Older People In Terms Research Articles

Vitamin B12 Deficiency Mediated Oxidative Stress And Its Effect On Cognitive Ability In Elderly Individuals

The world population is growing old and in many developed countries the fastest growing group of population is over 60 year age group. Almost all countries of the world are experiencing the growth of older people in terms of the number and proportion.

Process evaluation of a complex group-based intervention for older adults living alone

ABSTRACT A complex intervention called ‘participatory group-based care management’ was developed and carried out in Central and Eastern Finland to promote older adults’ wellbeing and quality of life. This study analyses the process of the intervention using two types of qualitative data. Firstly, during the six-month intervention, 120 reflection diaries in total were written by researchers and care managers, based on their observations of the group meetings. Secondly, 24 focus group discussions were carried out with the intervention participants. Both data were analyzed jointly by using the grounded theory method to evaluate the intervention process. Based on the data, three important elements of the intervention were social support exchange, needs-based counseling, and scheduled group meetings. These elements support older people in terms of social wellbeing, resources and capacity, experiences of meaningfulness, participation and routines, and empowerment. Contextual and intervening factors related to the intervention, group tutors, and participants, are essential for achieving outcomes. The three important elements of the intervention (social support exchange, needs-based counseling, and scheduled group meetings) appear to empower some older adults and engage some of them in activities. According to the results, the effectiveness of the intervention is based on socially and individually constructed causal pathways, but the intervention should be refined before its further implementation.

Older Adults' Access to Care during the COVID-19 Pandemic: Results from the LOckdown and LifeSTyles (LOST) in Lombardia Project.

The COVID-19 pandemic disproportionally affected older people in terms of clinical outcomes and care provision. We aimed to investigate older adults’ changes in access to care during the pandemic and their determinants. We used data from a cross-sectional study (LOST in Lombardia) conducted in autumn 2020 on a representative sample of 4400 older adults from the most populated region in Italy. Lifestyles, mental health, and access to healthcare services before and during the pandemic were collected. To identify factors associated with care delays, reduction in emergency department (ED) access, and hospitalisations, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) using multivariable log-binomial regression models. During the pandemic, compared to the year before, 21.5% of the study population increased telephone contacts with the general practitioner (GP) and 9.6% increased self-pay visits, while 22.4% decreased GP visits, 12.3% decreased outpatient visits, 9.1% decreased diagnostic exams, 7.5% decreased ED access, and 6% decreased hospitalisations. The prevalence of care delays due to patient’s decision (overall 23.8%) was higher among men (PR 1.16, 95% CI 1.05–1.29), subjects aged 75 years or more (PR 1.12, 95% CI 1.00–1.25), and those with a higher economic status (p for trend < 0.001). Participants with comorbidities more frequently cancelled visits and reduced ED access or hospitalisations, while individuals with worsened mental health status reported a higher prevalence of care delays and ED access reductions. Access to care decreased in selected sub-groups of older adults during the pandemic with likely negative impacts on mortality and morbidity in the short and long run.

Effects of long-term Tai-Chi Chuan practice on whole-body balance control during obstacle-crossing in the elderly

Older people are subject to an increased risk of falling compared to the young, especially during obstacle negotiation. This study aimed to quantify the effects of long-term Tai-Chi Chuan (TCC) practice on the balance control during obstacle-crossing in older people in terms of the inclination angles (IA) of the body’s centre of mass (COM) relative to the centre of pressure (COP), and the rate of change of IA (RCIA). Fifteen healthy older adults who had practised TCC for at least 13 years and 15 healthy controls without any experience in TCC performed obstacle-crossing in a gait laboratory. The TCC group showed significantly greater leading and trailing toe-obstacle clearances but smaller trailing stride lengths when compared to controls. In the sagittal plane, the TCC group showed significantly smaller average anterior IA when the COM was anterior to the COP but greater average posterior IA when the COM was posterior to the COP, with significantly smaller average and peak RCIA over the crossing cycle. Long-term TCC practitioners showed an obstacle-crossing technique for less risk of tripping and better balance control, as indicated respectively by significantly increased toe-obstacle clearances and more posterior COM position relative to the COP with smaller anterior IA and RCIA during leading crossing and greater posterior IA and frontal RCIA at trailing-toe crossing. These benefits appeared to be related to the main features of TCC movements that emphasized maintaining balance during single-leg support and keeping the body weight on the trailing limb during the slow weight-shifting of double-limb support.

The Effect of Information and Communication Technology and Social Networking Site Use on Older People's Well-Being in Relation to Loneliness: Review of Experimental Studies.

BackgroundIn the last decades, the relationship between social networking sites (SNSs) and older people’s loneliness is gaining specific relevance. Studies in this field are often based on qualitative methods to study in-depth self-perceived issues, including loneliness and well-being, or quantitative surveys to report the links between information and communication technologies (ICTs) and older people’s well-being or loneliness. However, these nonexperimental methods are unable to deeply analyze the causal relationship. Moreover, the research on older people’s SNS use is still scant, especially regarding its impact on health and well-being. In recent years, the existing review studies have separately focused their attention on loneliness and social isolation of older people or on the use of ICTs and SNSs in elderly populations without addressing the relationship between the former and the latter. This thorough qualitative review provides an analysis of research performed using an experimental or quasi-experimental design that investigates the causal effect of ICT and SNS use on elderly people’s well-being related to loneliness.ObjectiveThe aims of this review are to contrast and compare research designs (sampling and recruitment, evaluation tools, interventions) and the findings of these studies and highlight their limitations.MethodsUsing an approach that integrates the methodological framework for scoping studies and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, we identified 11 articles that met our inclusion criteria. A thematic and content analysis was performed based on the ex post categorization of the data on the selected studies, and the data were summarized in tables.ResultsThe analysis of the selected articles showed that: (1) ICT use is positively but weakly related to the different measures of older people’s well-being and loneliness, (2) overall, the studies under review lack a sound experimental design, (3) the main limitations of these studies lie in the lack of rigor in the sampling method and in the recruitment strategy.ConclusionsThe analysis of the reviewed studies confirms the existence of a beneficial effect of ICT use on the well-being of older people in terms of reduced loneliness. However, the causal relationship is often found to be weak. This review highlights the need to study these issues further with adequate methodological rigor.

Guidance for appropriate use of psychotropic drugs in older people

Psychotropic drugs are widely prescribed in older people although their use is associated with important risks. In this position paper, we discuss the appropriateness of using these medications in older people in terms of different aspects such as indications, contraindications, dosing, adverse drug reactions, interactions and duration of therapy. Consequently, we discuss different strategies to increase the appropriateness of therapy while formulating some practical recommendations to keep in mind when (de)prescribing psychotropic drugs in older people.

Assessing health system responsiveness to the needs of older people.

ABSTRACTObjective.To identify key indicators that will allow empirical measurement of a health system’s responsiveness to older people.Methods.We conducted a series of consultations with experts to develop a relevant list of indicators. Concept mapping was used to devise the list, including the steps of preparation, brainstorming and structuring. Additionally, four countries were used as national case studies to test the feasibility of measuring health system responsiveness with readily available national-level data (Barbados, Brazil, Chile, and Mexico).Results.Our study resulted in a list of 25 indicators scored with high usefulness for informing public policy, 10 of which were also categorized as being of high availability. National case studies were useful to assess the feasibility of measuring health system responsiveness in different settings.Conclusions.Responsiveness can be comprehensively assessed by (i) approaching the intrinsic features of the system via its inputs, outputs, and outcomes, and (ii) measuring the impact of the system on meeting the needs of older people in terms of their health, financial protection, and expectations. Further consensus is needed to develop a list of core indicators that could be used as a baseline for measuring a health system’s responsiveness to the needs of older people.

VARIETIES OF ACTIVE AGEING IN POLISH REALITY

The aim of the research is to check, in which areas older people actively shape their learning environment in everyday life. Method: 192 people participated in the study. Age of the respondents: from 60 to 92 years old. In order to group older people in terms of their activities, the k-medium cluster analysis method was used. Results: three dominant profiles of activity were identified: 1. Religious profile; 2. Profile characterized by striving to meet own needs; 3. Profile with low level of activity. The profiles were compared in terms of selected independent variables.

The Myth of Old Age: Addressing the Issue of Dependency and Contribution in Old Age Using Empirical Examples From the United Kingdom

In academia, policy-making and the media, population ageing often has negative connotations: it is associated with a rising care burden on society, with dependency, and with a fear of social isolation. The concepts pertaining to old age have evolved over time, and some of them challenge criticize this popular perception. This article begins with an overview of the development of social attitudes towards old age. Then, with the help of publicly available UK data, it addresses three areas in which old age and population ageing is perceived as problematic: poor health, dependency on other people’s productivity, and the role older adults play in the care cycle. Due to the diversity of the population aged 65+, we question the necessity of distinguishing older people in terms of age or dependency and instead recommend more research into the heterogeneity of the older population.

The Nexus Between Obesity, Health and Social Care Needs for Older Adults: A Literature Review

This article aims to critically review the literature on the consequences of obesity among older adults and its association with health, well-being, and social care need. A search was conducted using, primarily, three databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Medical Literature Analysis and Retrieval System Online, or MEDLARS Online (MEDLINE) and Academic Search Elite with the help of Boolean operators. Inclusion and exclusion criteria were set to avoid bias in the selection of articles. Publications were reviewed to identify the impact of obesity among older people in terms of health and social care needs and to establish a relation between them. Gaps in the literature have been identified concerning obesity in the older adults, their health status, well-being, and social care need. The research questions were formulated to satisfy these gaps. A conceptual model was developed to map out the theoretical threads to form a diagrammatic representation to satisfy the research questions based on existing literature.The literature review established that the degree of disabilities and comorbidities related to obesity are directly proportionate and identified the gaps in the literature, where further research work is needed. The research objectives were built according to the identified gaps, the research questions were formulated to satisfy the research objectives, and a conceptual framework was also drawn to establish the links between the research questions. This review will guide a way forward to explore the unmet care needs of the aging society.

Sexuality and sexual intimacy in later life.

Sexuality is as important in older age as it is throughout life, and its expression can be positive, empowering, joyful and life-affirming. The concept of sexuality has many dimensions including identity, need and desire, relationships and behaviour, all of which develop through ageing and life experiences. The evidence on all aspects of sexuality in later life tends to focus on biological dysfunction rather than fulfilment, well-being and quality of life, and does not acknowledge the enormous diversity of older people in terms of age, sexualities, ethnicity and culture. However, the evidence base is growing and, in broad terms, what older people want is becoming more clearly articulated. This article acknowledges the current evidence and, building on this, suggests ways in which nurses working in health and social care services can address some of the challenges, enhance their own understanding and skills, and work creatively with older individuals to offer services that help them to live, and end, their lives according to their individual identities, choices and deepest, most personal, priorities.

Improving access to quality services for vulnerable older people in Kyrgyzstan through engaging volunteers and establishing self-help groups

Very often older people are being excluded from community life and are therefore particularly prone to disorientation in a changing world. In this connection, a Model designed by the Red Crescent Society of Kyrgyzstan engages community volunteers to improve access to quality services for vulnerable older people. RCSK is supporting older people through creating new opportunities and better access to existing services for them while at the same time, fostering the capacity of elderly people to address and solve their problems. This requires that the target beneficiaries know where they can receive support and how to apply for it by demonstrating skills necessary to solve their problems and support other community members. Positive impact of this approach could be demonstrated in a project including 400 vulnerable older people supported by 200 community volunteers providing social and household support, according to the IFRC minimal standards of Community Based Home Care for Older people. 120 older people act as members of elderly clubs, 20% of the beneficiaries are participating in community initiatives. The people feel more confident to share their feelings and opinions. 100% of beneficiaries with low mobility requesting for support receive assistance with special equipment helping to stay socially active and as independent as possible. By the end of 2017, 1450 people were informed on services available for older people in their communities. 120 of them have moved from being “beneficiaries” to becoming “active community members” who are able to support others, develop and implement initiatives. Members of 5 elderly clubs volunteer to improve health literacy of communities through health promotion and disease prevention activities. Importance is given to a close collaboration with existing services in order to complement rather than duplicate activities. Social workers provided by the state are the key persons assisting to vulnerable older people. But due to time limitations (each social worker provides services up to 20 wards) and prioritizing the most urgent needs, the RC volunteers are working in pairs with them using participatory approach. Plans of service provision are designed jointly by a social worker and a coordinator. RC volunteers are helping to establish links between social care services and health institutions. Volunteers regular visits help to monitor persons’ health state. If changes are noticed, coordinator reveals the personal data, contacts the family doctor and assists with further observation and controls timeliness of procedures. In addition, Family doctors and nurses to design individual plans for older people integrating social, psychological and health related needs and particularities can be made available. Community volunteers are engaged in spreading the practices of healthy ageing, supporting self-management of older people in terms of monitoring of their state of health, building environment in the community and reducing the burden of already stretched public health system. Sustainability of the action is achieved by transferring the lead action to beneficiaries. Beneficiaries are empowered to retake the action through establishing self-help groups. This approach turns the beneficiaries into enthusiastic and energetic volunteers who are able to contribute to development of their community.

Productive activities of the older people in Vietnam

Productive activities are crucial factors leading to an “active aging” population. With the case of Vietnam, this paper aimed to explore the productive activities among Vietnamese older people by using data from the Vietnam Aging Survey (VNAS), which was conducted in 2011 as the first-ever nationally representative survey on persons aged 50 and over in Vietnam and contained 2789 older people (those aged 60 and over) representing all older people living in 6 ecological regions and urban and rural areas in Vietnam. Productive activities included working and/or taking care of any (great)grandchild(ren) in the past 12 months prior to the survey. Using paired t-tests and probit models, we compared the differences in these productive activities among older people in terms of sex and living area. The results from various t-tests showed that educational attainment, health status and poverty status were key factors differentiating older men and women and rural and urban older people in these productive activities. For the probit estimations in terms of both gender and living location, the results indicated that age, education, health status and supportive children were determinants of working decision, while age, marital status and size of household were consistently important factors of taking care of (great)grandchildren. The paper also discussed policy implications for socio-economic and health protection in promoting older people's productive activities as well as protecting them from a variety of risks and vulnerabilities.

Socioeconomic Position and Malnutrition among Older Adults: Results from the FRADEA Study

ObjectivesLow socioeconomic position (SEP) is related to many health-related conditions in older adults. However, there is a lack of knowledge on the association between SEP and malnutrition, a condition with serious consequences for older people in terms of quality of life and adverse health events. In the current study, we investigated socioeconomic inequalities in malnutrition and sub-domains of malnutrition in a sample of Spanish older adults.DesignCross-sectional population-based study.SettingUrban area of Albacete, Spain. Participants: 836 participants over age 70 from the first measurement wave (2007-2009) of the Frailty and Dependence in Albacete (FRADEA) study, a population-based cohort study.MeasurementsEducational level and occupational level were the indicators of SEP. Nutritional risk was measured with the Mini Nutrition Assessment® Short Form (MNA®-SF). Logistic regression analyses were performed.ResultsFor both socioeconomic indicators there was a statistically significant association with nutritional risk (OR low education=1.99, 95% CI=1.18-3.35; OR low occupational level=1.71, 95% CI=1.08-2.72). However, these associations disappeared after adjusting for age and sex (OR low education=1.51, 95% CI=0.88-2.60; OR low occupational level=1.32, 95% CI=0.80-2.17). In adjusted models, statistically significant associations between SEP and sub-domains of the MNA®-SF were observed, but these associations were not consistent across socioeconomic indicators.ConclusionsThis study found that malnutrition is a condition that can appear in any older adult, regardless of their socioeconomic group. These findings suggest that interventions to prevent malnutrition in older adults can be targeted at a general older population, and do not have to be SEP specific.

Understanding food vulnerability and health literacy in older bereaved men: A qualitative study.

BackgroundOlder people are sometimes challenged in maintaining a healthy diet but, because of age and disadvantage, are also more vulnerable to the adverse health consequences of poor nutrition. It has been claimed that older adults have low levels of health literacy regarding food and struggle to discern which foods are healthy from the vast range available in developed counties. However, nutrition and eating behaviour are modifiable risk factors for health in old age and health benefits can accrue from promoting healthy eating later in life. In order to achieve these health benefits, it is necessary to understand more about the capabilities and vulnerabilities of older people in terms of acquiring and maintaining a healthy diet.ObjectiveTo understand the potential for issues around food vulnerability to arise in that group and to characterize that vulnerability, if present.DesignNarrative interviews were conducted to collect the data. An interpretative thematic approach to analysis was utilized.ParticipantsTwenty older, bereaved men from two communities in the North of England.FindingsFive overarching themes were identified: financial security, social networks, cooking skills, food and routine and single servings.DiscussionOur findings suggest that some older men experience cumulative benefit from resources at their disposal, which contributes towards their capabilities to avoid food vulnerability.

Functioning and health-related quality of life following injury in older people: a systematic review

Aim and backgroundThere is growing evidence around the impact of injury and recovery trajectories but little focuses on older people, despite rising burden. The aim of this review was to...

Economic aspect of treatment in geriatrics

AbstractIntroduction.There are few publications related to the economic analysis of the cost of care and treatment of geriatric patients as compared with other fields of medicine. Aging of the population, especially in highly civilized countries is inevitable. Cost index is used in the literature to analyse the utility costs. They reflect the so-called cost-effectiveness of medical procedures with the estimated remaining number of years adjusted quality of life.Aim.Economic evaluation of treatment in geriatrics. Rating demographic and economic situation in Poland on the basis of statistical data.Material and methods.PubMed database was searched through and the base of Polish Central Statistical Office (CSO) was used. Qualified articles on the economic efficiency of the treatment of older people in terms of coexistence of multi morbidity were used for the analysis. Also, the existing legal acts and publications of the Polish National Health Fund, the reports from the Supreme Chamber of Control, data from the CSO, the Ministry of Health and Social Insurance Office were taken into account. Statistical analyses were performed basing on data from the CSO.Conclusions.Multiple morbidities are usually correlated with a significant increase in the use of resources, as it “multiplies” the costs of health and social care. The incidence of comorbidities has increased due to the effectiveness of treatment of chronic diseases, such as cancer, together with the increasing age of the patients. So there is a need for a system of health and social care, which will take into account the economics, and which will evolve and follow the problems that emerge. First of all, the authors recognize the need to create a properly equipped hospital wards and geriatric clinic. It is also important to take into account the cost-incurrence of geriatric treatment so that the provider would have the ability to optimally treat patients comprehensively and not only their singular particular diseases.

Evaluating the delivery, impact, costs and benefits of an active lives programme for older people living in the community.

The World Health Organisation recommends older people should be able to achieve physical, social and mental well-being throughout their lives, and that international, national and local policies should be developed to support older adults, promote their independence and well-being, and encourage physical exercise. Consequently, the West Lancashire programme was to establish preventative community support for older people to assist in improving their well-being and physical and mental health, particularly those isolated due to age-related illness or disability. It was to provide interventions not available from local social care providers. A mixed methods approach was adopted, with the qualitative evaluation utilising focus groups to establish people's experiences, identify impacts on their health and well-being, and suggestions for services development. This paper describes the quantitative evaluation, which involved three surveys and a costs analysis. The surveys were scheduled to give timely feedback to management about programme delivery and content, and overall benefits of participation. Findings The active lives programme and groups offered a wide range of flexible and local activities that provided benefits for older people in terms of health and well-being, social well-being and quality of life, and reducing social isolation. There was interconnectivity between these benefits. The programme was delivered in an affordable and flexible manner. Such programmes should be made more widely available.

Do computers increase older people’s inclusion and wellbeing?

Purpose – The purpose of this paper is to consider two recent studies on computer use by older people, who may become increasingly isolated due to infirmity and sensory impairments. Older people are less likely to use computer technology yet it has been suggested that it may help reduce isolation. These studies inquired into older people’s experience with computers. Design/methodology/approach – The first paper discussed here explored how a sample of older people in the USA acquired a computer and whether it contributed to their well-being. The second paper was about a similar study with a sample of older people in the UK. Findings – In the US sample, people who saw tablet computers being used by a friend were likely to purchase one. In the UK sample, people seemed to have had to overcome more fears of using computer technology, but in both samples, once initial difficulties were overcome, people were enthusiastic about using them. In both, people felt more able to keep up hobbies and interests through finding information or connecting with interest groups online, and able to keep connected with family members. Originality/value – In light of increasing migration of services and information to the internet, these studies explored the things that help and hinder older people in terms of using computers, in order to address the digital divide, whereby those unable to use them can be left isolated and with reduced information and support. These studies were able to explore personal meanings of computer use and specific fears and difficulties, which are important to understand in planning for training and support for older people who are not yet on line. They also demonstrated that, alongside face-to-face interaction, being online was experienced as reducing people’s isolation and enhancing their lives.

A Study on Home Support Service for Older People in terms of Necessity and Establishment of Roles： Focusing on the Perspectives of the Service Users and Providers in Gyeonggi province

A Study on Home Support Service for Older People in terms of Necessity and Establishment of Roles： Focusing on the Perspectives of the Service Users and Providers in Gyeonggi province