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Objectives: It is well known that there are associations between overall health, age, socioeconomic status and rural residency. The objective of this study was to determine the distribution of Australia's aged population by socioeconomic status, as well as remoteness., Methods: The study employed the Australian Statistical Geography Standard (Statistical Area Level 1 and Remoteness Areas). The database of the geographic boundaries was integrated into the ageing population and socioeconomic data using the Geographic Information System. The socioeconomic data was analysed through the Index of Relative Socioeconomic Disadvantage., Results: Over a decade, the older population in Australia has increased noticeably. In 2016, there was a high percentage of older people (≥65 years) in Tasmania (Tas), 19%, while the lowest percentage was recorded in the Northern Territory (NT), 7%. Across the country, Tasmania had the highest percentage of older citizens living in the most disadvantaged areas since 2006, with 48% recorded in 2016. There was an association between the remoteness areas and the education and income levels of the ageing cohort. However, this association differed between the states and territories. This socioeconomic gap becomes more evident in the very remote areas of the country., Conclusions: The ageing population in Australia is increasing rapidly; this was associated with an evolving socioeconomic disparity among this ageing society. Our results demonstrated that socioeconomic inequalities were to be found among the older people based on their distribution over the remoteness areas in Australia. This information should be used to target healthcare and ageing policies that meet the specific needs of older people., (© 2022 AJA Inc’.)

Objective: To identify and describe articles reporting the experiences and perceptions of ageing among older First Nations Australians., Methods: Following rapid review and PRISMA guidelines, we searched five databases for peer-reviewed articles published prior to October 2019 that reported qualitative accounts of ageing among older (≥ 45 years) First Nations Australians. Data were extracted and synthesised thematically., Results: Twenty-one articles were included in the final synthesis. Priorities in ageing highlighted the role of Elders, family, community, culture and connection to ancestral lands. Experiences and perceptions of ageing reflected cultural marginalisation in aged and health care services, and highlighted the importance of cultural identity, resilience and survival as key to ageing well., Conclusions: Our review suggests that mainstream ageing frameworks do not fully reflect the priorities of older First Nations Australians. This has important implications for ageing policy and the design and delivery of culturally safe aged and health care services., (© 2021 AJA Inc.)

Objectives: To assess levels of numerical, structural, timing and spatial aspects of ageing of the Aboriginal and Torres Strait Islander population., Methods: Population projections for 15 Australian regions were created by a multi-state cohort-component model., Results: The older (45-plus) population grew from 29,815 in 1986 to 167,259 in 2016. In the subsequent 30 years, we project growth to 448,785 people. Growth rates of the older population vary: from 200% in the 60-64-year-old group to 800% growth in the 85-plus age group by mid-century. This strong numerical ageing is reflected in a shift in structural ageing by about six percentage points. Selected areas outside of capital cities are structurally older than many cities. Numerical ageing is strongest in capital cities and New South Wales. Cohort flow is the primary driver of ageing., Conclusions: Numerical and structural ageing is projected to increase significantly to mid-century with important spatial variations. Population ageing is largely irreversible. Implications for public health: High numerical growth in the older Aboriginal and Torres Strait Islander population poses implications for increased demand for a range of health and care services. Variations in spatial and timing aspects of ageing indicate demand will peak earlier in some geographical locations relative to others., (© 2020 The Authors.)

Objective: Lifetime Health Cover (LHC) was introduced in mid-2000 to increase participation in private health insurance that includes hospital cover (PHI-HC) and improve the risk profile of PHI-HC participants. It initially achieved both objectives, but since 2001 the PHI-HC population has aged faster than the general population. The aim of this study was to determine if the excess ageing of the PHI-HC risk pool has been due to passive age-based adverse selection, an inherent risk of LHC. This study has potential implications for the retention of LHC. Methods: A descriptive population-level analysis of publicly available administrative datasets was performed. Data relating to PHI-HC were obtained from the Australian Prudential Regulatory Authority. National population data were obtained from the Australian Bureau of Statistics. Trends in demography, PHI-HC participation rates and LHC loading payments were analysed. Results: By 2021, age-based adverse selection had returned to the pre-LHC level. Based on the available data, this was due to passive age-based adverse selection not active age-based adverse selection. Specifically, it reflected the combination of an avoidable unintended consequence of the introduction of LHC (the over-representation, in 2001, of individuals aged 45–59) and one of LHC's intended effects (incentivisation of insured individuals to retain PHI-HC). Conclusions: This study supports the retention of LHC. Nonetheless, it highlights the risk of passive age-based adverse selection created by incentivising insured individuals to retain PHI-HC in the presence of distortions in the age distribution of the PHI-HC risk pool. Early targeted interventions are required when such distortions arise. What is known about the topic? Since the introduction of Lifetime Health Cover (LHC) in mid-2000, the participation rate for private health insurance that includes hospital cover (PHI-HC) has remained relatively stable, but the PHI-HC population has aged faster than the general population. What does this paper add? This paper makes a novel distinction between 'active' and 'passive' age-based adverse selection to explain LHC's role in the excess ageing of the PHI-HC risk pool. What are the implications for practitioners? Governments need to be vigilant for the emergence of distortions in the age distribution of the PHI-HC risk pool and respond with targeted interventions to normalise the age distribution, or risk problematic passive age-based adverse selection. [ABSTRACT FROM AUTHOR]

The article focuses on the Australian Association of Gerontology position paper summary of lesbian, gay, transgender and intersex (LGBTI) ageing research in Australia. Topics inlcude the LGBTI ageing research that has been published in Australia and overseas and other relevant literature reviews, the survey of LGBTI ageing researchers in Australia and identified some priority future research areas, and the LGBTI ageing policy context in Australia found there have been significant developments.

Objective: Ageing is a time of change that might involve financial, health and social losses. To maintain well-being, older people need to engage a range of resources to cope with these losses. However, national policies mainly focus on financial resources. This study used Folkman and Lazarus's transactional theory to identify coping methods engaged by older adults living in three rural communities., Design: A qualitative research design was undertaken using an ethnographic case study approach., Setting: Three rural communities within northern Australia., Participants: Older Australians aged 65 or over, living in their own homes., Main Outcome Measures: Exploration of techniques that older adults use to cope with ageing (including both problem-focused and emotion-focused strategies)., Results: People in rural areas planned their ageing journey using both problem-focused and emotion-focused coping strategies, to deal with the uncertainties of ageing. When participants could control the event, problem-focused coping strategies were mainly such as used seeking social support and planful problem-solving. Conversely, emotion-focused strategies were used to deal with uncertainty and emotive issues such as health decline, and the possibility of needing future care., Conclusion: There is a need for health community workers to encourage older people to consider initiating a discussion of future care needs with their social network. This is of particular importance in rural areas, which have larger numbers of older residents and limited resources to support ageing in place., (© 2020 National Rural Health Alliance Ltd.)

The article discusses the highlights of the poster presentations at the 2018 Annual Scientific Meeting Organising Committee held in Sydney, New South Wales in Australia. Topics covered include fractured neck of femur pathway, co-development of a model of care for a multidisciplinary memory clinic in South Western Sydney, and evaluation of patient and carer perceptions towards enteral tube feeding in hip fracture inpatients.

Objectives: This paper describes the rationale for and development of an innovative mental health service for people aged over 65 years living in Northern and Eastern Melbourne, Victoria, Australia. Conclusion: The Healthy Ageing Service (HAS) was established in July 2020 to provide care for people aged over 65 years experiencing mild-to-moderate mental health concerns. It embraces a prevention and early intervention model of care. It provides primary consultation and brief intervention, secondary consultation, and capacity building to the primary healthcare sector. This innovative service is a Commonwealth-funded partnership between two tertiary mental health service providers that incorporates the recommendations from two major Royal Commissions. It demonstrates a service that acts as a bridge between primary and specialist mental health care, thereby extending mental health services to target the 'missing middle' and is potentially a model for mental health service provision throughout Victoria and Australia. [ABSTRACT FROM AUTHOR]

Isolated rapid eye movement (REM) sleep behaviour disorder (iRBD) is a sleep disorder that is characterised by dream enactment episodes during REM sleep. It is the strongest known predictor of α-synuclein-related neurodegenerative disease (αNDD), such that >80% of people with iRBD will eventually develop Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy in later life. More research is needed to understand the trajectory of phenoconversion to each αNDD. Only five 'gold standard' prevalence studies of iRBD in older adults have been undertaken previously, with estimates ranging from 0.74% to 2.01%. The diagnostic recommendations for video-polysomnography (vPSG) to confirm iRBD makes prevalence studies challenging, as vPSG is often unavailable to large cohorts. In Australia, there have been no iRBD prevalence studies, and little is known about the cognitive and motor profiles of Australian people with iRBD. The Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) Sleep Study will investigate the prevalence of iRBD in Tasmania, an island state of Australia, using validated questionnaires and home-based vPSG. It will also explore several cognitive, motor, olfactory, autonomic, visual, tactile, and sleep profiles in people with iRBD to better understand which characteristics influence the progression of iRBD to αNDD. This paper details the ISLAND Sleep Study protocol and presents preliminary baseline results., (© 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)

The paper used to insulate the windings of power transformers is mostly made from wood pulp, a cellulosic material. Over decades the paper is slowly attacked by water, oxygen, oil acids, and high temperatures and eventually degrades to the point where it is no longer an effective insulator. The transformer is then likely to fail. Power utilities need to know when a transformer is nearing the end of its useful life in order to plan its replacement. However, a problem with monitoring the condition of the paper within a transformer is that it may be difficult to obtain a sample to test. Furthermore, a particular sample may not accurately reflect the overall paper condition. A power transformer operating in Australia failed in 2010. Thus we had the opportunity to study the paper condition at various points within the transformer and evaluate the validity of the current understanding of paper aging. In this article we discuss the mechanisms of cellulose degradation, and the associated equations, and apply them to the paper insulation in the failed transformer. [ABSTRACT FROM PUBLISHER]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

In Australia, similarly to other countries, the grid was designed and constructed to transport energy from large fossil-fuelled generators to load centers. There has been a very rapid uptake of large renewable generation and their lifecycle costs are continuing to fall. These solar farms are generally located in sparsely populated areas where large packets of land are available. However, the grid infrastructure in these areas has limitations as it was not designed to support large power flows. [ABSTRACT FROM AUTHOR]

Healthy ageing refers to the development and maintenance of the functional ability of ageing individuals. Aged care nurses provide nursing care to elderly individuals and usually work in aged care residential facilities, nursing homes, home care services, and/or hospital departments. The registered nurse working in the aged care sector has several important roles. Key roles cover both therapeutic and preventative paradigms, as discussed in this paper. The aged care nurse is also "tasked with" holistic patient-centred care and the promotion of healthy ageing via advocacy and sociocultural roles. This paper examined, described, and analysed the multifaceted role of an aged care nurse from an Australian perspective. We conducted meticulous searches using PubMed, Google Scholar, government guidelines, authoritative body regulations, quality control guidelines, and government portals pertaining to aged care nursing in Australia. This paper relied upon the information garnered from publications, reports, and guidelines resulting from these searches and analyses. Multiple aspects of healthy ageing and holistic aged care nursing are discussed. The key roles of the aged care nurse are enumerated next, in accordance with the code of conduct from the Nursing and Midwifery Board of Australia (NMBA). The NMBA promotes evidence-based, culturally sensitive, consultative, holistic aged care clinical practice that includes input from care recipients, their decision makers, and/or their health care providers. The difficult issue of loneliness is discussed with strategies to ameliorate aspects of this. Good social networks, community interactions, meaningful friendships, and participation in personalised spiritual/religious practices improve the quality of aged care. The key topic of elder abuse and its forms are discussed apropos of aged care nursing. Healthy ageing is promoted by identifying and reporting elder abuse at the earliest. Current Australian law and recent federal legislation changes pertaining to aged care nursing are discussed next. As a result of these legislation changes, several new quality control imperatives (for aged care organisations/facilities) under the Aged Care Quality and Safety Commission (ACQSC) have been implemented. Residential and flexible aged care providers should now have robust ongoing documentation and a well-developed behaviour support plan (BSP) for each care recipient who currently requires or may require restrictive practices, which must be reported under the new serious incident reporting scheme (SIRS). Various strategies to promote healthy ageing and approaches to communicate effectively with aged care recipients are also discussed. Healthy ageing is promoted when age care recipients are empowered with making their own autonomous choices in "major and minor" aspects of life. Finally, approaches to optimise quality aged care nursing care are discussed. The Roper–Logan–Tierney model is one of the models used to assess and optimise nursing care. This is premised on the capability of an ageing individual to accomplish 12 basic activities of daily living. [ABSTRACT FROM AUTHOR]

BACKGROUND: Design for All or Universal Design is a relatively new domain in Ergonomics. With globally ageing populations, it has however recently gained significant interest. OBJECTIVE: This position paper summarizes the outcomes of a workshop held at the virtual 21st Triennial Congress of the International Ergonomics Association. The paper expands the horizon of traditional Ergonomics into a domain where people are differently abled and establishes a platform for the essential needs of future ergonomic standards which are required to inform inclusive design guidelines, or Design for All, extending the range of users. METHODS: The paper includes contributions from Asian, Australian, European and US workshop participants who are accessibility design experts in their respective geographic regions. The paper summarizes issues related to anthropometry in the Design for All, based on recent work in the US (Access board) and actual developments in various national and international accessibility standardization bodies, such as the Standards Australia/Standards New Zealand, the European Standardization Organization (EN 17210:2021; EN 17161:2019) and the International Organization for Standardization (ISO 21542:2021 and BS ISO 7176-5:2008). CONCLUSIONS: The paper concludes that despite the identification of a significant gap in knowledge of the anthropometry of people with disabilities as far back as 1990, work towards bridging the gap and enabling ergonomic standardization has not progressed since then globally. The lack of standardization in anthropometric data on people with a physical disability continues to complicate provision of data for mobility and accessibility design and hampers accessibility standardization efforts. [ABSTRACT FROM AUTHOR]

Introduction: Managers from road freight transportation organizations were interviewed on barriers and facilitators to implementation of occupational health, safety, and well-being interventions for aging heavy vehicle drivers. As aging drivers are more likely to be seriously injured or die in a work-related incident than younger drivers, it is important to recognize strengths and weaknesses throughout the system to identify intervention that addresses their specific needs., Method: A Systems Theoretic Accident Model and Processes (STAMP) control structure was constructed to chart the controllers, controls, and feedback channels in the system to identify gaps in health, safety, and well-being intervention in the system. The STAMP control structure also charted the barriers and facilitators within levels across the system. Eleven managers were recruited into the study representing a range of road freight transportation organizations throughout Australia., Results: Interview data revealed that barriers and facilitators existed at most levels of the system. Facilitators included advice from external agencies, support from upper management, modern technology, and regular social communication with drivers. Barriers were a lack of guidance on aging issues, operational conflicts with health and safety objectives, and the drivers' fear of disclosing health information associated with their driving role. In regards to formalized intervention in place to support aging heavy vehicle drivers, the system is reliant on fitness to drive medical assessments based on age and jurisdiction., Conclusions: As there was generally a lack of senior direction cited from the upper levels of the system on aging issues, there was much variation across the study on how aging risks are managed in the workplace for heavy vehicle drivers., Practical Applications: This study recommends that managers across the road freight transportation industry receive formalized aging-awareness health and safety training in how to manage work-related driving hazards for aging heavy vehicle drivers., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The global population is ageing rapidly and there is a need for strategies to promote health and wellbeing among older adults. Nutrition knowledge is a key predictor of dietary intake; therefore, effective educational programmes are urgently required to rectify poor dietary patterns. Digital health technologies provide a viable option for delivering nutrition education that is cost‐effective and widely accessible. However, few technologies have been developed to meet the unique needs and preferences of older adults. Objective: The aim of this study was to explore technology use among older adults and qualitatively determine the content needs and design preferences for an online nutrition education resource tailored to older adult consumers in Australia. Methods: Twenty adult participants aged 55 years and older (95% female) participated in one of four 2‐h participatory design workshops. In each workshop, prompted discussion questions were used to explore participants' technology use and preferences and to explore content needs and design preferences for an online nutrition education resource specific to older adults. Results: All participants were regularly using a range of different devices (e.g., smartphones, tablets and computers) and reported being comfortable doing so. Participants wanted a website that provided general nutrition information, practical advice and recipes. To enhance engagement, they sought a personalised resource that could be adjusted to suit their needs, included up‐to‐date information and allowed for easy sharing with others by exporting information as a PDF. Conclusions: Participatory design methods generate new knowledge for designing and tailoring digital health technologies to be appropriate and useful for the target audience. Specifically, older adults seek an online resource that has large and simple fonts with clear categories, providing them with practical advice and general nutrition information that can be personalised to suit their own needs and health concerns, with the option to export and print information into a paper‐based format. Patient or Public Contribution: Older adults actively participated in the development and evaluation process to generate ideas about potential features, functionalities, uses and practicalities of an online nutrition education resource. [ABSTRACT FROM AUTHOR]

Introduction: Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well‐being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well‐being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. Methods: Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus‐based summaries, arriving at a preferred service model. Findings: This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well‐being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. Public Contribution: This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions. [ABSTRACT FROM AUTHOR]

Summary Little is known about the quantity, nature and range of Australian social work research on ageing and aged care. This scoping review involved a comprehensive search of seven online bibliographic databases. The review identified 108 peer-reviewed journal articles, published between January 2007 and June 2014, that reported Australian social work research on ageing and aged care. Findings The average number of authors per paper was 2.10 with most social work researchers co-authoring papers with non-social workers. The main topics of research focus were health and rehabilitation, elder abuse, asset management, community services and caregiving, housing and residential aged care, and ageing with an intellectual disability. The findings highlight the contribution social work researchers make to multidisciplinary gerontological research, and to understanding the lived experiences of older people and the provision of services. However, they also point to the relative paucity of research focusing on direct social work practice with older people, and the little evidence of the participation of older people and carers in the design and delivery of research. Applications The findings indicate the need for capacity-building strategies, such as developing networks of Australian social work researchers on ageing and aged care, to improve research outputs in this area. [ABSTRACT FROM AUTHOR]

Objective: With little research investigating older Australians' experience of companion animal (pet) ownership or wildlife encounters, this paper focuses on the value of animals in their lives. Methods: Three online focus groups explored 103 older adults' lived experience of home and community, with this paper focused on interactions with animals—companion animals and wildlife. Results: Most (60%) had at least one pet, which brought love and joy into their lives. Reflexive thematic analysis identified three themes: pets as family; challenges of pet ownership; and connection to everyday wildlife and nature. Conclusions: In addition to valuing companion animals (typically cats and dogs), this research is among the first to show that some older people also develop ongoing relationships with local Australian wildlife, such as kookaburras, kangaroos, lizards and birds, which raises the possibility that fostering connections with wildlife may enhance well‐being. [ABSTRACT FROM AUTHOR]

There is little research comparatively assessing prevalence of pain between older people either with or without intellectual disability. This paper explores health and social factors associated with chronic pain in these two groups. A cross-sectional survey was undertaken in New South Wales and Queensland, Australia. Inclusion criteria were adults either with or without intellectual disability, aged 60 years and older, and currently living in community-settings. Univariate and multivariable analyses were undertaken on a sample of 391 adults with intellectual disability and 920 adults without intellectual disability. Key findings included higher prevalence of pain in the intellectual disability group, along with higher rates of osteoarthritis, falls, oral health problems, and mood disorders. Mitigating risk factors for conditions that cause chronic pain in older adults is crucial. As longevity increases, the healthcare sector needs to prioritise chronic pain management for people with intellectual disabilities through appropriate treatment strategies. [ABSTRACT FROM AUTHOR]

Objective The need for residential care services will grow significantly over the coming years as the general population in Australia continues to age. The aim of this study was to assess the adequacy of residential care services across New South Wales (NSW), Australia, in relation to the current and predicted future aging population. Method This study was a secondary data analysis. Existing datasets were compiled for analysis by creation of a temporal geodatabase, with predicted population data from 2019 to 2029 linked to corresponding geographic zones. Results Demand for operational places was over capacity in 2019, at 101.5%. From 2019 to 2029, this will grow to 120.2% of 2019 capacity by 2024 and to 135.6% by 2029. An additional 25 800 operational places will be required by 2029 to meet targets. During the previous decade of 2008-18, operational places grew by only 11 502 places. Conclusions NSW was not providing an adequate level of residential aged care and, under current allocations, this problem will worsen substantially over time, with flow-on impacts for the health sector. With aged care reform a current federal government focus, the results of this study may guide decisions that better support the provision of residential aged care. What is known about this topic? The recently completed Australian Royal Commission into aged care noted widespread system failure and highlighted the gaps in medical services that older Australians were experiencing. What does this paper add? This paper reports that demand for residential aged care places in NSW was already over capacity in 2019 and that the availability of places varies considerably across the state. Further, an additional 25 800 operational places are required by 2029 to meet government targets. If the growth rate from the past decade is maintained, this will result in a shortfall of 14 298 aged care places in NSW alone. What are the implications? Without significant increases in the current rate of growth for aged care places, the mainstream medical and health sectors will face significant additional pressures arising from unmet need in both older patients and their informal carers.

Introduction: Occupational therapists recommending home modifications in Australia are often required by funding bodies to consider 'value' and 'value for money' (VFM); however, clear guidance on how to define and apply these concepts is not always provided. This paper reports on a qualitative study examining how the concepts of value and VFM are currently understood and operationalised by occupational therapists in Australian home modification practice, with the aim of positively contributing to both policy and practice in this area. Methods: The study utilised constructivist grounded theory to collect and analyse qualitative data from 20 occupational therapists who were currently working across Australia and had professional experience in home modifications. Findings: The grounded theory that was derived from the analysis highlights the unique position that occupational therapists occupy in home modification work as they strive to align the values of different stakeholders to create solutions that all consider to be valuable. In the absence of consistent frameworks or methods for determining value and VFM, evidence also emerged of occupational therapists using a range of individual approaches such as using formal and informal care as metrics, cheapest option approaches, and comparative costing. Conclusion: In addition to a clear need for consistent and transparent approaches to understanding and operationalising VFM in home modifications, there is also a need for further investigation into the value systems that underpin this work. A conceptualisation of occupational therapists as street‐level policy agents has proven useful here as it highlights the position occupational therapists occupy, enacting, making, and, at times, challenging policy in day‐to‐day practice as they work to align the values of the various stakeholders. [ABSTRACT FROM AUTHOR]

Objective: To review and synthesise research related to the ageing farming workforce influence on the health and sustainability of agricultural communities. Design: Using the PRISMA framework as a guide, the CINHAL and Medline databases were searched. Search 1 used the key search terms of ageing OR aging, farm*, workforce. Search 2 used health, sustainability and 'agricultural OR farm communit*. Search 3 combined Searches 1 and 2. Search 4 followed journal citations to identify other relevant articles. A process of narrative synthesis was applied to the results through the prism of rural social capital that described the current state of knowledge and understanding under four themes. Result: Database searches and searching of citations identified 16 contemporary articles. Seven of the papers were from Australia, and the balance from five other high‐income countries. The four that themes emerged are: vulnerabilities of ageing farmers; economic and climatic drivers; social capital and sustainability; and integrative strategies, that might offer a way forward. Conclusion: Integrating these forces of nature, economics and sociology to address the ageing farming workforce and the associated health and sustainability of agricultural communities remains a major challenge for researchers, governments, the agricultural sector and rural communities. [ABSTRACT FROM AUTHOR]

By 2050, approximately one quarter of Australia's ageing population will comprise culturally and linguistically diverse individuals. While a number of valid neuropsychological measures are available for use with English-speaking individuals, existing measures may not be appropriate for use with older immigrant populations. The purpose of this review is to highlight existing challenges facing the Australian neuropsychological community in the context of assessing older immigrant populations and offer suggestions to improve clinical practice. By conducting a review of existing research related to assessment of culturally and linguistically diverse populations, this paper provides a) a critical overview relating to factors known to impact on the validity of assessment outcomes, b) examines published Australian studies relating to neuropsychological test adaptation and the development of normative data for use with older immigrant populations, and c) offers recommendations to guide assessment and clinical practice. The use of existing English language test and norms has the potential to underestimate cognitive function in older immigrant populations, leading to erroneous diagnostic outcomes. These issues are related to a) level and quality of education, b) inappropriate test content, c) nonrepresentative normative data, and d) a lack of familiarity with test taking procedures. Research addressing issues relating to cross-cultural assessment is gaining momentum within Australia, resulting in the development of demographically focused normative data and adapted tests to accommodate some cultural groups. Initial results have reported mixed success, indicating the need for further and carefully considered research. What is already known about this topic: The prevalence of age-related cognitive disorders in Australia is predicted to rise over the next 30 years. A large number of elderly Australians represent culturally diverse older immigrant populations. Neuropsychological tests and norms are influenced by age, education, language and culture. What this topic adds: An overview of research identifying limitations of neuropsychological assessment within culturally diverse older immigrant populations. An overview of neuropsychological measures and norms that have been developed for use with culturally diverse older immigrant populations in Australia. Recommendations and strategies to improve assessment of culturally diverse populations in Australia. [ABSTRACT FROM AUTHOR]

The life expectancy of persons with intellectual disability is increasing, and this is often occurring concurrently with the aging of their long‐term parental carers. Research in both Australia and around the world indicates that proactive post‐parental care planning is not widely implemented, and transitions primarily happen suddenly following a personal crisis for the primary caregiver. Little focus in Australia has been placed on identifying the barriers that inhibit post‐parental care planning in rural areas, specifically in the context of the newly implemented National Disability Insurance Scheme. This paper examines the factors that limit disability services and their staff in supporting successful post‐parental care planning for individuals with intellectual disability and their aging carers in rural South Australia. Small focus groups were conducted with three groups of rural disability support workers using online technologies to assist with the participants' geographic disparity. A semi‐structured interview guide was developed prior to commencement and was used to initiate discussions on key points. A thematic analysis methodological approach was used for data analysis. There were three themes identified through the analysis; Recruitment; Provision of Care; and Retention. The key findings relating to these themes are presented and supported with exemplar quotes. This research proposes three recommendations for policy or practice change: developing a national advertising campaign for new disability staff that positively emphasizes the high‐level skillset need for proactive planning; supporting rural disability providers to collaborate to establish shared teams of staff with expertise in post‐parental care planning; and, using incentive payments to retain staff with these invaluable skillsets in the disability sector. [ABSTRACT FROM AUTHOR]

In this paper, we introduce the idea of the bio-socio-material body to think through the body politics that emerge within the nexus of health, well-being and domestic energy consumption as people age. Our work draws upon an ethnographic study with older Australians in regional New South Wales, Australia. We enrich social practice theory conceptualisations by foregrounding the body as a dynamic bio-socio-material entity that shapes and is shaped by practices. In doing so, we draw attention to the body politics of managing health, well-being and energy consumption while trying to age successfully. We identify that the bio-socio-material dimensions of the body play an important role in how health, well-being and energy practices are performed. Energy practices are bound up in understandings of health and well-being as an ongoing and contingent process. Here, the use of energy and appliances becomes integral to how people negotiate and work towards successful ageing. We found that embodied practices of health, well-being and energy consumption are linked to biological, emotional, affective, social and material concerns that create body politics. These include tensions and challenges relating to health and vitality, caring for the sick and the dying, maintaining good mental health, the affordances of buildings and appliances, energy affordability and billing anxiety, social connectedness, and pleasures and pains. We raise questions emerging from our research on the implications for successful ageing. We call for attention to how health, well-being and energy are imbricated and for policy and programmes that better support older people to navigate the nexus of health, well-being and energy consumption as they age., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

A number of empirical studies document that people tend to become more risk averse as they get older. But other studies find only little evidence that age matters for financial risk attitudes. This prompts a call for revisiting the relationship between age and risk attitude to better support policy recommendations. The current paper contributes to this effort by utilising large‐scale population data to conduct a dynamic panel analysis. Care is taken to avoid the problem of endogeneity of lagged risk attitude in modelling its effects. Analysis reveals that individuals' past risk attitude has a positive effect on their current risk attitude. However, there is only little evidence that risk attitude and age are systematically related. Our results shed some light on the previous contradictory empirical findings in the literature and suggest that past risk attitude is potentially of greater relevance than chronological age in determining current risk attitude. [ABSTRACT FROM AUTHOR]

The pathway to aging well is not always clear for older migrants living in a foreign country, who must navigate a range of challenges resulting from differences between the cultural expectations of aging in their country of origin and the realities of aging in their country of residence. Transnational migration scholars indicate that digital media are important resources for maintaining relationships and support networks across 'here' and 'there'. They say relatively little, however, about the experiences of maintaining a sense of home, particularly for older migrants. In this paper, we draw on ethnographic interview data with older migrants from Sri Lanka and Burma (Myanmar), who live in Australia, to examine how their practices of 'digital homing' help them to manage the challenges of aging well in a foreign land. Three key findings are proposed. First, older migrants are active and skilled in using digital devices to create spaces of belonging and home. Second, older migrants' access to and uses of digital media are structured by gendered, ethnic and generational roles, expectations and obligations. Third, the practices of digital homing that enhance migrant experiences of aging well tend to simultaneously reinforce and reproduce gendered inequalities within families and communities. We conclude by arguing that it is the very capacity of digital homing practices to reproduce ethnic and generational selves in host societies that simultaneously contributes to the reproduction of unequal gendered obligations and expectations, including in later life. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to describe the prevalence of cognitive impairment in hospital inpatients, the associated need for assistance with activities of daily living (ADL) and carer perceptions of hospital care. Methods: A prospective cross-sectional observational study was conducted in a large metropolitan teaching hospital in Brisbane, Australia. Participants were inpatients aged ≥65 years and their carers. Cognitive impairment was measured by clinician auditors using the validated 4 'A's test (4AT), with a score >0 indicating cognitive impairment (1–3, probable dementia; >3, probable delirium). The need for supervision and/or assistance with ADL was recorded from daily nursing documentation. Carers were invited to complete a brief questionnaire. Results: In all, 92 of 216 older inpatients (43%) had cognitive impairment, including 52 (24%) with probable delirium. The need for supervision and/or assistance with ADL increased significantly with 4AT score. Fifty-two carers of patients with cognitive impairment reported feeling welcome and that care was safe. They identified opportunities for better information, greater support and more inclusion of carers. Conclusions: Cognitive impairment is common in older inpatients and is associated with increased care needs. Workforce planning and health professional training need to acknowledge the needs of patients with cognitive impairment. There are opportunities for greater support and more involvement of carers. What is known about the topic?: Cognitive impairment due to delirium and dementia increases with age, and is common in older medical and surgical inpatients. However, cognitive impairment remains under-recognised by healthcare staff. Australian guidelines now recommend routine screening using valid tools, and including carers, when appropriate, when assessing, caring for and communicating with people with cognitive impairment. What does this paper add?: This cross-sectional study using the validated 4AT showed 43% of hospital inpatients aged ≥65 years had cognitive impairment. Participants with cognitive impairment had higher care needs and much longer hospitalisations. Carers of people with cognitive impairment reported unmet information needs in hospital and had limited involvement in assessment and care. What are the implications for practitioners?: Cognitive impairment is common in older inpatients. Hospitals and healthcare professionals must be prepared and equipped to recognise cognitive impairment, and address the accompanying patient and carer needs. [ABSTRACT FROM AUTHOR]

This paper illustrates how systems theory can be used in social work research design to understand the systemic issues associated with spousal care in rural Australia. Spousal caregiving is embedded within multiple formal and informal systems, including family, community, health and aged care practice, social policy, and social and cultural norms. It is therefore a complex phenomenon to explore in social research, with each of these systems interacting with and influencing other aspects of the care system. The purpose of this paper is to provide an illustration of a research design that explores this systemic complexity. The design is conceptually underpinned by the transformative paradigm; a critical approach that reflects social work principles of social justice. The methodology is based on an ecosystems approach to assessment, using multiple methods to explore interactions between systems of care at policy, practice and individual levels. This application of systems theory to research presents an innovative opportunity for social work research to reflect long-established practices of understanding complex phenomenon within its sociocultural context. [ABSTRACT FROM AUTHOR]

Economic, health and social issues associated with the ageing population and the disconnect between the generations call for novel approaches to care services. Intergenerational programs are known to enhance engagement between generations, improve health and well-being and create a stronger sense of community. While the health and social benefits are well documented, little attention has been given to the operational aspects of intergenerational programs within care facilities. This paper describes the research protocol used to develop, implement and evaluate an intergenerational learning program for preschool-aged children and older people attending care services. The research focuses on five key areas: (a) impact on older people and children; (b) intergenerational learning; (c) workforce development; (d) socio-economic implications and costs; and (e) program fidelity and sustainability. Findings from this research are expected to contribute to building age-friendly communities through the development of practical operational guidelines for intergenerational learning programs to be implemented more broadly across Australia., (© 2020 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc.)

We propose a framework for discourse on digital solutions to support consumers and carers in delivery of health care and services for aged persons, based on a major needs analysis conducted across 56 diverse business entities in Australia. The resulting framework was based on two major identified domains: "Ageing in Place" for independent living situations, and "Ageing with Care" for managed aged care facilities. The paper describes the process used and the intermediate outcomes which enabled the framework to be synthesized. It is anticipated that the framework could be used to inform future scoping studies and to enable collaborative design, implementation and delivery of appropriate smart ageing digital solutions.

The fast population ageing has generated and will continue to generate large social, economic and health challenges in the 21th century in Australia, and many other developed and developing countries. Population ageing is projected to lead to workforce shortages, welfare dependency, fiscal unsustainability, and a higher burden of chronic diseases on health care system. Promoting health and sustainable work capacity among mature age and older workers hence becomes the most important and critical way to address all these challenges. This paper used the pooled data from the longitudinal Household, Incomes and Labour Dynamics in Australia (HILDA) survey 2002-2011 data to investigate common and different factors predicting voluntary or involuntary workforce transitions among workers aged 45 to 64. Long term health conditions and preference to work less hours increased while having a working partner and proportion of paid years decreased both voluntary and involuntary work force transitions. Besides these four common factors, the voluntary and involuntary workforce transitions had very different underlying mechanisms. Our findings suggest that government policies aimed at promoting workforce participation at later life should be directed specifically to life-long health promotion and continuous employment as well as different factors driving voluntary and involuntary workforce transitions, such as life-long training, healthy lifestyles, work flexibility, ageing friendly workplace, and job security.

Study Question: What is the likelihood of having a child within 4 years for men and women with strong short-term reproductive intentions, and how is it affected by age?, Summary Answer: For women, the likelihood of realising reproductive intentions decreased steeply from age 35: the effect of age was weak and not significant for men., What Is Known Already: Men and women are postponing childbearing until later ages. For women, this trend is associated with a higher risk that childbearing plans will not be realised due to increased levels of infertility and pregnancy complications., Study Design, Size, Duration: This study analyses two waves of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey. The analytical sample interviewed in 2011 included 447 men aged 18-45 and 528 women aged 18-41. These respondents expressed a strong intention to have a child in the next 3 years. We followed them up in 2015 to track whether their reproductive intention was achieved or revised., Participants/materials, Settings, Methods: Multinomial logistic regression is used to account for the three possible outcomes: (i) having a child, (ii) not having a child but still intending to have one in the future and (iii) not having a child and no longer intending to have one. We analyse how age, parity, partnership status, education, perceived ability to conceive, self-rated health, BMI and smoking status are related to realising or changing reproductive intentions., Main Results and the Role of Chance: Almost two-thirds of men and women realised their strong short-term fertility plans within 4 years. There was a steep age-related decline in realising reproductive intentions for women in their mid- and late-30s, whereas men maintained a relatively high probability of having the child they intended until age 45. Women aged 38-41 who planned to have a child were the most likely to change their plan within 4 years. The probability of realising reproductive intention was highest for married and highly educated men and women and for those with one child., Limitations, Reasons for Caution: Our study cannot separate biological, social and cultural reasons for not realising reproductive intentions. Men and women adjust their intentions in response to their actual circumstances, but also in line with their perceived ability to have a child or under the influence of broader social norms on reproductive age., Wider Implications of the Findings: Our results give a new perspective on the ability of men and women to realise their reproductive plans in the context of childbearing postponement. They confirm the inequality in the individual consequences of delayed reproduction between men and women. They inform medical practitioners and counsellors about the complex biological, social and normative barriers to reproduction among women at higher childbearing ages., Study Funding/competing Interest(s): This research was partly supported by a Research School of Social Sciences Visiting Fellowship at the Australian National University and an Australian Research Council Discovery Project (DP150104248). Éva Beaujouan's work was partly funded by the Austrian Science Fund (FWF) project 'Later Fertility in Europe' (Grant agreement no. P31171-G29). This paper uses unit record data from the HILDA Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the authors and should not be attributed to either DSS or the Melbourne Institute. The authors have no conflicts of interest., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Background/objectives: Sedentary behavior (SB), defined as sitting (nonexercising), reclining, and lying down (posture), or by low energy expenditure, is a public health risk independent to physical activity. The objective of this systematic literature review was to synthesize the available evidence on amount of SB reported by and measured in older adults. Data source: Studies published between 1981 and 2014 were identified from electronic databases and manual searching. Large-scale population studies/surveys reporting the amount of SB (objective/ subjective) in older adults aged ≥ 60 years of age were included. Appraisal and synthesis was completed using MOOSE guidelines. Results: 349,698 adults aged ≥ 60 within 22 studies (10 countries and 1 EU-wide) were included. Objective measurement of SB shows that older adults spend an average of 9.4 hr a day sedentary, equating to 65-80% of their waking day. Self-report of SB is lower, with average weighted self-reports being 5.3 hr daily. Within specific domains of SB, older adults report 3.3 hr in leisure sitting time and 3.3 hr watching TV. There is an association with more time spent in SB as age advances and a trend for older men to spend more time in SB than women. Conclusion/ implications: Time spent sedentary ranges from 5.3-9.4 hr per waking day in older adults. With recent studies suggesting a link between SB, health, and well-being, independent of physical activity, this is an area important for successful aging. Limitations: Different methodologies of measurement and different reporting methods of SB made synthesis difficult. Estimated SB time from self-report is half of that measured objectively; suggesting that most self-report surveys of SB will vastly underestimate the actual time spent in SB. [ABSTRACT FROM AUTHOR]

This paper examines the available literature on single older non-home owning women in Australia and their housing issues. Preliminary information suggests that this subset of the population is increasingly at risk of becoming homeless or inadequately housed in later life. In fact, there is a historical dearth of research on women’s housing in general. This invisibility and vulnerability is interrogated within this paper through a feminist standpoint lens. We argue that in order to better understand the situation for single older women who do not own their own homes, it is necessary to revisit the social landscape inhabited by these women in their early years. Firstly, however, the current landscape is explored. It appears that ageing and single status are compounding factors which place non-home owning women at higher risk of homelessness or inappropriate housing. The paper then attempts to assess how the social and economic conditions that were extant in the mid-twentieth century led to the present situation. Our analysis leads us to suggest that women’s traditional roles in society are largely responsible for housing insecurity in their later years. [ABSTRACT FROM AUTHOR]

Rising demand for social housing has induced housing authorities to find ways to increase the utilisation of existing housing stock, including targeting households thought to be living in homes that are larger than they need. This "under-occupation" of social housing is common among older tenants who, as with other under-occupiers, have been subject to unpopular measures designed to encourage downsizing. Yet little attention has been given to the housing needs of under-occupying older tenants and the ability of the social housing sector to meet those needs. In reviewing a new housing initiative for older under-occupying social housing tenants in Brisbane, Australia, this paper explores the housing needs and experience of this cohort. It shows that under-occupancy is a lived experience for some tenants and that downsizing to a smaller property is an attractive, albeit limited option. This suggests that policy prescriptions about the problem of older under-occupiers in the social housing sector should be reframed around the issue of tenants housing needs as they age. [ABSTRACT FROM AUTHOR]

Housing wealth dominates the asset portfolios of the older population in Australia and many other countries. Given the anticipated spike in fiscal costs associated with population ageing, there is growing policy interest in housing equity withdrawal (HEW) to finance living needs in retirement. This paper sheds light on homeowners’ perceptions of the obstacles associated with two forms of HEW: mortgage equity withdrawal (where the in situ home owner increases his/her housing-related debt) and downsizing (where housing equity is released by moving to a lower-valued property). We uncover a series of age-specific barriers impeding older Australians’ use of these forms of HEW through qualitative analysis of semi-structured interviews conducted with home owners and professional service providers in related areas of policy and practice. To that end, we recommend the development of a range of safeguards that will minimise the risk exposure and other obstacles associated with HEW for older home owners. [ABSTRACT FROM AUTHOR]

Ageing Australian farmers face many uncertainties associated with wider social, economic and climate change. Significantly for many farmers, ageing means the end not only of a life-long occupation but the end of the farm that has often been in the family for many generations. In turn, the prospect of this discontinuity breaches long-held cultural images of Australian farming and farmers. For individual male farmers approaching retirement age, the lack of succession and discontinuation of the family's ownership of, and attachment to the land, poses threats for social and personal identity. This paper examines the narratives of three male, baby-boom Australian farmers to tease out the impact of ageing and the possible loss of the family farm on the ways that they construct their situations and their self-identity. It illustrates the narrative practices that these men employ as they work to validate their self-identities within particular narrative environments, and through a range of outmoded and contemporary material conditions that mediate their selves and lives. The approach exemplified in this paper focuses on the processes and phases of analysis to show how the farmers craft their narrative as well as the individuality, complexity and coherence of their accounts. [ABSTRACT FROM PUBLISHER]

Background: Vitamin D supplement use is recommended best practice in residential aged care facilities (RACFs) for the prevention of falls, however has experienced delays in uptake. Following successful international efforts at implementing this evidence into practice, the ViDAus study sought to replicate this success for the Australian context. The aim of this paper is to report on the process outcomes of implementing this intervention., Methods: Forty-one RACFs were engaged in a multifaceted, interdisciplinary knowledge translation intervention. This focused on raising awareness to improve knowledge on vitamin D, and supporting facilities to identify barriers and implement locally devised strategies to improve the uptake of evidence based practice (EBP)., Results: Staff members of participating facilities (n = 509 including nursing, care and allied health staff) were well engaged and accepting of the intervention, though engagement of servicing general practitioners (GPs) (n = 497) and pharmacists (n = 9) was poor. Facilities each identified between three and eight strategies focused on raising awareness, identifying residents to target for vitamin D and creating referral pathways depending upon their own locally identified barriers and capacity. There was variable success at implementing these over the 12-month intervention period. Whilst this study successfully raised awareness among staff, residents and their family members, barriers were identified that hindered engagement of GPs., Conclusions: The intervention was overall feasible to implement and perceived as appropriate by GPs, pharmacists, facility staff, residents and family members. More facilitation, higher-level organisational support and strategies to improve RACF access to GPs however were identified as important improvements for the implementation of vitamin D supplement use., Trial Registration: Retrospectively registered (ANZCTR ID: ACTRN12616000782437 ) on 15 June 2016.

Objective: This paper reports on undergraduate health care students' perception of societal vulnerability to disasters in the context of population aging. Forecast increases in extreme weather events are likely to have a particularly devastating effect on older members of the community., Methods: Undergraduate paramedicine and nursing students were surveyed using the Perceptions of Ageing and Disaster Vulnerability Scale (PADVS) to determine their views on the risks posed to older members of the community by disasters. Data analysis included a comparison of subscales relating to isolation, health system readiness, declining function, and community inclusiveness., Results: Students reported a moderate level of concern about disaster vulnerability. Students who had previously completed another university degree reported significantly higher levels of concern than those without a prior degree. Australian students reported lower concern about societal vulnerability compared to a previously reported cohort of Japanese students., Conclusion: Our study suggests current education of future health care students does not promote adequate levels of awareness of the health-related challenges posed by disasters, particularly among older members of the community. Without addressing this gap in education, the risk of negative outcomes for both unprepared first responders and older members of the community is significant. (Disaster Med Public Health Prep. 2019;13:449-455).

Background: The Australian Research Council Longevity Intervention (ARCLI) was designed to investigate the effects of two active supplements, Pycnogenol and Bacopa monnieri (CDRI08) on cognitive performance in a cohort of elderly participants. An additional antioxidant supplement has been included into the trial. A neuroimaging component has also been added to the ARCLI study to investigate the neurochemical biomarkers of oxidative stress in vivo, as well as structural and functional changes associated with ageing and oxidative stress. Faecal biomarkers of gut microflora will also be analysed to investigate if gut microbiota are associated with domains of cognition (e.g., attention, processing speed, memory), mood or other ARCLI outcome variables. The aim of this paper is to update the published methods of the ARCLI clinical trial before it is completed, and data analysis commences., Methods: ARCLI is a randomised, placebo controlled, double-blind, now 4-arm clinical trial including neuroimaging and gut microflora sub-studies. Along with the demographic, haematological, mood, cardiovascular and cognitive assessments described in the initial protocol, 80 eligible participants from the overall study pool of ~ 400 will be recruited into the neuroimaging study and undergo scans at baseline, 3 months and 12 months. Proton magnetic resonance spectroscopy, resting state functional connectivity and arterial spin labelled perfusion sequences are neuroimaging techniques included for each MRI visit in the study. Similarly, approximately 300 participants from the main study pool will be recruited to provide faecal samples at baseline, 3 months and 12 months so that the gut microbiome can be studied., Discussion: ARCLI is 12-month intervention study, currently underway with a group of older adults, investigating a range of outcomes and their association with ageing. The additional measurements in the ARCLI trial will further the understanding of the underlying mechanisms associated with healthy ageing and may provide insights into novel preventative therapeutic strategies for maintaining cognitive and brain health into old age., Trial Registration: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000487970 .

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

Objective: This paper draws attention to the rapidly growing number of Australian nonagenarians, presents previously unpublished information on this sub‐group of older people and explores the implications for future patterns of service delivery, planning and policy. Methods: Statistical analyses of Census data and other Australian Bureau of Statistics Surveys using Table Builder Pro, combined with analysis of de‐identified Australian Institute of Health and Welfare (AIHW) unit record data on aged care and AIHW GRIM (mortality) data. Results: Male nonagenarians almost doubled from 2006 to 2016, while their female counterparts grew by 55%. This cohort is the first to reap cumulative advantage from the dramatic reduction in death rates from 1970. Their demographic circumstances reveal both changes and continuities compared to the previous cohort. Conclusion: Men and women aged 90 and over use a substantial proportion of aged care services, and their characteristics and circumstances are highly relevant to planning current and future aged care services. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to develop a validated model to predict current and future Australian costs for people with dementia to help guide decision makers allocate scarce resources in the presence of capacity constraints. Methods: A hybrid discrete event simulation was developed to predict costs borne in Australia for people with dementia from 2015 to 2050. The costs captured included community-based care, permanent and respite residential aged care, hospitalisation, transitional care, pharmaceuticals, aged care assessments, out of hospital medical services and other programs. Results: The costs borne for people with dementia in Australia are predicted to increase from A$11.8 billion in 2015 to A$33.6 billion in 2050 at 2013–14 prices, ceteris paribus. If real per capita health and social expenditure increased by 1.0% annually, these costs are predicted to increase by around A$14.2 billion to a total of around A$47.8 billion by 2050. Conclusions: This simulation provides useful estimates of the potential future costs that will be borne for people with dementia and allows the exploration of the effects of capacity constraints on these costs. The model demonstrates that the level of real annual per capita growth in health and social expenditure has significant implications for the future sustainability of dementia care in Australia. What is known about the topic?: With the aging of the Australian population, the number of people living with dementia is predicted to rise markedly in the next four decades. As the number of people living with dementia increases, so too will the financial burden these debilitating and degenerative diseases place on private and public resources. These increases are likely to challenge the efficiency and sustainability of many health systems in the developed world. What does this paper add?: This research provides a validated model to predict current and future Australian costs for people with dementia to help guide decision makers allocate scarce resources in the presence of capacity constraints (i.e. where the supply of resources does not meet demand). The model predicts an increase in costs for people with dementia from A$11.8 billion in 2015 to A$33.6 billion in 2050 at 2013–14 prices. If real per capita health and social expenditure increased by 1.0% annually, these costs are predicted to increase by around A$14.2 billion to a total of around A$47.8 billion by 2050. What are the implications for practitioners?: This simulation provides useful estimates of the potential future costs that will be borne for people with dementia and allows the exploration of the effects of capacity constraints on these costs. The model demonstrates that the level of real annual per capita growth in health and social expenditure has significant implications for the future sustainability of dementia care in Australia. [ABSTRACT FROM AUTHOR]

Recently, McDonald et al. (2006) outlined a new method of projecting living arrangements, households and dwellings at the national and subnational level, using quinquennial census data. The purpose of this paper is to apply this new simulation method to project the composition of elderly living arrangements at the national and subnational level in Australia over the period 2001 to 2016.This study presents projections of living arrangements for Temporal Statistical Districts within New South Wales and for Australia as a whole. Results show a strong increase in the number of the elderly living alone, particularly elderly males. The rate of growth in lone-person households is particularly strong in coastal and regional New South Wales, underlining the importance of capturing subnational differences in probabilities of births, deaths, migration and household movements when producing regional projections of living arrangements. This paper concludes by considering implications of the findings and potential uses of the net transition probability method. [ABSTRACT FROM AUTHOR]

Learning is an important aspect of active ageing, yet older people are not often included in discussions of the issue. Older people vary in their need, desire, and ability to learn, and this is evident in the context of technology. The focus of the data analysis for this paper was on determining the place of learning and technology in active ageing. The paper describes results from 2,645 respondents aged from 50 to 74 + years, in Australia, to a 178-item variable postal survey. The survey measured aspects of learning;, work; social, spiritual and emotional status; health; vision; home; life events; and demographics. There was also an open-ended question about being actively engaged in life. Ordinal regression analysis showed that interest in learning, keeping up to date, valuing communication, being younger, and being male are predictors of learning about technology. The results are at variance with an earlier analysis of our data which showed that women are generally more interested in learning. The open statements contained mentions of learning about technology for the purposes of communication, learning, family links, keeping up to date, enjoyment, staying mentally alert, and just using the computer. These results are discussed in terms of the subtle but important differences between needing and wanting to learn about technology and the opportunities for such learning by older people. [ABSTRACT FROM AUTHOR]

Making allowance for the ageing structure of the population, this paper calculates the levels of optimal national saving and future living standards for Australia for the period 1999-2050. For this period, the optimal saving response to the ageing of the Australian population is for national saving to increase from its current level by 2.7 per cent of GDP by the year 2017 and then to decline to the year 2050. The implied growth of living standards is 1.20 per cent per year. Reduced immigration would reduce the rate of growth of living standards but reduced fertility would not. [ABSTRACT FROM AUTHOR]

This paper makes new projections of government social outlays for Australia. The calculations suggest that government social outlays will increase considerably as a percentage of GDP over the next 50 years; by 7.3 per cent of GDP in the base case. This is a greater increase than that found by previous investigation. Over 60 per cent of this increase will occur between 2011 and 2031, the years when the baby boom generation retires. The major contribution to this increase will have come from increased government outlays on social security. Lower rates of net immigration are shown to yield an even larger increase in the percentage of government social outlays in GDP. The paper also considers the disincentive effect of taxation and the effect of increasing the age of retirement. However, notwithstanding the trends suggested by the projections, the paper argues that there are a number of reasons to be sanguine about the implications of ageing on the share of government outlays in GDP. [ABSTRACT FROM AUTHOR]