Intergenerational Practice in the Community—What Does the Community Think?

The many changes that occur in the lives of older people put them at an increased risk of being socially isolated and lonely. Intergenerational programs for older adults and young children can potentially address this shortfall, because of the perceived benefit from generations interacting. This study explores whether there is an appetite in the community for intergenerational programs for community dwelling older adults. An online survey was distributed via social media, research team networks, and snowballing recruitment with access provided via QR code or hyperlink. Semi-structured interviews were undertaken with potential participants of a pilot intergenerational program planned for the Eastern Suburbs of Sydney, Australia in 2020. The interviews were thematically analyzed. Over 250 people completed the survey, and 21 interviews took place with older adults (10) and parents of young children (11). The data showed that participants were all in favor of intergenerational programs, but there were different perceptions about who benefits most and how. The study highlighted considerations to be addressed in the development of effective and sustainable intergenerational programs. For example, accessing people in the community who are most socially isolated and lonely was identified as a primary challenge. More evidence-based research is needed to support involvement of different cohorts, such as those who are frail, or living with physical or cognitive limitations.

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Prevalence of Impaired Kidney Function in the German Elderly: Results from the Berlin Aging Study II (BASE-II)

Gerontology ◽

10.1159/000454831 ◽

2017 ◽

Vol 63 (3) ◽

pp. 201-209 ◽

Cited By ~ 4

Author(s):

Maximilian König ◽

Maik Gollasch ◽

Ilja Demuth ◽

Elisabeth Steinhagen-Thiessen

Keyword(s):

Risk Factors ◽

Older Adults ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

The Elderly ◽

Community Dwelling ◽

Structured Interviews ◽

Cross Sectional ◽

Increased Risk ◽

Aging Study

Background: In aging populations with an ever-growing burden of risk factors such as obesity, diabetes, and hypertension, chronic kidney disease (CKD) is on the rise. However, little is known about its exact prevalence among elderly adults, and often albuminuria is not included in the definition of CKD. Moreover, novel equations for the estimated glomerular filtration rate (eGFR) have recently emerged, which have not been applied comprehensively to older adults. Data on CKD awareness among the elderly are sparse. Objectives: To determine the prevalence of CKD among older adults by eGFR and albumin/creatinine ratio (ACR), compare the performance of 6 established and novel eGFR formulas, explore risk factors, and determine the awareness of CKD in a large cohort of community-dwelling elderly from Germany. Methods: A total of 1,628 subjects from the Berlin Aging Study II (BASE-II) were included in this analysis (mean age 68.7 years; 51.2% female). Extensive cross-sectional data on sociodemographics, lifestyle, medication, and diagnoses were inquired during structured interviews and a medical examination, and blood and urine parameters were measured. Results: In all, 77.1% of the subjects had hypertension, 12.4% had diabetes, and 18.3% were obese. The prevalence of CKD strongly depended on the eGFR equations used: 25.4% (full age spectrum [FAS] equation), 24.6% (Berlin Initiative Study), 23.1% (Lund-Malmö revised), 19.3% (Cockcroft-Gault), 16.4% (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI]), and 14.7% (Modification of Diet in Renal Disease [MDRD]). Of the subjects with an eGFRFAS <60 mL/min/1.73 m2 and/or an ACR >30 mg/g, only 3.9% were aware of having CKD. Polypharmacy, age, BMI, coronary artery disease, non-HDL cholesterol, and female sex were independently associated with CKD. Conclusions: CKD is prevalent among older adults in Germany, but awareness is low. The FAS equation detects higher rates of CKD than MDRD and CKD-EPI, which are most widely used at present. Also, when CKD is defined based on eGFR and albuminuria, considerably more people are identified than by eGFR alone. Finally, polypharmacy is associated with an increased risk for CKD in the elderly.

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Social Isolation as a Risk Factor for Cigarette Smoking in Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.467 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 122-122

Author(s):

Gilbert Gimm ◽

Mary Lou Pomeroy ◽

Thomas Cudjoe

Keyword(s):

Older Adults ◽

Risk Factor ◽

Cigarette Smoking ◽

Social Isolation ◽

National Sample ◽

Community Dwelling ◽

Increased Risk ◽

Dual Eligible ◽

Socially Isolated ◽

Using Data

Abstract Objective This study examined the prevalence of social isolation and cigarette smoking in a national sample of community-dwelling older adults, and assessed the role of social isolation on the risk of cigarette smoking. Methods Using data from 8,044 participants (age 65+ years) across two waves of the National Health and Aging Trends Study (NHATS), we analyzed the prevalence of social isolation in older adults and as a risk factor for cigarette smoking. Social isolation was measured across 4 relationship domains (Cudjoe, 2018) on a scale of 0 to 4, using objective measures of social interactions. Descriptive and logistic regression analyses were conducted to assess how social isolation is associated with smoking. Results Preliminary results showed that 18.2% of older adults were socially isolated (3.5% severely isolated) and 7.1% of participants reported current smoking. We found that both social isolation (OR = 2.5, p<.001) and severe isolation (OR = 5.9, p<.001) increased the odds of smoking. Also, older adults with depression (OR = 1.6, p<.01) and dual-eligible beneficiaries (Medicare and Medicaid) with TRICARE coverage (OR = 4.6, p<.05) had greater odds of smoking. However, we did not find evidence that the odds of smoking varied significantly by the number of chronic conditions. Conclusion Social isolation is associated with an increased risk of cigarette smoking among older adults. Smoking may be an important behavior in the pathway between social isolation and its association with morbidity and mortality.

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Patterns and Predictors of Transitions Across Residential Care Settings and Nursing Homes Among Community-Dwelling Older Adults in the United States

The Gerontologist ◽

10.1093/geront/gnaa070 ◽

2020 ◽

Vol 60 (8) ◽

pp. 1495-1503

Author(s):

Linda C Chyr ◽

Emmanuel F Drabo ◽

Chanee D Fabius

Keyword(s):

Older Adults ◽

Nursing Homes ◽

Socioeconomic Factors ◽

Residential Care ◽

Behavioral Model ◽

The United States ◽

Community Dwelling ◽

Age In Place ◽

Cognitive Limitations ◽

Increased Risk

Abstract Background and Objectives Older adults prefer to age in place, but sociodemographic, health, and socioeconomic factors may influence their decision to remain in the community. Guided by Andersen’s behavioral model, we characterize incident transitions out of the community into residential care settings or nursing homes and identify predictors of these transitions. Research Design and Methods Study participants include 2,725 (weighted n = 13,704,390) community-dwelling U.S. older adults of the National Health and Aging Trends Study from 2011 to 2018. We examined the associations between sociodemographic, socioeconomic, and health factors and the probability of transition using a multinomial logit model. Results Over the study period, 86.2% of older adults remained in the community, whereas 9.0% and 4.9% transitioned to residential care settings and nursing homes, respectively. Older age, living alone, having functional and cognitive limitations, and hospitalization were associated with increased risk of transitioning to residential care settings or nursing homes from the community. Blacks and Hispanics were less likely to transition to residential care settings or nursing homes. Adults with lower income had a greater risk of transitioning to nursing homes. Medicaid enrollment did not affect the likelihood of transition. Discussion and Implications Majority of older adults remained in the community, and incident transition to residential care settings was more common than to nursing homes. Policy should target sociodemographic, health, and socioeconomic factors that enable older adults to age in place. Future work should examine whether these new residential care settings enhance the quality of life or result in subsequent transitions back into the community.

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COVID-19-Related Lifestyle Changes among Community-Dwelling Older Adult Day-Care Users: A Qualitative Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010256 ◽

2021 ◽

Vol 19 (1) ◽

pp. 256

Author(s):

Akira Teramura ◽

Yumi Kimura ◽

Kosuke Hamada ◽

Yasuko Ishimoto ◽

Masato Kawamori

Keyword(s):

Older Adults ◽

Day Care ◽

Leisure Activities ◽

Lifestyle Changes ◽

Community Dwelling ◽

Structured Interviews ◽

Care Needs ◽

Care Services ◽

Before And After ◽

Socially Isolated

In Japan, the community-based comprehensive care system is an important initiative. The purpose of this study was to understand COVID-19-related lifestyle changes experienced by older adults who lived in communities and used day-care services. Using a qualitative inductive research method, semi-structured interviews were conducted with 13 older adults who used day-care services in Kyoto City, which assessed lifestyle changes before and after the spread of COVID-19 during March–April 2021. The extracted lifestyle change codes were classified into six categories and 16 subcategories. The data revealed that older adults felt socially isolated and experienced multiple changes in their lives, including limited leisure activities, changes in roles, decreased interpersonal interaction with family and acquaintances, poor diet and sleep quality, and reduced attention to personal appearance and grooming. The findings suggest that during COVID-19, older adults had difficulty adapting to the various changes in their lives and showed a decline in physical and mental functioning. Thus, it is important for day-care facilities to create sustainable spaces in response to the various care needs of community-dwelling older adults whose lifestyles have changed as a result of the COVID-19 situation.

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COVID-19 Pandemic Restrictions Affecting Older Adults' Social Interactions and Communication

Current Developments in Nutrition ◽

10.1093/cdn/nzab029_048 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 247-247

Author(s):

Mackinsey Shahan ◽

Seung Eun Jung ◽

Frankie Palmer ◽

Amy Ellis

Keyword(s):

Social Support ◽

Older Adults ◽

Online Survey ◽

Community Dwelling ◽

Individual Interviews ◽

Funding Sources ◽

Phone Calls ◽

Use Of Technology ◽

Increased Risk ◽

The Impact

Abstract Objectives Due to increased risk of social isolation caused by COVID-19, this study was conducted to understand changes in health behaviors among older adults, particularly concerning means of social interaction. Methods Community dwelling adults ages 60 and older completed qualitative individual interviews via Zoom and a 24 item online survey, the Questionnaire for Assessing the Impact of the COVID-19 Pandemic in Older Adults. Data were analyzed using directed content analysis and descriptive statistics. Results A total of 23 participants completed interviews and 25 completed online surveys. Participants were mainly female (72%), white (96%), with a mean age of 71.96 years. Nineteen (76%) participants were very concerned by the pandemic, and only one participant was not at all concerned. Participants frequently reported more interactions with their immediate family. Only five (20%) reported communicating with close friends and family less often than before the pandemic began. Seven (28%) reported communicating with friends and family more often than before and about half (52%) reported that their frequency of communication was “about the same” as pre-pandemic. Twenty-one (84%) participants communicated with others daily or at least several times per week. However, participants reported less face-to-face interaction and increased use of technology, such as virtual happy hours. All participants stayed in touch with others by phone calls (100%). Other often used means of communication were texting (92%), video calls (68%), email (68%), social media (52%), and postal mail (48%). Participants also reported some social gatherings with individuals bringing their own food and social distancing maintained. Despite this, 16 participants (64%) reported feeling isolated from others sometimes or often. Conclusions Although many older adults have adjusted their usual behaviors to stay in contact with others during the pandemic, this study found that most still felt isolated. Long-term feelings of isolation and lack of social support may compromise nutrition for this population. Therefore, it is crucial that nutrition professionals incorporate aspects of social support when working with these individuals. Funding Sources Julie O'Sullivan Maillet Research Grant Award funded by the Academy of Nutrition and Dietetics Foundation (ANDF).

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Feasibility and Acceptability of the Technology-Based Fall Risk Assessments for Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.3598 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 1013-1013

Author(s):

Ladda Thiamwong ◽

Oscar Garcia ◽

Renoa Choudhury ◽

Joon-Hyuk Park ◽

Jeffrey Stout ◽

...

Keyword(s):

Older Adults ◽

Technology Acceptance ◽

Fall Risk ◽

Online Survey ◽

Structured Interview ◽

Activity Monitoring ◽

Community Dwelling ◽

Risk Assessments ◽

Balance Performance ◽

Structured Interviews

Abstract Promising technologies, which are simple, portable, quick, non-invasive, and inexpensive, may open new horizons on fall risk assessments and provide important information for older adults. We used a mixed-methods approach to examine the feasibility and acceptability of technology-based fall risk assessments, including the BTrackS Balance System, Bioelectrical Impedance Analysis, and activity monitoring devices among older adults. Data were collected via a Qualtrics survey and interviews. The acceptability was measured by the Senior Technology Acceptance (STA) and semi-structured interviews with 15 participants. The STA consists of four domains with 14 items, and the semi-structured interview includes three main questions related to experiences about balance performance tests, body composition, and activity monitoring. One hundred twenty-four community-dwelling older adults completed the online survey, and 15 older adults participated in the interviews. The majority of participants were female, and 72% had no history of falls. Race and ethnicity were 17% Hispanic, 7% African Americans, and 3% Asian Americans. About 7% had COVID-19 positive, 31% reported fear of COVID, and 14.5% were afraid of losing their life to COVID. The word-of-mouth strategy and key person approach were used and had an incredible impact on the recruitment process. None of the participants had ever had their fall risk and fear of falling assessed before agreeing to participate in this study. The technology-based fall risk assessments were feasible and acceptable. About 78% of participants liked the idea of using technology to assess falls risk, and 79% agreed that using technology would enhance their effectiveness in daily activities.

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HEARING LOSS AND SOCIAL ISOLATION: THE ROLE OF NEIGHBORHOOD SOCIAL COHESION AND DISORDER

Innovation in Aging ◽

10.1093/geroni/igz038.3462 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S954-S954

Author(s):

Sol Baik ◽

Amanda Lehning

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Social Isolation ◽

Social Cohesion ◽

Protective Factor ◽

Community Dwelling ◽

Random Coefficient ◽

Neighborhood Social Cohesion ◽

Increased Risk ◽

Socially Isolated

Abstract Social isolation is a critical public health issue that socially isolated individuals are at increased risk for mortality and deteriorated health. Those who acquire hearing loss in later life experience difficulties with communication, potentially leading to social isolation. However, less is known about the social consequences of age-related hearing loss, and few studies have assessed the influence of environmental factors on hearing loss and social isolation. The aims of this study are to examine: (1) the association between hearing loss and social isolation of older adults over time, and (2) the moderating effects of perceived neighborhood social cohesion and disorder on this relationship. We analyzed 2,080 community-dwelling Medicare beneficiaries aged 65 or above from Round 1 to 3 of National Health and Aging Trends Study. We conducted random coefficient models, entering hearing loss as a random coefficient. Older adults with hearing loss were less socially isolated than those without hearing loss. However, the effect of hearing loss on social isolation varied depending on perceived neighborhood social cohesion. Older adults with hearing loss who reported high neighborhood cohesion had significantly lower social isolation compared to those without hearing loss, while those with hearing loss who perceived low social cohesion had significantly higher social isolation. Our findings suggest neighborhood social cohesion can serve as a potential protective factor for older adults with hearing loss. This poster will propose neighborhood-level interventions that could supplement other services for those with hearing loss, such as assistive devices that are rarely covered by health insurance.

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“For me, it's connection”: Older Adults Experience with Technology during COVID-19

Innovation in Aging ◽

10.1093/geroni/igab046.3550 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 998-998

Author(s):

Vivian Miller ◽

HeeSoon Lee ◽

Erin Roark

Keyword(s):

Older Adults ◽

Technology Use ◽

Social Connectedness ◽

Adult Population ◽

Community Dwelling ◽

Structured Interviews ◽

Ict Use ◽

Primary Means ◽

Socially Isolated ◽

Barriers And Challenges

Abstract As a result of COVID-19, older adults have experienced isolation, lost social contacts, and a decrease in connections. A recent study found that “approximately one-quarter of community-dwelling older adults are considered to be socially isolated, and 43% of them report feeling lonely.” Various innovative interventions have emerged, including technology-based interventions as a means to reduce social isolation in older adults, particularly as information communication technology (ICT) use is on the rise among this population. However, it remains to be known how these connections are faring for older adults in the pandemic and whether these ICT connections lead to greater or lesser feelings of social connectedness. Thirty-nine (N=39) in-depth semi-structured interviews were conducted to explore the lived experiences of technology use among older adults during COVID-19. Participants experiences with ICT ranged from illiterate to savvy. Most participants indicated Zoom was the primary means to stay socially connected to family and friends. Participants emphasized that ICT may be a possible solution to deal with loneliness for those older adults who are especially isolated due to COVID-19 restrictions. Barriers and challenges to ICT use included taking too much time to use and needing help to fix any problems that arose. Finally, participants shared essential aspects of ICT use, revealing that it was ‘technology or nothing.’ Findings from this study indicate a need for a simple ICT for the older adult population. Moreover, findings suggest opportunities for peer-support ICT training programs for older adults.

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Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137067 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7067

Author(s):

Esther García-Esquinas ◽

Rosario Ortolá ◽

Iago Gine-Vázquez ◽

José A. Carnicero ◽

Asier Mañas ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Older Adults ◽

Social Isolation ◽

Community Dwelling ◽

Housing Conditions ◽

Older Individuals ◽

Lifestyle Risk Factors ◽

Increased Risk ◽

Lifestyle Risk

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

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Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study

Innovation in Aging ◽

10.1093/geroni/igaa057.2380 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 683-683

Author(s):

Asa Inagaki ◽

Ayumi Igarashi ◽

Maiko Noguchi-Watanabe ◽

Mariko Sakka ◽

Chie Fukui ◽

...

Keyword(s):

Older Adults ◽

Online Survey ◽

Physical Restraint ◽

Community Dwelling ◽

Physical Restraints ◽

Care Nurse ◽

Factors Associated ◽

Home Care Nurse ◽

Community Dwelling Older Adults ◽

At Home

Abstract Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.

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