Older Persons Research Articles

Do health and housing attributes motivate residential moves among older Chinese adults? Evidence from an 8‑year follow‑up study

Abstract Background and Objectives Despite the widespread belief in aging in place as the preferred housing arrangement for older adults, they are increasingly embracing moving. The person-environment fit theory explains that environmental changes due to residential moves can pose health risks, discouraging older people from moving. However, it also suggests that moves may be suitable when living conditions no longer meet their physical needs. The correlation between older people's health, housing, and their subsequent moving or staying actions in China remains underexplored. Research Design and Methods Using alternative operating variables of key concepts and the China Family Panel Studies 2012-2018 datasets, this study examines the effects of health and housing status on older people’s residential moves in China. The study outlines changes in health indicators and housing characteristics during multiple moves, as well as examines the relationship between the health and housing status of older adults and moving over a relatively long period of time using both regression models with lagged explanatory variables and fixed effects binary choice models. Results The results reveal that: 1) higher rates of subsequent moves were observed among older adults with better self-rated health, positive self-rated health changes, and no ADL impairment, but no significant associations were found between most health variables and moving; 2) The correlation between older persons' house ownership/ type and their residential moves was significant and consistent over time, steady and lasting. Discussion and Implications Potential mechanisms explaining the association between specific housing types and ownership statuses on moving are discussed. The findings encourage a focus on the positive benefits of moving in later life and how to provide additional housing options for older individuals.

A Review of the AGE Barometer 2023: EU Good Practices and Barriers in the Empowerment of Elderly in the Labour Market - The Case of Hungary

The 2023 edition of the AGE Barometer was released by the Age Platform Europe, aimed at consolidating data from European statistics and national-level sources and enriched by feedback from 19 European countries, including Hungary. The publication aimed at empowering older people in the labour market and promoting sustainable and high-quality working lives for them. The Barometer revealed that the European Union (EU) is far from reaching its 78% employment target for adults aged 20 to 64 with its current state of just 62.3%. This could be due to various barriers to the integration of older people in the labour market, which include inadequate supportive policies, ageism, and unfavourable workplace conditions. Conversely, these are broadly stated in the context of the EU; hence, a deeper analysis of these results, with a special focus on the case of a single country, such as Hungary, is relevant to establish a clearer understanding of the national and local framework of these findings and in determining facilitating policies and programmes as well as gaps in promoting elderly inclusion in the labour sector. Using various methods such as critical analysis, desk and literature review, and thematic analysis, this article examined the Barometer report and other relevant publications. The Barometer 2023 effectively provided general issues and actionable areas in supporting older people in the labour market, combating ageism, and ensuring an age-friendly work environment in the EU landscape. Moreover, it revealed that Hungary performed better in employing older persons compared to the EU average, likely associated with a favourable environment for older workers through its legal protection systems, financial incentives, equal treatment policy, and initiatives such as pensioner cooperatives and information technology education. However, this still falls below the target, and based on the analysis and review of existing relevant publications, this could be associated with some unfavourable policies, gender disparities, a continuous rise in the ageing population, an increased number of migrant workers, technology challenges, ageism, political mayhems, cultural and traditional constraints, and other challenges that continue to threaten the marketability of older people, thereby resulting in consequences for their financial, physical, social, psychological, and environmental wellbeing. Moreover, the report also stated few good practices in promoting elderly employment in the county, contrary to numerous efforts implemented by both the Hungarian government, non-government organisations, and other institutions, which remained unrecognised, perhaps due to limited data availability and gaps in the reporting schemes. Finally, the Barometer 2023 report was realized to be included and used as a part of the technical working papers of the European Economic and Social Committee, being the EU advisory body that deals on the issues and opinions regarding this matter. The latest edition of the Barometer has the potential to spark positive changes among policymakers and decision-makers in acknowledging the economic potential of the elderly and in eliminating barriers that hinder elderly integration in the labour market. In the case of Hungary, substantial policies, programmes, and welfare services exist that facilitate elderly employment; however, challenges were also identified, hence the precise recommendations provided in the Barometer report must transform into reality, taking into consideration the unique national, local, and cultural peculiarities of Hungary and its local communities. It is also suggested that systematic data collection and good practice documentation must be facilitated in Hungary, and feedback from the other 18 countries in the Barometer report must be thoroughly reviewed or benchmarked for possible inspiration and replication. Lastly, the potentials of the Barometer 2023 to be used at all levels of decision-making must be maximized.

A home health management app designed in the post-epidemic era using empirical evidence based on the demand collection of elderly users

In the context of the epidemic, the daily routines of China’s elderly populace underwent substantial transformations. The implementation of home-based pandemic containment strategies led to heightened levels of social isolation and loneliness, exerting a discernible influence on the subjective well-being of this demographic. Consequently, residing in retirement apartments has emerged as a more advantageous alternative for elderly individuals capable of self-care. To meet their life and emotional needs and improve their sense of well-being, we used the KANO model to design a health management app for the self-care of older persons. We summarised the functional requirements for the self-care of elderly people, distributed questionnaires to generate a list of requirements, and conducted data analysis. We optimised the low-fidelity prototype based on the usability test results combined with relevant interface design elements to implement emotional interaction design practices for older persons’ self-care. Furthermore, we completed a design evaluation and program optimisation of the design practice to guide the final visual design. The research findings identify the core principles of interactive design for elderly users to enable visual design specifications for improving the lives of the elderly population. This research highlights the need to design more appropriate products that meet demographic characteristics. This work contributes to strengthening the connection between elderly people and society while bridging the ‘digital divide’ based on this population’s cautious approach to technologies and declining abilities to learn.

Review of the Diagnostic and Prognostic Values of Cardiac Markers in Diabetes

Abstract Introduction Cardiovascular disease is a leading cause of mortality in people with diabetes (PWD). We aimed to explore the role of troponin T (TnT) and probrain natriuretic peptide (proBNP) as screening and prognostic indicators of cardiovascular morbidity and mortality in PWD in the existing literature. Methods This review paper is a focused narrative nonsystematic review of the literature which examined relevant publications pertinent to the significance of cardiac biomarkers. We aimed to investigate the diagnostic value of cardiac TnT (cTnT) and cTnI in addition to proBNP in diabetes and the prognostic value of cTnT and proBNP in diabetic and nondiabetic patients. The process of searching through literature was conducted from December 2022 to April 2023. Searches were done across PubMed and Google Scholar databases to identify relevant articles published from January 2001 to April 2023. The selected were entered into EndNote 20 software to extract the title and abstract. Results A total of 75 articles were identified in Google Scholar in addition to 32 articles from PubMed. After a thorough review, only a total of 22 articles were selected, pointing out those which discussed the pathophysiology and diagnostic, prognostic, and screening values of the types of Tn and proBNP markers. The value of TnT in PWD, specifically T2D, is threefold higher than in healthy patients. Individuals with high levels of high-sensitivity (hs) cTnI or cTnT were at the highest mortality risk. Nonetheless, N-terminal (NT)-proBNP and TnT function independently as predictors of unfavorable outcomes. Conclusions TnT is an important early screening tool prognostic indicator. Elevated TnT was associated with an increased risk of cardiovascular events in PWD. hs-cTn may help diabetes-related clinical care for older persons by identifying those at high mortality risk; furthermore, in diabetic individuals, NT-pro-BNP appears to be 92% sensitive and 90% specific for the diagnosis of heart failure.

Healthcare and social care professionals’ experiences of respite care: a critical incident study

ABSTRACT Introduction Aging in place is favoured among older persons and supported by research in Sweden, although it poses challenges for overburdened informal caregivers. While respite care can offer support, its accessibility is hindered by organizational challenges and informal caregivers’ delays in using it. The experiences of informal caregivers are well-studied, but the professionals’ experiences of respite care quality and critical incident management are underexplored. Aim To explore professionals’ experiences of critical incidents in respite care, consequences for the persons being cared for, and strategies to manage critical incidents. Materials and methods A qualitative, critical incident technique was used, and three group interviews with a total of 16 professionals were conducted. Results Barriers to quality respite care included communication gaps during care transitions, environmental shortcomings in respite care facilities, lack of support for informal caregivers, and inadequacies in respite care decisions. Strategies to manage critical incidents included individualized care, continuity and communication in care transitions, a conducive environment, support for informal caregivers, and care professionals’ positive approach. Conclusions The study emphasizes the need for focused efforts on communication, continuity, and a supportive environment. Addressing identified challenges and applying suggested strategies will be key to maximizing the potential of respite care as a vital support for care recipients and their informal caregivers.

Use of Adjuvanted Quadrivalent Influenza Vaccine in Older-Age Adults: A Systematic Review of Economic Evidence.

Influenza vaccination is an important public health measure that can reduce disease burden, especially among older persons (those aged 65 and over) who have weaker immune systems. Evidence suggests enhanced vaccines, including adjuvanted quadrivalent vaccines (aQIV), may be particularly effective in this group. This study reports the results of a systematic review of the cost-effectiveness of aQIV in this population. The review was undertaken and reported in accordance with good practice guidelines. Medline and EMBASE were searched from 2013 to the present. Pre-selected eligibility criteria were employed and quality assessment undertaken using the Consensus Health Economic Criteria (CHEC-extended) checklist and Consolidated Health Economic Evaluation Reporting Standard (CHEERS) 2022 checklists. A total of 124 records were returned, with 10 full text papers retained. All were modelling studies and exhibited heterogeneity in approach, perspective, and parameter estimation. Nine papers reported cost-effectiveness ranging from EUR 6694/QALY to EUR 20,000/QALY in evaluations employing a payer perspective and from EUR 3936/QALY to EUR 17,200/QALY in those using a societal perspective. Results remained robust to a range of sensitivity analyses. One paper that reported contrary findings adopted a distinct modelling approach. It is reasonable to conclude that there is a broad consensus as to the cost-effectiveness of aQIV in this population group.

Communal Effect Attitudes on Punjab Senior Citizens

Among the most vulnerable groups in society is the elderly, who face issues such as a deteriorating feeling of self-worth brought on by physical weakness, a dwindling social position, and limited financial resources. Feelings of insignificance have been exacerbated by the fact that families are finding it more difficult to care for the elderly due to socioeconomic and demographic changes. As a result, psychological difficulties frequently outweigh outward indications of aging as people age. With a specific focus on 260 senior individuals in Punjab between the ages of 60 and 90, this study sought to investigate the effects of family and social attitudes toward the old. The majority of respondents claimed financial independence, but only 11% reported having stable finances due to rental income and savings account interest. But 8% struggled to pay for everyday needs, and some experienced severe financial difficulties related to fundamental needs and family responsibilities. Remarkably, only 11.7% of older people consistently created strong social relationships, compared to 76.6% who did so on occasion. Furthermore, 16.7% of respondents admitted to their situation, suggesting a greater dedication to maintaining family togetherness. The behavioral changes aligned with the perceptions of 83% of senior respondents who observed a shift in the way older persons view their basic obligations. Family dynamics, economic dependence, physical abuse cases, feelings of isolation, inadequate social support, family members' disdain, and food-related issues were among the main concerns. The study emphasized the complex relationships that exist between aging, health problems, decreased physical activity, and elder abuse. It also clarified the critical roles that qualities, social interactions, financial dependence, and behaviors have in influencing these relationships.

Predicting unplanned hospitalisations in older adults using routinely recorded general practice data.

Unplanned hospitalisations represent a hazardous event for older persons. Timely identification of high-risk individuals using a prediction tool may facilitate preventive interventions. To develop and validate an easy-to-use prediction model for unplanned hospitalisations in community-dwelling older adults using readily available data to allow rapid bedside assessment by general practitioners. Retrospective study using general practice electronic health records of 243,129 community-dwelling adults aged ≥65 years linked with national administrative data. The dataset was geographically split into a development (58.7%) and validation (41.3%) sample to predict unplanned hospitalisations within 6 months. We evaluated the performance of three different models with increasingly smaller selections of candidate predictors (i.e. optimal, readily-available and easy-to-use model, respectively). We used logistic regression with backward selection for model development. The models were validated internally and externally. We assessed predictive performance by area under the curve (AUC) and calibration plots. In both samples, 7.6% had at least one unplanned hospitalisation within 6 months. The discriminative ability of the three models was comparable and remained stable after geographic validation. The easy-to-use model included age, sex, prior hospitalisations, pulmonary emphysema, heart failure and polypharmacy. Its discriminative ability after validation was AUC 0.72 [95% confidence interval: 0.72-0.71]. Calibration plots showed good calibration. Our models showed satisfactory predictive ability. Reducing the number of predictors and geographic validation did not impact predictive performance, demonstrating the robustness of the model. We developed an easy-to-use tool that may assist general practitioners in decision-making and targeted preventive interventions.

Geriatric health care in rural India: HR issues and public policy constraints

Purpose The purpose of this paper is to emphasize the need for holistic geriatric health care in rural India. Many older people in Indian villages suffer from chronic ailments without any relief or intervention because of inaccessible and unaffordable health-care services. This paper explores how holistic health care can be assured for older people in Indian villages. Design/methodology/approach This paper is based on reflections of the authors who have had experiences as caregivers to older persons within their respective families rooted in the Indian villages. Besides, they interacted with 30 older persons (18 males and 12 females in the age group of 60–80 years) living in the villages in three states of India, namely, Haryana, Rajasthan and Madhya Pradesh to develop a comprehensive viewpoint on the need of geriatric health care in rural India. Relevant reports, newspaper articles and research papers were also reviewed while developing viewpoints on such an important topic. Findings Geriatric health-care facilities in rural India are abysmal. The older people in the villages cannot leverage health-care facilities that are generally inaccessible, inadequate and unaffordable. Even the government support for medical treatment is minuscule. Furthermore, there is lack of trained health-care professionals at all levels, namely, doctors, nurses and paramedic personnel. Training opportunities in geriatrics are also negligible. The scenario vis-à-vis geriatric health care in rural India can be upturned by increasing public spending on health-care infrastructure, increasing numbers of health-care professionals and expanding training programmes in geriatrics. Originality/value This paper is based on the critical reflections of the authors as well as their informal interactions with some of the older people in the Indian villages.

Impact of early physiotherapy intervention in managing homonymous hemianopia due to posterior cerebral artery infarct—a case report

Homonymous hemianopia field loss can develop as a result of injury to any part of the retro chiasmal visual pathway and is frequently fatal for subjects. The most common cause of homonymous hemianopia in older persons is ischemic infarction of the occipital lobe and its causes are multifactorial, frequently providing a diagnostic challenge to the clinician and signaling the necessity for a thorough systemic health review. Hemianopia is a loss of half of the visual field in each eye in which the inner or nasal half of one eye and the outer or temporal half of the other eye is affected. We report a case of a 72-year-old male subject who visited our department with complaints of weakness on the right side with difficulty seeing on the right side for 3 days. After undergoing various investigations, it was found that there is an acute infarct in the posterior cerebral artery territory supplying the left medial temporal lobe, medial occipital lobe, left thalamus, and splenium of the corpus callosum. After a physiotherapeutic examination provisionally, he was diagnosed with right hemiparesis and homonymous hemianopia, and thus, we administered an early physical therapy intervention which was found to be effective.

Exploring the moderating effects of SIRT1 and gene polymorphisms rs7895833 on the relationship between hemoglobin levels and physical frailty in elderly adults with comorbid chronic diseases: A moderated mediation analysis

Background Relationship age, hemoglobin, and physical frailty have all been investigated in older people with more than one chronic disease. There has been little analysis of the relationship between hemoglobin, age, physical frailty, plasma levels of Sirtuin1 (SIRT1), and the gene polymorphism (SNP) rs7895833 A>G. The goal of this study was to find out how SIRT1 level, SNP rs7895833, hemoglobin, age, and physical frailty (frail score) are related in older Indonesian adults with comorbid chronic diseases. Methods This was an observational study. Demographic and clinical data were retrieved from the electronic health records of Universitas Sumatera Utara Hospital, Medan, Indonesia. Physical frailty, SIRT1 level, and SNP rs7895833 were measured using an appropriate and valid method. Purposive sampling was used to determine the eligibility of 132 elderly adults from November 2022 to February 2023. Results The indirect effect of hemoglobin on the frail score (FS) through age was negative and significant, according to a conditional mediation analysis (β=-0.0731; p=0.023). Meanwhile, the direct effect of hemoglobin on the FS was negative and not significant (β=0.1632; p=0.052). According to the conditional moderated mediation analysis, the size of the direct effect of age on FS was increased by genotype AG-GG and SIRT1 level (βlow=0.2647; p=0.002, βmiddle=0.2956; p<0.001, and βhigh=0.319; p<0.001). The size of the conditional indirect effect of Hemoglobin on FS through age was negative and significantly increased by SNP genotype AG-GG and SIRT1 level (βlow=-0.0647; p=0.032, βmiddle=-0.0723; p=0.024, and βhigh=-0.078; p=0.02). Conclusions Higher plasma levels of SIRT1 and the SNP genotype AG-GG may both contribute to physical frailty in the elderly population. Hemoglobin levels in the blood fall with age, which can negatively impact older persons who already have chronic diseases. However, the interactions between these factors are intricate, requiring more study to completely understand the processes underlying development.

ESPEN guideline on nutrition and hydration in dementia – Update 2024

Background & aimsDementia is accompanied by a variety of changes that result in an increased risk of malnutrition and low-intake dehydration. This guideline update aims to give evidence-based recommendations for nutritional care of persons with dementia in order to prevent and treat these syndromes. MethodsThe previous guideline version was reviewed and expanded in accordance with the standard operating procedure for ESPEN guidelines. Based on a systematic search in three databases, strength of evidence of appropriate literature was graded by use of the SIGN system. The original recommendations were reviewed and reformulated, and new recommendations were added, which all then underwent a consensus process. Results40 recommendations for nutritional care of older persons with dementia were developed and agreed, seven at institutional level and 33 at individual level. As a prerequisite for good nutritional care, organizations caring for persons with dementia are recommended to employ sufficient qualified staff and offer attractive food and drinks with choice in a functional and appealing environment. Nutritional care should be based on a written care concept with standardized operating procedures. At the individual level, routine screening for malnutrition and dehydration, nutritional assessment and close monitoring are unquestionable. Oral nutrition may be supported by eliminating potential causes of malnutrition and dehydration, and adequate social and nursing support (including assistance, utensils, training and oral care). Oral nutritional supplements are recommended to improve nutritional status but not to correct cognitive impairment or prevent cognitive decline. Routine use of dementia-specific ONS, ketogenic diet, omega-3 fatty acid supplementation and appetite stimulating agents is not recommended. Enteral and parenteral nutrition and hydration are temporary options in patients with mild or moderate dementia, but not in severe dementia or in the terminal phase of life. In all stages of the disease, supporting food and drink intake and maintaining or improving nutrition and hydration status requires an individualized, comprehensive approach. Due to a lack of appropriate studies, most recommendations are good practice points. ConclusionNutritional care should be an integral part of dementia management. Numerous interventions are available that should be implemented in daily practice. Future high-quality studies are needed to clarify the evidence.

The changing health-care system in Ghana: forms of care within residential aged care facilities in urban Accra

Purpose The emergence of residential aged care facilities (RACFs) within the Ghanaian health-care system has raised eyebrows because, hitherto, the concept of nursing homes had largely been perceived as an anomaly. The purpose of this study is to understand this emerging phenomenon and the activities of care provided within two facilities in the nation’s capital, Accra. Design/methodology/approach The study draws on participant observations and in-depth interviews with purposively sampled 15 residents in the two facilities and eight caregivers. The data were analysed using thematic approach. Findings The study found that the daily forms of care mostly performed for the elderly were intimate and non-intimate physical, medical, emotional and spiritual and end-of-life care. The bulk of activities of care were performed in the morning. Originality/value The study reveals that the changing landscape of health-care facilities in Ghana to include RACFs indicates RACFs have come to stay to provide different forms of care to older persons who otherwise were cared for by the family.

Determinants of older people labour market decision in Ghana

PurposeThe purpose of this paper is to examine the prevalence of labour force participation and the factors affecting labour supply among older persons in Ghana. Both the extensive and intensive margins of older persons’ labour supply were analysed.Design/methodology/approachThe paper uses nationally representative samples of household and individual data in 2016–2017 – Ghana Living Standard Survey (GLSS 7) data – for the analysis. Heckman’s sample selection model is used to analyse both the extensive and intensive margins of older persons’ labour supply.FindingsThe study found that older persons in Ghana who are pensioners, widowed, have high levels of education, poor health status and live in urban areas are less likely to participate actively in the labour market. On the other hand, being head of a household, married and owning certain assets increase the likelihood of an older person to work. Furthermore, pensions, household headship and post-secondary education have negative effects on the labour supply as having them make older persons work fewer hours per week compared to their counterparts.Originality/valueThis research is the first study to examine the prevalence of old age employment and factors that affect labour market decisions of older persons in Ghana. It also adds to the limited literature on pension and retirement decisions in developing countries.

An evaluation of the moderating effects of routine and busyness on the relationship between prospective memory and everyday functioning in older persons with HIV disease

ABSTRACT Introduction People living with HIV (PLWH) often experience difficulties in everyday functioning, which can arise in part from deficits in the strategic/executive aspects of prospective memory (PM). Using Suchy’s Contextually Valid Executive Assessment (ConVExA) framework, this study sought to determine whether the contextual factors of busyness and routine moderate the relationship between the strategic/executive aspects of PM and everyday functioning in older PLWH. Methods Participants in this cross-sectional analysis were 145 PLWH aged 50 years and older who had completed the Martin and Park Environmental Demands (MPED) questionnaire of routine and busyness, the performance-based Cambridge Test of Prospective Memory, and self-report measures of activities of daily living (ADLs) and cognitive symptoms in daily life. Results Multiple regression analyses covarying for relevant comorbidities showed that higher levels of busyness – but not routine – were associated with more frequent cognitive symptoms in daily life. Neither busyness nor routine interacted with PM in association with cognitive symptoms. However, routine and a strategic/executive measure of PM interacted in predicting ADLs; specifically, the association between time-based PM and ADLs was stronger in persons with higher levels of routine in their daily lives. Parallel analyses with less executively-demanding event-based PM were null and small. Conclusions Overall, findings provided mixed – and unexpected – evidence for the associations between contextual factors (i.e. routine and busyness), everyday functioning, and PM in this sample of older adults with HIV disease. Results and clinical implications are interpreted and discussed in the framework of the ConVExA model.

The smart home, a true home? How new technologies disrupt the experience of home for older persons

AbstractSmart home technologies (SHTs) can support older persons to age in place. However, adoption of SHTs remains low among this population. A reason for this is that they are not accustomed to having a home that is technologically enhanced. In this article, we focus on the older persons’ lived experience of “home” and show how SHTs potentially disrupt it. In consulting the currently available literature, both theoretical and empirical, we propose and use the concept of somatic capability assessment (SCA) in the discussion surrounding the design of SHTs for older persons. First, we propose SCA as a concept to grasp how humans take decisions while relying on their physical body, undisturbed by suggestions from technologies. Furthermore, we show that SCA functions best in a familiar and private environment—the home. SHTs have the potential to make the home seem unfamiliar and exposed, precisely through added data and the resulting suggestions, as we show through related empirical studies. Thus, SHTs hold an increased disruptive potential for older persons at home. By introducing SCA into the discussion of SHTs for older persons, and thus paying attention on how SHTs potentially disrupt the experience of home, further advances the ethical discussion on the adequate use and design of technologies in daily life, especially for the group of older persons. Our analysis offers important insights for the design and implementation processes of SHTs for older persons.

Effect of Clonal Hematopoiesis Mutations and Canakinumab Treatment on Incidence of Solid Tumors in the CANTOS Randomized Clinical Trial.

Clonal hematopoiesis (CH) is more common in older persons and has been associated with an increased risk of hematological cancers and cardiovascular diseases. The most common CH mutations occur in the DNMT3A and TET2 genes and result in increased pro-inflammatory signaling. The Canakinumab Anti-inflammatory Thrombosis Outcome Study (CANTOS, NCT01327846) evaluated the neutralizing anti-IL-1β antibody canakinumab in 10,061 randomized patients with a history of myocardial infarction and persistent inflammation; DNA samples were available from 3,923 patients for targeted genomic sequencing. We examined the incidence of non-hematological malignancy by treatment assignment and CH mutations and estimated the cumulative incidence of malignancy events during trial follow-up. Patients with TET2 mutations treated with canakinumab had the lowest incidence of non-hematological malignancy across cancer types. The cumulative incidence of at least one reported malignancy was lower for patients with TET2 mutations treated with canakinumab vs those treated with placebo. These findings support a potential role for canakinumab in cancer prevention and provide evidence of IL-1β blockade cooperating with CH mutations to modify the disease course.

Differences in access to privacy information can partly explain digital inequalities in privacy literacy and self-efficacy

ABSTRACT Users of digital technologies are still held legally responsible for managing their personal data. However, not all users have the same opportunities for privacy management as researchers find systematic sociodemographic differences in, for example, users’ privacy literacy and self-efficacy – two important predictors of privacy management. The present study argues that one reason for such digital inequalities is how easily people have access to privacy information in their everyday lives (e.g. through their profession or social contacts). Analysing data of a representative sample of German internet users (N = 3978) by means of a Bayesian structural equation model, we find that men and more educated persons report easier access to privacy information which, in turn, positively relates to both privacy literacy and self-efficacy. Older persons feel less confident about privacy protection while men and more highly educated persons have higher privacy literacy levels. In conclusion, the present study reveals that casual access to privacy information can be important in learning and being confident about privacy management, but it cannot fully explain digital inequalities in online privacy self-efficacy and literacy.

Cannabinoids and healthy ageing: the potential for extending healthspan and lifespan in preclinical models with an emphasis on Caenorhabditis elegans.

There is a significant global upsurge in the number and proportion of older persons in the population. With this comes an increasing prevalence of age-related conditions which pose a major challenge to healthcare systems. The development of anti-ageing treatments may help meet this challenge by targeting the ageing process which is a common denominator to many health problems. Cannabis-like compounds (cannabinoids) are reported to improve quality of life and general well-being in human trials, and there is increasing preclinical research highlighting that they have anti-ageing activity. Moreover, preclinical evidence suggests that endogenous cannabinoids regulate ageing processes. Here, we review the anti-ageing effects of the cannabinoids in various model systems, including the most extensively studied nematode model, Caenorhabditis elegans. These studies highlight that the cannabinoids lengthen healthspan and lifespan, with emerging evidence that they may also hinder the development of cellular senescence. The non-psychoactive cannabinoid cannabidiol (CBD) shows particular promise, with mechanistic studies demonstrating it may work through autophagy induction and activation of antioxidative systems. Furthermore, CBD improves healthspan parameters such as diminishing age-related behavioural dysfunction in models of both healthy and accelerated ageing. Translation into mammalian systems provides an important next step. Moreover, looking beyond CBD, future studies could probe the multitude of other cannabis constituents for their anti-ageing activity.

Factors Affecting Utilization of Health Services Among Elderly of Koshi Province, Nepal

Every country in the world is experiencing growth in the number and proportion of older persons. Aging is poised to become one of the most significant social transformations of the twenty-first century which affects all sectors of society. Aim of study was to assess factors affecting the utilization of health services among the elderly of Koshi province, Nepal. A quantitative descriptive cross-sectional study was conducted among 357 elderly. A multistage sampling technique was recruited for the selection of eight municipalities and wards for obtaining a representative sample from each ward. A semi structured interview schedule was used for data collection procedure. Descriptive statistics and inferential statistics were used after the normality test to measure the association of selected variables and utilization of health services. The study finding revealed that more than two-third (70.3) of the respondents was young old age. More than half of the respondents were female. Less than half (44.0%) of the respondents were hypertensive. A multivariate analysis revealed that the utilization of health services is higher among service holder elderly than non-service holder. The utilization health services by elderly were higher who had health insurance than who had not insurance service. The study concludes that only two-thirds of the elderly were satisfied with health insurance services facilities. Although One-thirds of elderly still not satisfied with the health insurance service facility so improve and easy access insurance service to elderly is essential.