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Horgan S, Prorok J, Ellis K, Mullaly L, Cassidy KL, Seitz D, Checkland C. Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:664. [PMID: 38928911 PMCID: PMC11203904 DOI: 10.3390/ijerph21060664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024]
Abstract
This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.
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Affiliation(s)
- Salinda Horgan
- Departments of Rehabilitation Therapy & Psychiatry, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Jeanette Prorok
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Katie Ellis
- Mental Health Commission of Canada, Ottawa, ON K1R 1A4, Canada; (K.E.); (L.M.)
| | - Laura Mullaly
- Mental Health Commission of Canada, Ottawa, ON K1R 1A4, Canada; (K.E.); (L.M.)
| | - Keri-Leigh Cassidy
- Department of Psychiatry, Dalhousie University, Dalhousie, NS B3H 2E2, Canada;
| | - Dallas Seitz
- Departments of Psychiatry & Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Claire Checkland
- Canadian Coalition for Seniors’ Mental Health, Markham, ON L3R 9X9, Canada;
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Pu X, He S, Lin X. The effect of urban-rural resident basic medical insurance on physical health of the rural older adult in China. Front Public Health 2024; 12:1319697. [PMID: 38344234 PMCID: PMC10853402 DOI: 10.3389/fpubh.2024.1319697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
Introduction Urban-Rural Resident Basic Medical Insurance (URRBMI) is an important system for effectively transferring disease risks to the rural older adult. As China experiences rapid aging, maintaining the physical health of the rural older adult is key to achieving the goal of healthy aging. Methods The study explores the impact of URRBMI on physical health of the rural older adult in China using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2018. Ordinary least square models were used to analyze the relationship between URRBMI and physical health of the rural older adult, and we used instrumental variable method to address the potential endogenous problem. Results We find that URRBMI greatly improves physical health of the rural older adult. The heterogeneity analysis indicates that URRBMI contributes more significantly to the rural older adult in eastern areas and the advanced rural older adult. The results also suggested that URRBMI improves physical health of the rural older adult through increasing life satisfaction and enhancing the timeliness of medical services. Recommendations This study implies that we need to further improve the participation rate, increase the actual reimbursement ratio and increase financial subsidies for URRBMI in central and western areas, and further integrate the distribution of medical resources to promote physical health of the rural older adult.
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Affiliation(s)
| | | | - Xi Lin
- School of Public Administration, Sichuan University, Chengdu, China
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Lim D, Grady A, Liu KPY. Public Mixed Funding for Residential Aged Care Facilities Residents' Needs in the Asia-Pacific Region: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7007. [PMID: 37947564 PMCID: PMC10648075 DOI: 10.3390/ijerph20217007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
Due to population aging and sociodemographic change, there is an increasing reliance on residential aged care facilities in the Asia-Pacific region. Most countries have adopted taxation as the primary means to levy capital for funding universal health services and means-testing of benefits may be further incorporated as a policy balance between horizontal equity and fiscal sustainability. It was hypothesized that residential care needs are evaluated by assessments relating to funding; this scoping review seeks to synthesize how such assessments relate to the care needs of residents. Searches were conducted in concordance with a priori protocol for English-language literature published since 2008 in Embase, CINAHL, PubMed, Scopus, JBI, TROVE, and four peak international organizations for studies and reports that describe the assessment of residents' needs in Asia-Pacific countries that used a mixture of taxation and means-testing to publicly fund residential aged care. One paper and 47 reports were included. Australia, New Zealand, and Singapore utilize a taxation and means-tested user charge approach to fund residential aged care needs. The common care needs assessed include health conditions, daily activities, cognition, psychiatric, and behavioral needs. While essential care needs are publicly funded, other holistic care needs, such as spirituality and autonomy-based needs, still need to be covered for meaningful occupation by the residents.
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Affiliation(s)
- David Lim
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Ashley Grady
- School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Karen P. Y. Liu
- School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong;
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Mogic L, Rutter EC, Tyas SL, Maxwell CJ, O'Connell ME, Oremus M. Functional social support and cognitive function in middle- and older-aged adults: a systematic review of cross-sectional and cohort studies. Syst Rev 2023; 12:86. [PMID: 37211612 DOI: 10.1186/s13643-023-02251-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Intact cognitive function is crucial for healthy aging. Functional social support is thought to protect against cognitive decline. We conducted a systematic review to investigate the association between functional social support and cognitive function in middle- and older-aged adults. METHODS Articles were obtained from PubMed, PsycINFO, Sociological Abstracts, CINAHL, and Scopus. Eligible articles considered any form of functional social support and cognitive outcome. We narratively synthesized extracted data by following the Synthesis Without Meta-Analysis (SWiM) guidelines and assessed risk of bias using the Newcastle-Ottawa Scale (NOS). RESULTS Eighty-five articles with mostly low risk-of-bias were included in the review. In general, functional social support-particularly overall and emotional support-was associated with higher cognitive function in middle- and older-aged adults. However, these associations were not all statistically significant. Substantial heterogeneity existed in the types of exposures and outcomes evaluated in the articles, as well as in the specific tools used to measure exposures and outcomes. CONCLUSIONS Our review highlights the role of functional social support in the preservation of healthy cognition in aging populations. This finding underscores the importance of maintaining substantive social connections in middle and later life. SYSTEMATIC REVIEW REGISTRATION Rutter EC, Tyas SL, Maxwell CJ, Law J, O'Connell ME, Konnert CA, Oremus M. Association between functional social support and cognitive function in middle-aged and older adults: a protocol for a systematic review. BMJ Open;10(4):e037301. https://doi.org/10.1136/bmjopen-2020-037301.
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Affiliation(s)
- Lana Mogic
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Emily C Rutter
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Colleen J Maxwell
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, 9 Campus Drive, 154 Arts, Saskatoon, SK, S7N 5A5, Canada
| | - Mark Oremus
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada.
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Mai S, Cai J, Li L. Factors associated with access to healthcare services for older adults with limited activities of daily living. Front Public Health 2022; 10:921980. [PMID: 36276353 PMCID: PMC9583939 DOI: 10.3389/fpubh.2022.921980] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/02/2022] [Indexed: 01/22/2023] Open
Abstract
Background Limited studies focused on the situation and related factors of access to healthcare services for older adults with limited activities of daily living (ADL) in China. This study explores factors associated with access to healthcare services of them based on Andersen's healthcare utilization model (namely, need, predisposing, and enabling dimensions). Methods A total of 3,980 participants aged 65 years and older adults with limited ADL from the latest wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included. Binary logistic regression was used to explore the influencing factors. Results Factors in enabling dimension were associated with access to healthcare services for older adults with limited ADL. Those who lived with better economic status (fair vs poor, OR = 2.98, P < 0.01; rich vs poor, OR = 7.23, P = 0.01), could afford daily life (yes vs no, OR = 2.33, P = 0.03), and lived in the eastern or central region of China (eastern vs western, OR = 2.91, P < 0.01; central vs western, OR = 2.40, P = 0.02) could access to healthcare services more easily. However, factors in predisposing dimension and need dimension showed no statistical significance. Meanwhile, inconvenience in the movement was the major barrier reported by some participants for not going to the hospital when they got sick. Conclusion Access to healthcare services for older adults with ADL limitation was mainly related to the factors of economic status, affordability for daily life, and living regions in enabling dimension. Strategies focused on health insurance, healthcare system, barrier-free facilities, and social support were proposed to increase the access to healthcare services for participants, which could benefit their health.
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Affiliation(s)
- Shumin Mai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingjing Cai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lu Li
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China,Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China,*Correspondence: Lu Li
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Grady A, Lim D, Liu KPY. Funding systems for care needs of older adults in residential aged care facilities in the Asia-Pacific region: a scoping review protocol. JBI Evid Synth 2022; 20:2579-2590. [PMID: 36065950 DOI: 10.11124/jbies-21-00259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The objective of this review is to explore the care needs as assessed by the public residential aged care funding systems of Asia-Pacific countries that use both taxation and means-tested user charge. INTRODUCTION The Asia-Pacific region is at the forefront of population aging. There is increasing reliance on residential aged care facilities to provide formal care, but limited understanding of how care needs are assessed. Most countries have adopted taxation as the primary means to levy capital for funding essential health services; funding may be means-tested for equity. INCLUSION CRITERIA The population of interest is older adults eligible for care in residential aged care facilities who receive assistance to fund their care. Sources that address the care needs of residents and the assessments relating to care needs, as well as funding systems (taxation, means-testing), will be considered for inclusion. This review will consider any quantitative study, qualitative study, mixed method study, or report from any country in the Asia-Pacific region. METHODS Databases to be searched include Embase, CINAHL, PubMed, Scopus, and the JBI Database for Evidence-based Practice. Additional records will be identified through the gray literature database Trove, reference lists of included studies, and relevant health organization websites. Sources published in English since 2008 will be eligible for inclusion. Two reviewers will independently screen titles, abstracts, and full-texts for inclusion. Data will be extracted and findings summarized in tabular format and narrative synthesis. Any disagreements between the reviewers will be resolved through discussion or with a third reviewer. SCOPING REVIEW REGISTRATION Open Science Framework; https://osf.io/h9g7q.
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Affiliation(s)
- Ashley Grady
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - David Lim
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.,Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
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Silverstein M, Xu Y. Older Grandparents Caring for Grandchildren in Rural China: Cohort Change in Resources and Deficits Across 17 Years. THE PUBLIC POLICY AND AGING REPORT 2022; 32:112-117. [PMID: 35992734 PMCID: PMC9380579 DOI: 10.1093/ppar/prac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Merril Silverstein
- Address correspondence to: Merril Silverstein, PhD, Aging Studies Institute, Syracuse University, 314 Lyman Hall, Syracuse, NY 13244 USA. E-mail:
| | - Ying Xu
- Department of Human Development and Family Science, Syracuse University, Syracuse, New York, USA
- Aging Studies Institute, Syracuse University, Syracuse, New York, USA
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Community Support for Persons with Disabilities in Low- and Middle-Income Countries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148269. [PMID: 35886121 PMCID: PMC9319493 DOI: 10.3390/ijerph19148269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 02/04/2023]
Abstract
Over the life course, persons with disabilities require a range of supports to be integrated into their communities, to participate in activities that are meaningful and necessary, and to have access, on an equal basis to persons without disabilities, to community living. We conducted a scoping review of the peer-reviewed and grey literature on community support for persons with disabilities in low- and middle-income countries (LMICs). The main findings of this review concern the following: there are gaps in access to community support for persons with disabilities in LMICs; there are barriers to the provision of such support; formal and informal strategies and interventions for the provision of community support exist across the life cycle and different life domains, but evidence concerning their effectiveness and coverage is limited; and the role of community-based rehabilitation and Organisations of Persons with Disabilities in the assessment of needs for, and the development and provision of, community support, needs to be more clearly articulated. Research needs a more robust theory of change models with a focus on evaluating different aspects of complex interventions to allow for effective community support practices to be identified.
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Corregidor-Sánchez AI, Segura-Fragoso A, Criado-Álvarez JJ, Rodríguez-Hernández M, Mohedano-Moriano A, Polonio-López B. Effectiveness of Virtual Reality Systems to Improve the Activities of Daily Life in Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6283. [PMID: 32872313 PMCID: PMC7504692 DOI: 10.3390/ijerph17176283] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 02/02/2023]
Abstract
(1) This review aims to evaluate the effectiveness of treatments with virtual reality systems (VRSs) on the functional autonomy of older adults versus conventional treatment. (3) Methods: Systematic review and meta-analysis. An electronic data search was carried out, following the PRISMA statement, up to February 2020. We combined results from clinical trials using VRSs for the improvement of basic and instrumental activities of daily living. The guidelines of the Cochrane Handbook for Systematic Reviews of Interventions were followed for calculations and risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence. (4) Results: The final analysis included 23 studies with a population of 1595 participants. A moderate, but clinically significant, effect was found for basic activities of daily living (BADLs), (Standard Medium Deviation, SMD 0.61; 95% CI: -0.15-1.37; P < 0.001). A small effect was found for instrumental ADLs (Instrumental Activities of daily living, IADLs) (SMD -0.34; 95% CI: -0.82-0.15; P < 0.001). Functional ambulation was the BADL which improved the most (SMD -0.63; 95% CI: -0.86, -0.40; P < 0.001). (5) Conclusion: The use of VRSs is an innovative and feasible technique to support and improve the functional autonomy of community-dwelling older adults. Due to the very low quality of the evidence for our main outcomes, the effects of a VRS on the BADLs and IADLs are uncertain. Clinical trials of a higher methodological quality are necessary to increase the level of knowledge of its actual effectiveness.
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Affiliation(s)
- Ana-Isabel Corregidor-Sánchez
- Faculty of Sciences Health, University of Castilla la Mancha, 45600 Talavera de la Reina, Spain; (A.S.-F.); (J.-J.C.-Á.); (M.R.-H.); (A.M.-M.); (B.P.-L.)
| | - Antonio Segura-Fragoso
- Faculty of Sciences Health, University of Castilla la Mancha, 45600 Talavera de la Reina, Spain; (A.S.-F.); (J.-J.C.-Á.); (M.R.-H.); (A.M.-M.); (B.P.-L.)
| | - Juan-José Criado-Álvarez
- Faculty of Sciences Health, University of Castilla la Mancha, 45600 Talavera de la Reina, Spain; (A.S.-F.); (J.-J.C.-Á.); (M.R.-H.); (A.M.-M.); (B.P.-L.)
- Institute of Sciences Health, 45006 Castilla la Mancha, Spain
| | - Marta Rodríguez-Hernández
- Faculty of Sciences Health, University of Castilla la Mancha, 45600 Talavera de la Reina, Spain; (A.S.-F.); (J.-J.C.-Á.); (M.R.-H.); (A.M.-M.); (B.P.-L.)
| | - Alicia Mohedano-Moriano
- Faculty of Sciences Health, University of Castilla la Mancha, 45600 Talavera de la Reina, Spain; (A.S.-F.); (J.-J.C.-Á.); (M.R.-H.); (A.M.-M.); (B.P.-L.)
| | - Begoña Polonio-López
- Faculty of Sciences Health, University of Castilla la Mancha, 45600 Talavera de la Reina, Spain; (A.S.-F.); (J.-J.C.-Á.); (M.R.-H.); (A.M.-M.); (B.P.-L.)
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