Are We Living Longer and Healthier?

Quality of life in assisted living facilities for seniors: A descriptive exploratory study

INTRODUCTION

Promoting individuals' health across different life spans has always been key to a holistic nursing practice. Seniors are a diverse population who go through many physical and mental changes as they age. During the last decade, assisted living facilities (ALFs) have dramatically increased in numbers to provide care and living services in a home-like environment.

AIM

The aim of this descriptive exploratory study was to explore the quality of life as perceived by seniors who reside in assisted living facilities (ALFs).

DESIGN

This study utilized a descriptive exploratory design to investigate the quality of life of seniors living in ALFs.

METHODS

Seventeen residents from two ALFs were interviewed to gather their perspectives on the quality of their lives while living in an ALF. The interviews were conducted by the researcher and were audio-recorded and transcribed verbatim. The data were analysed using thematic analysis.

RESULTS

Three major themes surfaced from residents' descriptions: 'physical environment', 'social environment' and 'home-like atmosphere'. The quality of life in ALFs was found to be predominantly an outcome of the exchange between the personal capability of residents to adapt to changes and the capacity of the facility to meet residents' diverse needs.

PATIENT OR PUBLIC CONTRIBUTION

Participants who discussed their quality of life in ALFs provided profound insights into this aspect of their lives. The findings from this study can potentially enlighten ALF stakeholders and enhance the quality of life for seniors residing in these facilities.

Impact of income inequalities on subjective perception of older adult health: An analysis of healthy life expectancy in China from 1997 to 2006

AIM

Driven by rapid socioeconomic development over recent decades, there are widening income inequalities and subjective health disparities among older adults in China. This study explored the relationship between income inequalities and self-rated healthy life expectancy (HLE) considering potential sex-specific differences.

METHODS

From a cohort of 1760 individuals aged ≥60 years from the China Health and Nutrition Survey (1997-2006), we calculated age-specific life expectancy (LE), HLE and the proportion of HLE to LE (HLE/LE) by sex using the IMaCh software, incorporated time-varying income levels of older adults.

RESULTS

Although longevity has significantly improved, the well-being of Chinese older adults could be further enhanced by assessing HLE, as the results showed that at age 60 years, ~20% of their LE was characterized by unhealthiness. Discriminated by economic status, lower-income individuals experienced worse self-rated health compared with the general population and affluent counterparts. For instance, at age 60 years, the LE, HLE and HLE/LE of low-income men were 19.8 (95% CI 18.4-21.1), 16.2 years (95% CI 15.0-17.5) and 81.8%, respectively, lower than their general (21.7, 95% CI: 20.4-23.0; 18.0, 95% CI 16.8-19.2; and 82.9%) and high-income counterparts (25.1, 95% CI 23.1-27.2; 21.4, 95% CI 19.5-23.3; and 85.3%). Sex disparities were noticeable among low-income individuals in HLE/LE, with low-income women showing the most significant disadvantage.

CONCLUSIONS

Income inequalities exacerbated subjective health disparities among older adults, particularly among lower-income individuals and women. Our findings carry significant implications for formulating public health and social welfare strategies, especially in nations grappling with an aging population and undergoing parallel socioeconomic development. Geriatr Gerontol Int 2024; 24: 109-115.

Multiple Roads to Success: A Latent Class Analysis on Successful Ageing Among Hong Kong Near-Centenarians and Centenarians (NCC)

Notwithstanding the oldest-old cohort being the fastest-growing population in most ageing societies, characterizing successful ageing in adults of advanced age, such as nonagenarians and centenarians, remains challenging. This study investigated the successful ageing subphenotypes using the data from Hong Kong Centenarian Study 2. Between April 2021 and September 2022, 146 family caregivers of community-dwelling older adults aged 95 or above were interviewed by phone. Latent class analysis identified three classes-Overall Frail (46.6%) with poor mobility, cognitive and functional health, Nonambulant (37.0%) but good functional health, and Robust (16.4%) with overall good health-from 11 indicators based on caregivers' reports. Although we found a low prevalence of fulfillment of all indicators of successful ageing, our findings will help care professionals appreciate the heterogeneity underlying partial successful ageing in this vulnerable cohort for segmented and targeted healthy longevity interventions.

Handgrip strength is positively associated with successful aging in older adults: A national cross-sectional study in China

OBJECTIVES

Muscle strength gradually decreases with advancing age. This study aimed to explore the relationship between handgrip strength and successful aging and its specific dimensions in older adults using a nationally representative sample.

METHODS

A total of 5269 adults aged 60 and older were included in this study. Handgrip strength was measured using a dynamometer and was organized into quartiles by sex. Successful aging was defined by Rowe and Kahn's conceptual model including the following five dimensions: (a) no major diseases; (b) freedom from disability; (c) high cognitive function; (d) good psychological status; and (e) active social engagement in life. Logistic regression models were used to examine the association between handgrip strength and successful aging and its specific dimensions.

RESULTS

The prevalence of successful aging was found to be 35.1 % in Chinese older adults. Compared to older adults with handgrip strength in the first quartile, those with handgrip strength in the second quartile, third quartile, and fourth quartile had a higher probability of successful aging (adjusted odds ratio (OR): 1.40 (95 % CI: 1.16, 1.69) to 2.06 (95 % CI: 1.70, 2.50)). We further found that the association between handgrip strength and successful aging was related to different ages.

CONCLUSION

This study suggested that there is a close association between handgrip strength and successful aging. Older adults who have greater handgrip strength can successfully deal with the challenges of aging. For older people, keeping a high level of muscle strength in late life may be helpful to the constant successful aging.

Loneliness at Older Ages in the United States: Lonely Life Expectancy and the Role of Loneliness in Health Disparities

We provide an empirical foundation for research on the demography of loneliness at older ages. First, we use published life tables and data from the U.S.-based Health and Retirement Study for the period 2008-2016 to calculate lonely life expectancy for Americans aged 55 or older. Using Sullivan's method, we demonstrate pronounced differences in lonely life expectancy by sex, race/ethnicity, and educational attainment that correspond to well-established patterns of stratification in other dimensions of well-being. Next, we estimate models that decompose observed sex, racial/ethnic, and educational differences in three key health outcomes into the part explained (in a statistical accounting sense) by loneliness and the part accounted for by other factors. We find little evidence of an important role for loneliness in understanding disparities in mortality and the onset of physical disability and cognitive impairment among Americans aged 55 or older, net of several established correlates of health disparities. These descriptive findings provide an empirical foundation for continued development of a demography of loneliness at older ages in response to the anticipated growth in scientific and policy emphasis on loneliness and the fundamental life changes that have accompanied the COVID-19 pandemic.

A Grounded Theory on Interment Stress Among Filipino Older Adults

Older adults deal with age-related challenges concerning death and dying. Their cognitive and emotional interactions on burial arrangement, funeral expenses and body disposition encapsulate interment stresses. This grounded theory research underscored the development of interment stress among Filipino older adults (n = 26). A three-stage (Yielding, Inflowing and Discharging) model, 'The spillway for cognitive and emotional interactions of interment stress' represented interment stress as a cognitive and emotional interactive process experienced by older adults. The emergent model may be vital to offer death awareness and preparation, and a basis for creating appropriate programs to cope with the interment stress among older adults. This interment stress framework may also contribute to geriatric and gerontological psychology focused on promoting the older adults' psychological well-being and assist in achieving harmonious aging. Ultimately, the findings hope to achieve advances on individuals' and organizations' management of older adults' interment stress within personal, social and professional context.

Determining the psychometric properties of a novel questionnaire to measure "preparedness for the future" (Prep FQ)

Background

People are living longer than ever before. However, with living longer comes increased problems that negatively impact on quality of life and the quality of death. Tools are needed to help individuals assess whether they are practicing the best attitudes and behaviors that are associated with a future long life, high quality of life, high quality of death and a satisfying post-death legacy. The purpose of paper is to describe the process we used to develop a novel questionnaire (“Preparedness for the Future Questionnaire™ or Prep FQ”) and to define its psychometric properties.

Methods

Using a multi-step development procedure, items were generated, for the new questionnaire after which the psychometric properties were tested with a heterogeneous sample of 502 Canadians. Using an online polling panel, respondents were asked to complete demographic questions as well as the Prep-FQ, Global Rating of Life Satisfaction, the Keyes Psychological Well-Being scale and the Short-Form 12.

Results

The final version of the questionnaire contains 34 items in 8 distinct domains (“Medico-legal”, “Social”, “Psychological Well-being”, “Planning”, “Enrichment”, “Positive Health Behaviors”, “Negative Health Behaviors”, and “Late-life Planning”). We observed minimum missing data and good usage of all response options. The average overall Prep FQ score is 51.2 (SD = 13.3). The Cronbach alphas assessing internal reliability for the Prep FQ domains ranged from 0.33 to 0.88. The intra-class correlation coefficient (ICC) used to assess the test–retest reliability had an overall score of 0.87. For the purposes of establishing construct validity, all the pre-specified relationships between Prep FQ and the other questionnaires were met.

Conclusion

Analyses of this novel measure offered support for its face validity, construct validity, test–retest reliability, and internal consistency. With the development of this useful and valid scale, future research can utilize this measure to engage people in the process of comprehensively assessing and improving their state of preparedness for the future, tracking their progress along the way. Ultimately, this program of research aims to improve the quality and quantity of peoples live by helping them ‘think ahead’ and ‘plan ahead’ on the aspects of their daily life that matter to their future.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01759-z.

Automatic and Real-Time Computation of the 30-Seconds Chair-Stand Test without Professional Supervision for Community-Dwelling Older Adults

The present paper describes a system for older people to self-administer the 30-s chair stand test (CST) at home without supervision. The system comprises a low-cost sensor to count sit-to-stand (SiSt) transitions, and an Android application to guide older people through the procedure. Two observational studies were conducted to test (i) the sensor in a supervised environment (n = 7; m = 83.29 years old, sd = 4.19; 5 female), and (ii) the complete system in an unsupervised one (n = 7; age 64–74 years old; 3 female). The participants in the supervised test were asked to perform a 30-s CST with the sensor, while a member of the research team manually counted valid transitions. Automatic and manual counts were perfectly correlated (Pearson’s r = 1, p = 0.00). Even though the sample was small, none of the signals around the critical score were affected by harmful noise; p (harmless noise) = 1, 95% CI = (0.98, 1). The participants in the unsupervised test used the system in their homes for a month. None of them dropped out, and they reported it to be easy to use, comfortable, and easy to understand. Thus, the system is suitable to be used by older adults in their homes without professional supervision.