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Aim: The aim of this was to psychometrically adapt and evaluate the Tilburg Frailty Indicator to assess frailty among older people living in Slovenia's community and nursing home settings. Design: A cross- cultural adaptation and validation of instruments throughout the cross- sectional study. Methods: Older people living in the community and nursing homes throughout Slovenia were recruited between March and August 2021. Among 831 participants were 330 people living in nursing homes and 501 people living in the community, and all were older than 65 years. Results: All items were translated into the Slovene language, and a slight cultural adjustment was made to improve the clarity of the meaning of all items. The average scale validity index of the scale was rated as good, which indicates satisfactory content validity. Cronbach's α was acceptable for the total items and subitems. Conclusions: The Slovenian questionnaire version demonstrated adequate internal consistency, reliability, and construct and criterion validity. The questionnaire is suitable for investigating frailty in nursing homes, community dwelling and other settings where older people live. Impact: The Slovenian questionnaire version can be used to measure and evaluate frailty among older adults. We have found that careful translation and adaptation processes have maintained the instrument's strong reliability and validity for use in a new cultural context. The instrument can foster international collaboration to identify and manage frailty among older people in nursing homes and community-dwelling homes. Reporting Method: The Strengthening the Reporting of Observational Studies in Epidemiology checklist for reporting cross-sectional studies was used. No Patient or Public Contribution: No patient or public involvement in the design or conduct of the study. Head nurses from nursing homes and community nurses helped recruit older adults. Older adults only contributed to the data collection and were collected from nursing homes and community dwelling. [ABSTRACT FROM AUTHOR]

Background: Over the last decade, the inadequacy and unsustainability of current healthcare services for managing long-term co-morbid and multi-morbid diseases have become evident. Methods: This study, involving 426 adults with at least one non-communicable disease in Slovenia, aimed to explore the link between quality of life, life satisfaction, person-centred care, and non-communicable disease management. Results: Results indicated generally positive perceptions of quality of life, general health, and life satisfaction of individuals with non-communicable diseases. Participants assessed their physical health as the highest of the four quality of life domains, followed by the environment, social relations, and psychological health. Significant differences occurred in life satisfaction, general health, quality of life, and person-centred care for managing non-communicable diseases. But, there were no significant differences in person-centred care according to the living environment. The study revealed a positive association between person-centred care and effective non-communicable disease management, which is also positively associated with quality of life, general health, and life satisfaction. Conclusions: Person-centred care is currently the most compassionate and scientific practice conceived, representing a high ethical standard. However, implementing this approach in healthcare systems requires a cohesive national strategy led by capable individuals to foster stakeholder collaboration. Such an approach is crucial to address the deficiencies of existing healthcare services and ensure person-centred care sustainability in non-communicable disease management. [ABSTRACT FROM AUTHOR]

Studies examining fear of falling among older adult men remain limited. The objectives of this study were to compare balance confidence in 2 age cohorts of older clergy and identify predictive determinants of balance confidence in a liturgical research initiative. Participants included 131 community-dwelling Roman Catholic priests age 60-97 yr living in religious communities in 10 mid-Atlantic states. Subjects completed the Activities-specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), timed up-and-go (TUG) test, and 15-item Geriatric Depression Scale (GDS). Younger priests (60-74 yr) demonstrated a significantly higher ABC score than the older cohort (75 and above yr) of priests (89.1 ± 12.6 vs.78.4 ± 13.9, p = .001). Confidence was significantly correlated with BBS (rho = .69, p < .01), TUG (r = -.58, p < .01), and GDS (r = -.39, p < .01) scores. A stepwise-regression model demonstrated that balance ability, mood, assistive-device use, and physical activity predicted 52% of the variance in balance confidence. [ABSTRACT FROM AUTHOR]

The article presents the authors' study which investigates the role played by African American church leaders in addressing the mental health issues of African American communities. Topics discussed include an overview of the survey techniques used by the authors to acquire the relevant data for the study, the use of the statistical tool SPSS version 22.0 in the analysis of the acquired data, and a comprehensive analysis of the results.

The authors examined the associations between acculturation, supervisors' multicultural competence, and clinicians' self-efficacy in a sample of 153 immigrant therapists currently practicing in the United States. Participants completed a demographic questionnaire and 3 additional questionnaires that examined their levels of acculturation, perceived supervisors' multicultural competence, and clinical self-efficacy. Results suggested that perceived prejudice, not level of acculturation, was significantly associated with foreign-born therapists' clinical self-efficacy. Perceived supervisors' multicultural competence was significantly associated with therapists' clinical self-efficacy. Recommendations for supervisors working with foreign-born therapists are provided. Los autores examinaron las asociaciones entre aculturación, competencia multicultural de los supervisores y autoeficacia de los profesionales clínicos en una muestra de 153 terapeutas inmigrantes actualmente en activo en los Estados Unidos. Los participantes completaron un cuestionario demográfico y tres cuestionarios adicionales que examinaron sus niveles de aculturación, la competencia multicultural percibida de sus supervisores y la autoeficacia clínica. Los resultados sugieren que los prejuicios percibidos, no el nivel de aculturación, están asociados de forma significativa con la autoeficacia clínica de los terapeutas nacidos en el extranjero. La competencia multicultural percibida de sus supervisores está asociada significativamente con la autoeficacia clínica de los terapeutas. Se proporcionan recomendaciones para supervisores que trabajan con terapeutas nacidos en el extranjero. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to assess the relationship between apolipoprotein E (APOE), life events and engagement, and subjective well-being (as measured by positive and negative affect) among centenarians. Based on the life stress paradigm, we predicted that higher levels of stress would allow APOE to influence positive and negative affect. Method: 196 centenarians and near-centenarians (98 years and older) of the Georgia Centenarian Study participated in this research. The APOE, positive and negative affect, the number of recent (last 2 years) and lifelong (more than 20 years prior to testing) events, as well as a number of life engagement tasks were assessed. Results: Results suggested that centenarians carrying the APOE ϵ4 allele rated lower in positive affect, the number of lifelong events, and in engaged lifestyle, when compared to centenarians without the APOE ϵ4 allele (t = 3.43, p <.01; t = 3.19, p <.01; and t = 2.33, p <.05, respectively). Blockwise multiple regressions indicated that the APOE ϵ4 predicted positive but not negative affect after controlling for demographics. Gene–environment interactions were obtained for the APOE ϵ4 and lifelong events, suggesting that carriers of the APOE ϵ4 allele had higher scores of negative affect after having experienced more events, whereas noncarriers had reduced negative affect levels after having experienced more events. Conclusion:APOE ϵ4 is directly related to positive affect and is related to negative affect in interaction with life events. [ABSTRACT FROM AUTHOR]

Low serum concentrations of 25-hydroxyvitamin D (25(OH)D) have been associated with poor physical function in older adults, but few, if any, studies have examined this relationship in the very old. Therefore, the purpose of this study is to examine this relationship in the very old. Serum 25(OH)D concentrations were obtained from 194 centenarians and near centenarians (98 years and older). The associations between 25(OH)D concentrations and measures of physical function were evaluated with unadjusted and adjusted regression models. We found that 35% of centenarians had 25(OH)D concentrations less than 50nmol/L. Adjusted mean grip strength was lower for centenarians with 25(OH)D concentrations less than 75nmol/L than for centenarians with higher concentrations (P<0.05). However, there were no differences in the Georgia Centenarian Study (GCS) Composite Scale, a global measure of physical function, between those with higher and lower 25(OH)D concentrations. We conclude that low 25(OH)D concentrations are associated with poor grip strength, but not GCS Composite Scale, in the very old. Considering the high burden of poor physical function in older adults, understanding the relationship between vitamin D and different measures of physical function, including strength, becomes increasingly important. [ABSTRACT FROM PUBLISHER]

Centenarians represent a rare but rapidly growing segment of the oldest-old. This study presents item-level data from the Mini- Mental State Examination ( MMSE) in a cross-sectional, population-based sample of 244 centenarians and near-centenarians (aged 98-108, 16% men, 21% African-American, 38% community dwelling) from the Georgia Centenarian Study (2001-2008) according to age, education, sex, race, and residential status. Multiple- Indicator Multiple- Cause ( MIMIC) models were used to identify systematic domain-level differences in MMSE scores according to demographic characteristics in this age group. Indirect effects of age, educational attainment, race, and residential status were found on MMSE scores. Direct effects were limited to concentration for education and race and orientation for residential status. Mean levels of cognitive functioning in centenarians were low, with mean values below most commonly-used cutoffs. Overall scores on the MMSE differed as a function of age, education, race, and residential status, with differences in scale performance limited primarily to concentration and orientation and no evidence of interactions between centenarian characteristics. Adjusting for education was not sufficient to account for differences according to race, and adjusting for residential status was not sufficient to account for differences according to age. [ABSTRACT FROM AUTHOR]

Oxidative stress is involved in age-related cognitive decline. The dietary antioxidants, carotenoids, tocopherols, and vitamin A may play a role in the prevention or delay in cognitive decline. In this study, sera were obtained from 78 octogenarians and 220 centenarians from the Georgia Centenarian Study. Brain tissues were obtained from 47 centenarian decedents. Samples were analyzed for carotenoids, α-tocopherol, and retinol using HPLC. Analyte concentrations were compared with cognitive tests designed to evaluate global cognition, dementia, depression and cognitive domains (memory, processing speed, attention, and executive functioning). Serum lutein, zeaxanthin, and β-carotene concentrations were most consistently related to better cognition (P < 0.05) in the whole population and in the centenarians. Only serum lutein was significantly related to better cognition in the octogenarians. In brain, lutein and β-carotene were related to cognition with lutein being consistently associated with a range of measures. There were fewer significant relationships for α-tocopherol and a negative relationship between brain retinol concentrations and delayed recognition. These findings suggest that the status of certain carotenoids in the old may reflect their cognitive function. The protective effect may not be related to an antioxidant effect given that α-tocopherol was less related to cognition than these carotenoids. [ABSTRACT FROM AUTHOR]

Objectives To describe the prevalence of diabetes mellitus ( DM) in centenarians. Design Cross-sectional, population-based. Setting Forty-four counties in northern Georgia. Participants Two hundred forty-four centenarians (aged 98-108, 15.8% male, 20.5% African American, 38.0% community dwelling) from the Georgia Centenarian Study (2001-2009). Measurements Nonfasting blood samples assessed glycosylated hemoglobin ( HbA1c) and relevant clinical parameters. Demographic, diagnosis, and DM complication covariates were assessed. Results 12.5% of centenarians were known to have DM. DM was more prevalent in African Americans (27.7%) than whites (8.6%, P < .001). There were no differences between men (16.7%) and women (11.7%, P = .41) or between centenarians living in the community (10.2%) and in facilities (13.9%, P = .54). DM was more prevalent in overweight and obese (23.1%) than nonoverweight (7.1%, P = .002) centenarians. Anemia (78.6% vs 48.3%, P = .004) and hypertension (79.3% vs 58.6%, P = .04) were more prevalent in centenarians with DM than in those without, and centenarians with DM took more nonhypoglycemic medications (8.6 vs 7.0, P = .02). No centenarians with HbA1c of less than 6.5% had random serum glucose levels greater than 200 mg/dL. DM was not associated with 12-month all-cause mortality, visual impairment, amputations, cardiovascular disease, or neuropathy. Thirty-seven percent of centenarians reported onset before age 80 (survivors), 47% between age 80 and 97 (delayers), and 15% aged 98 and older (escapers). Conclusion Diabetes mellitus is a risk factor for cardiovascular disease and mortality but is seen in persons who live into very old age. Aside from higher rates of anemia and use of more medications, few clinical correlates of DM were observed in centenarians. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which is concerned with research which investigated the association between anemia and physical function in Georgia centenarians.

The current study attempted to describe how personality traits of older adults are associated with components of successful aging (cognition, volunteering, activities of daily living, and subjective health). Three-hundred and six octogenarians and centenarians who participated in the third phase of the Georgia Centenarian Study provided data for this study. Factor analysis was conducted to test the existence of two higher-order factors of the Big Five personality traits, and a two-factor model (alpha and beta) fit the data well. Also, blocked multiple regression analysis was conducted to examine the association between personality traits and four components of successful aging. Results indicated that low scores on neuroticism and high scores on extraversion, openness to experience, agreeableness, and conscientiousness are significantly related to the components of successful aging. After controlling for demographic variables (age, gender, residential type, and race/ethnicity), alpha (i.e., emotional stability, agreeableness, and conscientiousness) was associated with higher levels of cognition, higher likelihood of engaging in volunteer work, higher levels of activities of daily living, and higher levels of subjective health. Beta (i.e., extraversion and openness to experience) was also positively associated with cognition and engaging in volunteer work. [ABSTRACT FROM AUTHOR]

Objective: To examine the feasibility, acceptability, and initial efficacy of a technology-based weight loss intervention for urban, low-income mothers. Methods: Eighteen obese, ethnic minority, socioeconomically disadvantaged mothers in the first year after childbirth were randomly assigned to either: 1) technology-based intervention, which included empirically supported behavior-change strategies, daily skills, and self-monitoring text messages with personalized feedback, biweekly counseling calls from a health coach, and access to a Facebook support group, or 2) usual-care control. Results: After 14 weeks of treatment, the technology-based intervention participants had significantly greater weight loss (−2.9 ± 3.6 kg) than usual care (0.5 ± 2.3 kg; adjusted mean difference: −3.2 kg, 95% confidence interval −6.2 to −0.1 kg, P = .04). One-third of intervention participants (3 of 9) and no control participants lost > 5% of their initial body weight at follow up. Conclusions and Implications: Results suggest the potential for using technology to deliver a postpartum weight loss intervention among low-income racial/ethnic minorities. [ABSTRACT FROM AUTHOR]

Serving larger portions of energy-dense foods has been shown to promote children's energy intake at meals. Whether larger portions increase children's intake of both fruits and vegetables (F&V) is less clear. A 2×2 within-subjects design systematically varied portion sizes of fruit (75 vs 150 g) and vegetable (75 vs 150 g) side dishes served at dinner. Children's F&V liking was measured using a validated tasting method. Thirty children aged 4 to 6 years were tested in a laboratory setting at 5:00 pm on weekdays from November 2008 through March 2009. Mixed linear models were used to determine effects of fruit portion size, vegetable portion size, and their interaction on food and energy intakes. Data are presented as model-based means±standard error unless otherwise indicated. When portions were doubled, children increased their vegetable intake by 37% (12±4 g; P<0.01) and their fruit intake by 70% (41±6 g; P<0.01). Vegetable portion size effects were not influenced by offering more fruit and vice versa. Portion size effects were limited to children who liked that particular food. Total meal energy intake did not vary by portion size condition. These results indicate that serving larger F&V portions at meals can be used to promote young children's intake of both foods without influencing total meal energy intake. Effects were not seen in children who disliked F&V, suggesting a need to combine increased F&V portions with strategies to increase their acceptance. [Copyright &y& Elsevier]