Enhancing later life: how older people perceive active ageing?

The experience of feeling old after a fragility fracture

BACKGROUND

There has been little exploration of the effect of fragility fractures on patient perceptions of their age. The common assumption is that fractures "happen to old people". In individuals with a fragility fracture, our objective was to explore the experience of feeling old after sustaining a fragility fracture.

METHODS

A secondary analysis of data from 145 community-dwelling women and men participating in six qualitative primary studies was conducted relying on a phenomenological approach. Participants were English-speaking, 45 years and older, who had sustained a recent fragility fracture or reported a history of previous fragility fractures. Data for the analysis included direct statements about feeling old as well any discussions relevant to age post-fracture.

RESULTS

We highlight two interpretations based on how individuals with a history of fragility fracture talked about age: (1) Participants described feeling old post-fracture. Several participants made explicit statements about being "old". However, the majority of participants discussed experiences post-fracture that implied that they felt old and had resigned themselves to being old. This appeared to entail a shift in thinking and perception of self that was permanent and had become a part of their identity; and (2) Perceptions of increasing age after sustaining a fracture were reinforced by health care providers, family, and friends.

CONCLUSIONS

Our findings challenge the notion that fractures "happen to old people" and suggest that fractures can make people feel old. Careful consideration of how bone health messages are communicated to patients post-fracture by health care providers is warranted. (Word Count: 248).

Evaluating an interactive tool that reasons about quality of life to support life planning by older people

Objectives

In response to the lack of digital support for older people to plan their lives for quality of life, research was undertaken to co-design and then evaluate a new digital tool that combined interactive guidance for life planning with a computerised model of quality of life.

Method

First, a workshop-based process for co-designing the SCAMPI tool with older people is reported. A first version of this tool was then evaluated over eight consecutive weeks by nine older people living in their own homes. Four of these people were living with Parkinson's disease, one with early-stage dementia, and four without any diagnosed chronic condition. Regular semi-structured interviews were undertaken with each individual older person and, where wanted, their life partner. A more in-depth exit interview was conducted at the end of the period of tool use. Themes arising from analyses of content from these interviews were combined with first-hand data collected from the tool's use to develop a description of how each older person used the tool over the 8 weeks.

Results

The findings provided the first evidence that the co-designed tool, and in particular the computerised model, could offer some value to older people. Although some struggled to use the tool as it was designed, which led to limited uptake of the tool's suggestions, the older people reported factoring these suggestions into their longer-term planning, as health and/or circumstances might change.

Conclusions

The article contributes to the evolving discussion about how to deploy such digital technologies to support quality of life more effectively.

Perceived Quality of Online Music Therapy Sessions by Older Adults Aging at Home

Online delivery is new to the field of music therapy (MT). This research investigated older adults' perceived quality of MT online by certified music therapists. In this feasibility study, applying both process and outcome assessments, nine older adults volunteered to participate. Zoom was used, and a virtual music therapy (VMT) kit was developed as a resource. Surveys and observed technical difficulties revealed that perceived quality varied slightly by level of technical difficulty experienced; however, overall mean perceived quality was 7.2 out of 9. Post-study interviews revealed three main themes: (a) individual experiences with VMT, (b) individuals' suggestions for further development of VMT sessions, and (c) individuals' personal outcomes from VMT sessions. Participants reported overall positive experiences with VMT. Despite a slight decline in perceived quality when more technical difficulties were present, each participant reported a desire for more sessions, and they would recommend it to others.

The aging mind: A complex challenge for research and practice

Cognitive decline as part of mental ageing is typically assessed with standardized tests; below-average performance in such tests is used as an indicator for pathological cognitive aging. In addition, morphological and functional changes in the brain are used as parameters for age-related pathological decline in cognitive abilities. However, there is no simple link between the trajectories of changes in cognition and morphological or functional changes in the brain. Furthermore, below-average test performance does not necessarily mean a significant impairment in everyday activities. It therefore appears crucial to record individual everyday tasks and their cognitive (and other) requirements in functional terms. This would also allow reliable assessment of the ecological validity of existing and insufficient cognitive skills. Understanding and dealing with the phenomena and consequences of mental aging does of course not only depend on cognition. Motivation and emotions as well personal meaning of life and life satisfaction play an equally important role. This means, however, that cognition represents only one, albeit important, aspect of mental aging. Furthermore, creating and development of proper assessment tools for functional cognition is important. In this contribution we would like to discuss some aspects that we consider relevant for a holistic view of the aging mind and promote a strengthening of a multidisciplinary approach with close cooperation between all basic and applied sciences involved in aging research, a quick translation of the research results into practice, and a close cooperation between all disciplines and professions who advise and support older people.

Self-management of depression and anxiety amongst frail older adults in the United Kingdom: A qualitative study

OBJECTIVES

Depression and anxiety are common in frail older people and are associated with high levels of morbidity and mortality, yet they typically face greater barriers to accessing mental health treatments than younger people and express preferences for self-managing their symptoms. This study aims to explore frail older adults' experiences of self-managing symptoms of depression and/or anxiety.

DESIGN

Qualitative semi-structured interviews, exploring experiences of depression and/or anxiety, ways participants self-managed these and the contexts within which this took place. Interviews were audio-recorded and transcribed verbatim.

PARTICIPANTS

28 frail older adults in the United Kingdom, purposively sampled for neighbourhood, frailty and symptoms of anxiety/depression.

ANALYSIS

Thematic analysis to inductively derive themes from the data.

RESULTS

Our findings suggest that frail older adults find maintaining independence, engaging in meaningful activities, and socialising and peer support important for self-managing depression and anxiety. These could all be adapted to the level of frailty experienced. Drawing on life experiences, addressing the perceived cause and faith were helpful in some situations and for some personalities. Distraction and avoidance were helpful for more severe symptoms or where the causes of symptoms could not be resolved. Self-management strategies were less well-established for anxiety symptoms, especially when linked to newer health fears and worries about the future.

CONCLUSIONS

Developing services and sources of information that support and facilitate key therapeutic components of self-management, which align with older adults' preferred coping styles and take into account levels of frailty, may be a way of supporting frail older people waiting for mental health treatments or those who prefer not to access these. Greater awareness of anxiety and how it can be self-managed in frail older people is needed.

Social position of older immigrants in the Netherlands: where do immigrants perceive themselves on the societal ladder?

Older Turkish and Moroccan immigrants are often ascribed a low social position based on their relatively unfavourable educational level, occupational status and income. Yet immigrants emigrated to improve their social position and came from contexts where determinants of social position might be based on different socio-cultural circumstances than those used in the country of settlement. In order to understand immigrants' own perception of their social position, we interviewed 23 60-68 year old immigrants from Turkish and Moroccan origin in the Netherlands. Using a ten rung ladder, participants were asked to position themselves in the societal hierarchy before migration, after settlement and currently. Most participants positioned themselves at a middle or high position on the societal ladder. Circumstances used for positioning were related to socioeconomic indicators, but also to social affirmation, family, social integration, physical, mental health, happiness and complying to religious prescriptions. When these circumstances were deemed favourable, participants tended to position themselves higher. Our findings also show that the circumstances that participants used for positioning themselves varied across the life course. These findings complement the picture of the often low objective low socioeconomic position of older immigrants and show that immigrants' perception of their subjective social position reflects a broader set of circumstances than just socioeconomic ones.

Ageing well? Older Adults’ Stories of Life Transitions and Serious Leisure

This (auto)ethnographic case study documents two intertwined stories. The first traces the author’s evolutionary path from a post in full-time teaching and management to lifestyle entrepreneurship as an exercise instructor for older adults. The second arises from the experience of the participants in those classes and their interaction with the author. As the stories merge life experiences are shared and compared. Identity is formed and reformed. This is an original study covering a period exceeding fifteen years. Offered as a piece of Creative Analytical Practice the stories aim to show rather than tell how serious leisure is allied to the concept of ageing well. The work invites readers to respond and question in the light of their own experience. Attention is especially drawn to periods of life transition, for example retirement or confinement due to COVID-19. Data is drawn from doctoral and post-doctoral research supported by longer term personal diary entries. The events involved, the timescale covered and the authenticity of the interaction document a unique trajectory and an example which other older adults are being encouraged to emulate.

Exploring the Relationships Between Four Aging Ideals: A Bibliometric Study

When examining research articles on the aging strategies, four ideals (i.e., successful aging, healthy aging, productive aging and active aging) could be explored by conducting bibliometric analyses. For the literature analysis, general information on the four aging ideals was understood through visualization analysis; the intellectual base and research hotspots were intuitively observed. CiteSpace was used as the method to conduct the co-occurrence analysis of keywords in order to obtain research trends and cutting-edge knowledge in the field of aging-related policies. Subsequently, the study revealed the nature of the link between these four aging ideals and disclosed the connection between their fundamental principles. The study ultimately enhanced the understanding of the diverse contexts that have impacted the way in which these ideals influence policy, which has caused dissimilar strategies for policy development. The study also extended the discussion of the definitions of and relationships between these four ideals with the goal of identifying new directions for aging-related practice and providing innovative insights and references for investigators.

Factors Associated With Participation in Physical Leisure Activities in Taiwanese Community-Dwelling Older Adults

This study was to identify factors at the intrapersonal, interpersonal, and community levels that relate to physical leisure participation in Taiwanese community-dwelling older adults and to examine their relative importance. We used a cross-sectional study with purposive sampling (N = 160). Physical leisure participation was quantified as the variety, frequency, and duration of participation. Data were analyzed using a series of hierarchical multiple linear regressions. The results showed that higher variety, frequency, or duration of physical leisure participation was associated with older males and with those who reported having better health, fewer depressive symptoms, and greater social support. Intrapersonal- and interpersonal-level factors play a relatively more important role in predicting physical leisure participation than factors at the community level. Understanding factors that relate to these three levels of participation has the potential to inform interventions that are tailored to individual profiles.

Active Aging in ASEAN Countries: Influences from Age-Friendly Environments, Lifestyles, and Socio-Demographic Factors

Active aging is a challenging issue to promote older population health; still, there is little clarity on research investigating the determinants of active aging in developing countries. Therefore, this research aimed to examine the factors associated with the active aging of the older populations in ASEAN's low and middle-income countries by focusing on Malaysia, Myanmar, Vietnam, and Thailand. The study is a cross-sectional quantitative research study using multi-stage cluster sampling to randomize the sample. The sample consists of 2031 older people aged 55 years and over, including 510 Thai, 537 Malaysian, 487 Myanmar, and 497 Vietnamese. We collected a quantitative questionnaire of age-friendly environmental scale and active aging scale based on the World Health Organization (WHO) concept. The predictors of active aging include age-friendly environments, lifestyles, and socioeconomic factors; the data are analyzed by using multiple logistic regression. After adjusting for other factors, we found that older people living in a community with higher levels of age-friendly environments are 5.52 times more active than those in lower levels of age-friendly environments. Moreover, the older population with healthy lifestyles such as good dietary intake and high physical activity will be 4.93 times more active than those with unhealthy lifestyles. Additionally, older adults with partners, higher education, and aged between 55 and 64 years will be 1.70, 2.61, and 1.63 times more active than those with separate/divorce/widow, primary education, and age at 75 years or higher, respectively. Our results contribute considerable evidence for ASEAN policy-making to promote active aging in this region.

Understanding the Perspectives and Experiences of Employed Older People on Active Ageing in Their Later Working Life (Biographical Narrative Approach)

This thesis aims to understand the perspectives and experiences of older people regarding the concept of active ageing in their later working life with biographical narratives. This research adopted a biographical narrative interview for data collection. A total of 15 employed older people were interviewed by the researcher. The collected data were analysed using the biographical narrative analysis of Schütze (1983). The research findings are the following: in the first theme, the driving force to enable older people to choose active ageing in the workplace was their confidence in their work ability to include a challenging attitude at work. In the second theme, another driving force to enable older people to participate in economic activity that was considered was the individual workability of active older workers, including health rather than their chronological ageing in the labour market. However, in the third theme, research participants believed that the barrier of active ageing is a negative social prejudice on the working ability of older people. From this point of view, the research participants suggested that negative social prejudice for older workers should be overcome by active ageing experiences in age-friendly working environments as the fourth theme.

Investigating Quality of Life from the Perspectives of Older Adults in Local Communities

Governments are increasingly interested in measuring quality of life (QoL) among older adults to inform policy. We demonstrate the advantages of situating an investigation of QoL in local contexts through a thematic analysis of focus group data collected in Chatham-Kent, Ontario, Canada. Local and broader factors relating to QoL among older adults were explored. We examine three themes: Natural Environment considers how participants derive aspects of their sense of QoL from the unique natural environment in Chatham-Kent; Amalgamation's Influence on Identity explores how participants' sense of belongingness and place-based identity were shaped by the amalgamation of townships and communities that now constitute Chatham-Kent; and Ease of Travel and Independence examines how older adults' conceptions of QoL are closely connected to their ease of travel, which they connect with a sense of independence. Our findings provide further support for the importance of engaging directly with older adults to understand their perspectives of QoL in a local context, particularly when seeking to inform policy changes.

Relationship between Active Aging and Quality of Life in Middle-Aged and Older Koreans: Analysis of the 2013-2018 KNHANES

With the increase in the aging population worldwide, social interest in having a vibrant and valuable old age has been increasing with changes in the perspectives on old age. This study aimed to determine the relationship between active aging and health-related quality of life (HRQOL) in middle-aged and older Korean using national data. The subjects were 14,117 adults aged ≥55 years. HRQOL was evaluated using the EuroQol-5 Dimension (EQ-5D) questionnaire, and active aging was defined based on the health factors, participation factors, and security factors. The average EQ-5D score was 91.04 ± 0.143. Hierarchical multiple regression analysis sequentially inputting the health, participation, and security factors showed that health factors had the strongest influence on HRQOL (F = 216.656, p < 0.001). In the final model, which included all variables, activity limit (B = -10.477, p < 0.001) and subjective health status (B = -7.282, p < 0.001) were closely related to the HRQOL. In addition, economic activity, income level, home ownership, private health insurance, and unmet healthcare needs were associated with HRQOL. The R2 of the model was 38.2%. To improve the HRQOL of middle-aged and older people, it is necessary to consider active aging factors. Furthermore, follow-up studies using various indicators reflecting active aging should be conducted.

Active ageing - perspectives on health, participation, and security among older adults in northeastern Thailand - a qualitative study

BACKGROUND

Health, participation, and security are the basic pillars of active ageing suggested by the WHO. The concept is used by professionals but requires exploration from the perspectives of older people themselves. This study aims to explore how older adults experience and describe health, participation, and security.

METHODS

A qualitative research approach was used based on open-ended interviews with 20 older Thai adults aged 60-92 years. The interviews were analysed using qualitative content analysis.

RESULTS

The results showed perspectives related to experiences of daily life and local culture. Health while ageing, was described as the absence of barriers to continued daily living, combined with a peaceful and adaptive mindset. Participation was described as maintaining social networks and being a formal volunteer, with an emphasis on the "making of merits", of meaningful activities and being respected. Security was described as manageable living conditions and managing to finalize life well by balancing dependency and independency in relation to children to sustain the traditional value of gratitude between generations.

CONCLUSIONS

These understandings will support healthy policy planning by providing resources and activities that relate to older Thai adults' perspectives of health, participation and security and ultimately contribute to a better quality of life.

Art activities and qigong exercise for the well-being of older adults in nursing homes in Indonesia: a randomized controlled trial

Objective: This study aims to investigate the effect of an integrated intervention of art activities and Qigong exercise on the well-being of older adults in nursing homes in Indonesia.Method: We employed a randomized controlled trial with 4 specific groups, i.e. art, Qigong, integration of art and Qigong, and control group. A total of 267 participants aged 50 years or older were recruited from 9 nursing homes in Jakarta, Indonesia. The participants were randomly allocated to one of the four groups, attending two intervention sessions per week for eight weeks (16 sessions), lasting 90 minutes each. Measurements were administered at baseline (T₀) and post-intervention (T₁). The primary outcome was well-being (WHOQOL-Bref) and secondary outcomes were satisfaction with life (SWLS), depression (BDI-II), and health status (SF-36).Results: The art intervention had a significant positive effect on well-being, in particular in the domain of social relations. It also led to a decrease in depressive symptoms, as did the integration intervention. No significant effects were visible in the Qigong group nor in the integrated intervention compared to either art or Qigong alone.Conclusion: Interventions such as art programs and an integration of art and Qigong may give psychological benefits to older adults. Yet, results of the study need to be interpreted with caution and need to be replicated. A qualitative approach would be welcome to get an in-depth understanding of why art intervention is especially beneficial. (Trial registration: Clinicaltrials.gov NCT02957773, registered 28 September 2016).

Exercise Spaces in Parks for Older Adults: A Qualitative Investigation

In response to demographic changes in recent years, an increasing number of parks have established exercise spaces for older adults. However, limited research has been conducted to investigate how older adults utilize, experience, and perceive these spaces. This study aims to explore their experiences of using these spaces and their perspectives on these spaces by using a qualitative descriptive research design. In-depth interviews were conducted with 32 users in three Hong Kong parks with low, medium, and high area-based socioeconomic statuses. The findings highlight that exercise spaces in parks can cultivate a positive environment allowing older adults with varying physical abilities and health statuses to remain active together as well as to support each other socially and emotionally in a natural outdoor setting. The participants' perspectives on the exercise space discussed in this study suggest that future plans for constructing such spaces in parks might benefit from a co-design approach.

‘It gives you a reason to be in this world’: the interdependency of communities, environments and social justice for quality of life in older people

Research regarding quality of life among older people has predominantly focused on functional elements experienced at individual or dyadic level despite the complex interplay of factors that contribute to quality of life. Perspectives which explore interdependencies within communities and the intersecting environments in which older people exercise agency have seen less study. They do, however, play an important role in influencing quality of life as experienced by older people across community settings. Qualitative data from a co-produced study of dimensions influencing quality of life in older people was subjected to secondary analysis using a critical human ecological approach. Findings demonstrate the importance of community interdependencies in supporting individual quality of life, the expression of active agency to foster quality of life within and across communities, and the importance of state infrastructures and service provision within these interdependencies. This article argues for a movement beyond functional conceptualisations of quality of life towards the inclusion of perspectives regarding communal wellbeing, alongside the role differing types of community play in influencing quality of life. Through developing conceptions of quality of life in social relations and community cohesion, in particular how quality of life is influenced by perceptions of solidarity and social justice including across generations, assessing quality of life at community level will assist in driving cultural change in policy making and practice.

Psychosocial Determinants of Quality of Life and Active Aging. A Structural Equation Model

Population aging is the 21st century's predominant demographic event. The old-age dependency ratio is projected to rise sharply in the next decades. Variables of health-related quality of life can be useful in designing interventions for promoting active aging to prevent dependency and save governments' budgets. This study aims to find a model capable of explaining how psychosocial variables are related to improved quality of life during active aging, and if this relationship varies with age. Structural equation modelling (SEM) was used to examine the relationships among the availability of social resources, memory, depression, and perception of quality of life from three community senior centers in Madrid (Spain) in a sample of 128 older adult volunteers. The results suggest a psychosocial model where the availability of social support improves quality of life and explicit memory, reduces depression in active older adults, and where there are two main elements for understanding quality of life: perception of health and satisfaction. Importantly, age does not modify the interactions between variables, suggesting that their behavior is constant across aging. We concluded that the availability of social resources, understood not only as the people we interact with daily but also other family members, close friends, or institutions that could help in case of an emergency, allows people to avoid isolation and loneliness, increasing satisfaction and well-being in older adults. Professionals and policymakers should promote well-being by incorporating psychosocial variables related to personal satisfaction in the existential project, not only health, functional activity, or a friendly environment. Older adults need to feel that they are not alone, and in this sense, the availability of social resources is key.

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

OBJECTIVE

To analyze social, environmental and health-related inequalities in the level of active aging among older adults who participated in the Health Survey conducted in the city of Campinas, Brazil.

METHODS

The level of active aging was estimated based on a ranking of engagement in activities using factor analysis. More active older adults (situated in the highest tertile of the ranking) were compared with the others through the prevalence ratios (PR) and respective 95 % confidence intervals (CI) estimated by Poisson regression.

RESULTS

The study population thus consisted of 986 older adults. The majority of the respondents were female (57.6 %), in the 60-69 years age group (56.7 %), had less than 8 years of schooling (65.3 %) and had a per capita family income of 1-3 minimum salaries (55.3 %). Access to public spaces for the practice of physical activity near the home (PR = 1.44; 95 % CI, 1.07-1.94) and higher level of education (PR = 2.14; 95 % CI, 1.60-2.86), income (PR = 1.73; 95 % CI, 1.25-2.40), physical health (PR = 1.44; 95 % CI, 1.13-1.82) and mental health (PR = 1.62; 95 % CI, 1.05-2.49) were more prevalent among older adults with a high level of active aging.

DISCUSSION

The findings demonstrate that the level of involvement in activities does not solely depend on personal choices. Social, economic, environmental, physical and mental contexts all exert a strong influence.

Factors influencing communication about frailty in primary care: A scoping review

OBJECTIVE

To summarise the available evidence on the factors influencing communication about frailty in the primary care setting.

METHODS

We conducted a scoping review, searching five electronic databases (PubMed, Scopus, CINAHL, PsycINFO, and ProQuest) for studies addressing communication about frailty in primary care practice. Reference list and grey literature searching was conducted to identify additional articles. A narrative descriptive method was used to synthesise the findings.

RESULTS

The search identified 3185 articles and 37 were included in the review. We identified five categories of factors influencing communication about frailty at the consumer, healthcare provider, and system levels: (1) consumer perceptions, information needs, and communication preferences; (2) healthcare providers' knowledge, capacities, and attitudes; (3) clinical communication skills and training; (4) availability of information and communication technologies; and (5) care coordination, collaboration, and case management.

CONCLUSION

Findings offer considerations for the design and delivery of initiatives to improve communication about frailty in primary care both at the local clinical level and at the broader level of healthcare service delivery.

PRACTICE IMPLICATIONS

Healthcare providers and systems require practical, evidence-informed guidance regarding the development of a systematic approach to the quality and timing of communication about frailty in healthcare encounters.

Older Adults’ Self-Perceptions of Aging and Being Older: A Scoping Review

Background and Objectives

Older adults’ self-perceptions of aging and being older can influence well-being and quality of life. This systematic scoping review aimed to map out current research on older adults’ self-perceptions of aging and being older.

Research Design and Methods

The scoping review followed Arksey and O’Malley’s methodological framework. A total of 5,037 records were identified (duplicates removed). After screening, a final 148 papers were included. Descriptives, including year of publication, methodology, age, gender, and location of participants, were calculated. Thematic analyses were conducted examining ways in which the topic was conceptualized.

Results

The most frequent method used in the research was quantitative. Participants were from 38 different countries. There were more female participants than male. Seven themes representing the main research emphasis emerged: attitudes towards one’s own aging (n = 48), aging well (n = 23), aging stereotypes, self-stigma (n = 23), construction of aging identities (n = 22), subjective age (n = 18), the aging body (n = 8), and future self-views (n = 6).

Discussion and Implications

The research within these themes approach self-perceptions of aging using varying points of reference for what participants compare their age to. The methods used to illicit aging perspectives held their own assumptions about aging.

‘It's our pleasure, we count cars here’: an exploration of the ‘neighbourhood-based connections’ for people living alone with dementia

The extent of social isolation experienced by people living with dementia who reside in the community has been well acknowledged, yet little is known about how people living alone with dementia maintain neighbourhood-based connections. The purpose of this study is to examine the experiences of people with dementia who live alone, focusing upon how they establish social networks and relationships in a neighbourhood context, and how they are supported to maintain this social context within everyday life. Multiple data collection methods were used including, semi-structured interviews, walking interviews, guided home tours and social network mapping, which were conducted with 14 community-dwelling people living alone with dementia (11 women and three men) situated across the three international study sites in England, Scotland and Sweden. Data were analysed using thematic analysis. The analysis revealed four main themes: (a) making the effort to stay connected; (b) befriending by organisations and facilitated friendships; (c) the quiet neighbourhood atmosphere; and (d) changing social connections. The analysis suggests that people with dementia who live alone were active agents who took control to find and maintain relationships and social networks in the neighbourhood. Our findings indicate the need to raise awareness about this specific group in both policy and practice, and to find creative ways to help people connect through everyday activities and by spontaneous encounters in the neighbourhood.

Expectations of Singaporean patients concerning activities after total knee arthroplasty

Background:

There are many factors that affect the experience and satisfaction of a patient undergoing knee replacement surgery.

Objective:

This study aims to explore the effects of demographic factors, disease severity and several novel parameters on patients’ expectations in a Singaporean population.

Methods:

Phone interviews were conducted with 69 patients to measure their expectations before total knee arthroplasty (TKA). Information such as demographics, surgical histories, baseline Medical Outcomes Study Short Form 36 (SF-36) score, Knee injury and Osteoarthritis Outcome Score (KOOS), Lower Extremity Activity Scale (LEAS), kneeling ability, quality of reviews from relatives or friends and histories of any traditional therapies utilised were obtained. Radiological severity of osteoarthritis was graded using the Kellgren–Lawrence scale; discordance with severity of knee pain was recorded.

Results:

Patients expected TKA to result in pain relief, improved mobility, increased ability to participate in physical activities, and paid employment. On multivariate regression analysis, LEAS, SF-36 physical, KOOS-pain and KOOS-activity of daily living scores remained significant predictors of expectations.

Conclusion:

The results indicated multiple factors influence patient’s expectations pre-operatively and their satisfaction post-operatively. Better patient outcomes may be achieved by making improvements in understanding and moderating patient expectations.

Level of evidence:

Diagnostic III

Perceived Control and Social Activity in Midlife and Older Age: A Reciprocal Association? Findings From the German Ageing Survey

Objectives

Perceived control may promote social activity in older adults because individuals with greater perceived control have greater confidence in their ability to achieve outcomes and are more likely to choose difficult activities, show persistence, and employ strategies to overcome challenges. Cross-sectional research has linked perceived control with social activity in life span and older adult samples but provides little insight into the direction of influence. We examined reciprocal associations between perceived control and social activity in order to establish temporal sequencing, which is one prerequisite for determining potential causation.

Method

Participants were 14,126 midlife and older adults from the German Ageing Survey. Using cross-lagged autoregressive modeling with age as the time metric (40-87 years), we examined reciprocal 3-year lagged associations between perceived control and social activity, while controlling for concurrent associations.

Results

Perceived control significantly predicted social activity 3 years later. Reciprocally, social activity significantly predicted perceived control 3 years later. The influence of perceived control on social activity was greater than the influence of social activity on perceived control.

Discussion

The finding that perceived control significantly predicts future social activity has potential implications for developing interventions aimed at promoting social activity in midlife and older adults.

Assimilative and Accommodative Coping and Older People's Leisure Activities

Objectives: Assimilative and accommodative coping strategies have hardly been studied in relation to leisure activities in old age. We investigated whether tenacious goal pursuit (TGP) and flexible goal adjustment (FGA) influence the association between physical performance and participation in leisure activities. Methods: A cross-sectional analysis was conducted among 187 community-dwelling people aged 79 to 93 years. TGP, FGA, and leisure activity participation were asked with questionnaires. Physical performance was assessed with the Short Physical Performance Battery (SPPB). Results: TGP moderated the relationship between physical performance and leisure activity participation. Despite low physical performance, people with high TGP had close to mean level of leisure activity participation, whereas low TGP was associated with very little activity. Most notably, people without high TGP had fewer outdoor activities and group activities outside home. Similar effects were not found for FGA. Discussion: Persistency, rather than flexibility, in goal pursuit appears to help older people be active in their leisure time.

Social determinants of multimorbidity and multiple functional limitations among the ageing population of England, 2002-2015

This study explores longitudinal relationships between material, psycho-social and behavioural social determinants of health and multimorbidity of people aged 50 years or older in England. We used data from the English Longitudinal Study of Ageing collected biannually between 2002 and 2015. Apart from the basic measure of multimorbidity (two or more diseases within a person) we constructed two distinct measures of health in order to take into account the biology of ageing (complex multimorbidity and multiple functional limitations).

We found that the likelihood of multimorbidity and multiple functional limitations was consistently associated with the levels of household wealth, sense of control over one's life, physical activity and loneliness. Larger health inequalities were observed when health was measured as complex multimorbidity and multiple functional limitations than basic multimorbidity. Compared to the population group with the highest wealth, those with the lowest wealth had 47% higher odds of basic multimorbidity (95% C.I. 1.34-1.61), 73% higher odds of complex multimorbidity (95% C.I. 1.52-1.96) and 90% higher odds of having 10 or more functional limitations (95% C.I. 1.59-2.26). We did not find a dose-response relationship between alcohol consumption, smoking and multimorbidity but rather evidence of people in ill health actively moderating their health behaviour.

We suggest that materialist models of multimorbidity and functional limitation at older age can not, on their own, explain the health inequalities as the behavioural and psycho-social factors play an important role. Policies aiming to reduce the risk of multimorbidity and functional limitation should address the issue at these three levels simultaneously, using the existing national infrastructure of General Practices.

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Multimorbidity and functional limitation were associated with household wealth, sense of control over life, physical activity, loneliness.

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We observed larger health inequalities for complex multimorbidity and multiple functional limitation than basic multimorbidity.

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Materialist models of multimorbidity do not explain inequalities.

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Behavioural and psycho-social factors play an important role.

What Is Meaningful Participation for Older People? An Analysis of Aging Policies

Background and Objectives

The language used to construct policy problems influences the solutions created. Recent aging policies emphasize participation as essential to aging well, encouraging independence and active involvement in all aspects of life. However, it is less clear whether participation in the creation of policies or in policy goals and aspirations is meaningful. This article addresses the question: “How is meaningful participation reflected and enabled in policy?”

Research Design and Methods

Eleven global, national, and local policies were purposively selected and analyzed using thematic and discourse analysis.

Results

Policies framed population aging as a challenge and active aging as a value as or part of the policy-making process, participation is enabled (or not) through the types of participation encouraged by policy makers and the kinds of participation used to engage with older people.

Discussion and Implications

Our analysis identifies a strong pattern of discourses regarding individual responsibility to age well; underlying tensions between productive and passive participation; and tensions inherent to the concept of consultation. Implications include the need for those in the consultative phase of policy making to engage with diverse older people and to use participatory methods to explore what meaningful participation means for older people themselves.

Study on Lifestyle Evaluation Systems for the Health of Chinese Elderly

Background/Objective: China is now faced with a serious population aging challenge, and the health of the Chinese elderly is becoming an imminent concern. Consequently, it is critical to establish a lifestyle evaluation system for promoting the health of the Chinese elderly. Methods: Interviews with experts and questionnaire surveys were conducted. Factor analysis, analytic hierarchy process, and statistical analyses were also adopted in this study. Results: Besides evaluation metrics and standards, a two-level category system including 50 indices and associated weights from three level 1 categories (physical and mental health and social wellbeing) and thirteen level 2 categories were obtained. Discussion and Conclusions: Based on the confirmatory factor analysis and Cronbach's test, such an evaluation system excels in effectiveness and reliability, and is ready to be popularized in Chinese society. We expect that the Chinese elderly will benefit from our system and that it will lead to a healthy lifestyle accordingly.

Social and leisure activity profiles and well-being among the older adults: a longitudinal study

OBJECTIVES

Studies highlight the beneficial effects of social and leisure activities on the well-being of aging people. Our aims were: to investigate activity profiles among older adults living in their own homes, to highlight potential changes in profiles over a period of five years and to examine effects of differences between these profiles on well-being variables.

METHODS

Three waves were considered in this longitudinal study, with 550, 410 and 374 people (76, 79, 82 years on average), respectively. We used cluster analysis to obtain activity profiles of social and leisure activities, ANOVAs with age and external variables (satisfaction with life, time occupation satisfaction, self-esteem and depression) to explore differences between cluster groups, and chi-square tests of association to explore whether the same individual belonged to the same activity profile over time.

RESULTS

The number of clusters decreased strongly from the first wave to the other two waves (n = 7 to n = 2 and 3). Two main types of activity differentiated the profiles: social activities (voluntary work and associations) and recreational activities outside the home/at home. The activities showed no systematic or strong effects on external variables, nevertheless for the oldest subjects when comparing the less active to the more active (recreational profile and social profile) the latter expressed a greater satisfaction of time occupation and self-esteem, and lower scores of depressive symptoms.

CONCLUSIONS

Such activities could be an indicator of a certain independence (physical and mental availability) which plays a strong role in the well-being of older adults.

Active Ageing: Mapping of Scientific Coverage

Population ageing is one of humanity's greatest achievements with the elderly who offer valuable resources and make an important contribution to the structure of our societies. At the same time, this ageing population poses great challenges, as it requires greater economic and social needs. Institutions such as the World Health Organization (WHO) are promoting policies that aim at promoting active ageing, which is understood as the process of optimizing health, participation and security opportunities in order to improve people's quality of life as they get older. The main objective of this study is to identify scientific production related to the area of Active Ageing. The work methodology used is the bibliometric analysis of the articles indexed in the multidisciplinary databases WoS and Scopus. There were 171 articles in WoS and 234 in Scopus that were selected, with a time limit in 2017. In the analysis carried out it is observed that active ageing is a topic that has aroused interest among researchers in recent years, proof of this is the increase both in the number of articles published in scientific journals and in the citations received. The Scopus database presents a greater coverage of the subject. The Overlap Index shows that Scopus covers 90.06% of the WoS articles and its Single Documents index is 34.19% versus 9.94% of WoS.

The Usability Study of a Proposed Environmental Experience Design Framework for Active Ageing

Growing ageing population today may be necessitating building design decision makers to reconsider the indoor environmental quality (IEQ) standards in a way that accommodates senior occupants’ diverse and individual needs and demands. An experience design approach to rationalising and individualising end-user experience on how to utilise tangible products may serve to reflect user perceptions. Generally, architectural design practices tend to incorporate neither IEQ monitoring and analysis data, nor environmental experience design today. In response to the need for filling this gap, the authors of this paper conducted a feasibility study previously that led to structuring and defining an ‘Environmental Experience Design’ (EXD) research framework. Based on the previous case study on the collective spatial analysis and IEQ monitoring results, this paper further explored the usability and applicability of this proposed EXD framework particularly to the previously documented aged care facility in Victoria, Australia, which has been stressing active ageing agendas. This EXD framework usability experiment helped to build the capacity for engaging the subjectivity and objectivity of end users’ expectations, desires, and requirements in the architectural design thinking process. Nonetheless, due to the limitation of this initial and fundamental usability study’s resources and the objective, the necessity of adjusting the scale and scope of EXD analyses emerged. Moreover, the universality of this EXD research framework usage under various architectural typologies and user conditions yet require further attempts and investigations.

A Narrative Review of School-Based Physical Activity for Enhancing Cognition and Learning: The Importance of Relevancy and Integration

Engaging in regular physical activity can have substantial cognitive and academic benefits for children, and is generally promoted for its beneficial effects on children's physical and mental health. Although embodied cognition research has convincingly shown the integral relationship of the human body and mind, in schools physical activity and cognitive activity are typically treated as unrelated processes. Consequently, most physical activities used are neither sufficiently relevant for nor fully integrated into the learning tasks. In reviewing the literature regarding the integration of physical activity into education to promote cognition and learning, two main lines of research emerged: exercise and cognition research vs. embodied cognition research. In this narrative review, we describe these two separately evolved schools of thought, highlighting their differences and commonalities. In categorising the existing studies on a 2 × 2 matrix, concerning the two main categories of relevance for and integration into the learning task, it becomes clear where the different foci lie, and how both lines of research could profit from learning from each other. Finally, a new instructional model that integrates task-relevant physical activities into the cognitive/learning task is proposed to inform both further research and educational practice.

Popular music scenes and aging bodies

During the last two decades there has been increasing interest in the phenomenon of the aging popular music audience (Bennett & Hodkinson, 2012). Although the specter of the aging fan is by no means new, the notion of, for example, the aging rocker or the aging punk has attracted significant sociological attention, not least of all because of what this says about the shifting socio-cultural significance of rock and punk and similar genres - which at the time of their emergence were inextricably tied to youth and vociferously marketed as "youth musics". As such, initial interpretations of aging music fans tended to paint a somewhat negative picture, suggesting a sense in which such fans were cultural misfits (Ross, 1994). In more recent times, however, work informed by cultural aging perspectives has begun to consider how so-called "youth cultural" identities may in fact provide the basis of more stable and evolving identities over the life course (Bennett, 2013). Starting from this position, the purpose of this article is to critically examine how aging members of popular music scenes might be recast as a salient example of the more pluralistic fashion in which aging is anticipated, managed and articulated in contemporary social settings. The article then branches out to consider two ways that aging members of music scenes continue their scene involvement. The first focuses on evolving a series of discourses that legitimately position them as aging bodies in cultural spaces that also continue to be inhabited by significant numbers of people in their teens, twenties and thirties. The second sees aging fans taking advantage of new opportunities for consuming live music including winery concerts and dinner and show events.

Selfie Aging Index: An Index for the Self-assessment of Healthy and Active Aging

Introduction

Governments across Europe want to promote healthy and active aging, as a matter of both public health and economic sustainability. Designing policies focused on the most vulnerable groups requires information at the individual level. However, a measure of healthy and active aging at the individual level does not yet exist.

Objectives

This paper develops the Selfie Aging Index (SAI), an individual-level index of healthy and active aging. The SAI is developed thinking about a tool that would allow each person to take a selfie of her aging status. Therefore, it is based entirely on self-assessed indicators. This paper also illustrates how the SAI may look like in practice.

Methods

The SAI is based on the Biopsychosocial Assessment Model (MAB), a tool for the multidimensional assessment of older adults along three domains: biological, psychological, and social. Indicators are selected and their weights determined based on an ordered probit model that relates the MAB indicators to self-assessed health, which proxies healthy and active aging. The ordered probit model predicts the SAI based on the estimated parameters. Finally, predictions are rescaled to the 0–1 interval. Data for the SAI development come from the Study of the Aging Profiles of the Portuguese Population and the Survey of Health, Aging, and Retirement in Europe.

Results

The selected indicators are BMI, having difficulties moving around indoors and performing the activities of daily living, feeling depressed, feeling nervous, lacking energy, time awareness score, marital status, having someone to confide in, education, type of job, exercise, and smoking status. The model also determines their weights.

Conclusion

Results shed light on various factors that contribute significantly to healthy and active aging. Two examples are mental health and exercise, which deserve more attention from individuals themselves, health-care professionals, and public health policy. The SAI has the potential to put the individual at the center of the healthy and active aging discussion, contribute to patient empowerment, and promote patient-centered care. It can become a useful instrument to monitor healthy and active aging for different actors, including individuals themselves, health-care professionals, and policy makers.

The Effectiveness of Combining Visual Art Activities and Physical Exercise for Older Adults on Well-Being or Quality of Life and Mood: A Scoping Review

Visual art activities and physical exercise are both low-intensity and low-cost interventions. The present study aims to comprehensively describe published literature on the effectiveness of a combination of these interventions on well-being or quality of life (QoL) and mood of older adults. Embase, CINAHL, Ovid Medline (R), PsycINFO, and Web of Science databases were searched for studies published between 1990 and 2015 that evaluated interventions combining visual art therapy and exercise for people aged 50 years or older with at least one resultant well-being or QoL or mood outcome. We found 10 studies utilizing different combination programs and outcome measures, and most had small sample sizes. Seventy percent of the studies reported that combining both interventions was effective in improving well-being or QoL and mood in older adults. Future studies are, however, requisite to investigate whether in the respective population such a combination is more effective than either of the interventions alone.

Comparison of two health measurements among older adults

The aims of this study were to develop composite indices for measuring the life relative independence of older adults and to compare the results with the self-rated health status to evaluate the reliability. The life relative independence measures were developed using a representative cross-sectional survey of 2336 samples in Taiwan. The results indicated that older adults have poor social health and economic security, the life relative independence is more effective in health evaluation than the self-rated health status and psychological health is associated with independence. This study provides an improved understanding of scenarios of independence for older adults.

An Empirical Comparison of Different Models of Active Aging in Canada: The International Mobility in Aging Study

Purpose

Active aging is a concept that lacks consensus. The WHO defines it as a holistic concept that encompasses the overall health, participation, and security of older adults. Fernández-Ballesteros and colleagues propose a similar concept but omit security and include mood and cognitive function. To date, researchers attempting to validate conceptual models of active aging have obtained mixed results. The goal of this study was to examine the validity of existing models of active aging with epidemiological data from Canada.

Methods

The WHO model of active aging and the psychological model of active aging developed by Fernández-Ballesteros and colleagues were tested with confirmatory factor analysis. The data used included 799 community-dwelling older adults between 65 and 74 years old, recruited from the patient lists of family physicians in Saint-Hyacinthe, Quebec and Kingston, Ontario.

Results

Neither model could be validated in the sample of Canadian older adults. Although a concept of healthy aging can be modeled adequately, social participation and security did not fit a latent factor model. A simple binary index indicated that 27% of older adults in the sample did not meet the active aging criteria proposed by the WHO.

Implications

Our results suggest that active aging might represent a human rights policy orientation rather than an empirical measurement tool to guide research among older adult populations. Binary indexes of active aging may serve to highlight what remains to be improved about the health, participation, and security of growing populations of older adults.

Active Aging in Very Old Age and the Relevance of Psychological Aspects

Background

Active aging encompasses a socially and individually designed mix of different domains that range from personal and familial, to social and professional. In being a key policy concept often focused on the young-old individuals, efforts in studying its dimensions in advanced ages have seldom been made. Nevertheless, there is a recognized need to promote adequate responses to the growing number of individuals reaching advanced ages and to recognize their specific dependability on health-related aspects, services attendance, social interactions, or on psychological characteristics for what it means to “age actively.”

Objective and methods

This study provides a secondary analysis of data and follows the preceding work on the operationalization of the World Health Organization’s (WHO) active aging model by means of an assessment protocol to measure which variables, within the model’s determinants, contribute the most for an active aging process (1). Authors used the achieved model (composed by six factors: health, psychological component, cognitive performance, social relationships, biological component, and personality) and performed multi-group analysis of structural invariance to examine hypothetical differences between age groups (<75 years vs. ≥75 years) and to contrast obtained findings with the originally achieved model for the total sample (1,322 individuals aged 55 +).

Results

The structural covariances for the two age groups were statistically different. The comparison of components between age groups revealed a major relevance of the psychological component for the older age group.

Conclusion

These findings reinforce the importance of psychological functioning in active aging in oldest old, and the need for further research on specific psychological features underlying the subjective meaning of active aging in more advanced ages.

Redefining agency in late life: the concept of ‘disponibility’

In light of an increased ageing population, policy makers are faced with the urgent problem of planning programmes that reflect active ageing or, in other words, the promotion of activities that help individuals to remain active in a societal context. The construct of agency, defined as the capacity to make decisions and to address situations depending on the individual's future plans, reflects a specific normative criterion: individuals are expected to live in an active and productive way, while those who are unable to live up to this expectation are considered dependent, passive, unproductive, weak. From a social constructionist perspective, the current study proposes a critical reflection on the qualities usually attributed to the construct of agency that are liable to appear reductive and oppressive when applied to an elderly population. Once the basic premises underlying agency, as it is commonly defined in the Western tradition, have been deconstructed, a different conceptualisation, based on interviews with older individuals, will be presented. The current work aims to produce a different conceptual framework that will permit examination of experiences and organisational modalities of agency typifying later life. The comments made by the interviewees in many cases resonate with ideas contained in Taoist philosophy and, more specifically, with the concept ofdisponibilité(or disponibility) outlined by the French sinologist François Jullien, which we discuss here.

Being occupied: supporting ‘meaningful activity’ in care homes for older people in England

The benefits of meaningful activity in later life are well documented. Studies show that being occupied contributes to both physical and mental health as well as quality of life. Research also suggests that activity may be beneficial to people residing in care homes, including people living with dementia. This paper presents findings from a study which used the Adult Social Care Outcomes Toolkit (ASCOT) to measure quality of life in six care homes located in the south-east of England. The study found, like previous ones, that care home residents’ days were characterised by a lack of activity. Drawing on observations, interviews and focus groups with residents and staff from these homes, this paper attempts to understand why care home residents do not engage in meaningful activities. We reject the idea that these low levels of activity are a natural part of the ageing process or that they can be explained by notions of resident choice. Instead, the findings point to both insufficient funding and working practices within care homes as more substantive explanations. These explanations inform a discussion of how the low levels of engagement in meaningful activity could be addressed and residents’ quality of life improved.

Gender differences in health promotion behaviors and quality of life among community-dwelling elderly

The differences of basic attributes, health promotion behaviors, and quality of life between elderly males and females in Taiwan were compared. Several scales were used to examine the gender differences and the factors associated with quality of life. Regression analysis revealed that gender, education level, depression level, and healthy diet were key factors influencing the overall quality of life. The education level of females was lower, and their depression level was higher; however, females had healthier diets. With regards to their satisfaction in the quality of life, elderly males scored higher than females in both the physical and psychological domains.

Gender, aging, and the economics of "active aging": Setting a new research agenda

The world is aging, and the percentages of older people are on a dramatic ascent. This dramatic demographic aging of human society is not gender neutral; it is mostly about older women. One of the key policy approaches to address the aging revolution is known as "active aging," crystalized by the WHO in 2002 by three pillars: participation, health, and security. The active aging policy has financial and economic aspects and affects both men and women. However, as argued in this article, a gender-based approach has not been adopted within the existing active aging framework. Therefore, a new gender-specific research agenda is needed, one that focuses on an interrelation between gender and different economic aspects of "active aging" from international, comparative, cultural, and longitudinal perspectives.

Does active ageing contribute to life satisfaction for older people? Testing a new model of active ageing

Several debates have emerged across the literature about the conceptualisation of active ageing. The aim of this study is to develop a model of the construct that is focused on the individual, including different elements of people's lives that have the potential to be modified by intervention programs. Moreover, the paper examines the contributions of active ageing to life satisfaction, as well as the possible predictive role of coping styles on active ageing. For this purpose, a representative sample of 404 Galician (Spain) community-dwelling older adults (aged ≥60 years) were interviewed using a structured survey. The results demonstrate that the proposed model composed of two broad categories is valid. The model comprises status variables (related to physical, psychological, and social health) as well as different types of activities, called processual variables. This model is tested using partial least squares (PLS) regression. The findings show that active ageing is a fourth-order, formative construct. In addition, PLS analyses indicate that active ageing has a moderate and positive path on life satisfaction and that coping styles may predict active ageing. The discussion highlights the potential of active ageing as a relevant concept for people's lives, drawing out policy implications and suggestions for further research.

Erfolgreiches kognitives Altern: Zusammenhang der kognitiven Leistungen mit Aktivität und Zufriedenheit

Zusammenfassung. Für erfolgreiches Altern sind Kognition, Zufriedenheit und tägliche Aktivitäten relevante Faktoren. In dieser Studie werden Zusammenhänge zwischen diesen Faktoren aufgedeckt. Bei 167 Senioren (60 bis 98 Jahre) wurden Aktivität und Zufriedenheit in einem Interview, Kognition durch die Neuropsychological Assessment Battery (dt. Version) erfasst. Alle Faktoren zeigen eine negative Altersentwicklung. Aktivitäten korrelieren mit allen Faktoren; insbesondere stehen Alltagsaktivitäten und kognitive Aktivitäten positiv mit Kognition im Zusammenhang, soziale Aktivität ist davon unabhängig. Die kognitiven Funktionsbereiche Aufmerksamkeit, Sprache und exekutive Funktionen variieren mit Aktivität und Zufriedenheit, Gedächtnis nur mit kognitiven Aktivitäten, Wahrnehmung ist davon unabhängig. Dies könnte bedeuten, dass kognitive Aktivitäten spezifisch mit der kognitiven Leistung und soziale Aktivitäten spezifisch mit der emotionalen Bewertung zusammenhängen und als Schutzfaktoren während der Entwicklung wirken könnten.

Assumptions about later-life travel and their implications: pushing people around?

Taking four assumptions in turn, this review article considers some of the lenses through which researchers might look at later-life leisure travel and the implications of adopting each of them. First, we consider the ‘active ageing’ agenda and what this means for how leisure travel may be thought about in academia and beyond. Second, we turn to studies underpinned by worries about the appetite for significant consumption thought to typify the ‘baby-boomer’ generation and question whether these studies could inadvertently be promoting the very future they hope to avoid. Third, we explore how research on the benefits of everyday ‘mobility’ in later life may have morphed into a more general belief about the value of travel in older age. Finally, we reflect on how relevant studies of tourism are often underpinned by an argument about the financial rewards that now await those ready to target the older traveller. Our overall contention is that, though for different reasons, all four could be serving to encourage more later-life travel. Whilst for some this prospect is not at all troubling, the spectre of adverse energy demand consequences leads us to explore a more critical view.

Empowering the elderly population through ICT-based activities

Purpose

– The purpose of this paper is to focus on elderly people who have adopted Information and Communication Technology (ICT) and participated in ICT-based activities, and explore variables associated with their individual and collective empowerment by using data collected by a questionnaire survey.

Design/methodology/approach

– A set of 14 questions was developed to measure older adults’ perceived psychological empowerment. A factor analysis was conducted to condense 14 individual variables into several large categories. Finally, a set of multiple regression analyses was employed to identify variables associated with the elderly’s individual and collective empowerment.

Findings

– Three factors, including a sense of meaning; competence/self-determination; and collective empowerment were extracted from the 14 questions. Multiple regression models revealed that elderly empowerment is not a matter of social skills, ICT skills, or complementary skills, but is more likely to result from their being interested in ICT and ICT-based activities. Learning activities in ICT-based activities and participation frequency were found to be predictors of both meaning and competence/self-determination dimensions.

Research limitations/implications

– The major finding of this study concerns the development of a measure that assesses three factors of empowerment in older adults, i.e., sense of meaning, competence/self-determination, and collective empowerment. This study represents an initial step in establishing the measure, and therefore, further work is needed to establish its psychometric properties, particularly external validity.

Originality/value

– This study is one of the first studies to focus on older people’s empowerment construct and its relation to ICT-based activities.