Healthy Aging In Place Research Articles

Benefit-Cost Analyses of Hearing Aids, Over-the-Counter Hearing Devices, and Hearing Care Services.

Limited accessibility to hearing health care threatens healthy aging in place for older adults with hearing loss. A willingness-to-pay (WTP) approach was used to determine benefits and value of prescription advanced digital technology (ADT) hearing aids, over-the-counter (OTC) hearing devices, and rehabilitative services using benefit-cost analyses. This study was a cross-sectional survey with chart review of hearing aid users at two independent audiology practices. Seventy hearing aid users (response rate: 15.6%) provided their WTP for ADT prescription hearing aids, OTC hearing devices, and hearing rehabilitative services. Benefit-cost ratios and net social benefit were calculated using deterministic and exploratory approaches. Point estimates for benefit-cost ratios and net social benefit were derived using bootstrap sampling with replacement (N = 5,000). Median WTP for ADT prescription hearing aids and rehabilitative services were $2,000 and $250, respectively. WTP was lowest for OTC devices (Mdn = $0; maximum = $500). Benefit-cost ratios and net social benefit for ADT prescription hearing aids, OTC devices, and hearing rehabilitative services favored these interventions when out-of-pocket costs remained low. Benefit-cost analyses also produced results favoring prescription ADT hearing aid intervention with costs as high as $1,530 per device. WTP results indicated that all interventions under study have a measurable consumer-perceived benefit. Results of benefit-cost analyses favored the interventions but only when costs were lower than market prices. The benefit-cost analysis results for hearing care services underscore their value when provided as part of a comprehensive rehabilitative plan that may inform future health policy changes.

Agent-based modelling and simulation of elderly residents’ dynamic usage patterns in neighbourhood squares during summer

Understanding how elderly residents use neighbourhood squares is helpful for designing these public areas to maximize their usage and minimize heat exposure risks, especially given the global increase in heatwaves and initiatives for healthy aging in place. This study aims to explore the dynamic use of a neighbourhood square with multiple shade configurations by its elderly residents. In-situ observations and measurements in three squares in public housing estates in Hong Kong were conducted in hot summer days to learn the relationship between elderly users' usage behaviours and multiple driving factors, including outdoor thermal environment, level of social interaction, and different shade types. The relationship was then used to develop an agent-based model (ABM) to simulate the dynamic usage pattern in a square over a day. The result indicates that the dynamic usage pattern from 9:00 to 18:00 in a square emerges from interactions between elderly users’ behaviours and shade configurations, which can be reasonably estimated by the developed ABM. Based on the ABM simulation, shade configurations that cover 60 % of the square and create microclimates with a maximum mPET not exceeding 34.0 °C during summer days encourage square usage and mitigate heat-stress risks of elderly users. The prototype ABM enables the understanding of the complex usage pattern in a neighbourhood square and can potentially assist planning and optimization of shade configurations at the design/renewal stage.

Technology Use, Barriers, and Future Needs Among Community-Dwelling Older Adults.

Social isolation and loneliness are social determinants of health (SDOH) that can negatively affect the well-being of older adults. Using technology has the potential to reduce social isolation; thus, increasing safe use of technology among older adults can positively impact their health and promote aging in place. Older adults (N = 730) were surveyed regarding their use of, access and barriers to, satisfaction with, and anticipated future needs related to technology. Survey respondents found technology was a significant resource for staying connected; however, low levels of satisfaction with devices and fear of scams indicate the need for additional training on the best and safest use of technology. By screening older adults for SDOH, identifying their current and anticipated needs, and advocating for changes in health care and communities to meet these needs, nurses can help facilitate safe and healthy aging in place for their patients. [Journal of Gerontological Nursing, 50(2), 26-31.].

Unveiling Seniors' Perception of Mobility: Urbanization, Region, and Physical Activity.

Maintaining mobility is fundamental to active aging, allowing older adults to lead dynamic and independent lives. The perception of mobility among older adults significantly impacts their overall well-being and quality of life. Given the aging population, mobility has become an increasingly pressing issue. This study focused on the perception of urban neighborhoods, including considerations of urban tissue (crossings and sidewalk maintenance), urban scenes (benches and traffic), and safety (fears and street lighting quality). We investigated the differences in the perception of the surroundings of residences by urban and rural seniors concerning their demographic and social characteristics and environmental determinants. A quantitative study design utilizing a questionnaire survey was employed. Data were collected mainly through face-to-face interviews in the field (PAPI) and via an online questionnaire (CAWI). The final sample comprised 525 participants. Hypotheses regarding the influence of gender, age, social status, level of physical activity, degree of urbanization, and region on environmental perception were tested using ordinal regression. The hypothesis regarding the dependence of the perception of the surroundings on the level of urbanization was confirmed; that regarding the dependence of the perception of the residence surroundings on seniors' age was not confirmed. The other hypotheses were partially confirmed. For the seven investigated environmental attributes, gender was significant in two cases, social status and physical activity in three cases, and region in four cases. While most studies have focused on urban settings, this study highlights the situation in rural municipalities. Substantially worse pedestrian conditions in availability of pedestrian crossings, benches, and lighting were recognized in rural municipalities versus cities. Understanding the complexity of mobility and the spatial locations relevant for older persons concerning potential barriers and facilitators for mobility aids in planning and adapting neighborhood environments to promote active and healthy aging in place.

Medication self-management capacity among older adults living in low-income housing communities

BackgroundMedication self-management capacity (MMC) is essential to safe and independent living. There is a need to understand the challenges low-income older adults face during the routine use of medications to promote safe medication use and healthy aging in place. ObjectiveTo assess the cognitive and physical deficiencies in MMC and the impact of using pharmaceutical aids/services on MMC among low-income older adults. MethodsThis was a cross-sectional study of 107 older residents of 5 low-income housing buildings in Richmond, VA. The Medication Management Instrument for Deficiencies in the Elderly was used to measure MMC during individual in-person interviews. Participants were asked whether they used any medication aids, including medication lists, organizers, or reminders, or pharmacy services such as specialized medication packaging, medication synchronization, prescription home delivery, or mail order services. Multiple regression modeling was used to assess the relationship between MMC and the use of pharmaceutical aids/services. ResultsEighty-nine percent of participants were African American with a mean (standard deviation [±SD]) age of 68.5 (7.2) years. The mean deficit in MMC was 3 (±2.0). The most challenging skill was naming all the medications (69.2%), followed by stating their indications (46.7%) and knowing how or when all of the medications should be taken (38.3%). Seventy-nine percent used at least 1 pharmaceutical aid/service; using 1 pharmaceutical aid/service was significantly associated with better MMC (P = .0285). Low educational level and health literacy were associated with deficits in MMC (P < .05). ConclusionMany older adults residing in low-income housing had impaired capacity to manage their medications independently. Inadequate medication knowledge affected their cognitive ability to manage medications. Using a pharmaceutical aid/service was associated with better MMC. Greater attention to developing medication self-management skills for older adults with low health literacy and adverse social determinants of health is needed.

COGNITION IN CONTEXT: INVESTIGATING THE ROLE OF BUILT, SOCIAL, AND NATURAL ENVIRONMENTS IN COGNITIVE AGING

Abstract While a growing body of evidence points to potentially modifiable individual risk factors for Alzheimer’s Disease and Related Dementias (ADRD), the contexts in which people develop and navigate cognitive decline are largely overlooked. Geographic variation in ADRD rates suggest that environmental risk and protective factors may be important in cognitive aging and dementia caregiving. Community hazards are often heavily concentrated in underserved and underrepresented neighborhoods. This symposium aims to identify specific built, social, and natural environmental features associated with cognitive aging outcomes. The papers provide much-needed evidence on the role of neighborhoods and community networks for cognitive health and well-being among diverse older adults. First, Godina finds significant associations between neighborhood greenspace and microstructural indicators of brain health. Second, Westrick investigates the role of neighborhood disadvantage on long-term memory aging of older adults with and without a cancer diagnosis in later-life. Third, Finlay presents a new concept of Cognability to demonstrate which constellation of positive and negative neighborhood features may contribute most to healthy cognitive aging. Fourth, Nkimbeng identifies community networks and resources needed to inform dementia education and support care among African immigrants. Fifth, expert discussant Besser will share how these findings may inform upstream health promotion and reduce ADRD risk. She will discuss critical future research directions and methods to investigate environments of cognition. The symposium advances research assessing contexts of aging, and may inform public health and policy efforts to ameliorate community barriers and create more equitable opportunities to promote healthy aging in place.

CONTEXTS OF COGNITIVE DECLINE: MAPPING NEIGHBORHOOD OPPORTUNITIES AND BARRIERS FOR HEALTHY AGING IN PLACE

Abstract Stark geographic variation in later-life health outcomes suggests that local built and social environments are critical in shaping disease and disability, physical and cognitive function, and engagement in everyday life among older adults. This paper presents a community-engaged mapping project aiming to depict the uneven distribution of hazards and amenities relevant to cognitive aging across the United States. Living in neighborhoods with opportunities for social interaction (e.g., coffee shops, senior centers), intellectual stimulation (e.g., museums, libraries) and physical activity (e.g., parks, walkable streets) may slow rates of cognitive decline and reduce risk for Alzheimer’s disease. We assembled a community advisory board to translate research findings into a pilot website and interactive map that assesses neighborhoods for cognitive aging resources and amenities. The objective is to increase public awareness and inform public health and policy efforts to ameliorate community barriers and create more equitable opportunities to promote healthy aging in place.

SOCIAL PLACES: SHIFTING NEIGHBORHOOD PERCEPTIONS AMONG AGING AMERICANS DURING COVID-19

Abstract This study examines individual and community factors related to older adults’ perceived losses in places to socialize with people of similar and different ages in their neighborhoods during COVID-19. In the 11-month wave of the COVID-19 Coping Study from March-April 2021, responses to perceived availability were “Less,” “About the Same,” or “More.” Most respondents reported less availability in places to socialize with those of similar (68.0%) or different (68.4%) ages. Ordinal logistic regressions showed respondents who lived alone perceived less availability in places to socialize with those of similar or different ages than those living with others (ORs 0.67, 95% CI 0.47, 0.97). Those living in metropolitan compared to non-metropolitan areas also perceived less availability in places to socialize with those of similar ages (OR 0.62, 95% CI 0.39, 0.98). These findings enhance our understanding of COVID-19-related losses in community resources that facilitate healthy aging in place.

COGNABILITY: AN ECOLOGICAL THEORY OF NEIGHBORHOODS AND COGNITIVE AGING

Abstract This paper presents a new theoretical concept, Cognability, which aims to conceptualize how supportive an area is to cognitive health among aging residents. Cognability incorporates a both positive and negative neighborhood features related to physical activity, social interaction and cognitive stimulation in later life. We analyzed data from the Reasons for Geographic and Racial Differences in Stroke Study, a national sample of older Black and white US adults (n=21,151; mean age at assessment=67; data collected 2006–2017). Generalized additive multilevel models examined how cognitive function varied by neighborhood features. Access to civic and social organizations, recreation centers, fast-food and coffee establishments, arts centers, museums, and highways were significantly associated with cognitive function. Race-, gender-, and education-specific models did not yield substantial improvements to the full-model. Cognability advances ecological theories of aging through an innovative “whole neighborhood” approach. Findings may inform community interventions and policy to support healthy aging in place.

Effects of neighborhood features on healthy aging in place: the composition and context of urban parks and traditional local coffeeshops in Singapore

BackgroundHealthy aging in place is affected by what the neighborhood provides for older adults. The mixed-methods ethnographic study explored the built environmental and contextual effects of urban parks and traditional local coffeeshops (kopitiam) on health practices among older adults in Singapore.MethodsA door-to-door survey with 497 older adults from 32 residential blocks in a public housing town assessed exercise and smoking. The walking distances from the residential blocks to the facilities were calculated. Regression analysis examined the associations between the distance and rates of exercise and smoking. Ethnographic assessment data contextualized the quantitative findings.ResultsOlder adults’ exercise was associated with proximity to an urban park but not traditional local coffeeshops. High rates of smoking were clustered in the housing blocks close to the coffeeshops, which provided casual drinking places with smoking tables. The proximity to the coffeeshops was significantly associated with increased smoking and decreased exercise. A walking distance of 200 m to the park and coffeeshops was found to discriminate the outcomes.ConclusionsThe findings suggested that walking distances of a few blocks influenced health behaviors among older adults. Their smoking habits appeared to be maintained through environmental features and cultural norms attached to the coffeeshops. Policy of urban planning and redevelopment for the aging population needs to consider the socioecology of healthy aging in place.

Healthy aging in place during the pandemic in Northern Italy

Abstract Many elderly people would like to stay in their own homes as long as possible. Therefore, a focus on enabling factors for a healthy aging in place in needed. Italy was the first European country to be hit hard by the pandemic. These had an impact on people’s everyday lives, on social participation and freedom of movement for all sections of the population. But especially elderly people were considered a risk group and were urged to leave their homes as little as possible. The project aimed to analyse the situation of elderly people in South Tyrol (Northern Italy), focusing on the characteristics of enabling factors for a healthy ageing in place. The main research question was: What kind of enabling factors ensure a healthy aging in place during the pandemic? Using a mixed-methods-approach, we conducted 10 semi-structured interviews (experts: social workers, health professionals, responsible persons from senior associations, ...) analysed by qualitative content analysis and a quantitative questionnaire (536 respondents, aged 60 to 101 still living in their own home) from 2020 to 2021. The questionnaire was distributed in digital and analogue form to reach a wider study group and to facilitate access to the research group despite the infection control measures or technical challenges. The results show that there were numerous changes in the everyday life of elderly people during the pandemic, which were described as particularly important for a healthy ageing in place. Based on the answers to the pandemic-related restrictions, 6 categories could be identified: Loneliness versus desire for social contact, mobility, emotions, needs, opportunities, restrictions. To be able to guarantee healthy ageing in place, we need to examine and promote these enabling factors in the long term. Key messages • A focus on enabling factors for a healthy aging in place in needed. • There were numerous changes in the everyday life of elderly people during the pandemic, which were described as particularly important for a healthy ageing in place.

Aging out: Place and sexuality

This paper explores LGBT retirees as agents of change who are renegotiating the terms of healthy aging in place and expanding our understanding of lifestyle and retirement migration. For the first time in history, a generation of self-identified lesbians, gay men, bisexuals, and transgender individuals have entered retirement. However, their subjective experiences have largely been glossed over in popular discourses of successful aging and migration in heteronormative society. This article explores why and how older LGBT people are choosing housing options to age “out of place” in order to support their sexual lives and identities. Examining the everyday experiences of these seniors—members of a double minority, both aged and LGBT—allows us to disrupt the idea of what healthy “aging in place” means and when it might actually be unhealthy. Employing standpoint theory pushes the analysis of marginalized voices to the fore and allows us to ask about these seniors’ subjective realities. What results is a reimagining of the aging landscape. Interview data from LGBT seniors who have migrated to LGBT naturally occurring retirement communities or LGBT-focused housing complexes in France, Sweden, and Germany are used to stretch our notions of wellbeing and aging in place for these diverse retirees. One finding is that for these LGBT seniors, disrupting social norms by aging out of place is not escapist or amenity-seeking, but is key to honoring their sexuality and aging process in a safe and supportive environment.

Destinations fostering older adults\u2019 walking for transport: a cross-sectional study from Germany

BackgroundHaving destinations within walking distance can encourage older people to walk. Yet, not all destinations may be equally important. Little is known about the types of destinations fostering older adults’ walking for transport in small and medium-sized towns and rural communities. The aim of this study was to explore the associations between the availability of different destinations and walking for transport among older adults living in communities with less than 100,000 inhabitants.MethodsBetween May and September 2019, self-reported data from 2242 older adults (≥ 65 years) living in the Metropolitan Region Northwest (Germany) were collected within the project AFOOT – Securing urban mobility of an aging population. Data from 2137 study participants were eligible for this analysis. Logistic regression models were used to investigate the relationship between the perceived destination availability of 19 different destinations within a 20-min or 10-min walk from home, respectively, and the engagement in walking for transport. Crude and adjusted models were run separately for each destination and distance category. Exploratory subgroup analyses examined the associations between the availability of destinations within a 20-min walk from home and walking for transport stratified by gender, use of a walking aid, and car availability.ResultsThe availability of each of the investigated destinations within a 20-min walk and of nearly all of these destinations within a 10-min walk from home was significantly positively associated with walking for transport in crude models. Most associations remained significant after adjustment for covariates. The strongest associations were found for the availability of small stores, pharmacy, and bakery. The availability of a bus stop showed the weakest associations and was not significantly associated with walking for transport after adjustment for covariates.ConclusionsThe provision of local amenities within walking distance may be a promising approach to foster older adults’ walking for transport in smaller communities with less than 100,000 inhabitants and to enable active and healthy aging in place. Further quantitative and qualitative research is needed to validate these findings and to better understand older adults’ walking behavior.

Single Time-Point Study of the Home Environment and Functionality of Older Adults in Spain.

Background: The literature favors discussion on socio-spatial conditions at the macro- (city) and micro- (housing) level that promote healthy aging in place. Objectives: (a) Identify the association between physical and social characteristics of the family home and the functional level and quality of life of older people and (b) provide normative data on adequate/inadequate households based on the Home Observation for Measurement of the Environment (HOME) inventory and the Spanish Informant Questionnaire on Cognitive Decline in the Elderly (S-IQCODE) test. Methods: In total, 79 healthy older adults completed the HOME inventory and the Montreal Cognitive Assessment (MoCA), S-IQCODE, Kessler Psychological Distress Scale (K-10) and ICEpop CAPability measure for Older people (ICECAP-O) tests. A regression model, the effect size and the means of the scores of HOME (adequate/inadequate) test and the cognitive level (optimal/normal) were calculated. Results: The regression model discloses that adequate home scores are associated with cognitive level (odds ratio (OR): 0.955, confidence interval (CI)95%: 0.918–0.955); quality of life (OR: 6.542, CI95%: 1.750–24.457), living with other people (OR: 5.753, CI95%: 1.456–22.733) and level of education (OR: 0.252, CI95%: 0.064–0.991). The normative data between HOME and S-IQCODE scores showed a good adjustment (d = 0.70). Conclusion: There is a significant relationship between the physical environment of the home and personal variables (sociodemographic information, quality of life and cognitive functionality). In addition, from this last variable, the normative data of an adequate/inadequate household for an older person have been established.

Intergenerational communities: A systematic literature review of intergenerational interactions and older adults' health-related outcomes.

Population aging is a major societal challenge that the US and many other countries are facing. The roles of intergenerational interactions are being increasingly recognized as important factors influencing health and well-being of older adults and other generations. This systematic review paper provides a critical assessment of the current state of knowledge about the impacts of intergenerational activities on older adults' health-related outcomes. Literature searches were conducted in October 2019 within MEDLINE, SocIndex, APA PsycInfo, and CINAHL Complete, using a pre-developed list of relevant keywords. Identified papers were reviewed and selected based on the following eligibility criteria: (1) older adults aged 50 or over as the study population, (2) nonfamily member intergenerational interactions as independent variables, (3) older adults' health-related outcomes as dependent variables, and (4) empirical and quantitative studies performed in the US and written in English. A total of 24 out of 22,674 identified articles met these eligibility criteria. All of the 24 studies focused on evaluating intergenerational programs and their intervention effects. No studies addressed community or environmental interventions/effects. Program-based intergenerational interactions showed positive associations with older adults' physical health, psychosocial health (e.g. reduced depression), cognitive function, social relationships, and well-being/quality of life. Moreover, engagement in intergenerational activities was linked with increased physical and social activities. This review showed solid evidence supporting the significance of program-based interventions in promoting intergenerational activities and associated health benefits. Significant knowledge gaps are also found resulting from the lack of studies examining the roles of physical environmental interventions/factors, diverse types of intergenerational interactions, and location-driven activities. Such studies can contribute to a better understanding of the specific attributes, both program-based and place-based supports, of the community environment that can promote intergenerational interactions and healthy aging in place.

In-Home Floor Based Sensor System-Smart Carpet- to Facilitate Healthy Aging in Place (AIP)

With the rapidly aging population, there is a need to detect elderly’s activity, monitor their health, alert health care personnel, and provide real-time and long-term access to the generated sensor data. With the advances in sensor technologies, communication protocols, computing power, and cloud and edge services, it is now possible to build smart assistive living systems to improve people’s lives. In this research, we present a Context-aware and private real-time reporting aging in place system. The proposed system, we call it smart carpet, consists of a sensor pad placed under a carpet; the electronics reads walking activity to provide an automated health monitoring and alert system. We extended the system’s functionalities to improve its ability to detect falls, measure gait, and count the number of people traversing the carpet (socializing). In an urgent and time-sensitive situation, we need to provide a real-time notification. We propose a cooperative cloudlet model, where the sensors’ data will be sent to the nearest Cloudlet for analysis and extracting real-time decisions in minimal delay. Results showed that our system could assist the elderly in detecting falls with 95% sensitivity and 85% specificity. Measuring and estimating their gait with a mean percentage error difference to GAITRite 1.43% in walking speed; hence, predicting a fall risk and counting people’s plurality socializing with the elderly with an average accuracy of 100%. We evaluated our system’s improvements in a controlled environment. We are looking forward to deploying the system in a nursing home (after the COVID -19 is over) for more data gathering and validations.

HEALTHY RESIDENCE IN RICHARDSVILLE: A PHOTOVOICE PROJECT ON AGING IN PLACE

Based on AARP’s domains of community livability, this presentation presents findings from a photovoice study of residents in an urban community in Atlanta, Georgia. Richardsville (pseudonym) is one of many communities in Atlanta’s inner city that has transformed from a blighted, long-derelict area to a hotbed of high rent apartment units, mixed with quarter-million-dollar-plus homes. With property values skyrocketing and rents soaring, it has becoming increasingly difficult for longtime, older residents of this historically African-American community to remain in the vicinity. Richardsville Senior Residences, an affordable rental unit, was built to provide housing for a mix of incomes and ages and retain longtime residents in Atlanta’s neighborhoods. Therefore, from this qualitative study, we share about residents’ motivations for moving into Richardsville Senior Residences and their perceived livability of the environment that influence healthy aging in place.

Forming and Living in a Seniors’ Cohousing: The Impact on Older Adults’ Healthy Aging in Place

Older adults in the twenty-first century are engaging in different activities to promote their healthy aging in place. The purpose of this article is to describe older adults’ experiences of forming and living in a seniors’ cohousing community, and its impact on their healthy aging in place. The author conducted a secondary data analysis of qualitative data. Seventeen older adults from a seniors’ cohousing community participated in the previous study. The findings from the secondary analysis of data showed that living in the building supported the older adults’ independence, social interaction, safety, and mental health, as well as provided supportive services. An implication of the study is for policy makers, service providers, researchers, and society as a whole to collaborate with older people to address their needs for healthy aging in place in the community.

Mobile and Connected Health Technology Needs for Older Adults Aging in Place: Cross-Sectional Survey Study.

BackgroundAn increasing number of mobile and wearable devices are available in the market. However, the extent to which these devices can be used to assist older adults to age in place remains unclear.ObjectiveThis study aimed to assess older adults’ perceptions of using mobile and connected health technologies.MethodsUsing a cross-sectional design, a total of 51 participants were recruited from a senior community center. Demographics and usage of mobile or wearable devices and online health communities were collected using a survey questionnaire. Descriptive statistics assessed usage of devices and online health communities. The Fisher exact test was used to examine the relationship between technology usage and having access to a smartphone.ResultsThe sample was primarily comprised non-Hispanic white (35/51, 69%), educated (39/51, 76% any college), and female (36/51, 71%) participants, with an average age of 70 (SD 8) years. All participants were insured and nearly all lived at home (49/51, 94%). A total of 86% (44/51) of the participants had heard of wearable health devices, but only 18 out of 51 (35%) had ever used them. Over 80% (42/51) expressed interest in using such devices and were interested in tracking exercise and physical activity (46/51, 90%), sleep (38/51, 75%), blood pressure (34/51, 67%), diet (31/51, 61%), blood sugar (28/51, 55%), weight (26/51, 51%), and fall risk (23/51, 45%). The greatest concerns about using wearable devices were cost (31/51, 61%), safety (14/51, 28%), and privacy (13/51, 26%); one-fourth (12/51) reported having no concerns. They were mostly interested in sharing data from mobile and connected devices with their health care providers followed by family, online communities, friends, and no one. About 41% (21/51) of the older adults surveyed reported having ever heard of an online health community, and roughly 40% (20/51) of the participants reported being interested in joining such a community. Most participants reported having access to a smartphone (38/51, 74%), and those with such access were significantly more likely to show interest in using a wearable health device (P<.001) and joining an online health community (P=.05).ConclusionsOur findings suggest that, although few older adults are currently using mobile and wearable devices and connected health technologies for managing health, they are open to this idea and are mostly interested in sharing such data with their health care providers. Further studies are warranted to explore strategies to balance the data sharing preference of older adults and how to best integrate mobile and wearable device data with clinical workflow for health care providers to promote healthy aging in place.

Paisaje natural y envejecimiento saludable en el lugar: el caso del Parque Nacional Cumbres de Monterrey (México)

&lt;p&gt;La investigación analiza los factores del paisaje natural cotidiano que favorecen el envejecimiento saludable en el lugar y la calidad de vida de las personas mayores residentes en los límites del Parque Nacional Cumbres de Monterrey (México). La metodología ha consistido en la utilización de métodos como fotovoz y mapas mentales aplicados a grupos de discusión por personas mayores, encuestas y Sistemas de Información Geográfica. Los resultados indican que la exposición a elementos naturales del paisaje, como árboles y flores, contribuye al envejecimiento saludable en el lugar, favoreciendo las actividades cotidianas, como relaciones sociales y ocio, mejoran la percepción de la salud y disminuyen las necesidades de ayuda. Asimismo, se muestra que el paisaje natural cotidiano, como elemento simbólico de la identidad ambiental, está asociado a la presencia de recuerdos y vivencias del parque, frecuencia de visitas, grado de conservación de la vegetación autóctona, la proximidad al parque, la práctica de ocio y las relaciones sociales. También, el estudio confirma la importancia de las implicaciones de los paisajes naturales en la calidad de vida de la población, en especial, de las personas mayores, por sus beneficios terapéuticos y simbólicos. Además, se propone impulsar esta línea investigación y generar políticas sostenibles de calidad de vida para favorecer el desarrollo y protección de los paisajes naturales en la región.&lt;/p&gt;