Rethinking community-based housing for older adults: a research agenda for spatial justice

As supporting active and healthy aging calls for different community-based housing alternatives, integrated knowledge of their impacts on older adults’ social participation is required. This study aimed to explore how community-based housing fostered social participation in older adults. A scoping review was used to systematically identify relevant studies according to 32 keywords in 8 electronic databases. Published during 2000–2021, the 46 studies were carried out in North America, Europe, Oceania, and Asia, documenting older adults’ social participation in six community-based housing models. Targeting different clienteles, these models mainly promote older adults’ social participation by providing: 1) accessible common space in a design favorable to social interactions; 2) proximity to resources; 3) flexible rules and policies that facilitate residents’ interactions with not only co-residents but community neighbors; and 4) benevolent communities. These results highlight the interactions between the physical and social environments; they suggest the importance of building benevolent communities as well as of sharing resources among residences and local communities to create a supportive living and neighborhood environment for active and healthy aging. Future studies should further explore the role of different stakeholders in developing benevolent communities by considering the dynamics between the person and the environment.

China’s rapidly growing ageing population fuels growing demand for healthcare. Yet institutional care facilities remains inaccessible to many. Policymakers have addressed this situation by emphasising community-based housing models that foster ageing in place. However, so far, the preferences of older people for the attributes of such community-based housing are not sufficiently known. This research performed a latent class choice analysis of Beijing survey data, identifying three distinct groups with differentiated housing preferences based on their health status, socioeconomic status, and current living situations. Respondents in the prosperous group exhibited preferences for spacious dwellings with professional healthcare. Respondents with physical disabilities favoured compact living spaces requiring healthcare to maintain their daily living. The marginal utilities for meal delivery services, dwelling location, and shared recreational spaces are highest among economically disadvantaged respondents. The findings of this study inform targeted community-based housing development for older people.

This article describes the development, delivery, and outcomes from an interprofessional evidence-based falls management course for undergraduate and graduate students. The 3-credit elective course was developed by a gerontological social work and nursing faculty member in partnership with community-based housing and case management organizations. Creation of the course was in response to a mandate by the Health Resources and Services Administration, funding source for federal Geriatric Education Centers, to train interprofessional students using an evidence-based approach while tying the outcomes to improved health measures in the target population. Therefore, this article describes student competencies pre- and postcourse completion and outcomes of community-dwelling older adults completing a Matter of Balance (MOB) program delivered by these students. A total of 16 students completed the course which included delivery of the MOB program to 41 older adults. Results indicate statistically significant improvements in student outcomes from a pre/post falls knowledge test. For older adult participants, many screened positively for fall risk factors pre–post MOB participation showed statistically significant improvements in falls efficacy, control, management, and overall mobility. Opportunities and challenges associated with course delivery are also described.

Spatial justice, specifically accessibility, Universal Design and the fulfilment of human rights for vulnerable groups are increasingly important issues in urban research and city-level agendas concerning public spaces. Although the development of older adult–friendly urban environments is part of the agenda to promote healthy ageing societies, public spaces (e.g., urban parks) often exclude those in the advanced age group in the community. This article aims to clarify the everyday activities of older adults in urban parks by focusing on the extreme case of Sham Shui Po. Sham Shui Po is a low-income, high-density and public space–scarce neighbourhood in Hong Kong, a city characterised by a rapidly ageing population and high socio-spatial inequality. Through on-site observations and notetaking, two small urban parks, namely the Nam Cheong Street Park (NCSA) and Tai Hung Tang Park (THTP), were studied. NCSA, located in a congested vehicular street median, is predominantly for social activities. It forms a part of the daily route of residents and inhabitants from different ethnicities. Unaccompanied older adults, with limited mobilities, regularly use NCSA to navigate the neighbourhood. THTP is a site for older adults to engage in physical activities and also accommodates large groups and caregivers. Defensive architecture and design layout may affect the group size in the parks, while sittable edges may directly contribute to the park use by older adults with physical impairment, particularly near street crossings. The findings from this extreme neighbourhood highlight the critical role of landscape infrastructure for healthy ageing societies. Read the full article in accessible html-format here.

Influence of Studies Published by the Journal of the American Geriatrics Society: Top 20 Articles from 2000-2015.

Age-related changes in prefrontal cortex activity are associated with behavioural deficits in both temporal and spatial context memory retrieval in older adults

<p>Age-related deficits in episodic retrieval have been associated with volume reductions in the middle frontal gyrus (MFG). However, it remains unclear how this age-related reduction in MFG volume correlates with neural activity during retrieval. To address this, we conducted <em>in vivo</em> volumetry of the frontal cortex in young and older human adults and found more volume loss on the right than on the left MFG with age. We then examined how left and right MFG volume correlated with fMRI activity during successful retrieval of item, spatial context, and temporal context information in both age groups. In young adults, larger right MFG volume was positively correlated with greater activity in a commonly found episodic retrieval network that included bilateral dorsolateral prefrontal cortex (DLPFC) and bilateral inferior parietal cortex. Within this network, left DLPFC and right inferior parietal cortex activity predicted memory performance. In older adults, a positive structure–function association in DLPFC for either left or right MFG/DLPFC was not observed. Instead, right MFG volume was negatively correlated with activity in several regions in older adults, including the parahippocampal cortex (PHC) and anterior cingulate. Less activity in the PHC region predicted better item memory, and less activity in the anterior cingulate predicted better spatial context accuracy in older adults. We conclude that age-related change in the structure–function association in MFG/DLPFC impacts retrieval activity and performance, and those older adults with larger right MFG volume attempt to compensate for this change by modifying activity in other brain regions to help retrieval performance.</p> <p> </p>

<p>Age-related deficits in episodic retrieval have been associated with volume reductions in the middle frontal gyrus (MFG). However, it remains unclear how this age-related reduction in MFG volume correlates with neural activity during retrieval. To address this, we conducted <em>in vivo</em> volumetry of the frontal cortex in young and older human adults and found more volume loss on the right than on the left MFG with age. We then examined how left and right MFG volume correlated with fMRI activity during successful retrieval of item, spatial context, and temporal context information in both age groups. In young adults, larger right MFG volume was positively correlated with greater activity in a commonly found episodic retrieval network that included bilateral dorsolateral prefrontal cortex (DLPFC) and bilateral inferior parietal cortex. Within this network, left DLPFC and right inferior parietal cortex activity predicted memory performance. In older adults, a positive structure–function association in DLPFC for either left or right MFG/DLPFC was not observed. Instead, right MFG volume was negatively correlated with activity in several regions in older adults, including the parahippocampal cortex (PHC) and anterior cingulate. Less activity in the PHC region predicted better item memory, and less activity in the anterior cingulate predicted better spatial context accuracy in older adults. We conclude that age-related change in the structure–function association in MFG/DLPFC impacts retrieval activity and performance, and those older adults with larger right MFG volume attempt to compensate for this change by modifying activity in other brain regions to help retrieval performance.</p> <p> </p>

Age-related deficits in episodic retrieval have been associated with volume reductions in the middle frontal gyrus (MFG). However, it remains unclear how this age-related reduction in MFG volume correlates with neural activity during retrieval. To address this, we conducted in vivo volumetry of the frontal cortex in young and older human adults and found more volume loss on the right than on the left MFG with age. We then examined how left and right MFG volume correlated with fMRI activity during successful retrieval of item, spatial context, and temporal context information in both age groups. In young adults, larger right MFG volume was positively correlated with greater activity in a commonly found episodic retrieval network that included bilateral dorsolateral prefrontal cortex (DLPFC) and bilateral inferior parietal cortex. Within this network, left DLPFC and right inferior parietal cortex activity predicted memory performance. In older adults, a positive structure-function association in DLPFC for either left or right MFG/DLPFC was not observed. Instead, right MFG volume was negatively correlated with activity in several regions in older adults, including the parahippocampal cortex (PHC) and anterior cingulate. Less activity in the PHC region predicted better item memory, and less activity in the anterior cingulate predicted better spatial context accuracy in older adults. We conclude that age-related change in the structure-function association in MFG/DLPFC impacts retrieval activity and performance, and those older adults with larger right MFG volume attempt to compensate for this change by modifying activity in other brain regions to help retrieval performance.

Group differences in anterior hippocampal volume and in the retrieval of spatial and temporal context memory in healthy young versus older adults

This symposium brings together five complementary papers focused on promoting the perspectives of older adults using applied methods in qualitative research. It underscores the importance of embedding the lived experiences and unique perspectives of older adults into the fabric of research processes and outcomes. Neller et al. present a six-step process for framing, critically evaluating, and revising prior knowledge within qualitative research. They discuss the development and advancement of a conceptual framework from their study exploring older adults’ experiences creating a legacy of values. Canham et al. present a case example of a community-based participatory knowledge mobilization project across Canada. They report lessons learned from their lived experience advisory board members as they implemented community-engaged initiatives to reduce the stigma experienced by older adults experiencing homelessness. Mahmood et al. discuss digital storytelling as a method of co-creating narratives with older adults experiencing homelessness as a powerful tool to advocate for policy change and address the needs of marginalized older adults. Grittner and Walsh explored the needs of older adults who have experienced homelessness using a trauma-informed design. They present design strategies to foster supportive housing for older adults. Ketcher et al. describe how they developed a qualitative analytic framework to incorporate researcher and community members’ perspectives in the analysis process. This process contributes to the methodological rigor of conducting qualitative analysis with a community-based participatory research design by reflecting community and cultural values. Presenters will emphasize innovative methods and lessons learned when conducting person-centered qualitative research across diverse demographic groups. Qualitative Research Interest Group Sponsored Symposium

The symposium aims to enhance the quality of life for low-income seniors in community-based housing in the US. The focus is on social connection, neighborhood resources, and community partnerships. Analyzing the 12-year-long national data, the first study used the synthetic difference in difference regression to compare social isolation and cognitive function in two groups of older individuals aged 70 and over. Residents in traditional housing were more likely to experience increased social isolation and decreased cognitive function than senior housing residents. Senior housing was protective, particularly for low-income older adults. A qualitative study on subsidized senior housing (SSH) in Baltimore City found some residents had a small network of connections; most were cordial but disconnected. Challenges related to aging, undesirable behaviors of others, and a desire for privacy limited social connections led to social isolation within the housing communities. Using A Geographic Information System approach, another study looked at SSH availability in New Jersey and its link to neighborhood disadvantage. SSH tends to be located in areas experiencing more significant economic deprivation, highlighting the need for government intervention to mitigate geographic disparities in SSH provision. The last study presented a case of Senior Housing Preservation-Detroit to address the displacement of older adults and improve the quality of life in senior housing. The presentation will cover COVID-19 outreach, lessons learned, milestones, and an emergency plan for Detroit’s older population. Our studies provides a rigorous basis for future research to identify factors and mechanisms for healthy aging among low-income senior housing residents.

Long-Term Care Facilities and the Coronavirus Epidemic: Practical Guidelines for a Population at Highest Risk

There exist various indicators that measure land tenure security for urbanites. Most of those indicators measure the degree to which land titling promotes the security of tenure. Based on the reviewed literature, it is admitted that land titling is not a panacea to land tenure security. Measuring the degree of land tenure security should not rely only on the legalisation of landownership. This paper makes a meta-analysis and conceptual modelling to connect spatial justice and land tenure security. It discusses the potential of inclusive urban development grounded on the claim that spatial justice enhances land tenure security. A comprehensive framework of indicators which can measure the degree of land tenure security from a spatial justice lens is thereafter derived. The meta-analysis and conceptual modelling were coupled with research synthesis to perform an in-depth review and qualitative content analysis of the literature on concepts of spatial justice, land tenure security, and urban (re)development processes. This study proposes 60 indicators which measure the degree of spatial justice and land tenure security along a continuum of spatial justice and land tenure security. Those indicators provide a more holistic approach for measuring land tenure security from a spatial justice lens than the separated sets of existing indicators.

Discourse on communities and aging traditionally has focused on the availability, accessibility, and quality of local services to support older adults in need of assistance. More recently, however, a growing worldwide "age-friendly" movement has pushed the conceptualization of community supports for an aging society beyond service provision. The term "age friendly" is used in considering how various aspects of a community facilitate or impede the health and well-being of individuals as they experience long lives. Frameworks on age friendliness include attention to health and community services for older adults but also encompass other aspects of communities, such as the physical design of outdoor spaces and buildings, the diversity of mobility options for drivers and nondrivers alike, and the availability of safe, affordable, and various types of housing. Age-friendly frameworks also highlight how the very social fabric of a community can influence older residents' quality of life. Over the past decade, a growing number of cities and communities have launched age-friendly initiatives as organized and comprehensive efforts to make localities better for residents as they age. This essay begins to explore how AFIs can address social inequalities in health and aging. It concludes by describing how embedding a spatial justice lens within age-friendly efforts could help AFIs realize more fully the changes that they seek to create at the local, national, and global levels.