The Impact of Oral Health and Dental Services on the Prevalence of Subjective Cognitive Decline Among Middle-Aged and Older US Adults: Behavioral Risk Factor Surveillance System, 2022.

Introduction: Subjective cognitive decline (SCD) may be associated with poor oral health because of difficulty with self-care or comorbid conditions. Our study aimed to examine oral health status, use of dental services, and the prevalence of SCD among US middle-aged (45-64 y) and older (≥65 y) adults.

Methods: We conducted a cross-sectional analysis of 2022 Behavioral Risk Factor Surveillance System (BRFSS) data.

Impact of Probable Deployment Traumatic Brain Injury on Post-9/11 Veteran's Productive Activity Participation After Service: A TVMI Study.

Objective: To assess the impact of probable deployment traumatic brain injury (TBI) history on post-9/11 US veterans' participation in productive activities-including employment, caregiving, volunteering, and education-after military service.

Methods: This secondary cross-sectional analysis of the Veterans Metrics Initiative (TVMI) study examined productive activities among 8946 veterans who transitioned from service in 2016 and completed the TVMI survey. Associations between probable deployment TBI and activity engagement were analyzed using bivariate analysis and multinomial logistic regression.

Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey.

Objective: Rural residents face challenges to realizing guideline-concordant healthcare. Less is known about the role of rurality in achieving guideline-concordant genetic testing. To address this gap, we estimated the association between rural residence and two types of clinician-ordered genetic testing among individuals who had heard of genetic testing.

Life Review Intervention Delivered by Family Caregivers of People Living with Dementia Improves Depression: A Mixed-Methods Study.

Background And Objectives: The prevalence of depression in people living with dementia is 40% in the United States. However, since pharmacological treatments tend to produce undesirable side effects, we developed a nonpharmacological, innovative depression intervention, for people living with dementia with mild depressive symptoms. We trained family caregivers in interview skills of the evidence-based depression intervention, , and caregivers conducted the intervention with people living with dementia at home.

The Epidemiology of the Long-Term Care Needs and Unmet Needs of Older Veterans in the United States.

Veterans differ in sociodemographic composition and experience higher frequencies of disability than non-Veterans of the same age. Yet the epidemiology of the long-term care needs of Veterans, specifically activities of daily living (ADLs) and instrumental activities of daily living (IADLs), remains an important gap in the literature. The objectives of this study were to (1) characterize Veterans across levels of hierarchy of ADL and IADL support needs; (2) compare Veterans across the degree of need for help, from those who can still "self-manage" to those with an "unmet need"; and (3) identify the types and prevalence of ADL and IADL need combination patterns.

Life Review Depression Intervention Conducted by Asian and White American Caregivers: A Mixed-Methods Study.

Approximately 10% of older Americans with dementia experience depression. Based on life review depression intervention, we developed the , trained Asian ( = 15) and White ( = 25) caregivers, and delivered life reviews to their loved ones with mild depressive symptoms and early-stage dementia. This mixed-methods study found that both Asian and White care recipients' depressive symptoms decreased (Asian: = 0.

Unmet Needs and Factors Impacting Home- and Community-Based Service Use Among Rural Appalachian Caregivers of People With Alzheimer's and Dementia.

Family caregivers of persons with Alzheimer's disease and related dementias (ADRD) living in rural areas face significant health and healthcare challenges. Limited research, however, has explored factors shaping their use of home- and community-based services (HCBS). This study identifies unmet needs among caregivers of people with ADRD in rural Western North Carolina and highlights contextual factors that facilitate HCBS use.

Feasibility of training family caregivers of people living with dementia online to deliver life review depression intervention at home.

Objectives: To alleviate the high prevalence of depressive symptoms and dementia in older Americans (≥65 years), we developed a depression intervention, , and taught family caregivers life review skills online compared to a synchronous group virtual training, and examined the feasibility and delivery impact ( = 20 dyads).

Method: In a cross-sectional, mixed-methods dyadic design, we recruited family caregiver-care recipient dyads nationwide, collected the pre- and post-intervention measures on care recipients' depression (primary outcome), life satisfaction, caregivers' burden, caregiving rewards, and dyads' relationship quality (secondary outcomes), and compared them using t-tests. We took fidelity scores to measure caregivers' feasibility of delivering life reviews adhering to the protocol.

Changes in Health Indicators Among Caregivers - United States, 2015-2016 to 2021-2022.

Caregivers provide support to persons who might otherwise require placement in long-term care facilities. Approximately one in five U.S.

Trajectories and Transitions in Service Use Among Older Veterans at High Risk of Long-Term Institutional Care.

Background: We aimed to identify combinations of long-term services and supports (LTSS) Veterans use, describe transitions between groups, and identify factors influencing transition.

Methods: We explored LTSS across a continuum from home to institutional care. Analyses included 104,837 Veterans Health Administration (VHA) patients 66 years and older at high-risk of long-term institutional care (LTIC).

Associations of Cognitively Active Versus Passive Sedentary Behaviors and Cognition in Older Adults.

Background: Cognitively stimulating sedentary behavior (SB) may positively impact cognition. This study aimed to (1) describe participation across types of SB among older adults with and without cognitive impairment and (2) examine how baseline SB participation impacts cognition, longitudinally.

Methods: We used National Health and Aging Trends Study data from rounds 6 to 11 for cross-sectional and longitudinal analyses.

Caregiver-specific quality measures for home- and community-based services: Environmental scan and stakeholder priorities.

Although family caregivers are increasingly recognized for their essential role in helping vulnerable adults live in the community for as long as possible, their priorities and perspectives have not been well-integrated into quality assessments of home- and community-based services (HCBS). Our overall goal was to identify measurement gaps to guide monitoring and improve HCBS. Caregiver-specific measurement priorities were identified during a multi-level stakeholder engagement process that included 34 Veterans, 24 caregivers, and 39 facility leaders, clinicians, and staff across four VA healthcare systems.

Comparing Unmet Service Needs Between Rural and Urban Family Caregivers of People Living With Alzheimer's Disease and Related Dementias: A Multisite Study.

Background And Objectives: The scarcity of resources and available caregiving services in rural areas in the United States has been well documented. However, less research has compared unmet service needs between caregivers of people with Alzheimer's disease and related dementias (ADRD) in rural versus urban areas.

Research Design And Methods: Using semistructured interviews guided by theories of health service use and dependent care, we interviewed 20 family caregivers residing in rural areas of Western North Carolina and 18 caregivers within the urban setting of Houston, Texas, and compared their unmet service needs and contextual factors that facilitate their service use.

Preimplementation Evaluation of a Self-Directed Care Program in a Veterans Health Administration Regional Network: Protocol for a Mixed Methods Study.

Background: The Veteran-Directed Care (VDC) program serves to assist veterans at risk of long-term institutional care to remain at home by providing funding to hire veteran-selected caregivers. VDC is operated through partnerships between Department of Veterans Affairs (VA) Medical Centers (VAMCs) and third-party Aging and Disability Network Agency providers.

Objective: We aim to identify facilitators, barriers, and adaptations in VDC implementation across 7 VAMCs in 1 region: Veterans Integrated Service Network (VISN) 8, which covers Florida, South Georgia, Puerto Rico, and the US Virgin Islands.

Association between low health literacy and adverse health behaviors in North Carolina, 2016.

Introduction: Health literacy (HL) is an urgent public health challenge facing the U.S. HL is a critical factor in health inequities and exacerbates underlying social determinants of health.

Measuring the unmet needs of American military Veterans and their caregivers: Survey protocol of the HERO CARE survey.

Background: Empowering Veterans to age in place is a Department of Veterans Affairs priority. Family or unpaid caregivers play an important role in supporting Veterans to achieve this goal. Effectively meeting the needs of Veterans and caregivers requires identifying unmet needs and relevant gaps in resources to address those needs.

Feasibility and Efficacy of Life Review Delivered by Virtually-Trained Family Caregivers.

Background: Due to the high prevalence of depressive symptoms and Alzheimer's disease and related dementias in older Americans (≥65 years), we developed a six-week depression intervention, Caregiver-Provided Life Review (C-PLR) for care recipients (CRs) with early-stage dementia and mild depression.

Objective: The objective of the study was to examine the feasibility and efficacy of C-PLR delivered by virtually-trained caregivers (CGs) on CRs who live with dementia and depression in community and long-term care settings (N = 25 CG-CR dyads).

Methods: We used fidelity scores as a measure of CG's feasibility to provide C-PLR.

Use of Caregiving Support Services Among Diverse Dementia Caregivers by Geographic Context.

Background And Objectives: Little is known about how race/ethnicity and geographic context relate to support service use among dementia caregivers. Our objectives were to investigate (a) whether the use of at least one formal caregiving service-support groups, respite care, and training-differed by race/ethnicity and across metro and nonmetro areas; and (b) whether predisposing, enabling, and need characteristics influenced support service use by race/ethnicity.

Research Design And Methods: Data were analyzed from a sample of primary caregivers of care recipients aged 65 years or older with probable dementia (n = 482) in the 2017 National Health and Aging Trends Study and National Study of Caregiving.

Dementia Caregiving Experiences and Health Across Geographic Contexts by Race and Ethnicity.

Objectives: Few studies have examined how the intersectionality of geographic context and race/ethnicity influences dementia caregiving. Our objectives were to determine whether caregiver experiences and health (a) differed across metro and nonmetro areas and (b) differed by caregiver race/ethnicity and geography.

Methods: We used data from the 2017 National Health and Aging Trends Study and National Study of Caregiving.

Caregiver burden and COVID-19: How epilepsy caregivers experienced the pandemic.

Introduction: Caregivers of adults with epilepsy face unique challenges, yet most studies focus on the impact of epilepsy on those living with the condition, rather than the impact on caregivers. Our objective was to evaluate whether caregivers' pandemic-related changes and experiences - namely those related to their health, healthcare access, and well-being - were associated with their caregiving burden.

Methods: Caregivers of adults with epilepsy (n = 261) were recruited through Qualtrics Panels to participate in an online survey examining health, well-being, COVID-19 experiences, and caregiver burden from October-December, 2020.