Jane Chung

Background Home‐based dementia caregiving is often complicated and may be fragmented due to differences in caregiver roles, needs, preferences and caregiving circumstances. The complex structure of informal caregiving and inadequate support result in negative health outcomes among informal caregivers. Prior methodologies appear to lack a systematic capture of the critical features and intricate structures of home‐based dementia caregiving. Objectives To characterize dimensions and delivery frequencies of dementia caregiving tasks provided by family members and explore how caregivers framed their everyday challenges related to providing dementia care and support at home. We evaluated the value of digital journaling (caregiver journaling with a messenger app) as a novel data collection technique to better characterize informal dementia caregiving in the home setting. Methods We incorporated multiple data sources from family caregivers, including qualitative interviews, digital journals over four weeks and self‐report caregiver and care recipient characteristics to characterize dimensions, types and frequencies of home‐based dementia care tasks and explore caregivers’ challenges and coping to adapt to the changing caregiving situations. Ten family caregivers completed qualitative interviews and digital journaling. Results A content analysis of 124 journal entries and a thematic analysis of 20 qualitative interviews show that caregivers offered assistance that extended far beyond activities of daily living (ADL) and instrumental ADL. The key themes identified centred around how caregivers shape caregiving tasks, their personas and caregiving strategies while performing multiple roles, as well as the emotional toll of being a caregiver in the face of maintaining coping and resilience. Conclusions The study suggests the use of novel methodology to characterize home‐based dementia caregiving and to identify day‐to‐day care delivery challenges to increase our understanding of how to better support family caregivers. Implications for Practice Nursing interventions aimed at improving informal caregivers’ well‐being need to focus on understanding the dynamic nature of caregiving roles and responsibilities, and the evolving needs of caregivers and care recipients.

Background Cognitive frailty, a condition characterized by physical frailty with cognitive impairment, is emerging as a determinant of adverse health outcomes in older adults. However, its prevalence and correlation with associated factors are unknown in the aging population of Korea. Objectives To estimate the prevalence of cognitive frailty and identify factors associated with it among older Korean adults. Methods A secondary analysis was performed using the Korean Longitudinal Study of Aging seventh survey dataset collected in 2018. Multinomial logistic regression analyses were conducted to examine the association between cognitive frailty and demographic, psychosocial, oral health and physical function factors. Individuals aged ≥65 years and without dementia were included ( N = 1024). Participants were classified into four groups based on the presence or absence of physical frailty and mild cognitive impairment. This article is executed in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Results The prevalence of cognitive frailty in the study sample was 11.2%. The results of multinomial logistic regression showed that advanced age, being female, lower education levels, heart disease, arthritis or rheumatoid arthritis, underweight, depression, non‐social activity, poor oral health and functional limitation were significantly associated with cognitive frailty. Conclusions Cognitive frailty is prevalent among community‐dwelling older adults in Korea. The findings provide primary care providers with insights about effective strategies for identifying at‐risk individuals and will guide the development of population‐level interventions to prevent or delay the onset of physical frailty and cognitive impairment in older adults. Implications for practice The findings provide practical information to healthcare providers for identifying cognitive frailty in older adults. The risk factors of cognitive frailty, such as psychosocial, oral health, and physical function factors, should be thoroughly monitored for older adults. Health personnel working in primary care have a critical role in identifying risk and beneficial factors and promoting preventative strategies that enhance health outcomes.