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Background: At the biological level, ageing results from a plodding decline in physical and mental capability, an emergent menace of malady, and eventually, fatality. Even though a few of the geriatric's health changes are hereditary, to a great extent is due to individual's physical and societal surroundings and their residence, locality, societies, gender, ethnicity or socio-economic status. The current debate is well popular by the relationship between increasing diversity and the ageing population with healthcare expenditure in the United States. Higher diversity in society and increasing ageing population have various socio-economic consequences. A good policy in this regard helpful to managed and get fruitful outcomes., Objective: This study aims to examine the direct effects of diversity and ageing population on healthcare spending. The assortment observed in geriatrics is not arbitrary. A huge portion emerges from individual's physical and social settings and the influence of these environs on their prospect and well-being demeanour., Method: This study used the Bayesian-vector autoregressive model, impulse response analysis, and variance decomposition and data over the period 1990-2018 for empirical analysis of the United States., Results: The empirical findings indicate that diversity and ageing population are more persistent with health expenditure in the United States. This study concludes that an increase in diversity and ageing population will rely on the long-term healthcare facility., Conclusion: The study suggests that cohesive society and effective health intervention might aid in curtailing expenditure pressure linked with elderly population. Furthermore, a recommendation of this study is a good opportunity for healthcare policymakers and further researches., (© 2021 John Wiley & Sons Ltd.)

Older people have been overlooked in recent debates over the relationship between age, class and culture despite their prevalence and the conceptual questions they raise. Seeking to bridge mainstream class analysis with debates in social gerontology, especially via a shared turn to Pierre Bourdieu's relational sociology, this paper draws on survey data from the US to examine not only the class position of older people but their internal social and cultural differentiation. I use geometric data analysis to construct a model of the class system, locate older people within it and then explore differences among older people. I then proceed to compare the cultural symbolisations of social positions among older people to those of the larger sample. The core structures of social and cultural differentiation among older people are roughly homologous with those of the broader sample, but there are also notable differences and even inversions pointing toward the specificity - and autonomy - of ageing as a principle of difference and practice., (© 2024 The Author(s). The British Journal of Sociology published by John Wiley & Sons Ltd on behalf of London School of Economics and Political Science.)

Background: Adversity suffered in childhood may profoundly affect aging over the subsequent life cycle. The field of childhood adversity and aging has amassed a certain number of publications, but there are no bibliometric studies in this field., Methods: Publications in 10 years on childhood adversity and aging were searched in the Web of Science Core Collection. Bibliometric tools were used to analyze and visualize these publications by country, institution, journal, author, keyword, research area, and co-citation., Results: Four hundred thirty-five publications were retrieved from 2014 to September 21, 2023, with a 4.9% annual growth rate. The United States (251), University of California, San Francisco (59), Elissa S. Epel (11), and Psychoneuroendocrinology (29) were the countries, institutions, authors, and journals contributing the highest number of publications in this field, respectively. "Early-life stress" (87), "depression" (82), "childhood trauma" (69), and "aging" (60) were the keywords that appeared more frequently., Conclusions: This is the first bibliometric study on childhood adversity and aging. The United States dominates the field regarding publication numbers, research institutions, and researchers. Publications in this field are interdisciplinary, covering several critical subject areas and having far-reaching impacts, with gerontology, neurosciences, psychology, and psychiatry at the core., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Availability of data and materials A summary record of the original literature used in this study is available to the reader on the Web of Science: http://ras.cdutcm.lib4s.com:7080/s/com/webofscience/www/G.https/wos/woscc/summary/fec3fec8- d3c6–4b75-afe1-edc3f8129604- a51287b5/relevance/1 (overlay: export/exp), (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Relationships between epigenetic aging markers and psychosocial variables such as socioeconomic status and stress have been well-documented, but are often examined cross-sectionally or retrospectively, and have tended to focus on objective markers of SES or major life events. Here, we examined associations between psychosocial variables, including measures of socioeconomic status and social stress, and epigenetic aging markers in adulthood, using longitudinal data spanning three decades from the Midlife in the United States (MIDUS) study. The largest effects were observed for epigenetic markers of change in health, such as DunedinPACE and GrimAge, and for associations involving education, income, net assets, general social stress, inequality-related stress, and financial stress. Analyses of polygenic indices suggests that at least in the case of education, the link to epigenetic aging cannot be accounted for by common genetic variants., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective. Aging is a growing public health concern for people, organizations, and governments. The current study was undertaken to provide insights into the global research output on geriatric nursing. Methods. A bibliometric study was implemented using the WoS database for the period from 1900 to 2020. Various tools and measures were used to analyze and visualized. Results. The search strategy found 4923 papers. The oldest paper was written by Beverly C. Andre in 1953. As team size increases, so does the number of citations. The USA was the active country and the highest number of coauthors. New York University was an active institution. Stig Karlsson was the most active author in Geriatric Nursing with 28 articles from Sweden, followed by Koen Milisen and Sandman, with 26 articles each from Sweden and Belgium. The most frequent words in this field were depression, malnutrition, education, Alzheimer's disease, and dementia. The latest research themes in this field were COVID-19, interprofessional locomotive syndrome, emergency nursing, and public health. The most influential papers were specified. Journal of the American Geriatrics Society was the most active journal. Conclusions. Geriatric nursing is a rooted field and has received special attention in the last decade. Policymakers, especially in developing countries, should pay attention to geriatric nursing as a specialty of nursing to solve aging issues they would face considering the increasing elderly population. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Alzheimer's disease is the leading cause of dementia in the world. It affects 6 million people in the United States and 50 million people worldwide. Alzheimer's disease is characterized by the accumulation of amyloid-β plaques (Aβ), an increase in tau protein neurofibrillary tangles, and a loss of synapses. Since the 1990s, removing and reducing Aβ has been the focus of Alzheimer's treatment and prevention research. The accumulation of Aβ can lead to oxidative stress, inflammation, neurotoxicity, and eventually apoptosis. These insults impair signaling systems in the brain, potentially leading to memory loss and cognitive decline. Aniracetam is a safe, effective, cognitive-enhancing drug that improves memory in both human and animal studies. Aniracetam may prevent the production and accumulation of Aβ by increasing α-secretase activity through two distinct pathways: 1) increasing brain derived neurotrophic factor expression and 2) positively modulating metabotropic glutamate receptors. This is the first paper to propose an evidence-based model for aniracetam reducing the accumulation and production of Aβ. [ABSTRACT FROM AUTHOR]

Objectives: This paper examines the family ties of older adults in the United States and how they are associated with mental health and social activity. We compare older adults with 4 types of family ties: adults "close" to family in proximity and social network, "kinless" older adults without a partner or children, "distanced" adults who live far from close kin, and "disconnected" older adults who do not report kin in their social network or do not report a location for some kin., Methods: Using pooled data from the National Health and Aging Trends Study 2015-2019 for older adults aged 70 and older (N = 24,818 person-waves), we examine how family ties are associated with mental health and social activity, and whether lacking family is tied to poor well-being because older adults' needs are not being met., Results: Kinless older adults and disconnected older adults have poorer outcomes (lower mental health scores and less social activity), compared to those close to their family. These findings suggest that both the presence and quality of the connection, as measured here via both location and social network, are critical for understanding which older adults are "at risk." Older adults who were not geographically proximate to their close kin (i.e., distanced) were not disadvantaged relative to those close to their families. Unmet needs do not help explain these patterns., Discussion: Our results highlight that family ties are important for older adults well-being, not just through their existence but also their quality and strength., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Epigenetic aging is one plausible mechanism by which socioeconomic status (SES) contributes to disparities in morbidity and mortality. Although the association between SES and epigenetic aging is well documented, the role of parental education into adulthood remains understudied. We examined (1) if parental education was independently associated with epigenetic aging, (2) whether upward educational mobility buffered this association, and (3) if the benefit of parental education was differentiated by race/ethnicity. Secondary data analysis of a subsample (n = 3875) of Non-Hispanic [NH] Black, Hispanic, NH White, and NH other race participants from the Venous Blood Study within Health and Retirement Study were examined. Thirteen clocks based on DNA methylation of cytosine-phosphate-guanine sites were used to calculate epigenetic aging. Participants' education (personal) and their report of their respective parent's education (parental; mother's and/or father's) were included as independent variables; several potential confounders were also included. Direct associations and interactions between parental and personal education were estimated via survey-weighted generalized linear models; marginal means for epigenetic aging were estimated and contrasts were made between the education subcategories. Analyses were also stratified by race/ethnicity. Our results showed that higher parental education was independently associated with slower epigenetic aging among four clocks, whereas higher personal education magnified this association among four different epigenetic clocks. Participants with the lowest parental and personal education had higher marginal means (i.e., accelerated aging) compared to participants with the highest parental and personal education, and there was little evidence of upward mobility. These associations were more frequently observed among NH White participants, whereas fewer were observed for Hispanic and NH Black participants. Overall, our findings support that early-life circumstances may be biologically embedded through epigenetic aging, which may also limit the biological benefits associated with one's own education., Competing Interests: Declaration of competing interest The authors have no conflicting interests that might be interpreted as influencing the content of the paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Recent declines in life expectancy in the US, especially for middle-aged White persons, have called attention to mortality from deaths of despair - deaths due to alcohol, drugs, and suicide. Using data from the Centers for Disease Control and the U.S. Census Bureau, this paper examined deaths of despair by race/ethnicity, age, cause of death, birth cohort, and sex in Missouri. We focused on Area Agencies on Aging as geographic units of interest to increase usefulness of our findings to public administrators. Deaths of despair began trending up for all age groups beginning in 2007-2009, with the sharpest increases occurring for Black or African American non-Hispanics beginning in 2013-2015. The most dramatic increases occurred for the population age 50-59 in St. Louis City and Area Agency on Aging regions in southern Missouri. For older adults, considerable variation in rates, trends, and cause of deaths of despair is evident across the state.

Little is known about brain aging or dementia in nonindustrialized environments that are similar to how humans lived throughout evolutionary history. This paper examines brain volume (BV) in middle and old age among two indigenous South American populations, the Tsimane and Moseten, whose lifestyles and environments diverge from those in high-income nations. With a sample of 1,165 individuals aged 40 to 94, we analyze population differences in cross-sectional rates of decline in BV with age. We also assess the relationships of BV with energy biomarkers and arterial disease and compare them against findings in industrialized contexts. The analyses test three hypotheses derived from an evolutionary model of brain health, which we call the embarrassment of riches (EOR). The model hypothesizes that food energy was positively associated with late life BV in the physically active, food-limited past, but excess body mass and adiposity are now associated with reduced BV in industrialized societies in middle and older ages. We find that the relationship of BV with both non-HDL cholesterol and body mass index is curvilinear, positive from the lowest values to 1.4 to 1.6 SDs above the mean, and negative from that value to the highest values. The more acculturated Moseten exhibit a steeper decrease in BV with age than Tsimane, but still shallower than US and European populations. Lastly, aortic arteriosclerosis is associated with lower BV. Complemented by findings from the United States and Europe, our results are consistent with the EOR model, with implications for interventions to improve brain health.

Every state is required to submit a State Plan on Aging describing how it will use resources from the Older Americans Act (OAA), including a section specific to serving rural older adults. This paper describes a policy content evaluation of all 50 State Plans on Aging, focusing on Section 307(a)(10), which describes how states will serve rural older adults. We identified the most common and innovative approaches to using OAA funds to serve rural older adults across states. The most common information included about using OAA funds to serve rural older adults was describing the funding formula used to allocate resources. However, states varied in their definition of rural and in the details of their funding formulas. A minority of states also described additional approaches to serving rural older adults, including prioritizing Black, Indigenous, or rural residents of color; outreach; and targeted service delivery.

Family quality of life (FQOL) is a multidimensional social construct that can be used to enhance a family's well‐being by providing a framework to plan interventions and evaluate outcomes. Although researchers and policymakers see value in the FQOL domains and dimensions, families and practitioners are often skeptical of lengthy evaluations and aggregate scores. Furthermore, many practitioners find that family caregivers who require support and services overwhelmingly focus on the family member needing the most care. In doing so, they perceive their situations in a "spaghetti‐like" way. This strong focus on one aspect of the situation, or one "spaghetti" strand, can result in conversations about planning and implementing interventions becoming cyclical, like a messy tangle of strands. The FQOL lens can be used in intervention planning to transform overlapping spaghetti‐like thoughts into a waffle‐like system of interconnected and compartmentalized thoughts. The purpose of this paper was to describe the individual‐level application of the FQOL theory to plan and evaluate the benefits of a peer‐mediated family empowerment project for aging caregivers of adults with intellectual/ developmental disabilities in Michigan, USA. The study provides examples of how individual‐level FQOL evaluation at pretest informed the development of individualized action plans that focused on the strengths, desires, and challenges of 100 aging families in this statewide project. [ABSTRACT FROM AUTHOR]

The genitourinary syndrome of menopause (GSM) has been proposed as a diagnosis by a consensus of clinicians and investigators. Our purpose for this paper is to review extant evidence about: 1) the breadth of symptoms and symptom clusters as related to the syndrome; 2) the prevalence of GSM (includes vulvar and vaginal atrophy); 3) factors that are associated with, predict, or explain the syndrome; and 4) what should be pursued for expanding meaningful evidence. Within recent literature, we found a wide range of prevalence estimates, likely a function of the differing populations studied, study design, and methods of data collection. Factors related to the prevalence of GSM included age and aging; reproductive aging stage; hormones, especially estrogen; and culture and language. We recommend further specification of diagnostic criteria for GSM; clarification of urinary symptoms in GSM; use of longitudinal study designs; validation of GSM-related measures; exploration of cultural equivalence of GSMmeasures; and assessing biases in completed research. [ABSTRACT FROM AUTHOR]

Repeated claims that a dwindling supply of potential caregivers is creating a crisis in care for the U.S. aging population have not been well-grounded in empirical research. Concerns about the supply of family care do not adequately recognize factors that may modify the availability and willingness of family and friends to provide care to older persons in need of assistance or the increasing heterogeneity of the older population. In this paper, we set forth a framework that places family caregiving in the context of older adults' care needs, the alternatives available to them, and the outcomes of that care. We focus on care networks, rather than individuals, and discuss the demographic and social changes that may alter the formation of care networks in the future. Last, we identify research areas to prioritize in order to better support planning efforts to care for the aging U.S. population. [ABSTRACT FROM AUTHOR]

As populations in the United States and around the world continue to age, it has become increasingly important to understand how organizations can create working conditions that attract, support, and retain workers across the lifespan. In this paper, we provide a primer on current theory and research on age in the workplace. We briefly describe lifespan theories that have guided recent advances in the field, discuss the implications of these theories for an aging workforce, and provide an overview of current research streams that address the work and nonwork factors affecting performance, well‐being, and workforce participation among mature workers. Based on this review, we provide recommendations for future research and practice. [ABSTRACT FROM AUTHOR]

Objective: Immigrant health discussions often focus on acculturation and omit discussions on historical events that may underlie health differences among immigrant older adults. This paper provides a historical overview of immigration policy and flows to the U.S. and examines insurance access and health difficulties by sending country. Methods: We analyzed the "Immigrants Admitted to the United States, Fiscal Years 1972–2000" and 2015–2019 American Community Survey datasets to examine the number of admitted immigrants, sociodemographic profiles for current immigrant older adults, and the predicted probabilities of health insurance access and health difficulties. Results: Our results highlight alignment of immigration flows with immigration legislation and vast heterogeneity in migration, health, and healthcare access of immigrants by sending country. Discussion/Implications: Public health practitioners must consider how historical events and social factors contribute to the healthcare access and health of immigrant populations, as demographic shifts will require interventions that promote equitable healthy aging. [ABSTRACT FROM AUTHOR]

Objectives: The third round (R3) of the National Social Life, Health, and Aging Project, a nationally representative, longitudinal survey of community-residing older adults, consisted of 4,777 in-person interviews and 6,100 completed visits to households to identify newly eligible respondents. It revisited respondents from the first rounds (Cohort 1), born in the years 1920 through 1947, and added new respondents (Cohort 2) born in the years 1948 through 1965. Coresidential romantic partners of both cohorts were also eligible. Data collection included in-person questionnaires, up to 11 biomeasures, and a self-administered, postinterview paper questionnaire., Methods: Questionnaire domains included social network and social support, elder mistreatment, physical health, cognitive function, romantic partners and sexuality, fertility and menopause, mental health, and employment and finances. Biomeasure collection included height, weight, waist circumference, blood pressure and heart rate, timed walk, balance, chair stands, smell, saliva passive drool in a tube (cortisol, dehydroepiandrosterone, estradiol, progesterone, testosterone), dried blood spots (C-reactive protein, Epstein-Barr virus antibodies, high-density lipoprotein cholesterol, hemoglobin, glycosylated hemoglobin [HbA1c], total cholesterol), and accelerometry (sleep patterns and physical activity). A brief questionnaire also collected data on respondents who were deceased or in too poor health to participate., Results: Measures such as response and cooperation rates are provided to evaluate the design and implementation., Discussion: This article describes innovation in the development and implementation of R3, the recruitment of a new cohort of respondents, and fidelity to prior rounds' study design and data collection procedures., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: Marital and intimate partner relationships are some of the most important social ties that shape older adults' health and well-being. This paper provides analytic guidelines for the couple data in Round 2 (2010-2011) and Round 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP) to encourage more research on marriage and partnership in late life., Method: First, we describe the recruitment of couples and outline how to identify partners in the data sets. Second, we provide descriptive information about the couple sample. Third, we offer guidance for analyzing the dyadic data cross-sectionally and longitudinally., Results: Round 2 interviewed all primary respondents and a sample of their current cohabiting partners and spouses (n = 955 couples). In Round 3, NSHAP reinterviewed the primary respondents and partners who participated in Round 2 (Cohort 1; n = 621 couples) and recruited a new sample of age-eligible adults along with any cohabiting romantic partners (Cohort 2; n = 766 couples). Couples can be identified using a household ID variable in Round 2 and a partner ID variable in Round 3. Demographic characteristics of the couple sample vary by round and cohort., Discussion: Researchers can use data from either round to conduct cross-sectional dyadic analyses to examine issues faced by older couples. A common strategy for couple analysis is the actor-partner interdependence model. With 2 rounds of couple-level data, researchers may consider using cross-lagged models in their research., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: Elder mistreatment has negative consequences for older adults' health and well-being. As such, scholars aim to understand its causes, the contexts in which it occurs, how to prevent victimization, and how to design interventions for mistreated older adults. This paper provides a detailed overview of the 2015-2016 National Social Life, Health, and Aging Project (NSHAP) Round 3 Elder Mistreatment Module (EMM) to encourage further research on the topic., Method: This paper reviews previous elder mistreatment scholarship, describes the EMM, provides descriptive analyses of elder mistreatment among community-dwelling older adults, and discusses promising approaches and limitations to future research with these data., Results: The EMM includes 10 stem questions to measure elder mistreatment behaviors experienced since age 60 and 2 follow-up questions about perceived severity and the identity of the perpetrator. The stem questions can be analyzed individually or combined into a scale, and researchers can account for severity as a robustness check. Analysts can also group the measures into specific types of elder mistreatment. A major strength of the EMM is its ability to identify perpetrators in victims' core social networks., Discussion: The NSHAP Round 3 EMM provides scholars an opportunity to study older Americans' mistreatment experiences, particularly as they relate to their physical and mental health, their social networks and personal relationships, and their broader social contexts., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: This paper introduces new measures of skin tone (self-reported) and perceived discrimination that are included in the third round of the National Social Life, Health, and Aging Project (NSHAP). We explain the rationale for these new measures, emphasizing, in particular, how they help researchers to conceptualize and measure the significance of race/ethnicity for health and aging beyond binary ethnoracial categories., Method: We describe new measures of skin tone and perceived discrimination for use in NSHAP 2015. We provide descriptive statistics on the distribution of skin tone (self-reported) by race/ethnicity. As a proof of concept, we use logistic and ordinary least squares regression analyses to examine the relationship between skin tone, perceived discrimination, and perceived stress among ethnoracial minorities., Results: We find that there is significant variation in skin tone among non-White respondents in NSHAP 2015 (e.g., non-Hispanic Black and Latinx). We also find that skin tone (self-reported) is a significant predictor of the frequency of perceived discrimination and perceived stress among African American, but not Latinx respondents in NSHAP., Discussion: The inclusion of new skin tone and discrimination measures in NSHAP 2015 provides a unique and novel opportunity for researchers to more deeply understand how race/ethnicity is connected to health and aging among ethnoracial minorities. Furthermore, it will enable analyses of how stress and perceived discrimination also affect patterns of health and aging among Whites against the backdrop of steadily increasing socioeconomic inequalities and shifting ethnoracial demographics in the United States., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Population aging is an important and increasingly relevant area of study for demographers. A growing body of research seeks to determine how long-term changes in births, mortality, and migration—the three drivers of any demographic process—have shaped the present aging situation. Using variable-r decomposition and cohort data, this research note presents a formula for the change in the old-age dependency ratio to determine the extent to which relative changes in births, as well as in mortality and migration rates, contribute to aging. This perspective provides a careful and in-depth picture of aging and contributes to the debate concerning whether changes in births or mortality have had the strongest effect on population aging. When applied to Australia, the United States, and several European populations, the decomposition of the old-age dependency ratio shows that aging occurred in all populations and that changes in both births and mortality contributed to this aging. Analysis of these populations demonstrates that although they differed regarding which of these factors contributed more, changes in births prevailed as the more significant factor. In nearly all populations, migration decreased the rate of population aging. [ABSTRACT FROM AUTHOR]

Using new weakness cutpoints individually may help estimate time to mortality, but their collective use could improve value. We sought to determine the associations of (a) each absolute and body size normalized cut point and (b) collective weakness on time to mortality in Americans. The analytic sample included 14,178 subjects aged ≥50 years from the 2006-2018 waves of the Health and Retirement Study. Date of death was confirmed from the National Death Index. Handgrip dynamometry measured handgrip strength (HGS). Men were categorized as weak if their HGS was <35.5 kg (absolute), <0.45 kg-kg-1 (body mass normalized), or <1.05 kg-kg-1-m-2 (body mass index [BMI] normalized). Women were classified as weak if their HGS was <20.0 kg, <0.337 kg-kg-1, or <0.79 kg-kg-1-m-2. Collective weakness categorized persons as below 1, 2, or all 3 cutpoints. Cox proportional hazard regression models were used for analyses. Subject values below each absolute and normalized cutpoint for the 3 weakness parameters had a higher hazard ratio for early all cause mortality: 1.45 (95% confidence interval [CI]: 1.36-1.55) for absolute weakness, 1.39 (CI: 1.30-1.49) for BMI normalized weakness, and 1.33 (Cl: 1.24-1.43) for body mass normalized weakness. Those below 1, 2, or all 3 weakness cut points had a 1.37 (CI: 1.26-1.50), 1.47 (CI: 1.35-1.61), and 1.69 (CI: 1.55-1.84) higher hazard for mortality, respectively. Weakness determined by a composite measure of absolute and body size adjusted strength capacity provides robust prediction of time to mortality, thus potentially informing sports medicine and health practitioner discussions about the importance of muscle strength during aging. [ABSTRACT FROM AUTHOR]

African Americans experience higher incidence and prevalence of Alzheimer's disease (AD). Yet, they continue to be underrepresented in AD research, limiting the ability to generalize findings to the increasingly diverse US population. To reduce AD disparities, targeted efforts are needed to increase the representation of African Americans in AD research. This mini review identified evidence-based strategies that increased research participation among older African Americans. Four recruitment strategies emerged from eight published peer-reviewed studies that directly evaluated the effectiveness of strategies aimed at increasing the number of African American participants in Alzheimer's research. The strategies include community outreach and education, face-to-face discussions, remote access, and referral and partnership with local organizations. Across different locations, these strategies increased the number of African Americans enrolled into AD research, the number of people that signed up to donate their brains for AD research upon death, and the knowledge and perception of AD in the communities. Targeted efforts are effective in increasing AD research participation among older African Americans, especially when combined with approaches that emphasize transparency and mutual trust and involve the community as stakeholders in the research process. [ABSTRACT FROM AUTHOR]

Mobility declines in older adults can be determined through monitoring longitudinal changes in gait speed. We examined longitudinal changes [in] ankle proprioception among those with and without baseline lower extremity numbness to develop a better understanding of mobility declines in healthy older adults. Participants included 568 adults (52.8% women) aged 60–98 years from the Baltimore Longitudinal Study of Aging. Larger ankle proprioception decreases during plantar flexion were found in the participants with lower extremity numbness compared with those without numbness (p =.034). Among participants with lower extremity numbness, slower baseline speeds from both usual and fast pace gait were associated with performance decline in ankle proprioception measured during ankle dorsiflexion (p =.039 and p =.004, respectively). Assisting older adults, especially those with lower extremity numbness, to maintain and improve ankle proprioception may help prevent mobility declines that have previously been considered age related. [ABSTRACT FROM AUTHOR]

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life's end. [ABSTRACT FROM AUTHOR]

To achieve optimal, equitable health outcomes for all older adults, the United States desperately needs equity in access to, quality of, and cost of aging care. To illustrate these needs, we discuss the current inequitable state of frailty care. Frailty disproportionately affects marginalized populations, yet these populations struggle to access high-quality geriatrics care and long-term care services and supports (LTSS) that mitigate frailty, leading to accelerated frailty trajectories. Health services research can provide the data needed to document, elucidate, and address health inequities in frailty care, including early identification and referral of frail adults to specialized care and financing LTSS. [ABSTRACT FROM AUTHOR]

This study examines caregiver networks, including size, composition, and stability, and their associations with the likelihood of hospitalization and skilled-nursing facility (SNF) admissions. Data from the National Health and Aging Trends Study linked to Center for Medicare and Medicaid Services data were analyzed for 3855 older adults across five survey waves. Generalized estimating equation models assessed the associations. The findings indicate each additional paid caregiver was associated with higher adjusted risk ratios (aRR) for hospitalization (aRR = 1.24, 95% CI 1.10–1.41) and SNF admission (aRR = 1.28, 95% CI 1.06–1.54) among care recipients, a pattern that is also observed with the addition of unpaid caregivers (hospitalization: aRR = 1.13, 95% CI 1.06–1.20; SNF: aRR = 1.12, 95% CI 1.02–1.23). These results suggest that policies and approaches to enhance the quality and coordination of caregivers may be warranted to support improved outcomes for care recipients. [ABSTRACT FROM AUTHOR]

The need to better understand the nature of work related to unpaid caregiving to older persons and its effect on the caregivers has become a pressing issue given the worldwide trend toward population aging. This study focuses on those who frequently provide this type of unpaid care in the US. Using pooled 2011–19 American Time Use Survey data for individuals aged 25–61-years old and a correlated system of regressions, we examine the gendered time allocation pattern of those who frequently provide care to older persons. We find that female caregivers spend less time on market work compared to male caregivers. Our results also suggest that frequent caregiving is associated with more time spent on domestic and care work and less time on market work and self-care. On days when they don't perform or just do little care work, frequent caregivers tend to spend long hours performing market work and reduce their time on domestic chores, care work, and leisure. Sensitivity checks confirm these findings. [ABSTRACT FROM AUTHOR]

Data from the Vietnamese Aging and Care Survey (VACS) showed the high prevalence of disability, depressive symptoms, and cognitive impairment in older Vietnamese immigrants and refugees. We proposed a Community-Engaged Dementia Education Program to examine the Houston Vietnamese American community's literacy on dementia and develop a one-pager educational material. This is a cross-sectional, qualitative study (interviews and focus groups) using the Cultural Exchange Model as a conceptual framework. We interviewed fourteen Vietnamese key informants and assessed the community's knowledge of dementia based on Edwards' 9-stage Community Readiness Model. The community's low literacy on dementia (Stages 2–3: Denial/resistance to vague awareness) was revealed. Approaches to introducing dementia conversations to the community and what to include in the one-pager were discussed. Based on the key informants' insight, we developed a dementia one-pager tailored to the community by using lay language with a representative image of the target population, indicating warning signs of dementia, and encouraging them to see their doctors for cognitive check-ups. The plan for the next steps includes utilizing the local ethnic media, collaborating with the existing pillars of the Cultural Exchange model, leveraging the university students' learning opportunities, and disseminating the culturally and linguistically tailored one-pager. [ABSTRACT FROM AUTHOR]

Researchers have identified immigration and marginalization as two processes that impact older immigrants' experience of aging in the U.S. Our paper draws on 42 interviews with a diverse group of older American immigrants to center issues of language, accent, and Othering. We argue that the importance of language extends beyond communication for older immigrants, as English proficiency and accent are important boundaries determining inclusion and recognition as an American. Accents are a racialized characteristic that can prompt microaggressions and exclusion. We identified a racial pattern in reported reactions to accents among the participants in our study. White immigrants generally described positive appraisals of their accent, and typically had a choice whether to emphasize their national origins. While white immigrants were viewed as "Acceptable Outsiders," many immigrants of color described microaggressions, ridicule, and discrimination related to their accented speech. We contend that these experiences of Othering can have a profound impact on sense of belonging, as many of the older immigrants of color in our study expressed a persistent sense of exclusion and even alienation. We advance the concept of "aging off center" to describe how repeated experiences of Othering and exclusion shape aging experiences for immigrants of color who are long-term residents of the United States. • Language proficiency and accent are sources of marginalization for older immigrants. • Race and ethnicity affect reactions to speech and accent in a patterned way. • Attitudes about language and accent influence immigrants' sense of belonging. • Experiences of Othering may shape aging differently based on length of residency. [ABSTRACT FROM AUTHOR]

This article introduces the special issue on Aging and Resilience in the Americas: Mexico and the United States. The article overviews the role that the annual International Conference on Aging in the Americas (ICAA) has played in the development of scholarship on aging of Latinos in the United States and older persons in Latin America and the Caribbean. A brief overview of the aging literature reveals a growing interest on the resiliency of older Latino and Latin American populations in the United States and more broadly the Americas. The article provides a short description of each of the five articles included in this special issue [ABSTRACT FROM AUTHOR]

Background: Studies show conflicting evidence on the association of age and occupational injury in agriculture, and few studies have addressed the effect of age on work-related chronic conditions or preventive practices among farmers. Methods: We examined the probability of injury, work-related stress, musculoskeletal symptoms (MSS), and preventive practices for MSS as a function of aging using surveillance data of 7,711 farm and ranch operators in the central United States. Findings: Segmented regression analyses of men (85% of sample) indicated that the probability of all four outcomes increased up to a certain age and then decreased; the changepoints in years of age being 59.6 for injury, 55.4 for work-related stress, 59.6 for MSS, and 67.9 for MSS preventive practices. Female operators had an increasing trend for stress up to age 29.7, while they showed no changepoints across their age spectrum in the proportion of injury, MSS, and prevention techniques. Conclusion/Application to Practice: These findings emphasize the need for preventive efforts particularly among younger and middle-aged farmers and ranchers, and the need to modify work duties to match work abilities at older ages. [ABSTRACT FROM AUTHOR]

Introduction: Social isolation is one of the strongest predictors of increased risk of mortality in older adulthood. The ability to form and maintain the social relationships that mitigate this risk is partially regulated by the oxytocinergic system and one's ability to attend to and process social information. We have previously shown that an epigenetic change to the DNA of the oxytocin receptor gene (OXTR methylation) affects the salience of social information in young adults. Little is known about how the oxytocinergic system ages and what effect this aging system has on social cognitive abilities throughout the lifespan. Methods: Here we explored age-related differences in the association between neural response during selective social attention and OXTR DNA methylation in young (age 18--31) and older (age 58-81) adults. Participants underwent fMRI during a selective social attention task and provided a DNA sample for the assessment of OXTR methylation. Results and Discussion: We found that older adults activated diffuse areas of visual cortex and dorsolateral prefrontal cortex during selective social attention, consistent with the dedifferentiation and compensatory neural activation commonly reported in aging. We found a significant age-by-OXTR methylation interaction on neural response when attending to social stimuli in a complex display; young adults displayed a positive association between OXTR methylation and neural activation, replicating our prior finding that young adults with presumed diminished endogenous access to oxytocin recruit regions of the attentional cortex to a greater extent. This association did not hold for older adults. Instead, perceived social support interacted with OXTR methylation to influence neural response during selective social attention. These data suggest that environmental factors like social support moderate biological processes in aging and highlight the importance of a lifespan perspective for understanding associations between individual differences in the oxytocinergic system, neural function, and social behavior. [ABSTRACT FROM AUTHOR]

Background: Recently developed absolute and body size normalized handgrip strength (HGS) cut-points could be used individually and collectively to predict mobility problems and falls. Aims: We examined the associations of (1) each absolute and normalized weakness cut-point, (2) collective weakness categories, and (3) changes in weakness status on future falls in older Americans. Methods: The analytic sample included 11,675 participants from the 2006–2018 waves of the Health and Retirement Study. Falls were self-reported. Men were classified as weak if their HGS was < 35.5-kg (absolute), < 0.45 kg/kg (body mass normalized), or < 1.05 kg/kg/m2 (body mass index normalized). While, women were considered weak if their HGS was < 20.0-kg, < 0.337 kg/kg, or < 0.79 kg/kg/m2. Collective weakness categorized those below 1, 2, or all 3 cut-points. The collective weakness categories were also used to observe changes in weakness status over time. Results: Older Americans below each absolute and normalized cut-point had greater odds for future falls: 1.23 (95% confidence interval (CI): 1.15–1.32) for absolute weakness, 1.20 (CI 1.11–1.29) for body mass index normalized weakness, and 1.26 (CI 1.17–1.34) for body mass normalized weakness. Persons below 1, 2, or all 3 weakness cut-points had 1.17 (CI 1.07–1.27), 1.29 (CI 1.18–1.40), and 1.36 (CI 1.24–1.48) greater odds for future falls, respectively. Those in some changing weakness categories had greater odds for future falls: 1.26 (CI 1.08–1.48) for persistent and 1.31 (CI 1.11–1.55) for progressive. Discussion: Collectively using these weakness cut-points may improve their predictive value. Conclusion: We recommend HGS be evaluated in mobility and fall risk assessments. [ABSTRACT FROM AUTHOR]

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This study explores factors associated with participation in moderate physical activity and muscle strengthening activity in adults with autism receiving state services (age: 18–78 years). Researchers analyzed the National Core Indicators-In Person Survey (2017–2018) data using multilevel mixed effects logistic regression. Older adults on the autism spectrum engaged in both moderate physical activity and muscle strengthening activity less often than younger adults on the autism spectrum (OR 0.99; p < 0.05; OR 0.98; p < 0.001). Individuals reportedly in fair/poor health had 50% lower odds of engaging in moderate physical activity and 30% lower odds of engaging in muscle strengthening compared to those in good/ excellent health (OR 0.50; p < 0.001; OR 0.70; p < 0.001). Moderate physical activity/muscle strengthening initiatives may help foster this group's healthy aging. [ABSTRACT FROM AUTHOR]

The article discusses research which examined the role of epigenetic aging in the link between arsenic exposure and cardiovascular disease (CVD) among Native American men and women. Study results indicate the association of higher arsenic levels with faster epigenetic aging. It suggests the involvement of DNA methylation in the causal pathways linking arsenic exposure with hallmarks of CVD, such as atherosclerotic lesions, and recommends epigenetic clocks as a tool for evaluating interventions.

The elderly population is growing at increased rates and is expected to double in size by 2050 in the United States and worldwide. The consumption of healthy foods and enriched diets have been associated with improved cognition and brain health. The key nutrients common to many healthy foods and diets are the omega-3 polyunsaturated fatty acids (omega-3 FAs), such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). We explored whether omega-3 FA levels are associated with brain volume and cognition. Forty healthy, cognitively normal, Seventh-day Adventist older adults (mean age 76.3 years at MRI scan, 22 females) completed neurocognitive testing, a blood draw, and structural neuroimaging from 2016 to 2018. EPA and an overall omega-3 index were associated with individual measures of delayed recall (RAVLT-DR) and processing speed (Stroop Color) as well as entorhinal cortex thickness. EPA, DHA, and the omega-3 index were significantly correlated with the total white matter volume. The entorhinal cortex, frontal pole, and total white matter were associated with higher scores on delayed memory recall. This exploratory study found that among healthy, cognitively older adults, increased levels of omega-3 FAs are associated with better memory, processing speed, and structural brain measures. [ABSTRACT FROM AUTHOR]

Objectives Measuring cognition in an aging populabtion is a public health priority. A move towards survey measurement via the web (as opposed to phone or in-person) is cost-effective but challenging as it may induce bias in cognitive measures. We examine this possibility using an experiment embedded in the 2018 wave of data collection for the U.S. Health and Retirement Study (HRS). Methods We utilize techniques from multiple group item response theory to assess the effect of survey mode on performance on the HRS cognitive measure. We also study the problem of attrition by attempting to predict dropout and via approaches meant to minimize bias in subsequent inferences due to attrition. Results We find evidence of an increase in scores for HRS respondents who are randomly assigned to the web-based mode of data collection in 2018. Web-based respondents score higher in 2018 than experimentally matched phone-based respondents, and they show much larger gains relative to 2016 performance and subsequently larger declines in 2020. The differential in favor of web-based responding is observed across all items, but is most pronounced for the Serial 7 task and numeracy items. Due to the relative ease of the web-based mode, we suggest a cutscore of 12 being used to indicate CIND (cognitively impaired but not demented) status when using the web-based version rather than 11. Discussion The difference in mode may be nonignorable for many uses of the HRS cognitive measure. In particular, it may require reconsideration of some cutscore-based approaches to identify impairment. [ABSTRACT FROM AUTHOR]

The aging population is rapidly growing both in the United States and many other parts of the world. Simultaneously, technology is rapidly progressing, and new forms of media have become integrated into daily life and societal participation. This study uses time diary data from a panel survey of members of nationally representative households (N = 1776) to explore patterns of media use and functionally equivalent leisure time among older adults. The data support a three-profile typology of older adult use of media and non-media leisure activities. These include the computer socializer, the hobbyist, and the television watcher. We elaborate on these patterns of use and explore correlates with demographic and well-being variables. We find no evidence that well-being significantly differs across profiles of media use but identify income and employment status as potential drivers of older adults' media activity, with implications for digital inequalities. [ABSTRACT FROM AUTHOR]

Despite the abundance of older people--many with disabilities--living in them, rural communities in the United States are not prepared to care for elders' needs. Elders and people with disabilities in rural communities face structural barriers to vital resources like healthy food, medical care, and transportation. This article explores how a human-centered design (HCD) process can circumvent entrenched ageism and ableism to yield creative solutions that positively impact everyone in a community, using the successful roll-out of a healthy food initiative in Wilkesboro, NC, as a case study. [ABSTRACT FROM AUTHOR]

Resilience, which relates to one's ability to respond to stressors, typically declines with age and the development of comorbid conditions in older organisms. Although progress has been made to improve our understanding of resilience in older adults, disciplines have employed different frameworks and definitions to study various aspects of older adults' response to acute or chronic stressors. "Overview of the Resilience World: State of the Science," a bench‐to‐bedside conference on October 12–13, 2022, was sponsored by the American Geriatrics Society and National Institute on Aging. This conference, summarized in this report, explored commonalities and differences among the frameworks of resilience most commonly used in aging research in the three domains of resilience: physical, cognitive, and psychosocial. These three main domains are intertwined, and stressors in one domain can lead to effects in other domains. The themes of the conference sessions included underlying contributors to resilience, the dynamic nature of resilience throughout the life span, and the role of resilience in health equity. Although participants did not agree on a single definition of "resilience(s)," they identified common core elements of a definition that can be applied to all domains and noted unique features that are domain specific. The presentations and discussions led to recommendations for new longitudinal studies of the impact of exposures to stressors on resilience in older adults, the use of new and existing cohort study data, natural experiments (including the COVID‐19 pandemic), and preclinical models for resilience research, as well as translational research to bring findings on resilience to patient care. [ABSTRACT FROM AUTHOR]

Background: Nurse practitioners (NPs) are the largest group of providers delivering home‐based primary care (HBPC) in the U.S. We examined the association of scope‐of‐practice regulations and NP‐HBPC rates. Methods: Using the Centers for Medicare and Medicaid Services Provider Utilization and Payment Data Public Use File for 2019, we conducted a state‐level analysis to examine the impact of scope‐of‐practice regulations on the utilization of NP‐HBPC. Healthcare Common Procedure Coding System codes were used to identify the HBPC visits in private residences (99341–99,345, 99,347–99,350) and domiciliary settings (99324–99,328, 99,334–99,337). We used linear regression to compare NP‐HBPC utilization rates between states of either restricted or reduced scope‐of‐practice laws to states with full scope‐of‐practice, adjusting for a number of NP‐HBPC providers, state ranking of total assisted living, the proportion of fee‐for‐service (FFS) Medicare beneficiaries and neighborhood‐level socio‐economic status and race and ethnicity. Results: Nearly half of NPs providing HBPC (46%; n = 7151) were in states with a restricted scope of practice regulations. Compared to states with full scope‐of‐practice, states with restricted or reduced scope‐of‐practice had higher adjusted rates of NP‐HBPC per 1000 FFS Medicare beneficiaries. The average level of the utilization rate of NP‐HBPC was 89.9, 63, and 49.1 visits, per 1000 FFS Medicare beneficiaries in states with restricted, reduced, and full‐ scope‐of‐practice laws, respectively. The rate of NP‐HBPC visits was higher in states with restricted (Beta coefficient = 0.92; 95%CI 0.13–1.72; p = 0.023) and reduced scope‐of‐practice laws (Beta coefficient = 0.91; 95%CI 0.03–1.79; p = 0.043) compared to states with full scope‐of‐practice laws. Conclusion: Restricted state NP scope‐of‐practice regulations were associated with higher rates of FFS Medicare NP‐HBPC care delivery compared with full or reduced scope‐of‐practice. Understanding underlying mechanisms of how scope‐of‐practice affects NP‐HBPC delivery could help to develop scope‐of‐practice regulations that improve access to HBPC for the underserved homebound population. [ABSTRACT FROM AUTHOR]

Social work supervision addresses professional development, staff support, and management of direct service workers. It is important in aging-services settings because of the impacts of complex and evolving biopsychosocial forces in clients' lives. This article presents findings of the Supervisory Leaders in Aging (SLA) study based on data available one-year post completion. SLA is a 30-hour certificate program for supervisors from aging-services settings addressing best practices in supervision of gerontological practice. The study compares participants' self-assessment of use of supervisory best practices before attending a 3-month workshop series and at two times following graduation. This article reports findings from the analysis of data provided by 114 out of 129 supervisors who completed the program. Participants increased the frequency of use of best practices at both three and 12 months after graduation. These increases were conceptually meaningful and statistically significant among participants who were low users of best practices prior to the program. SLA has led to significant adoption and maintenance of supervisory best practices among participating social work supervisors and especially among those who have not previously adopted routine use of best practices. The interactive small-group learning activities of SLA's educational model should be promoted and the curriculum of best practices should be further refined and tested as SLA is implemented in other communities. [ABSTRACT FROM AUTHOR]

Policy PointsCountries have adopted different strategies to support aging populations, which are broadly reflected in social, economic, and contextual environments. Referred to as "societal adaptation to aging," these factors affect countries' capacity to support older adults.Results from our study show that countries with more robust societal adaptation to aging had lower depression prevalence. Reductions in depression prevalence occurred among every investigated sociodemographic group and were most pronounced among the old‐old.Findings suggest that societal factors have an underacknowledged role in shaping depression risk. Policies that improve societal approaches to aging may reduce depression prevalence among older adults. Context: Countries have adopted various formal and informal approaches to support older adults, which are broadly reflected in different policies, programs, and social environments. These contextual environments, broadly referred to as "societal adaptation to aging," may affect population health. Methods: We used a new theory‐based measure that captured societal adaptation to aging, the Aging Society Index (ASI), which we linked with harmonized individual‐level data from 89,111 older adults from 20 countries. Using multi‐levels models that accounted for differences in the population composition across countries, we estimated the association between country‐level ASI scores and depression prevalence. We also tested if associations were stronger among the old‐old and among sociodemographic groups that experience more disadvantage (i.e., women, those with lower educational attainment, unmarried adults). Findings: We found that countries with higher ASI scores, indicating more comprehensive approaches to supporting older adults, had lower depression prevalence. We found especially strong reductions in depression prevalence among the oldest adults in our sample. However, we did not find stronger reductions among sociodemographic groups who may experience more disadvantage. Conclusions: Country‐level strategies to support older adults may affect depression prevalence. Such strategies may become increasingly important as adults grow older. These results offer promising evidence that improvements in societal adaptation to aging—such as through adoption of more comprehensive policies and programs targeting older adults—may be one avenue to improve population mental health. Future research could investigate observed associations using longitudinal and quasi‐experimental study designs, offering additional information regarding a potential causal relationship. [ABSTRACT FROM AUTHOR]

Increases in the elderly population (defined as people aged 65 years old and above by the United States Census Bureau) in the United States (U.S.) have reached an inflection point. This demographic shift fundamentally reshapes the magnitude of housing needs in U.S. communities. Planning housing markets for active aging, our study (1) examines how the overall housing market in the U.S. responds to increases in the elderly population, (2) identifies housing preferences of elderly populations by exploring the heterogeneous effects of increasing elderly populations on different types/sizes of houses. Our results suggest that increases in the elderly population are associated with a slight rise in prices in the overall housing market. It points towards the role of increasing elderly populations in shaping the housing market, bringing both opportunities and challenges in reframing urban and housing policy. The study also shows that increases in the elderly population have significant and positive effects on single-family homes and small homes, but no impact on condominiums and large homes. The heterogeneous effects on different types/sizes of housing represent the preferences of elderly populations to single-family homes and small homes. Given the increasing size and share of elderly populations and severe shortages in affordable elderly housing, our study suggests that a strong commitment to reframing urban policy and housing programs targeting assistance and support toward elderly populations such as the Sect. 202 Supportive Housing for the Elderly Program, is in great need of federal and local governments' interventions. [ABSTRACT FROM AUTHOR]