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Item Exploring autobiographical memory functions in Korean older adults: Development and application of the Korean version of Thinking About Life Experiences scale (TALE-K)(2021) Park, Sangmi; Lee, Chang Dae; Kim, Tae HuiObjective: The aim of this study was to develop a Korean version of the Thinking About Life Experiences scale (TALE-K) and to analyze the characteristics of autobiographical memory function (AMF) in community-dwelling older adults Methods: To develop TALE-K, a translation and back-translation procedure followed by an understanding test was performed. Then, a survey was conducted to examine the associations of AMF with psychosocial variables using TALE-K, Index of Well-Being (IWB), Meaning in life scale for older adults, Revised UCLA Loneliness Scale (RULS), Medical Outcomes Study Social Support Survey (MOS-SSS), Brief Resilience Scale (BRS). Results: Data from 75 community-dwelling older adults were used for the final analysis. The average scores of all three subscales of TALE-K were below 3 points (less frequent than occasionally). The correlation results showed that TALE-K total score was significantly associated with IWB and the Meaning in life scale for older adults. The multiple linear regression results presented that higher AMF was significantly associated with higher IWB, along with having siblings, higher meaning in life and resilience, and lower loneliness. Conclusion: Including a validation study of TALE-K, studies for understanding the characteristics of AMF in older adults using TALE-K are needed.Item Psychometric properties of self-reported instruments for occupational balance: A COSMIN-based systematic review(Taylor & Francis, 2023-08-14) Park, Sangmi; Lee, Chang DaeIntroduction Instruments being used currently to evaluate Occupational Balance (OB) are all self-report outcome measures which demand robust psychometric properties for precise assessment. This study aimed to systematically review the psychometric properties of the current OB instruments. Methods For this systematic review, COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 were adopted. Peer-reviewed articles published between January 2010 and February 2021 were searched for in PubMed, Cochrane, Web of Science, and PsycINFO databases. Search terms were full names and abbreviations of the OB instruments: Life Balance Inventory (LBI), Meaningful Activity Wants and Needs Assessment (MAWNA), Occupational Balance Questionnaire (OBQ), and Occupational Balance-Questionnaire (OB-Quest). Results Of the 400 articles identified in a systematic database search, 12 studies from 10 articles were analysed. Five instruments, including the revised version of the OBQ (i.e., OBQ11), were analysed within the COSMIN taxonomy. The LBI demonstrated ‘high’ evidence for insufficient structural validity. The others demonstrated ‘moderate’ or ‘high’ evidence for indeterminate structural validity. Less than sufficient structural validity led to indeterminate internal consistency across five instruments, and their quality of evidence varied from ‘very low’ to ‘high’. The MAWNA and OBQ demonstrated ‘very low’ evidence for sufficient reliability. Conclusion OB instruments with psychometric properties of sufficient overall ratings supported by ‘high’ quality of evidence are unavailable. Further studies are required to clarify the concept of OB, to examine more diverse psychometrics of OB instruments, and to consolidate their robustness.Item Occupational Therapy Intervention for Preventing Prescription Opioid Use Disorder in Older Adults(American Occupational Therapy Association, 2020-11) Lee, Chang Dae; Voelbel, Gerald TItem Postoperative Delirium Prevention as Standard Practice in Occupational Therapy in Acute Care(2020) Lee, Chang Dae; Chippendale, Tracy L; McLeaming, LizPostoperative delirium (POD) is common, especially among older adults, and can significantly impact health and rehabilitation outcomes. Research evidence suggests that a multicomponent intervention is most effective for delirium prevention. Given that this intervention includes diverse components, interdisciplinary collaboration among members of the healthcare team is essential. This paper presents how occupational therapists, as part of the interdisciplinary acute care team, contribute to preventing POD and embed their unique value, skills, and strengths in each component of the collaborative intervention. This paper also argues that POD preventive care should be standard practice for occupational therapy in the acute care setting.Item The relationship between active, balanced participation and well-being in older adults in the United States: A time-use perspective(Taylor & Francis, 2021-03-07) Lee, Chang Dae; Kim, Moon Young; Lee, Mi Jung; Kang, Jaewon; Foster, Erin RThe purpose of the study was to investigate the association between occupational balance and well-being in older adults. The sample was 2,142 older adults (aged 65 and older; mean age=73.4; 59.6% female) from the American Time-Use Survey (ATUS). Work and leisure time use was reported as the amount of time (min) spent on work and leisure occupations in the 24-hour day. A median split of total time spent on both work and leisure was used to create 4 time-use groups: high work high leisure = active balanced; high work-low leisure = work-focused; low work-high leisure = leisure-focused; and low work-low leisure = inactive balanced. Well-being was rated from 0 (the worst possible life) to 10 (the best possible life). Results showed that the active balanced group had significantly higher well-being than the inactive balanced group, after controlling for perceived health and well-restedness (p<0.05). There were no significant differences between any other group combinations (e.g., leisure-focused vs. work-focused and work focused vs. active-balanced). These findings are consistent with the occupational science literature indicating the importance of active participation in both work and leisure occupations for higher well-being and extended to the older adult population.Item Depressive Symptoms Mediate Associations between Subjective Memory Complaints, Cognitive Ability, and Instrumental Activities of Daily Living(Taylor & Francis, 2023-04-10) Lee, Chang Dae; Foster, Erin R.; Goverover, YaelObjectives: Cognitive ability (CA) and instrumental activities of daily living (IADL) performance are essential for productive aging. Therefore, it is important to understand if other common issues such as subjective memory complaints (SMCs) and depressive symptoms are related to CA and IADLs, and explore the nature of those relationships. This study aims to explore 1) the associations between SMCs, depressive symptoms, CA, and IADL performance and 2) the role of depressive symptoms in these associations. Method: The study sample included 1,621 community-dwelling oldest-old from the Health and Retirement Study. Results: SMCs were significantly and positively associated with cognitive decline and limitations in IADL performance. Additionally, depressive symptoms mediated the associations between SMCs and cognitive decline and between SMCs and limitations in IADL performance. Conclusion: Depressive symptoms associated with SMCs negatively affect CA and IADL performance. Therefore, healthcare providers should consider and assess SMCs and depressive symptoms in the oldest-old.Item Subjective memory complaints and social participation among older adults: results from the health and retirement study(Taylor & Francis, 2021-08-14) Lee, Chang Dae; Park, Sangmi; Foster, Erin RObjectives: This study aims to examine whether subjective memory complaints (SMC) contribute to social participation among older adults. Method: The study sample was 4,713 community-dwelling older adults aged 65 years and older from four waves (2010, 2012, 2014, 2016) of the Health and Retirement Study. Hierarchical linear modeling analysis was used to examine the association of SMC with social participation after controlling for factors influencing social participation. Demographic factors (i.e. age, gender, and perceived socioeconomic status) were entered in block 1, health-related factors (i.e. health conditions, perceived health, instrumental activities of daily living, memory-immediate and delayed, and depressive symptoms) were entered in block 2, environmental factors (i.e. perceived social support and strain from spouse, child, family, and friend) were entered in block 3, and SMC was entered in block 4. Results: The result showed that factors significantly contributing to social participation are age (standardized β = –0.08, p < 0.01), perceived socioeconomic status (β = 0.16, p < 0.001), perceived health (β = 0.15, p < 0.001), instrumental activities of daily living (β = 0.12, p < 0.001), memory-immediate and delayed (β = 0.09, p < 0.001; β = 0.08, p < 0.001, respectively), social support from spouse and friend (β = 0.04, p < 0.05; β = 0.13, p < 0.001, respectively), social strain from friend (β = 0.07, p < 0.001), and SMC (β = –0.05, p < 0.001). The demographic factors explained 9.5%, health-related factors explained 8.5%, environmental factors explained 2.4%, and SMC explained 0.1% of the variance in social participation. Conclusion: This finding suggests that SMC may contribute to social participation in older adults.Item Subjective Memory Complaints Predict Decline in Memory, Instrumental Activities of Daily Living, and Social Participation in Older Adults: A Fixed-Effects Model(American Occupational Therapy Association, 2023-08-21) Lee, Chang Dae; Foster, Erin RImportance: Although subjective memory complaints (SMCs) have been suggested to be associated with future memory impairment, limitations in instrumental activities of daily living (IADLs), and social participation restriction, these associations are still inconclusive. Objective: To determine whether changes in SMCs over time predict decline in memory, IADLs, and social participation in older adults. Design: Longitudinal study. Setting: Community. Participants: Sample 1 included 2,493 community-dwelling older adults drawn from the Health and Retirement Study (HRS) data collected between 2004 and 2018. Sample 2 included 1,644 community-dwelling older adults drawn from the HRS data collected between 2008 and 2018. Outcomes and Measures: Self-reported SMCs, memory function, self-reported IADL performance, and self-reported social participation. Results: The mean age of Sample 1 at baseline was 70.16 yr; 1,468 (58.88%) were female. In Sample 1, immediate and delayed memory (all ps < .001) and IADL performance (p < .01) declined over time. Increases in SMCs over time significantly predicted future immediate and delayed memory declines (p < .01 and p < .001, respectively) and future IADL performance decline (p < .001), after controlling for depressive symptoms. The mean age of Sample 2 at baseline was 71.52 yr; 928 (56.45%) were female. In Sample 2, social participation declined over time (all ps < .001). Increases in SMCs over time significantly predicted future social participation decline (p < .05), after controlling for depressive symptoms. Conclusions and Relevance: Increases in SMCs predict future decline in memory, IADL performance, and social participation after accounting for depressive symptoms. What This Article Adds: SMCs can be used as an early indicator of future memory impairment, IADL limitations, and social participation restrictions in older adults. Furthermore, interventions that minimize SMCs may help older adults achieve successful aging.Item Relationship Between Resilience, Community Participation, and Successful Aging Among Older Adults in South Korea: Mediating Role of Community Participation(Sage, 2023-07-31) Kim, Jung-Ran; Park, Sangmi; Lee, Chang DaeA high level of resilience is positively related to successful aging. However, interventions to increase resilience in older adults are not yet available. This study aimed to examine the mediating role of community participation in the relationship between resilience and successful aging. Data from 284 individuals aged 60 years and above were analyzed in this cross-sectional study. The pathways among resilience, community participation, and successful aging were statistically significant after controlling for sociodemographic characteristics, depression, disability, and chronic disease. The analysis revealed a partial mediating effect of community participation (unstandardized estimate = .01, p < .01), explaining 16.4% of the total effect of resilience on successful aging. Promoting community participation may be beneficial for enhancing successful aging in community-dwelling older adults. Further studies to examine the causal relationship between community participation and successful aging and to develop community services are recommended to use community resources as means to support successful aging.Item Understanding Travel Considerations and Barriers for People with Disabilities to Using Current Modes of Transportation Through Journey Mapping(Sage, 2023) Lee, Chang Dae; Koontz, Alicia M; Cooper, Rosemarie; Sivakanthan, Sivashankar; Chernicoff, William; Brunswick, Allison; Deepak, Nikitha; Kulich, Hailee R; LaFerrier, Justin; Lopes, Celia R; Collins, Nicole L; Dicianno, Brad E; Cooper, Rory AThis study aimed to apply a journey mapping methodology to identify travel considerations and barriers for people with disabilities (PWDs) at each travel stage, from considering a trip through to arriving at the destination for their current modes of transportation, with the objective of understanding and avoiding “pain points” during a transition to autonomous driving systems. Twenty PWDs, including those with physical, visual, aural, cognitive, and combined physical/visual impairments, participated in a semistructured one-on-one interview. Descriptive statistics were used for demographic information, and qualitative content analysis was used to analyze the transcribed interviews and extract themes. Themes were further organized by the modes of transportation used. The top four themes in considering and planning a trip were third-party assistance availability (private vehicle, public transportation, and paratransit), finding an accessible or suitable parking space (private vehicle), access to a service location (public transportation and paratransit), and transportation schedules (public transportation and paratransit). The top four travel barriers to locating, entering, riding, and exiting transportation and arriving at the destination were vehicle ingress/egress (private vehicle and public transportation), concerns about wheelchair securement (public transportation and paratransit), requiring third-party assistance (private vehicle and public transportation), and accessibility to service locations (public transportation). The study suggests that to mitigate travel considerations and barriers for PWDs, vehicle-specific barriers and infrastructure issues should be addressed simultaneously. We anticipate that the findings will provide insights into the design and development of autonomous vehicles, to better accommodate the needs of PWDs.