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Background and Objectives Long-term services and supports (LTSS) are vital for older adults with physical and cognitive disabilities. LTSS can be provided in settings such as nursing homes, assisted living, or via community-based services. During the transition to LTSS, older adults are at risk of increased depressive symptoms. In addition, older adults may identify unmet needs despite having access to new LTSS resources. The goal of this study was to examine the factors associated with increased depressive symptoms among a pool of older adults, with a focus on change in reported needs after starting LTSS. Research Design and Methods This cross-sectional analysis of a cohort study included 352 older adults new to LTSS (R01AG025524). The outcome of depressive symptoms was measured using the Geriatric Depression Scale—Short Form. Reported needs included supportive equipment, devices, transportation, and social activities. Bivariate and linear regression modeling using change in needs 3 months later were performed. Results Depressive symptoms were present among 40% of the LTSS recipients at enrollment and 3 months. At baseline, 29% of LTSS recipients reported a need for supportive equipment, 30% for transportation, and 23% for social activities. After 3 months, an average of 12% of LTSS recipients' needs were met, 13% of LTSS recipients' needs persisted, and 11% of LTSS recipients reported new needs. Depressive symptoms 3 months later were higher for those who reported persistent unmet needs compared with those who reported no needs at all, controlling for functional status and LTSS type. Discussion and Implications The transition to LTSS is a vulnerable time for older adults. Assessing the need for equipment, transportation, and social activities during this period may identify opportunities to improve the lives and emotional status of this population. [ABSTRACT FROM AUTHOR]

Objective: The goal of this study was to explore whether features of recorded and transcribed audio communication data extracted by machine learning algorithms can be used to train a classifier for anxiety.Materials and Methods: We used a secondary data set generated by a clinical trial examining problem-solving therapy for hospice caregivers consisting of 140 transcripts of multiple, sequential conversations between an interviewer and a family caregiver along with standardized assessments of anxiety prior to each session; 98 of these transcripts (70%) served as the training set, holding the remaining 30% of the data for evaluation.Results: A classifier for anxiety was developed relying on language-based features. An 86% precision, 78% recall, 81% accuracy, and 84% specificity were achieved with the use of the trained classifiers. High anxiety inflections were found among recently bereaved caregivers and were usually connected to issues related to transitioning out of the caregiving role. This analysis highlighted the impact of lowering anxiety by increasing reciprocity between interviewers and caregivers.Conclusion: Verbal communication can provide a platform for machine learning tools to highlight and predict behavioral health indicators and trends. [ABSTRACT FROM AUTHOR]

Background and Objectives To identify determinants of self-reported physical functioning (PF) among older adults new to long-term services and supports (LTSS). Research Design and Method Using the International Classification of Function, Disability, and Health (ICF) framework, we conducted a secondary analysis of self-reported data on symptoms, basic/instrumental activities of daily living, quality of life, assistive devices, physical therapy needs, prior healthcare utilization, health status, and demographics from 470 older adults new to LTSS (Home/Community-Based n = 156; Assisted Living n = 156; Nursing Home n = 158). Multiple linear regression was used to identify associations between ICF constructs and self-reported PF (SF-12 Physical Composite Summary score [SF12PCS], lower scores indicate worse PF). Results LTSS recipients were mostly female (71%) and over age 80 (Mean: 80.9 years, SD : 8.7). LTSS recipients' mean SF12PCS score was 37.3 (SD 11.0), indicating overall low self-reported PF. LTSS recipients living in their homes (b = −3.35, p =.003) or assisted living facilities (b = −2.93, p =.012) had significantly lower mean scores compared to recipients in nursing homes. Higher SF12PCS scores were associated with fewer activities of daily living deficits (p <.001), and better quality of life (p <.001). Lower scores were associated with more symptoms (p <.001), poorer nutrition (p =.013), ambulation aid use (p <.001), and physical therapy (p <.026). Discussion and Implications Diverse health, activity, and environmental factors may facilitate early identification of new LTSS recipients most in need of interventions to optimize self-reported PF. Several health conditions may be targets for such interventions. Additional research is needed to evaluate and compare PF trajectories among older adults receiving LTSS in diverse settings. [ABSTRACT FROM AUTHOR]