"Living happily despite having an illness": Perceptions of healthy aging among Korean American, Vietnamese American, and Latino older adults

Development of Older Adults' Perceptions on Community-based Connectedness with People Scale: Reliability and validity evaluation

AIM

We developed a self-assessment scale-Older Adults' Perceptions of Community-based Connectedness with People-to assess older adults' comprehensive perceptions of their connectedness with others in the community. A specific aim of this study is to evaluate the reliability and validity of this scale.

METHODS

Participants consisted of 1000 men and women aged 65 years or older, living in Sapporo, Hokkaido, Japan. Factorial validity was assessed using exploratory and confirmatory factor analysis, while concurrent validity was assessed using correlation analysis. Reliability was confirmed by Cronbach's α coefficient using the internal consistency method, and the stability coefficient was confirmed using the test-retest method.

RESULTS

Responses were received from 380 participants, and 358 participants who responded to all items were included in the analysis. The developed scale comprised 22 items with three factors: "Perception of Inclusion" (α = .947), "Perception of Reciprocity through Reception" (α = .937), and "Perception of Reciprocity through Provision" (α = .910). Correlation analyses indicated that concurrent scales were positively correlated with Ikigai and negatively correlated with loneliness on the total scale. The model fit was comparative fit index = 0.933, goodness-of-fit index = 0.854, adjusted goodness-of-fit index = 0.818, and root mean square of approximation = 0.081. The stability coefficient of the total scale scores was 0.875 (95% CI: [0.830, 0.908]).

CONCLUSIONS

The developed scale had adequate reliability and validity. The perceptions of connectedness measured using this scale can be used by public health and nursing care professionals to prevent loneliness and isolation among older adults living in the community.

Older people's connectedness with people in the community in contemporary contexts: A concept analysis

AIM

This study aimed to clarify the concept of older people's connectedness with people in the community within the literature.

METHODS

This study was based on Walker and Avant's concept analysis method. We used PubMed, MEDLINE, CINAHL, and Web of Science databases and included peer-reviewed articles that were published in English between January 2010 and April 2023. After assessing eligibility and applying exclusion criteria, 25 articles were analyzed.

RESULTS

Attributes included sense of belonging to the community achieved through interactions and feeling of togetherness through interrelationships, which consequently led to the maintenance of healthy physical and mental states and independent living, the acquisition of the ability to overcome difficulties, and the creation of a sense of meaning in life through coexistence.

CONCLUSION

We identified the concept of older people's connectedness with people in the community in a contemporary context. Connectedness is a useful concept to consider in nursing care because it seems to evolve into comprehensive health, including the physical and psychosocial health of older adults.

Definitions of successful aging among middle-aged Latinas residing in a rural agricultural community

INTRODUCTION

Latinos are the fastest growing aging population in the U.S. However, there has been limited attention to conceptualizing successful aging among Latinos, especially those residing in rural communities. Latinos are the largest racial or ethnic group residing in rural underserved communities and rural Latinos experience significant structural barriers to access the conditions they need to age well. The goal of this study is to make unique contributions to the successful aging literature by describing what successful aging means for middle-aged Latinas residing in a rural community.

METHODS

This qualitative paper used inductive thematic content analysis to examine definitions of successful aging among Latina women (n = 40) residing in an underserved agricultural community and entering mid-life (mean = 49 years old; age range 40-64).

RESULTS

With regards to definitions of successful aging, four themes emerged: 1) Having good health; 2) maintaining an active lifestyle; 3) the wellbeing of one's children; and 4) being independent.

DISCUSSION

Participants' definitions of successful aging aligned to some extent with existing frameworks, specifically related to health and independence. However, middle-aged Latina participants' unique definitions of successful aging also diverged from existing frameworks, especially around the wellbeing of their children and the importance of work as a way of maintaining an active lifestyle. More research is needed to understand the unique social context and circumstances of middle-aged Latinos residing in rural communities and how they influence their aging journeys. This can provide important information for the development of culturally sensitive services, interventions, and policies to help Latinos age well.

Could an optimally fitted categorization of difference between multi-disease score and multi-symptom score be a practical indicator aiding in improving the cost-effectiveness of healthcare delivery for older adults in developing countries?

BACKGROUND

Physio-psycho-socioeconomical health comprehensively declines during aging, the complexity of which is challenging to measure. Among the complexity, multiple chronic disorders continuously cumulated during aging, further aggravating the challenge.

METHODS

A population-based survey on Comprehensive Ageing Health Assessment was conducted in older adults (age >  = 60) enrolled from hospital settings and community settings in 13 working centers in six subnational regions in China. Cross-sectional datasets of 8,093 older participants with approximately complete assessment results were collected for the present analysis. Individual's multi-disease or multi-symptom was respectively scored by summing coexistent multiple diseases or multiple symptoms by respective weighting efficient for Self-Rated Health (SRH). Individual's age-dependent health decline was further summed of four SRH-weighted scores for daily function (activity of daily life, ADL), physical mobility (an average of three metrics), cognitive function (mini mental state examination, MMSE) and mental being (geriatric depression scale, GDS) plus multi-disease score (MDS) and multi-symptom score (MSS).Multi-disease patten among 18 diseases or multi-symptom pattern among 15 symptoms was latent-clustered in the older adults, the optimal outcome of which was categorized into high, moderate or low aging-associated clusters, respectively. Percentage distribution was compared between overall health decline score and multi-disease pattern cluster or multi-symptom patten cluster. A new variable of difference between MDS and MSS (hereinafter terming DMM) that displayed linear variation with socioeconomic factors was further fitted using multilevel regression analyses by substantial adjustments on individual confounders (level-1) and subnational region variation (level-2).

RESULTS

Consistent gradient distribution was shown between health decline and multimorbidity pattern cluster in the older adults. DMM was found linearly varied with personal education attainment and regional socioeconomic status. Using optimally fitted stratification of DMM (DMM interval = 0.02), an independent U-shaped interrelated tendency was shown between health decline, multi-disease and multi-symptom, which could be well explained by regional disparities in socioeconomic status.

CONCLUSION

Newly developed metrics for age-dependent health decline and aging-associated multimorbidity patten were preliminarily validated from within. The new variable of optimally fitted categorization of DMM might function as a practical indicator aiding in improving the cost-effectiveness and reduce inequity of healthcare delivery for older adults in developing countries.

"Aging is beautiful and graceful:" Exploring college students' perceptions of aging, older adults, and future older selves

Perception of one's own age and the aging process can influence healthy aging and encourage younger adults to be more proactive in taking care of themselves. There is a shortage of literature on college students' self-perceptions of aging and old age. This descriptive qualitative study explored how short-term aging research training and activities influenced college students' perceptions of aging, older adults, and their future older selves. Students were exposed to discussions about aging, the aging process, myths, a brief TED talk, and a video on positive age stereotypes in preparation for their encounter with older adults in a more extensive photovoice aging research project. Data for the study were collected using weekly guided reflections and drawing. Findings show that college students improved perceptions of aging and older adults after the short-term research training. We found cultural differences in self-perception of the onset of old age. Students perceived healthy aging in terms of biological, psychological, spiritual, and social dimensions of health. Students presented a hopeful, positive picture of their future older self as opposed to the negative stereotypic views they initially had of older adults. Reflections on one's own aging may be crucial in encouraging younger adults to be more proactive in taking care of themselves for a healthier life in later adulthood.

Empowerment of frail institutionalized older people for self-care: from administrators’ and staff caregivers’ perspectives

Purpose

To investigate the perspectives of administrators and staff caregivers in empowering older people living in long-term care facilities to improve self-care abilities.

Methods

A phenomenology research design was employed to generate data. The purposive sampling method was used to recruit administrator (n = 7) and staff caregiver groups (n =11). Data were collected via face-to-face interviews, observations, and daily recording. The data were then analyzed via content analysis.

Results

The results showed that two elements were of critical importance: professional supports and teamwork. The following professional supports activities were found of positive impacts: allowing residents to perform self-care and improving their mood status. The teamwork was developed via a partnership between staff and family caregivers, and preventing and resolving conflicts in the workplace.

Conclusion

The teamwork could not only reduce the burdens of both staff and family caregivers, but also improve the quality of life and the capacity of older residents. Thus, residents, staffs and family caregivers should work as a team and support older people to perform self-care.

Convivir (to Coexist) and Other Insights: Results From the Positive Aging for Latinos Study

Many Latinos in the United States do not have access to culturally sensitive services to help them age well. We combined community-based participatory research with concept mapping methods to understand how a sample of community-dwelling Latino older adults view positive aging. Nine focus groups (N = 101) generated 85 non-repeating statements, which were used to produce a final map with 11 clusters, organized into four overarching regions: Convivir (To Coexist), Self-Sufficiency, Perspectives on Life, and Healthy Behaviors. Further analyses revealed three themes: (1) the importance of varied social connections, as conveyed by the region labeled Convivir; (2) a multifaceted understanding of "stability" that includes finances, relationships, and spirituality; and (3) the need for a mature mindset reflected in the thematic cluster Tomalo Suave (Take It Easy). Findings can inform the development of interventions for Latino older adults and the cultural adaptation of programs initially designed for non-Latinos.

Healthy Aging Across the Stages of Old Age

Healthy aging is among the key frontiers for twenty-first century geriatrics and gerontology. Gerontology is positioned to address not only disease, debility, frailty, and death but also patients' hopes to remain healthy and high functioning and optimize their wellness. Definitions, models, and metrics of healthy aging are increasingly dynamic and multidimensional, drawing from biomedicine, social sciences, older adults' perspectives, and geroscience. Given current and projected demographics, focus on healthy aging at population, health system, research, clinical, and individual levels will lower costs and burdens while improving lives. Multiple models and strategies exist to guide progress in this critical emerging area.