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Purpose: The impact of a sedentary lifestyle on health and well-being is well recognized. However, there is limited understanding of how a lifetime of physical activity and sedentary behaviour influences an active lifestyle in older adults. The aim of this study was to describe how lived experience of physical activity and sedentary behaviour impacts daily activities among older adults, from a life course perspective. Methods: Qualitative content analysis was used; individual telephone interviews were conducted with fourteen older adults aged 71 to 92 years. The participants received initial support from community care and lived in ordinary housing in southern Sweden. Results: The interviews yielded one theme, "Navigating with an embodied activity compass," and two sub-themes: "Being guided by the past" and "Unveiling pathways through body awareness." Conclusions: Our study highlights how older adults' lived experiences of physical activity, with their connections to body awareness and acceptance, impact daily physical activity. These findings offer new knowledge for clinical practitioners balancing recommendations of sedentary behaviour and physical activity, to promote healthy daily physical activity among older adults. Future research and policies should consider the lived experiences of older adults when addressing public health matters related to sedentary behaviour and physical activity. [ABSTRACT FROM AUTHOR]

Summary: Hip structural analysis parameters are associated with risk of fracture in women across a long follow-up period, with buckling ratio persisting independent of total hip BMD. Purpose: Hip structural analysis (HSA) uses dual X-ray absorptiometry (DXA) hip scans to calculate geometries of narrow neck (NN), intertrochanter (IT), and shaft (S), which may complement bone mineral density (BMD) for assessing fracture risk. We aimed to determine whether HSA parameters were associated with fracture. Methods: Participants were women (n = 986, ages 40–94 year) from the Geelong Osteoporosis Study. HSA was calculated from Lunar DPX-L scans. Low-trauma incident fractures were identified radiologically. Participants were followed from baseline to first fracture, death, or end of follow-up period (31/12/16) (13,487 person-years follow-up). Time-updating Cox-proportional hazards modelling investigated associations between HSA parameters and fracture. Results: Three hundred thirty-five participants reported fractures (rate: 24.99/1000 person-years [95% CI 22.46–27.80]). Higher NN BMD (HR:0.12, 95% CI:0.05–0.29), cross-sectional area (CSA) (0.37, 0.26–0.52), cross-sectional moment of inertia (CSMI) (0.66, 0.50–0.89), section modulus (SM) (0.40, 0.24–0.68) and cortical thickness (CT) (0.00, 0.00–0.01 due to rounding) were associated with decreased risk. IT BMD (0.08, 0.04–0.20), CSA (0.58, 0.49–0.69), CSMI (0.90, 0.85–0.94), and SM (0.69, 0.59–0.81) were similarly associated. Decreased risk was observed at increased values of S BMD (0.20, 0.10-0.38), CSA (0.60, 0.47–0.76), SM (0.60, 0.43–0.83), and CT (0.03, 0.01–0.14). Higher S endocortical diameter (1.81, 1.29–2.53), and buckling ratio (BR) at all sites (NN: 1.07, 1.04-1.11; IT: 1.08, 1.05–1.11, S: 1.31, 1.19–1.46) were associated with increased risk. After adjustment for total hip BMD, the associations with BR at the shaft (1.14, 1.00–1.30) were sustained. Other associations were attenuated. Conclusion: A greater shaft buckling ratio was associated with an increased risk for fracture, independent of total hip BMD. [ABSTRACT FROM AUTHOR]

This study examines the in vitro effects of a soluble protein hydrolysate (SPH) derived from Atlantic salmon (Salmo salar) on incretin receptor activity and pancreatic islet cell protection to explore the mechanisms underlying SPH's observed benefits on weight loss and metabolic health in overweight individuals. SPH demonstrated a dose-dependent enhancement of glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) receptor activity, with significant increases of 2.4-fold (p < 0.05) and 2.6-fold (p < 0.01) at 10 mg/mL, respectively, compared to the control. Pancreatic islet cell assays showed a substantial proliferation effect, with up to a 57% increase at 50 µL/well, indicating potential protective properties against inflammation-induced cell loss. Notably, the smallest SPH peptide fraction (<1000 Da) exhibited GLP-1 agonist activity comparable to semaglutide, a widely used therapeutic agent, underscoring SPH's potential efficacy in modulating metabolic pathways. These results suggest that SPH not only enhances key incretin signaling but also promotes islet cell health, positioning it as a promising dietary intervention to improve age-related metabolic health, including the weight gain and underlying adverse metabolic changes frequently encountered through the menopause. [ABSTRACT FROM AUTHOR]

Background: Emotional prosody is the reflection of emotion types such as happiness, sadness, fear and anger in the speaker's tone of voice. Accurately perceiving, interpreting and expressing emotional prosody is an inseparable part of successful communication and social interaction. There are few studies on emotional prosody, which is crucial for communication, and the results of these studies have inconsistent information regarding age and gender. Aims: The primary aim of this study is to assess the perception of emotional prosody in healthy ageing. The other aim is to examine the effects of variables such as age, gender, language and neurocognitive capacity on the prediction of emotional prosody recognition skills. Methods and Procedures: Sixty‐nine participants between the ages of 18–75 were included in the study. Participants were grouped as the young group aged 18–35 (n = 26), the middle‐aged group aged 36–55 (n = 24) and the elderly group aged 56–75 (n = 19). Perceptual emotional prosody test, motor response time test, and neuropsychological test batteries were administered to the participants. Participants were asked to recognise the emotion in the sentences played on the computer. Natural (neutral, containing neither positive nor negative emotion), happy, angry, surprised and panic emotions were evaluated with sentences composed of pseudoword stimuli. Results and Outcomes: It was observed that the elderly group performed worse in recognising angry, panic, natural and happy emotions and in total recognition, which gives the correct recognition performance in recognition of all emotions. There was no age‐related difference in recognition of the emotion of surprise. The women were more successful in recognising angry, panic, happy and total emotions compared to men. Age and Motor Reaction Time Test scores were found to be significant predictors in the emotional response time regression model. Age, language, attention and gender variables were found to have a significant effect on the regression model created for the success of total recognition of emotions (p < 0.05). Conclusions and Implications: This was a novel study in which emotional prosody was assessed in the elderly by eliminating lexical‐semantic cues related to emotional prosody and associating emotional prosody results with neuropsychiatric tests. All our findings revealed the importance of age for the perception of emotional prosody. In addition, the effects of cognitive functions such as attention, which decline with age, were found to be important. Therefore, it should not be forgotten that many factors contribute to the success of recognising emotional prosody correctly. In this context, clinicians should consider variables such as cognitive health and education when assessing the perception of emotional prosody in elderly individuals. WHAT THIS PAPER ADDS: What is already known on the subject: Most of the studies compare young and old groups, and these studies evaluate the perception of emotional prosody by using sentences formed by observing the speech sounds, syllables, words and grammar rules in the vocabulary of the language. It has been reported that the perception of emotional prosody is lower, mostly in the elderly group, but there is inconsistent information in terms of age and gender. What this paper adds to existing knowledge: Perceptual Prosody Recognition was evaluated with an experimental design in which sentence structures consisting of lexemes were used as stimuli and neurocognitive tests were included, taking into account the phonological and syntactic rules of language. This study was a novel study in diagnosing emotional prosody in terms of comparing different age groups and determining the factors affecting multidimensional emotional prosody, including neuropsychiatric features. What are the clinical implications of this work?: All our findings revealed the importance of age for the perception of emotional prosody. In addition, it was determined that the effects of cognitive functions such as attention were important with age. [ABSTRACT FROM AUTHOR]

In recent decades, the rapid spread of various communication media has led to changes in traditional eating habits. In the Mediterranean region, the classic (Mediterranean) dietary pattern has been lost as a result. This has led to a shift in eating habits towards unhealthy eating patterns, which in turn has resulted in an inadequate distribution of body composition. It is known that, among other things, the number of non-communicable diseases increases with the inadequate distribution of body composition. The aim of our study was to examine the level of adherence to the Mediterranean diet (MD) of older adults in the Mediterranean region in relation to specific body composition parameters. This study included 521 older adults with a mean age of 69.6 ± 6.3 years. Body composition was measured using the BIA 101 Anniversary device (Akern s.r.l., Florence, Italy) and adherence to the MD was assessed using the MEDLIFE index questionnaire. This study found significant differences in body composition between males and females. The mean adherence to the MD was 17.0 ± 3.3 points among the participants and there was higher adherence in females (p = 0.002, ηp2 = 0.019). A multiple linear regression was performed to assess the relationship between the body composition parameters and MD. Multiple linear regression models were significant for reactance, fat mass (%), fat-free mass (%), skeletal muscle index, and total body water (%), with specific individual MEDLIFE items such as the consumption of processed meat, meat, white meat, fruit, vegetables, olive oil and limiting snacks between meals. Moreover, promising correlations were found between certain MD characteristics and BIA parameters, but the overall health effects of the MD remain unclear. [ABSTRACT FROM AUTHOR]

Background: Ageing is one of the most important challenges in our society. Evaluating how one is ageing is important in many aspects, from giving personalized recommendations to providing insight for long-term care eligibility. Machine learning can be utilized for that purpose, however, user reservations towards "black-box" predictions call for increased transparency and explainability of results. This study aimed to explore the potential of developing a machine learning-based healthy ageing scale that provides explainable results that could be trusted and understood by informal carers. Methods: In this study, we used data from 696 older adults collected via personal field interviews as part of independent research. Explanatory factor analysis was used to find candidate healthy ageing aspects. For visualization of key aspects, a web annotation application was developed. Key aspects were selected by gerontologists who later used web annotation applications to evaluate healthy ageing for each older adult on a Likert scale. Logistic Regression, Decision Tree Classifier, Random Forest, KNN, SVM and XGBoost were used for multi-classification machine learning. AUC OvO, AUC OvR, F1, Precision and Recall were used for evaluation. Finally, SHAP was applied to best model predictions to make them explainable. Results: The experimental results show that human annotations of healthy ageing could be modelled using machine learning where among several algorithms XGBoost showed superior performance. The use of XGBoost resulted in 0.92 macro-averaged AuC OvO and 0.76 macro-averaged F1. SHAP was applied to generate local explanations for predictions and shows how each feature is influencing the prediction. Conclusion: The resulting explainable predictions make a step toward practical scale implementation into decision support systems. The development of such a decision support system that would incorporate an explainable model could reduce user reluctance towards the utilization of AI in healthcare and provide explainable and trusted insights to informal carers or healthcare providers as a basis to shape tangible actions for improving ageing. Furthermore, the cooperation with gerontology specialists throughout the process also indicates expert knowledge as integrated into the model. [ABSTRACT FROM AUTHOR]

Background: The ageing population, coupled with the desire to age-in-place, highlight the need for programs that target health promotion as a means of maintaining functional ability, autonomy, and independence among community-dwelling older adults. This paper describes the development of the VIeSA intervention, which aimed to model a healthy ageing trajectory, including the identification of the necessary tools and methods, that would allow people older people, in partnership with health and social care professionals, to define personal health-related goals and the actions to achieve them. A key element of the intervention development was the creation of a support tool intended to assist this process. Methods: The UK Medical Research Council (MRC) guidance on developing and evaluating complex interventions was applied in the development of the intervention and of the support tool. A participatory approach was selected, with stakeholders engaged on different occasions to allow the refinement of the intervention and of the support tool. Following the steps and suggested actions in the MRC development phase, the development process was conducted by identifying (1) the evidence base and (2) the theoretical framework and (3) by modelling the process and outcomes of the intervention. Results: Following a literature review on effective interventions for functional ability, draft 1 of the support tool was designed. Focus groups with stakeholders provided feedback on this draft allowing for its refinement in terms of content, language use, and structure (draft 2). A review of the approaches for health promotion delivery led to further additions to the tool (draft 3) and informed the content of the training of health and social care professionals. After their training, professionals provided feedback on the acceptability, appropriateness, and feasibility of different elements of the intervention. Results suggested that no further major refinement to the intervention or support tool was necessary. Conclusions: The design and development of the VIeSA intervention using the MRC guidance allowed for a clarity of direction, an optimised content in terms of usefulness and accessibility for all concerned stakeholders, and greater opportunities for its implementation and uptake. [ABSTRACT FROM AUTHOR]

Purpose: Companion animals and social media are two important factors of social interaction and well-being among the older population. This study aims to compare social media use and/or having companion animals with respect to sociodemographic variables in conjunction with loneliness, social isolation, depression, satisfaction with life and satisfaction with social support. Design/methodology/approach: This cross-sectional study involves a sample of 250 older community-dwelling adults. The questionnaire comprised sociodemographic, companion animals and social media questions and scales to assess social isolation, loneliness, satisfaction with life and social support and depression. Data were analyzed using descriptive and inferential statistics. Findings: Four groups emerged: "companion animal/s, no social media" (37.6%); "none" (33.6%); "social media and companion animal/s" (14.4%); and "social media, no companion animal/s" (14.4%). Social media users (with or without companion animals) are the youngest and with higher levels of education; caregivers of companion animals (no social media use) are in-between in terms of age and level of education; and those without companion animals and no social media users are the oldest and with less formal education. Originality/value: This research examines and compares two key influencers of older adults' well-being and social interaction (social media and companion animals), that have been researched mostly separately. Findings underlined the cohort effect in the use of social media, suggesting that future older adult cohorts will use more social media whether they have or do not have companion animals. [ABSTRACT FROM AUTHOR]

Healthy ageing, which is the target of life' s later developmental stage, can be achieved through building a wise perspective towards life and existence. However, it may not be achievable for older people when the societal sources are limited. The TILDA project aimed to evaluate the associated factors with healthy ageing and to transfer that knowledge into practice. Hence, determining the perspectives of older people support and advocacy organisations on the enablers and facilitators of the healthy ageing strategies of TILDA is essential to gain a better understanding of the project and plan future strategies. This study aimed to investigate how the TILDA project has influenced or impacted upon these organisations from education, policy, or practice perspectives. The participants (n = 15) included in the study's sample were reached through representative organisations acting to support older people in the Republic of Ireland. Semi-structured interviews were conducted online via Zoom. A systematic thematic data analysis procedure was followed, and three themes emerged from the qualitative data, revealing the perceptions of participants about the TILDA project: (1) Limitations of TILDA, (2) Contributions of TILDA, and (3) Future recommendations for TILDA. In conclusion, among the disadvantages of TILDA, the most significant is not being representative and visible enough; it is evident that it is pivotal to develop a more inclusive culture of TILDA with close cooperation and effective marketing strategies. It is also apparent that TILDA has several advantages that include providing insights into ageing and rich data to plan future support for older people. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to develop and validate a functional ability index (FAI) that incorporates aspects of intrinsic capacity and environmental factors of older individuals based on the World Health Organization framework of healthy ageing. Methods Data of 7016 participants ≥60 years participating in the baseline survey of China Health and Retirement Longitudinal Study was used for the development and internal validation of the FAI. External validation was performed in a separate cohort of 1295 older individuals aged ≥60 years. Functional independency was considered the primary outcome and additional proxies of healthy ageing were considered as secondary outcomes. Cluster dendrogram was used to identify the distinct hierarchical clusters of all included variables for inclusion in the FAI. Backward elimination logistic regression model was implemented to identify the most significant variables associated with independency to be included in the FAI. Results The FAI score ranged from 0 to 19 and individuals having FAI ≥ 12 were more likely to be independent and at lower risk of negative outcomes. For each unit increase in the FAI the risk of having independency increased by 30%–58% cross-sectionally in the two cohorts, whilst the 2-year risk of independency increased by 20%. The FAI demonstrated a C-statistic of 0.73 (95% confidence interval, 0.72 and 0.75) for the primary outcome. Conclusions The FAI we developed effectively measured the functional ability status of community dwelling older individuals. FAI could serve as a tool for evaluating older individual's functional ability in routine health assessment. [ABSTRACT FROM AUTHOR]

China stands out as one of the countries with the largest and fastest-growing elderly populations. Elderly requirements for the quality of high-speed railway stations environment are increasing. The relationship between the built environment of high-speed railway stations and elderly health has become an urgent problem to be solved. The challenge necessitates a systematic approach to age-friendly design. Based on the practical experience of the authors in an age-friendly design of an indoor environment at Nanjing South Railway Station, questionnaire surveys and user interviews were employed to profile four types of typical elderly passengers. Data collection methods were used to create behavior maps. (1) This study identifies the age-friendly needs of elderly passengers, pinpointing the key environment issues. (2) It proposes age-friendly design strategies for various functional areas of Nanjing South Railway Station. (3) It introduces an age-friendly module combination design system, which including basic type I, enhanced type II, and optimized type III, in order to meet the demands for six levels of high-speed railway stations in China. This study promotes the age-friendly transformation of environments at a high-speed railway station, offering theoretical foundations and methodological references for constructing an age-friendly environment from a healthy ageing perspective. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To explore the longitudinal associations between eight-year trajectories of loneliness, social isolation and healthcare utilisation (i.e. inpatient, outpatient, and nursing home care) in US older adults. Methods: The study used data from the Health and Retirement Study in 2006–2018, which included a nationally representative sample of American adults aged 50 and above (N = 6,832). We conducted latent growth curve models to assess the associations between trajectories of loneliness and isolation and healthcare utilisation over 8 years. Results: Independent of sociodemographic and health-related confounders, social deficits were associated with a lower likelihood of baseline physician visits (loneliness β= -0.15, SE = 0.08; social isolation β= -0.19, SE = 0.08), but there was a positive association between loneliness and number of physician visits (β = 0.06, SE = 0.03), while social isolation was associated with extended hospital (β = 0.07, SE = 0.04) and nursing home stays (β = 0.05, SE = 0.02). Longer nursing home stays also predicted better trajectories of loneliness and isolation over time. Conclusion: Loneliness and social isolation are cross-sectionally related to complex patterns of different types of healthcare. There was no clear evidence that social deficits led to specific trajectories of healthcare utilisation, but nursing home stays may over time help provide social contact, supporting trajectories of isolation and potentially loneliness. Non-clinical services such as social prescribing could have the potential to address unmet social needs and further promote patients' health-seeking profiles for improving healthcare equity. [ABSTRACT FROM AUTHOR]

Introduction: With the ageing of the global population and the rise in noncommunicable diseases, there is an increased need for rehabilitation services, especially those that address the specific needs of ageing populations. Through their proximity to patients, nurses play a critical role in providing rehabilitation interventions for older adults in primary health care. However, they are not yet established as typical rehabilitation providers and further research is needed to clarify their role and competencies to optimize rehabilitation interventions for ageing populations. Objectives: Therefore, this secondary analysis of a scoping review aims to describe the role of nurses in the provision of rehabilitation interventions to ageing populations in primary health care. Methods: This review was carried out following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. It is built on all inclusion and exclusion criteria from the primary analysis and focused on studies including nurses and taking place in primary health care. Data analysis included descriptive statistics, as well as qualitative analysis on the role of nurses. Results: A total of 68 studies from high- and upper-middle income countries were included. Nurses typically had a managerial and clinical role (76%) and worked in multidisciplinary teams (54%), most often with physical therapists. Nurses provided 355 interventions, with assessments (n = 106; 30%), and coordination and management of the rehabilitation process (n = 105; 30%) being the most frequent ones. They had 117 different job titles and little information was available about their educational background. Discussion: This paper contributes to a better understanding of the key role nurses play in providing rehabilitation interventions to ageing populations in primary health care. Matching nurses' competencies with their level of proficiency is essential to ensure quality care in rehabilitation. [ABSTRACT FROM AUTHOR]

Dietary patterns contribute to overall health and diseases of ageing but are understudied in older adults. As such, we first aimed to develop dietary indices to quantify Mediterranean Diet Score (MDS) utilisation and Ultra-processed Food (UPF) intake in a well-characterised cohort of relatively healthy community-dwelling older Australian adults. Second, we aimed to understand the relationship between these scores and the association of these scores with prevalent cardiometabolic disease and frailty. Our major findings are that in this population of older adults, (a) pre-frailty and frailty are associated with reduced MDS and increased UPF intake; (b) adherence to MDS eating patterns does not preclude relatively high intake of UPF (and vice versa); and (c) high utilisation of an MDS eating pattern does not prevent an increased risk of frailty with higher UPF intakes. As such, the Mediterranean Diet pattern should be encouraged in older adults to potentially reduce the risk of frailty, while the impact of UPF intake should be further explored given the convenience these foods provide to a population whose access to unprocessed food may be limited due to socioeconomic, health, and lifestyle factors. [ABSTRACT FROM AUTHOR]

Background. In recent years, the size of geriatric population seems to have grown larger than that of younger children and is expected to grow even larger in few years from now. As older individuals are more vulnerable to health concerns and loneliness, it is necessary to focus on providing them opportunities for healthy ageing. Animalassisted therapy (AAT) has emerged as one of the simple yet effective approach to enhance physical, psychological, and social well-being in older adults. Methods. This review article presents collective information from various experiments on AAT's effectiveness in promoting healthy ageing. Results. The physiological impacts of AAT, on cardiovascular health, mobility, and day to day activities have been discussed. The psychological benefits of AAT, such as improvement of mood, cognition, and alleviation of anxiety, loneliness, and depression, are explored. This review also presents the possible mechanisms underlying the effectiveness of AAT, such as release of oxytocin, dopamine, and endorphins, which contribute to emotional well-being along with reduction of stress. The human-animal bond established during AAT sessions is discussed as a significant factor in promoting positive outcomes. Challenges faced and limitations involved in employing therapy animals within ageing populations are also discussed. Conclusions. Avenues for future research and potential applications of AAT in diverse healthcare settings are proposed, emphasizing the need for further empirical investigation to fully elucidate the mechanisms and benefits of AAT for healthy ageing. Through this comprehensive review, we aim to highlight the potential of AAT as a holistic intervention to enhance the well-being of older adults, providing valuable insights for healthcare practitioners, researchers, and policymakers invested in promoting healthy ageing strategies. Clin Ter 2024; 175 (5):362-369 doi: 10.7417/ CT.2024.5126 [ABSTRACT FROM AUTHOR]

This review explores the hypothesis that dementia in several forms, chronic kidney disease and idiopathic pulmonary fibrosis have a common cause in pulse-induced capillary haemorrhage. All three conditions are age-related and characterised by insidious onset, uncertainty about their cause, exacerbation by hypertension, resistance to treatment and the relentlessness of their progression. We argue that the three conditions are the clinical outcomes of damage caused by pulse-induced haemorrhage from capillaries. The damage, first detectable in mid-life, creates first mild and then severe symptoms of cognitive, renal and pulmonary dysfunction. We also review evidence that in all three organs there has developed, by young adulthood, a reserve of tissue that enables them to function well, despite the 'heartbeat by heartbeat' damage that accumulates from early mid-life; and that it is when that reserve is exhausted, typically in late age, that symptoms of organ failure emerge and progress. If this common cause can be established, a step will have been taken towards the understanding, treatment and delay of three conditions that have their beginnings in every individual and that, in those who survive other causes of death, become lethal in late age. [ABSTRACT FROM AUTHOR]

Background: This study explores the perceptions of supported accommodation staff and their managers of the support needs of residents ageing with intellectual disabilities, and their experiences of adjusting services for this group in the context of individualised funding. Method: Qualitative interviews were conducted with 21 staff working in Australian supported accommodation services. Findings: Four themes emerged. The first captured the staff's limited understanding of ageing and the medicalisation of support needs. The second identified staff practices and adjustments to service provision to facilitate residents' healthy ageing. The third described staff commitment to facilitating ageing residents to age in place, and the fourth identified staff challenges and opportunities in supporting ageing residents in the context of the National Disability Insurance Scheme (NDIS). Conclusions: Findings may inform the development of practice guidelines and training for supported accommodation staff, protocols for intersections between disability, aged care and health sectors, and adequate policy responses to support older residents' healthy ageing. [ABSTRACT FROM AUTHOR]

Objectives: To develop an instrument to facilitate the risk assessment of falls in older outpatients. Design: A quantitative methodological study using the cross‐sectional data. Methods: This study enrolled 1988 older participants who underwent comprehensive geriatric assessment (CGA) in an outpatient clinic from May 2020 to November 2022. The history of any falls (≥1 falls in a year) and recurrent falls (≥2 falls in a year) were investigated. Potential risk factors of falls were selected by stepwise logistic regression, and a screening tool was constructed based on nomogram. The tool performance was compared with two reference tools (Fried Frailty Phenotype; CGA with 10 items, CGA‐10) by using receiver operating curves, sensitivity (Sen), specificity (Spe), and area under the curve (AUC). Results: Age, unintentional weight loss, depression measured by the Patient Health Questionnaire‐2, muscle strength measured by the five times sit‐to‐stand test, and stand balance measured by semi‐ and full‐tandem standing were the most important risk factors for falls. A fall risk screening tool was constructed with the six measurements (FRST‐6). FRST‐6 showed the best AUC (Sen, Spe) of 0.75 (Sen = 0.72, Spe = 0.69) for recurrent falls and 0.65 (Sen = 0.74, Spe = 0.48) for any falls. FRST‐6 was comparable to CGA‐10 and outperformed FFP in performance. Conclusions: Age, depression, weight loss, gait, and balance were important risk factors of falls. The FRST‐6 tool based on these factors showed acceptable performance in risk stratification. Impact: Performing a multifactorial assessment in primary care clinics is urgent for falls prevention. The FRST‐6 provides a simple and practical way for falls risk screening. With this tool, healthcare professionals can efficiently identify patients at risk of falling and make appropriate recommendations in resource‐limited settings. Patient or Public Contribution: No patient or public contribution was received, due to our study design. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates which local area characteristics, included in the Healthy Ageing/Vulnerable ENvironment (HAVEN) Index, are the strongest factors predicting transition into permanent residential aged care (PRAC) and mortality, and the geographic distribution of these factors. Methods: A retrospective cohort study of older individuals living in the community in Adelaide who received their first eligibility assessment for age care services between 2013 and 2015 (n = 16,939) was conducted. The study cohort, from the Registry of Senior Australians (ROSA), was linked by postcode to HAVEN Index items, selected following item response theory (IRT) analysis to determine the strongest local area factors associated with PRAC and mortality. Geospatial mapping of the factors determined the geographic distribution of these significant factors. Results: Fourteen HAVEN Index items were associated with entry into PRAC and mortality. Three area‐level items, lower educational attainment, financial housing stress and low levels of volunteering by older people, were risk factors for entry into PRAC and mortality while the remainder of the items identified were different for each outcome. The mapped local area risk factors for each outcome highlighted similar geographical areas of vulnerability. Conclusions: Local area characteristics are associated with entering PRAC and mortality. Our findings can inform area‐level responses to make neighbourhoods more age‐friendly, potentially allowing more people to age longer in place. Similar analyses, conducted for other areas, could provide evidence to support the widespread development of age‐friendly neighbourhoods reducing area‐level inequalities in ageing. [ABSTRACT FROM AUTHOR]

Objectives: To identify official sources that routinely collect data on functioning in Switzerland, to provide an overview of the existing data and its comparability, and to assess the extent to which the data is suitable for developing a functioning metric and indicator. Methods: Data sources were identified through an iterative search. Standardized rules were applied to map the functioning information assessed by the sources using a current WHO functioning and disability survey as a reference framework for the content comparison. Results: Four sources were identified: the Swiss Survey of Health, Ageing and Retirement in Europe (SHARE), the Swiss Health Survey (SHS), the Lausanne cohort 65+ (Lc65+), and the Swiss Household Panel (SHP). All tools addressed sleep functions, energy level, emotional functions, and sensation of pain. Additionally, nine functioning categories were common across three sources. Conclusion: Population data sources in Switzerland routinely collect comparable functioning data, which can serve as the basis for creating a functioning indicator. Among others, this indicator is relevant to complement mortality and morbidity data and to support both the estimation of rehabilitation and long-term care needs. [ABSTRACT FROM AUTHOR]

Ageing is characterized by a gradual decline in the efficiency of physiological functions and increased vulnerability to diseases. Ageing affects the entire body, including physical, mental, and social well-being, but its impact on the brain and cognition can have a particularly significant effect on an individual's overall quality of life. Therefore, enhancing lifespan and physical health in longevity studies will be incomplete if cognitive ageing is over looked. Promoting successful cognitive ageing encompasses the objectives of mitigating cognitive decline, as well as simultaneously enhancing brain function and cognitive reserve. Studies in both humans and animal models indicate that cognitive decline related to normal ageing and age-associated brain disorders are more likely linked to changes in synaptic connections that form the basis of learning and memory. This activitydependent synaptic plasticity reorganises the structure and function of neurons not only to adapt to new environments, but also to remain robust and stable over time. Therefore, understanding the neural mechanisms that are responsible for age-related cognitive decline becomes increasingly important. In this review, we explore the multifaceted aspects of healthy brain ageing with emphasis on synaptic plasticity, its adaptive mechanisms and the various factors affecting the decline in cognitive functions during ageing. We will also explore the dynamic brain and neuroplasticity, and the role of lifestyle in shaping neuronal plasticity. [ABSTRACT FROM AUTHOR]

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Vaccine-preventable diseases continue to generate a substantial burden on health, healthcare systems, and societies, which is projected to increase with population ageing. There is a need to better understand the full value of adult immunisation programmes corresponding to the broader value of vaccine frameworks that are recommended for evidence-based decision-making. This review aims to summarise and map evidence for the value of selected adult immunisation programmes (seasonal influenza, pneumococcal disease, RSV, and HZ) in ten diverse countries. We conducted a structured literature review of evidence published from 2017 to 2023. An existing framework was used to structure the assessment, developing matrices demonstrating the elements of value evidenced for each vaccine and country of focus. Our analysis showed substantial evidence base on the value of adult immunisation programmes, but the availability of evidence varied by value element and by vaccine. The impact on the quality of life of the vaccinated individual was the most evidenced value element. Mortality benefits for vaccinated individuals and cost-offsets to healthcare systems were also well-evidenced. The availability of evidence for 'broader' societal value elements (such as transmission value, carer productivity and impact on social equity, and antimicrobial resistance prevention) varied. No evidence was identified relating to the broader value elements of macroeconomic effects, value to other interventions, or effects on the quality of life of caregivers. Robust evidence exists to show that adult immunisation programmes generate substantial value for population health and health systems, yet some elements of broader value remain underrepresented in the academic literature. Without such evidence, the full value of immunisation programmes is underestimated, risking suboptimal policy decisions. [ABSTRACT FROM AUTHOR]

Background: Population ageing represents a significant global challenge, particularly pronounced in countries like India. Aims: This study aims to explore how factors such as socio-economic status, behaviour, and health influence healthy ageing across the Indian older population. Methods: In this study, we utilized the Longitudinal Ageing Study in India – wave 1 dataset for analysis purposes. Scores were generated for five dimensions of healthy aging, including physical, functional, mental, cognitive, and social aspects and these scores were treated as the target variables. Multivariate Regression Trees analysis was employed to identify the behavioural and socio-demographic factors associated with each dimension of healthy ageing. Results: Years of education emerge as crucial across all dimensions, positively impacting cognitive health and mitigating age-related decline in healthy ageing. Marital status, engagement in household activities, spiritual practices, and living arrangements impacts the scores of different aspects of healthy ageing. Gender disparities in healthy aging are noticeable in the 60–74 age group, with women generally having lower scores. Safety of the living environment is a crucial determinant of the mental health of the elderly across all age groups.These findings highlight the complex interplay of factors in healthy ageing outcomes. Conclusion: Our study emphasizes the pivotal role of education in fostering healthy ageing in India. Factors such as environmental safety and social participation also influence well-being. Targeted interventions addressing education, gender equality, safety, and healthcare access are vital for enhancing the ageing experience and overall well-being of older adults. [ABSTRACT FROM AUTHOR]

Purpose: Growing elderly populations worldwide have sparked interest in factors promoting healthy aging. Diet and other lifestyle patterns are key factors for healthy ageing; however, evidence is sparse for specific dietary guidelines that are easily implemented in everyday life. Whole grains constitute specific dietary components with unexplored potential in healthy ageing. Methods: We applied an illness-death multistate model to assess the association between whole-grain intake and life expectancy, both with and without disease, over a 20-year period. Healthy ageing was defined as absence of cancer, ischemic heart disease, stroke, type 2 diabetes, asthma, chronic obstructive pulmonary disease, and dementia during follow-up. Results: Based on information from 22,606 men and 25,468 women in the Danish Diet, Cancer and Health cohort, followed for an average of 13.8 and 17.5 years, respectively, a doubling in whole-grain intake was associated with 0.43 (95% CI: 0.33–0.52) and 0.15 (0.06–0.24) additional years without disease for men and women, respectively. Comparing the highest and lowest quartiles of whole-grain intake, with a special emphasis on men, we found that those with the highest intake lived, on average, one year longer without disease compared to those with the lowest intake. Additionally, although a high intake of whole grains yielded longer life expectancy, the duration of living with disease was shorter. Conclusion: Intake of whole grains in mid-life was associated with healthy ageing looking 20 years ahead. [ABSTRACT FROM AUTHOR]

This study describes the development and testing of the Healthy Ageing/Vulnerable Environment (HAVEN) Index, a prototype composite spatial index for South Australia that reflects an area's age‐friendliness. The index incorporates over 40 indicator variables across six variable themes: income and employment; education; health and housing; social connectedness; geographic access; and physical environment. Based on the deficit accumulation approach, the modelling uses area‐level rather than individual‐level data and is compiled through quantitative geospatial methods. Analysis using the HAVEN Index of state‐wide mortality data and hospital emergency department (ED) presentations for Central Adelaide found that vulnerable areas were associated with a higher risk of mortality and ED presentation. Comparisons between the HAVEN Index and a widely used national area‐level measure of socio‐economic differences found that the HAVEN Index compares favourably and provides additional information about local areas, which can inform needs‐based approaches to support the reduction of spatial inequalities and the development of age‐friendly neighbourhoods. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of the drinking patterns of older adults and what influences them • To gauge how to approach the subject of alcohol misuse with older adults in your care • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Older adulthood is a unique time of transition often referred to as the ‘golden years’. It is characterised by positive life experiences such as retirement but also by a loss of routine, identity and meaning. The literature identifies alcohol misuse as a growing issue in this population. However, the stigma, perceptions and patterns of drinking associated with alcohol misuse among older people can be a barrier to individuals seeking health advice. This article identifies that older adulthood is a period when nurses can offer health education and support using their unique relationships with patients to encourage healthy drinking behaviours. [ABSTRACT FROM AUTHOR]

In recent years, there has been a paradigm shift with regards to ageing, challenging its traditional perception as an inevitable and natural process. Researchers have collectively identified hallmarks of ageing, nine of which were initially proposed in 2013 and expanded in 2023 to include disabled macroautophagy, chronic inflammation, and dysbiosis, enhancing our understanding of the ageing process at microscopic, cellular, and systemwide levels. Strategies to manipulate these hallmarks present opportunities for slowing, preventing, or reversing age-related diseases, thereby promoting longevity. The interdependence of these hallmarks underscores the necessity of a comprehensive, systems-based approach to address the complex processes contributing to ageing. As a primary risk factor for various diseases, ageing diminishes healthspan, leading to extended periods of compromised health and multiple age-related conditions towards the end of life. The significant gap between healthspan and lifespan holds substantial economic and societal implications. The inaugural Longevity Med Summit (4-5 May 2023, Cascais, Portugal) provided an international forum to discuss the academic and industry landscape of healthy longevity research, preventive medicine and clinical practice to enhance healthspan. [ABSTRACT FROM AUTHOR]

Human ageing is a normal process and does not necessarily result in the development of frailty. A mix of genetic, environmental, dietary, and lifestyle factors can have an impact on ageing, and whether an individual develops frailty. Frailty is defined as the loss of physiological reserve both at the physical and cellular levels, where systemic processes such as oxidative stress and inflammation contribute to physical decline. The newest "omics" technology and systems biology discipline, metabolomics, enables thorough characterisation of small-molecule metabolites in biological systems at a particular time and condition. In a biological system, metabolites--cellular intermediate products of metabolic reactions--reflect the system's final response to genomic, transcriptomic, proteomic, epigenetic, or environmental alterations. As a relatively newer technique to characterise metabolites and biomarkers in ageing and illness, metabolomics has gained popularity and has a wide range of applications. We will give a comprehensive summary of what is currently known about metabolomics in studies of ageing, with a focus on biomarkers for frailty. Metabolites related to amino acids, lipids, carbohydrates, and redox metabolism may function as biomarkers of ageing and/or frailty development, based on data obtained from human studies. However, there is a complexity that underpins biological ageing, due to both genetic and environmental factors that play a role in orchestrating the ageing process. Therefore, there is a critical need to identify pathways that contribute to functional decline in people with frailty. [ABSTRACT FROM AUTHOR]

Background: Maintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences. Methods: Cross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed. Results: Data of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors. Conclusions: We found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research. Trial registration: German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018). [ABSTRACT FROM AUTHOR]

Background and Purpose: Ageing has become one of the major global public issues and active ageing has become a global goal. Accurate and reproducible assessment tools are a prerequisite for robust and reliable measurement of active ageing and policy formulation. However, a broad scoping review describing the characteristics and heterogeneity of assessment tools for active ageing is lacking. This study aims to comprehensively portray current active ageing assessment tools and their features. Methods: We conducted a scoping review, focusing on the Active Ageing Assessment Tool, and searched seven databases: CNKI, WanFang, PubMed, Embase, Web of Science Core Collection, Medline, and Proquest. The research process adhered to the methodological framework of Arkey and O'Malley and the PRISMA-ScR specification. More so, we registered the research program with the Open Science Framework. Results: Ultimately, we included twenty-two pieces of literature. The development of the active ageing assessment tool predominantly occurred between 2012 and 2023, with a focus on foreign countries (16 studies). All included literature presented multidimensional Active ageing assessment tools. Eighteen studies examined active ageing assessment tools at the macro level, while four studies focused on the individual level. Also, fourteen out of the twenty-two studies were based on the World Health Organization's Theoretical Framework for Active Ageing. The literature contained only two active ageing assessment tools designed for specific subgroups of older people. Conclusion: Future development of active ageing assessment tools should integrate more comprehensive concepts and social theories of active ageing. Additionally, there is a need to explore active ageing measurement tools tailored for diverse subgroups of the older adults at various levels. [ABSTRACT FROM AUTHOR]

Objectives: With increasing life expectancy and rapid ageing, there is an expanding number of older people who have functional declines, greater needs for care and support and who are at increased risk of insufficient social interaction. Longitudinal investigations on the interplay between loneliness, social isolation and care dependence remain limited. This study thus aimed to investigate the longitudinal reciprocal association between social isolation/loneliness and care dependence among older adults in Latin America and China. Methods: We analysed data from the population‐based cohorts from the 10/66 Dementia Research Group (DRG) project (baseline 2003‐07 and follow‐up 2007–2010). The 10/66 DRG study recruited and followed up older adults aged 65 years or above in 11 catchment areas in Latin America and China. A total of 15,027 older adults from Latin America and China (mean age = 73.5, standard deviation = 6.5) were included in our analyses. Cross‐lagged panel models were used to investigate potential reciprocal associations. Results: Loneliness was positively associated with care dependence at baseline (β = 0.11, p < 0.001 in Latin America; β = 0.16, p < 0.05 in China]. Social isolation consistently had a stronger positive association with care dependence across all study sites in both waves. Longitudinally, care dependence positively predicted loneliness (β = 0.10, p < 0.001) and social isolation (β = 0.05, p < 0.001) in Latin American study sites but not in China. Yet there was no statistical evidence of lagged effects of loneliness and social isolation on care dependence in all study countries. Conclusions: Older people with care dependence are at risk of developing loneliness and social isolation. It is crucial to develop complex care models using a societal approach to address social and care needs holistically, especially for the older group with declining functional capacity. Future longitudinal research is required to explore the causal mechanisms of relationships and cultural differences, in order to inform the development of culturally appropriate care models. Key points: Loneliness and social isolation were positively associated with care dependence among older people in Latin America and China.Longitudinally, care dependence predicted later experiences of loneliness and social isolation in Latin America but not in China.There is a need for embedding interventions for tackling loneliness and social isolation into health and care arrangements.Policy inputs to launching complex care models for addressing comprehensive social and care needs among older people with care dependence are essential for better achieving healthy ageing goals. [ABSTRACT FROM AUTHOR]

Rising rates of insulin resistance and an ageing population are set to exact an increasing toll on individuals and society. Here we examine the contribution of age and insulin resistance to the association of cerebral blood flow and glucose metabolism; both critical process in the supply of energy for the brain. Thirty-four younger (20–42 years) and 41 older (66–86 years) healthy adults underwent a simultaneous resting state MR/PET scan, including arterial spin labelling. Rates of cerebral blood flow and glucose metabolism were derived using a functional atlas of 100 brain regions. Older adults had lower cerebral blood flow than younger adults in 95 regions, reducing to 36 regions after controlling for cortical atrophy and blood pressure. Lower cerebral blood flow was also associated with worse working memory and slower reaction time in tasks requiring cognitive flexibility and response inhibition. Younger and older insulin sensitive adults showed small, negative correlations between relatively high rates of regional cerebral blood flow and glucose metabolism. This pattern was inverted in insulin resistant older adults, who showed hypoperfusion and hypometabolism across the cortex, and a positive correlation. In insulin resistant younger adults, the association showed inversion to positive correlations, although not to the extent seen in older adults. Our findings suggest that the normal course of ageing and insulin resistance alter the rates of and associations between cerebral blood flow and glucose metabolism. They underscore the criticality of insulin sensitivity to brain health across the adult lifespan. [ABSTRACT FROM AUTHOR]

Background: There is emerging agreement that living in a home designed to support healthy cognitive ageing can enable people to live better with dementia and cognitive change. However, existing literature has used a variety of outcome measures that have infrequently been informed by the perspectives of older people or of professional in design and supply of housing. The DesHCA (Designing Homes for Healthy Cognitive Ageing) study aimed to identify outcomes that were meaningful for these groups and to understand their content and meanings. Methods: A presurvey of older people and housing professionals (n = 62) identified potential outcomes. These were then used in three rounds of a modified e-Delphi exercise with a panel of older people and housing professionals (n = 74) to test meanings and identify areas of agreement and disagreement. Descriptive statistics were used to present findings from previous rounds. Results: The survey confirmed a wide range of possible outcomes considered important. Through the e-Delphi rounds, panellists prioritised outcomes relating to living at home that could be influenced by design, and clarified their understanding of the meanings of outcomes. In subsequent rounds, they commented on earlier results. The exercise enabled five key outcome areas to be identified – staying independent, feeling safe, living in an adaptable home, enabling physical activity and enabling enjoyed activities- which were then tested for their content and applicability in panellists' views. Conclusion: The five key outcome areas appeared meaningful to panellists, whilst also demonstrating nuanced meanings. They indicate useful outcomes for future research, though will require careful definition in each case to become measures. Importantly, they are informed by the views of those most immediately affected by better or poorer home design. [ABSTRACT FROM AUTHOR]

Background: With the conflict between the promise of ageing in health and longevity and the limited availability of health resources and social support, older adults in China inevitably experience anxieties surrounding health risks. This study aims to investigate how older adults perceive the health risks that come with getting older, explore the degree to which health risks affect older adults, and advocate for active engagement in practices for managing health risks. Methods: Using purposive sampling, three districts of Beijing (Xicheng District, Fengtai District, and Daxing District, respectively) were selected for the research. Qualitative semi-structured and in-depth interviews were conducted with 70 community-dwelling older adults who participated in the study. Data were extracted and analyzed based on a thematic framework approach. Results: Three main themes were identified: (i) the anxieties of older adults concerning health risks in ageing; (ii) the priorities of older adults for health risk management in ageing; (iii) the expectations of older adults for health risk management in ageing. The primary health concerns among older adults included disease incidence and function decline. It was found that basic health management emerged as a critical need for older adults to mitigate health risks. Moreover, it was observed that healthcare support for older adults from familial, institutional, and governmental levels exhibited varying degrees of inadequacy. Conclusions: The primary source of anxieties among older adults regarding health risks predominantly stems from a perceived sense of health deprivation. It is often compounded by persistent barriers to primary care of priorities in managing health risks among older adults. In addition, the expectations of older adults for health risk management emphasize the necessity for integrated care approaches. Therefore, further research should give priority to the prevention and management of health risks, aim to reduce anxieties, provide integrated care to meet the primary needs and expectations of older adults, and ultimately strive toward the overarching goal of promoting health and longevity. [ABSTRACT FROM AUTHOR]

Background: Assessing and monitoring intrinsic capacity (IC) is an effective strategy to promote healthy ageing by intervening early in high-risk populations. This review systematically analyzed the global detection rates of IC deficits and explored variations across diverse populations and data collection methods. Methods: This study was preregistered with PROSPERO, CRD42023477315. In this systematic review and meta-analysis, we systematically searched ten databases from January 2015 to October 2023, for peer-reviewed, observational studies or baseline survey of trials that assessed IC deficits among older adults aged 50 and above globally following the condition, context and population approach. The main outcome was intrinsic capacity deficits which could be assessed by any tools. Meta-analyses were performed by a random-effect model to pool the detection rates across studies and subgroup analyses were conducted by populations and data collection methods. Results: Fifty-six studies conducted in 13 countries were included in the review and 44 studies with detection rates of IC were included in the meta-analysis. The pooled detection rate of IC deficits was 72.0% (65.2%-78.8%) and deficits were most detected in sensory (49.3%), followed by locomotion (40.0%), cognition (33.1%), psychology (21.9%), and vitality (20.1%). Variations in detection rates of IC deficits were observed across studies, with higher rates observed in low- and middle-income countries (74.0%) and hyper-aged societies (85.0%). Study population and measurement tools also explained the high heterogeneity across studies. Conclusion: IC deficits are common among older adults, while heterogeneity exists across populations and by measurement. Early monitoring with standardized tools and early intervention on specific subdomains of IC deficits are greatly needed for effective strategies to promote healthy ageing. [ABSTRACT FROM AUTHOR]

Background: Globally, frailty is associated with a high prevalence of avoidable hospital admissions and emergency department visits, with substantial associated healthcare and personal costs. International guidelines recommend incorporation of frailty identification and care planning into routine primary care workflow to support patients who may be identified as pre-frail/frail. Our study aimed to: (1) determine the feasibility, acceptability, appropriateness and determinants of implementing a validated FRAIL Scale screening Tool into general practices in two disparate Australian regions (Sydney North and Brisbane South); and (2) map the resources and referral options required to support frailty management and potential reversal. Methods: Using the FRAIL Scale Tool, practices screened eligible patients (aged ≥75 years) for risk of frailty and referred to associated management options. The percentage of patients identified as frail/pre-frail, and management options and referrals made by practice staff for those identified as frail/pre-frail were recorded. Semi-structured qualitative interviews were conducted with practice staff to understand the feasibility, acceptability, appropriateness and determinants of implementing the Tool. Results: The Tool was implemented by 19 general practices in two Primary Health Networks and 1071 consenting patients were assessed. Overall, 80% of patients (n = 860) met the criterion for frailty: 33% of patients (n = 352) were frail, and 47% were pre-frail (n = 508). They were predominantly then referred for exercise prescription, medication reviews and geriatric assessment. The Tool was acceptable to staff and patients and compatible with practice workflows. Conclusions: This study demonstrates that frailty is identified frequently in Australians aged ≥75 years who visit their general practice. It's identification, linked with management support to reverse or reduce frailty risk, can be readily incorporated into the Medicare-funded annual 75+ Health Assessment. In older persons, the risk of developing frailty increases with age, and people with frailty experience higher morbidity, mortality and lower quality of life. However, frailty risk is not currently formally assessed and tracked in general practice in Australia. This pilot study demonstrates that frailty in Australians aged ≥75 years is identified frequently, and its identification and the subsequent management recommendations to reverse or reduce frailty risk, can be readily incorporated into the general practice workflow. [ABSTRACT FROM AUTHOR]

Introduction: With Australiaʼs ageing population, especially in rural regions, promoting physical activity among older adults is crucial. Objective: To identify factors influencing participation of older adults (60 years or over) from a rural community in a modified sport program and assess satisfaction with a pilot modified sport program informed by these findings. Design: Insights and ideas from two focus groups exploring community perspectives on a modified sport program informed the development of a six‐week pilot modified sport program delivered with the local fitness centre. Post‐program surveys assessed participant satisfaction, willingness to continue, and likelihood of recommending the program to others. Findings: Nine participants attended the focus groups, highlighting increased social connection, health management, and healthy ageing as key motivators. Joint and health concerns, cost, and time constraints emerged as main barriers. Preferences for the program included weekly sessions, alternating sports, indoor venues, and supporting modifications, but maintaining traditional rules. Thirteen participants participated in the pilot modified sport program. There was strong program attendance (86%). All participants (13/13) rated their satisfaction as very satisfied. They were highly likely to recommend the program to others (8.5/10) and were interested in continuing modified sport after the pilot (7.7/10). Discussion: This study demonstrates for the first time that modified sport is of interest to older people in the rural setting, and that delivering such a program is feasible in a small community. Rural communities implementing modified sport should consider the availability of suitable facilities and equipment, access to an engaging facilitator and participant cost. Conclusion: Through a strong connection between the health service and community fitness centre, a modified sport program was developed and implemented, well‐attended and enjoyed by participants in a rural community. [ABSTRACT FROM AUTHOR]

Population ageing is a growing social and health issue in low and lower-middle-income countries (LLMIC). It will have an impact on rising healthcare costs, unaffordable pension liabilities, and changing healthcare demands. The health systems of many LLMICs are unprepared to meet these challenges and highlighting the modifiable factors that may help decrease these pressures is important. This review assessed the prevalence of healthy ageing and the modifiable factors that may promote/inhibit healthy ageing among older people in LLMIC. A systematic search of all articles published from 2000 to June 2022 was conducted in Scopus, PubMed (MEDLINE), and Web of Science. All observational studies reporting the prevalence of healthy ageing and its associations with socio-demographic, lifestyle, psychological, and social factors were examined. Random-effect models were used to estimate the pooled prevalence of healthy ageing, and meta-analyses were conducted to assess the risk/benefit of modifiable factors. From 3,376 records, 13 studies (n = 81,144; 53% of females; age ≥ 60 years) met the inclusion criteria. The pooled prevalence of healthy ageing ranged from 24.7% to 56.5% with lower prevalence for a multi-dimensional model and higher prevalence for single global self-rated measures. Factors positively associated with healthy ageing included education, income, and physical activity. Being underweight was negatively associated with healthy ageing. Almost half of older people in LLMIC were found to meet healthy ageing criteria, but this estimate varied substantially depending on the healthy ageing measures utilized (multi-dimensional = 24.7%; single indicator = 56.5%). The healthy ageing prevalences for both measures are lower compared to that in high-income countries. Developing health policies and educative interventions aimed at increasing physical exercise, social support, and improving socio-economic status and nutrition will be important to promote the healthy ageing of older people in LLMIC in sustainable ways. [ABSTRACT FROM AUTHOR]

Background: In the current context of ageing, the field of smart elderly care has gradually developed, contributing to the promotion of health among older adults. While the positive impact on health has been established, there is a scarcity of research examining its impact on the quality of life (QoL). This study aims to investigate the mediating role of social support in the relationship between smart elderly care and QoL among older adults. Methods: A total of 1313 older adults from Zhejiang Province, China, participated in the study. Questionnaires were used to collect data on participants' basic demographic information, smart elderly care, social support, and QoL. The descriptive analyses of the demographic characteristics and correlation analyses of the three variables were calculated. Indirect effects were tested using bootstrapped confidence intervals (CI). Results: The analysis revealed a positive association between smart elderly care and social support (β = 0.42, p < 0.01), as well as a positive correlation between social support and QoL (β = 0.65, p < 0.01). Notably, social support emerged as an important independent mediator (effect size = 0.28, 95% bootstrap CI 0.24 to 0.32) in the relationship between smart elderly care and QoL. Conclusions: The results of this study underscore the importance of promoting the utilization of smart elderly care and improving multi-faceted social support for older adults, as these factors positively contribute to the overall QoL. [ABSTRACT FROM AUTHOR]

Diet is integral to the healthy ageing process and certain diets can mitigate prolonged and deleterious inflammation. This review aims to assess the impact of diets high in sustainably sourced proteins on nutrient intake, gut, and age-related health in older adults. A systematic search of the literature was conducted on 5 September 2023 across multiple databases and sources. Studies assessing sustainably sourced protein consumption in community dwelling older adults (≥65 years) were included. Risk of bias (RoB) was assessed using 'RoB 2.0′ and 'ROBINS-E'. Narrative synthesis was performed due to heterogeneity of studies. Twelve studies involving 12,166 older adults were included. Nine studies (n = 10,391) assessed habitual dietary intake and had some RoB concerns, whilst three studies (n = 1812), two with low and one with high RoB, conducted plant-based dietary interventions. Increased adherence to sustainably sourced diets was associated with improved gut microbial factors (n = 4640), healthier food group intake (n = 2142), and increased fibre and vegetable protein intake (n = 1078). Sustainably sourced diets positively impacted on gut microbiota and healthier intake of food groups, although effects on inflammatory outcomes and health status were inconclusive. Future research should focus on dietary interventions combining sustainable proteins and fibre to evaluate gut barrier function and consider inflammatory and body composition outcomes in older adults. [ABSTRACT FROM AUTHOR]

Background A number of biomarkers denoting various pathophysiological pathways have been implicated in the aetiology and risk of age-related diseases. Hence, the combined impact of multiple biomarkers in relation to ageing free of major chronic diseases, such as cancer, cardiovascular disease and type 2 diabetes, has not been sufficiently explored. Methods We measured concentrations of 13 biomarkers in a random subcohort of 2,500 participants in the European Prospective Investigation into Cancer and Nutrition Potsdam study. Chronic disease-free ageing was defined as reaching the age of 70 years within study follow-up without major chronic diseases, including cardiovascular disease, type 2 diabetes or cancer. Using a novel machine-learning technique, we aimed to identify biomarker clusters and explore their association with chronic disease-free ageing in multivariable-adjusted logistic regression analysis taking socio-demographic, lifestyle and anthropometric factors into account. Results Of the participants who reached the age of 70 years, 321 met our criteria for chronic-disease free ageing. Machine learning analysis identified three distinct biomarker clusters, among which a signature characterised by high concentrations of high-density lipoprotein cholesterol, adiponectin and insulin-like growth factor-binding protein 2 and low concentrations of triglycerides was associated with highest odds for ageing free of major chronic diseases. After multivariable adjustment, the association was attenuated by socio-demographic, lifestyle and adiposity indicators, pointing to the relative importance of these factors as determinants of healthy ageing. Conclusion These data underline the importance of exploring combinations of biomarkers rather than single molecules in understanding complex biological pathways underpinning healthy ageing. [ABSTRACT FROM AUTHOR]

Background The EAT-Lancet commission has proposed a dietary pattern that is both sustainable and healthy. However, the impact of this diet on cognition in older adults remains unexplored. Therefore, we examined the association between adherence to the EAT-Lancet diet and cognitive ageing. Methods We used data from a previous intervention study involving cognitively healthy community-dwelling adults aged ≥65 years. Adherence to the EAT-Lancet diet was calculated using a recently published index and a 190-item food frequency questionnaire. Global and domain-specific cognitive functioning were assessed at baseline and after 2 years using a neuropsychological test battery. Multivariate-adjusted linear regression was conducted to examine associations between EAT-Lancet diet adherence and cognitive functioning (n  = 630) and 2-year change (n  = 302). Results Greater adherence to the EAT-Lancet diet was associated with better global cognitive functioning (β per SD = 3.7 points [95% CI]: 0.04 [0.00, 0.08]) and slower rate of decline (β per SD [95% CI]: 0.05 [0.02, 0.08]). With respect to domain-specific functioning, beneficial associations were observed cross-sectionally for executive functioning (P  < 0.01), and longitudinally for change in executive functioning (P  < 0.01) and attention and working memory (P  < 0.01). The degree of adherence to the EAT-Lancet was not associated with (changes in) information processing speed or episodic memory. Conclusion We demonstrated that greater adherence to the EAT-Lancet diet is associated with better global cognitive functioning and slower cognitive decline among cognitively healthy older adults. Further research is needed to confirm these findings and assess the potential benefits of the EAT-Lancet diet for the ageing population in a broader context. [ABSTRACT FROM AUTHOR]

With the rise in global life expectancy, ensuring healthier aging experiences for the older population becomes paramount. This scoping review delves into the technologies employed in the remote health monitoring of the elderly over the past 15 years. Exploring the concept of ”Healthy Ageing” as proposed by the World Health Organization, this paper attempts to highlight the techniques and technologies used in health monitoring of the elderly population. The integration of wearable sensors in health monitoring presents promising avenues for enhancing healthcare delivery to older adults. However, challenges such as limited digital literacy and privacy concerns persist, necessitating innovative solutions for unobtrusive monitoring. This paper discusses the potential of passive and ambient sensors to address these challenges, offering insights into enhancing the well-being of the older population while preserving their independence and privacy. [ABSTRACT FROM AUTHOR]

Introduction: Rehabilitation is essential to foster healthy ageing. Older adults have unique rehabilitation needs due to a higher prevalence of noncommunicable diseases, higher susceptibility to infectious diseases, injuries, and mental health conditions. However, there is limited understanding of how rehabilitation is delivered to older adults. To address this gap, we conducted a scoping review to describe rehabilitation delivery models used to optimise older adults' functioning/functional ability and foster healthy ageing. Methods: We searched Medline and Embase (January 2015 to May 2022) for primary studies published in English describing approaches to provide rehabilitation to older adults. Three authors screened records for eligibility and extracted data independently and in duplicate. Data synthesis included descriptive quantitative analysis of study and rehabilitation provision characteristics, and qualitative analysis to identify rehabilitation delivery models. Results: Out of 6,933 identified records, 585 articles were assessed for eligibility, and 283 studies with 69,257 participants were included. We identified six rehabilitation delivery models: outpatient (24%), telerehabilitation (22%), home (18.5%), community (16.3%), inpatient (14.6%), and eldercare (4.7%). These models often involved multidisciplinary teams (31.5%) and follow integrated care principles (30.4%). Most studies used a disease-centred approach (59.0%), while studies addressing multimorbidity (6.0%) and prevalent health problems of older adults, such as pain, low hearing, and vision, or incontinence were scarce. The most frequently provided interventions were therapeutic exercises (54.1%), self-management education (40.1%), and assessment of personcentred goals (40%). Other interventions, such as assistive technology (8.1%) and environmental adaptations (7.4%) were infrequent. Conclusions: Focusing on primary studies, this scoping review provides an overview of rehabilitation delivery models that are used to foster healthy ageing and highlights research gaps that require further attention, including a lack of systematic assessment of functioning/functional ability, a predominance of disease-centred rehabilitation, and a scarcity of programmes addressing prevalent issues like pain, hearing/vision loss, fall prevention, incontinence, and sexual dysfunctions. Our research can facilitate evidence-based decision-making and inspire further research and innovation in rehabilitation and healthy ageing. Limitations of our study include reliance on published research to infer practice and not assessing model effectiveness. Future research in the field is needed to expand and validate our findings. [ABSTRACT FROM AUTHOR]

Objective: Not only care professionals are responsible for the quality of care but other stakeholders including regulators also play a role. Over the last decades, countries have increasingly invested in regulation of Long-Term Care (LTC) for older persons, raising the question of how regulation should be put into practice to guarantee or improve the quality of care. This scoping review aims to summarize the evidence on regulatory practices in LTC for older persons. It identifies empirical studies, documents the aims and findings, and describes research gaps to foster this field. Design: A literature search (in PubMed, Embase, Cinahl, APA PsycInfo and Scopus) was performed from inception up to December 12th, 2022. Thirty-one studies were included. Results: All included studies were from high-income countries, in particular Australia, the US and Northwestern Europe, and almost all focused on care provided in LTC facilities. The studies focused on different aspects of regulatory practice, including care users' experiences in collecting intelligence, impact of standards, regulatory systems and strategies, inspection activities and policies, perception and style of inspectors, perception and attitudes of inspectees and validity and reliability of inspection outcomes. Conclusion: With increasingly fragmented and networked care providers, and an increasing call for person-centred care, more flexible forms of regulatory practice in LTC are needed, organized closer to daily practice, bottom-up. We hope that this scoping review will raise awareness of the importance of regulatory practice and foster research in this field, to improve the quality of LTC for older persons, and optimize their functional ability and well-being. [ABSTRACT FROM AUTHOR]

Background: Sexual health is an important contributor to the well-being and life satisfaction of people aged ≥85 years, known as the oldest old. However, little is known about sexual health in this population. Aim: To examine aspects of sexual health among the oldest old and explore its associations with sociodemographic, health-related, and lifestyle factors. Methods: We conducted a population-based cross-sectional study including 183 individuals aged ≥85 years who were residents in Stockholm County, Sweden. Responders (response rate, 63%) were interviewed on a range of health, sociodemographic, and lifestyle parameters, including aspects of sexual health. Participants' responses to the sexual health items were reported as proportions with 95% CIs. Associations were examined with multivariable logistic regression. Outcomes: We examined sexual activity, sexual satisfaction, problems related to sexual health, and inquiries on sexual health by a health care provider. Results: Twelve percent of participants (95% CI, 8%-17.6%) were sexually active, and 63.9% (95% CI, 56.5%-70.9%) were satisfied with their sexual lives during the past year. A third (35%; 95% CI, 28.4%-42.2%) reported at least a problem related to sexual health. Only 2.2% (95% CI, 0.6%-5.5%) were asked about sexual health by a health care provider, while 8.2% (95% CI, 4.7%-13.2%) identified a need for such an assessment. Yet, 85.2% (95% CI, 79.3%-90.0%) indicated no need for their sexual health to be evaluated by a health care provider. Being partnered was positively associated with sexual activity (adjusted odds ratio, 9.13; 95% CI, 2.53-32.90), whereas having strong social support was positively associated with being satisfied with one's sexual life (adjusted odds ratio, 2.96; 95% CI, 1.53-5.74). Clinical Implications: Health care providers should be proactive in assessing the sexual health of the oldest individuals. Strengths and Limitations: A representative sample of an underresearched population was used in this study. However, the generalizability of our findings may be restricted due to the small sample. To maintain statistical power from a relatively small sample, we might have lost explanatory power. Given the observational cross-sectional nature of the data, we cannot draw causal inferences based on the observed associations. Conclusions: A 10th of participants were sexually active, and the majority were satisfied with their sexual lives. Although many participants reported problems related to sexual health, few expressed the need to discuss sexual health with health care providers. Future studies should explore potential barriers to addressing sexual health and unmet health care needs among the oldest old. [ABSTRACT FROM AUTHOR]

The 9-Layered Model of Giftedness is an innovative conceptual framework composed of an integrated set of abilities, skills and values that align with Goals 3, 4 and 8 of the UN Sustainable Development Goals for 2030: Good Health and Well-Being, Quality Education, and Decent Work and Economic Growth, respectively. The corresponding hierarchical model considers metacognitive abilities, such as attentional control and self-regulation, as well as personal values and attitudes towards life, such as sustainability and inclusiveness, as major qualitative criteria encapsulated in the construct of giftedness, thereby reframing intelligence per se into collective intelligence. Moreover, a chatbot was developed, incorporating knowledge and computerised tools organised into modules that support lifelong learning—a key metacognitive competency for the Industry 4.0 era—thereby enhancing personal and professional development. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the importance of exercise in older people in preventing falls • To enhance your confidence in promoting exercise programmes suitable for older people • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Older people who sustain a fall may experience a range of adverse outcomes, such as distress, injury and loss of independence. Falls increase the risk of frailty and frailty increases the risk of falls. Regular exercise is a pillar of falls prevention and can have extensive benefits for older people’s health, well-being and ability to undertake activities they enjoy. As part of the multidisciplinary team, nurses have a pivotal role in implementing exercise-based falls prevention strategies for older people and in encouraging their patients to exercise. This article discusses exercise as a falls prevention strategy in hospital and in the community and supports nurses to develop their knowledge and confidence in promoting exercise in older people. [ABSTRACT FROM AUTHOR]