Active Aging in ASEAN Countries: Influences from Age-Friendly Environments, Lifestyles, and Socio-Demographic Factors

Geographical variation, demographic and socioeconomic disparities in Active Ageing: The situation in Thailand

Objectives

Being healthy and active is a goal to achieve a better quality of life as individuals age. This study aimed to explore and validate the Active Ageing (AA) model, and examine geographic variations, and demographic and socioeconomic disparities.

Study design

Utilising a cross-sectional secondary data analysis, the analytic unit is older adults aged 60-80 across all provinces in Thailand.

Methods

Exploratory Factor Analysis explored the AA structures, and the second-order Confirmatory Factor Analysis validated the model fit. Factor scores were used to identify geographic variation and sociodemographic disparities in AA. The association between geographic, and sociodemographic characteristics, and AA was examined through hierarchical regression analysis.

Results

The AA model, comprised of 14 indicators representing three latent factors-physical health, participation, and security-exhibited an optimal fit. Geographic inequality in AA emerged across the country, with specific areas linked to lower AA. An inverse relation between participation and security was observed. Rural residence, younger age, male, being married, and adequate income were associated with better AA. The association between AA and geographic, demographic, and socioeconomic emphasised the positive role of marital and economic status.

Conclusions

This study contributes to understanding the social determinants of health by constructing a comprehensive AA model. The findings highlight the geographic variations and demographic and socioeconomic disparities in AA across Thailand. While AA generally declines with age, a better economy may help alleviate these disparities. These findings underscore the need for tailored social and public health policies, avoiding a "one-size-fits-all" approach.

The active aging level of the rural older adults with disability in China: a cross-sectional study

Background

Active aging has been listed as an important indicator to measure the quality of life of the older adults and the construction of the senior care system. There is an imbalance between the supply and demand of senior care services for the disabled older adults in rural areas, and the quality of life needs to be improved.

Objectives

We aimed to analyze the current situation of active aging and the influencing factors of the rural disabled older adults, in order to provide a reference basis for improving the quality of life of the rural disabled older adults.

Methods

We conducted a multicenter and cross-sectional study, using the Barthel Index Scale and Chinese version of the Active Aging Scale, to facilitate the selection of 304 rural older adults with disability in 26 villages under Henan Province for a questionnaire survey.

Results

The mean score for the level of active aging of rural older adults with disability was 1.87 (SD 0.36), with the highest score for the dimension of being self-reliant (Mean2.29, SD 0.61) and lower scores for the dimension of active contribution to society (Mean 1.37, SD 0.55) and building up financial security (Mean 1.37, SD 0.57). The results of the multiple regression analysis showed higher levels of active aging among the disabled older adults with retirement pay, mild disability, and longer time per activity/rehabilitation exercise (p < 0.05).

Conclusion

Active aging of the rural disabled older adults is at a low level, with insufficient economic security and social participation. The national government should help improve the quality of primary health care in rural areas, build a friendly environment for senior communities, and improve policies to protect the welfare of the older adults, so as to collaboratively empower the disabled older adults in rural areas at three levels: health, participation, and protection.

Explicit potentially inappropriate medications criteria for older population in Asian countries: A systematic review

BACKGROUND

Explicit potentially inappropriate medications (PIM) criteria are commonly used to identify and deprescribe potentially inappropriate prescriptions among older patients. Most of these criteria were developed specifically for the Western population, which might not be applicable in an Asian setting. The current study summarizes the methods and drug lists to identify PIM in older Asian people.

METHODS

A systematic review of published and unpublished studies were carried out. Included studies described the development of explicit criteria for PIM use in older adults and provided a list of medications that should be considered inappropriate. PubMed, Medline, EMBASE, Cochrane CENTRAL, CINAHL, PsycINFO, and Scopus searches were conducted. The PIMs were analyzed according to the general conditions, disease-specific conditions, and drug-drug interaction classes. The qualities of the included studies were assessed using a nine-point evaluation tool. The kappa agreement index was used to evaluate the level of agreement between the identified explicit PIM tools.

RESULTS

The search yielded 1206 articles, and 15 studies were included in our analysis. Thirteen criteria were identified in East Asia and two in South Asia. Twelve out of the 15 criteria were developed using the Delphi method. We identified 283 PIMs independent of medical conditions and 465 disease-specific PIMs. Antipsychotics were included in most of the criteria (14/15), followed by tricyclic antidepressants (TCAs) (13/15), antihistamines (13/15), sulfonylureas (12/15), benzodiazepines (11/15), and nonsteroidal anti-inflammatory drug (NSAIDs) (11/15). Only one study fulfilled all the quality components. There was a low kappa agreement (k = 0.230) between the included studies.

CONCLUSION

This review included 15 explicit PIM criteria, which most listed antipsychotics, antidepressants, and antihistamines as potentially inappropriate. Healthcare professionals should exercise more caution when dealing with these medications among older patients. These results may help healthcare professionals in Asian nations to create regional standards for the discontinuation of potentially harmful drugs for elderly patients.

The promotion of active aging through older adult education in the context of population aging

We have entered an era of population aging, and many public health problems associated with aging are becoming more serious. Older adults have earlier onset of chronic diseases and suffer more disability. Therefore, it is extremely important to promote active aging and enhance health literacy. These involves full consideration of the need for education and the provision of solutions to problems associated with aging. The development of OAE is an important measure for implementing the strategy of active aging, and curriculum construction is a fundamental component of achieving OAE. Various subjective and objective factors have limited the development of OAE. To overcome these difficulties and ensure both active and healthy aging, the requirements for active aging should be implemented, the limitations of current OAE should be addressed, system integration should be increased, and the curriculum system should be improved. These approaches will help to achieve the goal of active aging. This paper discusses OAE from the perspective of active aging, based on the promotion of health literacy and provides suggestions to protect physical and mental health among older adults, while promoting their social participation. The provision of various social guarantees for normal life in older adults is a new educational concept.

Living a Nonlinear Concept of Aging: Toward A Global Perspective

The author in this article suggests that applying a simple linear concept of time to the phenomenon of aging and development in the United States and around the world is both outdated and problematic, and he explores an alternative view. The author suggests that nursing and other sciences should stop considering age as a non-modifiable risk factor. Various nursing and other theories that support a nonlinear view of time and aging are included, as well as reports from the growing field of geoscience that holds that we can and should target aging and that it can be slowed and, in some cases, reversed. Some implications for nursing and the world are included.

Assessment of Environmental Demands of Age-Friendly Communities from Perspectives of Different Residential Groups: A Case of Wuhan, China

Age-friendly communities (AFCs) are an important measure for fostering active aging. The key to achieving an age-friendly living environment is to construct or renovate it according to the residents’ demands. To date, very few studies have attempted to delve into the AFCs’ environmental demand from different groups’ perspectives. Based on the theory of place attachment, the aim of this paper is to explore the demand diversity of different groups for the AFC environment. This study employs the nonparametric test and the Ordinal Priority Approach (OPA) to investigate the demands from the residents’ perspectives, and is enhanced by incorporating experts’ opinions. The empirical analysis shows that residents have a high level of demand for the physical environment (indoor and outdoor) and social environment (community services and social participation). At the same time, experts advocate the importance of using digital technologies to support people aged 45–65 who have higher requirements for a community environment than older adults. The findings also show that other backgrounds, such as gender, living arrangements, and year of the community establishment, lead to different demands. However, the impact of residents’ education level, occupation, income, and self-care ability on the environmental demands is low. Based on the research findings, the paper provides some practical suggestions for the future design and development of AFCs.

Suggesting Indicators of Age-Friendly City: Social Participation and Happiness, an Ecological Study from the JAGES

Ascertaining progress in building age-friendly cities (AFCs) requires community diagnostic indicators. This study examines the relationship between social participation and happiness at the municipal level. The data from the Japan Gerontological Evaluation Study (JAGES) from 2013, 2016, and 2019, comprising 442,079 older people from 289 municipalities, are used. We also employ linear mixed-effects models to evaluate the association between social participation and happiness. In these models, we adjust for seven variables as potential confounders. This study reveals that the higher the social participation, except for neighborhood association, the higher the state of happiness (B = 0.14-0.30). Our study suggests that social participation is useful, as a community diagnostic indicator, for monitoring the progress of building AFCs, developing strategies, and creating evidence.

Biopsychosocial inequality, active lifestyle and chronic health conditions: a cross-sectional National Health Survey 2013 in Brazil

This study estimated the biopsychosocial factors related to active physical behavior in the Brazilian population with and without chronic non-transmissible disease (NCD). Cross-sectional study of the National Health Survey (NHS) in Brazil, with 60,202 individuals in 2013. Participants were randomly selected by complex sampling. The outcome was physically active behavior measured by performing a minimum of 150 min of physical exercise per week. The independent variables were social and psychological characteristics, lifestyle and health. Cox regression was applied to estimate the prevalence ratio (PR). There are 29,666 (48.3%; 95% CI 47.0–50.0) participants reported having NCD. Not being a smoker or alcoholic, living in an urban area (PR = 1.44; CI95% 1.23–1.68/PR = 1.38; CI95% 1.08–1.75), having informal social support (PR = 1.26; CI95% 1.10–1.44/PR = 1.19; CI95% 1.05–1.34), A social class (PR = 0.43; CI95% 0.25–0.73/PR = 0.46; CI95% 0.26–0.80), high schooling (PR = 0.34; CI95% 0.23–0.51/PR = 0.33; CI95% 0.24–0.46) as well as paid work (PR = 0.87; CI95% 0.78–0.96/PR = 0.89; CI95% 0.79–0.99) are more associated with active lifestyle in both groups. However, only in the group without NCD, the male sex (PR = 1.42; CI95% 1.28–1.57), no having some disability (PR = 1.31; CI95% 1.03–1.66) and having private health insurance (PR = 1.26; CI95% 1.13–1.41) were more associated with active behavior, while in the group with NCD, being elderly (PR = 1.22; CI95% 1.05–1.42), not be white (PR = 0.85; CI95% 0.77–0.95) and not having restful sleep (PR = 1.23; CI95% 1.08–1.40) are associated with active lifestyle. People with and without NCD in Brazil have very close active behavior, however, some biopsychosocial factors such as: sex, age, lifestyle, socioeconomic level are unevenly associated with the active lifestyle in the groups. Thus, therapeutic or preventive proposals as well as public policies for health promotion must observe these distinctions when elaborating their actions.

Differences of body composition and physical strength among Japanese and Thai older adults living in Chiang Mai, Thailand: an inter-ethnic cross-sectional study

BACKGROUND

The number of adults aged over 65 years is rapidly increasing in several Southeast Asian countries. Muscle mass decreases with age, leading to sarcopenia. The primary objective of this study was to determine whether differences exist in the body composition and physical strength, according to ethnicity, among community-dwelling Japanese and Thai older adults living in Chiang Mai Province, Thailand.

METHODS

A survey was conducted in February and March 2019. Japanese and Thai adults aged ≥ 60 years living in Chiang Mai Province were recruited through community clubs. Participants completed a self-administered questionnaire that enabled collection of data on age, sex, educational background, marital status, annual income, current medical conditions, smoking and alcohol consumption, and exercise habits. Measurements were collected on height, weight, body composition, blood pressure, hand grip, and walking speed for 6 m. Body composition was measured using a standing-posture 8-electrode multifrequency bioimpedance analysis analyzer. Hand grip of each hand was measured with the patient in the standing position using a digital grip dynamometer. Multivariable logistic regression was used to determine factors associated with skeletal muscle mass index (SMI).

RESULTS

Of the total 119 participants, 47 were Japanese (26 men, 21 women) and 72 were Thai (16 men, 56 women). The prevalence of a low SMI was 3/26 (12%), 1/21 (5%), 6/16 (38%), and 5/56 (9%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. The prevalence of low muscle strength was 2/26 (8%), 2/21 (10%), 3/16 (19%), and 13/56 (23%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. There were significant differences between ethnic groups in body mass index for both sexes, percentage body fat in women, SMI in men, and average grip strength in men. Ethnic group, sex, age, and body mass index were independent predictors of SMI.

CONCLUSIONS

Ethnicity had a clinically important effect on body composition and physical strength among older Japanese and Thai adults living in a similar environment.