Prevalence and related factors of Active and Healthy Ageing in Europe according to two models: Results from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Changes in successful aging and its related indicators among community-dwelling older adults: The Korean Frailty and Aging Cohort Study (KFACS)

This study aims to determine the prevalence of successful aging (SA) and examine the association of changes in the indicators of SA and variations in SA status between 2016 and 2020. The study included 548 participants recruited for the Korean Frailty and Aging Cohort Study (KFACS). Compared to participants who achieved SA in 2016 (N = 393, 71.7%), the number of older adults with SA decreased by 7.8% in 2020. Among older adults preserving SA (SA→SA group, 54%), there were relatively small numbers of older adults who successfully maintained indicators, including chronic diseases (no→no, 9.5%), employment (yes→yes, 12.2%), and volunteer activities (yes→yes, 2.9%). Our findings suggest that interventions to strengthen the physical and psychological function of older adults are needed, and social support needs to be guaranteed to improve social engagement for older adults.

The Association of Self-Perception of Aging and Quality of Life in Older Adults: A Systematic Review

BACKGROUND AND OBJECTIVES

Self-perception of aging is an important psychosocial factor that can influence quality of life in older age. This review aimed to synthesize findings on the association between self-perception of aging and quality of life among older adults aged 60 and above.

RESEARCH DESIGN AND METHODS

A systematic search was conducted in 4 electronic databases (Ovid Medline, PsycInfo, CINAHL, and Web of Science). Studies conducted in English and including measures on the perception of aging and quality of life were included in this review. A total of 32 observational studies (21 cross-sectional, 8 longitudinal, 2 mixed-method, and 1 qualitative) met the inclusion criteria. Outcomes reported in the included studies were quality of life, physical health and functioning, psychological health, mental health, and general well-being.

RESULTS

Overall, 20 quantitative studies indicated a strong association between positive perception of aging and increased quality of life. Similarly, 9 quantitative studies demonstrated that negative perception of aging is associated with lower quality of life. Results of the mixed-method and qualitative studies indicated that older adults with higher morale and good physical capability had more positive perceptions of health.

DISCUSSION AND IMPLICATIONS

These results suggest that promoting a positive perception of aging and a self-care attitude would help to enhance older adults' quality of life and should be incorporated into future health promotions and interventions.

Can aging population affect economic growth through the channel of government spending?

The demographic transition toward an aging society is a global phenomenon. An increase in the aging population directly challenges the government positions and public expenditures as it directly affects a country's aggregate demand and, thus, the country's income level. This paper investigates the impact of an aging population on the size of government spending. Using an updated dataset of 87 countries from 1996 to 2017, we study the aggregate level and each composition of government expenditures. Furthermore, we investigate whether the aging population influences the allocation of government spending toward different categories and economic growth changes. The paper uses the generalized method of moment (GMM) model for the dynamic panel data analysis to address the endogeneity problem. Our main findings suggest that an increase in the old-age population significantly induces higher aggregate government spending but only in developed countries and in particular on the spending in the social protection and environment categories. However, the aging society leads to lower government expenditure on education. Other critical findings reveal that changes in some compositions of government spending toward cultural expenditures impact growth slowdown, while an allocation toward education spending positively impacts economic growth.

Efficacy of Health Promotion Interventions Aimed to Improve Health Gains in Middle-Aged Adults-A Systematic Review

Population aging will be one of the major social transformations in the coming decades, with a very significant impact in all countries. The consequences of this will cause an overload of social and health services. It will be necessary to prepare for an aging population. The promotion of healthy lifestyles is necessary to increase quality of life and well-being as people age. The aim of this study was to identify and synthesize interventions in middle-aged adults that promote healthy lifestyles and translate this knowledge into health gains. We performed a systematic review of the literature with research on the EBSCO Host-Research Databases platform. The methodology followed the PRISMA guidelines, and the protocol was registered with PROSPERO. A total of 10 articles out of 44 retrieved were included in this review, which identified interventions to promote healthy lifestyles with an impact on well-being, quality of life, and adherence to healthy behaviors. The synthesized evidence supports the efficacy of interventions that contributed to positive changes at the biopsychosocial level. Health promotion interventions were educational or motivational and related to physical exercise, healthy eating, and changes in habits and lifestyles related to harmful behaviors (tobacco use, excess carbohydrates in the diet, physical inactivity, and stress). The health gains found were increased mental health knowledge (self-actualization), adherence to physical exercise, improvement in physical condition, adherence to the consumption of fruits and vegetables, increased quality of life, and well-being. Health promotion interventions in middle-aged adults can significantly improve healthy lifestyles, protecting them from the negative effect of aging. For aging to be a successful experience, continuity of healthy lifestyles practiced in middle age is necessary.

The Impact of Digital Coaching Intervention for Improving Healthy Ageing Dimensions among Older Adults during Their Transition from Work to Retirement

Retirement is a critical step in older adults' lives, so it is important to motivate them to stay physically active, mentally healthy, and socially connected in the transition from work to retirement, including through digital health coaching programs. This study aims to: evaluate the impact of a digital coaching intervention to enhance three healthy ageing dimensions, i.e., physical activity, mental well-being, and socialization of a group of adults near retirement; understand the users' experience; and identify the system strengths and weaknesses. This longitudinal mixed-methods study, carried out in 2021 in Italy and the Netherlands, enrolled 62 individuals. In the first 5 weeks of the trial, participants used a digital coach with the support of human coaches, and then they continued autonomously for another 5 weeks. The use of the digital coach improved the participants' physical activity, mental well-being and self-efficacy during the first period and only the physical activity in the second. An effective coaching system should be flexible and attractive. High levels of personalization remain the golden key to aligning the health program to the physical, cognitive and social status of the intended target, thus increasing the user-system interaction, usability, and acceptability, as well as enhancing adherence to the intervention.

Predictors of healthy physiological aging across generations in a 30-year population-based cohort study: the Doetinchem Cohort Study

BACKGROUND

Predicting healthy physiological aging is of major interest within public health research. However, longitudinal studies into predictors of healthy physiological aging that include numerous exposures from different domains (i.e. the exposome) are scarce. Our aim is to identify the most important exposome-related predictors of healthy physiological aging over the life course and across generations.

METHODS

Data were used from 2815 participants from four generations (generation 1960s/1950s/1940s/1930s aged respectively 20-29/30-39/40-49/50-59 years old at baseline, wave 1) of the Doetinchem Cohort Study who were measured every 5 years for 30 years. The Healthy Aging Index, a physiological aging index consisting of blood pressure, glucose, creatinine, lung function, and cognitive functioning, was measured at age 46-85 years (wave 6). The average exposure and trend of exposure over time of demographic, lifestyle, environmental, and biological exposures were included, resulting in 86 exposures. Random forest was used to identify important predictors.

RESULTS

The most important predictors of healthy physiological aging were overweight-related (BMI, waist circumference, waist/hip ratio) and cholesterol-related (using cholesterol lowering medication, HDL and total cholesterol) measures. Diet and educational level also ranked in the top of important exposures. No substantial differences were observed in the predictors of healthy physiological aging across generations. The final prediction model's performance was modest with an R² of 17%.

CONCLUSIONS

Taken together, our findings suggest that longitudinal cardiometabolic exposures (i.e. overweight- and cholesterol-related measures) are most important in predicting healthy physiological aging. This finding was similar across generations. More work is needed to confirm our findings in other study populations.

Aging in Place: Connections, Relationships, Social Participation and Social Support in the Face of Crisis Situations

OBJECTIVES

We seek to identify active coping strategies used by older adults to face the pandemic and to deal with daily stressors, and to clarify which factors had an effect on stress, positive emotions and depression in active and healthy community-dwelling older adults in the first and second year of the pandemic in Costa Rica.

METHODS

Participants were living in their own homes in Costa Rica (n = 218, mean age 69.96, 82.1% women). Participants were interviewed by phone and answered an online survey, which included socio-demographic information, mental health variables such as stressors (perceived health and fear of COVID-19, illness, perception of pandemic gravity), loneliness (whether they felt lonely and how often they felt lonely), access to Information and Communication Technologies, socio-emotional coping variables, social participation and physical activity level during the pandemic.

RESULTS

Positive socio-emotional indicators related to well-being such as self-efficacy, social support, perceived health and proactive behavior were high. Negative well-being indicators such as perceived stress, emotional COVID-19 fear and loneliness showed low values in the sample studied during both years. We found significant relations across the dependent variables (perceived stress, positive emotions and depression) by studying the psychological well-being coping strategies.

CONCLUSIONS

Findings highlight the importance of coping strategies and social participation in the capacity of older adults to mitigate the negative psychological consequences of crisis situations and provide evidence of "aging in place".

Active ageing profiles among older adults in Spain: A Multivariate analysis based on SHARE study

BACKGROUND

Following the active ageing model based on the Health, Lifelong Learning, Participation and Security pillars, this research has a twofold objective: i) to classify older adults according to active ageing profiles, taking into account the four pillars, and ii) to ascertain the relationship between the profiles and personal and contextual factors, as well as well-being and quality of life in old age.

METHODS

A study sample of 5,566 Spanish older adults who participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was included. Data were analysed in different steps applying several statistical analyses (Principal Component, Cluster, Discriminant, Multiple Correspondence and bivariate analysis with Pearson chi-square and ANOVA).

RESULTS

Five older adult profiles were obtained (I: with moderate activity; II: quasi-dependents; III: with active ageing-limiting conditions; IV: with diverse and balanced activity; V: with excellent active ageing conditions). The first three profiles were characterised by subjects with a high average age, low educational level, who were retired or housewives, and who perceived a moderate level of loneliness, satisfaction with the social network and quality of life, as well as having a larger family network, but living in small households or alone. In contrast, the latter two profiles showed better personal and contextual conditions, well-being and quality of life.

DISCUSSION AND CONCLUSIONS

The multidimensional approach to active ageing followed in this article has revealed the presence of several older adult profiles, which are confined to groups with better or worse active ageing conditions. In this context, if ageing is a process that reflects the previous way of life, intervention priorities will have to consider actions that promote better conditions during the life cycle.

Rotating Night Shift Work and Healthy Aging After 24 Years of Follow-up in the Nurses' Health Study

Importance

Rotating night shift work is associated with higher mortality. Whether it is also associated with overall health among those who survive to older ages remains unclear.

Objective

To examine whether rotating night shift work is associated with healthy aging after 24 years of follow-up in the Nurses' Health Study, a cohort study among registered female nurses.

Design, Setting, and Participants

For this cohort study, a composite healthy aging phenotype was ascertained among 46 318 participants who were aged 46 to 68 years and free of major chronic diseases in 1988 when the history of night shift work was assessed. In a secondary analysis in which cognitive function decline was considered in the healthy aging definition, 14 273 nurses were involved. Data were analyzed from March 1 to September 30, 2021.

Exposures

Duration of rotating night shift work.

Main Outcomes and Measures

Healthy aging was defined as reaching at least 70 years of age and being free of 11 major chronic diseases, memory impairment, physical limitation, or deteriorated mental health.

Results

Of 46 318 female nurses (mean [SD] age at baseline, 55.4 [6.1] years), 3695 (8.0%) achieved healthy aging after 24 years of follow-up. After adjusting for established and potential confounders, compared with women who never worked rotating night shifts, the odds of achieving healthy aging decreased significantly with increasing duration of night shift work. The odds ratios were 0.96 (95% CI, 0.89-1.03) for 1 to 5 years, 0.92 (95% CI, 0.79-1.07) for 6 to 9 years, and 0.79 (95% CI, 0.69-0.91) for 10 or more years of night shift work (P = .001 for trend). This association did not differ substantially by age and lifestyles and was consistent for 4 individual dimensions of healthy aging. Results were similar in a secondary analysis, with an odds ratio of 0.73 (95% CI, 0.60-0.89; P < .001 for trend) comparing 10 or more years of night shift work vs no night shift work.

Conclusions and Relevance

In this cohort study, rotating night shift work was associated with decreased probability of healthy aging among US female nurses. These data support the notion that excess night shift work is a significant health concern that may also lead to deteriorated overall health among older individuals.

Aging Well for Indigenous Peoples: A Scoping Review

As life expectancy increases for Indigenous populations, so does the number of older adults with complex, chronic health conditions and age-related geriatric syndromes. Many of these conditions are associated with modifiable lifestyle factors that, if addressed, may improve the health and wellbeing of Indigenous peoples as they age. If models of healthy aging are to be promoted within health services, a clearer understanding of what aging well means for Indigenous peoples is needed. Indigenous peoples hold a holistic worldview of health and aging that likely differs from Western models. The aims of this review were to: investigate the literature that exists and where the gaps are, on aging well for Indigenous peoples; assess the quality of the existing literature on Indigenous aging; identify the domains of aging well for Indigenous peoples; and identify the enablers and barriers to aging well for Indigenous peoples. A systematic search of online databases, book chapters, gray literature, and websites identified 32 eligible publications on Indigenous aging. Reflexive thematic analysis identified four major themes on aging well: (1) achieving holistic health and wellbeing; (2) maintaining connections; (3) revealing resilience, humor, and a positive attitude; and (4) facing the challenges. Findings revealed that aging well is a holistic concept enabled by spiritual, physical, and mental wellbeing and where reliance on connections to person, place, and culture is central. Participants who demonstrated aging well took personal responsibility, adapted to change, took a positive attitude to life, and showed resilience. Conversely, barriers to aging well arose from the social determinants of health such as lack of access to housing, transport, and adequate nutrition. Furthermore, the impacts of colonization such as loss of language and culture and ongoing grief and trauma all challenged the ability to age well. Knowing what aging well means for Indigenous communities can facilitate health services to provide culturally appropriate and effective care.

Successful ageing among a national community-dwelling sample of older adults in India in 2017-2018

This study aimed to determine the prevalence and correlates of successful ageing in older community-dwelling adults in India. The cross-sectional sample included 21,343 individuals (≥ 65 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017-2018. Successful ageing was assessed utilizing a multidimensional concept, including five components: (1) absence of major illness, (2) free of disability, (3) no major depressive disorder, (4) social engagement and (5) life satisfaction. Overall, 27.2% had successful ageing, including 83.3% had no major diseases, 51.0% free from disability, 91.8% had no major depressive disorder, 73.6% were socially engaged and 74.6% had high life satisfaction. In the adjusted logistic regression analysis, male sex (Adjusted Odds Ratio-AOR 1.40, 95% Confidence Interval-CI 1.21-1.26), married (AOR 1.48, 95% CI 1.22-1.79), having formal education (AOR 1.47, 95% CI 1.23-1.74), high subjective socioeconomic status (AOR 1.61, 95% CI 1.29-2.01), urban residence (AOR 1.42, 95% CI 1.19-1.70), Sikhs (AOR 1.76, 95% CI 1.38-2.24), high physical activity (AOR 1.65, 95% CI 1.38-1.97), and daily Yoga practice (AOR 1.34, 95% CI 1.11-1.61) increased the odds of successful ageing, while increasing age (AOR 0.96, 95% CI 0.94-0.79), poor childhood health (AOR: 0.47, 95% CI 0.29-0.75), and underweight (AOR 0.70, 95% CI 0.61-0.81) decreased the odds of successful ageing. Almost one in three older adults in India were successfully ageing. Factors associated with successful ageing included, male sex, married, having formal education, high subjective socioeconomic status, urban residence, Sikhs, physical activity, Yoga practice, younger age, good childhood health, and not having underweight.

User Requirements Analysis of an Embodied Conversational Agent for Coaching Older Adults to Choose Active and Healthy Ageing Behaviors during the Transition to Retirement: A Cross-National User Centered Design Study

Background: Retirement is recognized as a factor influencing the ageing process. Today, virtual health coaching systems can play a pivotal role in supporting older adults’ active and healthy ageing. This study wants to answer two research questions: (1) What are the user requirements of a virtual coach (VC) based on an Embodied Conversational Agent (ECA) for motivating older adults in transition to retirement to adopt a healthy lifestyle? (2) How could a VC address the active and healthy ageing dimensions, even during COVID-19 times? Methods: Two-wave focus-groups with 60 end-users aged 55 and over and 27 follow-up telephone interviews were carried out in Austria, Italy and the Netherlands in 2019–2020. Qualitative data were analysed by way of framework analysis. Results: End-users suggest the VC should motivate older workers and retirees to practice physical activity, maintain social contacts and emotional well-being. The ECA should be reactive, customizable, expressive, sympathetic, not directive nor patronizing, with a pleasant and motivating language. The COVID-19 outbreak increased the users’ need for functions boosting community relationships and promoting emotional well-being. Conclusions: the VC can address the active and healthy ageing paradigm by increasing the chances of doing low-cost healthy activities at any time and in any place.

Ethnic and Gender Disparities in Healthy Ageing among People 50 Years and Older in South Africa

OBJECTIVE

this study aimed to determine the prevalence and correlates of healthy ageing in older adults living in the community in South Africa.

METHODS

the cross-sectional sample consisted of 3734 individuals (≥50 years) from the cross-sectional South African National Health and Nutrition Survey (SANHANES-1) in 2011-2012. Healthy ageing was assessed using a multidimensional concept, which includes five components: (1) absence of major illness, (2) absence of disability, (3) good mental health, (4) social engagement and (5) well-being or good health.

RESULTS

in general, 36.6% had a healthy ageing, including 73.3% had no major diseases, 87.1% were free of disability, 62.3% had good mental health, 73.0% were socially engaged and 64.0% had a high well-being. In the adjusted logistic regression analysis, male sex (Adjusted Odds Ratio-AOR: 1.33, 95% confidence interval-CI: 1.03-1.72), white population group (AOR: 3.46, 95% CI: 2.29-5.22) and coloured population group (AOR: 1.82, 95% CI: 1.34-2.47), were positively associated with healthy ageing, while increasing age (AOR: 0.96, 95% CI: 0.94-0.97), daily tobacco use (AOR: 0.56, 95% CI: 0.42-0.74), perceived underweight (AOR: 0.48, 95% CI: 0.34-0.66) and perceived overweight (AOR: 0.53, 95% CI: 0.34-0.81) were negatively associated with associated with healthy ageing.

CONCLUSION

almost two in five older adults in South Africa were successfully ageing. Factors associated with healthy ageing included, younger age, male sex, population group (Whites, Coloureds), not daily tobacco users, not having underweight and overweight.

Socioeconomic position and healthy ageing: A systematic review of cross-sectional and longitudinal studies

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.

Ambient assisted living technology-mediated interventions for older people and their informal carers in the context of healthy ageing: A scoping review

BACKGROUND AND AIMS

There is a growing demand for health and social care services to provide technology-mediated interventions that promote the health and well-being of older people with health or care needs and of their informal carers. The objectives of this study were to scope and review the nature and extent of prior intervention studies involving ambient assisted living technology-mediated interventions for older people and their informal carers, and how and in what ways (if any) the goals and aims of these interventions reflected the domains of the World Health Organization framework for healthy ageing.

METHODS

We conducted a scoping review. Data were collected between June and October 2018 with an updated search in October 2020. A total of 85 articles were eligible for inclusion.

RESULTS

Nine categories described the aims and content of the included studies. The healthy ageing domain "Ability to meet basic needs" was mirrored in four categories, whereas "Ability to contribute to society" was not addressed at all.

CONCLUSION

The ways in which domains of healthy ageing are mirrored suggest that there is an emphasis on individual factors and individual responsibility, and a lack of attention given to broader, environmental factors affecting healthy ageing. Only a few of the studies used a dyadic approach when assessing health outcomes concerning older people and their informal carers.

Subjective life expectancy and associated factors among cancer survivors over 45 years old: evidence from the CHARLS

PURPOSE

Associations between subjective life expectancy (SLE) and a variety of factors are well documented, but the relationship regarding cancer is limited. The purpose of this study was to disclose this potential relationship and identify the covariates that might influence this relationship.

METHODS

Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS), and a sample of 448 cancer survivors and 43,795 individuals without cancer were analyzed. Multilevel mixed-effects logistic regression was performed to examine the SLE associated with cancer survivors and participants without cancer after controlling for demographic, socioeconomic, health-related, and psychosocial factors.

RESULTS

The findings revealed that cancer survivors had a 39% reduction in longer life expectancy compared to respondents without cancer. Disparities in SLE existed based on diverse individual characteristics. The rate of high SLE in urban citizens was 75% higher compared to that of rural residents, while the rate of high SLE in participants with disability fell by 55%. The rate of high SLE decreased by 22% and 35% in respondents with high blood pressure and diabetes, respectively. The proportion of respondents with high SLE was reduced by 70% when depression was present. Furthermore, the out-of-pocket expenditures of participants with and without cancer showed a significant difference, but discrepancies with respect to SLE among different cancer treatment options were not found.

CONCLUSION

The more challenging one's socioeconomic status is and the unhealthier one's physical and mental conditions are, the lower one's prospect of subjective life expectancy is. Further work is warranted to confirm the causal association between subjective life expectancy and certain characteristics in cancer survivors.

Projecting health-ageing trajectories in Europe using a dynamic microsimulation model

The extent of the challenges and opportunities that population ageing presents depends heavily on the population's health. Hence, for the development of appropriate strategies that enable countries to adopt the emerging demographic and epidemiological realities, information on future health trajectories of elderly population is a natural requirement. This study presents an innovative methodological framework for projecting the health of individuals using a dynamic microsimulation model that considers interactions between sociodemographic characteristics, health, mortality, bio-medical and behavioral risk factors. The model developed, called ATHLOS-Mic, is used to project the health of cohorts born before 1960 for the period 2015-2060 for selected European Countries using SHARE data to illustrate the possible effects of some selected risk factors and education on future health trajectories. Results show that, driven by a better educational attainment, each generation will be healthier than the previous one at same age. Also, we see that, on average, an individual of our base population will live about 18 more years since the start of the projection period, but only 5 years in good health. Finally, we find that a scenario that removes the effect of having a low level of education on individual health has the largest impact on the projected average health, the average number of years lived per person, and the average number of years lived in good health.

Healthy Ageing in Place: Enablers and Barriers from the Perspective of the Elderly. A Qualitative Study

BACKGROUND

Most elderly people wish to grow old at their own homes. The sociodemographic characteristics; home and neighbourhood conditions; and the social services support and networks are determinants in the possibility of "ageing in place". The present study aimed to explore the ageing in place phenomenon, as well as the enablers and barriers that interact in a healthy ageing from the perspective of the elderly connected to local entities.

METHODS

A generic qualitative design was proposed in the Health Region of Girona in Catalonia (Spain). Seventy-one elderly people were purposefully selected. Six focus groups were conducted, and data were thematically analysed.

RESULTS

Three key themes were generated: (1) Participants experienced ageing differently. The physical and mental health, the family environment and financial stability were key elements for life quality. (2) The perception of the elderly's role in the community depended on their age, health status and attitude towards life. (3) The participants identified several enablers and barriers to healthy ageing in place.

CONCLUSIONS

The promotion of older people's autonomy and wellbeing, together with the creation of an active network of health and social services, may improve the possibility for elderly to age at home and avoid or delay institutionalisation.

Dietary Selenium Intakes and Musculoskeletal Function in Very Old Adults: Analysis of the Newcastle 85+ Study

Background: Selenium is a trace element essential for health. Severe selenium deficiencies are associated with poor musculoskeletal (MSK) function. However, the effects of moderate deficiency on MSK function, especially in older adults, is unclear. Objectives: To determine the associations between selenium intake and MSK function in very old adults. Methods: Selenium intake at baseline and, hand-grip strength (HGS) and timed-up-and-go (TUG) at four phases over 5 years, were available in 791 participants in the Newcastle 85+ Study, a community-based, longitudinal cohort of ≥85 year old individuals. We investigated relationships between selenium intake and HGS and TUG in cross-sectional analyses at baseline using multivariate analyses and, prospectively using linear mixed models to explore HGS and TUG changes over 5 years in association with baseline selenium intake. Results: At baseline, 53% of participants had selenium intakes that were classified as low. These individuals had 2.80 kg lower HGS and were 2.30 s slower performing the TUG, cross-sectionally. In multivariate, baseline analyses, selenium intake had no significant impact on HGS or TUG. Selenium intake had no significant effect on MSK function, prospectively. Conclusion: Low selenium intake is common among very old adults and, in cross-sectional analyses, is associated with poorer MSK function.

Proposal of Nursing Diagnosis "Readiness for Enhanced Healthy Aging": A Concept Analysis

PURPOSE

To analyze the concept of healthy aging and propose the development of a nursing diagnosis METHODS: Concept analysis using the method proposed by Walker and Avant FINDINGS: Four bibliographic databases were searched, and 36 articles were included in the analysis. Seven antecedents, seven attributes, and three consequences for "healthy aging" were identified.

CONCLUSIONS

The concept analysis supported the development of the new nursing diagnosis "readiness for enhanced healthy aging," which can assist nurses in implementing actions aimed at promoting the health of older adults.

IMPLICATION FOR NURSING PRACTICE

The establishment of a nursing diagnosis may provide nurses the opportunity to implement interventions that promote the maintenance of functional and cognitive capacity, psychological and spiritual well-being, and social engagement, aiming at healthy aging with high quality of life.

Applying machine learning methods to develop a successful aging maintenance prediction model based on physical fitness tests

AIM

The purpose of this study was to develop a machine learning prediction model for successful aging (SA) based on physical fitness tests.

METHODS

A total of 3657 community-dwelling adults aged ≥60 years from Nanchang city were recruited in this study. A 3-year follow-up test was carried out for all the participants to determine whether they turn to non-SA. Developed questionnaires and physical fitness tests were used to obtain overall health condition, balance, agility, speed, reactions and gait. Four machine learning models (logistic regression, deep learning, random forest and gradient boosting decision tree) were applied to develop the prediction models, the analyzed sample was 890.

RESULTS

The baseline prevalence of successful aging was 26.99%, The average annual incidence rate of SA to non-SA was 11.04%. There were significant differences between the SA and non-SA groups for all physical fitness tests at baseline. The accuracy and area under the curve of all four machine learning models was >85%, the positive predictive value and sensitivity was >75%, and the specificity was >86% on the average. The deep learning model outperformed the other model, with area under the curve 90.00%, accuracy 89.3%, positive predictive value 85.8% and specificity 93.1%, respectively. Compared with other models, the logistic regression model performed best in sensitivity. Age, arm curl, 30-s sit-to-stand and reaction time were important predictors in all models.

CONCLUSION

The deep learning model is ideal in the prediction of SA maintenance, and the corresponding physical fitness interventions are essential to ensuring SA. Geriatr Gerontol Int 2020; ••: ••-••.

Determinants of Active and Healthy Ageing in Sub-Saharan Africa: Evidence from Cameroon

This paper examines the determinants and policy implications of active and healthy ageing in Sub-Saharan Africa, taking the case of Bamenda, in Cameroon. Specifically, the study sought to identify and explore the determinants of active and healthy ageing using a mixed-methods approach involving qualitative and quantitative data collection and analysis. Focus group discussions were conducted complemented by a survey (random and snowball sampling) using a structured questionnaire. Narratives and thematic analysis were used to analyze the data generated from the focus group discussion and Tobit regression was employed to analyze the multiple determinants of active ageing by dimensions and on a global scale in Cameroon. Results identified three key dimensions of active and healthy ageing: employment/livelihood options (EL), community support and health (CH) and housing and living in Bamenda (HL). The regression results reveal gender bias in active ageing, a non-effect of education and health on active ageing, and a positive effect of income on active and healthy ageing. This study contributes, among others, to the competence-environmental press theory on active ageing with regards to unbundling context specific determinants of active and healthy ageing. It equally derives policy considerations with regards to gender mainstreaming and the identification of age friendly income earning options to enhance the active and healthy ageing process.

Robust older adults in primary care: factors associated with successful aging

OBJECTIVE

To estimate the prevalence of robustness among older adults assisted in primary health care and identify factors in successful aging.

METHODS

This is a cross-sectional study conducted with older adults in Northern Minas Gerais, Brazil. Two questionnaires were used for data collection: the Brazilian Older Americans Resources and Services Multidimensional Function Assessment Questionnaire (BOMFAQ) and the Clinical-Functional Vulnerability Index IVCF-20). The adjusted prevalence ratios were obtained by robust Poisson regression. Statistical analysis was performed for older adults in general (60 to 107 years) and stratified by age: from 60 to 79 years and 80 years or more.

RESULTS

A total of 1,750 older adults aged 60 to 107 years participated; between them, 48.7% were robust. Older adults aged 60 to 79 years (n = 1,421) and 80 years or more (n = 329) had a prevalence of robustness of 55.4% and 19.3%, respectively. Some factors associated with successful aging were: positive self-perception of health, dancing habits, walking habits, absence of cognitive impairment, absence of depressive symptoms and polypathology, as well as daily life independence. After adjustment by age, the absence of polypathology and independence for activities of daily living stand out for robustness between 60 and 79 years; in those aged 80 years and over, independence for activities of daily living and dance practice presented greater strength of association.

CONCLUSION

The prevalence of robust older adults in primary care is considered satisfactory for the older population in general but decreases with age and is associated with the absence of diseases and disabilities. These results denote the need to redesign the health care system, focusing on promoting and preventing clinical-functional vulnerability.

The Impact of Population Aging and Public Health Support on EU Labor Markets

Population aging and public health expenditure mainly dedicated to older dependent persons present major challenges for the European Union (EU) Member States, with profound implications for their economies and labor markets. Sustainable economic development relies on a well-balanced workforce of young and older people. As this balance shifts in favor of older people, productivity tends to suffer, on the one hand, and the older group demands more from health services, on the other hand. These requisites tend to manifest differently within developed and developing EU countries. This research aimed to assess population aging impacts on labor market coordinates (employment rate, labor productivity), in the framework of several health dimensions (namely, health government expenditure, hospital services, healthy life years, perceived health) and other economic and social factors. The analytical approach consisted of applying structural equation models, Gaussian graphical models, and macroeconometric models (robust regression and panel corrected standard errors) to EU panel data for the years 1995–2017. The results show significant dissimilarities between developed and developing EU countries, suggesting the need for specific policies and strategies for the labor market integration of older people, jointly with public health expenditure, with implications for EU labor market performance.

Issues in Building a Nursing Home Syndromic Surveillance System with Textmining: Longitudinal Observational Study

Background

New nursing homes (NH) data warehouses fed from residents’ medical records allow monitoring the health of elderly population on a daily basis. Elsewhere, syndromic surveillance has already shown that professional data can be used for public health (PH) surveillance but not during a long-term follow-up of the same cohort.

Objective

This study aimed to build and assess a national ecological NH PH surveillance system (SS).

Methods

Using a national network of 126 NH, we built a residents’ cohort, extracted medical and personal data from their electronic health records, and transmitted them through the internet to a national server almost in real time. After recording sociodemographic, autonomic and syndromic information, a set of 26 syndromes was defined using pattern matching with the standard query language-LIKE operator and a Delphi-like technique, between November 2010 and June 2016. We used early aberration reporting system (EARS) and Bayes surveillance algorithms of the R surveillance package (Höhle) to assess our influenza and acute gastroenteritis (AGE) syndromic data against the Sentinelles network data, French epidemics gold standard, following Centers for Disease Control and Prevention surveillance system assessment guidelines.

Results

By extracting all sociodemographic residents’ data, a cohort of 41,061 senior citizens was built. EARS_C3 algorithm on NH influenza and AGE syndromic data gave sensitivities of 0.482 and 0.539 and specificities of 0.844 and 0.952, respectively, over a 6-year period, forecasting the last influenza outbreak by catching early flu signals. In addition, assessment of influenza and AGE syndromic data quality showed precisions of 0.98 and 0.96 during last season epidemic weeks’ peaks (weeks 03-2017 and 01-2017) and precisions of 0.95 and 0.92 during last summer epidemic weeks’ low (week 33-2016).

Conclusions

This study confirmed that using syndromic information gives a good opportunity to develop a genuine French national PH SS dedicated to senior citizens. Access to senior citizens’ free-text validated health data on influenza and AGE responds to a PH issue for the surveillance of this fragile population. This database will also make possible new ecological research on other subjects that will improve prevention, care, and rapid response when facing health threats.