Aging Society Research Articles

A study on street walkability for older adults with different mobility abilities combining street view image recognition and deep learning - The case of Chengxianjie Community in Nanjing (China)

China is on the brink of transitioning into an aged society, resulting in a growing demand for an age-friendly street-built environment. However, previous research has paid limited attention to the differentiated walking needs of older adults. To address this gap, this study investigated the relationship between street-built environments and the subjective perception of older adults with different physical capabilities, focusing on safety, comfort, and interest. The older adults were classified into three types based on their physical mobility abilities. The TrueSkill algorithm was used to develop an online image selection website to obtain perception scores for sampled pictures from these three types of older adults. Image segmentation and deep learning were combined to extract indices of street view factors, and machine learning was used to train a scoring prediction model for all streetscape pictures of the area. The study found differences in the subjective perception among all three types of older adults, namely independent elderly (A), mediated-assisted elderly (B), and dependent elderly (C). Type A older adults might be attracted to factors related to the interest of walking despite their negative impact on safety and comfort; Type B older adults were more concerned about street conditions for safety and comfort. Type C older adults were prone to the convenience of barrier-free access and visibility. This study contributes to the study of walkability by providing a research framework for the subjective walking perceptions of older adults with different physical capabilities. Additionally, the visualized walkability map can serve as a reference for architects and urban designers, further strengthening the development of age-friendly communities with the aid of human-centric computational analysis, evaluation, and design.

The impact of residential environment on stroke onset and its spatial heterogeneity: A multiscale exploration in Shanghai

BackgroundStroke is a worldwide concern due to its high disability and mortality rates, especially in many countries entering ageing societies. This study aims to understand the spatial heterogeneity of stroke onset and residential environment influence scopes from multiscale. MethodsThe 2013 to 2022 spatiotemporal distribution pattern of stroke onset was obtained via out-patient data from a hospital in Shanghai. Then nine residential environmental factors were selected to estimate the association of stroke onset by multiscale geographically weighted regression (MGWR), in three scenarios. ResultsAccessibility to pubs/bars (PUB) and building density (BD) were the top two residential environmental factors both for the entire sample and by gender. Stress-related environmental factors have a greater impact on the onset of stroke in men but are limited in scope. The population of elderly people have relevance to environmental variables heterogeneity. The indicators relating to unhealthy food and alcohol suggest that habit-inducing environmental factors have a limited impact on stroke onset, but rather that pre-existing habits play a greater role. ConclusionsMGWR analyses individual components across multiple bandwidths, revealing geographical disparities in the impact of elements that would otherwise be undetected on a global scale. Environmental factors have a limited impact on the onset of stroke. When society is faced with both heavy ageing and fiscal constraints, some of the blue-green space budgets can be scaled back to invest in more secure facilities.

Research on the Protection of Labor Rights and Interests of Retirees' Re-employment

With the deepening of the development of China's aging society, the insufficient supply of the labor market has become increasingly apparent. The protection of the labor rights and interests of retirees in their re-employment can effectively respond to the strategic requirements of active aging, which is in line with the principle of respecting labor and opposing discrimination. Specific measures can be taken to clarify the labor subject status of the elderly retirees, improve the system of receiving and issuing pensions, clarify the composition of the labor remuneration of the retired re-employed personnel and protect it reasonably, establish a special labor safety system, and improve the protection of the labor rights and interests of the retired re-employed personnel with the collective protection of trade unions.

Stone axes throw new light on Baltic stone age mortuary rites

Despite their ubiquity, Mesolithic lithic tools given as funerary offerings have rarely been studied in detail. Whereas personal ornaments (e.g. beads, pendants) are commonly interpreted as markers of social identity and status, archaeologists have struggled to understand the stone tools, commonly regarded as “utilitarian” items. As a result, this class of grave goods has not received the same level of attention, leaving a significant gap in our understanding of Mesolithic mortuary behaviours. Our research challenges long-lasting perceptions of lithic tools as strictly utilitarian objects and draws on studies of one of the most substantial stone axe funerary collections from one of the largest Stone Age cemeteries in Europe–Zvejnieki, Latvia. Evidence suggests the selection of unused axes as grave offerings, while unusual wear traces on an axe found in a female grave (no 57) raises questions about its use in the burial rites. Using a multi-proxy approach, we compare life histories of axes placed in burials to those recovered from contemporary, nearby settlement contexts. Finally, a strong correlation between axes and women and children at Zvejnieki challenges gendered stereotypes of stone tools, historically regarded as possessions of the adult male members of Stone Age societies.

Exploring the Viability of Socially Assistive Robots for At-Home Cognitive Monitoring: Potential and Limitations

AbstractThe early detection of mild cognitive impairment, a condition of increasing impact in our aging society, is a challenging task with no established answer. One promising solution is the deployment of robotic systems and ambient assisted living technology in the houses of older adults for monitoring and assistance. In this work, we address and discuss a qualitative analysis on the feasibility and acceptability of a socially assistive robot (SAR) deployed in prospective users’ houses to monitor their cognitive capabilities through a set of digitalised neuropsychological tests and spot questions conveniently integrated within the robotic assistant’s daily tasks. We do this by describing an experimental campaign where a robotic system, integrated with a larger framework, was installed in the house of 10 users for a duration of at least 10 weeks, during which their cognitive capabilities were monitored by the robot. Concretely, the robots supervised the users during the completion of the tests and transparently monitored them by asking questions interleaved in their everyday activities. Results show a general acceptance of such technology, being able to carry out the intended tasks without being too invasive, paving the way for an impactful at-home use of SARs.

Relationship between quantitative physical activity and deterioration of locomotive function: a cross-sectional study using baseline data from a cohort

BackgroundIn aged society, health policies aimed at extending healthy life expectancy are critical. Maintaining physical activity is essential to prevent the deterioration of body functions. Therefore, it is important to understand the physical activity levels of the target age group and to know the content and intensity of the required physical activity quantitatively. Especially we focused the role of non-exercise activity thermogenesis and sedentary time, which are emphasized more than the introduction of exercise in cases of obesity or diabetes.MethodsA total of 193 patients from 25 institutions were included. Participants underwent a locomotive syndrome risk test (stand-up test, 2-step test, and Geriatric Locomotive Function Scale-25 questionnaire) and were classified into three stages. Physical activity was quantitatively monitored for one week with 3-axial accelerometer. Physical activity was classified into three categories; (1) Sedentary behavior (0 ∼ ≤ 1.5 metabolic equivalents (METs)), (2) Light physical activity (LPA:1.6 ∼ 2.9 METs), and (3) Moderate to vigorous physical activity (MVPA: ≥3 METs). We investigated the relationship between physical activity, including the number of steps, and the stages after gender- and age- adjustment. We also investigated the relationship between social isolation using Lubben’s Social Network Scale (LSNS), as social isolation would lead to fewer opportunities to go out and less outdoor walking.ResultsComparison among the three stages showed significant difference for age (p = 0.007) and Body Mass Index (p < 0.001). After gender-and age-adjustment, there was a significant relation with a decrease in the number of steps (p = 0.002) and with MVPA. However, no relation was observed in sedentary time and LPA. LSNS did not show any statistically significant difference. Moderate to high-intensity physical activity and the number of steps is required for musculoskeletal disorders. The walking, not sedentary time, was associated to the locomotive stages, and this finding indicated the importance of lower extremity exercise.ConclusionsAdjusting for age and gender, the number of steps and moderate to vigorous activity levels were necessary to prevent worsening, and there was no effect of sedentary behavior. Merely reducing sedentary time may be inadequate for locomotive disorders. It is necessary to engage in work or exercise that moves lower extremities more actively.

A community of practice approach to the management of metal resources, metalworking and hoarding in Bronze Age societies

The burial of metals in hoards is a trademark phenomenon of prehistoric Europe that may be counterintuitive to perceptions of value nowadays. For the first time here, we establish detailed biographies of a large corpus of hoarded metal objects, providing new insights into how societies in the second millennium BC engaged with their convertible material wealth. We move beyond previous research on prehistoric hoarding commonly focussing on separate questions such as what was placed in hoards, who selected the objects, what were the origins of materials, and where and when they were buried. Analysing ca. 200 metal tools and weapons, we use data reduction methods to define technological pathways in the long biographies of hoarded objects extending across the sourcing of materials, production, use, decommissioning, and deposition in the Carpathian Basin. We show how the differential treatment of materials and objects was strongly biased by social decisions across artefact types. We identify shared, standardised signature treatments that crossed over social-spatial boundaries. Our findings bring new insights on the interface between communal and elite wealth management at the intersection of technological reasoning and cultural beliefs in prehistoric communities.

Adopting STOPP/START Criteria Version 3 in Clinical Practice: A Q&A Guide for Healthcare Professionals.

The growing complexity of geriatric pharmacotherapy necessitates effective tools for mitigating the risks associated with polypharmacy. The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP)/Screening Tool to Alert doctors to Right Treatment (START) criteria have been instrumental in optimizing medication management among older adults. Despite their large adoption for improving the reduction of potentially inappropriate medications (PIM) and patient outcomes, the implementation of STOPP/START criteria faces notable challenges. The extensive number of criteria in the latest version and time constraints in primary care pose practical difficulties, particularly in settings with a high number of older patients. This paper critically evaluates the challenges and evolving implications of applying the third version of the STOPP/START criteria across various clinical settings, focusing on the European healthcare context. Utilizing a "Questions & Answers" format, it examines the criteria's implementation and discusses relevant suitability and potential adaptations to address the diverse needs of different clinical environments. By emphasizing these aspects, this paper aims to contribute to the ongoing discourse on enhancing medication safety and efficacy in the geriatric population, and to promote more person-centred care in an aging society.

Longitudinal analysis on inflammatory markers and frailty progression: based on the English longitudinal study of aging.

Frailty is a common health state that is closely linked to adverse health outcomes in aging society. Although many inflammatory biomarkers have been cross-sectionally associated with frailty, knowledge on the longitudinal association is still limited. This study investigated the associations between inflammatory factors in clinical practice and frailty progression over time. To investigate the associations of three common inflammatory markers (hypersensitive C-reactive protein [hsCRP], white blood cell [WBC] and fibrinogen) with the progression of frailty. Data of 2316 participants (age 67.9 ± 6.1 years) were obtained from the English longitudinal study of aging (wave 4, 6 and 8) over an 8-year follow-up. The frailty index (FI) was calculated from 52 items. Mixed-effects models and Cox proportional hazards (Cox-PH) models were used to analyze the associations of hsCRP, WBC and fibrinogen with frailty progression. Values of inflammatory biomarkers were log-transformed. Age, sex and gross wealth were controlled. Mixed-effects models showed that at a cross-sectional level, higher levels of hsCRP (β: 0.007, 95% CI 0.004-0.010), WBC (β: 0.021, 95% CI 0.010-0.032) and fibrinogen (β: 0.022, 95% CI 0.005-0.038) were associated with greater FI values while no significant time interaction was found. Cox-PH models showed that higher baseline levels of hsCRP (HR: 1.10, 95% CI 1.03-1.17) and WBC (HR: 1.23, 95% CI 1.10-1.37) were linked to a greater risk of developing frailty within 8 years. We concluded that hsCRP, WBC and fibrinogen can reflect frailty status at a cross-sectional level while only hsCRP and WBC are associated with frailty progression over an 8-year period.

Integrating and Dividing in a Late Bronze Age Society: Internal Organization of Settlements of the Tisza Site Group in the Southern Carpathian Basin, 1600–1200 b.c.

ABSTRACT Recent research in the later Bronze Age of the southern Carpathian Basin has revealed an extensive network of large, often-enclosed settlements. Within this network, a particularly dense group of sites has recently been characterized: the Tisza Site Group (TSG). Building on advances in inter-site relations in recent research, we explore social organization within settlements using five case studies from different parts of this network. Using a multi-proxy approach of satellite imagery, systematic surface survey, and geophysical prospection, we studied the distribution of archaeological features and surface traces of activity within the enclosed space. Results indicate that sites in the TSG shared a common ethos regarding the use of space and the role of the built environment that was specific to LBA occupation of this landscape. Activity areas with domestic assemblages distributed in low-density relative to the enclosed space indicates settlement and specialist subsistence activities took place in parallel.

Research on the Demand Survey and Service Quality Improvement Strategy of the Elderly Aviation Service

With the increase in the proportion of elderly population, the importance of optimizing aviation services for the elderly and their service quality has gradually become apparent. This study firstly investigates the current situation of elderly people in terms of aviation services, and reveals the main problems that exist. Subsequently, by designing a targeted survey questionnaire, a comprehensive investigation and analysis of the aviation service needs of elderly consumers is conducted in order to accurately grasp their specific requirements. Combined with the evaluation system, this paper proposes a targeted service quality evaluation method and explores strategies to improve the service quality for the elderly population in the aviation industry. The research results have high practical value for the aviation industry to provide more humane and refined services and have significant practical guidance in addressing the new challenges posed by an aging society in the aviation service field.

Relationship between the HeartMate Risk Score category on admission and outcome in patients with acute heart failure referred to a cardiac intensive care unit.

The HeartMate Risk Score (HMRS), a simple clinical prediction rule based on the patients' age, albumin, creatinine, and the international normalized ratio of the prothrombin time (PT-INR), is correlated with mortality in the cohort of left ventricular assist device (LVAD) recipients. However, in an aging society, an LAVD is indicated for only a small proportion of patients with acute heart failure (AHF), and whether the HMRS has prognostic implications for unselected patients with AHF is unknown. This study aimed to assess the prognostic value of HMRS categories on admission in patients with AHF. We analyzed 339 hospitalized patients with AHF who had albumin, creatinine, and the PT-INR recorded on admission. The patients were categorized as follows: the High group (HMRS > 2.48, n = 131), Mid group (HMRS of 1.58-2.48, n = 97) group, and Low group (HMRS < 1.58, n = 111). The endpoints of this study were all-cause death and readmission for heart failure (HF). During a median follow-up of 247days, 24 (18.3%) patients died in the High group, 7 (7.2%) died in the Mid group, and 8 (7.2%) died in the Low group. In a multivariable analysis adjusted for highly imbalanced baseline variables, a high HMRS was independently associated with survival, with a hazard ratio of 2.90 (95% confidence interval 1.42-5.96, P = 0.004). With regard to the composite endpoint of all-cause death and readmission for HF, the Mid group had a worse prognosis than the Low group, and the High group had the worst prognosis. A high HMRS on admission is associated with all-cause mortality and readmission for HF, and a mid-HMRS is associated with readmission for HF after AHF hospitalization. The HMRS may be a valid clinical tool to stratify the risk of adverse outcomes after hospitalization in unselected patients with AHF.

A mechanism of customizing learning programs for older adults’ lifelong learning

AbstractJapan, like many countries, is facing problems with an aging society, and lifelong learning is becoming more and more important. To provide older adults with the opportunity to enroll in lifelong learning programs, it is essential to offer suitable programs. However, designing learning programs for older adults is not easy because they may have various physical and mental conditions. To approach the problem, the authors have proposed a mechanism for personalizing learning programs for older adults. The basic ideas of the mechanism are: (1) omitting unessential steps and (2) suggesting collaboration with others. In this paper, the algorithm and the data structures of the mechanism are explained, and results of experiments are shown.

Analysis of Service Marketing Strategies in the Senior Study Travel Tour Market

Senior study travel, as an emerging form of tourism, combines the dual characteristics of educational learning and leisure travel. It not only meets the elderly’s desire for spiritual and cultural life and self-fulfillment but also promotes the construction of a healthy aging society. This study comprehensively uses methods such as literature analysis, interviews, and case studies to analyze the current status and existing problems of the senior study travel market. Based on the 7Ps service marketing model, it explores service marketing strategies for the senior study travel market, aiming to provide reference and guidance for related tourism enterprises to supply more attractive senior study travel services.

Preparing the Younger Generation for an Aging Society: Strategies, Challenges, and Opportunities.

The global demographic landscape is experiencing a monumental shift as populations age, driven by advances in healthcare and declining birth rates. This transition underscores the need to prepare the younger generation to navigate and contribute effectively to an aging society. This manuscript comprehensively reviews strategies to equip younger generations with the requisite knowledge, skills, and empathy to support an aging population. This study identifies critical challenges and opportunities in fostering intergenerational solidarity and understanding through an extensive analysis of existing literature and innovative educational programs. The review highlights the importance of early education, community engagement, and policy interventions in bridging the generational divide. Additionally, it explores the role of technology and digital media in facilitating awareness and empathy among young people. Key findings suggest that incorporating aging-related content into educational curricula, promoting volunteerism, and implementing supportive policies can significantly enhance the younger generation's readiness to support an aging society. The manuscript concludes with recommendations for future research and practical steps for educators, policymakers, and community leaders to foster a more inclusive and age-friendly environment. By preparing the younger generation today, we can build a more cohesive and supportive society for tomorrow.

Spatial-temporal distribution of debt and delinquency of the elderly in Thailand: Perspectives from the National Credit Bureau data.

Household debt in Thailand has become a serious problem, particularly for the elderly, because they have less ability to pay debts compared to the working population. Therefore, better understanding of the elderly's debt and delinquency is crucial in policy formulation for the aged society. Previous works have focused on the elderly's debt, either at the macro or individual levels. Little is known about geographic differences at the regional level. Knowing where the elderly debt and delinquency tend to cluster could guide area-specific policies to tackle the elderly financial stability. This research aims to examine the spatio-temporal distribution of the debt and delinquency of the near-elderly population (age 50-59) and the elderly (age 60 and above) using data from the National Credit Bureau of Thailand from 2008 to 2019. The analysis focuses on various types of loans. Spatial clusters are identified by Moran's I and Local Geary statistics. The results show that the pattern of elderly debt and delinquency generally follows the life cycle hypothesis, except for credit card and business-related loans. There exist spatial clusters and spatial differences in different types of loans, suggesting regional heterogeneities that require area-specific policy responses.

CORRELATION OF MORBIDITY WITH SMOKING STATUS AND POSBINDU PTM TO PREPARE AGING SOCIETY HEALTH MANIFESTATION IN INDONESIA

Aging increases vulnerability to diseases, necessitating comprehensive strategies promoting healthy lifestyles. Posbindu PTM (Integrated Guidance Post for NCDs) is Indonesia's community-based program which was aimed to mitigate the impact of NCDs through monitoring risk factors and empowering individuals for early intervention and lifestyle’s changes. This study examined the correlations between smoking status, and implementation of Posbindu PTM among Indonesia's elderly population with morbidity rates. Data from 34 provinces were analyzed using Spearman's correlation test (α=5%) to examine relationships between morbidity rates (dependent variable) from the 2022 Elderly Population Statistics data, smoking status (active smokers, ex-smokers, non-smokers), and the percentage of Posbindu PTM implementation (independent variables) from the data of the 2021 Indonesia Health Profile. Active smokers (p=0.007, r=0.455) and ex-smokers (p=0.003, r=0.497) showed positive correlations with morbidity, while non-smokers (p=0.002, r=-0.506) exhibited a negative correlation. Posbindu PTM implementation (66,4% average in 2021) was not significantly correlated with morbidity (p=0.367). High smoking rates among Indonesia's elderly affect morbidity levels. Posbindu PTM, as an early detection and health promotion program, has not been well-implemented nationwide. Efforts and government commitment to prioritize health promotion and prevention at the grassroots level are essential for achieving a prosperous and effective aging society.

Fluid Grey: A Co-Living Design for Young and Old Based on the Fluidity of Grey Space Hierarchies to Retain Regional Spatial Characteristics

Architectural design and urban renewal that adapt to an ageing society and are localized are urgent needs around the world. On the other hand, the concept of grey space, which refers to transitional space and is an in-between concept, has been proposed since the 1980s, but few studies have further explored its hierarchy, fluidity, and relationship with regional characteristics. Therefore, this study hopes to use the fluidity of the grey space hierarchy to solve the problem of design that adapts to an ageing society and preserves regional characteristics. This study mainly focuses on the spatial characteristics of Beitou Heart Village, summarizes five grey space hierarchies and fluidity modes, and finally designs social housing for young and old cohabitation in a bottom-up manner based on them, restoring local unique neighborhood care and multi-ethnic communication methods. There are three innovations in this study: (1) defining the division method of the grey space hierarchy; (2) exploring the richness and scalability of the grey space hierarchy in terms of fluidity; (3) using the grey space hierarchy to achieve neighborhood care and multi-ethnic communication, making social housing for urban renewal more people-oriented and retaining spatial regional characteristics. This paper may provide a theoretical foundation and practical help for grey-space-based design and urban renewal in the future.

Visible and invisible factors affecting the job satisfaction of agency home caregivers in the UK

This qualitative study investigates the factors that affect the job satisfaction of home caregivers. It draws upon a thematic analysis of data from in-depth interviews with home caregivers in the UK and finds that both visible and invisible factors have an effect. Overall factors pertaining to the way the caregiving agencies are run and behave have a significant influence on caregivers’ job satisfaction. Identifying these factors will assist both policymakers and professional care agencies to be aware of the needs of caregivers in practice. These experiences can be used as references to handle the challenges of an ageing society in other countries with similar care industry characteristics.

Immunological foundations of neurological diseases

Neurodegenerative diseases represent an increasing challenge in ageing societies, as only limited treatment options are currently available. New research methods and interdisciplinary interaction of different disciplines have changed the way neurological disorders are viewed and paved the way for the comparatively new field of neuroimmunology, which was established in the early 1980s. Starting from neurological autoimmune diseases, such as multiple sclerosis, knowledge about the involvement of immunological processes in other contexts, such as stroke or traumatic brain injury, has been significantly expanded in recent years. This review article provides an overview of the role of the immune system and the resulting potential for novel treatment approaches. The immune system plays acentral role in fighting infections but is also able to react to the body's own signals under sterile conditions and cause inflammation and subsequent adaptive immune responses through the release of immune mediators and the recruitment and differentiation of certain immune cell types. This can be beneficial in initiating healing processes; however, chronic inflammatory conditions usually have destructive consequences for the tissue and the organism and must be interrupted. It is now known that different cells of the immune system play an important role in neurological diseases. Regulatory mechanisms, which are mediated by regulatory Tcells or Th2 cells, are usually associated with agood prognosis, whereas inflammatory processes and polarization towards Th1 or Th17 have adestructive character. Novel immunomodulators, which are also increasingly being used in cancer treatment, can now be used in atissue-specific manner and therefore offer great potential for use in neurological diseases.