Editorial: Insights in Aging and Public Health: 2021

Nutritional Status of the Elderly Residing in a 24-Hour Medical Care Facility After Nutritional Intervention

Malnutrition is a significant issue among elderly individuals in 24-hour care facilities, leading to increased morbidity. The aim of the study was to compare the nutritional status before and after nutritional intervention based on selected indicators of nutritional status among residents of a 24-hour care institution. The study included a group of 104 people aged 65 to 97 years. Nutritional status was assessed before and after the nutritional intervention based on indicators: levels of prealbumin, albumin, transferrin, total lymphocyte count, BMI, and MNA scale. The nutritional intervention consisted of administering oral nutritional supplements (ONS) to patients, regardless of nutritional status. The method of retrospective analysis of patients' medical records was used. Statistical analysis was performed using IBM SPSS Statistics 24 for Windows. Improvements in nutritional status occurred among patients with malnutrition based on MNA and prealbumin indices, and in groups of patients with moderate or mild malnutrition as determined by transferrin, prealbumin and albumin. The mean levels of nutritional indices significantly increased: MNA (p = .001), BMI (p = .001), prealbumin (p = .001), and albumin (p < .001). The use of ONS resulted in better nutritional status parameters based on MNA, albumin and prealbumin. These indices may be predictors of reducing the risk of various disorders among the elderly.

Exploring configurations of social determinants for enhancing older adult health in China: an fuzzy-set qualitative comparative analysis based on 31 provinces in China

With China's aging population on the rise, addressing population aging has become a national priority, particularly focusing on improving older adult health. This study employs the social determinants of health framework, considering China's unique macro-social, economic, policy, healthcare, and family cultural factors, to develop a framework for understanding the social determinants of health for older adult in China. Using the fsQCA method and a configurational perspective, the complex relationship between social determinants of health and older adult health status is examined. The findings indicate that individual social determinants alone are insufficient for achieving high levels of older adult health. Instead, three configurations of social determinants have been identified as conducive to high older adult health: Economic Development-Environment - Cultural Dominant Type, Socio-Economic Development - Older Adult Security - Environment - Cultural Dominant Type, and Economic Development Dominant Type. These configurations offer diverse pathways for enhancing older adult health. Conversely, the study identifies two configurations associated with low older adult health levels, exhibiting an asymmetric relationship with the configurations resulting in high older adult health levels. Moreover, economic development consistently emerges as a core condition across all three configurations associated with high older adult health levels, while two configurations associated with low older adult health lack this core condition. These findings underscore the universal contribution of enhancing economic development to improving older adult health.

Neuromechanics-Based Neural Feedback Controller for Planar Arm Reaching Movements

Based on the principles of neuromechanics, human arm movements result from the dynamic interaction between the nervous, muscular, and skeletal systems. To develop an effective neural feedback controller for neuro-rehabilitation training, it is important to consider both the effects of muscles and skeletons. In this study, we designed a neuromechanics-based neural feedback controller for arm reaching movements. To achieve this, we first constructed a musculoskeletal arm model based on the actual biomechanical structure of the human arm. Subsequently, a hybrid neural feedback controller was developed that mimics the multifunctional areas of the human arm. The performance of this controller was then validated through numerical simulation experiments. The simulation results demonstrated a bell-shaped movement trajectory, consistent with the natural motion of human arm movements. Furthermore, the experiment testing the tracking ability of the controller revealed real-time errors within one millimeter, with the tensile force generated by the controller's muscles being stable and maintained at a low value, thereby avoiding the issue of muscle strain that can occur due to excessive excitation during the neurorehabilitation process.

Impact of perceived social support and physical fitness on quality of life of institutionalized and non-institutionalized older adults in Sri Lanka

Background and aim

Quality of life (QoL) in old age contributes to enhance active aging. This study aimed to assess and compare QoL and associated factors of institutionalized and non-institutionalized older adults (aged 60+ years) in Southern Sri Lanka.

Methods

A total of 160 older adults (80 institutionalized and 80 non-institutionalized) were surveyed. Physical and cognitive skills were measured using Barthel index, and Mini Mental State Examination scales. Nutritional status and perceived social support were measured using Mini Nutritional Assessment and Multidimensional Scale of Perceived Social Support. Descriptive statistics and multiple regression techniques were used in the analysis.

Results

The mean age of the institutionalized older adults was higher than that of non-institutionalized older adults (74.9 years versus 72.1 years, p < 0.01). About half of the sample consisted of older men (48.8%). Economically under privileged older adults who were unmarried were more likely to become institutionalized. The mean value of the QoL score was higher in non-institutionalized older adults compared to that of institutionalized older adults (63.1 (SD = 21.9) versus 49.1 (SD = 25.6), p < 0.05). Activities of daily living (ẞ=-0.46, p < 0.01) and perceived social support (ẞ=-0.20, p < 0.05) were found to be significant determinants of QoL of institutionalized older adults while activities of daily living (ẞ=-0.28, p < 0.05) and nutritional status (ẞ=-0.27, p < 0.05) were found to be significant determinants of QoL of non-institutionalized older adults. Cognitive impairments was not a significant determinant of QoL in both institutionalized and non-institutionalized older adults.

Conclusions

Promotion of physically active life style especially among young older adults to maintain their independence as they age and improvements of social support and social connectedness among older adults would be practical and cost-effective strategies to promote active aging in Sri Lankan older adults.