TY - JOUR T1 - Healthcare Utilization and Advance Care Planning among Older Adults Across Cognitive Levels. JF - J Appl Gerontol Y1 - 2023 A1 - Rahemi, Zahra A1 - Malatyali, Ayse A1 - Bacsu, Juanita-Dawne R A1 - Sefcik, Justine S A1 - Petrovsky, Darina V A1 - Baker, Zachary G A1 - Ma, Kris Pui Kwan A1 - Smith, Matthew L A1 - Adams, Swann A KW - Advance care planning KW - cognitive levels KW - Healthcare KW - Older Adults AB -

This study examined the impact of advance care planning (ACP) on healthcare utilization among older adults with normal cognition and impaired cognition/dementia. Using datasets from the Health and Retirement Study, we conducted a cross-sectional study on 17,698 participants aged 51 years and older. Our analyses included survey descriptive and logistic regression procedures. ACP measures included a living will and durable power of attorney for healthcare. Healthcare utilization was measured using the days spent in hospitals, hospice care, nursing homes, and home care. Of the participants, 77.8% had normal cognition, and 22% had impaired cognition/dementia. The proportion of impaired cognition/dementia was higher among racially minoritized participants, single/widowed participants, and those who lived alone and were less educated. The results showed that having an ACP measure was associated with longer stays in hospitals, nursing homes, and home healthcare in all participants.

ER - TY - THES T1 - The Influence of Mental, Physical, and Social Activity on Episodic Memory of Persons Aged 50 and Above in the United States T2 - Nursing Y1 - 2020 A1 - Malatyali, Ayse KW - cognitive functioning KW - Episodic Memory KW - Mental activity KW - Older Adults KW - Physical activity KW - Social activity AB - The purpose of this study was to describe the relationship between mental, physical, and social activity, and episodic memory (EM) of cognitively intact older persons. The specific aims were (a) to describe the relationship between EM and mental, physical, and social activity, (b) to describe the role of gender, marital status, and race on EM, (c) to describe the moderating effects of each activity on the relationship between each of the remaining two activities and EM, and (d) to describe the moderating effects of gender, marital status, and race on the relationship between each activity and EM. Two theoretical frameworks: Cognitive Reserve Theory (Stern, 2002) and Theory of Nursing as Caring (Boykin & Schoenhofer, 1993) guided the study. This study was designed as a correlational and retrospective secondary analysis of data sets from the Health and Retirement Study. The sample consisted of 3,903 cognitively intact persons who were 50 years and older and completed immediate and delayed recall tests in the 2016 HRS and the 2015 Consumptions and Activities Mail Survey. Descriptive statistics included the means for age: 67 (SD 9.54), education:13.85 (SD 5.89), and total cognition 16.86 (SD 3.11). The sample was predominantly Caucasian (78.3%), female (59.8%), and married (60.9%). The regression model, including mental, physical, and social activity as the predictors, and EM as the criterion was non-significant. There was a significant relationship between gender and EM, indicating that women had higher EM scores than men had. Regression results also showed significant associations between marital status, race, and EM. Compared to the married group, EM scores significantly reduced in the divorced and widowed group. Compared to Whites/Caucasians, African Americans had significantly lower EM scores. The moderation analysis indicated that mental activity significantly moderated the relationship between physical activity and EM. There was a positive relationship between physical activity and EM in the low mental activity group. Gender moderated the relationship between mental activity and EM, indicating a negative relationship between mental activity and EM for women. Marital status also moderated the relationship between physical activity and EM, revealing a positive relationship between physical activity and EM for the widowed group. The study findings can guide primary care services and health-promoting interventions for cognitively intact adults to maintain and improve their episodic memory. JF - Nursing PB - Florida Atlantic University CY - Boca Raton, FL VL - Doctor of Philosophy SN - 9798664739381 UR - https://search.proquest.com/openview/cef6bd54bc560188cb9262fbe73aa154/1?pq-origsite=gscholar&cbl=18750&diss=y ER -