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Background and Objectives: The purpose of this study was to investigate individuals residing in senior living communities (SLCs) amid the coronavirus disease 2019 (COVID-19) pandemic. One reason those living in SLCs often choose these communities is to have a readily available social network. Necessary social distancing disrupted this socialization, thus, possibly increasing perceptions of loneliness in residents of SLCs. This study examined relationships among loneliness, perceived provider communication about the pandemic and related restrictions, as well as individual characteristics. Research Design and Methods: In December 2020, a survey was administered to older adults residing in a network of SLCs in Nebraska. Utilizing data from 657 residents aged 60 and older, ordinary least squares regression models were used to examine associations between 2 distinct measures of perceived provider communication and feelings of loneliness during the pandemic. The analysis also considered whether these associations varied as a function of education. Results: The respondents were, on average, 84 years of age, primarily female (72%), and living independently (87%) in the SLC. The linear regression results revealed that 53% of respondents were very lonely during the pandemic. However, provider communication that was rated as helpful to residents' understanding of the COVID-19 pandemic was associated with lower perceived loneliness. There was not a similar association for provider communication regarding services and amenities, and the association was not present for those with the highest level of education. Discussion and Implications: Provider communication in times of disruption from normal activities, such as with the COVID-19 pandemic, is important to perceptions of loneliness among those living in SLCs, particularly for those with lower educational attainment. SLCs are communities that individuals select to reside in, and through communication, providers may have the opportunity to positively affect resident experiences, especially in times of stress.

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This study examines the potential of AI-powered personal voice assistants (PVAs) in reducing loneliness and increasing social support among older adults. With the aging population rapidly expanding, innovative solutions are essential. Prior research has indicated the effectiveness of various interactive communication technologies (ICTs) in mitigating loneliness, but studies focusing on PVAs, particularly considering their modality (audio vs. video), are limited. This research aims to fill this gap by evaluating how voice assistants, in both audio and video formats, influence perceived loneliness and social support. This study examined the impact of voice assistant technology (VAT) interventions, both audio-based (A-VAT) and video-based (V-VAT), on perceived loneliness and social support among 34 older adults living alone. Over three months, participants engaged with Amazon Alexa™ PVA through daily routines for at least 30 min. Using a hybrid natural language processing framework, interactions were analyzed. The results showed reductions in loneliness (Z = -2.99, p < 0.01; pre-study loneliness mean = 1.85, SD = 0.61; post-study loneliness mean = 1.65, SD = 0.57), increases in social support post intervention (Z = -2.23, p < 0.05; pre-study social support mean = 5.44, SD = 1.05; post-study loneliness mean = 5.65, SD = 1.20), and a correlation between increased social support and loneliness reduction when the two conditions are combined (ρ = -0.39, p < 0.05). In addition, V-VAT was more effective than A-VAT in reducing loneliness (U = 85.50, p < 0.05) and increasing social support (U = 95, p < 0.05). However, no significant correlation between changes in perceived social support and changes in perceived loneliness was observed in either intervention condition (V-VAT condition: ρ = -0.24, p = 0.37; A-VAT condition: ρ = -0.46, p = 0.06). This study's findings could significantly contribute to developing targeted interventions for improving the well-being of aging adults, addressing a critical global issue.

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Response to challenging situations is important to avoid falls, especially after medial perturbations, which require active control. There is a lack of evidence on the relationship between the trunk's motion in response to perturbations and gait stability. Eighteen healthy adults walked on a treadmill at three speeds while receiving perturbations of three magnitudes. Medial perturbations were applied by translating the walking platform to the right at left heel contact. Trunk velocity changes in response to the perturbation were calculated and divided into the initial and the recovery phases. Gait stability after a perturbation was assessed using the margin of stability (MOS) at the first heel contact, MOS mean, and standard deviation for the first five strides after the perturbation onset. Faster speed and smaller perturbations led to a lower deviation of trunk velocity from the steady state, which can be interpreted as an improvement in response to the perturbation. Recovery was quicker after small perturbations. The MOS mean was associated with the trunk's motion in response to perturbations during the initial phase. Increasing walking speed may increase resistance to perturbations, while increasing the magnitude of perturbation leads to greater trunk motions. MOS is a useful marker of resistance to perturbations.

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Caring for a person living with dementia (PLWD) can be challenging, making support services like respite important. Of the types of respite, research on paid professional in-home care specific to family caregivers of PLWD is limited. This study aimed to identify characteristics of dementia caregivers using paid in-home respite. A self-administered online survey (N = 98) examined use of in-home respite. Measures assessed depressive symptoms, burden, and self-rated health. Analyses included descriptive statistics and qualitative coding. Most respondents utilized weekly schedules of in-home respite with a moderate correlation between dependency and hours of respite. Caregivers' self-reported average health, depressive symptoms, and mild-to-moderate burden. The majority of users had lowered perceived stress, were satisfied with services, and indicated the importance of in-home respite during a pandemic. Future research should assess changes in use of paid in-home respite services and overall landscape of respite options for dementia caregivers.

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Background: The effect of physical activity and exercise on hunger and satiety has been well-studied in younger adults, but the influence of aging is less understood. While some evidence suggests that acute bouts of exercise induce a compensatory eating drive, long-term activity may improve satiety sensitivity. The objective of this study was to investigate the effects of exercise on appetite in older adults. Methods: We systematically reviewed available literature investigating the effect of exercise on appetite in older adults adults (CRD42020208953). PubMed, PsycINFO, Academic Search Complete, the Sports Medicine & Education Index, and Web of Science, were searched for peer-reviewed articles published in English with no date restriction. Included studies implemented a primary exercise or physical activity intervention with a control group, on a generally healthy population ≥60 years of age. Selected studies included at least one appetite outcome. Risk of bias was assessed using the 11-point Physiotherapy Evidence Database (PEDro) tool. Standardized mean difference summary statistics (Hedge's g effect sizes) and 95% confidence intervals were reported. Results: We identified 15 reports (13 studies) which met all inclusion criteria (5 resistance training, 3 aerobic, 6 mixed modalities). Studies included 443 participants (Age = 68.9 ± 5.2, 82.3% female) and had generally "good" bias scores (PEDro = 6.4 ± 0.88). Random effects meta-analyses revealed that the exercising group showed statistically significant reductions in glucose [SMD = -0.34 (95% CI: -0.67, -0.02), p < 0.05, PEDro =6.4 ± 0.45] and leptin [SMD = -0.92 (95% CI: -1.28, -0.57), p < 0.00001, PEDro = 6.2 ± 0.75]. Discussion: This systematic review revealed that exercise and physical activity may modulate resting hunger and satiety in older adults. Decreases in fasting leptin and glucose hormones suggest that exercise promotes satiety sensitivity in adults aged 60+. This review highlights that engaging in exercise and activity programs may provide a meaningful avenue for improving chronic and functional disease burden in later life by promoting appetite control and balanced energy intake. Recommendations for future research include investigations of appetite in response to varied exercise modalities within more diverse and representative samples of older adults.

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BACKGROUND AND PURPOSE: Completing simultaneous tasks while standing or walking (ie, a high cognitive load situation [HCLS]) is inevitable in daily activities and can lead to interference in task performances. Age-related physical and cognitive changes may confound performance variability during HCLS in older and younger adults. Identification of these confounding effects may reveal therapy targets to maintain optimal physical function later in life. The aim of this study was to investigate the effect of increasing the difficulty levels of an additional motor task and restricting visual information, on gait parameters in younger and older adults while considering the effect of cognitive and physical covariates. METHODS: Fifteen healthy younger and 14 healthy older adults were asked to complete assessments of cognitive function, balance, and strength. They were then asked to walk on a self-paced treadmill with or without carrying a plastic tray. Opaqueness of the tray (vision) and the presence of water in glasses placed on the tray (increasing task difficulty) were varied. Mean, standard deviation, and regularity (sample entropy) of step width and length were compared across conditions and groups using repeated-measures analyses of variance with and without covariate analysis. Only significantly correlated covariates of cognition, balance, and strength were entered into each model. RESULTS AND DISCUSSION: Older adults had greater step width irregularity compared with younger adults across all conditions when controlling for concentric plantar- and dorsiflexion strength. A decline in strength may likely alter neuromuscular control of gait, specifically control of step width, which has been associated with fall risk in older adults. Adjusting for the same covariates revealed increased regularity of step length, as visual feedback from the feet was restricted. Specifically, step length was more regular while carrying an opaque tray compared with not carrying a tray. Visual restriction was a contributing factor, which led to more predictable gait kinematics, indicating the role of sensory information to enhance the adaptability during walking under HCLS. CONCLUSION: The knowledge of the regularity behavior of human movement can expand physical therapists' treatment approaches to promote further interactivity and coordination across body systems that model behavior of healthy young individuals. Targeting strength during therapy may provide additional benefits for gait performance under HCLS.

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OBJECTIVE: The purpose of the present study was to examine whether multiple constructs of depressive symptoms explained discrepancies between subjective (SM) and objective memory (OM) in older adulthood. METHOD: A sub-sample (Range: 65-98 years, N = 606) of the 2000 Wave Panel 3 of the Long Beach Longitudinal Study was used to explore underlying latent factors within the Geriatric Depression Scale (GDS). RESULTS: Four GDS factors were identified (Dysphoria, Vigor/Withdrawal, Cognitive Concerns, and Agitation); the factor solution was tested in a confirmatory factor analysis. Mechanisms of the GDS factors on SM and OM were tested by using structural equation modeling. Dysphoria negatively predicted OM, but not SM, suggesting that people who scored high in Dysphoria might not sense their memory failures although they obviously performed poorly in OM. Cognitive concerns negatively predicted SM, but not OM, suggesting that cognitive concerns were not influential for OM, but negatively affected one's evaluation of SM. CONCLUSION: The study results have clinical implications since such relationships can be concealed while assessing depressive symptoms as a single GDS factor. Thus, the patterns of the GDS factors, SM, and OM derived from this study can be very useful for clinicians who conduct assessments on depressive symptoms and memory failures.

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The need to manage chronic diseases and multiple medications increases for many older adults. Older adults are aware of memory declines and incorporate compensatory techniques. Everyday memory strategies used to support medication adherence were investigated. A survey distributed to 2000 households in the Atlanta metropolitan area yielded a 19.9% response rate including 354 older adults, aged 60-80 years. Older adults reported forgetting to take their medications, more so as their activity deviated from normal routines, such as unexpected activities. The majority of older adults endorsed at least two compensatory strategies, which they perceived to be more helpful in normal routines. Compensatory strategies were associated with higher education, more medications, having concern, and self-efficacy to take medications. As memory changes, older adults rely on multiple cues, and perceive reliance on multiple cues to be helpful. These data have implications for the design and successful implementation of medication reminder systems and interventions.

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We investigated cognitive training effects on accuracy and number of items attempted in inductive reasoning performance in a sample of 335 older participants (M = 72.78 years) from the Seattle Longitudinal Study. We assessed the impact of individual characteristics, including chronic disease. The reasoning training group showed significantly greater gain in accuracy and number of attempted items than did the comparison group; gain was primarily due to enhanced accuracy. Reasoning training effects involved a complex interaction of gender, prior cognitive status, and chronic disease. Women with prior decline on reasoning but no heart disease showed the greatest accuracy increase. In addition, stable reasoning-trained women with heart disease demonstrated significant accuracy gain. Comorbidity was associated with less change in accuracy. The results support the effectiveness of cognitive training on improving the accuracy of reasoning performance.

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We examined the association of proximal and distal training gain to subsequent mental status ratings in 302 participants (M = 76.62 years) trained on inductive reasoning or spatial orientation in the Seattle Longitudinal Study. Only training effects on reasoning ability were predictive of mental status group membership. Participants subsequently rated as probably demented did not significantly differ from nondemented participants in magnitude of reasoning training gain 14 years prior to assessment, but they did 7 years prior to status ratings. Proximal training gain 1 year prior to assessment was 0.40 SD for nondemented participants, compared with 0.25 and 0.10 SD for at-risk and probably demented participants, respectively. The combination of reasoning ability training and increased proximal training gain on reasoning ability was associated with a decreased likelihood of being rated as probably demented.

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