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This essay re-examines Henry James’s complex relationship with Edgar Allan Poe by focusing on the echoes of one of Poe’s most celebrated tales, “The Tell-Tale Heart” (1843), that later reverberate in James’s “The Aspern Papers” (1888). It highlights the similarities, both in mindset and behavior, between the two stories’ devious and deranged first-person narrators, whose actions result in the death of a fellow human being. It further discusses the narrators’ fear and refusal of their own mortality, which finds expression in their hostility, and barely contained revulsion against a man (in “The Tell-Tale Heart”) and a woman (in “The Aspern Papers”), whose principal defining traits are old age and physical decay.

Social workers, especially in the Global North/developed countries such as the United States of America, Australia, Canada, and the United Kingdom, have been actively involved in implementing social programs to improve the psychosocial, health, and wellbeing of older adults during the COVID-19 pandemic. However, this is not the case in the Global South/developing countries like Nigeria, Ghana, etc. This concept paper aims to describe the current state of Nigerian social workers' role in developing and implementing social programs for older adults during the COVID-19 pandemic and to identify action plans for further strengthening their involvement. We systematically reviewed the literature to identify Nigerian social workers' role in developing and implementing social programs for older adults during COVID-19. Our review reflected that social workers are rarely involved in developing and implementing social programs; when involved, their involvement is on a consultation basis, which limits their active involvement in multidisciplinary team of COVID-19 prevention and vaccination ad hoc committees in Nigeria. [ABSTRACT FROM AUTHOR]

The European Commission Horizon 2020 project—PreventIT—evaluated two approaches to delivering Lifestyle-Integrated Functional Exercise (LiFE) programs for maintaining older adults' physical function: the paper-based adapted LiFE and mobile health device delivered enhanced LiFE. A self-reported method was used to measure users' monthly adherence over 12 months. This analysis aimed to explore young seniors' adherence patterns between enhanced LiFE and adapted LiFE groups. Results showed that adherence level decreased with time in both groups. The enhanced LiFE group had slightly higher adherence than the adapted LiFE group during most of the 12 months. However, the overall adherence levels were not significantly different during either intervention or follow-up periods. Monthly self-reported adherence measurement can help to understand users' adherence comprehensively. The comparable adherence levels between both groups indicate mobile health could be an alternative to delivering home-based physical activity for young seniors. However, this feasibility study was not powered to detect differences between groups. [ABSTRACT FROM AUTHOR]

Depression is a global health issue. It is spoken about everywhere and can affect anyone at any age. In the past century, medical technology and preventative medicines have increased in availability and accessibility, resulting in an increase in global life expectancy. However, as a result of increased life expectancy, the number of elderly adults have also increased. Due to chronic conditions, decreased social support, increased physical dependency and other natural events that come with age, it has caused a great number of elderly individuals to be impacted by depression. Furthermore, changes in traditional family and social structures have made it harder for the elderly to be cared for at home by their children and has resulted in an increase of elderly individuals living in nursing homes. Due to the loss of independence associated with nursing homes, it has further increased the prevalence of depression amongst the elderly. Elderly depression is not normal and can greatly impact quality of life and result in poor health outcomes, thus it is imperative that nurses address this issue. The purpose of this paper is to explore the significance of depression to the elderly population and to community health nursing, as well as to explore potential solutions for elderly depression using a strengths-based approach. Furthermore, this paper discussed implications for nursing practice on elderly depression. Depression is a serious health concern to the elderly population that nurses must address using strength and asset-based perspectives. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to shed some light on the subject matter of the exploration of public medical coverage and elderly done as such far across the world. To achieve this objective, a comprehensive bibliometric examination was used to investigate papers published between the years 1960 and 2020. An aggregate of 366 papers was selected and analysed for the same. The investigation endeavours to recognise the journals with outstanding performance in this field, distribution of papers concerning the year of their publication, most referred to papers. Then various maps depicting bibliometric networks are provided, namely, the joint-authorship network map, inter-country joint-authorship network map and keyword co-occurrence network map. Design/methodology/approach: To achieve the objective of this study, the Scopus database was used for comprehending the vast magnitude of information about numerous papers included in this paper. VOSviewer has been used to create a joint-authorship network map, inter-country joint-authorship network map and keywords concurrences network map. Findings: The result of this investigation demonstrates that the highest number of publications came out in the year 2019, the most notable journal is Journal of Aging and Social Policy, and the most referred to research paper is about long-term care insurance (LTCI) in Japan. The USA is the most productive nation with the most elevated number of papers published under its name. Tamiya N. has teamed up with the highest number of authors, which is 29. Again the USA is the nation that participated with the highest number of authors of different countries in the research paper. Originality/value: This paper accord with the current writing on public health insurance and elderly. A much far-reaching and solid image of this sector is given using the bibliometric analysis technique. The authors keen on directing future exploration on this topic can take guidance from the results of this study. [ABSTRACT FROM AUTHOR]

Mobility can be defined as the ability to move or be moved freely and easily. In older adults, mobility impairments are common and associated with risk for additional loss of function. Mobility loss is particularly common in these individuals during acute illness and hospitalization, and it is associated with poor outcomes, including loss of muscle mass and strength, long hospital stays, falls, declines in activities of daily living, decline in community mobility and social participation, and nursing home placement. Thus, mobility loss can have a large effect on an older adult's health, independence, and quality of life. Nevertheless, despite its importance, loss of mobility is not a widely recognized outcome of hospital care, and few hospitals routinely assess mobility and intervene to improve mobility during hospital stays. The Quality and Performance Measurement Committee of the American Geriatrics Society has developed a white paper supporting greater focus on mobility as an outcome for hospitalized older adults. The executive summary presented here focuses on assessing and preventing mobility loss in older adults in the hospital and summarizes the recommendations from that white paper. The full version of the white paper is available as Text S1. J Am Geriatr Soc 67:11–16, 2019. [ABSTRACT FROM AUTHOR]

Purpose: To examine the validity and usability of a paper log for evaluating exercise duration in older women. Method: Data from 23 females (mean age = 70.4 years) who completed an 8-week pilot randomized controlled trial investigating the effects of yoga and aerobic/strength training on knee osteoarthritis were included in this secondary analysis. Participants were asked to complete a paper log and video recording of their home exercise sessions. Results: Concurrent validity was high between minutes reported on the paper logs and video recordings during Weeks 2 to 7 (r = 0.878). Usability was high, with participants completing 79% to 91% of paper logs and 74% to 100% of video diaries weekly. Overall minutes reported on the paper exercise logs and video diaries were positively correlated to Physical Activity Scale for the Elderly scores at 8 weeks. Conclusion: Exercise logs are a valid and useful method in assessing adherence to prescribed exercise duration in unsupervised home programs. [Research in Gerontological Nursing, 17(5), 219–225.] [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) inflicts severe illness and courses of infections not only in neonates, infants, and young children, but also causes significant morbidity and mortality in older adults and in people with immunosuppression, hemato-oncologic disease, chronic lung disease, or cardiovascular disease. In June and August 2023, effective vaccines against RSV were approved for the first time by the European Medicines Agency (EMA) for the EU. The respective pivotal studies showed a very high efficacy of the vaccine in preventing severe RSV-associated respiratory infections. At this point, use of the respective vaccines is restricted to persons aged 60 years or older, according to the registration studies. We therefore recommend use of the vaccination in persons aged 60 years or older. In addition, we recommend use of the vaccination in adults of any age with severe pulmonary or cardiovascular pre-existing conditions, as well as in adults with significant immune compromise, after individual consultation with the treating physician. Cost coverage can be applied for individually with the responsible health insurance company. [ABSTRACT FROM AUTHOR]

This study explores policy makers’, health-care professionals’ and senior volunteers’ perceptions of senior volunteers. Two Norwegian government white papers regarding older adult care and welfare services, which were published over a period of 19 years, were selected for close examination. Furthermore, focus group interviews with a purposeful sample of five senior volunteers and 15 health-care professionals were conducted. The study explores the discursive formations of senior volunteers in the government white papers and how they are negotiated in the senior volunteers’ and the health-care professionals’ narratives. Two dominant discourses were presented in the white papers: a prevention discourse (in which volunteering was presented primarily as a means to prevent volunteers’ loneliness and need for care services) and a sustainability discourse (in which the volunteers were presented as instrumental in future sustainable care services). Both discourses echo a common overarching discourse about a capacity crisis due to the ageing population. The senior volunteers were positioned as partners and active agents in both their own narratives and the health-care professionals’ narratives. Their position as independent and as spokespersons for the less empowered were evident only in the senior volunteers’ own narratives. Only the health-care professionals referenced the prevention discourse and capacity issues. The senior volunteers presented themselves as competent, efficient political actors, and they resisted both the prevention and sustainability discourses. In the senior volunteers’ narratives, social and political participation were interrelated. The study demonstrates that new discursive landscapes must be created to capture the diversity among senior volunteers and their efforts. While senior volunteers must be meaningfully involved in decision making, planning and design, their positions as independent and active agents must also be ensured. Authentic partnerships between senior volunteers and public care services involve a balance between involvement and independence. [ABSTRACT FROM AUTHOR]

The author comments on the research paper "Group-based pelvic floor muscle training is not inferior to individual training for the treatment of urinary incontinence in older women," by C. Dumoulin, et al., which was published within the issue.

We present the results of the user studies of the CareMe prototype telecare service for supporting older adults with remote telecare services. The CareMe solution targets older adults who are capable of living independently and outside of a dedicated medical institution or a nursing home, but require occasional medical attention, and formal or informal care. The studies were conducted between November 2013 and March 2014 and followed the participatory design approach. The research questions focused on understanding the difference in the participatory design approach when older adults use paper prototypes vs interactive prototypes, and the difference when older adults use interactive prototypes with poor interface design vs interactive prototypes with rich interface design. In total, 45 older adults living in Slovenia participated in the field trial. They were retired, 32 of whom were nursing home residents and 13 were living independently at home. The study sample's age distribution was between 64 and 91 years. The analysis of the filed trial results indicated the importance of the factors that influence users' decision about how and when they use new technology, i.e., the perceived usefulness and the perceived ease-of-use. Main insights gained from the studies show, that it is very difficult to keep older people focused on the topics of discussion and that they have often difficulties to clearly present/express their ideas. Furthermore, abstract concepts, such as paper only prototypes proved to be challenging to cope with, whereas using real applications and services when trying out scenarios using interactive prototypes provided much better experience and feedback. [ABSTRACT FROM AUTHOR]

The article presents a brief summary of the research "Group-based pelvic floor muscle training is not inferior to individual training for the treatment of urinary incontinence in older women" which was published within the issue.

Aging is a heterogeneous process. Most newly diagnosed cancers occur in older adults, and it is important to understand a patient's underlying health status when making treatment decisions. A geriatric assessment provides a detailed evaluation of medical, psychosocial, and functional problems in older patients with cancer. Specifically, it can identify areas of vulnerability, predict survival and toxicity, assist in clinical treatment decisions, and guide interventions in routine oncology practice; however, the uptake is hampered by limitations in both time and resources, as well as by a lack of expert interpretation. In this review, we describe the utility of geriatric assessment by using an illustrative case and provide a practical approach to geriatric assessment in oncology. [ABSTRACT FROM AUTHOR]

People with learning disabilities are living longer. Older people with learning disabilities should be included in policies and plans that are for all older people. National plans and policies for older people often do not say anything about older people with learning disabilities, and it is hard to know whether older people with learning disabilities are benefiting. People who plan services locally often do not have good information on older people with learning disabilities. Using the Equalities Act 2010 could help people who plan services and write policy to think about older people with learning disabilities but this is not happening at the moment. People who work with older people with learning disabilities should be aware of policy for all older people, so that older people with learning disabilities do not miss out. This paper seeks to explore the opportunities and challenges generated by current policy, guidance and legislation in England relating to older people, in terms of the practical implications for older people with learning disabilities. Using the broad themes housing, employment, social inclusion and isolation, care and support, and promoting better health and well-being, this paper discusses potential practical opportunities and concerns for older people with learning disabilities arising from policy and legislation such as current initiatives regarding integration, personalisation and the dementia policy. Consideration is given to the implications of changing policy and practice for both current and future generations of people with a learning disability as they reach older age. This discussion paper concludes that whilst there is potential for older people with a learning disability to benefit from policy and practice aimed at improving the lives of older people generally, the tendency for policy to be targeted at specific groups without adequately considering the diversity of those groups often leaves those with a learning disability at the margins of being able to make the most of changes. [ABSTRACT FROM AUTHOR]

Introduction: Anemia is a major public health problem amongst elderly population in India. Anemia in old age further worsens the age-related decline in functional ability, mobility, fatigue, bone density, and skeletal muscle mass. There is lack of evidence on the prevalence and risk factors of anemia among elderly population. Hence, this study was undertaken. Methodology: A community-based cross-sectional study was conducted during the year 2015–2016 in District Nainital, Uttarakhand state, India. A total of 958 subjects were selected from 30 clusters (villages) identified using population proportional to size methodology. Information on sociodemographic profile, nutritional status, body mass index, and dietary intake was obtained. Blood sample was collected from each subject on the filter paper for estimation of hemoglobin (Hb) level using cyanmethemoglobin method. Results: We found that 92.1% of the elderly subjects were anemic. Moderate and severe anemia was found to be significantly higher among female subjects, unemployed, illiterates, subjects using smoke-producing fuel, subjects belonging to lower socioeconomic status, malnourished and underweight subjects, subjects with self-reported hyperacidity, and subjects who had not utilized health facility and had lower iron and vitamin C intake when compared with subjects with mild anemia and normal hemoglobin levels. Conclusion: High prevalence of anemia exists amongst elderly subjects living at high-altitude region of rural Uttarakhand State, India. There is a need to educate the elderly population about the importance of adequate intake of foods rich in iron and vitamin C to reduce the prevalence of anemia among them. [ABSTRACT FROM AUTHOR]

Molecular imaging using radiopharmaceuticals has a clear role in visualising the presence and extent of tumour at diagnosis and monitoring response to therapy. Such imaging provides prognostic and predictive information relevant to management, e.g. by quantifying active tumour mass using positron emission tomography/computed tomography (PET/CT). As these techniques require only pharmacologically inactive doses, age and potential frailty are generally not important. However, this may be different for therapy involving radionuclides because the radiation can impact normal bodily function (e.g. myelosuppression). Since the introduction of Iodine-131 as a targeted therapy in thyroid cancer, several radiopharmaceuticals have been widely used. These include antibodies and peptides targeting specific epitopes on cancer cells. Among therapeutic bone seeking agents, radium-223 ( 223 Ra) stands out as it results in survival gains in patients with castration-resistant prostate cancer and symptomatic bone metastases. The therapeutic use of radiopharmaceuticals in elderly cancer patients specifically has received little attention. In elderly prostate cancer patients, there may be advantages in radionuclides' ease of use and relative lack of toxicity compared with cytotoxic and cytostatic drugs. When using radionuclide therapies, close coordination between oncology and nuclear medicine is needed to ensure safe and effective use. Bone marrow reserve has to be considered. As most radiopharmaceuticals are cleared renally, dose adjustment may be required in the elderly. However, compared with younger patients there is less, if any, concern about adverse long-term radiation effects such as radiation-induced second cancers. Issues regarding the safety of medical staff, care givers and the wider environment can be managed by current precautions. [ABSTRACT FROM AUTHOR]

Aim: To synthesize suicide prevention strategies for older adults. The review question was Which suicide prevention strategies are useful for older adults? Design: Integrative review. Data sources: Academic Search Premier, CINAHL, Ovid PsycINFO and PubMed were searched for articles published between January 2009 and December 2019. Review methods: An integrative review of quantitative, qualitative and theoretical papers with a qualitative thematic analysis. Results: Key aspects of the included studies contributed to the formulation of four themes: (1) Recognizing older adults' physical and/or mental health problems and referring them for help and treatment, (2) Designing an educational programme, (3) Communication and dialogue about warning signs and (4) Social support and awareness of causing significant others emotional pain. The findings indicate an urgent need to identify effective suicide prevention strategies for older adults. [ABSTRACT FROM AUTHOR]

Simple Summary: This position paper aims to provide practitioners a proposal for multidisciplinary care planning for older patients with ovarian cancer from the time of suspected diagnosis. The first-line treatment of advanced ovarian cancer involves several interdependent sequences: cytoreductive surgery, (neo)adjuvant chemotherapy and maintenance targeted treatments. In older patients, care planning must be adapted to their geriatric parameters and consider the geriatric impact of each treatment sequence to allow treatment completion. Care planning should be centered on patient motivation and imply multidisciplinarity. Each step of treatment plan should be reconsidered in light of a geriatric assessment and follow-up. Studies are needed to prospectively evaluate the impact of geriatric vulnerability parameters at each step of the treatment agenda and the impact of geriatric interventions on patient outcomes. In this position paper the Société Francophone d'OncoGériatrie (SOFOG; French-speaking oncogeriatric society), the Société Française de Pharmacie Oncologique (SFPO, French society for oncology pharmacy), the Groupe d'Investigateurs Nationaux pour l'Étude des Cancers de l'Ovaire et du sein (GINECO, National Investigators' Group for Studies in Ovarian and Breast Cancer) and the Groupe Français de chirurgie Oncologique et Gynécologique (FRANCOGYN) propose a multi-disciplinary care planning of ovarian cancer in older patients. The treatment pathway is based on four successive decisional nodes (diagnosis, resectability assessment, operability assessment, adjuvant, and maintenance treatment decision) implying multidisciplinarity and adaptation of the treatment plan according to the patient's geriatric covariates and her motivation towards treatment. Specific attention must be paid to geriatric intervention, supportive care and pharmaceutical conciliation. Studies are needed to prospectively evaluate the impact of geriatric vulnerability parameters at each step of the treatment agenda and the impact of geriatric interventions on patient outcomes. [ABSTRACT FROM AUTHOR]

Anthony Ellis (2011, 13) examines an excerpt from Thomas Elyot's Castel of Health (1541) in which he observes a doctor's conception about growing old: "old age equals the inception of 'bad humor' and calls for professional intervention." The depiction of senescence or biological aging in literature can be analyzed from the perspective of the abovementioned doctor who attaches negative attributes to senescence. This paper focuses on the effects of aging and ageism on Amanda Wingfield from The Glass Menagerie by Tennessee Williams and Ephraim Cabot from Desire Under the Elms by Eugene O'Neill. Both these aging characters are inclined to stick to their habits, lifestyles and preferences they have developed in their earlier years. Their fixation with their earlier lifestyle gives rise to hatred or indifferent attitude of the younger people around them. The paper examines the detachment and disengagement of the two characters from society and their loved ones due to ageism. [ABSTRACT FROM AUTHOR]

This paper critically considers the concept of 'productive aging,' maintaining that although the term emerged as an effort to aid older people, it may be normative and potentially coercive. The paper illustrates this premise through an examination of Japan, through analysis of interviews conducted over decades, and, more fully, an analysis of advice books for Japanese seniors over the past twenty years. These advice books show how seniors in Japan are now increasingly urged to find contentment in old age as they themselves see fit, without concern over 'contributing to society.' In crucial respects, Japan has been moving from 'productive aging' to 'happy aging' as a guide for how to age. The paper then considers the judgment inherent in the term 'productive aging'—are some forms of aging better than other forms of aging?—by examining competing conceptions of happiness, advocating on the basis of this examination that the term 'productive aging' be replaced by 'happy aging.' [ABSTRACT FROM AUTHOR]

The rapid increase in the number of older people under the background of population aging has gradually changed the disease spectrum of society, making aging diseases more prevalent, and increasing the demand for health care services, medical and health services, and health insurance among older people, ultimately leading to increasing household and social spending on old age. This study is conducted to assess the impact of those spending burden on the sustainable development of economy and find out some practical and effective solutions. This paper constructs a theoretical model to illustrate the relationship between the old-age dependency ratio and the marginal product of capital (MPK), and then establishes a two-way fixed effect model based on transnational panel data of 81 countries from 1981 to 2017 to verify this relationship empirically. This paper finds that, after controlling a series of variables, an increased burden of old-age dependency leads to a decline in the MPK, a key macroeconomic variable and also a sustainable development criteria, but in which health care, health security systems, and technological innovation play a key and moderating role. The conclusion is also valid after tackling the problem of endogeneity with different methods, like two-stage least squares (TSLS) and the generalized methods of moments (GMM). Overall, before population aging, countries that are old-but-not-rich should encourage more supply-side investments in public health system or technological innovation, and adjust retirement system, or gradually encourage childbearing to strive for time and space for later sustainable development of public health system and economy. [ABSTRACT FROM AUTHOR]

Compared with intravenous (i.v.) chemotherapy, oral administration is convenient, requires fewer healthcare resources, is generally preferred by patients, and may be appropriate in older people with breast, colorectal and lung cancers. The effects of organ dysfunction on drug metabolism and drug interactions in patients with multiple comorbidities must be considered but are not specific to oral chemotherapy. Single-agent oral chemotherapy with capecitabine or vinorelbine is active in older patients with advanced or metastatic breast cancer. Choice of treatment is based mainly on different safety profiles. In the adjuvant treatment of colorectal cancer (CRC), single-agent oral capecitabine is an effective alternative to i.v. fluorouracil (5-FU) regimens. In metastatic CRC, oral, single-agent capecitabine has recently shown encouraging median overall survival in combination with bevacizumab. In non-small cell lung cancer, fit older patients, like their younger counterparts, benefit from platinum-based doublets, with carboplatin preferred to cisplatin. Single agent vinorelbine is an option for those less suited to combination chemotherapy, and oral may be an alternative to i.v. administration. For elderly cancer patients in general, metronomic chemotherapy combines good tolerability with acceptable activity. [ABSTRACT FROM AUTHOR]

In the context of current and expected demographic changes, the issues of which services the welfare state should offer and, ultimately, the very function of the welfare state are currently debated in Norway. The political discourse on health and care services for older adults has morphed into an accepted reality in which the system must be altered, prompting policy makers and stakeholders to find new and novel solutions to problems associated with population ageing. In this paper, we discuss one such proposed solution: the transformation of health and care services for the older adult population through the increased involvement of volunteers. We ask how volunteer efforts are articulated and delineated through official accounts and discuss the implications of such an articulation and delineation. We seek answers to these questions through a critical discourse analysis of recent governmental white papers. We investigate, in other words, volunteer efforts as a political instrument. We argue that the official representation of how efforts in health and care services should be re-aligned take the form of a distinct discourse of 'voluntarism'. Within this 'voluntarism', volunteer efforts have been altered from a third sector comprising charity and non-profit organisations that contribute within or as a supplement to the largely public-run welfare system to a limitless and extensive concept that is blurring the boundaries to informal care. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this integrative review was to investigate current literature exploring relationships between general self‐efficacy and the healthy ageing of older people. Background: Enhancing the health and well‐being of older adults, while mitigating consequences of illness and frailty are important priorities in healthy ageing. General self‐efficacy is closely associated with human behaviour and has been linked with improved health and well‐being. Design: An integrative review using the five‐stage method described by Whittemore and Knafl (Journal of Advanced Nursing, 2005, 52, 546). Methods: Academic databases CINAHL, MEDLINE and APA PsycInfo were searched between 2010 and 2020 for original, peer‐reviewed papers, published in English that investigated general self‐efficacy and factors associated with the healthy ageing of older people. Included papers were critically appraised using the Appraisal tool for Cross‐Sectional Studies (AXIS tool) and Critical Appraisal Skills Programme, and underwent data abstraction and synthesis via a constant comparative method. This review was also evaluated using the PRISMA checklist. Results: Twenty‐one papers were included in this review. Two main themes emerged. The first highlights positive relationships between general self‐efficacy and health and ageing perceptions, with subsequent influence on health behaviours. The second includes two sub‐themes, which explores general self‐efficacy's role in maintaining well‐being through its effects on psychological health and overcoming physical decline through adaption to changing physical and health conditions. Conclusions: Promoting general self‐efficacy has potential benefits for the healthy ageing of older people through positive effects on ageing and health perceptions, health behaviours, psychological health and overcoming physical decline. Relevance to clinical practice: Understanding how general self‐efficacy facilitates healthy ageing can guide nursing practices that reduce or mitigate consequences of illness and physical decline on the health and well‐being of older people. Strategies aimed at increasing older people's general self‐efficacy can help to facilitate subsequent positive effects on factors that promote healthy ageing. [ABSTRACT FROM AUTHOR]

As a super-aging society, health promotion activities in local Japanese communities are increasingly essential. Developing the health-promotion programs must include the perspective of older people residing in these communities and what they believe to be their regional strengths. This study aimed to clarify the elements of regional strengths perceived by older people living in local Japanese communities from the literature review. Using the internet edition of the Japan Medical Abstracts Society (Ichu-shi), the authors examined papers on Japanese regional residents using relevant keywords. Of 342 considered papers, 14 papers were extracted in this study. As a result, the contents related to the regional strengths perceived by the older people living in the local Japanese community were extracted, classified based on the similarity of the meanings and contents, and then summarized into the elements of the strengths. As the regional strengths, three categories were cited for individual elements: "Actions or behaviors underpinned by experience," "Continuing to live with positivity and vigor," and "Extensive support for the subject and their family." Three categories were cited for environmental elements: "A comfortable environment," "Maintaining intimate and friendly interpersonal relations," and "Support that meets the regional characteristics." Along with individual and environmental elements, support from experts in the region was cited. Hence, it was concluded that the active participation of experts is essential for promoting activities in local communities, and that deepening relationship with older people has the potential to improve their quality of life. [ABSTRACT FROM AUTHOR]

Few older adults regain their pre-fracture mobility after a hip fracture. Intervention studies evaluating effects on gait typically use short clinical tests or in-lab parameters that are often limited to gait speed only. Measurements of mobility in daily life settings exist and should be considered to a greater extent than today. Less than half of hip fracture patients regain their pre-fracture mobility. Mobility recovery is closely linked to health status and quality of life, but there is no comprehensive overview of how gait has been evaluated in intervention studies on hip fracture patients. The purpose was to identify what gait parameters have been used in randomized controlled trials to assess intervention effects on older people's mobility recovery after hip fracture. This scoping review is a secondary paper that identified relevant peer-reviewed and grey literature from 11 databases. After abstract and full-text screening, 24 papers from the original review and 8 from an updated search and manual screening were included. Records were eligible if they included gait parameters in RCTs on hip fracture patients. We included 32 papers from 29 trials (2754 unique participants). Gait parameters were primary endpoint in six studies only. Gait was predominantly evaluated as short walking, with gait speed being most frequently studied. Only five studies reported gait parameters from wearable sensors. Evidence on mobility improvement after interventions in hip fracture patients is largely limited to gait speed as assessed in a controlled setting. The transition from traditional clinical and in-lab to out-of-lab gait assessment is needed to assess effects of interventions on mobility recovery after hip fracture at higher granularity in all aspects of patients' lives, so that optimal care pathways can be defined. [ABSTRACT FROM AUTHOR]

A response to the paper "Use of Technology by Older Adults With an Intellectual Disability in Ireland to Support Health, Well-Being and Social Inclusion During the COVID-19 Pandemic,"by Darren McCausland, Mary McCarron and Philip McCallion, is presented. Topics include ways to present quantitative data in academic journals for easier understanding, practical information that should be included in research papers and the importance of the research to people with learning disabilities.

Aims: The purpose of this study was to investigate the status of self‐management behaviour and illness perceptions and to examine illness perceptions in relation to self‐management behaviour in elderly patients with chronic obstructive pulmonary disease (COPD). Methods: A cross‐sectional study was conducted, and 152 elderly COPD patients were recruited via the convenience sampling method. The COPD Self‐Management Scale and the Revised Illness Perception Questionnaire for COPD patients were used to examine self‐management behaviour and illness perceptions. Pearson correlation analysis, univariate analysis and hierarchical linear regression analysis were used to explore illness perceptions in relation to self‐management behaviour. Results: The mean overall score for self‐management behaviour was 2.90 ± 0.39. Among the subscales of self‐management behaviour, information management had the lowest score of 2.20 ± 0.76. Patients' demographic and clinical characteristics, including educational level, smoking status, type of primary caregiver, home oxygen therapy and COPD duration, were found to be significant determinants of self‐management behaviour. After controlling for these variables, several illness perception subscales, including treatment control, personal control, coherence, timeline cyclical and identity, were significantly correlated with self‐management behaviour. Conclusions: This study confirmed that elderly COPD patients' self‐management behaviour was unsatisfactory and that illness perceptions were significant determinants of self‐management behaviour. The findings may contribute to the development of self‐management interventions for elderly COPD patients. Summary statement: What is already known about this topic? Self‐management behaviour plays an essential role in managing COPD.Illness perceptions are predictors of self‐management behaviours in COPD patients, but little is known about how illness perceptions influence self‐management behaviour in elderly patients with COPD. What this paper adds? Several illness perception subscales, including treatment control, personal control, coherence, timeline cyclical and identity, were significantly correlated with self‐management behaviour.Patients' demographic and clinical characteristics, including educational level, smoking status, type of primary caregiver, home oxygen therapy and COPD duration, were found to be determinant of self‐management behaviour. The implications of this paper: The findings may contribute to developing tailored interventions that help patients establish beneficial illness perceptions to improve their self‐management behaviour. [ABSTRACT FROM AUTHOR]

This research paper aimed to identify the level of psychological hardiness, the level of death anxiety, and the level of existential vacuum among the elderly, also the role of the predictive ability of death anxiety and existential vacuum in the psychological hardiness of the elderly at the governorates of Tafilyah and Ma'an in light of the Corona pandemic in Jordan. The descriptive-analytical approach was utilized. sample consists (500) elderly, that were selected by a simple random approach. Then the needed statistical measure was operated to achieve the required results. The results indicated a low level of psychological hardiness, a high level of death anxiety, and an existential vacuum in the elderly. The results show a suitable predictive ability for each of death anxiety and the existential vacuum in reducing psychological hardiness. The research paper recommended the necessity of rehabilitating the elderly in Jordan regarding the mental and psychological aspects. [ABSTRACT FROM AUTHOR]

The primary aim of this systematic review was to examine the efficacy of driving interventions with regard to a reduction in motor vehicle crashes and improvements in driving skills among older people. The secondary aim was to identify the optimal type (on‐road or off‐road) and dosage (period, sessions, and duration) of driving interventions for improving driving skills in older people. We searched MEDLINE, EMBASE, PsycINFO, and Scopus of Systematic Reviews for papers published from their inception to December 1, 2020, as well as the reference lists of the included papers. The selected studies were randomized controlled trials examining the effects of driving interventions among community‐dwelling older drivers aged 65 years and over. A meta‐analysis of two studies (n = 960) showed that driving interventions significantly reduced the number of motor vehicle crashes per person‐years. Ten studies (n = 575) were included in the meta‐analysis showing that the interventions significantly improved the driving skill scores. Driving skill scores significantly improved after on‐road training, and in interventions of at least 3 h, 3 sessions, and 3 weeks. Driving interventions significantly improve driving skills and reduce motor vehicle crashes among older drivers aged 65 years and over. On‐road training is more efficacious than off‐road training and driving interventions of at least 3 h taking place in 3 sessions over a period of 3 weeks may be required to improve driving skills in older drivers. Geriatr Gerontol Int 2023; 23: 771–778. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this paper is to respond to a gap in the literature around resilience in later life for older people from minority groups of identity or experience. Specifically, it argues that we need to pay greater attention to how access to different types of social capital may leave some older people more or less able to cope with adverse events and how experiences of social exclusion can limit access to important networks of support during times of crisis. Design/methodology/approach: This paper draws on research conducted to inform the resilience strategy of Greater Manchester in 2019, and specifically looked at how this strategy could better address the needs of the regions' diverse ageing population. It used a qualitative design including focus groups with older women of Punjabi heritage living in Greater Manchester, interviews with staff from a community and voluntary organisation working with these women, and interviews with staff at an organisation supporting refugees and asylum seekers in Greater Manchester who specifically worked with older adults. Findings: The research found that belonging to a minority group and experiences of social exclusion gave participants in this study both resources and vulnerabilities when it came to dealing with external shocks in later life. Whilst participants in this study had access to strong networks of bonding capital based on shared identity and experience, social exclusion often meant they faced barriers to accessing network of support outside of these communities. Research limitations/implications: Findings from this study have implications for both future research and policy. In the case of the latter there are implications for those working in resilience planning in terms of how to address the needs of diverse older populations. For researchers, this paper has implications for how we understand the impacts on inequality in later life particularly in the context of the COVID-19 pandemic. Originality/value: The originality of this paper lies in its consideration of the impact of inequalities and social exclusion on the resilience of older people in times of crisis. It included older people from minority groups of identity and experience addressing an important gap in the literature. [ABSTRACT FROM AUTHOR]

High health literacy (HL) is important to optimise health outcomes, particularly for older people (who are substantial consumers of health services) and their adult caregivers. The aim of this systematic review was to evaluate measurement properties of HL instruments tested with these population groups. Six databases (MEDLINE (OVID); CINAHL; EMBASE (OVID); PsycInfo; Scopus; Cochrane Library) were searched for studies evaluating eight measurement properties of HL tools administered to older people or their caregivers. Only studies evaluating multi-domain self-report HL tools were included in analyses, using the COSMIN methodology. From 4261 unique papers located, 11 met inclusion criteria; six reported measurement properties of three HL self-report tools administered to older people (HLQ, eHEALS, and HeLMS) so are reported in this review, none involved caregiver samples. The HLQ and HeLMS were rated "moderate," and eHEALS "low" for tool development. The HLQ, examined in four included studies, had the highest ratings and quality of evidence across the three measurement properties investigated in included papers. The HLQ was the most highly rated self-report HL tool of just three tested with older people. Further studies evaluating measurement properties of self-report HL tools used with older people and/or their caregivers are needed. Health literacy is important to optimise health outcomes of interventions for older people and their adult caregivers. Few studies have evaluated measurement properties of self-report / multi-domain health literacy tools for this population. The Health Literacy Questionnaire (HLQ) had the highest ratings and quality of evidence across the three measurement properties investigated in included studies, and is recommended for use in rehabilitation settings. [ABSTRACT FROM AUTHOR]

This essay re-examines Henry James's complex relationship with Edgar Allan Poe by focusing on the echoes of one of Poe's most celebrated tales, "The Tell-Tale Heart" (1843), that later reverberate in James's "The Aspern Papers" (1888). It highlights the similarities, both in mindset and behavior, between the two stories' devious and deranged first-person narrators, whose actions result in the death of a fellow human being. It further discusses the narrators' fear and refusal of their own mortality, which finds expression in their hostility, and barely contained revulsion against a man (in "The Tell-Tale Heart") and a woman (in "The Aspern Papers"), whose principal defining traits are old age and physical decay. [ABSTRACT FROM AUTHOR]

Exercise can effectively slow aging and prevent the onset and reduce the complications of chronic diseases in the elderly. However, roughly one-third of older adults are inactive. Joyful learning is an effective method for promoting physical activity, while using games is a feasible strategy for achieving joyful learning that enables individuals to fully immerse themselves in and enjoy an activity. Therefore, exploring gaming strategies to enhance physical activity among the elderly is worthwhile. In this paper, a set of gaming strategies based on the literature and practical experience is proposed. The name of this strategy, GAME, is an acronym of the following: goal setting and educational content development (G), activity design and game content creation (A), mechanics and dynamics implementation (M), and evaluation of qualitative and quantitative health outcomes (E). This systematic descriptive approach helps clearly demonstrate how gamification strategies can promote physical activity and health in older adults. The aim of this paper is to provide a reference and guide for education, research, and clinical practice in health promotion programs targeting older adults. [ABSTRACT FROM AUTHOR]

This paper explores the critical role of prognostication tools in identifying high-risk hospitalized older adults who may benefit from palliative care. With an ageing population and increasing prevalence of chronic illnesses, the demand for patient-centered healthcare is paramount. The study evaluates three key tools—the Palliative Performance Scale, CARING criteria, and Palliative Care Rapid Emergency Screening tool. Each tool is analyzed for its psychometric properties, advantages, and limitations. Despite their strengths and limitations, these tools emerge as crucial screening tools for identifying older adults at heightened mortality risk within one year of hospital admission. Our paper calls for ongoing research to adapt and validate existing tools, ensuring their applicability across diverse clinical settings and patient populations. [ABSTRACT FROM AUTHOR]

Purpose: As populations are ageing and the global average life expectancy is rising, the provision of care for older people is an increasingly salient issue. This paper aims to focus on family-provided care for older immigrants, examining how older immigrants and care providers experience and construct family caregiving. Design/methodology/approach: Based on interviews with care recipients, family care providers, municipal staff and representatives for migrant organisations in Sweden, this study presents a typology of family caregiving for older immigrants. Findings: The authors found three caregiving types, namely, solely family-provided care and a combination of family care and public care (predominantly one or the other). The decision to select family-provided or publicly-funded care depends on personal and institutional factors. Originality/value: The paper makes three empirical contributions to the literature on care provision for older immigrants. Firstly, this study provides insights into the structural and personal factors that shape care-giving arrangements for older immigrants. Secondly, this study examines the perspectives of care recipients and care providers on family-provided care. Care expectations differ between both groups and sometimes result in intergenerational disagreement. Thirdly, in terms of institutional support, this study finds that the Swedish state's notion of individual needs does not match the needs of immigrant elderly and their caregivers. The paper places the care types in a broader discussion about eldercare provision in the Swedish welfare state, which has experienced a decline in publicly funded care services and an increase in family caregiving in the past 30 years. In addition, it addresses questions of dignified ageing from a minority perspective. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to develop and test the feasibility of using an electronic tool to ascertain falls and their circumstances (TASeFALL) in people aged over 60 years. Methods: Forty participants (mean age: 69.3 ± 5.4 years, 55% women) were randomised to receive a monthly paper‐based questionnaire (control group n = 19), compared with the same questionnaire sent via email with LimeSurvey software (TASeFALL n = 21). Falls and their circumstances were recorded prospectively over 12 months in all participants. The main outcomes were feasibility of enrolment, number of falls, adherence to completion of questionnaires and cost. Results: The incidence, number of falls and adherence to the completion of the questionnaire over the 12‐month follow‐up were similar in both the TASeFALL and control groups. However, the monthly paper‐based questionnaire approach was 45% more expensive. Conclusions: The TASeFALL is a feasible and cost‐effective method of falls ascertainment for older people with email access that could have a wide research uptake. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to critique and evaluate need-driven dementia compromised behavior theory and the health behavioral model using Meleis' (2010) criteria of theory evaluation. Design/methodology/approach: Theory critique using Meleis' (2010) criteria of theory evaluation. Findings: This paper provides a conclusion about each theory in terms of agitation in the elderly. Meleis's (2010) criteria will be used for both theories to evaluate different components such as the relationship between structure and function, diagram of the theory, circle of the contagiousness, usefulness and external components. Originality/value: The critique of the two theories broadened the nurses' understanding of the connection between the NDB model and the behavior symptoms, including agitation and its related issues. Further studies need to be conducted to shed light on the other aspects of the behavioral symptoms in elderly with dementia that supports the results of this study, like its specific causes, trigger factors and other intervention strategies. Nurses should be able not only to understand the patient's behavior symptoms but also to decode them into communication signals to meet their needs in a more effective way. [ABSTRACT FROM AUTHOR]

Background and Objectives: One of the pathogenetic hypotheses of delirium is the "neuroinflammatory theory" with consequent neurotoxicity of brain connectivity networks. Micronutrients may play a significant role in the prevention of neuroinflammation. This systematic review addresses the role of micronutrients in the development of delirium in older populations. Methods: The EBSCO, Cochrane, PubMed, and Web of Science databases were searched for articles on delirium and micronutrients. The methodological quality of the studies included in the review was evaluated with the Newcastle-Ottawa Scales for observational studies and for case-control studies. Results: 1326 papers were identified from the searches, 7 of which met the inclusion criteria (see section 2.3). All the papers included were written in English. Delirium was predominantly secondary to post-operative dysfunction or acute medical conditions. By altering the production of neurotransmitters resulting in an imbalance, and by reducing their immunomodulatory role with a consequent increase in inflammatory oxidative stress, micronutrient deficiency seems to be associated with an increased incidence of delirium. Conclusions: This review supports the existence of an association between micronutrient deficiency (i.e. cobalamin, thiamine, and vitamin D) and an increased incidence of delirium, with a greater prevalence in hospitalized patients. [ABSTRACT FROM AUTHOR]

Simple Summary: This position paper aims to address specific clinical questions regarding the use of cyclin-dependent kinase 4/6 inhibitors in elderly patients with early or advanced breast cancer. Its objectives are to delineate the current state of knowledge regarding the efficacy of these treatments in the elderly population and their tolerance profile, including the impact on quality of life, with a particular focus on the frailest subgroups, and to attempt to define the optimal treatment strategy for elderly and fragile patients (dosage and therapeutic sequence). Background: Breast cancer (BC) incidence increases with age, particularly in HR-positive/HER2-negative subtypes. Cyclin-dependent kinase 4 and 6 inhibitors (CDK 4/6is) alongside endocrine therapy (ET) have emerged as promising treatments for HR-positive/HER2-negative advanced and early BC. However, their efficacy, safety, and impact on quality of life (QoL) in older and frail patients remain underexplored. Methods: This position paper assesses the existing literature from 2015 to 2024, focusing on CDK4/6is use in patients aged 65 years and older with HR-positive/HER2-negative BC. Results: Our analysis methodically addresses critical questions regarding the utilization of CDK4/6is in the elderly BC patient population, organizing findings from the metastatic and adjuvant settings. In the metastatic setting, CDK4/6is significantly improve progression-free survival (PFS), paralleling benefits observed in younger patients, and suggest potential overall survival (OS) benefits, warranting further investigation. Despite an increased incidence of grade ≥ 3 adverse events (AEs), such as neutropenia and asthenia, CDK4/6is present a markedly lower toxicity profile compared to traditional chemotherapy, with manageable side effects. QoL analysis indicates that integrating CDK4/6is into treatment regimens does not significantly impact elderly BC patients' daily life and symptom management. Special attention is given to frail subgroups, and personalized approaches are recommended to balance efficacy and adverse effects, such as starting with ET alone and introducing CDK4/6is upon progression in patients with a low disease burden. Transitioning to the adjuvant setting, early results, particularly with abemaciclib, indicate positive effects on disease-free survival (DFS), emphasizing the need for continued analysis to validate these findings and assess long-term implications. However, data on older patients are insufficient to conclude whether they truly benefit from this treatment. Conclusion: Overall, CDK4/6is present a favorable benefit-risk profile in older BC patients, at least in advanced BC; however, further research is warranted to optimize treatment strategies and improve outcomes in this population [ABSTRACT FROM AUTHOR]

Aims: To explore the nature of interactions that enable older inpatients with cognitive impairments to engage with hospital staff on falls prevention. Design: Ethnographic study. Methods: Ethnographic observations on orthopaedic and older person wards in English hospitals (251.25 h) and semi‐structured qualitative interviews with 50 staff, 28 patients and three carers. Findings were analysed using a framework approach. Results: Interactions were often informal and personalised. Staff qualities that supported engagement in falls prevention included the ability to empathise and negotiate, taking patient perspectives into account. Although registered nurses had limited time for this, families/carers and other staff, including engagement workers, did so and passed information to nurses. Conclusions: Some older inpatients with cognitive impairments engaged with staff on falls prevention. Engagement enabled them to express their needs and collaborate, to an extent, on falls prevention activities. To support this, we recommend wider adoption in hospitals of engagement workers and developing the relational skills that underpin engagement in training programmes for patient‐facing staff. Implications for Profession and Patient Care: Interactions that support cognitively impaired inpatients to engage in falls prevention can involve not only nurses, but also families/carers and non‐nursing staff, with potential to reduce pressures on busy nurses and improve patient safety. Reporting Method: The paper adheres to EQUATOR guidelines, Standards for Reporting Qualitative Research. Patient or Public Contribution: Patient/public contributors were involved in study design, evaluation and data analysis. They co‐authored this manuscript. [ABSTRACT FROM AUTHOR]

In China, the number of senior citizens has grown, along with the burden of old age, and aging has hampered economic growth. The advent of the digital age has led to the emergence of the digital economy as a new engine for economic growth. This paper uses DEA-Malmquist index model to measure the total factor productivity growth rate of 31 provinces in China from 2011 to 2021, and uses the moderating effects model to empirically investigate the relationship between the digital economy, aging and total factor productivity, and to verify whether the development of the digital economy can mitigate the negative impact of aging on total factor productivity. The results show that aging inhibits total factor productivity growth, and the digital economy can promote total factor productivity growth. Digital economy can alleviate the negative impact of aging on total factor productivity growth, and has a moderating effect. Digital economy plays a moderating role by improving the level of human capital and facilitating technological progress. The regional heterogeneity analysis shows that the moderating effect of the digital economy exists in the eastern and western regions and the southern region, but not in the central region and the northern region. Furthermore, the digital economy has a moderating effect on both the high and low aging groups. The research in this paper not only helps to evaluate the productivity effects of the digital economy, but also has important implications for finding ways to mitigate the negative effects of aging. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of motivational interviewing based on the trans‐theoretical model promoting physical activity in older adults. Methods: A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans‐theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24‐week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. Results: Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self‐Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre‐test, while in the post‐test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post‐test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. Conclusion: The trial indicated that after the trans‐theoretical model‐based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans‐theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults. Summary statement: What is already known about this topic? Physical immobility ranks fourth among the leading risk factors for mortality globally.Older adults constitute the age group which leads the most sedentary life in society and is most affected by physical inactivity.In Turkey, one out of every two people undertakes insufficient physical activity, and this rate increases with advancing age. What this paper adds? Nurse‐led motivational interviewing based on the trans‐theoretical model was effective in increasing the physical activity levels of the older adults. The implications of this paper: It is recommended that the trans‐theoretical model and motivational interviewing should be used by nurses to improve healthy lifestyle behaviours in older adults.It is recommended that studies be conducted to assess the effectiveness of interventions aimed at promoting physical activity in older adults via both qualitative and quantitative methods. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to critically examine the effects of COVID-19 social discourses and policy decisions specifically on older adult volunteers in the UK, comparing the responses and their effects in England, Scotland, Wales and Northern Ireland, providing perspectives on effects of policy changes designed to reduce risk of infection as a result of COVID-19, specifically on volunteer involvement of and for older adults, and understand, from the perspectives of volunteer managers, how COVID-19 restrictions had impacted older people's volunteering and situating this within statutory public health policies. Design/methodology/approach: The study uses a critical discourse approach to explore, compare and contrast accounts of volunteering of and for older people in policy, and then compare the discourses within policy documents with the discourses in personal accounts of volunteering in health and social care settings in the four nations of the UK. This paper is co-produced in collaboration with co-authors who have direct experience with volunteer involvement responses and their impact on older people. Findings: The prevailing overall policy approach during the pandemic was that risk of morbidity and mortality to older people was too high to permit them to participate in volunteering activities. Disenfranchising of older people, as exemplified in volunteer involvement, was remarkably uniform across the four nations of the UK. However, the authors find that despite, rather than because of policy changes, older volunteers, as part of, or with the help of, volunteer involving organisations, are taking time to think and to reconsider their involvement and are renewing their volunteer involvement with associated health benefits. Research limitations/implications: Working with participants as co-authors helps to ensure the credibility of results in that there was agreement in the themes identified and the conclusions. A limitation of this study lies in the sampling method, as a convenience sample was used and there is only representation from one organisation in each of the four nations. Originality/value: The paper combines existing knowledge about volunteer involvement of and for older adults. [ABSTRACT FROM AUTHOR]

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]