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Dlima SD, Hall A, Aminu AQ, Akpan A, Todd C, Vardy ERLC. Frailty: a global health challenge in need of local action. BMJ Glob Health 2024; 9:e015173. [PMID: 39122463 DOI: 10.1136/bmjgh-2024-015173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 06/24/2024] [Indexed: 08/12/2024] Open
Abstract
Frailty is a complex, age-related clinical condition that involves multiple contributing factors and raises the risk of adverse outcomes in older people. Given global population ageing trends, the growing prevalence and incidence of frailty pose significant challenges to health and social care systems in both high-income and lower-income countries. In this review, we highlight the disproportionate representation of research on frailty screening and management from high-income countries, despite how lower-income countries are projected to have a larger share of older people aged ≥60. However, more frailty research has been emerging from lower-income countries in recent years, paving the way for more context-specific guidelines and studies that validate frailty assessment tools and evaluate frailty interventions in the population. We then present further considerations for contextualising frailty in research and practice in lower-income countries. First, the heterogeneous manifestations of frailty call for research that reflects different geographies, populations, health systems, community settings and policy priorities; this can be driven by supportive collaborative systems between high-income and lower-income countries. Second, the global narrative around frailty and ageing needs re-evaluation, given the negative connotations linked with frailty and the introduction of intrinsic capacity by the World Health Organization as a measure of functional reserves throughout the life course. Finally, the social determinants of health as possible risk factors for frailty in lower-income countries and global majority populations, and potential socioeconomic threats of frailty to national economies warrant proactive frailty screening in these populations.
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Affiliation(s)
- Schenelle Dayna Dlima
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration - Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alex Hall
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Abodunrin Quadri Aminu
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Asangaedem Akpan
- Bunbury Regional Hospital, Bunbury, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration - Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma R L C Vardy
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration - Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Oldham Care Organisation, Northern Care Alliance NHS Foundation Trust, Rochdale Road, Oldham, UK
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Bolster-Foucault C, Vedel I, Busa G, Hacker G, Sourial N, Quesnel-Vallée A. Social inequity in ageing in place among older adults in Organisation for Economic Cooperation and Development countries: a mixed studies systematic review. Age Ageing 2024; 53:afae166. [PMID: 39137063 PMCID: PMC11321251 DOI: 10.1093/ageing/afae166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/11/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Most older adults wish to remain in their homes and communities as they age. Despite this widespread preference, disparities in health outcomes and access to healthcare and social support may create inequities in the ability to age in place. Our objectives were to synthesise evidence of social inequity in ageing in place among older adults using an intersectional lens and to evaluate the methods used to define and measure inequities. METHODS We conducted a mixed studies systematic review. We searched MEDLINE, EMBASE, PsycINFO, CINAHL and AgeLine for quantitative or qualitative literature that examined social inequities in ageing in place among adults aged 65 and older in Organisation for Economic Co-operation and Development (OECD) member countries. Results of included studies were synthesised using qualitative content analysis guided by the PROGRESS-Plus framework. RESULTS Of 4874 identified records, 55 studies were included. Rural residents, racial/ethnic minorities, immigrants and those with higher socioeconomic position and greater social resources are more likely to age in place. Women and those with higher educational attainment appear less likely to age in place. The influence of socioeconomic position, education and social resources differs by gender and race/ethnicity, indicating intersectional effects across social dimensions. CONCLUSIONS Social dimensions influence the ability to age in place in OECD settings, likely due to health inequalities across the lifespan, disparities in access to healthcare and support services, and different preferences regarding ageing in place. Our results can inform the development of policies and programmes to equitably support ageing in place in diverse populations.
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Affiliation(s)
- Clara Bolster-Foucault
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Giovanna Busa
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Georgia Hacker
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Nadia Sourial
- Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Amélie Quesnel-Vallée
- Department of Equity, Ethics and Policy, McGill University, Montreal, QC, Canada
- Department of Sociology, McGill University, Montreal, QC, Canada
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Walsh K, Carroll B, O'Shea E, O'Donovan D. Countering social exclusion through inclusive homecare provision: Utilising a participatory life-course approach to influence policy. Soc Sci Med 2024; 352:117003. [PMID: 38901211 DOI: 10.1016/j.socscimed.2024.117003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 03/04/2024] [Accepted: 05/19/2024] [Indexed: 06/22/2024]
Abstract
Homecare models can be effective mechanisms in securing wellbeing and ageing-in-place goals prevalent in health policy agendas. However, the relevance and utility of these models for those living in socially and environmentally insecure conditions has rarely been considered. This is marked by an assumption of in-situ care delivery in private dwellings, and the absence of such groups from homecare development processes. This study aims to harnesses the experiences and preferences of older people in homelessness (OH), older Irish Travellers (OT), and professional stakeholders in an evidence-based co-production of policy recommendations for inclusive homecare provision. The study employed a participatory approach involving the integration of lived experience evidence in a multistakeholder co-production process. Methods comprised: five separate focus groups with OH, OT and service providers (n = 30); two consultative forums involving focus group participants together; and 49 life-course interviews with OH (n = 27) and OT (n = 22) and adults. Findings demonstrate that sizeable gaps in care remain for these groups, and that resource constraints and legislative restrictions prevail for professional stakeholders. Co-produced policy recommendations for inclusive homecare provision based on these experiences and group preferences are presented and discussed.
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Affiliation(s)
- Kieran Walsh
- Irish Centre for Social Gerontology, Institute for Lifecourse and Society, University of Galway, Galway, Ireland.
| | - Brídín Carroll
- Irish Centre for Social Gerontology, Institute for Lifecourse and Society, University of Galway, Galway, Ireland.
| | - Eamon O'Shea
- Irish Centre for Social Gerontology, Institute for Lifecourse and Society, University of Galway, Galway, Ireland.
| | - Diarmuid O'Donovan
- School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Antrim, Ireland.
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Prina M, Khan N, Akhter Khan S, Caicedo JC, Peycheva A, Seo V, Xue S, Sadana R. Climate change and healthy ageing: An assessment of the impact of climate hazards on older people. J Glob Health 2024; 14:04101. [PMID: 38783708 PMCID: PMC11116931 DOI: 10.7189/jogh.14.04101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Climate change not only directly impacts older people's longevity but also healthy ageing, which is the process of maintaining physical and mental capacities while optimising functional abilities. The urgency to address both population ageing and climate change necessitates a rethink and assessment of the impact of climate change on older people. This includes identifying what can be done to anticipate, mitigate and adapt to climate change and engage older persons. Methods A review of climate change and healthy ageing forms the basis of evidence in this report. We developed a comprehensive search to assess current literature, combining terms related to ageing and climate change across four major data sets and assessing articles published up to the end of 2021. Results We summarised the current and future impact of climate change on older people and developed a framework identifying climate change impacts on older persons, recognising social and environmental determinants of healthy ageing. Major hazards and some key exposure pathways include extreme temperatures, wildfire, drought, flooding, storm and sea level rise, air quality, climate-sensitive infectious diseases, food and water insecurities, health and social care system displacement, migration, and relocation. Strategies to address climate change require interventions to improve systems and infrastructure to reduce vulnerability and increase resilience. As a heterogeneous group, older people's perceptions of climate change should be integrated into climate activism. Increasing climate change literacy among older people and enabling them to promote intergenerational dialogue will drive the development and implementation of equitable solutions. Pathways may operate via direct or indirect exposures, requiring longitudinal studies that enable assessment of exposures and outcomes at multiple time points, and analyses of cumulative impacts of hazards across the life course. Conclusions The lack of systematic reviews and primary research on the impact of most climate hazards, except for heat, on older people is apparent. Future research should include outcomes beyond mortality and morbidity and assess how older people interact with their environment by focusing on their capacities and optimising abilities for being and doing what they value.
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Affiliation(s)
- Matthew Prina
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England, UK
| | - Nusrat Khan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England, UK
| | - Samia Akhter Khan
- Department of Global Health & Social Medicine, King’s College London, London, England, UK
- Department of Health Service & Population Health, King’s College London, London, England, UK
| | | | - Anna Peycheva
- Department of Child and Adolescent Psychiatry, King’s College London, London, England, UK
| | - Veri Seo
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, USA
| | - Siqi Xue
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ritu Sadana
- World Health Organization, Geneva, Switzerland
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5
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Khalatbari-Soltani S, Si Y, Dominguez M, Scott T, Blyth FM. Worldwide cohort studies to support healthy ageing research: data availabilities and gaps. Ageing Res Rev 2024; 96:102277. [PMID: 38499160 DOI: 10.1016/j.arr.2024.102277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Population ageing is a transforming demographic force. To support evidence-based efforts for promoting healthy ageing, a summary of data availabilities and gaps to study ageing is needed. METHOD Through a multifaceted search strategy, we identified relevant cohort studies worldwide to studying ageing and provided a summary of available pertinent measurements. Following the World Health Organization's definition of healthy ageing, we extracted information on intrinsic capacity domains and sociodemographic, social, and environmental factors. RESULTS We identified 287 cohort studies. South America, the Middle East, and Africa had a limited number of cohort studies to study ageing compared to Europe, Oceania, Asia, and North America. Data availabilities of different measures varied substantially by location and study aim. Using the information collected, we developed a web-based Healthy Ageing Toolkit to facilitate healthy ageing research. CONCLUSIONS The comprehensive summary of data availability enables timely evidence to contribute to the United Nations Decades of Healthy Ageing goals of promoting healthy ageing for all. Highlighted gaps guide strategies for increased data collection in regions with limited cohort studies. Comprehensive data, encompassing intrinsic capacity and various sociodemographic, social, and environmental factors, is crucial for advancing our understanding of healthy ageing and its underlying pathways.
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Affiliation(s)
- Saman Khalatbari-Soltani
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia.
| | - Yafei Si
- ARC Centre of Excellence in Population Ageing Research (CEPAR), UNSW Business School, University of New South Wales, Sydney, NSW, Australia
| | - Marielle Dominguez
- ARC Centre of Excellence in Population Ageing Research (CEPAR), UNSW Business School, University of New South Wales, Sydney, NSW, Australia
| | - Tabitha Scott
- ARC Centre of Excellence in Population Ageing Research (CEPAR), UNSW Business School, University of New South Wales, Sydney, NSW, Australia; School of Demography, Australian National University, Canberra, Australia
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, NSW, Australia
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Rodríguez-Monforte M, Fernández-Jané C, Bracha M, Bartoszewska A, Kozakiewicz M, Leclerc M, Nimani E, Soanvaara P, Jarvinen S, Van Sherpenseel M, van der Velde M, Alves-Lopes A, Handgraaf M, Grüneberg C, Carrillo-Alvarez E. Defining a competency framework for health and social professionals to promote healthy aging throughout the lifespan: an international Delphi study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10316-4. [PMID: 38441827 DOI: 10.1007/s10459-024-10316-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/04/2024] [Indexed: 03/27/2024]
Abstract
The promotion of healthy aging has become a priority in most parts of the world and should be promoted at all ages. However, the baseline training of health and social professionals is currently not adequately tailored to these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals' competencies to promote healthy aging throughout the lifespan within the SIENHA project. Materials and methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy aging with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. The SIENHA competence framework for healthy aging may help students and educators enrich their learning and the academic content of their subjects and/or programs and incentivize innovation.
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Affiliation(s)
- Míriam Rodríguez-Monforte
- Global Research on Wellbeing (GRoW), Blanquerna School of Health Sciences - Ramon Llull University, Barcelona, Spain
| | - Carles Fernández-Jané
- Global Research on Wellbeing (GRoW), Blanquerna School of Health Sciences - Ramon Llull University, Barcelona, Spain.
- Departament deSalut, Universitat Pompeu Fabra, Tecnocampus, Mataró-Maresme, Barcelona, Spain.
| | - Marietta Bracha
- Department of Geriatrics, Nicolaus Copernicus University, Torun, Poland
| | | | | | | | | | | | - Sari Jarvinen
- JAMK University of Applied Sciences, Jyvaskyla, Finland
| | | | - Miriam van der Velde
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, The Netherlands
| | | | | | | | - Elena Carrillo-Alvarez
- Global Research on Wellbeing (GRoW), Blanquerna School of Health Sciences - Ramon Llull University, Barcelona, Spain
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Araya AX, Iriarte E, De Oliveira G, Baeza MJ, Jankowski C. Factors Related to the Need for Informal Care Among Community-Dwelling Older Adults in Chile. J Gerontol Nurs 2024; 50:43-52. [PMID: 38290095 DOI: 10.3928/00989134-20240111-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
PURPOSE To identify factors contributing to the need for informal care among community-dwelling older adults with functional impairment in Chile. METHOD A secondary data analysis was conducted using cross-sectional data from 540 Chilean older adults aged ≥60 years (mean age = 72.2 years, SD = 6.22 years). RESULTS Informal care need was reported by 24.3% (n = 131) of participants. Among the variables that most influenced the need for informal care among older adults were hospitalization in the past 1 year, functionality, comorbidities, and multidimensional frailty (all p < 0.05). CONCLUSION This study identified factors that clinicians and nurses should be aware of when caring for this population to prevent or manage the need for informal care. [Journal of Gerontological Nursing, 50(2), 43-52.].
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Mrejen M, Nunes L, Giacomin K. Socioeconomic inequalities in health and healthcare utilization among the elderly in Brazil: results from the 2019 National Health Survey. Public Health 2024; 226:165-172. [PMID: 38071949 DOI: 10.1016/j.puhe.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES To assess socioeconomic-related inequalities in health and healthcare utilization among the elderly in Brazil. STUDY DESIGN Cross-sectional nationally representative household-based survey. METHODS We evaluated the Brazilian National Health Survey data collected in 2019. We computed the prevalence of measures of health conditions and healthcare utilization by age-bracket and markers of socioeconomic status-income, educational attainment, and race/ethnicity-among individuals aged 60 or older. We further employed logistic regression models, adjusted for a wide set of covariates, to estimate the relationship between socioeconomic status and those outcomes. RESULTS Higher-income and more educated individuals exhibit better health conditions compared to their lower-income and less-educated counterparts within each age bracket. Results from regression models showed strong associations with income and educational attainment for most health conditions: health status, physical activity, difficulties with activities of daily living and instrumental activities of daily living, and depression. For most conditions, weaker or no associations with race/ethnicity were found. Individuals in the highest income quintile and that completed higher education also had higher odds of having consulted a physician, while high-income individuals had lower odds of having received emergency care at home. CONCLUSIONS The findings of this study highlight the significant socioeconomic inequalities in the health of the elderly population in Brazil. The substantial and pervasive nature of these inequalities stresses the need for action to address them.
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Affiliation(s)
- M Mrejen
- Instituto de Estudos para Políticas de Saúde (IEPS), São Paulo, SP, Brazil.
| | - L Nunes
- Insper, São Paulo, SP, Brazil
| | - K Giacomin
- NESPE, FIOCRUZ/UFMG, Belo Horizonte, MG, Brazil
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Vennu V. Biological ageing and the risk of decreased handgrip strength among community-dwelling older adult Indians: a cross-sectional study. BMC Geriatr 2023; 23:782. [PMID: 38017427 PMCID: PMC10685496 DOI: 10.1186/s12877-023-04498-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Evidence from the literature demonstrates that the risk of decreased handgrip strength is associated with various health issues, particularly in older persons. To make judgments regarding their general health condition that are well-informed for longevity, it is crucial to assess the risk level of decreased handgrip strength among community-dwelling older adult Indians. However, no study has examined the relationship between biological aging and the risk of decreased handgrip strength in Indian men and women aged 60 and older. The goal of the current study was to fill this gap in the literature. METHODS In this cross-sectional study, we included 31,464 (15,098 men and 16,366 women) community-dwelling older adult Indians aged 60 years and older using data from the Longitudinal Aging Study in India (LASI). The LASI is the world's most extensive and India's first multidisciplinary, internationally harmonized, longitudinal aging study. It has enrolled 72,250 individuals aged 45 and above across all 28 states and 8 union territories of India. Secondary analysis of biological ageing was performed by stratifying for age groups (60-64, 65-69, 70-74, 75-79, 80-84, and 85 + years) for both genders. The dominant right and nondominant left handgrip strength was assessed using the portable Smedley's Hand Dynamometer. All individuals had a dominant right hand. The adjusted logistic regression analysis assessed the association between biological ageing and the risk of decreased handgrip strength for both genders. RESULTS Compared to those between the ages of 60-64, those at age 65 and those aged 85 and above had 1-fold and 12-fold odds of decreasing handgrip strength, respectively. Men 85 years or older had a 12-fold higher chance than women in the same age group of having decreased handgrip strength. CONCLUSIONS The results indicate that community-dwelling older adult Indians aged 65 years and older are significantly associated with a higher risk of decreased handgrip strength, especially among older men. The results of this study can help assess and implement handgrip strength measurement in medicine for older Indians as part of regular admission assessment, particularly for older men.
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Affiliation(s)
- Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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10
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Carrillo-Alvarez E, Rodríguez-Monforte M, Fernández-Jané C, Solà-Madurell M, Kozakiewicz M, Głowacka M, Leclère M, Nimani E, Hoxha A, Hirvonen A, Järvinen S, van der Velde M, van Scherpenseel M, Lopes AA, Santos H, Guimarães I, Handgraaf M, Grüneberg C. Professional competences to promote healthy ageing across the lifespan: a scoping review. Eur J Ageing 2023; 20:45. [PMID: 37999781 PMCID: PMC10673769 DOI: 10.1007/s10433-023-00794-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 11/25/2023] Open
Abstract
As societies age, the development of resources and strategies that foster healthy ageing from the beginning of life become increasingly important. Social and healthcare professionals are key agents in this process; therefore, their training needs to be in agreement with societal needs. We performed a scoping review on professional competences for social and health workers to adequately promote healthy ageing throughout life, using the framework described by Arksey and O'Malley and the Joanna Briggs Institute Guidelines. A stakeholder consultation was held in each of the participating countries, in which 79 experts took part. Results show that current literature has been excessively focused on the older age and that more attention on how to work with younger population groups is needed. Likewise, not all disciplines have equally reflected on their role before this challenge and interprofessional approaches, despite showing promise, have not been sufficiently described. Based on our results, health and social professionals working to promote healthy ageing across the lifespan will need sound competences regarding person-centred communication, professional communication, technology applications, physiological and pathophysiological aspects of ageing, social and environmental aspects, cultural diversity, programs and policies, ethics, general and basic skills, context and self-management-related skills, health promotion and disease prevention skills, educational and research skills, leadership skills, technological skills and clinical reasoning. Further research should contribute to establishing which competences are more relevant to each discipline and at what level they should be taught, as well as how they can be best implemented to effectively transform health and social care systems.
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Affiliation(s)
- Elena Carrillo-Alvarez
- Global Research on Wellbeing (GRoW), Facultat de Ciències de la Salut Blanquerna, Universitat Ramón Llull, Barcelona, Spain
| | - Míriam Rodríguez-Monforte
- Global Research on Wellbeing (GRoW), Facultat de Ciències de la Salut Blanquerna, Universitat Ramón Llull, Barcelona, Spain
| | - Carles Fernández-Jané
- Global Research on Wellbeing (GRoW), Facultat de Ciències de la Salut Blanquerna, Universitat Ramón Llull, Barcelona, Spain.
| | - Mireia Solà-Madurell
- Global Research on Wellbeing (GRoW), Facultat de Ciències de la Salut Blanquerna, Universitat Ramón Llull, Barcelona, Spain
| | - Mariusz Kozakiewicz
- Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Mariola Głowacka
- Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | | | | | | | - Armi Hirvonen
- JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Sari Järvinen
- JAMK University of Applied Sciences, Jyväskylä, Finland
| | | | | | | | - Hugo Santos
- Alcoitão School of Health Sciences, Alcabideche, Portugal
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Wingfield T. Ending Tuberculosis in Older People: New Strategies for an Age-old Disease. Clin Infect Dis 2023; 77:1476-1479. [PMID: 37506252 PMCID: PMC10654857 DOI: 10.1093/cid/ciad439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 07/30/2023] Open
Affiliation(s)
- Tom Wingfield
- Departments of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
- World Health Organization Collaborating Centre in Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, Norrbackagatan 4, 171 76 Stockholm, Sweden
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12
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Carroll B, Walsh K, Scharf T, O'Donovan D, Keogh S. Positive health and ageing policies for older Irish travellers and older people who have experienced homelessness in Ireland: Life-course meanings and determinants. Soc Sci Med 2023; 336:116264. [PMID: 37806148 DOI: 10.1016/j.socscimed.2023.116264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 04/25/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
Marginalised groups of older people remain neglected in positive health and ageing (PHA) agendas, whether they concern healthy or active ageing concepts. Questions exist around the meaning of such constructs and the factors that enable disadvantaged populations to achieve equitable later-life experiences. Focusing on two such groups in Ireland, this study investigates the constituent dimensions of PHA for older Irish Travellers and older people who have experienced homelessness and the role of life-course and structural determinants in constructing PHA trajectories for these groups. The study involves a qualitative, participatory voice-led methodology, with analysis based on 49 in-depth life-course interviews with people aged 50 years and over from the two populations. Five interconnected dimensions of PHA are identified and presented. Four determinants related to life-course experiences and structural factors are identified as contributing to these dimensions: social relations, material and accommodation circumstances, formal supports and systems, and critical transitions and resilience. While illustrating the validity of PHA agendas for these groups when understood through their lived experiences, the findings highlight the significant deprivations and risks to rights that must be accounted for to secure meaningful gains in PHA for the groups.
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Affiliation(s)
- Brídín Carroll
- Irish Centre for Social Gerontology, Institute for Lifecourse and Society, J.E. Carines School of Business and Economics, University of Galway, Galway, Ireland.
| | - Kieran Walsh
- Irish Centre for Social Gerontology, Institute for Lifecourse and Society, J.E. Carines School of Business and Economics, University of Galway, Galway, Ireland.
| | - Thomas Scharf
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE1 4LP, UK.
| | - Diarmuid O'Donovan
- School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Antrim, Northern Ireland.
| | - Sinéad Keogh
- Department of Enterprise and Technology, School of Business, Atlantic Technological University, Galway, Ireland.
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13
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Wang X, Wu Y, Miao J, Pu K, Ming WK, Zang S. Factors associated with eating behaviors in older adults from a socioecological model perspective. BMC Public Health 2023; 23:1726. [PMID: 37670266 PMCID: PMC10481492 DOI: 10.1186/s12889-023-16651-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/29/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND The eating behaviors of older adults are associated with multiple factors. To promote older adults' healthy diets, it is imperative to comprehensively study the factors associated with the eating behaviors of the aging population group. This study aimed to probe the associated factors of older adults' eating behaviors from a socioecological model (SEM) perspective. METHODS In 2021, a cross-sectional survey was performed to recruit participants in China. The survey data were analyzed using a multivariate generalized linear model to identify the factors associated with eating behaviors in older adults. Standardized regression coefficients (β) and 95% confidence intervals (CIs) were estimated using a multivariate generalized linear model. RESULTS The survey contained 1147 valid older adult participants. Multivariate generalized linear model results showed that older adults with older age [aged 71-80 (β = -0.61), ≥ 81 (β = -1.12)], conscientiousness personality trait (β = -0.27), and higher family health levels (β = -0.23) were inclined to have better eating behaviors. The older adults with higher education levels [junior high school and high school (β = 1.03), junior college and above (β = 1.71)], higher general self-efficacy (β = 0.09), more severe depression symptoms (β = 0.24), and employment (β = 0.82) tended to have poorer eating behaviors. CONCLUSIONS This study identified factors that are specifically associated with older adults' eating behaviors from an SEM perspective. The comprehensive multiple-angle perspective consideration may be a valuable idea for studying healthy eating behaviors in older adults.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Juanxia Miao
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, China
| | - Keping Pu
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, To Yuen Building, No.31 To Yuen Street, Hong Kong, 999077, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, China.
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14
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Boateng R, Yawson AE, Adoma PO. Rural-urban and socio-demographic differentials in perceived health state among aging population in Ghana. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:92. [PMID: 37658469 PMCID: PMC10474759 DOI: 10.1186/s41043-023-00433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 08/19/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND The variations in health between rural and urban population have become an increasingly significant public health concern in developing countries including Ghana where urbanization is occurring. Whereas urbanization results in improved access to healthcare services, the concomitant negative consequences of urbanization coupled with unfavorable compositional and contextual attributes can affect the health of populations. The study sought to examine the effect of rural-urban residence and selected socio-demographic factors on perceived health state among aging population by employing a nationally representative data collected by the WHO from 2014 to 2015. METHODS The data were derived from the WHO Study on Aging wave 2 released in 2019. A total of 4511 individuals, made up of 1018 adults between 18 and 49 years and 3493 respondents within the ages of 50 years and above, were involved in this study. The study examined the Spearman's rho correlations between perceived health, rural-urban residence, age, sex, marital status, ever schooled, current work state, religion, and regional location. Subsequently, the study employed a multivariable ordinal logistic regression model to test the effect of the selected biosocial and contextual variables on perceived health state. RESULTS The selected socio-demographic variables significantly correlated with health state, except for rural-urban residence. However, the predictive ability of rural-urban residence and the socio-demographic variables on perceived health state were strongly ascertained. It was observed that age, sex, rural-urban residence, and current state of work among aging populations were significant predictors of perceived health state as demonstrated by odds ratios and significant p values. The contextual factor of regional location was the most significant variable that increases the perceived health state of respondents in the study. CONCLUSIONS Continues engagement in work-related activities, an individual's age within the aging continuum and regional location coupled with its environmental and ecological attributes, may significantly influence the development of positive perception toward health state, which forms a vital constituent of an individual health seeking behavior.
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15
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Stone T, Trepal D, Lafreniere D, Sadler RC. Built and social indices for hazards in Children's environments. Health Place 2023; 83:103074. [PMID: 37482035 DOI: 10.1016/j.healthplace.2023.103074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 06/02/2023] [Accepted: 06/15/2023] [Indexed: 07/25/2023]
Abstract
Leveraging the capabilities of the Historical Spatial Data Infrastructure (HSDI) and composite indices we explore the importance of children's built and social environments on health. We apply contemporary GIS methods to a set of 2000 historical school records contextualized within an existing HSDI to establish seven variables measuring the relative quality of each child's built and social environments. We then combined these variables to create a composite index that assesses acute (short-term) health risks generated by their environments. Our results show that higher acute index values significantly correlated with higher presence of disease in the home. Further, higher income significantly correlated with lower acute index values, indicating that the relative quality of children's environments in our study area were constrained by familial wealth. This work demonstrates the importance of analyzing multiple activity spaces when assessing built and social environments, as well as the importance of spatial microdata.
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Affiliation(s)
- Timothy Stone
- Social Sciences Department, Michigan Technological University, USA.
| | - Dan Trepal
- Social Sciences Department, Michigan Technological University, USA
| | - Don Lafreniere
- Social Sciences Department, Michigan Technological University, USA
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16
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John EE, Astell-Burt T, Yu P, Brennan-Horley C, Feng X. Development of a composite healthy ageing score: evidence from middle-to-older aged Australians. Health Promot Int 2023; 38:daad043. [PMID: 37480585 PMCID: PMC10682690 DOI: 10.1093/heapro/daad043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023] Open
Abstract
We developed and validated a composite healthy ageing score (HAS) to address the absence of a definitive composite score comprising multiple health domains that measure healthy ageing in epidemiology. The HAS is developed from 13 health domains reported to influence healthy ageing. Data to measure these domains was extracted from the 45 and Up Study baseline. We applied best practices for scale validation and development. Physical functioning, cognitive function, mental health, sleep, quality of life, balance, social connections and overall health were retained. Functional capacity and resilience were uncovered as underlying latent structures. The HAS ranges from 0 to 16 with higher scores indicating a better health profile. This research contributes a comprehensive measuring tool, HAS, It enables examination and comparison of individual or collective health profiles and the investigation of the factors that influence their chances of living healthy for longer.
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Affiliation(s)
- Eme Eseme John
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for IT Enabled Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Chris Brennan-Horley
- School of Geography and Sustainable Communities, and Australian Centre for Culture, Environment, Society and Space (ACCESS), University of Wollongong, Wollongong, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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17
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Okamoto S, Sakamoto H, Kamimura K, Komamura K, Kobayashi E, Liang J. Economic effects of healthy ageing: functional limitation, forgone wages, and medical and long-term care costs. HEALTH ECONOMICS REVIEW 2023; 13:28. [PMID: 37162614 PMCID: PMC10170784 DOI: 10.1186/s13561-023-00442-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/22/2023] [Indexed: 05/11/2023]
Abstract
This study aims to estimate the potential economic benefits of healthy ageing by obtaining estimates of the economic losses generated by functional limitations among middle-aged and older people. Utilising two data sources retrieved from nationally representative samples of the Japanese people, we analysed the association between functional limitation and economic indicators, including labour market outcomes, savings, investment, consumption, and unpaid activities among individuals aged ≥ 60. Using the estimated parameters from our micro-econometric analyses and the official statistics by the Japanese government and a previous study, we calculated the financial costs that can be averted if healthy ageing is achieved as foregone wages and formal medical/long-term care costs incurred by functional limitations. Our micro-econometric analyses found that functional limitation was associated with a 3% point increase in retirement probability, with a stronger association among those aged 60-69. Moreover, functional limitation was linked with higher total health spending and less active involvement in domestic work. Foregone wages generated by functional limitation were estimated to be approximately USD 266.4 million, driven mainly by individuals in their 60s. Long-term care costs, rather than medical care costs, for older people aged ≥ 85 accounted for most of the additional costs, indicating that the estimated medical and long-term costs generated by functional limitations were approximately USD 72.7 billion. Health interventions can yield economic benefits by preventing exits from the labour market due to health issues and reducing medical and long-term care costs.
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Affiliation(s)
- Shohei Okamoto
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae- cho, Itabashi-ku, Tokyo, 1730015, Japan.
- Institute of Global Health Policy Research, National Centre for Global Health and Medicine, Tokyo, Japan.
- Research Center for Financial Gerontology, Keio University, Tokyo, Japan.
| | - Haruka Sakamoto
- Department of Hygiene and Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazuki Kamimura
- Research Center for Financial Gerontology, Keio University, Tokyo, Japan
- Hirao School of Management, Konan University, Hyogo, Japan
| | - Kohei Komamura
- Research Center for Financial Gerontology, Keio University, Tokyo, Japan
- Faculty of Economics, Keio University, Tokyo, Japan
| | - Erika Kobayashi
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae- cho, Itabashi-ku, Tokyo, 1730015, Japan
| | - Jersey Liang
- Department of Health Management and Policy, School of Public Health, University of Michigan, Michigan, USA
- Department of Health Care Management and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
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18
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Andrade FMDD, Machado ÍE, Freitas MIDF, Souza MDFMD, Malta DC. Patterns of abuse of elderly people in Brazil: analysis of notifications. CAD SAUDE PUBLICA 2023; 39:e00075722. [PMID: 36790280 DOI: 10.1590/0102-311xen075722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/12/2022] [Indexed: 02/12/2023] Open
Abstract
This study aimed to describe the characteristics of elderly people abuse notifications by gender and to assess notification patterns according to gender. We analyzed data from the Brazilian Information System for Notificable Diseases (SINAN) in 2017. We carried out a descriptive analysis of victim characteristics, violence, and the probable perpetrator according to gender. Pearson's χ2 test was used to assess the significance between groups. Then, we verified the main relationships between the studied characteristics and the victim's gender by simple correspondence analysis (SCA). Thus, 17,311 cases/suspicions of elderly people abuse were notified, corresponding to 7.2% of the total number of violence notifications. Of these victims, 50.4% were white, 42.3% were married, and 17.2% had a disability/disorder; 76.9% occurred at home, 62.8% included physical violence, and 49.5% were cases of repeated violence. Most perpetrators were men (62%), and violence by two or more perpetrators was observed in 62.8% of the cases. SCA evidenced inequalities in older adults' gender, which proved to be higher among women. Physical violence was the most common among younger and old individuals, whereas neglect/abandonment tended to occur more frequently among the oldest individuals, and was most often committed by daughters. In sum, this study demonstrated evidence of gender-based violence, especially among older adults. Disability proved to be an essential characteristic for neglect/abandonment in older adults. In this context, policies are needed to reduce gender inequalities and implement a care network for older adults who are victims of violence.
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Affiliation(s)
| | - Ísis Eloah Machado
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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19
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Kim H, Choi H, Jung YI, Kim E, Lee W, Yi JY. Evaluation of a technology-enhanced, integrated community health and wellness program for seniors (HWePS): protocol of a non-randomized comparison trial. BMC Public Health 2023; 23:25. [PMID: 36604644 PMCID: PMC9813466 DOI: 10.1186/s12889-022-14921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Healthy aging for all in the community is a shared public health agenda for countries with aging populations, but there is a lack of empirical evidence on community-wide preventive models that promote the health of older people residing in socially-disadvantaged communities. The Health and Wellness Program for Seniors (HWePS) is a technology-enhanced, multi-level, integrated health equity intervention model. This study evaluates the effect of the HWePS on the health and well-being of older adults residing in urban, low-income communities. METHODS/DESIGN: HWePS is a prospective, non-randomized comparison trial conducted in an intervention and a control neighborhood (dong) in Seoul, South Korea, over 12 months. Older people who reside in the small areas and meet the inclusion/exclusion criteria are eligible to participate. The multi-level, multi-faceted HWePS intervention is a preventive community care model for older residents guided by the expanded chronic care model, the comprehensive health literacy intervention model, and the Systems for Person-centered Elder Care model along with health equity frameworks. HWePS consists of four components: a health literacy intervention based on individual and community needs assessments, personalized (self-)care management featuring nurse coaching and peer support, a healthy-living and healthy-aging community initiative, and information and communication technology (ICT) systems. The primary outcomes are self-reported health and health-related quality of life. Outcome assessors and data analysts are blinded to group assignment. Process evaluation will be also conducted. DISCUSSION As a multi-level health equity project, HWePS has adopted a novel study design that simultaneously targets individual- and community-level factors known to contribute to health inequality in later life in the community. The study will provide insights into the effectiveness and implementation process of an integrated, multi-level, preventive community care model, which in turn can help improve the health outcomes of older residents and reduce disparities in underserved urban communities. TRIAL REGISTRATION ISRCTN29103760. Registered 2 September 2021, https://www.isrctn.com/ISRCTN29103760.
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Affiliation(s)
- Hongsoo Kim
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak-Gu, Seoul, South Korea ,grid.31501.360000 0004 0470 5905Institute of Health and Environment, Seoul National University, 1 Gwanak-Ro, Gwanak-Gu, Seoul, South Korea ,grid.31501.360000 0004 0470 5905Seoul National University Institute of Aging, 1 Gwanak-Ro, Gwanak-Gu, Seoul, South Korea
| | - Hyoungshim Choi
- grid.443782.e0000 0004 0647 3634College of Nursing, Hansei University, 30 Hansei-Ro, Gunpo-Shi, Gyeonggi-Do, South Korea
| | - Young-il Jung
- Department of Environmental Health, National Open University, 86 Daehak-Ro, Jongno-Gu, Seoul, South Korea
| | - Eunji Kim
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak-Gu, Seoul, South Korea
| | - Woojoo Lee
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak-Gu, Seoul, South Korea
| | - Jae Yoon Yi
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak-Gu, Seoul, South Korea
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20
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Zelalem AT, Adamek ME, Gebremariam Kotecho M. Barriers to Active Aging in Rural Ethiopia: A Call for a Paradigm Shift to a Rights-Based Approach. J Aging Soc Policy 2022; 35:440-462. [DOI: 10.1080/08959420.2022.2139988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Abraham Teshome Zelalem
- MSW, Department of Social Work, Ambo University, Ambo, Ethiopia
- PhD student, Indiana University, Indianapolis, IN, USA
| | - Margaret E. Adamek
- PhD, School of Social Work, Indiana University, Indianapolis, IN 46202, USA
| | - Messay Gebremariam Kotecho
- PhD, School of Social Work, Addis Ababa University, Addis Ababa, Ethiopia
- Senior Research Associate, Department of Social Work and Community Development, University of Johannesburg, Johannesburg, South Africa
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21
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Madani MT, Madani L, Ghogomu ET, Dahrouge S, Hébert PC, Juando-Prats C, Mulligan K, Welch V. Is equity considered in systematic reviews of interventions for mitigating social isolation and loneliness in older adults? BMC Public Health 2022; 22:2241. [PMID: 36456997 PMCID: PMC9713122 DOI: 10.1186/s12889-022-14667-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Social isolation and loneliness affect one in four older adults in many regions around the world. Social isolation and loneliness are shown to be associated with declines in physical and mental health. Intersecting social determinants of health influence both the risk of being socially isolated and lonely as well as the access and uptake of interventions. Our objective is to evaluate what evidence is available within systematic reviews on how to mitigate inequities in access to and effectiveness of interventions. METHODS We performed an overview of reviews following methods of the Cochrane Handbook for Overviews of Reviews. We selected systematic reviews of effectiveness of interventions aimed at mitigating social isolation and loneliness in older adults (aged 60 or above) published in the last 10 years. In addition, we assessed all primary studies from the most recent systematic review with a broad intervention focus. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus in collaboration with a librarian scientist. We used a structured framework called PROGRESS-Plus to assess the reporting and consideration of equity. PROGRESS-Plus stands for place of residence, race/ethnicity/culture/language, occupation, gender or sex, religion, education, socioeconomic status (SES), social capital, while "plus" stands for additional factors associated with discrimination and exclusion such as age, disability, and sexual orientation. We assessed whether PROGRESS-Plus factors were reported in description of the population, examination of differential effects, or discussion of applicability or limitations. RESULTS We identified and assessed 17 eligible systematic reviews. We assessed all 23 primary studies from the most recent systematic review with a broad intervention focus. All systematic reviews and primary studies described the population by one or more PROGRESS-Plus factor, most commonly across place of residence and age, respectively. None of the reviews and five primary studies examined differential effects across one or more PROGRESS-Plus dimension. Nine reviews and four primary studies discussed applicability or limitations of their findings by at least one PROGRESS-Plus factor. CONCLUSIONS Although we know that social isolation and loneliness are worse for the poorest and most socially disadvantaged older adults, the existing evidence base lacks details on how to tailor interventions for these socially disadvantaged older people.
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Affiliation(s)
- Mohamad Tarek Madani
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Leen Madani
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Elizabeth Tanjong Ghogomu
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Simone Dahrouge
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Paul C. Hébert
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Clara Juando-Prats
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON Canada
| | - Kate Mulligan
- grid.17063.330000 0001 2157 2938Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Vivian Welch
- grid.28046.380000 0001 2182 2255Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
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Kasimovskaya N, Egorova E, Shustikova N, Poleshchuk I, Khvostunov K, Malkina O, Ermilova V. Development of healthcare and social care services for the elderly population. J Comp Eff Res 2022; 11:1263-1276. [PMID: 36197003 DOI: 10.2217/cer-2022-0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background & aim: The percentage of older people has been growing in all economically developed countries over the past several decades. The purpose of this research was to optimize the healthcare and social care model based on the in-depth study of social, hygienic and clinical characteristics of elderly individuals. Materials & methods: The authors' study included individuals aged 65 years and older. Results: The proportion of elderly and senile individuals increased from 15.3% in 2011 to 18.6% in 2020. The authors found that the existing healthcare system does not meet the needs of the aging population and thus developed a new organizational model for healthcare and social care services designed to integrate the activities of social welfare centers and local polyclinics. Conclusion: Implementation of the authors' model enables a range of healthcare and social care services and allows for management of a patient's health based on individual characteristics.
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Affiliation(s)
- Nataliya Kasimovskaya
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Elena Egorova
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Natalia Shustikova
- Moscow University for Industry and Finance «Synergy», Moscow, Russian Federation
| | - Ilia Poleshchuk
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Konstantin Khvostunov
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Olga Malkina
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Victoria Ermilova
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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23
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Wickramasinghe A, Gamage M, Torabi MR, Perera B. Impact of perceived social support and physical fitness on quality of life of institutionalized and non-institutionalized older adults in Sri Lanka. DIALOGUES IN HEALTH 2022; 1:100079. [PMID: 38515873 PMCID: PMC10953875 DOI: 10.1016/j.dialog.2022.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 03/23/2024]
Abstract
Background and aim Quality of life (QoL) in old age contributes to enhance active aging. This study aimed to assess and compare QoL and associated factors of institutionalized and non-institutionalized older adults (aged 60+ years) in Southern Sri Lanka. Methods A total of 160 older adults (80 institutionalized and 80 non-institutionalized) were surveyed. Physical and cognitive skills were measured using Barthel index, and Mini Mental State Examination scales. Nutritional status and perceived social support were measured using Mini Nutritional Assessment and Multidimensional Scale of Perceived Social Support. Descriptive statistics and multiple regression techniques were used in the analysis. Results The mean age of the institutionalized older adults was higher than that of non-institutionalized older adults (74.9 years versus 72.1 years, p < 0.01). About half of the sample consisted of older men (48.8%). Economically under privileged older adults who were unmarried were more likely to become institutionalized. The mean value of the QoL score was higher in non-institutionalized older adults compared to that of institutionalized older adults (63.1 (SD = 21.9) versus 49.1 (SD = 25.6), p < 0.05). Activities of daily living (ẞ=-0.46, p < 0.01) and perceived social support (ẞ=-0.20, p < 0.05) were found to be significant determinants of QoL of institutionalized older adults while activities of daily living (ẞ=-0.28, p < 0.05) and nutritional status (ẞ=-0.27, p < 0.05) were found to be significant determinants of QoL of non-institutionalized older adults. Cognitive impairments was not a significant determinant of QoL in both institutionalized and non-institutionalized older adults. Conclusions Promotion of physically active life style especially among young older adults to maintain their independence as they age and improvements of social support and social connectedness among older adults would be practical and cost-effective strategies to promote active aging in Sri Lankan older adults.
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Affiliation(s)
- Anuradha Wickramasinghe
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka
| | - Madushika Gamage
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka
| | - Mohammad R. Torabi
- School of Public Health – Bloomington, Indiana University, IN 47405, USA
| | - Bilesha Perera
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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McAiney C, Markle-Reid M, Ganann R, Whitmore C, Valaitis R, Urajnik DJ, Fisher K, Ploeg J, Petrie P, McMillan F, McElhaney JE. Implementation of the Community Assets Supporting Transitions (CAST) transitional care intervention for older adults with multimorbidity and depressive symptoms: A qualitative descriptive study. PLoS One 2022; 17:e0271500. [PMID: 35930542 PMCID: PMC9355229 DOI: 10.1371/journal.pone.0271500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background Older adults with multimorbidity experience frequent care transitions, particularly from hospital to home, which are often poorly coordinated and fragmented. We conducted a pragmatic randomized controlled trial to test the implementation and effectiveness of Community Assets Supporting Transitions (CAST), an evidence-informed nurse-led intervention to support older adults with multimorbidity and depressive symptoms with the aim of improving health outcomes and enhancing transitions from hospital to home. This trial was conducted in three sites, representing suburban/rural and urban communities, within two health regions in Ontario, Canada. Purpose This paper reports on facilitators and barriers to implementing CAST. Methods Data collection and analysis were guided by the Consolidated Framework for Implementation Research framework. Data were collected through study documents and individual and group interviews conducted with Care Transition Coordinators and members from local Community Advisory Boards. Study documents included minutes of meetings with research team members, study partners, Community Advisory Boards, and Care Transition Coordinators. Data were analyzed using content analysis. Findings Intervention implementation was facilitated by: (a) engaging the community to gain buy-in and adapt CAST to the local community contest; (b) planning, training, and research meetings; (c) facilitating engagement, building relationships, and collaborating with local partners; (d) ensuring availability of support and resources for Care Transition Coordinators; and (e) tailoring of the intervention to individual client (i.e., older adult) needs and preferences. Implementation barriers included: (a) difficulties recruiting and retaining intervention staff; (b) difficulties engaging older adults in the intervention; (c) balancing tailoring the intervention with delivering the core intervention components; and (c) Care Transition Coordinators’ challenges in engaging providers within clients’ circles of care. Conclusion This research enhances our understanding of the importance of considering intervention characteristics, the context within which the intervention is being implemented, and the processes required for implementing transitional care intervention for complex older adults.
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Affiliation(s)
- Carrie McAiney
- School of Public Health Sciences, University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
- * E-mail:
| | - Maureen Markle-Reid
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca Ganann
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Carly Whitmore
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Ruta Valaitis
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Diana J. Urajnik
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
| | - Kathryn Fisher
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Penelope Petrie
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Fran McMillan
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
| | - Janet E. McElhaney
- Northern Ontario School of Medicine and Health Sciences North Research Institute, Sudbury, Ontario, Canada
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Kobashi Y, Sok K, Hayashi Y, Chhay H, Tsubokura M, Chou K, Hokamura N, Ozaki A, Nishikawa Y, Okawada M. Discrepancy of financial burden among elderly visiting a private general hospital in Phnom Penh, Cambodia: A three-year cross-sectional study. PUBLIC HEALTH IN PRACTICE 2022; 4:100306. [PMID: 36570394 PMCID: PMC9773053 DOI: 10.1016/j.puhip.2022.100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives This study aims to clarify the financial burden of health on the elderly. Out-of-pocket payment (OOPP) in a major private general hospital in Phnom Penh was considered an indicator of financial burden. Study design This study is a three-year cross-sectional study. Methods To investigate the characteristics of patients who visited the Sunrise Japan Hospital (SJH), their data were obtained from the electronic reception database. Results A total of 119,938 patients who visited SJH from January 2017 to September 2019 were included. The median age (25th, 75th centiles) was 52 years (36, 66) and 38.31% of patients were aged over 60 years. The OOPP median (25th, 75th centiles was 73.78 USD (32, 161.89). The median OOPP was the lowest in the 20s and highest in the 90s. The OOPP of an emergency patient was the highest in the consultation classifications. Conclusions The need to raise public awareness regarding the financial burden on the elderly is becoming increasingly urgent. It is vital to establish a social system to prevent the medical catastrophes.
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Affiliation(s)
- Yurie Kobashi
- Department of General Internal Medicine, Sunrise Japan Hospital Phnom Penh, Sangkat Chroy Changvar, Phnom Penh, Cambodia,Corresponding author.
| | - Khemvitou Sok
- Department of Radiology, Sunrise Japan Hospital Phnom Penh, Sangkat Chroy Changvar, Phnom Penh, Cambodia
| | - Yoshifumi Hayashi
- Department of Neurosurgery, Sunrise Japan Hospital Phnom Penh, Sangkat Chroy Changvar, Phnom Penh, Cambodia,Department of Neurosurgery, Kitahara International Hospital, Owadamachi, Hachioji, Tokyo, 192-0045, Japan
| | - Hong Chhay
- Department of General Internal Medicine, Sunrise Japan Hospital Phnom Penh, Sangkat Chroy Changvar, Phnom Penh, Cambodia
| | - Masaharu Tsubokura
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, 976-0016, Japan
| | - Kimhab Chou
- Department of Medicine, University of Puthisastra, Sangkat Boeung Raing, Phnom Penh, Cambodia
| | - Nobukazu Hokamura
- Department of Gastroenterology, Sunrise Japan Hospital Phnom Penh, Sangkat Chroy Changvar, Phnom Penh, Cambodia
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Jyobankamiyunagaya, Iwaki, Fukushima, 972-8322, Japan
| | - Yoshitaka Nishikawa
- Department of Health Informatics, Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Manabu Okawada
- Department of Pediatrics, Sunrise Japan Hospital Phnom Penh, Sangkat Chroy Changvar, Phnom Penh, Cambodia
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26
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Mussie KM, Setchell J, Elger BS, Kaba M, Memirie ST, Wangmo T. Care of Older Persons in Eastern Africa: A Scoping Review of Ethical Issues. Front Public Health 2022; 10:923097. [PMID: 35874990 PMCID: PMC9298985 DOI: 10.3389/fpubh.2022.923097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The aging population is rapidly increasing globally, with 80% of the older population living in low- and middle-income countries. In Eastern African countries, there exists an incongruence between readiness-economically, structurally, politically, and culturally-to create a conducive environment for healthy aging, which implies public health as well as ethical concerns. The aim of this scoping review was to explore existing evidence addressing the various ethical issues in connection with elder care in the region of Eastern Africa. Methods We searched six databases (Africa-Wide Information, AgeLine, CINHAL, MEDLINE, APA PsycInfo, and SocINDEX) to identify peer-reviewed journal articles that could meet some eligibility criteria such as being a peer-reviewed journal article written in English, having been published in any year until July 2020, and focusing on ethical issues in the care of older people aged 60 years and older from Eastern Africa. We also searched for additional evidence in the references of included papers and web-based platforms. We included 24 journal articles and analyzed them using the inductive content analysis approach. Results The included articles represent seven (38.9%) of the 18 countries in the Eastern African region. The articles covered six ethical concerns: lack of government attention to older persons (n = 14, 58.3%), inaccessibility of health care services (n = 13, 54.2%), loneliness and isolation (n = 11, 45.8%), gender inequalities in old age (n = 9, 37.5%), mistreatment and victimization (n = 8, 33.3%), and medical errors (n = 2, 8.3%). Conclusion This scoping review summarized ethical issues arising in relation to providing care for older persons in the Eastern African context. In light of the rapid increase in the number of older persons in this region, it is critical for governments and responsible bodies to implement and accelerate efforts promptly to generate more evidence to inform programs and policies that improve the health and wellbeing of older persons. Further research is needed to inform global health efforts that aim at improving the lives of older persons, particularly in low- and middle-income countries. Clinical Trial Registration https://osf.io/sb8gw, identifier: 10.17605/OSF.IO/SB8GW.
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Affiliation(s)
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Tessema Memirie
- Addis Centre for Ethics and Priority Setting, Addis Ababa University, Addis Ababa, Ethiopia.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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27
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Raisi-Estabragh Z, Salih A, Gkontra P, Atehortúa A, Radeva P, Boscolo Galazzo I, Menegaz G, Harvey NC, Lekadir K, Petersen SE. Estimation of biological heart age using cardiovascular magnetic resonance radiomics. Sci Rep 2022; 12:12805. [PMID: 35896705 PMCID: PMC9329281 DOI: 10.1038/s41598-022-16639-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/13/2022] [Indexed: 11/08/2022] Open
Abstract
We developed a novel interpretable biological heart age estimation model using cardiovascular magnetic resonance radiomics measures of ventricular shape and myocardial character. We included 29,996 UK Biobank participants without cardiovascular disease. Images were segmented using an automated analysis pipeline. We extracted 254 radiomics features from the left ventricle, right ventricle, and myocardium of each study. We then used Bayesian ridge regression with tenfold cross-validation to develop a heart age estimation model using the radiomics features as the model input and chronological age as the model output. We examined associations of radiomics features with heart age in men and women, observing sex-differential patterns. We subtracted actual age from model estimated heart age to calculate a "heart age delta", which we considered as a measure of heart aging. We performed a phenome-wide association study of 701 exposures with heart age delta. The strongest correlates of heart aging were measures of obesity, adverse serum lipid markers, hypertension, diabetes, heart rate, income, multimorbidity, musculoskeletal health, and respiratory health. This technique provides a new method for phenotypic assessment relating to cardiovascular aging; further studies are required to assess whether it provides incremental risk information over current approaches.
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Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK.
| | - Ahmed Salih
- Department of Computer Science, University of Verona, 37134, Verona, Italy
- Dept. de Matematiques I Informatica, University of Barcelona, 95P7+JH, Barcelona, Spain
| | - Polyxeni Gkontra
- Dept. de Matematiques I Informatica, University of Barcelona, 95P7+JH, Barcelona, Spain
| | - Angélica Atehortúa
- Dept. de Matematiques I Informatica, University of Barcelona, 95P7+JH, Barcelona, Spain
| | - Petia Radeva
- Dept. de Matematiques I Informatica, University of Barcelona, 95P7+JH, Barcelona, Spain
| | | | - Gloria Menegaz
- Department of Computer Science, University of Verona, 37134, Verona, Italy
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Karim Lekadir
- Dept. de Matematiques I Informatica, University of Barcelona, 95P7+JH, Barcelona, Spain
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK
- Health Data Research UK, London, UK
- Alan Turing Institute, London, UK
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28
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Analysis of Scientometric Indicators in Publications Associated with Healthy Aging in the World, Period 2011–2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158988. [PMID: 35897359 PMCID: PMC9329745 DOI: 10.3390/ijerph19158988] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023]
Abstract
Today, the world population is aging at a fast rate. This scenario of the accelerated aging of human populations entails increased concern for healthy aging that is associated with a rise in scientific production related to the topic. In this study, the Scopus database from Elsevier was used, with a final search carried out on 5 January 2022, and various bibliometric indicators were obtained from SciVal. The study was fundamentally intended to characterize, determine trends, and understand the evolution and current state of research on the concept of “healthy aging” in the last decade. We found that there has been proportionally greater and more accelerated growth in the subject with respect to the general productivity of the world and that countries with high life expectancies tend to have made more effort to investigate this topic. The “hottest” research areas were found to be related to the cognitive aspect and the biological mechanisms involved in aging.
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29
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Ramírez-Vélez R, Izquierdo M, García-Hermoso A, Ordoñez-Mora LT, Cano-Gutierrez C, Campo-Lucumí F, Pérez-Sousa MÁ. Sit to stand muscle power reference values and their association with adverse events in Colombian older adults. Sci Rep 2022; 12:11820. [PMID: 35821249 PMCID: PMC9276682 DOI: 10.1038/s41598-022-15757-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022] Open
Abstract
Recently, a valid method to assess lower-body muscle power based on a sit-to-stand field test (STS) has been published. Our study aimed to describe lower-body muscle power in older individuals aged ≥ 60 years and examine the relationship of muscle weakness with adverse events according to gender- and age-specific muscle weakness cut-off points. A total of 3689 Colombian older adults (57.6% women, age 69.1 ± 6.9 years) from the 2015 Survey on Health, Well-Being, and Aging in Latin America and the Caribbean (SABE) participated in this study. Lower-body muscle power normalized to body mass was estimated by the five-repetitions STS test. Anthropometric, physical performance and clinical characteristics were collected. Age-specific percentiles using the LMS method, cut-off points and association with adverse events were calculated. Lower-body muscle power was greater in men than among women (2.2 ± 0.7 vs. 1.6 ± 0.5 W·kg−1, respectively; p < 0.001) at all ages. Muscle power ranked in the 50th percentile between 2.38 and 1.30 W·kg−1 in men, whereas women ranked between 1.79 and 1.21 W·kg−1. According to the cut-off points, lower-limb muscle power < 1 standard deviation in men was associated with having dynapenia, poor gait speed, cognitive impairment and mental, visual, hearing and memory problems. While, women were associated with having sarcopenia, dynapenia, poor gait speed, cognitive impairment, mental, hearing and memory problems, dementia and hospitalizations of > 24 h in the last year. Overall, participants with poor lower-limb muscle power had a significantly higher risk of adverse events [in men: odds ratio (OR) = 1.51, 95% confidence interval (CI) = 1.19–1.91, p < 0.001; in women: OR = 1.52, 95% CI = 1.27–1.87, p = 0.001] than their stronger counterparts. This study is the first to describe lower-limb muscle power values and cut-off points among a nationally representative sample of Colombian older adults. In men, 7 of the 14 adverse events studied were associated with lower muscle strength, whereas in women, it was 9 of the 14 adverse events.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain. .,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain. .,Facultad de Ciencias de la Educación, Unidad Central del Valle del Cauca (UCEVA), Túlua, Colombia.
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Leidy T Ordoñez-Mora
- Grupo de Investigación Salud y Movimiento, Programa de Fisioterapia, Facultad de Salud, Universidad Santiago de Cali, Cali, Colombia
| | - Carlos Cano-Gutierrez
- Unidad de Geriatría, Instituto de Envejecimiento, Facultad de Medicina, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Florelba Campo-Lucumí
- Grupo de Investigación en Estudios Aplicados al Deporte, Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia
| | - Miguel Ángel Pérez-Sousa
- Department of Specific Didactics, Faculty of Education, University of Córdoba, Córdoba, Spain.,Epidemiology of Physical Activity and Fitness Across Lifespan Research Group, University of Seville, Seville, Spain
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30
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Walsh K, Carroll B, MacFarlane A, O’Donovan D, Cush P. Life-Course Marginalities of Positive Health and Aging: A Participatory Approach Integrating the Lived Experiences of Older Irish Travelers and Older Homeless Adults in Multistakeholder Research Processes. QUALITATIVE HEALTH RESEARCH 2022; 32:1139-1152. [PMID: 35578753 PMCID: PMC9254379 DOI: 10.1177/10497323221100346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There is increased emphasis on adopting positive health and aging policy goals for heterogeneous older populations, and recognition of the role that participatory research approaches can play in supporting their implementation. However, questions remain about how to represent the marginalized experiences of some older populations within such processes. With a focus on older Irish ethnic Travelers and older homeless adults as two vulnerable populations in Ireland, this article presents and critically discusses a participatory approach developed to integrate marginalized older adult perspectives on positive health and aging in a multistakeholder research and development process. The qualitative methodology is first detailed, incorporating methods that harness collaboratively derived views and individual narratives (e.g., focus groups; consultation forums; in-depth interviews). Critical reflections on research implementation and specific considerations relevant to these populations are presented (e.g., trust building; one-to-one facilitation), with lessons then drawn for the design of multistakeholder participatory approaches with marginalized older populations.
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Affiliation(s)
- Kieran Walsh
- Irish Centre for Social Gerontology,
Institute for Lifecourse and Society, National University of Ireland
Galway, Galway, Ireland
| | - Brídín Carroll
- Irish Centre for Social Gerontology,
Institute for Lifecourse and Society, National University of Ireland
Galway, Galway, Ireland
| | - Anne MacFarlane
- School of Medicine, and Health Research
Institute, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Diarmuid O’Donovan
- School of Medicine, Dentistry and
Biomedical Sciences, Queens University, Belfast, Antrim, UK
| | - Peter Cush
- Irish Centre for Social Gerontology,
Institute for Lifecourse and Society, National University of Ireland
Galway, Galway, Ireland
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31
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Yellow Horse AJ, Patterson SE. Greater Inclusion of Asian Americans in Aging Research on Family Caregiving for Better Understanding of Racial Health Inequities. THE GERONTOLOGIST 2022; 62:704-710. [PMID: 34698339 PMCID: PMC9154291 DOI: 10.1093/geront/gnab156] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Indexed: 11/12/2022] Open
Abstract
With the substantial demographic changes in racial composition in the United States since 1965, research on racial health inequities must build upon the Black-White binary to assess the complex ways "race" affects health and aging. Considering variation in the prevalence and meanings of aging across racialized groups requires concerted efforts to expand and disaggregate samples. Aligned with the goals of the intersectionality framework, we argue that greater inclusion of Asian Americans is critical to advance both theoretical and methodological considerations that enable us to investigate the lived experiences of Asian Americans. Using caregiving as an example, we discuss how systemic, cultural, and interpersonal marginalization from racism and other oppressive systems intertwine with "race" to produce the race effects. Greater inclusion of Asian Americans helps further provide the opportunity to conceptualize culture as dynamic and interacting with structure to produce different racial patterns. Meaningful inclusion of Asian Americans in research requires more systemic effort to collect accurate, reliable, and quality data for Asian Americans that can be disaggregated by other important axes of stratification.
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Affiliation(s)
| | - Sarah E Patterson
- Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
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32
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de Godoi Rezende Costa Molino C, Chocano-Bedoya PO, Sadlon A, Theiler R, Orav JE, Vellas B, Rizzoli R, Kressig RW, Kanis JA, Guyonnet S, Lang W, Egli A, Bischoff-Ferrari HA. Prevalence of polypharmacy in community-dwelling older adults from seven centres in five European countries: a cross-sectional study of DO-HEALTH. BMJ Open 2022; 12:e051881. [PMID: 35487733 PMCID: PMC9058693 DOI: 10.1136/bmjopen-2021-051881] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To investigate the prevalence of polypharmacy and characteristics associated with polypharmacy in older adults from seven European cities. DESIGN Cross-sectional study of baseline data from DO-HEALTH. SETTING AND PARTICIPANTS DO-HEALTH enrolled 2157 community-dwelling adults age 70 and older from seven centres in Europe. Participants were excluded if they had major health problems or Mini-Mental State Examination Score <24 at baseline. PRIMARY OUTCOME MEASURES Extensive information on prescription and over-the-counter medications were recorded. Polypharmacy was defined as the concomitant use of five or more medications, excluding vitamins or dietary supplements. Bivariate and multivariable logistic regression was used to test the association of sociodemographic factors (age, sex, years of education, living situation and city) and health-related indicators (number of comorbidities, cognitive function, frailty status, body mass index (BMI), prior fall, self-rated health and smoking status) with polypharmacy. RESULTS 27.2% of participants reported polypharmacy ranging from 16.4% in Geneva to 60.8% in Coimbra. In the multivariable logistic regression analyses, older age (OR 1.07; 95% CI 1.04 to 1.10), greater BMI (OR 1.09; 95% CI 1.06 to 1.12) and increased number of comorbidities (OR 2.13; 95% CI 1.92 to 2.36) were associated with polypharmacy. Women were less likely to report polypharmacy than men (OR 0.65; 95% CI 0.51 to 0.84). In comparison to participants from Zurich, participants from Coimbra were more likely to report polypharmacy (OR 2.36; 95% CI 1.56 to 3.55), while participants from Geneva or Toulouse were less likely to report polypharmacy ((OR 0.36; 95% CI 0.22 to 0.59 and OR 0.64; 95% CI 0.42 to 0.96), respectively). Living situation, smoking status, years of education, prior fall, cognitive function, self-rated health and frailty status were not significantly associated with polypharmacy. CONCLUSION Polypharmacy is common among relatively healthy older adults, with moderate variability across seven European cities. Independent of several confounders, being a woman, older age, greater BMI and greater number of comorbidities were associated with increased odds for polypharmacy. TRIAL REGISTRATION NUMBER NCT01745263.
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Affiliation(s)
- Caroline de Godoi Rezende Costa Molino
- Centre on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid, University of Zurich, Zurich, Switzerland
- Department of Pharmacy, University of São Paulo, São Paulo, Brazil
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Patricia O Chocano-Bedoya
- Centre on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid, University of Zurich, Zurich, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Lab, University of Fribourg, Fribourg, Switzerland
| | - Angélique Sadlon
- Centre on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid, University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Robert Theiler
- Centre on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid, University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - John E Orav
- Department of Biostatistics, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Center Hospitalo-Universitaire de Toulouse, Toulouse, France
- UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - Rene Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Reto W Kressig
- University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - John A Kanis
- Centre for Metabolic Diseases, University of Sheffield Medical School, Sheffield, UK
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Sophie Guyonnet
- Gérontopôle, Department of Geriatrics, CHU Toulouse, Toulouse, France
- Cerpop Inserm UMR 1295, University of Toulouse III, Toulouse, France
| | - Wei Lang
- Centre on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid, University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andreas Egli
- Centre on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid, University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid, University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- University Clinic for Aging Medicine, City Hospital Zurich, Waid, Zurich, Switzerland
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de Albuquerque-Araújo L, Quintiliano-Scarpelli D, Masferrer Riquelme D, Ferreira Santos JL. Influence of Sociodemographic, Health-Related, and Behavioral Factors on Food Guidelines Compliance in Older Adults: A Hierarchical Approach from the Chilean National Health Survey 2016-17 Data. Geriatrics (Basel) 2022; 7:47. [PMID: 35447850 PMCID: PMC9030007 DOI: 10.3390/geriatrics7020047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 02/01/2023] Open
Abstract
Dietary habits are determinants in the development of a range of conditions and age-related diseases. We explored the associations of sociodemographic, health-related indicators, and health behavioral factors on dietary guideline compliance in elderly Chileans. We used a cross-sectional design using the publicly available database from the last Chilean National Health Survey (2016−17). The sample of 1831 older adults (≥60 y) from a national representative sample. The dependent variable was compliance with Food Guidelines (FG) (daily consumption of water, dairy, and fruits and vegetables; and weekly consumption of legumes and fish). The independent variables included sociodemographic, health-related, and behavioral factors. Over half (51.8%) of the sample was female and 85.7% belonged to the 60−79 age group. Satisfactory compliance to FG was observed in 3.9% of the sample. In the adjusted analysis, for those between 60 and 79 y, marital status was the only significant variable associated with FG noncompliance (PR: 1.34; 95%CI: 1.04−1.71). For those over 80 y, income of >2 minimum wages (PR: 0.10; 95%CI: 0.02−0.61), living alone (PR: 1.72; 95%CI: 1.20−2.47), and self-reported cardiovascular disease (PR: 0.63; 95%CI: 0.43−0.93) were associated with FG noncompliance. We observed low FG compliance among elderly Chilean adults, especially in the oldest group. Factors associated with the FG compliance was different between age groups.
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Affiliation(s)
| | - Daiana Quintiliano-Scarpelli
- Carrera de Nutrición y Dietética, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile
| | - Dominique Masferrer Riquelme
- Carrera de Nutrición y Dietética, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Jair Licio Ferreira Santos
- Departamento de Medicina Social, Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto 14049-900, Brazil
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Abstract
Like many countries, the increase in the population of older adults in Nepal has led to national policies and programs to address their needs. It would, however, also be fair to say that not enough is yet known about older adults and hence it is unclear if government programs truly address those needs. Nepal is a very poor country that is still largely rural and characterized by extremes of inequality based on caste/ethnicity, gender, region, and income/wealth. In this paper, we describe the demographic and social conditions of older adults in Nepal, inequality, sources, and limitations of the data about older adults, and public policy and programs for older adults. We believe that studies of older adults in Nepal would benefit from adopting social determinants of health, healthy aging, and life course perspectives to both identify needs and formulate policy for older adults in Nepal.
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Affiliation(s)
- Mark Tausig
- Department of Sociology, University of Akron, Akron, Ohio, USA
| | - Janardan Subedi
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
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Schladitz K, Förster F, Wagner M, Heser K, König HH, Hajek A, Wiese B, Pabst A, Riedel-Heller SG, Löbner M. Gender Specifics of Healthy Ageing in Older Age as Seen by Women and Men (70+): A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053137. [PMID: 35270831 PMCID: PMC8909956 DOI: 10.3390/ijerph19053137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 02/05/2023]
Abstract
(1) The rising proportion of older adults in the population represents a challenge for the healthcare system. Women and men age differently. This study aims to examine gender-specific characteristics of health in old age from male and female perspectives. (2) Two focus groups were formed in this qualitative study of older (70+) women (n = 10) and men (n = 8) in accordance with the theoretical framework of the World Health Organization (WHO) on healthy ageing determinants. The data were audio recorded and fully transcribed. Qualitative content analysis was performed using MAXQDA. (3) In both focus groups (average age: women 77.1 years, men 74.9 years), gender-specific characteristics regarding healthy ageing were discussed. Women focused on healthy eating, while men focused on an active lifestyle and meaningful activities. Physical and social activities were considered as important for healthy ageing in both groups. (4) Important gender-specific characteristics of health in old age were identified and recommendations for gender-unspecific and gender-specific recommendations were derived. The results provide important information for promoting and maintaining health in old age. Women and men show both similarities and differences in terms of health-related needs and individual experiences. We suggest gender-specific features in nutrition and health programs for older adults.
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Affiliation(s)
- Katja Schladitz
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (F.F.); (A.P.); (S.G.R.-H.); (M.L.)
- Correspondence: ; Tel.: +49-341-97-15-481
| | - Franziska Förster
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (F.F.); (A.P.); (S.G.R.-H.); (M.L.)
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany; (M.W.); (K.H.)
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany; (M.W.); (K.H.)
| | - Hans-Helmut König
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (H.-H.K.); (A.H.)
| | - André Hajek
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (H.-H.K.); (A.H.)
| | - Birgitt Wiese
- Working Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, 30625 Hannover, Germany;
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (F.F.); (A.P.); (S.G.R.-H.); (M.L.)
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (F.F.); (A.P.); (S.G.R.-H.); (M.L.)
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (F.F.); (A.P.); (S.G.R.-H.); (M.L.)
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Lucantoni D, Principi A, Socci M, Zannella M, Barbabella F. Active Ageing in Italy: An Evidence-Based Model to Provide Recommendations for Policy Making and Policy Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052746. [PMID: 35270438 PMCID: PMC8910036 DOI: 10.3390/ijerph19052746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 12/04/2022]
Abstract
In ageing societies, active ageing (AA) has been recognized as a useful conceptual tool due to its holistic approach to social issues and recognised benefits from it at multiple levels (micro, meso and macro) for addressing demographic challenges. However, one of the main problems identified in relation to AA, is to turn into practice, at the policy making level, the many positive aspects that it promises at the conceptual level, as is demonstrated by the available evidence based on experiences carried out in some European countries. As an advancement in this field, through an original research experience carried out in Italy between 2019 and 2021, this study for the first time provides a model for producing recommendations for policy making and policy implementation in the field of AA, by managing the main problematic aspects related to the operationalization, at the policy making level, of the AA concept, with the potential for replication in other countries. The main challenges were identified, as well as the way to deal with them through a model, for a proper operationalization of the AA concept, based, among other aspects, on a solid international framework concerning this matter, on a mainstreaming ageing approach (at the public policy level) and on a wide stakeholder participation through co-decisional tools. A multi-level (national-regional-local) perspective was adopted to consider cultural and geographical diversity, among other challenges.
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Jaramillo ET, Haozous E, Willging CE. The Community as the Unit of Healing: Conceptualizing Social Determinants of Health and Well-Being for Older American Indian Adults. THE GERONTOLOGIST 2022; 62:732-741. [PMID: 35092427 PMCID: PMC9154240 DOI: 10.1093/geront/gnac018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives Multiple racial and social inequities shape health and access to health care for American Indian Elders, who have a lower life expectancy than all other aging populations in the United States. This qualitative study examines how upstream social determinants of health influence Elders’ ability to access and use health care. Research Design and Methods Between June 2016 and March 2017, we conducted individual, semistructured interviews with 96 American Indian Elders, aged 55 and older, and 47 professionals involved in planning or delivering care to Elders in 2 states in the U.S. Southwest. Transcripts were analyzed iteratively using grounded theory approaches, including open and focused coding. A group of American Indian Elders and allies called the Seasons of Care Community Action Board guided interpretation and prioritization of findings. Results Participants described multiple barriers that hindered Elders’ ability to access health care services and providers, which were largely tied to funding shortages and bureaucratic complexities associated with health care and insurance systems. Where available, community resources bridged service gaps and helped Elders navigate systems. Discussion and Implications Longstanding structural inequities for American Indians manifest in barriers to health equity, many of which are situated at the community level. These are compounded by additional disparities affecting older adults, rural residents, and marginalized citizens in general. Findings underscore the importance of health and policy initiatives for American Indian Elders that emphasize the community as the focus of intervention.
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Affiliation(s)
| | - Emily Haozous
- Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
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Haupt S, Niedrist T, Sourij H, Schwarzinger S, Moser O. The Impact of Exercise on Telomere Length, DNA Methylation and Metabolic Footprints. Cells 2022; 11:153. [PMID: 35011715 PMCID: PMC8750279 DOI: 10.3390/cells11010153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023] Open
Abstract
Aging as a major risk factor influences the probability of developing cancer, cardiovascular disease and diabetes, amongst others. The underlying mechanisms of disease are still not fully understood, but research suggests that delaying the aging process could ameliorate these pathologies. A key biological process in aging is cellular senescence which is associated with several stressors such as telomere shortening or enhanced DNA methylation. Telomere length as well as DNA methylation levels can be used as biological age predictors which are able to detect excessive acceleration or deceleration of aging. Analytical methods examining aging are often not suitable, expensive, time-consuming or require a high level of technical expertise. Therefore, research focusses on combining analytical methods which have the potential to simultaneously analyse epigenetic, genomic as well as metabolic changes.
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Affiliation(s)
- Sandra Haupt
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany;
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8010 Graz, Austria;
| | - Harald Sourij
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria;
| | - Stephan Schwarzinger
- NBNC—North Bavarian NMR-Centre, University of Bayreuth, 95440 Bayreuth, Germany;
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany;
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria;
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Health Patterns among Migrant and Non-Migrant Middle- and Older-Aged Individuals in Europe-Analyses Based on Share 2004-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212047. [PMID: 34831800 PMCID: PMC8622058 DOI: 10.3390/ijerph182212047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION European populations are becoming older and more diverse. Little is known about the health differences between the migrant and non-migrant elderly in Europe. The aim of this paper was to analyse changes in the health patterns of middle- and older-aged migrant and non-migrant populations in Europe from 2004 to 2017, with a specific focus on differences in age and gender. We analysed changes in the health patterns of older migrants and non-migrants in European countries from 2004 to 2017. METHOD Based on data from the Survey of Health, Ageing and Retirement in Europe (6 waves; 2004-2017; n = 233,117) we analysed three health indicators (physical functioning, depressive symptoms, and self-rated health). Logistic regression models for complex samples were calculated. Interaction terms (wave * migrant * gender * age) were used to analyse gender and age differences and the change over time. RESULTS Middle- and older-aged migrants in Europe showed significantly higher rates of depressive symptoms, lower self-rated health, and a higher proportion of limitations on general activities compared to non-migrants. However, different time trends were observed. An increasing health gap was identified in the physical functioning of older males. Narrowing health gaps over time were observed in women. DISCUSSION An increasing health gap in physical functioning in men is evidence of cumulative disadvantage. In women, evidence points towards the hypothesis of aging-as-leveler. These different results highlight the need for specific interventions focused on healthy ageing in elderly migrant men.
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Buzzell A, Chamberlain JD, Schubert M, Mueller G, Berlowitz DJ, Brinkhof MWG. Perceived sleep problems after spinal cord injury: Results from a community-based survey in Switzerland. J Spinal Cord Med 2021; 44:910-919. [PMID: 31977291 PMCID: PMC8725774 DOI: 10.1080/10790268.2019.1710938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objective: To investigate the burden of sleep problems within the Spinal Cord injured (SCI) community with respect to the general population (GP) in Switzerland. The study further explored potential predictors for receiving treatment for sleep problems after SCI.Design: Cross-sectional study.Setting: SCI community in Switzerland.Participants: Individuals diagnosed with an SCI, aged 16 years or older that permanently reside in Switzerland (N = 1549).Interventions: Not applicable.Outcome measures: Perceived sleep problems within the SCI community and GP. For those with sleep problems and SCI, an indicator for having received treatment was measured.Results: 58.8% of survey participants indicated having a sleep problem; 69.4% of those with a sleep problem did not indicate receiving treatment. Amongst people living with an SCI, individuals between the ages of 46-60 years (adjusted Odds Ratio, OR = 3.07; 95% CI 1.54-6.16), participants reporting severe financial hardship (OR = 2.90; 95% CI) 1.69-4.96, and those that indicated having pain (OR = 5.62; 95% CI 3.52-8.98) were more likely to have a chronic sleep problem. In comparison to the Swiss GP, the prevalence of having a sleep problem was 18% higher among persons with SCI, with the largest discrepancy for males with paraplegia between the ages of 46-60 years (Prevalence ratio, PR = 1.28; 95% CI, 1.21-1.36).Conclusion: Individuals with SCI experience more sleep problems compared to the Swiss GP. Findings from this study suggest that clinical screening for sleep issues targeting high risk groups is needed to reduce the large prevalence of non-treatment in individuals with SCI.
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Affiliation(s)
- Anne Buzzell
- Swiss Paraplegic Research, Nottwil, Switzerland,University of Lucerne, Department of Health Sciences and Medicine, Lucerne, Switzerland
| | - Jonviea D. Chamberlain
- Swiss Paraplegic Research, Nottwil, Switzerland,University of Lucerne, Department of Health Sciences and Medicine, Lucerne, Switzerland,University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team VINTAGE, UMR1219, Bordeaux, France,France Inserm, CIC1401-EC, Bordeaux, France
| | | | | | - David J. Berlowitz
- The University of Melbourne and the Institute for Breathing and Sleep, Austin Hospital, Melbourne, Australia
| | - Martin W. G. Brinkhof
- Swiss Paraplegic Research, Nottwil, Switzerland,University of Lucerne, Department of Health Sciences and Medicine, Lucerne, Switzerland,Correspondence to: Martin W. G. Brinkhof, Swiss Paraplegic Research, Guido A. Zäch Strasse 4, CH-6207Nottwil, Switzerland; Ph: +41 41 939 65 92.
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Arokiasamy P, Selvamani Y, Jotheeswaran AT, Sadana R. Socioeconomic differences in handgrip strength and its association with measures of intrinsic capacity among older adults in six middle-income countries. Sci Rep 2021; 11:19494. [PMID: 34593926 PMCID: PMC8484588 DOI: 10.1038/s41598-021-99047-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 09/20/2021] [Indexed: 12/18/2022] Open
Abstract
Handgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. This study documents socioeconomic (SES) differences in handgrip strength among older adults aged 50 years and over in six middle-income countries and investigates the association of handgrip strength with measures of intrinsic capacity-a composite of all the physical and mental capacities of an individual. Secondary data analysis of cross-sectional population-based data from six countries from the WHO's Study on global AGEing and adult health (SAGE) Wave 1 were conducted. Three-level linear hierarchical models examine the association of demographic, socioeconomic status and multimorbidity variables with handgrip strength. Regression-based Relative Index of Inequality (RII) examines socioeconomic inequalities in handgrip strength; and multilevel linear and logistic hierarchical regression models document the association between handgrip strength and five domains of intrinsic capacity: locomotion, psychological, cognitive capacity, vitality and sensory. Wealth quintiles are positively associated with handgrip strength among men across all countries except South Africa while the differences by education were notable for China and India. Work and nutritional status are positively associated with handgrip strength. Our findings provide new evidence of robust association between handgrip strength and other measures of intrinsic capacity and confirms that handgrip strength is a single most important measure of capacity among older persons.
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Affiliation(s)
- P Arokiasamy
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India
| | - Y Selvamani
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India.
| | - A T Jotheeswaran
- Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Ritu Sadana
- Head, Ageing and Health, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
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Ochoa Pacheco P, Castro Pérez R, Coello-Montecel D, Castro Zazueta NP. Quality of Life in Older Adults: Evidence from Mexico and Ecuador. Geriatrics (Basel) 2021; 6:geriatrics6030092. [PMID: 34562993 PMCID: PMC8482232 DOI: 10.3390/geriatrics6030092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
Older adults are a growing population group in Latin America, hence the importance of deepening studies, proposals, and policies to guarantee their well-being. This article analyzes the perception of quality of life in older adults from Mexico and Ecuador and its association with several socioeconomic variables. The study design was cross-sectional. The sample comprised 450 older adults, 238 from Mexico and 212 from Ecuador. The WHOQOL-OLD Quality of Life Questionnaire and a set of sociodemographic variables were used. The results showed a higher perception of quality of life in the Mexican sample regarding most of the dimensions, except for sensory skills and social participation. An association was also found between sensory skills and sports practice, as well as between social participation and education level. The study achieves a binational approach to the reality of older adults in Latin America and confirms that there are differences in each sample that are due to the particularities of each reality. This research contributes to deepening the reality of the elderly, especially in Ecuador, where the quality-of-life studies in all age segments must be strengthened.
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Affiliation(s)
- Paola Ochoa Pacheco
- ESPAE Graduate School of Management, Escuela Superior Politécnica del Litoral (ESPOL), Campus Las Peñas Malecón No. 100 y Loja, Guayaquil 090306, Ecuador
- Correspondence: (P.O.P.); (D.C.-M.)
| | - Rafael Castro Pérez
- Facultad de Psicología, Universidad Autónoma de Sinaloa, Ciudad Universitaria Culiacán, Culiacán 80013, Mexico; (R.C.P.); (N.P.C.Z.)
| | - David Coello-Montecel
- ESPAE Graduate School of Management, Escuela Superior Politécnica del Litoral (ESPOL), Campus Las Peñas Malecón No. 100 y Loja, Guayaquil 090306, Ecuador
- Correspondence: (P.O.P.); (D.C.-M.)
| | - Nancy Pamela Castro Zazueta
- Facultad de Psicología, Universidad Autónoma de Sinaloa, Ciudad Universitaria Culiacán, Culiacán 80013, Mexico; (R.C.P.); (N.P.C.Z.)
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Gómez F, Osorio-García D, Panesso L, Curcio CL. Healthy aging determinants and disability among older adults: SABE Colombia. Rev Panam Salud Publica 2021; 45:e98. [PMID: 34475887 PMCID: PMC8369129 DOI: 10.26633/rpsp.2021.98] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/12/2021] [Indexed: 12/29/2022] Open
Abstract
Objective. To identify the main factors associated with disability in older adults in Colombia, adjusted according to structural and intermediary determinants of healthy aging. Methods. This study used cross-sectional data from 23 694 adults over 60 years of age in the SABE Colombia nationwide survey. Structural determinants such as demographic and socioeconomic position variables were analyzed. Intermediary variables were classified into three blocks: intrinsic capacity, physical and built environment, and health care systems. Data analysis employed multivariate logistic regression. Results. The prevalence of overall disability was 21% for activities of daily living, 38% for instrumental activities of daily living, and 33% for mobility disability. Disability was associated with sociodemographic structural determinants such as older age, female sex, rural residence, never married/divorced, living alone, low educational level, and Indigenous/Black ethnicity. With regard to determinants of socioeconomic position, net low income, poor socioeconomic stratum, insufficient income perception, and a subsidized health insurance scheme exerted a major influence on disability. Intermediary determinants of intrinsic capacity, such as poor self-rated health, multimorbidity, low grip strength, sedentary lifestyle, early childhood economic adversity, no social support, and no participation in activities, were significantly associated with disability. Conclusions. Actions that affect the main factors associated with disability, such as reducing health inequities through policies, strategies, and activities, can contribute significantly to the well-being and quality of life of Colombian older adults.
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Affiliation(s)
- Fernando Gómez
- Universidad de Caldas Manizales Colombia Universidad de Caldas, Manizales, Colombia
| | - David Osorio-García
- Universidad de Caldas Manizales Colombia Universidad de Caldas, Manizales, Colombia
| | - Luisa Panesso
- Universidad de Caldas Manizales Colombia Universidad de Caldas, Manizales, Colombia
| | - Carmen-Lucia Curcio
- Universidad de Caldas Manizales Colombia Universidad de Caldas, Manizales, Colombia
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Kurnat-Thoma EL, Murray MT, Juneau P. Frailty and Determinants of Health Among Older Adults in the United States 2011-2016. J Aging Health 2021; 34:233-244. [PMID: 34470533 PMCID: PMC9100462 DOI: 10.1177/08982643211040706] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To characterize frailty phenotype in a representative cohort of older
Americans and examine determinants of health factors. Methods Retrospective analysis of data from 5,553 adults ≥60 years old in the
2011–2016 cross-sectional National Health and Nutrition Examination Survey
(NHANES). World Health Organization “Determinants of
Health” conceptual model was used to prioritize variables for
multinomial logistic regression for the outcome of modified Fried frailty
phenotype. Results 482 participants (9%) were frail and 2432 (44%) prefrail. Four factors were
highly associated with frailty: difficulty with ≥1 activity of daily living
(77%; OR 24.81 p < 0.01), ≥2 hospitalizations in the
previous year (17%, OR 3.94 p < 0.01), having >2
comorbidities (27%; OR 3.33 p < 0.01), and polypharmacy
(66%; OR 2.38 p < 0.01). Discussion A modified Fried frailty assessment incorporating five self-reported criteria
may be useful as a rapid nursing screen in low-resource settings. These
assessments can streamline nursing care coordination and case management
activities, thereby facilitating targeted frailty interventions to support
healthy aging in vulnerable populations.
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Affiliation(s)
- Emma L Kurnat-Thoma
- National Institute of Nursing Research, 35047National Institutes of Health, Bethesda, MD, USA.,Georgetown University School of Nursing & Health Studies, Department of Professional Nursing Practice, Washington, DC, USA
| | - Meghan T Murray
- National Institute of Nursing Research, 35047National Institutes of Health, Bethesda, MD, USA.,Columbia University, School of Nursing, New York, NY, USA
| | - Paul Juneau
- Division of Data Services, NIH Library, Office of Research Services, National Institutes of Health, 10952Bethesda, MD, USA
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Welch V, Mathew CM, Babelmorad P, Li Y, Ghogomu ET, Borg J, Conde M, Kristjansson E, Lyddiatt A, Marcus S, Nickerson JW, Pottie K, Rogers M, Sadana R, Saran A, Shea B, Sheehy L, Sveistrup H, Tanuseputro P, Thompson‐Coon J, Walker P, Zhang W, Howe TE. Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1175. [PMID: 37051456 PMCID: PMC8988637 DOI: 10.1002/cl2.1175] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background By 2030, the global population of people older than 60 years is expected to be higher than the number of children under 10 years, resulting in major health and social care system implications worldwide. Without a supportive environment, whether social or built, diminished functional ability may arise in older people. Functional ability comprises an individual's intrinsic capacity and people's interaction with their environment enabling them to be and do what they value. Objectives This evidence and gap map aims to identify primary studies and systematic reviews of health and social support services as well as assistive devices designed to support functional ability among older adults living at home or in other places of residence. Search Methods We systematically searched from inception to August 2018 in: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, PsycINFO, AgeLine, Campbell Library, ASSIA, Social Science Citation Index and Social Policy & Practice. We conducted a focused search for grey literature and protocols of studies (e.g., ProQuest Theses and Dissertation Global, conference abstract databases, Help Age, PROSPERO, Cochrane and Campbell libraries and ClinicalTrials.gov). Selection Criteria Screening and data extraction were performed independently in duplicate according to our intervention and outcome framework. We included completed and on-going systematic reviews and randomized controlled trials of effectiveness on health and social support services provided at home, assistive products and technology for personal indoor and outdoor mobility and transportation as well as design, construction and building products and technology of buildings for private use such as wheelchairs, and ramps. Data Collection and Analysis We coded interventions and outcomes, and the number of studies that assessed health inequities across equity factors. We mapped outcomes based on the International Classification of Function, Disability and Health (ICF) adapted categories: intrinsic capacities (body function and structures) and functional abilities (activities). We assessed methodological quality of systematic reviews using the AMSTAR II checklist. Main Results After de-duplication, 10,783 records were screened. The map includes 548 studies (120 systematic reviews and 428 randomized controlled trials). Interventions and outcomes were classified using domains from the International Classification of Function, Disability and Health (ICF) framework. Most systematic reviews (n = 71, 59%) were rated low or critically low for methodological quality.The most common interventions were home-based rehabilitation for older adults (n = 276) and home-based health services for disease prevention (n = 233), mostly delivered by visiting healthcare professionals (n = 474). There was a relative paucity of studies on personal mobility, building adaptations, family support, personal support and befriending or friendly visits. The most measured intrinsic capacity domains were mental function (n = 269) and neuromusculoskeletal function (n = 164). The most measured outcomes for functional ability were basic needs (n = 277) and mobility (n = 160). There were few studies which evaluated outcome domains of social participation, financial security, ability to maintain relationships and communication.There was a lack of studies in low- and middle-income countries (LMICs) and a gap in the assessment of health equity issues. Authors' Conclusions There is substantial evidence for interventions to promote functional ability in older adults at home including mostly home-based rehabilitation for older adults and home-based health services for disease prevention. Remotely delivered home-based services are of greater importance to policy-makers and practitioners in the context of the COVID-19 pandemic. This map of studies published prior to the pandemic provides an initial resource to identify relevant home-based services which may be of interest for policy-makers and practitioners, such as home-based rehabilitation and social support, although these interventions would likely require further adaptation for online delivery during the COVID-19 pandemic. There is a need to strengthen assessment of social support and mobility interventions and outcomes related to making decisions, building relationships, financial security, and communication in future studies. More studies are needed to assess LMIC contexts and health equity issues.
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Affiliation(s)
- Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | | | | | - Yanfei Li
- Evidence‐Based Social Science Research Center, School of Public HealthLanzhou UniversityLanzhouChina
| | | | | | - Monserrat Conde
- Cochrane Campbell Global Ageing Partnership FieldFaroPortugal
| | | | | | - Sue Marcus
- Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | | | | | - Morwenna Rogers
- NIHR ARC, South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | | | | | - Beverly Shea
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Lisa Sheehy
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Heidi Sveistrup
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
- Faculty of Health SciencesUniversity of OttawaOttawaCanada
| | | | - Joanna Thompson‐Coon
- NIHR ARC South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | - Peter Walker
- Faculty of MedicineUniversity of OttawaOttawaCanada
| | - Wei Zhang
- Access to Medicines, Vaccines and Health ProductsWorld Health OrganizationGenevaSwitzerland
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Wagg E, Blyth FM, Cumming RG, Khalatbari-Soltani S. Socioeconomic position and healthy ageing: A systematic review of cross-sectional and longitudinal studies. Ageing Res Rev 2021; 69:101365. [PMID: 34004378 DOI: 10.1016/j.arr.2021.101365] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/25/2021] [Accepted: 05/13/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The association between socioeconomic position (SEP) and health is well-established. However, the association between SEP and healthy ageing as a multidimensional construct is unclear. METHODS We conducted a systematic review of peer-reviewed cross-sectional and longitudinal studies on the associations between SEP and multidimensional healthy ageing measures. Studies were identified from a systematic search across major electronic databases from inception to February 2021. RESULTS Fourthy-five articles met inclusion criteria (26 cross-sectional and 19 longitudinal studies). There was no consistency in method of operationalizing healthy ageing across studies, domains included in the healthy ageing measures, or in the definition and number of levels of SEP indicators. Overall, regardless of heterogeneity between studies, a positive association between educational level (85.0 % of studies) and income/wealth (81.4 % of studies) and healthy ageing was evident. Regarding occupational position, evidence from 11 studies was inconclusive. The number of studies including home ownership, parenteral SEP, or composite SEP scores was insufficient to be able to draw a conclusion. CONCLUSIONS There is evidence that socioeconomic inequalities, as assessed by educational level and income/wealth, are associated with healthy ageing. These findings, and the broader evidence base on SEP and healthy ageing, highlight the importance of addressing inequality through integrated health and social policies and strategies.
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Affiliation(s)
- Emma Wagg
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia
| | - Fiona M Blyth
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, Australia
| | - Robert G Cumming
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, Australia
| | - Saman Khalatbari-Soltani
- The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, Australia.
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Markle-Reid M, McAiney C, Fisher K, Ganann R, Gauthier AP, Heald-Taylor G, McElhaney JE, McMillan F, Petrie P, Ploeg J, Urajnik DJ, Whitmore C. Effectiveness of a nurse-led hospital-to-home transitional care intervention for older adults with multimorbidity and depressive symptoms: A pragmatic randomized controlled trial. PLoS One 2021; 16:e0254573. [PMID: 34310640 PMCID: PMC8312945 DOI: 10.1371/journal.pone.0254573] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 06/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of a nurse-led hospital-to-home transitional care intervention versus usual care on mental functioning (primary outcome), physical functioning, depressive symptoms, anxiety, perceived social support, patient experience, and health service use costs in older adults with multimorbidity (≥ 2 comorbidities) and depressive symptoms. DESIGN AND SETTING Pragmatic multi-site randomized controlled trial conducted in three communities in Ontario, Canada. Participants were allocated into two groups of intervention and usual care (control). PARTICIPANTS 127 older adults (≥ 65 years) discharged from hospital to the community with multimorbidity and depressive symptoms. INTERVENTION This evidence-based, patient-centred intervention consisted of individually tailored care delivery by a Registered Nurse comprising in-home visits, telephone follow-up and system navigation support over 6-months. OUTCOME MEASURES The primary outcome was the change in mental functioning, from baseline to 6-months. Secondary outcomes were the change in physical functioning, depressive symptoms, anxiety, perceived social support, patient experience, and health service use cost, from baseline to 6-months. Intention-to-treat analysis was performed using ANCOVA modeling. RESULTS Of 127 enrolled participants (63-intervention, 64-control), 85% had six or more chronic conditions. 28 participants were lost to follow-up, leaving 99 (47 -intervention, 52-control) participants for the complete case analysis. No significant group differences were seen for the baseline to six-month change in mental functioning or other secondary outcomes. Older adults in the intervention group reported receiving more information about health and social services (p = 0.03) compared with the usual care group. CONCLUSIONS Although no significant group differences were seen for the primary or secondary outcomes, the intervention resulted in improvements in one aspect of patient experience (information about health and social services). The study sample fell below the target sample (enrolled 127, targeted 216), which can account for the non-significant findings. Further research on the impact of the intervention and factors that contribute to the results is recommended. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT03157999.
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Affiliation(s)
- Maureen Markle-Reid
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Carrie McAiney
- School of Public Health and Health Systems and Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada
| | - Kathryn Fisher
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca Ganann
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Alain P. Gauthier
- School of Human Kinetics, Laurentian University, Sudbury, Ontario, Canada
| | - Gail Heald-Taylor
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Janet E. McElhaney
- Northern Ontario School of Medicine and Health Sciences North Research Institute, Sudbury, Ontario, Canada
| | - Fran McMillan
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
| | - Penelope Petrie
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Diana J. Urajnik
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
| | - Carly Whitmore
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Epidemiological Conceptual Models and Health Justice for Critically Ill Older Adults. Crit Care Med 2021; 49:375-379. [PMID: 33438978 PMCID: PMC8803212 DOI: 10.1097/ccm.0000000000004793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kristiansen M, Nedergaard Jensen A, Norredam M, Srivarathan A. Targeting preventive home visits to older adults in disadvantaged communities: Perspectives of professionals. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1051-1060. [PMID: 32794327 DOI: 10.1111/hsc.13139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
This study explored the implementation of multidimensional preventive home visits targeted to older adults living in a disadvantaged community in Denmark. The intervention was adapted to include the following key components: involvement of community members in recruitment processes; a combination of individual and group-based dissemination; adaptation of materials to overcome language barriers; and diversity-sensitivity training for professionals. The study took place over 12 months between August 2016 and August 2017 and used various data sources: registry-based data, participant observations, combined with individual and focus group interviews with the target population (n = 22) and relevant health care professionals (n = 8). Here, we report on findings pertaining to implementation barriers and facilitators as seen from the perspective of professionals. Socioeconomic vulnerability was prominent, and uptake of health care services was low, indicating under-utilisation. Implementation facilitators and barriers were identified including potentials in nurturing local partnerships and proximity during recruitment; overcoming language barriers; offering diversity-sensitivity training for professionals; and a need for a more multidisciplinary, comprehensive scope of preventive visits for diverse older adults in disadvantaged communities. Thus, more focus on participatory, comprehensive and community-based health promotion are needed to ensure healthy ageing in the context of social inequality and ethnic diversity.
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Affiliation(s)
- Maria Kristiansen
- Center for Healthy Aging & Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Andrea Nedergaard Jensen
- Center for Healthy Aging & Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity and Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Abirami Srivarathan
- Center for Healthy Aging & Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen K, Denmark
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Enwo OO, Player E, Steel N, Ford JA. The impact of life events on later life: a latent class analysis of the English Longitudinal Study of Ageing. J Public Health (Oxf) 2021; 43:e180-e187. [PMID: 32157284 DOI: 10.1093/pubmed/fdaa002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/03/2020] [Accepted: 01/14/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Inequalities in life events can lead to inequalities in older age. This research aimed to explore associations between life events reported by older people and quality of life (QoL) and functional ability. METHODS Participants were grouped according to eight life events: parental closeness, educational opportunities in childhood, financial hardship, loss of an unborn child, bereavement due to war, involvement in conflict, violence and experiencing a natural disaster. Linear and logistic regressions were used to explore associations between these groups and the main outcomes of functional ability and QoL. RESULTS 7555 participants were allocated to four LCA groups: 'few life events' (n = 6,250), 'emotionally cold mother' (n = 724), 'violence in combat' (n = 274) and 'many life events' (n = 307). Reduced QoL was reported in the 'many life events' (coefficient - 5.33, 95%CI -6.61 to -4.05), 'emotionally cold mother' (-1.89, -2.62 to 1.15) and 'violence in combat' (-1.95, -3.08 to -0.82) groups, compared to the 'few life events' group. The 'many life events' group also reported more difficulty with activities of daily living. CONCLUSIONS Policies aimed at reducing inequalities in older age should consider events across the life course.
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Affiliation(s)
- O O Enwo
- Norwich Medical School, University of East Anglia
| | - E Player
- Norwich Medical School, University of East Anglia
| | - N Steel
- Norwich Medical School, University of East Anglia
| | - J A Ford
- Norwich Medical School, University of East Anglia.,Institute of Public Health, University of Cambridge
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