What Could Interfere with a Good Night’s Sleep? The Risks of Social Isolation, Poor Physical and Psychological Health among Older Adults in China

This study provides one of the first population-based investigations of the longitudinal association between social isolation and sleep difficulty among older adults in China. We analyzed three waves of longitudinal data from the China Longitudinal Aging Social Survey (2014–2018), in which 8456 respondents contributed 16,156 person-year observations. Results from multilevel logistic regression models showed that social isolation was related to a higher risk of sleep difficulty. We also found that socially isolated older adults were more likely to report higher levels of depressive symptoms, a greater prevalence of loneliness and pain, and more chronic diseases compared to their socially integrated counterparts, which in turn increased their risks of sleep difficulty. Moreover, socially isolated older adults with chronic diseases were particularly vulnerable to the risk of sleep difficulty. These findings provide helpful guidance for policymakers and practitioners to design effective intervention strategies to help older adults with sleep problems.

Older Americans’ Perceptions of the Federal Government’s Pandemic Response: Voices From the COVID-19 Coping Study

There is limited understanding of how older adults evaluated the federal government’s COVID-19 response, despite their increased health risks during the pandemic and their important role in politics. We conducted qualitative thematic analysis on a nationally representative subsample of respondents aged 55+ from the COVID-19 Coping Study ( N = 500) who were asked: “How do you feel about federal government responses to and handling of the COVID-19 pandemic?” Analyses identified largely negative opinions about the federal government and former President Trump’s leadership, though some were neutral or positive. Participants expressed concerns that the federal government was undermining science, and that sending mixed messages about personal protective equipment and masks was dangerous. Perspectives were divergent and reflective of the country’s polarization surrounding COVID-19 policies. Results can inform efforts to build unity between political parties and identify strategies that governments can use to better respond to future public health crises.

Factors Influencing Intention to Technological Use in Older Adults. The TAM Model Aplication

The use of digital technology by older adults has improved in recent years in response to the need for their functional adaptation to an increasingly technological social context. Understanding this type of technological adaptation has recently become an important field of inquiry in both social and gerontological studies. Working within this framework, the aim of this study is to identify the main determinants that influence the intention of older people to use digital technology in their daily lives, using the Technological Acceptance Model. A study was carried out with the participation of 1155 people over 65 years of age in Spain. Confirmatory Factor Analysis and structural equation models (SEM) were performed. The results show that the TAM is a useful model to explain the intention of older adults to use Digital Technology, showing a high predictive power, highlighting Perceived Usefulness and Perceived Ease of Use as the main predictor variables.

The Impact of Ambulatory Dementia Care Models on Hospitalization of Persons Living With Dementia: A Systematic Review

This systematic review presents an overview of the existing dementia care models in various ambulatory care settings under three categories (i.e., home- and community-based care models, partnership between health systems and community-based resources, and consultation models) and their impact on hospitalization among Persons Living with Dementia (PLWD). PRISMA guidelines were applied, and our search resulted in a total of 13 studies focusing on 11 care models. Seven studies reported that utilization of dementia care models was associated with a modest reduction in hospitalization among community-residing PLWD. Only two studies reported statistically significant results. Dementia care models that were utilized in specialty ambulatory care settings such as memory care showed more promising results than traditional primary care. To develop a better understanding of how dementia care models can be improved, future studies should explore how confounders (e.g., stage of dementia) influence hospitalization.

Intergenerational Caregiving Patterns, Living Arrangements, and Life Satisfaction of Adults in Mid and Later Life in China

While the health implications of intergenerational caregiving have been broadly investigated in the aging literature, less is known about caregivers in four-generation families and their living arrangements. Using 2011 and 2013 waves of China Health and Retirement Longitudinal Study ( N = 12,914 obs.), we document enhanced life satisfaction of grandchild caregivers and sandwich caregivers caring for both grandchildren and parents than non-caregivers. When further taking living arrangements into consideration, we find that parent caregivers also benefit from care provision when not living with their parents and sandwich caregivers only have an advantage when co-residing with care recipients with adult children present in households. By contrast, grandchild caregivers living with grandchildren show substantially higher life satisfaction no matter adult children are present or not. The subgroup comparison suggests that females and rural residents enjoy psychological advantages over their male counterparts and urban counterparts in grandparenting within skipped-generation households and sandwich caregiving.

Does Receiving Informal Care Lead to Better Health Outcomes? Evidence From China Longitudinal Healthy Longevity Survey

Population aging has become a global challenge. Drawing data from Chinese Longitudinal Healthy Longevity Survey 2008, 2011, and 2014, this study examines the effect of informal care receipt on functional limitations and depressive symptoms among older people in China using lagged fixed effects model. Our findings suggest that receiving informal care is significantly associated with a slower functional decline. We also find that this effect varies across different income groups. The protective effect of informal care is more pronounced among older people with higher income compared to those with lower income. We do not observe any significant associations between receiving informal care and depressive symptoms of older people. This study highlights a pressing need for the Chinese government to establish a comprehensive long-term care system.

Effects of Mindfulness-Based Interventions on Depressive Symptoms, Anxiety, Stress, and Quality of Life in Family Caregivers of Persons Living with Dementia: A Systematic Review and Meta-analysis

Objective: This systematic review and meta-analysis examined effects of mindfulness-based interventions (MBIs) on depressive symptoms, anxiety, stress, and quality of life in family caregivers of people with dementia. Methods: A comprehensive search was conducted within the PubMed, CINAHL, PsycINFO, and SCOPUS databases to identify relevant randomized controlled trials (RCTs). Depending on I2 statistic values for heterogeneity, either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the types of control groups and MBIs. Results: 15 RCTs met the eligibility criteria. Meta-analyses showed medium to large effects of MBIs on depressive symptoms, anxiety, stress, and quality of life at the immediate posttest. Small to large effects of MBIs were found at follow-up. Conclusions: Future high-quality studies involving different types of MBIs and delivery modes are needed to better understand effects of MBIs on family caregivers of people with dementia and examine effective intervention features.

Do Early-Life Social, Behavioral, and Health Exposures Increase Later-Life Arthritis Incidence?

Objectives: This study investigates direct and indirect influences of childhood social, behavioral, and health exposures on later-life osteoarthritis and rheumatoid arthritis development. Methods: Drawing from cumulative inequality theory and six waves of the Health and Retirement Study (2004–2014), we estimate structural equation modeling-based discrete-time survival analysis of the association between six childhood exposure domains and both osteoarthritis and rheumatoid arthritis incidence for men ( n = 2720) and women ( n = 2974). Using the delta method to test for mediation, we examine indirect effects via selected health-related risks and resources. Results: Risky adolescent behavior is associated with rheumatoid arthritis incidence for women (h.O.R. = 1.883, 95% C.I. [1.016, 3.490]), whereas several types of childhood exposures are associated with later-life osteoarthritis development for both men and women. Experiencing two or more childhood socioeconomic disadvantages is indirectly associated with osteoarthritis (men: coef. = 0.024, 95% C.I. [0.003, 0.045]; women: coef. = 0.111, 95% C.I. [0.071, 0.150]) and rheumatoid arthritis (men: coef. = 0.037, 95% C.I. [0.000, 0.074]; women: coef. = 0.097, 95% C.I. [0.035, 0.159]) development through adult body mass index. Discussion: Findings highlight the importance of childhood contexts in understanding the development of later-life osteoarthritis and rheumatoid arthritis.

Childhood Adversities and Unmet Needs of Older Chinese Adults: The Mediation Effects of Family Relationships

Ensuring equality and adequacy of care for older adults is vitally important. This study investigates the relationships between childhood adversities and unmet long-term care needs of older adults in China and the mediation effects of family relationships. The data came from a nationally representative sample of older Chinese adults aged 60 and over with long-term care needs ( N = 2186). We conducted mediation analyses and decomposed the total effects of childhood adversities on unmet needs into direct and indirect effects. The probability of unmet needs is significantly higher among older adults experiencing childhood adversities. Satisfaction with marriage mediates the association between childhood adversities and unmet personal care needs. Relationships with children mediate the association between childhood adversities and unmet domestic care needs. The causes of unmet needs can be traced back to early life, which underscores the importance of concerted efforts in family, education and long-term care policies to tackle unmet needs.

Psychological and Social Factors Associated with Coexisting Frailty and Cognitive Impairment: A Systematic Review

Those living with coexistent frailty and cognitive impairment are at risk of poorer health outcomes. Research often focuses on identifying biological factors. This review sought to identify the association psychological and social factors have with coexisting physical and cognitive decline. Six databases were systematically searched in July 2020. Studies included individuals aged 60 years or older identified as being both frail and cognitively impaired. A narrative synthesis examined patterns within the data. Nine studies were included, most employed a cross-sectional design. Depression was investigated by all nine studies, those with coexistent frailty and cognitive impairment had higher levels of depressive symptoms than peers. Findings were mixed on social factors, although broadly indicate lower education, living alone and lower material wealth were more frequent in those living with coexistent decline. Further research is needed to explore potentially modifiable psychological and social factors which could lead to the development of supportive interventions.