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The social distancing imposed by the Covid-19 pandemic accelerated the digitalisation of societies, which also influenced habits related to the consumption and dissemination of news. In this context, older individuals are often blamed for contributing to disinformation, which is associated with the echo chambers fostered by social media. Mass media, social media and personal communication tools act as mass, social or personal intermediaries when it comes to keeping up to date with the news. This paper analyses the preferred intermediaries of older online adults (aged 60 and over) for following the news and how they change over time. We analysed two waves of an online survey-based longitudinal study conducted in Canada and Spain, before Covid-19 pandemic (2016/17), and during Covid-19 (in 2020). We found that most participants exclusively use mass intermediaries or combine mass with social and personal intermediaries to keep abreast of the news. However, only 28% of respondents inform themselves exclusively through the alleged echo chambers of social and personal intermediaries. Results also show that media ecologies evolve in different directions, and, despite the forced digitalisation driven by the pandemic, digital media usage did not always increase or evolve towards newer technologies. This paper contributes to understanding the diverse intermediaries used by older adults to obtain news and how such media ecologies can contribute to contrasting different sources of information beyond the alleged echo chambers of social media. [ABSTRACT FROM AUTHOR]

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]

Recently, the role of personal ties in migration decisions has received considerable attention. However, this aspect has seldom been studied in the context of retirement. This paper addresses this gap by shedding light on the composition of personal networks, types of mobility patterns and retirement locations for four groups of older adults. To this end, two methodological approaches are employed: (1) a qualitative Social Network Analysis to examine the composition of older adults' personal networks and (2) thematic coding to analyse the relational aspects of migration decisions. This paper draws on 29 semi‐structured interviews conducted in Spain and Switzerland in 2020 and 2021. The findings demonstrate that pre‐retirement migration trajectories shape personal network composition. Moreover, personal ties play a critical role in older adults' mobility patterns and choices of retirement location. Overall, this study provides valuable insights into the impact of personal networks on migration decisions of older adults. [ABSTRACT FROM AUTHOR]

Copyright of Migraciones is the property of Universidad Pontificia Comillas, Instituto Universitario de Estudios sobre Migraciones 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.)

Transnational ageing processes are usually studied by focusing on the various cross-border practices and mobilities of different categories of ageing migrants. This paper introduces a retirement mobilities approach as an analytical framework that draws on both transnational studies and the new mobilities paradigm to widen the theoretical and empirical debates. It argues that both migrant and non-migrant populations, as well as human and non-human cross-border circulations, have to be taken into account when studying transnational ageing. Based on a mixed-methods study combining original data from a quantitative survey conducted in Switzerland with residents 55+ and semi-structured interviews held in Spain and Switzerland with older adults receiving a Swiss pension, we demonstrate the heuristic value of this approach. Indeed, empirical findings indicate that older adults with and without a migration background represent an internationally mobile population with similar mobility aspirations and transnational lifestyles. However, the motivations driving these two groups' transnational mobility differ significantly. Moreover, transnational circulations of financial resources, and in particular retirement pensions, are interlinked with mobility in old age. To conclude, a retirement mobilities approach sets a new research agenda, inviting scholars to examine transnational ageing beyond the ageing-migration nexus. [ABSTRACT FROM AUTHOR]

This paper addresses the intersections between international migration, care and ageing. Through an analysis of the life stories of 24 Ecuadorian women who migrated to Spain between the years 1990–2000 and who work or have worked in the older people care sector, we aim to analyse the transnational strategies they have developed to care for their older relatives and also to explore how these women foresee their own old age and what strategies they are developing to face this stage. The results underscore the fact that while these women are capable of getting involved in transnational care arrangements to guarantee the wellbeing of their older relatives, they are faced with constraints that prevent them from achieving this objective due to their socially unequal position in terms of the intersecting axes of gender, social class and migratory status. Their main difficulties stem from limited access to geographic mobility, but also from the economic pressure they are subjected to in supporting long‐term care for their older relatives. Furthermore, their own old age planning is weighed down by their work itineraries in the field of care. In some cases, transnational social protection strategies become a way to compensate for this position of social disadvantage, but they are not readily accessible to the women migrants who need them the most. [ABSTRACT FROM AUTHOR]

Most studies on the benefits of late life civic engagement have focused exclusively on formal volunteering. Older adults' political participation is much more overlooked. The current paper explores the benefits of long-term participation in political organizations as described by actively engaged Spanish older people. We used an adaptation of McAdams' life-story interview with 40 participants from three types of political organizations who occupy a responsible position within the organization. We identified three main themes in participants' answers: personal benefits, relational benefits, and community benefits. Overall, our results showed that the benefits arising from long-term political participation go far beyond the well-studied individual benefits that research on late-life volunteering has typically identified, and spread to relational and community areas. Social work practitioners should consider these benefits when they implement plans and programmes to promote healthy, active ways of aging, fostering age-friendly communities or reducing old-age social exclusion. [ABSTRACT FROM AUTHOR]

Recent years have seen a growth in research on retirement/lifestyle migration to Spain, however this has tended to focus on the reasons for moving, as well as the lifestyles adopted as part of a healthy and active retirement. However, ageing in Spain can bring challenges as a person's resources for independent living diminish. This paper draws on narrative interviews with vulnerable older British people in Spain, focusing on those who have encountered a severe decline in health, are frail and in need of care. It looks at the formal and informal networks and agencies that support these individuals, in particular the resources and strategies they employ to access care. Drawing on a framework of care provision developed by Glucksmann and Lyons, four broad modes of provision for old age care used by older British people in Spain are identified: state/public, family/community, voluntary/not-for-profit and market/for-profit. The paper argues that there are language, cultural, spatial and financial barriers when accessing care in Spain as an older British citizen. It is concluded that there are some frail, vulnerable people that may fall through a support gap, whereby they are no longer the responsibility of UK welfare services, yet not fully recognised in their new country of residence, and asks if more should be done to support this population. [ABSTRACT FROM PUBLISHER]

Increased life expectancy coupled with decreased birth rates has led to a notable aging of the population. In the social care sector, resources for the older persons should be allocated by means of objective instruments that ensure an appropriate fit between older people's needs and the characteristics of the services. This paper analyzes the appropriacy of actual assignments of resources in a sample of 632 older users of social services, evaluating the degree of fit between these assignments and those made by a Decision Making Model (DMM) which is strictly based on an objective assessment of user's needs and characteristics. The results indicate that biopsychosocial variables included as predictors in the DMM are appropriate for ensuring that the needs of the older persons are met and resources are optimized. However, the current assignments of users to services cannot be explained by relying solely on these variables, suggesting that the allocation of users to services may be conditioned by factors that are different from those covered by the DMM. [ABSTRACT FROM AUTHOR]

Introduction: Regular moderate‐to‐vigorous physical activity (MVPA) is associated with improved mental health, but the evidence for the effect of reducing sedentary behavior (SB) or increasing light PA (LPA) in older adults is lacking. Using isotemporal substitution (IS) models, the aim of this paper was to investigate the effect of substituting SB with LPA or MVPA on associations with mental health in older adults. Methods: Data from 1360 older adults (mean age 75.18 years) in four countries were utilized. PA and SB was measured using ActiGraph wGT3X‐BT + accelerometers worn for 7 days. Self‐rated mental health was measured using the Hospital and Anxiety Depression Scale (HADS). IS models estimated cross‐sectional associations when 30 minutes of one behavior was substituted with another. Models were adjusted for age, sex, marital status, and educational attainment. Results: Substituting 30 minutes of SB with LPA (β −.37; 95% CI −0.42, −0.32) or MVPA (β −.14; 95% CI −0.21, −0.07) and substituting LPA with MVPA (β −.11; 95% CI −0.18, −0.04) were associated with improvements in anxiety. However, substituting 30 minutes of SB with LPA (β.55; 95% CI 0.49, 0.62) was associated with increased depression. Conclusion: Replacing 30 minutes of SB with LPA or MVPA was associated with improved anxiety symptoms in older adults. Greater benefits were observed when shifting SB and LPA to MVPA. [ABSTRACT FROM AUTHOR]

Copyright of Revista Canadiense de Estudios Hispánicos is the property of Asociacion Canadiense de Hispanistas 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.)

Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalised, and coordinated intervention under the value-based care approach to address frailty's multidimensional nature in older people in the primary care setting. It employed a pre–post randomised controlled design involving 242 frail individuals aged over 65 years living in the community in Valencia (Spain) between 2021 and 2023. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalised care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty, and social frailty. The study found significant improvements in physical frailty, quality of life, reduced health resource use and hospitalisations and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalised, comprehensive programs for older individuals with frailty. [ABSTRACT FROM AUTHOR]

The aim of this paper is to investigate the association between structural and cognitive aspects of social capital and self-rated health among adults aged 50 or more, living in three countries: Finland, Poland and Spain. The study, which was based on data from the European Social Survey (2008/09), was a part of the EU research project COURAGE in Europe. More specifically the paper assesses the association between social capital indicators – informal social network and general trust – and good self-rated health through single-level and joint effects analyses. The results showed that Finland was a country of high social capital, in terms of both social networks and general trust, while Spain showed low levels of general trust and Poland low levels of informal social networks. As to the association between social capital and self-rated health, high levels of general trust and high networks were found to be associated with good health among all countries' respondents. Older persons living in partnerships, with higher education, higher levels of engagement in informal networks and general trust, were found to be more likely to show good self-rated health. Our comparative analyses revealed different associations between social capital and health according to country. [ABSTRACT FROM PUBLISHER]

With a growing ageing population and the advent of interactive TV (iTV), understanding how older people use iTV services is a timely and important task. Working towards this end, this paper reports on in situ conversations of, and observations with, almost 400 older people, with different levels of educational attainment and experience with ICTs, while talking about and using online video portals and similar interactive systems in Spain, Brazil and Denmark. The results show more similarities than differences in their reasons for adopting online video portals and patterns of use. All our participants used these portals for keeping or remaining in touch with people they trusted. The results also show that privacy online was a common concern to all the participants. Differences in the acceptance of e-government services and the type of content that drove most of their interactions were also found. Implications for designing more accessible and meaningful iTV services are discussed. [ABSTRACT FROM AUTHOR]

Background: Data on overuse of diagnostic and therapeutic resources underline their contribution to the decline in healthcare quality. The application of "Do Not Do" recommendations, in interaction with gender biases in primary care, remains to be fully understood. Therefore, this study aims to identify which low-value practices (LVPs) causing adverse events are susceptible to be applied in primary care setting with different frequency between men and women. Methods: A consensus study was conducted between November 1, 2021, and July 4, 2022, in the primary care setting of the Valencian Community, Spain. Thirty-three of the 61 (54.1%) health professionals from clinical and research settings invited, completed the questionnaire. Participants were recruited by snowball sampling through two scientific societies, meeting specific inclusion criteria: over 10 years of professional experience and a minimum of 7 years focused on health studies from a gender perspective. An initial round using a questionnaire comprising 40 LVPs to assess consensus on their frequency in primary care, potential to cause serious adverse events, and different frequency between men and women possibly due to gender bias. A second round-questionnaire was administered to confirm the final selection of LVPs. Results: This study identified nineteen LVPs potentially linked to serious adverse events with varying frequencies between men and women in primary care. Among the most gender-biased and harmful LVPs were the use of benzodiazepines for insomnia, delirium, and agitation in the elderly, and the use of hypnotics without a previous etiological diagnosis. Conclusions: Identifying specific practices with potential gender biases, mainly in mental health for the elderly, contributes to healthcare promotion and bridges the gap in gender inequalities. Trial registration: NCT05233852, registered on 10 February 2022. [ABSTRACT FROM AUTHOR]

Purpose: The current study reports preliminary findings from a pilot sample that sought to compare the emotional responses of older adults toward death in Egyptian and Spanish cultures. Method: A cohort of 90 eligible older adults from Egypt and Spain were recruited using a cross-sectional descriptive design. Results: Egyptian participants recorded a significantly higher score in approaching acceptance of death compared to their Spanish counterparts (mean = 21.57, SD = 9.4 and mean = 13.51, SD = 7.11, respectively). Post-hoc test showed there were differences in levels of valence (F[1,86] = 23.88, p < 0.001), indicating that older adults in Spain perceived such images as more unpleasant compared to Egyptian older adults. A significant difference related to death attitude profile scale was noted between Egyptian and Spanish older adults. Conclusion: Egyptian and Spanish older adults demonstrated different attitudes toward death in addition to differences in death anxiety and depression. This preliminary study validates the importance of developing effective nursing strategies to lessen anxiety and fear about death. [Research in Gerontological Nursing, 17(3), 112–120.] [ABSTRACT FROM AUTHOR]

Background: The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission. Aim: To explore the role of the NCCR in predicting longer length of stay (LOS) in older adults (≥65 years) admitted to a tertiary hospital and determine possible clinical differences at discharge between patients who had a short LOS (≤7 days) and a prolonged LOS (>7 days). Research Design and Setting: A retrospective cohort study was conducted including all patients with a completed NCCR admitted to the hospital between 2015 and 2019. Sociodemographic data, risk of pressure injuries, level of dependence, presence and intensity of pain, and presence and type of pressure injury were the variables registered in the NCCR. Results: A total of 41,354 patients were included in this study, with a mean age of 78 years, of whom 47% were female. At admission, 21% of patients were at potential risk of developing pressure ulcers. Age, admission to the internal or respiratory medicine unit, and having at least medium risk of developing pressure ulcers were the predictors of prolonged LOS using a random sample of 950 patients. At discharge, patients with prolonged LOS presented higher risk of pressure ulcers and a higher level of dependency and were more likely to present hospital‐acquired pressure ulcers. Conclusions: Older adults from the internal or respiratory medicine unit who exhibited higher risk of pressure ulcers were related to a prolonged LOS, a higher level of dependency, and hospital‐acquired ulcers at hospital discharge. Relevance to Clinical Practice: Identifying clinical data that have a greater relationship with LOS could be a useful tool for nursing management and for the implementation of strategies to prevent adverse events during hospitalisation. No Patient or Public Contribution: No direct patient contact was made during the data collection. [ABSTRACT FROM AUTHOR]

The objective of this paper is to present the findings of a quantitative study of Swiss elderly residents on the Costa Blanca (in the Province of Alicante, Spain) and of an ethnographic study of their British counterparts in Fuengirola and Los Boliches on the Costa del Sol (in the Province of Málaga). We examine the German concept Heimat and its value as an organising construct for understanding the aspirations and actions of foreign retirees resident in Spain, and explore whether globalisation undermines locality to the extent that being in a particular geographical place is no longer a prerequisite for feeling at home. The paper describes the social life and patterns of association of these groups of retired people, in terms of social clubs, leisure activities, voluntary associations, charity groups and self-help groups, relations with home, and relations to Spaniards and people from other countries. It compares the results of the two studies in an analysis of the strategies that the two groups adopt for constructing social communities and for finding a new home. This paper thus provides some insights into what older people seek in later life in terms of their residence, co-resident groups, social contacts and lifestyle choices. [ABSTRACT FROM AUTHOR]

(1) Background: Healthy aging is the process of developing and maintaining functional capacity and optimizing involvement in order to improve one's quality of life as people age. This study aimed to encourage healthy aging in people with cognitive impairment, as well as a control group, via the use of the Nintendo Switch combined with occupational therapy sessions, aiming to improve gross and fine motor skills, functionality, quality of life, and cognitive status. (2) Methods: A randomized clinical trial was undertaken. The sample was randomized using the OxMar software program Attribution 4.0 International, facilitating the division into a control group (CG), who received conventional occupational therapy sessions, and an experimental group (EG), who received therapy incorporating the Nintendo Switch, in addition to conventional occupational therapy sessions. The intervention period with the Nintendo Switch lasted for 8 weeks. (3) Results: Thirty-two participants were included in the study. Significant differences were found in the vast majority of the variables analyzed, which shows an improvement following the intervention; these improvements were mainly observed in measures of skill and the perception of quality of life. (4) Conclusions: An eight-week intervention with the Nintendo Switch alongside conventional occupational therapy helps to maintain cognitive status and functional independence. Following 8 weeks of intervention with the Nintendo Switch, improvements in gross motor dexterity, fine motor dexterity, and quality of life were observed in older people with cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Poor sleep quality is prevalent in older people and impairs their quality of life. Various studies show an association between sleep disorders and altered levels of inflammatory cytokines. The cytokine IL-1β has been shown to display both somnogenic and insomnia-promoting effects in experimental animals. Objectives: to evaluate the relationship between insomnia and salivary IL-1β concentration and the role of associated factors such as the symptoms of depression, use of hypnotics, intake of caffeinated beverages, smoking, and alcohol use in older individuals. An analytical, cross-sectional, observational research was carried out with a population of community-dwelling individuals over 60 years of age in Valencia (Spain). Sleep quality was measured with the Athens insomnia scale (AIS) and depressive symptoms with Geriatric Depression Scale (GDS). Results: 287 individuals participated in the study (mean age 74.08 years (76.7% women). 41.5% of the participants had insomnia, 36.9% took drugs for sleep problems, and 32.4% had relevant depressive symptoms. There was a significant inverse correlation between the IL-1β and total AIS score (rho = −0.302, p < 0.001), the sleep difficulty subdomain (rho = −0.259, p < 0.001), and the daytime sleepiness subdomain (rho = −0.322, p < 0.001). No significant correlation was observed between GDS and salivary IL-1β concentration. The IL-1β concentration was significantly lower in individuals taking drugs for sleeping compared with those not taking those drugs (1.11 ± 0.09 and 1.48 ± 0.08, respectively; p = 0.001). Regarding the AIS score, there was no significant difference in marital status, smoking, or the number of cups of tea or cola drinks, but there was a significant association with alcohol intake (p = 0.019) and in the number of daily intakes of coffee (p = 0.030). The receiver operating characteristic (ROC) curve analysis of IL-1β for diagnosis of moderate-severe insomnia showed an area under the curve (AUC) value of 0.78 (95% confidence interval 0.71–0.85). At the cut-off of 0.83 pg/µL of Il-1β, it had a sensitivity of 70.3% and a specificity of 69.8%. [ABSTRACT FROM AUTHOR]

Active ageing policies seek to increase the quality of life of older people in three areas: health, security and participation. This paper focuses on a specific type of participation: associations. Its objective is to explore the possible self-selection effects of this type of participation, using global subjective quality of life indicators (satisfaction with life) and domain-specific indicators (satisfaction with leisure, community social integration and emotional resources). For this, a structural equation modelling analysis was conducted, taking into account bi-directional relationships between the variables of interest. The data come from a conditions and quality of life survey conducted in 2008 among a sample of 1,106 individuals aged 60 or over, living in community-dwellings in Spain. The results illustrate a complex model of relationships in which associative participation is not statistically significantly associated with the satisfaction measures used. This highlights the importance of self-selection effects and raises the issue of the effectiveness of associative participation as a tool to enhance the life satisfaction of older adults. [ABSTRACT FROM PUBLISHER]

The objectives of this paper were to evaluate the association of subjective memory complaints (SMC) with perceived state of health, mood and episodic memory (associative and everyday memory). We studied these areas using two different complaint assessment methods (three general questions and a validated scale). The study included 269 older adults (aged 65-87) with age-related memory changes, but without cognitive impairment. They were evaluated with Mini-cognitive Exam, Rivermead Behavioural Memory Test (a test of everyday memory), Paired Associates Learning Test, Memory Failures of Everyday Questionnaire, three memory complaints questions, Nottingham Health Profile and Geriatric Depression Scale. The results indicated that memory for everyday performance, mood and perceived health were independent predictors of SMC, with mood and perceived health being stronger predictors than actual memory performance. Age was not associated with subjective memory and, with regard to level of education, only the illiterate level was associated with SMC. A specific questionnaire on subjective memory was found to be preferable to an aggregate of complaints questions on self-reported memory; only health profile was found to predict the outcomes on memory complaints questions. Our conclusion is that a group of underlying factors other than everyday memory were playing a role in SMC; these SMC of subjects with age-related memory changes were mainly associated with subjective evaluations of their health. [ABSTRACT FROM AUTHOR]

Previous research has shown that exchanges of support within social networks reduce the loneliness of older adults. However, there is no consistent evidence on how types of support (instrumental and emotional) and the direction of that support (giving and receiving) are related to loneliness, and whether the effects are culture-specific. The aim of this study was to investigate support exchanges and their effects on loneliness in Spain and the Netherlands. We suggest that cultural differences, such as more interdependent cultural values in Southern Europe and more independence-related values in Northern Europe, influence social realities such as the social support exchanged. In Spain relationships with family members are determined by mutual obligations; older people expect to receive instrumental support from them. However, in Northern Europe independence is highly valued and intimacy and closeness are shown primarily by confiding about personal matters. This paper examined data from two comparable surveys, one in Spain (N=646) and one in the Netherlands (N=656). Older adults in Spain provide for, and receive, high amounts of instrumental support and this proved to be a protective factor against loneliness. An alternative pattern was found in the Netherlands where respondents provided more and received more emotional support than Spanish older adults; emotional support is a protective factor in the Netherlands (but only for support received). [ABSTRACT FROM PUBLISHER]

The first objective of this work was to compare scores obtained in the daily memory function between young and elderly people, and to check whether there are differences between the groups for each of the profile scores obtained in the memory test. A second aim of this paper is to study the relationship between everyday memory and age, while controlling for gender and educational level. The total and profile scores obtained in the Rivermead Behavioural Memory Test were compared in a sample of 60 young and 120 elderly people from Valencia (Spain). Results showed significant differences between the two groups: those between 18 and 30 years obtained a higher average than those over 65. Once the group comparison was controlled for gender and educational level, the statistical effect of age group disappeared. The non-significant effect of group can not be explained by the introduction of gender, because both its main effect and the interaction were not statistically significant. However, educational level had a statistically significant effect which may explain the non-significant effect of group in this new analysis. The main conclusion is the need to carefully control for educational level in all studies related with everyday memory and ageing, as the differences found could be due to generational differences more than to biological deterioration. [ABSTRACT FROM AUTHOR]

This article explores how older husbands' caregiving experiences are interwoven with the social representation of 'the village,' understood herein as an intimate, local community that actively contributes to long-term care on a daily basis. The concepts of belonging and doing kinship form the analytical basis for illuminating this interaction between care from husbands and daily community care. I use the social representation of the imagined community both as the axis for articulating the singular experiences of care, and the construct of a village that values its collective history, local rituals, natural environment, and ordinary routines. Study data are based on ethnographic observations of the daily long-term care trajectories of five married couples in two villages and one small town in the rural Spanish Mediterranean. [ABSTRACT FROM AUTHOR]

Background: Anti-CGRP monoclonal antibodies have shown notable effectiveness and tolerability in migraine patients; however, data on their use in elderly patients is still lacking, as clinical trials have implicit age restrictions and real-world evidence is scarce. In this study, we aimed to describe the safety and effectiveness of erenumab, galcanezumab and fremanezumab in migraine patients over 65 years old in real-life. Methods: In this observational real-life study, a retrospective analysis of prospectively collected data from 18 different headache units in Spain was performed. Migraine patients who started treatment with any anti-CGRP monoclonal antibody after the age of 65 years were included. Primary endpoints were reduction in monthly migraine days after 6 months of treatment and the presence of adverse effects. Secondary endpoints were reductions in headache and medication intake frequencies by months 3 and 6, response rates, changes in patient-reported outcomes and reasons for discontinuation. As a subanalysis, reduction in monthly migraine days and proportion of adverse effects were also compared among the three monoclonal antibodies. Results: A total of 162 patients were included, median age 68 years (range 65–87), 74.1% women. 42% had dyslipidaemia, 40.3% hypertension, 8% diabetes, and 6.2% previous cardiovascular ischaemic disease. The reduction in monthly migraine days at month 6 was 10.1 ± 7.3 days. A total of 25.3% of patients presented adverse effects, all of them mild, with only two cases of blood pressure increase. Headache and medication intake frequencies were significantly reduced, and patient-reported outcomes were improved. The proportions of responders were 68%, 57%, 33% and 9% for reductions in monthly migraine days ≥ 30%, ≥ 50%, ≥ 75% and 100%, respectively. A total of 72.8% of patients continued with the treatment after 6 months. The reduction in migraine days was similar for the different anti-CGRP treatments, but fewer adverse effects were detected with fremanezumab (7.7%). Conclusions: Anti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To identify the flow charts and discriminators of the Manchester Triage System that are most likely to identify the onset of delirium in older people. Background: Delirium is an underdiagnosed geriatric syndrome, and up to 80% of all cases of delirium go undetected in emergency departments. Patient triage seeks to manage clinical risk with a view to safely and appropriately managing patient flows. Design: A case–control study was performed according to the STROBE checklist. Setting: The emergency department of a secondary hospital. Participants: Older adults aged ≥65 years and admitted from 1 January to 31 December 2020. Methods: Older patients were identified from the emergency department research database. Cases were defined as patients diagnosed with delirium (n = 128), excluding cases of delirium due to alcohol or substance abuse. Controls were randomised from the remaining patients (n = 128). Results: A total of 29.35% of the subjects admitted to the emergency department were older adults with an incidence of delirium of 0.7%. The flow charts with the highest probability of delirium were 'unwell adult' [OR = 3.04 (95%CI:1.82–5.1)] and 'behaving strangely' [OR = 16.06 (95%CI:3.72–69.29)], and the discriminators were 'rapid onset' [OR = 3.3 (95%CI:1.85–5.88)] and 'new neurological deficit less than 24 h old' [OR = 4.76 (95%%CI:1.01–22.5). The area under the curve for 'unwell adult' in the presence of dementia, previous stroke and fall in the previous 30 days was 0.73 (95%CI: 0.67–0.79), and that for 'behaving strangely' in the presence of diabetes was 0.75 (95%CI: 0.69–0.81). Conclusions: Knowing which flow charts, discriminators and risk factors are most likely to predict delirium allows the identification of the older population at risk for triage screening in emergency departments. Relevance to clinical practice: Risk factors such as diabetes, dementia, previous stroke and recent fall among 'unwell adult' or 'behaving strangely' triaged older persons should be assessed for the probable presence of delirium. [ABSTRACT FROM AUTHOR]

While life expectancy increases in developed countries and there is evidence that demonstrates the potential of the internet to optimise or compensate for the losses associated with ageing, there is a high proportion of older people who continue to be disconnected from the digital world. In this scenario, the technological support offered by public institutions has the potential to be an accessible source for the digital literacy of older people. This study, using the model of digital inequality, had the aim of analysing the ability of these institutional supports to determine and predict the digital inclusion of older people. The sample was retired adults (over 54 years) residing in Spain who are users of technological support services in four organisational contexts: nursing homes, senior community centres, University Programs for Seniors and adult education programmes. Through binary logistic regression analysis, we found that the ability of the availability of literacy support to determine and predict access, autonomy, skills and use of the internet for social connectivity depends on the social and organisational context of the technology support service. These findings support empirically the situated nature of technological support for the digital inclusion of older people and provide a useful comparative vision for the design of accessible support services adapted to the needs of its users. [ABSTRACT FROM AUTHOR]

Objectives: To assess the cross-sectional and longitudinal associations between nut consumption and depression in two cohorts of older adults. Design, Setting, Participants and Measurements: The first cohort (Seniors-ENRICA-I or SE-I) included a representative sample of Spanish noninstitutionalized adults aged ≥65 years interviewed in 2010 and 2013. The second cohort (SE-II) included individuals from the Madrid region, Spain, aged ≥65 years interviewed in 2017 and in 2019. Nut consumption was estimated with a validated computer-based diet history. Depression was defined as self-reported physician-diagnosed depression or the use of antidepressants. Logistic regression models were adjusted for the main confounders. The DerSimonian and Laird random-effect method was used to meta-analyze the results from both studies. A participant-level pooled analysis was conducted to examine the robustness of our analyses. Results: The SE-I included 2278 individuals (233 prevalent cases) in the cross-sectional analysis and 1534 (108 incident cases) in the longitudinal analysis; the corresponding figures for SE-II were 2726 (407 prevalent cases) and 1566 (74 incident cases). In the meta-analysis of cross-sectional results from the two studies, compared to consuming <1 serving (30 g) of nuts/week, the odds ratio (95% confidence interval) for depression was 0.90 (0.64, 1.16) for consuming 1 to <3 servings/week and 0.92 (0.70, 1.13) for consuming ≥3 servings/week; the corresponding figures for the longitudinal results were 0.90 (0.41, 1.38) and 0.66 (0.35, 0.97). Conclusion: Nut consumption was associated with a lower risk of depression in a pooled longitudinal analysis using data from two cohorts of older adults. Nuts should be recommended as part of a healthy diet in older adults. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer (PCa) is considered one of the most important medical problems in the male population, with a very high incidence after the age of 65. Frailty represents one of the most critical issues facing healthcare due to its inherent relationship with poor healthcare outcomes. The physical phenotype of frailty syndrome based on Fried criteria has been associated with poor outcomes, morbidity, and premature mortality. To date, there are few studies that have analyzed frailty syndrome in patients with localized and advanced (mPCa) disease under androgen-deprivation therapy. Objective: Our goal was to assess whether there are differences in frailty criteria between mPCa and localized PCa. We also evaluated the role of other geriatric variables such as depressive and insomnia symptoms, which are frequently reported in cancer patients. Methods: In this cross-sectional study, frailty syndrome was evaluated in both groups, as well as its possible relationship with cognitive functions, depressive and insomnia symptoms, and other clinical variables related to PCa and its treatment. Frailty was defined on Fried's criteria: low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed; prefrailty was defined as having one or two of those criteria and frailty as having three or more, depressive symptoms were defined by the Yesavage scale, cognitive functions with the Mini-Mental examination test, and insomnia symptoms by the Athens scale and self-reported health status. Results: The prevalence of prefrailty/frailty was slightly higher in mPCa compared to localized PCa (81.5% versus 72.3%, respectively), however by analyzing each of the frailty criteria, two of them were significantly reduced in mPCa compared to localized PCa patients, e.g., gait speed (p = 0.001) and muscle strength (p = 0.04). The reduced gait speed and muscle strength in mPCa were not due to the increased age in mPCa group, or to an increase in comorbidities or shorter time under androgen-deprivation therapy. The symptoms of insomnia were significantly higher in mPCa patients compared to those with localized PCa (p < 0.05) whereas cognitive functions or depressive symptoms were not significantly different between the two groups. Conclusion: Patients with mPCa under androgen-deprivation therapy display higher alterations in gait speed and muscular strength and insomnia symptoms, thus interventions should be aimed to reduce these alterations in order to limit adverse outcomes related to them and to improve quality of life in these patients. [ABSTRACT FROM AUTHOR]

(1) Background: Falls are a significant health problem among older adults, and can result in severe injuries, disability, and even death. In Spain, the prevalence of falls is lower if the person lives in the community than if they are institutionalized. Research has shown that exercise is an effective strategy for reducing the risk of falls among older adults. The objective of this study was to study the influence of a multicomponent exercise intervention on falls in people between 65 and 80 years of age despite the presence of diseases and drug use that are risk factors for falls; (2) Methods: This is a quasi-experimental study that focuses on people aged 65–80 who attended 21 primary healthcare centres. Target: Inclusion criteria were people between 65 and 80 years of age, living in the community with independent ambulation, and who were served by the healthcare centre of their region. Variables analysed: The number and characteristics of falls, sociodemographic, drug use, and previous diseases; (3) Results: The drugs associated with falls are benzodiazepines (OR 2.58), vasodilators (OR = 2.51), and psychotropics (OR = 1.61). For one of the years, a relationship was found between the consumption of antidepressants and falls (OR = 1.83). The associated diseases were mental and behavioural (OR = 2.53); (4) Discussion: The intervention has been related to the reduction in falls in people who consumed benzodiazepines, vasodilators, and psychotropics and in people with mental disorders; (5) Conclusion: This research concludes the importance of the implementation of the Otago Exercise Programme in the prevention of falls in the elderly. [ABSTRACT FROM AUTHOR]

Aims and objectives: The objectives of this study were to assess the benefits of a caregiver training programme on the cognitive and functional status of older adults, and to compare the effects of this programme according to type of caregiver (professional vs. family caregiver). Background: Due to demographic changes that have resulted in an aging population, the role of caregiver of an older adult has become very important in recent years. Design and Methods: The sample was composed of 160 older adults: (a) 100 received care from caregivers who had taken the three‐month training programme (treatment group), of which 60 were professional caregivers and 40 were family caregivers, and (b) 60 received care from caregivers who had not taken the programme (control group). In order to evaluate programme effects on cognitive and functional status, we used both direct measures answered by the older adults (MMSE, CAPE and EuroQol) and caregiver reports (Barthel and RMPBC). We used a quasi‐experimental, pre‐post design. We followed SQUIRE 2.0 guidelines for reporting. Results: The results showed that older adults who were cared for by caregivers that had participated in the training programme showed gains in quality of life and cognitive ability and maintenance of functional ability. Within the treatment group, although everyone significantly improved their scores, the older adults cared for by family caregivers improved in more of the cognitive sub‐items than did their peers in the professional caregiver group. Conclusions: The data obtained show that a caregiver training programme based on cognitive stimulation produces cognitive, functional and health‐related quality‐of‐life benefits in older adults. Furthermore, the caregivers reported increased satisfaction with their work. Relevance to clinical practice: The improvements obtained in the older adults and in caregivers show the relevance of this type of intervention when working in the clinical field of caregiving. [ABSTRACT FROM AUTHOR]

This article examines the concept of active aging (AA) empirically, focusing on the viewpoint of older people and of professionals involved in the implementation of AA programs. A qualitative study based on interviews performed in a local community in Spain found that both convergence and divergence patterns are shown by older people and professionals in their reception and appropriation of the AA concept. The authors also discuss concordance and discordance between the institutional and individual narratives concerning AA. The institutional discourse on AA has reached the local level and shapes some of the narratives and practices of older people and professionals, but these agents display heterogeneous and even opposing patterns in their reception and appropriation of that discourse. The presence of such a wide range of AA narratives at the local level deserves closer attention by policymakers in their efforts to promote AA. The following four main lessons may be withdrawn from this research: local AA story lines deserve closer attention by policymakers; local reception and appropriation of AA is still in an early stage; greater awareness of undesirable impacts from AA policies is needed; top-down active AA are not likely to be fully effective. [ABSTRACT FROM AUTHOR]

Successful aging is closely related to self-care behaviors. In fact, self-care is one of the most important aspects of a healthy life. It is in this context that the Self-Care Scale for the Older People appears. The main aim of this study is to offer evidence on the measurement invariance of the scale in samples of older adults from countries with cultural differences, specifically Costa Rica and Spain. The research approach is a panel design of 272 Costa Rican older adults and 1166 Spanish older adults. Statistical analyses considered were a series of Confirmatory Factor analyses. The results indicate an adequate reliability, and a strong invariance of the SCOP held across the two Spanish-speaking countries studied. SCOP is a valid instrument for intercultural comparisons between these groups, and it offers indirect evidence for comparisons with other Spanish-speaking countries of the same cultural background. This results may aid to design better interventions. [ABSTRACT FROM AUTHOR]

Introduction: During the SARS-CoV-2 pandemic, there has been a decrease in the supervision of the medication of subjects with chronic diseases. Customized automated dosing systems (SPDA) are devices that allow medication to be dispensed and administered, which have proven to be safe and effective for the patient and cost-effective for the healthcare system. Methods: an intervention study was carried out on patients from January to December 2019 in a residential centre for the elderly with more than 100 beds. The economic costs derived from manual dosing were compared with those of an automated preparation (Robotik Technology®). Results: Of the 198 patients included, 195 (97.47%) of them were polymedicated. Of the total of 276 active substances of registered medicinal products, it was possible to include them in the process of automating the preparation of the SPDA 105 active pharmaceutical ingredients. A cost reduction of EUR 5062.39 per year was found using SPDA. Taking into account the active ingredients of emblistable and non-emblistable medicines, the use of SPDA resulted in savings of EUR 6120.40 per year. The system contributed to the detection of cases of therapeutic duplication and reduced the time to prepare the medication. Conclusions: the use of SPDA is a useful and economically profitable strategy for its use in residential centres for the elderly. [ABSTRACT FROM AUTHOR]

Objectives: The impact of functional capacity over the entire functional continuum in older adults undergoing aortic valve replacement (AVR) has not been studied to date. This study aims to analyze 1.- the distribution of a cohort of older adults presenting severe aortic stenosis (AS) amenable to AVR in the different categories of the Functional Continuum Scale (FCS); 2.- its association with decision-making regarding valve disease; and 3.- its impact upon the one-year mortality rate of surgical (SAVR), transcatheter (TAVR) aortic valve replacement, or the decision to provide conservative management (OMT). Methods: This prospective study included patients from the FRESAS (FRailty-Evaluation-in-Severe-Aortic-Stenosis) registry evaluated by the reference Heart-Team of a region in northern Spain. All the patients underwent comprehensive geriatric assessment. Results: The study comprised 257 patients aged 84.0 ± 3.9 years. Management: SAVR: 25.3%, TAVR: 58.0% and OMT: 16.7%. Increased patient functional capacity was associated with an increased tendency to perform more invasive valve disease treatment. The overall one-year survival rate was 81.3%. One-year all-cause mortality: FCS-1 to FCS-2 "robust" 11.5%, FCS-3 to FCS-4 "prefrail" 14.7%, FCS-5 "frail" 19.2% and FCS-6 to FCS-8 "dependent" 45.0%; p < 0.001. Adjusted mortality analysis: FCS with HR = 1.206 [95%CI, 0.999–1.451 (p = 0.051)]; EuroSCORE-II with HR = 1.071 [95%CI, 1.006–1.161 (p = 0.033)]; and OMT with HR = 2.840 [95%CI, 1.409–5.772 (p = 0.004)] were retained in the final multivariable logistic regression model. Conclusions: In older AS patients amenable to AVR, the FCS is a useful predictive tool that may aid clinical decision-making. [ABSTRACT FROM AUTHOR]

To describe the nutritional and functional changes that occurred in older patients with a femur fracture following a dietary intervention and oral nutritional support implemented at an orthogeriatric unit in Aragon, Spain. Open-label, prospective study. Patients were consecutively recruited and arranged into three groups based on their CONtrolling NUTritional (CONUT®) score and nutritional needs. Nutritional status was assessed while in hospital, and at 45-, 100- and 180-days post-hospital discharge. One hundred and sixty-nine patients [mean age: 86 years (SD ± 5.48)] were recruited (July 2017 to January 2020). At admission, 53.3% were at risk of malnutrition; 26.6% were malnourished; 20.1% were well-nourished. Variable proportions of malnourished patients at admission were well-nourished 45-, 100-, and 180-days post-discharge. CONUT® and Barthel index correlations showed that as nutritional status enhanced, patients gained functionality. Dietary interventions and nutritional support may help restoring the nutritional and functional status of older patients with a femur fracture. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

To reduce the spread of COVID‐19, governments initiated lockdowns, limiting mobility and social interaction of populations. Lockdown is linked to health issues, yet the full impact on health remains unknown, particularly in more vulnerable groups. This study examined the impact on frailty and outcomes in high and low COVID‐19 risk older adults. We examined health‐related behaviours and support resources participants used during lockdown(s). Lockdown impacts in two countries were compared across four time points to examine impacts of different rules. We recruited 70 participants (aged >70 years) in England and Spain. Participants were allocated to higher or lower COVID‐19‐risk groups based on UK NHS guidelines. They completed assessments for frailty, quality‐of‐life, loneliness, exercise frequency and social interaction, coping resources and perception of age‐friendliness of their environment. The four assessments took place over a 7‐month period. Frailty was highest at Time 1 (most severe lockdown restrictions) and significantly higher in the Spanish group. It was lower at Time 3 (lowest restrictions), but did not continue to reduce for the English participants. Perceptions of the age friendliness of the environment matched these changes. Coping resources did not mitigate changes in frailty and outcomes over time, but more frequent physical activity predicted more reduction in frailty. Lockdown had a negative impact on frailty, increasing risk of adverse events for older people, but recovery once lockdowns are eased is evidenced. Further research is required to consider longer term impacts and methods to mitigate effects of lockdown on health. [ABSTRACT FROM AUTHOR]

This study aims to analyse the effectiveness of a psychosocial intervention programme in preventing loneliness and increasing self‐efficacy and social participation among older women living alone in Spain. A sequential, nested experimental design was used, with a primary quantitative quasi‐experimental pre‐post study with a control group (CG) and a secondary qualitative study. A total of 48 women participated, and 34 of them (the experimental group, EG) received a 25‐hour psychosocial support intervention delivered by volunteers who focused on three aspects: conversation, attribution retraining and behavioural activation. The other women remained on the waiting list (CG = 14). The women (EG and CG) were all interviewed before and after the intervention and a follow‐up of the EG was performed at 6 months (N = 25). Semi‐structured interviews were used to collect sociodemographic and health‐related data, as well as data on satisfaction with the programme and its benefits. Validated instruments were used to collect data on the dependent variables (self‐efficacy in ageing, subjective social participation and loneliness). Quantitative and qualitative methods were used for data analysis. Compared to the pre‐test results, women in the EG improved their self‐efficacy in ageing (t‐test: −2.246; p: 0.031; d: 0.30), and, more specifically, their self‐efficacy in managing socio‐emotional problems such as loneliness (t‐test: −1.995; p: 0.054; d: 0.25) and in managing their health (t‐test: −2.450; p: 0.020; d: 0.47). No significant differences were observed between the follow‐up and the post‐test results, meaning that the changes identified after the intervention remained stable. Four additional categories of benefits were identified in the participants' discourses. In conclusion, the intervention appears to be beneficial and effective in improving self‐efficacy, which is a well‐established predictor of loneliness in old age, in a group of vulnerable individuals. Further studies on this type of community intervention are necessary to prevent loneliness among older people. [ABSTRACT FROM AUTHOR]

Dependency and care assistance during old age has become an increasing focus of debate and change in society. Consequently, people must cope with diverse and even contradictory values and ideas about the issue. This study aimed to understand the social representations of dependency based on the dialogical approach of the Social Representations theory. Total 26 semi‐structured interviews were conducted in the Basque Country (north of Spain) with relatives, care workers, and older adult care recipients. The thematic analysis results show that social representations are articulated around seven themes, reflecting people's tensions and contradictions at cultural, organizational, and relational levels. In addition, the polyphasic and dynamic nature of social representations is discussed, addressing current public debates about the meaning of dependency in a changing sociocultural context. [ABSTRACT FROM AUTHOR]

Mortality curves of extinct rodents can be reconstructed by using relative wear calculated from the amount of dentine exposed. MicroCT scanning of molars of the extinct Eomyid genus Ligerimys shows that this Wear Index increases gradually with wear; this means that wear classes can serve as a proxy for age and can therefore be used to reconstruct mortality curves. We reconstructed mortality curves of three species of Ligerimys from the late early Miocene of Spain. These curves show a similar trend, with decreasing numbers of molars as the amount of wear in each class increases. The curves show remarkable similarities to those of the wood mouse Apodemus. This suggests that Ligerimys was, like Apodemus, at the fast end of the fast-slow continuum, in other words r-selected, though not as extreme as some other rodents. [ABSTRACT FROM AUTHOR]

In many countries across the world, older people are one of the groups most vulnerable to loneliness. Community‐based responses are well placed to support and enhance pre‐existing coping strategies in older people. However, the evidence base of these responses remain scattered and obscured, particularly in relation to their design and reasons behind their success. In this systematic review, we focus on qualitative studies on community‐based responses to loneliness among older people to learn how these responses work in practice with in‐depth details. At the end of a systematic searching and screening process, 17 studies conducted in five countries (Australia, Canada, New Zealand, Spain and the UK) published in English were selected and reviewed initially in October 2020 and then updated at the end of August 2021. Three themes were identified as being most valuable to addressing loneliness in a specific community, namely, autonomy, new social connections, and belonging. These interventions were also employed according to three primary considerations: what the community lacked, how that community experienced loneliness, or a combination of both. Several implications for policymakers and future research emerged, urging future interventions to take a more contextual approach that encompasses community‐level considerations before establishing a user‐led and tailored setting that facilitates social engagement. [ABSTRACT FROM AUTHOR]

OBJECTIVES Elderly patients show a higher incidence of ischemic and bleeding events after percutaneous transluminal coronary intervention (PCI). We sought to investigate outcomes in elderly patients treated with antithrombotic strategy guided by bleeding and ischemic risks after revascularization with last generation everolimus-eluting stent (EES). METHODS Prospective multicenter registry including patients over 75 years revascularized with EES and antithrombotic therapy guided by clinical presentation, PCI complexity and PRECISE DAPT score. Co-primary safety endpoints were: (1) composite of cardiac death, myocardial infarction and stent thrombosis and; (2) bleeding (BARC 2-5). Primary efficacy endpoint was target lesion revascularization. A matched group of patients revascularized with current drug-eluting stents and no such tailored antithrombotic therapy was used as control. RESULTS Finally, 1064 patients were included in SIERRA-75 cohort, 80.8 ± 4.2 years, 36.6% women, 71% acute coronary syndromes (ACS) and 53.6% complex PCI. Co-primary safety endpoint of major adverse cardiovascular events was met in 6.2%, coprimary safety endpoint of bleeding in 7.8% and primary efficacy endpoint of TKLR in 1.5%. The multivariable adjusted model showed no significant association of the prescribed short/long dual antiplatelet therapy (DAPT) durations with any endpoint suggesting a well tailored therapy. No stent thrombosis reported in the subgroup with 1-3 months DAPT duration. As compared to control group, bleeding BARC 2-5 was significantly lower in SIERRA-75 group (7.4% vs. 10.2%, P = 0.04) as well as the net safety-efficacy endpoint (14.3% vs. 18.5%, P = 0.02). CONCLUSIONS In elderly population, the application of this risks-adjusted antithrombotic protocol after revascularization with last generation EES seems to be associated with an improved prognosis in terms of ischemic and bleeding outcomes. [ABSTRACT FROM AUTHOR]

The Pain Anxiety Symptoms Scale (PASS-20) is well validated in adults and younger populations, but not in older adults. This study aimed to analyze the psychometric properties of the PASS-20 in Spanish older adults who experience chronic pain. Participants were 111 older adults with chronic pain living in nursing homes (mean age = 83.36; SD = 6.53; 78.6% female). Face-to-face interviews were conducted which included assessment of pain anxiety (PASS-20), chronic pain acceptance (CPAQ), depression symptoms (GDS), catastrophizing beliefs (PCS), pain severity, and sociodemographic information. An Exploratory Structural Equation Modeling (ESEM) approach was used to refine the scale. The final scale was composed of seven items, measuring two factors that could be labeled "Internal experiences" and "Escape/Avoidance behaviors". The two factors explained 60.98% of the total variance. PASS-7 version fit properly: χ2/df = 14.57/13, CMIN/df = 1.121, CFI = 0.99, RMSEA = 0.033, TLI = 0.98, GFI = 0.96, AGFI = 0.92. Good validity indices were found and acceptable reliability results in the scale and its subscales (Chronbach´s α; Internal Experiences = 0.70; Escape/Avoidance Behaviors= 0.73; Total Scale = 0.77). The short version of the PASS-7 has good psychometric properties. The brevity of the PASS-7 increases the feasibility of this instrument which could potentially be utilized in a variety of clinical settings and research studies with older people with chronic pain samples, specially institutionalized older adults. [ABSTRACT FROM AUTHOR]

Aim: The Memory Failures of Everyday (MFE) is a widely used instrument for assessing memory failure. The aim of the study was to analyze the MFE items using the Rasch model in a sample of cognitively older adults in Spain. Methods: A cross‐sectional validation study in a sample of 214 healthy people aged ≥60 years who used centers for older people in Madrid (Spain). The MFE for the assessment of memory complaints was used. The following properties of the Rasch model were assessed: data fit, reliability, unidimensionality, local dependence and lack of differential item functioning by gender, age and marital status. Results: The MFE showed a good fit to the Rasch model (χ2(140) = 160.2; P = 0.116) and high reliability (person separation index = 0.808). The questionnaire was unidimensional (6.54% t‐test; IC binomial = 0.036–0.095). The items showed lack of local dependence between them and differential item functioning. The MFE scores were transformed into linear interval scores with a median of 44.31 and an observed range of 17.9–89.2 (theoretical range: 0–100). Conclusions: The MFE is a unidimensional, reliable instrument to assess memory complaints in cognitively healthy older adults in Spain, with usefulness in clinical research and practice. The construct validity of the MFE linear score could not be fully confirmed and this deserves further investigation. Geriatr Gerontol Int 2022; 22: 332–337. [ABSTRACT FROM AUTHOR]

Patients with a dementia diagnosis and COVID-19 sometimes manifest an atypical clinical picture. However, differences between elderly COVID-19 patients having dementia and those not having dementia have not been described yet. The in-hospital mortality and out-of-hospital mortality from both groups has not been reported. The primary aim of this study is to determine if there is a significant difference in-hospital and out-of-hospital mortality in the elderly patients admitted for COVID-19, comparing those with dementia and those without dementia. A secondary aim is to determine whether there are significant clinical and laboratory differences between elderly COVID-19 patients with dementia and without dementia. Data collection of hospitalizations of elderly patients aged 70 years old or older admitted for COVID-19 in 2020 at the Hospital de San Juan de Alicante. In-hospital mortality in a context of admission for COVID-19 is significantly higher in patients with out dementia. However, post-discharge out-of-hospital mortality is significantly higher in patients with dementia. The out-of-hospital mortality of elderly patients with dementia appears to be significantly higher than those who do not. Therefore, the importance of caring for elderly patients with dementia after being discharged from hospital should be emphasized. [ABSTRACT FROM AUTHOR]

This article examines COVID-19 and residential care for older people during the first wave of the pandemic in 2020, comparing a range of countries – Denmark, England, Germany, Italy and Spain – to identify the policy approaches taken to the virus in care homes and set these in institutional and policy context. Pandemic policies towards care homes are compared in terms of lockdown, testing and the supply of personal protective equipment. The comparative analysis shows a clear cross-national clustering: Denmark and Germany group together by virtue of the proactive approach adopted, whereas England, Italy and Spain had major weaknesses resulting in delayed and generally inadequate responses. The article goes on to show that these outcomes and country clustering are embedded in particular long-term care (LTC) policy systems. The factors that we highlight as especially important in differentiating the countries are the resourcing of the sector, the regulation of LTC and care homes, and the degree of vertical (and to a lesser extent horizontal) coordination in the sector and between it and the health sector. [ABSTRACT FROM AUTHOR]