Search

Physical and cognitive decline at an older age is preceded by changes that accumulate over time until they become clinically evident difficulties. These changes, frequently overlooked by patients and health professionals, may respond better than fully established conditions to strategies designed to prevent disabilities and dependence in later life. The objective of this study was twofold; to provide further support for the need to screen for early functional changes in older adults and to look for an early association between decline in mobility and cognition. A cross-sectional cohort study was conducted on 95 active functionally independent community-dwelling older adults in Havana, Cuba. We measured their gait speed at the usual pace and the cognitive status using the MMSE. A value of 0.8 m/s was used as the cut-off point to decide whether they presented a decline in gait speed. A quantitative analysis of their EEG at rest was also performed to look for an associated subclinical decline in brain function. Results show that 70% of the sample had a gait speed deterioration (i.e., lower than 0.8 m/s), of which 80% also had an abnormal EEG frequency composition for their age. While there was no statistically significant difference in the MMSE score between participants with a gait speed above and below the selected cut-off, individuals with MMSE scores below 25 also had a gait speed<0.8 m/s and an abnormal EEG frequency composition. Our results provide further evidence of early decline in older adults-even if still independent and active-and point to the need for clinical pathways that incorporate screening and early intervention targeted at early deterioration to prolong the years of functional life in older age., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 García-Agustin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Leptospirosis is a zoonosis of worldwide incidence, with a broad spectrum of health risk factors., Aim: The objective was to determine risk factors associated with acute human leptospirosis and to explore predictive variables of risk to human leptospirosis., Methods: The study was carried out in the Department of Córdoba, in the north of Colombia. We conducted a longitudinal prospective descriptive study with non-probabilistic sampling, which included 339 patients suspected of leptospirosis. Positive cases were confirmed by MAT and PCR. The determination of social and environmental risk factors was done with a survey on epidemiological and environmental variables to establish an association between cases of leptospirosis and risk factors as well as predictive variables., Results: We found 19.8% (67/339) cases of acute leptospirosis, and the seroprevalence was 27.1% (92/339). The most frequent serogroups were Sejroe, Australis, Pomona, Batavie, Pyrogenes and Grippotyphosa. We identified the following risk factors: age between 10 and 19 years (OR = 2.571; 95% CI); pig ownership (OR = 2.019; 95% CI); bathing or recreational activities in lake/lagoon (OR = 3.85; 95% CI) and in dams (OR = 3.0; 95% CI); floodings 30 days before the onset of symptoms (OR = 2.019; 95% CI), and a mean temperature of 28°C (p 0.044; 95%CI). As significant predictor variables, we identified age (10-19 years), bathing or recreational activities in the lake/lagoon, and flooding 30 days before symptoms were again evidenced. This region presents classic risk factors (pig ownership) and emerging environmental risk factors (recreational practice or bathing in a lake/lagoon and flooding 30 days before the onset of symptoms), and demographic factors such as young age (10-19 years)., Conclusions: These factors are also predictors of human cases of acute leptospirosis and provide contextual information on environmental and public health that should be considered for epidemiological surveillance in this endemic area., (© 2023 Wiley-VCH GmbH. Published by John Wiley & Sons Ltd.)

The ageing in place (AIP) model enjoys widespread recognition in gerontology and has been strongly encouraged through social policy. However, progress remains to be made in terms of analysing AIP for minority groups and groups with diverse life pathways in old age. This systematic review aims to identify studies that address the AIP model in indigenous communities, answering the following questions: In which geographical contexts and for which Indigenous Peoples have AIP been researched? Which physical dimensions are considered in the assessment of AIP? Which social dimensions are considered in the assessment of AIP? This systematic review applied the SALSA (Search, Appraisal, Synthesis and Analysis) method to AIP among Indigenous older adults on the Web of Science, PsycINFO, MEDLINE and Scopus digital platforms for publications from 2011 to 2021. We identified 12 studies conducted in five countries in North and South America and Oceania. The results show that the following elements of the physical environment are assessed: household, neighbourhood, local surroundings or reserve and native territories. Meanwhile, assessed elements of the social environment are as follows: personal characteristics, attachment to place, social networks, social participation and social policies. There is discussion of the need to develop AIP in order to promote successful ageing among Indigenous older adults., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Background: Loneliness is one of the most recurrent public health problems in older people. However, there is little data available in Chile on its prevalence in people over 60 years of age living in rural areas and belonging to native or Afro-descendant groups., Aim: To examine the prevalence of loneliness among older people living in rural areas by ethnic group and to analyze the socio-demographic, family, and health variables related to loneliness., Methods: We interviewed 1,692 elderly people living in Chilean rural areas of the regions of Arica and Parinacota, Tarapacá, Antofagasta, Atacama, Coquimbo, Valparaíso, Los Lagos, Aisén and Magallanes. The instruments applied were the DJGLS-6 loneliness scale, Family-APGAR, questionnaire of 13 most frequent health problems in Chilean older people, and Barthel index., Results: We found a high prevalence of loneliness (over 55%) among Afro-descendants, Quechua, Atacameño, Colla, Chango, Huilliche, Kawesqar and non-indigenous people. Emotional loneliness is the most prevalent among indigenous and non-indigenous older people living in rural areas (≥ 71%). Variables associated with loneliness were being female, age, not having a partner, living alone, family dysfunctionality, and having health problems., Conclusions: Loneliness in rural areas is higher in older people, and this situation becomes more complex at the crossroads of ethnic-cultural diversity; it is necessary to continue to address this problem that affects biopsychosocial well-being in old age.

Objective: During the ageing process the loss of family and social relationships is frequent which conditions loneliness, similarly the current COVID-19 pandemic has generated more social limitations in this age group and has increased the risk factors to trigger feelings of loneliness. This paper aimed to examine how loneliness among older people had been studied in Europe over the last ten years. Specific objectives were: i) to describe the methodological aspects; ii) to identify the scales or questions for the assessment of loneliness; iii) what were the main variables or dimensions that were related to loneliness in old age., Methods: A total of 1,591 articles were found in WoS and Scopus digital platforms. After initial assessment of titles and abstracts, full text reading and review of the established criteria, 42 scientific articles were finally included in the systematic review., Results: The countries that had carried out the most studies were the Netherlands and Spain. Most of the research was quantitative and uses the De Jong Gierveld Loneliness Scale (DJGLS) and the University of California at Los Angeles (UCLA) Loneliness Scale. The most analysed variables were: marital status, household structure, social support networks, social participation, depression, health problems, co-morbidity and physical functioning., Conclusions: The scientific interest in studying loneliness, with a focus on social support networks, in older people in Europe and strategically addressing loneliness as a public health problem is confirmed.

This study aimed to analyze the determinants of quality of life (QoL) in older people in three European countries (Portugal, Spain and Sweden). A sample of 7589 participants in waves 4 (2011) and 6 (2015) of the Survey on Health, Aging, and Retirement in Europe (SHARE) project, aged 50 and over and living in Portugal, Spain and Sweden, was included. The CASP-12 scale was used to measure QoL. A principal component analysis was performed to group preselected variables related to active and healthy ageing into the dimensions of health, social participation, and lifelong learning. A linear regression model was built using the change in CASP-12 scores over the 4-year follow-up as the dependent variable, including the interactions between country and each independent variable in the model. After four years, the average QoL increased in Portugal (difference = 0.8, p < 0.001), decreased in Spain (-0.8, p < 0.001), and remained constant in Sweden (0.1, p = 0.408). A significant country-participation component interaction ( p = 0.039) was found. In Spain, a higher participation (β = 0.031, p = 0.002) was related to a higher QoL improvement at 4 years, but not in Sweden or Portugal. Physical health and emotional components (β = 0.099, p < 0.001), functional ability (β = 0.044, p = 0.023), and cognitive and sensory ability (β = 0.021, p = 0.026) were associated with QoL changes over time in all countries. The country-specific associations between health, social participation and QoL should be taken into account when developing public health policies to promote QoL among European older people.

Purpose: Loneliness and social isolation have detrimental effects on health in old age; however, the prospective associations with quality of life (QoL) remain unclear. Furthermore, despite the existence of a European north-south gradient in the distribution of loneliness and social isolation, little is known whether the associations are context-specific. We investigated the relationships between loneliness, social isolation and QoL of older adults residing in the North (Sweden) and South (Spain) of Europe., Methods: Study sample consisted of 2995 Swedish and 4154 Spanish older adults who participated in waves six and seven of the Study on Health, Aging and Retirement in Europe (SHARE). Loneliness and social isolation were measured at the baseline, and QoL was measured at the baseline and follow-up using CASP-12. Prospective associations were assessed via multivariate linear regression., Results: In Sweden, subjects with higher vs. lower loneliness had 1.01 (95% CI: -1.55, -0.40) units lower QoL, while every standard deviation increase in social isolation was associated with a 0.27 (95% CI: -0.42, -0.09)-unit decrease in QoL. In Spain, every standard deviation increase in social isolation was associated with a 0.66 (95% CI: -1.11, -0.22)-unit decrease in QoL. The association was stronger in subjects aged ≤65 years old and those with no chronic diseases. The association with loneliness was not statistically significant in Spain., Conclusion: Loneliness and social isolation are prospectively associated with decreased QoL among older adults, yet the associations are contextually bound. Future interventions should target both exposures, among others, in order to increase QoL in this group.

Background: The academic literature contains little information regarding the interventions that create age-friendly cities and communities in order to promote active ageing. Objectives: A systematic review was carried out to determine the available empirical evidence in relation to the characteristics, content and effectiveness of interventions aimed at improving environmental and psychosocial risk factors for older people, from the perspective of age-friendly communities and the promotion of active ageing. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the studies retained in this review were identified through a systematic search of the academic literature in selected electronic databases including Web of Science and Scopus. Independent critical appraisal and data extraction were conducted by two reviewers. The checklist was used to assess the quality of the articles. Findings : The search identified 1020 potentially eligible documents, of which 11 satisfied the established criteria. Non-exhaustive practices prevailed over rigorous investigations, with a high proportion of studies observed to be of low methodological quality and at high risk of bias. This reflected the predominance of uncontrolled interventions. Environmental interventions were focused on reducing risk and adapting the everyday environmental setting, while psychosocial interventions prioritised social strategies (behavioural changes, promotion of participation) and training. Interventions were more effective in certain domains of age-friendly cities and communities such as transportation and housing, followed by increased participation as a lifestyle-related behavioural change. The inferred changes were associated with providing information and enhancing skills; modifying access, barriers, exposures, and opportunities; enhancing services and support; continuity and effectiveness of changes over time; and modifying policies based on the bottom-up approach of age-friendly cities and communities (AFCC). Discussion and conclusion: Interventions focused on personal and organisational aspects might have positive effects in the longer term. However, fewer changes would be observed in interventions revolving around changing lifestyles owing to the impact of complex multi-causal factors. The relative effectiveness in terms of health calls into question the design of interventions and the supposed "friendliness" of certain communities. There is a need to encourage sound longitudinal research aimed at providing key knowledge for the implementation and evaluation of public policies, and to encourage age-friendly community programmes to promote active ageing., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study, in the collection, analyses and interpretation of data, in the writing of the manuscript, or in the decision to publish the results.

During the economic crisis, developed countries have experienced financial fraud, with effects on the physical and mental health of the people affected, and on social domains. Based on the theoretical framework in literature reviews and in quantitative studies, this paper aims to obtain evidence on the effects of financial fraud on health and on the family and social environments of those affected. An intentional sample of 32 people affected by abusive and multi-currency mortgages, preferred and swap stock in Madrid was approached. In-depth interviews were conducted, and the resulting data was analysed using content analysis. Fraud-affected individuals had conditions of age, sex, educational level and occupations that possibly allowed them to accumulate economic resources throughout the course of their lives and, predictably in many cases, to take out fraudulent financial products, based on trust in the financial institutions. Financial fraud has led to the emergence of various processes of anomia and adverse health effects. The consequences on health were physical ailments (symptoms and diseases in various systems and parts of the body) and mental disorders (anxiety, depression, suicidal ideation), all affecting lifestyles, behaviour and personal and social relationships, both in affected individuals and their families. The increase in the use of medical drugs and health services serves as a final corollary to the imbalances on the affected people's health. Individuals and the Spanish society demand public health policy measures to mitigate the effects on health and the recovery of their confidence in the banking and political system., (Copyright © 2019 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: To demonstrate that selection of a probabilistic sample at a national level for a study of aging in Spain is subject to selection bias. To quantify the losses produced after each phase of the administration of a questionnaire., Methods: We performed a cross-sectional study of the Spanish community-dwelling population aged 50 years or older between 2010 and 2011. Through multivariate logistic regressions, the characteristics of the census tract of the patients' residence were compared between those who agreed (n = 5,813) or refused (n = 7,023) to be included in the sampling frame and between those who agreed (n = 1,677) or refused (n = 2,875) to participate in the study. The individual characteristics of persons who responded (n = 1,398) or refused to respond (n = 346) to a face-to-face questionnaire administered after a telephone interview were also compared. In addition, the reasons for refusal were studied., Results: The most frequent specific reasons for refusing to be included in the sampling frame or to participate in the study were poor health and disability (14.4% and 27.9%, respectively). In both cases, refusal was more frequent in the census tracts of districts with a lower socioeconomic level or those located in Catalonia, Guipúzcoa or Biscay. Individuals older than 81 participated less frequently in the face-to-face questionnaire. Between 8.6% and 18.4% of participants were lost at each stage of information retrieval., Conclusion: Probabilistic sampling in sampling points chosen by the researchers would allow more resources to be devoted to increasing response rates among the groups who are less likely to participate. Questions should be concentrated in only one shorter questionnaire, administered before blood extraction., (Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.)

Researchers, stakeholders and policy makers agree about the importance of the population ageing in modern societies, so a broad analysis of current research strategies is in progress, such as FUTURAGE, a network for drawing a map for future research on ageing. This document presents the Spanish contribution to this map following FUTURAGE guidelines, drawn from the debates held in the 'Ageing. Research in Spain and Europe' Workshop. The first part consists of general ideas seeking to define future challenges on research using a multidisciplinary approach, in which the theoretical and methodological debate, the comparative and multilevel perspective, the transfer of knowledge and involvement of the older people would be essential to consider. Some of the main issues according to FUTURAGE structure are, the bio-gerontology of ageing, healthy and active ageing, and the socioeconomic and environmental resources of ageing. The interaction between these contents is pivotal to understand the research on ageing. Finally, the document provides some methodological and instrumental ideas to reinforce the need for cross-sectional research initiatives, integrating different data and combining methods in order to develop assessment and intervention strategies. Other aspects look into the mechanisms to coordinate research within a European context. The map on ageing research has been published after the consultation process in Europe (http://futurage.group.shef.ac.uk/road-map.html) and is now ready to be considered for integration into future European and Spanish research programs., (Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.)

Objective: To assess the psychometric quality of an instrument designed to measure functional independence (Functional Independence Scale [FIS]) in several activities of daily living domains and to be applied by trained non-health-related interviewers. The study was carried out in the autonomous region of Madrid in community-dwelling elders., Methods: We performed a cross-sectional validation study. In addition to the FIS, Pfeiffer's questionnaire, the Depression Subscale of the Hospital Anxiety and Depression Scale, the Comorbidity Index, the Barthel Index, and EQ-5D were used. These measures were cross-sectionally applied to community-dwelling elders (n=500) and outpatients in a general hospital (n=100) aged 65 years. The following FIS psychometric attributes were analyzed: acceptability, scaling assumptions, internal consistency, construct validity, and precision., Results: A fully computable FIS total score was obtained in 94.3% of the subjects. A ceiling effect (60.65%), but no floor effect (0.22%) was evident in the community-dwelling elders. No floor or ceiling effects were detected in the hospital sample. Scaling assumptions and internal consistency were satisfactory (item-total correlations: 0.57-0.91; Cronbach's alpha: 0.94). Factor analysis identified three factors that explained 74.3% of the variance. Indexes of convergent, internal, and known-groups validity were satisfactory. The scale's precision, determined by the standard error of measurement (2.49; 95%CI=4.88), was also satisfactory., Conclusion: The FIS is an easy-to-use instrument with appropriate metric attributes. This scale can be usefully applied in broad samples of non-institutionalized elders by non-health related personnel.

Background: The study of the emotional state and personal coping resources has drawn an increasing interest in the Quality of Life (QoL) field. Diverse researches have demonstrated its contribution to satisfaction with life, and the interconnection with other life domains of great importance in ageing, as health is. The aim of this work is to analyze the relationships of emotional wellbeing (in terms of affects and coping resources) with sociodemographic and health factors., Methods: A survey on QoL among older people living in family housing of Madrid province (CadeViMa-2005) was used. Multivariate analyses were applied for generating an indicator of emotional wellbeing which integrated positive and negative affects, as well as personal coping resources. A logistic regression model was created to explain a positive emotional wellbeing, according to sociodemographic and health characteristics., Results: People without anxiety or depression problems were around three times more likely to evaluate their emotional wellbeing positively than those who had problems. Older adults whose health was better than in the previous 12 months, seemed to be five times more likely to report a high emotional wellbeing, compared to those who experienced a health decline. Individuals with a very good perceived health status were 26 times more likely of having a high emotional wellbeing than people with a negative health perception. Those with middle and upper social class were three times more likely to experience a positive emotional wellbeing than those belonging to a low social class., Conclusions: Health greatly influences emotional wellbeing with a relevant role of the subjective experience of health, together with social class as an indicator of educational level and socioeconomic status.