Locations that Support Social Activity Participation of the Aging Population

Developing the Intergenerational Community Survey for older adults: Assessing neighborhood environments, social and physical activities, and health

Many survey instruments have been developed to assess neighborhood environments for their impacts on people's health and daily activities. However, no instruments are available for capturing social interactions with different age groups among older populations. This study introduces a four-phase process of developing a comprehensive Intergenerational Community Survey (ICS) covering six domains: (1) physical activities, walking, and sedentary activities; (2) mental health and quality of life; (3) social activities (e.g. intergenerational and peer interactions) in and outside the neighborhood; (4) neighborhood environments (e.g. safety, streets and sidewalks); (5) supportive services or programs (e.g. intergenerational programs, transportation services); and (6) personal characteristics. Test-retest reliability assessments among 38 community-dwelling older adults (aged 65+) showed fair to good reliability results. ICS can serve as a useful tool to facilitate future research on intergenerational communities and interactions for older adults.

Individual Momentary Experiences of Neighborhood Public Spaces: Results of a Virtual Environment Based Stated Preference Experiment

Although it has become increasingly recognized that the spatial design of public space plays an important role in the perceived quality of the built environment by users, there is still little known about the influences of specific attributes on individuals’ experiences. Therefore, this study aims at (1) identifying the factors underlying momentary experiences in public space given both cognitive (satisfaction) and affective (emotion) responses and (2) understanding the experiences as a function of green and design attributes and analyzing the heterogeneity in preferences. To achieve the research goals, this study innovatively introduced an online video-based stated preference experiment. A national sample of 316 individuals from the Netherlands were invited to complete the experiment. The results of a factor analysis indicate that the momentary experiences of the environments presented can be reduced to a single preference dimension capturing the cognitive as well as affective elements of experiences. The results of a latent class regression analysis furthermore show that there is substantial heterogeneity on how attributes are experienced. Three classes emerge which differ in terms of satisfaction with life and satisfaction with availability of green in the current living environment on dwelling, neighborhood, and city level. Presence of trees, vertical green on façades, and grass surfaces were found to be most important for individuals’ experiences generally. The paper provides a new understanding of how spatial attributes in neighborhood public spaces can influence individuals’ momentary experiences. For cities pursuing both greenification and densification, this study offers quantitative evidence to support the selection of design attributes of neighborhood public spaces which can evoke positive experiences.

Self-management perspectives of elderly patients with multimorbidity and practitioners - status, challenges and further support needed?

Background

Patients with multimorbidity (here defined as three or more chronic conditions) require constant treatment and care. Furthermore, they have to manage their health and diseases in daily life. Offering support to patients’ medical self-management is an important task of primary care. The aim of this study was to explore, what further support is needed from the perspective of patients’ and primary care practitioners.

Methods

A qualitative study using individual semi-structed interviews with 17 patients with multimorbidity and 7 practitioners (4 primary care physicians and 3 practice assistants) was conducted in Germany. Data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA.

Results

The three broad themes: current status, challenges and further support emerged. Patients reported on unfulfilled needs regarding role or emotional management, like coping with loneliness, loss of independence and, changing habits. The importance of social contact was highlighted by patients and practitioners. Patients articulated further support from their primary care practitioners on coping with the disease. Practitioners’ wished for further support in aspects of social participation, public transport, and community resources.

Conclusion

Challenges regarding self-management of elderly patients with multimorbidity may be addressed by harnessing social support and community initiatives.

Community participation of community dwelling older adults: a cross-sectional study

BACKGROUND

With the advancing age of the population, and increasing demands on healthcare services, community participation has become an important consideration for healthy ageing. Low levels of community participation have been linked to increased mortality and social isolation. The extent to which community participation has been measured objectively in older adults remains scarce. This study aims to describe where and how older adults participate in the community and determine the feasibility of measurement methods for community participation.

METHODS

This observational cross-sectional study obtained data from 46 community dwelling older adults. A combination of Global Positioning Systems (GPS), accelerometry, and self-reported diaries were used over a 7-day monitoring period. Feasibility of methods were determined by calculating the loss of GPS data, questionnaires, and comparison of self-reported locations with GPS co-ordinates. Relationships between community participation, physical activity, social interactions, health related quality of life, sleep quality and loneliness were explored.

RESULTS

Older adults took a median (IQR) of 15 (9.25-18.75) trips out of home over the 7-day monitoring period, most frequently visiting commercial and recreational locations. In-home activities were mainly sedentary in nature, with out of home activities dependent on location type. Self-reported and GPS measures of trips out of home and the locations visited were significantly correlated (self-report 15.7 (5.6) GPS 14.4 (5.8) (r = 0.94)). Significant correlations between both the number of trips taken from home, with social interactions (r = 0.62) and the minutes of moderate to vigorous physical activity (MVPA) (r = 0.43) were observed. Daily MVPA was higher in participants who visited local walk/greenspaces (r = 0.48).

CONCLUSION

Participants performed more activities with social interactions out of home and visited commercial locations most frequently. The combination of GPS, accelerometry and self-report methods provided a detailed picture of community participation for older adults. Further research is required with older adults of varying health status to generalise the relationships between community participation, location and physical activity.

TRIAL REGISTRATION

Ethical approval was gained from the Flinders University Social and Behavioural Research Ethics Committee (protocol no. 8176).

Natural History of Social Participation in the Very Old: Findings from the Newcastle 85+ Study

Objective: To describe the natural history of social participation in people aged 85 years and over. Methods: Prospective cohort study; Newcastle 85+ study. Data were collected at baseline (n = 850) and at 18-, 36- and 60-month follow-ups (n = 344). Participation in 19 social activities (e.g. playing bingo, doing volunteer work and watching television) was measured at each time point. Results: The mean number of activities reported at baseline was 8.7 (SD 2.6). The number of activities was higher in those with higher educational attainment and intact walking ability (both p < .001). Social participation decreased significantly over time (p < .001) and at a similar rate in both sexes and for those with/without limited walking ability but at a higher rate in those with higher than lower educational attainment (p = .019). Discussion: Social participation seems to decrease significantly between ages 85 and 90 years; ways of encouraging social participation in this age group are needed.

Where do People Interact in High-rise Apartment Buildings? Exploring the Influence of Personal and Neighborhood Characteristics

Early studies conclude that high-rise apartment buildings present challenges for people’s quality of life, resulting in social isolation, social annoyance and anonymity for residents. Nevertheless, empirical research into factors supporting social interaction in high-rise apartment buildings is still scarce. This study aims to investigate how often and where people in high-rise neighborhoods interact, and how this is affected by personal and neighborhoods characteristics. A mixture of both quantitative and qualitative methods was used including social interaction diaries and questionnaires among 274 residents, in-depth interviews with 45 residents and objective measurement of the physical environments in four high-rise apartment buildings for low in-income people in Hanoi, Vietnam. Results demonstrate that social interaction is influenced by a number of personal and neighborhood characteristics. Furthermore, most social interactions—also gathering and accompanying playing children—take place in the circulation areas of the apartment buildings. However, the use of these spaces for different purposes of interaction is found to have negative impact on people’s privacy, the feeling of safety and cleanliness of the shared spaces. The findings of this study provide information for planners and designers on how to design and improve high-rise apartment buildings that support social interaction.

The Correlation of Self-efficacy and Social Support with Social Participation: A Cross Sectional Study among the Elderly

There is ample evidence that a key contributor to healthy aging is social participation; thus, identifying its determinants can help to improve it. The current study aimed at assessing the relationship between social support and general self-efficacy with social participation. This cross-sectional study was conducted on 456 (male: 237, female: 219) older adults, aged 60-74 years, who were the member of community centers in Tehran, Iran, in 2016. The multi-stage cluster sampling method was employed to select the participants. Primarily, Tehran was divided into five areas (i e, North, South, East, West, and Center). Then, two community centers were randomly selected from each area. Participants with the ability to perform their daily activities independently were enrolled in the study. Participants responded to four self-report questionnaires: socio-demographic, social participation, social support, and general self-efficacy. The majority of the participants were within the age range of 62–68 years with the maximum proportion of social participation (mean ± standard deviation (SD): 37.69 ± 8.34). Findings of the current study indicated that gender, education level, reading books, newspapers, or magazines (p <0.001), living area, living arrangement, and occupational status (p<0.05) were associated with social participation. Multiple linear regression adjusted for living area, sex, and educational level showed that self-efficacy (β= .08; p<.001) and social support (β= .64; p<.001) predicted social participation. Findings showed the importance of social support and self-efficacy in social participation. Also enhancing the literacy of seniors should be given priority.

FRED: Exergame to Prevent Dependence and Functional Deterioration Associated with Ageing. A Pilot Three-Week Randomized Controlled Clinical Trial

Introduction: Frailty syndrome and advanced age may decrease the acceptance of illness and quality of life, and worsen patients' existing health conditions, as well as leading to an increase in health care expenses. Purpose: The purpose of this study is to reduce frailty risk via the use of a FRED game which has been expressly designed and put together for the study. Materials and methods: A total of 40 frail volunteers with a score of <10 points in the short physical performance battery (SPPB) took part in a feasibility study in order to validate the FRED game. Following randomisation, the study group (20 subjects) took part in nine sessions of 20 min each over a three-week period. The control group (19 subjects) continued to lead their daily lives in the course of which they had no physical activity scheduled; Results: After three weeks and having taken part in nine physical activity sessions with the FRED game, 60% of subjects from the study group (12/20) obtained a score of ≥10 points at the end of the study, i.e., less risk of evidencing frailty. This result proved to be statistically significant (p < 0.001). The degree of compliance with and adherence to the game was confirmed by 100% attendance of the sessions. Discussion: Our findings support the hypothesis that FRED, an ad hoc designed exergame, significantly reduced the presence and severity of frailty in a sample of sedentary elders, thus potentially modifying their risk profile. Conclusions: The FRED game is a tool that shows a 99% certain improvement in the degree of frailty in frail elderly subjects. The effectiveness of the design of ad hoc games in a certain pathology or population group is therefore evidenced.

Effects of the Residential Environment on Health in Japan Linked with Travel Behavior

This paper aims to clarify how the residential environment is associated with overall health-related quality of life (QOL) via active travel (walking and cycling), by reflecting the influence of different trip purposes in Japan. The health-related QOL includes physical, mental, and social dimensions. For this study we implemented a questionnaire survey in 20 cities in Japan in 2010 and obtained valid answers from 1202 respondents. The residential environment is defined in terms of distances to and densities of different daily facilities extracted from both the survey and external GIS data. We found that the effects of residential environment on active travel behavior are mixed and limited, depending on types of trip makers. Unexpectedly, travel behavior has no direct effects on the health-related QOL. The residential environment, which is only observed indirectly via lifestyle habits for commuters, has limited effects on health. As for noncommuters, neither their travel behavior nor the residential environment influences their health-related QOL.

Housing Stakeholder Preferences for the "Soft" Features of Sustainable and Healthy Housing Design in the UK

It is widely recognised that the quantity and sustainability of new homes in the UK need to increase. However, it is important that sustainable housing is regarded holistically, and not merely in environmental terms, and incorporates elements that enhance the quality of life, health and well-being of its users. This paper focuses on the “soft” features of sustainable housing, that is, the non-technological components of sustainable housing and neighbourhood design that can impact occupants’ health and well-being. Aims of the study are to ascertain the relative level of importance that key housing stakeholders attach to these features and to investigate whether the opinions of housing users and housing providers are aligned with regards to their importance. An online survey was carried out to gauge the level of importance that the key stakeholders, such as housing users, local authorities, housing associations, and developers (n = 235), attach to these features. Results revealed that while suitable indoor space was the feature regarded as most important by all stakeholders, there were also a number of disparities in opinion between housing users and housing providers (and among the different types of providers). This implies a scope for initiatives to achieve a better alignment between housing users and providers.