scholarly journals USE OF SERVICES BY PEOPLE LIVING ALONE WITH COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S907-S907
Author(s):  
Amy Rosenwohl-Mack ◽  
Anna Chodos ◽  
Sarah Dulaney ◽  
Min-Lin Fang ◽  
Jennifer Merrilees ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Ethnic Minorities ◽  
Service Providers ◽  
The United States ◽  
High Income ◽  
Living Alone ◽  
Use Of Services ◽  
Services And Supports ◽  
Racial Ethnic

Abstract At least one third of older adults with dementia live alone in the United States. Living alone may represent an opportunity to maintain independence and autonomy, while remaining in a familiar home environment. However, living alone with cognitive impairment is also associated with health risks and unmet needs. No systematic reviews on this population have been published. We systematically reviewed research on use of healthcare and long-term services and supports (LTSS) by people living alone with cognitive impairment. Following PRISMA guidelines, we searched six electronic databases for studies reporting quantitative findings on use of services by people living alone with cognitive impairment; 33 studies met inclusion criteria. Nine countries were represented, all high-income economies. Race/ethnicity data was reported in just five studies, and only one included a majority of racial/ethnic minorities. Overall, people living alone with cognitive impairment appear to use health services at similar or lower rates compared to those living with others; however, LTSS use is higher among people living alone. Representation of non-white participants was poor, but the evidence available suggests that among racial/ethnic minorities with cognitive impairment, there is no difference in LTSS use between those living alone and living with others. Findings highlight inconsistencies in access to and use of essential services by older adults living alone with cognitive impairment. As the populations of the US and other high-income countries become both older and more diverse, with increasing numbers living alone, researchers and service providers must consider the specific needs and preferences of this population.

scholarly journals Effects of COVID-19 Pandemic on the Lived Experience of Diverse Older Adults Living Alone With Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 943-943
Author(s):  
Elena Portacolone ◽  
Anna Chodos ◽  
Jodi Halpern ◽  
Kenneth Covinsky ◽  
Sahru Keiser ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Lived Experience ◽  
Qualitative Content Analysis ◽  
The United States ◽  
Living Alone ◽  
Ethnographic Interviews ◽  
Essential Services ◽  
Design And Methods ◽  
Racial Ethnic

Abstract Background and Objectives: Even before the COVID-19 pandemic, older adults with cognitive impairment living alone (an estimated 4,3 million individuals in the United States) were at high risk for negative health outcomes. There is an urgent need to learn how this population is managing during the pandemic. Research Design and Methods: This is a qualitative study of 24 adults aged 55 and over living alone with cognitive impairment from diverse racial/ethnic backgrounds. Participants’ lived experiences during the pandemic were elicited via 59 ethnographic interviews conducted over the phone either in English, Spanish, or Cantonese. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Results: Qualitative analysis of transcripts revealed five themes: 1) fear generated by the pandemic; 2) distress stemming from feeling extremely isolated; 3) belief in misinformation, 4) strategies for coping during the pandemic; and 5) the importance of access to essential services. Discussion and Implications: This pandemic put a spotlight on the precarity and unmet needs of older adults living alone with cognitive impairment living. Findings underscore the need to expand access to home care aides and mental health services for this population.

scholarly journals Living Alone in Late Life

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 479-479
Author(s):  
Jacqueline Torres
Keyword(s):  
United States ◽  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Unmet Needs ◽  
The United States ◽  
Living Alone ◽  
The Us ◽  
Services And Supports

Abstract Approximately one third of older adults in the United States (US) and 13% of older adults in Mexico live alone. In both countries, the prevalence of living alone is higher for women and increases with advanced age; in the US, an estimated 4.3 million older adults continue to live alone with cognitive impairment or dementia. We will present research from the US and Mexico on the receipt of long-term services and supports and unmet needs for care among older adults living alone, including with cognitive impairment, as well as factors that may modify these outcomes. For the US, we will describe recent findings about the health, health care, and caregiving outcomes of older adults living alone vs. living with others during the COVID-19 pandemic.

scholarly journals Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Xia Wu ◽  
Li Fan ◽  
Songqing Ke ◽  
Yangting He ◽  
Ke Zhang ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Univariate Analysis ◽  
The United States ◽  
Hazard Ratio ◽  
Multivariable Model ◽  
The Future ◽  
Longitudinal Associations ◽  
Weighted Proportion

Objective: The aim of this study was to explore the longitudinal associations of stroke with cognitive impairment in older US adults.Method: The data used in this longitudinal analysis were extracted from the National Health and Aging Trends Study (NHATS) from 2011 to 2019. Univariate and multivariable Cox proportional hazards regression models were used to estimate the longitudinal association of stroke with cognitive impairment. The multivariable model was adjusted by demographic, physical, and mental characteristics, and the complex survey design of NHATS was taken into consideration.Results: A total of 7,052 participants with complete data were included. At the baseline, the weighted proportion of cognitive impairment was 19.37% (95% CI, 17.92–20.81%), and the weighted proportion of the history of stroke was 9.81% (95% CI, 8.90–10.72%). In univariate analysis, baseline stroke history was significantly associated with cognitive impairment in the future (hazard ratio, 1.746; 95% CI, 1.461–2.088), and the baseline cognitive impairment was significantly associated with future report of stroke (hazard ratio, 1.436; 95% CI, 1.088–1.896). In multivariable model, stroke was also significantly associated with cognitive impairment (hazard ratio, 1.241; 95% CI, 1.011–1.522); however, the reverse association was not significant (hazard ratio, 1.068; 95% CI, 0.788–1.447). After the data from proxy respondents were excluded, in the sensitive analyses, the results remained unchanged.Conclusion: Older adults in the United States who suffered strokes are more likely to develop cognitive impairment as a result in the future than those who have not had strokes. However, the reverse association did not hold. Furthermore, the study suggests that it is necessary to screen and take early intervention for cognitive impairment in stroke survivors and prevent the incidence of stroke by modifying risk factors in the general population with rapidly growing older US adults.

A Systematic Review of Parenting Scales Measurement Invariance/Equivalence of by Race and Ethnicity: Recommendations for Inclusive Parenting Research

Assessment ◽  
2021 ◽  
pp. 107319112110386
Author(s):  
Violeta J. Rodriguez ◽  
Dominique L. La Barrie ◽  
Miriam C. Zegarac ◽  
Anne Shaffer
Keyword(s):  
Systematic Review ◽  
Measurement Invariance ◽  
Ethnic Minorities ◽  
Race And Ethnicity ◽  
Parenting Practices ◽  
The United States ◽  
Weak Evidence ◽  
Race Ethnicity ◽  
Development And Validation ◽  
Racial Ethnic

The limited inclusion of racial/ethnic minorities in the development and validation of parenting measures limits our understanding of whether parenting constructs are valid in racial and ethnic minorities. Tests of measurement invariance/equivalence (MI/E) of parenting measures can help evaluate the validity of parenting constructs among racial/ethnic minorities. This systematic review summarized studies on MI/E of parenting constructs by race/ethnicity and evaluated the strength of the evidence. A literature search was conducted using various databases and references to retrieve studies from the United States. Indeed, 10 studies were identified that tested for MI/E of eight parenting scales by race/ethnicity. Only one scale showed moderate evidence of MI/E, five showed weak evidence of MI/E, and two showed no evidence of MI/E. Most studies (80%) used factor analytic methods to test for MI/E, but only two studies (20%) examined all levels of invariance. These findings show that differences exist in how racial/ethnic minorities perceive parenting constructs. Further research is needed to develop more inclusive parenting measures, to protect against the ways in which biased measures may pathologize or misrepresent parenting practices among racial/ethnic minorities.

scholarly journals Preventable Cancer Burden Associated With Poor Diet in the United States

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Fang Fang Zhang ◽  
Frederick Cudhea ◽  
Zhilei Shan ◽  
Dominique S Michaud ◽  
Fumiaki Imamura ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Minorities ◽  
The United States ◽  
Dietary Factors ◽  
Assessment Model ◽  
Annual Number ◽  
Cancer Type ◽  
Middle Aged ◽  
Cancer Burden ◽  
Racial Ethnic

Abstract Background Diet is an important risk factor for cancer that is amenable to intervention. Estimating the cancer burden associated with diet informs evidence-based priorities for nutrition policies to reduce cancer burden in the United States. Methods Using a comparative risk assessment model that incorporated nationally representative data on dietary intake, national cancer incidence, and estimated associations of diet with cancer risk from meta-analyses of prospective cohort studies, we estimated the annual number and proportion of new cancer cases attributable to suboptimal intakes of seven dietary factors among US adults ages 20 years or older, and by population subgroups. Results An estimated 80 110 (95% uncertainty interval [UI] = 76 316 to 83 657) new cancer cases were attributable to suboptimal diet, accounting for 5.2% (95% UI = 5.0% to 5.5%) of all new cancer cases in 2015. Of these, 67 488 (95% UI = 63 583 to 70 978) and 4.4% (95% UI = 4.2% to 4.6%) were attributable to direct associations and 12 589 (95% UI = 12 156 to 13 038) and 0.82% (95% UI = 0.79% to 0.85%) to obesity-mediated associations. By cancer type, colorectal cancer had the highest number and proportion of diet-related cases (n = 52 225, 38.3%). By diet, low consumption of whole grains (n = 27 763, 1.8%) and dairy products (n = 17 692, 1.2%) and high intake of processed meats (n = 14 524, 1.0%) contributed to the highest burden. Men, middle-aged (45–64 years) and racial/ethnic minorities (non-Hispanic blacks, Hispanics, and others) had the highest proportion of diet-associated cancer burden than other age, sex, and race/ethnicity groups. Conclusions More than 80 000 new cancer cases are estimated to be associated with suboptimal diet among US adults in 2015, with middle-aged men and racial/ethnic minorities experiencing the largest proportion of diet-associated cancer burden in the United States.

scholarly journals CHANGES IN COGNITIVE FUNCTION AMONG SENIOR AMERICANS: TRENDS AND DIFFERENCES BY RACE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S650-S650
Author(s):  
Keqing Zhang ◽  
Wei Zhang ◽  
Yanyan Wu
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Hispanic Americans ◽  
Racial Diversity ◽  
Cultural Influences ◽  
The United States ◽  
Sociodemographic Factors ◽  
Future Research ◽  
Past Century

Abstract Improvements in health and increase in life expectancy have contributed to the increasing proportion of older population over the past century. It is estimated that by 2050, the number of older adults with cognitive impairments in the United States will increase by 2.5-4 fold, while age-specific rates remain constant. This paper uses data from 10 waves (1996-2014) of the Health and Retirement Study (N= 33213) to crystalize the trends in cognitive function changes and cognitive impairment rates in a nationally representative sample of older adults. OLS and logistic regressions are used to estimate the trends and determine the contribution of sociodemographic variables to decreasing trends in the prevalence of cognitive impairment over time. Results show that with the increase of age, the cognitive function of older adults decline in all races, after adjustment for age, gender, education, and other sociodemographic factors. Also, the annual decline rate of cognitive function is larger for African Americans and Hispanic Americans, while smaller for white and other races. A further investigation of the possibility of cognitive impairment reveals a different scenario: as individual ages, the Hispanic are the least likely to suffer from cognitive impairment, followed by the white, other and black. Improvements in educational level contribute to declines in cognitive impairment across all races, particular the Hispanic Americans. Race-specific findings suggest that future research need to take into account the racial diversity and possibly cultural influences when examining the cognitive functions of older adults.

A Review of the Validity of Juvenile Risk Assessment Across Race/Ethnicity

2018 ◽  
Author(s):  
Christina Campbell ◽  
William Miller
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Ethnic Minorities ◽  
Minority Groups ◽  
Critical Role ◽  
The United States ◽  
Risk Assessments ◽  
Assessment Instruments ◽  
Race Ethnicity ◽  
Racial Ethnic

Juvenile risk assessment instruments have provided juvenile courts with the opportunity to make standardized decisions concerning sentences and intervention needs. Risk assessments have replaced the reliance on professional decision-making practices in which court officials relied on their hunches or previous experience to determine what to do with youth once they became involved in corrections. A primary goal of juvenile risk assessment is to improve case management and help courts focus resources on juveniles who exhibit the greatest intervention needs. Further, juvenile risk assessments play a critical role in estimating which juveniles will likely reoffend by identifying factors that increase the propensity of future offending. Although some researchers believe that the implementation of standardized juvenile risk assessments is a good strategy for reducing biased decision-making for racial/ethnic minorities, other researchers have called into question the extent to which risk assessments overestimate risk for certain juveniles, especially those in minority groups who have a history of being marginalized due to their race, culture, or ethnicity. This article provides an overview of how well juvenile risk assessment instruments predict future delinquency across race and ethnicity. The review suggests that in general, risk assessments do a good job in predicting recidivism across racial/ethnic groups for diverse populations inside and outside the United States. However, there is still some room for improvement concerning the assessment of risk and needs for ethnic minorities. In addition, while there are some studies that do not report the predictive validity of risk assessment scores across race/ethnicity, risk assessments overall seem to be a promising effort to correctly classify and/or identify juveniles who are at greatest risk for future recidivism.

scholarly journals “We Are Here to Assist All Individuals Who Need Hospice Services”: Hospices’ Perspectives on Improving Access and Inclusion for Racial/Ethnic Minorities

2020 ◽  
Vol 6 ◽  
pp. 233372142092041 ◽  
Author(s):  
M. Courtney Hughes ◽  
Erin Vernon
Keyword(s):  
United States ◽  
Native American ◽  
Ethnic Minority ◽  
Ethnic Minorities ◽  
Community Outreach ◽  
The United States ◽  
Medical Community ◽  
Major Theme ◽  
Language Services ◽  
Racial Ethnic

Background: Racial/ethnic minority populations in the United States are less likely to utilize hospice services nearing their end of life, potentially diminishing their quality of care while also increasing medical costs. Objective: Explore the minority hospice utilization gap from the hospice perspective by examining perceived barriers and facilitators as well as practices and policies. Method: Qualitative surveys were conducted with 41 hospices across the United States. Qualitative data analysis included performing a limited content analysis, including the identification of themes and representative quotations. Results: Commonly reported barriers to hospice care for racial/ethnic minorities included culture/beliefs, mistrust of the medical system, and language barriers. A major theme pertaining to successful minority hospice enrollment was an inclusive culture that provided language services, staff cultural training, and a diverse staff. Another major theme was the importance of community outreach activities that extended beyond the medical community and forming relationships with churches, racial/ethnic minority community leaders, and Native American reservations. Conclusion: The importance of incorporating a culture of inclusivity by forming committees, providing language services, and offering culturally competent care emerged in this qualitative study. Building strong external relationships with community groups such as churches is a strategy used to increase racial/ethnic minority utilization of hospice.

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