Number Of Older People Research Articles

Co-designing collaborative health deterioration prevention together with older people, civic society, and community health and social care

Introduction: As the population ages, the number of older people whose health is at risk of deteriorating is expected to increase. This may imply decreased quality of life for the individual and rising costs for social and health care. This project acknowledges that health in older people is a complex matter, that includes physical, social, and psychological dimensions, and needs to be targeted at individual, societal and structural levels. Thereby, we recognize that collaborative efforts by diverse actors are necessary to prevent the deterioration of health. Development of collaboration, defined as cross-organizational integration in networks, accomplished through agreements, adjustments, and a willingness to work together, requires the substantial efforts of all stakeholders. We therefore use experience-based co-design to develop collaborative prevention. We will present findings from co-design processes aiming at developing collaborative prevention of deterioration of health. 
 Method: This multiple case design study is performed in Stockholm, Sweden. A case is defined as a community social care unit and its interacting partners who currently are – or potentially could be – involved in collaborative prevention. In each of the project’s three cases, a series of six co-design workshops is conducted. Participants in these workshops are older people and participants from community social care, health care, and civic society (e.g., voluntary and faith/religious organisations). In each case, the participants explore their current collaboration, define their collaborative challenges and work together to develop and test ideas and solutions for improved collaboration to prevent deterioration of health for older people. The workshops are led by researchers.
 During the workshops, data on the outcomes and process are collected using audio-recordings and field notes. Between workshops, individual and dyad semi-structured interviews are conducted with participants on their perspectives of the outcomes and process. Data are analyzed with qualitative content analysis. 
 Results: The co-design series are ongoing and at the conference we will present 1) participants’ reasonings about participation, 2) strengths/opportunities/solutions in collaboration identified by the participants, 3) the co-designed collaborative models and 4) factors that were imperative for the development of these new models, 5) the development of collaborative governance regarded as important for sustainability. We will also critically discuss 6) lessons learned about researcher facilitation of co-design processes. 
 Next step: The three cases will be longitudinally evaluated regarding the impact and structures of the collaborative process.

Laos’ Social Health Insurance (SHI) program’s impact on older people’s accessibility and financial security against catastrophic health expense

Laos has introduced various SHI schemes for multiple groups of the population, such as government officials and other population groups under the NHI schemes. There is no specific health insurance policy for this group of people who need special health services and may have a higher possibility of entering financial catastrophe. This study aims to assess the impact of SHI schemes on accessibility and financial catastrophe against catastrophic health expenditures for older people in Laos. A structured questionnaire has been used to retrieve information from 400 older people across 39 villages in Kaysone Phomvihane District, Savannakhet province, the largest province in Laos. In the analytical process, this study used a cross-sectional study design and binary logistic regression models to predict the likelihood of accessing health facilities and experiencing financial catastrophe. The study outcome shows that the increase in age, occupation, number of older people within a household, and presence of chronic conditions increase the likelihood of using health services. Despite the existence of various SHI schemes, this study found that 74 out of 165 households reported using health services experienced catastrophic health expenditure. Several characteristics are associated with catastrophic health expenditure: age, income level, and gender are prone to suffer from catastrophic health expenditure. The difficult problems stem from the absence of comprehensive legislation regarding the older population. Recommendations for policymakers in various timeframes have been made, which cover short- and long-term policy proposals, including providing a specialized lane or fast-track for an older population, building health facilities exclusively for older people, and providing transportation services for older individuals living alone.

Experience of hope in older people with chronic illness: A meta-synthesis.

The increase in life expectancy has contributed to an increase in the number of older people, but this population has to learn to live with at least one chronic illness. Thus, hope has become an important resource for the older adult to face the repercussions of chronic illness. To synthesise qualitative evidence on the experience of hope in older people with chronic illness. This meta-synthesis included qualitative studies which present the experiences of hope in older people diagnosed with at least one chronic illness. The searches were made from six databases, guided by the SPIDER tool. The identified articles were then independently screened by two reviewers. The results were analysed according to the thematic synthesis approach. Eighteen articles were included, and four analytical themes were constructed. The results allow us to understand that older people live with long-term conditions and hope for an ordinary life. To react to new changes and to maintain hope, they create goals that motivate them in daily life. The treatment is initially seen as a salvation, but the information acquired with the evolution of the illness modifies this perception. In addition, the uncertainty about the success of the treatment creates conflict in their hope. In the support and care of older people in the new context of illness, meaningful relationships strengthen hope most of the time. There is still the hope of being reconciled with death, but there are times when suffering overcomes the hope of living. This meta-synthesis highlights that the experience of hope in older people is dynamic and influenced by the context of changes related to illness, treatment, significant relationships and proximity to death. A better understanding of the role and characteristics of hope in older people with chronic illness may help to develop more effective interventions to promote and maintain hope.

Structural Model of Family Caregiver for Elderly with Dementia.

The number of older people with dementia was continuously increasing globally. Unfortunately, many of them had received inappropriate medical treatment to overcome the dementia they suffered. This current research aimed to analyze the factors that affected family-based caregiver empowerment. An analytic observational method with a cross-sectional approach was applied. The population was all families with dementia elderly in East Java, Indonesia, in 2021, who met the inclusion and exclusion criteria. The sample size was determined to be 100 respondents. The results showed that the factors (i.e., elderly factors, family factors, health service factors, family's filial value, family assessment, and the need for care) had significant effects directly or indirectly on the family's ability to do home care. Factors that influenced directly (i.e., elderly factors, family factors, family assessment, and care needs) and indirectly (i.e., health service factors) were essential in constructing a structural model of family care for the elderly with dementia.

Statistical model of trajectories of reduced mobility in older people with locomotive disorders: a prospective cohort study with group-based trajectory model

BackgroundToday we experience “Super-aged society”, and a drastic increase in the number of older people needing assistance is an urgent matter for everyone from medical and socio-economical standpoints.Locomotive organ dysfunction due to musculoskeletal disorders is one of the main problems in these patients. Although the concepts of frailty and sarcopenia have been proposed for functional decline, pain remains the main and non-negligible complaint in these of such disorders.This prospective cohort study aimed to observe the changes of reduced mobility in patients with locomotive disorders and to determine the risk factors for functional deterioration of those patients using statistical modeling.MethodsA cohort of older adults with locomotive disorders who were followed up every 6 months for up to 18 months was organized. Pain, physical findings related to the lower extremities, locomotive function in performing daily tasks, and Geriatric Locomotive Function Scale-25 (GLFS-25) score were collected to predict the progress of deterioration. Group-based trajectory analysis was used to identify subgroups of changes of GLFS-25 scores, and multinomial logistic regression analysis was performed to investigate potential predictors of the GLFS-25 trajectories.ResultsOverall, 314 participants aged between 65 and 93 years were included. The participants were treated with various combinations of orthopedic conservative treatments on an outpatient basis.The in-group trajectory model analysis revealed a clear differentiation between the four groups. The mild and severe groups generally maintained their GLFD-25 scores, while the moderate group included a fluctuating group and a no change group. This study showed that comorbidity of osteoporosis was related to GLFS-25 score over 18 months. Age was a weak factor to be moderate or severe group, but gender was not. In addition, the number of pain locations, number of weak muscles, one-leg standing time, grip strength and BMI significantly contributed to the change in GLFS-25 score.ConclusionsThis study proposes an effective statistical model to monitor locomotive functions and related findings. Pain and comorbid osteoporosis are significant factors that related to functional deterioration of activities. In addition, the study shows a patient group recovers from the progression and their possible contributing factors.

Working More Years In Spain Has to Start from a Young Age: Lessons from the Labour Market Exit of People Aged from 50 to 65 in the Last Decade

Since 2013, retirement age in Spain has been rising slowly from 65 to an expected 67 in 2027 and, with it, the minimum number of years of National Insurance contributions from 35 to 38. This policy is justified by sustainability of the social security system since the number of older people is increasing faster than the number of contributors. However, the policy has been criticised for not taking into account the diversity of working lives. The labour market and social construction of work differ with occupations and with gender, thus creating pluralities of working lives. Hence, the ways of leaving the labour market should take this diversity into account. Since the present wholesale policy of equally postponing retirement age for everyone overlooks the actual state of retirements, the aim of this study is to ascertain who has retired earlier or later in the last decade, the causes of exits from the labour market, and the repercussions on the number of years of National Insurance contributions. Premature exits from the labour market of people aged between 50 and 65 during the decade from 2010 to 2020 are analysed using data from the Continuous Sample of Working Lives (CSWL) taken from Spanish Social Security records. These are people who were born between 1945 and 1954. The results show that women work later than men, that people in Routine occupations tend to leave the labour market early, and that the number of years worked between the ages of 50 and 59 are a good predictor of prolongation of working life after the age of 60, although there are differences between the sexes.

Setting up a journal club for healthcare professionals in an older people's residential care setting.

With the rise in the number of older people in the population and new developments in older people's services such as integrated care hubs, there is a need for healthcare professionals working with older people to keep up to date with the latest research. This article describes the process of establishing a multidisciplinary journal club in a residential care setting and recognising the potential of such clubs to develop staff members' critical thinking, presentation and communication skills. The authors emphasise the importance of fostering a culture of learning in older people's services and describe how a journal club can support healthcare professionals to maintain their knowledge and improve care.

Application of generalizability theory to evaluate the Kessler Psychological Distress Scale and distinguish between enduring and dynamic distress

ObjectivesNowadays, the number of older people is increasing rapidly, both in absolute figures and as a proportion of the population, which makes the maintenance of psychological well-being among aging population imperative. Neuropsychological distress may promote cognitive impairment and impact on the health of older people, which makes accurate assessment of distress an important clinical and research issue. The Kessler Psychological Distress Scale (K-10) is a widely used instrument used to measure individual distress. However, the ability of K-10 to distinguish between enduring and dynamic distress symptoms, and the generalizability of its scores, have not been investigated in older populations using appropriate methodology. MethodGeneralizability theory (G-theory) was applied to differentiate enduring and dynamic distress and examine the reliability of K-10 in a sample of 201 adults (43% males) aged 70 to 90 years old who participated in Sydney Memory and Ageing Study. The data were collected biennially over ten years. ResultsThe K-10 scale showed strong reliability (Ga=0.81, Gr=0.89) in assessing enduring distress and its assessment scores were generalizable across occasions and older adults. Most of distress symptoms represented by K-10 items were enduring. LimitationsGeneralizability of these findings may be limited to older adults. ConclusionsThe K-10 appears more suitable to evaluate enduring distress in aging populations over time, which is important for interventions targeting older adults’ mental health given its scores will likely capture enduring changes in neuropsychological health before and after interventions.

Ageing, migration, and old age care in transnational Cuba

In Cuba, the number of older people in need of care is increasing rapidly. At the same time, many younger people are leaving the country in search of a better life. This article focuses on these two processes by asking how care for older people is organized when (some) children live abroad. It shows that in the absence of an adequate public old age care infrastructure, a private market for home-based old age care has emerged. This development is linked to the sending of remittances and may potentially exacerbate social inequalities between older people receiving and not receiving money from abroad.

The effects of frailty on quality of recovery and complications in older adults undergoing major abdominal surgery: a prospective cohort study

Aims: There is an increase in the number of older people who have undergone surgical intervention in proportion to the aging of the global population. This situation creates the need to adapt surgical care according to the pathophysiological profile of older people. Recently, it has been argued that chronological age alone does not explain biological age, and frailty will be an appropriate parameter in organizing surgical care of older people. This study aimed to determine the effect of frailty on 30-day postoperative complications and quality of recovery in older people undergoing major abdominal surgery.
 Methods: A prospective cohort study was conducted in the General Surgery Department of the Erciyes University Medical Center in Türkiye. Overall, 222 patients aged 65 and over underwent major abdominal surgery between February 2021 and 2023. Frailty was determined using Fried Frailty Index. 30-day postoperative complications were evaluated using the Clavien Dindo Classification. Quality of recovery- 40 (QoR-40) was filled three days after surgery to determine the quality of recovery of the patients. Receiver-operating characteristic curves analysis was used to evaluate the ability to predict 30-day complications of frailty. Univariate linear regression analysis was performed to determine frailty to be an independent predictor of the QoR-40. 
 Results: The majority of the participants were male (56.8%), the mean age was 71.41±5.29 years, and 50% of patients were frail. Frail patients (28.1%) showed a higher rate of major complications compared to non-frail patients (9.3%). The Fried frailty index score significantly predicted 30-day postoperative complications (AUC=0.653, 95%=0.565-0.741). The total mean score of the QoR-40 scale was 147.09±15.82. Univariate linear regression analysis found frailty (OR -3.81, 95% CI -4.79- -2,83), age (OR -0,46, 95% CI -0,79- -0,12), Charlson comorbidity index (OR -2,40, 95% CI -3,23- -1,57), and operation time (OR -0,04, 95% CI -0,06- -0,02) as independent predictors of quality of recovery. 
 Conclusion: Frailty is a significant predictor for 30-day postoperative complications and quality of recovery in older people undergoing major abdominal surgery.

Risk factors for vascular dementia

Background. An increase in the number of older people with cognitive disorders, including dementia, is expected.The aim. To study the risk factors for vascular dementia.Material and methods. 39 patients with vascular dementia (ICD-10 diagnosis code F01) were examined. The comparison group consisted of 167 people. According to the MMSE (Mini Mental State Examination) scale, moderate dementia was detected in 56.4 % of cases, severe – in 43.6 %; in the comparison group, 94 % had mild and 6 % – moderate cognitive impairment.Results. In the vascular dementia group, the following risk factors were registered significantly more often: ischemic heart disease – at the age of 70–79 years (57.1 %; p = 0.000) and in the group as a whole (56.4 %; p = 0.000); diabetes mellitus – at the age of 60–69 years (100 %; p = 0.005); arterial hypertension – at the age of 70–79 years (100 %; p = 0.000) and in the group as a whole (87.2 %; p = 0.000). In the comparison group, the frequency of body mass index over 25 was significantly higher at the age of 70–79 years (60 %; p = 0.000), 80 years and older (64.3 %; p = 0.037) and in the group as a whole (68.9 %; p = 0.000). Among people with moderate cognitive impairment, the following risk factors were significantly more common: coronary heart disease – at the age of 60–69 years (10 %; p = 0.001); diabetes mellitus – at the age of 70–79 years (40 %; p = 0.025) and in the group as a whole (50 %; p = 0.033), the frequency of body mass index over 25 – at the age of 80 years and older (70 %; p = 0.000) and in the group as a whole (100 %; p = 0.000).Conclusion. Risk factors for the development of cognitive disorders (coronary heart disease, hypertension, diabetes mellitus, overweight) are potentially reversible; their timely detection can reduce the development of cognitive disorders and dementia.

Development of Ankle-Joint Rehabilitation Device for Bedridden Patient Using Fan-Shaped Pneumatic Soft Actuator Driven at Low Pressure

Recently, the number of older people and the reduction in infant birth rates in Japan have increased. Elderly against the younger increased to more than 28.9% in 2020. According to the Japanese aging society, a welfare pneumatic device to rehabilitate the temporally injured elderly and the disabled has been actively researched and developed. However, the developed rehabilitation device is almost always used for a patient who is not bedridden. Therefore, the joint of a bedridden patient is given only a passive exercise, by a physical therapist (PT). In this study, in order to reduce the burden of PTs, we aim to develop a rehabilitation device that can be used by anyone assisting the bedridden patient. The target joint was decided to be an ankle-joint because it is difficult for patients with contractions to walk. Therefore, a fan-shaped pneumatic soft actuator (FPSA) using a no-stretch hose with weaved bellows and silicone rubber string was proposed and tested. In addition, the characteristics of FPSA with different pitches and lengths are measured. To predict the bending angle of FPSA, a simplified shape analytical model of it is proposed. It can be confirmed that a calculated bending angle of FPSA using the model generally agrees with the experimental result. The proposed analytical model is a first-stage model that does not include the influence of external forces on FPSA. The ankle-joint rehabilitation device using FPSAs is proposed and tested, where an ankle-joint is changed from a plantarflexion to a dorsiflexion motion by pressurizing both FPSAs on the tested device. And it can be confirmed that a range of motion (“ROM” for short) is satisfied in an inversion and eversion driven by operating one or another FPSA on the device.

Exploring the impact of nursing home managers' leadership on staff job satisfaction, health and intention to leave in nursing homes.

To explore the impact of nursing home leadership and staffing characteristics on staff job satisfaction, health and intention to leave. The number of older people has outpaced growth in the nursing home workforce worldwide. Identifying predictors with the potential to positively impact staff job satisfaction, health and intentions to leave are important. Leadership of the nursing home manager can be one such predictor. Cross-sectional design. A sample of 2985 direct care staff in 190 nursing homes in 43 randomly selected municipalities in Sweden completed surveys on leadership, job satisfaction, self-rated health and intention to leave (response rate 52%). Descriptive statistics and Generalised Estimating Equations were conducted. The STROBE reporting checklist was applied. Nursing home managers' leadership was positively related to job satisfaction, self-rated health and low intention to leave. Lower staff educational levels were related to poorer health and lower job satisfaction. Nursing home leadership plays a significant role in the job satisfaction, self-reported health and intention to leave of direct care staff. Low education levels among staff seem to negatively influence staff health and job satisfaction, suggesting that educational initiatives for less-educated staff could be beneficial for improving staff health and job satisfaction. Managers seeking to improve staff job satisfaction can consider how they support, coach and provide feedback. Recognising staff achievement at work can contribute to high job satisfaction. One important implication for managers is to offer continuing education to staff with lower or no education, given the large amount of uneducated direct care workers in aged care and the impact this may have on staff job satisfaction and health. No patient or public contribution was required to outcome measures in this study. Direct care staff and managers contributed with data.

The Association of Sociodemographic Variables and Unhealthy Behaviors With Limitations in Activities of Daily Living Among Thai Older Adults: Cross-sectional Study and Projected Trends Over the Next 20 Years.

Extended life spans have led to an increase in the number of older people and an increase in the prevalence of disability among people older than 60 years of age. This study aims to investigate the association of sociodemographic variables and unhealthy behaviors with limitations in activities of daily living (ADL) among Thai older adults. The study also projects the number of older individuals likely to experience ADL limitations in the next 20 years. We performed sex-specific multinomial logistic regression analysis based on the 5th Thai National Health Examination Survey in 2014 to investigate the association between sociodemographic variables and health behaviors with ADL limitations among Thai older adults. Age- and sex-specific prevalence estimates of ADL limitations were obtained by applying the same models. These estimates were combined with population projections up to 2040 from the Office of the National Economic and Social Development Board, Thailand, to generate projections of older individuals with ADL limitations. Age and physical activity were significant factors for both sexes, with age positively associated with the level of ADL limitations and low physical activity associated with an increased relative probability of mild or moderate to severe ADL limitations compared to individuals with no ADL limitation (1.2-2.2 times). Other variables such as education, marital status, diabetes, hypertension, smoking, alcohol consumption, and having a fruit- and vegetable-based diet showed significant associations, but the results varied regarding sex and levels of ADL limitations. This study also projected the number of older adults with mild and moderate to severe ADL limitations over the next 20 years from 2020 to 2040, revealing an increase of 3.2 and 3.1 times, respectively, along with a significant increase in men compared to that in women. This study identified age and physical activity as significant factors associated with ADL limitations in older adults, while other factors showed varying associations. Over the next 2 decades, projections suggest a significant increase in the number of older adults with ADL limitations, particularly men. Our findings emphasize the importance of interventions to reduce ADL limitations, and health care providers should consider various factors impacting them.

Features of the self-concept of the elderly

The study of the self-concept in late adulthood seems an essential topic. This happens since people's lives are becoming longer. The number of older people is increasing, and the correct interaction with the younger generation is possible with a deep understanding of the specifics of their age psychology. The self-concept develops throughout a person's life and absorbs everything that was the most significant in each of the periods of personal development. Therefore, the self-concept of late adulthood and old age is a complex formation in which information about the many self-images that arises in a person in various variants of his self-perception and self-representation is "recorded." This is a selective memory of the individual, reflecting events so as not to disturb prominent personal positions. Therefore, it is challenging to investigate the self-concept of a particular person in his life transformation.

KNOWLEDGE, ATTITUDE AND PRACTICE OF DENTISTS TOWARD PROVIDING CARE TO THE GERIATRIC PATIENTS IN TAMIL NADU – A CROSS SECTIONAL SURVEY.

Introduction:Worldwide,there have been rapid changes in the demographics,including an increase in the number of old people. The number of elderly adults is predicted to quadruple by 2050 and reach two billion individuals at the current trend.The study aims to find out the perception of dentist towards geriatric dentistry. Materials And Methods: This cross-sectional study was approved by the Ethics Committee of Adhiparasakthi dental college and hospital. The total sample size was estimated around 240 samples and a self-administered questionnaire was sent online survey. The collected data were subjected to statistical analysis. Results: A total of 231 completed questionnaires (response rate = 88%) were obtained.Mean of age was 34.4 ± 8.1 (23–71 years) and 62.8% (n = 145) were female.The percentage of the patients in different age groups visited by the dentists during the past month showed that the most frequent age group was the 18–40 year group (40%).A significant correlation was observed between their practice and attitude.Availability of equipment for the ease of access revealed that 54% of dental offices/clinics had adequate lifts. Only about 20% of them had ramps and wall hangings and almost 24% had good flooring.Conclusion:The dentists in our study exhibited a modest level of expertise and skill in treating the dental issues of elderly patients. A major of them, were sympathetic towards the elderly. Therefore, dental education policy makers should prioritise developing geriatric education in dental institutions,particularly clinical education

Promoting resilience among older people in prisons: a systematic literature review.

The number of older people in UK prisons has increased significantly in recent years and most of them have at least one health condition. Research has shown that the physical and mental health of older people living in the community is positively correlated with resilience, but there is limited research on how to promote resilience in older prisoners. This systematic literature review offers a synthesis of interventions, practices and processes that may improve resilience in older prisoners. The review included eight peer-reviewed studies and identified three elements that support resilience in older prisoners: organised interventions; relational activities; and subjective processes. Healthcare professionals working in prisons can use the findings to identify how to support older prisoners' well-being and develop the conditions that may enable older prisoners to sustain and strengthen their resilience.

Age-related Hearing Loss and Aldosterone Treatment

Hearing loss is a common cause of disability in the global population. The prevalence of hearing loss is estimated to dramatically increase in the next decades with an increase in the number of older people. The fact that hearing loss correlates with aging suggests that age-related hearing loss (presbycusis) will be a critical issue and hearing care will be required. Untreated hearing loss has negative effects at multiple levels, such as hearing loss affecting the quality of life of hearing-impaired individuals, deteriorating family relationships, and interfering with economic growth. Unfortunately, treatments for hearing loss are limited to the use of hearing devices. Studies have shown that the number of hearing aid users is approximately 20% of all hearing-impaired individuals. Therefore, having alternative treatments is critical to reduce the number of people with hearing loss and to prevent a dramatic increase in the number of hearing-impaired individuals. In the future, a potential medication may be aldosterone (ALD). Studies have reported positive effects of ALD treatments on hearing loss in aged mice. ALD treatment in aged mice shows an improvement in hearing sensitivity and a healthier cochlear structure. Although higher ALD concentrations are associated with better hearing sensitivity and hearing in noise ability than lower concentrations, there is no clinical trial in ALD treatment in human has been reported.

Understanding registered nurses’ career choices in home care services: a qualitative study

BackgroundThe anticipated growth in number of older people with long-term health problems is associated with a greater need for registered nurses. Home care services needs enough nurses that can deliver high quality services in patients’ homes. This article improves our understanding of nurses’ career choices in home care services.MethodsA qualitative study using individual semi-structured interviews with 20 registered nurses working in home care services. The interviews were audio-recorded, transcribed and thematically analyzed.ResultsThe analysis resulted in three themes emphasizing the importance of multiple stakeholders and contextual factors, fit with nurses’ private life, and meaning of work. The results offer important insights that can be used to improve organizational policy and HR practices to sustain a workforce of registered nurses in home care services.ConclusionThe results illustrate the importance of having a whole life perspective to understand nurses’ career choices, and how nurses’ career preferences changes over time.

Edukasi Gizi dalam Upaya Pencegahan Osteoporosis pada Lansia di Kota Padang

Increasing the degree of health means that life expectancy will also increase, and the number of older people will also increase. The consequence of increasing life expectancy is the emergence of disease problems due to old age, one of which is osteoporosis. This activity aimed to determine the health status of the elderly by conducting health checks and providing nutrition education to prevent osteoporosis in Padang City. The service was held in Korong Gadang Elderly Posyandu in April - September 2021. The community service included health checks by measuring blood pressure, measuring the nutritional status of the elderly, as well as nutrition education to prevent osteoporosis in the elderly, especially for menopausal women. This activity received a positive response from the community, and it was agreed that ongoing activities would be carried out in the form of routine health checks and counselling for the older people in the area.