We hypothesized that benzodiazepine/z-drug (BZRA) dose, insomnia symptoms, and obstructive sleep apnea (OSA) risk are associated with cognitive performance above and beyond other modifiable dementia risk factors. In this cross-sectional study, we used baseline data from recruited patients without dementia from one VA site and one academic site to analyze regression models based on previously published risk factors for cognitive impairment, adapted to include sleep and benzodiazepine usage interactions. Changes in R2 and model fit (F-tests) were examined for four nested regression models predicting Mini-Mental State Examination (MMSE), Trail Making Test (TMT)-A, TMT-B, and Digit Symbol Substitution Test (DSST). Base Models included common dementia risk factors. Model-2 = Base + Insomnia Severity Index; Model-3 = Model-2 + dose; Model-4 = Model-3 + OSA risk; and Model-5 = Model-4 + OSA-BZRA. R2 for the base model predicting MMSE was 0.139 (n = 313), 0.241 for TMT-A (n = 298), 0.229 for TMT-B (n = 287), and 0.189 for DSST (n = 285). Model-5 R2 was 0.142 for MMSE, 0.246 for TMT-A, 0.238 for TMT-B, and 0.190 for DSST, with all F-test p-values >.145. Sleep disorder variables did not significantly explain additional variation in cognition performance. Studies with a wider range of cognitive performance are needed.
Little is known about the cognitive health of older adults living in rural Ecuador, where more than 70
This study investigates the correlates of social exclusion among older adults from an ecological social work perspective. Recognizing social exclusion as a multidimensional phenomenon, the research examines characteristics across micro, meso, exo, and macro levels. Data were collected from 400 individuals aged 65 and over using an ‘Interview Form’ and the ‘Social Exclusion Scale for Older Adults.’ Multiple linear regression analysis was used to examine the relationship between ecological characteristics and participants’ social exclusion status. Findings revealed that lower levels of social exclusion were associated with higher education, income, health, physical activity, and suitable housing at the micro level. At the meso level, consumption patterns, digital connectivity, and age-friendly environments were key associated factors. Exo-level correlates included satisfaction with local services, awareness of socioeconomic rights, utilization of social assistance, and active community participation. At the macro level, the absence of ageism, equitable resource access, and fewer employment barriers were associated with lower exclusion levels. The results suggest that social exclusion in later life is linked to interconnected factors across all ecological systems. Consequently, multi-level interventions and policies targeting these systems are essential to effectively address social exclusion and improve the quality of life for older adults.
Intergenerational solidarity remains central to the exchange of emotional, practical and normative support across generations, particularly in settings where formal systems of long-term care and social protection are limited. Yet solidarity is not an automatic consequence of kinship; it is negotiated within changing family, cultural and socioeconomic conditions. This study examined how university students in southwest Nigeria interpreted relationships with their grandparents, the ageing stereotypes through which older people were understood, and the relational and structural conditions that strengthened or strained intergenerational solidarity. Eight gender-segregated focus group discussions involving 72 undergraduates aged 18–25 years were analysed using theoretically sensitised reflexive thematic analysis. Intergenerational solidarity provided the principal relational framework, while intergenerational ambivalence informed interpretation of coexisting affection, obligation, resistance and autonomy. Five themes were developed: cultural images of ageing as wisdom, dependence and frailty; solidarity as a negotiated and potentially repairable relationship; gendered spiritual suspicion directed particularly towards materially vulnerable older women;contested relational jurisdiction around intimacy, appearance, religion and sociability; and the relational infrastructure of solidarity involving migration, parental mediation, language and family conflict. The findings show that participants did not simply reject grandparental authority. Rather, they negotiated where, when and how that authority was considered legitimate. Intergenerational solidarity in this university setting was therefore relationally negotiated and structurally conditioned, with important implications for ageism, family communication and intergenerational practice in comparable Nigerian settings.
