Gerontology Commons^™

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

《香港多重照顧者面對的挑戰》研究報告, Chak Kwan, Dickson Chan, Meng Soi, Florence Fong, Hiu Wai, Avery Li, Ka Chung, Tom Kwong

APIAS Research Report 研究報告

本研究以質性訪談方式，探討香港「多重照顧者」在日常生活中面對的主要困難及採用的應對策略，並就未來政策及服務提出建議。在本研究中，多重照顧者是指同時需要照顧兩名或以上家庭成員（例如長者、配偶、子女或其他親屬），而其中一名為殘疾或長期病患者。本研究共訪問了45位多重照顧者，結果顯示他們長期承受多方面的壓力，包括時間貧乏、情緒困擾、財政壓力及使用服務困難，影響他們的身心健康、人際關係及職業發展。

就照顧歷程而言，多數受訪者已持續提供照顧，需在工作、家庭與多位照顧對象之間不斷拉鋸，出現「永遠做不完」的感受。在主觀感受上，多重照顧者普遍視照顧為理所當然的責任，但同時感到沉重壓力。他們主要依靠家人分工、嚴密的時間管理、降低對家務與個人生活質素的期望，以及有限度使用社會服務來勉強維持照顧安排。然而，服務分散、申請程序繁複、輪候時間長及資訊不足，使他們難以獲得及時和合適的支援服務。

研究建議有多個方面，包括(1)推行個案經理制度、(2)建立常規化和科學化的照顧者意見收集機制、(3)調整照顧者津貼申請門檻與金額、(4)建立照顧者友善工作環境、(5)優先發展具策略性的「一站式支援」及喘息資源，以及(6)將「多重照顧者」納入長期規劃與制度設計。

Structural Empowerment And The Work Environment Of Nursing Home Care Workers In China, Yawen Ou

Lingnan Theses (MPhil & PhD)

China is experiencing a profound demographic transformation as its population ages rapidly, driven by declining fertility, increased longevity, and long-term effects of the One- Child policy. Traditional family-based elderly care has become increasingly unsustainable due to the pressures of the “4-2-1” family structure and the rising prevalence of empty-nest households. In this context, there is an increasing trend in institutionalized elderly care, accompanied by a growing demand for Nursing Home Care Workers (NHCWs). In spite of their vital importance, NHCWs often face heavy workloads, poor compensation, low recognition, and limited professional autonomy. This study explores the work environment and structural …

Assessing Neurocognitive Functioning Among Adults Ageing With And Without Hiv At The Kenyan Coast: Measurement Issues And Correlates, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan Wagner, Mihaela Duta, Gaia Scerif, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines …

Community Perspectives On Factors Contributing To Resilience For Healthy Aging In Kenya, Linda Khakali, Everline Onchari, Maureen Ondire, Catherine Onyancha, Chinedu Momoh, Edna Bosire

Brain and Mind Institute

Background: The global elderly population is increasing and expected to double in thenext decade. Aging increases the likelihood of adversities, with resilience becomingan important aspect of healthy aging. Understanding how individuals conceptualizeresilience offers an opportunity to create contextually relevant interventions forpromoting healthy aging. This study aimed to explore adults’ perspectives on factorsinfluencing resilience in Kenya.

Method: Using qualitative methods, 36 adults aged 35 years and above werepurposively recruited from various communities in Nairobi County to participate ininterviews. We asked questions about their understanding of aging, adversity andresiliency. We also provided them with case scenarios of two individuals respondingdifferently to the …

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Vitality Tracking In Kenyan Adults Using Wearable Devices And Ecological Momentary Assessments, Karen Blackmon, Benard Alaka, Catherine Onyancha, Litha Musili, Raechel Kamau, Cyprian Mostert, Mansoor Saleh, Zul Merali, Chinedu Momoh, Thomas Thesen

Brain and Mind Institute

Background: Vitality is essential to healthy aging but is elusive to define and measure.Dynamic capture of fluctuations in vitality can uncover abnormal trajectories thatcould be a harbinger of frailty in older adults. Yet, these fluctuations are missed bystatic and/or sparse sampling strategies. To address the need for dynamic and high-density capture of vitality in older adults, we developed a passive sensing and activeprobing digital platform using wearable devices and smartphones. We deployed thisparadigm in older Kenyan adults and evaluated its potential for use in research on thedynamics of accelerated aging.

Method: Cognitively unimpaired (CU) Kenyan adults ≥ 35 years of …

Predicting Accelerated And Delayed Aging In Global Settings: Biobehavioral Age Gaps And The Role Of Global Exposomes, Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilne, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Cyprian Mostert, Chinedu Momoh, Zul Merali

Brain and Mind Institute

Background: Global health challenges like aging and dementia are shaped bysocioeconomic disparities, environmental factors, and social determinants of health.We developed a behavioral age gap (BAG), measuring the difference between expectedbehavioral age and chronological age

Method: We utilized a cross-sectional sample (n = 161,981) comprising countriesfrom Latin America, Europe, Asia, and Africa. Behavioral age was estimated usinga Gradient Boosting Regressor with 10-fold cross-validation, incorporating multiplerisk factors (hypertension, diabetes, heart disease, female sex, visual impairment andhearing impairment) and protective factors (cognition, functional ability, education)associated with healthy aging. BAG was calculated as the difference between predictedand chronological age, and adjusted gaps were derived …

Public Views Towards Lifespan, Healthspan, And Healthy Longevity Medicine In Singapore: A Qualitative Study From The Healthy Longevity (Helo) Initiatives, Belinda Wang, Anna Szucs, Elena Sandalova, Zhi Meng Lim, E. J. Horberg, Paul A. O’Keefe, Louis Island, Sonny Rosenthal, Andrea B. Maier

Research Collection College of Integrative Studies

Introduction: Healthy Longevity Medicine (HLM) offers a strategy to reduce the healthspan-lifespan gap, yet public perspectives remain unclear. This study refines the Healthy Longevity (HELO) framework through a qualitative exploration of public views towards lifespan, healthspan, and HLM.Methods: Individuals living in Singapore participated in semi-structured group or individual discussions to explore (a) their understanding of lifespan and healthspan, (b) motivational factors for health behaviours, and (c) their awareness of HLM. Sampling maximised variation across age, sex, and ethnicity. Data obtained through 13 discussions were analysed with a mixed, inductive-deductive approach employing the HELO framework.Results: Thirty-six participants (mean age = 49.4 …

Stay Independent: Enhancing Healthy Aging In Iowa And Louisiana, Sarah L. Francis, Elizabeth Gollub, Savannah Schultz

Journal of Human Sciences and Extension

This evaluation study assessed the impact of Stay Independent participation on topic familiarity and the likelihood of making a recommended behavior change among community-residing older adults. Stay Independent focuses on the nutritional needs of older adults, emphasizing Whole Person Wellness and the Health Belief Model. It was initially created in Iowa for community-residing adults aged 60 and older and has been adapted for cultural appropriateness in Louisiana. Stay Independent is a healthy aging program consisting of six standalone food and health modules. It is offered both virtually and face-to-face (F2F) in Iowa and Louisiana. Participants who attended Stay Independent between …

Identifying Key Influencing Factors Of Elderly Health Information Search Based On Meta-Ethnography, Zhumei Sun, Zhibing Wang

Journal of Scientific Information Research

[Purpose/significance] Health information search is an important way for elderly people to actively cope with aging. Identifying the key factors affecting of their health information searching and exploring the correlation among these factors are of positive significance for promoting the elderly proactive health ability.

[Method/process] This paper firstly integrated the original research through a meta-ethnographic approach to form a set of factors influencing the elderly health information search. The DEMATEL method was then used to analyze the interrelationships among the influencing factors and identify the key influencing factors.

[Result/conclusion] The study finds that, the influencing factors of elderly health information …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

Reforming Pensions In Africa: Addressing Coverage, Payout Disparities, And Dementia Outcomes For Sustainable Aging, Cyprian Mostert, Catherine Ajalo, David Andai

Brain and Mind Institute

No abstract provided.

Older Women In The U.S. Were Lonelier Than Men During The Covid-19 Pandemic, Qiyu Deng

Population Health Research Brief Series

Loneliness damages health and quality of life. The COVID-19 pandemic increased social isolation and loneliness among some groups in the U.S. This data slice uses data from the 2020 Health and Retirement Study to examine gender and age differences in loneliness among older adults (50+) in the U.S. during the first year of the pandemic. The author finds that loneliness was more prevalent among women than among men, with the highest rate among women ages 80 and older.

Factors Affecting The Joy Of Life In Old Age: A Scale Development Study, Yalçın Karagöz, Yusuf Karaşi̇n, Mustafa Filiz, Mehmet Ateş

Adultspan Journal

This study aims to introduce a measurement tool into the literature that can reveal the factors affecting the joy of life in older adulthood. Participants included 266 individuals aged 55 and over living in Izmir, Turkey. The process of developing the scale includes the following stages: problem identification, item pool creation, expert opinion, form shaping, pilot application, and finalizing the scale. The exploratory factor analysis revealed that the scale consists of 6 different dimensions, and the variance explained by these dimensions was found to be 65.184%. The acceptable values for the scale's fit indicators are as follows: χ²/df0.90, IFI > 0.90, …

Exploring The Role Of Bingocize® Workshops In Enhancing Health And Well-Being In Older Adults, Kaitlyn Gray

Mahurin Honors College Capstone Experience/Thesis Projects

As the population of older adults grows, the need for better health and well-being also grows, making it necessary to implement effective strategies for healthy aging to improve the length and quality of life of older adults (CDC, 2024). This study evaluates the effectiveness of a Bingocize^® Workshop in improving the physical health of older adults. Bingocize^®, a unique program combining bingo with exercise, is designed to increase physical activity. Eleven (11) participants aged 68.55 ± 6.235 attended a ten-week workshop, two times per week focusing on physical exercises tailored to their abilities. The primary objective was …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Impacts Of Social Media Use On The Wellbeing Of Older Adults : Evidence From China During The Covid-19 Pandemic, Xuying Dong

Lingnan Theses (Doctoral degree)

Given the trend of increasing use of information and communication technologies among Chinese elder population, more attention should be drawn on the relationship between social media use and wellbeing of older adults. This research explores the social media use situation among older adults in mainland China as well as its influences on their wellbeing, and employs a mixed approach including quantitative questionnaire distributed via WeChat social media platform and qualitative interview among Chinese older adults who are over 60 years of age in Jingzhou, Hubei Province. Generally speaking, social media use can improve the wellbeing of Chinese older adults, more …

Framing The Path To Fitness: Age Differences In Response To Framed Exercise Messages, Iliya Sherif, David B. Taullahu, Alyssa R. Minton, Joseph A. Mikels

DePaul Discoveries

Physical activity is one of the most protective health behaviors one can engage in, yet 75% of active adults in the US, meaning those who exercise regularly, fall short of the recommended levels of physical activity, with an even greater percentage of older adults living inactive lives, meaning they exercise minimally and engage in prolonged sedentary behavior (CDC, 2019). The goal of the current study was to explore different types of message framing targeted at encouraging older and younger adults to exercise. We recruited older adults (n = 184; Mage = 69.45 years, age range: 65- 80 years) and younger …

America Is Unprepared To Meet The Needs Of Its Growing Older Adult Population, Sierra Kaplan

Population Health Research Brief Series

In 2030, nearly 73 million Americans will be aged 65 years or older. As Americans continue to have fewer children than in the past, the number of older adults will outnumber children. Thus, fewer young adults will be around to support and care for the older adult population. Coupled with COVID-19 pandemic-driven disruptions to the healthcare industry, America’s health and aging care system is unprepared to support its large and growing older adult population. Over time, we will see increased health care scarcity and inequality in the distribution of elder care services, especially with continued healthcare worker shortages and drastic …

How Did Cognitive Status Impact Health Care Use Among Older Adults During The Covid-19 Pandemic?, Katarina Sako, Janet Wilmoth

Population Health Research Brief Series

Physical distancing measures during the COVID-19 pandemic disrupted the lives of older adults. Older adults experiencing dementia and other forms of cognitive decline have impaired executive functioning that made it even more difficult to contend with these disruptions. This brief presents findings from research that used data from the 2021 Health and Retirement Study to examine differences in health care delays and health outcomes during the COVID-19 pandemic among a nationally representative sample of U.S. older adults (ages 50+) with versus without cognitive decline. Results show that most older adults did not delay getting health care and did not experience …

A Qualitative Exploration Of Well-Being In Cancer Survivorship: Implications For Counselors, Hallie M. Sylvestro, Lindsey K. Umstead, Heather Delgado, Christopher Lawrence, Keith Mobley, Kelly L. Wester, Andrew Wood

Adultspan Journal

Adult cancer survivors represent an important–and growing–population that could benefit from counseling services. This study employed consensual qualitative research to examine the well-being experiences of eight cancer survivors. Findings suggest a broad range of changes to individual well-being following cancer diagnosis and treatment, and indicate counseling can provide an ideal setting for processing such changes. Recommendations for counseling practice and future research are provided.

Supporting South Korea’S Aging Population: How Ai And Iot Acceptance Connects The Young And Old, Bobby Im

Master's Projects and Capstones

In 2024, South Korea surpassed every other nation by becoming the country with the lowest fertility rate (below 0.7%). Population decline will hinder future ability to care for their aging population and although the government and private corporations are investing millions of dollars on developing Artificial Intelligence-Internet of Things (AI-IoT) devices to support the aging, the acceptance levels and the amount of family support required is undervalued. By examining AI-IoT’s current use and role in South Korea’s public health system this paper shows how intergenerational support helps optimize existing procedures and equipment, increases the level of acceptance and use, and …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

What Factors Increase Risk Of Alzheimer's Disease And Related Dementia?, Elizabeth Vásquez, Kai Zhang

Population Health Research Brief Series

Alzheimer’s disease is the most common form of dementia and ranks 7th in the leading causes of death in the United States (U.S.). This data slice uses nationwide data from 3,155 counties in the U.S. to identify the factors that best predict county-level rates of Alzheimer’s Disease and Related Dementias (ADRDs) in 2018. The results indicate that insufficient sleep, consuming less than one serving of fruits and vegetables per day, having no high school diploma, Black population percentage, and social vulnerability were among the leading factors predicting county-level ADRD prevalence.

Profiles Of Activity Engagement And Depression Trajectories As Covid-19 Restrictions Were Relaxed, Jonathan L. Chia, Andree Hartanto, William Tov

Research Collection School of Social Sciences

Given elevated depression rates since the onset of the pandemic and potential downstream implications, this research examined the association between activity engagement and depression among middle-aged and older adults postlockdown. This study aimed to (a) identify activity engagement profiles among middle-aged and older adults, (b) understand factors associated with profile memberships, and (c) compare depression trajectories across profiles as COVID-19 restrictions eased over 16 months in Singapore. This longitudinal study involved 6,568 middle-aged and older adults. Latent growth analysis was first conducted to obtain estimates of depression trajectories for each individual. Latent profile analysis was then conducted to identify different …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

Impact Of A Covid-19 Related Lockdown On The Experience Of Informal Caregiving In Singapore, Vicky Mengqi Qin, Abhijit Visaria, Rahul Malhotra

ROSA Journal Articles and Publications

Introduction: Lockdowns, while limiting COVID-19 transmission, can affect provision of care by informal caregivers and their caregiving experience. We assessed, among informal caregivers in Singapore, (a) the perceived impact of a 2-month (April to May 2020) nationwide lockdown on their care provision, (b) correlates of different perceptions of the impact of the lockdown on care provision, and (c) association of different perceptions of the impact with negative and positive experiences of caregiving. Methods: In the August 2020 wave of the Singapore Life Panel (SLP; nationally representative, longitudinal monthly survey of Singapore citizens and permanent residents aged 50-70 years at baseline), …

The Impact Of Social Determinants Of Health And Acculturation On Quality Of Life In Older Chinese American Adults With Chronic Pain: A Quantitative Study, Chi Lam

Dissertations

Despite a rapid increase in the older Chinese American adult population, there are very few research studies examining the impact of social determinants of health and acculturation on the quality of life in older Chinese American adults. The purpose of the study was to determine the impact of social determinants of health and acculturation on quality of life in older Chinese American adults with chronic pain. This quantitative, descriptive correlational study utilized Madeleine Leininger’s Transcultural Theory as its theoretical framework. Two research questions guided this study: (1) Was there a difference in the quality of life in older Chinese American …