Few psychometrically tested, comprehensive measures exist for assessing dementia caregivers' unmet needs. This has limited unmet need from being used as a key outcome in efficacy and/or effectiveness testing of programs supporting family/friend caregivers. This investigation tested the psychometric properties of the Benjamin Rose Unmet Need Instrument; a comprehensive measure designed for use in research with dementia caregivers. The Instrument was examined for three types of validity (structural, concurrent, discriminant) and internal consistency reliability using secondary baseline data from a large-scale translation study of 192 community-dwelling family/friend dementia caregivers living in the U.S. Exploratory factor analysis confirmed structural validity of a 45-item Total Unmet Need Scale (loadings=.31-.66), and eight multi-item and one single-item subscales (loadings=.34-.81). Total Unmet Need and all subscales demonstrated high internal consistency reliability (α=.70-.95). Concurrent validity was demonstrated for Total Unmet Need and seven subscales by significant relationships with measures of depressive symptoms (β=.16-.32) and care-related strains (β=.15-.42). Discriminant validity was partially confirmed through principal component analysis for Total Unmet Need (loading=.92) and nine subscales (loadings=.90-.95). Results suggest the Benjamin Rose Unmet Need Instrument is a valid and reliable measure to understand dementia caregivers' expressed need for help across a variety of medical and non-medical domains. It also can be used as a research outcome in studies of programs and services for caregivers. Additional research is needed to further test the Instrument's validity with caregivers of people with mild dementia and those living in facilities.

Black men face elevated risks for chronic disease and cognitive decline yet remain underrepresented in exercise and brain-health research. Although resistance training (RT) improves cognition in older adults, little is known about how older Black men perceive RT as a brain-health strategy. This study examined beliefs, motivations, and barriers related to RT (Aim 1) and used these findings to inform the design of a culturally-grounded RT intervention (Aim 2). A mixed-methods exploratory design included surveys (N = 37) and semi-structured interviews with Black men ≥55 years old. Quantitative measures assessed RT behavior, stage of change, cognitive-health beliefs, and perceived barriers and motivators. Qualitative data were analyzed thematically using phenomenology and theory-informed frameworks. Integrated findings informed a design thinking-based, community-centered 12-week intervention framework. Only 21.6% engaged in RT two or more times weekly, though most expressed concern about cognitive aging and interest in maintaining mental clarity. Cognitive-health beliefs were strongly associated with RT participation (Pseudo R2 = .71). Practical barriers-time, pain, limited knowledge, and access-were more influential than attitudinal barriers. Qualitative themes highlighted cultural influences and a strong desire to maintain independence with aging. Findings indicate high motivation to protect cognitive health but limited culturally responsive pathways for RT adoption. Results support the use of mixed-methods, community-engaged approaches to develop feasible strategies promoting cognitive vitality and independence among aging Black men.

Subsidized senior housing (SSH) is widely valued for its affordability and housing stability, yet its potential social benefits, particularly for cognitive health, remain underexplored. Although congregate or shared housing environments are often theorized or presumed to foster social engagement and well-being, empirical evidence remains limited, especially from longitudinal, quasi-experimental studies in the context of subsidized senior housing. This study examines whether social engagement mediates the association between SSH residency and cognitive function, and whether this indirect pathway varies by neighborhood cohesion. We analyzed five waves (2015-2019) of the National Health and Aging Trends Study (NHATS) using a quasi-experimental design with propensity score weighting to compare low-income older adults residing in SSH with demographically comparable peers in traditional unsubsidized housing. Weighted random-effects panel regression models with wave fixed effects and individual-clustered standard errors were used to estimate a moderated mediation model. Older adults residing in SSH reported higher levels of social engagement than matched controls. Higher engagement was positively associated with cognitive function. The indirect association between SSH residency and cognitive function via social engagement was observed in high-cohesion neighborhoods but not in low-cohesion contexts. No direct association between SSH residency and cognitive function was found. These findings provide a rigorous longitudinal test of a commonly assumed but rarely examined pathway linking subsidized senior housing to cognitive outcomes. Results suggest that SSH may function as a socially embedded residential context associated with cognitive health through engagement, particularly where neighborhood cohesion is strong.

Hospice is designed to support comfort-focused care at the end of life, yet enrollment often depends on whether supportive caregiving infrastructures are in place. Prior studies rely on single indicators such as living arrangements, offering limited insight into the structural care environments that shape hospice feasibility. This study conceptualizes end-of-life care environments as graded structural positions: care formalization (how care is organized across household and institutional settings) and care scarcity (the availability of hands-on support) and examines their associations with hospice use among older decedents, including gender differences shaped by gendered life-course trajectories. Using nationally representative data from the HRS Harmonized End-of-Life Interview (1994-2021; N = 12,477), we estimated multivariable logistic regression models of hospice use in the last year of life. Occupying more formalized structural care positions was associated with greater odds of hospice use (OR = 1.39), whereas greater care scarcity was associated with lower odds (OR = 0.69). Gender moderated both associations: the facilitating effect of formalization was weaker for women (OR = 0.87), while the constraining effect of scarcity was attenuated for women (OR = 1.20), indicating steeper structural gradients among men. Hospice use is embedded within structurally patterned caregiving ecologies rather than driven solely by clinical trajectories or preferences. Erosion of support may constrain hospice access, whereas more formalized care settings may enhance referral and coordination. Strengthening caregiving infrastructures and targeting older adults experiencing care scarcity may promote more equitable end-of-life care.

Assessing financial exploitation (FE) in older adults has proved challenging for various reasons, including low base rates, underreporting, and/or inaccurate reporting. Measuring FE risk is one way to overcome some of these inherent challenges, yet few measures exist that do so. One measure that holds great promise is the Financial Exploitation Vulnerability Scale, and its short-form (FEVS, FEVS-SF, respectively). The present study examined the measurement property evidence for a Hebrew version of the FEVS and FEVS-SF. Participants (N = 1281; M age = 69.98; SD = 7.39) from four separate studies were included in an amalgamated sample. Participants completed basic demographic measures, the FEVS in Hebrew (from which the FEVS-SF was derived), and a questionnaire on self-reported history of FE. Factor structure (structural validity), internal consistency estimates, and discriminative (known groups) construct validity of the FEVS and FEVS-SF were examined. A clear factor structure was not found for the FEVS, but a two-factor solution yielded a good model fit for the FEVS-SF, with two conceptually meaningful factors identified (financial well-being and financial decision making). Reliability estimates were acceptable for both the FEVS (.77) and FEVS-SF (.81). Discriminative validity was also supported; participants with a self-reported history of FE scored significantly higher on both measure versions compared to participants denying a history of FE. Findings support the use of the FEVS-SF in Hebrew to measure FE vulnerability. The measure can be administered easily and at low cost, and may serve useful to researchers and clinicians alike.

Physical activity (PA) helps delay the progression of cognitive and functional decline among persons living with dementia. Neighborhood social environments are well-known to support or hinder PA among older adults, but their associations with PA among persons living with dementia remain poorly understood. This study examines how neighborhood characteristics (affluence, deprivation, safety, friends, relatives, cohesion, and disorder) relate to PA among U.S. community-dwelling persons living with dementia. We used 2006-2018 Health and Retirement Study data merged with census-tract data from the Contextual Data Resource. The analytic sample included 2,031 respondents classified as having dementia. PA was measured as a summary score reflecting activity frequency and intensity (light, moderate, and vigorous), along with binary indicators for being "regularly active" (≥1×/week) at each intensity. We used negative binomial regression to model total PA and logistic regression for intensity-specific activity. Neighborhood friendships were associated with higher overall PA score (B = 0.28; 95% CI = 0.16-0.41) and regular engagement across intensity levels. Social cohesion was also linked to increased total activity (B = 0.16; 95% CI = 0.03-0.29) and light PA (OR = 1.31; 95% CI = 1.01-1.71). Affluent neighborhoods supported moderate PA (OR = 1.39; 95% CI = 1.08-1.77), while having nearby relatives was associated with lower odds of vigorous activity (OR = 0.61; 95% CI = 0.42-0.88). No significant associations were observed for neighborhood deprivation, disorder, or safety. Our findings provide empirical evidence for the importance of neighborhood social resources as facilitators of sustained PA among persons living with dementia and highlight neighborhoods as key components of the continuum of dementia care.

The time between diagnosis with a mild neurocognitive disorder (MND) and definitive loss of decisional capacity presents a window of opportunity to participate in advance care planning (ACP). To implement early planning, we need to know how to promote healthy relationships between people with MND and their healthcare proxies. Our objective is to examine how people with MND and their proxies discuss engagement in ACP and how proxies orient toward the ability and right of the person with MND to provide answers. We undertake a conversation analysis of an interview related to ACP between a researcher, a person with MND and their proxy, recorded in Switzerland. The way in which the proxy and the researcher orient to the person with MND changes throughout the interview. In the beginning, they recognize the person with MND as a knowledgeable and competent participant (facilitating answers or allowing her to speak first). Later, practices bypass the speakership primacy of the person with MND (correcting or describing her as dependent). The person with MND sometimes resists these stances, for example, by contradicting her proxy's answer. Our study contributes to understandings of how the epistemic rights of a person with MND to participate and provide information within interactions are constructed variably. This has implications for promoting the people with MND's individual and relational autonomy in interactions and decision-making and developing awareness-raising resources about how to improve the conditions of decisional autonomy of people with MND.

Perú, a middle-income country in South America with a population of approximately 34 million, is experiencing a demographic shift toward an aging population. Whereas the working-age population remains large, the proportion of adults aged 65 and older has been steadily increasing, with a rising old-age dependency ratio that is projected to continue in the coming decades. Aging in Perú occurs within highly unequal social and geographic contexts, exposing older adults to disparities in income, health care, and long-term care access. Despite recent growth in gerontological research, significant gaps persist, particularly in the study of social determinants of health such as caregiving, social protections, and access to health care and infrastructure. We provide an overview of demographic aging in Perú, review the emerging landscape of aging research, highlight key scholars and institutions, summarize available data sets, and identify pressing policy and social challenges affecting older adults in Perú. Addressing these issues is essential for promoting equitable, healthy, and dignified aging in a country facing a rapid demographic transformation.