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Living standards capabilities are an important determinant of healthy ageing. The Living Standards Capabilities for Elders scale (LSCAPE) is the main instrument available to assess living standards capabilities among older adults based on Sen's Capability Approach. The objectives of this study were: (a) to adapt and validate LSCAPE for use in the Spanish population; (b) to examine the dimensionality, validity and reliability; and (c) to establish the convergent validity of LSCAPE using self-reported measures of quality of life and income. The LSCAPE was administered to 441 Spanish seniors aged 65 and over. Confirmatory Factor Analysis (CFA) was used to analyse the dimensionality, validity and reliability. Discriminant and convergent validity of the model were assessed using Average Variance Extracted (AVE). Reliability was shown by Composite Reliability (CR) and Cronbach's alpha. Convergent validity was tested by correlating the LSCAPE scales and sub-scales with the Short-form Health Survey (SF-12) sub-scales. CFA showed that the LSCAPE Six-factor Model fits well to the data, showing Standardised Root Mean Square Residual < 0.09 (0.084), Comparative Fit Index and Tucker–Lewis Index > 0.9 (0.925 and 0.917, respectively). LSCAPE showed also good reliability (CR indices > 0.7) and validity (AVE > 0.5) measures. Finally, LSCAPE had moderate to strong associations with SF-12 sub-scales (>0.6) and a moderate relationship with income (>0.3). Thus, LSCAPE has been demonstrated to be a reliable and valid instrument in measuring living standards capabilities among the Spanish older population. [ABSTRACT FROM AUTHOR]

Abstract Background Older persons often have multiple health and social problems and need a variety of health services. A coordinated preventive approach that integrates the provision of health and social care services could promote healthy ageing. Such an approach can be organised differently, depending on the availability and organizational structures in the local context. Therefore, it is important to evaluate the effectiveness of a coordinated preventive care approach in various European settings. Objectives This study explored the effects of a coordinated preventive health and social care approach on the lifestyle, health and quality of life of community-dwelling older persons in five European cities. Design International multi-center pre-post controlled trial. Setting Community settings in cities in the United Kingdom, Greece, Croatia, the Netherlands and Spain. Participants 1844 community-dwelling older persons (mean age = 79.5; SD = 5.6). Methods The Urban Health Centres Europe (UHCE) approach consisted of a preventive multidimensional health assessment and, if a person was at-risk, coordinated care-pathways targeted at fall risk, appropriate medication use, loneliness and frailty. Intervention and control sites were chosen based on their location in distinct neighbourhoods in the participating cities. Persons in the catchment area of the intervention sites 'the intervention group' received the UHCE approach and persons in catchment areas of the control sites 'the control group' received care as usual. A questionnaire and two measurements were taken at baseline and at one-year follow-up to assess healthy lifestyle, fall risk, appropriate medication use, loneliness level, frailty, level of independence, health-related quality of life and care use. To evaluate differences in outcomes between intervention group and control group for the total study population, for those who received follow-up care-pathways and for each city separately (multilevel) logistic and linear regression analyses were used. Results Persons in the intervention group had less recurrent falls (OR = 0.65, 95% CI = 0.48; 0.88) and lower frailty (B=-0.43, 95% CI= −0.65 to −0.22) at follow-up compared with persons in the control group. Physical health-related quality of life and mental well-being was better (B = 0.95; 95% CI = 0.14–1.76; and B = 1.50; 95% CI = 0.15–2.84 respectively). The effects of the UHCE approach were stronger in the subgroup of persons (53.6%) enrolled in care-pathways. Conclusions Our study found promising but minor effects for the use of a coordinated preventive health and social care approach for the promotion of healthy ageing of older persons. Future studies should further evaluate effects of coordinated preventive health and social care aimed at healthy ageing. Trial registration ISRCTN registry number is ISRCTN52788952. Date of registration is 13/03/2017. [ABSTRACT FROM AUTHOR]