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Sapkota KP, Shrestha A, Ghimire S, Mistry SK, Yadav KK, Yadav SC, Mehta RK, Quasim R, Tamang MK, Singh DR, Yadav OP, Mehata S, Yadav UN. Neighborhood environment and quality of life of older adults in eastern Nepal: findings from a cross-sectional study. BMC Geriatr 2024; 24:679. [PMID: 39138405 PMCID: PMC11323633 DOI: 10.1186/s12877-024-05278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024] Open
Abstract
INTRODUCTION Quality of life (QoL) is a subjective measure reflecting individuals' evaluations based on their personal goals and values. While global research shows the role of neighborhood factors like ethnic diversity and socio-cultural dynamics on QoL, these are unexplored in the Nepali context. Therefore, this study examined the relationship between neighborhood environment and QoL among Nepali older adults in eastern Nepal. METHODS This cross-sectional study involved 847 non-institutionalized older adults (aged ≥ 60 years) from two districts in eastern Nepal. QoL was evaluated using the 13-item brief Older People's Quality of Life questionnaire, where a mean score of < 3 indicated low/poor QoL. The neighborhood environment, conceptualized across three domains (demographic, socio-cultural, and built environment), included ethnic diversity, connections with family, friends, and neighbors, cultural ties, residential stability, and rurality. Their association with QoL was examined using multivariable logistic regression. RESULTS Around 20% of older adults reported poor QoL. Higher ethnic diversity (adjusted Odds Ratio [aOR] = 0.12, 95% confidence interval [CI]: 0.04-0.36), moderate contact with family and relatives (aOR = 0.26, CI: 0.11-0.61), and high contact with neighbors (aOR = 0.09, CI: 0.03-0.21) were associated with lower odds of poor QoL. Conversely, high contact with friends (aOR = 2.29, CI: 1.30-4.04) and unstable residence (OR = 6.25, CI: 2.03-19.23) increased the odds of poor QoL. Additionally, among the covariates, chronic disease, tobacco use, unemployment, and lack of education were also significantly associated with poor QoL. CONCLUSION Overall, the demographic environment, socio-cultural factors, and the built environment of the neighborhood influence QoL. Therefore, diversifying the neighborhood's ethnic composition, promoting social connections such as frequent contact with family, relatives, and neighbors, and ensuring residential stability can enhance the QoL of older adults.
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Affiliation(s)
- Krishna Prasad Sapkota
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Aman Shrestha
- Division of Gerontology, Department of Epidemiology and Public Health, School of Medicine, University of Maryland Baltimore, Maryland, USA
| | - Saruna Ghimire
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Sabuj Kanti Mistry
- School of Population Health, University of New South Wales, Sydney, Australia
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | | | | | | | - Rubina Quasim
- Dow Institute of Nursing and Midwifery, Dow University of Health Sciences, Karachi, Pakistan
| | - Man Kumar Tamang
- Queensland Brain Institute, The University of Queensland, Queensland, Australia
| | - Devendra Raj Singh
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | | | - Suresh Mehata
- Ministry of Health, Koshi Province, Biratnagar, Nepal
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
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Yu J, Si H, Liu Q, Li Y, Zhou W, Wang C. Does Social Support Moderate the Relationship Between Frailty and Functional Ability Trajectory Among Community-Dwelling Older Adults? J Gerontol A Biol Sci Med Sci 2024; 79:glae145. [PMID: 38813979 DOI: 10.1093/gerona/glae145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Functional ability is the important prerequisite to live independently and achieve aging in place, which depends on the complex interaction of intrinsic and extrinsic factors. Identifying the trends and influencing factors of functional ability would contribute to the accurate assessment and intervention of geriatric health. This study aimed to disentangle the moderating effect of 3 types of social support, namely objective support, subjective support, and support utilization, on the relationship between frailty and functional ability trajectories. METHODS This was a secondary analysis using data from a prospective 3-wave study with a sample of 777 Chinese community-dwelling older adults. Social support was assessed using the Social Support Rating scale. Frailty was assessed using the FRAIL scale. Functional ability was measured by the Lawton Instrumental Activities of Daily Living scale. Latent growth curve models were implemented to test their relationships. RESULTS Objective support but not subjective support or support utilization moderated on the relationship between frailty and functional ability slope. Functional ability decline over time was buffered by objective support among robust individuals but exacerbated among (pre)frail individuals. CONCLUSIONS The moderating effect of social support on the relationship between frailty and functional ability trajectory varies by support types, which reminded that social support may be a promising intervention target to maintain functional independence for frail individuals, opening up a new perspective on social support in the field of disability prevention. Effective interventions should particularly address objective support in conjunction with empowering the frail older population to optimize the trajectory of functional ability.
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Affiliation(s)
- Jiaqi Yu
- School of Nursing, Peking University, Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, Beijing, China
| | - Qinqin Liu
- School of Nursing, Peking University, Beijing, China
| | - Yanyan Li
- School of Nursing, Peking University, Beijing, China
| | - Wendie Zhou
- School of Nursing, Peking University, Beijing, China
| | - Cuili Wang
- School of Nursing, Peking University, Beijing, China
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Mohd Tohit NF, Haque M. Gerontology in Public Health: A Scoping Review of Current Perspectives and Interventions. Cureus 2024; 16:e65896. [PMID: 39092340 PMCID: PMC11292002 DOI: 10.7759/cureus.65896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2024] [Indexed: 08/04/2024] Open
Abstract
The intersection of gerontology and public health is increasingly vital due to the global aging population and its implications for health systems. This scoping review aims to map existing literature on gerontology within public health, identify current perspectives, and evaluate interventions tailored to the needs of older adults. A systematic search was performed using predefined keywords across multiple databases, including PubMed, Google Scholar, Scopus, and Web of Science. The review included 42 studies that employed various designs, all focusing on public health interventions targeting the aging population. Key findings indicate a pressing need to integrate gerontological principles into public health practice, recognizing the heterogeneous nature of older adults and the significance of social determinants of health. Interventions ranged from preventive health measures and chronic disease management programs to health promotion activities and caregiver support, including the application of technology to improve health outcomes. However, there was a notable lack of research on diverse populations and mental health interventions. The review also uncovered critical gaps in the literature, such as economic barriers to care access and the necessity for comprehensive policies addressing the aging population's diverse needs. In conclusion, this review emphasizes the importance of a multidimensional approach to effectively addressing older adults' health needs. While several effective interventions exist, there is an urgent need to tackle identified gaps, particularly concerning diverse populations and mental health, to enhance overall health strategies for the aging demographic.
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Affiliation(s)
- Nor Faiza Mohd Tohit
- Department of Community Health, Universiti Pertahanan Nasional Malaysia (National University of Defence Malaysia), Kuala Lumpur, MYS
| | - Mainul Haque
- Department of Research, Karnavati Scientific Research Center (KSRC) School of Dentistry, Karnavati University, Gandhinagar, IND
- Department of Pharmacology and Therapeutics, Universiti Pertahanan Nasional Malaysia (National University of Defence Malaysia), Kuala Lumpur, MYS
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Xu J, Saeedi M, Zalzal J, Zhang M, Ganji A, Mallinen K, Wang A, Lloyd M, Venuta A, Simon L, Weichenthal S, Hatzopoulou M. Exploring the triple burden of social disadvantage, mobility poverty, and exposure to traffic-related air pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 920:170947. [PMID: 38367734 DOI: 10.1016/j.scitotenv.2024.170947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/26/2024] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
Understanding the relationships between ultrafine particle (UFP) exposure, socioeconomic status (SES), and sustainable transportation accessibility in Toronto, Canada is crucial for promoting public health, addressing environmental justice, and ensuring transportation equity. We conducted a large-scale mobile measurement campaign and employed a gradient boost model to generate exposure surfaces using land use, built environment, and meteorological conditions. The Ontario Marginalization Index was used to quantify various indicators of social disadvantage for Toronto's neighborhoods. Our findings reveal that people in socioeconomically disadvantaged areas experience elevated UFP exposures. We highlight significant disparities in accessing sustainable transportation, particularly in areas with higher ethnic concentrations. When factoring in daily mobility, UFP exposure disparities in disadvantaged populations are further exacerbated. Furthermore, individuals who do not generate emissions themselves are consistently exposed to higher UFPs, with active transportation users experiencing the highest UFP exposures both at home and at activity locations. Finally, we proposed a novel index, the Community Prioritization Index (CPI), incorporating three indicators, including air quality, social disadvantage, and sustainable transportation. This index identifies neighborhoods experiencing a triple burden, often situated near major infrastructure hubs with high diesel truck activity and lacking greenspace, marking them as high-priority areas for policy action and targeted interventions.
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Affiliation(s)
- Junshi Xu
- Civil and Mineral Engineering, University of Toronto, Canada.
| | - Milad Saeedi
- Civil and Mineral Engineering, University of Toronto, Canada.
| | - Jad Zalzal
- Civil and Mineral Engineering, University of Toronto, Canada.
| | - Mingqian Zhang
- Civil and Mineral Engineering, University of Toronto, Canada
| | - Arman Ganji
- Civil and Mineral Engineering, University of Toronto, Canada.
| | - Keni Mallinen
- Civil and Mineral Engineering, University of Toronto, Canada.
| | - An Wang
- Urban Lab, Massachusetts Institute of Technology, United States.
| | - Marshall Lloyd
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada.
| | - Alessya Venuta
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada.
| | - Leora Simon
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada.
| | - Scott Weichenthal
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada.
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Navarro C, Salazar J, Díaz MP, Chacin M, Santeliz R, Vera I, D′Marco L, Parra H, Bernal MC, Castro A, Escalona D, García-Pacheco H, Bermúdez V. Intrinsic and environmental basis of aging: A narrative review. Heliyon 2023; 9:e18239. [PMID: 37576279 PMCID: PMC10415626 DOI: 10.1016/j.heliyon.2023.e18239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/26/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Longevity has been a topic of interest since the beginnings of humanity, yet its aetiology and precise mechanisms remain to be elucidated. Aging is currently viewed as a physiological phenomenon characterized by the gradual degeneration of organic physiology and morphology due to the passage of time where both external and internal stimuli intervene. The influence of intrinsic factors, such as progressive telomere shortening, genome instability due to mutation buildup, the direct or indirect actions of age-related genes, and marked changes in epigenetic, metabolic, and mitochondrial patterns constitute a big part of its underlying endogenous mechanisms. On the other hand, several psychosocial and demographic factors, such as diet, physical activity, smoking, and drinking habits, may have an even more significant impact on shaping the aging process. Consequentially, implementing dietary and exercise patterns has been proposed as the most viable alternative strategy for attenuating the most typical degenerative aging changes, thus increasing the likelihood of prolonging lifespan and achieving successful aging.
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Affiliation(s)
- Carla Navarro
- Endocrine and Metabolic Diseases Research Center. School of Medicine. University of Zulia. Maracaibo 4001, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center. School of Medicine. University of Zulia. Maracaibo 4001, Venezuela
| | - María P. Díaz
- Endocrine and Metabolic Diseases Research Center. School of Medicine. University of Zulia. Maracaibo 4001, Venezuela
| | - Maricarmen Chacin
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia
| | - Raquel Santeliz
- Endocrine and Metabolic Diseases Research Center. School of Medicine. University of Zulia. Maracaibo 4001, Venezuela
| | - Ivana Vera
- Endocrine and Metabolic Diseases Research Center. School of Medicine. University of Zulia. Maracaibo 4001, Venezuela
| | - Luis D′Marco
- Universidad Cardenal Herrera-CEU Medicine Department, CEU Universities, 46115 Valencia, Spain
| | - Heliana Parra
- Endocrine and Metabolic Diseases Research Center. School of Medicine. University of Zulia. Maracaibo 4001, Venezuela
| | | | - Ana Castro
- Endocrine and Metabolic Diseases Research Center. School of Medicine. University of Zulia. Maracaibo 4001, Venezuela
| | - Daniel Escalona
- Endocrine and Metabolic Diseases Research Center. School of Medicine. University of Zulia. Maracaibo 4001, Venezuela
| | - Henry García-Pacheco
- Universidad del Zulia, Facultad de Medicina, Departamento de Cirugía. Hospital General del Sur “Dr. Pedro Iturbe”. Maracaibo, Venezuela
- Unidad de Cirugía para la Obesidad y Metabolismo (UCOM). Maracaibo, Venezuela
| | - Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla 080001, Colombia
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Jiang YS, Shi H, Kang YT, Shen J, Li J, Cui J, Pang J, Zhang C, Zhang J. Impact of age-friendly living environment and intrinsic capacity on functional ability in older adults: a cross-sectional study. BMC Geriatr 2023; 23:374. [PMID: 37328844 PMCID: PMC10276510 DOI: 10.1186/s12877-023-04089-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 06/02/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) has proposed healthy aging framework, supposing that intrinsic capacity (IC), environment and their interaction may have influence on functional ability (FA). It was still unclear how the IC level and age-friendly living environment impact on FA. This study aims to confirm the relationship between the IC level and age-friendly living environment with FA, especially in older adults with low IC. METHODS Four hundred eighty-five community-dwelling residents aged ≥ 60 years were enrolled. IC constructed by locomotion, cognition, psychological, vitality, and sensory domains was assessed using full assessment tools recommended by WHO. Age-friendly living environment was measured with 12 questions adapted from the spatial indicators framework of age-friendly cities. FA was assessed using activities of daily living (ADL) and one question about mobile payment ability. Multivariate logistic regression was used to explore the association between IC, environment and FA. The influence of the environment on electronic payment and ADL under the IC layer was assessed. RESULTS Of 485 respondents, 89 (18.4%) had ADL impairment, and 166 (34.2%) had mobile payment function impairment. Limited IC (odds ratio [OR] = 0.783, 95% confidence interval [CI] = 0.621-0.988) and poor environment (OR = 0.839, 95% CI = 0.733-0.960) were associated with mobile payment ability impairment. Our results suggested that a supportive age-friendly living environment influenced FA was more prominent in older adults with poor IC (OR = 0.650, 95% CI = 0.491-0.861). CONCLUSIONS Our results confirmed IC and the environment had an impact on mobile payment ability. The relationship between environment and FA showed differences according to IC level. These findings suggest that an age-friendly living environment is important to maintain and enhance elders' FA, especially in those with poor IC.
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Affiliation(s)
- Yi-Shan Jiang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong Shi
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO.1 Da HuaRoad, DongDan, Beijing, 100730, P. R. China
| | - Yu-Ting Kang
- Office of the National Clinical Research Center for Geriatric Diseases, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Ji Shen
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO.1 Da HuaRoad, DongDan, Beijing, 100730, P. R. China
| | - Jing Li
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO.1 Da HuaRoad, DongDan, Beijing, 100730, P. R. China
| | - Ju Cui
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, P. R. China
| | - Jing Pang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, P. R. China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, P. R. China
| | - Jie Zhang
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO.1 Da HuaRoad, DongDan, Beijing, 100730, P. R. China.
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Ibrahim FA, Mehta UM, Thekkumkara SN, Rakesh KR, Swetha G, Kumar CN, Kumar KJ, Narayana A, Ravisundar S, Satyanarayana P, Thirthalli J. Multivariate associations between cognition and neighborhood geospatial characteristics in schizophrenia. Asian J Psychiatr 2023; 84:103593. [PMID: 37084467 DOI: 10.1016/j.ajp.2023.103593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/06/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
Cognitive impairment contributes to functional impairment in schizophrenia. Yet, little is known about how environmental characteristics are related to cognition in schizophrenia. By examining how cognition and the environment are intertwined, it may be possible to identify modifiable risk and protective factors that can improve cognitive outcomes in schizophrenia. We aimed to identify multivariate associations between cognition and three geospatial characteristics (built-space density, habitable green spaces, and public spaces for social interaction) within one's immediate neighborhood among individuals with schizophrenia. We recruited participants with schizophrenia from three sites - an urban metropolitan and two towns in southern India. We administered standard cognitive assessments and performed a principal axis factoring to identify episodic memory, cognitive control, and social inference-making factors for use in further analyses. We estimated geospatial characteristics of an individual's neighborhood, i.e., up to 1 km2 around the residence, by sourcing data from Google Earth. We performed unconditional and conditional (to examine the effect of clinical covariates) canonical correlation analyses to understand the multivariate relationship between cognition and geospatial characteristics. We analyzed data from 208 participants; the first canonical cognitive variate (higher social inference-making and poorer cognitive control) shared 24% of the variance (r = 0.49; P < 0.001) with the first geospatial variate (lower built density and poorer access to public spaces). Years of education, age at onset, and place of residence significantly modulated this relationship. We observe differential associations of the built environment with social and non-social cognition in schizophrenia, and highlight the clinical and demographic characteristics that shape these associations.
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Affiliation(s)
- Ferose Azeez Ibrahim
- Department of Psychiatry National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
| | - Sreekanth N Thekkumkara
- Department of Psychiatry National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - K R Rakesh
- Department of Psychiatry National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - G Swetha
- Department of Psychiatry National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - C Naveen Kumar
- Department of Psychiatry National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Keshav J Kumar
- Clinical Psychology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | | | | | | | - Jagadisha Thirthalli
- Department of Psychiatry National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
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Simpson G, Stuart B, Hijryana M, Akyea RK, Stokes J, Gibson J, Jones K, Morrison L, Santer M, Boniface M, Zlatev Z, Farmer A, Dambha-Miller H. Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231194552. [PMID: 37692105 PMCID: PMC10483969 DOI: 10.1177/26335565231194552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Background Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions. Methods A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers. Results Our findings suggest a care system which is still predominantly single condition focused. 'Person-centred and holistic care' and 'coordinated and joined up care', were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort. Conclusions Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.
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Affiliation(s)
- Glenn Simpson
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Beth Stuart
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Marisza Hijryana
- Institute of Epidemiology and Health Care, University College London (UCL), London, UK
| | - Ralph Kwame Akyea
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Jonathan Stokes
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jon Gibson
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Karen Jones
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Leanne Morrison
- Primary Care Research Centre, University of Southampton, Southampton, UK
- School of Psychology, University of Southampton, Southampton, UK
| | - Miriam Santer
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Michael Boniface
- Digital Health and Biomedical Engineering, School of Electronics and Computer Science, University of Southampton, Southampton, UK
| | - Zlatko Zlatev
- Digital Health and Biomedical Engineering, School of Electronics and Computer Science, University of Southampton, Southampton, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Yi H, Ng ST, Chang CM, Low CXE, Tan CS. Effects of neighborhood features on healthy aging in place: the composition and context of urban parks and traditional local coffeeshops in Singapore. BMC Geriatr 2022; 22:969. [PMID: 36522627 PMCID: PMC9753030 DOI: 10.1186/s12877-022-03679-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Healthy aging in place is affected by what the neighborhood provides for older adults. The mixed-methods ethnographic study explored the built environmental and contextual effects of urban parks and traditional local coffeeshops (kopitiam) on health practices among older adults in Singapore. METHODS A door-to-door survey with 497 older adults from 32 residential blocks in a public housing town assessed exercise and smoking. The walking distances from the residential blocks to the facilities were calculated. Regression analysis examined the associations between the distance and rates of exercise and smoking. Ethnographic assessment data contextualized the quantitative findings. RESULTS Older adults' exercise was associated with proximity to an urban park but not traditional local coffeeshops. High rates of smoking were clustered in the housing blocks close to the coffeeshops, which provided casual drinking places with smoking tables. The proximity to the coffeeshops was significantly associated with increased smoking and decreased exercise. A walking distance of 200 m to the park and coffeeshops was found to discriminate the outcomes. CONCLUSIONS The findings suggested that walking distances of a few blocks influenced health behaviors among older adults. Their smoking habits appeared to be maintained through environmental features and cultural norms attached to the coffeeshops. Policy of urban planning and redevelopment for the aging population needs to consider the socioecology of healthy aging in place.
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Affiliation(s)
- Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
| | - Shu Tian Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheng Mun Chang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheryl Xue Er Low
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Huang JY, Hsu HC, Hsiao YL, Chen FY, Lo SY, Chou TY, Liu MF. Developing Indicators of Age-Friendliness in Taiwanese Communities through a Modified Delphi Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14430. [PMID: 36361310 PMCID: PMC9658640 DOI: 10.3390/ijerph192114430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
This study developed indicators of age-friendliness for communities in Taiwan that conform to international standards by referring to the World Health Organization Checklist of Essential Features of Age-Friendly Cities and Taiwan's existing indicators. The first stage of the research was based on the WHO's framework and involved a literature review to identify candidate indicators. In the second stage, experts' opinions were collected through a modified Delphi method, and the indicators were screened and revised on the basis of their importance, community enforceability, and generality. The third stage focused on practical feasibility. External parties were invited to offer their opinions regarding the indicators, which were adjusted accordingly. After three rounds of review and re-examination based on the modified Delphi method, the final set of indicators comprised five core indicators and five optional indicators. These indicators can be used to monitor various aspects of communities and determine their age-friendliness.
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Affiliation(s)
- Jo-Ying Huang
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Hui-Chuan Hsu
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Research Center of Health Equity, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Ling Hsiao
- Department of Nursing, Center of Geriatric Care Resource, College of Medicine, Fu Jen Catholic University, Taipei 242062, Taiwan
| | - Feng-Yin Chen
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Shu-Ying Lo
- Division of Community Health, Health Promotion Administration, Ministry of Health and Welfare, Taipei 103205, Taiwan
| | - Tzu-Yun Chou
- Division of Community Health, Health Promotion Administration, Ministry of Health and Welfare, Taipei 103205, Taiwan
| | - Megan F. Liu
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
- Research Center of Health Equity, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
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11
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Inclusive Environments: Home, Work, Public Spaces, Technology, and Specialty Environments within Occupational Therapy Practice. Am J Occup Ther 2022; 76:24009. [PMID: 36735994 DOI: 10.5014/ajot.2022.76s3001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This position statement describes the role and importance of occupational therapy practitioners in integrating inclusive environments into their professional services and into their underlying science. Primary documents that define the occupational therapy profession clearly support its role in creating and ensuring inclusive environments.
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Wood GER, Pykett J, Stathi A. Active and healthy ageing in urban environments: laying the groundwork for solution-building through citizen science. Health Promot Int 2022; 37:6697208. [PMID: 36102480 PMCID: PMC9472256 DOI: 10.1093/heapro/daac126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Urban age-friendly initiatives strive to promote active and healthy ageing by addressing urban influences that impact individuals as they age. Collaborative community partnerships with multi-level stakeholders are crucial for fostering age-friendly initiatives that can transform urban community health. Employing a citizen social science (CSS) approach, this study aimed to engage older adults and stakeholders in Birmingham, UK, to (i) identify key urban barriers and facilitators to active and healthy ageing, and (ii) facilitate collaboration and knowledge production to lay the groundwork for a citizen science project. Older adults (n = 16; mean age = 72(7.5 SD); 11 female) and community stakeholders (n = 11; 7 female) were engaged in six online group discussions, with audio recordings transcribed and thematically analysed to present key urban barrier and facilitator themes. Ageism, winter, technology and safety were barriers identified by both groups. Outdoor spaces and infrastructure, transportation, community facilities, and Covid-19 pandemic were identified as barriers and/or facilitators. Older adults identified the ageing process as a barrier and diversity of the city, health and mobility and technology as facilitators. For stakeholders, barriers were deprivation and poverty, gender differences, and ethnicity, whereas age-inclusive activities were a facilitator. Organic and active opportunities for older adults and stakeholders to connect, co-produce knowledge on urban environments and share resources presented foundations of solution-building and future collaboration. CSS effectively facilitated a range of stakeholders across local urban spaces to collaborate and co-produce ideas and solutions for enhancing local urban environments to promote active and healthy ageing.
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Affiliation(s)
- Grace E R Wood
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston Park Road, Birmingham, West Midlands, B15 2TT, UK
| | - Jessica Pykett
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Ring Road S, Birmingham, West Midlands, B15 2TT, UK
| | - Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston Park Road, Birmingham, West Midlands, B15 2TT, UK
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Greenfield EA, Pestine-Stevens A, Scher C. Responding to Local Needs by Mobilizing Community Assets: Age-Friendly Community Initiatives During the COVID-19 Pandemic. THE GERONTOLOGIST 2022; 62:1431-1442. [PMID: 35592887 PMCID: PMC9384139 DOI: 10.1093/geront/gnac070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Age-friendly community initiatives (AFCIs) strive to make localities better for long and healthy lives by fostering improvements across social, physical, and service environments. Despite the heightened need for community supports during the coronavirus disease 2019 pandemic, very little research has addressed the work of AFCIs in the context of this crisis. We aimed to develop theory on how AFCI core teams have contributed to community responses during the pandemic, as well as what contexts have influenced the initiatives' ability to contribute. RESEARCH DESIGN AND METHODS As part of a multiyear, community-partnered study on the development of philanthropically supported initiatives in northern New Jersey, we conducted qualitative interviews with 8 AFCI core teams during the winter of 2020-2021. The interviews focused on the leaders' efforts at that time, with probing questions concerning enabling factors for their community responses. We analyzed the data using an inductive coding process encompassing open, axial, and subcoding. RESULTS The analysis indicated four distinct roles of AFC core groups: good community partner, creator, advocate, and communications broker. We further found that AFC leaders primarily drew on three types of capital-human, social, and tangible-to enact these roles, oftentimes in cumulative ways. DISCUSSION AND IMPLICATIONS We interpret our study's findings and their implications by integrating insights from theories of social impact. We further highlight the importance of continued research on community-centered approaches to promote aging in community during times of societal crisis, and otherwise.
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Affiliation(s)
| | - Althea Pestine-Stevens
- Address correspondence to: Althea Pestine-Stevens, PhD, School of Social Work at Rutgers, The State Unviersity of New Jersey, New Brunswick, New Jersey, USA. E-mail:
| | - Clara Scher
- School of Social Work at Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
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14
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Rugel EJ, Chow CK, Corsi DJ, Hystad P, Rangarajan S, Yusuf S, Lear SA. Developing indicators of age-friendly neighbourhood environments for urban and rural communities across 20 low-, middle-, and high-income countries. BMC Public Health 2022; 22:87. [PMID: 35027016 PMCID: PMC8759164 DOI: 10.1186/s12889-021-12438-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background By 2050, the global population of adults 60 + will reach 2.1 billion, surging fastest in low- and middle-income countries (LMIC). In response, the World Health Organization (WHO) has developed indicators of age-friendly urban environments, but these criteria have been challenging to apply in rural areas and LMIC. This study fills this gap by adapting the WHO indicators to such settings and assessing variation in their availability by community-level urbanness and country-level income. Methods We used data from the Prospective Urban and Rural Epidemiology (PURE) study’s environmental-assessment tools, which integrated systematic social observation and ecometrics to reliably capture community-level environmental features associated with cardiovascular-disease risk factors. The results of a scoping review guided selection of 18 individual indicators across six distinct domains, with data available for 496 communities in 20 countries, including 382 communities (77%) in LMIC. Finally, we used both factor analysis of mixed data (FAMD) and multitrait-multimethod (MTMM) approaches to describe relationships between indicators and domains, as well as detailing the extent to which these relationships held true within groups defined by urbanness and income. Results Together, the results of the FAMD and MTMM approaches indicated substantial variation in the relationship of individual indicators to each other and to broader domains, arguing against the development of an overall score and extending prior evidence demonstrating the need to adapt the WHO framework to the local context. Communities in high-income countries generally ranked higher across the set of indicators, but regular connections to neighbouring towns via bus (95%) and train access (76%) were most common in low-income countries. The greatest amount of variation by urbanness was seen in the number of streetscape-greenery elements (33 such elements in rural areas vs. 55 in urban), presence of traffic lights (18% vs. 67%), and home-internet availability (25% vs. 54%). Conclusions This study indicates the extent to which environmental supports for healthy ageing may be less readily available to older adults residing in rural areas and LMIC and augments calls to tailor WHO’s existing indicators to a broader range of communities in order to achieve a critical aspect of distributional equity in an ageing world. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12438-5.
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Versey HS. Perceptions of community among suburban and urban-dwelling adults aging in place. J Aging Stud 2021; 59:100969. [PMID: 34794714 DOI: 10.1016/j.jaging.2021.100969] [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: 07/30/2020] [Revised: 08/22/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
Community is important for late-midlife adults, offering a sense of belonging and opportunities for social engagement during the transition to older age. The current study examines perceptions of community and geographical ties among a sample of older adults aging in place. Using data from the Foley Longitudinal Study of Adulthood (FLSA; N = 163; aged 61-64) and a qualitative GIS approach, major themes were categorized and mapped to create a comprehensive picture of how perceptions of community varied among respondents and neighborhoods. Core themes were connections to place, space, people, and relational benefits gained from community involvement. Residents of a suburban enclave more frequently noted connections to people as being important to community, compared to residents in more densely-populated areas. Implications for future research are discussed.
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Affiliation(s)
- H Shellae Versey
- Department of Psychology, Fordham University, United States of America.
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Li T, Wang S. How to Improve the Public Trust of the Intelligent Aging Community: An Empirical Study Based on the ACSI Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041971. [PMID: 33670605 PMCID: PMC7922467 DOI: 10.3390/ijerph18041971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/03/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Abstract
In order to enhance social trust in intelligent aging services, the formation mechanism of public trust in the intelligent aging community was studied. Based on the classic American Customer Satisfaction Index (ACSI) model, this paper establishes the public trust formation model of the intelligent aging community by proposing relevant assumptions. Using 306 questionnaires from China’s intelligent aging care model community as the original data, the model is empirically tested through structural equation modeling. The empirical results show that: firstly, the public satisfaction with the intelligent aging community directly determines the formation of public trust, and the key to improving public trust in the intelligent aging community is to improve customer satisfaction. Secondly, perceived quality, perceived ease of use, perceived risk, and perceived cost economical directly affect public satisfaction and indirectly affect the formation process of public trust in the intelligent aging community. Public satisfaction serves as a complete intermediary in this process.
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van Hoof J, Marston HR. Age-Friendly Cities and Communities: State of the Art and Future Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041644. [PMID: 33572181 PMCID: PMC7914698 DOI: 10.3390/ijerph18041644] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Joost van Hoof
- Faculty of Social Work & Education, The Hague University of Applied Sciences, 2521 EN Den Haag, The Netherlands
- Faculty of Environmental Engineering and Geodesy, Institute of Spatial Management, Wrocław University of Environmental and Life Sciences, 50-357 Wrocław, Poland
- Correspondence: ; Tel.: +31-6-23381404
| | - Hannah R. Marston
- Health & Wellbeing Strategic Research Area, School of Health, Wellbeing & Social Care, The Open University, Buckinghamshire MK7 6HH, UK;
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Marston HR, Niles-Yokum K, Silva PA. A Commentary on Blue Zones ®: A Critical Review of Age-Friendly Environments in the 21st Century and Beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020837. [PMID: 33478140 PMCID: PMC7844621 DOI: 10.3390/ijerph18020837] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/04/2021] [Accepted: 01/14/2021] [Indexed: 12/14/2022]
Abstract
This paper explores the intersection of the World Health Organization’s (WHO) concepts of age-friendly communities and The Blue Zones® checklists and how the potential of integrating the two frameworks for the development of a contemporary framework can address the current gaps in the literature as well as consider the inclusion of technology and environmental press. The commentary presented here sets out initial thoughts and explorations that have the potential to impact societies on a global scale and provides recommendations for a roadmap to consider new ways to think about the impact of health and wellbeing of older adults and their families. Additionally, this paper highlights both the strengths and the weaknesses of the aforementioned checklists and frameworks by examining the literature including the WHO age-friendly framework, the smart age-friendly ecosystem (SAfE) framework and the Blue Zones® checklists. We argue that gaps exist in the current literature and take a critical approach as a way to be inclusive of technology and the environments in which older adults live. This commentary contributes to the fields of gerontology, gerontechnology, anthropology, and geography, because we are proposing a roadmap which sets out the need for future work which requires multi- and interdisciplinary research to be conducted for the respective checklists to evolve.
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Affiliation(s)
- Hannah R. Marston
- Health & Wellbeing Strategic Research Area, School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, Buckinghamshire MK7 6HH, UK
- Correspondence:
| | - Kelly Niles-Yokum
- Department of Health and Public Management, College of Business & Public Management, University of La Verne, La Verne, CA 91750, USA;
| | - Paula Alexandra Silva
- Centre for Informatics and Systems (CISUC), Department of Informatics Engineering (DEI), University of Coimbra, 3030-290 Coimbra, Portugal;
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Healthy Places for Children: The Critical Role of Engagement, Common Vision, and Collaboration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249277. [PMID: 33322469 PMCID: PMC7764690 DOI: 10.3390/ijerph17249277] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023]
Abstract
Planning plays a critical role in promoting healthy communities for children. We conducted a national survey of United States (US) cities and counties in 2019 and found only half of the 1312 responding communities report they give attention to the needs of children in their community plans. Those that do, provide more services and have more child-friendly zoning codes. We use a human ecological framework to build structural equation models of child-friendly zoning and services. We find communities with more engagement of families with children and youth and a common vision across generational, race, and ethnic lines report higher levels of child-friendly zoning and services. Collaboration between health providers and schools builds trust and leads to more services. However, child-friendly zoning is lower in communities with higher child poverty, and in suburbs and rural areas. Our results support a dynamic human ecological model where the processes of collaboration, inclusion, and engagement are key to creating healthy places for children. These processes may be especially important in addressing the unique challenges of suburban and rural communities.
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