Before evening falls: Perspectives of a good old age and healthy ageing among oldest-old Swedish men

The timescapes of older adults living alone and receiving home care: An interview study

In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape lens to our analysis of how nine older adults who live alone, receive home care and are considered by home care professionals to be frail, experience living (in) time. Over a period of eight months, we conducted three interviews with each of the nine participants. We analysed the data using reflexive thematic analysis and drew on timescapes to further interpret our preliminary analysis. Our results show that situated everyday time, place across time, and large-scale time interact in the framing and shaping of older adults' everyday lives. Older adults' embodied experiences of being of advanced age, living alone and receiving home care influenced their timescapes. We propose that paying attention to older adults' timescapes can enable home care professionals and other supporters to consider older adults' health, well-being, vulnerabilities and strengths from a broader perspective than the 'here and now' and thereby enhance the provision of person-centred care.

Association between the anthropometric measurements and dietary habits on telomere shortening in healthy older adults: A-cross-sectional study

AIM

This study aimed to evaluate the effect of anthropometric measurements and dietary habits on telomere length in healthy older residents in rural and urban areas.

METHODS

This was a cross-sectional study. The study population included 81 healthy older individuals aged ≥80 years. A quantitative food frequency questionnaire was used to determine dietary habits. Anthropometric measurements were taken by researchers. The telomere length of individuals was determined from leukocytes using quantitative polymerase chain reaction.

RESULTS

Urban women had longer telomeres than rural women (P < 0.05). Rural men had significantly higher hip circumference, middle-upper arm circumference and fat-free mass than urban men (P < 0.05). It was shown that while fresh vegetable consumption was higher in rural areas, carbonated drink consumption was higher in urban areas (P < 0.05). In women, homemade bread and sugar consumption were higher in rural areas, and honey consumption was higher in urban (P < 0.05). Red meat, milk-based dessert and pastry consumption explain telomere shortening by 22.5%, 24.8% and 17.9%, respectively. In addition, the model based on anthropometric measurements also contributes to explaining telomere shortening by 42.9%.

CONCLUSION

Red meat, milk-based dessert and pastry consumption, and waist circumference, hip circumference, waist-to-hip ratio and waist-to-height ratio are associated with telomere length. Longer telomeres are associated with a healthy, balanced, adequate diet and maintaining a healthy body weight/proportion, and they are crucial for achieving healthy aging. Geriatr Gerontol Int 2023; ••: ••-••.

Individual and environmental factors associated with successful aging among Korean older adults: Multilevel analysis of cross-sectional nationwide survey data

PURPOSE

The importance of environmental influences on successful aging has recently been emphasized. However, existing studies that investigated environmental factors related to successful aging in older adults did not apply multi-level analysis while simultaneously examining individual and environmental factors related to successful aging. Therefore, this study aimed to determine the level of successful aging in older adults and the individual and environmental factors related to successful aging.

MATERIALS AND METHODS

Data from a nationwide survey were used. The study comprised a cross-sectional sample of 73,942 community-dwelling adults aged ≥65 years with individual-level data drawn from the 2019 Korea Community Health Survey. Community-level data of 255 local administrative districts (cities or counties) were extracted from the Community Health Determinant Database from 2017 to 2019. These data were merged and used in multi-level logistic regression analyses.

RESULTS

Generally, 27.1% of the participants achieved successful aging. Individual factors including sex, age, marital status, education level, job, monthly household income, smoking, physical activity, and body mass index were significantly associated with successful aging. Four environmental factors, urban residential area, social network, satisfaction with living environment, and air quality, were positively associated with successful aging at the community level; among them, high satisfaction with living environment (OR = 6.06, 95% CI: 2.43-15.12) was the most strongly associated factor with successful aging.

CONCLUSIONS

The findings suggest that environmental factors are essential for successful aging among older adults in addition to individual factors. Therefore, multiple strategies considering individual and environmental factors are needed to improve successful aging.

Patient and health professional perspectives on participations in a feasibility study on exercise-based cardiac telerehabilitation after transcatheter aortic valve implantation: A qualitative study. (Preprint)

Background

Aortic valve stenosis affects approximately half of people aged ≥85 years, and the recommended surgical treatment for older patients is transcatheter aortic valve implantation (TAVI). Despite strong evidence for its advantages, low attendance rate in cardiac rehabilitation is observed among patients after TAVI. Cardiac telerehabilitation (CTR) has proven comparable with center-based rehabilitation; however, no study has investigated CTR targeting patients after TAVI. On the basis of participatory design, an exercise-based CTR program (TeleTAVI) was developed, which included a web-based session with a cardiac nurse, a tablet containing an informative website, an activity tracker, and supervised home-based exercise sessions that follow the national recommendations for cardiac rehabilitation.

Objective

This study aims to explore patients’ and health professionals’ experiences with using health technologies and participating in the exercise-based CTR program, TeleTAVI.

Methods

This study is a part of a feasibility study and will only report patients’ and health professionals’ experiences of being a part of TeleTAVI. A total of 11 qualitative interviews were conducted using a semistructured interview guide (n=7, 64% patients and n=4, 36% health professionals). Patient interviews were conducted after 8 weeks of participation in TeleTAVI, and interviews with health professionals were conducted after the end of the program. The analysis was conducted as inductive content analysis to create a condensed meaning presented as themes.

Results

Reticence toward using the website was evident with reduced curiosity to explore it, and reduced benefit from using the activity tracker was observed, as the patients’ technical competencies were challenged. This was also found when using the tablet for web-based training sessions, leading to patients feeling worried before the training, as they anticipated technical problems. Disadvantages of the TeleTAVI program were technical problems and inability to use hands-on guidance with the patients. However, both physiotherapists and patients reported a feeling of improvement in patients’ physical fitness. The home training created a feeling of safety, supported adherence, and made individualization possible, which the patients valued. A good relationship and continuity in the contact with health professionals seemed very important for the patients and affected their positive attitude toward the program.

Conclusions

The home-based nature of the TeleTAVI program seems to provide the opportunity to support individualization, autonomy, independence, and adherence to physical training in addition to improvement in physical capability in older patients. Despite technological challenges, basing the relationship between the health professionals and patients on continuity may be beneficial for patients. Prehabilitation may also be considered, as it may create familiarity toward technology and adherence to the training.

Aging Well for Indigenous Peoples: A Scoping Review

As life expectancy increases for Indigenous populations, so does the number of older adults with complex, chronic health conditions and age-related geriatric syndromes. Many of these conditions are associated with modifiable lifestyle factors that, if addressed, may improve the health and wellbeing of Indigenous peoples as they age. If models of healthy aging are to be promoted within health services, a clearer understanding of what aging well means for Indigenous peoples is needed. Indigenous peoples hold a holistic worldview of health and aging that likely differs from Western models. The aims of this review were to: investigate the literature that exists and where the gaps are, on aging well for Indigenous peoples; assess the quality of the existing literature on Indigenous aging; identify the domains of aging well for Indigenous peoples; and identify the enablers and barriers to aging well for Indigenous peoples. A systematic search of online databases, book chapters, gray literature, and websites identified 32 eligible publications on Indigenous aging. Reflexive thematic analysis identified four major themes on aging well: (1) achieving holistic health and wellbeing; (2) maintaining connections; (3) revealing resilience, humor, and a positive attitude; and (4) facing the challenges. Findings revealed that aging well is a holistic concept enabled by spiritual, physical, and mental wellbeing and where reliance on connections to person, place, and culture is central. Participants who demonstrated aging well took personal responsibility, adapted to change, took a positive attitude to life, and showed resilience. Conversely, barriers to aging well arose from the social determinants of health such as lack of access to housing, transport, and adequate nutrition. Furthermore, the impacts of colonization such as loss of language and culture and ongoing grief and trauma all challenged the ability to age well. Knowing what aging well means for Indigenous communities can facilitate health services to provide culturally appropriate and effective care.

Meaning of aging for caregivers of senile elderly people

OBJECTIVES

to understand the meaning of aging for caregivers of senile elderly people.

METHODS

qualitative study carried out with 12 caregivers of elderly people registered in the Home Care Service, adopting the Explanatory Model of Kleinman's Disease as a theoretical framework. Data were collected from April to June 2019, through semi-structured, audio-recorded interviews, carried out at home and submitted to content analysis.

RESULTS

taking care of senile elderly people triggers reflections on aging that sometimes lead to a new meaning of this process, besides stimulating the recognition of the factors that influence it, with emphasis on the life history, occupation and deleterious behaviors adopted throughout life.

FINAL CONSIDERATIONS

the care experience influences the meaning attributed to aging, favoring: the identification of modifiable and non-modifiable aspects and behaviors that make it healthy; reflection on aging itself, with a new meaning of habits and behaviors to be adopted.

Ambient assisted living technology-mediated interventions for older people and their informal carers in the context of healthy ageing: A scoping review

BACKGROUND AND AIMS

There is a growing demand for health and social care services to provide technology-mediated interventions that promote the health and well-being of older people with health or care needs and of their informal carers. The objectives of this study were to scope and review the nature and extent of prior intervention studies involving ambient assisted living technology-mediated interventions for older people and their informal carers, and how and in what ways (if any) the goals and aims of these interventions reflected the domains of the World Health Organization framework for healthy ageing.

METHODS

We conducted a scoping review. Data were collected between June and October 2018 with an updated search in October 2020. A total of 85 articles were eligible for inclusion.

RESULTS

Nine categories described the aims and content of the included studies. The healthy ageing domain "Ability to meet basic needs" was mirrored in four categories, whereas "Ability to contribute to society" was not addressed at all.

CONCLUSION

The ways in which domains of healthy ageing are mirrored suggest that there is an emphasis on individual factors and individual responsibility, and a lack of attention given to broader, environmental factors affecting healthy ageing. Only a few of the studies used a dyadic approach when assessing health outcomes concerning older people and their informal carers.

General Practitioners’ Perspective towards Healthy Ageing in Indonesia

Background: The rapid ageing population among older adults from 2020 to 2040 has led to an emerging focus as this group begins to experience ageing and has a higher risk of having chronic illness of non-communicable diseases. Therefore, it is important to provide General Practitioners (GPs) with adequate knowledge and attitude of healthy ageing to ensure the quality of health service among older adults.Objectives: To identify the perspective of general practitioners including the knowledge, attitude and practice towards adult health and nutrition to support healthy ageing in Indonesia.Methods: An online survey was conducted among 100 general practitioners registered at the Indonesian Medical Council (KKI) and domiciled in the Greater Jakarta area and outside the Jabodetabek area. The sample recruitment process was carried out using the Alomedika online application. All data were analyzed using SPSS software.Results: Almost all (92%) of respondents who took this survey had a supportive attitude in providing additional nutrition to adults to support healthy ageing. About 76% of the respondents did so by recommending milk. However, in terms of knowledge, around 67% of the respondents showed inadequate results, especially about physiological changes that occurred in adults. There is no statistically significant difference between respondents’ demographic characteristics and all perspectives measured in this study (i.e., knowledge, attitude and practice)Conclusions: The study indicates that it is important to educate general practitioners about the healthy aging process in order to maintain general practitioners' attitudes and behavior in health services to support the success of achieving healthy aging in Indonesia.

Healthy aging predicts mortality risks: Results from the Korean longitudinal study of aging (2006-2014)

INTRODUCTION

While there has been some gerontological research on healthy aging, few studies have identified a reasonable health status for the older adults. Guided by the four healthy aging concepts in studies from the US and Spain, this study sought to determine a useful definition for Korean older adults by examining the associations between each of the four healthy aging definitions and mortality.

METHODS

A longitudinal analysis was conducted based on the 2,960 older people (65 years or older) who participated in the Korean Longitudinal Study of Aging (2006-2014). Four healthy aging gradient definitions (Rowe and Kahn, Group Ⅰ, Group II, and Group III) were determined: absence of disease, free of disability, physical and cognitive function, and engagement with life.

RESULTS

The young old who failed to achieve healthy aging were found to have a higher risk of mortality in all four healthy aging gradient definitions in both males (HR range from 4.15 to 5.39) and females (HR range from 4.07 to 9.55). In old old, however, the unhealthy aging mortality risk in Rowe and Kahn's definition was disappeared, but predominant mortality risks were found in Group III for both male (HR = 3.16, 95% CI 1.67 - 5.98) and female (HR = 3.65, 95% CI 1.36 - 9.81) CONCLUSION: To promote healthy aging, we suggest that the definition for the young old includes rigid disease criteria, and old old emphasize functional ability. Age-specific aims for healthy aging may be useful for defining healthy aging.