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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]

Background Studies on the association between frailty and health-related quality of life (HRQoL) are scarce and show contradictory results. This study aimed to evaluate the association between physical, psychological and social frailty and HRQoL among community-dwelling older people. Methods A cross-sectional study was performed with baseline data collected in 2015 from the Urban Health Centers Europe (UHCE) project in five European countries, the United Kingdom, Greece, Croatia, The Netherlands and Spain. A total of 2325 participants were included in the baseline measurements of the Urban Health Centers Europe project; 2167 participants (mean age = 79.7; SD=5.6) were included in the analyses after excluding participants with missing data. The Tilburg Frailty Indicator measured overall frailty as well as physical, psychological and social frailty. The 12-Item Short-Form Health Survey was used to measured physical and mental HRQoL. Results Regarding physical HRQoL, a large difference (d =1.29) between physically and not physically frail participants was observed. Regarding mental HRQoL, a large difference (d =1.20) between psychologically and not psychologically frail participants was observed. In the full model with all three domains of frailty and the covariates to explain physical HRQoL, physical (P <0.001) and social frailty (P <0.001) remained significant. In the full model to explain mental HRQoL, all three domains of frailty remained significant (P <0.001). Conclusion Physical frailty had the strongest association with physical HRQoL, and psychological frailty had the strongest association with mental HRQoL. The associations between social frailty and both physical and mental HRQoL remain significant when controlling for physical and psychological frailty. [ABSTRACT FROM AUTHOR]

Introduction: ValueCare is an EU H2020 funded project (No 875215) which applies the principles of 'value-based care' using an integrated health and social care approach, and is supported by a robust, secure, and scalable digital solution in line with the nine pillars of Integrated Care. In the Valencia pilot (Spain), the aim is to improve the quality of life of both older people (over 65 years old) suffering from frailty, and that of their families. It also aims to improve staff satisfaction and greater efficiency in the use of resources and coordination of care. Aims Objectives Theory or Methods: From October 2020 to February 2021, the Valencia pilot researchers conducted a process of codesign to develop the integrated value-based concept and digital solution to support a personalised care pathway for frail older people. A total of 52 participants were engaged in 28 different co-design activities. All agents participating in the delivery of care were involved (older people, formal and informal caregivers, social and health care professionals, ICT experts, hospitals Managers, municipal social care services, among others). Co-design activities were adapted to the Covid-19 situation, combining in-person and virtual meetings with a reduced number of participants. All activities were recorded. Highlights or Results or Key Findings: The results of the co-design activities were analysed to define the value-based integrated care concept and requirements for the ICT solution. Regarding the value-based concept, specific outcomes for frailty were discussed with professionals. Older people's psychosocial needs are not being met under the current siloed health and social care systems, due to lack of coordination and personnel. A stronger emphasis should be placed on preventative actions and patient empowerment. An integrated social and health care system would minimise the effort and time needed to receive a more personalised and improved care plan. Regarding the ICT solution, for the older person, the solution must be intuitive, easy to manage, with minimum text and more use of images and icons, voice controlled, and friendly. For professionals, the solution must not imply a duplication of tasks and its benefits must be clear. Conclusions: An integrated intervention plan for frail older people and a supportive ICT solution have been developed based on the co-design results. Both will be tested during 12-months in a group of 120 older people (plus 120 control group). Implications for applicability/transferability sustainability and limitations: The co-design results can be used to develop other digital solutions for integrated care in other settings addressing the same target group (frail older people). Moreover, the methods applied to engage agents during the pandemic can be transferred to other researchers willing to develop codesign with the current social restrictions. [ABSTRACT FROM AUTHOR]

Background: The Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC) project intends to empower citizens at risk of or with type 2 diabetes (T2DM) and/or cardiovascular disease (CVD) to self-manage their chronic conditions through the SEFAC intervention. The intervention combines the concepts of mindfulness, social engagement and information and communication technology support, in order to reduce the burden of citizens with chronic conditions and to increase the sustainability of the health system in four European countries.Methods: A prospective cohort study with a 6-month pre-post design will be conducted in four European countries: Croatia, Italy, the Netherlands and the United Kingdom. A total of 360 community-dwelling citizens ≥50 years of age will be recruited; 200 citizens at risk of T2DM and/or CVD in the next 10 years (50 participants in each country) and 160 citizens with T2DM and/or CVD (40 participants in each country). Effects of the intervention in terms of self-management, healthy lifestyle behavior, social support, stress, depression, sleep and fatigue, adherence to medications and health-related quality of life will be assessed. In addition, a preliminary cost-effectiveness analysis will be performed from a societal and healthcare perspective.Discussion: The SEFAC project will further elucidate whether the SEFAC intervention is feasible and (cost-) effective among citizens at risk of and suffering from T2DM and/or CVD in different settings.Trial Registration: ISRCTN registry number is ISRCTN11248135 . Date of registration is 30/08/2018 (retrospectively registered). [ABSTRACT FROM AUTHOR]