Aging Baby Boomers Research Articles

Clinical differences and management trends of localized breast cancer in the advanced geriatric population.

e12543 Background: Breast cancer remains the most common cancer diagnosis in women and, with the aging Baby Boomer population, is poised to represent an even larger volume of oncologic care in the United States over the coming decades. Combined with limited evidence-based guidelines for geriatric patients, particularly those above the age of 80, there exists the potential for unnecessary morbidity and mortality. This study aims to shed light on the characteristics of this population, including disparities, with an aim to identify subsets of patients who may benefit from more aggressive treatment. Methods: This was a retrospective cohort study to examine key clinical differences between the advanced geriatric breast cancer population (≥80 years) and those of younger age, comparing comorbidities, tumor characteristics, and management trends. The Charleston Area Medical Center cancer registry was queried from 2009-2022 for females diagnosed with invasive breast cancer who had surgery for localized disease, excluding those with previous malignancies. Data were analyzed with SAS 9.4 using student’s t-test for continuous variables, Chi-square or Fisher’s exact for categorical variables, and 5-year survival rates attained via Cox regression models. Results: The analysis involved 1041 female patients, divided into two age groups: 969 who were < 80 years old and 72 who were ≥80 years old at time of breast cancer diagnosis. The ≥80 group had significantly more individuals with hypertension, 83.3% v 63.7% (p < .001), osteoporosis, 26.8% v 9.5% (p < .001), cardiac arrhythmia, 18.1% v 7.3% (p = .001), and CVA, 11.1% v 4.5% (p = .014), than the < 80 group. Looking at overall trend, tumor grade was significantly (p = .040) lower in the ≥80 group than the < 80 group, G1 34.7% v 24.9%, G2 44.4% v 45.4%, G3 20.8% v 29.7%, respectively. Her2neu positivity was significantly (p = .010) lower in the ≥80 group at 0.0% compared to the < 80 group at 8.4%. There was no difference in the rate of endocrine therapy between the two groups (p = 0.320). Only 26.4% of the ≥80 group received radiotherapy compared to 79.0% of the < 80 group (p < .001). None of the ≥80 group received chemotherapy compared to 22.5% of the < 80 group (p < .001). Overall, 5-year survival for those < 80 and ≥80 was 92% and 84%, respectively (p < .001). Conclusions: In summary, patients 80 years of age or older were more likely to have hypertension, osteoporosis, cardiac arrhythmia, and history of CVA. Regarding tumor characteristics, both grade and Her2neu positivity were significantly higher in the < 80 group. There was no difference in the administration of endocrine therapy. Radiotherapy and chemotherapy, however, were used at significantly lower rates in the advanced geriatric population, likely in adherence with current NCCN guidelines for adjuvant therapy in patients ≥70. Further investigation may help to elucidate subgroups amenable to more aggressive adjuvant therapies.

Care and Treatment of Frail Older Adults in the Dental Office: A Case Report.

Population aging is a worldwide phenomenon that is changing healthcare systems globally, including dentistry. The percentage of frail older adults living in the community has increased as baby boomers age. The majority of these frail older adults are not edentulous, and require the services of a general dentist. Using a longitudinal case history, the authors have discussed the problems and decision making required to care for such an individual in a private dental office. We believe that with a better understanding of medicine and pharmacology, a general dentist should be able to develop a rational treatment plan for frail and dependent older adults who live in the community.

Factors Affecting Employee Retention Among SMES’ Millennial Employees in Klang Valley, Malaysia

MEs have been a significant driver of Malaysia’s economy. SMEs provide opportunities for business expansion and employment for people in need. Therefore, it is important to understand the workforce now as well as in the future. According to earlier studies by others, businesses are currently aggressively seeking the best employees on the market as well as the talent that will eventually replace the ageing baby boomer generation in the upcoming few years. It is because one of their biggest talent concerns is how difficult it is to attract and retain younger employees, especially for millennials and generation Z. The purpose of this study is to examine the factors affecting employee retention among SMEs’ millennial employees in the Klang Valley. Three independent variables: career development opportunities, compensation, and workplace flexibility, were selected to examine the relationship with employee retention. The Klang Valley region was chosen as it is the fastest-growing area in Malaysia with a variety of businesses, educational institutions, and entertainment that attract people from all over the nation to these economic hubs. The quantitative research was used for this study. In this study, three data analysis models have been applied in data analysis descriptive analysis, multiple linear regression, and Pearson correlation coefficient analysis. A total of 384 responses were received for data analysis. The research approach was by survey questionnaires via Google Forms and all the data collected will be analysed by IBM SPSS version 28.0.0.0 throughout the pilot test and final analysis. The findings demonstrate that all the three hypotheses were supported. All the independent variables (career development opportunities, compensation, and workplace flexibility) are found to have a significant positive relationship with the dependent variable. Finally, a summary of the main discussion, implication of the study, its limitations, and some recommendations for future study are mentioned in this paper.

Charbons ardents par Maryline Desbiolles

Reviewed by: Charbons ardents par Maryline Desbiolles Kate M. Bonin Desbiolles, Maryline. Charbons ardents. Seuil, 2022. ISBN 978-2-02-149547-8. Pp. 144. The publisher classifies this work of writing under the rubric "roman," but this category is an uneasy fit. The I narrator is demonstrably Desbiolles herself, embarked on a project of revisiting a real-life event: the 1983 Marche pour l'égalité et contre le racisme. This protest march, the first of its kind in France, took place October-December of 1983: a 1200-kilometer trajectory from Marseille to Paris. The proximal cause of the march was a rise in unprovoked violence against French citizens of Maghrebi origin; more generally, it questioned the role of immigrants within contemporary French society. The artistry of Charbons ardents—what differentiates it from a work of history or sociology—lies in the creative juxtaposition of two timelines: the 1983 March, and the author's own moment of 2020, as she attempts to track down and interview surviving marchers, set against a backdrop of the COVID lockdown and the psychic stress it caused ("la pandémie me scie les pattes," laments the narrator, 13). The mobility of the marchers contrasts vividly with the claustrophobia and discouragement engendered by the lockdown. Time, for Desbiolles, is not a linear forward movement, but rather "un paysage où aller et venir, déambuler, errer, se perdre" (122). Indeed, there are subtle shifts in the first-person narrative voice, as the je of Desbiolles gives way (without punctuation or other markers) to the je of various marchers who agreed to an interview: among them, Djamel Atallah, Christian Delorme, Fatimah Mehallel. In this way, Desbiolles demonstrates a conscientious effort to foreground the marchers' opinions of their own experience, both in the moment and in thirty-seven years' hindsight (for example, Farid L'Haoua's sense of disaffection and disappointment with the March's lack of concrete achievements). At the same time, revisiting the March entails revisiting Desbiolles's own past, although she admits having been unaware of the event as it unfolded ("Je ne l'ai pas entendu en 1983. Qu'est-ce que je n'entends pas aujourd'hui?" 53). Desbiolles constantly seeks connections between the marchers' experience and her own (the age of Élisabeth's daughter and Desbiolles's own daughter; the marchers' music tastes in the 1980s and her own, etc.). This impulse to make connections occasionally leads Desbiolles to odd moments of speculative numerology, of identifying emblematic meaning in the roots of words or in names (the activist priest Christian Delorme becomes "un arbre," 103). Clearly, one of the main focal points of the work is Desbiolles's quest to understand her own positionality as an aging baby boomer and soixante-huitarde coming to grips with what she terms "les traumatismes de l'histoire de France" (87): colonization; the Algerian War for Independence, the 1980s rise in racist violence. Recent tragic events—the deaths of George Floyd, Adama Traoré, and Samuel Paty, all of which claim space in Chardons ardents—demonstrate the depressingly persistent cycle of racism: "Le [End Page 228] temps ne passe pas" writes Desbiolles (63). Less predictably, in the same line, she also observes: "Les temps se chevauchent, s'empilent, s'interpénètrent:" a fitting image for this rambling, provocative, and moving work. [End Page 229] Kate M. Bonin Arcadia University (PA) Copyright © 2023 American Association of Teachers of French

Slow demographic change and neurological rehabilitation-Part 1: state of affairs

In the next two decades the aging baby boomers in Germany will gradually be leaving the work force. They are being followed by the much less numerous, "baby bust" generation who now need to finance and staff healthcare for the growing number of old people in society. In order to care for more needy persons with a smaller working population, the healthcare system must be restructured; however, despite these worrisome prospects, the awareness of the problem is still low in many areas. Here we focus on the area in the healthcare system that is growing particularly rapidly and additionally has the greatest need of personnel per patient: the care of the critically ill and functionally impaired patients. The lack of coordination of hospitals, rehabilitation centers and nursing institution is historical in origin. It promotes the tendency to discharge functionally impaired patients to nursing facilities without giving them a chance for recovery of functional autonomy. As the demographic change progresses, this tendency threatens to increase. In afirst of two parts, we attempt to describe the present situation.

Media portrayals of transitions from work to retirement in two ageing societies: the case of ageing baby boomers in Japan and Finland

This article explores media portrayals of the transition from work to retirement under the circumstances of demographic change through a focus on newspaper discussions about ageing baby boomers in Japan and Finland. Due to their shared characteristics as a distinct population group that advances the rapid ageing of the population, media representations of Japanese and Finnish baby boomers during the transitional period to retirement give insight into the social perceptions of retirement and their implications on later life. Manifest content analysis and subsequent thematic analysis identify that the topic of “work, retirement and pension” dominates media discussions in both countries. Analysis also conveys that this topic involves specific themes on three levels: macro level, attitudinal level and behavioural level regarding working, subjective and social perceptions of retirement. Social and cultural differences between Japan and Finland are well accounted for in shaping each theme, which is characterised by even contrasting expressions regarding the extension of working life and attitudes toward work and retirement. However, deeper analysis suggests that the idea that values an active, productive and engaged lifestyle beyond retirement underlies both Japanese and Finnish media discourses. Media discussions in both countries risk creating a discriminatory dichotomy among older people: the Finnish media marginalises those who are out of work and without work-like activities, while the Japanese media tend to exclude those without socially desirable competence.

Care

Care

“Same, same but different”: insights on ageing consumers and their expectations of institutional food

PurposeSocieties are experiencing a rapidly ageing population, which puts pressure on health services and institutions for the elderly. Ageing baby boomers have unique characteristics compared to previous generations, yet very little is known about these consumers' expectations of institutional food. The importance and issues with institutional food are well-recognized, and new approaches to improving institutional food offerings are warranted. The purpose of this study was to identify various segments of ageing consumers based on individual characteristics (entitlement, subjective food knowledge, disconfirmation sensitivity and age) and investigate differences in expectations between the groups.Design/methodology/approachData were collected using a cross-sectional survey (n = 300) of ageing consumers (50–80 years old). A two-step cluster analysis was used to identify meaningful clusters.FindingsA four-cluster solution was reached, with clusters (1) “Uninvolved oldies”, (2) “Humble old foodies”, (3) “Entitled youngsters” and (4) “Food experts”. This study found significant differences in expectations of institutional food between the clusters.Practical implicationsRecommendations for public policy implications for each segment are provided. This study contributes to preparing healthcare services and institutions to meet the institutional food expectations of various types of ageing consumers.Originality/valueThis paper measures ageing consumers' normative expectations of institutional food and concludes that expectations of food quality, freedom of choice, servicescape and sustainability differ by segments of ageing consumers.

COVID-19 preventive interventions for high-risk pregnant women and preschool children: a rehearsal for the baby boomers' old-age pandemic? : Interventions préventives pour les femmes enceintes et les jeunes enfants à risque pendant et après la COVID-19 : une préparation à la pandémie du vieillissement des baby-boomers?

A large research-based consensus was achieved over the past 30 years concerning the importance of prenatal and early childhood development: Preventive interventions are needed early in life because physical and psychological problems during pregnancy and early childhood often lead to serious physical, psychological, educational, and social problems throughout the life course. These problems are also transmitted to the next generation. The COVID-19 pandemic is likely to have increased the number of families who need these early-life preventive interventions. Without intensive support, children from high-risk families are likely to fail in school, to have serious physical and mental health problems, and to reproduce another generation of children with similar physical, cognitive, and mental health problems. We underline the need to: (1) assess the extent of the COVID-19 damage on pregnant women and on their spouses, as well as on the families with preschool children; (2) help service providers identify the state-of-the art services they should implement; (3) assess the implementation of these services; and (4) help service providers maintain highly effective interventions. For the next 20 to 30 years at least, governments will be under intense pressure to invest massively in the health and care of the baby boomers. We are thus facing abysmal health care and retirement costs for the next 3 decades. Governments should be pressured to substantially invest in the support of pregnant women and preschool children, rather than in the sustained quality of life of the aging baby boomers.

Explaining Gender Differences in Depressive Symptoms Among Caregivers of Older Patients With Critical Illness

The aging of baby boomers makes caring for the elderly an increasingly important topic. As rising cost of health care, the care for seriously ill patients has gradually shifted from hospitals to families, particularly in the countryside. Along with growing demand for informal care, informal caregivers are at increased risk of depression. The aim of this study was to explore the potential protective factors or risk factors associated with depressive symptoms of caregivers for patients with critical illness (45 to 93 years of age) across gender groups, explain their different pathways of influence, and elucidate targeted measures to improve their outcomes (N=518). Results from the statistical model showed that the paths of effect from care needs to caregiver depressive symptoms differed between male and female informal caregivers. Care needs were not significantly associated with depression symptoms among informal caregivers, for either men or women. Care hours of more than 12 hours per day and financial difficulties at home are risk factors for depressive symptoms in caregivers, with significance of OR=3.42; 95%CI,1.97 to 5.94; P=0.000 and OR=2.98; 95%CI, 1.46 to 6.05; p=0.003, respectively. For male caregivers, years of caregiver education and the feel relied upon by relative's were both protective factors, whereas Job-Caregiving conflict, was a risk factor (P<0.05). For female caregivers, caregiver burden and higher caregiver age were its risk factors (P<0.05). These important findings demonstrate that to be effective in reducing depressive symptoms among informal caregivers, both cointerventions and triage interventions by gender are warranted.

How many Black men in cognitive intervention trials? A persistent barrier to equity

AbstractBackgroundThere has been sparse attention paid to the cognition of older men and potential race differences in cognitive ability among older men. Men’s health disparities are likely to continue to increase in the next few decades, likely due to an aging baby boom cohort; increases in racial diversity in the US; and increases in life expectancy among both Black and White men. Our objective was to examine the completed cognitive intervention trials to ascertain the proportion of Black men and racial differences in such trials.MethodWe conducted a scoping review of reported cognitive intervention trials between the years 2000 and 2020. We searched PubMed, Google Scholar, CINHAL, Cochrane, and Clinicaltrials.gov for cognitive intervention trials using the following MeSH terms – “cognitive intervention”, “mild cognitive impairment”, “dementia”, “Alzheimer’s disease”, and “cognitive disorder”. Inclusion criteria included U.S, based interventions intended to improve cognition.ResultWe found 293 unique trials that met our search terms of which 66 were included for final analysis. The rest were excluded due to not being in the US, only including healthy participants, and use of non‐cognitive interventions. We were able to assess the number of Black men in 9 out of the 66 trials, because the trials were either all White (n=8) or all Black (n=1). Of the 9 trials we could assess, 8 had no Black participants (thus no Black men) and the one with all Black participants had 21% men. Of the remaining 57 trials, 32 did not report race and 25 included race and sex data but did not include race‐sex categories and thus we were unable to determine the number of black men included.ConclusionWe were unable to determine if cognitive intervention trials included sufficient proportions of Black men due to non‐reporting of race, race‐sex categories, and lack of inclusion of Black persons in trials. Our results beg the question of how we can understand cognitive health disparities and improve representation in trials if we don’t include the information that would allow us to make that determination.

Presidential Address: The Next Generation Workforce, A Call to Action

Presidential Address: The Next Generation Workforce, A Call to Action

Effectiveness of eHealth Technology-Based Interventions in Reducing Substance Misuse Among Older Adults: A Systematic Review.

Generally considered an epidemic among young people, substance misuse has been a growing issue among older Americans for the past 40 years. Legal substances, such as alcohol, tobacco, and prescription drugs, including opioids and marijuana, are of primary concern when it comes to aging Baby Boomers. By 2050, 22% of Americans will be aged ≥65 years. Currently, eHealth interventions are receiving attention in treating substance misuse among younger Americans. The current study has two aims: to evaluate the effectiveness of eHealth interventions for older adults treated for substance misuse problems, as well as to investigate behavioral outcomes in reducing substance misuse. A comprehensive search of databases yielded 35,041 articles that examined reductions in substance misuse and problem behaviors as a primary outcome with eHealth interventions delivered to older adults. Once duplicate and irrelevant articles were removed, seven were left to be analyzed. Findings suggest use of technology to assess and intervene with older adults using various substances shows promise and, as a whole, older adults are receptive to online learning, screening and assessment, and interventions. [Journal of Gerontological Nursing, 47(10), 23-29.].

Rethinking Older Adult Murder Victims: Looking Back at 25 Years of Homicide Studies to Inform Future Research Needs

Over the past 25 years, homicide researchers have largely ignored older adults. This pattern continues even in light of the ongoing demographic shift associated with the aging baby boomer generation. This article reflects on the current state of the literature and discusses areas in need of attention. Future research needs can be categorized into substantive and methodological issues. The insights gained by exploring these topics can generate nuanced explanations for fatal violence against older adults and support future evidence-based prevention policies.

Surgery Versus Radiation Therapy for Early-Stage Lung Cancer: Patient Selection is Crucial

Lung cancer remains the leading cause of cancer related death in the United States with mortality rates surpassing breast, prostate, brain, and colorectal cancers combined [1,2]. Recent data shows that susceptibility for both men and women for developing invasive lung and bronchogenic carcinoma peak after the age of 70 years [2]. As the generation of baby boomers age, those older than 65 years will nearly double and the number of elderly population older than 85 years will triple from 2020 to 2050

Comparison of hepatitis C treatment outcomes between primary care and specialty care.

Hepatitis C virus (HCV) infections have increased significantly in the United States recently, having tripled by 2014. Seventy-five percent of those with HCV are aging baby boomers, which places increased pressure on the medical system to provide treatment. There are not enough specialists available to treat everyone infected with HCV. The aim of this research was to determine whether treatment of hepatitis C with new direct-acting antivirals in primary care settings resulted in equivalent cure rates when compared with those patients treated by specialists. A retrospective cohort design was used. Participants were those treated for hepatitis C in specialty care at large public hospitals by gastroenterologists and/or hepatologists and those treated in two primary care community health centers in Seattle. Multivariate logistic regression was used to determine differences of sustained virologic response between those treated in primary care and those treated in specialty care. Treatment failure and those lost to follow-up were combined into one category. Failure rates were only 4% in primary care and 1.1% in specialty care. After adjustment, patients treated in primary care were statistically significantly less likely to have failure/lost to follow-up than those treated in specialty care. Hepatitis C treatment can be successfully provided in primary care with equivalent treatment outcomes. Primary care advanced practice nurses are in a good position to identify and treat hepatitis C. In addition, as patients are typically more engaged with their primary care provider, follow-up rates may be better versus referring these patients to a specialty provider.

The Effect of a Discharge Disposition Algorithm on Patient Outcomes and Satisfaction.

Total joint arthroplasties are one of the most common procedures performed in the United States. As changes have occurred in the surgical techniques of these procedures, postoperative recovery time has decreased and patients have been able to safely transition to home rather than a post-acute care facility. The demand for total joint arthroplasty (TJA) is expected to grow 44% as the prevalence of lower extremity osteoarthritis continues to rise (Sher et al., 2017) because of an aging baby boomer population. In the next 20 years, it is expected that the demand for total hip arthroplasty will grow by 174% and demand for total knee arthroplasty will grow by as much as 670% (Napier et al., 2013). An area with high variability in the postoperative period is in postdischarge rehabilitation. Post-acute inpatient care can account for up to 36% of the bundled costs of a TJA. There is a lack of evidence that patients recover better or have decreased complications by transitioning to an inpatient rehabilitation setting compared with transitioning to home. The aims of this literature search were to (a) identify the safest discharge disposition for patients following TJA; (b) determine the rate of complications and readmissions among those discharged to skilled nursing facility, inpatient rehabilitation unit, and home; and (c) explore how specified care pathways affect patient expectations and outcomes. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, ProQuest, and Cochrane were searched using the following key terms: discharge disposition, total joint arthroplasty, joint replacement, hip arthroplasty, knee arthroplasty, care pathway, discharge outcomes and readmissions, discharge protocols, and discharge algorithms. Five key themes emerged. Patients with significant comorbidities may require longer length of stay in the hospital or potentially discharge to a facility, discharge to facility associated with high rate of complications, setting patient expectations increases likelihood of discharge home, discharge to inpatient facilities does not improve outcomes, and discharge to any post-acute care facility is more expensive than discharge to home. This review identified themes in postoperative care of TJA patients that can be utilized to create a discharge disposition algorithm using best practices to stratify patients into the appropriate discharge disposition while setting appropriate expectations for patients undergoing these procedures to ensure high levels of patient satisfaction following these procedures.

Filipino Formal Caregivers to the Elderly and Normalized Exploitation in the Workplace

The goal of this exploratory study was examine formal Filipino/a caregivers' sociocultural contexts in working as caregivers for the elderly and its impacts on their health. As the demand for care workers for the aging Baby Boomer generation grows in the United States, Filipinos/as migrant workers are among the ethnic migrants who answer this call. In a mixed-methods study, we find that Filipino/a formal caregivers normalize exploitation in their work with elderly patients because of sociocultural contexts that include transnational financial obligations to their families in the Philippines. Caregivers’ health outcomes relies on their ability to mediate various social contexts.

Substance use disorder and the baby boom generation: Does Berlin outpatient addiction care face a sustained change?

IntroductionThe ageing of baby boomers is expected to confront addiction care with new challenges. This cohort had greater exposure to psychoactive substances in youth than earlier cohorts. In this study, we aimed to investigate whether Berlin addiction care is confronted with a sustained change in its clientele initiated by the baby boomers.MethodsUsing data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an earlier and a later cohort. To isolate cohort effects, two‐level random intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each of the other cohorts.ResultsCompared with the earlier cohort, alcohol use disorder lost importance whereas illicit substance use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the earlier cohort. Comparing baby boomers with the later cohort, these relationships pointed in the opposite direction.Discussion and ConclusionsOutpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. With increasing life expectancy and the ageing of baby boomers marked by higher substance use than previous cohorts, older clients, who had been under‐represented in outpatient addiction care, will gain relevance. Hence, addiction care has to adapt its offers to appropriately meet the changing needs of its clientele.

Early Indicators of Cognitive Decline in Online Financially Active Older Adults

As access to computers and use of technology becomes more common in older adults, the incidence of online financial fraud increases. Law enforcement officials and fraud experts predict this trend to continue as aging baby boomers increasingly become targets. One reason this population might be at risk for financial fraud is due to subtle, undetected decline in cognitive abilities that have been associated with decline in financial capacity. Many cases of incipient cognitive decline go undetected. Further, those with early cognitive decline often have poor insight to its potential impact on daily functioning. Assessment of Activities of Daily Living Skills (ADLs) is paramount to determine early decline in daily activities. The ORCATECH Life Lab was designed to evaluate subtle neurological and other health changes and their relation to changes in daily functioning. Older adults participating in the Life Lab complete annual ADL and neurocognitive assessments. Additionally, 97 participants completed an online technology questionnaire where 64 participants reported participating in online financial activity. Results revealed that within the online financially active group, some assistance in ADL’s was required. However, inconsistencies in ADL change over time highlight the challenges of screening for early signs of mild cognitive impairment (MCI) in patients that fall between normal cognition and MCI. In-home information technology may help overcome these challenges. Defining subtle changes in ADLs is a crucial step to enable early diagnosis of neurocognitive disorders and assist health care providers in improving disease management and to prevent incidents of financial fraud in this vulnerable population.