Older People In Community Research Articles

QUALITY OF LIFE: THE SPIRITUALITY AND SPIRITUAL WELLBEING OF ELDERLIES IN MALAYSIA

With an increasing aging population worldwide, there is a need for greater focus on the spirituality of older people, to better support them and lead them to an enhancement of their inner peace. This study used a qualitative with exploratory sequential design approach (with semi-structured interviews) in exploring spirituality with older people in community of Federal Territory of Kuala Lumpur, which is related to a sense of personal belief and connection that helped them in their daily lives. The research involved a rigorous exploratory process. The fifteen (15) participants provided information about their rich experiences and their connections in four domains: (1) Faith, (2) Belief, (3) Practice and (4) Emotion. Results: The reliability of the dimensions was all high as the Cronbach’s Alpha coefficients were above 0.90. Therefore, this spirituality measurement tool can be considered highly reliable. Conclusion: This paper has developed as well as validate the spirituality measurement tool. It was used to construct a profile of elderly in Malaysia, and it may be applied to profile elderly in other countries.

Psychometric properties of instruments for measuring abuse of older people in community and institutional settings: A systematic review.

Psychometric properties of instruments for measuring abuse of older people in community and institutional settings: A systematic review.

Bridging participation and work in a mature and older people community on Facebook in Brazil

Bridging participation and work in a mature and older people community on Facebook in Brazil

Differences in self-reported signs related to central sensitization and pressure pain threshold related to knee osteoarthritis and sarcopenia.

Neuroinflammation, which occurs in knee osteoarthritis and sarcopenia, has attracted attention as a mechanism of central sensitization, but the relationship between central sensitization and these conditions has not been widely studied. This study investigates differences in self-reported signs of central sensitization and pressure pain threshold in individuals with knee osteoarthritis and sarcopenia. We examined 340 patients (mean age ± standard deviation: 76 ± 5.9, women were 86.9%) with knee osteoarthritis scheduled to undergo total knee arthroplasty. For comparison, 129 community-dwelling older people (mean age ± standard deviation: 76 ± 5.5, women were 68.9%) individuals without a history of knee osteoarthritis or any other diagnosed illnesses were matched for age and sex. We assessed central sensitization inventory-9, pressure pain threshold, pain-related factors, skeletal muscle mass index, and hand grip strength. ANCOVA using 2 (patients with knee osteoarthritis and community older people without knee osteoarthritis) × 2 (sarcopenia and robust) was performed to assess outcome measurements. The prevalence of sarcopenia among patients with knee osteoarthritis was 50.3%. ANCOVA revealed an interaction effect for the central sensitization inventory-9. For the main effect of knee osteoarthritis, there was a significant difference in central sensitization inventory-9, and for the main effect of sarcopenia, there was a significant difference in pressure pain threshold. Discrepancies in the evaluation of central sensitization were identified between knee osteoarthritis and sarcopenia. Individuals with knee osteoarthritis had elevated score of self-reported indications of central sensitization, whereas sarcopenic patients had reduced pressure pain thresholds.

Development and Validation of Knowledge Assessment Scales for Dementia and Urinary Incontinence in Community Older People.

To develop and validate scales for reliably assessing dementia and urinary incontinence knowledge of older adults in the community. Items were generated through a literature review, refined through a Delphi study (n = 19), and then revised through a pilot study (n = 29). Item analysis and exploratory factor analysis were applied to finalize the scales (n = 244). Construct validity, reliability, and acceptability were evaluated (n = 243). The two knowledge assessment scales for dementia and urinary incontinence, respectively, comprised 12 items and 8 items. Model fit indicators of both met the criteria of confirmatory factor analysis. Cronbach's α were .82 and .70, respectively. Completion ratio and completion time of the two scales was 83.51% and 4.22 ± 1.90minutes. The knowledge assessment scales for dementia and urinary incontinence with satisfactory validity, reliability, and acceptability, could be served as valid tools for disease prevention and management among older adults in the community.

Prevalence and Psychosocial Risk Factors Associated with Depression in Older People in A Rural Community

Depression is a multifactorial disease that globally impacts all ages and sectors of the population. In this sense, it has become a public health problem, since it affects 280 million people in the world, according to information from the World Health Organization. Older adults represent 5.7% of the population that experiences this disease, with the moderate to severe stage being the one that most impacts their health, and, therefore, quality of life. For this reason, the objective of the research is to know the prevalence and psychosocial risk factors associated with depression in older people in the community of Santa Cruz, Hecelchakán, Campeche. The methodology used is with a quantitative approach because information was collected, based on the application of the Yesavage scale of geriatric depression, and the sociodemographic registry of 60 older adults of both sexes, in order to measure the percentage of prevalence through its respective epidemiological formula. Likewise, it is cross-sectional because it collected data in a single time: November 2022 – October 2023. Results: 46.7% experienced mild depression, 41.7% moderate depression and 11.6% severe depression. 55% of those interviewed were male and 45% female. The actual prevalence of depression is 100%. Likewise, the psychosocial risk factors identified were: the absence of recreational activities and social support networks, the economy, health services and family disintegration. Finally, it is necessary to design and implement socio-health intervention projects in the locality and with a socio-cultural perspective that impacts this age group, the family and from an intergenerational perspective, with the promotion of mental health being a priority goal in their execution.

Ruthless times—Songs of care: Crisis in older people care sector

AbstractBackgroundThe Finnish‐language documentary, “Ruthless Times ‐ Songs of Care,” highlighted the challenges of older people care in Finland. Through a blend of choral scenes and documentary footage, it exposed the ethical and economic disparities in caregiving.ObjectiveTo provide a narrative of the documentary and its implications in the older people care sector.MethodsMedia review.ResultsThe film explored the consequences of nursing personnel shortages, showcasing the impact on patient care and nursing staff morale. It also featured a choir of nursing staff and pensioners, adding depth to the narrative.ConclusionThe documentary compellingly emphasized the intrinsic connection between the shortage of nursing staff and the quality of care within the older people community, advocating for a holistic approach to improve older people care within the Finnish social and healthcare framework.Implications for practiceThere is a need for systemic reforms and increased support for nursing staff to enhance the quality of care for older people in Finland.

A study on community older people's willingness to use smart home-an extended technology acceptance model with intergenerational relationships.

Despite the potential of smart home technology to promote sustainable lifestyles, the adoption rate among older adults remains relatively low. This study aims to investigate the influence of intergenerational relationships on the acceptance of smart home services among seniors. A survey was conducted among 298 older adults in China, and data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Ten predictor variables were examined to assess their impact on the willingness to use smart home services. Intergenerational relationships significantly influenced the utilization of smart home services among older adults. Specifically, intergenerational instrumental support had a direct positive effect on the behavioral intention to use smart homes. Additionally, intergenerational emotional and financial support affected life satisfaction, which subsequently influenced the behavioral intention to use smart homes. The assistance and guidance provided by younger generations play a crucial role in shaping the willingness of older adults to adopt smart home technology. Intergenerational support can contribute positively to enabling aging individuals to age in place through the utilization of technology.

Effectiveness and Benefits of Exercise on Older People Living With Mental Illness' Physical and Psychological Outcomes in Regional Australia: A Mixed-Methods Study.

Regular exercise is reported to improve depressive symptoms and quality of life for people experiencing mental illness. For older adults, including strength and balance can also decrease falls. Mental health services seldom include funding for Accredited Exercise Physiologist programs. A 9-week Accredited Exercise Physiologist-led program for older adults receiving mental health treatment with a community Older People's Mental Health Service was trialed in regional Australia. This clinician-conceived small-scale feasibility study utilized a two-phase concurrent triangulation mixed-method design to evaluate physical and psychological program outcomes and identify factors related to engaging in physical activity. This tailored exercise program led to improvements in measures of psychological distress and physical and psychological function. These changes corresponded with participants identifying benefits of exercising as a group of adults living with mental illness. Such findings suggest a supervised, individualized program for older mental health consumers confers physical and psychological benefits; however, further research evaluating exercise interventions with this population is required.

The association between frailty and anxiety: A systematic review.

Previous systematic reviews show a clear relationship between frailty and depression, however the association with anxiety is much less frequently explored. Previous single studies indicate evidence is mixed. We completed a systematic review and meta-analysis to identify the relationship between frailty and anxiety. We searched five electronic databases for observational studies in older people in community, care home and outpatient settings with any/no health conditions that measured the association between anxiety and frailty using validated measures. Studies were screened by one reviewer with 10% checked by a second reviewer. The Mixed Methods Appraisal Tool was used to assess study quality. We used meta-analysis to aggregate study findings, with subgroup analyses to explore heterogeneity. Out of 1272 references, a total of 20 cross-sectional and 1 longitudinal studies were eligible. Older adults with frailty were substantially more likely to display anxiety symptoms than robust populations, across both dichotomous and continuous data sets (n=10, OR=3.48, 95% CI: 2.08, 5.81, p<0.0001, I2 =94%; N=5, SMD=3.13, 95% CI: 1.06, 5.21, I2 =98%). Similarly, pre-frail older adults were more likely to have anxiety symptoms than robust older adults but to a lesser extent (N=6, OR=1.95, 95% CI: 1.41, 2.71, I2 =63%; N=3, SMD=1.70, 95% CI: 0.01, 3.38, I2 =98%). There is a clear association between pre-frailty/frailty and anxiety in older adults. However, data are heterogeneous and primarily from cross-sectional studies so causality cannot be determined. Future research should evaluate the effectiveness of anxiety screening and treatments in frail older adults.

Effects of a ‘social activity program that encourages interaction’ on rural older people's psychosocial health: Mixed‐methods research

We developed a program that encourages interaction among older people living at home by combining face-to-face and online activities and examined its effects on older adults' psychosocial health. In this mixed-methods study, we recruited 11 women and 6 men (Mage=79.5 ± 6.4 years), who lived in a rural community and participated in a senior citizen club. The intervention was conducted for 13months, comprising monthly face-to-face group and social media activities. For the program process evaluation, we collected focus-group interview data on participants' perceptions of their personal lives, club membership, and community post-intervention. For the outcome evaluation, we collected six outcome measures pre- and post-intervention: loneliness, subjective health, subjective well-being, self-esteem, social support and social activity satisfaction. Finally, through the integration of the process-outcome evaluation, we inferred what effects the program had on participants' psychosocial health. In the process evaluation, we identified four themes: 'Stimulation brought about by relationships with peers,' 'Realization as to where they feel they belong,' 'Rethinking of oneself in the community,' and 'Awareness of attachment to and coexistence with the community.' In the outcome evaluation, the outcome measures were maintained without significant decline post-intervention. Through the integration of the process-outcome evaluation, we deduced three effects of the program on psychosocial health: (1) fulfilment of subjective health, (2) maintenance and assurance of moderate distance connectedness and (3) orientation toward aging in place. This study offers a promising opportunity for further development and research into community-based preventive nursing care intervention strategies to maintain the psychosocial health of homebound older people in communities with social activity groups.

Multidimensional analysis of frailty in older people of a Brazilian community: a cross-sectional study

In Brazil, the aging process takes place under unfavorable economic, social and health conditions. Therefore, a better understanding of the functionality patterns of different elderly populations becomes essential, especially in times of Covid-19. The objective of study is to assess the functionality of institutionalized and community older people. Cross-sectional study with 51 older people, divided into two groups: Institutionalized Older People Group (GII) and Community Older People Group (GIC), assessed by the Mini Mental State Examination, Clinical Functional Vulnerability Index-20 (IVCF-20), Barthel Scale, Lawton Scale and Tinneti Scale, descriptive analysis, multivariate multiple correspondence technique, multinomial and binomial logistic regression, with the R software were performed. The results showed: the quartiles: robust GIC (IVCF-20=6.75), independent (Lawton=21/Barthel=100). The fragile GII (IVCF-20=18), partially dependent (Lawton=13/Barthel=100). In GII association of frail older people and high risk of falls. In the GIC there is no association. The GIC showed more chances compared to the GII: 198.34 cognitively normal; 5.48 robust; more than 100,000 independents; and 14 low risk of falls. In this way, it is concluded that older people in the community have better functional performance than older people living in the two Long Term Care Institutions.

The ENJOY MAP for HEALTH: Exercise interveNtion outdoor proJect in the cOmmunitY for older people—More Active People for HEALTHier communities: a study protocol

BackgroundPhysical activity is important to maintain health in older age, with physical activity in the outdoors providing mental and physical health benefits for all age groups. One way by which older people can engage in physical activity in the outdoors is through using suitable age-friendly outdoor exercise equipment, the Seniors Exercise Park. The ENJOY MAP for HEALTH aims to evaluate the effect of the Seniors Exercise Park installation and associated capacity building activities on park visitation, park-based physical activity by older people and delivery of community physical activity programs.MethodThis study is a quasi-experimental (natural experiment) with pre and post study design evaluating the effect of age-friendly outdoor spaces with specialised outdoor exercise equipment on older people’s physical activity and wellbeing in six Victorian municipalities (local governments/councils). Each council will undergo four stages (site construction and development, promotion and marketing, capacity building and training, evaluation and sustainability). Several activities and methods will be employed from stage one through stage four to evaluate the potential impact of the age-friendly outdoor spaces on physical activity and wellbeing and will comprise the following elements: site observation and equipment utilisation, face to face intercept surveys, development of an online access monitor and community building activities.DiscussionThe project is expected to result in a significant change in the physical outdoor environment for the participating councils and communities whereby older people and other community members will be able to engage in safe physical and social activity programs, socialise more and hence improve the overall wellbeing of older people.Trial registrationThis trial is retrospectively registered with the Australian New Zealand Clinical Trials Registry. Trial registration number ACTRN12621000965808. Date registered 23/07/2021.

The Relationship Between Health Changes and Community Health Screening Participation Among Older People.

The utilization of health screening and other community health services has been a hot topic in China. Thus, this study examined the effect of health changes (self-rated health, physical health, and mental health) on older people's community health screening participation in China. We derived the data from the 2016 and 2018 waves of the Chinese Longitudinal Aging Social Survey (CLASS). This paper included 10,992 observations in two waves. We tested the causal relationship using the fixed effects model. Approximately 29.56% of the respondents participated in a health screening. Notably, after controlling for covariates, changes in mental and physical health both significantly influenced seniors' participation in health screenings (self-rated health: β = 0.188, 95% CI [−0.037, −0.413]; physical health: β = 0.078, 95% CI [0.032, −0.124]; mental health: β = 0.034, 95% CI [−0.057, −0.002]). The findings showed age, educational level, income level, and family support to be significant factors associated with community health screening participation. Additionally, we identified a partial mediating effect of mental health between self-rated health and health screening participation and a partial mediating effect of depression between physical health and health screening participation. The results highlight the important role of health changes in influencing participation and promoting health screening in China. On this basis, healthcare providers in the community may consider health changes as a screening criterion to promote health screening, guiding other health promotion and prevention programs while promoting healthy aging.

The Effect of the ENJOY Seniors Exercise Park Physical Activity Program on Falls in Older People in the Community: A Prospective Pre-Post Study Design.

BackgroundThe ENJOY project (Exercise interveNtion outdoor proJect in the cOmmunitY for older people) is a community-based research project actively promoting physical activity engagement through the delivery of an exercise program using outdoor multimodal exercise equipment. This study investigated the impact of the physical activity program on falls in older people.MethodThis study was a multi-site prospective study with a pre-post intervention design and 12-month follow up. Eighty older people with increased falls risk underwent a 12-week supervised outdoors exercise program followed by a 6-month maintenance phase. The proportion of fallers and falls incidence were compared between the preceding and the prospective years.ResultsA sample of 54 (age 72.4±7.3, 79.6% women) was available for the 12 months analysis (due to COVID19 lockdowns, data of 19 participants were excluded and 4 dropped out). Number of fallers (from 51.8% to 31.4%, p=0.03) and falls incidence (from 42 to 29 falls, p<0.01) were significantly reduced at the 12-months follow up.ConclusionThe ENJOY Seniors Exercise Park program integrates outdoor multimodal exercise stations including specific exercises designed to challenge dynamic balance during functional daily movements. The outcomes provide preliminary evidence for the potential positive impact of the ENJOY Seniors Exercise Park in reducing falls for older people.

Aging and Masculinity in Bibliotherapy and Poetry Groups for Men in Late Life

The transition to residential care facility may symbolize the joining into the 'community of older people'. This may influence the ways men in late life construct their identities and the intersection of aging and masculinity. Due to some barriers, this experience may be difficult to express explicitly. Bibliotherapy aims to bridge this gap by using literature to address diverse issues in the form of reading and writing activities. In this presentation we will present "The Literary Parliament" project, in which bibliotherapy and poetry groups of men in late life were conducted in residential care facilities in Israel. We will present findings of a qualitative research which explored poems written by group participants, and the way these helped participants to express their perceptions and feelings of ageing and masculinity in the context of residential care. The use of bibliotherapy to encourage psychological discourse among men in late life will be discussed.

A Window to Telehealth Geriatric Social Work Job Market Landscape: A Cross-Sectional Study

The purpose of this research study is to explore current Telehealth geriatric social work by describing its most recent job market characteristics. As part of a larger longitudinal research, data for this cross- sectional study was collected in January 2021. Three top job search engines, Google, ZipRecruiter, and Indeed, were used to collect data on Telehealth social work job openings. On each search engine, five searches were completed with the five key words: "social work" Telehealth jobs, LCSW Telehealth jobs, remote LCSW jobs, Telehealth "social work" jobs, and Telehealth "social worker" jobs. It analyzed 112 Telehealth geriatric social work job ads, 12.8% of total 873 ads from these fifteen searches. Results from descriptive and thematic data analysis show large, for-profit organizations are dominating the Telehealth geriatric social work field while small private practices are emerging during the pandemic. The study found Telehealth geriatric social work is providing vital continuum services to older people in communities, hospitals, and long-term care facilities at individual, family, and group levels. The results document innovative technological tools present new methods to engage, assess, and intervene, particularly with mental health needs. The Telehealth organizations are making the pitch to attract competitive professionals. While nearly 1/3 of the sampled organizations stated they intended to make Telehealth/remote positions temporary, the study concludes Telehealth has built its infrastructure and workforce to become an indispensable and ongoing part of gerontological and geriatric social work. Social work education, research, and practice must pay close attention to its implications in skill building.

Intrinsic Capacity vs. Multimorbidity: A Function-Centered Construct Predicts Disability Better Than a Disease-Based Approach in a Community-Dwelling Older Population Cohort.

Objective: This study aimed to assess the status of intrinsic capacity (IC)—a novel function-centered construct proposed by the WHO and examine whether impairment in IC predicts subsequent 1-year activities of daily living (ADL) disability better than a disease-based approach, i. e., multimorbidity status.Methods: This study included data of community-dwelling older adults from the Beijing Longitudinal Study on Aging II aged 65 years or older who were followed up at 1 year. Multivariate logistic regressions were performed to estimate the odds of ADL disability at baseline and 1-year follow-up.Results: A total of 7,298 older participants aged 65 years or older were included in the current study. About 4,742 older adults were followed up at 1 year. At baseline, subjects with a higher impairment in IC domains showed higher odds of ADL disability [adj. odds ratio (OR) = 9.51 for impairment in ≥3 domains, area under the curve (AUC) = 0.751] compared to much lower odds of ADL disability in subjects with a higher number (≥3) of chronic diseases (adj. OR 3.92, AUC = 0.712). At 1-year follow-up, the overall incidence of ADL disability increased with the impairment in IC domains higher than the increase in multimorbidity status. A higher impairment in IC domains showed higher odds of incidence ADL disability for impairment in 2 or ≥3 IC domains (adj. OR 2.32 for impairment in ≥3 domains, adj. OR 1.43 for impairment in two domains, AUC = 0.685). Only subjects who had ≥3 chronic diseases had higher odds of 1-year incident ADL disability (adj. OR 1.73, AUC = 0.681) that was statistically significant.Conclusion: Our results imply that a function-centered construct could have higher predictability of disability compared to the multimorbidity status in community older people. Our results need to be confirmed by studies with longer follow-up.

Clinical Characteristics and Risk Factors for Mortality in Older Patients with Dialysis-Receiving Community-Acquired Acute Kidney Injury.

IntroductionOlder people in community are susceptible to acute kidney injury (AKI) and hemodialysis is the most important supportive measure used in the management of severe AKI. This study aims to investigate the clinical characteristics, outcomes and risk factors for mortality in older patients with dialysis-receiving-community-acquired AKI (CA-AKI).MethodsA total of 1953 CA-AKI patients aged 65 years old and above were recruited from 2013 to 2016. Among which, 200 patients received hemodialysis. Clinical characteristics, outcomes, suspected nephrotoxic drug use after CA-AKI and risk factors for mortality in older CA-AKI patients with dialysis were analyzed.ResultsThe percentage of CA-AKI patients receiving hemodialysis was 10.2%. Compared with non-dialysis patients, dialysis-receiving patients had more comorbidity, and worse renal function. The types of suspected nephrotoxic drugs used in dialysis patients were more than those in non-dialysis patients. Moreover, dialysis-receiving patients had worse outcomes, including complete recovery of renal function (42.0% vs 71.6%), intensive care unit (ICU) (69.0% vs 15.3%) transfer and in-hospital mortality (50.5% vs 5.6%) (P<0.01). Age, moderate/severe liver disease, beta lactam antibiotics, glycopeptide antibiotics, antifungal agents, drugs for anti-heart failure, category of suspected nephrotoxic drugs, hyperkalemia, increased leucocyte count, ICU transfer, multiple organ dysfunction (MODS), cardiogenic shock and cardio-pulmonary resuscitation (CPR) were risk factors for mortality by univariate logistic regression analysis. After adjusting for confounding factors, the independent risk factors were glycopeptide antibiotics, drugs for anti-heart failure, ICU transfer, MODS and CPR.ConclusionThe percentage of older CA-AKI patients receiving dialysis was high, and these patients had more comorbidity and worse prognosis. Glycopeptide antibiotics, drugs for anti-heart failure, ICU transfer, MODS and CPR were independent risk factors for mortality.

Association between sleep quality and depression among institutionalized and community older people - Brazilian Western Amazonia.

BackgroundThe transition in the population pyramid is a reality in several locations around the world and projections of an increase in the older population in Brazil demonstrate the relevance of studies on factors that may interfere in the functionality and quality of life in this age group. Thus, the present study aims to assess depression levels and their relationship with sleep quality in institutionalized and community older adults.MethodsThis cross-sectional study included 220 older people of both sexes, divided into two groups, institutionalized older adults, and community older adults. The older adults were monitored by Community Health Agents (CHA), through identification of everyone in their micro area using a method of random name generation, based on geographic location. Due to the small number of institutionalized older adults, all residents in the institutions were recruited, according to the inclusion and exclusion criteria. The Geriatric Depression Scale (GDS-15) and Pittsburgh Sleep Quality Index (PSQI) were used to assess depression and sleep quality.ResultsAmong the 220 older adults, 175 were community members and 45 were institutionalized. The survey revealed that institutionalized older adults had a higher percentage of severe depression compared to community dwelling older adults (p < 0.039).ConclusionOlder adults in the community present greater symptoms of depression and better sleep than institutionalized older adults. There was a direct association between sleep quality and depression. In our sample, being institutionalized and female positively influenced and feeling alone negatively influenced depressive symptoms.