Well-being Of Older People Research Articles

Older people's out-of-home mobility and wellbeing in Australia: Personal, built environment, and transportation factors associated with unmet mobility needs.

Out-of-home mobility is fundamental to older people's wellbeing and quality of life. Understanding the unmet mobility needs of older people is a necessary starting point for determining how they can be supported to be mobile. This study estimates the extent of unmet mobility needs among older Australians and identifies the characteristics of those most likely to report unmet mobility needs. Analysis was conducted on nationally representative data of 6,685 older Australians drawn from the 2018 Survey of Disability, Aging and Carers conducted by the Australian Bureau of Statistics. Twelve predictor variables from two conceptual frameworks on older people's mobility were included in the multiple logistic regression model. Twelve percent (n = 799) of participants had unmet mobility needs, and associated factors significant in multivariable models included being among the "young-old", having a lower income, having lower levels of self-rated health, having a long-term condition, being limited in everyday physical activities, experiencing a higher level of distress, being unlicensed, having decreased public transport ability, and residing in major cities. Efforts to support older people's mobility must make equity an explicit consideration, reject a one-size-fits-all approach, and prioritize the accessibility of cities and communities.

Coaching Robots for Older Seniors: Do They Get What They Expect? Insights from an Austrian Study.

To support the increasing number of older people, new (assistive) technologies are constantly being developed. For these technologies to be used successfully, future users need to be trained. Due to demographic change, this will become difficult in the future, as the resources for training will no longer be available. In this respect, coaching robots could have great potential to support younger seniors in particular. However, there is little evidence in the literature about the perceptions and potential impact of this technology on the well-being of older people. This paper provides insights into the use of a robot coach (robo-coach) to train younger seniors in the use of a new technology. The study was carried out in Austria in autumn 2020, involving 34 participants equally distributed among employees in their last three years of service and retirees in their first three years of retirement (23 female; 11 male). The aim was to assess participants' expectations and perceptions by examining the perceived ease of use and user experience of the robot in providing assistance during a learning session. The findings reveal a positive impression of the participants and promising results for using the robot as a coaching assistant in daily tasks.

Understanding and Improving Older People's Well-Being through Social Prescribing Involving the Cultural Sector: Interviews from a Realist Evaluation.

Social prescribing is a non-clinical approach to addressing social, environmental, and economic factors affecting how people feel physical and/or emotionally. It involves connecting people to "community assets" (e.g., local groups, organizations, and charities) that can contribute to positive well-being. We sought to explain in what ways, for whom, and why the cultural sector can support social prescribing with older people. We conducted semi-structured interviews with 28 older people (aged 60+) and 25 cultural sector staff. The following nine concepts, developed from interview data, progressed the understanding of tailoring cultural offers, which came from our previous realist review-immersion, buddying, café culture, capacity, emotional involvement, perseverance, autonomy, elitism, and virtual cultural offers. Through tailoring, we propose that older people might experience one or more of the following benefits from engaging with a cultural offer as part of social prescribing-being immersed, psychological holding, connecting, and transforming through self-growth.

Health and wellbeing of older people in LMICs: a call for research-informed decision making

An estimated 80% of the world's older people (defined as those aged ≥60 years) will live in low-income or middle-income countries (LMICs) by 2030.1 Ageing well requires addressing the complex financial, health, and social care needs of older people. But, despite economic growth and investment in health, LMICs continue to struggle with fragile and under-resourced health and social care systems to support older people.2 Such issues can be particularly problematic in rural areas, from which younger people often leave to find economic opportunities, leading to a loss of labour and depletion of carers for older people, and worsening unmet needs for social care.

Ageism and the Pandemic: Risk and Protective Factors of Well-Being in Older People

The COVID-19 pandemic has particularly affected the older population both in terms of the high number of victims and the psychological impact. Moreover, the pandemic has made older people more vulnerable to isolation and loneliness, and victims of ageism. The aim of the present study was to investigate the risk and protective factors for the well-being of older people during the pandemic. The role of positive affect, confidence in the future, current physical health, social isolation, loneliness, and ageism were analysed. A self-report questionnaire was administered to 1301 participants (mean age: 77.3 years, DS: 5.46), almost equally distributed by gender (56.1% female). Descriptive and correlational analyses were performed, together with SEM. The results showed that perceived age discrimination positively predicts loneliness and negatively and indirectly predicts well-being. Furthermore, positive affect, confidence in the future, and current physical health are protective factors, while loneliness, social isolation, and ageism are risk factors. Future emergency policies must take into account the impact of such actions on the well-being of this segment of the population.

Dismantling the structural ageism of ‘ageing in place’ to ensure ‘ageing in the right place’

Dismantling the structural ageism of ‘ageing in place’ to ensure ‘ageing in the right place’

Loneliness and social isolation among the elderly: Are we doing enough?

Loneliness and social isolation among the elderly: Are we doing enough?

Impact of On-line Physical Activity Sessions on the Well-Being of Older People: The Value of the University Extension

The purpose of this study was to carry out an exploratory analysis of the value of on-line physical activity sessions proposed from the university extension on the well-being of a group of older adults. Methodology: A protocol for physical activities focused on virtual sessions for older adults was developed. 12 sessions were applied and at the end, both the participants and the instructors were sent a digital questionnaire to provide their impressions of what they experienced in this period. Results: The participants showed in general, a better physical state and a positive response when doing physical activities on-line, and instructors expressed their satisfaction with the on-line modality. Conclusion: The participants indicated that the on-line sessions felt very good and helped them improve their physical condition, so the university should consider this strategy in its actions to be developed from the university extension.

Validating the Well-Being of Older People (WOOP) Instrument in China.

Generic health-related quality of life (HRQoL) measures have been used for estimating utility value, which is then used for calculating quality-adjusted life years (QALYs). HRQoL measures may not capture many of the relevant and important non-health aspects of quality of life. The well-being of older people (WOOP) instrument was first developed in the Netherlands. This study aimed to validate this new instrument among older people in China. WOOP was first translated into simplified Chinese (for use in Mainland China) by two experienced translators. From July to August 2022, a cross-sectional study was conducted on a convenience sample of 500 older people in Southwestern China. Older people who provided consent reported their demographic information and completed the simplified Chinese version of the WOOP instrument using a pencil and paper. The feasibility of WOOP was determined by the percentage of missing responses. Then, using the data without any missing responses, we examined the item response distributions, pairwise Spearman correlations, underlying factors, and known-group validity of WOOP. Among the nine items of WOOP, three had more than 10% missing responses. The response distributions of the nine items were overall good without signs of ceiling and floor effects. The correlations among the WOOP items were low. A two-factor exploratory factor analysis model suggested that the WOOP items can be categorized into either internal or external well-being items. Good known-group validity results were found. Some WOOP items may not be easily understood by a small proportion of rural residents. However, other results have suggested WOOP to be a valid instrument for measuring the well-being of the elderly in China. The availability of WOOP enables the measurement of well-being-related utility.

Does the transition to grandparenthood influence the health and well-being of older people? Evidence from the CHARLS study in China

ObjectivesThe birth of a new grandchild may lead to role enhancement, positively affecting the wellbeing of grandparents. It may also lead to role overload and role conflict, resulting in negative effects. We examine how the transition to grandparenthood influences the health and well-being of older people in China. MethodsEmploying longitudinal data from the China Health and Retirement Longitudinal Study, we estimate individual fixed-effects models to examine the impact of transitioning to grandparenthood on functional limitations, life satisfaction and depression. ResultsTransitioning to grandmotherhood was associated with a higher probability of reporting one or more functional limitations of daily living, but transitioning to grandparenthood was associated with higher life satisfaction. Effects were similar for grandparents with a rural or urban hukou status. DiscussionFindings suggest that the combination of role enhancement and role strain may generate mixed impacts of transitioning to grandparenthood on older adults’ health and well-being.

THE JOURNAL OF APPLIED GERONTOLOGY: AN INTERNATIONAL PERSPECTIVE

Abstract The mission of applied gerontology is to bridge science and practice to benefit the health and well-being of older people, their families, their communities, and other contexts. The Journal of Applied Gerontology features original investigations or meta-analyses/systematic reviews with significant clinical, policy, and/or practice implications. This presentation will provide insights from the Journal of Applied Gerontology and its commitment to publish and disseminate scholarship with international application. Following an overview of the growing internationalization of peer-reviewed submissions to the Journal of Applied Gerontology on a variety of topics and from a range of perspectives, the presentation will highlight opportunities to apply gerontological scholarship to aging contexts worldwide. Concluding comments will examine how outlets for dissemination and authors themselves can better position their work to enhance their influence on aging in an international context.

Transit-oriented development for older people: Does using multiple public transport options improve their physical and mental health?

Transit-oriented cities often use urban rail transit (e.g., metro) to lead public transport development (TOD), which might overlook other public transport options (e.g., bus) that matter for the health and wellbeing of older people. We investigate older people’s public transport use patterns and how multiple public transport options are related to the physical and mental health of older people. In the case city of Hong Kong, which is well-known for its metro-led transit-oriented development, we collected questionnaire data from 826 older people on their public transport use behaviors, route environment to normally used stops/stations, and physical and mental health. We used univariate analysis to measure explanatory factors (P<0.25). We applied multivariable linear regression models with several sensitivity analyses to test the associations among public transport use, route environment, and health outcomes, adjusting for covariates of individual factors, physical activity, and self-reported chronic disease. We found that (1) using multiple public transport options was positively associated with better physical health (p<0.001); (2) mixed metro and bus users had the highest physical activity (high level with MET-mins/week>3,000, 75%) as well as the best physical health (physical component summary (PCS) >50, 41.42%) and mental health (mental component summary (MCS) > 50, 68.28%), compared to bus-only or metro-only users; and (3) for mixed-mode users, pedestrian crowdedness was negatively associated with physical health (p < 0.01), while satisfaction in sidewalk width was positively related to mental health (p=0.038). We found that older people prefer multiple public transport options rather than the metro-dominated single-mode, and this travel preference benefits the physical and mental health of this population. Our research helps deepen the understanding of public transport use and associated health outcomes among older people and has policy implications for TOD planning concerning the aging population.

“What If I Die and No One Notices?” A Qualitative Study Exploring How Living Alone and in Poverty Impacts the Health and Well-Being of Older People in Hong Kong

Despite the growing number of older people who live alone and in poverty, the intersection of these two social risk factors and the impacts on older adults' health and well-being have not been widely examined. This qualitative study explores the challenges and strengths of 47 older people who live alone and in poverty in Hong Kong. Thematic analysis was used to identify eight themes related to challenges: (i) social isolation and loneliness, (ii) self-esteem and self-efficacy, (iii) declining mobility, health and activity levels, (iv) high medical expenses, (v) age discrimination and long wait times for medical health services, (vi) age discrimination, retirement, and wanting part-time employment, (vii) not enough gender-specific social participation activities, and (viii) housing insecurity. Four themes related to strengths were identified: (i) An "I have enough" mindset, (ii) strong formal social support, (iii) contributing to the community and others, and (v) "Most of us like to be alone." Successfully addressing poverty in old age and tackling the challenges associated with living alone will require focusing on and activating not only external and systemic resources but also the intrinsic capacities and strengths of older adults themselves. Five discussion points are raised addressing the implications for future gerontological research and practice.

Friendly Residential Environments and Subjective Well-Being in Older People with and without Help Needs

Previous studies have shown that friendly environments are associated with well-being and higher quality of life in older people. This study aimed to investigate the relationship between friendly environments and subjective well-being by segmenting the population according to the need for help in performing activities of daily living (ADLs) in a representative sample of people over 55 years of age in the Basque Country (Spain) (n = 2760). To determine the predictive power of friendliness on subjective well-being, two separate linear regression models were obtained according to the need for help in ADLs. The results obtained show a greater explanatory power of the model in the case of people who required help. However, in the case of people who do not need help, subjective health had a greater weight in the predictions. This paper's findings support the greater importance of the characteristics of the physical and social environment, as people's functional status worsens, with friendliness being an explanatory factor for people's well-being as they age and their dependency increases.

Older people, medication safety, and the role of the community pharmacist: a longitudinal ethnographic study

AbstractBackgroundOlder people with frailty and multimorbidity are at high risk of problematic polypharmacy. Community pharmacists have a key role in medication safety for older people.AimThe aim of this study was to investigate the perspectives of older people with frailty, multimorbidity, and polypharmacy, and their family caregivers or whānau on the role of community pharmacists, including in situ pharmacist care practices.MethodThis study was part of a larger video reflexive ethnography (VRE) study to explore medication safety and wellbeing for older people with frailty across care transitions including hospital, home, aged residential care, primary care, and outpatient care. This paper reports data from the interview, participant observation, and filming phases of the study.ResultsCommunity pharmacists play a significant role in the medication safety of older people with frailty and polypharmacy. Analysis resulted in three main themes: (1) the older person–determined role of the pharmacist, (2) the ‘taken for granted’ safety work of the pharmacist, and (3) collective agency and medication safety.ConclusionIn circumstances where older people and their family caregivers or whānau had a trusted relationship with a community pharmacist, the pharmacist played a key role as mediator of medication safety and was central to older people's care. This key role as a member of the multidisciplinary team in the care of older people with frailty and multimorbidity should be better recognised and legitimised by clinicians and policy makers and resourced accordingly.

Examining Quality, Use and Impact of Psychotropic (Use) in older adults with intellectual disabilities (EQUIP): study protocol

Widespread, and sometimes inappropriate use of psychotropics in adults with intellectual disability has been an international concern. These medicines have been used to treat mental health conditions, but also, controversially, some types of behaviours not necessarily associated with the diagnosis or in the absence of a relevant diagnosis. Results from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) study of older adults with intellectual disability in Ireland revealed that 60% were taking psychotropics in 2010. In the intervening decade changes in regulations, policy, and increased decongregation of people with intellectual disability have taken place likely influencing the use of psychotropics. The HSE National Clinical Programme for People with Disability (NCPDD) established in the 2020 has medicines optimisation as a key priority. Existing multi-wave data from the IDS-TILDA study and the HSE national prescribing database offers an opportunity to better understand psychotropic use and prescribing patterns. This is a novel collaboration on lived experience, research, practice and policy. The aim of this research is to examine the quality and trends of psychotropic use of older adults with intellectual disability over a ten-year period in Ireland to evaluate the effects of and to inform both practice and policy to optimise medicines use and health outcomes. Health and medication data from ten years (four waves) of the IDS-TILDA study and corresponding medicines data from the HSE-PCRS prescribing database are available. Descriptive and longitudinal analysis will examine association between long-term psychotropic use, changes in trends of use, and the impact of decongregation on medicines use. This research will inform the development of national guidance on medicines optimisation for older people with intellectual disability and has the potential to change prescribing practices and improve health and wellbeing for older people with intellectual disability.

Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China

BackgroundLiving arrangements are critical to the survival and well-being of older people, especially in China where the filial piety culture demands adult children care for and serve their parents. The study aimed to explore the association between living arrangements and cognitive decline among older people in China.MethodsParticipants included 6,074 older adults over 60 years old (49.65% male, mean age 67.2 years [range 60–98]) from four waves (2011–2018) of the China Health and Retirement Longitudinal Study. Two to four assessments were conducted over a follow-up of an average of 5.3 years (range, 2–7). Cognitive function was assessed using an adapted Chinese version of Mini-Mental State Examination (MMSE). Living arrangements were classified as follows: living alone, living with spouse, living with adult children, living with spouse and adult children and living with others. Multilevel models were used to investigate the relationship between living arrangements and cognitive decline, as well as the gender difference.ResultsAs the main type of living arrangements of the study participants (44.91%), living with spouse was taken as the reference group. Compared to the reference group, living alone (β=-0.126, P < 0.001), living with adult children (β=-0.136, P < 0.001), living with spouse and adult children (β=-0.040, P < 0.05) and living with others (β=-0.155, P < 0.05) were all related to a faster rate of cognitive decline. Further, the association between living arrangements and cognitive decline varied by gender. Living alone (β=-0.192, P < 0.001) was associated with a faster cognitive decline only in older men. Living with spouse and adult children (β=-0.053, P < 0.05) and living with others (β=-0.179, P < 0.05) were associated with faster cognitive decline only in older women.ConclusionThis study suggests that living arrangements in older people in China were associated with cognitive decline, and these associations varied by gender. Greater attention to living arrangements might yield practical implications for preserving the cognitive function of the older population.

Motor Imagery as a Key Factor for Healthy Ageing: A Review of New Insights and Techniques.

Motor imagery (MI) describes a dynamic cognitive process where a movement is mentally simulated without taking place and holds potential as a means of stimulating motor learning and regaining motor skills. There is growing evidence that imagined and executed actions have common neural circuitry. Since MI counteracts cognitive and motor decline, a growing interest in MI-based mental exercise for older individuals has emerged. Here we review the last decade's scientific literature on age-related changes in MI skills. Heterogeneity in the experimental protocols, as well as the use of populations with unrepresentative age, is making it challenging to draw unambiguous conclusions about MI skills preservation. Self-report and behavioural tasks have shown that some MI components are preserved, while others are impaired. Evidence from neuroimaging studies revealed that, during MI tasks, older individuals hyperactivate their sensorimotor and attentional networks. Some studies have argued that this represents a compensatory mechanism, others claim that this is a sign of cognitive decline. However, further studies are needed to establish whether MI could be used as a promotion factor to improve cognitive functioning and well-being in older people.

How working-age population education and health of older people shape the burden of population aging: A comparative study of Macau, Hong Kong, and Singapore.

To compare the population aging burden in Macau, Hong Kong, and Singapore by including working-age population education and elderly health. The overall, working-age and old-age population and proportion, as well as the Old-Age Dependency Ratio of Macau, Hong Kong, and Singapore, were collected from the World Bank database. The life expectancy at 65 was extracted from the 2022 World Population Prospect. The tertiary education rate of the working-age population and the self-rated health status of the old-age population were retrieved from governments' statistical reports. We then calculated the Education-Health Adjusted Old-Age Dependency Ratio, a set of four equations showing the support of the working-age population on the old-age population, where OADRh_t and OADRuh_t represent the burden of healthy and unhealthy old-age population on the working-age population with tertiary education; similarly, OADRh_nt and OADRuh_nt indicate the burden placed on the working-age population without tertiary education by healthy and unhealthy old-age population. Lastly, for comparison with the conventional Old-Age Dependency Ratio, we generated the Weighted Education-Health Adjusted Old-Age Dependency Ratio. Hong Kong has the greatest old-age population proportion and Old-Age Dependency Ratio, yet its growth rates are moderate and stable, ranging from 0 to 4% and 0 to 6%, respectively. Macau and Singapore experienced sharper changes in old-age population proportion and the Old-Age Dependency Ratio, with Macau's Old-Age Dependency Ratio varying between -2.66 and 8.50% and Singapore's ranging from -1.53 to 9.70%. Three cities showed different patterns in four Education-Health Adjusted Old-Age Dependency Ratio indicators. In Macau, the OADRh_nt and OADRuh_nt increased by 0.4 and 6.2, while the OADRh_t and OADRuh_t decreased by 13.5 and 15.3 from 2004 to 2016. In Hong Kong, only the OADRuh_t fell by 9.4, and the other three increased from 2003 to 2015. In Singapore, the OADRh_nt and OADRh_t increased by 3.8 and 1.0, while OADRuh_nt and OADRuh_t decreased by 1.2 and 3.9 from 2007 to 2011. The Weighted Education-Health Adjusted Old-Age Dependency Ratios are all smaller than the conventional Old-Age Dependency Ratio in the three regions, particularly in Singapore. The Weighted Education-Health Adjusted Old-Age Dependency Ratio of Singapore was reduced by 9.5 to 30.5% compared with the conventional Old-Age Dependency Ratio, that of Hong Kong reduced by 6.2 to 22.5%, and that of Macau reduced by 4.4 to 16.1%. This is the first study to compare the aging burden in Macau, Hong Kong, and Singapore in connection to working-age population education and elderly health. With the new assessment, the burden of population aging in three regions has been reduced, showing that improving the education of the working-age population and maintaining older people's wellbeing can assist authorities to deal with population aging, especially in Macau and Hong Kong.

Co-creation of activities to promote health and well-being of older people – a scoping review

Abstract Background The global population is ageing and the need to promote health and well-being of this generation is essential. Co-creative practices can be solutions to welfare challenges in the health care sector and local policies. However, literature addressing co-creation of activities to promote health and well-being is sparse. The review aimed to identify health promotive activities co-created between the public and older people, the influence of co-creative activities on health and well-being of older people, and facilitators and barriers for doing co-creation. Methods We searched for peer-reviewed and grey literature in eight scientific and five non-scientific databases. Two reviewers independently screened publications for eligibility according to inclusion and exclusion criteria and extracted data. An inductive thematic content analysis was applied for the analysis. Results We included nineteen publications. Four themes related to co-creative activities emerged: “Social activities”, “Activities to create age-friendly environments”, “Discussions of healthy ageing”, and “Physical activities”. The co-creative activities influenced the overall well-being, and promoted active and healthy ageing, physical functioning, and quality of life. Identified facilitators for co-creation were the role of the facilitator, a supportive environment, recognition of competencies, while the main barriers were time and resources, and recruitment of participants. Conclusions Few studies have investigated co-creation of activities to promote health and well-being of older people. The included studies dealt with activities in any form and not merely social and physical activities co-created. Future co-creation of activities with older people should consider the role of facilitators, the environment in which the co-creation takes place and value time, resources, and competencies of participants. Key messages • Studies on co-creation of activities to promote health and well-being of older people is sparse and must be explored further. • Future research may focus on co-creation of social and physical activities to promote health and well-being of older people and consider known facilitators for co-creation.