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Occupation-based literature has not explored the specific community-level occupational processes that support inclusion or exclusion of Latine older adults in senior centers. This study examined occupation at the community level and its role in the inclusion or exclusion of older adult Spanish speakers in a senior center community. In addition, it sought to examine potential roles for occupational therapy practice in this realm. A 6-month ethnographic study used interviews, observations, document review, group mapping activities, and collaborative analysis to explore occupation of a senior center as the community and staff welcomed older adult Spanish speakers. Being culturally proactive, considering values and interests, offering regular activities, and cross-group doing together encouraged cohesion and communal habits of inclusion. These tailored modes of community occupation benefit Spanish-speaking older adults. Occupational therapy practitioners have opportunities to utilize tailored community occupations to support community inclusion and cohesion for this population.

This pilot randomized control trial (RCT) tested “Do More, Feel Better” (DMFB), a lay-delivered Behavioral Activation intervention for depressed senior center clients. The study examined: 1. the feasibility of training older lay volunteers to fidelity; and 2. the acceptability, safety, and impact of the intervention. Twenty-one lay volunteers at four senior centers were trained in DMFB. Fifty-six depressed clients were randomized to receive 9 sessions of DMFB or Behavioral Activation delivered by social workers (MSW BA). Research assessments of overall client activity level (BADS) and depression severity (HAM-D) were conducted at baseline and weeks 3, 6, and 9. Eighty-one percent of lay volunteers who underwent training were formally certified in DMFB. Depressed clients receiving each intervention reported high levels of satisfaction and showed large and clinically significant changes in 9-week activity level (d ≥ 1.35) and depression severity (d ≥ 3.34). Differences between treatment groups were very small for both activity level (dMSW = 0.16; 95% CI, -0.70 to 1.02) and depression (dMSW = 0.14; 95% CI, -0.63 to 0.91). Increases in activity level were associated with decreases in depression (β = -0.42; 95% CI, -0.55 to -0.30). Both interventions appeared to work as intended by increasing activity level and reducing depression severity. “Do More, Feel Better” shows the potential of evidence-based behavioral interventions delivered by supervised lay volunteers, and can help address the insufficient workforce available to meet the mental health needs of community-dwelling older adults.

Objective: The main objective was to evaluate the preparedness of senior centers (SCs) for active shooter (AS) events and test the hypothesis that most SCs were not organized to properly handle AS incidents. Design: A cross-sectional study based on questionnaire with quantitative measures. Setting: A questionnaire-based multistate survey of SC Directors (SCDs) of public and private SCs. Participants: SCs were included upon receipt of answers from SCDs to questionnaire-based survey, resulting in 139 SCs from Ohio, Pennsylvania, Michigan, Maryland, Indiana, Illinois, New York, and West Virginia. Main outcome measure: SCs, SCDs, and SCs’ staff preparedness and vulnerability to an AS event. Results: Over half (56 percent) of SCDs replied that their center was not prepared for an AS event. A significant (p < 0.01) association was found between the SCD’s perception of being prepared and the availability of a formal AS preventive policy. The lack of panic buttons and surveillance cameras was significantly (p < 0.01) associated with the feeling of inability by SCDs to respond effectively to an AS event. Those SCDs who were confident about their AS preparedness felt significantly (p < 0.01) better prepared to respond to an AS incident. Personal interviews with content experts agreed that all SCDs should take steps to develop an official AS preparedness policy, but its implementation should be the direct responsibility of local policymakers and legislators. Conclusions: Most SDCs and SCs are unprepared for AS incidents. SCDs should review or develop specific recommendations and implement plans for a better preparedness of SCs and SCDs for AS events. Considering the inherent high vulnerability of older adults, there is an urgent need to have such AS policy in place.

Introduction Depression is common among community-dwelling older adults who make use of senior centre services yet remains undertreated due to a lack of acceptable and available treatments. Emerging evidence suggests that lay health providers can offer psychosocial interventions for mental health disorders experienced by older adults. We developed a streamlined Behavioural Activation intervention (called ‘Do More, Feel Better’; DMFB) to be delivered by older adult volunteers and propose to compare its effectiveness to that of clinician-delivered behavioural activation (BA). Methods and analysis This study is a type I collaborative randomised effectiveness trial testing the effect of DMFB in comparison to BA among 288 senior centre clients (aged 60+). Participant clients will be recruited from 6 Seattle, 6 New York City and 6 Tampa area senior centres serving economically and ethnically diverse communities. Primary outcomes will be increased activity level (target) and decreased depressive symptoms. Secondary outcomes will be functioning and client satisfaction, and an exploratory outcome will be treatment fidelity. Ethics and dissemination The study received ethics approval from the University of Washington Institutional Review Board (STUDY00011434). Client, volunteer and clinician participants will all provide informed consent for study procedures through in-person or remote contact with investigators. Results of this study will be presented in peer-reviewed journals and at professional conferences. Trial registration number NCT04621877; ClinicalTrials.gov.

We aim to identify challenges and recommendations for senior centre health services focusing on nurses' roles in an urban South Korean community.Senior centres can potentially provide easily accessible and cost-effective health services to older adults. It is essential to identify current challenges to improve health services.This study used an explanatory sequential mixed-methods design. Quantitative descriptive data were obtained from a survey of all nurses at senior centres in Seoul (n = 30). For the qualitative data, focus group interviews were conducted with various senior centre stakeholders (n = 15).Two main themes, discrepancy between services and needs and reform senior centres, were identified with six subthemes.Challenges identified included insufficient availability to meet health service needs, overlapping health services, and no legal clarification of nurses' roles. Recommendations to improve the senior centre health services include to focus on the centres' main goals, function as health and welfare hubs, establish legal guidelines, and provide adequate nurse staffing.The senior centres need to hire more nurses and define nurses' occupational roles legally for the centres to serve as a hub connecting medical care and welfare.

Senior centre staff members seemingly have an important organisational and administrative role, as well as engage in outreach activities, referral and follow-up in relation to health issues among senior centre users. However, their role in health promotion and illness prevention is easily overlooked and under researched. This study aimed to explore municipal senior centre staffs' awareness of and response to signs of deteriorating health or well-being among users. A multisite ethnographic field study was conducted at seven municipal senior centres in Denmark from November 2019 to February 2020. Data were obtained from participant observation and semi-structured individual interviews with 16 staff members. A thematic analysis strategy helped identify themes of importance. Senior centre staff followed a process of three steps when remaining aware of and responding to signs of deteriorating health and well-being among users: detecting, tracing and reacting. Three themes with corresponding subthemes were identified: Establishing close and trusting relationships, facilitating a community feeling and utilising joint collaboration. Each subtheme was linked to some or all of the three steps in the process. The municipal senior centre staff had a strong and explicit focus on detecting, tracing and reacting to signs of deteriorating health and well-being among senior centre users. This makes the senior centres a promising arena for illness prevention and health promotion.

Senior centers must re-envision their programs to appeal to today’s increasingly older and more diverse older adults. Using a purposeful aging framework, this study aims to inform senior center programming by capturing diverse older adults’ perspectives on future goals, perceptions of aging, attitudes about senior centers, and experience with technology. Participants age 70 and older ( N = 64) joined one of eight focus groups organized by race/ethnicity and preferred spoken language. Transcripts were coded using a grounded theory approach to identify perspectives in each domain. Across groups, shared perspectives included aspirations to make a difference, maintain health and independence, continue learning, and embrace positive perceptions of aging. However, both positive and negative attitudes about participating in senior centers and the effects of technology were presented. We discuss how to redesign senior center programming to meet members’ proactive approach to aging and future goals, and facilitate more confidence with new technology.

To address the paucity of research investigating the implementation of multi-domain dementia prevention interventions, we implemented and evaluated a 24-week, bi-weekly multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres (SCs). It comprised dual-task exercises, cognitive training, and mobile application-based nutritional guidance. An RCT design informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework was adopted. Outcome measures include cognition, quality of life, blood parameters, and physical performance. Implementation was evaluated through questionnaires administered to participants, implementers, SC managers, attendance lists, and observations. The program reached almost 50% of eligible participants, had an attrition rate of 22%, and was adopted by 8.7% of the SCs approached. It was implemented as intended; only the nutritional component was re-designed due to participants’ unfamiliarity with the mobile application. While there were no between-group differences in cognition, quality of life, and blood parameters, quality of life reduced in the control group and physical function improved in the intervention group after 24 weeks. The program was well-received by participants and SCs. Our findings show that a multi-domain program for at-risk older adults has benefits and can be implemented through neighborhood SCs. Areas of improvement are discussed.Trial registration: ClinicalTrials.gov NCT04440969 retrospectively registered on 22 June 2020.

Background The Internet is considered an important channel for providing health information to older adults. We developed an intervention to improve eHealth literacy in older adults according to the information-motivation-behavioral skills (IMB) theory and Intervention Mapping. This study aimed to analyze the effect of a developed intervention on information, motivation, behavioral skills, and behaviors related to eHealth information in older adults. Methods Forty-six older adults over the age of 65 were recruited from two senior welfare centers in a city in South Korea. We divided the participants into four groups and conducted one intervention per group from March to December 2019. One intervention consisted of 5 sessions and was performed once a week (2 h/1 time) for 5 weeks, culminating in a total lecture time of 10 h. One lecture instructor and two assistant instructors supported the participants in the computer practices. Results Participants’ computer/web knowledge, perceived ease of use, perceived enjoyment, and attitude toward eHealth information showed statistically significant increases. The eHealth literacy efficacy score, searching performance score, and understanding score were also significantly increased. However, there was no significant difference in perceived usefulness. Conclusion The application of the current theory-based methodology can improve the quality of research in eHealth literacy. Additionally, various interventions should be developed and continuously applied to improve eHealth literacy among older adults.

Objectives: Multiple tuberculosis (TB) exposures have been reported in New York City (NYC) adult day care and senior centers. Strategies to identify TB transmission at such locations are needed. Method: Review of the NYC TB Registry identified 12 contact investigations (CIs) at adult day care or senior centers (2011–2018). Results: Median age of the 12 index patients was 81 years. Of 148 contacts identified who had no history of TB infection or disease, 141 (95%) were tested for TB, primarily with interferon gamma release assays; 46 (33%) tested positive. Transmission was probable ( n = 3) or possible ( n = 1) at 4 (33%) centers; at all of these, the index patient had an acid-fast bacilli–positive sputum smear. Transmission was not found from index patients with negative sputum smears. Discussion: We found evidence of transmission of smear-positive respiratory TB disease to contacts in adult day care or senior centers, underscoring the importance of CI.

Introduction: COVID-19 not only acutely compromises peoples health but can also generate symptoms that remain weeks after the infection. Moreover, older adults may have different symptomatologic patterns than other age groups. Objective: To describe the acute and persistent symptoms of COVID-19 in older adult users of Social Security senior centers. Methods: A retrospective descriptive study was carried out by telephone call to older adults from five Peruvian senior centers, from July to September 2020, who reported being positive for COVID-19 in the last three months. Older adults were asked about associated symptoms, with a follow-up of up to four months. Results: The most frequent acute symptoms were cough, fever, headache, and myalgia. The mean num- ber of symptoms per person was one to three. We also found that 4.4% of COVID-19 cases had symptoms that persisted over three weeks. Conclusions: Older persons in senior centers have a low frequency of persistent COVID-19 symptoms. Introducción: COVID-19 no sólo compromete agudamente la salud de las personas, sino que puede generar síntomas que permanecen luego de la infección aguda, incluso por más de tres semanas. Más aún, las personas adultas mayores podrían tener patrones sintomatológicos diferentes a otros grupos etarios. Objetivo: Describir los síntomas agudos y persistentes de COVID-19 en personas adultas mayores usuarias de centros del adulto mayor de la Seguridad Social. Método: Se realizó un estudio descriptivo retrospectivo por llamada telefónica a adultos mayores de cinco centros del adulto mayor peruanos, de julio a septiembre de 2020, quienes habían reportado ser positivos a COVID-19 en el monitoreo telefónico de los últimos tres meses. En las llamadas se les pregunto por los síntomas asociados, con un seguimiento de hasta cuatro meses. Resultados: Los síntomas agudos más frecuentes fueron tos, fiebre, cefalea y mialgia. La media de síntomas por persona fue de uno a tres. Un 4,4% de los casos tuvo COVID-19 prolongado. Conclusiones: Las personas mayores de los centros del adulto mayor presentan una baja frecuencia de síntomas post COVID-19 agudo.

Low-income, minority seniors face high rates of hypertension that increase cardiovascular risk. Senior centers offer services, including congregate meals, that can be a valuable platform to reach older adults in underserved communities. We implemented two evidence-based interventions not previously tested in this setting: DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. The study enrolled congregate meal program participants, provided training and support for SMPB, and nutrition and BP education. DASH-aligned meals delivered 40% (lunch) or 70% (breakfast and lunch) of DASH requirements/day. Primary outcomes were change in BP, and BP control, at Month 1. Implementation data collected included client characteristics, menu fidelity, meal attendance, SMBP adherence, meal satisfaction, input from partner organizations and stakeholders, effort, and food costs. We used the RE-AIM framework to analyze implementation. Study Reach included 94 older, racially diverse participants reflecting neighborhood characteristics. Effectiveness: change in systolic BP at Month 1 trended towards significance (−4 mmHg, p = 0.07); change in SMBP reached significance at Month 6 (−6.9 mmHg, p = 0.004). We leveraged existing community-academic partnerships, leading to Adoption at both target sites. The COVID pandemic interrupted Implementation and Maintenance and may have attenuated BP effectiveness. DASH meals served were largely aligned with planned menus. Meal attendance remained consistent; meal satisfaction was high. Food costs increased by 10%. This RE-AIM analysis highlights the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers. It encourages future research and offers important lessons for organizations delivering services to older adults and addressing cardiovascular risk among vulnerable populations.

BACKGROUND/OBJECTIVES The Centers for Disease Control and Prevention recommends that patients at risk of falling engage in evidence-based community fall prevention programs (EBCFPPs). EBCFPPs are often delivered in senior centers (SCs). This is the first independent assessment of availability of EBCFPPs in SCs. DESIGN Cross-sectional study of four types of EBCFPPs in the 25-mile radius of 10 US academic centers (ACs). SETTING SCs. PARTICIPANTS SCs. INTERVENTION None. MEASUREMENTS Number and types of EBCFPPs offered at SCs. RESULTS Across the 10 ACs, 249 SCs were sampled. Of the SCs, 35% offered zero, 54% offered at least one, 9% offered at least two, and 2% offered at least three EBCFPPs. Tai Chi of any type was offered in 59.8%, A Matter of Balance was offered in 8.9%, Stepping On was offered in 8.0%, and Staying Active and Independent for Life was offered in 1.2% of SCs sampled. SCs near Columbia University offered all four of the programs, while those near the University of Utah, Johns Hopkins University, and Seattle University only offered three of the programs. In univariate analysis, the number of local SCs was significantly associated with quantity of EBCFPPs (odds ratio [OR] = 2.2; 95% confidence interval [CI] = 1.9-2.6; P

Purpose: This study shows how the spatial organization of objects and their use may impact locally produced order of activities and how that can affect the accomplishment of everyday activities by people with dementia. Methods: The study is based on ethnomethodological conversation analysis of eight and a half hours of video recordings in three different settings. Eighteen sequences of activities identified were multimodally transcribed and analyzed. Results: The availability or non-availability of objects, their arrangements and manipulations play a crucial role in the management of the order of activities and may present both challenges and facilitations for people with dementia. The organizations of objects directly influence the order of the activity, and the objects potential use may afford actions that deviate from the trajectory and the order of the main activity. Conclusions: One of the significant uses of objects is how they contribute to the perceptual field where attention is organized for building actions. Participants in activities modify the perceptual field by manipulating objects in the material surrounds in response to the relevancies resulting from the unfolding activities. Therefore, spatial contingency is significant in the accomplishment of activities by people with dementia. As it is not self-evident that verbal instructions may result in the instructed actions accordingly, the rearrangement of objects and making them timely available to people with dementia may increase the possibilities of keeping the order of the activities intact.

Upon the outbreak of Covid-19, recommendations to cease all non-essential in person services were mandated across the United States to prevent transmission to non-infected individuals. As a result, approximately 96% of all senior centers in the United States were closed to in-person programming. Senior centers have had a long history of engaging older adults, maintaining community connections, enhancing social support and reducing social isolation. SAGE, the first publicly funded senior center for LGBT older adults in the US, serves a traditionally under-served population with a vast array of services and programs. This exploratory, cross-sectional study utilized an online survey to evaluate the experiences of 113 SAGE members after the Coronavirus pandemic closed their senior center. Participants reported a relatively easy adaptation to technology, steady participation in programs and services, satisfaction with virtual senior center programming and a stable sense of engagement with their peers. Higher levels of engagement with senior center programs was associated with stronger feelings of social support. Additionally, stronger perceptions of social support and participation in exercise and fitness programming were associated with higher life satisfaction and lower depression and anxiety. Implications and recommendations for other gerontological service providers are offered.

Background: Latinx elders are underrepresented in dementia research. In a previous study we assessed research attitudes in urban minority elders and found a significant minority expressed neutral to negative attitudes relating to trust, safety, and personal responsibility to help research. Objective: To assess the impact of a composite intervention on attitudes toward research and research participation among elderly Latinx. The intervention was a collaboratively produced research participation video shown during presentations with our elderly community advisory board (CAB) as co-presenters. Methods: The video was created by the ADRC and CAB. All senior center attendees were eligible to participate. Afterwards, the Research Attitudes Questionnaire (RAQ) and a brief questionnaire on the impact of the video were administered. Using Wilcoxon Rank Sum Tests, Chi Square, and OLS regressions, RAQ responses were compared to those from a historical cohort from similar centers. Results: 74 in the “Historical Cohort 1” and 104 in “Intervention Cohort 2” were included. RAQ total score was higher in Cohort 2 than Cohort 1 (28.5 versus 26.1, p

It is imperative to have effective programs to improve or maintain the health of aged people.To evaluate the effectiveness of an intervention based on a multidimensional program in Senior centers in Chile five months after its implementation, in the domains of physical and mental health, functionality and quality of life in aged people.Sixty participants older than 60 years completed a multidimensional program for one month that included interventions of guided physical exercises, in addition to educational and social activities. They were evaluated at baseline and one and five months after the intervention.After the first and fifth months, significant improvements were observed in the five times sit to stand test (5TSTS) and gait speed (WST), in addition, significant improvements were observed in literacy measured by the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). At the fifth month, slight improvements were observed in the Yesavage and short Falls efficacy scales, Barthel index, Unipodal Station and EuroQol five-dimensional quality of life tests.A multidimensional program for aged people lasting one month, improved the physical health dimension and literacy by the fifth month of evaluation.

This study aimed to examine the daily time use by activity and identified factors related to health management time (HMT) use among 195 older adults (mean age = 77.5, SD = 6.28 years, 70.8% women) attending a Korean senior center. Descriptive statistics were analyzed and gamma regression analyses were performed. Participants used the most time on rest, followed by leisure, health management, daily living activities, and work. The mean duration of HMT was 205.38 min/day. The mean score for the subjective evaluation of health management (SEHM) was 13.62 and the importance score for SEHM was 4.72. Factors influencing HMT included exercise, number of chronic conditions, fasting blood sugar level, low density lipoprotein level, and cognitive function. HMT and frailty significantly predicted SEHM. HMT interventions focus on promoting exercise and acquiring health information to improve health outcomes among older adults in senior centers.

Purpose A better understanding of service utilization patterns at senior service centers can improve program development and constituent usage Theory This research examines whether participation in senior center activities is a function of senior socialization that reinforces and supports existing social ties by selecting specific activities in senior centers. Methods A total of 924 participants of senior centers in a municipality in the Southwest were surveyed. Results We find that having closer friends influences participation in certain senior center services. We also find that gender, race, ethnicity, and income also explain different usage rates beyond age. Conclusion Opportunities to foster social interaction to grow and reduce barriers to participation and market to a broader range of current and potential participants are discussed.

When people have more negative perceptions about aging or attribute health decline to old age, they engage in less health promotion behavior. We tested whether an intervention of brief anti-ageism messages addressing views of aging could motivate engagement in physical activities at senior centers. Attendees aged 50 and older ( n = 349; Mage = 72, SD = 9) at seven centers were randomly assigned to read one of three intervention messages (different approaches addressing views of aging) or to not read a message before rating their likelihood of attending a variety of center programs, including physical activities. Multilevel regression models indicated the intervention increased motivation to attend physical activities compared with the control group among participants aged 72 and older. The three anti-ageism messages were similarly effective suggesting some flexibility in framing. The results indicate anti-ageism messages may be a scalable, low-cost approach to promoting physical activity in older adults.

This study examined the effects of a person-centered nursing intervention program for frailty (PNIF) targeting community-dwelling prefrail older people in South Korea. The study participants were 40 community-dwelling older adults (&ge, 65 years) who were classified as prefrail on the Cardiovascular Health Study (CHS) frailty index. The intervention group (n = 20) received group intervention sessions two days/week for twelve weeks and the control group (n = 20) attended lectures about frailty prevention one day/week for four weeks. The evaluation instruments included the CHS Frailty Index, a JAMAR&reg, hydraulic hand dynamometer, the Short Physical Performance Battery (SPPB), the Korean version of the Community Healthy Activities Model Program for Seniors Questionnaire (K-CHAMPS), the Mini Nutritional Assessment (MNA), the Geriatric Depression Scale Short Form-Korea Version (GDSSF-K), the ENRICHD Social Support Instrument (ESSI), and the Goal Attainment Scale (GAS). Significant differences were found in the CHS Frailty Index (p &lt, 0.001), left-hand grip strength (p = 0.022), right-hand grip strength (p = 0.009), SPPB (p = 0.007), K-CHAMPS (p = 0.009), MNA (p = 0.018), and GDSSF-K (p = 0.001) between the two groups after 12 weeks. No significant between-group differences in ESSI scores were observed. The PNIF effectively improved grip strength, physical function, physical activity, and nutritional status, reduced depression, and prevented frailty among community-dwelling older adults.

Research shows that felt age among older adults is a good proxy for their current and future physical and mental health. Using both quantitative and qualitative interview data, we examined correlates of and self-reported reasons for felt age among 102 low–socioeconomic status (SES), non-Hispanic Black and Hispanic older adults who were members of a senior activity center. Fewer activities of daily living (ADL)/instrumental activities of daily living (IADL) impairments, more positive affect, and higher self-efficacy were associated with higher odds of feeling younger, while financial stress was associated with lower odds. The most common self-reported reasons for younger felt age were staying active, followed by good health, positive attitudes, exercise/dancing, independence, interpersonal/intimate relationships, faith/spirituality, volunteering, family, driving/traveling, and being of sound mind. Poor health, lack of energy, and limited ability to engage in activities were self-reported reasons for older felt age. Senior center programs that enable older adults to stay active and socially integrated may contribute to their well-being.

OBJECTIVE: This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC). METHODS: Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics—Sense of Coherence (SOC), anxiety and depression using HADS, happiness—, and oral clinical evaluation—use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05). RESULTS: In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0–4.2) for older adults who did not participate in SC. CONCLUSION: Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.

RÉSUMÉLes centres pour personnes âgées ont été identifiés comme des points focaux pour la prestation de services pour la population vieillissante, qui est en forte croissance au Canada et aux États-Unis. Malgré ce rôle important des centres pour personnes âgées, peu de recherches leur ont été consacrées. Cet examen de portée a ciblé les études empiriques en langue anglaise portant sur les centres pour personnes âgées qui ont été publiées dans des revues scientifiques depuis 2000. Un total de 58 études ont été repérées (n = 51 pour les études américaines, n = 7 pour les études canadiennes). La majorité de ces articles était centrée sur des thèmes liés à la participation d’individus dans les centres pour personnes âgées, et quelques études seulement traitaient du milieu associé aux centres pour personnes âgées. Ces résultats suggèrent que les recherches futures devraient cibler les avantages de la programmation des centres pour personnes âgées, avec une attention particulière sur les besoins des baby-boomers, sur les facteurs clés liés au financement, aux espaces et au personnel, ainsi que sur les caractéristiques et les rôles des centres pour personnes âgées dans le contexte canadien.

Nutritional status is important to elders to live without disabilities. Food Insecurity (FI) is a risk factor associated with poorer nutritional status among elderly as well as a social determinant. This research aimed to identify FI prevalence and to explore the relation between FI, weight status and socio-demographic factors. Methods This cross-sectional study was conducted from September 2015 to February 2016 in Lisbon. Malnutrition was determined using Mini Nutritional Assessment (MNA). FI was assessed using FIES (Food Insecurity Experience Scale) and social risk using Gijon’s social-familiar evaluation scale. Data were collected through face-to-face interviews and anthropometric indices were measured according to Isak procedures. Results A sample of 337 subjects, with an average age of 78.4 years old (range 66–99), mostly women (n = 210; 62.3%) were enrolled. 70.0% were FI, whereas 40.7% was at risk of malnutrition, 4.7% were malnourished and 34.7% of participants presented high social risk. Being a woman, FI, reported Depression, Loneliness, Acute Myocardial Infarction, Cerebrovascular Accident, Diabetes, being aged 74–85 years old, Health status and attending SC for less than 5 years were contributors to risk of malnutrition/malnutrition. Lack of money, socialization as a reason for attending SC, Social Risk and Diabetes were related to FI. There was no correlation between FI and obesity, but a positive correlation between FI and weight was found. Conclusion Nutritional status and food insecurity on the studied sample were associated with their health status and also with their social circumstances, such as diabetes, loneliness and lack of economic resources.

The Institute of Medicine (IOM) suggests that linkages between primary care practices and community-based resources can improve health in lower income and minority patients, but examples of these are rare. We conducted a prospective, mixed-methods observational study to identify indicators of primary care–community linkage associated with the frequency of visits to community-based senior centers and improvements in diabetes-related outcomes among 149 new senior center members (72% Hispanic). We used semistructured interviews at baseline and 9-month follow-up, obtaining visit frequency from member software and clinical assessments including hemoglobin A1c (HbA1c) from colocated primary care clinics. Members’ discussion of their activities with their primary care providers (PCPs) was associated with increased visits to the senior centers, as well as diabetes-related improvements. Direct feedback from the senior centers to their PCPs was desired by the majority of members and may help to reinforce use of community resources for self-management support.

A mixed-methods needs assessment was conducted in an urban senior center serving lower-income seniors in Toronto, Ontario, to determine whether they should offer a congregate meal program. Methods included three focus groups with participants (n = 31), a focus group with staff (n = 8), a center-wide survey (n = 36), and a community scan of programs in the area. Interviews with five coordinators at other seniors' centers who offered meal programs were also used to gauge interest and assist with program development. The results of these activities supported offering a twice weekly lunch program with user fees. Over a 6-month pilot period, process evaluation was conducted, comprising observations, record review, and focus groups with participants (n = 9) and staff/volunteers (n = 7) to examine delivery, usage, and costs. Results indicated that the program was well-received and affordable, and that demands on staff were reasonable when a facilitator with culinary training was available. The lessons learned can be used to guide other senior centers in developing and evaluating congregate meal programs.

BACKGROUND: The majority of older adults take prescription or over-the-counter medications and about half consume alcohol regularly. Despite high risk for alcohol medication interactions (AMI), few community-level interventions exist to prevent AMI. The current study assessed the acceptability of educational materials created for use in a brief intervention to prevent AMI among older adults. METHODS: Older adults from two senior centers reviewed intervention materials (poster, patient and pharmacist brochures, and public service announcement) and participated in a pre and post-test to provide feedback and to assess changes in AMI-related awareness and intentions. RESULTS: Post-test data showed positive feedback and an increase in participant understanding of AMI prevention, with statistically significant changes in perceived importance of messaging surrounding risky alcohol use and potential consequences of AMI. DISCUSSION: The intervention materials were positively received, and participant feedback indicated that the collective presentation of all the materials was the most preferred tool for educating the community. With positive trends in awareness and knowledge, intervention effectiveness needs be further evaluated in future large-scale studies. LESSONS LEARNED: This study provides health education specialists with information for future interventions to prevent alcohol and medication interactions among older adults.

Senior centers in the United States play a vital role in the aging continuum of care as the focal points of a community-based system of services targeting independent older adults to promote their social integration and civically engagement. Although several studies have evaluated the diversity of senior center programs, demographic characteristics of participants, and benefits of participation, very few have explored motivations to volunteer among participants. Many senior centers rely on a cadre of participants who volunteer there to assist with programs and meal services. However, a systematic examination of volunteering interests and the rationale for volunteering among senior center participants has been missing from the literature. This mixed-methods study, conducted at a large suburban senior center, explores the interests and motivations of volunteerism among the participants. The study found that there was limited interest in volunteering among senior center participants. Those who were motivated to volunteer wanted to do so in order to stay connected with their community. There was strong interest in volunteering for single events or projects rather than a long-term commitment. Implications for senior centers are discussed.

Purpose: To understand how demographic variables and depression symptoms relate to the prevalence of wellness, resilience, and age perception within a sample of community-dwelling older adults. Design: In all, 200 residents across 12 senior housing sites were surveyed. Research questions included the following: (1) Do group differences exist in wellness, resilience, and age perception based on age, sex, race, education, and depression symptoms? (2) Which profile of variables is most strongly associated with self-rated depression among older adults? Method: Multivariate analyses of variance were used to examine group differences. A discriminant analysis demonstrated which variables comprised the profile of individuals who ascribed to depression symptoms. Findings: Younger respondents (i.e., age 55-70) had significantly lower levels of wellness (η2 = .034) and resilience (η2 = .052). Respondents suffering from depression symptoms had lower levels of wellness (η2 = .155), resilience (η2 = .163), and positive age perception (η2 = .067) and higher rates of negative age perception (η2 = .052). The discriminant analysis correctly categorized 75.3% of the cases related to depression symptoms, and resilience and certain forms of wellness were most relevant. Conclusions: The current study sheds light into within-group differences in wellness, resilience, and age perception that depend on variables such as age and depression.

• Senior centers varied in their organizational ties, social capital from ties, and how ties impacted centers' functioning.

OBJECTIVE: We examined: 1. depression rates among senior center clients; and 2. the acceptability of a lay-delivered intervention for depression (“Do More, Feel Better”) from the perspective of key stakeholders prior to its implementation. METHOD: We conducted cross-sectional surveys at four Seattle-area senior centers of 140 clients, 124 volunteers, and 12 administrators and staff. Client measures included the Patient Health Questionnaire-9 (PHQ-9) to determine depression severity, and items assessing depression treatment preferences. Following description of “Do More, Feel Better” as a lay-delivered intervention focused on increasing participation in rewarding activities, we used quantitative and qualitative items to assess acceptability to: 1. clients participating in; 2. volunteers administering; and 3. administrators and staff supporting the intervention. RESULTS: 25% of senior center clients (35/140) endorsed elevated depressive symptoms (PHQ-9≥10). 81% of clients (114/140) reported that they would consider participating in “Do More, Feel Better,” and 59% percent of volunteers (73/123) expressed interest in learning how to assist others using the intervention. Administrators and staff reported high comfort levels with proposed volunteer training procedures, and they identified funding and staffing considerations as challenges to sustaining the intervention. CONCLUSION: Findings indicate high depression rates among senior center clients and support the acceptability of lay-delivered behavioral interventions for depression from a variety of stakeholders. Further investigation of the feasibility, effectiveness, and implementation of “Do More, Feel Better” is warranted, particularly in the context of a lack of health care professionals available to meet the mental health needs of older adults.

Background. The National Council on Aging’s Aging Mastery Program (AMP) aims to help older adults implement health behavior and lifestyle changes to promote healthy aging and social engagement. The purpose of the present community-partnered evaluation was to test the effectiveness of AMP implementation in Los Angeles County to improve participants’ quality of life, global physical and mental health, and patient activation. Method. A modified randomized wait-list controlled trial design was used to examine experimental, quasi-experimental, and dose-response evidence in five senior centers. Participants completed questionnaires at baseline and after the 10-week intervention, self-reporting their overall quality of life, physical health, mental health, and patient activation. Results. Experimental, intention-to-treat analyses found AMP assignment did not affect any measured outcomes ( n = 71). Quasi-experimental, “as treated” analyses ( n = 106) controlling for study site and sociodemographic characteristics indicated that participants who attended AMP reported more positive changes in global mental health than the control group. Attending AMP was not associated with changes in quality of life, physical health, or patient activation. Dose-response analyses among AMP participants who attended at least one class ( n = 75) found that attending more classes was not significantly associated with greater improvements in mental health. Conclusions. Experimental, intention-to-treat analyses did not support effectiveness of AMP on quality of life, physical or mental health, or patient activation; quasi-experimental analyses found attending AMP was associated with improvements in mental health. Recruitment challenges and participants’ nonadherence with condition assignment decreased our ability to detect effects. https://clinicaltrials.gov/ct2/show/NCT03342729?term=Aging+Mastery+Program&rank=1 .

Although the rate of cannabis use by older adults is increasing more quickly than all other age groups, little is known about the reasons why older adults use cannabis and the outcomes they experience. The objective of this study was to identify the most salient themes concerning the use of medical and recreational cannabis by older adults living in Colorado. Specifically, we sought to (1) characterize perceptions of cannabis use by users and non-users, (2) determine how older adults access cannabis, and (3) explicate both positive and negative outcomes associated with cannabis use. Between June and November 2017, we conducted 17 focus groups in senior centers, health clinics, and cannabis dispensaries in 15 Colorado cities. Participants included 136 persons aged over 60 years who were both users and non-users of cannabis. We coded and analyzed session transcripts using thematic analysis with NVivo software. We identified 16 codes from which five main themes emerged. These themes included: a lack of education and research about cannabis, a lack of provider communication, access to medical cannabis, the outcomes of cannabis use, and a reluctance to discuss cannabis use. Older adults want more information about cannabis and desire to communicate with their healthcare providers. Older adults who used cannabis for medical purposes reported positive outcomes but highlighted difficulties in accessing medical cannabis. Older adults in Colorado also revealed how a stigma continues to be attached to using cannabis.

OBJECTIVE The purpose of this study was to evaluate the mastication ability of elderly women by assessing the number of their remaining teeth, subjective mastication comfort, subjective chewing ability of five food items, relative occlusion balance and mastication performance involving in chewing gum. BACKGROUND Korea has already entered an aged society, issues related to the elderly are also growing; for example, dementia is emerging as a social problem. In addition, oral health of the elderly is very important because it is directly related to nutrient intake. A total of 101 subjects aged ≥65 who attended senior citizen centres in Daegu city provided consent and were included in this study. MATERIALS AND METHODS The Korean version of the Mini-Mental State Examination (MMSE-DS) was used to evaluate cognitive function. To assess the degree of objective mastication, we measured colour changes using a chewing gum and posterior occlusion force using a T-scan Ⅲ® system. RESULTS There was an association between mastication ability and cognitive function, indicated by the colour changes in the chewing gum (P

Background Racial/ethnic minority older adults have worse stroke burden than non‐Hispanic white and younger counterparts. Our academic‐community partner team tested a culturally tailored 1‐month (8‐session) intervention to increase walking and stroke knowledge among Latino, Korean, Chinese, and black seniors. Methods and Results We conducted a randomized wait‐list controlled trial of 233 adults aged 60 years and older, with a history of hypertension, recruited from senior centers. Outcomes were measured at baseline (T0), immediately after the 1‐month intervention (T1), and 2 months later (T2). The primary outcome was pedometer‐measured change in steps. Secondary outcomes included stroke knowledge (eg, intention to call 911 for stroke symptoms) and other self‐reported and clinical measures of health. Mean age of participants was 74 years; 90% completed T2. Intervention participants had better daily walking change scores than control participants at T1 (489 versus −398 steps; mean difference in change=887; 97.5% CI, 137–1636), but not T2 after adjusting for multiple comparisons (233 versus −714; mean difference in change=947; 97.5% CI, −108 to 2002). The intervention increased the percent of stroke symptoms for which participants would call 911 (from 49% to 68%); the control group did not change (mean difference in change T0–T1=22%; 99.9% CI, 9–34%). This effect persisted at T2. The intervention did not affect measures of health (eg, blood pressure). Conclusions This community‐partnered intervention did not succeed in increasing and sustaining meaningful improvements in walking levels among minority seniors, but it caused large, sustained improvements in stroke preparedness. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 02181062.

Objective We describe the development of a lay-delivered behavioral intervention ("Do More, Feel Better") for depressed senior center clients, and we present preliminary data from a pilot randomized controlled trial (RCT) on (a) the feasibility of training lay volunteers to fidelity and (b) the acceptability, impact, and safety of the intervention. Methods We trained 11 volunteers at two aging service settings in "Do More, Feel Better" and randomized 18 depressed clients to receive the intervention or referral to mental health services. Results Pilot data indicated that we can successfully train and certify 64% of older volunteers and that depressed clients receiving the intervention reported high levels of session attendance and satisfaction. While there were no significant differences in 12-week reduction in Hamilton Depression Rating Scale scores between groups, intervention clients showed an 8-point reduction in comparison with a 0-point reduction among referral clients. Conclusions "Do More, Feel Better" has the potential of transferring evidence-based behavioral interventions to the hands of supervised lay volunteers and can address the insufficient workforce providing geriatric mental health services.

We report on the use of home- and community-based services and other senior services and factors affecting utilization of both among Americans over age 60 in the Health and Retirement Study. Those using home- and community-based services were more likely than to be older, single, Black, lower income, receiving Medicaid, and in worse health. Past use of less traditional senior services, such as exercise classes and help with tax preparation, were found to be associated with current use of home- and community-based services. These findings suggest use of less traditional senior services may serve as a ‘gateway’ to home- and community-based services that can help keep older adults living in the community.

This article describes an interdisciplinary pilot study exploring the impact of LGBTQ senior centers on the lives of center members. Many LGBTQ adults face the future having experienced stigma and bias, restricted rights, and rejection from family of origin, and are now growing older without the support of a partner and adult children. As a result, older LGBTQ adults experience higher rates of depression, loneliness and isolation, and shortened life expectancy as compared to non-LGBTQ peers. Findings from focus group and key informant interviews highlight features of LGBTQ senior center experiences that can significantly improve members' quality of life. These include providing family, acceptance and a home, which can have an impact on outlook and outcomes. Moreover, findings suggest the need for re-thinking hetero-normative definitions of "community" in the context of LGBTQ aging. Beyond sharing findings from the study, suggesting a conceptual framework for deepening understanding about LGBTQ aging, and identifying lines of future inquiry, the article articulates implications for social work research, practice and education. Ultimately, the article argues that social work is well positioned to improve quality of life for this under-served population when it adopts a cultural humility stance in research, practice and education.

In May 2014, a short-term study-abroad experience was conducted in Finland through a course offered at Indiana State University (ISU). Students and faculty from ISU and Eastern Illinois University participated in the experience, which was created to facilitate a cross-cultural comparison of long-term-care settings in the United States and Finland. With its outstanding system of caring for the health and social needs of its aging populace, Finland is a logical model to examine when considering ways to improve the quality of life for older adults who require care in the United States . Those participating in the course visited a series of long-term-care facilities in the region surrounding Terre Haute, Indiana, then travelled to Lappeenranta, Finland to visit parallel sites. Through limited-participation observation and semistructured interviews, similarities and differences in experiences, educations, and policies affecting long-term care workers in the United States and Finland were identified and are described here.

The incidence and consequences of falls for older adults are well documented and well known to home care clinicians. In the absence of a falls-prevention program targeting older adults living in the community, home healthcare professionals at Cooley Dickinson VNA & Hospice in Northampton, MA, observed a high rate of falls and hip fractures. The clinicians designed a falls reduction program titled Strength in Numbers, an evidence-informed, multifaceted approach offered in community settings such as local senior centers and retirement communities. Physical and occupational therapists presented sessions that addressed risk factors for falls: fear of falling, strength, balance, medications, vision, and home safety. This article describes the program, its evolution and expansion, and outcomes. Between 2008 and 2015, 1,974 people received falls-prevention education through one of several variations of Strength in Numbers. Nearly 20% of those returning for a follow-up session who had fallen before did not fall again after completing it. Presenters recorded statistically significant improvement for participants in Single-Leg Standing, Timed Up and Go, and Functional Reach tests.

Healthy diet and weight control are important for elders and senior centers (SCs). The authors consider effects of SCs on attendee nutrition and health and efforts to improve diets and weight. Data derive from surveys in 2006 (N = 798) and 2007 (N = 742) at 21 multipurpose SCs in Tarrant County, Texas, supplemented with data from 2012 (N = 1,402). Measures included attendee agreement that SC meals improved nutrition, improved health, attempts to improve diets, and success in controlling weight. Cumulative and binary logistic regression methods were employed. SC attendance and social engagement explained agreement that SC meals improved nutrition and health but were not shown to predict changes in diet or weight control. Findings suggest success of SC programs, as well as physician recommendations, in influencing attendee nutritional behavior and perceptions of nutrition and health effects. Practice recommendations include SC collaborations with local health providers to promote attendee nutritional health.

Facing dramatic growth in its elderly population, Shanghai, China's economic center, has strategically exercised decentralized policy-making power to develop community-based service centers for the elderly. A growing number of elders have been using such services, particular dining services, since 2007. We discuss the evolution in community-based eldercare services in Shanghai, using dining services as an example. We also compare these service centers in Shanghai to multipurpose senior centers in the United States to offer policy recommendations for Shanghai and China's growing eldercare industry. Tailored policy recommendations are discussed.

Purpose: Senior centers are focal points of services and programs. Study aims were to describe the frequency of and benefits of attending senior centers and nonmembers’ reasons for nonattendance. Methods: A total of 597 senior center members and 298 community-residing nonmembers in New York City were interviewed. Males and age of 75+ years members were oversampled. Results: Mean days attended weekly = 3.00 days/week ( SD = 1.71). Latinx seniors attended 1 day > White non-Latinx seniors. Seniors in poor/bad health attended .67 fewer days than seniors in excellent health. Almost all members (96.3%) reported benefiting from attendance. The most common benefits were socialization/making friends, educational programs, something to do, being with people like them, meals, and improved mental and physical health. Reasons nonmembers gave for nonattendance were too busy with social/leisure activities or work, not interested or do not need programs/services, do not want/need socialization, and members were older or more disabled than them. Conclusion: Implications for recruiting underserved and isolated seniors are discussed.