Aging-related Resiliency Theory Development

Concepts and definitions of healthy ageing: a systematic review and synthesis of theoretical models

BACKGROUND

Healthy ageing (HA) has been defined using multiple approaches. We aim to produce a comprehensive overview and analysis of the theoretical models underpinning this concept and its associated normative terms and definitions.

METHODS

We conducted a systematic review of peer-reviewed HA models in Embase.com, Medline (Ovid), Cochrane CENTRAL, CINAHL, PsycINFO, and Web of Science until August 2022. Original theoretical papers, concept analyses, and reviews that proposed new models were included. Operational models/definitions, development psychology theories and mechanisms of ageing were excluded. We followed an iterative approach to extract the models' characteristics and thematically analyze them based on the approach of Walker and Avant. The protocol was registered in PROSPERO (CRD42021238796).

FINDINGS

Out of 10,741 records, we included 59 papers comprising 65 models/definitions, published in English (1960-2022) from 16 countries in Europe, Asia, and America. Human ageing was described using 12 normative terms, mainly (models (%)): successful (34 (52%)), healthy (eight (12%)), well (five (8%)), and active (four (6%)). We identified intrinsic/extrinsic factors interacting throughout the life course, adaptive processes as attributes, and outcomes describing ageing patterns across objective and subjective dimensions (number of models/definitions): cognitive (62), psychological (53), physical (49), social (49), environmental (19), spiritual (16), economic (13), cultural (eight), political (six), and demographic (four) dimensions. Three types of models emerged: health-state outcomes (three), adaptations across the life course (31), or a combination of both (31). Two additional sub-classifications emphasized person-environment congruence and health promotion.

INTERPRETATION

HA conceptualizations highlight its multidimensionality and complexity that renders a monistic model/definition challenging. It has become evident that life long person-environment interactions, adaptations, environments, and health promotion/empowerment are essential for HA. Our model classification provides a basis for harmonizing terms and dimensions that can guide research and comparisons of empirical findings, and inform social and health policies enabling HA for various populations and contexts.

FUNDING

MM, ZMRD, and OI are supported by the European Union's Horizon 2020 Marie Skłodowska-Curie grant No 801076, and MM is also supported by the Swiss National Foundation grant No 189235.

Social environment support to overcome loneliness among older adults: A scoping review

Background

Loneliness is a problem experienced by most older adults due to internal and external factors. This condition may lead to various physical and psychological health problems, including depression, sleep disturbances, stress, and suicidal ideation. Therefore, exploring social environment support to reduce loneliness is a necessity.

Objective

This study aimed to identify various kinds of social support to overcome loneliness in older adults.

Methods

A scoping review was performed on studies retrieved from Embase, CINAHL, Cochrane, PubMed, and Google Scholar from 2012 until early 2022. Data were analyzed according to Arksey and O'Malley's scoping review guideline.

Results

Ten studies were systematically selected from 2,410 articles. The analysis indicated that the social environment support, including family support (affection, attention, emotional, motivation, and financial support), friends (peer group, partnership, advice, and appreciation), neighbors (work around the house, society involvement, and emergency), and government support (healthcare facilities and community programs), contribute to loneliness in older adults.

Conclusion

The social environment support from families, friends, neighbors, and government may potentially help older adults to reduce their loneliness but need further validation. The variables included in each component also need construct exploration. However, the study findings may serve as basic knowledge for nurses to provide interventions to prevent and reduce loneliness among older adults.

Transitional care interventions to reduce emergency department visits in older adults: A systematic review

Background

Preventable illnesses cause many emergency department visits in older adults, which can be minimized by implementing appropriate transitional care interventions. However, the most effective transitional care strategies for older adults are unknown.

Objective

To discover and consolidate transitional care interventions that can help older people avoid going to the emergency department.

Methods

From January 2011 to August 2021, PubMed, The Cochrane Library, CINAHL, Web of Science, ProQuest, and The JAMA Network were used to search. Two authors independently screened and selected papers, assessed the risk of bias, and extracted data into a standardized form in accordance with Cochrane guidelines. For the risk of bias in studies, the RevMan 5.4.1 program was utilized.

Results

Six randomized controlled trials, four non-randomized controlled trials, and three retrospective investigations were among the 13 studies examined. All studies evaluated emergency department visits but in different periods (ranging from 1-12 months after discharge) and with varying groups of baselines (pre-post intervention and between groups). The multi-component strategies, either pre or postdischarge phase using high-intensity care delivered within six months of discharge, were implemented in transitional care that had been shown to reduce emergency department visits in older adults.

Conclusion

To prevent emergency department visits by older patients, nurses should arrange for a high-intensity transitional care intervention that involves both pre-and postdischarge interventions. The effectiveness of the intervention in reducing emergency department visits in older adults is difficult to determine due to inter-study heterogeneity and poor methodological quality. There is a need for more evidence-based research with consistent and trustworthy effect assessments.

PROSPERO registration number

CRD42021261326.