A Quality Mobility Program Reduces Elderly Social Isolation

Dementia-Friendly Transportation Services: A Scoping Review

BACKGROUND AND OBJECTIVES

Transportation is an important component of dementia-friendly communities. People living with dementia have the right to access transportation services to keep their mobility in their community, which is essential for independence, well-being, and quality of life. This scoping review maps the literature on dementia-friendly transportation services and explores their characteristics to inform future development and research.

RESEARCH DESIGN AND METHODS

Empirical quantitative and qualitative studies in English or French that informed on transportation services for people living with dementia in the community were searched in 15 databases. Two authors independently screened records and charted relevant characteristics from selected publications. Important findings were summarized with a narrative synthesis approach.

RESULTS

Thirty-five studies informed on important dimensions of transportation services in urban and/or rural context: availability, accessibility, acceptability, adaptability, and affordability. Important insights were identified: the importance of staff training and attitude, and the challenges of availability of affordable services in the rural context. Emerging policy and program intervention areas include the need for access to quiet areas in transit hubs, training to use mass public transit and mobility management.

DISCUSSION AND IMPLICATIONS

The literature on dementia-friendly transportation services is important in the expansion and maintenance of mobility for people living with dementia in the community. The scope of the existing scientific literature remains limited. Although several studies indicated a clear need for better access to dementia-friendly transportation services, the best practices still need to be demonstrated in the scientific literature.

Assessing the Effectiveness of Intergenerational Virtual Service-Learning Intervention on Loneliness and Ageism: A Pre-Post Study

BACKGROUND

Service-learning is an effective intervention to solve social issues. The purpose of this study is to assess the effectiveness of intergenerational virtual service-learning on loneliness and ageism.

METHOD

This study used a pre-post design. A group of undergraduate students were randomly assigned to a "service-learning" project (n = 18). They were paired with seniors (n = 22) to have at least a 30-min weekly virtual interaction for six weeks. The following scales were used: the Aging Semantic Differential (ASD) Scale, the UCLA Loneliness Scale, a one-item researcher generated Likert-rating of loneliness, and two-item researcher generated Likert-rating of student competence.

RESULTS

Among college students, the service-learning group showed lower ASD and ageism scores at the post-test compared to the non-service-learning group, t (1, 40) = -2.027, p = 0.049; t (1, 40) = -2.102, p = 0.042, respectively. Among seniors, loneliness scores on the UCLA Scale and the one-item scale of loneliness dropped significantly from pre- to post-interactions with students, t (1, 19) = 2.301, p = 0.033, and t (1, 22) = 2.412, p = 0.009, respectively.

CONCLUSION

Virtual service-learning is an effective way to solve social issues such as loneliness and ageism.

Mechanisms of Social Interaction and Virtual Connections as Strong Predictors of Wellbeing of Older Adults

Socially engaged older adults are less likely to decline in health and happiness and have a higher quality of life. Building upon this premise, examination was conducted on the domains of social determinants of health, specifically the social and community context per Healthy People 2030 objectives. These mechanisms of social interaction, in the form of group activities, community engagement, and virtual interactions via email or text message, were assessed using hierarchical regression analysis to find out their association with wellbeing, depression symptoms, and cognition of older adults. The data included a total of 4623 sample of older adults from the National Health and Aging Trend Study (NHATS) Round 8. The results showed that social support explained a 40.3% unique variance on wellbeing. The use of text message and email had a moderating effect on community engagement and self-reported depression level in older adults. Findings suggest that community programs, shared group activities, or technology training workshops can improve social interaction and support cognition and reduce depression in older adults. Directions for future research include examining human behaviors and perceptions and increasing technology training sessions to promote independence of older adults and increase their social connections. In addition, participant involvement in interventions would enhance the possibility of success of such endeavors.

Effectiveness and Benefits of Exercise on Older People Living With Mental Illness’ Physical and Psychological Outcomes in Regional Australia: A Mixed-Methods Study

Regular exercise is reported to improve depressive symptoms and quality of life for people experiencing mental illness. For older adults, including strength and balance can also decrease falls. Mental health services seldom include funding for Accredited Exercise Physiologist programs. A 9-week Accredited Exercise Physiologist-led program for older adults receiving mental health treatment with a community Older People’s Mental Health Service was trialed in regional Australia. This clinician-conceived small-scale feasibility study utilized a two-phase concurrent triangulation mixed-method design to evaluate physical and psychological program outcomes and identify factors related to engaging in physical activity. This tailored exercise program led to improvements in measures of psychological distress and physical and psychological function. These changes corresponded with participants identifying benefits of exercising as a group of adults living with mental illness. Such findings suggest a supervised, individualized program for older mental health consumers confers physical and psychological benefits; however, further research evaluating exercise interventions with this population is required.

Practical Recommendations for Maintaining Active Lifestyle during the COVID-19 Pandemic: A Systematic Literature Review

Diminished volumes of habitual physical activity and increased sedentary levels have been observed as a result of COVID-19 home-confinement. Consequences of inactivity, including a higher mortality rate and poorer general health and fitness, have been reported. This systematic review aimed to provide practical recommendations for maintaining active lifestyles during pandemics. In May 2020, two electronic databases (PubMed; Web of Science) were used to search for relevant studies. A total of 1206 records were screened by two researchers. Thirty-one relevant studies were included in this systematic review, in which the methodological quality was assessed. With regard to six studies, which explicitly dealt with physical activity during COVID-19, the evidence level is classified by three articles to level II, and in the other three to level VI. Regarding the physical activity recommendations in these papers, three of them were classified to a medium, and the same number to a weak evidence base. Of the 25 papers which refer to other pandemics and/or isolation situations, one was classified to evidence level I, four were ranged to level II, three to level III, one to level V, and the others to level VI. This systematic review revealed that reduced physical activity levels are of serious concern during home confinement in pandemic times. The recommendations provided by many international organizations to maintain active lifestyles during these times mainly target the general population, with less consideration for vulnerable populations (e.g., older adults, people with health issues). Therefore, personalized and supervised physical activity programs are urgently needed, with the option to group-play physical activity programs (e.g., exergames). These can be assisted, delivered, and disseminated worldwide through information and communication technology solutions. If it is permitted and safe, being active outside in daylight is advised, with an effort level of mild to moderate using the rating of perceived exertion scale. Relaxation techniques should be integrated into the daily routine to reduce stress levels. On the evidence base and levels of the included articles in this review, the results need to be interpreted with caution. Given that policies are different across regions and countries, further research is needed to categorize recommendations according to different social-distancing scenarios.