Is Subjective Cognitive Decline Associated with Behavioral Health Outcomes Among Mothers?

OBJECTIVES: Studies suggests that pregnancy can alter the maternal neurological function of the brain (i.e., result in cognitive decline) in a way that remains prevalent well into middle and older adulthood. However, little research has explored these changes and how they might affect behavioral health outcomes, such as substance use and depression. METHODS: We merged data from the 2016, 2017, and 2018 Behavioral Risk Factor Surveillance System (BRFSS) surveys, with a final analytic sample of 1330 female participants (649 participants were mothers). Chi-square tests or t-tests were used to examine differences in demographic and health characteristics of the sample by subjective cognitive decline (SCD) status. To test the study hypotheses, three generalized linear mixed models were estimated with a logit link. RESULTS: SCD was not associated with alcohol misuse among mothers (aOR = 0.27, p = 0.23). Mothers with SCD were more likely to smoke (aOR = 3.33, p = 0.01) and experience mental distress (aOR = 6.59, p < 0.001) than those without SCD. CONCLUSION: Interventions aimed at supporting mothers should consider how existing mental health and tobacco cessation programs can be adapted to better serve this population and should aim to identify those that may have early signs of early signs of neurodegenerative conditions.

Perspectives on a good death: A comparative study of veterans and civilians.

This study aimed to identify any differences between veterans and non-veterans in the importance of domains of the Good Death Inventory. Participants were recruited from Amazon Mechanical Turk to complete a Qualtrics survey on the importance of the 18 domains of the Good Death Inventory scale. Logistic regression models were then used to analyze any differences between veterans (n = 241) and nonveterans (n = 1151). Results showed that veterans (mostly aged 31-50, men, and White) were more likely to indicate that pursuing all treatment possible and maintaining their pride were important aspects of a good death. The results support other studies that have found military culture to be a significant factor in the way veterans view preferences at the end of life. Interventions may include increasing access to palliative care and hospice services for military members and veterans and providing education/training on end-of-life care for healthcare providers who work with this population.

Access Barrier in Rural Older Adults' Use of Pain Management and Palliative Care Services: A Systematic Review.

BACKGROUND: Pain and symptom management is critical in ensuring quality of life for chronically ill older adults. However, while pain management and palliative care have steadily expanded in recent years, many underserved populations, such as rural older adults, experience barriers in accessing such specialty services, in part due to transportation issues. The purpose of this systematic review is to examine the specific types of transportation-related barriers experienced by rural older adults in accessing pain and palliative care. METHODS: Studies were searched through the following 10 databases: Abstracts in Social Gerontology, Academic Search Premier, CINAHL, MEDLINE, PsycINFO, SocINDEX with Full Text, Cochrane Database of Systematic Reviews, Nursing & Allied Health Database, Sociological Abstracts, and PubMED. Studies were chosen for initial review if they were written in English, full text, included older adults in the sample, and examined pain/palliative care/hospice, rural areas, and transportation. A total of 174 abstracts were initially screened, 15 articles received full-text reviews and 8 met the inclusion criteria. RESULTS: Findings of the 8 studies identified transportation-related issues as major access barrier to pain and palliative care among rural older adults: specifically, lack of public transportation; lack of wheelchair accessible vehicles; lack of reliable drivers; high cost of transportation services; poor road conditions; and remoteness to the closest pain and palliative care service providers. CONCLUSION: Results suggest that rural older adults have unique transportation needs due to the urban-centric location of pain and palliative care services. Implications for practice, policy and research with older adults are discussed.