Effectiveness of the Vital Aging program to promote active aging in Mexican older adults

The translation process of the culturally sensitive active aging scale for community-dwelling older adults in Pakistan

BACKGROUND

The assessment of active aging levels in Pakistani older adults is crucial yet; research tools are scarce in the local language. Therefore, this study aims to translate and validate the English version of an Active Aging Scale into a cross-culturally sensitive Urdu version to assess active aging levels in Pakistani older adults.

METHODS

To translate and validate the scale, we used the ISPOR (International Society for Pharmacy Economic and Outcome Research) standards. Reliability, concurrent validity, construct validity, convergent validity, and discriminatory validity were checked on a total sample of 160 community-dwelling older adults. After two weeks, the test-retest reliability was examined. AMOS version 23 and SPSS version 23 were used to analyze the data.

RESULTS

The average content validity index for clarity was 0.91 and relevancy was 0.80. The total variance in the pilot study of all items secured > 0.3 variances except for two items scored < 0.30 that were omitted before the validity and reliability test. The remaining items explained 65.46% of the overall variation and had factor loadings ranging from 0.46 to 0.90 in the principal factor analysis (PFA). The confirmatory factor analysis of the Active Aging Scale revealed that the model fit was good with a Chi-square value (418.18 (DF = 2.2) which is less than 3.00. This is further evidenced by the root mean square error of approximation (RMSEA) of 0.042, goodness of fit index (GFI) of 0.92, adjusted goodness of fit index (AGFI) of 0.94, and comparative fit index (CFI) values of 0.92 and 0.96 (unstandardized and standardized, respectively). The scale's Cronbach's alpha coefficient was 0.88, indicating dependability and its test-retest reliability with the significance of (P. < 0.05).

CONCLUSION

The Urdu version of the Active Aging Scale was successfully translated and validated in a culturally sensitive manner, and can be used to evaluate the effectiveness of various active aging interventions for older adults in Pakistan.

Active aging needs from the perspectives of older adults and geriatric experts: a qualitative study

Introduction

With an increasing rate of population aging and its consequences, preparation for active aging based on older adults' needs is an unavoidable priority. Active aging needs must be identified to help strategic planning for older adults' health and wellbeing. This study aimed to explore the active aging needs from the perspectives of older adults and geriatric experts.

Methods

This exploratory-descriptive qualitative study was conducted in four provinces with the oldest populations in Iran. Semi-structured and focus group interviews were conducted with 41 participants (20 older adults and 21 geriatric experts), who were chosen through purposive and snowball sampling. Data were analyzed using the conventional content analysis.

Results

This study identified three themes and thirteen categories from the data: (1) basic individual needs with three categories of physiological, psycho-emotional, and spiritual needs; and (2) managerial needs with seven categories of political-legal, socio-economic, and cultural-spiritual infrastructures, academic strategies, an age-friendly environment; technological services, and provision of specialized services and daycare for older adults, and (3) educational needs with three categories of training self-care and self-efficacy, empowering the health care workers; and empowering the family.

Conclusion

The results revealed personal, managerial, and educational needs for active aging and could assist policymakers and geriatric experts to promote and meet active aging needs successfully.

Passive smoking as a risk factor among older adults: an ordered probability approach for Türkiye

Background/aim

Older adults represent a significant proportion of the population of many societies, and being one of the disadvantaged groups, they struggle with various difficulties in their social lives. Undoubtedly, passive smoking is one of these difficulties. Passive smoking among older adults, which is an important public health problem, is an issue that needs to be investigated. The aim of this study is to determine the relationship between the demographic and socio-economic characteristics of adults aged 60 and older in Türkiye and their exposure to secondhand smoke (SHS).

Methods

In this study, a microdata set of the 2016 and 2019 Turkey Health Survey conducted by the Turkish Statistical Institute (TUIK) was used. This survey was conducted by TUIK in the relevant years using a stratified sampling method to best represent the whole of Turkey. The study considered only demographic and socio-economic characteristics to investigate passive smoking. Since all the variables used in the study were categorical, the relationship between the dependent variable and the independent variables was first investigated using chi-square tests. In addition, since the dependent variable has an ordered-categorical probability form, the generalized ordinal logit model was used for the analysis of passive smoking and related factors.

Results

The rate of exposure to tobacco smoke of older adults who participated in the study in 2016 was 16%, while the rate of those who participated in the study in 2019 was 21%.

Conclusion

According to the findings of the study, older, uneducated, and uninsured smokers carry a more serious SHS risk. It may be beneficial for society for policy makers to carry out studies by considering these features a priority and focusing on policies in this context. Expanding smoke-free areas to cover older adult, increasing penalties as a deterrent, facilitating education, increasing state support for education, increasing education and public service announcements about tobacco harms, and facilitating social security are the main examples. This study's findings are crucial as a source of information for the development of policies and programs aimed at preventing the exposure of older adults to tobacco smoke.

Essential factors and key features in designing active aging programs and their outcomes: A narrative review study

With an increase in the older adult population, many countries have designed programs to promote active aging. Thus, knowledge of the factors and features of these programs is necessary to design a comprehensive active aging program. This study aimed to review the active aging programs focusing on the extraction of essential factors, key features, and outcomes of these programs. This narrative review was carried out to examine the conducted active aging programs. Through systematic searches of databases within the time limit of 2002-2021, articles were identified and assessed against inclusion and exclusion criteria. Using the findings, three sections were developed: (1) essential factors in designing programs that consist of older adults' participation, health maintenance and, promotion, leisure time, and technology use; (2) key features of the program, include affordability, voluntary participation, intergenerational consideration, social networks and government support, lifelong learning and teaching, cross-sectoral and inter-professional collaboration, and an enabling-supportive environment; (3) the program outcomes, include increasing awareness and knowledge, activities and participation, quality of life, life satisfaction in various psychological dimensions of well-being, and physical, mental, cognitive, and behavioral health in older adults. Some gaps were identified. Consequently, future planners are recommended to address older adults' sexual health, community culture, and gender in addition to other key features and essential factors in designing active aging programs to promote older adults' health.

A new multidimensional group intervention for cognitive and psychosocial functioning for older adults: Background, content, and process evaluation

Introduction

An essential element of quality aging is the maintenance of cognitive and psychosocial functioning. The principal objective of the present paper was to present the theoretical framework, content and process evaluation of a newly developed multi-dimensional group intervention designed to strengthen/improve areas of cognitive and psychosocial functioning in adults over 65.

Methods

The intervention implements multiple methodologies aiming to facilitate contextual integration of learned concepts and strategies derived from clinical psychology and rehabilitation. It moves seamlessly on the cognition-emotion axes and consists of five active ingredients selected to address challenges associated with aging: Memory Compensatory Strategies, Problem-Solving, Emotion Regulation, Mindfulness, and Locus of Control. Thirty participants joined the intervention group aged 65-75  years (M = 69.03; SD = 3.04). All 30 participants who were included in the intervention group completed the program.

Results

Results from the Participant Satisfaction Scale indicate that the program was perceived very positively by participants, who also reported implementing their newly learned strategies in activities of daily life. Furthermore, there was high correlation between internal locus of control and the learned strategies.

Discussion

The outcomes of this analysis indicate that the intervention is feasible and well tolerated by our target group. This multidimensional intervention may offer a valuable contribution to public health care and dementia prevention for older adults.

Clinical Trial Registration

[https://clinicaltrials.gov/ct2/results?cond=NCT01481246], identifier [NCT01481246].

Interventions simultaneously promoting social participation and physical activity in community living older adults: A systematic review

Background

In recent years, there has been a global trend toward an increase in life expectancy and the proportion of elderly people among the population. In this regard, it becomes important to promote active and healthy aging. Physical inactivity and social isolation are both risk factors of many chronic illnesses and highly prevalent in older adults. This challenges communities to develop interventions that reduce these risk factors among elderly populations. The main aims of this study were to summarize community-based interventions that aim to simultaneously promote social participation and physical activity in older adults and to examine their effects.

Methods

We performed a systematic review based on the PRISMA standards. Literature searches were conducted in six scientific databases in July 2021. Articles were included if they had an interventional design, focused on older adults living in the community and measured social participation and physical activity as an outcome. The data were summarized narratively due to the heterogeneity of studies and the variety of outcome measures.

Results

Overall, 46 articles published in English were included. The studies were grouped in (1) interventions with main focus on physical activity promotion; (2) social activities that included a physical activity component; (3) health behavior interventions/ health education interventions; (4) multicomponent interventions; (5) environmental interventions. The majority of the reviewed studies reported positive effects of interventions on physical activity and/or social participation. No study reported negative effects. Analysis of quantitative studies showed that multicomponent interventions have great positive effects on both outcomes. In qualitative studies positive effects were found regardless of intervention type.

Conclusion

This review summarizes the evidence about the effects of community-based interventions that aim to promote social participation and physical activity in older adults. Multicomponent interventions seem to be most suitable for simultaneous promotion of physical activity and social participation. However, high variability in measurement methods used to assess both social participation and physical activity in the included studies made it difficult to compare studies and to indicate the most effective.

Systematic review registration

www.crd.york.ac.uk, identifier: PROSPERO [CRD42021268270].

Effect of a Community Gerontology Program on the Control of Metabolic Syndrome in Mexican Older Adults

Background: Metabolic syndrome (MS) is highly prevalent in older adults; it constitutes a risk factor for cognitive deterioration, frailty, and Alzheimer’s disease. For this reason, the WHO has pointed out the importance of the implementation of community programs for the training of healthy aging. The aim of this study was to evaluate the effect of a community gerontology program framed in active aging on the control of metabolic syndrome in older adults. Methods: An experimental study was carried out in a convenience sample of 80 older adults diagnosed with MS according to the ATPIII criteria, comprising (1) experimental group (EG), n = 40; (2) control group (CG), n = 40. During a 6-month period, the EG participated in a supervised community gerontology program, and the CG was assessed monthly. Results: A statistically significant decrease was observed in the number of components for the diagnosis of MS. In this regard, of the total of participants with a diagnosis of MS in EG, only 28% maintained the diagnosis of MS (ATPIII ≥ 3 criteria), in contrast to 83% of the CG participants (p < 0.0001). Conclusions: Our findings suggest that health self-care training within the framework of active aging is effective for the control of MS in older adults.

How Do Older Portuguese and Mexican Adults Experience Their Sexual Well-Being? A Cross-Cultural Qualitative Study

Sexual well-being (SWB) refers to the subjective emotional and cognitive evaluation of the quality of the individual's sexuality. SWB plays a relevant role in quality of life and health promotion on old age and has cross-cultural implications. In addition to the scarcity of in-depth qualitative studies in this area and studies with cross-cultural samples, no studies have compared perceptions of SWB among Portuguese and Mexican older adults. The aim of this study was to comparatively analyze perspectives on SWB among older adults residing in Portugal and Mexico. Data were collected from 86 Portuguese and 80 Mexican community-dwelling participants aged 65 years and older, using a semi-structured interview protocol. Older adults were asked about factors that significantly contribute to their SWB. Sociodemographic data were also gathered. Content analysis was used to identify key themes. Eight themes were identified across both studied samples: eroticism, supportive relationship, positive self-concept, health and self-care, romance, active life, tenderness and care, and no pain and no pregnancy restrictions. Eroticism was most pertinent to Portuguese participants (31.4%). Health and self-care was most frequently reported by Mexican participants (26.5%). The findings of this study indicate that SWB is strongly influenced by sociocultural and psychosocial values. Cross-cultural comparisons between older Portuguese and Mexican people provide a broader understanding of SWB in older age and suggest a scenario for future culture-adapted interventions and comprehensive policies.

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.

Cognitive Functioning, Life Satisfaction, and Their Relationship with the Financial Attitudes of Older Individuals Who Participate in an Active Aging Program

Life expectancy has increased in many countries throughout the world over recent years, leading to new challenges related to aging. A large part of the population is over 60 years old, and therefore studies that focus on financial autonomy and active aging are necessary. In this paper, we analyze the relationship between cognitive functioning and life satisfaction in relation to financial attitudes in a sample of 251 elderly adults (71% women) participating in an active aging program (M = 67.5, SD = 4.5). We used the Mini-Mental State Examination, the Satisfaction with Life scale, and a questionnaire about financial attitudes to gather data. Our results show that cognitive functioning and life satisfaction are related to certain financial attitudes. We also observed differences associated with gender, education level, and financial independence. According to our findings, life satisfaction should be taken into account when the financial attitudes of older adults are evaluated. The importance of support groups for the elderly is highlighted as well as of all those recreation and health programs, since they constitute a means of promoting well-being.

The power of knowledge about dementia in Latin America across health professionals working on aging

INTRODUCTION

Expert knowledge is critical to fight dementia in inequitable regions like Latin American and Caribbean countries (LACs). However, the opinions of aging experts on public policies' accessibility and transmission, stigma, diagnostic manuals, data-sharing platforms, and use of behavioral insights (BIs) are not well known.

METHODS

We investigated opinions among health professionals working on aging in LACs (N = 3365) with regression models including expertise-related information (public policies, BI), individual differences (work, age, academic degree), and location.

RESULTS

Experts specified low public policy knowledge (X2  = 41.27, P < .001), high levels of stigma (X2  = 2636.37, P < .001), almost absent BI knowledge (X2  = 56.58, P < .001), and needs for regional diagnostic manuals (X2  = 2893.63, df = 3, P < .001) and data-sharing platforms (X2 = 1267.5, df = 3, P < .001). Lack of dementia knowledge was modulated by different factors. An implemented BI-based treatment for a proposed prevention program improved perception across experts.

DISCUSSION

Our findings help to prioritize future potential actions of governmental agencies and non-governmental organizations (NGOs) to improve LACs' dementia knowledge.

Elderly patients with hypertension self-perceived of aging status and compliance with medical behaviour

At present, it is rare for studies to be performed on the impact of self-perceptions of aging on the compliance behaviour of elderly people.The present study explored the relationship between self-perceived of aging level and compliance behavior among asample of elderly Chinese hypertension patients. Participants (N=1129) were recruited from four community health service centres and two township hospitals in Suzhou. Self-perceptions of aging represent an independent risk factor for compliance behaviour in elderly patients with hypertension. Self-perceptions of aging had acute/chronic timeliness (OR=0.793), periodic timeliness (OR=1.439), emotional representation (OR=0.735), positive results (OR=1.322), and identity latitude (OR=0.995). Gender (OR=1.390), age (OR=1.982), residence (OR=7.037), hypertension grade (OR=0.598), sleep (OR=1.709), number of hospital admissions in a year (OR=2.757), number of daily uses of antihypertensive drugs (OR=0.338), and frequency of blood pressure measurement (OR=0.387) were independent factors affecting the compliance behavior of elderly patients with hypertension. The results suggest that self-perceptions of aging can be used as an indirect index to monitor the compliance behaviour of the elderly. In the future medical staff should combine the characteristics of the elderly patients with hypertension, which would help them to establish a positive self-perception of aging, thus improving their compliance behaviour, and the levels of health and literacy.

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.

Community Gerontology Model for Healthy Aging Developed in Mexico Framed in Resilience and Generativity

BACKGROUND

The aims of this paper are to present the evolutionary development of the Community Model of Healthy Aging (CMHA) and to show the main results of the community gerontology studies framed in each of the stages of the CMHA.

METHOD

The study employs a qualitative community-based participatory research approach. We also measured several biochemical parameters, social support networks, and indicators of physical and cognitive functioning.

RESULTS

We identified three stages in the development of the CMHA. The first stage was informative (CMHA-I, 1994-2000) with more than 70% of the older adults participating in self-care programs for health. The second stage was formative (CMHA-F, 2001-2015) with more than 80% of older adults participating in self-care, mutual aid, and self-management programs. The third stage was emancipatory (CMHA-E, 2016-2018). In this last stage, we added resilience and generativity as basic elements to strengthen and enhance human capacities during aging, and more than 90% of older adults made optimal use of social support networks as a key strategy.

CONCLUSION

Our findings suggest that the addition of resilience and generativity in the CMHA contributed to the active participation of older adults in the maintenance of functioning and the prevention and control of diseases linked to aging.

Teaching general practitioners to activate older patients: The intervening role of changes in perceived communication skills

OBJECTIVE

This report examined whether a change in the perceived communication behaviour (PeCoBe) of general practitioners (GPs) influenced the effect of the Promoting Active Aging (PRACTA) intervention on activation of older patients as perceived by GPs.

METHODS

Pre- and post-intervention questionnaires were filled out by 225 GPs, who were assigned to three groups, e-learning, pdf-article, and control. GPs self-reported their communication behaviour and their perceptions of the attitudes of older patients toward treatment and health.

RESULTS

Participation in the e-learning intervention showed an increase in the PeCoBe of GPs, while reading the pdf-article resulted in a decrease of such behaviours. An increase in the PeCoBe of GPs was positively related to an increase in their perception of an active attitude among older patients. The indirect effects observed for e-learning and pdf-article interventions had opposite directions.

CONCLUSION

Both types of PRACTA intervention exerted an impact on GPs' perception of the attitudes of older patients, and change in PeCoBe of GPs could be considered as a mechanism driving this effect.

PRACTICAL IMPLICATIONS

The methods based on a combination of knowledge delivery and modelling of communication skills are strongly recommended forms of teaching for GPs on how to communicate with and activate seniors.

Influence of the Self-Perception of Old Age on the Effect of a Healthy Aging Program

It has been shown that health programs are useful for the prevention and control of chronic diseases in community-dwelling older people; however, a negative self-perception of old age could have an effect on the results. Therefore, our aim was to evaluate the effect of a healthy aging program linked to self-perception of old age in Mexican community-dwelling older people. A pre-test/post-test single-group design study was conducted in a convenience sample of 64 older people who undertook the entire healthy aging program workshop (five months’ duration). We measured self-perception of old age, efficacy of self-care, blood glucose concentration, anthropometric measures, and blood pressure before and after the workshop. A statistically significant decrease in blood glucose concentration was observed (baseline 136 ± 50 vs. post-intervention, 124 ± 45 ± 29 mg/dL, p < 0.01), LDL (baseline 153 ± 47 vs. post-intervention, 130 ± 36 mg/dL, p < 0.01), systolic blood pressure (130 ± 20 vs. 119 ± 11 mm/Hg, p < 0.001), and diastolic blood pressure (75 ± 9 vs. 72 ± 7 mm/Hg, p < 0.05) after community intervention. However, when we analyzed the data regarding self-perception, we found that this difference was only maintained in the subgroup of older adults with a positive self-perception of old age. Our findings suggest that the self-perception of old age influences the effect of healthy aging programs on the health of community-dwelling older people.