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Background and Objectives: Although prior research has shown that social relationships and daily stress are strongly associated with cognitive function, few studies have explored the link between the quality of daily social encounters and subjective cognitive decline (SCD). The present study explores whether the quality of older adults' daily social encounters is associated with SCD through daily stress., Research Design and Methods: This study used data from 254 adults aged 70 or older ( M age  = 76.5 years, SD  = 4.4; 67.7% women) who completed the Einstein Aging Study, a 2-week experience sampling study. Multilevel mediation analyses were conducted to account for daily measurements nested within individuals. We tested the indirect effect of the quality of daily social encounters on SCD through daily stress levels., Results: There was a significant positive association between ambivalent and neutral social encounters and daily stress levels at both the within- and between-person levels. Between-person daily stress was, in turn, associated with greater SCD. Specifically, there was a significant indirect path from ambivalent social encounters to SCD through daily stress., Discussion and Implications: This study contributes to a more detailed understanding of how the quality of daily social encounters can influence cognition via increased exposure to daily stress. The findings suggest that emotional support may be crucial to preserving perceptions of older adults' cognitive functioning., Competing Interests: None., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Background: Early identification of cognitive impairment is an important part of health promotion in aging. However, many older adults do not seek help for cognitive problems until their ability to function independently is substantially impacted. The purpose of this descriptive study was to explore older adults' experiences with patient-provider communication specific to cognition as well as compare barriers and facilitators between those with and without memory concerns., Methods: We conducted an online survey with individuals aged 65 + years (n = 409; mean age = 71.4(4.73); 54% female; 79% non-Hispanic White), purposively sampled to include those with and without memory concerns. Questionnaires included measures of subjective memory decline (SMD), memory concerns, past healthcare experiences, as well as open-ended questions regarding patient-provider communication about cognition. Content analysis was used to code open-ended responses. Logistic regression was used to examine differences in facilitators and barriers to communication among three groups: no SMD (n = 130), SMD without memory concerns (n = 143), and SMD with memory concerns (n = 136)., Results: Only 16.6% of participants reported discussing cognition with a healthcare provider. Of the remaining 83.4%, approximately two-thirds would be open to such discussions in certain circumstances, most frequently if they had worsening memory problems. Over half of participants reported that their provider had never offered cognitive testing. Compared to the no SMD and SMD without memory concerns groups, participants reporting SMD with memory concerns were more likely to: (1) discuss cognition if their healthcare provider initiated the conversation, and (2) avoid discussions of cognitive problems due to fears of losing independence., Conclusions: We found that most participants, including those reporting SMD with memory concerns, had never discussed cognition with their healthcare providers. Patient-reported barriers and facilitators to communication about cognition differed in several areas based on SMD status and the presence or absence of memory concerns. Consideration of these differences can guide future efforts to improve early identification of subtle cognitive changes that would benefit from further monitoring or intervention., (© 2023. The Author(s).)

Objectives: The present study aims to identify distinct types of relationships between grandparents and their adult children, measure the associations between these relationship types and depressive symptoms among grandparents, and determine whether these associations vary by grandparent status. Method: This study uses data from a sample of 1,196 grandparents age 51 and older from the 2014 Health and Retirement Study. Latent class analysis (LCA) is applied and identifies types of grandparent-adult children relationships. Ordinary Least Squares (OLS) regression models are used to estimate the association between relationship types and depressive symptoms by grandparent status. Results: LCA identified four grandparent-adult children relationship types: amicable, ambivalent, detached, and disharmonious. Custodial and co-parenting grandparents were most likely to report having an ambivalent relationship with their adult children. Among co-parenting and custodial grandparents, disharmonious relationships were associated with more depressive symptoms. Conclusion: Interventions are suggested to improve emotional relationships with adult children and dyadic family relationships among grandparent families.

The World Health Organization recently highlighted the serious worldwide problem of the emergence of antibiotic-resistant or antibiotic multidrug-resistant bacteria. Carbapenem-resistant Enterobacterales, including carbapenemase-producing Enterobacterales (CPE), are major antibiotic-resistant bacteria that can be identified by various methods, including antibiotic susceptibility testing, PCR, and immunologic assays. However, there is a need for a faster, more accurate, low-cost, and easy method to detect CPE strains. We previously developed an osmotic shock matrix-assisted laser desorption/ionization mass spectrometry (OS-MALDI MS) method for directly detecting intact Klebsiella pneumoniae carbapenemase (KPC) using osmotic shock cell lysis. In this study, we evaluated the OS-MALDI MS method and compared it with two other methods (octyl-glucoside-aided direct KPC detection method [OG-MALDI MS] and Bruker's MBT subtyping module indirect method [MBT-SM MALDI MS]). We first completed an analytical performance evaluation of the OS-MALDI MS method according to Clinical and Laboratory Standards Institute guidelines. Clinical testing was performed with 437 clinical isolates, including 292 KPC-producing bacteria and 145 non-KPC-producing bacteria. The OS-MALDI MS method exhibited 95.9% sensitivity, 100.0% specificity, and 100.0% precision for detecting KPC. Accuracy of the OS-MALDI MS, OG-MALDI MS, and MBT-SM MALDI MS methods was 97.3%, 55.9%, and 50.2%, respectively. In conclusion, the OS-MALDI MS method clearly outperformed the other methods, exhibiting the highest accuracy and sensitivity of the three methods. We propose the OS-MALDI MS method as a practical, useful method for clinic environments, which may help guide appropriate antibiotic treatment and contribute to the prevention of the spread of CPE.

Objectives: This study examined the longitudinal association of depressive symptoms with grandchild care intensity and whether the association varies by household structure, residential area, and gender for Chinese grandparents., Methods: Using data from three waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015), we applied multilevel mixed effects models to examine changes in depressive symptoms and the associations with caregiving intensity and to test the moderation effects of residence, living arrangement, and gender., Results: After controlling for sociodemographic and health covariates, we found that providing a medium level of grandchild care was associated with fewer baseline depressive symptoms compared with non-caregivers. Providing low-level care among those living with spouse/partner and among those living with child(ren)/others was associated with fewer depressive symptoms relative to non-caregivers with similar living arrangements., Conclusion: Findings indicate that a medium level of involvement in childcare was associated with better mental wellness and low levels of caregiving may benefit nonresidential caregivers. More prospective longitudinal studies are needed to improve the operationalization of grandparent caregiving, validate the associated health outcomes, and apply a contextual approach to examine socioeconomic, cultural, and policy-related contexts of caregiving in the changing world of China.

Guided by a convoy model of social relations, this study explores the complex relationships between loneliness, age at immigration, familial relationships, and depressive symptoms among older immigrants. This study used 2010 Health and Retirement Study data from a sample of 575 immigrants (52% female, age range 65-99 years). Ordinary least squares regression models were estimated. The findings indicate that for older immigrants who came to the United States at age 45 or older, loneliness was significantly positively associated with depressive symptoms. Further, perceived negative strain and hours spent helping family moderated this relationship such that the effect of loneliness on depressive symptoms was stronger among respondents who perceived more negative family strain and spent fewer hours helping family. Familial relationships are crucial for the psychological well-being of older immigrants because they can be a source of either stress or support. The results have implications for how research and practices can support the immigrant families., Competing Interests: Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Guided by a convoy model of social relations, this study investigates the relationships between grandparenting status, social relations, and mortality among community-dwelling grandparents age 65 and older who are caring for their grandchildren. The data were drawn from the 2008 and 2016 waves of the Health and Retirement Study ( N = 564). Latent class analysis was used to identify the social network structure based on six indicators of interpersonal relationships and activities. A series of hierarchical Weibull hazard models estimated the associations between grandparent caregiving, social relations, and mortality risk. Results of survival analyses indicate that co-parenting and custodial grandparents had higher all-cause mortality risk than grandparents who babysat occasionally; however, for custodial grandparents, the association was not significant once social relation variables were added to the model. This study suggests that community-based support may be beneficial to older grandparents and improved relationship quality is integral to the well-being of older adults.

Objectives: For the growing population of older immigrants in the United States, both age at immigration and familial relationships are important factors affecting psychological well-being. This study explores how age at immigration and contemporary relationships with adult children combine to explain older immigrants' depressive symptoms., Method: This study uses 2014 Health and Retirement Study data from a sample of 759 immigrants aged 65 and older who have at least one adult child aged 21 or older. A series of ordinary least squares regressions and mediational analyses were conducted., Results: Findings indicate that structural solidarity significantly mediates the association between age at immigration and depressive symptoms. Specifically, immigrating in later life was associated with a lower level of depressive symptoms through its relationship with structural solidarity. In addition, giving monetary support to children and providing care for grandchildren may alleviate depressive symptoms for older immigrants., Discussion: This study suggests that relationships with adult children may differ with age at immigration. The types of support that older immigrants provide to their adult children may be crucial because such support may instill a sense of obligation and reciprocity that may be beneficial to the psychological well-being of older immigrants., (© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: Clinical mass spectrometry requires a simple step process for sample preparation. This study aims to optimize the method for isolating periplasmic protein from Gram-negative bacteria and apply to clinical mass spectrometry., Experimental Design: The Klebsiella pneumoniae carbapenemase (KPC)-producing E. coli standard cells were used for optimizing the osmotic shock (OS) lysis method. The supernatant from OS lysis was analysed by LC-MS/MS and MALDI-TOF MS. The effectiveness of the OS lysis method for KPC-2-producing Enterobacteriaceae clinical isolates were then confirmed by MALDI-TOF MS., Results: The optimized OS lysis using KPC-2 producing E. coli standard cells showed a high yield of KPC-2 protein and enriches periplasmic proteins. Compared with other lysis methods, the detection sensitivity of KPC-2 protein significantly increased in MALDI-TOF MS analysis. Nineteen clinical isolates were validated by MALDI-TOF MS using the OS method, which also showed higher detection sensitivity compared to other lysis method (e.g., 1.5% n-octyl-β-D-glucopyranoside) (p < 0.001)., Conclusions and Clinical Relevance: This study provides a straightforward, rapid, affordable, and detergent-free method for the analysis of periplasmic proteins from Enterobacteriaceae clinical isolates. This approach may contribute to MS-based clinical diagnostics., (© 2021 Wiley-VCH GmbH.)

This study examined the effects of group art therapy on depression, burden, and self-efficacy in primary family caregivers of patients with brain injuries. This was a quasi-experimental, nonequivalent control group and a pre- and post-test design. This study was carried out in one national rehabilitation hospital targeting 41 primary family caregivers of patients with brain injuries. Group art therapy intervention was carried out three days per week comprising 12 sessions over four consecutive weeks. The experimental group ( n = 20) received group art therapy, whereas the control group ( n = 21) did not. We used a time difference method to minimize the risk of contaminating the control group by sampling sequentially. For depression, although there was a significant difference after the intervention ( t = 3.296, p = 0.004), the mean difference score was not statistically significant between the experimental group and the control group ( t = 0.861, p = 0.395). The experimental group showed a significantly greater decrease in burden ( t = 2.462, p = 0.020) and significantly greater improvement in self-efficacy ( t = -6.270, p < 0.001) than the control group. Group art therapy may be an effective nursing intervention for primary family caregivers of patients with brain injuries.

This study aims to examine the effect of the death of a family member or friend on psychological well-being, specifically the moderating effects of first-time volunteering and social network. With the sample of 354 volunteers from the Experience Corps® (EC) programs, Analysis of covariance (ANCOVA) estimated the differences in psychological well-being. Among volunteers who had experienced the death of a family member or friend, new volunteers showed significant improvement in positive affect compared to experienced volunteers. EC members gained additional social contacts through volunteering. Formal volunteering has a salutatory effect on older adults' health after the loss of family members.

Guided by a stress-buffering model, this study examined the effect of the caregiver stress on depressive symptoms, specifically the moderating effects of social support and volunteering on the relationship between stress and depressive symptoms among grandparent caregivers. The 2010 Health and Retirement Survey included a sample of 1,973 grandparent caregivers who reported their stress scores. Findings suggest that positive social support and volunteering significantly moderated the relationship between stress and depressive symptoms. In particular, the study revealed that perceived quality of relations may help grandparent caregivers cope with their ongoing stress and enlarged social interaction may buffer the increase of negative stressor outcomes., (© The Author(s) 2016.)

Caring for an older adult with memory loss is stressful. Caregiver stress could produce negative outcomes such as depression. Previous research is limited in examining multiple intermediate pathways from caregiver stress to depressive symptoms. This study addresses this limitation by examining the role of self-efficacy, social support, and problem solving in mediating the relationships between caregiver stressors and depressive symptoms. Using a sample of 91 family caregivers, we tested simultaneously multiple mediators between caregiver stressors and depression. Results indicate that self-efficacy mediated the pathway from daily hassles to depression. Findings point to the importance of improving self-efficacy in psychosocial interventions for caregivers of older adults with memory loss.

This study evaluated the effect of a tailored stage-matched intervention designed to increase exercise among Korean adults with chronic diseases. A physician and a nurse collaborated to deliver the intervention to 21 patients; the control group (CG) consisted of 20 patients. A nonequivalent CG pretest-posttest design was used. On follow-up, commitment to a plan for exercise was significantly greater in the intervention group (IG) than in the CG. Furthermore, the proportion of the IG in the active stage was significantly increased compared to that of the CG. The results suggest the potential of a stage-matched intervention program for increasing commitment to physical activity and for promoting progress through stages of exercise among patients with chronic diseases in a physician-based Korean clinic.

The purpose of this study was to test seven constructs (prior experience of exercise, perceived health status, exercise benefits, exercise barriers, exercise self-efficacy, social support for exercise, and options for exercise) from the health promotion model (HPM) as a causal model of commitment to a plan for exercise in a sample of 400 Korean adults with chronic disease. Using structural equation modeling (SEM), we found that all fit indices indicated a good fit. The final model accounted for 54% of the variance in commitment to a plan for exercise. Prior experience with exercise and exercise benefits were the factors most highly related. Health professionals can assess prior experience and emphasize personally relevant benefits of exercise in designing intervention programs to help Korean adults with chronic disease become more physically active.