proposing that transcendence and adaptation predict successful aging. In this cross-sectional exploratory study, a convenience sample of older adults (N = 152) were surveyed about self-transcendence, proactive coping, and successful aging. Using hierarchical multiple regression, self-transcendence, proactive coping, and all control variables (i.e., sex, race, perceived health, place of residence) together explained 50% of the variance in successful aging (p < 0.001). However, proactive coping alone was not a significant predictor of successful aging. Thus, this study did not support the theory that both self-transcendence and proactive coping predict successful aging. Self-transcendence was the only significant contributor to this multidimensional view of successful aging. Self-transcendence is an important variable in the pursuit of successful aging, which merits further investigation.

Pilot Community-Based Intervention To Address The Needs Of Elderly Caregivers In The Eastern Cape Province, South Africa, Priscilla Reddy, Shegs James, H. Mutumba Bilay-Boon, Eka Esu-Williams, Hena Khan

HIV and AIDS

The HIV epidemic in South Africa has placed a substantial burden on elderly caregivers, mainly women, who are often tasked with caring for their grandchildren who are orphaned and rendered vulnerable by the death or illness of their parents. The Medical Research Council (MRC), Age-in-Action, and the Horizons Program conducted formative research, as described in this research summary, to assess the needs of elderly caregivers in the Eastern Cape Province of South Africa in 2005. The investigations revealed that elderly caregivers faced a number of challenges including difficulty communicating with youth, fears and a sense of hopelessness around matters regarding …

Urban Versus Rural Mortality Among Older Adults In China, Zachary Zimmer, Toshiko Kaneda, Laura Spess

Poverty, Gender, and Youth

For some time, Chinese government policies have treated rural and urban areas very differently, and a by-product of China’s rapid development seems to be an even greater differentiation between urban and rural social and economic life. Over the next several decades, in part because of rapid fertility declines and in part as a result of mortality declines at older ages, China and other developing countries will experience enormous increases in the proportion of older adults and the proportion of the “oldest-old.” It is reasonable to expect that these age structure changes will alter the provision of health care, making an …

Poverty, Wealth Inequality, And Health Among Older Adults In Rural Cambodia, Zachary Zimmer

Poverty, Gender, and Youth

This working paper examines the distribution of household wealth and tests whether associations exist between wealth inequality and health outcomes among older adults living in one of the world’s poorest regions, rural Cambodia. Results confirm difficult economic conditions among most elderly in rural Cambodia. This study suggests there is some validity to generalizing the relationship between wealth inequality and health to extremely poor populations and that a very small difference in wealth makes a relatively large difference in regard to the association with health among those living in impoverished surroundings.

Education Of Adult Children And Mortality Of Their Elderly Parents In Taiwan, Zachary Zimmer, Linda G. Martin, Mary Beth Ofstedal, Yi-Li Chuang

Poverty, Gender, and Youth

Research shows an older adult’s education is strongly associated with mortality. But in societies such as Taiwan, where families are highly integrated, the education of family members may be linked to survival. Such may be the case in settings where there are large gaps in levels of education across generations and high levels of resource transfers between family members. This Population Council study employs 14 years of longitudinal data from Taiwan to examine the combined effects of education of older adults and their adult children on mortality outcomes of older adults. Results indicate that educational levels of both parent and …

Population Aging And The Rising Cost Of Public Pensions [Arabic], John Bongaarts

Poverty, Gender, and Youth

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful …

Trends And Transitions In Children's Coresidence With Older Adults In Beijing Municipality, Zachary Zimmer, Xianghua Fang, Toshiko Kaneda, Zhe Tang, Julia Kwong

Poverty, Gender, and Youth

The reduction in family size in China and concurrent social and economic change are raising concerns that traditional sources of support may be eroding. This Population Council working paper paper examines a) whether rates of coresidence between older adults and their adult children in the Beijing municipality of China have been declining, and b) the determinants of coresidence and coresidence transitions. Results suggest that family support structures for the elderly, when they are facilitated through coresidence, remain basically intact, particularly for those who require the greatest amount of support. Further assessment is required to elucidate the effects of availability, need, …

How Indicators Of Socioeconomic Status Relate To Physical Functioning Of Older Adults In Three Asian Societies, Zachary Zimmer, Napaporn Chayovan, Hui-Sheng Lin, Josefina N. Natividad

Poverty, Gender, and Youth

In developed countries, socioeconomic status has been identified as one of the most important demographic and social determinants of older adult health. The relationship has not been well studied or contrasted across much of the developing world. Yet, with population aging occurring rapidly in much of Asia, understanding the factors that distinguish between those in better and worse health becomes important. To this end, the current study has two main aims. It first examines the degree to which two measures commonly used to indicate socioeconomic status, education and income, relate to the physical functioning of older adults in three Asian …

Determinants Of Old-Age Mortality In Taiwan, Zachary Zimmer, Linda G. Martin, Hui-Sheng Lin

Poverty, Gender, and Youth

Relationships among socio-demographic characteristics, general assessments of health, and old-age mortality are well established in developed countries. There is also an increasing focus on the connection between early-life experiences and latelife health. This paper tests these and other associations using representative survey data from Taiwan on the population aged 60 and older in 1989, 1993, and 1996 that have been linked to data on deaths between 1989 and 1999 from a national death registry. The study also explores the possible influence of Taiwan’s Universal Health Insurance Program, instituted in 1995, and whether or not the survival of some groups of …

Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang

Poverty, Gender, and Youth

This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted …

How Long Do We Live?, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

Period life expectancy is calculated from age-specific death rates using life table methods that are among the oldest and most fundamental tools of demography. These methods are rarely questioned, much less criticized. Yet changing age patterns of adult mortality in contemporary countries with high life expectancy provide a basis for questioning the conventional use of age-specific death rates and life tables. This paper argues that when the mean age at death is rising, period life expectancy at birth as conventionally calculated overestimates life expectancy. Estimates of this upward bias, ranging from 1.6 years for the United States and Sweden to …

Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim

Poverty, Gender, and Youth

Since the takeover of Cambodia by the Khmer Rouge in 1975, analysis of social conditions in the country has been lacking. Only recently has dependable socio-demographic data become available. We use some of these data to examine living arrangements and other socio-demographic conditions among Cambodia’s older population and compare results to those recently found in Thailand and Vietnam. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a grown child and in a variety of arrangements involving different family members. To determine gender preference for coresident children we …

The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth

Poverty, Gender, and Youth

The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …

Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys, John Bongaarts, Zachary Zimmer

Poverty, Gender, and Youth

Using data from Demographic and Health Surveys, this study examines living arrangements of older adults in 43 developing countries and compares patterns by gender, world regions, and macro-level measures of socioeconomic development. Indicators include household size, headship, relationship to head, and coresidence with spouse, children, and others. Unweighted regional averages and OLS regressions determine whether variations exist. Average household sizes are large, but a substantially higher proportion of elderly adults live alone than do individuals in other age groups. Females are more likely than males to live alone and are less likely to live with a spouse or to head …

Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys [Arabic], John Bongaarts, Zachary Zimmer

Poverty, Gender, and Youth

Using data from Demographic and Health Surveys, this study examines living arrangements of older adults in 43 developing countries and compares patterns by gender, world regions, and macro-level measures of socioeconomic development. Indicators include household size, headship, relationship to head, and coresidence with spouse, children, and others. Unweighted regional averages and OLS regressions determine whether variations exist. Average household sizes are large, but a substantially higher proportion of elderly adults live alone than do individuals in other age groups. Females are more likely than males to live alone and are less likely to live with a spouse or to head …