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Dancing is an attractive form of exercise among older adults and may positively influence physical and psychosocial health. The aim of this systematic review was to synthesize the evidence examining the dance prescription and effectiveness of dance in community dwelling older adults. Eight databases were searched to identify randomized controlled trials that evaluated the effectiveness of dance programs on community-dwelling older adults from 2007 to December 2020. Data regarding participants, dance programs and outcomes of interest were extracted and narratively synthesized. A meta-analysis was performed on the outcome data where possible. Twenty-two studies met the inclusion criteria, of those 15 were deemed to be fair quality and 7 high quality using the PEDro scale. Nineteen studies included in the meta-analysis found that dancing can improve mobility and endurance compared to no intervention and afforded equivalent outcomes compared to other exercise programs. The findings suggest that dance is an effective, safe and viable activity for community-dwelling older adults.. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the course of psychotropic drug use in people with young-onset dementia and to explore possible associations with age, sex, dementia severity, dementia subtype and neuropsychiatric symptoms. Psychotropic drug use was studied in 198 community-dwelling persons participating in the Needs in Young-onset Dementia study. Data about psychotropic drug use were retrieved at baseline, as well as at 6, 12, 18 and 24 months and was classified into five groups (antiepileptics, antipsychotics, anxiolytics, hypnotics/sedatives and antidepressants) and quantified as 'present' or 'absent'. Generalized Estimating Equation modeling and chi-square tests were used to study associations between the determinants and psychotropic drug use. There was a statistically significant increase in the prevalence of psychotropic drug use from 52.3% to 62.6% during the course of the study. Almost three-quarters (72.4%) of the participants were treated with any psychotropic drug during the study, and more than one-third (37.4%) received psychotropic drugs continuously. Antipsychotics were used continuously in more than 10% of the participants and antidepressants in more than 25%. Increasing age was positively associated (p =.018) with psychotropic drug use at baseline, while apathy symptoms were negatively associated (p =.018). Despite the recommendations of various guidelines, the prolonged use of psychotropic drugs in community-dwelling people with young-onset dementia is high. Therefore, more attention is needed to timely evaluate psychotropic drug use and the introduction of self-management programs for caregivers should be encouraged to support caregivers in dealing with the neuropsychiatric symptoms caused by the dementia. [ABSTRACT FROM AUTHOR]

Objective: Spousal caregiving is increasingly common, and it is a role that can alter the nature of marriage in later life. Some may find spousal caregiving to be distressing, while others may have more positive experiences. Spousal caregiving, in particular, may be difficult due to caregiver burden as well as a loss of couplehood within the relationship. The current study used grounded theory methods to better understand the experience of and changes in couplehood among spousal caregivers. Method: Thirteen spousal caregivers completed semi-structured interviews. Spousal caregivers ranged in age from 53 to 85 (mean age = 66.00, SD = 9.04). Results: Qualitative analysis revealed four major themes upon evaluation of the interviews (couplehood, positive mindset, later life roles and transitions, and looking towards the future). Conclusion: These themes exemplified the complex interplay of couplehood and caregiving as well as the range of perceptions of couplehood. Results showed that while some caregivers struggle to find meaning and happiness within their caregiver role, and others said the illness/impairment bonded them together. Caregivers who reported a low sense couplehood discussed feeling trapped in their relationship, sad, and isolated. For some caregivers, a strong sense of couplehood may have helped them reframe the experience as an opportunity to be a role model for others and a reminder that their situation could be worse. Future research should focus on pre-illness couplehood and whether the nature of the impairment (e.g., cognitive, physical) is related to caregiver's couplehood. [ABSTRACT FROM AUTHOR]

Objective: As part of a large mixed-method study aimed at capturing understandings of dignity, and care expectations of community dwelling older women from Black and minority ethnic (BME) backgrounds living in Wales, the aim of this paper is to compare service providers' perceptions of their care and support provided to older people in general, and to older women from BME backgrounds in particular, with a focus on two dignity indicators: care and support needs, and effective communication. Design: A survey design was used. Results: A total of 124 responses from service providers in Wales were received. Perceived inequalities in care and support were found. Although most respondents reported that care and support provision was generally acceptable, more respondents believed that compared to older people in general, older women from BME backgrounds were seldom or never offered opportunities and support to express their needs, were involved in their own care, were provided appropriate information, had their key needs especially less visible needs (psychological and religious needs) been taken into account, or were communicated with effectively (all p < 0.05). In some cases, respondents tended to report more positively in areas related to their own practice. Conclusion: We suggest that learning from the views and perceptions of service providers, as well as older people and their families, remains key to developing services for the UK's increasingly diverse and ageing population. A better understanding of how inequalities may occur, their impact on older people and their families, and how they may be minimised can inform the development of high quality care for older people regardless of their ethnic and cultural backgrounds in Wales, other parts of the UK and beyond. [ABSTRACT FROM AUTHOR]

This study assessed nine participants, who sustained multiple strokes and had spatial neglect, one year after participation in a prior trial on whether Prism Adaptation Treatment (PAT) was a feasible and effective treatment for spatial neglect remediation compared to standard care. The objectives were to: (1) describe the sample, (2) measure the degree of spatial neglect symptoms if present, and (3) determine group differences in motor and spatial performance. Three (60%) participants from the PAT group and two (50%) from the comparison group still displayed spatial neglect. A series of two-way mixed ANOVAs exploring group (PAT vs. comparison of standard care) and time effects (pretest vs. posttest vs. follow-up) found a main effect of time for all participants on the Kessler Foundation Neglect Assessment (F(1,2) = 30.28, p<.001), Functional Independence Measure (F(1,2) = 16.998, p<.001), and star cancelation (F(1,2) = 11.077, p<.001). An interaction effect of time*prism was observed when assessing the line bisection test (F(1,2) = 6.986, p =.008), suggesting that the PAT group performed significantly better on this test. Additional research should be completed with a larger sample in order to better understand the PAT long term effects as well as develop clinical recommendations for occupational therapy practitioners. [ABSTRACT FROM AUTHOR]

Objective: To describe health and wellness characteristics of persons with TBI living in the community, compare to other disability populations and evaluate the associations between health-related constructs. Design: Observational. Setting: Outpatient rehabilitation hospital and a Veterans Affairs Medical Centre. Participants: Seventy-four community-dwelling adults with moderate-to-severe TBI. Interventions: None. Main measures: Health Promoting Lifestyle Profile II (HPLP-II), Self Rated Abilities Health Practices Scale (SRAHP), Barriers to Health Promoting Activities for Disabled Scale (BHPAD), Medical Outcomes Study 12-Item Health Status Survey Short Form (SF-12), Personal Resource Questionnaire-adapted (PRQ-a), Perceived Wellness Survey (PWS), Diener Satisfaction with Life Scale (SWLS) and Participation Assessment with Recombined Tools-Objective (PART-O). Results: Health-promoting behaviours, self-efficacy and barriers to health were comparable to other disability populations. Perceived health status, participation and life satisfaction were decreased. Measures of health promotion and self-efficacy were positively associated with perceived mental health status, life satisfaction and participation. Barriers to healthy activities were negatively associated with health promotion, self-efficacy and perceived mental health status. Conclusions: Health and wellness status was below desired levels for the study cohort, and comparable to other disability populations. Better understanding of associations among health-related constructs is needed. Continued research on conceptually-based health and wellness interventions for persons with TBI is recommended. [ABSTRACT FROM AUTHOR]

Aim: To compare depression in a sample of the medically hospitalized elderly with elderly people participating in a population-based health study in Norway and further to study the odds for depression, controlling for demographic and health differences between the two samples. Method: This cross-sectional observational study evaluated 484 medical inpatients from rural areas and 10,765 drawn from the Nord-Trøndelag Health Study 3 (HUNT-3 Study) including participants from rural and urban areas. All participants were elderly (≥65 years) with a mean (± standard deviation) age of 80.7 ± 7.4 and 73.3 ± 6.3 years, respectively. Symptoms of depression were screened by the Hospital Anxiety and Depression Scale (HAD). Results: The prevalence of symptoms indicating mild, moderate or more severe depression (depression score ≥8) was about the same in both groups. In regression analyses, adjusting demographic and health differences, the odds for depression was lower for the elderly in the hospital sample than in the HUNT-3 Study. Older age, male gender, perceiving general health as poor, having impaired ability to function in daily life, previous consultation or treatment for emotional problems and anxiety (anxiety score ≥8) were associated with increased odds for depression in the elderly independent of being hospitalized or not. Conclusion: Surprisingly, we found the odds for depression after controlling for demographic and health variables to be lower in the hospitalized elderly individuals than in the elderly participating in the population-based health study. The health variables that were most strongly associated with an increased risk of depression were poor physical health and anxiety. [ABSTRACT FROM AUTHOR]

Recognizing that older adults are among the biggest consumers of medication, and the demographic group most likely to suffer an adverse drug reaction (ADR), this paper details the findings from a recent study on how older adults come to understand medication and its related use. Using a qualitative content analysis method, semi-structured interviews were conducted with 21 individuals from British Columbia, Canada. Study participants ranged in age from 65 to 89 years (male=9, female=11). Using NVIVO† 7 software, data were subjected to comparative thematic content analysis in an effort to capture the role of medication use in the context of everyday living as understood by older adults. While there was variability in how older adults come to understand their medication use, an overarching theme was revealed whereby most participants identified their prescription medications as being life-sustaining and prolonging. Deeper thematic content analysis of participant narratives drew attention to three key areas: (A) medications are viewed as a necessary, often unquestioned, aspect of day-to-day life (B) a relationship is perceived to exist between the amount of medications taken and ones current state of health (C) the overall medication experience is positively or negatively influenced by the doctor patient relationship and the assumption that it is the physicians role to communicate medication information that will support everyday living. The article concludes that medical authority and the complexities surrounding medication use need to undergo significant revision if community dwelling older adults are to experience greater success in safely managing their health and medication-related needs. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to identify and describe two couples' approaches to changes in everyday life during the first year after a stroke. An additional aim was to describe how the couples viewed rehabilitation as well as their own personal training relative to changes in everyday life during the first year at home after stroke. Method: The study design was a prospective longitudinal case study based on two couples where one of the spouses in each couple had experienced a stroke. Data collection consisted of interviews and a questionnaire and took place in the participants' homes. Data analysis utilized a constant comparative method. Results: The findings showed a divergence in the couples' approaches to changes in their everyday life at home and were described through the following categorizations: engaging in occupations, getting experience and thereby feedback from doing, changing one's occupational needs and demands, contributing to a picture of a possible future and, integrating training in everyday life. Getting experience and feedback from doing was found to be a key category or ''driver'' in the change process. Conclusion: The couples' experiences of changes in everyday life after stroke illustrated two very divergent approaches, which is discussed in the paper. The approaches in turn had consequences for how daily life was spent after stroke which is also discussed. [ABSTRACT FROM AUTHOR]

Sleep disturbances are a common problem among institutionalized older people. Studies have shown that this population experiences prolonged sleep latency, increased fragmentation and wake after sleep onset, more disturbed circadian rhythms, and night-day reversal. However, studies have not examined the extent to which this is because of individual factors known to influence sleep (such as age) or because of the institutional environment. This article compares actigraphic data collected for 14 days from 122 non-demented institutional care residents (across ten care facilities) with 52 community dwelling poor sleepers >65 yrs of age. Four dependent variables were analyzed: (i) “interdaily stability” ( IS); (ii) “intradaily variability” ( IV); (iii) relative amplitude ( RA) of the activity rhythm; and (iv) mean 24 h activity level. Data were analyzed using a fixed-effect, single-level model (using MLwiN). This model enables comparisons between community and institutional care groups to be made while conditioning out possible “individual” effects of “age,” “sex,” “level of dependency,” “level of incontinence care,” and “number of regular daily/prescribed medications.” After controlling for the effects of a range of individual level factors, and after controlling for unequal variance across groups (heteroscedascity), there was little difference between community dwelling older adults and institutional care residents in IS score, suggesting that the stability of day-to-day patterns (such as bed get-up, lunch times, etc.) is similar within these two resident groups. However, institutional care residents experienced more fragmented rest/wake patterns (having significantly higher IV scores and significantly lower mean activity values). Our findings strongly suggest that the institutional care environment itself has a negative association with older people's rest/wake patterns; although, longitudinal studies are required to fully understand any causal relationships. (Author correspondence: ) [ABSTRACT FROM AUTHOR]

The aim of this study was to measure a range of psychological factors identified as important in the literature (resilience, psychological distress, feelings of hopelessness, personal and interpersonal control) among community-dwelling elderly women (N = 31) who had suicidal intentions or attempted suicide. The target group was matched to a control group on age within 5 years. The target group reported lower resilience, personal and interpersonal control but higher psychological distress and feelings of hopelessness compared to the control group. Women who had suicidal ideation or attempts in the last 12 months reported higher personal and interpersonal control. This suggests that although suicide among older women is strongly linked to psychological factors, it warrants further investigation. [ABSTRACT FROM AUTHOR]

Background: The primary aim of this review was to identify existing instruments that have been used to assess the mobility status of community-dwelling older adults. The secondary aims were to identify instruments that have face validity for measuring across the full mobility spectrum and to summarise and compare their clinimetric properties. Methods: MEDLINE, CINAHL, PEDro, and EMBASE were searched until April 2007. The first stage included searching for papers that reported mobility outcome measures that had been applied to healthy community-dwelling older adults. The second stage identified these outcome measures and the third stage compared clinimetric properties of the instruments that had face validity for measuring across the full mobility spectrum (from bed-bound to high levels of independent mobility). Two independent reviewers extracted data from the included studies. Results: From the 128 included papers, 14 outcome measures were identified, two of which, the Lower Extremity Functional Scale (LEFS) and the Elderly Mobility Scale (EMS), measured across the full spectrum of mobility. No clinimetric evidence was found for the LEFS amongst a community-dwelling older population and only evidence of known groups validity was identified for the EMS. Discussion: An outcome measure that has face validity for measuring across the full mobility spectrum and has sufficient clinimetric evidence in a community dwelling population was not identified. Conclusion: This review supports the need for the development of such an instrument. [ABSTRACT FROM AUTHOR]

Objectives: To explore outlooks for the future which exist in an older population, through construction of a typology of combinations of absence or presence of reported hopes and fears for the future and a detailed analysis of the characteristics of older people in each of the four outlook categories created: optimistic, pessimistic, realistic or detached. Methods: The findings are based on population survey responses from 8881 older Australians (65 + yr) living independently in the community. The Cochrane-Armitage test was used to detect the presence of trends, while logistic regression modelling was used to examine predictors of respondents expressing no main hope and/or no main fear. Results: The logistic regression modelling identified predictors of outlook category, which have face validity and are consistent with the literature. In addition, the proportion of older people in the pessimistic category with scores indicating psychological distress (Kessler 6) was significantly higher than in the three other categories, providing support for the validity of the typology. Conclusion: The vast majority of independently living older Australians have realistic or optimistic outlooks about their future. The small minority who are pessimistic, and more likely to be experiencing psychological distress, can be identified through self-reported absence of hopes accompanied by presence of fears. [ABSTRACT FROM AUTHOR]

This study examined social network characteristics associated with older adults' intentions to participate and actual participation in social activities at a new senior center. Face-to-face interviews (N = 126) were conducted prior to the opening of a senior center in the participants' community. Measures included social network characteristics, social support, social connectedness, and demographic characteristics. Actual participation was assessed approximately 14 months after the senior center's opening. Smaller proportions of network members living in close proximity, having 10% or more network members be children, higher perceived availability of social support, and lower perceived levels of social connectedness were associated with higher intentions to participate in social activities. Levels of intention did not significantly predict actual participation. Older adults with little social support may not perceive senior centers as places to gain desired support. However, individuals who lack companionship may perceive them as a resource for boosting their social engagement. [ABSTRACT FROM AUTHOR]

The present study sought to compare the chronic pain experiences and identify the variables that may differentiate community-dwelling older people who attend a multidisciplinary pain centre and those who seek community-based interventions. This cross-sectional study used discriminant function analysis to identify the variables that differentiate two samples of older people with chronic non-malignant pain. The first group comprising 150 patients from a multidisciplinary pain management centre, and the second group comprising 99 older persons who responded to a community-based pain management program. The results suggest marked differences in the chronic pain experience between these groups. The variables that contribute to differentiate the two study groups were: use of coping strategies that include praying or hoping, diverting attention, and reinterpreting pain sensation, level of physical activity, self-reported pain intensity level and length of pain history. The findings of the present study also suggest that the sample of older people who attend a multidisciplinary pain management centre are more likely to experience increased anxiety, and have conditions other than a musculoskeletal condition as the main cause of pain. The findings also support the notion that older people who attended the multidisciplinary pain management centre are probably not representative of those with chronic pain in the general community. Thus, we suggest that the use of coping strategies are important variables that differentiate the two study groups, influence the adjustment to chronic pain and highlight the need for multidimensional assessment in order to gain better understanding of pain experiences, and to evaluate the needs of those with chronic pain. Further investigations that enhance our understanding of the chronic pain experiences of subgroups of older people with chronic pain should be undertaken, in order to guide the development of effective pain management programs that meet the needs of older people with chronic pain. [ABSTRACT FROM AUTHOR]