Older People's Quality Research Articles

Optimising protein intake in older people to maintain their musculoskeletal health.

The concept of healthy ageing has become a significant aspect of the public health approach to older people's well-being. Physiological changes that occur with ageing, such as a lack of mobility and sarcopenia (an age-related decline in muscle mass and strength), have the potential to negatively affect older people's quality of life and musculoskeletal health, often contributing to falls and fractures. Protein intake is a crucial element in maintaining optimal health in older people, and is important in delaying sarcopenia. This article discusses the role of protein in healthy ageing and outlines various recommendations for optimising protein intake in older people.

Predictors of driving among older Australian women from 2002 to 2011: A longitudinal analysis of Australian Longitudinal Study on Women’s Health based on the World Health Organization’s Healthy Ageing Framework

IntroductionThe number of older drivers is quickly rising as the world's population is ageing. Driving was found to be essential in improving older people's quality of life. However, in assessing factors associated with driving in old age, previous studies have focused on medical conditions and sociodemographic factors, such as age and sex. Little is known about the effect of environment and social roles in determining driving in old age. ObjectiveThis study aimed to identify the predictors of driving among women as they age from 76 to 81 to 85–90 years based on the World Health Organization's (WHO) Healthy Ageing framework. MethodThe study analysed longitudinal data from the 1921–26 cohort of the Australian Longitudinal Study on Women's Health (ALSWH), nine years of follow up from survey waves three (aged 76–81 years) to six (aged 85–90 years). The study examined factors associated with driving based on the WHO's healthy ageing approach. Generalised estimating equation (GEE) models were used to identify predictors of driving over time. ResultAt baseline (ages 76–81 years), 55.7% of women were driving themselves, and this was their main means of transport. Over time, the odds of driving decreased as the women aged. In multivariable analyses, personal factors including education, providing care, grandparenting, and volunteering had positive associations with driving. In addition, the environmental factors of living in remote, outer regional and inner regional Australia, living in the states of Victoria and Western Australia, and living alone were also positively associated with driving. In contrast, medical conditions like diabetes, stroke, visual impairment, and need for assistance with daily tasks had negative associations with driving. ConclusionAge alone does not determine driving. Therefore, the context of personal, social, and environmental factors should also be considered and aligned with the healthy ageing goals when developing driving policy for older people.

Community-living older people's interpretation of the Norwegian version of older people's quality of life (OPQOL) questionnaire.

The aim of this study is to investigate how community-living older people interpret the Norwegian version of Older People's Quality of Life (OPQOL) questionnaire. The original OPQOL questionnaire was translated based on guidelines for cross-cultural translation. The Three-Step Test-Interview instrument was adopted to investigate how community-living older people interpreted the questionnaire. Data were collected from 14 participants (72-89years). The questionnaire was filled in under observation. Semi-structured interviews were then conducted to clarify the observational data and elicit the participants' experiences and opinions. Lastly, data were analysed using a hermeneutic interpretation approach. Our findings indicate that most of the participants managed to complete the OPQOL questionnaire without problems. The data analysis resulted in four primary themes: relevance & applicability, formulation, consistency & accuracy and subjectivity. The questionnaire covered all aspects related to the participants' quality of life. However, statements related to religion were found to be irrelevant to their quality of life. Most of the participants thought that religion, philosophy and culture should be separate rather than included in the same statement. The participants missed the option of 'not applicable' when the statements were irrelevant to them. The statements are formulated in both positive and negative ways, which was sometimes confusing to them. The participants perceived phases such as "around me" "local," and "things" as ambiguous, and thus they raised concerns about whether the OPQOL questionnaire could capture consistent data regarding their quality of life. The results of this study pinpoint the issues that community-living older people faced when interpreting and answering the Norwegian version of OPQOL questionnaire. These issues were mostly caused by sociocultural differences. Our work provides an overview of the changes that must be made in the questionnaire in order to address these sociocultural differences while using the OPQOL questionnaire in the Norwegian context.

Good in Providing Oral Care, but we Could be Better-Nursing Staff Identification of Improvement Areas in Oral Care.

IntroductionOral care to older people in short-term care units is a complex and challenging everyday practice for nursing staff. Oral care research and knowledge about prerequisites and obstacles is extensive. However, there is a lack of knowledge about how nursing staff in short-term care units describe their satisfaction about provided oral care in order to maintain older people's oral health.ObjectiveThe purpose of this study was to describe how nursing staff perceive their satisfaction of oral care provided for older people in short-term care units and to identify oral care improvements.MethodsThis study reports on the results of two open-ended questions that were part of a larger study. Informants (n = 54) were nursing staff working in the involved short-term care units in municipalities from both densely and sparsely populated regions in central and northern Sweden. The answers to the open-ended questions were analyzed using content analysis.ResultsThe analysis yielded one main category; “Working together to improve satisfaction with older people's oral care” and four subcategories: “Older people's oral health,” “Consideration and respect for the older person's autonomy,” “Having access to adequate products,” and “Working together in the same direction.”ConclusionIdentification of older people's oral health problems together with adequate nursing intervention will increase older people's health outcomes and quality of life. However, regardless of work role, the nursing staff might have difficulty changing their behavior or transforming intentions into actions. Oral care is a complicated and proactive practice that requires nursing staff's attention as well as both educational and organizational initiatives. Working in a supportive and collaborative relationship provides prerequisites for optimal oral care in short-term care units.

Use of potentially inappropriate medications among older outpatients and inpatients in a tertiary care hospital in Malaysia.

Older individuals are seemingly having more medical conditions, which predispose them to a greater risk of polypharmacy. Potentially inappropriate medications (PIMs), including those having anticholinergic and sedative properties, are common in their prescriptions, often associated with functional decline and negative health outcomes. Thus, this study reports proportions of inappropriate drugs and drug burden exposures and its correlation with patient-reported outcomes (PROs) among cognitively intact older adults admitted to a ward or visiting the outpatient clinic at a tertiary care hospital in Malaysia. This cross-sectional study included data from 344 older (173 inpatients and 171 outpatients) patients, aged 60years and above, through validated questionnaires. Medication appropriateness was assessed via Medication Appropriateness Index (MAI) tool, whereas Beers and Screening Tool of Older Person's Potentially Inappropriate Prescribing (STOPP) criteria were used to evaluate PIMs and potentially inappropriate prescribing (PIP), respectively. The Drug Burden Index (DBI) and polypharmacy, as well as PROs, included Groningen Frailty Indicator (GFI), Katz Index of Independence in Activities of Daily Living (Katz ADL) and Older People's Quality of Life (OPQOL) were also evaluated. Overall, inpatients received significantly higher medications (6.90±2.70 vs 4.49±3.20) than outpatients. A significantly higher proportion of inpatients received at least one PIM (65% vs 57%) or PIP (57.4% vs 17.0%) and higher mean MAI score (1.76±1.08 and 1.10±0.34) and DBI score (2.67±1.28 vs 1.49±1.17) than outpatients. Inpatients had significantly higher total OPQOL (118.53 vs 79.95) and GFI score (5.44 vs 3.78) than outpatients. We only found significant correlations between GFI and DBI and total OPQOL and the number of PIMs. Proportions of PIMs and DBI exposure were significantly higher in an inpatient setting. No significant correlations between exposures to inappropriate medications or drug burden and PROs were observed.

Advanced ophthalmic nurse practitioners: the potential to improve outcomes for older people with cataracts.

An ageing population has led to a substantial increase in the prevalence of visual impairments, which can compromise lifestyle, health and general physical and psychological well-being. Age-related cataracts can have a negative effect on older people's quality of life but can be corrected by surgery. It is imperative that older people have access to cataract surgery and, given government objectives of NHS efficiency gains, advanced level nurse practitioners have the potential to increase capacity for and access to cataract surgery. This article outlines the aetiology of cataracts, developments in ophthalmic nursing and the broadened scope of practice of advanced ophthalmic nurse practitioners (AONPs). It explores how the AONP is well-placed to provide high quality care to the older person who requires cataract surgery. Professional drivers for role development are explored in relation to older people.

Gender, capital endowment and digital exclusion of older people in China

AbstractAmid rapid population ageing and the high-speed progress of information and communications technology, use of smart electronics can improve older people's quality of life by helping them to stay connected, active and independent, which may, in turn, increase their overall happiness and sense of social belonging. Taking a gender perspective, this paper aims to understand variations in digital exclusion among older people. Using data from the 2016 China Longitudinal Ageing Social Survey, it finds that digital exclusion seems to vary by gender, with rural female older people being most excluded, possibly because they have the lowest capital endowment. The gender difference in the digital divide is even more salient with all other things being equal. Digital exclusion in the information era may further exacerbate gender inequality, particularly for those who are already most vulnerable. Since digital inclusion is somewhat inherent in the concept of intelligent old-age support, it should be considered an urgent necessity to help older people, especially rural women, become familiar with smart electronic products.

Acupressure to improve sleep quality of older people in residential aged care: a randomised controlled trial protocol

BackgroundSleep disturbance in older people is an important health issue that is associated with many other health problems. Effective interventions are required to address sleep problems in this group. Acupressure has been suggested as a potential therapeutic technique to improve sleep. The aim of this study is to evaluate the effects of an acupressure intervention on sleep quality, anxiety, depression, and quality of life among older persons in residential aged care facilities within an Australian context.Methods/designThis is a randomised controlled trial with two parallel groups in a pre- and post-test study. Study participants will be older people living in residential aged care facilities. They will be assigned to intervention and control groups using computer-generated random numbers. The intervention group will receive 12-min acupressure three times per week for four consecutive weeks, applied on three acupoints: HT7, PC6, and SP6. The control group will receive only routine care. The primary outcome measure is sleep quality, and secondary outcomes include anxiety, depression, and quality of life. Data will be collected before the intervention, immediately after the end of the intervention, and 2 weeks after the intervention.DiscussionThis study targets a poorly met healthcare need of older people who are experiencing sleep disturbance and its negative consequences. To the researchers’ knowledge, this is the first study evaluating acupressure in an Australian aged care context, using specific acupoints and a standardised acupressure protocol. If the results show positive outcomes, acupressure could be used to manage sleep disturbances for older people in the Australian context as well as in the global ageing population. This will contribute to reducing negative consequences of sleep disturbance and use of sleep medications.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12619000262101. Registered on 20 February 2019.

Effect of Whole-Body Vibration Training on the Physical Capability, Activities of Daily Living, and Sleep Quality of Older People with Sarcopenia

Aim: To investigate the effect of whole-body vibration on older people with sarcopenia, and their physical capability, activities of daily living, and sleep quality. Methods: This study is quasi-experimental and adopts single-group pretest–posttest design. The study included participants aged older than 65 years who lived in nursing homes and care centers in Taipei, Taiwan. The whole-body vibration training was performed for 3 months, and during each training session, a participant received ten cycles of 60-sec vibration with 30-sec breaks between the cycles. The physical capability, activities of daily living, and sleep quality of the participants were examined to understand the pretest and posttest results of whole-body vibration training. Concerning the statistical methods adopted, nonparametric method-based tests were employed. Results: In addition to sleep quality (z = 7.367, p > 0.05), significant differences were observed between before and after whole-body vibration training intervention for one-foot balance (z = −2.447, p < 0.05), shoulder and arm flexibility (z = −3.159, p < 0.05), walking speed (z = −2.692, p < 0.05), right-hand grip (z = −3.388, p < 0.05), left-hand grip (z = −3.264, p < 0.05), five sit–stand repetitions (z = −2.936, p < 0.05), skeletal muscle mass index (z = −3.621, p < 0.05), and activities of daily living (z = 1.163, p < 0.05). Conclusions: According to this study, with the 12-week whole-body vibration training in older people with sarcopenia, their physical capability and activities of daily living have improved, though sleeping quality is not statistically significant.

Findings from an exploration of a social network intervention to promote diet quality and health behaviours in older adults with COPD: a feasibility study

BackgroundDiet quality in older people with chronic obstructive pulmonary disease (COPD) is associated with better health and lung function. Social factors, such as social support, social networks and participation in activities, have been linked with diet quality in older age. A social network tool—GENIE (Generating Engagement in Network Involvement)—was implemented in a COPD community care context. The study aimed to assess the feasibility of the GENIE intervention to promote diet quality and other health behaviours in COPD.MethodsTwenty-two community-dwelling older adults with COPD were recruited from a local COPD service. Participants were offered usual care or the GENIE intervention. Process evaluation methods were used to assess intervention implementation, context and mechanisms of impact; these included observations of patient interactions with the intervention, documented in observational field notes and in films of a patient group discussion. Diet quality was assessed by food frequency questionnaire; ‘prudent’ diet scores were used to describe diet quality at baseline and at 3-month follow-up. Change in diet quality was expressed per month, from baseline to follow-up.ResultsFeasibility data showed that the GENIE intervention could be implemented in this sample of community-living older people. The intervention was acceptable to clinicians and older people with COPD, especially for those with less severe disease, when facilitated appropriately and considering the levels of literacy of participants. There was no significant change in diet quality in the intervention group over the follow-up period (median change in prudent diet score per month (interquartile range (IQR), 0.03 (− 0.24–0.07)), whereas an overall fall in diet quality was observed in the control group (− 0.15 (− 0.24–0.03)).ConclusionThe process evaluation findings suggest that this intervention is feasible and acceptable to both patients and clinicians. Although the sample size achieved in this study was small, findings suggest that the intervention may have a protective effect against declines in diet quality, and other health behaviours, in an older COPD population. Findings from this feasibility study indicate that further evaluation of the GENIE intervention is warranted in a larger study, with a longer follow-up.Trial registrationClinicalTrials.gov, NCT02935452. NIH U.S. National Library of Medicine. Registered 17 October 2016.

Relationship between Cortisol Changes during the Night and Subjective and Objective Sleep Quality in Healthy Older People.

The aim of this study was to investigate whether the nighttime cortisol release was associated with subjective and objective sleep quality and the discrepancy between them. Forty-five healthy older adults (age range from 56 to 75 years) collected salivary samples immediately before sleep and immediately after awakening on two consecutive nights. Actigraphy was used to assess objective sleep quality and quantity. A sleep diary was used to assess subjective sleep quality. Linear mixed models were performed using subjective and objective sleep quality data from 76 nights to investigate between-subject associations. We observed that larger changes in cortisol levels between sleep onset and awakening, reflecting a healthier circadian rhythm of the Hypothalamic-Pituitary-Adrenal (HPA) axis, were associated with better subjective sleep quality, but not with objective sleep quality. Moreover, smaller changes in nighttime cortisol were associated with lower subjective sleep quality relative to objective sleep quality. All these results were observed even after controlling for important confounders such as sleep quantity, age, sex, subjective socioeconomic status, stress perception, depression, physical activity, and adherence to the salivary sampling protocol. This study demonstrates that subjective sleep quality in older people may be explained, to some extent, by the activity of the HPA axis.

Association between Neighborhood Environment and Quality of Sleep in Older Adult Residents Living in Japan: The JAGES 2010 Cross-Sectional Study.

Poor sleep is associated with lifestyle, however, few studies have addressed the association between sleep quality and the neighborhood environment. This study aimed to investigate the associations between living environment factors and sleep quality in older people. Participants were community-dwelling people aged ≥65 years who participated in the 2010 Japanese Gerontological Evaluation Study. The data of 16,650 people (8102 men, 8548 women) were analyzed. Sleep quality (good or poor) was evaluated using a self-administered questionnaire. Multilevel Poisson regression analysis stratified by depressive status (measured by the Geriatric Depression Scale-15 [GDS]) was conducted with sleep quality as the dependent variable and social and physical environmental factors as explanatory variables. The 12,469 non-depressive respondents and 4181 depressive respondents were evaluated. The regression analysis indicated that non-depressive participants slept better if they lived in environments with few hills or steps (prevalence ratio [PR] = 0.75, 95% CI: 0.56–0.9) and with places where they felt free to drop in (PR = 0.51, 95% CI: 0.26–0.98). For depressive participants, these associations were not evident. Living alone, poor self-rated health, low income, and unemployment were associated with poor sleep quality. In addition to support with these individual factors, improving environmental factors at the neighborhood level may improve the sleep quality of community-dwelling older adults.

Drug burden index, polypharmacy and patient health outcomes in cognitively intact older residents of aged care facilities in Malaysia

AbstractBackgroundThe complexity of drug regimens among older people tend to increase over time, as multiple medications are required to treat a single condition.AimThis study examined the association of the drug burden index (DBI) and polypharmacy with patient health outcomes among cognitively intact older residents in aged care facilities (ACFs).MethodsA review of prescribed medications and related outcomes was conducted in a cross‐sectional sample of older adults (≥60 years), recruited from 11 ACFs in Peninsular Malaysia. Frailty and quality of life (QoL) were evaluated using the Groningen frailty indicator and ‘Older People's Quality of Life – 35’ questionnaire, respectively; patients’ exposure to anticholinergic and sedative medicines was quantified using the DBI; and the mental health of residents was evaluated using the Hospital Anxiety and Depression Scale.ResultsMore than two‐thirds of a sampled population received at least one anticholinergic or sedative medication and more than one‐quarter was exposed to polypharmacy. Exposure to DBI‐associated medications was noted in three of every four frail participants and was significantly correlated with frailty (r = 0.184, p = 0.023). The frail population had significantly increased risk of polypharmacy (odds ratio 6.07; 95% confidence interval 1.71–21.56; p = 0.005), but exposure to DBI‐associated medications was not significantly associated with overall QoL and activity of daily living measures.ConclusionPolypharmacy and anticholinergic and sedative burden were noticed in a substantial number of older adults in residential aged care facilities and were associated with frailty. Investing in the recruitment of pharmacists may benefit recognition of residential ACF quality of care, because pharmacy services (including pharmacists) are virtually non‐existent in Malaysian residential ACFs.

Determining the prevalence of depression among older adults living in Burdur, Turkey, and their associated factors.

This study aimed to determine the prevalence of depression among older adults living in Burdur, Turkey, and their associated factors. This analytical cross-sectional study was conducted between May 1, 2015 and August 20, 2015 comprising 35 339 subjects aged ≥65 years living in Burdur; the sample was 770 subjects identified using a population-weighted cluster sampling method. Data were collected by using personal information forms, Geriatric Depression Scale, and the Older People's Quality of Life Scale of the World Health Organization. The statistical analysis was performed by using t-test for independent samples, one-way analysis of variance and post hoc multiple comparison tests, Pearson correlation, and regression analysis. P < 0.05 was considered as significant. Of the study population, 51.8% had a score of ≥14 (definite depression). According to the regression model, the prevalence of depression was higher in older adults aged ≥85 years than in older adults aged 65-74 years (P < 0.01), in females than in males (P < 0.01), in individuals who never consumed alcohol than in those who consumed alcohol (P = 0.04), and in older adults who perceived their health as poor than in those who were unsure about their health and perceived their health as good (P < 0.01). Correlation analysis showed a poor, negative, and significant correlation (r = -0.38; P < 0.01) between the total scores of Older People's Quality of Life Scale of the World Health Organization and Geriatric Depression Scale. The prevalence of depression is high among older adults aged ≥65 years. Age, gender, alcohol consumption, health perception, and quality of life are important predictors of depression.

Impact of atrial fibrillation on frailty and functionality in older adults.

Atrial fibrillation (AF), the most common sustained arrhythmia in older adults, causes significant complications such as stroke, dementia, and decreased quality of life. Frailty is a geriatric syndrome that is associated with increased risk of poor clinical outcomes including falls, disability, and mortality. We aimed to investigate the relationship between AF and frailty and functionality in older adults. A total of 123 patients 64 with AF and 59 with normal sinus rhythm were enrolled in the study with cross-sectional design. All patients underwent comprehensive geriatric assessment (CGA). Frailty status was assessed using Fried criteria and FRAIL scale. The brief Older People's Quality of Life questionnaire was applied for quality of life. Results of the laboratory tests were recorded and compared for both groups. Although the frequency of frailty status determined by the Fried criteria and the FRAIL scale was higher in the AF group, this difference was not statistically significant. However, it was found that there was a positive correlation between the European Heart Rhythm Association (EHRA) AF symptom score and frailty according to the FRAIL scale (Goodman and Kruskal gamma coefficient = 0.39, p = 0.020). Comorbidities and polypharmacy were more common in the AF group (p < 0.001, both). CGA revealed lower Lawton-Brody Instrumental Activities of Daily Living scores (p = 0.024), higher fall rates in the previous year (p = 0.016), and slower walking speed (p = 0.020) in the AF group. Total cholesterol, LDL, HDL, total protein, albumin, and prealbumin were lower; brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels were higher in the AF group. EHRA AF symptom severity score is positively correlated with frailty. AF is associated with worse metabolic profile and clinical features on CGA that AF might be a frailty marker. Frailty should be investigated in AF patients.

The Effect of Sensory Stimulation on Quality of Life of the Elderly and their Self-efficacy for Coping with the Fear of Falling.

Background:Aging causes major changes that affect the performance of all senses, and as a result, a critical change in the quality of life is expected. Falling and the fear of falling is one of the major health risks that affect the quality of life among elderly, threatening their independent living. This study was conducted to determine the role of sensory stimulation on the quality of life and self-efficacy in coping with fear in the elderly population.Materials and Methods:During this randomized controlled trial, 80 elderly volunteers from healthcare centers were divided into four intervention groups (music, photo album, aromatherapy, and hand massage) and one control group. Data collection was performed using the Older People's Quality of Life Questionnaire and Falls Efficacy Scale-International tools. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software program, version 16.0.Results:Comparing the scores of the quality of life and self-efficacy questionnaires, no statistically significant difference was reported among the groups (p < 0.05).Conclusions:Sensory stimulation seems to have no impressive effect on the improvement of self-efficacy in coping with the fear of falling and the quality of life in the older population.

Analysis of the Types and Affecting Factors of Older People's Health-related Quality of Life, Using Latent Class Analysis

Purpose: This study aims to identify the types of health-related quality of life (QoL) based on the EuroQoL 5 Dimensions among community older people and predict the factors affecting these types. Methods: This study used data from the 2016 Korea Health Panel Survey, whose participants included 3,848 older people. The data were analyzed using the software jamovi 1.2.17 and Mplus 8.2 for latent class analysis. Results: The subgroups of the older people’s health-related QoL were identified as three latent classes: General stable type (43.9%), pain-related low type (35.0%), and general low type (21.1%). The types and characteristics of health-related QoL among the latent classes differed. Comparing the difference between the general low type and general stable type, the subjects showed higher probability of belonging to the general stable type when they were men, younger, higher education level, employment, better subjective health, lower BMI and stress level, and no suicidal ideation. A comparison between the general low type and the pain-related low type showed that the subjects were more likely to be classified as the pain-related low type when they were younger, higher education, employment, and better subjective health. Conclusion: The results showed a significant heterogeneity in the types of health-related QoL among community older people, and the predictors for each type were not the same. These findings present basic data for cultivating nursing interventions that enhance health-related QoL.

Effects of sedentary behavior and physical activity on sleep quality in older people: A cross-sectional study.

The aim of this cross-sectional study was to investigate the influence of replacing sedentary time with time engaged in one of two levels of physical activity on sleep quality using an isotemporal substitution model. The participants were 70 community-dwelling older Japanese adults (approximately 70% female). Physical activity types were measured using a triaxial accelerometer and categorized based on intensity as sedentary, light-intensity, and vigorous-intensity. The Pittsburgh Sleep Quality Index assessed subjective sleep quality. Objective sleep parameters were assessed using an actigraph. A series of multi-linear regression models analyzed the statistical relationships. Our findings showed that replacing 30 min of sedentary activity per day with an equal period of light-intensity physical activity significantly influenced sleep quality parameters. However, there was no significant difference in sleep quality when light-intensity activity was replaced with vigorous-intensity activity. Engaging in one activity type means less available time for other types of activity; habitual replacement of sedentary activity with light-intensity physical activity might have long-term benefits on the sleep quality of older people.

A Review of the Development and Application of Generic Preference-Based Instruments with the Older Population.

Older people (aged 65years and over) are the fastest growing age cohort in the majority of developed countries, and the proportion of individuals defined as the oldest old (aged 80years and over) living with physical frailty and cognitive impairment is rising. These population changes put increasing pressure on health and aged care services, thus it is important to assess the cost effectiveness of interventions targeted for older people across health and aged care sectors to identify interventions with the strongest capacity to enhance older peoples' quality of life and provide value for money. Cost-utility analysis (CUA) is a form of economic evaluation that typically uses preference-based instruments to measure and value health-related quality of life for the calculation of quality-adjusted life-years (QALYS) to enable comparisons of the cost effectiveness of different interventions. A variety of generic preference-based instruments have been used to measure older people's quality of life, including the Adult Social Care Outcomes Toolkit (ASCOT); Health Utility Index Mark 2 (HUI2); Health Utility Index Mark 3 (HUI3); Short-Form-6 Dimensions (SF-6D); Assessment of Quality of Life-6 dimensions (AQoL-6D); Assessment of Quality of Life-8 dimensions (AQoL-8D); Quality of Wellbeing Scale-Self-Administered (QWB-SA); 15 Dimensions (15D); EuroQol-5 dimensions (EQ-5D); and an older person specific preference-based instrument-the Investigating Choice Experiments Capability Measure for older people (ICECAP-O). This article reviews the development and application of these instruments within the older population and discusses the issues surrounding their use with this population. Areas for further research relating to the development and application of generic preference-based instruments with populations of older people are also highlighted.

The Relation between Objective and Perceived Physical Characteristics of a Neighborhood Environment for Older People

This paper aims to investigate the relation between objective and perceived neighbourhood walkability and its influence on the physical activity level of older adults. The relationships were used to measure older people's neighbourhood liveability, whereas physical activity relates to older people's quality of life in Johor Bahru neighbourhoods, Malaysia. The study outcomes show residents in a highly dense area with higher accessibility to facilities perceived higher walkability but showed a lower physical activity level. Residents in high intersection density areas who recognised high walkability demonstrated higher physical activity level, whereas residents in a highly dense area with higher accessibility show lower physical activity level.Keywords: Active ageing; physical neighbourhood environment; neighbourhood liveability; quality of lifeeISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning &amp; Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i11.1732