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Background: Health-related behaviors may change after retirement and induce changes in the mental health. This systematic review aimed to investigate the nature of changes in physical activity and leisure activities, as well as the relationship between physical activity, leisure, and psychological adjustment among retirees. Methods: Search of papers was done in three electronic databases of PubMed, ISI Web of Science, and Scopus without constraints on time, geographical regions, or languages in February 2022. The papers that had examined the relationship between physical activity and adjustment among retirees using observational design (cross-sectional or longitudinal) were included in the present study. To evaluate the methodological quality of cross-sectional studies, Joanna Briggs Institute (JBI) Critical Appraisal Checklist, and for longitudinal studies, Newcastle-Ottawa Scale (NOS) were used. Results: The search results identified 1458 records. Twenty-six papers were included in this review based on the inclusion and exclusion criteria. The findings of most of these studies indicated a significant positive correlation between physical activity, leisure, and psychological adjustment in retirees. Retirees were mostly engaged in passive leisure activities such as reading, watching TV and movies, and less engaged in physical activities, sport, or physical exercise. General organized assessment of the total physical activity among retirees was not possible. Conclusions: Based on the study findings, it can be stated that there is a positive correlation between physical activity, leisure, and the retirees' adjustment. Usage of the same and valid measurement method specific to old age and retirement period can be useful in more precise assessment of physical activity and its association with adjustment among retirees. [ABSTRACT FROM AUTHOR]

There is a vast literature on household solar-panel uptake but there are mixed results for many explanatory variables such as income, education, age, and race. This creates a major challenge for policymakers, who devise solar-panel policies that relate to variables such as income. This study uses logit, probit, and linear probability models, along with the matching method of entropy balancing. We use household data from the 2019 American Housing Survey. Results using entropy balancing suggest that high housing values and older respondent age are key factors promoting solar-panel uptake. Income has some positive impacts, although detailed analysis tends to show insignificance. Education and race variables have insignificant coefficients when controlling for key variables. This paper could provide a basis for future policy approaches, such as means testing based on asset thresholds rather than income thresholds. [ABSTRACT FROM AUTHOR]

Given the need to assign categories while also fostering free thought when conducting research, the aim of this paper is to highlight how the third and fourth age categories are addressed risks inducing ageism in the current ageing society. Considering the role that language plays in the construction of the world (Berger & Luckmann, 1966), this literature review aims to identify the ways that the third and fourth age categories have been applied in social science research. Therefore, the potential to avoid the dichotomization of old age necessarily lies in placing things in context so that we comprehend the complexity of old age, e.g., the third or fourth age. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the perceptions and experiences of a group of extra care tenants, who, as novice internet users, began to maintain their social relationships online. Housing transitions in later life may jeopardise existing social relationships, leading to loneliness and social isolation. More recently, Covid-19 restrictions have limited familial face-to-face contact and wider social interactions. Thus, extra care tenants, who are not already online, may benefit from acquiring internet skills. This paper aims to enhance understanding of the participants' transition from novices to experienced internet users and the impact on their social relationships and sense of self. Design/methodology/approach: A longitudinal, hermeneutic phenomenological study was conducted over eight months in two extra care housing schemes in north east England. Ten participants (56–98 years) with age-related physical, sensory and cognitive losses were recruited to the study. A series of semi-structured interviews and participant diaries captured the participants' experience as they developed internet skills and communicated online. Findings: All participants, including a blind individual, learnt to communicate online. Personalised adaptive strategies, peer support, training and management involvement facilitated internet uptake. Participants felt their social relationships were supported, and they regained biographical continuity, through being and feeling they belonged in the modern digital world. Originality/value: The online experiences of extra care tenants are rarely voiced. Their perceptions may assist others to engage online, maintaining social connections, which could otherwise be lost. [ABSTRACT FROM AUTHOR]

Growing life expectancy also increases the risk of longevity (age risk) associated with a longer-than-expected life expectancy. This risk has an individual and a group dimension. On an individual basis, the realization of this risk may mean exhaustion of additional retirement savings and scarcity, and often even poverty, of elderly people who live longer-than-expected. The subjective assessment of life expectancy has a significant impact on household decisions regarding the division of income between current consumption and saving (deferred consumption), and thus - the amount of additional resources accumulated for the old age, and thus - the level of individual longevity risk. This paper aims at comparing the subjective life expectancy estimates with the values provided by the Statistics Poland in the life tables for given age groups (demographic cohorts). Subjective life expectancy estimates for selected age groups of women and men were identified in a nation-wide sample survey. [ABSTRACT FROM AUTHOR]

Neopterin, a product of activated white blood cells, is a marker of nonspecific inflammation that can capture variation in immune investment or disease-related immune activity and can be collected noninvasively in urine. Mounting studies in wildlife point to lifetime patterns in neopterin related to immune development, aging, and certain diseases, but rarely are studies able to assess whether neopterin can capture multiple concurrent dimensions of health and disease in a single system. We assessed the relationship between urinary neopterin stored on filter paper and multiple metrics of health and disease in wild geladas (Theropithecus gelada), primates endemic to the Ethiopian highlands. We tested whether neopterin captures age-related variation in inflammation arising from developing immunity in infancy and chronic inflammation in old age, inflammation related to intramuscular tapeworm infection, helminth-induced anti-inflammatory immunomodulation, and perturbations in the gastrointestinal microbiome. We found that neopterin had a U-shaped relationship with age, no association with larval tapeworm infection, a negative relationship with metrics related to gastrointestinal helminth infection, and a negative relationship with microbial diversity. Together with growing research on neopterin and specific diseases, our results demonstrate that urinary neopterin can be a powerful tool for assessing multiple dimensions of health and disease in wildlife. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate depressive symptoms, emergency department visits, re‐hospitalization and discharge to the same residence of comprehensive geriatric care in patients receiving hip‐fracture surgery. Background: Hip fractures among older persons result in restricted activities of daily living, longer hospital stays, frequent emergency department visits and re‐presentation to hospital, which may increase depressive symptoms and death risk. The benefits of comprehensive geriatric care have not been determined. Design: A five‐step Cochrane collaboration meta‐analysis was used. Data Sources: Randomized controlled trials published from 1980 to 2020 in which comprehensive geriatric care was provided following hip‐fracture surgery were retrieved from the Cochrane Library, Clinical Key, Embase, MEDLINE, OVID and PubMed databases. Indicators were depressive symptoms, emergency department visits, re‐hospitalization and discharge to the same residence. Review Methods: The Group Reading Assessment, Risk of Bias 2.0 tool, modified Jadad scale and Comprehensive Meta‐Analysis Version 3 software were used. Results: Overall, 1291 patients from six randomised controlled trials were included. Comprehensive geriatric care improved depressive symptoms and lowered emergency department visits but did not improve re‐hospitalization rates or discharge to the same residence. Conclusion: Comprehensive geriatric care should include depression management and individualized care plans. Further depression‐related studies are required to verify their benefits. Summary statement: What is already known about this topic? Given the high prevalence of hip fractures and consequent disability, death and care costs, appropriate postoperative care must be provided to enhance patient health.Older persons who received comprehensive geriatric care after hip‐fracture surgery may experience reduced fatality rates and increased self‐care ability. What this paper adds? Comprehensive geriatric care content should be personalized, depending not on the preferences for care packages at each hospital but on the condition, situation and needs of the patient.Comprehensive geriatric care is beneficial for older persons with a hip fracture; hence, it can be promoted to enhance the quality of nursing care. The implications of this paper: Hospitals and healthcare systems should standardize comprehensive care for older persons with appropriate intervention parameters, establish a multidisciplinary care approach and deliver timely comprehensive geriatric care interventions.Comprehensive geriatric assessment should include management to detect and reduce depressive symptoms among older persons undergoing hip surgery.Hospital and community nurses should enhance their knowledge and skills regarding comprehensive geriatric care interventions and implement comprehensive geriatric care from hospitalization to discharge for older patients following hip fracture and surgery. [ABSTRACT FROM AUTHOR]

Aim: Cognitive assessment services were found to be beneficial to older people with cognitive complaints but information is limited on adherence to the recommendations provided. This study aimed to identify predictors of clients' adherence to nursing recommendations after attending a community‐based nurse‐led cognitive assessment service in Hong Kong. Methods: A cross‐sectional design was adopted. We analysed a dataset routinely collected from clients attending the services between January 2012 and January 2018. Multiple regression analyses were conducted to identify predictors (demographics, functional health status and cognitive performance) of the clients' adherence. Their satisfaction with the services was also examined. Results: Two hundred and twenty‐three clients attended the clinic. Of the 133 who completed the telephone follow‐up at the 6 months postconsultation, 44.1% did not adhere to the recommendations. Clients with a higher Clinical Dementia Rating (OR = 4.17), lower Clock Drawing Test score (OR = 1.13) and lower education level (OR = 0.91) were found to be less likely to adhere to the nursing recommendations. Ninety‐six percent (190/198) were satisfied with the overall services. Conclusion: Cognitive assessment services in nurse‐led clinics could provide a self‐referred service for older people with cognitive complaints. However, low adherence to nursing recommendations was found among clients with poorer cognitive functions and lower education levels. Summary statement: What is already known about this topic: Community‐based nurse‐led cognitive assessment services were found to be beneficial to older people with cognitive complaints by providing clients with timely screening, assessment, education and advice.Nonadherence to the recommendations of health‐care professionals could pose significant risks to the clients' health.There has been limited research on clients' adherence to the recommendations of nurses at community‐based cognitive assessment services. What this paper adds: About 44.1% of clients receiving a cognitive assessment did not adhere to the nursing recommendations. Those with poorer cognitive functions and lower education levels were found to be less likely to be adherent.About 96% of clients attending the community‐based cognitive assessment services in a nurse‐led clinic expressed satisfaction with them. The implications of this paper: Community‐based cognitive assessment clinics should develop appropriate strategies to improve clients' adherence, especially those with poor cognitive functions and lower education levels.Future research should investigate why clients with poor cognitive functions and lower education levels are less likely to adhere to nursing recommendations. [ABSTRACT FROM AUTHOR]

Background: Heatwave warnings provide crucial information about the nature of the event and the steps that can be taken to mitigate its impact. It is well known that heat events disproportionately impact the health of older adults. Therefore, it's critical that heatwave warnings reach this population. However, our current understanding of the effectiveness of heatwave warning messages among older Queenslanders is limited. Methods: A Queensland wide survey was conducted in 2022 among 547 older adults (≥65 years), aiming to collect information on their perception of heat-related health risk, their knowledge of the existing heatwave warnings, and if they had ever heard of a heatwave warning. Chi-square analysis followed by multinomial or binomial logistic regression was utilized to understand various socio-economic and personal factors that impact the heatwave warning reach to older Queenslanders. Results: Only 43% of the respondents had heard a heatwave warning and only 49% of those who heard a warning(s) changed their behavior as a result. The results showed 20% of respondents perceived themselves to be at heat-related health risk, and these individuals were 1.98 times more likely to have heard heatwave warnings. Further, individuals who perceived themselves to be at heat-related health risk were 3.62 times more likely to adopt adaptive measures in response to heatwave warnings. Implications: This study suggests that in older adults, higher knowledge and perception of heat-related health risk are associated with higher likelihoods of attention to heatwave warnings and adoption of cooling measures. [ABSTRACT FROM AUTHOR]

Our standards of beauty have become sufficiently diverse. However, the representation of older women continues to be marginalized in mainstream media platforms, with the dominant ageist message revolving around the notion of 'failure.' For a woman, the 'horrors' of aging are felt more conspicuously, which renders her a devalued commodity. Within Indian society, aging is further contested by varied socio-cultural factors that prescribe an older woman to dress, behave and act according to her age and firmly reprimand any transgression from normative practices. This paper explains the complexities related to the prevailing aging/anti-aging discourses and discerns how older women influencers engage in challenging the negative stereotypes (like body shaming and sexageist derision) through the model of successful aging. Through select Instagram handles, the study analyses how the graying individuals collectively seek to direct or reclaim their power to forge alternative narratives/perspectives that encourage the aging/aged self to 'be' in her skin. The visual content from the Instagram profiles of Manjri Varde, Ravi Bala Sharma, Rajani Chandy, Seema Anand, and Usha Soman, who serve as representatives of redefining aging with purpose, has been critically analyzed. The results obtained have delineated how the social networking site has emerged as a space of resistance and empowerment- redefining beauty, desire, and agency within the contemporary youth-centric Indian culture and rendering possibilities that one can explore while growing old. [ABSTRACT FROM AUTHOR]

Hiring migrant live-in caregivers to take care of older adults with dementia, chronic disease or frailty has become more common in Europe, North America, the Middle East, and Asia. When older couples hire a non-relative to provide live-in caregiver services for a family member, the attendant household transformation – from couple to triad – gives rise to social and psychological challenges. Although live-in caregivers can be indispensable, living together can be very stressful for older adults and live-in caregiver. This article describes the emotional distress of two older adult wives in their eighties, and the therapeutic methods used to reduce it, including empathic understanding, legitimation of emotions, promotion of open communication, and formulation of a household 'management strategy,' establishing specific expectations concerning the parties' roles and a daily activity schedule. Involvement of older couples' children was found helpful, and was aided through psychoeducation. Gerontologists, therapists, educators, and social workers who serve the needs of older adults can effectively assist this population in the evolution of their perceptions of their new situation, the regaining of a sense of equilibrium, mastery and control over their lives, and the development of greater tolerance and understanding of migrant live-in caregivers' work burden, native culture, and individual practices. Professionals should actively screen for risks of burden, stress, depression, and anxiety in households in which live-in caregiver services may be considered. Psychoeducation and preparation of both the older adults and their live-in caregivers entering the new relationship may lessen the incidence of potential stressors. Implications: Clinical and Practical implications: Professionals need to triage and diagnose the difficulties and stressors that arise when older couples or their children invite a paid live-in caregiver into the home, changing the day-to-day routine and relationship dynamics of the household. Professionals should actively screen for risk of burden, stress, depression, and anxiety among healthier older spouses, who may feel discomfort and frustration when their independence and privacy are compromised and their primary role seems to be eclipsed by the activity of a paid live-in caregiver. Older adults, their family members, and paid live-in caregivers can benefit from psychoeducation to understand and address emotional difficulties inherent in situations where serious health decline leads to the hiring of a paid live-in caregiver. Following the clinical implications, this paper suggest some practical implications when proving therapy to older adults. It includes outreach and work with the spouses, and if possible with the children of the frail older adult. While frail older adults are usually the primary object of physical and emotional support, their healthier older spouses also require significant emotional support, especially in the early period after a paid live-in caregiver is hired. The children of older adults can be a very useful resource in promoting early intervention and providing continuing support for parents coping with the addition of a paid live-in caregiver to their parents' household. [ABSTRACT FROM AUTHOR]

Objectives Informal care provided by adult children is of great importance for older adults' well-being in China. This paper investigates and compares the functional transitions among older adults living in rural areas who receive care from daughters' and from sons' families. Methods This study utilizes the "Well-being of Elderly Survey in Anhui Province" (WESAP) from 2001 to 2021. Our sample included 2,797 individuals aged 60 years or older. Functional status was based on the activities of daily living and the instrumental activities of daily living. We employed a random-effects ordered logit model to examine the functional transitions among the older adults. Results Receiving care from daughters' families is significantly associated with a lower likelihood of functional decline compared to receiving care from sons' families in rural China. The advantage associated with daughter care becomes more pronounced among older individuals with a severe functional difficulty compared to those with a mild or moderate functional difficulty. The difference is prevalent among older adults aged 75 and older, with less wealth or multiple chronic diseases, or who live alone. Furthermore, among those with severe functional difficulties, the daughter advantage is more significant for fathers as compared to mothers. Discussion Nowadays, daughters' families can provide high-quality informal care, often surpassing that offered by sons' families. This daughter advantage becomes even more significant among older adults who have a higher need for family care, such as those with severe disabilities and limited financial resources. [ABSTRACT FROM AUTHOR]

Background and Objectives Social frailty is an emerging concept characterized by state of vulnerability due to the lack or absence of social resources that enable health and well-being, particularly among older people. However, there is no consensus on how to accurately measure and assess social frailty, given the broad coverage of social dimensions affecting older individuals. This scoping review aimed to identify the existing tools and scales used to measure social frailty in older people. Research Design and Methods A scoping review methodology was employed. Articles published between January 2014 and April 2024 were searched in 6 electronic databases: PubMed, PsycINFO, ProQuest, Scopus, SocIndex, and CINAHL. The scoping review followed a 5-stage process by Arksey and O'Malley and adhered to the guidelines provided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Results Nine social frailty tools were identified across the 58 papers included in this review. The individual question item commonly used in the scales were classified into main categories based on their conceptual characteristics and intentions. The most common individual questionnaire constructs used to measure social frailty included financial status, social resources, social behaviors and activities, and sense of purpose. The reviewed tools varied in terms of their robustness and the process of scale development. Discussion and Implications Our review suggested the development of a standardized, psychometrically tested, and accurate screening tool to screen social frailty status. An accurate social frailty assessment can inform the development of useful interventions, which also has implications in preventing the development of physical frailty. [ABSTRACT FROM AUTHOR]

Objective: Dementia affects more than 55 million people worldwide. Use of restraints for hospitalized older adults with dementia is a social issue that should be addressed systematically and should not depend on the characteristics of nurses. This study reviewed the literature on organizational factors associated with reducing use of restraints in older adults with dementia admitted to acute care hospitals. Methods: A scoping review was performed. Three databases were searched for papers that met our eligibility criteria. Factors related to restraint reduction were extracted, and results were deduced. Through inductive analysis, subthemes were categorized according to similarities and differences, which were then integrated into broader themes. Results: Sixteen studies were eligible for inclusion. The prevalence of restraints ranged from 5.1% to 80.0% depending on how the meaning of restraint was interpreted. The most common indications for restraints were history of falls and fall risk. Interdisciplinary screening for restraints was associated with reduced prevalence of restraints, with a 0.18‐fold (confidence interval [CI]: 0.12–0.24) reduction through use of a restraint decision flowchart and a 0.76‐fold (CI: 0.63–0.92) reduction through consultation with a psychiatrist. Interdisciplinary members included nurses, physicians, clinical psychologists, pharmacists, respiratory therapists, and therapists. Conclusions: Research is needed to introduce and develop an interdisciplinary restraint decision‐making system and to test its effectiveness. Important factors in implementing alternatives to restraints are the harmful effects of restraints, expertise in dementia, regular education on alternative methods, an inpatient environment that ensures patient safety, and the development of human resources. [ABSTRACT FROM AUTHOR]

Aim: Respiratory sarcopenia (RS) has been newly defined in a position paper by four professional organizations in Japan, and it is necessary to examine its incidence and influencing factors using this new definition. So far, little work has been undertaken; we therefore conducted a longitudinal study to fill this gap. Methods: Our data were extracted from the China Health and Retirement Longitudinal Study. A total of 4301 older adults with complete data and without RS were chosen in 2011, of whom 3065 were followed up until 2015. The presence of low respiratory muscle strength plus low appendicular skeletal muscles mass was defined as RS based on t. A logistic regression model was used to identify the influencing factors for incident RS. Results: After an average of 4 years of follow‐up, the cumulative incidence of RS was 5.2%, and it was particularly high in participants aged >80 (20.9%). Logistic regression analysis showed that being unmarried/divorced/widowed (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.28–2.66, P = 0.001), not having dyslipidemia (OR = 0.35, 95% CI = 0.19–0.65, P = 0.001), having digestive disease (OR = 1.56, 95% CI = 1.11–2.19, P = 0.010), asthma (OR = 2.77, 95% CI = 1.55–4.94, P = 0.001), edentulism (OR = 1.73, 95% CI = 1.24–2.42, P = 0.001), low handgrip strength (OR = 2.82, 95% CI = 1.99–3.99, P < 0.001), or low 5‐m gait speed (OR = 1.92, 95% CI = 1.23–3.01, P = 0.004) were associated with a greater likelihood of developing RS. After further adjustment for age and body mass index, asthma, edentulism, and low handgrip strength remained significant. Conclusions: The identification and management of older adults with the influencing factors described above could be important in preventing RS. Geriatr Gerontol Int 2024; 24: 1015–1021. [ABSTRACT FROM AUTHOR]

While debts are widely used financial tools, few longitudinal studies investigating potential causal links between debts and mental wellbeing exist among older adults. Older adults, particularly those not employed, are less likely to have increasing incomes to help them pay off their debts. This study investigates whether older adults with non-mortgage debts in three different labour market states have lower mental wellbeing and, separately, whether it is likely that reducing their debts helps to improve mental wellbeing. Using the English Longitudinal Study of Ageing, the study focuses on the English context, which is particularly interesting due to the high levels of, and a unique policy approach to, private indebtedness. The results indicate that people with debts have lower mental wellbeing (more depressive symptoms and lower quality of life) in all categories, but the mental pain linked to debts is stronger for people who are jobless (not working, not retired). The analysis from a causal perspective suggests that getting rid of debts may reduce depressive symptoms among people who are jobless but may also improve quality of life among the retired and employed. Both these findings suggest that mental health services should work closely with debt advice when needed. [ABSTRACT FROM AUTHOR]

Objectives: To improve our understanding of older informal caregivers' (ICs) health, this paper aimed to compare multidimensional frailty and sociodemographic and economic characteristics between (subgroups of) older ICs and non-caregivers. Methods: Using data originating from the Belgian Ageing studies (n = 6054), intergroup differences between older ICs and non-caregivers and between care-dependent and -independent older ICs/non-caregivers were conducted. In addition binary logistic regressions were carried out to determine which variables were related to caregiver status and need of assistance. Results: Among all respondents, 14.3% were ICs reporting care needs themselves. Informal and non-caregivers with care needs, relative to those without, more often only (partially) completed primary education, were significantly older, more likely to be female and widowed, found it more difficult to make ends meet, and reported higher levels of frailty in each domain. Moreover, environmental and psychological frailty were associated with an increase in the likelihood of reporting need of assistance among older non-caregivers and ICs, respectively. Conclusions: This study revealed a particular vulnerable subpopulation of older ICs with care needs. Clinical Implications: It is essential for clinicians to be observant for unrecognized frailty and care needs in older ICs and to develop targeted intervention and prevention strategies. [ABSTRACT FROM AUTHOR]

Background: Many older people from minority ethnic groups experience inequalities towards the end of life, including barriers to accessing palliative care. With levels of international migration increasing, there is a need to understand these differences and consider the needs of minority ethnic groups in healthcare policies. This review aimed to map evidence on how older people from minority ethnic groups access and utilise palliative and end of life care, preferences for palliative and end of life care, experiences of palliative and end of life care, and how this varies between minority ethnic groups in different countries, and with different health conditions. Methods: Scoping review, following Joanna Briggs Institute (JBI) guidance. Searches of eight online databases (MEDLINE, Embase, Web of Science, CINAHL, PsycInfo, Assia, Scopus, and the Cochrane Library) and grey literature were undertaken in 2024. Qualitative sources that focused on older people from minority ethnic groups' and carers' access to and use of palliative and end of life care were included, as well as those focusing on healthcare professionals' experiences. Results: Twenty-three sources were included in the review, the majority of which were interview studies from the USA. Findings reflect a range of preferences, inequalities, facilitators and barriers to accessing palliative and end of life care, with themes relating to: (1) Knowledge of hospice and palliative care, (2) societal and structural issues, (3) language and health literacy, (4) migratory experiences, (5) trust in healthcare services and professionals, (6) religion and hope, and (7) cultural values. Conclusions: This review identified areas for healthcare providers to consider developing more culturally appropriate palliative and end of life care practice, including building trust and improving communication, sharing information, reducing language barriers, addressing stigma, and, if relevant, acknowledging the importance of culture and religion. Further qualitative research from an intersectional perspective, such as geographical location or socio-economic status, rather than race, ethnicity, and culture alone, is needed in more diverse geographical settings and on specific health conditions. [ABSTRACT FROM AUTHOR]

Leisure activities enjoyed by older married couples play an important part in creating more meaningful married lives. The study focuses on the prevalence of joint leisure activities by older couples, the factors influencing older adults' engagement in leisure activities together, and the relationship between joint participation in leisure activities and marital satisfaction of older couples. The quantitative sample included 414 married respondents aged 55 years and above from different parts of Vietnam. The leisure activities analyzed in the paper include vacation/travel, watching movies, music, karaoke singing outside the house, walking around the house, attending cultural events and festivals, watching TV, drinking tea, and doing exercise. The study results showed that the level of joint engagement in leisure activities in places near home with less cost was higher than those engaged in elsewhere. Couples with better living standards, higher education, better health, and who lived in urban areas more actively participated in leisure activities far from home. Vietnamese couples who engage in more leisure activities together had a higher level of overall satisfaction with their marriage, and greater satisfaction in several dimensions of their marital relationship than those who did not participate in leisure activities with their partners. [ABSTRACT FROM AUTHOR]

This article introduces the special issue "Leisure and older adults in Asia." Although the study of older adults' participation in leisure has gained traction over the last decade, there is need to consider in greater depth the central role that leisure activities may play in the construction of identities and lifestyles in later life. The collection of articles in this special issue contributes to the emerging literature on the intersection of leisure and aging by presenting diverse contexts and methodologies to build a comprehensive understanding of leisure participation among older adults in China, India, Sri Lanka, Japan, Vietnam, Indonesia, and Singapore. They reveal a common thread highlighting the close relationship between leisure participation and various quantitative and qualitative markers of well-being and quality of life in old age, such as health, social participation, and sense of self. The papers also highlight the importance of leisure as a socio-cultural resource through which older adults can negotiate their experiences in later life. Through the different case studies and discussion, the special issue contributes to critical Asian perspective regarding the place of leisure within discourses of 'productive'/'successful'/'active' aging. [ABSTRACT FROM AUTHOR]

This paper explores how some older residents in B Town, a residential estate in northern Singapore, engage in community building through their 'serious leisure' and 'devotee work' participation in a resident landscaper program. Using data from ethnographic fieldwork conducted from February to November 2020 with participants aged from 60 to 81, I analyze how they built connections with each other, and the wider B Town community, through their participation. Particularly, I examine how the shared identity marker of being former farmers in now-evicted kampungs (villages) before the 1980s drew them together, and informed their continued involvement as resident landscapers. The 'kampung spirit' that they built up through the program enabled the construction of not only social connections, but also exclusionary mechanisms that prevented more older adults from engaging in the activities. These findings highlight participants' agency, and complicate static and/or monolithic conceptualizations of 'aging in place/the community' and 'active aging'. [ABSTRACT FROM AUTHOR]

This paper examines how paid and unpaid work affects leisure differently for older women and men in China and India. We use data from the World Health Organization's Study on Global Aging and Health. We find that urban China, with higher levels of public welfare and gender equality, represents the best scenario for older adults' leisure life in developing countries. Although urban Chinese women are disadvantaged relative to urban Chinese men, they still enjoy longer hours of leisure and relaxing leisure than both men and women in rural China, urban India and rural India. Furthermore, the Blinder-Oaxaca decomposition results show gender disparities in unpaid housework to be the primary driver of gender inequalities in leisure in all societies, albeit to varying degrees. These findings highlight the role of public welfare, gender equality, and the gendered consequences of the family support model in shaping older adults' leisure life. [ABSTRACT FROM AUTHOR]

This paper examines which leisure activities appear more attractive to older people, considering health status, disability and demographic-socio-economic and environmental variables. It employed data from Survei Penduduk Antar Sensus (SUPAS), the nationwide survey, conducted in 2015 by Indonesia's national statistical office. The sample selected 228,718 individuals aged 60 years old and above. Leisure activities were differentiated between active, sedentary, and no leisure activities. Health is measured with both health status and disability. Disability measures were adopted from Washington Group Short Set on Functioning-Enhanced (WG-SS Enhanced). Our multinomial regression models confirmed that health status was correlated with the choice of leisure activities in old age. Compared to older persons in good health, those reported in poor health without disruption to daily life were more likely to participate in sedentary or active leisure, but those with disruption to daily life were less likely to do so. Older persons with disability were disadvantaged in participating in either passive or active leisure. However, among all selected variables, employment and source of finance had the highest odds ratios and confounded the relationship between health and leisure activity. [ABSTRACT FROM AUTHOR]

Background Adults with frailty have palliative care needs [ 1 ] but have disproportionately less access to palliative care services [ 2 ]. Frailty affects ~4000 patients admitted to hospital per day in the UK [ 3 ], making the hospital admission a unique opportunity to assess palliative care needs and deliver interventions. Objectives Synthesise the evidence regarding hospital palliative care (HPC) for patients with frailty. Narratively analyse the evidence regarding methods used to identify palliative care needs; types of palliative care interventions studied; and whether HPC improves outcomes. Methods Systematic literature review and narrative synthesis of experimental, observational and systematic review articles investigating palliative care interventions for hospitalised adults aged ≥65 years with frailty. Electronic search of five databases from database inception to 30 January 2023. Included studies analysed using narrative synthesis according to Popay et al [ 4 ]. Results 15 465 titles retrieved, 12 included. Three studies detailed how they identified palliative care needs; all three used prognostication e.g. the 'surprise question'. Most papers (10/12) investigated specialist palliative care interventions. These interventions addressed a wider range of care needs than non-specialist interventions. Evidence suggested an improvement in some symptom burden and healthcare utilisation outcomes following HPC. Conclusion Prognostication was the main method of identifying palliative care needs, rather than individuals' specific needs. Specialist palliative care interventions were more holistic, indicating that non-specialist palliative care approaches may benefit from specialist team input. Despite suggestions of improvement in some outcomes with palliative care, heterogenous evidence prevented establishment of conclusive effects. [ABSTRACT FROM AUTHOR]

The pandemic has undoubtedly affected almost every aspect of life for people around the world. However, the most affected are older adults living in developing countries like India. In fact, the second wave of the pandemic in India was the most devastating wave so far. Now that the worst appears to be over, there is a need to study the impact of the pandemic on the wellbeing of older adults recovering from the virus in the country. Hence, the aim of the present study is to examine the long-term impact of covid 19 on older adults, its connection with wellbeing, and the role of social workers in their recovery. A total of 203 older adults from India took part in the study. The results show that the majority of the respondents have poor wellbeing and have been more frequently plagued by chest pain, fatigue, and isolation, ever since they became infected. Moreover, respondents who are female, those with co-morbidities, and are suffering from other problems such as frequent chest pain, fatigue, and feelings of isolation, have lower levels of wellbeing. The implications of social work practice have also been discussed in the full paper. [ABSTRACT FROM AUTHOR]

The rapid pace of ageing raises concerns regarding financial security, health and long-term care and place for older people to live as they age. This paper examined the factors associated with preference to age in place (AIP) among 2231 respondents aged 60 and older from the Malaysia Ageing and Retirement Survey (MARS). The Categorical Principal Component Analysis (CATPCA) was utilized to identify variables that represent family supports, social connectedness and social participation. 75% of the respondents indicated that they would like to age in place with the binary logistic regression showing a greater likelihood among respondents with strong family and social connectedness, having a spouse, being non-Chinese and being in a good health condition. Urban respondents, with a high individual capacity and social participation, are less likely to age in place. There is a need to strengthen the family institutions and communities, providing incentives and support to promote ageing in place and empower them to remain sustainable for future generations. [ABSTRACT FROM AUTHOR]

The adoption of technology and the rising digital divide among the older adult population, predominantly in lower-middle income countries such as Bangladesh, have posed a precarious challenge. Hence, the time has come to navigate this upcoming challenge. Thus, the current research aims to investigate the impact of perceived usefulness (PU), perceived ease of use (PE), and perceived risk (PR) on the behavioral intention to adopt mHealth (BI). Furthermore, multigroup analysis (MGA) is used to examine BI regarding gender and income groups. Data from 140 older adults in Bangladesh were gathered and later analysed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to estimate the measurement and structural model parameters and produce concurrent bootstrap evaluations. The findings revealed that PE and PU substantially affect the intention to adopt mHealth, whereas PR has small effect on mHealth adoption. Furthermore, the MGA depicts that the effect of PR is statistically significant for older adult males and females. Additionally, the effect of PE on behavioral intention to adopt mHealth between income groups (lower income vs. higher income) is significant. Therefore, this research advances our theoretical and empirical understanding by yielding new scholarly evidence in the domain of mHealth adoption by older adults. Finally, the paper concludes with augmented practical considerations concerning the adoption of mHealth as a technology by older adults, which will assist in alleviating the digital divide for any such lower-middle income country across the globe. [ABSTRACT FROM AUTHOR]

In celebration of the National Institute on Aging's (NIA) 50th anniversary, this paper highlights the significant advances in cognitive aging research and the promotion of cognitive health among older adults. Since its inception in 1974, the NIA has played a pivotal role in understanding cognitive aging, including cognitive epidemiology, interventions, and methods, for measuring cognitive change. Key milestones include the shift toward understanding cognitive impairment and Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD), the development of large-scale longitudinal studies, and the incorporation of AD/ADRD-related biomarkers in cognitive aging cohorts. Additionally, NIA has championed diversifying the scientific workforce through initiatives, such as the Resource Centers for Minority Aging Research and the Butler-Williams Scholars Program. The next 50 years will continue to emphasize the importance of inclusion, innovation, and impactful research to enhance the cognitive health and well-being of older adults. [ABSTRACT FROM AUTHOR]

Objectives Previous studies have indicated that compared to older adults, younger older adults (e.g. baby boomers) are more susceptible to obesity, but their risk decreases as they age. However, there is a lack of research on how individuals experience sarcopenic obesity, which increases in later life and is a mortality risk factor. This study examined how younger cohorts of older Americans and their demographic traits are related to sarcopenic obesity. Methods Generalized estimating equations were used to analyze participants aged 65 years and older, stratified by sex using data from the 2006–2016 Health and Retirement Study, with survey weights (n = 2,896 men and n = 4,268 women). Results The findings indicate that the youngest cohort (born between 1948 and 1953) had greater odds of sarcopenic obesity than older cohorts (born before 1931). However, the youngest cohort did not have significantly different risks from those born between 1931 and 1947. Unexpectedly, the youngest cohort of older women living alone tended not to have sarcopenic obesity compared to the older cohorts living alone. These results remained significant even after adjusting for various covariates, including marital status, race, education level, wealth, and other factors. Discussion This paper contributes to the existing literature on population health and demographic change in 2 ways. First, the risk of sarcopenic obesity is higher among younger cohorts of older Americans relative to older cohorts (born before 1931). Second, living alone may not necessarily be considered a worse health condition, particularly for younger female cohorts. [ABSTRACT FROM AUTHOR]

The International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee aims to improve the use of drugs in older adults and develop new therapeutic approaches for the syndromes and diseases of old age through advocacy, education, and research. In the present paper, we propose strategies relevant to drug development and evaluation, spanning preclinical and the full range of clinical studies. Drugs for older adults need to consider not only age, but also other characteristics common in geriatric patients, such as multimorbidity, polypharmacy, falls, cognitive impairment, and frailty. The IUPHAR Geriatric Committee's position statement on 'Measurement of Frailty in Drug Development and Evaluation' is included, highlighting 12 key principles that cover the spectrum of translational research. We propose that where older adults are likely to be major users of a drug, that frailty is measured at baseline and as an outcome. Preclinical models that replicate the age, frailty, duration of exposure, comorbidities, and co‐medications of the proposed patients may improve translation. We highlight the potential application of recent technologies, such as physiologically based pharmacokinetic–pharmacodynamic modeling informed by frailty biology, and Artificial Intelligence, to inform personalized medicine for older patients. Considerations for the rapidly aging populations in low‐ and middle‐income countries related to health‐care and clinical trials are outlined. Involving older adults, their caregivers and health‐care providers in all phases of research should improve drug development, evaluation, and outcomes for older adults internationally. [ABSTRACT FROM AUTHOR]

Aim: The aim of this concept analysis is to seek clarity as to what end‐of‐life conversations involve by developing a clear working definition and using model cases to conceptualise the defining attributes of an end‐of‐life conversations with the older person. Design: Walker and Avant's eight step approach to Concept Analysis. Data Sources: Four databases were searched, including PubMed, CINAHL, PsycINFO, and Scopus. A total of 339 publications were identified with 30 papers meeting the inclusion criteria and put forward for the final conceptual analysis. Results: The defining attributes associated with end‐of life conversations included (1) an ongoing process of older person empowerment, (2) discussion's concerning values and preferences concerning end‐of‐life issues, and (3) maintaining an open dialogue between all concerned individuals. Antecedents were associated with the older person is their readiness to talk openly about death and dying. Consequences were identified as having a better understanding of what death and dying may mean to the older person in a more specific manner. Conclusions: End‐of‐life conversations are vital in understanding an individual's values and preferences at the end of life, and yet, the concept of the end‐of‐life conversation has not been well defined in the literature. End‐of‐life conversations with the older person encompass ongoing discussions and maintaining open dialogue around end‐of‐life care while developing strategies to promote individual empowerment in making informed choices. Using a conceptual model, aides in addressing aspects of end‐of‐life conversations and an acknowledgment of the dynamic process of end‐of‐life conversations. [ABSTRACT FROM AUTHOR]

Background: Loneliness, anxiety and depressive symptoms are common among older residents in long‐term care facilities (LTCFs), which can negatively impact their quality of life and increase mortality rates. Addressing these psychological health issues is an important task for nursing staff. There is a need for easy and accessible interventions to improve older residents' negative emotions. Tactile massage (TM) is a form of touch therapy that induces oxytocin, which can help individuals feel relaxed, experience pleasure and reduce anxiety. TM can also provide a sense of security and care for individuals. Objective: This study aimed to evaluate the effects of TM in improving older residents' psychological health in LTCFs. Design: In this study, we applied a two‐arm randomised controlled trial research design. Methods: We used convenience sampling to enrol 55 older residents in three long‐term care facilities who were randomly assigned to an intervention group and a comparison group. The intervention group received TM by research assistants on both hands for 15 min per time, twice a week for 4 weeks and the comparison group received regular care. Data were collected before and after the intervention. Generalised estimating equations (GEEs) were used to evaluate the effectiveness of the intervention. Results: There were no significant differences in loneliness, anxiety, depressive symptoms, happiness, ear temperature, heart rate or diastolic blood pressure between the two groups after the intervention. However, the intervention group had significant improvements in comfort (B = 0.86, p < 0.001), relaxation (B = 1.00, p < 0.001), respiratory rate (B = −0.16, p = 0.021) and systolic blood pressure (B = − 4.17, p = 0.002) compared to the control group. Conclusions: TM can help older residents who live in LTCFs feel relaxed and comfortable. Implications for Practice: TM can be easily implemented as it requires no tools. We recommend that nursing staff and healthcare professionals incorporate TM as part of their care routines. They also can encourage family members to perform TM on residents during their visits to enhance residents' comfort and relaxation. Reporting Method: The Consolidated Standards of Reporting Trials (CONSORT) checklist was used for this paper. Trial Registration: ClinicalTrials.gov (NCT05052138) [ABSTRACT FROM AUTHOR]

Despite the growing demand for long‐term care (LTC), the uptake of private LTC insurance (LTCI) is low and even declining in the United States. One reason is the complexity of LTCI decisions. Researchers have therefore suggested to support decision‐making abilities. This paper shows, however, that such support would not unambiguously enhance functioning of the LTCI market. We analyze whether selection arises from two correlated but different decision‐making abilities at old age, education and numeracy, and interactions thereof with private information. Using historical data from the Health and Retirement Survey we find that education generates adverse selection, which is only partially offset by advantageous selection due to numeracy. In addition, individuals with greater decision‐making abilities make better LTCI choices, amplifying selection by education and numeracy. This points at a trade‐off between decision simplicity and selection in insurance markets and suggests other steps are needed to enhance the performance of private LTCI markets. [ABSTRACT FROM AUTHOR]

Background: Vitamin D is associated not only with effects on calcium and bone metabolisms but also with many chronic diseases. Low vitamin D levels in patients with Alzheimer's disease have been widely reported in the literature. Aim: The purpose of this study was to critically review the potential benefit of vitamin D supplementation in individuals with Alzheimer's disease living in the community. Methods: A systematic literature search was conducted in PubMed, CINAHL, EMBASE and the Cochrane Library for papers published 2011–2018. Results: Seven papers were selected, consisting of one clinical trial, five cohort studies and one systematic review. Studies showed an association only between vitamin D deficiency and lower attention in older people. None of the reviewed studies provided evidence of a positive impact of vitamin D supplementation on cognitive function in older people with Alzheimer's disease. Conclusion: There was no evidence that vitamin D supplementation has a direct benefit for Alzheimer's disease. The review synthesised the existing body of knowledge and concluded that optimum levels of vitamin D (neither too low nor too high) do appear to have positive effects on patient outcomes and quality of life. It is still unclear why vitamin D intake is inadequate as people age. Further research is needed to clarify vitamin-D-related aspects of Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Unnecessarily prolonged stays in hospitals can have negative impacts on patients and present avoidable costs to health and social care systems. This paper presents the qualitative findings of a multi‐methods study of the social care causes of delayed transfers of care (DTOC) for older people in England. The quantitative strand of this study found that DTOC are significantly affected by homecare supply. In this paper, we explore in depth how and why social care capacity factors lead to delays, from the perspectives of those working within the system. We examined the local transfer arrangements in six English local authority (LA) sites that were purposively sampled to include a range of DTOC performance and LA characteristics. Between March and December 2018, 52 professionals involved in arranging or facilitating discharge from hospitals in these sites provided qualitative data, primarily through semi‐structured interviews. Topics included discharge teams and processes, strategic issues and perceived causes of delays. The thematic analysis uncovered the nuances behind the causes of DTOC previously categorised broadly as 'provider capacity' and 'patient choice'. In particular, our analysis highlights the lack of fit between available provision and the needs of people leaving hospital (theme 1); workforce inconsistencies (theme 2) and a myth of patient choice (theme 3). We are now at a turning point in the development of policy to reduce DTOC in the English system, with the full implications of a new national discharge to assess programme yet to be seen. Our research shows the significance of the alignment of service capacity, including the type and location of provision, with the needs and preferences of those leaving hospital. As the new system becomes established, attendance to such nuances behind blockages in the system will be more important than ever. [ABSTRACT FROM AUTHOR]

Individuals with chronic obstructive pulmonary disease (COPD) often have mobility limitations; these may include challenges with balance and being at high risk of falling. Risk of falling can be reduced through exercise programs targeting balance; however, older adults with COPD may experience many barriers to exercise adherence. In this paper we present qualitative findings about the feasibility of a six-month home-based fall-prevention exercise program for older adults with COPD. The aim of the study is to describe the experiences of older adults with COPD who participated in a home-based fall prevention exercise program in order to determine their perceived facilitators and barriers to participation. 15 participants with COPD who had completed the six-month home-based program participated in one-on-one semi-structured interviews over the phone. Interpretive description methodology and thematic analysis were used. Two major themes emerged with respect to participants' perspectives of the intervention and facilitators and barriers to participation: program personalization based on each individual's characteristics, lifestyles, and preferences; and self-motivation and support from family, friends, and healthcare providers. Fall prevention exercise programs that are personalized and focus on providing support for older adults with COPD may help to improve adherence and reduce participants' risk of falling. Individuals with COPD often have balance problems and a high risk of falling. Fall prevention programs can improve balance, but adherence is a commonly cited challenge. Patient experiences suggest that fall prevention programs should be personalized and incorporate social support to improve adherence to fall prevention exercises. [ABSTRACT FROM AUTHOR]

Health monitoring can provide scientific and reasonable care for elderly users, professionally monitor the health parameters of the human body, and timely understand the user's own physical condition. By installing sensors with different functions in the rooms where the elderly often move and by installing vital signs sensors on their bodies, the data detected by the sensors are collected and analyzed in real time. Nursing refers to the fact that nursing staff must strictly follow the nursing system and operating procedures in the nursing work, accurately implement the doctor's orders, implement the nursing plan, and ensure that the patient is physically and mentally safe during treatment and recovery. Osteoporosis is a systemic bone disease in which bone density and bone quality are decreased due to various reasons, and the microstructure of bone is destroyed, resulting in increased bone fragility, which is prone to fractures. Osteoporosis is divided into two main categories: primary and secondary. Primary osteoporosis is divided into postmenopausal osteoporosis (Type I), senile osteoporosis (Type II), and idiopathic osteoporosis (including adolescent forms). This paper aims to study the healthcare effect of health monitoring system on elderly patients with osteoporosis, expecting to use the health monitoring system to provide more scientific care for the elderly and reduce the pain caused by osteoporosis. This paper proposes a study from the users of the elderly health monitoring products and the elderly home health products and analyzes the influencing factors of the usability design of the elderly home health monitoring system. This paper designs the overall framework of the elderly health monitoring system and designs the main components and application functions of the system. The experimental results in this paper show that there are 20 patients with osteoporosis due to lack of light, accounting for 16%. There are 10 patients with osteoporosis due to excessive coffee intake, accounting for 8%. There are 90 people who normally eat eggs, accounting for 75%, and 66 people who eat meat normally, accounting for 55%. According to the data, the health monitoring system can effectively control the diet of patients with osteoporosis. [ABSTRACT FROM AUTHOR]

This paper explores Freud's later life and the extent to which Freud internalized a subject position as aged. Drawing upon Sartre and de Beauvoir's idea of the unrealizability of death and old age, I argue that throughout his adult life while Freud confronted desires, experiences and fears that were previously unacceptable and even unthinkable, including the presence of a death instinct, an intrapsychic desire for oblivion, old age remained to the end for him, always and only an object position. Age had for him no subjectivity, no inner experience upon which to reflect. It remained external, an "old Freud" existing as a third person, a recognition of how he was regarded rather than how he felt. This illustrates what I suggest is a fundamental separateness between the psychic representation of ageing and dying. In practice this has left an unresolved legacy for the profession of psychoanalysis in planning retirement rather than dying by the couch. [ABSTRACT FROM AUTHOR]

Background: Diadochokinetic rates tasks are frequently used for the assessment of diadochokinesia (DKK) in young and elderly adults. However, there is scarce research on healthy elderly adults over 65 years old, and little is known about the effect of different types of stimuli (non‐words/real words) in this specific population. Furthermore, the current research supports significant language variations, highlighting the need for language‐specific norms. Aims: To investigate the effect of age, gender and type of stimuli (non‐words versus real words) in DDK rates in healthy elderly adults of over 65 years of age, and to provide normative data for the Greek language. Methods & Procedures: The participants were 791 healthy monolingual Greek‐speaking adults (531 adults, aged 20–39 years; 157 participants aged 65–74 years; and 103 participants aged over 75 years). All participants were monolingual speakers of Greek and had normal hearing acuity, which allowed them to understand and follow instructions. Participants with a medical condition, which would affect DDK rates' performance, were excluded from the study. The time‐by‐count method was used, and all participants had to repeat as accurately and fast as possible: (1) four disyllabic non‐words (/′gaba/, /′taka/, /′kata/, /′baga/); (2) four disyllabic real words (/′kapa/, /′tapa/, /ka′la/, /′paka/); and (3) two trisyllabic non‐words (/′pataka/, /′badaga/). All responses were recorded and the speech samples that did not include at least 5 s of correct repetitions were excluded from the analysis. Outcomes & Results: Age affected DDK rates significantly, with older adults achieving slower DDK rates for all speech stimuli (non‐words/real words). Gender did not have an effect on the performance of DDK rates. The type of speech stimuli affected DDK rates significantly for all age groups. Analytically, trisyllabic non‐word stimuli were articulated more slowly than disyllabic non‐word stimuli, and real words were produced faster than non‐words. A linear regression analysis revealed that only the repetition of non‐words predicted 68.4% of the performance on the repetition of trisyllabic non‐words. Conclusions & Implications: The above results complement prior research, which supports that real word stimuli yield faster performance than non‐word stimuli. Clinicians should keep in mind that age, language and type of stimuli (non‐words/real words) affect significantly the performance of DDK rates, as well as the fact that different types of stimuli tap distinct underlying levels of speech. The current research highlights the need for language‐specific norms for different populations. What this paper adds: What is already known on the subject: DDK rates are significantly affected by the types of stimuli and language used. Moreover, the normal ageing process decreases performance in terms of DDK rates, but scarce evidence exists for healthy elderly adults over 65 years old. What this paper adds to existing knowledge: Most studies have examined DDK rates in healthy elderly people with restricted samples and using non‐word stimuli. The current study administered different types of stimuli (non‐words/words) in a large sample of healthy elderly participants. This is also the first study to attempt to provide DDK normative data for this population in the Greek language. What are the potential or actual clinical implications of this work?: The results of this study strongly suggest that clinicians should bear in mind the significant impact age and language have on performance in terms of DDK rates, especially when normative data are not available for a certain language or age group. Furthermore, non‐word and real‐word stimuli cannot be used interchangeably since they tap into distinct underlying levels of speech, thus providing clinicians with useful information about the level of breakdown and the proper treatment plan. [ABSTRACT FROM AUTHOR]

Fall prevention and management of behavioural and psychological symptoms of dementia (BPSD) in long-term care (LTC) facility is a major challenge. The objective of this systematic review is to assess the evidence of digital technology in their management. All studies of English-language excluding case-reports were eligible for review. Databases chosen were MEDLINE, EMBASE, Scopus, Web of Science and PSYCINFO from January 2000 to June 2020. Downs and Black checklist was used to check for risk of bias. Papers with a focus in LTC setting, using digital technology as intervention for older adults with dementia, and with measurable outcomes (outcomes that are quantified, not descriptive) were included in the final review. Seventeen original papers (8 RCTs, 8 quasi-experimental and 1 mixed method) were included. Three articles examining position-sensor technology for fall prevention showed mixed results. Two showed no difference and 1 showed small reduction in fall after alarm removal but the positive effect might be due to bias. Overall, the sample sizes were too small to draw meaningful conclusion. Fourteen studies (9 pet robots of which 8 were robotic seal/PARO) were identified for BPSD and results were mixed. Overall, PARO might have modest benefit in BPSD compared to usual care but might be no better than plush toy with more hallucinations or delusions seen in advanced dementia. However, the significant heterogeneity in methodology (intervention intensity, lack of record in psychoactive drug use), clinical tools used (different BPSD scales, different digital technologies) and variability in outcomes made it difficult to draw clear-cut conclusion. Studies involving other digital technologies are scarce and in pilot phases; hence, conclusion is premature. One limitation of the review was that only 9 out of 17 studies were of good quality. The limited research work in position-sensors meant insufficient evidence to prove efficacy for their use in LTC setting. The possible modest benefit of PARO in BPSD (e.g. in agitation, apathy or reduction in psychoactive drugs) was off-set by possible adverse events such as delusions or hallucinations in advanced dementia. [ABSTRACT FROM AUTHOR]

Adults aged 65 and over are disproportionately impacted by the coronavirus disease 2019 (COVID‐19) pandemic and represent by far the largest share of severe disease and death. This paper critically examines ethical arguments for using implicit and explicit age criteria as a standard for allocating scarce lifesaving resources during the pandemic. Section 1 introduces the topic. Section 2 distinguishes standard from pandemic triage. Section 3 assesses ethical arguments for criteria that are implicitly age‐based, including quality‐adjusted life years, disability adjusted‐life years, and total number of future life years. Section 4 examines ethical arguments for criteria that are more directly age‐based, including fair innings, equality between old and young, and priority to the worse off. The paper concludes that neither implicit nor explicit age‐based allocation withstands careful scrutiny. [ABSTRACT FROM AUTHOR]

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A global ageing population presents opportunities and challenges to designing urban environments that support ageing in place. The World Health Organization's Global Age-Friendly Cities movement has identified the need to develop communities that optimise health, participation and security in order to enhance quality of life as people age. Ensuring that age-friendly urban environments create the conditions for active ageing requires cities and communities to support older adults' rights to access and move around the city ('appropriation') and for them to be actively involved in the transformation ('making and remaking') of the city. These opportunities raise important questions: What are older adults' everyday experiences in exercising their rights to the city? What are the challenges and opportunities in supporting a rights to the city approach? How can the delivery of age-friendly cities support rights to the city for older adults? This paper aims to respond to these questions by examining the lived experiences of older adults across three cities and nine neighbourhoods in the United Kingdom. Drawing on 104 semi-structured interviews with older adults between the ages of 51 and 94, the discussion centres on the themes of: right to use urban space; respect and visibility; and the right to participate in planning and decision-making. These themes are illustrated as areas in which older adults' rights to access and shape urban environments need to be addressed, along with recommendations for age-friendly cities that support a rights-based approach. [ABSTRACT FROM AUTHOR]

Objectives Research among older adults reveals that the loss of core network members is a risk factor for loneliness. Still, it is not clear whether all such losses induce similar levels of loneliness, particularly as network members are distributed at varied geographic distances. Neither is it clear whether tie addition—the other ubiquitous aspect of network turnover in later life—offsets the loneliness that arises from different network loss scenarios. Methods This paper scrutinized core network losses across multiple relationship–distance scenarios. We used the fourth and sixth waves of data from the Survey of Health, Ageing, and Retirement in Europe and estimated fixed-effect models. Results The loss of a child from a core network increases feelings of loneliness across variant distances, especially when not complemented by additional connections. Losing relatives or nonkin core connections in proximity (within 1 km and 5 km radius, respectively) is also associated with increased loneliness, yet such effects are also largely mitigated by the addition of new core network members. Discussion The relationship between core network member losses and loneliness can significantly differ based on the nature of the lost connection and its geographic distance. Active rebalancing of one's core network following losses and proactive network expansion can serve as pivotal strategies to prevent loneliness for the aging population. [ABSTRACT FROM AUTHOR]

Context: Patient experience is an important component of high‐quality care and is linked to improved clinical outcomes across a range of different conditions. Patient‐reported experience measures (PREMs) are psychometrically validated instruments designed to identify where strengths and vulnerabilities in care exist. Currently, there is no validated instrument available to measure patient experience among people aged over 65 years attending the emergency department (ED). Objective: This paper aims to describe the process of generating, refining and prioritising candidate items for inclusion in a new PREM measuring older adults' experiences in ED (PREM‐ED 65). Design: One hundred and thirty‐six draft items were generated via a systematic review, interviews with patients and focus groups with ED staff exploring older adults' experiences in the ED. A 1‐day multiple stakeholder workshop was then convened to refine and prioritise these items. The workshop entailed a modified nominal groups technique exercise comprised of three discrete parts—(i) item familiarisation and comprehension assessment, (ii) initial voting and (iii) final adjudication. Setting and Participants: Twenty‐nine participants attended the stakeholder workshop, conducted in a nonhealthcare setting (Buckfast Abbey). The average age of participants was 65.6 years. Self‐reported prior experiences of emergency care among the participants included attending the ED as a patient (n = 16, 55.2%); accompanying person (n = 11, 37.9%) and/or as a healthcare provider (n = 7, 24.1%). Results: Participants were allocated time to familiarise themselves with the draft items, suggest any improvements to the item structure or content, and suggest new items. Two additional items were proposed by participants, yielding a total of 138 items for prioritisation. Initial prioritisation deemed most items 'critically important' (priority 7–9 out of 9, n = 104, 75.4%). Of these, 70 items demonstrated suitable inter‐rater agreement (mean average deviation from the median < 1.04) and were recommended for automatic inclusion. Participants then undertook final adjudication to include or exclude the remaining items, using forced choice voting. A further 29 items were included. Thirty‐nine items did not meet the criteria for inclusion. Conclusions: This study has generated a list of 99 prioritised candidate items for inclusion in the draft PREM‐ED 65 instrument. These items highlight areas of patient experience that are particularly important to older adults accessing emergency care. This may be of direct interest to those looking to improve the patient experience for older adults in the ED. For the final stage of development, psychometric validation amongst a real‐world population of ED patients is now planned. Patient and Public Contribution: Initial item generation was informed using qualitative research, including interviews with patients in the ED. The opinions of patients and members of the public were integral to achieving outcomes from the prioritisation meeting. The lay chair of the Royal College of Emergency Medicine participated in the meeting and reviewed the results of this study. [ABSTRACT FROM AUTHOR]

The optimization of the human-centeredness of technological innovations – policy digitalization - has exceedingly proliferated in most policy sectors. Yet, a few studies exist on the implications of digital policy tools in realizing social protection policies for older people, particularly in Africa. This paper discusses this issue. It examines data on the 'digital capabilities' of older persons and how digital technologies impact their usage and access to social safety net programs in Kenya, where digital policy tools like mHealth and e-Payment platforms are used to realize them. The data collection involved interviews with 81 respondents between 65-90 years of age (individuals targeted by social safety net programs and Social Protection officers). Findings show a need for more robust and policy target-sensitive efforts and budget allocation to overcome policy digitalization challenges, especially those arising from structural governance inequalities or older people's capability deficits that underpin digital transformation pathways for different policy targets. Most older people in rural areas have negative attitudes and low user digital capabilities toward digital services. This is partly due to a range of challenges from infrastructural deficiencies, low access to internet resources to inadequate policy communication around digital tools. However, higher digital capabilities of policy targets and positive societal attitudes toward digital platforms could improve effective 'public policy digitalization' with more targeted investments and user-sensitive designs in place. [ABSTRACT FROM AUTHOR]

Mobility is often referred to as a 'sixth vital sign' because of its ability to predict critical health outcomes in later adulthood. In the World Health Organization (WHO) World Report on Aging and Health, mobility is described as movement in all its forms whether powered by the body or a vehicle. As such, mobility encompasses basic physical actions such as getting up from a chair and walking, as well as activities such as exercising, driving and using public transportation. A plethora of measurement tools have been developed to assess various aspects of mobility; however, there is wide variability in the mobility constructs being measured which limits standardisation and meaningful comparison across studies. In this paper, we propose a comprehensive framework for measuring mobility that considers three distinct facets of mobility: perceived mobility ability ('what can you do'), actual mobility ability ('what you actually do') and locomotor capacity for mobility ('what could you do'). These three facets of mobility are rooted in the three components of healthy aging endorsed by the WHO: functional ability, intrinsic capacity and environments. By proposing a unified framework for measuring mobility based on theory and empirical evidence, we can advance the science of monitoring and managing mobility to ensure functional ability in older age. [ABSTRACT FROM AUTHOR]

Objective this study aims to conduct a systematic review on available instruments for measuring older persons' ability to learn, grow and make decisions and to critically review the measurement properties of the identified instruments. Methods we searched six electronic databases, which include PubMed, Embase, PsycINFO, SciELO, ERIC and AgeLine, between January 2000 and April 2022. Reference lists of the included papers were also manually searched. The COSMIN (CONsensus-based Standards for the selection of health Measurement Instruments) guidelines were used to evaluate the measurement properties and the quality of evidence for each instrument. Results 13 instruments from 29 studies were included for evaluation of their measurement properties. Of the 13 reviewed, 6 were on the ability to learn, 3 were on the ability to grow and 4 were on the ability to make decisions. The review found no single instrument that measured all three constructs in unidimensional or multidimensional scales. Many of the instruments were found to have sufficient overall rating on content validity, structural validity, internal consistency and cross-cultural validity. The quality of evidence was rated as low due to a limited number of related validation studies. Conclusion a few existing instruments to assess the ability to learn, grow and make decisions of older people can be identified in the literature. Further research is needed in validating them against functional, real-world outcomes. [ABSTRACT FROM AUTHOR]

Background: Older people in the nursing home environment are much less mobile and capable of taking care of themselves as they age, and most of them face the plight of loneliness, which seriously affects the quality of life of older people in their later years. Aims: A systematic review and synthesis of older people's experiences of loneliness in nursing homes. Design: Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. Methods: A search of PubMed, Cochrane Library, Web of Science, Embase, the Chinese biomedical literature service system, the China National Knowledge Infrastructure, the Wanfang Database and the Wipu Database for qualitative studies of older people's experiences of loneliness in nursing homes was conducted with a search time frame of March 2023. Evaluation of the quality of the literature using the Joanna Briggs Institute's Australian Centre for Evidence‐Based Health Care Quality Assessment Criteria for Qualitative Research, And the data were synthesised using Thomas and Harden's method of thematic and content analysis. Results: A total of 13 papers were included, and 36 research findings were distilled and integrated into three themes: causes of loneliness; feelings of loneliness; coping with loneliness; and seven sub‐themes: aging and loss; environmental transformation; loneliness is a pain; loneliness is a choice; participation; strengthening social ties; and diverting attention. Conclusions: Older people in nursing homes face varying degrees of loneliness, which is a subjective feeling influenced by the interplay between personal awareness and the external environment, so future care interventions should be developed in a comprehensive manner, taking into account the characteristics of the older people themselves and their external environment. No Patient or Public Contribution: This study is a meta‐synthesis and does not require relevant contributions from patients or the public. [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]