Perspectives on the Role and Synergies of Architecture and Social and Built Environment in Enabling Active Healthy Aging

Postgraduate education in healthy and active ageing: a systematic scoping review of learning needs, curricula and learning impact

To inform a new European-based online master's programme in active aging and age-friendly society, a scoping review was performed to identify previously reported learning needs and learning outcomes on this topic. Four electronic databases (PubMed, EBSCO [Academic Search Complete], Scopus, and ASSIA) were systematically searched, along with gray literature. Dual, independent review of an initial 888 studies led to 33 included papers which underwent independent data extraction and reconciliation. Just 18.2% of studies employed a student survey or similar to determine learning needs, with the majority reporting educational intervention objectives, learning outcomes or curriculum content. Main study topics were intergenerational learning (36.4%), age-related design (27.3%), health (21.2%), attitudes toward aging (6.1%), and collaborative learning (6.1%). This review found limited literature on student learning needs in healthy and active aging. Future research should elucidate student- and other stakeholder-determined learning needs, with robust evaluation of post-education skills, attitudes, and practice change.

The Role of the Built Environment in Supporting Older Adults' Engagement: A Narrative Literature Review

OBJECTIVE

This literature review aimed to summarize the existing knowledge surrounding the role of the built environment in supporting older adults' physical and social engagement and identify opportunities for future research and design that facilitates older adults' engagement at multiple environmental scales: from interior spaces to neighborhoods.

BACKGROUND

Physical environments can support or impede older adults' physical and social engagement: willful, motivated involvement in meaningful activity or occupation. Research shows that engagement is a core component of health and well-being and relates to positive health outcomes, including reduced disease risk, better mental health, and improved physical and cognitive function. Thus, designing supportive built environments for engagement can yield significant, positive health and well-being impacts.

METHODS

A systematized search of five databases, a hand search, and an iterative screening process identified 55 studies for inclusion in this review. Through inductive thematic analysis, this review summarizes findings regarding the built environment's role in physical and social engagement in older age and design strategies to facilitate engagement and support health and well-being.

RESULTS

Evidence indicates that built environment characteristics can influence older people's physical and social engagement in homes, neighborhoods, and care settings. The thematic analysis of the included studies identified three key themes concerning the relationships of built environment characteristics to older adults' engagement across multiple environmental scales: connection, access, and security.

CONCLUSIONS

Built environments influence older people's physical and social engagement, significantly affecting their health, well-being, abilities, and longevity. Numerous design strategies can support older adults' engagement, but more research is needed.

Implications of immersive technologies in healthcare sector and its built environment

Objectives

This research focuses on how built environment experts can contribute to the MXR-enabled digital innovation as part of the multidisciplinary team effort to ensure post-pandemic resilience in healthcare built environment. The goal of this research is to help healthcare providers, built environment experts, and policy makers respectively: (1) Advocate the benefits of MXR for innovating health and social care; (2) Spark debate across networks of expertise to create health-promoting environment; and (3) Understand the overriding priorities in making effective pathways to the implementation of MXR.

Methods

To highlight the novelty of this research, the study relies on two qualitative methodologies: exploratory literature review and semi-structured interviews. Based on the evaluation of prior works and cross-national case studies, hypotheses are formulated from three arenas: (1) Cross-sectional Initiatives for Post-pandemic Resilience; (2) Interoperability and Usability of Next-gen Medicines; and (3) Metaverse and New Forms of Value in Future Healthcare Ecosystems. To verify those hypotheses, empirical findings are derived from in-depth interviews with nine key informants.

Results

The main findings are summarized under the following three themes: (1) Synergism between Architecture and Technology; (2) Patient Empowerment and Staff Support; and (3) Scalable Health and Wellbeing in Non-hospital and Therapeutic Settings. Firstly, both built environment and healthcare sectors can benefit from the various capabilities of MXR through cross-sectional initiatives, evidence-based practices, and participatory approaches. Secondly, a confluence of knowledge and methods of HCI and HBI can increase the interoperability and usability of MXR for the patient-centered and value-based healthcare models. Thirdly, the MXR-enabled technological regime will largely affect the new forms of value in healthcare premises by fostering more decentralized, preventive, and therapeutic characteristics in the future healthcare ecosystems.

Conclusion

Whether it's virtual or physical, our healthcare systems have placed great emphasis on the rigor of evidence-based approach linking health outcome to a clinical environment. Henceforth, built environment experts should seek closer ties with the MXR ecosystems for the co-production of scalable health and wellbeing in non-hospital and therapeutic settings. Ultimately, this is to improve resource efficiency in the healthcare sector while considering the transition of health resources towards in silico status by increasing the implementation of MXR.

Social Network and Environment as Determinants of Disability and Quality of Life in Aging: Results From an Italian Study

Background

The increase in life expectancy is leading to a worldwide increase in chronic diseases and disability, with significant concern about their management and long-term care. Investigating the aging process using a bio-psychosocial perspective is essential to understanding how to reduce disability and improve the quality of life of aging people. This study aims to explore the role of social networks and built environment as predictors of disability and quality of life in the Italian population aged over 50 years.

Materials and Methods

The research protocol is composed of several tools: World Health Organization Disability Assessment Scale 2.0 (WHODAS 2.0), World Health Organization Quality of Life Assessment in Aging (WHOQOL-AGE), Social Network Index (SNI), the Courage Built Environment Self-Reported Questionnaire (CBE-SR), and collection of sociodemographic information and information on health system coverage.

Results

A total of 431 people were administered the protocol, and among them, 209 were males and 222 were females, with a mean age of 70 years. The majority of the sample reported earning a middle or high school diploma, and 60.6% of the sample declared to have a good health status. The results showed that people with a good social support network have higher levels of functioning and quality of life. However, the built environment did not significantly predict either disability or quality of life.

Conclusions

These results could provide elements for dialogue with institutions and policymakers. This is fundamental to develop active policies aimed at the implementation of services and systems to promote healthy aging process.

An ecological approach to the development of an active aging measurement in urban areas (AAMU)

BACKGROUND

An essential element in the process of "aging well" is the concept of Active Aging (AA). To propose an operational definition of Active Aging, the present study seeks to develop a new measurement tool through an ecological approach. The aim is to recognize significant indicators that play a role in assessing AA in urban areas.

METHODS

This study was conducted through a two-phase process of consensus-building: 1) identifying a set of indicators that were likely candidates for inclusion based on literature review, and 2) a two-round modified Delphi survey using an international panel of academic experts in environmental sciences and gerontology to achieve consensus on the importance of the extracted indicators and validate the items. The panelists were asked to complete a researcher-developed questionnaire with an 11-point Likert scale based on the indicators derived in phase 1. Finally, the Delphi survey's valid indicators and criteria were utilized to develop the measurement tool.

RESULTS

At the outset, a list of 111 indicators of AA was prepared through the desk study. A panel of 22 experts reviewed the extracted items and arrived at a consensus on 99 items in the first round and finalised in the second round. Thematic analysis of the panelists' open-ended responses revealed new concepts that would be explicitly considered by the consensus group. This developed measurement scale consists of five domains, i.e., individual, spatial, socio-economic, governance, and health-related, which contain 15 criteria and 99 indicators.

CONCLUSIONS

The present researchers have developed the active aging measure for urban settlements (AAMU), which can be used both by policy-makers and as an informal self-reported statement among the elderly. AAM's results in the elderly's residential environmental communities can improve policy-making to address urban design to sustain an active, healthy life among older people in urban environments.

The World Health Organization (WHO) approach to healthy ageing

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The ageing global population is the important medical and social demographic problem.

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WHO underlines the importance of maintaining functional ability in older age.

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WHO identified strategic objectives and priorities to promote healthy ageing.

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Person-oriented long-term integrated care is the key issue.

The ageing of the global population is the most important medical and social demographic problem worldwide. The World Health Organization (WHO) has defined healthy ageing as a process of maintaining functional ability to enable wellbeing in older age. The WHO, Member States and Partners for Sustainable Development Goals have created a Global Strategy and Action Plan for Ageing and Health for 2016–2020 and its continuation with the WHO programme The Decade of Healthy Ageing 2020–2030. The WHO has established main priorities such as supporting country planning and action, collecting better global data and promoting research on healthy ageing, aligning health systems to the needs of older people, laying the foundations and ensuring the human resources necessary for long-term integrated care, undertaking a global campaign to combat ageism, and enhancing the global network for age-friendly cities and communities. There are several reports of coordinated preventive health and social health initiatives in well developed countries. However, there is little evidence on the application of the active ageing frameworks in developing countries. Greater national capacities and closer monitoring of the progress through age-disaggregated data is needed to effectively implement the intended programmes on healthy ageing.

Comprehensive 5P framework for active aging using the ecological approach: an iterative systematic review

BACKGROUND

"Active aging" is an inclusive term and has been defined from a variety of aspects in different domains throughout the literature. The aim of this review was to identify those aspects that play significant roles in building this concept using an ecological approach.

METHODS

In this study, seven online databases, including JSTOR, Pub-Med, Web of Science, Google Scholar, ProQuest, EBSCO, and Scopus, were searched from 2002 to 2018 for both qualitative and quantitative articles published in English. Two reviewers independently found the related articles using the search terms "active aging" and "built environment" and included both "ageing" and "aging".

RESULTS

Of 1500 records which passed the screening stage, 92 were eligible for inclusion in the review. A total of 15 subthemes were derived: (1) personal characteristics, (2) behavioral attitude, (3) land use, (4) access, (5) physical form, (6) cityscape/city image, (7) public open spaces, (8) housing, (9) social environment, (10) cultural Environment, (11) economic environment, (12) good governance, (13) physical health, (14) mental health, and (15) social health. Ecological themes of active aging can be defined as the 5P model: person, processes, place, prime, and policymaking.

CONCLUSIONS

The results of this study can shed light on different aspects of active aging. Also, the results emphasized the significance of the multidimensional nature of active aging, micro (person), meso (process), and macro systems (place and policymaking), based on health (prime) environments. Moreover, the results were based on the relationships between the person and the environment at the individual, interpersonal, and environmental levels, which can be used to conduct future studies and develop policies on aging populations.

Early-life adversity, later-life mental health, and resilience resources: a longitudinal population-based birth cohort analysis

ABSTRACTBackground:Robust and persistent links between early-life adversities and later-life mental distress have previously been observed. Individual and social resources are associated with greater mental health and resilience. This study aimed to test these resources as moderators and mediators of the association between childhood psychosocial adversity and later-life mental distress.

METHODS

Participant data came from the Medical Research Council National Survey of Health and Development, a nationally-representative birth cohort study. The General Health Questionnaire-28 (GHQ-28) captured mental distress at ages 53, 60-64, and 68-69. An eight-item cumulative psychosocial adversity score was created (0, 1, 2, ≥3 adversities). Individual (i.e., education, occupational status, physical activity) and social (i.e., social support, neighborhood cohesion) resources were examined as mediators and moderators of CPA and GHQ-28 in longitudinal multilevel models.

FINDINGS

Greater adversity was associated with an average GHQ-28 score increase of 0.017, per unit adversity (β = 0·017, p < 0·001, 95% CI 0·011, 0·022). Lower mental distress was associated with higher levels of physical activity, occupational status, education, social support, and neighborhood cohesion. There was no evidence that resources moderated the relationship between GHQ-28 and adversity. All resources, save for physical activity and occupational status, partly mediated this relationship.

CONCLUSIONS

Individual and social resources were associated with lower mental distress. They did not modify, but partly mediated the association between childhood adversity and adult mental distress. Social support was the most important mediator, suggesting that interventions to promote greater social support may offset psychosocial adversities experienced in childhood to foster better mental health in older adults.