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Objectives: To estimate the prevalence of unmet needs for assistance among middle-aged and older adults with subjective cognitive decline (SCD) in the US and to evaluate whether unmet needs were associated with health-related quality of life (HRQOL). Design: Cross-sectional Setting: US – 50 states, District of Columbia, and Puerto Rico Participants: Community-dwelling adults aged 45 years and older who completed the Cognitive Decline module on the 2015-–2018 Behavioral Risk Factor Surveillance System reported experiencing SCD and always, usually, or sometimes needed assistance with day-to-day activities because of SCD (n = 6,568). Measurements: We defined SCD as confusion or memory loss that was happening more often or getting worse over the past 12 months. Respondents with SCD were considered to have an unmet need for assistance if they sometimes, rarely, or never got the help they needed with day-to-day activities. We measured three domains of HRQOL: (1) mental (frequent mental distress, ≥14 days of poor mental health in the past 30 days), (2) physical (frequent physical distress, ≥14 days of poor physical health in the past 30 days), and (3) social (SCD always, usually, or sometimes interfered with the ability to work, volunteer, or engage in social activities outside the home). We used log-binomial regression models to estimate prevalence ratios (PRs). All estimates were weighted. Results: In total, 40.2% of people who needed SCD-related assistance reported an unmet need. Among respondents without depression, an unmet need was associated with a higher prevalence of frequent mental distress (PR = 1.55, 95% CI: 1.12–2.13, p = 0.007). Frequent physical distress and social limitations did not differ between people with met and unmet needs. Conclusions: Middle-aged and older adults with SCD-related needs for assistance frequently did not have those needs met, which could negatively impact their mental health. Interventions to identify and meet the unmet needs among people with SCD may improve HRQOL.

Introduction Caregivers are a critical and highly used health care resource. Caregivers may experience adverse health outcomes and practice less self-care, including obtaining vaccinations, while serving in their roles. Influenza (flu) is a common infectious disease responsible for millions of doctor visits, hospitalizations, and approximately 43,000 US deaths annually that can largely be prevented by receiving seasonal vaccinations. We aimed to estimate and compare the prevalence of flu vaccination among caregivers and noncaregivers. We hypothesized that caregivers would have a lower prevalence of flu vaccination than noncaregivers and that sociodemographic variables, health-related variables, and caregiving-specific characteristics would be associated with vaccine uptake. Methods We analyzed Behavioral Risk Factor Surveillance System data from 2016 through 2018 on 154,170 respondents from 27 US states and the District of Columbia. We used bivariate analysis to estimate the difference in flu vaccination uptake among caregivers and noncaregivers and logistic regression to estimate differences after adjusting for individuals’ characteristics. Results Logistic regression indicated no significant difference in flu vaccine uptake between caregivers and noncaregivers. Caregiving characteristics such as years in a caregiver role, weekly time spent caregiving, relationship to care recipient, and recipient’s risk for flu complications were also nonsignificant. Sociodemographic factors such as marital status, income, health insurance coverage, and race had a significant impact on flu vaccine uptake. Conclusion Although no significant differences in flu vaccine uptake were found between caregivers and noncaregivers, flu vaccine coverage remains low in both groups. Evidence-based programs and policies to improve vaccine coverage in the caregiver and general populations remains a public health priority.

Background In the Gambia, three out of four women of reproductive age have undergone Female Genital Cutting (FGC). Many studies and policy advocates suggest that for such a practice that is deeply rooted in culture, a more holistic approach focusing on educating the population will have sustainable impact. This research examined whether educational level of women has an association with their attitude towards the practice of FGC. Methods Data from the 2013 Gambia Demographic Health Survey (GDHS) were analyzed. The sample included 6217 households: 10,233 females aged between 15 to 49 years and 3831 males between 15–59 years. This study focused only on women participants. The outcome variable was the attitude of women toward the practice of FGC. Results In multivariate regression model, women who were circumcised are found to have 80 times higher odds of supporting FGC [Odds Ratio = 80 (95% CI 50.93–124.4)] compared to uncircumcised women. Women with primary and secondary level education have lower odds of supporting FGC [OR = 0.73 (95% CI 0.915–0.007)) and those with higher education had the lowest odds [OR = 0.28 (95% CI 0.147–0.543)) of supporting FGC relative to women with no education at all. Conclusions Education and awareness programs targeting women who are married and older, those with less education and those who are already circumcised can help change attitudes towards the practice of FGC.

The Citywide Guide ("Guide") is an online and bound publication in New York City that lists low-or no-cost resource and service providers-organized by 21 different service categories-available at no cost to New York City residents and service providers by the Women Creating Change (formerly Women's City Club of New York). Women Creating Change (WCC) aims to empower underrepresented women with the information and tools they need to become civically engaged change-makers. The primary purpose of the evaluation was to determine the value of the Citywide Guide to New York City residents living in or near poverty, and to determine how web-based information resources can be better marketed and utilized by the less advantaged populations in large urban settings. This mixed methods evaluation of the Citywide Guide includes information collected from endusers of the Guide including results of an online survey with 57 total respondents and of a focus group discussion of seven participants that was held at WCC headquarters. Forty-seven percent and 38% of the survey respondents reported using the online and hardcopy versions of the Guide, respectively, and "Housing and Homelessness" was the category explored most frequently by respondents when using the Guide. We conclude that the Citywide Guide is a valued resource for ABOUT THE AUTHOR The evaluation reported here was conducted by researchers at the Center for Long-Term Care

Approximately 20% of U.S. adults provide unpaid care to family members and friends with a health condition or disability, and 20% of caregivers reported being in fair or poor health themselves. Much of the assistance caregivers provide have cognitive components, such as medication or financial management, yet little is known about caregivers’ cognitive functioning. Subjective cognitive decline (SCD), or self-reported worsening of memory over the past year, among caregivers could impact the quality of care they provide. This study assessed prevalence of SCD by caregiving status and, among caregivers, the distribution of sociodemographic and other characteristics by SCD status. The study included 93,851 community-dwelling adults aged ≥45 years in 22 states who completed both the Behavioral Risk Factor Surveillance System Cognitive Decline and Caregiving modules during 2015-2019. All data were weighted; comparisons are based on modified Rao-Scott chi-square tests (α=0.05). Among caregivers (n=21,238), 12.6% (95%CI:11.7-13.5) reported SCD, compared with 10.2% (95%CI:9.7-10.7) of non-caregivers (p<0.0001). Caregivers with SCD had more chronic health conditions, lower educational attainment, and were less likely to be married or employed than caregivers without SCD, despite a similar age distribution. Caregivers with SCD were also more likely than caregivers without SCD to report fair or poor health, frequent mental distress, a history of depression, and frequent activity limitations. SCD may negatively impact caregivers’ health, function, and ability to provide care. With the anticipated increases in the need for caregiving, it is critical to understand the cognitive health of caregivers to better support caregivers and care recipients.

Food insecurity, a critical problem in the developing

Informal caregivers can provide assistance that can help family members and friends live in the community longer but can place caregivers at increased risk for poorer health outcomes. Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss. The objective of this study is to describe SCD in caregivers. Data were analyzed from 21 states, Puerto Rico, and District of Columbia who administered both the Caregiver and Cognitive Decline modules of the Behavioral Risk Factor Surveillance System in the same year for 2015–2017. A higher proportion of caregivers reported SCD (13.4%) compared to non-caregivers (10.2%). Of those who did need assistance with daily activities due to SCD, 1 in 8 non-caregivers were unable to the necessary assistance compared to 1 in 4 caregivers. SCD among caregivers is of particular concern because it affects both the caregiver and care recipient.