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The National Institute on Aging (NIA), the newest of the 11 National Institutes of Health, is dedicated to improving the quality of life of the old in America through biomedical, social, and behavioral research. Aging is viewed as more than just decline and deterioration; it is also a process of continued development and accumulated knowledge. The NIA will encourage innovative research but will not support the delivery of health services, as that is the domain of the other agencies. In areas of overlap, such as diseases common to the old, the NIA will collaborate with other Institutes. A good target area for collaboration is senile dementia. Other areas of interest to the NIA are: encouraging the incorporation of geriatric medicine as a subspecialty, developing retirement test patterns, and investigating drug-drug and drug–age interactions, personality and social processes, and immunocompetence. [ABSTRACT FROM AUTHOR]

The average age at which U.S. researchers receive their first grant from NIH has increased from 34.3 in 1970, to 41.7 in 2004. These data raise the crucial question of the effects of aging on the scientific productivity and impact of researchers. Drawing on a sizeable sample of 6,388 university professors in Quebec who have published at least one paper between 2000 and 2007, our results identify two turning points in the professors' careers. A first turning point is visible at age 40 years, where researchers start to rely on older literature and where their productivity increases at a slower pace-after having increased sharply since the beginning of their career. A second turning point can be seen around age 50, when researchers are the most productive whereas their average scientific impact is at its lowest. Our results also show that older professors publish fewer first-authored papers and move closer to the end of the list of co-authors. Although average scientific impact per paper decreases linearly until about age 50, the average number of papers in highly cited journals and among highly cited papers rises continuously until retirement. Our results show clearly that productivity and impact are not a simple and declining function of age and that we must take into account the collaborative aspects of scientific research. Science is a collective endeavor and, as our data shows, researchers of all ages play a significant role in its dynamic. [ABSTRACT FROM AUTHOR]

Objective. Aging is a growing public health concern for people, organizations, and governments. The current study was undertaken to provide insights into the global research output on geriatric nursing. Methods. A bibliometric study was implemented using the WoS database for the period from 1900 to 2020. Various tools and measures were used to analyze and visualized. Results. The search strategy found 4923 papers. The oldest paper was written by Beverly C. Andre in 1953. As team size increases, so does the number of citations. The USA was the active country and the highest number of coauthors. New York University was an active institution. Stig Karlsson was the most active author in Geriatric Nursing with 28 articles from Sweden, followed by Koen Milisen and Sandman, with 26 articles each from Sweden and Belgium. The most frequent words in this field were depression, malnutrition, education, Alzheimer's disease, and dementia. The latest research themes in this field were COVID-19, interprofessional locomotive syndrome, emergency nursing, and public health. The most influential papers were specified. Journal of the American Geriatrics Society was the most active journal. Conclusions. Geriatric nursing is a rooted field and has received special attention in the last decade. Policymakers, especially in developing countries, should pay attention to geriatric nursing as a specialty of nursing to solve aging issues they would face considering the increasing elderly population. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Ninety-six experts in the fields of elder abuse and aging in New York State met in Albany, NY on May 10-12, 2004 to "Target Elder Abuse" and to create a New York State Action Agenda to combat elder abuse. Lifespan of Greater Rochester convened and sponsored the Summit, modeled after the 2001 National Summit in Washington. DC The New York State (NYS) Office of Children and Family Services--Bureau of Adult Services, NYS Office for the Aging, NYS Division of Criminal Justice Services, as well as Excellus BlueCross BlueShield and MedAmerica Insurance Company of New York were co-sponsors. The Summit was largely funded through the Administration on Aging by a federal grant obtained by US Senator Charles E. Schumer (NY). Other contributors included Excellus BlueCross Blue Shield, NYS Office for the Aging, and Alfred University's Rural Justice Institute. [ABSTRACT FROM AUTHOR]

The article discusses the response of some critics on the themes related to aging. An integral part of the Ethics and Aging Convening consisted of individual critiques of the four papers by some of the members of the Commission of Aging. Each reactor presented a statement which supported, challenged or sought practical applications for the issues raised in the papers. The central themes which consistently surfaced in the reactors' critiques are, first the "need for structural reorganization". Strong support was given to the assertion that Medicare has floundered in "ethical ambiguity" and has historically lacked a consistent, ethically sensitive response to its problems. Several reactors offered practical suggestions in light of the need to structurally reorganize health, long-term care, and income support programs for the elderly. The second is the "nature of government's role". Each of the four papers attempted to address the role of government in providing services to the poor aged. Several reactors attempted to draw from Catholic social teaching which argues that the state must assume responsibility in guaranteeing basic human rights, one of which is adequate health care. Third was the "legitimacy of the elderly". A major issue picked up by several reactors was whether the elderly are any more legitimate in receiving services and benefits than other groups.

Alzheimer's disease is the leading cause of dementia in the world. It affects 6 million people in the United States and 50 million people worldwide. Alzheimer's disease is characterized by the accumulation of amyloid-β plaques (Aβ), an increase in tau protein neurofibrillary tangles, and a loss of synapses. Since the 1990s, removing and reducing Aβ has been the focus of Alzheimer's treatment and prevention research. The accumulation of Aβ can lead to oxidative stress, inflammation, neurotoxicity, and eventually apoptosis. These insults impair signaling systems in the brain, potentially leading to memory loss and cognitive decline. Aniracetam is a safe, effective, cognitive-enhancing drug that improves memory in both human and animal studies. Aniracetam may prevent the production and accumulation of Aβ by increasing α-secretase activity through two distinct pathways: 1) increasing brain derived neurotrophic factor expression and 2) positively modulating metabotropic glutamate receptors. This is the first paper to propose an evidence-based model for aniracetam reducing the accumulation and production of Aβ. [ABSTRACT FROM AUTHOR]

This paper provides an introduction to the collection of papers presented in this special issue on positive adaptations to aging in various cultural contexts. The concept of positive adjustment as one ages is not just an issue of personal adaptation or `successful aging' but can be understood more fully in light of the community context within which the individual lives out his/her life. Two of the papers focus on the aging experiences of African Americans in the United States. Another paper discusses the phenomenon of retirement in American society. The fourth paper provides a sophisticated analysis of the perception of old age activities among the contemporary Guatemalan Maya. The final paper explores the experiences of childless older adults in rural Wales. [ABSTRACT FROM AUTHOR]

Some observers have argued that the projections for high and rising debt pose a grave threat to the country's economic future and give the government has less fiscal space to respond to recessions or other unexpected developments, so they urge significant changes in tax or spending policies to reduce federal borrowing. In stark contrast, others have noted that interest rates on long-term federal debt are extremely low and have argued that such persistently low interest rates justify additional federal borrowing and investment, at least for the short and medium term. We analyze this controversy focusing on two main issues: the aging of the US population and interest rates on US government debt. It is generally understood that these factors play an important role in the projected path of the US debt-to-GDP ratio. What is less recognized is that these changes also have implications for the appropriate level of US debt. We argue that many-though not all- of the factors that may be contributing to the historically low level of interest rates imply that both federal debt and federal investment should be substantially larger than they would be otherwise. In conclusion, although significant policy changes to reduce federal budget deficits ultimately will be needed, they do not have to be implemented right away. Instead, the focus of federal budget policy over the coming decade should be to increase federal investment while enacting changes in federal spending and taxes that will reduce deficits gradually over time. [ABSTRACT FROM AUTHOR]

Summary: This position paper reviews how the National Bone Health Alliance (NBHA) will execute a project to help assure health professionals of the clinical utility of bone turnover markers; the current clinical approaches concerning osteoporosis and the status and use of bone turnover markers in the USA; the rationale for focusing this effort around two specific bone turnover markers; the need to standardize bone marker sample collection procedures, reference ranges, and bone turnover marker assays in clinical laboratories; and the importance of harmonization for future research of bone turnover markers. Introduction: Osteoporosis is a major global health problem, with the prevalence and incidence of osteoporosis for at-risk populations estimated to be 44 million Americans. The potential of bone markers as an additional tool for health care professionals to improve patient outcomes and impact morbidity and mortality is crucial in providing better health care and addressing rising health care costs. This need to advance the field of bone turnover markers has been recognized by a number of organizations, including the International Osteoporosis Foundation (IOF), National Osteoporosis Foundation, International Federation of Clinical Chemistry, and Laboratory Medicine (IFCC), and the NBHA. Methods: This position paper elucidates how this project will standardize bone turnover marker sample collection procedures in the USA, establish a USA reference range for one bone formation (serum procollagen type I N propeptide, s-PINP) and one bone resorption (serum C-terminal telopeptide of type I collagen, s-CTX) marker, and standardize bone turnover marker assays used in clinical laboratories. This effort will allow clinicians from the USA to have confidence in their use of bone turnover markers to help monitor osteoporosis treatment and assess future fracture risk. This project builds on the recommendations of the IOF/IFCC Bone Marker Standards Working Group by developing USA reference standards for s-PINP and s-CTX, the markers identified as most promising for use as reference markers. Results: The goals of this project will be realized through the NBHA and will include its governmental, academic, for-profit, and non-profit sector stakeholders as well as major academic and commercial laboratories. Upon completion, a parallel effort will be pursued to make bone turnover marker measurements reliable and accepted by all health care professionals for facilitating treatment decisions and ultimately be reimbursed by all health insurance payers. Conclusions: Successful completion of this project will help assure health professionals from the USA of the clinical utility of bone turnover markers and ties in with the parallel effort of the IOF/IFCC to develop worldwide bone turnover reference ranges. [ABSTRACT FROM AUTHOR]

Copyright of Movement & Sport Sciences / Science & Motricité is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To review and synthesise research related to the ageing farming workforce influence on the health and sustainability of agricultural communities. Design: Using the PRISMA framework as a guide, the CINHAL and Medline databases were searched. Search 1 used the key search terms of ageing OR aging, farm*, workforce. Search 2 used health, sustainability and 'agricultural OR farm communit*. Search 3 combined Searches 1 and 2. Search 4 followed journal citations to identify other relevant articles. A process of narrative synthesis was applied to the results through the prism of rural social capital that described the current state of knowledge and understanding under four themes. Result: Database searches and searching of citations identified 16 contemporary articles. Seven of the papers were from Australia, and the balance from five other high‐income countries. The four that themes emerged are: vulnerabilities of ageing farmers; economic and climatic drivers; social capital and sustainability; and integrative strategies, that might offer a way forward. Conclusion: Integrating these forces of nature, economics and sociology to address the ageing farming workforce and the associated health and sustainability of agricultural communities remains a major challenge for researchers, governments, the agricultural sector and rural communities. [ABSTRACT FROM AUTHOR]

Family quality of life (FQOL) is a multidimensional social construct that can be used to enhance a family's well‐being by providing a framework to plan interventions and evaluate outcomes. Although researchers and policymakers see value in the FQOL domains and dimensions, families and practitioners are often skeptical of lengthy evaluations and aggregate scores. Furthermore, many practitioners find that family caregivers who require support and services overwhelmingly focus on the family member needing the most care. In doing so, they perceive their situations in a "spaghetti‐like" way. This strong focus on one aspect of the situation, or one "spaghetti" strand, can result in conversations about planning and implementing interventions becoming cyclical, like a messy tangle of strands. The FQOL lens can be used in intervention planning to transform overlapping spaghetti‐like thoughts into a waffle‐like system of interconnected and compartmentalized thoughts. The purpose of this paper was to describe the individual‐level application of the FQOL theory to plan and evaluate the benefits of a peer‐mediated family empowerment project for aging caregivers of adults with intellectual/ developmental disabilities in Michigan, USA. The study provides examples of how individual‐level FQOL evaluation at pretest informed the development of individualized action plans that focused on the strengths, desires, and challenges of 100 aging families in this statewide project. [ABSTRACT FROM AUTHOR]

The genitourinary syndrome of menopause (GSM) has been proposed as a diagnosis by a consensus of clinicians and investigators. Our purpose for this paper is to review extant evidence about: 1) the breadth of symptoms and symptom clusters as related to the syndrome; 2) the prevalence of GSM (includes vulvar and vaginal atrophy); 3) factors that are associated with, predict, or explain the syndrome; and 4) what should be pursued for expanding meaningful evidence. Within recent literature, we found a wide range of prevalence estimates, likely a function of the differing populations studied, study design, and methods of data collection. Factors related to the prevalence of GSM included age and aging; reproductive aging stage; hormones, especially estrogen; and culture and language. We recommend further specification of diagnostic criteria for GSM; clarification of urinary symptoms in GSM; use of longitudinal study designs; validation of GSM-related measures; exploration of cultural equivalence of GSMmeasures; and assessing biases in completed research. [ABSTRACT FROM AUTHOR]

Repeated claims that a dwindling supply of potential caregivers is creating a crisis in care for the U.S. aging population have not been well-grounded in empirical research. Concerns about the supply of family care do not adequately recognize factors that may modify the availability and willingness of family and friends to provide care to older persons in need of assistance or the increasing heterogeneity of the older population. In this paper, we set forth a framework that places family caregiving in the context of older adults' care needs, the alternatives available to them, and the outcomes of that care. We focus on care networks, rather than individuals, and discuss the demographic and social changes that may alter the formation of care networks in the future. Last, we identify research areas to prioritize in order to better support planning efforts to care for the aging U.S. population. [ABSTRACT FROM AUTHOR]

As populations in the United States and around the world continue to age, it has become increasingly important to understand how organizations can create working conditions that attract, support, and retain workers across the lifespan. In this paper, we provide a primer on current theory and research on age in the workplace. We briefly describe lifespan theories that have guided recent advances in the field, discuss the implications of these theories for an aging workforce, and provide an overview of current research streams that address the work and nonwork factors affecting performance, well‐being, and workforce participation among mature workers. Based on this review, we provide recommendations for future research and practice. [ABSTRACT FROM AUTHOR]

Objective: Immigrant health discussions often focus on acculturation and omit discussions on historical events that may underlie health differences among immigrant older adults. This paper provides a historical overview of immigration policy and flows to the U.S. and examines insurance access and health difficulties by sending country. Methods: We analyzed the "Immigrants Admitted to the United States, Fiscal Years 1972–2000" and 2015–2019 American Community Survey datasets to examine the number of admitted immigrants, sociodemographic profiles for current immigrant older adults, and the predicted probabilities of health insurance access and health difficulties. Results: Our results highlight alignment of immigration flows with immigration legislation and vast heterogeneity in migration, health, and healthcare access of immigrants by sending country. Discussion/Implications: Public health practitioners must consider how historical events and social factors contribute to the healthcare access and health of immigrant populations, as demographic shifts will require interventions that promote equitable healthy aging. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to identify the benefits for individuals with dementia from participating in highly creative engagement activities. It also aims to analyse the ways of promoting access for this generation in settings such as museums and galleries, identifying the various ways the USA and UK differ when providing new opportunities for this generation. It also seeks to depict how the USA measures and acknowledges creativity, alongside the decrease of cognitive ability. Design/methodology/approach – The Winston Churchill Travelling Fellowship study was carried out in six cities across the USA; these were Milwaukee, Chicago, Minneapolis, New York, San Francisco and Washington, DC. Data, observations and knowledge were gathered from various access programmes in museums and galleries, creative access organisations and in alternative environments from hospitals, to day centres and residential care. Findings – This article highlights the benefits of coordinating creative activities within a healthcare setting, looking at ways of changing cultural views and improving the health service. Research limitations/implications – The research was limited to the USA and its six biggest cities. The results presented are predominantly qualitative and the results rely on extensive evaluation. Practical implications – Collaboration between health staff and artists can prove difficult so it is essential to utilize practitioners that share the same values and visions of the end goal. Both leadership and job roles need to be discussed in great detail before beginning any access project. Social implications – Arts in a healthcare context will bridge the gap between age and ability, altering the views of today's general culture. Instead the "elderly" will be seen as creative, innovative and pro-active. The arts can transform the stereotypical views that today's culture have of the elderly, from negative to positive. The arts will inspire intergenerational collaboration between the young and old which will enhance self-esteem, respect and knowledge for both age groups. Originality/value – This paper will promote the arts as a positive tool to improve the quality of life for individuals with dementia. Providing guidelines, insight and access programmes to health care staff, carers and individuals with dementia. This information and support will boost dementia care, lowering medical costs and allow for a better environment for the third age to be a part of. [ABSTRACT FROM AUTHOR]

Copyright of ANAFORA is the property of Anafora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The purpose of this paper is to analyze the main global transformations of the healthcare sector and their underlying causes and effects. Design/methodology/approach: The study focuses on several important trends including the increasing life expectancy and aging, the rise of non-communicable diseases, the risks of pandemics, medication expenditure, the globalization of healthcare and technological innovations such as digitization, robotic and nanomedicine. Findings: The analysis indicates that the world populations will be much older in the near future and the healthcare sector will witness significant growth opportunities. The aging populations will put more pressure on healthcare systems and increase the incidence of non-communicable diseases. In a globalized world, the risks of global pandemics are expected to increase. The surge in the medication expenditure will put much pressure on healthcare systems, insurers, patients, employers and providers. The healthcare sector is characterized by its above-average growth in the USA and much of the developed world. Therefore, the share of healthcare in gross domestic product will continue to rise. The digitization and globalization of healthcare may involve major disruptions in the location and the type of care. New materials particularly nanoparticles will be used to enhance the precision, quality and efficacy of diagnostics, medications and treatments. Originality/value: The paper touches on several areas including demographic, clinical, financial, managerial and technological transformations and examines their implications for the healthcare sector. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide an overview of rural older veterans in the USA and discuss how the US Department of Veterans Affairs (VA) is increasing access to health care for older veterans in rural areas.Design/methodology/approach This is a descriptive paper summarizing population and program data about rural veterans.Findings VA provides a variety of health care services and benefits for older veterans to support health, independence, and quality of life. With the creation of the Veterans Health Administration Office of Rural Health (ORH) in 2006, the needs of rural veterans, who are on average older than urban veterans, are receiving greater attention and support. ORH and VA have implemented several programs to specifically improve access to health care for rural veterans and to improve quality of care for older veterans in rural areas.Originality/value This paper is one of the first to describe how VA is addressing the health care needs of older, rural veterans. [ABSTRACT FROM AUTHOR]

In 2019, the National Institutes of Health combined the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV Study (WIHS) into the MACS/WIHS Combined Cohort Study (MWCCS). In this paper, participants who made a study visit during October 2018–September 2019 (targeted for MWCCS enrollment) are described by human immunodeficiency virus (HIV) serostatus and compared with people living with HIV (PLWH) in the United States. Participants include 2,115 women and 1,901 men with a median age of 56 years (interquartile range, 48–63); 62% are PLWH. Study sites encompass the South (18%), the Mid-Atlantic/Northeast (45%), the West Coast (22%), and the Midwest (15%). Participant race/ethnicity approximates that of PLWH throughout the United States. Longitudinal data and specimens collected for 35 years (men) and 25 years (women) were combined. Differences in data collection and coding were reviewed, and key risk factor and comorbidity data were harmonized. For example, recent use of alcohol (62%) and tobacco (28%) are common, as are dyslipidemia (64%), hypertension (56%), obesity (42%), mildly or severely impaired daily activities (31%), depressive symptoms (28%), and diabetes (22%). The MWCCS repository includes serum, plasma, peripheral blood mononuclear cells, cell pellets, urine, cervicovaginal lavage samples, oral samples, B-cell lines, stool, and semen specimens. Demographic differences between the MACS and WIHS can confound analyses by sex. The merged MWCCS is both an ongoing observational cohort study and a valuable resource for harmonized longitudinal data and specimens for HIV-related research. [ABSTRACT FROM AUTHOR]

Background/objectives: Sedentary behavior (SB), defined as sitting (nonexercising), reclining, and lying down (posture), or by low energy expenditure, is a public health risk independent to physical activity. The objective of this systematic literature review was to synthesize the available evidence on amount of SB reported by and measured in older adults. Data source: Studies published between 1981 and 2014 were identified from electronic databases and manual searching. Large-scale population studies/surveys reporting the amount of SB (objective/ subjective) in older adults aged ≥ 60 years of age were included. Appraisal and synthesis was completed using MOOSE guidelines. Results: 349,698 adults aged ≥ 60 within 22 studies (10 countries and 1 EU-wide) were included. Objective measurement of SB shows that older adults spend an average of 9.4 hr a day sedentary, equating to 65-80% of their waking day. Self-report of SB is lower, with average weighted self-reports being 5.3 hr daily. Within specific domains of SB, older adults report 3.3 hr in leisure sitting time and 3.3 hr watching TV. There is an association with more time spent in SB as age advances and a trend for older men to spend more time in SB than women. Conclusion/ implications: Time spent sedentary ranges from 5.3-9.4 hr per waking day in older adults. With recent studies suggesting a link between SB, health, and well-being, independent of physical activity, this is an area important for successful aging. Limitations: Different methodologies of measurement and different reporting methods of SB made synthesis difficult. Estimated SB time from self-report is half of that measured objectively; suggesting that most self-report surveys of SB will vastly underestimate the actual time spent in SB. [ABSTRACT FROM AUTHOR]

Objectives This paper examines health profiles and work environments of hired U.S. farmworkers to understand the risk to essential workers and their employers, to the food supply, and to rural health systems such as what is possible with the COVID-19 pandemic. Methods Large-sample statistical methods and proprietary data from the National Agricultural Workers Survey from 2000 to 2018 were used to assess factors associated with exposure to COVID-19 and vulnerabilities associated with medical complications. Results An aging workforce and increased access to health care within the crop worker population has been associated with a higher reported incidence of diabetes, asthma, and heart disease among workers over time. These trends confirm a vulnerable, but essential, workforce with higher risks for COVID-19 complications than would have been true of U.S. farmworkers as a group in earlier years. Conclusions Increasing age and disease burden in the U.S. agricultural labor force puts workers at increased risk for developing COVID-19 complications. Limits to field sanitation and housing quality inflate the probability of the development of COVID-19 hotbeds in rural communities that could further compromise the physical health of workers, the economic health of farm establishments, the agricultural supply-chain, and rural health capacities. Additional and more targeted worker protections may minimize public health and economic costs in the long run. [ABSTRACT FROM AUTHOR]

This paper describes normative data for newly collected exemplar responses to 70 semantic categories described in previous norming studies (Battig & Montague, Journal of Experimental Psychology, 80(3, pt.2): 1–46, 1969; Van Overschelde, Rawson, & Dunlosky, Journal of Memory and Language, 50(3): 289–335, 2004; Yoon et al., Psychology and Aging, 19(3), 379–393, 2004). These categories were presented to 246 young (18–39 years), middle (40–59 years), and older (60 years and older) English-speaking adults living in the United States who were asked to generate as many category exemplars as possible for each of the 70 categories. In order to understand differences in normative responses, we analyzed these responses a) between age groups within the current sample and b) in comparison to three previously published sets of norms. Experimental studies using such norms typically assume invariance of normative likelihoods across age and historical time. We replicate previous findings such that exemplar frequency correlations suggest moderate stability in generated category members between age groups and cohorts for many, but not all, categories. Further, analyses of rank-order correlations highlight that the traditional measure of typicality may not capture all aspects of typicality, namely that for some categories there is high consistency in the frequency of exemplars across age groups and/or norms, but the ordering of those exemplars differs significantly. We include a cluster analysis to aid in grouping categories based on relative stability across time, cohort, and age groups. These results emphasize the importance of maintaining and updating age-differentiated category norms. [ABSTRACT FROM AUTHOR]

A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 30 years of clinical research and practice using the MNA® worldwide. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

This paper assesses whether the usually favorable depictions of older homeowners in the United States can be generalized to those who have extremely low incomes and occupy the oldest housing stock. Theoretical treatments and past empirical research findings offer a strong rationale for distinguishing this subgroup of older households. Analyzing 1999 American Housing Survey data, this paper finds that poor older homeowners in very old dwellings are more likely to be demographically disadvantaged and to occupy physically deficient dwellings. The paper calls for public debate on the comparative benefits and costs of governmental programs that help these vulnerable older persons to age in place as opposed to offering them alternative affordable housing options. [ABSTRACT FROM AUTHOR]

The rise in health expenditure in the U.S. has generated interest in the determinants of health expenditure at the micro-level; however, individuals may exhibit differential behaviour across different types of health care. In addition, public and private insurance may have an heterogeneous effect on expenditure. In this paper, we examine the determinants of health expenditure with a multivariate regression model along with controls for insurance choice and unobserved health care utilization. We find age-related effects and evidence of moral hazard related to private insurance, while the primary effect of income on expenditure appears to be through the purchase of insurance. The implications of the study are that: (i) policymakers should be less concerned about the effect of ageing on health expenditure; (ii) drug spending may not be related to the expansion of public insurance coverage; and (iii) income may have a negative impact on most elements of health spending.The Geneva Papers (2006) 31, 669–691. doi:10.1057/palgrave.gpp.2510098 [ABSTRACT FROM AUTHOR]

In collaboration with distinguished scholars and National Institute on Aging (NIA) staff, we designed, implemented, and evaluated a research training program in aging for psychology faculty from 4-year colleges. The goal of the program was to build and sustain a community of college faculty committed to conducting aging research, incorporating recent advances in their courses, and engaging undergraduate students in aging research. Program design included an initial 2-week summer institute, ongoing consultation, a midyear meeting during the intervening year, and a follow-up institute. The initial institute focused on research methodology, selected content areas, and procedural matters related to preparation and submission of grant applications. There were 2 follow-up meetings that provided participants with extended opportunities to discuss the proposal they were developing. Between 1998 and 2004, 6 cohorts of psychology faculty (with 13–15 members in each cohort) participated in the program. This paper reports the results of a follow-up evaluation we conducted in September 2004. [ABSTRACT FROM AUTHOR]

Today China has the world’s largest older population, defined as aged 65 and over. The size of the older population in the United States is also large, ranking third in the world in 2000. The combined older populations of China and the United States represented 29 percent of the world’s population 65 and older in 2000. The large older populations in these two countries are projected to more than double in size over the next three decades. Although currently China is younger than the United States and many other countries, its aging process will accelerate in the next few decades, with a speed surpassing the experience of many Western European countries and the United States. This paper examines the current and future situation of the older population in China and compares China’s aging with that of the United States, using 2000 and earlier censuses from both countries as well as the population projections data from the U.S. Census Bureau. Growth of the older population, changes in the age distribution in China with comparisons to the United States, and the projections of the older population’s future growth are analyzed and presented. The paper also discusses sources of financial support and living arrangements in China and the United States. Finally, the paper assesses trends in the older population support ratio and the implications for the economic well-being of an aging population. [ABSTRACT FROM AUTHOR]

Data for the United States and countries in western Europe indicate a negative correlation between the dependency ratio and labor tax rates and the generosity of social transfers, after other factors that influence the size of the welfare state are controlled for. This occurs despite the increased political clout of the dependent population implied by the aging of the population. This paper develops an overlapping generations model of intra- and intergenerational transfers (including old-age social security) and human capital formation that addresses this seeming puzzle. We show that with democratic voting, an increase in the dependency ratio can lead to lower taxes or less generous social transfers. [ABSTRACT FROM AUTHOR]

A substantial amount of healthcare and costs are attributable to arthritis, which is a very common chronic disease. This paper presents the results of a systematic review of arthritis cost studies published from 2008 to 2013. MEDLINE, Embase, EconLit databases were searched, as well as governmental and nongovernmental organization websites. Seventy-one reports met the inclusion/exclusion criteria, and 24 studies were included in the review. Among these studies, common methods included the use of individual-level data, bottom-up costing approach, use of both an arthritis group and a control group to enable incremental cost computation of the disease, and use of regression methods such as generalized linear models and ordinary least squares regression to control for confounding variables. Estimates of the healthcare cost of arthritis varied considerably across the studies depending on the study methods, the form of arthritis and the population studied. In the USA, for example, the estimated healthcare cost of arthritis ranged from $1862 to $14,021 per person, per year. The reviewed study methods have strengths, weaknesses and potential improvements in relation to estimating the cost of disease, which are outlined in this paper. Caution must be exercised when these methods are applied to cost estimation and monitoring of the economic burden of arthritis. [ABSTRACT FROM PUBLISHER]

Population aging is an important and increasingly relevant area of study for demographers. A growing body of research seeks to determine how long-term changes in births, mortality, and migration—the three drivers of any demographic process—have shaped the present aging situation. Using variable-r decomposition and cohort data, this research note presents a formula for the change in the old-age dependency ratio to determine the extent to which relative changes in births, as well as in mortality and migration rates, contribute to aging. This perspective provides a careful and in-depth picture of aging and contributes to the debate concerning whether changes in births or mortality have had the strongest effect on population aging. When applied to Australia, the United States, and several European populations, the decomposition of the old-age dependency ratio shows that aging occurred in all populations and that changes in both births and mortality contributed to this aging. Analysis of these populations demonstrates that although they differed regarding which of these factors contributed more, changes in births prevailed as the more significant factor. In nearly all populations, migration decreased the rate of population aging. [ABSTRACT FROM AUTHOR]

Despite significant research on purpose in adolescence and early adulthood, little is known about purpose in older adults. This paper defines purpose as ongoing commitment to and sustained action toward goals that are meaningful to the self and aim to contribute beyond the self. This study of purpose in later life draws on interviews of 102 respondents drawn from a U.S. nationally representative sample of 1198 men and women aged 50–92. Eighteen interviewees are identified as exemplars of purpose beyond the self and are matched with a comparison group of non-purposeful peers. Interview coding revealed that, in contrast to the non-purposeful comparison group, the purpose exemplars describe their lives as including several interconnected sources of well-being: purpose beyond the self, positive relationships, positive life engagement, a sense of competence, and freedom balanced with the desire to contribute. Implications for practitioners and the public are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the impact of three types of perceived healthiness (physical, psychological and economic health) on restaurant consumption activities among senior consumers. Design/methodology/approach: Data were collected from 325 restaurant customers in the USA through a Web-based survey conducted by an online marketing research firm. Following previous studies' categorization of senior consumers, this study distinguished between "senior consumers" (age 60 or older) and "younger consumers" (age 39 or younger) to better compare different age-related behaviors. A series of two-way ANOVA was conducted for dining-out frequency and the number of choice sets. Findings: The results revealed that senior diners' perceptions of healthiness are critical in determining senior consumers' restaurant behaviors, such as information processing and purchasing behaviors. The results provide evidence that seniors with a positive perception of their physical and psychological status seek a greater number of alternative restaurant choices, which is actively related to purchasing frequency. Practical implications: The managerial implications indicate that restaurant marketers should avoid stereotypes and instead rely on more recent and accurate information regarding today's senior consumers. Originality/value: The position taken in this study recognizes the need to enhance the understanding of senior consumers' patterns regarding their perceived physical, psychological and economic health. To the best of authors' knowledge, this is the first attempt to investigate the impact of three types of health on seniors' dining behaviors. [ABSTRACT FROM AUTHOR]

The internationalization of universities and the aging of the global population are two current issues that converge and challenge undergraduate gerontology curriculum development in Canada. One response to this challenge is to envision an intercultural gerontology curriculum. What might this curriculum encompass? How might it be taught? An exploratory study was undertaken to address these two questions. This paper presents findings from this study based primarily on interviews with university-based stakeholders from Canada, the United States, and Europe. Thematic analysis of the interviews resulted in five themes: multiple perspectives on cultural diversity; the dynamic nature of cultural diversity and aging; flow of an intercultural curriculum; institutional culture and intercultural curricula; and principles and practice for intercultural gerontology. Framed by principles of gerontology theory and educational approaches, this paper focuses on the principles and practice suggested by study participants. Scaffolding learning, active learning strategies, experiential learning opportunities, teacher modelling, and internet-based learning are discussed as key to intercultural learning. An appendix includes a list of resources that may be useful to developing an intercultural gerontology curriculum. [ABSTRACT FROM AUTHOR]

BACKGROUND: The need for mentorship in aging research among postdoctoral trainees and junior faculty across medical disciplines and subspecialties is increasing, yet senior personnel with expertise in aging are lacking to fulfill the traditional dyadic mentorship role. Facilitated peer mentorship is grounded in collaborative work among peers with the guidance of a senior mentor. METHODS AND RESULTS: We evaluated the Columbia University Mentor Peer Aging Research (CoMPAdRE) program, an interprofessional facilitated peer mentorship program for early stage investigators, using the Reach Effectiveness Adoption Implementation and Maintenance framework (RE‐AIM). Reach: A total of 15 participants, of which 20% were women, from five states and across six medical specialties participated. Effectiveness: Participants published 183 papers, of which more than 20% were collaborative papers between CoMPAdRE mentees or mentees‐mentor. Participants reported developing skills in negotiation, navigating the academic role, organizing a seminar, management, and leadership over the course of the program. According to the qualitative findings, the most important components of the program included alignment around the aging, learning from national leaders, developing leadership skills and career networking. Adoption: Individual‐level factors included selecting participants with a research track record, willingness to sign a compact of commitment and involvement in shaping the program. An institutional‐level factor that facilitated program adoption included strong commitment from department leaders. Implementation: The program cost $3,259 per participant. Maintenance: CoMPAdRE is being maintained and currently incorporating a second cohort of mentees. CONCLUSION: This RE‐AIM evaluation provides lessons learned and strategies for future adoption, implementation, and maintenance of an aging‐focused facilitated peer mentorship program. J Am Geriatr Soc 67:804–810, 2019. See related editorial by High et al. in this issue. [ABSTRACT FROM AUTHOR]

Mobility declines in older adults can be determined through monitoring longitudinal changes in gait speed. We examined longitudinal changes [in] ankle proprioception among those with and without baseline lower extremity numbness to develop a better understanding of mobility declines in healthy older adults. Participants included 568 adults (52.8% women) aged 60–98 years from the Baltimore Longitudinal Study of Aging. Larger ankle proprioception decreases during plantar flexion were found in the participants with lower extremity numbness compared with those without numbness (p =.034). Among participants with lower extremity numbness, slower baseline speeds from both usual and fast pace gait were associated with performance decline in ankle proprioception measured during ankle dorsiflexion (p =.039 and p =.004, respectively). Assisting older adults, especially those with lower extremity numbness, to maintain and improve ankle proprioception may help prevent mobility declines that have previously been considered age related. [ABSTRACT FROM AUTHOR]

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life's end. [ABSTRACT FROM AUTHOR]

Over fourteen years ago, the concept of "gray and green" was first introduced by Wright and Lund (2000) to represent a new awareness and a call for increased scholarship at the intersection of environmental issues and the aging process. This review paper revisits that concept with a fresh perspective on the specific role of gardens and gardening in the aging experience. As example, gardening is one of the most popular home-based leisure activities in the US and represents an important activity in the lives of older adults in a variety of residential settings. Yet, there has been a lack of any comprehensive and multidisciplinary (science and humanities) examination of the nexus between gardening and the aging experience, and in particular with research connections to stewardship and caring. In this paper, we review contemporary articles demonstrating the multidisciplinarity of gardening and the aging process. First, we will focus on the beneficial psychological effects resulting from the cultivation of caring, including personal contentment and artistic expression. Second, we will focus on stewardship and how gardening increases health, community awareness, and a connection to future generations. On the surface, this may demonstrate a separation between the humanities and science, but we will clarify a symbiotic relationship between the two disciplines in our conclusion. [ABSTRACT FROM AUTHOR]

Background: Outside of the United States, international perspectives on normative data for neuropsychological test performance, within diverse populations, have been scarce. The neuropsychological test battery from the Uniform Data Set (UDS) of the Alzheimer's Disease Centers (ADC) program of the United States National Institute on Aging (NIA) is one of the most sensitive batteries for the evaluation of both normal cognitive aging and pathological cognitive decline.Objective: This study aimed to determine the feasibility of the Czech Neuropsychological Test Battery from the Uniform Data Set (UDS-Cz 2.0), while also evaluating the results obtained from an international perspective.Methods: This paper describes data from 520 cognitively normal participants. Regression analyses were used to describe the influence of demographic variables on UDS-Cz test performance.Results: Cognitive performance on all measures declined with age, with patient education level serving as a protective factor. Therefore, the present study provides normative data for the UDS-Cz, adjusted for the demographic variables of age and education.Conclusion: The present study determines the psychometric properties of the UDS-Cz and establishes normative values in the aging Czech population, which can be used in clinical settings. [ABSTRACT FROM AUTHOR]

Using new weakness cutpoints individually may help estimate time to mortality, but their collective use could improve value. We sought to determine the associations of (a) each absolute and body size normalized cut point and (b) collective weakness on time to mortality in Americans. The analytic sample included 14,178 subjects aged ≥50 years from the 2006-2018 waves of the Health and Retirement Study. Date of death was confirmed from the National Death Index. Handgrip dynamometry measured handgrip strength (HGS). Men were categorized as weak if their HGS was <35.5 kg (absolute), <0.45 kg-kg-1 (body mass normalized), or <1.05 kg-kg-1-m-2 (body mass index [BMI] normalized). Women were classified as weak if their HGS was <20.0 kg, <0.337 kg-kg-1, or <0.79 kg-kg-1-m-2. Collective weakness categorized persons as below 1, 2, or all 3 cutpoints. Cox proportional hazard regression models were used for analyses. Subject values below each absolute and normalized cutpoint for the 3 weakness parameters had a higher hazard ratio for early all cause mortality: 1.45 (95% confidence interval [CI]: 1.36-1.55) for absolute weakness, 1.39 (CI: 1.30-1.49) for BMI normalized weakness, and 1.33 (Cl: 1.24-1.43) for body mass normalized weakness. Those below 1, 2, or all 3 weakness cut points had a 1.37 (CI: 1.26-1.50), 1.47 (CI: 1.35-1.61), and 1.69 (CI: 1.55-1.84) higher hazard for mortality, respectively. Weakness determined by a composite measure of absolute and body size adjusted strength capacity provides robust prediction of time to mortality, thus potentially informing sports medicine and health practitioner discussions about the importance of muscle strength during aging. [ABSTRACT FROM AUTHOR]

African Americans experience higher incidence and prevalence of Alzheimer's disease (AD). Yet, they continue to be underrepresented in AD research, limiting the ability to generalize findings to the increasingly diverse US population. To reduce AD disparities, targeted efforts are needed to increase the representation of African Americans in AD research. This mini review identified evidence-based strategies that increased research participation among older African Americans. Four recruitment strategies emerged from eight published peer-reviewed studies that directly evaluated the effectiveness of strategies aimed at increasing the number of African American participants in Alzheimer's research. The strategies include community outreach and education, face-to-face discussions, remote access, and referral and partnership with local organizations. Across different locations, these strategies increased the number of African Americans enrolled into AD research, the number of people that signed up to donate their brains for AD research upon death, and the knowledge and perception of AD in the communities. Targeted efforts are effective in increasing AD research participation among older African Americans, especially when combined with approaches that emphasize transparency and mutual trust and involve the community as stakeholders in the research process. [ABSTRACT FROM AUTHOR]

To achieve optimal, equitable health outcomes for all older adults, the United States desperately needs equity in access to, quality of, and cost of aging care. To illustrate these needs, we discuss the current inequitable state of frailty care. Frailty disproportionately affects marginalized populations, yet these populations struggle to access high-quality geriatrics care and long-term care services and supports (LTSS) that mitigate frailty, leading to accelerated frailty trajectories. Health services research can provide the data needed to document, elucidate, and address health inequities in frailty care, including early identification and referral of frail adults to specialized care and financing LTSS. [ABSTRACT FROM AUTHOR]

This study examines caregiver networks, including size, composition, and stability, and their associations with the likelihood of hospitalization and skilled-nursing facility (SNF) admissions. Data from the National Health and Aging Trends Study linked to Center for Medicare and Medicaid Services data were analyzed for 3855 older adults across five survey waves. Generalized estimating equation models assessed the associations. The findings indicate each additional paid caregiver was associated with higher adjusted risk ratios (aRR) for hospitalization (aRR = 1.24, 95% CI 1.10–1.41) and SNF admission (aRR = 1.28, 95% CI 1.06–1.54) among care recipients, a pattern that is also observed with the addition of unpaid caregivers (hospitalization: aRR = 1.13, 95% CI 1.06–1.20; SNF: aRR = 1.12, 95% CI 1.02–1.23). These results suggest that policies and approaches to enhance the quality and coordination of caregivers may be warranted to support improved outcomes for care recipients. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to learn lessons from North America on housing an ageing population, both in terms of supporting people to "age in place", and available options for those who need/wish to move. The project, funded by the Winston Churchill Memorial Trust, comprised a six-week travel fellowship to USA and Canada to meet with housing professionals from the public and private sectors and find out about best practice initiatives and efficient models for housing older people.Design/methodology/approach – The paper is in two parts, of which this is the second. Part 2 focuses on the links between housing and health and, recognising significant differences between the countries, draws out lessons which may be applied as similar challenges of austerity, an ageing population and the increasing interest in personal budgets are faced.Findings – There is no one size fits all approach to addressing the housing needs of the older population; a continuum of options across tenures is required. There are opportunities for growth in the private and non-profit sectors in terms of the provision of services for the ageing population. Large scale social change comes from better cross-departmental coordination and cannot be achieved by the isolated intervention of a single organisation. Originality/value – This was a unique opportunity to learn lessons from North America on how to effectively meet the needs of the older population, now and in the future. The findings are based on the personal observations and conclusions of a housing practitioner. [ABSTRACT FROM AUTHOR]

Small area estimates on where services for potential Medicare beneficiaries may be needed, could provide unique research opportunities for improving the healthcare quality of the ageing U.S. population. The project described in this paper validates this argument by contrasting the spatial clustering results from an analysis that uses large geographical units with proxy measures to the results from an analysis using small area geographic units with direct measures. Large-area proxy measures come from county-level U.S. Census Bureau 2010 cross sectional data on the number of people aged 65 and over. Medicare beneficiary estimates in 2007 with Primary Care Service Areas (PCSAs) make up the small-area direct-measure analysis. Findings show that the latter offers a more geographically defined appraisal of where healthcare quality efforts should focus to aid potential Medicare beneficiary populations. Because the healthcare quality of an aging population will only increase in importance as their numbers grow in the US, further research is needed. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to outline learning and good practice across Europe on the deployment of asset based approaches for promoting active ageing and intergenerational solidarity. Design/methodology/approach – The paper draws on a wide ranging review of good practice across Europe distilled from desktop analysis and two European roundtable sessions with key stakeholders. Findings – The paper analyses the current level of volunteering by older people across Europe and the evidence for its benefits to the health and wellbeing of older people. It then goes on to provide analysis and good practice regarding area and individual based asset approaches, as well those relevant to addressing the social exclusion faced by people with dementia. Practical implications – The analysis and good practice examples in the report provide resources for developing effective asset based approaches to promoting active ageing and intergenerational solidarity. Originality/value – The review of European experience is particularly original. There has been little if any European review of asset based approaches to active ageing and intergenerational solidarity. Learning from practice elsewhere enables more confident initiatives to be taken up and developed. [ABSTRACT FROM AUTHOR]

The current U.S. health and long term care systems are inadequately prepared to meet the diverse and changing needs of the rapidly growing senior population. This paper describes the importance of naturally occurring retirement communities (NORCs) to promote the health and mental well being of older individuals through the collaborative efforts of formal and informal home and community based services and support. NORCs are considered a crucial model for aging in place since older adults prefer to remain in the comfort of their homes, and services can be provided in a much more efficient and cost effective manner. This paper examines the strengths, opportunities, and challenges of existing NORCs and discusses the need for the development and expansion of additional NORC programs as an innovative and viable solution for older adults aging in place. [ABSTRACT FROM AUTHOR]