Ageing International

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Online ISSN: 1936-606X
Print ISSN: 0163-5158
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As populations across the world age, there is a recognised need for promoting social participation in older adults. Previous studies related to social participation have addressed that interactions perceived as meaningful may improve quality of life in old age. However, what is less clear is the nature of such participation from the perspective of older adults, as the vast majority of studies have been quantitative. The present study aimed to explore what characterises social participation that contributes to a meaningful everyday life, from the viewpoint of independently living Finnish older adults. Thematic analysis was used as an interpretative method drawing on semi-structured in-depth interviews with six residents aged 82 to 97 years from one senior housing facility. The analysis showed that social participation perceived as meaningful involved caring reciprocal interactions with people they connected with; having the freedom to make autonomous decisions and influence matters that affected their own or others’ everyday life; and, on a more abstract level, feeling significant as a person. It furthermore fostered independence and companionship as well as reduced loneliness. To describe social participation that is perceived as meaningful from a theoretical perspective, we used Levasseur and colleagues’ (2010) taxonomy and found that such involvement creates a sense of connectedness, a sense of belonging and relates to the concepts of social integration, social networking and social engagement. This type of involvement is associated with enhanced quality of life and a more meaningful life, highlighting the importance of creating environments where older adults can socially connect.
Working with people living with dementia in residential facilities for older adults can be challenging, and this is exacerbated when staff have a limited understanding of dementia. However, the relationship between knowledge of dementia and strain in caring for people with dementia among residential facility staff is unclear. This cross-sectional study investigated the relationship between dementia knowledge and strain in caring for people with dementia. A questionnaire containing the Dementia Knowledge Assessment and Strain in Dementia Care Scales was administered in 2017 and 2019 to 141 staff in three southern Australian residential facilities for older adults. Bivariate and hierarchical regression analysis examined inter-scale relationships and the power of dementia strain to explain knowledge variance. It was found that staff had substantial gaps in dementia knowledge (mean score 32/50) and low strain in dementia care (mean score 4/16). A positive relationship was found between higher dementia knowledge and greater strain in dementia care (rs = 0.319, p < .001), particularly with feeling that residents are not receiving appropriate care from colleagues (Factor 1 Frustrated Empathy; rs = 0.392, p < .001). Frustrated Empathy explained a significant amount of variance in dementia knowledge beyond demographic variables. The findings suggest that more comprehensive dementia knowledge is associated with higher strain in care of people with dementia, particularly in the context of perceived lapses in the quality of care provided by colleagues. Arguably, organisational-wide dementia education to address identified gaps should be supported by facilitating staff enaction of their knowledge to improve care.
Path diagram of the effects of education on older person’s depression
Path diagram of the effects of education on older women’s depression
Path diagram of the effects of education on older men’s depression
Geriatric depression is a key public health issue, as it leads to many negative health consequences. This study examines the effects of education on depression of older adults in Vietnam, focusing on gender differences. The study utilizes the 2011 Vietnam Aging Survey. The sample consists of individuals aged 60 years and older (N = 2,789, comprising 1,683 females and 1,106 males). Path analysis is used to analyze the direct and indirect effects of education on depression of older males and females. For the indirect effects, the following three channels are investigated: family resources, economic resources, and health status. Education significantly lowers depression for both genders. Education has both direct and indirect effects on the depression of females, but only indirect effects in the case of males. While several channels through which education affects depression are similar for males and females, there are some differences which reflect gender roles in Vietnam. Policies promoting education and gender equality should be strengthened to improve old-age mental health. Specific policies for different groups of older persons are also needed, such as older persons with ADL difficulty and those living alone, as these groups are more likely to suffer from depression.
Schematic sample of congruent and incongruent conditions in the selective attention and inhibitory processing task (Ulrich et al., 2021)
Actions required according to screen appearance (congruent and incongruent). The grey shadows were not part of the screen image, they were placed on the figure for easy viewing purposes only
Aims: The purpose was to examine the relationship between dietary creatine intake obtained in food and selective attention and inhibitory control processes in older adults. Methods: Forty-five (n = 11 males; n = 34 females) participants over 60 years of age volunteered. Participants completed a 5-day dietary recall survey to estimate creatine intake and a cognitive assessment which included an adaptation of the Eriksen flanker task and a mini-mental state examination (MMSE). Cohorts for two groups were derived based on higher (HCr) versus lower (LCr) median creatine intake. To compare the groups, an unpaired Mann-Whitney U test was performed. In addition, Spearman’s correlation analysis was used to test a potential association between the daily amount of creatine with selective attention and inhibitory processing task results. Results: There were significant differences between the groups in the flanker task. In the incongruent condition, HCr responded on average about 646 ms faster than LCr (p = .005). HCr also responded about 25% more accurately than LCr in the incongruent condition (p < .001). Response time to incongruent stimuli (Spearman’s -0.424) and per cent correct (Spearman’s rho 0.565) showed moderate correlations with daily creatine intake. Conclusions: Creatine intake from food is positively associated with selective attention and inhibitory processing in older adults.
Mean subjective well-being (CASP-12) by informal regular care received and the group of countries (with 95% CI). Source: own elaboration based on 6th wave of SHARE (unweighted results)
Mean subjective well-being (CASP-12) by the perception of the quantity of informal care received and by the group of countries (with 95% CI). Source: own elaboration based on 6th wave of SHARE (unweighted results)
A person’s health status is one of the strongest determinants of well-being. The negative impact of poor health on subjective well-being may be moderated by providing care to individuals in need. In this paper, we investigate the relationships between receiving informal care and the amount of care received and subjective well-being among people aged 65 or older in selected European countries. Our analysis of data from the 6th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) showed that receiving regular informal care was associated with higher subjective well-being among older people in Northern European countries, and with lower subjective well-being among older males in Southern European countries. Moreover, we found that the perception of the amount of help received affected the subjective well-being of older people, as those who reported that the support they received was either insufficient or met their needs had lower subjective well-being than those who were not in need of care. Our results also showed that receiving formal care was negatively related with subjective well-being among older adults in Northern Europe and Central and Eastern Europe. In the context of population ageing and the growing need for care, social policies that support both sides of the caregiving relationship could enhance subjective quality of life.
Gender disparities in the mean health outcomes over cohort
Predicted health trajectories of older Chinese adults by gender during 2008–2018
Predicted health trajectories of older Chinese adults by cohort during 2008–2018
This study investigates the gender disparities and cohort differences in the health trajectories of older Chinese adults. Drawn on a nationally representative dataset from the 2008–2018 Chinese Longitudinal Healthy Longevity Survey, this paper uses a growth-curve model to identify the health trajectories of older adults in functional limitations, chronic diseases, depressive symptoms and cognitive skills. Older women are found to have slightly fewer functional limitations than older men at an earlier age; however, this gap is reversed later because of women’s higher deterioration rate in physical function. Compared to men, older women have more chronic diseases at younger ages, but this trend is changed after age 90 years due to a faster decline rate in chronic diseases for women. The gender gap in the depressive symptom trajectories narrows with age, whereas the gap in the trajectories of cognitive skills widens. The cohort differences favouring later-born cohorts decrease with age in the trajectory of functional limitations. The latest cohort born in 1940 or after has the fastest increase in chronic diseases and depressive symptoms among all the cohorts. These results are further verified using the random-effect model and pooled ordinary least squares. Policymakers should promote gender equality and reduce cohort differences to achieve the national goal of “Healthy China”.
India’s traditional kinship behavior have undergone certain fundamental changes due to recent development and functioning of Indian society. Of all, the most dominant change is in the form of co-residence of children with their parents in old age. Without familial support, falling or no income and poor health, today, older adults are the most vulnerable population sub-group in the total population. Therefore, by using the India Human Development Survey-II, 2011-12 data we study the relevant association of living arrangement on health status of the older adults. Our results indicate that older adults living alone have significant and strong association with adverse health conditions such as Cataract, Hypertension, and Heart Disease. On the backdrop of health variations of older adults, it is understood that among other socio-economic conditions, living arrangement have serious implications on the health status of the older adults. Thus, we strongly support the notion that older adults with proper family care and support are more likely to be in a better health position as compared to those deprived of it.
In this paper, we contend that urban middle-class older Indians engaged in “serious leisure” as a way to reimagine and reconfigure the structure of everyday life during the pandemic-led epochal downtime. In particular, we heuristically show that leisure activity patterns and constraint negotiation strategies among older Indians followed conceptual semblances with the dominant leisure-based typology of Serious Leisure Perspective. By thematically analysing household surveys (n = 71), time-use diaries and in-depth interviews (n = 15) of middle to upper middle-class individuals (55–80 years), we show how both men and women distinguished between serious leisure that is marked by motivation, agency and perseverance with that of unstructured, routinized free-time (or causal leisure). Time-use diaries suggested that despite the changed realities of heightened domestic time available to both genders due to the pandemic, women recorded higher proportion of their daily hours in household management and caregiving. Although women were governed by moral-cultural self-descriptions in their engagement with leisure, it was often associated with an enhanced sense of self-actualisation, self-management and identity. Overall, we show how the social codes of age and gender were inextricably linked with the practice of leisure during the pandemic.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method
Selected articles from the systematic literature review
Analysis of selected countries from previous studies
The number of developed and developing countries globally is steadily increasing due to the advanced development in various fields. Nevertheless, the development of a country can cause the nation to face an ageing population with a sizeable older adult population due to demographic changes. The changes in the overall demographics have resulted in shifting the role of providing support and care for older adults to the local community. The significant population of older adults and higher demand for older adults’ support and care have caused the shift in caring for them. Hence, this study aimed to investigate community support for senior citizens in this country through a Systematic Literature Review (SLR) of previous research papers. This study utilised the SLR method according to the publication standard of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) by reviewing various research and survey designs. The findings from 14 articles highlighted the forms of community support and the role of the community towards older adults. This literature analysis is critical and valuable for future research to understand the relationship between support for older adults and the well-being of older adults.
Despite increasing awareness of mental health problems among older adults, limited mental health services are available to meet their needs. The proposed study aimed to evaluate the need for mental health services among older adults in Shanghai, China, and identify gaps in the existing service system to inform policy making. Based on 80 face-to-face interviews amongst several groups of older adults and community officers, doctors and government stakeholders, the study found that (a) the mental health needs of older adults living with family members mainly present as needs for social interaction, sense of belonging, and self-realization; (b) special groups, such as older adults living alone, mainly desire support to address loneliness, older adults with physical disabilities desire social respect, and those with mental disabilities seek social acceptance; and (c) community cadres and other stakeholders have paid little attention to demands related to mental well-being among older people. It is necessary to deliver mental health education to community stakeholders and the public, popularize mental health knowledge, and publicize professional psychological counseling and treatment services. Meanwhile, policy makers should allocate resources to train professional mental health services personnel to meet these growing mental health needs and increase financial support for mental health services for older adults.
As in the whole world, the older population is increasing in Turkey as well. They get older, people need more healthcare. Therefore, it communicates more with health professionals. This study examines the relationship between attitudes of health professionals toward older people and personality traits of health professionals affecting these attitudes. Quantitative cross-sectional and correlational design was used in this study. Between February 2019–2020, a total of 235 health professionals working in 2 research hospitals completed a questionnaire of Kogan’s Attitudes Toward Old People Scale and The Eysenck Personality Questionnaire-Revised/Abbreviated Form. The study group was consisted of health professionals with 27.38 ± 5.6 years mean age. It was found that health professionals showed extraversion personality traits, and their attitudes towards the older people were positive (98.19 ± 14.18). It was determined that female health professionals displayed extraversion personality traits compared to men, and their attitudes towards the older people was within the edge of positive. It was found that those with 1–4 years of working duration and poor income had neuroticism personality trait, and those with poor income had negative attitudes towards older people. In general, health professionals’ attitudes and behaviors towards older people are positive. Personality traits and some socio-demographic characteristics may be effective in attitudes and behaviors towards older people. During the training of health professionals, the issues of attitude to older patient should be emphasized. The education they receive can affect their attitude towards the patient.
Children are considered as social and economic safety nets for their elderly parents in many developing countries, including Nigeria. This perception is driven by the fact that state-sponsored welfare systems are almost non-existent thereby placing parents as the sole care providers for their young children, and grown children as the sole care providers for their older parents. What this may mean for older people without children is that they are left with inadequate material support which could affect their well-being and life satisfaction. This study examines the adequacy of material support systems for childless older adults in southeast Nigeria with the aim to inform policy and social work interventions to ensure adequate support for the older adults. Twelve childless older adults aged 75 and older partook in the in-depth interview. The collected data was analyzed thematically. Except for the government support system, childless older adults receive material support from the networks of family, community, and churches. However, the support available from these networks seems to be inadequate and irregular. The study recommends for the political will by government to ensure that the newly approved national policy on ageing benefits older adults. Social workers are highly needed to ensure that other necessary programmes are established, and also strengthen the systems that support older adults.
Lake, Cottage and Tranquility
Music, Reading and Fresh Fish in Summer
Caring for Reindeer and Kota
Picking Cloudberries in the woods
Ageing among older Northern Finnish women was the subject of this qualitative study where community-based group interviews were held to learn about the experiences and views of 36 women about the activities that they thought helped them to remain active and well. Focus group discussions and self-produced drawings were used as methods to elicit ideas and experiences about what active ageing meant to those who participated. Manual thematic coding and collective analysis of the themes from group data were applied. The study participants identified outdoor pursuits and experiences in natural environments as well as group activities that they thought contributed to active ageing and well-being in older age. Nordic pole walking, berry picking, balancing time alone and gathering with others were featured in these group discussions, as were cultural aspects, such as sisu, that played a role in motivating the participants. The participants also provided some suggestions for ageing actively and maintaining well-being as women aged. The results of this study have implications for policies and services that promote active ageing and well-being of older women and for the development of culturally relevant local and national programs and activities.
PRISMA Flow Chart
Dementia is caused by neurological problems resulting in a deterioration in cognitive functions; it negatively affects all aspects of life in older adults. However, there are few research studies examining the health outcomes of people with dementia (PWD). To analyze previous research on environmental and caregiver-related factors influencing the psychological and behavioral well-being of PWD residing in community or nursing home settings. A systematic review method was used. An electronic search was conducted in June 2021 using several electronic research databases, limited to the years between 2016 and 2021, and restricted by abstract and full text, English language, and the combination of keywords. Two researchers independently selected and screened the articles based on the eligibility criteria. The articles were summarized according to aim, design, sample size, setting, instruments, and main findings. An analysis of previous research on the impact of physical and social environment and caregiver-related factors on the psychosocial and behavioral outcomes of PWD was performed. The reviewed studies indicated a significant correlation between environmental factors, mental health, quality of life (QoL), positive and negative affectivity, and agitation in PWD; those who lived in their own homes or in a similar setting had higher levels of social interactions with relatives and caregivers and higher QoL. The communication between PWD and their caregivers was also highlighted, as it helped reduce aggressiveness, anxiety, depression, and isolation among PWD. Moreover, many caregiver-related factors, including financial and social burdens, correlated negatively with their quality of care.
The association of physical frailty and psycho-social health is well established. However, it appears no study on the interaction of these conditions in determining the Health-related Quality of Life (HRQoL) has yet been attempted in India. Hence, present study aims to investigate the interaction effects of physical frailty and psychosocial health in determining the HRQoL. A cross-sectional survey was conducted on 500 community-dwelling rural older adults from West Bengal, India. The modified Fried’s Frailty instrument was assessed physical frailty status. Psycho-social characteristics investigated were depression, anxiety and stress using the 21-item DASS instrument, loneliness using the UCLA Loneliness instrument, and cognitive function using the Mini-Mental State Examination instrument. HRQoL was assessed by the 36-items Short Form health survey questionnaire. Overall prevalence of frail, pre-frail and non-frail was 26.2%, 60.2%, and 13.6%, respectively. One-way ANOVA highlighted that mean scores of psycho-social traits are significantly differed among different physical frailty status groups (p < 0.01). All the participants were clustered with their psycho-social characteristics instrument scores as clustering variables using Hierarchical Cluster Analysis to understand psycho-social health of the participants. Two-way ANCOVA showed significant interaction of physical frailty status (frail, pre-frail and non-frail) and empirically occurring clusters of psychosocial health (low, moderate and good) in determining the overall HRQoL [F(8,491) = 8.904,p < 0.01]. Thus, the study findings suggest that consideration of physical frailty and psycho-social health status will be a prudent approach for a better diagnosis of HRQoL and challenges related to the same
Motoric cognitive risk syndrome (MCR) envelops a set of cognitive and motor complaints, determined by slow gait, subjective memory complaints, without mobility disability or neurocognitive disorders (NCD’s) in older adults. The study aimed to find an association between MCR and the risk of mortality during a follow up of 5 years in older adults who attended the Peruvian Naval Medical Center “Cirujano Mayor Santiago Tavara” in Peru. 1617 older adults were selected from the database, who reached the selection criteria: the absence of NCDs, absence of mobility disability through the Barthel Index, a low gait speed indicator and subjective memory complaint through the Short Portable Mental Status Questionnaire (SPMSQ); and finally, the mortality factor which was the death of the participant in the follow-up period of 5 years. At the end of the 5 years of study, the prevalence of death was 8.7% of those with MCR, it should be noted that the prevalence of MCR was 14.7%. Also, after the analysis, the MCR, age, complete or incomplete secondary education, having two or more comorbidities and two or more harmful habits were associated with mortality in older adults. MCR and mortality are associated after a 5-year follow-up period, also considering comorbidities and harmful habits. It can be considered as a predictive factor of mortality and more attention should be paid to this syndrome, as it is a valuable tool for the health care of older adults.
The loss of family-based support services along with the preference of the older adults to age-in-place, have increased the importance of neighbourhood and community based support services for the older adults in India. This study first proposes a framework for identification of the neighbourhood-based support services, which are perceived by the older adults to contribute to their overall QoL, by understanding the concerns and perception of overall QoL of older adults living in Kolkata, India. The quality and type of available services also vary considerably based on the different classes of cities in India. This study, through analysis of data collected from structured interviews with older adults living in Kolkata and Midnapore in India, also proposes a framework that can help in exploring if living in different classes of cities impacts upon on the prioritisation of the support services by the older adults. In the process of identification of the support services, the initial list was first identified from literature and interviews with caregivers and beneficiaries of non-governmental organizations providing older adults care services, and the final list of support services were selected on the basis of researchers’ judgement. The importance or prioritisation of support services was determined using RIDIT analysis. Considering the limitations of funds for social support services in a developing country like India, the proposed framework of identification and prioritisation can be utilised by future policy makers for formulation of policies and programs catering to essential support services, based on the class of city and the socioeconomic and cultural background of the city residents.
Flow Chart of Sample Selection
Conceptual Framework
Categories Comprises Food Insecurity among Older Adults in India, 2017–18
State-Wise Prevalence of Food Insecurity among Older Adults in India, 2017–18
Food security is an important agenda in MDG goals for people of all age groups irrespective of socio-economic strata in all developing and developed countries. For India, with increasing hunger index, provision of food security among older adults comes out to be a rising concern and matter of discussion under hunger eradication programmes and policies. The study concentrated on prevalence of food insecurity among population aged 60 and above in India and their associated health factors controlling the level of food insecurity. The data used for the research is taken from a nationally representative survey, Longitudinal Ageing Study in India (LASI), Wave I (2019–2020) with a sample of 31,464 people aged 60 and above all over India. The outcome variable of food insecurity is made with composite scores from 5 sets of questions and made a binary variable of whether the respondent is food secure or insecure. Descriptive and bivariate analysis are performed to understand the correlation between the food insecurity and associated explanatory variables, with special focus on various types of functional impairments and chronic diseases. Through binary logistic regression models, the likelihood of food insecurity under different vulnerable conditions are analysed. The result describes 10.6% of older population aged 60 years and above of India experience food insecurity especially in rural areas (12.6%). Older adults living alone, in rural areas, with poor household income, with multimorbidity and functional impairments are more susceptible to be food insecure in India. With increasing number of functional limitations, the likelihood of being food insecure increases around 1.6 times. While presence of multimorbidity increases food insecurity; individual diseases like diabetes and hypertension negatively affects food insecurity among older adults.
Percentage distribution of older adults by their role in household decision making
Percentage distribution of older adults by the change in the role of household decision making
Indian population is ageing at a higher pace coupled with the increase in life expectancy, and the prevalence of cognitive impairment, dementia, and comorbidities increase dramatically with age. Such cognitive and physical changes are intimately linked with declines in everyday functioning that include loss of decision-making skills. The present study explored the relationship between socioeconomic and health status of older adults and their role in household decision making. The study used data from the “Building a Knowledge Base of Population Ageing in India” (BKPAI) survey conducted in 2011 (n = 9181). Descriptive statistics along with multivariate negative binomial and binary logistic regression analyses were conducted. A proportion of 29.7% of older adults had no or partial involvement in household decision making and 26.5% of older adults reported that they had witnessed a decline in their role as decision-maker. The involvement of older adults in household decision making was 1.51 times lower among those who did not contribute money in household expenditure (incidence rate tatio (IRR):1.51; 95% confidence interval (CI): 1.24, 1.84) than those who contributed. Respondents who had low cognitive ability (IRR: 1.22; 95% CI: 1.09, 1.37) or had more than one disability (IRR: 1.27; 95%CI: 1.09, 1.47) were significantly 1.22 and 1.27 times less likely to have involvement in household decision making, respecctively. Older adults who reported low self-rated health (adjusted odds rati (aOR): 1.4; 95% CI: 1.21, 1.61), low general health (aOR: 2.85; 95% CI: 2.46, 3.31), low subjective wellbeing (aOR: 2.29; 95% CI: 1.99, 2.64) and low IADL (aOR: 1.49; 95% CI: 1.31, 1.69) were significantly more likely to report a decline in the role as a decision maker compared to their healthy counterparts. Along with the poor socioeconomic characteristics, the negative effects of cognitive and health markers of ageing further diminish the role of older adults in household decision making. Further research in the field of familial role and importance of older adults in different family settings is required in tackling a wide range of issues related to the wellbeing of the aged population.
Social network mapping example. All the names in red ink represent new addition to participants’ social network after joining Oasis. The contacts that provided participants with the most support during physical distancing are underlined
Naturally occurring retirement communities (NORCs) are unplanned communities with a high proportion of residents aged 65 years and older. Oasis is a Canadian aging in place model that combines health and supportive community services for adults aged 65 years and older within NORCs. The aims of this study were to explore how physical distancing restrictions during the COVID-19 pandemic impacted older adults living in a NORC (Oasis members) and to investigate whether Oasis served as a context for social connection and well-being during the COVID-19 pandemic. An interpretive description methodology guided this study. Semi-structured interviews were conducted with nine Oasis members (aged 66–77 years) and two Oasis site coordinators. The Oasis members also completed a social network mapping activity guided by the hierarchical mapping technique. Three overarching themes related to the impact of physical distancing on Oasis members during the COVID-19 pandemic were identified: (1) unintended consequences of physical distancing restrictions on participants’ wellbeing; (2) face-to-face interactions are important for social connection; and (3) family, friend, healthcare provider, and community support mitigated the impact of physical distancing restrictions during the COVID-19 pandemic. In addition, two of Oasis’ core pillars were found to support participants: strengthening social connectivity and connection to pre-existing community services. Findings illustrate that community programs like Oasis acted as a source of resilience during the COVID-19 pandemic and advance our understanding of the impact of aging in place models on community dwelling older adults’ experience of the COVID-19 pandemic.
Scatter plot showing the correlation between the total scores on the English and the Igbo versions of the Short Falls Efficacy Scale-International
Scatter plot showing the correlation between the total scores on the Igbo version of the Modified Falls Efficacy Scale and the Short Falls Efficacy Scale-International
Bland–Altman plot of the scores on the Igbo and English versions of the Short Falls Efficacy Scale-International
Scree plot of items on the Igbo version of the Falls Efficacy Scale-International
To cross-culturally adapt and validate the original English version of the Short Falls Efficacy Scale-International (SFES-I) to the Igbo culture and environment. The study was a cross-cultural adaptation and validation study that employed the guidelines for cross-cultural adaptation by the American Academy of Orthopedic Surgeons. The SFES-I was translated, adapted and validated. The English (E-SFES-I) and Igbo (I-SFES-I) versions of the SFES-I, and the Modified Falls Efficacy Scale were administered to purposively recruited 109 consenting older adult residents (53.2% females; mean age = 73.75 ± 7.63 years) of Nnewi community, South-east Nigeria. Descriptive statistics and graphs were used to summarize participants’ socio-demographic and questionnaire data. Mann Whitney-U test, Spearman rank order test, principal component analysis and Cronbach’s alpha were used to analyze data at alpha level of 0.05. All the seven items on the E-SFES-I were retained on the I-SFES-I. There was no significant difference between the scores on the E-SFES-I and the I-SFES-I (p > 0.05). The I-SFES-I showed evidence of excellent known-group validity (ρ = 0.96–1.00) in all the item and total scores. The I-SFES-I also demonstrated excellent convergent validity (rho = 0.93) and internal consistency (α = 0.96). The I-SFES-I is a valid and reliable fear of falling tool, and can be used as an outcome measure for Igbo-speaking older adults.
CONSORT flow chart. This figure shows the flow of patients through the trial according to the criteria recommended in the CONSORT Guidelines.
Research Application Plan
Construction of the Nursing Interventions according to Watson’s Caring Model
This study aims to identify the effect of reflexology based on Watson’s Caring Model on lombalgia and quality of life in older adults. This study was conducted as a randomized-controlled study. The target population included 194 older patients who received outpatient physical therapy and rehabilitation service in a city located in the eastern part of Turkey between February 2020 and October 2020. The sample of the study was 68 patients who agreed to participate in the study and met the research criteria. Data were collected through the Socio-Demographic Form, the Visual Analogue Scale, the Geriatric Pain Measure, and the World Health Organization Quality of Life Instrument-Older Adults Module. The pre-test and post-test mean scores of the experimental group indicated a statistically significant decrease in the pain levels and a statistically significant increase in the quality-of-life mean scores (p < 0.01). A negative and statistically significant relationship was detected between the quality-of-life total mean score and the Geriatric Pain Measure mean score and the Visual Analogue Scale mean score (p < 0.01). No significant differences were detected between the experimental and control groups’ Visual Analogue Scale, Quality of Life and Geriatric Pain Measure post-test mean scores. Reflexology based on Watson’s Caring Model was found to have positive effects on lombalgia and quality of life in older adults.
The effect of Different GDP/c on the Predicted Retirement Age across Countries*
The decision about the timing of retirement and actual retirement age is based on financial factors as well as personal characteristics and country-level macro indicators. The goal of this research is to examine the associations between the mentioned factors and actual retirement age while focusing on similarities and differences between European countries. The data came from 34,478 respondents in 20 countries who participated in waves 2, 4 and 5 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using Ordinary least squares regression models, we explored associations between actual retirement age and personal as well as the country-level variables. Results reveal that higher Gross Domestic Product (GDP), higher pension spending, being a male, and being self-employed were found to be associated with higher actual retirement age, while being a female, civil servant, having fair or poor health, and secondary education were found to be associated with lower actual retirement age. The effect of net household wealth and GDP were not consistent across countries. The contribution of our study is the ability to make predictions about actual retirement age based on each country’ GDP per capita, thus adding the country variables to the individual characteristics and improving our understanding concerning actual retirement age. The different effects of wealth and GDP across countries suggest that policymakers should take into account the specific effect in their country to better assess the implications of different policy measures on the actual retirement age.
Concentration curve for lower subjective well-being among older adults in India
Mean and odds ratio for lower subjective well-being by background characteristics among older adults in India
According to census 2011, India had nearly 104 millions of 60 years and above population. The share is projected to increase from 8 per cent in 2015 to 29 per cent in 2050, which is a matter of concern as rapid population ageing is accompanied by serious social and economic implications which are often linked with different health outcomes in general and lower subjective well-being (SWB) in particular. This paper aims to focus on how socio-economic inequality affects lower SWB among older adults. Bivariate, binary logistic regression and decomposition analysis were used for carving out the results using data from the Building a Knowledge Base on Population Ageing in India (BKPAI). The effective sample size for the analysis was 9181 older adults. The value of the concentration index for lower SWB was -0.28 in India, depicting that lower SWB was concentrated among older adults with poor socio-economic status. Educational status (22%), living arrangement (13%), trust over someone (13%), self-rated health (6%), instrumental activities of daily living (6%) and cognitive ability (5%) explained significant portion of socio-economic inequality for lower SWB among older adults. Our research highlights the urgent need for more empirical exposure to socio-economic inequality and its dynamic impact on lower SWB among older adults. Moreover, the present study recommends strengthening the current government programme to focus especially on older adults from lower socio-economic status.
Senior women's access to medical care in rural Bangladesh is a major public health concern. This study aims to explore the system determinants that impact on rural senior women's utilization of healthcare. Following a qualitative critical social research design, healthcare staff and senior women living in three rural villages of Bangladesh were approached to participate in face-to-face audio-recorded interviews. A total of 11 staff and 25 senior women were interviewed with questions about health policy, healthcare services and management of aged care. Data was analyzed using a blend of critical discourse and thematic analysis methods. Several healthcare system determinants were identified that were complex and cross-sectional. Three major themes emerged from the system determinants: legal framework of aged care; inadequate healthcare support; and professional knowledge and skills of healthcare staff that led the rural senior women to avoid or delay access to hospitals and clinics. The findings revealed that a lack of health focus and professional skills among healthcare staff can be considered as critical. This study recommends that policy and organizational changes are made to improve the women's access to rural hospitals and clinics in Bangladesh.
Sub-items of the DBD score in the MCI group. In this figure, 0 points is completely absent, 1 point is almost absent, and 2, 3, and 4 indicate a symptom.
Sub-items of the DBD score in the AD group. In this figure, 0 point is completely absent, 1 point is almost absent, and 2, 3, and 4 indicate a symptom.
In Alzheimer's disease (AD), attention and executive dysfunction occur early in the disease. However, little is known about the relationship between these disorders and behavioral and psychological symptoms of dementia (BPSD). This study investigated the relationship between BPSD and attention and execution functions. Twenty-five patients with mild cognitive impairment (MCI) and early AD were included. Neuropsychological tests, mini-mental state examination (MMSE), Raven’s colored progressive materials (RCPM), and trail making test (TMT) were conducted for patients with dementia. The dementia behavior disturbance scale (DBD) was used for psychological and behavioral evaluations of patients with dementia. The AD group showed significantly lower MMSE, DBD, and TMT-B scores than the MCI group. Multiple regression analyses revealed a significant correlation between DBD score, MMSE, and TMT-B.Conclusion: BPSD is associated with cognitive function severity in patients with MCI and early AD, suggesting that attentional and executive functions are independent risk factors for these neural substrates.
The present study aimed to investigate the effect of social determinants and socio-demographic factors on driving among older adults living in Tehran, Iran. This cross-sectional study was conducted on 1280 older adults in Tehran in 2020. The participants were randomly selected from people aged 60 years and above. Data were collected using a questionnaire. Multiple logistic regression was employed to estimate the effects of socio-demographic characteristics on driving status among older persons. Data analysis was performed by SPSS 23.0. The driving among older adults was found to be 33.3% while it was 70.6% among the older adults with a driver's license. There was a significant relationship between internet use, gender, health status, education level, loneliness and driving status (p < 0.05). The results also revealed that male participants (OR = 19.51, 95% CI: 13.10–29.06), those with good (AOR = 6.06, p < 0.001) or fair (AOR = 2.34, p < 0.051) health status, those with diploma degree (AOR = 2.46, p < 0.021), high education (AOR = 2.14, p < 0.033), internet users (AOR = 2.44, p < 0.001), and being married (AOR = 2.28, p < 0.001) were more likely to report driving. According to the results, driving was found to be low among older adults and gender gaps regarding car use are much wider in this group. On the other hand, there is a significant association between driving with well-being, loneliness, and internet use by older persons. Therefore, it is suggested that policies be designed and implemented to motivate them to drive.
Leisure serves an important role in the lives of most people, especially in later life. Leisure activities assist elderly individuals not only in enhancing their physical health, mental health and social support but also in rebuilding their self-confidence and self-respect. The purpose of this study is to explore the leisure activity demand of older adults. Semistructured interviews were conducted with 15 participants, and answers to the following questions were sought: Why do older adults participate or not participate in leisure activities? The findings suggest that planners should adapt to the comprehensive and diverse needs of older adults by providing flexible programs, help them to regain confidence, consider the possibility of activities to send home, and increase the types and locations of older adult leisure activities. These findings have implications for leisure activities in future planning and development.
This study explored the associations between the perceived walkability of neighborhood environment, walking time, and functional mobility by community-dwelling older adults in Hong Kong SAR, China. Seventy community-dwelling older adults (Mean age = 78.00 ± 7.40 years) participated in this study. Their perceived walkability of neighborhood environment was evaluated by the Chinese abbreviated version of Neighborhood Environment Walkability Survey (NEWS-A) and their walking time within a week was self-reported. The 10-Meter Walk Test and Tinetti Performance-Oriented Mobility Assessment (POMA) were used to assess the functional mobility of the participants, regarding their gait speed, balance, and gait performance, respectively. Results suggest that the perceived walkability of neighborhood environment (Aesthetics subscale) positively associated with the gait speed (rs = .35, p = .003), scores of the POMA-Balance (rs = .389, p = .001) and POMA-Gait (rs = .343, p = .004). This exploratory analysis augmented our contemporary understanding that older adults who could walk faster and with better balance and gait performance are associated with more positive perceived walkability of their neighborhood environment. It provides useful insight that could inform future high-impact investigations.
Primary objective of the study was to assess health-related quality of life and associated factors (gender, age, education, income, marital status and expenses) that affect quality of life among senior citizens in Islamabad, Pakistan. A community-based cross-sectional study was designed to assess the health-related quality of life among senior citizens in the territory of Islamabad, Pakistan. Convenient sampling technique was used to collect the data from 385 participants. A pre-validated tool SF-36 was used to collect the data. Data was clean coded and analyzed by SPSS. The overall health-related quality of life score (55.79) was poor. Females had less quality-of-life score (50.84) as compared to males (59.74). Uneducated had a poor score (46.54) than educated (64.70). Age group (60-70 years) had a good quality of life score (60.07) as compared to the elder age groups (47.16). Married participants had a better quality of life score (57.67) than unmarried, divorced and widowed participants (53.58, 46.85, and 47.39 respectively). Participants with low monthly income showed low quality of life score (46.99) which was increased to (63.95) with an increment in monthly income. Participants who were financially independent had a better health-related quality of life score (59.44) as compared to those who were dependent on family (53.05) or government annuity (41.16). These findings suggested the requirement for effective health promotion strategies to improve overall health status among the elderly. The health systems needed to be aligned to meet the needs of older people. Retirement age should be extended to 65 year of age.
The Active Aging Index (AAI) is a tool for detecting and tracking active aging in the older population. The proportion of the aging population is growing very fast, from 6.4% in 2020 to around 20.0% in 2041, in Bangladesh. But the country does not have a calculated AAI to know its active aging situation or to make a global comparison. Objective: The objective of the study was to calculate and compare AAI for Bangladesh with a European AAI approach. Method: Secondary analysis was conducted based on the data from Bangladesh Bureau of Statistics (BBS), General Economic Division, Ministry of Planning, Department of Population Sciences, and the United Nations (UN) study to calculate the individual indicators of the four domains of AAI. Results: For Bangladesh, 15 out of 22 indicators of AAI were available from the analysis. The result of the study shows that the AAI value for Bangladesh is 30.1. Among the four domains of the AAI, the ‘capacity and enabling environment’ domain scored the best (59.9) and the participation domain scored the second highest (40.3). The score of the ‘independent, healthy and secure living’ domain was poor (28.2) and the score in the employment domain was very poor (3.3). Conclusion: Policy-makers should pay special attention immediately to improve each of the individual indicators of AAI for better active aging of the seniors. At the same time, policy-makers should focus on the immediate initiative for the generation of data for the missing 7 indicators for AAI. The study findings would be a basic reference case for Bangladesh to know the situation of active aging and what to do for the betterment of the upcoming huge number of seniors of the country and also possible to compare with other countries.
Ghana’s economy is predominantly informal with about 80% of workers in small enterprises run and managed by family members with no fixed retirement procedures. Although, retirement is basically an individual decision, it has social policy implications for the nation as a whole. The purpose of this study is to provide empirical evidence on what is likely to inform the decision to retire for the over 50s in Ghana’s informal economy. This is to ensure the development of effective policies for the ageing informal work force. Using an exploratory sequential method, to examine the understanding and preferred type of retirement, family business owners aged 50 years and above participated in a study, (n = 35 qualitative; n = 383 quantitative), conducted in Kumasi, Ghana’s second largest city. Findings, revealed that retirement for business owners, largely meant a gradual withdrawal from economic activities. Also, gender, family and work-related factors significantly predicted retirement decision-making of family business owners. Recommendations included tailored retirement planning education by both Social Workers and insurance providers, and a more flexible phased pension plan for those in the informal economy to ensure the wellbeing of aging self-employed who have poor health and are financially insecure.
The outdoor environment offers an important platform for engaging older adults from a variety of social, cultural and ethnic orientations for the purpose of improving or maintaining their physical and mental health as well as facilitating their social and cultural connections. Using a multidisciplinary lens, this study looks at the requirements and potential of a more inclusive landscape design that acknowledges different modes of health, recovery and rehabilitation, drawing from both the past and the future and providing suggestions on how more efficient and culturally appropriate ways of maintaining health and social connectivity can be achieved in later life.
Older women are more likely to live alone in later life in the UK; however, relatively little is known as to how this has an association with poorer health. This paper attempts to fill this research gap, assessing if living alone is a risk factor for poorer health in later life. The Household Panel Survey data, wave 8 were used which was collected during 2017 in the United Kingdom. Women’s household types were divided into three types: living alone, living with a partner and living with others (not a partner). Seven health and wellbeing outcome variables were used. Descriptive analysis and regression analyses examined the role of living alone in predicting health and wellbeing, controlling for demographic and socioeconomic (SES) factors. Results showed significant differences between the household types. However, living alone was not found to be a risk factor for poorer health once SES variables were included in the regression models. While there were differences in the health and wellbeing of the three household composition types, these differences were not found to be significant once demographic and socioeconomic variables were accounted for. Future UK policy should aim to reduce inequalities in SES throughout the life course to improve health and wellbeing in later life. Future research directions include a more detailed examination of the determinants of health of this population.
Prevalence of high quality of life (HQOL) among older adults in six selected countries during 2007–10.
Source: Author’s own calculation
Association of disability and high quality of life among 50 + population in six selected countries-2007–10.
Source: Author’s own calculation
It has been found that people with disabilities remain at the margin as far as the different aspects of their lives are concerned. This paper tests the hypothesis that disability leads to lower quality of life among older adults in low and middle-income countries. The data from the Study on Global Ageing and Adult Health (SAGE) was used in this study which was conducted in Ghana, China, India, Russia, South Africa and Mexico. The disability scores have been made utilising Item Response Theory, Partial Credit Model and are centered on eight functioning and health areas. Bivariate analysis, binary logistic regression and pooled regression analysis have been used to fulfil the objectives of the paper. The findings reveal that disability acts as a hindrance in attaining a high quality of life (HQOL) amongst the older adults in the above mentioned low and middle-income countries. The older adults with disability are as much as 60% less likely to enjoy an HQOL with respect to the older adults without disability. Better socio-economic development like improved health care for disabled older adults with disability enhanced living standards for both abled and disabled, efficient pension schemes for older adults with disability and effective social service schemes would be very much essential to improve overall QOL among older adults.
This study determined the mental health condition and psychological well-being of older people in the Province of Iloilo, Philippines. A total of two-hundred sixty four older people served as respondents of the study, which constituted 20% of the 1,308 total populations of older people in 8 identified areas. They were classified as young-old (60–70), middle-old (71–80), and old-old (81 and above). Mental health is state of mind functioning at a satisfactory level of emotional and behavioral adjustment characterized by the absence of mental health problems. While, psychological well-being has been examined as an indicator of successful adaptation in life as having the capacity for self-determination, positive evaluation of oneself and one’s life, and effectively manage one’s life and the surrounding environment. The results show that older people have good mental condition and were rated fair in psychological well-being and is significantly correlated to psychological well-being (Gamma = 0.267, p = 0.030). A good mental health implies that the older people have the ability to make good life choices, maintain physical health and well-being, and having healthy relationships. Thus, the mental health of the older people is fundamental to good health, better well-being, and improved quality of life. Recommendations include improving mental health promotion strategies, increasing physical activity and educational opportunities, enhancing social policy initiatives, particularly for older women, fostering collaboration between different sectors through active partnerships and exchange networks, and improving access to and quality mental health services for older people.
Flow chart of article selection
Elevated susceptibility of older people at concurrently growing, convergent, and intersecting impacts of Climate Change, Urbanisation, and Population Ageing
The present century faces developmental fallout as vulnerability and risk mount on the global systems due to climate change, urbanisation, and population ageing. Moreover, population ageing is gaining a stronger hold in urban areas, and so are climate change and related shocks and stresses. Consequently, repercussions for the weakest sections of society – including the elderly – remain under academic consideration. In this context, the paper aims to understand the perilous predicament of older people due to the occurrence and interaction between climate change, urbanisation, and population ageing. This review investigates the underpinnings of the nature of the interaction among the three phenomena; and discerns how as a result of the interaction, various climate change related shocks and stresses affect older people in urban settings. It emerges that these three phenomena exhibit: concurrence; a positive trend of growth; and a cyclic pattern of interaction with four linkages, implying (i) rapid urbanisation is fuelling climate change, (ii) climate change is impacting urban areas, (iii) older people are increasing in urban areas, and (iv) urbanisation provides opportunities and barriers for older people. This interplay further discloses that older people stand vulnerable and at heightened risk from climate change related stressors in urban areas. These understandings highlight the need to ensure that urban environments remain age-friendly even in the face of climate change.
Cognitive ageing continues to be a significant burden for society and a primary contributor to individuals’ diminishing independence and quality of life. Therefore, improving our understanding of life-course influences on cognitive function is a necessity for public health. Parenthood and marriage are two such influences that may affect cognition in old age. Using the Health and Retirement Study, the relationship between family histories and cognitive functioning in adults in the ‘older’ age group in the United States is investigated through a sequence-analysis approach. The results show that most of the relationship between fertility and partnership history and cognition later in life is explained by childhood health and socioeconomic conditions, and current sociodemographic characteristics. However, those individuals who have never been married, and in particular those who have never been married and have had no children, report a significantly lower level of cognitive functioning in older age, especially women.
Diagram of selection and pairing of frail elderly participants
Sociodemographic, clinical, and pharmacoepidemiological characteristics
Method This is a case-control study paired by sex and age, with the cases defined as frail older persons with self-reported falls in the last year and controls as frail older persons with no fall report. Odds ratio (OR) was analyzed by means of conditional logistic regression, with a 95% confidence interval. Main outcome measure: The occurrence of falls in frail older persons is associated with the following clinical and pharmacoepidemiological factors: urinary incontinence and polypharmacy. Results The sample consisted of 1028 older persons, 514 in the case group and 514 in the control group. The prevalence of falls was 26.5%. The frequency of polypharmacy, use of drugs inappropriate according to Beers’ criteria and drugs that increase the risk of falls were 58%, 85% and 87%. The frequency of drugs with anticholinergic properties ranged from 12 to 65% according to the type of scale used. It was observed that the fall is associated with urinary incontinence (OR 1.73, 95% CI 1.28–2.34) and use of five or more medications (OR 1.68, 95% CI, 1.30–2.17). Conclusions With this research, is possible to conclude that falling in the frail older persons is associated with the use of five or more drugs and the presence of urinary incontinence.
Consort process flow chart of research project implementation stages
The effect of care burden and its subscales on social support of the older adults based on the results of path analysis
Improved health facilities have increased life expectancy and longevity; the older adults population has thus been on the rise globally; and most families have taken responsibility for caring for the older adults. The aim of this study was to determine the effect of caregivers' educational program, reducing their care burden and perceived social support of the older adults in Jahrom, Iran. This is a quasi-experimental study utilizing an educational intervention implemented in 2018. The pivotal intervention was the education program for older adult’s caregivers in the field of caregiver training. The training methods included face-to-face training, pamphlet distribution and use media. Training lasted three weeks. The sample (152 caregivers and 152 older adults) were selected by snowball sampling and randomly divided into the intervention and control groups. Data collection tools included demographic information questionnaire, care burden, perceived social support scale and activities of daily living scale. Data were analyzed using Stata14 software and multiple linear regression considering perceived social support as a dependent variable based on the SEM model of path analysis. Before the educational intervention, no significant difference was observed between care burden and perceived social support in the experimental and control group (p > 0.05). However, after the intervention, the care burden score ranged from 73.72 ± 26.94 to 39.07 ± 23.049 decreased (p = 0.001) and the perceived social support score of the older adults increased from 44.45 ± 7.81 to 54.97 ± 4.09 (p = 0.001). The result show that subscales of care load include evolutionary with a coefficient of 0.87 (p = 0.015), physical 0.86(p < 0.001), social 0.84 (p < 0.001), emotional 0.87 (p < 0.001), time-dependent 0.19 (p = 0.035) and overall care burdens with a coefficient of 0.91(p < 0.001) had an effect on perceived social support. Measures of model fit (χ2 = 17.20, RMSEA = 0.087, GFI = 0.81, AGFI = 0.86), indicated that the model had an acceptable goodness of fit.Educational intervention for caregivers reduces care burden and increases the perceived social support of the older adults. Therefore, caregivers can care for the older adults with a better feeling and as a result the older adults feel more valuable and have a higher self-esteem.
“Between surprised being happy and disappointed not being happy”
Research indicates that happiness increases with age, however, the common layperson perception is that happiness decreases with age. Late-life repartnering is a phenomenon developing with the increase in life expectancy, entered to enjoy life. It is not officially recognized as an option in Israel, culturally located between tradition and modernity. Within this social context, the aim is to explore the experience of happiness in late life repartnering relationships from a dyadic partner perspective and understand its meaning within the cultural society it is developing in. Data was drawn from a larger phenomenology study conducted on the meaning of late life repartnering from a dyadic view. 38 semi-structured qualitative interviews (19 couples) were conducted with functionally independent repartners, aged 66-92 who entered their relationship after a lifelong marriage. Happiness was an issue addressed by participants. It was not part of the interview guide thus results represent secondary analysis of interviews with participants who addressed happiness. Results illustrate a range of happiness experiences from a dyadic view related to expectations experienced on a continuum between surprised being happy and disappointed not being happy including six subthemes. Results are discussed relating to expectations and disappointment theory, and to how happiness is valued linked to culture. Implicit ageism is suggested for understanding why happiness is experienced as unexpected in late life repartnering, although entered to enjoy life. Implications are addressed.
This research was carried out with the objective of comparing the states of holistic health of older adults residing in different communities, as well as different types of older people. The research sample consisted of older adults residing in middle part of Thailand, with 928 people who were 60 years of age and higher. Data were collected through a questionnaire containing 25 items comprising three dimensions; namely: the physical (10 items), the mental/emotional (5 items), and the social/environmental (10 items). Data analysis was carried out with one-way MANOVA for the comparison of the different dimensions of holistic health status between types of communities (urban and rural) and between types of older adults (homebound and socially bound). From the results of the research, it was found that: 1) the social and environmental holistic health of the older adults between communities differed with a statistical-significance level of 0.05 (F = 51.39, df = 1, p < 0.001); and 2) the mental and emotional aspects of each type of older adults did not differ with a statistical-significance level of 0.05 (F = 0.003, df = 1, p = 0.955). Accordingly, it may be stated that the social and environmental holistic health promotion of the older adults should be considered according to their communities of residence, while promotion in the physical, mental, and emotional aspects should be considered according to the different types of older adults.
We examined whether an internet use promotion intervention influences low-income older adults’ communication modes, internet use, and social networks using existing data collected for an intervention. Participants living in public senior housing facilities in the United States (n = 77) completed surveys before and after a 12-week computer and internet training. The six-item Lubben Social Network Scale (LSNS-6) was used to measure the extent of older adults’ social networks. The primary mode of communication shifted from more traditional means to internet-based communications (p < .0005 in a Fisher’s exact test). The frequency of internet use significantly increased (p < .00005 in a one-sided Sign test). Overall, the LSNS-6 score increased by 4.1 points (p < .00005 in a Welch’s t-test). The LSNS-6 score increase was significantly larger among African Americans than Whites, controlling for gender (p < .05 in negative binomial regression). Moderate (p < .005) and frequent internet users (p < .05) had higher LSNS-6 scores than rare internet users at posttest when gender and race were controlled for in linear regression. Comparatively more improvement in the extent of social networks among African Americans suggests greater benefits of such interventions for population groups of disadvantaged backgrounds. Larger social networks among moderate and frequent internet users than rare users suggest positive impacts of internet communications on social networks.
Falls and fear of falling (FOF) are very pervasive and debilitating problems among older adults globally. Their occurrence, expression and risk factors vary considerably across environments, cultures, races and socio-demographics. Therefore, there is need for availability of culturally- and environmentally-specific interventions to tackle them. However, there is hardly any fall and FOF intervention that is tailor-made to suit older adults in middle/low-income countries. To develop educational intervention guideline for addressing falls and FOF in an African context. This was a qualitative study involving older adults (≥ 65 years) with significant FOF (as measured on the Short Falls Efficacy Scale International) and their caregivers purposively recruited from conveniently selected semi-urban community and assisted-living facility in South-east Nigeria. Data were analyzed using General Inductive Approach. Using the results as a guide, local content and information from literature were used to develop an environment-specific intervention protocol for addressing FOF and falls. The drafted intervention guideline was then pilot-tested on ten older adults using adaptive design. Risks of falls and FOF were elevated among sampled older adults by unhealthy environments, habits and behaviours/dispositions, poverty, nonchalance and misconceptions probably due to ignorance. The guideline was well-accepted by the older adults. An environment- and cultural-specific intervention protocol for addressing FOF and falls among older adults in a low/middle-income country has been made available. The protocol was well-accepted by the older adults and should be used by clinicians and public health experts to tackle falls and FOF in this group.
PRISMA flowchart
Distribution of Ecuadorian older adults-related publications from 2008 to 2018
Older adults historically have been excluded from biomedical research, especially in low-and middle-income countries (LMICs). This study aims to assess the scientific production of older adults-related publications (OARPs) in Ecuador and uncover research gaps to inform health and aging policy. A Scopus search was performed to retrieve OARPs published from 2008 to 2018. Bibliometric indicators studied included the number of publications per year, study design, research focus, and research lines. A total of 121 OARPs were retrieved. Sixty-four articles (~ 53%) were excluded. Overall, the most common study designs were cross-sectional and case–control studies, 84.2% (n = 48) and 8.8% (n = 5), respectively. The primary research focus was in the clinical-surgical area (~ 51%), and the most prevalent research lines were in the epidemiology of older-related diseases (35%) and causes of older-related diseases (26.3%). Across the analyzed period, we were not able to find studies related with aging policy, and we found only one OARP dedicated to diagnosis/treatment and provision of geriatric services, respectively. Ecuadorian OARPs were scarce during the last decade, providing limited evidence to address health priorities of the local older population and to inform health policy making. Improving research on the older population would provide valuable inputs to key stakeholders to perform evidence-based policy development that ultimately will improve quality of life and long-term health outcomes in Ecuador and other LMICs.
Structure of categories and subcategories identified in coding process. Source: Authors’ own compilation
Structure of concepts expressing seniors’ message treated as central component of their intergenerational message. Source: Authors’ own compilation
The goal of the paper is to identify the message in letters written by Polish and Czech seniors. The letters were subject to qualitative analysis. The method used was the analysis of the inspired texts—letters written by older people to the younger generation, which may become a didactic tool for the younger generations to learn from the biographies of seniors. The result of the analysis is a list of categories reflecting the main aspects dominating in the letters. These categories are: message addressed to a younger generation, important events and people in individual life story, reflection upon the meaning of life and concerns and challenges in the course of life. All the seniors express their affirmation of family, share ethical reflections on their relationships with other people and on passing. Thus, the main message of the letters is a call to cherish family relationships, nurture relations with other people and show respect to others.
Significant correlation between the age and the low intensity physical activity (A), moderate intensity physical activity (B), MVPA (C) and number of steps per day (D)
The aim of the study was to examine changes in objective and self-reported physical activity (PA) among women aged 60 years and older. The study included 200 women aged over 60 years, divided into three groups according to age (60-65 years, 66-70 years, > 70 years). The subjective assessment was provided with the International Physical Activity Questionnaire (IPAQ)-short version with self-reported PA assessment, and objective data was provided by an Actigraph GT3-BT worn for seven days. Significant differences in moderate and high intensity PA, moderate-to-vigorous PA and steps per day were found between the oldest and youngest groups; as well as in low, moderate, moderate-to-vigorous PA and steps per day between groups middle and oldest. In all three age groups, 1) significant differences were observed between subjective and objective measurements of physical activity and 2) no correlation was found between assessment measures. It was found that only direct PA measurement declined with age in women over 60 years old, and that sedentary behavior is underestimated, and moderate and vigorous PA overestimated, with the self-reported IPAQ.
Background India is undergoing a huge demographic and epidemiological change, resulting in an increase in population ageing. With this, the number of people with coexistence of multiple chronic diseases is also set to rise. The present study aims to identify gender differential in the most prevalent combinations of chronic conditions among the elderly living with multimorbidity in India. This study also examines the factors affecting multimorbidity status among the Indian elderly. This study used the data from Building a Knowledge Base on Population Ageing in India (BKPAI), conducted in 2011. The presence or not of multimorbidity was considered as the outcome variable. The bivariate and logistic regression analysis was done to access the pattern and predictors of multimorbidity among the elderly. The relative risk of having different chronic conditions were calculated among the population with multimorbidity. The prevalence of most prevalent disease combinations among the overall population and multimorbidity group was also calculated. The overall prevalence of multimorbidity among the elderly was 32.96% and higher among women (34.69%). The most prevalent diseases among respondents with multimor-bidity conditions were arthritis or rheumatism (54.75%), hypertension (45.79%), loss of all-natural teeth (32.94%), cataract (31.34%), diabetes (23.01%) and asthma (21.06%). The prevalence of arthritis or rheumatism, diabetes and hypertension were higher among women in the multimorbidity group than men of the same group. The relative risks for conditions like dementia, loss of all-natural teeth, depression, cerebral embolism, stroke or thrombosis and osteoporosis are higher in the multimorbidity group. Hence these conditions have a higher possibility to co-exist with other chronic conditions. The most prevalent combination of diseases in the multimorbidity group was arthritis, rheumatism or osteoarthritis, hyperten-sion, and cataract (4.68%). The prevalence of this combination is higher among women than men (women: 5.79%, men: 3.30%). Age, gender, religion, wealth quintile, current working status, smoking, alcohol were significant determinants of multimorbidity among the elderly. Multimorbidity is an emerging issue and highly Extended author information available on the last page of the article Ageing International 1 3 associated with ageing. There lie gender differences in the combination of diseases and their prevalence. Therefore, there is a need to strengthen healthcare services for both men and women using gender-specific analysis as both genders have different priorities regarding healthcare utilisation. One of the relevant implications based on our findings is that researchers and policymakers need to work together to develop effective intervention strategies separately for men and women, which will help to reduce the burden of multimorbidity in the population.
PRISMA flow diagram: Inclusion and exclusion process of the final included articles
Better home care and home care technologies are no longer requested solely by nonimmigrant older adults but also by members of the fast-growing older adult immigrant population. However, limited attention has been given to this issue, or to the use of technology in meeting the needs of aging populations. The objective of this review is to map existing knowledge of older adult immigrants' use of information and communication technologies for home care service published in scientific literature from 2014 to 2020. Twelve studies met the established eligibility criteria in a systematic literature search. The results showed older adult immigrants faced similar barriers, which were independent of their ethnic backgrounds but related to their backgrounds as immigrants including lower socioeconomic status, low language proficiency, and comparatively lower levels of social inclusion. Technology use could be facilitated if older adult immigrants received culturally-tailored products and support from family members and from society. The results imply that the included studies do not address or integrate cultural preferences in the development of information and communication technology for home care services. Caregivers might provide an opportunity to bridge gaps between older immigrants' cultural preferences and technology design. This specific research field would also benefit from greater interest in the development of novel methodologies.
Mean social cohesion score among older adults in six selected countries during 2007–10
Rich-Poor ratio of mean social cohesion score among older adults of selected countries during 2007–10
Concentration curves representing the economic inequality in social non-cohesion among older adults in selected countries, 2007–10
Though a continued increase in life expectancy is a significant public health achievement, keeping older adults active and maintaining their well-being is challenging. Active aging requires physical health, mental health, functional independence, economic stability, social participation, and spiritual identification. Among all these factors, social cohesion has significant importance, but there is a dearth of studies focusing on older adults' social cohesion. Thus, the present study focuses on the level of social cohesion among older adults and its variation among the different economic classes. This article uses data from the Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa during 2007–10. Social cohesion scores have been constructed using Item Response Theory Partial Credit Model. Also, bivariate analysis, concentration curves, concentration indices, and multivariate regressions have been used for the analysis presented in this paper. This study confirms the strong predictive power of age, wealth, education, and working status of older adults on their social cohesion across the countries. Higher social non-cohesion is found among the economically poor older adults in Mexico, Russia, India, and China. In contrast, it is just opposite in the case of older adults in South Africa. Governments should develop policies to foster a society with a high level of social inclusion, social capital, and social diversity, to achieve further advancement in social cohesion.
Top-cited authors
Shereen Hussein
  • London School of Hygiene and Tropical Medicine
Hafiz T. A. Khan
  • University of West London
Mohamed Ismail
  • Analytical Research Ltd
Pat Armstrong
  • York University
Shobhit Srivastava
  • International Institute for Population Sciences