The health care industry has continued its efforts to promote health and prevent disease among elderly populations. In this book, however, the authors argue that simple health promotion and disease prevention are not enough to address the many challenges of aging-whether it entails being physically frail, living with dementia, or approaching death. Instead, the unique focus of this groundbreaking text centers on maximizing function and well-being for the elderly. This book promotes the development and maintenance of optimal physical, mental, and social functioning, irrespective of acquired dis
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Abstract Adaptive survey designs are increasingly used by survey practitioners to counteract ongoing declines in household survey response rates and manage rising fieldwork costs. This paper reports findings from an evaluation of an early-bird incentive (EBI) experiment targeting high-effort respondents who participate in the 2019 wave of the US Panel Study of Income Dynamics. We identified a subgroup of high-effort respondents at risk of nonresponse based on their prior wave fieldwork effort and randomized them to a treatment offering an extra time-delimited monetary incentive for completing their interview within the first month of data collection (treatment group; N = 800) or the standard study incentive (control group; N = 400). In recent waves, we have found that the costs of the protracted fieldwork needed to complete interviews with high-effort cases in the form of interviewer contact attempts plus an increased incentive near the close of data collection are extremely high. By incentivizing early participation and reducing the number of interviewer contact attempts and fieldwork days to complete the interview, our goal was to manage both nonresponse and survey costs. We found that the EBI treatment increased response rates and reduced fieldwork effort and costs compared to a control group. We review several key findings and limitations, discuss their implications, and identify the next steps for future research.
Background U.S.-focused studies have reported decreasing dementia prevalence in recent decades, but have not yet focused on the implications of the coronavirus disease 2019 (COVID-19) pandemic for trends.
Methods We use the 2011–2021 National Health and Aging Trends Study (N = 48 065) to examine dementia prevalence, incidence, and mortality trends among adults ages 72 and older, and the contribution to prevalence trends of changes in the distribution of characteristics of the older population ("compositional shifts") during the full and prepandemic periods. To minimize classification error, individuals must meet dementia criteria for 2 consecutive rounds.
Results The prevalence of probable dementia declined from 11.9% in 2011 to 9.2% in 2019 and 8.2% in 2021 (3.1% average annual decline). Pre-pandemic declines continued for women and non-Hispanic White individuals and emerged over the 2011–2021 period for men and those ages 80–89. Declines in dementia incidence were stronger for the 2011–2021 period than for the prepandemic period, while mortality among those with dementia rose sharply with the onset of the COVID-19 pandemic. Shifts in the composition of the older population accounted for a smaller fraction of the decline over the full period (27%) than over the prepandemic period (45%).
Conclusions Declines in dementia prevalence continued into years marked by onset of the COVID-19 pandemic, along with declines in incidence and sharp increases in mortality among those with dementia. However, declines are no longer largely attributable to compositional changes in the older population. Continued tracking of dementia prevalence, incidence, and mortality among those with and without dementia is needed to understand long-run consequences of the pandemic.
Objectives Limited research has explored caregivers' activities beyond caregiving duties, which may offer positive experiences and counterbalance caregiving stress. This study aimed to (a) identify the most pleasant non-caregiving activities, (b) assess time allocation based on activity categories and pleasantness, and (c) investigate the association between activity pleasantness and duration, considering differences between caregivers to older adults with Alzheimer's Disease and Related Dementias (ADRD) and those without.
Methods This study included 2,136 caregivers (33% ADRD) from the 2017 National Study of Caregiving (NSOC) who participated in a time diary interview. Participants reported all activities from the previous day, including their pleasantness appraisal and duration.
Results Weighted descriptives showed organizational activities (e.g., religious practices) were rated as the most pleasant, followed by active leisure (e.g., sports), for both ADRD and non-ADRD caregivers. Caregivers spent most time on non-active leisure (e.g., TV viewing), with about 10.6 hours daily on pleasant non-caregiving activities and 35 minutes on unpleasant ones. Weighted linear regression models indicated that both groups reported comparable pleasantness ratings for various activities and allocated similar amounts of time to activities based on categories and pleasantness. For non-ADRD caregivers, greater activity pleasantness was temporarily linked to longer durations.
Discussion This study enhances understanding of caregivers' appraisals and time spent on non-caregiving activities. While ADRD caregiving is more stressful than non-ADRD caregiving, no spillover effect was observed on the pleasantness ratings or time spent on non-caregiving activities. However, ADRD caregivers may encounter challenges in sustaining pleasant activities over time.
The Panel Study of Income Dynamics (PSID) is the world's longest running household panel survey. Since it began in 1968, it has collected data on the same families and their descendants, making it an essential part of America's data infrastructure for empirically based social science research. The PSID arose from the War on Poverty as a tool for evaluating poverty dynamics, and this year (2018) marks 50 years of data collection. Because of its long history and distinctive design of following adult children as they form their own households, the PSID is uniquely positioned to address emerging social and behavioral research questions and related policy issues. This overview presents the design and structural aspects and its evolution over the past 50 years, the successes of the current survey, possible future directions, and the value of using the PSID to understand the challenges facing American families.
The authors examined associations between marital quality and both general life satisfaction and experienced (momentary) well‐being among older husbands and wives, the relative importance of own versus spouse's marital appraisals for well‐being, and the extent to which the association between own marital appraisals and well‐being is moderated by spouse's appraisals. Data are from the 2009 Disability and Use of Time daily diary supplement to the Panel Study of Income Dynamics (N = 722). One's own marital satisfaction is a sizable and significant correlate of life satisfaction and momentary happiness; associations do not differ significantly by gender. The authors did not find a significant association between spouse's marital appraisals and own well‐being. However, the association between husband's marital quality and life satisfaction is buoyed when his wife also reports a happy marriage, yet flattened when his wife reports low marital quality. Implications for understanding marital dynamics and well‐being in later life are discussed.
AbstractObjectivesPandemic-specific changes to the caregiving context (e.g., attempts to reduce exposure, physical distancing requirements) may lead to changes in care provision. This study uses the 2020 National Health and Aging Trends Study Family Members and Friends coronavirus disease 2019 (COVID-19) questionnaire to explore changes in the amount of care provision during COVID-19 and associations with stress process outcomes of caregiving.MethodsThe sample includes 1,020 caregivers who provided care for an older adult during COVID-19. Caregivers indicated whether their hours of care decreased, stayed stable, or increased during the pandemic. We describe reasons for change in care and compare changes in care by demographic and care-related characteristics using chi-squares and analyses of variance, and relate changes in care with stress process outcomes (e.g., overload, COVID-related anxiety) using multivariable linear regression.ResultsCaregivers were 60.7 years old on average, 69.3% were female, and 18.6% were non-White. While most caregivers reported no change, 30.5% reported an increase and 11.5% reported a decrease in the amount of pandemic care provided. Relative to maintaining stable care provision, an increase was associated broadly with worse mental health and care-related stress, whereas a decrease was associated with greater emotional difficulty related to care and lower levels of positive affectivity.DiscussionThose who changed their care provision during the pandemic predominantly did so to protect their care recipient from COVID-19 exposure. Increasing one's care provision was strongly associated with worse mental health and well-being. Supports for caregivers who take on additional care tasks during the pandemic could have great public health benefit.
