The population of older adults worldwide is growing, with an urgent need for approaches that develop and maintain intrinsic capacity consistent with healthy aging. Theory and empirical research ...converge on feeling safe as central to healthy aging. However, there has been limited attention to resources that cultivate feeling safe to support healthy aging. Nostalgia, "a sentimental longing for one's past," is established as a source of comfort in response to social threat, existential threat, and self-threat. Drawing from extant theory and research, we build on these findings to position nostalgia as a regulatory resource that cultivates feeling safe and contributes to intrinsic capacity to support healthy aging. Using a narrative review method, we: (a) characterize feeling safe as a distinct affective dimension, (b) summarize the character of nostalgia in alignment with feeling safe, (c) propose a theoretical account of the mechanisms through which nostalgia cultivates feeling safe, (d) highlight the contribution of nostalgia to feeling safe and emotional, physiological, and behavioral regulatory capabilities in healthy aging, and (e) offer conclusions and direction for research.
This review identifies evidence-based psychological treatments (EBTs) for reducing distress, and improving well-being, of family members caring for an older relative with significant cognitive and/or ...physical impairment. Three categories of psychologically derived treatments met EBT criteria: psychoeducational programs (
N
= 14 studies), psychotherapy (
N
= 3 studies), and multicomponent interventions (
N
= 2 studies). Specifically, support within the psychoeducational category was found for skill- training programs focused on behavior management, depression management, and anger management and for the progressively lowered threshold model. Within the psychotherapy category, cognitive-behavioral therapy enjoys strong empirical support. Within the multicomponent category, programs using a combination of at least 2 distinct theoretical approaches (e.g., individual counseling and support group attendance) were also found to be effective. Suggestions for future research include the development of more well-integrated multicomponent approaches, greater inclusion of ethnically diverse family caregivers in research protocols, and greater incorporation of new technologies for treatment delivery.
Guided by a Sociocultural Health Belief Model (SHBM), this study examined the roles of cultural beliefs of Alzheimer's disease (AD) and scientific knowledge of AD in influencing the perceived threat ...of AD in a sample of Chinese American older adults.
With the input from focus groups of 17 older Chinese volunteers, survey questionnaires were refined and then delivered through face-to-face interviews to 385 participants aged 55-100 in the Phoenix metropolitan area.
Hierarchical regression analyses found that those aged 55-64 were more worried about AD than those aged 85 or older. Both cultural beliefs of AD and AD factual knowledge contributed to higher levels of perceived threat of AD. Education tended to moderate the effect of cultural beliefs of AD and AD knowledge on perceived threat of AD.
Findings support inclusion of key factors in the SHBM relevant to perceived threat of AD and help enrich the understanding of AD literacy from both scientific and cultural perspectives. AD education programs and interventions should help address crucial cultural beliefs related to AD and the emotional consequences (e.g., concerns or fear of AD) that might be due to the exposure to AD factual knowledge, particularly for those with limited education.
Aims
To examine how perceived balance problems are associated with self‐reported falls in the past month after controlling for known correlates of falls among older adults.
Background
Approximately ...30% of adults age 65 and older fall each year. Most accidental falls are preventable, and older adults' engagement in fall prevention is imperative. Limited research suggest that older adults do not use the term ‘fall risk’ to describe their risk for falls. Instead, they commonly use the term ‘balance problems’. Yet, commonly used fall risk assessment tools in both primary and acute care do not assess older adults' perceived balance.
Design and Method
The Health Belief Model and the concept of perceived susceptibility served as the theoretical framework. A retrospective, cross‐sectional secondary analysis using data from the National Health and Aging Trends Study from year 2015 was conducted. The outcome variable was self‐reported falls in the last month.
Results
A subsample of independently living participants (N = 7499) was selected, and 10.3% of the sample reported a fall. Multiple logistic regression analysis revealed that the odds of reporting a fall in the past month was 3.4 times (p < .001) greater for participants who self‐reported having a balance problem compared to those who did not. In contrast, fear of falling and perceived memory problems were not uniquely associated with falls. Using a mobility device, reporting pain, poor self‐rated health status, depression and anxiety scores were also associated with falling.
Conclusion and Implications
Older adults' perceived balance problem is strongly associated with their fall risk. Perceived balance may be important to discuss with older adults to increase identification of fall risk. Older adults' perceived balance should be included in nursing fall risk assessments and fall prevention interventions. A focus on balance may increase older adults' engagement in fall prevention.
To examine the extent to which older adults' perceived balance, a balance performance test, and fear of falling (FOF) were associated with falls in the last month.
The Health Belief Model served as ...the theoretical framework. A retrospective, cross-sectional, secondary analysis using data from the National Health and Aging Trends Study was conducted (
= 7499).
Multiple logistic regression analysis revealed that the odds of reporting a fall in the past month were 3.3 times (
< .001) greater for participants who self-reported having a balance problem compared to those who did not. The Short Physical Performance Battery and FOF were not uniquely associated with falls.
Our findings support limited evidence suggesting that older adults' perceived balance is a better predictor of falls than balance performance. Assessing older adults' perceived balance may be a new way to assess older adults' fall risk to prevent future falls.
Black/African American women represent 54% of new HIV cases among all women in the United States, face higher rates of morbidity and mortality, and are often understudied. The patient-provider ...relationship is an important motivator to keeping people who live with HIV retained in care and adherent to a medical regimen, thereby improving chances for viral suppression and maintaining overall better health. This scoping review sought to determine the extent of documented provider actions that encourage Black women with HIV to stay engaged in care. The review investigated five databases for peer-reviewed studies in the United States that included Black women from 2009 to 2023 and specifically described beneficial provider actions or behaviors. Of 526 records, 12 met the criteria. Studies revealed that women are motivated by providers who create a respectful, nonjudgmental emotionally supportive relationship with them rather than those who rely on an authoritative transactional exchange of information and orders.
Alzheimer's disease (AD) affects Latinos disproportionately. One of the reasons underlying this disparity may be type 2 diabetes (T2D) that is a risk factor for AD. The purpose of this study was to ...examine the associations of T2D and AD blood biomarkers and the differences in these associations between Mexican Americans and non-Hispanic Whites. This study was a secondary analysis of baseline data from the observational Health and Aging Brain Study: Health Disparities (HABS-HD) that investigated factors underlying health disparities in AD in Mexican Americans in comparison to non-Hispanic Whites. HABS-HD participants were excluded if they had missing data or were large outliers (z-scores >|4|) on a given AD biomarker. Fasting blood glucose and glycosylated hemoglobin (HbA1c) levels were measured from clinical labs. T2D was diagnosed by licensed clinicians. Plasma amyloid-beta 42 and 40 (Aβ42/42) ratio, total tau (t-tau), and neurofilament light (NfL) were measured via ultra-sensitive Simoa assays. The sample sizes were 1,552 for Aβ42/40 ratio, 1,570 for t-tau, and 1,553 for NfL. Mexican Americans were younger (66.6±8.7 vs. 69.5±8.6) and had more female (64.9% female vs. 55.1%) and fewer years of schooling (9.5±4.6 vs. 15.6±2.5) than non-Hispanic Whites. Mexican Americans differed significantly from non-Hispanic Whites in blood glucose (113.5±36.6 vs. 99.2±17.0) and HbA1c (6.33±1.4 vs. 5.51±0.6) levels, T2D diagnosis (35.3% vs. 11.1%), as well as blood Aβ42/40 ratio (.051±.012 vs. .047±.011), t-tau (2.56±.95 vs. 2.33±.90), and NfL levels (16.3±9.5 vs. 20.3±10.3). Blood glucose, blood HbA1c, and T2D diagnosis were not related to Aβ42/40 ratio and t-tau but explained 3.7% of the variation in NfL (p < .001). Blood glucose and T2D diagnosis were not, while HbA1c was positively (b = 2.31, p < .001, β = 0.26), associated with NfL among Mexican Americans. In contrast, blood glucose, HbA1c, and T2D diagnosis were negatively (b = -0.09, p < .01, β = -0.26), not (b = 0.34, p = .71, β = 0.04), and positively (b = 3.32, p < .01, β = 0.33) associated with NfL, respectively in non-Hispanic Whites. To conclude, blood glucose and HbA1c levels and T2D diagnosis are associated with plasma NfL levels, but not plasma Aβ and t-tau levels. These associations differ in an ethnicity-specific manner and need to be further studied as a potential mechanism underlying AD disparities.
It is widely assumed that genetic differences in gene expression underpin much of the difference among individuals and many of the quantitative traits of interest to geneticists. Despite this, there ...has been little work on genetic variability in human gene expression and almost none in the human brain, because tools for assessing this genetic variability have not been available. Now, with whole-genome SNP genotyping arrays and whole-transcriptome expression arrays, such experiments have become feasible. We have carried out whole-genome genotyping and expression analysis on a series of 193 neuropathologically normal human brain samples using the Affymetrix GeneChip Human Mapping 500K Array Set and Illumina HumanRefseq-8 Expression BeadChip platforms. Here we present data showing that 58% of the transcriptome is cortically expressed in at least 5% of our samples and that of these cortically expressed transcripts, 21% have expression profiles that correlate with their genotype. These genetic-expression effects should be useful in determining the underlying biology of associations with common diseases of the human brain and in guiding the analysis of the genomic regions involved in the control of normal gene expression.
We recently surveyed the relationship between the human brain transcriptome and genome in a series of neuropathologically normal postmortem samples. We have now analyzed additional samples with a ...confirmed pathologic diagnosis of late-onset Alzheimer disease (LOAD; final n = 188 controls, 176 cases). Nine percent of the cortical transcripts that we analyzed had expression profiles correlated with their genotypes in the combined cohort, and approximately 5% of transcripts had SNP-transcript relationships that could distinguish LOAD samples. Two of these transcripts have been previously implicated in LOAD candidate-gene SNP-expression screens. This study shows how the relationship between common inherited genetic variants and brain transcript expression can be used in the study of human brain disorders. We suggest that studying the transcriptome as a quantitative endo-phenotype has greater power for discovering risk SNPs influencing expression than the use of discrete diagnostic categories such as presence or absence of disease.
Maintaining brain health and promoting healthy lifestyle strategies to manage modifiable risk factors is vital to ensuring well-being for all - not only for the individuals with memory challenges but ...also their family caregivers and professional providers. In this brief review paper, we highlight modifiable risk and protective factors and opportunities for dementia risk reduction (e.g., limited alcohol use and reduced exposure to air pollution, secondhand smoke, and excessive noise); provide an overview of the World-Wide FINGERS Network and its goal to adapt the original Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multidomain lifestyle approach in various settings to determine whether the protocol is effective across different populations in varied geographic, cultural, and economic settings and to optimize the model across a continuum of cognitive decline; and, comment on challenges and opportunities for researchers and clinicians including opportunities for risk reduction and intervention in primary care settings and the need to establish linkages across multiple levels of intervention to sustain behavior change in prevention, treatment, and care.
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