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Geospatial technologies have the potential to transform the lives of older adults by providing them with necessary tools to navigate their local communities, access services, connect with others, and access valuable information. However, the usability and accessibility of such technologies often fall short of the needs of older adults. Many existing geospatial tools are not designed with the needs and preferences of older adults in mind; this can lead to usability challenges and limit their usage. This paper explores a participatory approach in developing an inclusive geodata-collection tool that is specifically tailored to older users' needs. The paper also highlights the importance of incorporating user-centered design principles, participatory design methods, and accessibility guidelines throughout the entire geodata-tool-development process. It also emphasizes the need for ongoing user engagement and feedback in order to ensure that the tool remains relevant and usable in the evolving digital landscape. This participatory approach has resulted in a tool that is easy to use and accessible for older adults; it is available in various languages, thus ensuring that the elderly can actively participate in the prototype's creation and contribute to the collection of the geospatial information that reflects their lived experiences and needs. [ABSTRACT FROM AUTHOR]

This study describes the development and testing of the Healthy Ageing/Vulnerable Environment (HAVEN) Index, a prototype composite spatial index for South Australia that reflects an area's age‐friendliness. The index incorporates over 40 indicator variables across six variable themes: income and employment; education; health and housing; social connectedness; geographic access; and physical environment. Based on the deficit accumulation approach, the modelling uses area‐level rather than individual‐level data and is compiled through quantitative geospatial methods. Analysis using the HAVEN Index of state‐wide mortality data and hospital emergency department (ED) presentations for Central Adelaide found that vulnerable areas were associated with a higher risk of mortality and ED presentation. Comparisons between the HAVEN Index and a widely used national area‐level measure of socio‐economic differences found that the HAVEN Index compares favourably and provides additional information about local areas, which can inform needs‐based approaches to support the reduction of spatial inequalities and the development of age‐friendly neighbourhoods. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this research is to investigate the dynamic developmental trends between Age-Friendly Environments (AFE) and healthy aging in the Chinese population. Methods This study focused on a sample of 11,770 participants from the CHARLS and utilized the ATHLOS Healthy Aging Index to assess the level of healthy aging among the Chinese population. Linear mixed model (LMM) was used to explore the relationship between AFE and healthy aging. Furthermore, a cross-lagged panel model (CLPM) and a random-intercept cross-lagged panel model (RI-CLPM) were used to examine the dynamic developmental trends of healthy aging, taking into account both Between-Person effects and Within-Person effects. Results The results from LMM showed a positive correlation between AFE and healthy aging (β = 0.087, p

Background: The objective of this research is to investigate the dynamic developmental trends between Age-Friendly Environments (AFE) and healthy aging in the Chinese population. Methods: This study focused on a sample of 11,770 participants from the CHARLS and utilized the ATHLOS Healthy Aging Index to assess the level of healthy aging among the Chinese population. Linear mixed model (LMM) was used to explore the relationship between AFE and healthy aging. Furthermore, a cross-lagged panel model (CLPM) and a random-intercept cross-lagged panel model (RI-CLPM) were used to examine the dynamic developmental trends of healthy aging, taking into account both Between-Person effects and Within-Person effects. Results: The results from LMM showed a positive correlation between AFE and healthy aging (β = 0.087, p < 0.001). There was a positive interaction between the geographic distribution and AFE (central region * AFE: β = 0.031, p = 0.038; eastern region * AFE: β = 0.048, p = 0.003). In CLPM and RI-CLPM, the positive effect of healthy aging on AFE is a type of Between-Person effects (β ranges from 0.147 to 0.159, p < 0.001), while the positive effect of AFE on healthy aging is Within-Person effects (β ranges from 0.021 to 0.024, p = 0.004). Conclusion: Firstly, individuals with high levels of healthy aging are more inclined to actively participate in the development of appropriate AFE compared to those with low levels of healthy aging. Furthermore, by encouraging and guiding individuals to engage in activities that contribute to building appropriate AFE, can elevate their AFE levels beyond the previous average level, thereby improving their future healthy aging levels. Lastly, addressing vulnerable groups by reducing disparities and meeting their health needs effectively is crucial for fostering healthy aging in these populations. [ABSTRACT FROM AUTHOR]

Background and Objectives Age-friendly communities are those with characteristics that can support and promote healthy aging. Among the common domains of these characteristics, transportation and neighborhood spaces are particularly relevant for older adults maintaining mobility in their communities. The objective of this scoping review is to provide a synthesis of age-friendly community indicators, developed for research and planning, that evaluate characteristics most associated with community-level mobility, specifically transportation and neighborhood spaces. Research Design and Methods We conducted a systematic search of PubMed, Scopus, Medline, APA PsychInfo, CINAHL Plus, SocIndex, Academic Search Premier, and Web of Science. We reviewed 8 articles and reports that described the development or evaluation of a set of generalizable indicators to measure the age-friendliness of a community's transportation and neighborhood spaces resources. Results Indicators of transportation and neighborhood spaces ranged from self-reported measures of accessibility and convenience to objective measures of the availability and cost of services. Explicit discussion of mobility at the community level was variable in these records, and few authors specifically discussed common life transitions impacted by these age-friendly community indicators, such as driving cessation. Discussion and Implications Although age-friendly communities are a well-established goal for promoting healthy aging, our review found few validated approaches for measuring age-friendliness that researchers and communities can use to investigate mobility at the community level. This is an important gap in studying life transitions such as driving cessation. Further research can provide a better understanding of which community characteristics support ongoing mobility. [ABSTRACT FROM AUTHOR]

Sustainable healthcare is "healthcare that is economical and has a positive impact on society". Considering the definition of sustainable healthcare and the increase in life expectancy, the healthcare system is expected to face an increase in presentations addressed to healthcare facilities of older persons with multiple chronic diseases. Age-friendly environments support active living of older persons and healthcare support in their home. Our goal was to assess how the regulatory landscape undertaken in Romania and the ongoing research project initiatives with Romanian partners reflect the concept of age-friendly environments. Romania had a poor overall active aging index (rank 26/28) and a decrease in life expectancy by 1.4 years in 2020, with a high gender gap of 8 years in favor of women. Key findings highlight the integration of EU principles into Romania's policies, which emphasize inclusivity, non-discrimination, and active aging. Romania's involvement in European collaborative initiatives is primarily through private associations, lacking representation from governmental structures. National focus in Romania has been on social services for the elderly. The partners in ongoing research projects range from enterprises to universities and research institutes. The majority of ongoing research focuses on assistive technology solutions. The findings underscore the importance of national, regional, and local attention to the environmental and societal aspects of age-friendly initiatives, alongside promoting technology acceptance and adoption. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the prevalence and impact of loneliness (De Jong Gierveld scale) and isolation (Lubben scale) on the effects of a hospital-based exercise programme. Design: Secondary analysis of a randomised clinical trial. Setting: Acute Geriatric Unit of a tertiary hospital in Spain. Participants: 103 hospitalised older adults. Intervention: Individualised multicomponent exercise program (20-minute sessions twice a day for 3 consecutive days). Results: Among the 103 randomised patients included in the analysis (both arms included), 58.3% were male, and their mean age was 87.3 (4.5) years. According to the Lubben scale, 15.8% of patients were at risk of isolation, while 62.7% were in a situation of severe or moderate loneliness according to the De Jong Gierveld scale. In the non-isolated group, training showed a substantial positive impact on Geriatric Depression Scale (B = −1.25, 95% CI = −0.24 to −0.27). In the isolated group, all outcomes improved, but only the Quality of Life showed significant changes (B = 35, 95% CI = 4.96–35.8). The SPPB test (B = 1.62, 95% CI = 0.19–3.04) and Quality of Life, (B = 17.1, 95% CI = 1.84–32.3) showed a significant improvement in the non-loneliness exercise group while no differences were found in the loneliness group. Conclusion: Despite the high prevalence of loneliness and social isolation, individualised exercise programs provide significant benefits to hospitalised patients, especially in quality of life.

This paper argues for a greater theorization of "place" within aging-in-place research. It extends calls for a relational conceptualization of place by demonstrating the need for aging-in-place researchers to also pay greater attention to territorial aspects of place. This complementary understanding will help establish a new spatial grammar within aging-in-place research, that not only would improve conceptual clarity to aging in place, but would also support a more critical engagement of aging in place in questions of inequality. The paper demonstrates this through a discussion of 2 forms of inequality pertinent to older people: the uneven capacity of places to support older people and experiences of social exclusion in relation to place attachment for older people from marginalized groups. [ABSTRACT FROM AUTHOR]

To live in a good mood is not only a key consideration for future age-friendly communities, but also a critical necessity for positive ageing. Despite growing evidence of correlations between contact with nature and stress reduction, little is known about the effect of nature integration in indoor environments. Thus, this study aimed to answer the following research questions: (a) How do biophilic characteristics of home environments correlate with older adults' experience of the multiple levels of the theory of gerotranscendence? and (b) What is the relationship between these experiences and the mood states of these older adults? The study was based on a comparative analysis to scrutinise the impact of the COVID-19 pandemic on these questions. The data were gathered through questionnaires with 450 older adults aged between 65 and 95 years, and stratified by the biophilic characteristics of their living environments: indoor biophilic, outdoor biophilic and non-biophilic. Two sets of data were collected with the same participants, respectively, before the COVID-19 pandemic (June to October 2018) and during the COVID-19 pandemic (June to October 2020). It found that the biophilic characteristics of home environments are correlated dynamically with older adults' ageing experience and mood states. The study indicates that outdoor biophilic features facilitate the recovery of tension mood effects of the COVID-19 pandemic, whereas indoor biophilic features facilitate recovery from depression and anger. [ABSTRACT FROM AUTHOR]

The constant monitoring of human physical activity, behaviour, and physiological signs has undergone a revolution thanks to wearable technology, which has provided invaluable insights into many facets of everyday life. Wearable technology has become a potent instrument for improving healthcare efficiency and lowering costs as the prevalence of an ageing population and the need for technology-assisted care increase. By analysing gait patterns and promoting a healthy lifestyle in age-friendly settings, this study aims to investigate how valid and trustworthy wearable devices, in conjunction with technology-assisted care, can facilitate the monitoring and improvement of the health of the elderly population. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 standards for data inclusion and exclusion are used in the study, which collects data from the Scopus database. The results show that wearable technology, which offers two main device categories--those intended for healthcare professionals and those aimed at consumers--plays a critical role in gait-pattern analysis. These gadgets offer robust data-collecting capabilities, allowing for precise evaluation and tracking of walking habits. Furthermore, the incorporation of wearable technology with eHealth solutions enhances the quality of life for the aged population by enabling them to live in settings that are age-friendly and successfully manage their health. The study also emphasises how critical it is to use reliable wearable technology to address the diversity of health issues and the occurrence of chronic diseases among the senior population. According to the study's findings, wearable technologies have great promise for promoting the health and well-being of senior citizens. To meet the unique requirements and problems of the ageing population and to guarantee the successful integration of wearable devices into healthcare practices, more research and development are needed. In the end, wearable technology has enormous potential to revolutionise aged care and enhance health outcomes in ageing-friendly settings. [ABSTRACT FROM AUTHOR]

In Chile, 18% of the population is over 60 years old and is projected to reach 31% in three decades. An aging population demands the development of strategies to improve quality of life (QoL). In this randomized trial, we present the implementation and evaluation of the Quida platform, which consists of a network of unintrusive sensors installed in the houses of elderly participants to monitor their activities and provide assistance. Sixty-nine elderly participants were included. A significant increase in overall QoL was observed amongst participants allocated to the interventional arm (p < 0.02). While some studies point out difficulties monitoring users at home, Quida demonstrates that it is possible to detect presence and movement to identify patterns of behavior in the sample studied, allowing us to visualize the behavior of older adults at different time intervals to support their medical evaluation. [ABSTRACT FROM AUTHOR]

Background and Objectives Age-friendly community initiatives (AFCIs) strive to make localities better for long and healthy lives by fostering improvements across social, physical, and service environments. Despite the heightened need for community supports during the coronavirus disease 2019 pandemic, very little research has addressed the work of AFCIs in the context of this crisis. We aimed to develop theory on how AFCI core teams have contributed to community responses during the pandemic, as well as what contexts have influenced the initiatives' ability to contribute. Research Design and Methods As part of a multiyear, community-partnered study on the development of philanthropically supported initiatives in northern New Jersey, we conducted qualitative interviews with 8 AFCI core teams during the winter of 2020–2021. The interviews focused on the leaders' efforts at that time, with probing questions concerning enabling factors for their community responses. We analyzed the data using an inductive coding process encompassing open, axial, and subcoding. Results The analysis indicated four distinct roles of AFC core groups: good community partner , creator , advocate , and communications broker. We further found that AFC leaders primarily drew on three types of capital—human, social, and tangible—to enact these roles, oftentimes in cumulative ways. Discussion and Implications We interpret our study's findings and their implications by integrating insights from theories of social impact. We further highlight the importance of continued research on community-centered approaches to promote aging in community during times of societal crisis, and otherwise. [ABSTRACT FROM AUTHOR]

Background and Objectives: Age-Friendly Community Initiatives (AFCIs) have gained recognition as essential responses to the needs of aging populations. Despite their growing significance, there is a notable lack of effective measurement tools to assess the planning, implementation, and sustainability of AFCIs. The purpose of this study was to develop and validate a survey tool for evaluating AFCIs., Research Design and Methods: A sequential exploratory mixed-method design was used in two phases. First, we identified key themes from interviews with AFCI leads to generate AFCI survey items and regional workshops. Then, we conducted a pilot of the survey and assessed its measurement properties., Results: Thematic analysis of interviews with 68 key informants from 58 AFCIs revealed four main themes: AFCI priorities, enablers, challenges, and benefits. These themes, combined with feedback from AFCI stakeholders at the regional workshops and a AFCI conference, informed the development and refinement of a reliable and valid AFCI survey in 2019, supported by a high Cronbach's Alpha value (α = 0.881). Steps were identified to maintain and sustain the AFCI survey over time., Discussion and Implications: The survey accommodates AFCIs' diverse demographics, governance structures, and priorities with a standardized and flexible approach for effective measurement. This research contributes to the academic understanding of AFCIs and aids community leaders and policymakers in planning, implementing, and evaluating AFCIs., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Since the early 2000s, a global age-friendly movement has emerged with aspirations to make environments and systems within localities more supportive of long and healthy lives. Despite growth in the social movement over the past decade, research on how to work toward community change, especially in systematic and comprehensive ways across diverse geo-political and sociocultural contexts, has been relatively slower to develop. This special issue of the Journal of Aging & Social Policy aims to accelerate this area. It features articles that advance knowledge on processes and contexts toward enhancing the age-friendliness of cities and communities. In this introductory essay, we provide background on the age-friendly cities and communities movement – including its accomplishments alongside key challenges. We then discuss the importance of research at the intersection of policy and practice to strengthen the movement into the 21st century. Next, we introduce the articles in this special issue, organized under four themes: implementation and sustainability processes; partnerships and multisectoral collaboration; theory-based program design; and policy and practice diffusion. A final article provides an overview of the career contributions of Dr. Frank Caro, an age-friendly champion and gerontologist to whom this special issue is dedicated. [ABSTRACT FROM AUTHOR]

Resumen El presente trabajo aborda el reto del envejecimiento activo desde la perspectiva del diseño urbano: ¿son los espacios públicos de las ciudades españolas “amigables” para las personas mayores? Se ha realizado una caracterización de las necesidades específicas del adulto mayor y los elementos de diseño del espacio público que deberían tenerse en cuenta en proyectos de renovación urbana. Esta caracterización, junto con una revisión de guías y documentos técnicos, ha dado como resultado la selección de 25 elementos para la evaluación de un caso de estudio en el casco urbano de la ciudad consolidada de las 3 ciudades españolas más pobladas. Los resultados muestran un mínimo de habitabilidad y accesibilidad de los espacios públicos, pero un déficit en los parámetros de calidad para favorecer entornos “amigables” con las personas mayores, como zonas estanciales con bancos ergonómicos, elementos de apoyo cada cierta distancia o señalética accesible para orientarse en las calles. Abstract This study addresses active ageing from the urban perspective: are public spaces in Spanish cities age-friendly? A characterization of the older adult has been done identifying the elements of the public space that should be considered in projects of urban renovation. From this characterization, as well as a review of guides and technical documents, 25 elements have been proposed in order to evaluate one study case in the urban city centre of the 3 largest cities in Spain. Results show a minimum quality of habitability and accessibility in the built environment. However, there is a lack of quality parameters in order to promote healthy and age-friendly urban environments, such as ergonomic benches in places to stay, minimum distance between supports or signals to support way-finding in streets.

Background and Objectives The Global Network of Age-Friendly Cities and Communities has grown steadily over the past decade across the United States. The age-friendly model calls for a 5-year process of continuous improvement across the stages of engagement, planning, action, and measurement, culminating in an evaluation of age-friendly progress. However, surprisingly, little is known regarding American age-friendly communities' accomplishments to date. Research Design and Methods We utilized content analysis to assess the progress reported by American age-friendly communities (n = 30) that joined by end of year 2015 using the Age-Friendly Community Evidence-based Tool with expanded program evaluation measures including health equity as defined by the World Health Organization. We employed deductive analytic techniques to assess reported community performance in 11 thematic areas across the range of structures and processes that characterize age-friendly efforts. Results We found strong evidence in the areas of leadership and governance, harnessed resources, application of the age-friendly framework, and in multisector collaboration as well as reported provisions. All of the communities reported health equity aims, particularly in promoting accessible physical environments and social inclusion efforts. Our analysis further revealed relatively moderate evidence of older adult involvement and weak performance in the monitoring and reporting of evaluative findings as well as overall summation and dissemination plans. Discussion and Implications We conclude by synthesizing the overall performance reported by the age-friendly communities, highlighting both strengths and weaknesses. We also offer suggestions to enhance evaluative efforts and advance the dissemination of age-friendly community progress. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the prevalence and impact of loneliness (De Jong Gierveld scale) and isolation (Lubben scale) on the effects of a hospital-based exercise programme., Design: Secondary analysis of a randomised clinical trial., Setting: Acute Geriatric Unit of a tertiary hospital in Spain., Participants: 103 hospitalised older adults., Intervention: Individualised multicomponent exercise program (20-minute sessions twice a day for 3 consecutive days)., Results: Among the 103 randomised patients included in the analysis (both arms included), 58.3% were male, and their mean age was 87.3 (4.5) years. According to the Lubben scale, 15.8% of patients were at risk of isolation, while 62.7% were in a situation of severe or moderate loneliness according to the De Jong Gierveld scale. In the non-isolated group, training showed a substantial positive impact on Geriatric Depression Scale (B = -1.25, 95% CI = -0.24 to -0.27). In the isolated group, all outcomes improved, but only the Quality of Life showed significant changes (B = 35, 95% CI = 4.96-35.8). The SPPB test (B = 1.62, 95% CI = 0.19-3.04) and Quality of Life, (B = 17.1, 95% CI = 1.84-32.3) showed a significant improvement in the non-loneliness exercise group while no differences were found in the loneliness group., Conclusion: Despite the high prevalence of loneliness and social isolation, individualised exercise programs provide significant benefits to hospitalised patients, especially in quality of life., (Copyright © 2024. Published by Elsevier Masson SAS.)

In Chile, 18% of the population is over 60 years old and is projected to reach 31% in three decades. An aging population demands the development of strategies to improve quality of life (QoL). In this randomized trial, we present the implementation and evaluation of the Quida platform, which consists of a network of unintrusive sensors installed in the houses of elderly participants to monitor their activities and provide assistance. Sixty-nine elderly participants were included. A significant increase in overall QoL was observed amongst participants allocated to the interventional arm (p < 0.02). While some studies point out difficulties monitoring users at home, Quida demonstrates that it is possible to detect presence and movement to identify patterns of behavior in the sample studied, allowing us to visualize the behavior of older adults at different time intervals to support their medical evaluation.

In this study, we examined (1) group differences with regard to age-friendly environments (AFE), loneliness, and depressive symptoms among younger, middle-aged, and older Korean adults; (2) the relationship of AFE to loneliness and depressive symptoms; and (3) the mediating effect of loneliness on the relationship between AFE and depressive symptoms among three Korean adult groups. We used a cross-sectional survey design featuring multistage quota sampling. Study participants were 1,017 Korean adults aged 18 years or older. Multi-group structural equation modeling was used for data analysis. Statistically significant age group differences were found in the mean values of loneliness and depressive symptoms, but no significant age group differences in the mean values of AFE were observed. Older adults showed a significant relationship between AFE and loneliness, while their younger counterparts demonstrated a significant relationship between AFE and depressive symptoms. The mediating effect of loneliness on the association between AFE and depressive symptoms was found only for the older age group. The results of the study contribute to the existing understanding of AFE and mental health among Korean adults, while providing service providers and policy makers with fundamental background information on alleviating depression. [ABSTRACT FROM AUTHOR]

We examined intergenerational differences in the prevalence of age-friendly environments (AFE), social support, depressive symptoms, and chronic diseases, and the complex associations among those variables in Korean adults. A cross-sectional survey of 1,000 respondents and multi-group structural equation modeling results showed intergenerational differences in the prevalence of AFE, social support, depressive symptoms, and chronic diseases, and complex pathways of the major variables, including the mediating effect of social support. These findings have implications for health professionals in identifying environmental risk factors and implementing effective physical and mental health interventions targeting different age groups among Korean adults. [ABSTRACT FROM AUTHOR]

Abstract Background Many interventions have been developed to promote respect and social inclusion among older people, but the evidence on their impacts on health has not been synthesised. This systematic review aims to appraise the state of the evidence across the quantitative and qualitative literature. Methods Eligible studies published between 1990 and 2015 were identified by scanning seven bibliographic databases using a pre-piloted strategy, searching grey literature and contacting experts. Studies were included if they assessed the impact (quantitatively) and/or perceived impact (qualitatively) of an intervention promoting respect and social inclusion on the physical or mental health of community-residing people aged 60 years and older. Titles and abstracts were screened for eligibility by one reviewer. A second reviewer independently screened a 10% random sample. Full texts were screened for eligibility by one reviewer, with verification by another reviewer. Risk of bias was assessed using standardised tools. Findings were summarised using narrative synthesis, harvest plots and logic models to depict the potential pathways to health outcomes. Results Of the 27,354 records retrieved, 40 studies (23 quantitative, 6 qualitative, 11 mixed methods) were included. All studies were conducted in high and upper middle-income countries. Interventions involved mentoring, intergenerational and multi-activity programmes, dancing, music and singing, art and culture and information-communication technology. Most studies (n = 24) were at high or moderate risk of bias. Music and singing, intergenerational interventions, art and culture and multi-activity interventions were associated with an overall positive impact on health outcomes. This included depression (n = 3), wellbeing (n = 3), subjective health (n = 2), quality of life (n = 2), perceived stress and mental health (n = 2) and physical health (n = 2). Qualitative studies offered explanations for mediating factors (e.g. improved self-esteem) that may lead to improved health outcomes and contributed to the assessment of causation. Conclusions Whilst this review suggests that some interventions may positively impact on the health outcomes of older people, and identified mediating factors to health outcomes, the evidence is based on studies with heterogeneous methodologies. Many of the interventions were delivered as projects to selected groups, raising important questions about the feasibility of wider implementation and the potential for population-wide benefits. Systematic review registration PROSPERO registration number CRD42014010107

Background according to the World Health Organisation, the role of the environment for older adults is to maintain and facilitate independence and promote quality of life. However, measures that examine the environment in terms of its potential impact on older people are either oriented towards specific aspects of the environment, specifically designed for community-level assessment rather than individually oriented, or are unwieldy for everyday use. Objectives this article describes the development and validation of the Age-Friendly Environment Assessment Tool (AFEAT), assessing whether individual function and frailty impact on perceptions of environmental age-friendliness. The extent to which such perceptions may have moderate impacts of frailty on outcomes such as need for care support, quality of life and loneliness is examined. Methods a total of 132 participants aged 58–96 were recruited from retirement villages and local communities in the Midlands of the UK. Participants completed the AFEAT, and a series of measures designed to assess frailty and assessments of quality of life, loneliness and perceptions of functional limitations. Results internal reliability assessment indicated that the AFEAT possesses a Cronbach's Alpha score of 0.745. The AFEAT significantly predicted quality of life and loneliness, accounting for 17.1% and 5.8% of variance respectively, indicating high concurrent and predictive validity. Furthermore, the AFEAT moderated the predictive strength of frailty in predicting the amount of formal care an individual receives, but not quality of life or loneliness. Discussion the AFEAT is a valid and reliable tool, and analyses highlight the need for an individual-oriented Age-Friendly environment tool. [ABSTRACT FROM AUTHOR]

This article aims to examine factors associated with falls in older adults residing in apartments designed with age-friendly features in Singapore. A cross-sectional study was conducted with 925 older adults aged 55 years and older, residing in studio apartments in Singapore. Multivariable backward logistic regression and independent factors associated with falls include older age, cataracts, urinary-tract disorders, general weakness, participation in family gatherings, and functional difficulty in dressing. Interaction effects were found for gender and walking long distances. Environmental factors were not independent factors for falls, although they were associated on bivariate analysis. Findings have implications on the importance of age-friendly design setting on fall prevention. Fall prevention efforts should be multidimensional and target modifiable risk factors for falls. [ABSTRACT FROM AUTHOR]

Long-term care facilities in the Netherlands try to implement new design approaches to enrich their environments and to cope with the changes and innovations in the Dutch healthcare sector. An enriched environment supports both quality of life of people with frail health and the well-being of the healthcare professionals who take care of them. Despite the increased attention devoted to built environments in relation to health, a gap in knowledge remains how to implement new design approaches. The aim of this study is to present a structural approach for a decision-making process to help to create enriched small-scale care facilities for older people with a frail health condition. A case study was conducted to understand how the structural approach contributes to implementing design features of an enriched environment. The structural approach identifies the key factors (such as shared language, collective understanding and involvement of stakeholders) that should be considered when developing such facilities and describes the critical steps for decision-makers for such environment. This case study provides a rich source of information from actual experiences for a better understanding of steering mechanisms for decision-making by the management of small-scale care facilities. [ABSTRACT FROM AUTHOR]

If people should age at their own homes, how to align technological development with the building industry for smart environments in terms of POLICY and FUNDING, enhancing a more efficient health care system that may add better quality for less investment? Moving age-related topics to the big umbrella themes of Health and Digital Single Market is a vital process to pursue the societal scope of a Europe prepared to provide quality of life and well-being through the whole life cycle. The revitalization of Active and Healthy Ageing initiatives (preparing post2020) will imply high-level crossover discussion between different groups, networks, DGs, EIPs and even international organisations, understanding the symbiotic interdependence of these subjects towards a Healthy and Competitive Europe. The Thematic Network Smart Healthy Age-Friendly Environments, and approved by the European Commission for 2018, aims to create a high-level policy alignment of all these networks and initiatives towards Health in Ageing subjects. SHAFE is coordinated by Cáritas Coimbra and AFEdemy, in close cooperation with main partners, such as the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA), European Innovation Partnership on Smart Cities and Communities (EIP-SCC), Reference Sites Collaborative Network, European Covenant on Demographic Change, Eurocities, European Construction, Built Environment and Energy Efficient Building Technology Platform (ECTP), European Centre Social Welfare Policy, European Health Telematics Association (EHTEL) and ECHAlliance. SHAFE is producing a Joint Statement 2018 that summarizes a common position on Smart Healthy Age-friendly Environments – focused on eHealth and mHealth – with priorities for policy making and recommendations for the European Commission and the Member States also thinking beyond 2020. For this purpose, the Thematic Network developed a comprehensive desk-research, an Europe-wide online survey collecting more than 80 contributions and 37 interviews to EU opinion leaders. This work led to 5 areas of recommendations: - INTEGRATIVE APPROACH - Create a shared European Vision on Smart Healthy Age-Friendly Environments - GOVERNANCE AND COORDINATION - Ensure cross-sectoral cooperation - FUNDING, ECONOMICS AND BUSINESS MODELS - Fund the implementation of Smart Healthy Age-Friendly Environments - LEARNING AND KNOWLEDGE MANAGEMENT - Invest in research that derives from societal needs and challenges and use knowledge to prediction and prevention - COMMUNICATION, PEOPLE AND SOCIETAL CHALLENGES - Guarantee the empowerment of citizens and the promotion of people-centered policies and measures This presentation intends to share the main recommendations that derived from the funding, economics and business models area, especially on integrated solutions with health, social care, digital tools and infrastrucutres. The workshop would present the results to the audience and then create a working session to discuss further on the implementation of Smart-Healthy Age-Friendly Environments and its connection to financing models.

The aim of the present study was to empirically investigate the role of age‐friendly environments (AFE) on the associations between income, informal social networks, and health among South Korean older adults. We used data from the "2017 Age Integration Survey" collected nationally and ultimately analyzed 615 older adults over 50 years of age. Structural equation modeling and multi‐group analysis were used to test the hypothesis. Specifically, two groups of perceived levels of AFE (top 25%, bottom 25%) were compared in order to examine the moderating effects. The results indicated that poor income and scarce informal social networks each had a significantly adverse impact on health. However, the effect of income on health was no longer significant for older adults living in environments that were more age‐friendly. In both groups, the presence of fewer informal social networks adversely impacted health, although the sizes of the effects decreased when the level of AFE perceived by older adults was improved. Finally, several implications of the study findings were discussed. [ABSTRACT FROM AUTHOR]

Population ageing is creating opportunities and challenges for many communities across the globe, as one in six people is expected to be older than 65 by 2050. Initiatives to develop age-friendly communities (AFC) have increased in popularity for more than two decades. While the physical environment and outdoor spaces are recognized as the core domain of the concept of AFC in the literature, most articles are published in the journals of ageing, gerontology, health and social policy and not in mainstream urban planning or design journals. The aim of the paper is to examine the spatial interventions and built-environment related discussions in the scholarly literature in the realm of AFC in the fields of landscape architecture and urban planning and identify gaps in the literature with the focus on spatial interventions. In addition, this paper aims to call urban planners and designers to action to be more engaged in the discussions and implementation of age-friendliness of communities. Findings suggest that urban planners and designers have the ability and power to contribute to the implementation of AFCs by raising awareness, changing attitude towards ageing issues, develop networks and collaboration, increase empathy, initiate and change policies, and put policies into action. [ABSTRACT FROM AUTHOR]

Background: Many interventions have been developed to promote respect and social inclusion among older people, but the evidence on their impacts on health has not been synthesised. This systematic review aims to appraise the state of the evidence across the quantitative and qualitative literature. Methods: Eligible studies published between 1990 and 2015 were identified by scanning seven bibliographic databases using a pre-piloted strategy, searching grey literature and contacting experts. Studies were included if they assessed the impact (quantitatively) and/or perceived impact (qualitatively) of an intervention promoting respect and social inclusion on the physical or mental health of community-residing people aged 60 years and older. Titles and abstracts were screened for eligibility by one reviewer. A second reviewer independently screened a 10% random sample. Full texts were screened for eligibility by one reviewer, with verification by another reviewer. Risk of bias was assessed using standardised tools. Findings were summarised using narrative synthesis, harvest plots and logic models to depict the potential pathways to health outcomes. Results: Of the 27,354 records retrieved, 40 studies (23 quantitative, 6 qualitative, 11 mixed methods) were included. All studies were conducted in high and upper middle-income countries. Interventions involved mentoring, intergenerational and multi-activity programmes, dancing, music and singing, art and culture and information-communication technology. Most studies (n = 24) were at high or moderate risk of bias. Music and singing, intergenerational interventions, art and culture and multi-activity interventions were associated with an overall positive impact on health outcomes. This included depression (n = 3), wellbeing (n = 3), subjective health (n = 2), quality of life (n = 2), perceived stress and mental health (n = 2) and physical health (n = 2). Qualitative studies offered explanations for mediating factors (e.g. improved self-esteem) that may lead to improved health outcomes and contributed to the assessment of causation. Conclusions: Whilst this review suggests that some interventions may positively impact on the health outcomes of older people, and identified mediating factors to health outcomes, the evidence is based on studies with heterogeneous methodologies. Many of the interventions were delivered as projects to selected groups, raising important questions about the feasibility of wider implementation and the potential for population-wide benefits. Systematic review registration: PROSPERO registration number CRD42014010107 [ABSTRACT FROM AUTHOR]

In Chile, 18% of the population is over 60 years old and is projected to reach 31% in three decades. An aging population demands the development of strategies to improve quality of life (QoL). In this randomized trial, we present the implementation and evaluation of the Quida platform, which consists of a network of unintrusive sensors installed in the houses of elderly participants to monitor their activities and provide assistance. Sixty-nine elderly participants were included. A significant increase in overall QoL was observed amongst participants allocated to the interventional arm (p < 0.02). While some studies point out difficulties monitoring users at home, Quida demonstrates that it is possible to detect presence and movement to identify patterns of behavior in the sample studied, allowing us to visualize the behavior of older adults at different time intervals to support their medical evaluation.

The importance of age-friendly environments (AFEs) for older adults has been empirically and theoretically highlighted by the extant literature. However, the strength of the association between environments and older adults’ well-being has not been comprehensively quantified. Given the different attributes of the physical and mental dimensions, this meta-analysis aims to synthesise and quantify the association between AFEs and the physical and mental well-being of older adults. Fourteen eligible studies were included in this analysis: among which eight explored the link between AFEs and physical well-being, and eleven investigated AFEs in association with mental well-being. A random-effects model showed a small but significant correlation between AFEs and the mental well-being of older adults (r = 0.160, 95% CI [0.084, 0.224], p < 0.001), and the correlation between AFEs and physical well-being was also significant (r = 0.072, 95% CI [0.026, 0.118], p < 0.01). The number of environmental factors involved in AFEs moderated the association with physical well-being, from which the association was only significant among studies focusing on fewer environmental factors (n < 6). Results of this meta-analysis indicated that AFEs may be more effective in promoting the emotions of older adults, compared to ameliorating their physical functioning. The limitations of current empirical studies and directions for future research in the field of environmental gerontology were also discussed.

Globally, policy aimed at stimulating generational renewal in agriculture is reported to pay meagre regard to the mental health and wellbeing of an older farmer, overlooking their identity and social circles, which are inextricably intertwined with their occupation and farm. This paper, in probing this contentious issue, casts its net across what could be deemed as disparate literatures, namely connected to transferring the family farm and social gerontology, in order to determine what steps could be taken to reassure older farmers that their sense of purpose and legitimate social connectedness within the farming community will not be jeopardised upon handing over the farm business to the next generation. A number of practical 'farmer-sensitive' actions that can be taken at both policy and societal level are subsequently set forth in this paper to help ease the fear and anxiety associated with 'stepping aside' and retirement from farming amongst older farmers. A particular focus is placed on social and emotional wellbeing benefits of being a member of a social group reflecting farmer-relevant values and aspirations in later life. The potential of the multi-actor EIP-AGRI initiative and the long-established livestock mart sector in facilitating the successful rollout of a social organisation designed to fit the specific needs and interests of the older generation of the farming community is then outlined. In performing this, the paper begins a broad international conversation on the potential of transforming farming into an age-friendly sector of society, in line with the World Health Organization's (WHO) age-friendly environments concept. [ABSTRACT FROM AUTHOR]

As age-friendly community (AFC) initiatives grow, it will be essential to determine whether older adults who live in an AFC have better health than those who live in other environments. This study uses data from the 2017 AARP AFC Surveys and the AARP Livability Index to assess whether AFCs promote the health of older adults. We analyze data for 3027 adults aged 65 and older who reside in 262 zip code areas. Following AARP guidelines, we allocated the sample into two groups: an AFC group (livability score of 51+; n = 2364) and a non-AFC (score ≤ 50, n = 663). The outcome variable was self-rated health (M = 3.5; SD = 1.1; range: 1-5). We used an inverse probability weighting approach to evaluate whether older adults who live in an AFC reported better self-rated health than those who live in a non-AFC. Findings showed that older adults who lived in an AFC had better self-rated health than those in a non-AFC (b = 0.08, p = 0.027). Compared to non-Hispanic Whites, Black and Hispanic older adults reported worse self-rated health. Inasmuch as living in an AFC can promote the well-being of older adults, policymakers and practitioners should continue to develop and sustain high-quality, accessible built and social environments.

In the UK, as in many other European countries, the population is growing older, and older adults are becoming more diverse. As a result, there is a mounting interest in supporting healthy ageing and independence, acknowledging the needs and agency of older adults from diverse backgrounds, expectations, and life trajectories. Healthy ageing is promoted as a critical component of sustainable ageing to ensure meaningful social and economic contributions through the life course for all individuals. However, the definitions of healthy ageing are debatable. The public and policy discourse treat all older adults through generic and homogeneous models that do not consider the heterogeneity of experiences and perspectives of old age among different groups. In this context, independence has often been defined in terms of functional independence, i.e., cognitive and physical functioning, as a core construct of healthy ageing. However, this focus excludes older adults' interpretations and day-to-day experiences of this concept. This article investigates the interpretation and lived experience of independence amongst older Turkish adults in the UK as a central explanatory concept of healthy ageing. Semi-structured individual interviews (n = 48) and community mapping workshops (n = 5) were conducted with 65 older Turkish adults in London, supplemented by interviews with professional service providers (n = 13) within the community. The data collection was conducted between March and November 2017. We identified three main themes integral to understanding healthy ageing and independence: 1—interdependency and having reciprocal care relations; 2—individual autonomy at home and choice in housing options; and 3—functional independence, mobility, and control over the physical environment. Independence appears to remain an essential element of healthy ageing. However, it is a fluid and complex construct constantly negotiated around personal and community resources. Therefore, there is a need to develop more comprehensive interventions that capture the diverse experiences in old age to enable healthy ageing and social sustainability. These are timely considering current policy directions such as the UN Decade of Healthy Ageing and the 2030 Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

A growing body of research has shown that barriers in the urban environment can be disabling by reducing the ability of older people to manage independently in the community, but also because they can negatively affect health by limiting the possibilities to move outside the home. In this study, we ask how obstacles in the urban environment are associated with the need for help to go to places in the community. To respond to this question, we used the Annual Household Survey of the City of Buenos Aires, Argentina 2018, which had a specific questionnaire for people with disabilities. From this sample, we selected adults aged 65 years or older with difficulties in at least one of six domains: vision; hearing; upper and lower body mobility; cognition; self-care; and communication. The final sample consisted of 513 persons (weighted = 109,316). First, we conducted a principal component analysis identifying three factors from variables of obstacles to access and use the urban environment: transportation; outdoor spaces; and information. Second, through a logistic regression model, we observed a direct relationship between these factors and the need for help to move in the community, controlling for sociodemographic characteristics, health status, and number of disabilities. This paper provides evidence on the significance of improving urban spaces to reduce dependent mobility. In Latin America, cities still face many challenges in becoming more age-friendly.