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Li Q, Guo Z, Hu F, Xiao M, Zhang Q, Wen J, Ying T, Zheng D, Wang Y, Yang S, Hou H. Tourism experiences reduce the risk of cognitive impairment in the Chinese older adult: a prospective cohort study. Front Public Health 2023; 11:1271319. [PMID: 37942247 PMCID: PMC10629014 DOI: 10.3389/fpubh.2023.1271319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Background Given the etiological complexity of cognitive impairment, no effective cure currently exists for precise treatment of dementia. Although scholars have noted tourism's potential role in managing cognitive impairment and mild dementia, more robust empirical investigation is needed in this area. This study aimed to examine the associations between tourism and cognitive impairment and dementia in older Chinese adults. Method From a nationwide community-based cohort, 6,717 individuals aged ≥60 were recruited from 2011 to 2014, of whom 669 (9.96%) had had at least one tourism experience in the 2 years prior to enrollment. All the participants were then prospectively followed up until 2018. The association between tourism and cognitive impairment was examined by the Cox proportional hazards regression model. The adjusted hazard ratio (aHR) and its 95% confidence interval (CI) were calculated to evaluate the effect of tourism experience on cognitive impairment and dementia. Results A total of 1,416 individuals were newly diagnosed with cognitive impairment and 139 individuals with dementia onset during follow-up. The incidence of cognitive impairment was significantly lower among participants with tourism experiences (316.94 per 10,000 person-years) than those without such experiences (552.38 per 10,000 person-years). Cox regression showed that tourism decreased the risk of cognitive impairment (aHR = 0.69, 95% CI: 0.41-0.62) when adjusted for behavioral covariates and characteristics. Compared with participants without tourism experiences, those with 1, 2, and ≥3 tourism experiences had a lower risk of cognitive impairment with the aHRs of 0.72 (95% CI: 0.52-0.99), 0.65 (0.42-1.01), and 0.68 (0.44-0.98), respectively. Tourism experiences also reduced participants' risk of dementia (aHR = 0.41, 95% CI: 0.19-0.89). Conclusion Our findings demonstrated associations between tourism and reduced risks of cognitive impairment and dementia in older Chinese adults. Thus, tourism could serve as a novel approach to dementia prevention.
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Affiliation(s)
- Qian Li
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Zheng Guo
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Fangli Hu
- Centre for Precision Health, Edith Cowan University, Joondalup, WA, Australia
| | - Mengfei Xiao
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Qiang Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Jun Wen
- School of Business and Law, Edith Cowan University, Joondalup, WA, Australia
| | - Tianyu Ying
- Department of Tourism and Hotel Management, Zhejiang University, Hangzhou, China
| | - Danni Zheng
- Department of Tourism, Fudan University, Shanghai, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Song Yang
- Department of Endocrinology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, China
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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Tahir S, Abdulrazak B, Baillargeon D, Girard C, Provencher V. Adapting Transportation Planning e-Tools to Older Adults' Needs: Scoping Review. JMIR Aging 2023; 6:e41938. [PMID: 37191985 DOI: 10.2196/41938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/17/2023] [Accepted: 02/26/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Aging is often accompanied by a decrease in physical and sensory capacities and financial resources, which makes travel and the use of public transport a big challenge for older adults. These mobility limitations may prevent them from going out for groceries, medical appointments, or entertainment, which increases the risk of social isolation. A key element in helping older adults to maintain healthy aging and social engagement is to foster autonomy, freedom, and active mobility. A transportation planning e-tool can provide older adults with information about transport and trip options. There are many transportation planning e-tools, but little is known about whether and how their characteristics and functionalities address older adults' needs and preferences. OBJECTIVE This study aims to map existing transportation e-tools and identify gaps to be filled in order to match their functionalities with older adults' needs and preferences. METHODS A scoping review of existing transportation planning e-tools was conducted based on the approach developed by Arksey and O'Malley. A search in the scientific literature (Academic Search Complete, MEDLINE, CINAHL, SocINDEX, and ERIC) as well as gray literature (TRID Database, Google Scholar, Proquest, Google Play, etc) was conducted in June 2020 and updated 3 times; in September 2021, December 2021, and May 2022. After the studies were selected, a comparative analysis was performed by 2 evaluators; an occupational therapy student and a computer science student. These e-tools were analyzed with respect to some characteristics (eg, tool's development status, target customers, and geographic coverage) as well as 10 functionalities (time autonomy, walkability, crowd avoidance, incline avoidance, weather consideration, dark avoidance, winter obstacles avoidance, amenities inclusion, taxi driver's information, and support affordance) that we defined based on older adults' needs and preferences (mainly Canadians). These needs were identified from a literature review and confirmed by workshops (focus groups). RESULTS The scientific and gray literature search yielded 463 sources, and 42 transportation e-tools were included. None of the e-tools reviewed addresses all 10 functionalities. More specifically, functionalities such as dark avoidance and support affordance were not addressed by any of the included e-tools. CONCLUSIONS Most of the e-tools currently available to plan trips do not address older adults' needs and preferences. The results of this scoping review helped fill this gap by identifying functionalities to include in transportation planning e-tools designed to promote active aging. The findings of this study highlight the need to use a multicriteria optimization algorithm to address older adults' mobility needs and preferences. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/33894.
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Affiliation(s)
- Sahar Tahir
- AMbient Intelligence Lab, Département Informatique, Faculty of Science, University of Sherbrooke, Sherbrooke, QC, Canada
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Bessam Abdulrazak
- AMbient Intelligence Lab, Département Informatique, Faculty of Science, University of Sherbrooke, Sherbrooke, QC, Canada
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Dany Baillargeon
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Department of Communication, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Catherine Girard
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
- School of Rehabilitation, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Véronique Provencher
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
- School of Rehabilitation, University of Sherbrooke, Sherbrooke, QC, Canada
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Vecchio G, Tiznado-Aitken I, Castillo B, Steiniger S. Fair transport policies for older people: accessibility and affordability of public transport in Santiago, Chile. TRANSPORTATION 2022:1-27. [PMID: 36407886 PMCID: PMC9643989 DOI: 10.1007/s11116-022-10346-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
In this paper, we test how different public transport policy scenarios score in terms of fairness for a specific population group, considering a more complex representation of mobility-related inequalities and the policy implications of transport justice. To do so, we assess potential accessibility to public transport in Santiago de Chile under different policy scenarios, focusing on older people as a group whose demographic and socioeconomic conditions can determine different forms of disadvantage. We compare alternative accessibility policies based on the expansion of the Metro infrastructure network or on reduced public transport fares, considering the interaction between the spatial availability and the affordability of public transport. Results show that subsidized fares for public transport services are more beneficial to expand the accessibility of older people, especially those with lower incomes, while the expansion of the Metro network benefits mainly middle- and high-income older people. The proposed analysis is a first step towards a more detailed, place-based reading of mobility-related inequalities, aimed at assessing alternative policy measures.
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Affiliation(s)
- Giovanni Vecchio
- Instituto de Estudios Urbanos y Territoriales, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Desarrollo Urbano Sustentable - Cedeus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Bryan Castillo
- Centro de Desarrollo Urbano Sustentable - Cedeus, Pontificia Universidad Católica de Chile, Santiago, Chile
- Partners for Action (P4A), University of Waterloo, Waterloo, Canada
| | - Stefan Steiniger
- Centro de Desarrollo Urbano Sustentable - Cedeus, Pontificia Universidad Católica de Chile, Santiago, Chile
- Escuela de Ingeniería de Construcción y Transporte, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Du M, Tao L, Liu M, Liu J. Tourism experiences and the lower risk of mortality in the Chinese elderly: a national cohort study. BMC Public Health 2021; 21:996. [PMID: 34044805 PMCID: PMC8157616 DOI: 10.1186/s12889-021-11099-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/18/2021] [Indexed: 12/25/2022] Open
Abstract
Background Cohort studies about the effects of tourism experiences on the risk of death among Chinese older adults are still lacking. We aimed to examine the association between tourism experiences and mortality in Chinese aged 65 or above. Methods We included 9520 participants aged 65 years or above from the Chinese Longitudinal Healthy Longevity Survey at baseline in 23 provinces in 2011. They were followed up in 2014 and 2018. Cox proportional hazards models were used to assess the association between tourism experiences and the risk of death. Results Among 9520 participants, 7.85% had at least one tourism experience outside of their local city/county during the past 2 years. During 35,994.26 person-years of follow-up, in total 4635 deaths were observed. The crude rate of death was greater in participants who had no tourism experience than in older travelers (incidence rate: 13.70 versus 5.24 per 100 person-years). Elderly travelers had a significantly lower risk for all-cause mortality (crude hazard ratio: 0.38, 95% CI: 0.33–0.44) compared with non-travelers. After adjustment for all covariates, the risk of all-cause mortality was 27% lower among those with at least one tourism experience than among non-travelers (adjusted hazard ratio: 0.73, 95% CI: 0.62–0.85). Subgroup analysis showed that the associations between tourism and the decreased risk of mortality were stable. Conclusions Tourism decreases the risk of mortality in the Chinese elderly. Tourism should be considered as a modifiable lifestyle factor and an effective way to reduce mortality and promote longevity and healthy aging. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11099-8.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 Huayuan North Road, Haidian District, Beijing, 100083, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China. .,Institute for Global Health and Development, Peking University, Beijing, 100871, China. .,Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100083, China.
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