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This study explored the association between socioecological factors and outdoor physical activity (PA) and play in children with disabilities during the COVID-19 pandemic. Parents (N = 133) completed a survey to report changes in their child's outdoor PA and play during the pandemic (from prepandemic levels), and child, household, and neighborhood environment factors. Children with a PA-supporting parent and from multichild and White households had lower odds of reporting decreased outdoor PA. Children from multichild, higher income, married couple households and a PA-supporting parent had lower odds of decreased outdoor play. Living in neighborhoods with higher urbanization (i.e., high dwelling density, street intersections, and land-use mix) was associated with greater odds of decreased outdoor PA and play. Future research that uses larger and more representative samples of children with disabilities is needed to test for the multivariate effects of socioecological variables on outdoor PA and play. [ABSTRACT FROM AUTHOR]

To assess professional reintegration, the perceived impact of stroke on work, and the main determinants of return to work (RTW) among stroke survivors. A cross-sectional study was performed, based on a cohort of stroke survivors. A structured questionnaire was administered to previously working stroke survivors, 18–24 months post-stroke. Data on sociodemographic characteristics, stroke features and their impact on work, access to rehabilitation services during hospital admission and after discharge, social support, and professional reintegration were reported by 553 stroke survivors. On average, 56.6% (95% CI 52.4–60.8) of stroke survivors resumed professional activity, 20 months after stroke. Approximately 90% of survivors who RTW, returned to the same job and same function they performed before stroke. The majority did not receive reintegration support. The main determinants of RTW were lower age, higher socioeconomic status, and better functional status. Professional reintegration and vocational support after stroke, remained below the international goals for community reintegration of stroke survivors. Future studies should explore the impact of professional and social reintegration on the psychological health and quality of life of stroke survivors and the barriers, challenges, and strategies used to overcome them, to allow for effective professional reintegration policies. The amount of professionally active people affected by stroke events is rising worldwide, with increasing numbers of survivors with restricted occupational participation. Higher age and lower socioeconomic status appear to be main determinants for no return to work and so, a special attention should be given to this particular group of stroke survivors. Vocational and social support after stroke is highly needed to help in the reintegration of a professionally active life. Social and community support after stroke should be offered as soon as possible after stroke to promote a successful professional reintegration. [ABSTRACT FROM AUTHOR]

Abstract\nPoints of interestIn the past four decades, Independent Living (IL) has gained prominence in inspiring services for people with intellectual disabilities. Yet, its practical application faces challenges within a field still influenced by medical-rehabilitative and paternalistic perspectives. This study seeks to explore the fundamental characteristics that IL models assume within the field of intellectual disabilities, focusing on the Spanish experience, identifying pioneering projects, influential models, and their ripple effects. A comprehensive mapping of IL projects has been conducted, analyzing publicly available information on 86 identified cases. In seven significant cases, in-depth interviews were conducted with people responsible for their development. Our analysis sheds light on some emerging tensions, with a focus on what is identified as a family-centered approach, an emphasis on skills-oriented services, and an overreliance on housing accessibility. Finally, this paper offers recommendations to enhance these initiatives and foster the integration of IL in the intellectual disability context.This study examines difficulties encountered when implementing independent living services for people with intellectual disabilities in Spain.The study shows that independent living for people with intellectual disabilities has the following characteristics: it is mostly oriented towards the families, it is focused on the development of personal skills, and it is strongly dependent on the possibility of housing access.We suggest the need to find ways to place people with intellectual disabilities at the center, while considering their social networks. It is also important to promote personal assistance, allowing support in tasks lead by the people themselves. And it is a fundamental responsibility of the administrations to ensure that everyone has access to housing.Independent living for individuals with intellectual disabilities should no longer be seen as something exceptional, but rather as the center of services provided in this field.This study examines difficulties encountered when implementing independent living services for people with intellectual disabilities in Spain.The study shows that independent living for people with intellectual disabilities has the following characteristics: it is mostly oriented towards the families, it is focused on the development of personal skills, and it is strongly dependent on the possibility of housing access.We suggest the need to find ways to place people with intellectual disabilities at the center, while considering their social networks. It is also important to promote personal assistance, allowing support in tasks lead by the people themselves. And it is a fundamental responsibility of the administrations to ensure that everyone has access to housing.Independent living for individuals with intellectual disabilities should no longer be seen as something exceptional, but rather as the center of services provided in this field. [ABSTRACT FROM AUTHOR]

Background: Monitoring the lifestyles of older adults helps promote independent living and ensure their well-being. The common technologies for home monitoring include wearables, ambient sensors, and smart household meters. While wearables can be intrusive, ambient sensors require extra installation, and smart meters are becoming integral to smart city infrastructure. Research Gap: The previous studies primarily utilized high-resolution smart meter data by applying Non-Intrusive Appliance Load Monitoring (NIALM) techniques, leading to significant privacy concerns. Meanwhile, some Japanese power companies have successfully employed low-resolution data to monitor lifestyle patterns discreetly. Scope and Methodology: This study develops a lifestyle monitoring system for older adults using low-resolution smart meter data, mapping electricity consumption to appliance usage. The power consumption data are collected at 15-min intervals, and the background power threshold distinguishes between the active and inactive periods (0/1). The system quantifies activity through an active score and assesses daily routines by comparing these scores against the long-term norms. Key Outcomes/Contributions: The findings reveal that low-resolution data can effectively monitor lifestyle patterns without compromising privacy. The active scores and regularity assessments calculated using correlation coefficients offer a comprehensive view of residents' daily activities and any deviations from the established patterns. This study contributes to the literature by validating the efficacy of low-resolution data in lifestyle monitoring systems and underscores the potential of smart meters in enhancing elderly people's care. [ABSTRACT FROM AUTHOR]

Individuals who have been exposed to trauma experience high levels of sleep impairment. Given the well‐established negative effects of stress on sleep, the ways in which trauma‐exposed individuals cope with stress is likely to be associated with their sleep. This study examined how the use of health behaviours (i.e., exercise, comfort eating, and maintaining a self‐care routine) to cope relate to sleep impairment in a community sample of trauma‐exposed adults (N = 84, mean age = 35.1, 83% female). We also tested whether use of health behaviours to cope moderates the relationship between psychological distress and sleep impairment. Results demonstrate that exercise and maintaining a self‐care routine to cope are associated with less sleep impairment, while comfort eating to cope is associated with greater sleep impairment. Further, comfort eating to cope moderated the relationship between distress and sleep impairment. Findings suggest that the use of health behaviours to cope is differentially associated with sleep impairment, which has important clinical and research implications for the health of trauma‐exposed adults. [ABSTRACT FROM AUTHOR]

Introduction: Supporting the health and well‐being of older Australians necessitates the implementation of effective and sustainable community‐based interventions. Rural settings, however, pose unique challenges to intervention implementation and sustainability, with limited research exploring strategies employed to overcome these complexities. Objective: To identify enabling strategies that support the sustainable implementation of community‐based health and well‐being interventions for older adults in rural Australia. Design: A scoping review, following methods by Arksey and O'Malley and enhanced by elements of the Joanna Briggs Institute methodology for scoping reviews and Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR), was conducted. An electronic search of seven databases was completed in April 2023. A thematic analysis was applied to provide a comprehensive and contextualised understanding of the phenomenon of interest. Findings: Of 1277 records screened, 15 studies were identified and included for review. Five themes identified key enablers for rural implementation: (1) Co‐designing for the local context; (2) Embedding local champions; (3) Leveraging existing local resources; (4) Maintaining impact beyond the end of the funded period and (5) Flexibility in funding models. Discussion: The sustainable implementation of interventions requires active community involvement and consultation through all stages of program design and delivery to effectively meet the health and well‐being needs of older rural‐dwelling Australians. Conclusion: Our findings advocate for clear implementation guidelines to support the design, delivery and adaptation of community‐based programs that appropriately reflect the unique contextual needs and strengths of rural communities. [ABSTRACT FROM AUTHOR]

Introduction: With Australiaʼs ageing population, especially in rural regions, promoting physical activity among older adults is crucial. Objective: To identify factors influencing participation of older adults (60 years or over) from a rural community in a modified sport program and assess satisfaction with a pilot modified sport program informed by these findings. Design: Insights and ideas from two focus groups exploring community perspectives on a modified sport program informed the development of a six‐week pilot modified sport program delivered with the local fitness centre. Post‐program surveys assessed participant satisfaction, willingness to continue, and likelihood of recommending the program to others. Findings: Nine participants attended the focus groups, highlighting increased social connection, health management, and healthy ageing as key motivators. Joint and health concerns, cost, and time constraints emerged as main barriers. Preferences for the program included weekly sessions, alternating sports, indoor venues, and supporting modifications, but maintaining traditional rules. Thirteen participants participated in the pilot modified sport program. There was strong program attendance (86%). All participants (13/13) rated their satisfaction as very satisfied. They were highly likely to recommend the program to others (8.5/10) and were interested in continuing modified sport after the pilot (7.7/10). Discussion: This study demonstrates for the first time that modified sport is of interest to older people in the rural setting, and that delivering such a program is feasible in a small community. Rural communities implementing modified sport should consider the availability of suitable facilities and equipment, access to an engaging facilitator and participant cost. Conclusion: Through a strong connection between the health service and community fitness centre, a modified sport program was developed and implemented, well‐attended and enjoyed by participants in a rural community. [ABSTRACT FROM AUTHOR]

Background and Objectives Person-centered planning (PCP) allows recipients of home- and community-based service (HCBS) to plan services and supports according to their preferences and needs. The extent to which HCBS systems engage in PCP and evidence for the relationship between PCP and beneficiary outcomes are limited. We examine the prevalence of PCP among HCBS recipients and the relationship between PCP and person-reported outcomes. Research Design and Methods We used the 2018–2019 National Core Indicators—Aging and Disability survey, collected among adult Medicaid HCBS recipients in 12 states (n = 5,849). We examined 2 general PCP measures (1 on decision making and another on whether service plans reflected preferences/choices). We also constructed a scale to assess the fidelity of recipients' service planning meeting to the PCP process. Outcomes included unmet service needs and community living (i.e. participation, control, and satisfaction). We examined recipient characteristics associated with PCP and used adjusted logistic regression models to assess the relationship between PCP and outcomes. Results About 72% of HCBS recipients were involved in decision making, 72% reported their service plan reflected their preferences/choices, and 47% had meetings that scored "high fidelity" on the PCP fidelity scale. PCP measures were consistently related to lower likelihood of unmet service needs and greater likelihood of experiencing community living outcomes. Discussion and Implications Findings suggest PCP is important for adequately meeting service needs and ensuring community living among HCBS beneficiaries. Additional standardized measures should be developed to facilitate quality improvement and accountability for delivering person-centered HCBS. [ABSTRACT FROM AUTHOR]

Background and Objectives Chronological age is invariably used as a categorizing tool for spaces, collections, and programs in public libraries. With age-based conceptions of human experience in library practice, education, and scholarship primarily focused on those under the age 18, little is known how age-based classifications are implemented in public libraries, and with what impacts, for older library patrons. Research Design and Methods Stemming from a larger project that seeks to bring attention to the ways in which public libraries engage with community-dwelling older adults, this paper explores 51 older patrons' perspectives on the numbers and language (e.g. 55+, older adult, seniors, adult) assigned to older adults in library programs and which label best (or least) suits their sense of identity and, in turn, what language encourages or deters their engagement with library programs. Results Findings illustrate that age-based language describing older adult library programs is often at odds with patrons' perceptions of how library programming relevant to them ought to be labeled. Common to all participants was a clear dislike for the term "elderly." While most participants preferred "older adult" to "senior," others voiced no preference, as long as they felt heard and valued. Many participants linked the use of language used to describe library programs to being excluded from and treated differently from other (younger) library patrons. Discussion and Implications The language used to group and describe different library populations directly shapes feelings of belonging (or exclusion) in library programs. Insights from this research contribute to our evolving understandings of the ways in which language connected to age can shape one's sense of identity. Results also serve to cultivate a more sensitive and critical approach to the question of age within library science, and, by extension, the experiences of older adults who frequent the library. [ABSTRACT FROM AUTHOR]

Background and Objectives This study aimed to investigate the diagnostic accuracy of four questionnaire-based tools (i.e. the FRAIL scale, Groningen Frailty Indicator [GFI], Tilburg Frailty Indicator [TFI], and PRISMA-7) for screening frailty in older adults. Research Design and Methods The 4 databases comprising the Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed, and ProQuest were searched from inception to June 20, 2023. Study quality comprising risks of bias and applicability was assessed via a QUADAS-2 questionnaire. A bivariate network meta-analysis model and Youden's index were performed to identify the optimal tool and cutoff points. Results In total, 20 studies comprising 13 for FRAIL, 7 for GFI, 6 for TFI, and 5 for PRISMA-7 were included. Regarding study quality appraisal, all studies had high risks of bias for study quality assessment domains. Values of the pooled sensitivity of the FRAIL scale, GFI, TFI, and PRISMA-7 were 0.58, 0.74, 0.66, and 0.73, respectively. Values of the pooled specificity of the FRAIL scale, GFI, TFI, and PRISMA-7 were 0.92, 0.77, 0.84, and 0.86, respectively. The Youden's index was obtained for the FRAIL scale with a cutoff of 2 points (Youden's index = 0.65), indicating that the FRAIL scale with a cutoff of 2 points was the optimal tool for frailty screening in older adults. Discussion and Implications The FRAIL scale comprising 5 self-assessed items is a suitable tool for interview older adults for early frailty detection in community settings; it has the advantages of being short, simple, and easy to respond to. [ABSTRACT FROM AUTHOR]

Objectives Some research conceptualizes routineness of daily life as an indicator of cognitive vulnerability that would lead to lower well-being in older age, whereas other research expects routineness to give rise to more meaning and stability in life and thus to higher well-being. Further research is needed to understand routineness in older adults in relation to cognitive abilities and well-being. This study examined routineness of social interactions. Methods We examined data from an event-contingent experience sampling study with 103 Swiss community-dwelling older adults (aged 65 to 84 years). Participants completed in-lab cognitive assessments (reasoning, episodic memory, speed, and vocabulary) and reported their well-being (positive affect, negative affect, and life satisfaction). For more than 21 days, participants reported the time and context of their social interactions (including modality, partner type, and location). Routineness of social interactions was defined as social interactions that occurred at the same time of day over the study period. It was calculated using recurrence quantification analysis. Results Linear regressions showed that higher routineness of social interaction in general, of social interaction through the same modality, and of social interaction with the same partner type were associated with higher positive affect. Higher routineness of social interaction in general was associated with lower negative affect. Routineness of social interactions was not associated with life satisfaction or cognitive abilities. Discussion A routine social life may increase older adults' affective well-being. Results are discussed in the context of activity engagement and time use in older age. [ABSTRACT FROM AUTHOR]

Objectives To characterize the effect of the actual and potential ability to get rides from others on older adults' driving reduction at 3-year follow-up in the United States. Methods We analyzed National Health and Aging Trends Study data from community-dwelling drivers in 2015 (unweighted n  = 5,102). We used weighted logistic regression models to estimate whether getting rides from others in 2015 was associated with older adults increasing the number of driving behaviors they avoided, decreasing the frequency with which they drove, or not driving at 3-year follow-up after adjusting for biopsychosocial variables. We also measured presence of social network members living nearby including household and non-household members and estimated associated odds of driving reduction at 3-year follow-up. Results Older adults who got rides from others in 2015 had greater odds of reporting no longer driving at 3-year follow-up compared to those who did not get rides (adjusted odds ratio [aOR] = 1.53, 95% confidence interval [CI]: 1.11–2.11). We found no statistically significant association between older adults living with others or having more nearby confidantes outside their household and their odds of reducing driving at 3-year follow-up. Discussion These findings suggest that getting rides from others plays an important role in the transition to non-driving for older adults. Future research should examine whether other aspects of social networks (e.g. type, quality, and closer proximity) might also be key modifiable coping factors for older adults transitioning to non-driving. [ABSTRACT FROM AUTHOR]

Objectives It is well known that low educational attainment is associated with cognitive function decline in older age. Childhood book availability may help to preserve cognitive function in older adults with low education. The study objective was to examine the association between childhood book availability and cognitive function among older adults with low educational attainment, and to investigate the mediating effect of the volume of reading-related brain regions (e.g. superior temporal cortex). Methods A cross-sectional study of community-dwelling older Japanese adults aged 65–84 years was conducted (n  = 474). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Childhood book availability was assessed using a retrospective questionnaire. Brain region volume was measured using magnetic resonance imaging. Multivariate regression modeling and structural equation modeling were used for analysis. Results Both high educational attainment and childhood book availability were independently associated with high MMSE score. Stratification of educational level showed that childhood book availability was positively associated with MMSE score among participants with low educational attainment (coefficient = 1.48, 95% confidence interval [CI]: 0.31 to 2.66), but not among those with moderate or high educational attainment (coefficient = −0.01, 95% CI: −1.44 to 1.42 and −1.21, 95% CI: −3.85 to 1.42, respectively). Among participants with low educational attainment, left superior temporal cortex volume mediated the association between childhood book availability and MMSE score. Discussion The availability of books in childhood helps to preserve cognitive function in older adults with low education via left superior temporal cortex volume. Further research is needed to replicate these findings. [ABSTRACT FROM AUTHOR]

Objectives This study provides one of the first national longitudinal studies of the association between caring for grandchildren (i.e. grandparenting) and the risk of dementia in the United States, with a focus on gender-specific variations. Methods We estimated discrete-time event history models, drawing upon data from the Health and Retirement Study (2000–2016). The analytic sample included 10,217 community-dwelling White and Black grandparents aged 52 years and older at baseline. Results Noncoresident grandparenting was associated with a lower risk of dementia for both women and men compared to grandparents who did not take care of grandchildren. However, the cognitive advantage showed different patterns based on gender and the combination of care intensity and family structure. Grandmothers had a lower risk of dementia than noncaregiving grandmothers when providing a light level of noncoresident grandparenting, whereas grandfathers who provided intensive noncoresident grandparenting had a reduced risk of dementia compared to their noncaregiving counterparts. Grandparenting experiences within multigenerational households and skipped-generation households were not associated with dementia risk. Discussion Intergenerational caregiving plays a pivotal role in shaping cognitive health during later life; however, the impact is nuanced, depending on factors such as gender, care intensity, and family structure. [ABSTRACT FROM AUTHOR]

Aims: For older adults with limited life space and activity, social participation in the neighborhood community is essential to ensure social interaction and activity levels. This study examined the association between social participation in the neighborhood community and the onset of disability in older adults with different life spaces and activities. Methods: The participants were 9513 older adults from a cohort study conducted at the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes (NCGG‐SGS). Social participation in the neighborhood community was assessed by participating in the community meetings. Life space with activities was evaluated using the Activity Mobility Index (AMI) developed in the NCGG‐SGS, with higher scores indicating better mobility and movement. The participants were divided into four groups based on the quartiles of their AMI scores (Q1–Q4). Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for disability incidence by social participation in each quartile. Results: Over the 2‐year follow‐up period, disability occurred in 4.3% of the participants (n = 409). In the Q1 group, participants who participated in the neighborhood community had a significantly lower risk of developing a disability than those who did not (HR, 0.47; 95% CI, 0.28–0.76). There were no significant differences in onset of disability between the presence and absence of social participation for groups Q2, Q3, and Q4. Conclusions: Social participation in the neighborhood community was associated with the onset of disability in the lowest life space group. Social participation within a limited life space with activities may prevent disability onset. Geriatr Gerontol Int 2024; 24: 609–618. [ABSTRACT FROM AUTHOR]

Aim: The serum creatinine/cystatin C ratio (CCR) or sarcopenia index is considered a useful marker of muscle mass. However, its usefulness in late‐stage older adults remains unclear. We aimed to determine the usefulness of CCR as an indicator of sarcopenia in community‐dwelling Japanese adults aged >75 years. Methods: Our study recruited participants aged 70, 80, and 90 ± 1 years during the baseline years, and included a 3‐year follow‐up in the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians study. From 2015 to 2018, 955 participants were eligible: 367 in their 70s, 304 in their 80s, and 284 in their 90s. The diagnostic components of sarcopenia, including "low muscle mass, plus low muscle strength, and/or low physical performance," were evaluated using the bioelectrical impedance analysis‐measured skeletal muscle mass index (SMI), handgrip strength, and short physical performance battery (SPPB) score, respectively, in accordance with the Asia Working Group for Sarcopenia 2019 criteria. Separate analyses were performed between each component and CCR, adjusting for sex, body mass index, and other blood biomarkers in each group. Results: The relationship between CCR and sarcopenia components was significant for handgrip strength (β = 0.21, 0.13, 0.19, and P < 0.0001, =0.0088, <0.0001, for the 70s, 80s, and 90s age groups, respectively); however, it was limited for SMI (β = 0.14; P = 0.0022, only for the 90s) and not significant for the SPPB score. Conclusion: CCR is a limited indicator of sarcopenia in late‐stage older adults. Although its association with muscle strength was significant, its relationship with muscle mass and physical performance was less pronounced. Geriatr Gerontol Int 2024; 24: 529–536. [ABSTRACT FROM AUTHOR]

Aim: Advanced glycation end‐products (AGEs) are irreversibly and heterogeneously formed compounds during the non‐enzymatic modification of macromolecules, such as proteins. Aging and lifestyle habits, such as high‐fat and high‐protein diets, and smoking, promote AGEs accumulation. This study aimed to investigate the relationship between fall risk and AGEs in community‐dwelling older adults. Methods: This cross‐sectional study included patients from the 2022 Yakumo Study who were evaluated for fall risk index 5‐items version, locomotive syndrome stage and AGEs. AGEs were evaluated using Skin autofluorescence (SAF) measured by the AGE reader (DiagnOptics Technologies BV, Groningen, the Netherlands). We divided the participants into two groups according to the presence or absence of fall risk (fall risk index 5‐items version ≥6 or not), and investigated the factors associated with fall risk. Results: The fall risk group had a higher age and SAF, and a higher proportion of locomotive syndrome stage >2 than the without fall risk group in patients aged ≥65 years (P < 0.01). The multivariate logistic regression analysis after adjustment of age, sex and body mass index showed that locomotive syndrome stage ≥2 and SAF were independent associators of fall risk in older adults (odds ratio 3.26, P < 0.01, odds ratio 2.96, P < 0.05, respectively). The optimal cutoff value of the SAF for fall risk was 2.4 (area under the curve 0.631; 95% CI 0.53–0.733; sensitivity 0.415; specificity 0.814; P < 0.05). Conclusion: The accumulation of AGEs in skin tissues can be used to screen for fall risk comprehensively. Geriatr Gerontol Int 2024; 24: 517–522. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between housing and psychological damage caused by the Great East Japan Earthquake (GEJE) and modifiable risk factors (MRFs) of dementia for general population of older adults. Methods: This cross‐sectional study enrolled 29 039 community‐dwelling older adults (mean age 69.1 ± 2.9 years, 55.5% women). We evaluated disaster‐related damage (by complete or not complete housing damage) and psychological damage (by post‐traumatic stress reaction [PTSR]) after the GEJE using a self‐report questionnaire. MRFs encompassed the presence of depression, social isolation, physical inactivity, smoking, and diabetes. We examined the association between disaster‐related damage and MRFs using ordinary least squares and modified Poisson regression models adjusted for sociodemographic and health status variables. Results: Complete housing damage and PTSR were identified in 2704 (10.0%) and 855 (3.2%) individuals, respectively. The number of MRFs was significantly larger for the individuals with complete housing damage (β = 0.23; 95% confidence interval [CI]: 0.19–0.27) and PTSR (β = 0.60; 95% CI: 0.53–0.67). Prevalence ratios (PRs) for depression and physical inactivity were higher in individuals with complete housing damage. The PRs for all domains of the MRFs were significantly higher in individuals with PTSR. Conclusions: Housing and psychological damage caused by the GEJE were associated with an increased risk factor of dementia. To attenuate the risk of dementia, especially among older victims who have experienced housing and psychological damage after a disaster, multidimensional support across various aspects of MRFs is required. Geriatr Gerontol Int 2024; 24: 509–516. [ABSTRACT FROM AUTHOR]

Despite the recognized importance of community social service and community built facility for enhancing older adults' life satisfaction, the mechanisms underlying their relationship have not been thoroughly examined. This study aims to complement the existing knowledge by investigating the mediating role of social disconnectedness and loneliness in the association between community support and life satisfaction among older adults. Using data from the 2018 China Longitudinal Aging Social Survey, the study analyzes responses from 9,874 Chinese older adults (mean age = 71.30 years, SD = 7.30). We conducted descriptive statistics and Pearson's correlation to explore the variables. This study also used Mplus 8.0 to conduct a path analysis model that evaluated both the direct and indirect effects of community social service and built facility on life satisfaction. Social disconnectedness and loneliness were included as mediating variables in this model. The present study results show that both community social service and community built facility are positively associated with life satisfaction among older adults, and community social service is more imporatant for enhancing the life satisfaction. In addition, these associations are mediated by social disconnectedness and loneliness. Our research suggests that strengthening community social service programs and improving the built environment can reduce social disconnectedness and loneliness among older adults, ultimately enhancing their life satisfaction. Specifically, policymakers can invest in targeted interventions to enhance social connectedness and reduce loneliness, with the goal of improving the overall well-being of older adults. [ABSTRACT FROM AUTHOR]

This paper presents an analysis of statements issued by the Polish Ministry of Family and Social Policy, relating to care homes and the threat to the health and lives of their inhabitants during the COVID-19 pandemic. Despite the declared intention by the government to carry out the transition from residential care to community-based support, the results of the study reveal that under the slogans of care, safety, and commitment, the traditional vision of disability that promotes the operation of segregated institutions is reinforced. Ensuring safety is understood as strengthening the institution of a care home by emphasizing its importance, allocating additional resources, and introducing organized isolation practices that do not necessarily account for subjectivity and residents' rights. The authors, using the critical approach, point to elements of the discourse that may be remembered most by recipients. The paper is focused on an approach presented by the Polish Ministry of Family and Social Policy during the COVID-19 pandemic regarding care homes. While the discussion about transition from residential care to community-based support in Poland seems to be advanced, there are still facilities for over 100 inhabitants. In the face of the COVID-19 crisis, the Ministry's communication related to facilitating the transition to independent living was pushed aside, while the traditional institutional-oriented approach came to the fore. The communication by the Ministry is transmitting to the public a strong message that presents care homes as safe places that should be supported and developed as a key housing option. The lack of attention to issues such as transition from residential care to community-based support and a human-rights approach in communication led us to formulate the concept of a turbo-institutional approach implicit in the Ministry's communiques. [ABSTRACT FROM AUTHOR]

Purpose: The potential benefits of vegetarian diets in reducing cognitive impairment have garnered attention due to existing mixed results; hence, our study aims to examine the impact of vegetarianism on cognitive function and neuropsychological status among urban community-dwelling adults from Telangana. Methods: The dietary patterns were self-reported and dietary data collected using a Food Frequency Questionnaire while cognitive function was assessed using Mini-Mental State Examination (MMSE) and depression, anxiety, and stress (DASS-21) questionnaire for psychological measures. Adults (N = 304) aged 40 years and above, who followed either a vegetarian or non-vegetarian diet for at least 6 months prior to data collection, scored MMSE ≥ 19 indicating mild cognitive impairment, and were recruited using convenience sampling. Results: Among the participants, vegetarians (n = 155) exhibited significantly better mood states compared to non-vegetarians (n = 149), as indicated by lower scores on the DASS subscales for depression (10.0 ± 0.06 vs. 17.0 ± 0.07, p = < 0.001), anxiety (4.0 ± 0.05 vs. 6.0 ± 0.07, p = 0.005), and stress (8.0 ± 0.02 vs. 10.0 ± 0.05, p = 0.007). Vegetarians also demonstrated superior cognitive functioning compared to non-vegetarians, as indicated by higher MMSE scores (26.0 ± 0.04 vs. 24.0 ± 0.03, p = < 0.001). MMSE scores were inversely correlated with depression, anxiety, and stress for vegetarians (ρ = − 0.371, p = 0.000; ρ = − 0.027, p = 0.734; and ρ = − 0.105, p = 0.914), respectively. Similar to the vegetarians group, MMSE scores were negatively correlated with depression (ρ = − 0.059), but the correlation is not significant. Conclusion: Vegetarianism exerted a positive influence on the cognitive and neuropsychological status of the investigated population. Nevertheless, additional research is required to comprehend the underlying mechanisms that elucidate the long-term effects of vegetarianism and plant-based nutritional interventions on brain health. [ABSTRACT FROM AUTHOR]

This study aimed to assess the level of public trust in general practitioners (GPs) and its association with primary care contract services (PCCS) in China. Cross-sectional study. Between September and December 2021, 4158 residents across eastern, central, and western China completed a structured self-administered questionnaire. Trust was assessed using the Chinese version of Wake Forest Physician Trust Scale. Multivariable linear regression models were established to identify predictors of trust. The effect size of PCCS on trust was estimated by the average treatment effect for the treated (ATT) through propensity score matching. The study participants had a mean Wake Forest Physician Trust Scale score of 36.82 (standard deviation = 5.45). Enrollment with PCCS (β = 0.14, P < 0.01), Han ethnicity (β = 0.03, P < 0.05), lower educational attainment (β = −0.06, P < 0.01), higher individual monthly income (β = 0.03, P < 0.05), better self-rated health (β = 0.04, P < 0.05), chronic conditions (β = 0.07, P < 0.01), and higher familiarity with primary care services (β = 0.12, P < 0.01) and PCCS (β = 0.21, P < 0.01) were associated with higher trust in GPs. The ATT of PCCS exceeded 1 (P < 0.05). PCCS are associated with higher levels of trust in GPs. PCCS may become an effective tool to attract public trust in GPs, although the relationship between the two may be bi-directional. [ABSTRACT FROM AUTHOR]

Purpose: The Child Friendly Cities Initiative (CFCI) is a UNICEF framework based on the UN Convention on the Rights of the Child (CRC). CFCI was launched globally in 1996 to protect children's rights throughout the world. There are child friendly cities in over 44 countries around the globe, but none presently in the United States. The purpose was to establish a Child Friendly City in the United States. Description: Child friendly cities are a child-rights and equity-based approach designed to ensure all children in a community reach their full potential for optimal health, development, and well-being. The paper discusses the development of the guiding principles of the CFCI-Minneapolis Model as well as a community needs assessment. Assessment: The assessment consisted of a digital survey of 60 questions on the SurveyMonkey platform. The sample included 173 Minneapolis youth 10-18 years of age and 85 parents with children less than five years of age. The participants were drawn from four of the 83 Minneapolis neighborhoods that had the highest concentration of children and youth, communities of color, and immigrant families that have historically been under resourced. Conclusion: The results of the community assessment guided the development of four programmatic initiatives. These included child rights learning & awareness, emergency preparedness & planning, community safety, and youth participation in decision making. The paper concludes with the lesson learned to date in the implementation of the CFCI-Minneapolis Model. These include partnership, dedication, leadership, community engagement, coalition building, and celebrating success. CFCI-Minneapolis received full designation from UNICEF USA as a child friendly city in February 2024. [ABSTRACT FROM AUTHOR]

A brain‐computer interface for operating an electric wheelchair (wheelchair BCI) has been studied to support independent living for physically disabled patients. The current wheelchair BCI systems are facing the problem that the wheelchair cannot be moved or rotated to an arbitrary place or direction in a single measurement. To solve this problem, we developed a BCI that uses audiovisual stimuli based on mixed‐reality (MR) and virtual sound sources. During the online analysis, six out of seven participants were able to move or rotate the wheelchair to the target location or direction at a rate higher than the chance level. Thus, our results indicate that audiovisual stimulation with MR and virtual sound sources may be useful for intuitive wheelchair operation. © 2024 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

In the United States, direct support professionals (DSPs) support people with intellectual and developmental disabilities (IDD) so they can live in the community. Thirty years of deinstitutionalization and the development of community living options would not have been possible without DSPs. Although life for people with IDD improved greatly, working conditions, wages/benefits, demands, stress/burnout, and trauma experienced by DSPs have worsened. Turnover and vacancy rates threaten the availability of community supports for too many people with IDD. DSPs from diverse racial, ethnic, linguistic, and cultural backgrounds face significant workplace disparities. These issues were discussed during the Research and Training Center on Community Living's 2022 State of the Science Conference. We propose important research questions needing solutions to continue constructively addressing these critical issues. [ABSTRACT FROM AUTHOR]

Objectives: To study cross-sectional and longitudinal associations between objectively assessed neighborhood walkability, walking difficulties, and participation in leisure activities among older people. Methods: Self-reported 2 km walking difficulty (intact, modifications, difficulties) at baseline and participating in organized group, outdoor recreation and cultural activities at baseline and follow-up were studied in community-dwelling persons (N = 848) aged 75–90. A walkability index, calculated using a geographic information system, was categorized into tertiles (lowest, middle, highest). Results: Residence in the highest walkability areas was associated with higher participation in cultural activities and lower participation in outdoor recreation, while the latter was most frequently reported by residents in the lowest walkability areas. Those reporting no difficulties were more likely than those reporting difficulties to participate in all studied activities. Residence in the middle or highest walkability areas predicted higher participation in cultural activities at follow-up. Discussion: Older persons activity profiles associate with neighborhood walkability and walking difficulties. [ABSTRACT FROM AUTHOR]

Objectives: Patient trust in physicians is associated with patient satisfaction with healthcare, patients engaging in follow-up care, and positive health-related outcomes. The current study investigated whether age moderated the relation between trust in physicians and four health outcome variables, including patient satisfaction, doctor visits, emergency room visits, and hospital admissions. Methods: 398 English-speaking, community-dwelling adults completed measures of physician trust and important health outcome variables via Amazon Mechanical Turk. Results: Age significantly moderated relations between trust in physicians and hospital admissions, and trust in physicians and patient satisfaction, with both positive relations becoming stronger with increasing age. Discussion: The results highlight the need for a lifespan approach to the study of physician trust and related health outcomes. They offer an avenue for increasing physician trust, engagement with the healthcare system prior to the need for hospitalization, and the reduction of healthcare costs. [ABSTRACT FROM AUTHOR]

Objective: This study examined alignment of subjective balance confidence with Stopping Elderly Accidents, Deaths and Injuries (STEADI) fall risk. Methods: Cross-sectional analysis of 155 community-dwelling adults (60 + y/o) from 2016 to 2018 who completed a STEADI fall assessment. Descriptive statistics, Chi-Square analysis, and biserial point correlations were applied. Results: Adults who overestimate balance confidence, 55.6% (n = 50) reported a fall in the past year, 62.2% (n = 56) were worried about falling, 48.9% (n = 44) felt unsteady when standing/walking, and 70.0% (n = 63) had a score of ≥4 on the Stay Independent Questionnaire (SIQ). Physical performance for these adults were mean TUG score 10.9s (SD = 3.4), mean 30 second chair stands 10.8 (SD = 3.5), and mean 4-stage balance score 3.1 (SD =.76). Discussion: Older adults are more likely to overestimate their subjective balance confidence. Individuals are equally likely to have reported a fall in the past year if they were "at fall risk," regardless of their subjective balance confidence. [ABSTRACT FROM AUTHOR]

Objectives: Leading an active life in old age underpins positive life experience. This study aimed to compare the levels of active aging in senior housing residents and community-dwelling older people. Methods: We combined data from the BoAktiv senior house survey (N = 336, 69% women, mean age 83 years) and AGNES cohort study among community-dwelling older adults (N = 1021, 57% women, mean age 79 years). Active aging was assessed with the University of Jyvaskyla Active Aging scale. Data were analyzed with general linear models, and the analyses were stratified by sex. Results: Men in senior houses demonstrated lower active aging scores in general than community-dwelling men. Women in senior houses showed greater will to be active, but poorer ability and possibilities for activity than community-dwelling women. Discussion: Despite the social and supporting environment, senior housing residents' possibilities for leading an active life seem to be compromised, potentially leading to an unmet activity need. [ABSTRACT FROM AUTHOR]

The first objective was to evaluate clinical data from a multi-component fall prevention program. The second objective was to explore the relationship between physical function and fear of falling (FoF) Adults (N = 287, mean age = 76 years) who participated in the Building Balance Program between 2011–2020 were assessed with five physical function measures and two FoF measures. Repeated measures ANOVA controlling for age and sex were performed to assess change from baseline. Linear regressions were conducted to evaluate how physical function explained variations in FoF There were significant improvements between pre and post-program Berg Balance Scale (BBS) scores (p <.001), Timed-Up and Go (TUG) times (p <.001), 30 second Chair-Stand (30 CST repetitions) (p <.001), Functional Reach (FR) distance (p <.001), gait speed (p <.001), single item-FoF score (p <.001), and short Falls Efficacy Scale-International (FES-I score) (p <.001). After controlling for sex on all regression analyses, age, and pre-program gait speed explained variations in pre-program short FES-I scores (Adjusted R2 = 0.19). Age, pre-program BBS and 30 CST repetitions explained variations in pre-program level of FoF (Adjusted R2 = 0.25). Variations in post-program short FES-I scores (Adjusted R2 = 0.17) were explained by age, post-program TUG times and FR distance after controlling for age and sex. Robust regressions indicated variations in post-program level of FoF explained by age, post-program TUG and FR distance with a two-way interaction between age and FR A multi-component fall prevention program improved physical function and decreased FoF. A small association between physical function and FoF similar between pre- and post-program conditions was identified. [ABSTRACT FROM AUTHOR]

We aimed to investigate health care needs, health service utilization, and their socio-economic and health-related determinants in people with spinal cord injury (SCI) living in Jiangsu and Sichuan Provinces of China. A total of 1355 participants with SCI living in the community were recruited using a multi-stage stratified random sample and surveyed by telephone or online. Outcomes evaluated included the presence of health care needs, mode of health service utilization, and specific provider types seen within 12 months preceding the survey. The prevalence of healthcare needs was 92%. Needs were higher in Sichuan (98%) as compared to Jiangsu (80%). Of those in need of health care, 38% reported not having utilized care, more in Sichuan (39%) than in Jiangsu (37%). In Jiangsu, inpatient care was more often used than in Sichuan (46% vs. 27%), while in Sichuan outpatient services were utilized more often (33% vs. 17%). On average, 1.6 provider types were seen, with Sichuan reporting fewer different provider types. Considerable differences in the prevalence of health care needs and service utilization patterns were found between provinces, mostly in favour of the economically more developed Jiangsu Province. People with low income, particularly those below the World Bank poverty line for middle-income countries, had increased health care needs but utilized health care less often. Moreover, environmental barriers contributed significantly to unmet health care needs. This implies the necessity to provide better accessible and more affordable rehabilitation services for people with spinal cord injury (SCI) in China such as community-based rehabilitation programming. Policies for alleviation of poverty in the case of SCI including insurance for catastrophic health expenditure should also be reviewed and adapted where applicable. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to present key findings from the 2019 national adult oral health survey in Singapore (NAOHS). Methods: A multi‐stage stratified sampling method was used to recruit participants for a representative national adult oral health survey. A total of 12 212 households were randomly selected from the National Database on Dwellings in Singapore. Within each household eligible persons aged ≥65 years were automatically invited to participate while a Kish selection method was used to invite those between 21 and 64 years old. The survey comprised a face‐to‐face interview questionnaire and a clinical examination which recorded details of tooth loss, DMFT, DMFS and prevalence of periodontal disease according to the CPITN and the US CDC‐AAP classifications. Weighted analysis was performed to adjust for oversampling, non‐response and post‐stratification. Multivariate regression with backward stepwise selection was carried out to identify predictors of chronic periodontal disease and untreated dental caries. Results: Six hundred and sixty‐three participants completed both the questionnaires and the clinical examination. The prevalence of edentulousness was 2.7%. Of participants, 34.8% presented with untreated dental caries with a higher proportion found in those who were aged ≥60 years, of Malay ethnicity, living in 1–2‐room public housing and who only visited the dentist when there was a problem. Mean DMFS and DMFT indices were 24.7 and 7.9 respectively. Based on the CDC‐AAP classification, the prevalence of moderate–severe chronic periodontitis was 56.9% and increased with age, with a higher proportion in males. Participants with untreated dental caries were more likely to have moderate or severe periodontal disease. Conclusions: Survey findings showed high prevalence of dental caries and periodontal disease, at 34.8% and 77.6% respectively. A clear socio‐economic gradient in the distribution of tooth loss, untreated dental caries and moderate‐to‐severe periodontitis was observed. [ABSTRACT FROM AUTHOR]

Objectives: The objectives were to investigate the association between oral functional status (defined by the number of functional teeth and functional occluding units [FOUs]) on oral health‐related quality of life (OHRQoL). It also aimed to determine if dentures could compensate for the loss of FOUs in terms of OHRQoL in community‐dwelling older adults in Singapore. Methods: Community‐dwelling older adults, aged 60 years and above, were recruited from a community‐based oral health functional screening programme from 1 May 2018 to 31 December 2019. During the screening, an Oral Health Impact Profile‐14 (OHIP‐14) questionnaire and oral examination were administered. Statistical analysis was performed using the chi‐square test, univariate logistic regression and multivariate predictive modelling. Results: Data from 1037 participants were analysed (52% female; mean age 71.5 (SD 7.15)). The mean OHIP‐14 score was 4.5 ± 7.2. The OHIP‐14 scores were significantly associated with the number of functional teeth and the number of FOUs (p <.001). Having at least 20 functional teeth or 10 FOUs was associated with a significantly lower OHIP‐14 score. Those with no FOUs had higher OHIP‐14 scores compared to those with at least 10 FOUs, even in the presence of a satisfactory denture. Conclusion: Maintaining at least 20 functional teeth or 10 FOUs was associated with better OHRQoL among community‐dwelling older adults in Singapore. Dentures may have limited compensatory ability in terms of replacing natural functional occlusal units and maintaining OHRQoL. [ABSTRACT FROM AUTHOR]

We, an international group of autistic scholars of autism and neurodiversity, discuss recent findings on the origins of the concept and theorising of neurodiversity. For some time, the coinage and theorising of the concept of 'neurodiversity' has been attributed to Judy Singer. Singer wrote an Honours thesis on the subject in 1998, focused on autistic activists and allies in the autistic community email list Independent Living (InLv). This was revised into a briefer book chapter, published in 1999. Despite the widespread attribution to Singer, the terms 'neurological diversity' and 'neurodiversity' were first printed in 1997 and 1998, respectively, in the work of the journalist Harvey Blume, who himself attributed them not to Singer but rather to the online community of autistic people, such as the 'Institute for the Study of the Neurologically Typical'. Recently, Martijn Dekker reported a 1996 discussion in which one InLv poster, Tony Langdon, writes of the 'neurological diversity of people. i.e. the atypical among a society provide the different perspectives needed to generate new ideas and advances, whether they be technological, cultural, artistic or otherwise'. Going forward, we should recognise the multiple, collective origins of the neurodiversity concept rather than attributing it to any single author. This letter discusses the origins of the concept and theory of neurodiversity. It is important to correctly attribute concept and theories to the people who developed them. For some time, the concept of neurodiversity has primarily been attributed to one person, Judy Singer. We consider the available evidence and show that the concept and theory in fact has multiple origins. We draw particular attention to recent archival findings that show the concept of 'neurological diversity' was being used years earlier than previously thought. 'Neurodiversity' means the same thing as 'neurological diversity' and does not change the theory in any way. We conclude that both the concept of neurological diversity or neurodiversity, and the body of theory surrounding it, should be understood as having been collectively developed by neurodivergent people. [ABSTRACT FROM AUTHOR]

different populations have different averages of life-space assessment scores and defining cutoff values of clinical significance by each population should take into consideration. Different cutoffs to define restricted life space have been reported. The most common is a score of 60 points. There are other cutoffs derived from receiver operating characteristic (ROC) analysis and used to classify older adults according to their ability in activities of daily living (ADLs) (52.3 points) or instrumental activities of daily living (IADLs) (56 points); other cutoffs are specialized for people with cognitive impairment (26.75 points) or people with spinal cord injury who need mobility aids (78.5 points). The aims were to identify cutoff points of Life Space Assessment (LSA) in older adults in different sites and to determine the relationship of the cutoff scores with mobility disability and depression. The study population was composed of community-dwelling adults aged 65–74 years who were not institutionalized. An ROC analysis was constructed, and the area under the curve (AUC) was calculated to identify the optimal cutoff that discriminates life-space restriction for each city. Logistic regressions were executed by site to comprehend the association among restricted LSA and mobility disability and depression. In total, 1890 participants were included in the analyses (52.38% women, 37.19% mobility disability and 21.32% had depression). Canada cities had the highest cutoff, while Tirana and Natal had the lowest cutoff (< 50). Kingston was the site with the highest association between life-space restriction and mobility disability (OR 5.4, 95% CI 2.9–10). Saint-Hyacinthe, Tirana, and Manizales had significant associations between depression and restricted life space (OR 3.25, 95% CI 1.53–6.89, OR 3.14, 95% CI 1.88–5.24, and OR 3.99, 95% CI 2.28–6.98, respectively). Different cutoffs to define restricted life-space have been identified in elderly people at different sites. The analysis of the relationship between the restricted life space and personal characteristics like depression and mobility disability supported these findings. The groupings produced by the cutoff points for each site showed notable variations. These findings emphasize the importance of population-based cutoffs to improve the general applicability of LSM criteria and take into consideration the importance of site-specific approaches. [ABSTRACT FROM AUTHOR]

There are a number of challenges in recruiting people living with dementia for research purposes, and consequently, studies may be underpowered or fail. This commentary describes barriers experienced by a research study in recruiting people with early-stage dementia living in the community, for a focus group about their perceptions of using a technology-enabled pain assessment tool to detect and quantify pain. Four potentially important groups of barriers encountered during the recruitment phase are discussed, namely dementia, pain, mobile health application (mHealth) technology and COVID-19. The strategies used in an attempt to overcome these barriers are also discussed. Despite a comprehensive approach to recruitment, the required participant number was not achieved. It is recommended careful consideration be given to recruitment including flexibility in recruitment strategies tailored to the unique contexts of a study. [ABSTRACT FROM AUTHOR]

This study aims to explore the role of social resilience in providing community-based healthcare to older adults in Northeast Thailand during the COVID-19 pandemic. Purposive sampling was used to recruit 20 community-dwelling older adults in Maha Sarakham province, Thailand, and semi-structured interviews were conducted from 2020 to 2021. Interview transcripts were analyzed using an interpretative phenomenological analysis (IPA) approach with multiple coders to triangulate findings. The results of the IPA show that, during the pandemic, social resilience was related to social distancing, social isolation, social control, social safety, and social support. The respondents identified that providing community-based healthcare during the pandemic was associated with primary care, rehabilitative care, healthcare delivery, health behaviors, and distress intolerance. These findings highlight that social reciprocity, preventative healthcare, residential care, and good healthcare practices are important aspects of resilience among community-dwelling older adults in times of pandemic. [ABSTRACT FROM AUTHOR]

To verify the factor structure of the LIFE-H 3.1-Brasil in a sample of independent older adults, and to analyze their responses to the instrument. Cross-sectional study with175 older adults assisted by the Family Health Strategy in the interior of the State of São Paulo/Brazil. We used Cronbach's alpha to assess internal consistency, Pearson's correlation coefficient for retained dimensions, and exploratory factor analysis to examine the factor structure. Among participants, 62.3 per cent were women, 49.2 per cent were aged between 60–69 years, 54.3 per cent had 0–3 years of schooling and 67.4 per cent were retired. Based on our factor analysis, four factors were identified that explained 43.5 per cent of the variance: personal care, community, recreation, and communication. Cronbach's alphas ranged from.76 to.93. We demonstrated that a 4-dimensional model for the LIFE-H 3.1-Brasil was valid and reliable to measure the quality of social participation of independents older adults living in the community. Findings support its use in clinical practice and research. Nonetheless, future research is warranted to confirm the proposed factorial structure. This study supports the importance of identifying older adults' social participation through a valid instrument such as the LIFE-H, which has been widely used internationally. [ABSTRACT FROM AUTHOR]

Background: There are numerous publications on inpatient medication errors. However, little focus is given to medication errors that occur at home. Aims: To describe and analyse the types of medication errors among community-dwelling patients following their discharge from an acute care hospital in Singapore. Method: This is a retrospective review of a 'good catch' reporting system from December 2018 to March 2022. Medication-related errors were extracted and analysed. Findings: A total of 73 reported medication-related error incidents were reviewed. The mean age of the patients was 78 years old (SD=9). Most patients managed their medications independently at home (45.2%, n=33). The majority of medications involved were cardiovascular medications (51.5%, n=50). Incorrect dosing (41.1%, n=39) was the most common medication error reported. Poor understanding of medication usage (35.6%, n=26) and lack of awareness of medication changes after discharge (24.7%, n=18) were the primary causes of the errors. Conclusion: This study's findings provide valuable insights into reducing medication errors at home. More attention must be given to post-discharge care, especially to preventable medication errors. Medication administration and management education can be emphasised using teach-back methods. [ABSTRACT FROM AUTHOR]

The personal futures of older adults are continually in mind, motivating goals, desires and plans. People approach the near and long term with differing agentic traits and dispositions, and they face forward, as well, from differing standpoints according to socio-economic position. This is a study of how persons who are economically privileged diverge in their future thought from persons of modest means, asking how income level qualifies the capacity to imagine, and foresee affecting, the future. We draw upon interviews conducted with 42 older, community-dwelling individuals in the Midwestern United States of America, a sample that was partitioned into two groups, one with below-median incomes versus one with incomes above 200 per cent of median. Interviews disclosed various foci of future thought with common contents among the two groups. Three foci, however, confirmed between-group differences in confidence about handling possible material and support needs, and also in enacting idealised norms of retirement. The underlying theme of these foci – financial security, long-term supports and services, and trips and travel – was the perceived affordability of the future. We conclude that there is indeed a material basis for imagination of and proactivity toward the future. When paradigms about later life set expectations that idealise lifestyle choice, consumption and prudential preparation for the future, these are prospects towards which some can reach more readily than others. [ABSTRACT FROM AUTHOR]

Aims: To examine how perceived balance problems are associated with self‐reported falls in the past month after controlling for known correlates of falls among older adults. Background: Approximately 30% of adults age 65 and older fall each year. Most accidental falls are preventable, and older adults' engagement in fall prevention is imperative. Limited research suggest that older adults do not use the term 'fall risk' to describe their risk for falls. Instead, they commonly use the term 'balance problems'. Yet, commonly used fall risk assessment tools in both primary and acute care do not assess older adults' perceived balance. Design and Method: The Health Belief Model and the concept of perceived susceptibility served as the theoretical framework. A retrospective, cross‐sectional secondary analysis using data from the National Health and Aging Trends Study from year 2015 was conducted. The outcome variable was self‐reported falls in the last month. Results: A subsample of independently living participants (N = 7499) was selected, and 10.3% of the sample reported a fall. Multiple logistic regression analysis revealed that the odds of reporting a fall in the past month was 3.4 times (p <.001) greater for participants who self‐reported having a balance problem compared to those who did not. In contrast, fear of falling and perceived memory problems were not uniquely associated with falls. Using a mobility device, reporting pain, poor self‐rated health status, depression and anxiety scores were also associated with falling. Conclusion and Implications: Older adults' perceived balance problem is strongly associated with their fall risk. Perceived balance may be important to discuss with older adults to increase identification of fall risk. Older adults' perceived balance should be included in nursing fall risk assessments and fall prevention interventions. A focus on balance may increase older adults' engagement in fall prevention. [ABSTRACT FROM AUTHOR]

According to the broaden-and-build theory, positive emotions can broaden our awareness and build psychological resources, which leads to better psychological outcomes. Previous studies demonstrated that hope partially mediates the association between positive emotions and life satisfaction in college students. Yet, there has no similar model been tested among older adults. The objective of the current study was to evaluate the mediating role of hope agency and pathways in the association between positive emotions and life satisfaction. Three hundred and forty-one Chinese community-dwelling older adults (mean = 70.83, SD = 9.16) were asked to complete a survey questionnaire comprising measures assessing positive emotions, hope, life satisfaction, and other sociodemographic variables. Results showed that hope agency, but not hope pathways, partially mediated the relationship between positive emotions and life satisfaction. We discussed the importance of these initial findings concerning positive emotions and hope as predictors of life satisfaction in the older adult population. [ABSTRACT FROM AUTHOR]

Older adults prefer ageing in place (AIP) rather than institutionalized facilities. Although its advantages, AIP can be challenging when communities are unable to meet residents' needs. This study aims to identify the relationship between the level of age-friendliness of community and AIP. We used AARP Age-friendly Community Survey data with 6670 older adults in the USA. We used responses from 63 items assessing various aspects of a community's age-friendliness to identify different types of age-friendly communities (AFCs) through latent profile analysis (LPA). We then ran multinomial logistic regression to examine whether the types of AFC were associated with AIP. LPA revealed three types of AFC: Underdeveloped, developing, and developed. Regression results showed older adults living in underdeveloped and developing communities are less likely to AIP compared to those in the developed community. These results show a positive impact of AFC on intention to AIP. Policymakers should consider expanding AFC initiatives for the growing number of older adults. [ABSTRACT FROM AUTHOR]

Aim: A key perspective in examining dignity, which is important for older adults, is spirituality. Therefore, this study aimed to identify the components of spirituality in older adults through interviews based on dignity therapy (DT). Methodological Design and Justification: Colaizzi's descriptive phenomenology was applied to understand experiences rooted in the life world of older adults from their own perspective. Ethical Issues and Approval: This study was approved by the ethical review committee of the author's university. All participants provided consent to participate. Research Methods: Semi‐structured interviews based on DT were conducted with 11 community‐dwelling adults aged 65 years or older who were using some form of medical or social services. The interviews were transcribed, and the text was analysed based on Colaizzi's phenomenological method. Results: Four themes were identified as components of spirituality in older adults: trauma, being silent about hard experiences, forming connections and taking on challenges and discovering one's own spirit. The participants felt a sense of helplessness and frustration as they dealt with traumatic events. Feelings of shame, guilt and/or resignation prevented them from talking about the distress they were experiencing, but they were able to move forward after receiving emotional support and having opportunities to share with others. These processes led to the discovery of a new self. Study Limitations: This study assessed the experiences of older adults in Japan and may therefore have been influenced by the social background and culture of Japan. Future research should target older adults from a variety of social backgrounds as well as those with specific health conditions. Conclusion: The findings suggest the importance of creating opportunities for healthcare professionals as well as family, friends and community members to help older adults reflect on their lives and talk about their accomplishments and unresolved issues. Doing so should help older adults maintain their dignity while remaining aware of their mortality. [ABSTRACT FROM AUTHOR]

Background: People with learning disabilities following a long‐term stay in forensic settings may experience difficulties reintegrating in the wider community. Indirect interventions can be helpful for care providers and family members to reflect on their practices and improve the quality of life of people with learning disabilities. Although indirect interventions are being implemented in learning disability settings, research is limited. Methods: This clinical case study recounts an indirect intervention with care providers of a male with mild learning disability. Findings: We recount the referral and assessment processes, the initial hypotheses and formulation of the service users' presenting difficulties. We demonstrate how a systemically informed indirect intervention with staff can be used to improve the living conditions of a man with mild learning disability and provide reflections on working with multiple interdependent systems surrounding vulnerable individuals in a specialist learning disability setting. Conclusion: Indirect interventions with the care networks supporting an individual with a learning disability can be a useful way to conceptualise the barriers and facilitators for community integration. Indirect interventions can also offer a reflective space for staff to share their own difficulties and prevent burnout. Accessible summary: This case study explores working with staff supporting a man with mild learning disability in the community.This case study helped staff better understand the difficulties a man with mild learning disability experiences and the ways he can be supported to navigate integrating the community following long‐term stay in forensic settings.We discuss how helpful it may be to work with people around individuals with learning disabilities, such as care providers, to improve someone's quality of life.This case study also provides reflections about working with multiple systems and professionals in learning disability settings. [ABSTRACT FROM AUTHOR]

Fibromyalgia (FM) is a chronic pain condition often accompanied by sleep problems and depression that are each associated with reduced physical ability including postural control. Research supports a sequential association between pain intensity and depression in FM, and poor sleep quality may play a key role in this relationship. This study aimed to verify a serial pattern of associations among sleep quality, pain intensity, and depressive symptoms and quantify these effects on objective postural control. Community-residing adults diagnosed with FM (n = 155; Mage = 61.08, SD = 7.70; 93% female; 79% White) were included in this cross-sectional study. Participants self-rated sleep quality (restorative sleep, sleep waking, and sleep latency), pain intensity, and depressive symptoms, and the Fullerton Advanced Balance (FAB) scale and 8-Foot Up and Go Test (8FUPGT) measured objective postural control. Findings indicated that the serial association between pain intensity and depressive symptoms fully mediated the relationship between sleep quality and both FAB (95% CI [-.125, -.013]), and 8FUPGT (95% CI [.002,.033]) performance. Findings highlight the serial association of pain intensity and depressive symptoms with objective postural control performance and the potential for sleep and depression interventions that may maximize functional outcomes in FM. [ABSTRACT FROM AUTHOR]

This study compared the effect of traditional exercise training and game-based exercise by TRAZER© on dynamic balance activities, vestibular ocular motor sensory (VOMS), falls efficacy scale-international (FES-I), and muscular performance in healthy older adults. Twenty-two older adults (mean age: 77.59 ± 6.20 years) randomly divided into two groups (1) exercise training (ET) and (2) ET + TRAZER©. Both groups participated in one-hour exercise sessions, three days a week for 10 wk. The ET + TRAZER© group completed the three dynamic/agility balance assessments each day. The results showed the three TRAZER© assessments significantly increased in the ET + TRAZER© group. However, there was not a statistically significant difference between the groups for timed up and go (TUG), sit-to-stand (STS), and FES-I. Our findings provided evidence that game-based exercise intervention improved muscular function and VOMS, especially dynamic balance and reaction time in older adults. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effects of a life review intervention on older adults' self-perceived ratings of quality of life, depression, and mastery. A sequential explanatory mixed-methods design was used. Quantitative data was gathered via a pre-posttest design. Qualitative data was gathered regarding participants' perceived value of the life review program. A Wilcoxon signed rank sum test indicated that one item on the WHO-QOL BREF (modified) had a significant change, indicating fewer negative feelings after the life review intervention. Six themes emerged from the qualitative data: (1) Nostalgia; (2) Reflection; (3) Appreciation; (4) Proliferation of additional memories; (5) Sharing in similar experiences with others; and (6) Gratefulness. Results indicated that participation in a five-week, home-based, life-review intervention program has the potential to improve self-perceived quality of life and sense of personal mastery for older adults sheltering at home during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

To understand and discuss the perceptions about fear of falling (FOF) in older adults without a history of falls. A qualitative study with a convenience sample consisting of 51 older adults. Data collection was out through semi-structured interviews during the Covid-19 pandemic. Data were analyzed using thematic analysis. Three themes were grouped: FOF and its repercussions; Reactions to FOF in the daily life of the pandemic; and No fear, but aware of aging. The older adults reported a fear of dependence, difficulties and cautious behaviors in activities of daily living and mobility in the community. Understanding FOF can contribute for your approach and building multidisciplinary and intersectoral strategies aimed at maintaining independence and strengthening the identity of older adults without a history of falls in the community. [ABSTRACT FROM AUTHOR]

Developing new health promotion strategies is crucial, considering the physical inactivity among older people due to COVID-19. This study conducted health promotion activities by utilizing online group exercises to examine their immediate psychological effects. Thirty-six community-dwelling older women performed online group exercises with instructions live-streamed via Zoom. We used a shortened version of the 2nd edition of the Profile of Mood States (POMS 2) to collect data on physical, mental, and cognitive function before and after the activity. All 36 participants had an age range of 75 ± 7. They completed the activity without dropping out. Participants were active and had high cognitive function, but 30% showed depressive tendencies before the activity. After the activity, the results of the POMS 2 showed a significant improvement in depressive tendencies. Online group exercise can improve negative psychological feelings, such as anxiety, stress, and depression, among community-dwelling older people. [ABSTRACT FROM AUTHOR]