Age Health Research Articles

Clear as a bell? Policy stringency and elderly health during Covid-19

This paper investigates how restriction policies have impacted elderly self-assessed health (SAH) in Europe during the pandemic, and how the Covid-19 infection interacts with policy stringency to modulate the SAH deterioration. Using the Survey of Health, Aging and Retirement in Europe (SHARE) between October 2019 and August 2021, including 9,034 adults aged 50 years and above, alongside with a stringency index from the Oxford's Coronavirus Government Response Tracker (OxCGRT), we design both an adjusted probit model and a recursive bivariate probit model to test for endogeneity of Covid-19 infection. Estimations results show a bell curve between stringency and SAH degradation: a deleterious effect of restrictions at low levels of stringency up to a tipping point after which more stringent policies become protective. Covid-19 infection moderates this association. Depending on individuals' initial health, the effect of restrictions is uneven: highly stringent policies become damaging for individuals most likely to enter a vulnerabilization path, for whom the bell curve is thus inverted. Overall, this study shows clear patterns of association between policy stringency and perceived health among older Europeans, and highlights the potential trade-off between targeting as many people as possible, those in poor health or those on the edge of vulnerability.

Exploring the knowledge and skills for effective family caregiving in elderly home care: a qualitative study.

Family caregivers play a crucial role in providing physical, emotional, and social support to the elderly, allowing them to maintain their independence and stay in their preferred living environment. However, family caregivers face numerous challenges and require specific knowledge and skills to provide effective care. Therefore, understanding the knowledge and skills required for effective family caregiving in elderly home care is vital to support both the caregivers and the elderly recipients. The research was carried out in Mekelle City, Ethiopia, utilizing the phenomenology study design and purposive sampling technique. A total of twenty-two in-depth interviews were conducted. Individuals with experience in providing care for elderly people in their homes were targeted. Data was gathered through the use of an open-ended guide, transcribed word-for-word, inputted into ATLAS.ti8 software, and translated. Codes and themes were then extracted from the transcribed data, and a thematic analysis was performed. To minimize personal biases, the collected data were coded independently by the data collection assistants and the PI. The analysis was carried out by authors who were not involved in the data collection process. The interviews were conducted in a quiet place. A total of 22 in-depth interviews were conducted as part of this research. The results indicated that although the participants had knowledge about common health problems experienced by older people, they were uninformed about how to manage these conditions at home and were unaware of specialized healthcare resources for the elderly. Furthermore, they had limited knowledge about suitable exercise routines, strategies to prevent falls, and home healthcare practices for older individuals. On the other hand, they exhibited a solid comprehension and awareness of abusive behaviors specifically directed at older adults. The results emphasized the importance of enhancing education and training for family caregivers in handling elderly health issues, raising awareness about specialized healthcare services catered to the elderly, improving understanding of activities of daily living (ADLs) and fall prevention, and offering inclusive training in healthcare tasks related to elder care. Participants should receive comprehensive education and training programs to enhance their knowledge and skills in managing these conditions. Efforts should also be made to raise awareness about the availability of geriatric hospitals or specialized nurses for the elderly. Participants need to be educated about suitable exercise routines for the elderly and fall prevention strategies. Healthcare skills training is also necessary for participants, focusing on activities such as wound dressing, vital sign monitoring, and establishing a specific schedule for changing positions.

Advantages, Risks, and Safeguards on Digital Engagement to Elderly Mental Health: A Literature Review of China

Recently, China's elderly population has confronted escalating mental health challenges, and prompted immediate interventions. This study roots in an extensive literature review, and explores the potential of digital engagement as a solution. By analyzing the relevant domestic and international publications, the researches delved into the interplay between digital engagement and elderly mental health. Findings indicates that digital platforms play a pivotal role in granting the elderly vital health information and fostering intergenerational communication. The internet notably boosts the elderly's social capital, improves life satisfaction, and defies age-associated productivity misconceptions. However, over-reliance on digital platforms risks reducing personal interactions, further straining their mental health. For optimal mental well-being enhancement via digital tools, a collaborative approach involving the government, community entities, families, and the elderly is paramount. As we leverage these digital advantages, it is crucial to stay vigilant to potential pitfalls, and it aims to a holistic strategy towards elderly mental health.

Overlap between Osteosarcopenia and Frailty and their Association with Poor Health Conditions: The Bushehr Elderly Health Program.

The aim of this study was to investigate the association of osteosarcopenia with frailty and poor health conditions among older Iranian adults. This cross-sectional study analyzed data from the Bushehr Elderly Health Program. Osteosarcopenia was defined as the presence of osteopenia/osteoporosis and sarcopenia, while the Fried criteria were used to assess frailty. We assessed the history of falls and health-related quality of life (HRQoL), including physical and mental component summaries (PCS and MCS, respectively), history of fractures, activities of daily living (ADL), and instrumental activities of daily living (IADL), as indicators of poor health conditions. This study included a total of 2,371 older adults. The prevalence rates of osteosarcopenia-only, frailty-only, and osteosarcopenia with frailty were 17.4%, 3%, and 4.8%, respectively. The prevalence of a history of falls, poor ADL, and poor IADL was significantly higher in the frailty-only and osteosarcopenia with frailty groups. Osteosarcopenia with frailty was significantly associated with a history of falls (adjusted odds ratio [adjOR]=1.94; 95% confidence interval [CI], 1.20-3.15), poor ADL (adjOR=2.85; 95% CI, 1.81-4.50), and poor IADL (adjOR=5.09; 95% CI, 2.85-9.11). However, the frailty-only group also showed an association with falls and poor ADL and IADL. Only osteosarcopenia was associated with an increased OR for fracture. Frailty had the greatest effect on the MCS and PCS scores, whereas osteosarcopenia with frailty had a moderate impact. Osteosarcopenia with frailty significantly increased the odds of falls, poor ADL, poor IADL, and lower HRQoL compared with the robust group. Combined osteosarcopenia and frailty were not associated with poor health. These findings indicate the importance of diagnosing osteosarcopenia and frailty as separate entities to provide appropriate interventions and treatment.

IJCM_338A: Burden Of Common Mental Health Disorders Using GHQ-12 Scale Among The Tribal And Rural Elderly Population In Mysore District.

Background: Common mental disorders (CMD) are a group of distress states manifesting with anxiety, depressive, and unexplained somatic symptoms and are the contemporary equivalent to the older concept of neurotic disorders. Various prevalence studies have shown that elderly population are more vulnerable to such mental health disorders as compared to the younger population. The available literature indicates that there is hardly any effort to understand the morbidity and the needs of such elderly people. Objective: i. To estimate the burden of common mental disorders among tribal and rural elderly population using GHQ -12. ii. To estimate the association between common mental disorders and sociodemographic factors. Methodology: This is a community based cross sectional study. It was among the tribal and rural elderly population of Mysore district from June to September 2023 using General Health Questionnairre-12(GHQ-12). The 12-Item General Health Questionnaire (GHQ-12) is the most extensively used screening instrument for common mental disorders. The GHQ-12 has generally demonstrated good sensitivity and specificity in various populations. The sampling method adopted for this study was multistage sampling and in the final stage participants were selected using simple random sampling Results: The prevalence of common mental disorders was 35% among rural elderly population and 43% among tribal elderly population. The prevalence of common mental disorders was found to be high among women in both rural and tribal elderly population and the difference was found to be statistically significant Conclusion: There are limitations in the study as cross-sectional type of study design was used. Further, analytical studies can be conducted to prove the causative association between common mental disorders and various socio- cultural factor. However, the findings of the study can be used to plan the necessary interventions in the field of elderly mental health

Integration of Geriatric Psychiatry and Geriatrics: Enhancing Mental Health Assessment in the Elderly

IntroductionThe ageing population presents complex clinical challenges, particularly in the realm of mental health among the elderly. The intersection of geriatric psychiatry and geriatrics plays a critical role in providing a holistic and comprehensive approach to addressing psychiatric issues in older adults. This abstract explores the integration of these two disciplines and their significance in elderly mental health care.ObjectivesThis study aims to underscore the benefits of collaboration between geriatric psychiatry and geriatrics while highlighting areas of intersection. These areas include the assessment of medical and psychiatric comorbidities, the management of neuropsychiatric disorders, and the promotion of healthy ageing, both physically and mentally.MethodsWe comprehensively reviewed the literature, encompassing research studies, case reports, clinical guidelines, and reports published in the last 10 years. The research was conducted on medical databases, including PubMed, Medline, and specialized sources in gerontology.Results Effective integration between geriatric psychiatry and geriatrics provides a more comprehensive and patient-centred approach to addressing the mental health needs of the elderly. This includes enhanced assessment and treatment of a wide range of psychiatric conditions commonly found in older adults, such as cognitive disorders (including dementia and mild cognitive impairment), mood disorders (including depression and bipolar disorder), anxiety disorders, psychotic disorders, and substance use disorders. Additionally, the collaboration ensures a better understanding of the complex interplay between physical and mental health in the ageing population. The integration approach also encompasses the management of neuropsychiatric symptoms associated with various medical conditions common in older adults, such as delirium and behavioural disturbances in dementia. This coordinated care extends to the judicious use of psychotropic medications, considering the unique pharmacokinetics and pharmacodynamics in the elderly population, with a focus on minimizing adverse effects and drug-drug interactions. Furthermore, promoting emotional well-being and preventing mental illnesses emerge as critical areas of collaboration between these disciplines. Strategies for achieving this goal include psychoeducation, lifestyle interventions, and fostering a supportive environment for the elderly.Conclusions In summary, the collaboration between geriatric psychiatry and geriatrics is crucial for addressing the complex mental health needs of the elderly, providing patient-centred care, and optimizing resources. This integrated approach is essential in ensuring the well-being of older adults, emphasizing a holistic, multidisciplinary approach to mental health issues in this population.Disclosure of InterestNone Declared

Determinants of Elderly Health Service Utilization in Mangunrejo Village, Wonorejo Health Center Working Area Ngadiluwih District, Kediri Regency

Determinants of Elderly Health Service Utilization in Mangunrejo Village, Wonorejo Health Center Working Area Ngadiluwih District, Kediri Regency

The Effects of a Healthy Lifestyle on Depressive Symptoms in Older Chinese Adults: The Mediating Role of Psychological Resilience.

Objectives This study aimed to validate the interrelationships and potential pathways of influence between healthy lifestyles, psychological resilience, and depressive symptoms in the Chinese elderly population. Methods We utilized data from the Chinese Elderly Health Influential Factors Tracking Survey 2018 and included 9448 samples for the study after screening according to the qualifying conditions. The interrelationships among healthy lifestyles, psychological resilience and depressive symptoms were analyzed using stepwise regression, and the robustness of mediation effects was assessed using Sobel and Bootstrap test. Results Among Chinese older adults, healthy lifestyles were negatively associated with depressive symptoms (β = -0.310, 95% CI: -0.405, -0.215), positively associated with psychological resilience (β = 0.137, 95% CI:0.071, 0.023), and psychological resilience was negatively associated with depressive symptoms (β = -1.014, 95% CI: -1.037, -0.990). Conclusions Psychological resilience partially mediated the association between healthy lifestyles and depressive symptoms, with the mediating effect accounting for 44.8% of the total effect. Our study contributes to the understanding of the relationship between healthy lifestyles and depressive symptoms in the elderly population and emphasizes the important role of psychological resilience. It is recommended that the government and policymakers improve depressive symptoms among older adults through comprehensive measures such as promoting healthy lifestyles and education, providing psychological support services, and creating a favorable environment.

Progressive Muscle Relaxation Therapy to Lower High Blood Pressure in the Elderly Through Community Service Midwifery Lecturer Unand

Background: Elderly health is an increasingly urgent aspect in today's social dynamics. With the increasing number of elderly people in the population, healthcare challenges specific to them are increasingly important to discover. Purpose: This study aims to analyze Progressive Muscle Relaxation Therapy to Lower High Blood Pressure in the Elderly Through Community Service Method: A series of activities were carried out in several stages, with active participation from the elderly Results: The results are in line with previous research that has also shown the effectiveness of this therapy in lowering blood pressure and relieving stress in the elderly population. Increased understanding of progressive muscle relaxation therapy is an important first step in the management of high blood pressure. Participants who better understand these relaxation techniques can use them as aids to maintain their health in the long term. Conclusion: Community service by applying progressive muscle relaxation therapy has proven its benefits in lowering high blood pressure in the elderly. Increased understanding of this therapy, decreased blood pressure, and increased feelings of relaxation are encouraging results

Aspects that Influence Patient Satisfaction at the Elderly Clinic at Puskesmas X Surabaya

In 2021 figures pain elderly reached 21.61%, while 41.42% of the population elderly experience complaint health and 36.97% of the population elderly No experience disturbance health. Treatment efforts undertaken to Public health center recorded 14.25% figure the low compared to effort treatment carried out in practice doctor amounting to 47.50%. Obstacle in increase health and well-being elderly influenced by quality services provided Public health center for all over patients in the elderly clinic. Measurement level satisfaction patients in the study This using five aspects of service quality (SERVQUAL), namely aspect evaluation including aspects reliability, aspect responsiveness, aspect guarantee, aspect empathy and aspect proof physique. Research purposes This for know description level satisfaction patient based on SERVQUAL aspects in patients at the Elderly Clinic X Surabaya Community Health Center. Study manifold observational analytic Cross-Sectional design. Amount respondents used as many as 62 patients using Simple Random Sampling Technique. Data collection using questionnaire with scale likert. Data analysis used the Spearmen Rank correlation test. Research result obtained quality service aspect reliability of 49 patients satisfied (79%), aspect responsiveness of 53 patients satisfied (85.5%), aspect guaranteed 44 patients satisfied (71%), aspect empathy 47 patients satisfied (75.8%), and aspects proof physical of 50 patients satisfied (80.6%) but 2 patients not enough satisfied (3.2%). Analysis results there is significant relationship between quality elderly poly services to satisfaction patients at Puskesmas X Surabaya with mark significance 0.000 (< 0.05).

The Effects of Psychoeducation Intervention with Progressive Muscle Relaxation Video Therapy on Anxiety Levels in Elderly with Hypertension in Salem Village

Background: Anxiety is a common reaction to situations individuals perceive as dangerous or threatening. Prolonged anxiety can disrupt a person's thoughts and behaviors. Elderly individuals often experience anxiety, primarily related to their illnesses, with hypertension being prevalent among them. The advantage of health education using video media lies in its ability to provide effective visualization to facilitate the learning process. Method: This study employed a Pre - Experimental research design with a quantitative approach, explicitly utilizing a one-group pretest-posttest design. Sampling was conducted using random sampling, with a sample size of 54 respondents. The Hamilton Anxiety Rating Scale (HARS) was used to measure anxiety. Results: The average pre-test anxiety score before the intervention was 29.79, while the average post-test score showed a decrease of 4.00, resulting in a score of 25.79. Statistical analysis using the Wilcoxon test obtained a p-value for the pre-test and post-test of 0.000 (0.050), indicating that psychoeducation intervention with PMR video therapy affected anxiety levels in the elderly with hypertension at the Salem Village Elderly Health Post. Conclusion: Psychoeducation intervention with PMR video therapy affects anxiety levels in the elderly with hypertension in Salem Village.

The association between quality of life and diabetes: the Bushehr Elderly Health Program

Background and objectiveConsidering the importance of diabetes and its increased prevalence with aging, this study aimed to evaluate the association between diabetes status and quality of life (QOL) and the determining factors in individuals over 60.MethodsTwo thousand three hundred seventy-five individuals including 819 (34.5%) with diabetes, aged 69.4 ± 6.4, from Bushehr Elderly Health Program (BEHP) were enrolled. We categorized the participants as non-diabetic, controlled diabetic, and poorly controlled diabetic. The QOL was assessed using the SF-12 questionnaire. The physical (PCS) and mental (MCS) component summaries of QOL were estimated. We compared the SF-12 domains and components between the categories using ANOVA. Further, the association of diabetes status with PCS and MCS was assessed after adjustment for possible confounders including age, sex, depression, cognitive impairment, physical activity, and other relevant factors using linear regression analysis.ResultsIndividuals with diabetes had lower PCS (40.9 ± 8.8 vs. 42.7 ± 8.6, p-value < 0.001), and MCS scores (45.0 ± 10.2 vs. 46.4 ± 9.4, p-value < 0.001) compared to participants without diabetes. No significant differences were observed in PCS or MCS scores between controlled or poorly controlled individuals with diabetes. Diabetes status was associated with PCS and MCS scores in univariable analysis. Regarding physical component of QOL, after adjusting for other confounders, poorly controlled diabetes was significantly associated with PCS [beta: -1.27 (-2.02, -0.52)]; some other determinants include depression [-7.66 (-8.51, -6.80)], male sex [3.90 (3.24,4.57)], and good physical activity [1.87 (1.17,2.57)]. As for the mental component, controlled diabetes was significantly associated with MCS [-1.17 (-2.13, -0.22)]; other contributing factors include depression [-14.35 (-15.34, -13.37)], male sex [1.97 (1.20,2.73)], good physical activity [-1.55 (-2.35, -0.75)], and smoking [-1.42 (-2.24, -0.59)]. BMI had an inverse association with PCS [-0.19 (-0.26, -0.13)] and a direct association with MCS [0.14 (0.07,0.21)].ConclusionIndividuals with diabetes exhibited reduced QOL scores. Upon adjusting for other variables, it was found that uncontrolled diabetes correlated with decreased PCS scores, whereas controlled diabetes was linked to lower MCS scores. Factors such as depression and being female were identified as contributors to diminished QOL in both physical and mental aspects. These results have the potential to guide healthcare decision-making, facilitating the creation of tailored interventions aimed at improving the QOL for individuals with diabetes, with a specific focus on women and depression.

Analysis of Health Data for the Elderly based on Medical Website Mining

The development of Internet medicine provides a convenient platform for doctor-patient communication, and provides an important data source for paying attention to the health of the elderly. In this study, a large number of consultation records obtained from the medical website was screened and cleaned, and the medical thesaurus was generated by training of its own data to solve the problem of inaccurate professional terminology segmentation caused by using default jieba segmentation. At the same time, we use the trained medical thesaurus to conduct topic mining of the consultation data, and it is found that the most concerned problems in the field of elderly health are cerebro-cardiovascular, pulmonary and stomach diseases, so as to provide further medical advice and targeted services.

Determinants of multimorbidity in older adults in Iran: a cross-sectional study using latent class analysis on the Bushehr Elderly Health (BEH) program

Background and objectivesMultimorbidity, defined as the presence of two or more long-term health conditions in an individual, is one of the most significant challenges facing health systems worldwide. This study aimed to identify determinants of classes of multimorbidity among older adults in Iran.Research Design and methodsIn a cross-sectional sample of older adults (aged ≥ 60 years) from the second stage of the Bushehr Elderly Health (BEH) program in southern Iran, latent class analysis (LCA) was used to identify patterns of multimorbidity. Multinomial logistic regression was conducted to investigate factors associated with each multimorbidity class, including age, gender, education, household income, physical activity, smoking status, and polypharmacy.ResultsIn 2,426 study participants (mean age 69 years, 52% female), the overall prevalence of multimorbidity was 80.2%. Among those with multimorbidity, 3 latent classes were identified. These comprised: class 1, individuals with a low burden of multisystem disease (56.9%); class 2, individuals with predominantly cardiovascular-metabolic disorders (25.8%) and class 3, individuals with predominantly cognitive and metabolic disorders (17.1%). Compared with men, women were more likely to belong to class 2 (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.52–2.54) and class 3 (OR 4.52, 95% CI 3.22–6.35). Polypharmacy was associated with membership class 2 (OR 3.52, 95% CI: 2.65–4.68) and class 3 (OR 1.84, 95% CI 1.28–2.63). Smoking was associated with membership in class 3 (OR 1.44, 95% CI 1.01–2.08). Individuals with higher education levels (59%) and higher levels of physical activity (39%) were less likely to belong to class 3 (OR 0.41; 95% CI: 0.28–0.62) and to class 2 (OR 0.61; 95% CI: 0.38–0.97), respectively. Those at older age were less likely to belong to class 2 (OR 0.95).Discussion and implicationsA large proportion of older adults in Iran have multimorbidity. Female sex, polypharmacy, sedentary lifestyle, and poor education levels were associated with cardiovascular-metabolic multimorbidity and cognitive and metabolic multimorbidity. A greater understanding of the determinants of multimorbidity may lead to strategies to prevent its development.

Unlocking the potential of smartphone and ambient sensors for ADL detection

The detection of Activities of Daily Living (ADL) holds significant importance in a range of applications, including elderly care and health monitoring. Our research focuses on the relevance of ADL detection in elderly care, highlighting the importance of accurate and unobtrusive monitoring. In this paper, we present a novel approach that that leverages smartphone data as the primary source for detecting ADLs. Additionally, we investigate the possibilities offered by ambient sensors installed in smart home environments to complement the smartphone data and optimize the ADL detection. Our approach uses a Long Short-Term Memory (LSTM) model. One of the key contributions of our work is defining ADL detection as a multilabeling problem, allowing us to detect different activities that occur simultaneously. This is particularly valuable since in real-world scenarios, individuals can perform multiple activities concurrently, such as cooking while watching TV. We also made use of unlabeled data to further enhance the accuracy of our model. Performance is evaluated on a real-world collected dataset, strengthening reliability of our findings. We also made the dataset openly available for further research and analysis. Results show that utilizing smartphone data alone already yields satisfactory results, above 50% true positive rate and balanced accuracy for all activities, providing a convenient and non-intrusive method for ADL detection. However, by incorporating ambient sensors, as an additional data source, one can improve the balanced accuracy of the ADL detection by 7% and 8% of balanced accuracy and true positive rate respectively, on average.

Evaluation of the prevalence of cardiometabolic disorders (diabetes, hypertension, and hyperlipidemia) diagnosed, undiagnosed, treated, and treatment goal in the elderly: Bushehr Elderly Health Program (BEH)

As the population ages, the global burden of cardiometabolic disorders will increase. This study aimed to investigate the prevalence of cardiometabolic disorders (diabetes, hypertension, and hyperlipidemia) in elderly and to evaluate the effects of various variables including age, sex, education, marital status, smoking, income, physical activity, dementia and depressed mood on untreated cardiometabolic disorders. This was a cross sectional study conducted in Bushehr Elderly Health Program. A total 2381 participants were included. Medical data were collected by trained interviewers. The mean age of the study participants was 69.34 years. Proportions of diabetes, hypertension, hyperlipidemia and hypercholesterolemia were 43.25%, 75.71%, 64.74% and 35.31% respectively. Untreated diabetes prevalence was higher for males (OR = 1.60, 95%CI = 1.20–2.15), older adults (OR = 1.02, 95%CI = 1.00–1.05), and pre-frail status (OR = 0.69, 95%CI = 0.52–0.92). Males (OR = 2.16, 95%CI = 1.64–2.84) and current smokers (OR = 1.42, 95%CI = 1.05–1.93), in contrast to married participants (OR = 0.25, 95%CI = 0.08–0.78), people with higher education levels (OR = 0.51, 95%CI = 0.29–0.89) and dementia (OR = 0.78, 95%CI = 0.61–1.00) were more likely to have untreated HTN. Untreated dyslipidemia is more common in smokers (OR = 1.78, 95%CI = 1.19–2.66) and males (OR = 1.66, 95%CI = 1.21–2.27), while untreated hypercholesteremia is more common in males (OR = 3.20, 95%CI = 1.53–6.69) and is reported lower in people with dementia (OR = 0.53, 95%CI = 0.28–1.01).

Care workers’ practices in oral healthcare for the elderly : Mediating role of elderly oral healthcare education and behavioral needs

Objectives: This study aimed to assess the impact of care workers’ knowledge of elderly oral health, education on elderly oral healthcare and behavioral needs, awareness of elderly oral healthcare, and actual practices in elderly oral healthcare. Furthermore, it explores the mediating effects of elderly oral healthcare education and behavioral needs on the relationship between awareness and practice. Methods: Data were collected from October 11 to December 29, 2023, from 172 certified care workers employed in nursing hospitals and other workplaces. For analyzing the data, t-test, one-way ANOVA, Pearson’s correlation, and hierarchical regression were conducted using SPSS Statistics 21.0. Results: Elderly oral health knowledge, education and behavioral needs, awareness, and practice were significantly higher among: those aged 51 years and older, female, primarily working in nursing hospitals, with a total career span of 10 years, higher job satisfaction, in organizations prioritizing elderly oral healthcare, and with superior education in elderly oral health. Elderly oral healthcare education and behavioral needs had partial mediating effects on the relationship between care workers’ awareness and practice of elderly oral healthcare. Conclusions: The current practices and challenges in care workers’ oral healthcare for the elderly will be analyzed, and recommendations and strategies for improving practices will be formulated.

Development of an evidence-informed governance and stewardship framework for elderly healthcare in Iran: A qualitative study

BackgroundThe ageing population poses significant challenges to healthcare systems, necessitating the establishment of high-functioning, integrated frameworks for elderly healthcare. This study aimed to explore the key challenges associated with the stewardship of elderly care in Iran and to develop a holistic stewardship framework. MethodsFor this qualitative study, thirty semi-structured interviews were conducted with key Iranian healthcare stakeholders, utilizing purposive and snowball sampling during 2021–2022. Inductive open coding was utilized to generate new concepts related to key stewardship challenges. The World Health Organization's conceptual framework, outlining the three stewardship tasks, served as the basis for crafting a tailored framework for elderly healthcare stewardship in Iran. ResultsFourteen main challenges and 38 sub-challenges were identified for elderly healthcare stewardship in Iran, categorized according to the WHO framework's three stewardship tasks. Challenges related to WHO stewardship task 1, involving health policy formulation and vision definition, included challenges in vision definition, planning, policymaking, and intergovernmental institutional superiority. Challenges related to WHO stewardship task 2, delineating governance and stewardship through control and regulation, encompassed issues such as support for the elderly, system responsiveness, behavior of healthcare providers, organizational structure, and cross-sectoral leadership challenges. Challenges associated with WHO stewardship task 3, about the use of collective intelligence, explored stakeholder collaboration, information for decision-making, and challenges within the elderly information system, covering data documentation, reporting, analysis, accessibility, distribution, and circulation. Subsequently, a framework was developed, covering areas like defining the vision and direction of health policy, managing information systems, evidence-informed policymaking, and delivering elderly health services with a holistic approach. ConclusionThe present framework shows how a management information system, guided by evidenced-informed policymaking and the formulation of customized health policies, can facilitate the provision of elderly health services based on identified needs. It presents a governance and stewardship pathway that can be adopted by Iranian health policymakers and similar middle-income countries facing analogous challenges in ageing and aged care system stewardship, serving as a model for developing their own frameworks.

PREVALENCE OF DEATHS IN ELDERLY PEOPLE WITH ACQUIRED HUMAN IMMUNODEFICIENCY SYNDROME IN THE NORTHEAST REGION

Acquired Immunodeficiency Syndrome (AIDS) is a disease of the immune system caused by the retrovirus HIV ― from English, Human Immunodeficiency Virus and the present study aims to analyze the prevalence and cases of AIDS deaths in the elderly population in the Northeastern state, from 2015 to 2019. This is a descriptive study obtained from the Health Information System provided by TABNET, referring to elderly people with HIV/AIDS, who were notified in the northeast region in the period from 2015 to 2017. Thus, in the years 2015 and 2017, there were 76 deaths from the Human Immunodeficiency Virus (HIV) reported in the Northeast region of Brazil. Of these, 22 cases of deaths were related to the elderly population of Bahia, and the State of Alagoas had the lowest number, just 2 deaths. Regarding AIDS cases identified in the Northeast state, from 2015 to 2019, 1,204 cases of AIDS were reported. Absolutely, the states that reported the most were Bahia (233 cases), Pernambuco (224 cases), Maranhão (190 cases) and Ceará (185 cases). Based on above considerations, prevention campaigns aimed only at the elderly population, health professionals and caregivers unprepared are necessary to provide information regarding sexuality and sexual practices for elderly people in the Federative Units and regions.

AI-Driven cardiac wellness: Predictive modeling for elderly heart health optimization

AI-Driven cardiac wellness: Predictive modeling for elderly heart health optimization