PURPOSE: To examine screening procedures and tools for post-stroke cognitive impairment (PSCI) to guide future practices and research. METHOD: Searches in PubMed, CINAHL, PsycINFO, and Google Scholar included articles fr...PURPOSE: To examine screening procedures and tools for post-stroke cognitive impairment (PSCI) to guide future practices and research. METHOD: Searches in PubMed, CINAHL, PsycINFO, and Google Scholar included articles from 2013 to 2023 focusing on individuals with first ever ischemic stroke and confirming PSCI within 1 year. Thematic analysis was synthesized narratively. RESULTS: Eight studies (two cross-sectional and six prospective cohorts) with 25,443 participants were reviewed. Screening for PSCI was typically performed within 3 to 6 months post-stroke. Montreal Cognitive Assessment and Mini-Mental State Examination were the most commonly used tools, but cutoff scores varied widely. Screening involved pre- and post-stroke cognitive screening and identifying risk factors. CONCLUSION: Significant variability exists in PSCI assessment tools, cutoff, and timing. Further research is needed to standardize screening protocols, focusing on criteria, timing, accuracy, and feasibility. Early and repeated screening with risk management can improve PSCI prevention. [(3), 19-27.].
PURPOSE: Studies examining the link between cancer survivorship and subjective cognitive decline (SCD) are lacking. Therefore, the current study aimed to determine the association between cancer survivorship and SCD amon...PURPOSE: Studies examining the link between cancer survivorship and subjective cognitive decline (SCD) are lacking. Therefore, the current study aimed to determine the association between cancer survivorship and SCD among a nationally representative sample of middle-aged and older adults. METHOD: Data were obtained from the 2021 Behavioral Risk Factor Surveillance System Survey. Crude and adjusted logistic regression models, controlling for age, gender, race/ethnicity, educational level, income, and work status, were used to determine the association between cancer survivorship characteristics and SCD. RESULTS: Respondents who were currently undergoing treatment had 86% higher odds of SCD (adjusted odds ratio [aOR] = 1.86; 95% confidence interval [CI] [1.06, 3.27]) compared to respondents who completed treatment. However, those who refused treatment were less likely to report SCD (aOR = 0.006; 95% CI [<0.001, 0.059]) compared to respondents who completed treatment. CONCLUSION: Cognition interventions may be helpful for individuals diagnosed with cancer who are undergoing treatment, middle-aged, and have not started treatment. [(4), 12-18.].
PURPOSE: To explore how social media affects older adults' subjective well-being (SWB) through underlying mechanisms. METHOD: Path analysis was performed with 106 Chinese older adults to examine the effects of social med...PURPOSE: To explore how social media affects older adults' subjective well-being (SWB) through underlying mechanisms. METHOD: Path analysis was performed with 106 Chinese older adults to examine the effects of social media's interactive communication, information acquisition, and leisure and entertainment on SWB via social support, self-efficacy, and depressive symptoms. RESULTS: The model fit well (χ/ = 5.28, goodness of fit index = 0.86). Social support mediated the positive relationship between interactive communication and SWB, and self-efficacy mediated the positive relationship between information acquisition and SWB. Leisure and entertainment activities on social media showed no significant association with SWB. CONCLUSION: Social media addresses social support deficits from physical limitations and enhances self-efficacy through information retrieval, thus improving SWB. Findings elucidate how social media influences SWB in older adults, offering theoretical guidance for interventions to enhance their well-being. [(4), 47-56.].
PURPOSE: To examine the association between circadian syndrome (CircS) and instrumental activities of daily living (IADL) disability in middle-aged and older adults with diabetes, as well as the moderating effect of age...PURPOSE: To examine the association between circadian syndrome (CircS) and instrumental activities of daily living (IADL) disability in middle-aged and older adults with diabetes, as well as the moderating effect of age on CircS and IADL disability. METHOD: Participants included 939 individuals with diabetes. IADL disability was defined as having trouble finishing specific tasks. CircS was defined as having four or more specific symptoms. Binary logistic regression analysis was used to examine associations among CircS, age, and IADL disability. RESULTS: Of total participants, 29.3% had IADL disability. CircS and age were associated with IADL disability (CircS: odds ratio [OR] = 1.898, 95% confidence interval [CI] [1.370, 2.630]; age: OR = 1.045, 95% CI [1.027, 1.063]; both < 0.001). The interaction effect of age on CircS and IADL disability was significant (OR = 1.047, 95% CI [1.004, 1.092], = 0.032). CONCLUSION: Individuals with diabetes and CircS had a higher risk of IADL disability than those without CircS, and the difference in predicted probabilities of IADL disability between the two groups increased with age. [(4), 37-45.].
PURPOSE: Older adults have a strong desire to self-manage their overall well-being, including their mental health. However, there is a risk that low mood could be associated with aging, normalized and accepted, and impac...PURPOSE: Older adults have a strong desire to self-manage their overall well-being, including their mental health. However, there is a risk that low mood could be associated with aging, normalized and accepted, and impacts help-seeking behavior by older adults. Thus, the current study explored how older adults in New Zealand manage low mood. METHOD: This qualitative descriptive study was embedded in a study exploring community-dwelling older adults' well-being. Semi-structured interviews were conducted with 37 older adults aged between 66 and 99 years (mean age = 83 years). Reflexive thematic analysis was used to analyze the data. RESULTS: Four themes emerged: (1) ; (2) ; (3) ; and (4) . Importantly, older adults developed positive ways of managing low mood. CONCLUSION: Successful strategies older adults implemented can be shared, challenging stereotypes that low mood is specifically part of the aging process. For nurses, greater awareness of the strategies older adults use to combat low mood is vital to ensure they can maintain overall well-being. [(4), 29-35.].
PURPOSE: The purpose of this 8-week interdisciplinary educational program was to provide evidence-based fall prevention information to adults aged ≥65 years residing in an assisted living community. METHOD: Eight 1-hour...PURPOSE: The purpose of this 8-week interdisciplinary educational program was to provide evidence-based fall prevention information to adults aged ≥65 years residing in an assisted living community. METHOD: Eight 1-hour sessions on fall education were performed by interdisciplinary experts at an assisted living community. Control and intervention groups completed four assessments at baseline and completion of the program. RESULTS: Both groups had decreased Timed Up and Go (TUG) and Fear of Falling scores. The intervention group had increased scores on the knowledge of falling questionnaire, whereas the control group had decreased scores, indicating the education was effective in increasing knowledge of falls. Although not statistically significant, these results are clinically significant and reveal the positive effects of the interdisciplinary program. CONCLUSION: Fall prevention education was successful in increasing older adults' knowledge about fall risk factors. There were decreases in TUG and Fear of Falling scores, revealing a positive impact of the program. [(5), 13-16.].
PURPOSE: To evaluate the factor structure of the Brief Pain Inventory-Short Form (BPI-SF) and measurement invariance across two age groups for African American (AA) older adults with osteoarthritis (OA). METHOD: Particip...PURPOSE: To evaluate the factor structure of the Brief Pain Inventory-Short Form (BPI-SF) and measurement invariance across two age groups for African American (AA) older adults with osteoarthritis (OA). METHOD: Participants were AA older adults aged 50 to 94 years with self-reported OA and chronic pain ( = 110). Cross-sectional data from the BPI-SF were obtained from all participants, and confirmatory factor analysis (CFA) was used to evaluate the factor structure. Measurement invariance across young-old (aged 50 to 69 years) and old-old (aged 70 to 94 years) participants was examined at configural, full metric, and full scalar levels. RESULTS: CFA revealed that a three-factor model (i.e., pain intensity, activity interference, and affective interference) demonstrated the best fit (χ/df = 1.595, comparative fit index [CFI] = 0.949, root-mean-square error of approximation = 0.074). The change of CFI between configural and metric invariance was below the cutoff point of 0.01, supporting full metric (i.e., factor loadings) invariance across the two age groups. However, full scalar (i.e., item intercepts) invariance was not demonstrated. CONCLUSION: Results support a three-factor structure of the BPI-SF, which is consistent across two age groups for AA older adults with OA. This study provides evidence that the BPI-SF can reliably measure pain intensity and two distinct dimensions of pain interference in this population. [(2), 13-22.].
The impact of laws and policies that involve social determinants of health (SDOH), particularly among older, retired populations, needs to be considered as a public health intervention. The Social Security Fairness Act w...The impact of laws and policies that involve social determinants of health (SDOH), particularly among older, retired populations, needs to be considered as a public health intervention. The Social Security Fairness Act was signed into law in 2025, as a new amendment to the Social Security Act first introduced in 1935. The Social Security Fairness Act ends two provisions that have reduced benefits for spouses, widows, and widowers and for public service workers, which include teachers, fire fighters, police officers, nurses, and others who are receiving pensions from state or local government. Specifically, this new bill involves economic stability, which is considered an important SDOH for older adults. The purpose of the current article is to evaluate policy changes through the Social Security Fairness Act, including potential impact and benefits, limitations or unintended consequences, and implications and recommendations for future research, policy, and practice. Findings will help guide gerontological nurses and interprofessional researchers, clinicians, and educators promoting healthy aging. [(2), 7-12.].
J Gerontol Nurs
· 2025 Mar · PMID 39778161
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PURPOSE: Stroke family caregivers often struggle to provide care. The purpose of the current study was to determine: (a) ease or difficulty with caregiving tasks; (b) life changes because of providing care; and (c) relat...PURPOSE: Stroke family caregivers often struggle to provide care. The purpose of the current study was to determine: (a) ease or difficulty with caregiving tasks; (b) life changes because of providing care; and (c) relationship between caregiving tasks and life changes. METHOD: A descriptive correlational design was used. Telephone interviews were conducted with 74 stroke caregivers. Tasks were measured using the Oberst Caregiving Burden Scale; life changes with the Bakas Caregiving Outcomes Scale. RESULTS: The most difficult tasks were managing survivor behaviors and the most negative life changes were lack of time for social activities. The easiest tasks were medical or nursing treatments, whereas the most positive life change was an improved relationship with the survivor. Tasks and life changes were different for each caregiver. Caregiver tasks and life changes were moderately correlated ( = 0.33, < 0.01). CONCLUSION: Caregiver tasks and life changes are important for designing strategies to support stroke caregivers. [(3), 13-18.].
PURPOSE: To report the prevalence and risk factors of elder self-neglect (ESN) among community-dwelling older adults ( = 604). METHOD: The current cross-sectional study was conducted from July 2019 to October 2020 in Lan...PURPOSE: To report the prevalence and risk factors of elder self-neglect (ESN) among community-dwelling older adults ( = 604). METHOD: The current cross-sectional study was conducted from July 2019 to October 2020 in Lanzhou City, China. ESN was determined by the Scale of Elderly Self-Neglect, which evaluates five dimensions: (a) medical health and care, (b) environmental sanitation and personal hygiene, (c) mental health, (d) safety, and (e) social engagement. Frailty was assessed using the Physical Frailty Phenotype scale. Participants were asked whether they had bothersome and activity-limiting pain over the past 1 month. Characteristics associated with ESN were identified through multiple linear regression analyses. RESULTS: Mean age of participants was 71.34 years ( = 7.15 years), and 255 (57.8%) were female. The prevalence of ESN among participants was 16.2%. Among the five dimensions of ESN, medical health and care accounted for the largest proportion (44%). Approximately 58% of participants were pre-frail and 11.4% were frail, and 45% reported experiencing bothersome pain. Older adults with a household monthly income per capita <2,000 RMB (β = -0.112, < 0.05), larger waist circumference (β = 0.185, < 0.001), pre-frailty (β = 0.176, < 0.001), frailty (β = 0.420, < 0.001), and pain (β = 0.102, < 0.05) were more prone to ESN. CONCLUSION: ESN is a prevalent issue among community-dwelling older adults. Frailty, pain, low economic status, and larger waist circumference are identified as independent risk factors for ESN. There is a need to improve the understanding of ESN among health care providers and policymakers. Personalized interventions aimed at preventing or addressing these risk factors may lead to improvements in ESN outcomes. [(3), 45-54.].
Bell SA, Kruger K, Ikari R
… +3 more, Kuhnmuench C, Gates K, Rosemberg MA
J Gerontol Nurs
· 2025 Mar · PMID 39778159
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PURPOSE: To uncover the barriers, facilitators, and adaptations that affected home care workers' care practices for their clients with dementia during the coronavirus disease 2019 (COVID-19) pandemic. METHOD: Semi-struct...PURPOSE: To uncover the barriers, facilitators, and adaptations that affected home care workers' care practices for their clients with dementia during the coronavirus disease 2019 (COVID-19) pandemic. METHOD: Semi-structured interviews were conducted with home care workers employed during the COVID-19 pandemic in Southeast Michigan. Respondent-driven sampling was used to recruit participants who were interviewed using a guide informed by the Theoretical Domains Framework. To identify themes across interviews, the research team combined content analysis with coding software for qualitative data. RESULTS: Participants ( = 34) were predominantly female and ranged in age from 19 to 79 years. From the analyzed transcripts, five themes emerged: (1) ; (2) ; (3) ; (4) ; and (5) . CONCLUSION: Home care workers adapted to meet their clients' health and well-being needs in the face of the demands of the pandemic. This study's findings are critical to informing the development of strategies to support home care workers and people living with dementia during future pandemics. [(3), 29-36.].
PURPOSE: To gain a better understanding of the perceptions of RNs on medication safety concerns and potential solutions for nursing home (NH) residents. METHOD: This prospective, qualitative study used semi-structured ph...PURPOSE: To gain a better understanding of the perceptions of RNs on medication safety concerns and potential solutions for nursing home (NH) residents. METHOD: This prospective, qualitative study used semi-structured phone interviews with a description approach. We used purposeful sampling to recruit 12 RNs employed at two NHs in the northeastern region of the United States. The Systems Engineering Initiative for Patient Safety constructs informed the interview guide, coding, and qualitative theme identification. RESULTS: We categorized non-user-friendly charting systems and gained insights into more experience with paper-based charting under the technology component. For the organization component, participants identified the importance of teamwork, communication, and leadership. Participants also mentioned how education and nationality of training impact medication administration (MA) safety. Task-related concerns revealed how different care approaches, extreme workload variation, and task prioritization during the day are perceived as critical issues that need to be addressed. Staff shortages were also expressed as an environment-related concern. CONCLUSION: Findings highlight the importance of appropriate nurse-to-patient ratio, the significance of user-friendly charting systems, and customizing the interface of MA in the charting system. [(3), 38-43.].
PURPOSE: The current review examined the application of artificial intelligence (AI) and machine learning (ML) techniques in palliative care, specifically focusing on models used to identify potential beneficiaries of pa...PURPOSE: The current review examined the application of artificial intelligence (AI) and machine learning (ML) techniques in palliative care, specifically focusing on models used to identify potential beneficiaries of palliative services among individuals with chronic and terminal illnesses. METHODS: A systematic review was conducted across four electronic databases. Five studies met inclusion criteria, all of which applied AI/ML models to predict outcomes relevant to palliative care, such as mortality or the need for services. RESULTS: Of 1,504 studies screened, five studies used supervised ML algorithms, whereas one used natural language processing with a deep learning model to identify potential palliative care candidates. The most common AI/ML algorithms included neural network-based models, logistic regression, and tree-based models. CONCLUSION: AI and ML models offer promising avenues for identifying palliative care beneficiaries. As AI continues to evolve, its potential to reshape palliative care through early identification is significant, providing opportunities for timely and targeted care interventions. [(1), 7-14.].
PURPOSE: Orthostatic hypotension (OH) is a common manifestation of Parkinson's disease (PD). Factors including autonomic dysfunction from the disease, use of PD medications, comorbidities, and aging can contribute to an...PURPOSE: Orthostatic hypotension (OH) is a common manifestation of Parkinson's disease (PD). Factors including autonomic dysfunction from the disease, use of PD medications, comorbidities, and aging can contribute to an increased risk of OH, which can be detrimental to patients' quality of life. Maintaining a fine balance to prevent harm related to OH and retain the benefit medications used to treat PD is crucial. The current article reviews various considerations in selecting and adjusting pharmacotherapy for OH in patients with PD. METHOD: Current evidence and guidance on pharmacological strategies of OH in patients with PD were reviewed. RESULTS: Current strategies include medication regimen review and adjustment of patient's medication regimen and single or combination pharmacotherapy (midodrine, droxidopa, fludrocortisone, pyridostigmine) used in addition to nonpharmacological strategies. CONCLUSION: A patient-specific approach is needed to address OH in PD. Larger studies on safety and management of OH in PD are recommended given paucity of studies. [(12), 5-10.].
PURPOSE: To present an overview of current definitions of informal caregiving and informal caregivers for persons living with dementia (PLWD). We suggest definitional criteria of informal caregiving for dementia caregivi...PURPOSE: To present an overview of current definitions of informal caregiving and informal caregivers for persons living with dementia (PLWD). We suggest definitional criteria of informal caregiving for dementia caregiving research that incorporate current dementia caregiving policy and programs. METHOD: A multi-pronged review and analysis was performed of the scientific literature from 2014 to 2024 and online documents from professional, public advocacy, and government organizations for definitions of informal caregiving and applications to informal caregiving of PLWD. RESULTS: Definitional inconsistencies in informal caregiving center primarily on parameters around compensation ("unpaid") and relationships that are not in keeping with state, federal, and long-term care insurance programs that provide financial assistance, compensation, or stipends for caregiving. These inconsistencies extend to public policy and advocacy websites as well as peer-reviewed dementia and family caregiving literature. CONCLUSION: In general, contemporary applications of the term "informal caregiver" for PLWD include relatives and non-relatives (kin/nonkin) who provide a broad array of assistance to PLWD. Informal care activities may be provided in residence with or near PLWD or at a distance. Definitions and inclusion criteria for informal caregiver should specify relative or unpaid non-relative, having some prior relationship or social ties to the PLWD, and not receiving compensation for care for the PLWD from a caregiving institution. [(12), 41-45.].