Level of active aging: Influence of environmental, social and health-related factors

Geographical variation, demographic and socioeconomic disparities in Active Ageing: The situation in Thailand

Objectives

Being healthy and active is a goal to achieve a better quality of life as individuals age. This study aimed to explore and validate the Active Ageing (AA) model, and examine geographic variations, and demographic and socioeconomic disparities.

Study design

Utilising a cross-sectional secondary data analysis, the analytic unit is older adults aged 60-80 across all provinces in Thailand.

Methods

Exploratory Factor Analysis explored the AA structures, and the second-order Confirmatory Factor Analysis validated the model fit. Factor scores were used to identify geographic variation and sociodemographic disparities in AA. The association between geographic, and sociodemographic characteristics, and AA was examined through hierarchical regression analysis.

Results

The AA model, comprised of 14 indicators representing three latent factors-physical health, participation, and security-exhibited an optimal fit. Geographic inequality in AA emerged across the country, with specific areas linked to lower AA. An inverse relation between participation and security was observed. Rural residence, younger age, male, being married, and adequate income were associated with better AA. The association between AA and geographic, demographic, and socioeconomic emphasised the positive role of marital and economic status.

Conclusions

This study contributes to understanding the social determinants of health by constructing a comprehensive AA model. The findings highlight the geographic variations and demographic and socioeconomic disparities in AA across Thailand. While AA generally declines with age, a better economy may help alleviate these disparities. These findings underscore the need for tailored social and public health policies, avoiding a "one-size-fits-all" approach.

The active aging level of the rural older adults with disability in China: a cross-sectional study

Background

Active aging has been listed as an important indicator to measure the quality of life of the older adults and the construction of the senior care system. There is an imbalance between the supply and demand of senior care services for the disabled older adults in rural areas, and the quality of life needs to be improved.

Objectives

We aimed to analyze the current situation of active aging and the influencing factors of the rural disabled older adults, in order to provide a reference basis for improving the quality of life of the rural disabled older adults.

Methods

We conducted a multicenter and cross-sectional study, using the Barthel Index Scale and Chinese version of the Active Aging Scale, to facilitate the selection of 304 rural older adults with disability in 26 villages under Henan Province for a questionnaire survey.

Results

The mean score for the level of active aging of rural older adults with disability was 1.87 (SD 0.36), with the highest score for the dimension of being self-reliant (Mean2.29, SD 0.61) and lower scores for the dimension of active contribution to society (Mean 1.37, SD 0.55) and building up financial security (Mean 1.37, SD 0.57). The results of the multiple regression analysis showed higher levels of active aging among the disabled older adults with retirement pay, mild disability, and longer time per activity/rehabilitation exercise (p < 0.05).

Conclusion

Active aging of the rural disabled older adults is at a low level, with insufficient economic security and social participation. The national government should help improve the quality of primary health care in rural areas, build a friendly environment for senior communities, and improve policies to protect the welfare of the older adults, so as to collaboratively empower the disabled older adults in rural areas at three levels: health, participation, and protection.

Active aging awareness and well-being among older adults in Portugal

Objective

This study aims to assess the active aging awareness of older adults in mainland Portugal and their levels of overall well-being and to identify social and health-related factors.

Methods

A cross-sectional study was conducted with a representative sample of 613 older adults, aged 65 or older, who participated in the PROKnos - Knowing Social Prescribing needs of the elderly study in Portugal. The questionnaire consisted of the Active Ageing Awareness Questionnaire and the World Health Organization - Five Well-Being Index, as well as sociodemographic, economic, and health status questions. Correlation coefficients, t-tests for independent samples, and one-way ANOVA were used to explore potential associations between variables.

Results

The active aging awareness levels were significantly higher for women (p = 0.031), and those who were younger (p = 0.011), more educated (p < 0.001), had a better financial situation (p < 0.001), and had better health (p < 0.001). The same pattern was found for well-being, except in relation to gender, as men had higher levels (p = 0.016). These variables were found to be correlated.

Discussion

Even though active aging is an important strategy to implement, it is indispensable to consider the perceptions and conditions that need to be in place before that. This study reveals that several social and health-related factors are associated with well-being and active aging awareness, as well as the differences between groups that exist in mainland Portugal in relation to that. This emphasizes how vital it is to address social inequalities in active aging efforts, which are not necessarily uncovered when only considering actual active aging measures.

Active ageing profiles among older adults in Spain: A Multivariate analysis based on SHARE study

Background

Following the active ageing model based on the Health, Lifelong Learning, Participation and Security pillars, this research has a twofold objective: i) to classify older adults according to active ageing profiles, taking into account the four pillars, and ii) to ascertain the relationship between the profiles and personal and contextual factors, as well as well-being and quality of life in old age.

Methods

A study sample of 5,566 Spanish older adults who participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was included. Data were analysed in different steps applying several statistical analyses (Principal Component, Cluster, Discriminant, Multiple Correspondence and bivariate analysis with Pearson chi-square and ANOVA).

Results

Five older adult profiles were obtained (I: with moderate activity; II: quasi-dependents; III: with active ageing-limiting conditions; IV: with diverse and balanced activity; V: with excellent active ageing conditions). The first three profiles were characterised by subjects with a high average age, low educational level, who were retired or housewives, and who perceived a moderate level of loneliness, satisfaction with the social network and quality of life, as well as having a larger family network, but living in small households or alone. In contrast, the latter two profiles showed better personal and contextual conditions, well-being and quality of life.

Discussion and conclusions

The multidimensional approach to active ageing followed in this article has revealed the presence of several older adult profiles, which are confined to groups with better or worse active ageing conditions. In this context, if ageing is a process that reflects the previous way of life, intervention priorities will have to consider actions that promote better conditions during the life cycle.

Examining active aging among Iranian provinces: a TOPSIS analysis

Background

Planning and decision-making for the elderly requires a special attention due to the beginning of aging process in Iran. By emphasizing the concept of active aging, determining the status of the elderly like their ability to continue work over time, to attain income and to participate in social and political life is significant. Active aging uses the indicators measuring the non-used potential of the elderly for having an active and healthy aging. This study aimed to determine the level of active aging among the provinces of Iran in 2018 by considering 11 indicators related to elderly’s health, well-being and socioeconomic participation.

Methods

The raw data were obtained from Statistical Center of Iran. After establishing the indicators based on the Global Age Watch approach, the provinces were ranked by the TOPSIS method in terms of aging status.

Results

The results indicated that only Tehran and Alborz had the highest development level of active aging while 16% of the provinces had a semi-developed status and 77% failed at experiencing a satisfactory welfare, economic and social status.

Conclusions

Four indicators had the highest importance included the percentage of the elderly with a diploma and academic degree, the percentage of the elderly with lower incomes than the median income, the median income of the elderly to the median income of the other people in society, and life expectancy among the 65-year old men. Studying the indicators deeply can result in the appropriate planning for each area in line with the improvement of the elderly status.

Differential moderation effects of ApoE and 5-HTTLPR genotypes on social vulnerability in predicting mortality among community-dwelling middle-aged and older adults: a nationwide population-based study

Aging is a dynamic complex process involving social vulnerability over time. The social vulnerability index (SVI) was developed that predicted adverse health outcomes. This study examined effects between SVI status and two genotypes, apolipoprotein E (ApoE) and Serotonin transporter genotyping (5-HTTLPR), on all-cause mortality. Data from the Social Environment and Biomarkers of Aging Study (SEBAS) were obtained, and SVI was constructed using 32 self-reported items of social determinants. Data from 985 participants (age: 65.73 ± 9.47 years, 54.62% males) were obtained for analysis, and the median SVI was 0.35 (IQR 0.29–0.42) with a near normal distribution. Participants with a higher SVI were more likely to be women and have poor cognitive function, more depressive symptoms and poor physical function. Adjusted for age and sex, each incremental deficit in SVI was associated with a 12% increase in mortality risk (HR: 1.12, 95% CI: 1.04–1.20, p = 0.002). An interaction was found between ApoE and SVI but not 5-HTTLPR. The strata-specific hazard ratio confirmed that associations between SVI and mortality was only in non-ε4 carriers (HR: 1.15, 95% CI: 1.07–1.24, p < 0.001), and SVI did not significantly predict mortality among ε4 carriers (HR: 0.84, 95% CI: 0.65–1.10). Differential SVI effects on mortality among middle-age and older adults were identified. In conclusion, a higher SVI was associated with all-cause mortality among middle-aged and older adults, and the association was moderated by ApoE genotypes but not 5-HTTLPR. Further study is needed to evaluate the clinical efficacy of healthy aging intervention programs considering gene-environment interactions and social vulnerability.