Community-dwelling Older People Research Articles

Physical Frailty Prediction Using Cane Usage Characteristics during Walking

This study aimed to determine the characteristics of accelerations and angular velocities obtained by an inertial measurement unit (IMU) attached to a cane between older people with and without physical frailty. Community-dwelling older people walked at a comfortable speed using a cane with a built-in IMU. Physical frailty was assessed using exercise-related items extracted from the Kihon Check List. The efficacy of five machine learning models in distinguishing older people with physical frailty was investigated. This study included 48 older people, of which 24 were frail and 24 were not. Compared with the non-frail participants, the older people with physical frailty had a small root mean square value in the vertical and anteroposterior directions and angular velocity in the anteroposterior direction (p < 0.001, r = 0.36; p < 0.001, r = 0.29; p < 0.001, r = 0.30, respectively) and a large mean power frequency value in the vertical direction (p = 0.042, r = 0.18). The decision tree model could most effectively classify physical frailty, with an accuracy, F1 score, and area under the curve of 78.6%, 91.8%, and 0.81, respectively. The characteristics of IMU-attached cane usage by older adults with physical frailty can be utilized to effectively evaluate and determine physical frailty in their usual environments.

Cost-effectiveness analysis of the digital fall preventive intervention Safe Step among community-dwelling older people aged 70 and older

Falls are the most common cause of injury in older people, with consequences for the individual and society. With an increasing population of older people, falls and related costs are expected to increase. It is crucial to identify scalable and cost-effective interventions and subsequently reduce fall-related costs. The aim was to evaluate the cost-effectiveness of the Safe Step digital fall preventive exercise intervention over a period of 12 years and, in addition, to evaluate the impact of increased recruitment cost and decreased intervention effect. The intervention was evaluated in an observational study in a municipality context targeting community-dwelling older people of age 70 + . A Markov model with five states was used to model the cost-effectiveness of the Safe Step intervention and evaluate quality-adjusted life years (QALYs) and fall-related costs from a societal perspective. By using data from a meta-analysis as basis for the estimated intervention effect, the Safe Step intervention was compared with a no-intervention alternative. The results showed that the Safe Step intervention dominated no intervention. In the sensitivity analysis with the most conservative estimate of intervention effect, the ICER was €7 616 per QALY gained. Hence, Safe Step showed to be a cost-saving fall preventive intervention in older people at risk of falling and potentially cost-effective even with a low estimated intervention effect. Future studies on efficacy of fall preventive digital interventions will contribute in precising effect estimates and enhance the validity of these cost-effectiveness results.

Mediating effects of physical activities and cognitive function on the relationship between dietary diversity and all-cause mortality in community-dwelling older adults.

Although dietary diversity (DD) has been confirmed to be associated with multiple health outcomes and longevity in older people, the related mechanisms have not been elucidated. In this study, we explored the mediating roles of physical activities and cognitive function in the relationship between DD and all-cause mortality. We recruited 34 068 community-dwelling older adults aged ≥60 years from the Chinese Longitudinal Healthy Longevity Study and followed them up until 2018. Dietary diversity score (DDS) was assessed by the intake frequency of nine food sources. We evaluated physical activities and cognitive function using the Katz index and Mini-Mental State Examination. We explored the mediating roles of physical activities and cognitive function between DDS and all-cause mortality using mediated analyses in Cox proportional risk regression models. A total of 25 362 deaths were recorded during 148 188.03 person-years of follow-up. Participants with physical disability and cognitive impairment had lower DDS than the normal group (P < 0.001). After controlling for all covariates, DDS, physical activities, and cognitive functioning were negatively associated with all-cause mortality. Physical activities and cognitive function mediated 18.29% (95% confidence interval (CI) = 12.90-23.10) and 27.84% (95% CI = 17.52-37.56) of the total effect of DDS on mortality, respectively. Physical activities and cognitive function mediated the association between DDS and all-cause mortality. Maintaining DD may benefit early death prevention by reducing physical disability and cognitive impairment in community-dwelling older people.

Risk factors for hospitalisation in community-dwelling pre-frail and frail older people: results of a longitudinal study.

Older adults account for a large proportion of hospital admissions. In this study we aim to bridge a gap between medical and psychosocial factors in predicting hospitalisation. Demographic and social characteristics of community-dwelling pre-frail and frail older people were collected by questionnaires every six months during a two year follow-up. Hospital admission within this period was dichotomised as yes/no. To define pre-frailty and frailty the Fried frailty criteria were used. Analysis of risk factors for hospitalisation was performed using multivariable logistic regression. Hospitalised participants (n = 1803) were more often male and frail in comparison to not-hospitalised participants. They also experienced more chronic diseases (54.5% ≥ 4 chronic diseases), poorer self-perceived health (SPH) (76.4% fair to very poor) and lack of informal care (20.1%). In multivariable logistic regression male gender (Odds ratio (OR) 1.65, p < 0.001), frailty (vs. pre-frailty) (OR 1.66, p = 0.002), reporting lower SPH (OR 3.12, p < 0.001) and lacking informal care (OR 1.69, p < 0.001) showed significant associations with hospital admission. Subgroup analysis of pre-frail and frail participants, showed consistent associations between male gender (respectively OR 1.61, p < 0.001 ; OR 1.72, p = 0.085), lower SPH (OR 2.23, p = 0.001; OR 31.16, p < 0.001), lack of informal care (OR 1.64, p = 0.005; OR 2.63, p = 0.012) and hospitalisation. Frailty, male gender, lower SPH and lack of informal care are risk factors for hospitalisation within community-dwelling older people, showing the need of a holistic approach to possibly prevent hospitalisation. Further research should focus on evaluating individual factors for hospitalisation, particularly targeting pre-frail individuals.

The Association of Walking Ability with Oral Function and Masticatory Behaviors in Community-Dwelling Older People: A Cross-Sectional Study.

Background/Objectives: An association between oral function and physical fitness, including walking capacity, has been reported. However, the association between masticatory behaviors and walking ability-both of which represent patterns of movement in daily life-has not been clarified. This study aimed to investigate the association between masticatory behaviors, oral function, and walking capacity in older people. Methods: One hundred community-dwelling older people (31 men, 69 women, mean age 75.7 ± 6.3 years) were selected to participate in this study. Age, sex, masticatory behaviors, oral functions (tongue pressure, tongue-lips motor function, occlusal force, and masticatory performance), and walking capacity were assessed. Masticatory behaviors were assessed during the consumption of one rice ball (100 g) using a wearable chewing counter, and the number of chews, chewing rate, the number of chews per bite, and meal time were recorded. Walking capacity was assessed using the timed up and go test (TUG). Spearman's rank correlation coefficients were calculated to assess the strength and direction of the association. Results: Moderate negative correlations were observed between TUG time and tongue pressure and between TUG time and tongue-lips motor function (/ta/ and /ka/) (rs = -0.33, -0.21, -0.28, respectively). In addition, moderate negative correlations between TUG time and chewing rate (rs = -0.22) and between TUG time and meal time (rs = 0.33) were observed, suggesting that lower walking capacity was associated with slower chewing rate and longer meal times. Conclusions: In community-dwelling older people, declines in mastication speed and dexterity and tongue strength are associated with lower walking capacity.

Successful Aging and Self-Neglect Among Community-Dwelling Older People.

It was aimed to explore the relationship between successful aging and self-neglect and factors affecting successful aging among community-dwelling older people. This cross-sectional study was conducted with 316 participants aged 60 years and older in a Family Health Center (FHC). The data were collected by using the questionnaire form, Successful Aging Scale and Self-Neglect Scale. The questionnaire form includes sociodemographic characteristics, independence (Katz Daily Life Activities Scale) and well-being status (WHO-5 Well-Being Index), psychosocial support (Multidimensional Perceived Social Support Scale), and depressive symptoms (two questions-complaints such as feeling depressed or hopeless and loss of interest and inability to enjoy life). Participants had a mean age of 67.5 (SD: 6.5) years, 55.4% were female. A strong positive correlation was determined between successful aging score and self-neglect score (r = 0.741, p < 0.001). Factors affecting successful aging were age, working status, education level, body mass index, physical activity, subjective health perception, health screening status, self-neglect level, depressive symptoms, independence in activities, well-being status, and psychosocial support. Gender, income status, chronic disease presence, cigarette and alcohol use, living alone, and family type did not affect it. According to multivariate linear regression, the factors affecting successful aging were age, psychosocial support presence, and self-neglect level (p < 0.05). Older people have low successful aging and self-neglect scores. Successful aging is better at a young age, in the presence of psychosocial support and a low level of self-neglect. It is recommended to increase the existence of psychosocial support for them and to plan interventions to reduce self-neglect.

Respiratory Function is Associated with Cognitive Function Change in Japanese Community-Dwelling Older People: A 1-Year, Longitudinal, Observational Study

Respiratory Function is Associated with Cognitive Function Change in Japanese Community-Dwelling Older People: A 1-Year, Longitudinal, Observational Study

What Benefits Does Local Sports Club Membership Confer On Community-Dwelling Older People In Ireland?

Abstract Background There is a strong culture of sports club membership amongst older people in Ireland. It has been suggested that this confers health benefits due to increased physical activity and social connection, but studies examining this are currently lacking. The aim of this study therefore was to assess the relationship of sports club membership with markers of health and well-being in a large population-representative cohort of older people. Methods Over 3,500 participants ≥65 years at Wave 5 (mean 74 years, 54% female) of the Irish Longitudinal Study on Ageing were included. Sports club membership (GAA, soccer, rugby, tennis, golf) was elicited by self-report. Depressive symptoms (Centre for Epidemiological Studies Depression Scale), loneliness (UCLA Scale), and quality of life (Control Autonomy Self-Realization Please Scale) were assessed with internationally validated scales. Physical Activity was by self-report and mobility impairment was defined as Timed-Up-and-Go≥14s. The associations between sports club membership and these outcomes were assessed with regression models adjusted for age, sex, education, polypharmacy, chronic disease burden and heart disease. Results One fifth (708/3,510) of participants were a member of a local sports club. Sports club membership was associated with lower rates of depressive symptoms (Odds ratio 0.51 (95% CI 0.34,0.75)), lower levels of loneliness (Beta = -0.28 (95% CI -0.46, -0.10)) and better quality of life (Beta= 0.93 (95% CI 0.49,1.38)) in fully-adjusted models. Sports club members spent more days doing moderate physical activity per week (2.0 (95% CI 1.85,2.21) vs 1.64 (95% CI 1.54,1.73); p&amp;lt;0.001) and had lower likelihood of mobility impairment (Adjusted Odds Ratio 0.49 (95% CI 0.36,0.68)). Conclusion Sports Club Membership is prevalent amongst community-dwelling older people in Ireland and is associated with lower rates of loneliness, depressive symptoms and mobility impairment, and better quality of life. Older sports club members should be encouraged to maintain this activity where feasible.

Everyday Ageism experienced by Community-Dwelling Older People with Frailty

Abstract Background Ageism encapsulates stereotypes, prejudice and discrimination towards others or oneself based on age. While identified as the most frequent form of discrimination, relatively little work has captured the problem of day-to-day ageism faced by older people with frailty in community settings. The aim of this study therefore was to examine the prevalence of everyday ageism experienced by older people attending hospital-based ambulatory care services, and to clarify its association with measures of quality of life (QOL) and frailty. Methods A consecutive series (n=100) of patients aged ≥70 years attending ambulatory care completed focused interviews. Day-to-day experience of ageism was measured with the Everyday Ageism Scale, QOL was measured with the Control Autonomy Self-Realisation Pleasure Scale (CASP-19). Results Just over half of participants reported exposure to ageist messages; over 5/6 reported experiencing ageism in interpersonal interactions and 2/3 held some ageist beliefs themselves. Logistic regression demonstrated that experiencing ageism in interpersonal interactions was associated with a higher likelihood of internalised ageism (Adjusted Odds Ratio 6.02 (95% CI 1.70, 21.34); p=0.005)). Both ageism in interpersonal interactions (β= -5.22 (95% CI -9.52, -0.91); p=0.018) and internalised ageism (β= -5.36 (95% CI -8.75, -1.97); p=0.002) were associated with significantly lower QOL. Conclusion This study highlights the striking prevalence of everyday ageism experienced by a cohort of community-dwelling older people with frailty and multimorbidity. In the context of further projected demographic changes in coming decades, with increasingly higher proportions of older people worldwide, these findings highlight an important societal issue that needs to be addressed.

Are There Missed Opportunities For Falls Prevention In Older People With Fractures? Data From TILDA

Abstract Background Fractures can represent a seminal event in later life associated with significantly higher rates of functional impairment, nursing home admission and mortality. The aim of this study therefore was to measure the cumulative incidence of hip and wrist fractures longitudinally in a population-representative sample of community-dwelling older people and examine opportunities to intervene prior to the fracture. Methods Participants aged ≥65 years from the Irish Longitudinal Study on Ageing were included and followed from Wave 1 to Wave 5 (8-year follow-up). Falls and Fractures (Hip and Wrist) and were elicited by self-report at each wave. Participants were also asked how steady they feel when standing / walking. Logistic regression models assessed the relationship between reported falls and unsteadiness, and subsequent fracture. Results 3,072 participants were included (Mean age 73 years, 53% female) and followed for a median of 6.3 years, with over 7% (228/3,072) reporting a fracture. Over one quarter (69/267) of fractures were preceded by an injurious fall requiring medical attention in the prior 24 months, 45% were preceded by a fall of any type (121/267). One third of participants who subsequently had a fracture (89/267), reported that they were unsteady on their feet when interviewed prior to the fracture. One fifth (19/89) of these participants accessed physiotherapy services prior to the fracture. The combination of either a fall or unsteadiness reported during the preceding 24 months significantly increased the likelihood of future fracture (Odds Ratio 2.62 (95% CI 2.05 – 3.35)). Conclusion Most fractures are predictable with almost two thirds heralded by falls or unsteadiness in the preceding 24 months. Falls prevention strategies, which can reduce further falls by 20-40%, targeted at those with unsteadiness and falls would likely prevent an important proportion of future fractures, and have a positive impact on health outcomes in this cohort.

Feasibility of a person-centred multidimensional interdisciplinary rehabilitation programme in community-dwelling people with dementia: a randomised controlled pilot trial

BackgroundA team-based, individualised rehabilitation approach may be required to meet the complex needs of people with dementia. This randomised controlled pilot trial evaluated the feasibility of a person-centred multidimensional interdisciplinary rehabilitation programme for community-dwelling older people with dementia and their informal primary caregivers.MethodsParticipants with dementia were randomised to an intervention group (n = 31, mean age (SD) 78.4 (6.0) years) or usual care (n = 30, mean age 79.0 (7.1)). The rehabilitation programme consisted of a 20-week rehabilitation period containing assessments and interventions based on each individual’s goals, and group-based physical exercise plus social interaction twice a week for 16 weeks at a rehabilitation unit. After 5 and 14 months, the interdisciplinary team followed up participants over two four-week periods. For both groups, dates of deaths and decision to move to nursing home over three years, as well as interventions for the relevant periods, were collected. Blinded assessors measured physical functions, physical activity, activities of daily living, cognitive functions, nutritional status, and neuropsychiatric symptoms at baseline and at 5, 12, 24, and 36 months.ResultsParticipants in the intervention group received a mean of 70.7 (20.1) interventions during the 20-week rehabilitation period, delivered by all ten team professions. The corresponding figures for the control group were 5.8 (5.9). In the intervention group, all but one participated in rehabilitation planning, including goal setting, and attendance in the exercise and social interaction groups was 74.8%. None of the adverse events (n = 19) led to any manifest injury or disease. Cox proportional hazard regression showed a non-significant lower relative risk (HR = 0.620, 95% CI 0.27–1.44) in favour of the intervention for moving to nursing home or mortality during the 36-month follow-up period. Linear mixed-effect models showed non-significant but potentially clinically meaningful between-group differences in gait, physical activity, and neuropsychological symptoms in favour of the intervention.ConclusionsThe rehabilitation programme seems feasible among community-dwelling older people with dementia. The overall results merit proceeding to a future definitive randomised controlled trial, exploring effects and cost-effectiveness. One could consider to conduct the programme earlier in the course of dementia, adding cognitive training and a control attention activity.Trial registrationThe study protocol, ISRCTN59155421, was registered online 4/11/2015.

Senior Theater Projects: Enhancing Physical Health and Reducing Depression in Older Adults.

The aim of this study was to clarify the effects of a theater training program intervention on the physical and cognitive functions in community-dwelling older people. Of the 59 participants, 30 were the control group, and 29 were the intervention group. We assessed physical and mental/cognitive functions and criteria of physical frailty. Statistical analysis showed that the usual walking speed (UWS) (p < 0.01), grip strength (GS) (p < 0.01), and GDS-15 (p < 0.05) improved significantly in the intervention group, whereas the Geriatric Depression Scale short-form (GDS-15) (p < 0.01) worsened significantly in the control group. Cognitive function was not significantly different between the two groups. Physical frailty was unchanged in the control group but significantly improved in the intervention group (p < 0.05), and a significant interaction was found for GDS-15 in ANOVA (F = 5.76, p < 0.05). The results of this study suggest that a theater intervention for the older adults may be effective in preventing and improving depression and physical frailty in old age.

Impact of social isolation on change in brain volume in community-dwelling older Japanese people: The NEIGE Study

BackgroundSeveral studies have shown that social isolation is a risk factor for cognitive decline and dementia; however, its neurological mechanisms are not fully understood. Using longitudinal data, this study examined the effects of social isolation on hippocampal and total gray matter volumes in community-dwelling older Japanese individuals. MethodsData were obtained from the Neuron to Environmental Impact Across Generations (NEIGE) Study conducted in Tokamachi City (Niigata Prefecture, Japan), including 279 community-dwelling persons aged 65–84 years who underwent brain magnetic resonance imaging in 2017 and 2021 (male: 47.6 %; mean age: 73.0 years). We investigated two dimensions of social isolation: poor social networks and solitary living. ResultsMultiple regression analysis with inverse probability weighting showed that individuals with a social contact frequency of <1 time/week had a greater decrease in hippocampal volume than those with a contact frequency of more than or equal to 4 times/week, whereas those who lived alone tended to have a smaller decrease in hippocampal volume than those who lived with others. We found no association between the frequency of social contact, living alone, and total gray matter volume. Furthermore, there was no interaction between sex and age for any of the outcomes. ConclusionOur longitudinal analysis suggested that the relationship between social isolation and dementia onset may be mediated by hippocampal atrophy; however, the direction of the influence depends on the isolation type. These findings are expected to contribute to the elucidation of the social mechanisms underlying dementia onset.

Linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China: a cross-sectional study

BackgroundDepression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China.MethodsFrom November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately.ResultsBased on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (β) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (β = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (β = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (β = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (β = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes.ConclusionBoth the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life.

A multicomponent personalized prevention program in the primary care setting: a randomized clinical trial in older people with noncommunicable chronic diseases (Primacare_P3 study)

BackgroundMulticomponent interventions based on a comprehensive geriatric assessment (CGA) could promote active aging and improve health status in older people with Noncommunicable Chronic Diseases (NCDs), but conflicting evidences are available.AimTo evaluate the efficacy of a CGA-based multicomponent personalized preventive program (PPP) in reducing unplanned hospitalization rates during 12-month follow-up in community-dwelling older people with NCDs.Materials and methodsIn this randomized clinical trial (RCT), 1216 older adults recruited by 33 general practitioners (GPs) will be randomly allocated to intervention group (IG) or usual care control group (CG). The IG will receive a multicomponent PPP developed on the findings of the CGA-based Multidimensional Prognostic Index short-form (Brief-MPI), including structured interventions to improve functional, physical, cognitive, and nutritional status, to monitor NCDs and vaccinations, and to prevent social isolation. Participants in the CG will receive usual care. Brief-MPI, resilience, and health-related quality of life will be assessed after 6 and 12 months. Moreover, saliva samples will be collected at baseline in IG to measure biomarkers of oxidative stress, inflammatory cytokines, and oral microbiome.Expected resultsThe CGA-based PPP might reduce unplanned hospitalization rates and potentially institutionalization rates, emergency department (ED) and unplanned GP visits, and mortality. Further outcomes explored in the IG will be the adherence to PPP, resilience, health-related quality of life, and multidimensional frailty as assessed by the Brief-MPI.ConclusionsResults will suggest whether the CGA-based multicomponent PPP is able to improve specific outcomes in a primary care setting.Trial registrationClinicalTrials.gov; identifier: NCT06224556; Registered January 25, 2024.

The Association between Frailty, Quality of Life and Resilience in Community-dwelling Retirement Village Residents

ObjectivesHousing quality has significant impact on the wider determinants of health and quality of life (QoL). Retirement villages are considered age-friendly accommodation for community-dwelling older people, offering a variable range of services and supports. We wished to explore the relationship among frailty, QoL, and resilience in older people residing in retirement villages. DesignCross-sectional analysis within a longitudinal study. Setting and participantsResidents from 33 retirement villages in Auckland, Aotearoa, New Zealand. MethodsFrailty [using an interRAI-Community Health Assessment-based frailty index FI)], QoL [World Health Organization Quality of Life–Brief Version (WHOQOL-BREF) and WHOQOL–Older Adults Module (WHOQOL-OLD)], and resilience [Brief Resilience Scale (BRS)]. Associations among frailty, QoL, and resilience were examined using regression analysis adjusting for confounders. ResultsMean (SD): FI 0.2 (0.1) in 479 residents, BRS 3.7 (0.8) in 395 residents, WHOQOL-OLD total score 69.9 (12.2). FI was inversely related to BRS [adjusted mean difference (MD) −0.35; 95% CI −0.43 to −0.26; P < .001] and WHOQOL-OLD (MD, −5.45; 95% CI −6.89 to 4.01; P < .001). FI inverse relationship was seen across all facets of WHOQOL-OLD and all WHOQOL-BREF facets except psychological. Conclusions and ImplicationsFrailty was inversely related to resilience and multiple domains of QoL in those living in presumed age-friendly and relatively resource-rich environments. Studies exploring causal relationships between these facets could inform interventions necessary to improve QoL and resilience in those living with frailty. Specific multidimensional needs, wishes, and concerns of older people living with frailty needs to be explored in order to potentially intervene on frailty, QoL, and resilience.

Association between Motoric Cognitive Risk Syndrome and Indicators of Reflecting Independent Living among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study.

The purpose of this study was to examine whether motoric cognitive risk syndrome (MCR) is associated with various indicators of independent living among community-dwelling older adults in Japan. The study design was a cross-sectional study, and the participants were 107 community-dwelling older adults (mean age 79 ± 7 years) who were living independently. The participants were administered the Questionnaire for Medical Checkup of Old-Old (QMCOO) as an indicator of health status and the Japan Science and Technology Agency Index of Competence (JST-IC) as an indicator of higher levels of functioning capacity, among others. In addition, we assessed physical frailty (J-CHS), sarcopenia (AWGS2019), and MCR (slow gait + subjective memory complaints), which are predictors of adverse events in the elderly. Multiple regression analysis with QMCOO as the response variable showed that MCR (p = 0.01, β: 0.25) and physical frailty (p < 0.01, β: 0.43) were significantly associated. In addition, analysis with JST-IC as the response variable showed that MCR (p = 0.03, β: -0.20), physical frailty (p = 0.01, β: -0.24) and age (p = 0.02, β: -0.21) were significantly associated. In conclusion, MCR was found to be similarly associated with QMCOO and JST-IC as physical frailty. It is expected that the MCR will be used as an initial screening tool to identify signs of risk in community-dwelling older people, as it is easy to diagnose.

Everyday ageism experienced by community-dwelling older people with frailty.

Ageism encapsulates stereotypes, prejudice and discrimination towards others or oneself based on age. While identified as the most frequent form of discrimination, relatively little work has captured the problem of day-to-day ageism faced by older people with frailty in community settings. The aim of this study therefore was to examine the prevalence of everyday ageism experienced by older people attending hospital-based ambulatory care services, and to clarify its association with measures of quality of life (QOL) and frailty. A consecutive series (n = 100) of patients aged ≥ 70years attending ambulatory care completed focused interviews. Day-to-day experience of ageism was measured with the everyday ageism scale, QOL was measured with the control autonomy self-realisation pleasure scale. Just over half of participants reported exposure to ageist messages; over 5/6 reported experiencing ageism in interpersonal interactions and 2/3 held some ageist beliefs themselves. Logistic regression demonstrated that experiencing ageism in interpersonal interactions was associated with a higher likelihood of internalised ageism [Adjusted Odds Ratio 6.02 (95% CI 1.70, 21.34); p = 0.005)]. Both ageism in interpersonal interactions [β = -5.22 (95% CI -9.52, -0.91); p = 0.018] and internalised ageism [β = -5.36 (95% CI -8.75, -1.97); p = 0.002] were associated with significantly lower QOL. This study highlights the striking prevalence of everyday ageism experienced by a cohort of community-dwelling older people with frailty and multimorbidity. In the context of further projected demographic changes in coming decades, with increasingly higher proportions of older people worldwide, these findings highlight an important societal issue that needs to be addressed.

Exercise and Sports Science Australia updated position statement on exercise for preventing falls in older people living in the community

BackgroundsFalls affect a significant number of older Australians and present a major challenge to health care providers and health systems with over 380 older Australians hospitalised for a fall each day. ObjectivesThis statement seeks to inform and guide exercise practitioners and health professionals in safe and effective prescription of exercise to prevent falls amongst community-dwelling older people. Exercise prescription to prevent fallsExercise is crucial for preventing falls in older age. Research evidence has identified that programmes which include functional balance and muscle strength training are the most effective in preventing falls. It is also important for exercise to be progressively challenging, ongoing and of sufficient dose to maximise its benefits in reducing falls. Additional (non-exercise) interventions are necessary for people with complex medical conditions, recent hospitalisation and/or particular risk factors not improved by exercise. People at a higher risk of falls may need greater support to undertake safe and effective fall prevention exercise. SummaryGlobal guidelines for fall prevention and management recommend that all older adults should receive advice about exercise to prevent falls. Qualified exercise professionals are well placed to prescribe and supervise functional balance and muscle strength training to older people with varied functional abilities, including those with co-morbidities.

Factors Influencing Older People's Intentions to Vaccinate.

Vaccination is crucial in reducing the spread of disease and improving overall patient mortality. Limited information exists regarding pharmacist accessibility outside traditional medical settings or impact on older patients' intention to vaccinate. This study aimed to examine patient perceptions regarding pharmacist accessibility and vaccination intention. Researchers used a quantitative research method of older people from Ohio, Kentucky, and Indiana. A survey was given to community-dwelling older people who attended different vaccine clinics. The survey included 10 questions describing reasons for not receiving vaccines in the past, how likely they are to receive vaccines if administered at community events, and the importance of having easy access to vaccines. For Likert-type items, a 5-point scale was used. The surveys were collected electronically and anonymously from several community events. Aggregate data were analyzed with descriptive and inferential statistics. One hundred seventy-eight responses were collected. The average age of participants was 75 years, and 70.8% were females. Of the respondents, 44.9% preferred to receive vaccines at a community center, 17.4% at the doctor's office, 4.5% at a clinic, and 9.6% at a sporting event like a boxing match. Men were more likely to receive a vaccine at a sporting event, while women were more likely to be interested in receiving a vaccine at a community center (P < 0.05). Respondents somewhat agreed (median = 4, interquartile range = 3-5) that they do not have transportation to places with vaccines. Age was significantly and negatively correlated with educational attainment (P < 0.001). However, as participants' ages increased, they were significantly more likely to have a belief that vaccines do not work (P = 0.011). The study addressed how pharmacists should consider more community outreach events in convenient locations, like community centers, for older people to improve vaccination rates.