Older People In Research Research Articles

Violence against older people and associations with mental health: A national probability sample survey of the general population in England

BackgroundOfficial estimates of violence prevalence in England exclude older people. There are few studies of elder abuse and these excluded violence from acquaintances and strangers and lack comparability with younger adults. ObjectivesTo estimate prevalence of past-year violence victimisation in older people, identify factors associated with violence in older age, quantify the extent to which experience of violence in older people was associated with common mental disorder (CMD). Study design/methodsAnalysis of a 2014 general population probability sample survey of 2570 adults aged 60+ and 4484 16–59 year olds. Modified version of the Conflict Tactics Scale measured domestic violence and List of Threatening Experiences captured bullying and serious assault. CMD were assessed using the revised Clinical Interview Schedule. Associations were examined using regression models adjusted for childhood victimisation and other adversities. Results2.0 % (n = 52,CI:1.4–2.6) of older people experienced violence in the past year, with intimate partner violence the most prevalent form. Older people of non-white ethnicity, those who were socially isolated or lonely, and the formerly married were more likely to experience violence. Violence was associated with CMD in older people (adjusted odds ratio 2.2, CI:1.0–4.8), controlling for impairments, adversities and other factors. ConclusionViolence, especially from an intimate partner, is evident in later life and strongly associated with poor mental health. Better instruments for the identification of violence and abuse in older people in research and safe enquiry in practice settings are needed, with recognition of and attention to ethnic and other inequalities among older people in exposure.

The participation of hard-to-reach older people in the research and development process of health technologies from the perspective of multipliers-A qualitative analysis.

The participation of older people in research and development processes has long been called for but has not been sufficiently put into practice. In addition, participation is often late and not particularly intensive, so that certain older groups of people are underrepresented in the development of health technologies (HT). Heterogeneity, e.g., between urban and rural populations, in access to and motivation for participation is also rarely taken into account. The aim of this study was to investigate form and phases of participation for hard-to-reach older people in the research and development process of HT. The qualitative study among multipliers was conducted using focus groups and telephone interviews and took place in a city and an adjacent rural area in northwestern Lower Saxony, Germany. A content analysis of the data was undertaken using deductive-inductive category formation. Seventeen participants (13 female) took part in the study (median age 61, 33-73). Participants from both areas identified particular forms and phases of participation in the research and development process. Longer forms of participation for hard-to-reach groups and the development process of technologies for older people from the rural area were viewed as challenges. Passive and active access strategies are needed to achieve sufficient heterogeneity in the research and development process. Trusted multipliers can play an important role in gaining access to hard-to-reach older people, but also during the research process. Apart from facilitating factors (e.g., age-specific study materials), inhibiting factors such as contact anxieties are also indicated. Only urban participants mention financial/material incentives and community as possible motivations. The results provide important insights from the perspective of multipliers. They show specificities in access and participation for rural areas and for hard-to-reach older people. Many older people may have uncertainties about research projects and HT. Multipliers can assume a key role to help reduce these uncertainties in the future.

Research collaboration with older people as a matter of scientific quality and ethics: a focus group study with researchers in ageing and health

BackgroundSociety is placing increasing demands on collaboration with actors outside the academia to be involved in the research process, and the responsibility for turning this into reality lies with the researchers. As research collaboration is a way to increase the societal relevance of research and since older people have the right to be actively involved in research that concerns them, this study is addressed to researchers who work with and for older people. The purpose of this article is to explore researchers’ experiences of research collaboration with the heterogeneous group of older people, from healthy to frail.MethodsThe focus group method was applied based on a qualitative approach that is based on a social constructivist research tradition. It differs from other qualitative methods, such as interviews, in that it encourages interaction between research participants and contributes to shedding light on a collective understanding of the world. A total of 14 researchers participated in four focus groups (three to five participants/group).ResultsThe results provided support for the overall theme: “Good scientific quality and ethics are balanced against the needs and abilities of older people”. This means a balance between the researcher and the older people collaborating with them to receive the best possible scientific quality. This is highlighted in the core category “Positioning for research collaboration” with the subcategories “Involvement or not”, “Traditional or innovative thinking” and “Selectivity or representativeness”, and the core category “Research collaboration – an ethical issue of power” with the subcategories “Research collaboration a risk for freedom of research”, “Research collaboration a risk of abuse of power” and “Discriminatory academic power structures create ethical issues”.ConclusionsAddressing the balancing act of collaborating with older people in research, the findings contribute with an understanding of the importance of researchers’ awareness of social and academic structures to minimise the risk of epistemic injustices in research on ageing and health. We want to highlight the researchers’ voice and clarify the role that researchers have in terms of the opportunities for older people to become part of the collective understanding of ageing and health and make their voices heard.

BENEFITS AND BARRIERS OF COMMUNITY-ENGAGED RESEARCH AND STRATEGIES FOR STRENGTHENING PARTNERSHIP PRACTICE

Abstract The meaningful engagement of older people in research may help to address their lag behind other groups in health outcomes and low participation in studies. This symposium addresses the critical gap in the aging literature and advances knowledge about community engagement by offering insight from experts on the complexities of partnership and engagement processes that vary by context as well as tools and tactics for overcoming obstacles. The first speaker will present findings and lessons gained from evaluating the needs of a self-organizing community advisory board of Black older adults to increase enrollment in a participant research pool. The second will focus on the challenges of centering a diverse range of partners in the design of a health and wellness program tailored to the needs of formerly incarcerated mid and late-life adults. The third speaker will provide recommendations for researchers interested in working with Indigenous communities and strategies for working collaboratively, and how to overcome relational challenges. The fourth speaker will present findings from a reflective evaluation process of a community-based participatory research partnership that evolved over seven years and discuss how the partnership evaluation tool can enhance partner practice. This symposium concludes with reflections about meaningful and authentic academic-community partnerships in line with supporting and building bridges between aspiring and existing community engaged scholars and older people who are experts on aging.

Ethical conditions for research with the elderly: a narrative review [Version 1; Peer Review - In Progress

Introduction: the population aging raises the need for the inclusion of older people in research, and therefore, the review of ethical guidelines that grant protection to this age group, especially in conditions of vulnerability. Objective: to find out about the ethical conditions involved in research with older people and the protection they should be afforded as research subjects. Methods: narrative review of 15 original articles published between 2001 and 2021, indexed in the PUBMED, Web of Science, CINAHL, and SCOPUS databases. The descriptors used were Ethics in Research and Aged/ Elderly. Results: the main findings point to the poverty of research on aging issues and unjustified discrimination in the participation of older people in clinical studies. An update is provided on the ethical conditions for research on older people, according to the requirements set out by Emanuel. Conclusions: the need to include older people in clinical research is imperative, for which it is necessary to integrate advances in Chilean legislation that allow the participation of this age group in different situations of vulnerability while maintaining the conditions of protection contemplated in international ethical guidelines and agreements. Participatory research and methods that include the community can be an opportunity to approach research within a framework of respect and citizen education

23 CO-DESIGNING A PRIMARY-CARE INTERVENTION TO REVERSE FRAILTY AND BUILD RESILIENCE THROUGH PUBLIC AND PATIENT INVOLVEMENT WITH OLDER PEOPLE

Abstract Background An essential consideration in health research is to conduct research with members of the public rather than for them. Public and Patient Involvement (PPI) of older people in research can improve enrolment, relevance and impact. However, few studies with PPI in frailty research have been identified. PPI has fallen during the Covid-19 pandemic. We aimed to involve older people in co-designing a Randomised-Control Trial (RCT) intervention to reverse frailty and build resilience. We also wished to encourage wider use of PPI with older people by outlining our approach. Methods Involvement of older people was undertaken in three stages. Eighteen over 65-year-olds helped co-design an exercise intervention in two group discussions using the Socratic education method. Ninety-four contributed intervention feedback in one-on-one telephone interviews over nine months. Ten contributors helped optimise the intervention in three online workshops. Multidisciplinary team input and systematic review supported co-design. Results Eleven home-based resistance exercises were co-designed by group discussion contributors (mean age 75, 61% female). Frailty intervention format, gender balance and GP follow-up were shaped in telephone interviews (mean age 77, 63% female). Dietary guidance and patient communication were co-designed in workshops (mean age 71, 60% female). Technology proved no barrier to PPI. The co-designed frailty intervention is being evaluated in a definitive RCT. Conclusion We enabled meaningful involvement of 112 older people in co-design of an intervention to reverse frailty and build resilience in diverse ways. Inclusive involvement can be achieved during a pandemic. Feedback enhanced intervention feasibility for real-world primary-care.

Engaging older people through visual participatory research: Insights and reflections

Although there is an ageing population in Europe which acts as an increasingly influential social and economic force, there remains limited scholarship concerning the involvement of older people in research. This paper responds to the question of how visual participatory research engages older people through three illustrative case studies, set in England and Italy, all of which incorporated different visual elements within their participatory design. These cases highlight; the value of the visual as a trigger for memories as an entry point for research discussions, that the sharing of experiences is facilitated by both the participatory and visual elements of the approach and that greater engagement is forthcoming once trust is established through the socialisation of older research participants. Reflections and good practice suggestions are offered to other qualitative researchers on the practicalities of adopting this approach.

Awareness of and attitudes towards public involvement in research on ageing and health among older people in Sweden.

BackgroundWhile the importance of involving older people in research is increasingly acknowledged, quantitative studies exploring the perspectives of larger samples of older people who take an active role in research on ageing and health are scarce. The aim of this study was to investigate the awareness of and attitudes towards public involvement in research on ageing and health among older people in Sweden.Materials and methodsData derived from a survey (N = 881) of people aged 60 years or older in Sweden. Demographics, self-rated health, and attitudes were analysed using descriptive statistics. Awareness of and previous active involvement in research were analysed using chi-square tests and Mann Whitney tests. Factors associated with willingness to be actively involved in research were determined by logistic regressions.ResultsOf the 26% who responded (N = 881), 39% (n = 343) were aware that they could be actively involved in research. Awareness and previous active involvement in research were significantly associated with a higher level of education. Public involvement was believed to enhance research communication and enable valuable contributions related to ageing. The proportion of respondents who were willing to be actively involved in research was significantly higher for respondents with previous experience and a higher level of education.ConclusionsEngaging older people in Sweden in research targeting active involvement in research presents a challenge. The study shows an over-representation of people with higher education, who tend to be more aware, have previous experience, and are more willing to be involved in research with public involvement. This implies a risk that groups with lower education are not represented, and that knowledge co-produced with mostly highly educated groups will lead to a biased picture. Further studies are needed to understand how an increased awareness of research and willingness to participate can be achieved.IRRID: RR2-10.2196/17759.

Research as an essentiality beyond one\u2019s own competence: an interview study on frail older people's view of research

BackgroundThere is an increased interest to make the voices of frail older people heard in research by actively involving them in research processes. Involving frail older people in research could, however, be perceived as challenging by researchers. To actively involve frail older people in research processes in a meaningful way, the knowledge about their own views on what research is must be widened and deepened.MethodsIndividual interviews were conducted with 17 frail older men and women with former experience of participation in research studies. Qualitative data were analysed using content analysis.ResultsFrail older people’s views on what research means are described through the main category; An essentiality beyond one’s own competence, which describes research as a complex process that is important for society but difficult to understand. This is described in the sub-categories; A driving force for societal development, A benefit when based on lived experience, A source of knowledge difficult to access and understand, and A respected job filled with responsibilities.ConclusionDifferent views on research from the perspective of frail older people show that research is viewed as a complex yet important phenomenon to frail older people. Research was also seen as a natural part in society. Research was viewed as difficult to access and understand. Thus, researchers must train themselves to communicate research findings to the public in an understandable way. To create common understandings through information and education, researchers might be better placed to involve frail older people in a meaningful way and thereby also have the possibility to develop good working practice and relationships with those involved.

Involving older people in co-designing an intervention to reverse frailty and build resilience.

BackgroundAn essential consideration in health research is to conduct research with members of the public rather than for them. Public and patient involvement (PPI) of older people in research can improve enrolment, relevance and impact. However, few studies with PPI in frailty research have been identified. PPI has fallen during the Covid-19 pandemic.ObjectiveWe aimed to involve older people in co-designing a randomised control trial (RCT) intervention to reverse frailty and build resilience. We also wished to encourage wider use of PPI with older people by outlining our approach.MethodsInvolvement of older people was undertaken in three stages. Eighteen over 65-year-olds helped co-design an exercise intervention in two group discussions using the Socratic education method. Ninety-four contributed intervention feedback in one-on-one telephone interviews over nine months. Ten contributors helped optimise the intervention in three online workshops. Multidisciplinary team input and systematic review supported co-design.ResultsEleven home-based resistance exercises were co-designed by group discussion contributors (mean age 75, 61% female). Frailty intervention format, gender balance and GP follow-up were shaped in telephone interviews (mean age 77, 63% female). Dietary guidance and patient communication were co-designed in workshops (mean age 71, 60% females). Technology proved no barrier to PPI. The co-designed frailty intervention is being evaluated in a definitive RCT.ConclusionsWe enabled meaningful the involvement of 112 older people in the co-design of an intervention to reverse frailty and build resilience in diverse ways. Inclusive involvement can be achieved during a pandemic. Feedback enhanced intervention feasibility for real-world primary-care.

Ethical Issues in Dementia Research.

Dementia is a global public health issue with an urgent need for developing newer and more effective treatment strategies. Research in the area of dementia, however, poses unique ethical and legal challenges. Epidemiological studies, studies on pharmacological and non-pharmacological interventions have to deal with obtaining consent from persons with cognitive impairments, those from diverse cultural groups and need to contend with privacy and confidentiality issues. The caregiver support intervention research has not yet translated into policy change and effective clinical care. Biomedical research that involves invasive procedures may not translate into short- or long-term therapeutic benefits but is necessary research. Palliative care research in dementia has to deal with ethical issues involving people at end-of-life research. Proposed research may not receive approval, citing necessary safeguards to the vulnerable older people against invasive studies even when it is least invasive. This article aims to review the ethical aspects for safeguarding vulnerable older people with dementia and the potential challenges in conducting dementia research from a researcher’s perspective.Some of the safeguards for ethical research include determining capacity to consent, obtaining advanced directives in early stages and proxy consent from caregivers, obtaining informed consent in cognitively impaired individuals. Future research policies need to consider the logistics of involving older people in research, enhancing caregiver support, and encouraging supportive decision-making. It will also need to address developing capacity assessment tools while addressing advanced care planning that will ensure the well-being of subjects in research.Background:Dementia has become a global public health issue, with hospitalization rates being 65% higher in seniors with dementia than others.1,2 The pressures on healthcare systems mean an urgent need to develop robust preventive and treatment strategies for dementia, which requires multidisciplinary research. However, the patient’s stage of illness and ability to engage in discussions around the merits of participating in research and caregiver concerns is an important aspect of dementia research.Hence, dementia research poses unique ethical challenges compared to populations with other diseases, which has led to the evolution of an ethical framework for dementia research. This article aims to review and give a viewpoint on the ethical aspects for safeguarding vulnerable older people with dementia and the potential challenges in conducting dementia research from a researcher’s perspective.

Engaging older people to explore the age-friendliness of a rural community in Northern England: A photo-elicitation study

An ageing society brings with it increased health costs due to the prevalence of long term conditions increasing with age. It is therefore vital to support good health in older people, both to improve their quality of life and to reduce the financial implications of an ageing society. Isolation and loneliness can put people at risk of dying early, and increasing opportunities for social interaction and engagement could mitigate some of the health effects of ageing. However, this requires society to create the conditions that enable older people to participate fully. The World Health Organization's Age-Friendly Cities programme has identified factors that make urban areas Age-Friendly, but research shows that older rural dwellers have unique unmet needs preventing full engagement in their communities. This article describes a pilot project which adapted photo-elicitation to explore the age-friendliness of a rural area in Calderdale, Northern England. It shows that photo-elicitation is a successful method for identifying what older people think is important in making their community age-friendly and it reveals differences between ageing in a city and in a rural setting. This rich data can be used to inform the development of policy in rural areas which is more closely aligned to the needs, preferences and interests of the growing population of older residents. The project also demonstrates the engagement potential of this methodology. Participants continued as co-researchers, learning new skills and taking responsibility for a variety of dissemination activities such as photographic exhibitions, a public report and presentations. This suggests that adapted photo-elicitation is a useful tool for engaging older people in research.

A research tool for measuring non-participation of older people in research on digital health

BackgroundHealthcare services are being increasingly digitalised in European countries. However, in studies evaluating digital health technology, some people are less likely to participate than others, e.g. those who are older, those with a lower level of education and those with poorer digital skills. Such non-participation in research – deriving from the processes of non-recruitment of targeted individuals and self-selection – can be a driver of old-age exclusion from new digital health technologies. We aim to introduce, discuss and test an instrument to measure non-participation in digital health studies, in particular, the process of self-selection.MethodsBased on a review of the relevant literature, we designed an instrument – the NPART survey questionnaire – for the analysis of self-selection, covering five thematic areas: socioeconomic factors, self-rated health and subjective overall quality of life, social participation, time resources, and digital skills and use of technology. The instrument was piloted on 70 older study persons in Sweden, approached during the recruitment process for a trial study.ResultsResults indicated that participants, as compared to decliners, were on average slightly younger and more educated, and reported better memory, higher social participation, and higher familiarity with and greater use of digital technologies. Overall, the survey questionnaire was able to discriminate between participants and decliners on the key aspects investigated, along the lines of the relevant literature.ConclusionsThe NPART survey questionnaire can be applied to characterise non-participation in digital health research, in particular, the process of self-selection. It helps to identify underrepresented groups and their needs. Data generated from such an investigation, combined with hospital registry data on non-recruitment, allows for the implementation of improved sampling strategies, e.g. focused recruitment of underrepresented groups, and for the post hoc adjustment of results generated from biased samples, e.g. weighting procedures.

Can Patient Frailty Be Estimated from Inpatient Records? A Prospective Cohort Study

Background: Frailty is a common condition in older people affecting around 1.8 million people in the UK and is independently associated with adverse outcomes. Frailty is commonly measured with the Clinical Frailty Scale (CFS) which involves a face to face assessment. There is evidence the CFS can be assigned retrospectively from information in patient records, but no research has assessed whether scores can be assigned using routine inpatient records. We aimed to assess whether a CFS could be accurately assigned using hospital inpatient records in a UK setting. Methods: Forty newly admitted patients aged 65 and over were prospectively recruited at Bradford Royal Infirmary. A CFS score was assigned to each patient using a face to face assessment. A CFS score was independently assigned to each patient solely using information in the inpatient records. A quadratically weighted Cohen’s Kappa was used to estimate inter-rater reliability (IRR) between the assessments. Results: A Kappa of 0.84 was estimated for the IRR between the scores derived from a face to face assessment and those based solely on inpatient records, indicating good agreement. The Kappa score fell to 0.7 when a 4 category collapsed version of the CFS was used. The IRR appeared unaffected by the number of times a patient had been admitted recently. Conclusion: The CSF may accurately be determined from data routinely recorded in inpatient records. Retrospectively derived scores can, therefore, be used in analysis of patient outcomes of older people in research and service improvement.

Methods for Involving Older People in Health Research-A Review of the Literature.

Demographic change has increased the need for research on healthcare for older people. Recently there has been a growing awareness that research might benefit from actively involving patients and the public in study design and conduct. Besides empowering patients and democratizing research, involvement enhances the quality of research and the development of equitable healthcare solutions. Little is known about how to involve older people. This review aims to support scientists intending to involve older people in health research by systematically identifying and describing studies involving older people and analyzing associated facilitators and challenges. Old people were operationalized as people living with old-age-related conditions. We conducted a systematic search in PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane library for the period 2007 to July 2017 and also manually searched reference lists of the nine retrieved articles and other relevant sources. While involvement of older people in research is feasible, specific challenges related to this group need be taken into account. Strategies to enhance effective involvement comprise a thoughtful choice of location, use of visualization and accessible communication, building good relationships and flexible approaches. Further research is needed on the involvement of people in care homes or with vision, hearing or mobility limitations.

How older people as pedestrians perceive the outdoor environment - methodological issues derived from studies in two European countries.

This paper has re-analysed and compared data between three studies conducted in the United Kingdom and in Sweden (the OPUS 'Older People's Use of Unfamiliar Space' study in the United Kingdom and the Swedish studies 'Let's Go for a Walk' and 'Walking in Old Age') to provide a comprehensive account of the issues facing older people in the outdoor environment. All three studies draw on the 'fit' between the person and their environment as a guiding conceptual base - capturing the dynamics of the relationship between older people's personal needs and their wider environmental context. This common conceptual base allowed us to test theory against practice, and to explore the utility of this concept across different geographical contexts. Participatory research was also applied, highlighting the importance of the voice of older people and involving older people in research. The studies also used a mixed-method approach involving both quantitative and qualitative methods. The paper highlights that although not generalisable, you can compare cross-locales and cross-nationally using different methodology; it investigates the challenges of cross-national comparative analysis and draws on findings from the three studies to illustrate the different challenges and solutions and finally looks at lessons that are transferable.

Strategies to improve engagement of \u2018hard to reach\u2019 older people in research on health promotion: a systematic review

BackgroundThis systematic review aimed to identify facilitators, barriers and strategies for engaging ‘hard to reach’ older people in research on health promotion; the oldest old (≥80 years), older people from black and minority ethnic groups (BME) and older people living in deprived areas.MethodsEight databases were searched to identify eligible studies using quantitative, qualitative, and mixed research methods. Using elements of narrative synthesis, engagement strategies, and reported facilitators and barriers were identified, tabulated and analysed thematically for each of the three groups of older people.ResultsTwenty-three studies (3 with oldest-old, 16 with BME older people, 2 within deprived areas, 1 with both oldest-old and BME, 1 with both BME and deprived areas) were included. Methods included 10 quantitative studies (of which 1 was an RCT), 12 qualitative studies and one mixed-methods study. Facilitators for engaging the oldest old included gaining family support and having flexible sessions. Facilitators for BME groups included building trust through known professionals/community leaders, targeting personal interests, and addressing ethnic and cultural characteristics. Among older people in deprived areas, facilitators for engagement included encouragement by peers and providing refreshments. Across all groups, barriers for engagement were deteriorating health, having other priorities and lack of transport/inaccessibility. Feeling too tired and lacking support from family members were additional barriers for the oldest old. Similarly, feeling too tired and too old to participate in research on health promotion were reported by BME groups. Barriers for BME groups included lack of motivation and self-confidence, and cultural and language differences. Barriers identified in deprived areas included use of written recruitment materials. Strategies to successfully engage with the oldest old included home visits and professionals securing consent if needed. Strategies to engage older people from BME groups included developing community connections and organising social group sessions. Strategies to engage with older people in deprived areas included flexibility in timing and location of interventions.ConclusionsThis review identified facilitators, barriers and strategies for engaging ‘hard to reach’ older people in health promotion but research has been mainly descriptive and there was no high quality evidence on the effectiveness of different approaches.

Some ethical issues in research on the housing of older people

In this article some ethical issues that arise in research on older people and their housing are discussed. It starts by underlining the importance of defining older people, the dangers of generalising, and the effect of excluding them from research. Ethical issues over the involvement of older people in research are then discussed. It looks at their living arrangements including the role of home and whether there are special issues for certain groups. The challenges over the use of assistive technology, including practical ones, are considered. There are particular issues connected with longitudinal studies and these are addressed. Finally, guidance over ethical issues and research on older people including housing and technology are discussed. It is also concluded that the use of measures that are generally agreed to enable comparisons across the world would be helpful.

Discussion paper on participation and participatory methods in gerontology.

The concept of "participation" and the use of "participatory methods" in human, healthcare, nursing, and gerontological research, as well as the corresponding fields of practice, represent an expanding field of interest. However, the objectives and organization of "participation" are not always sufficiently explicated. The Critical Gerontology Working Group of the German Society of Gerontology and Geriatrics presents astatement on this phenomenon, and proposes acatalogue of criteria for reflection upon and assessment of participation by older people in research and practice, which can also be considered astimulus for further discussions.

Belgian Ageing Studies: participatief actie-onderzoek naar en met ouderen

Population ageing is affecting all western countries. The average age of people is increasing and older people constitute a larger proportion of our society. In response to this evolution, Flemish local policymakers became aware of the need to develop evidence-based local senior policy plans. This contribution seeks to reflect on the challenges and opportunities of involving older people in research, policy and social change at the local level. In particular, it focuses on ‘Belgian Ageing Studies’, a research program which monitors the needs and quality of life among home-dwelling older people (e.g. on housing, community, participation, care) in order to provide tools for evidence-based ‘age-friendly’ policies at the local level. The research program was developed in co-creation with older people, senior associations, senior advisory boards, local authorities, and other stakeholders. Older people are involved in this research as experts and actors by playing a significant role in the development of the study as well as the data collection and the evaluation (peer-research). In 10 years time, over 80 000 older respondents and 8000 older volunteers participated in the research program. The process of the BAS program in which older people actively engage as participants and develop a sense of co-ownership shows how participatory research can play a role in promoting evidence-based senior policies.