Rapid Aging Research Articles

Caring for the Rapidly Aging Incarcerated Population: The Role of Policy.

The population of incarcerated adults in the United States is aging rapidly. Incarcerated adults experience accelerated aging, the process in which exposure to incarceration speeds up biological aging. The current article highlights unique structural factors and care practices that incarcerated older adults face in correctional and community health systems. These factors and practices are often in direct opposition to age-friendly care. Opportunities exist to expand research, modify existing policies, and change current care practices. Given their expertise in health system processes, gerontological nurses in correctional and community health care systems can play a pivotal role in improving the care of this growing and vulnerable population. [Journal of Gerontological Nursing, 49(3), 7-11.].

On the Socio-Economic Effects of the Retirement Age Extension

The extension of retirement age is a hot issue of debate in South Korea. The unprecedentedly rapid aging due to the low fertility and longevity made the South Korea to show the highest level of old-age poverty among OECD countries. The rapid ageing brings the shortage of labor supply and the old-age poverty. The shortage of labor supply will eventually bring a slowdown of growth potentials of the economy. The alternative for the shortage of labor is the extension/delay of retirement. We analyze the impact of raising the retirement age on the employment, industry output, and economic growth. We used CGE model to analyze the retirement extension in South Korea. The overall effects can be summarized as follows: (1) the delay of retirement causes the increase in labor employed by –0.007% ~ 0.248%, and the real wage changes by –0.190 ~ –0.093. (2) Employment by industry varies according to the labor skills required in that sector. In general, the skill-intensive sector has higher employment growth. (3) The delayed retirement in the skill-biased sector cause real GDP to grow more (e.g., professional services, etc.).

Faith-based organizations' support for older adults in Vietnam: A comparison of Catholic and Buddhist efforts

How faith-based organizations (FBOs) take part in the social welfare system for older adults is of interest to policy-makers and researchers in the face of a rapid aging population. Since FBOs are underexplored in Vietnam, this study provides an insightful understanding and analysis of Vietnamese Catholic and Buddhist FBOs’ participation in social service provision to older adults. By conducting secondary data analysis, semi-structured interviews and field observation at some FBOs’ and public social protection centers for older adults, this article presents some insights into the way Catholic and Buddhist organizations provide short and long-term services to older adults, compare Catholic and Buddhist services, and discuss the challenges of sustainability. To advance understanding, authors also analyze the findings on the context of the complicated relationships between FBOs, government and the welfare state in Vietnam. Based on the findings, the authors suggest a coordinated and planned universalization strategy by the public/ private sectors. Further research is needed to leverage support for the implementation of a cooperative partnership approach in providing social service provisions within a Vietnamese context.

Значення мультидисциплінарного, міжвідомчого і міжсекторального підходів як умов впровадження системи паліативної та хоспісної допомоги в Україні

Purpose - to carry out medical and social analysis of conditions and organizational aspects of the Palliative and Hospice Care (PHC) System implementation and development in Ukraine. Materials and methods. There were analyzed: domestic and foreign scientific literary sources; data of official statistics of the State Statistics Service and the Ministry of Health of Ukraine; normative-legal documents of Ukraine and authoritative international professional organizations. Аnd the following research methods were applied: bibliosemantic, system approach and system analysis, comparative content analysis and generally accepted medical-statistical methods. Results. The peculiarities of the medical and demographic situation in Ukraine in recent decades are the rapid population aging, high morbidity and mortality from cancer and severe complications of chronic noncommunicable diseases, significant spread of HIV/AIDS, tuberculosis, viral hepatitis B and C etc. This requires the creation and improvement of an adequate regulatory framework (RF), which regulates the development of an accessible multidisciplinary, interagency and intersectoral PHC System, which requires the development of outpatient PHC services and inpatient PHC facilities, coordination of institutions and agencies subordinate to various ministries and agencies, first of all, the Ministry of Health of Ukraine and the Ministry of Social Policy of Ukraine; introduction of a system of motivation and training of PHC providers and involvement primary health care facilities medical staff in the palliative care provision at home. Thus, affordable and high-quality PHC should be integrated into the Health Care and Social Protection System, as PHC in the early stages of a life-threatening or incurable disease can significantly reduce suffering and improve the quality of life for both palliative patients (PPs) and their families. Conclusions. The urgency of the problem of creating and developing a System of affordable, high quality and effective PHC in Ukraine is due to the unfavorable medical and demographic situation - population aging, increasing morbidity and mortality from cancer and chronic diseases, often accompanied by chronic pain syndrom and other severe symptoms that significantly reduce the quality of life of PPs. The implementation of the PHC System for the population requires political support from the Government of Ukraine, Regional and Local Authorities, appropriate financial support and the whole society participation. Implementation and development of the PHC System in Ukraine with adequate funding from the State Budget (National Health Service of Ukraine), as well as through state, regional and local targeted PHC Programs will provide quality and effective multidisciplinary and interagency palliative care on equal terms, regardless of the nosology of the disease, PPs place of residence/stay and social status. The results of the study allowed to adapt international experience and identify different forms of PНC, which, depending on the severity of the disease and at the request of PPs and their families, can be provided in specialized inpatient PНC facilities, PНC departments of secondary and tertiary health care facilities or outpatient settings, including at home, as well as in PHC facilities of any form of ownership and departmental affiliation, subject to compliance with the standards and requirements of the RF. No conflict of interests was declared by the authors.

Why Do They Not Come Home? Three Cases of Fukushima Nuclear Accident Evacuees

Many people wish to return to where they used to live after evacuation due to disaster. After the Fukushima nuclear accident in 2011, many residents were forced to evacuate due to concerns about radiation. Subsequently, the evacuation order was lifted, and the government promoted a return policy. However, it has been reported that a considerable number of residents living in evacuation sites or other areas wish to return but are unable to do so. Here, we report three cases of Japanese men and one woman who evacuated after the 2011 nuclear accident in Fukushima. These cases reveal the rapid aging of residents and their health issues. These issues suggest that enhancing medical supply systems and access to medical care can aid in post-disaster reconstruction and residents' returning.

Financial inclusion for the elderly in Thailand and the role of information communication technology

One of the financially vulnerable groups is older people, who receive little attention in the financial inclusion literature. The elderly is financially excluded in Thailand, an emerging economy with high financial inclusion and rapid aging of the population. Using the Findex survey data 2017, we construct financial inclusion (FI) scores with five measures and explore the influence of aging, mobile phones, and mobile money, controlling for individual characteristics. Among non-account holders, more than half are older than 55 years old. A significantly negative association between FI and age/age group is confirmed. We also prove the positive effect of mobile phones and mobile money on FI scores, by 0.48–0.49 percentage points. This study sheds light on the drivers of mobile banking among the elderly with Thai ICT data, showing that low internet access and mobile phone use are the biggest barriers to financial inclusion. No gender disparity in FI is found.

Ageing threatens sustainability of smallholder farming in China.

Rapid demographic ageing substantially affects socioeconomic development1-4 and presents considerable challenges for food security and agricultural sustainability5-8, which have so far not been well understood. Here, by using data from more than 15,000 rural households with crops but no livestock across China, we show that rural population ageing reduced farm size by 4% through transferring cropland ownership and land abandonment (approximately 4 million hectares) in 2019, taking the population age structure in 1990 as a benchmark. These changes led to a reduction of agricultural inputs, including chemical fertilizers, manure and machinery, which decreased agricultural output and labour productivity by 5% and 4%, respectively, further lowering farmers' income by 15%. Meanwhile, fertilizer loss increased by 3%, resulting in higher pollutant emissions to the environment. In new farming models, such as cooperative farming, farms tend to be larger and operated by younger farmers, who have a higher average education level, hence improving agricultural management. By encouraging the transition to new farming models, the negative consequences of ageing can be reversed. Agricultural input, farm size and farmer's income would grow by approximately 14%, 20% and 26%, respectively, and fertilizer loss would reduce by 4% in 2100 compared with that in 2020. This suggests that management of rural ageing will contribute to a comprehensive transformation of smallholder farming to sustainable agriculture in China.

Trends in Postmortem Neurodegenerative and Cerebrovascular Neuropathologies Over 25 Years

With rapid aging of the US population, understanding trends over time in dementia occurrence is essential to public health planning and intervention; this understanding includes trends in neuropathologies underlying clinical dementia. To characterize trends in pathways underlying dementia by examining prevalence of postmortem neuropathologies in birth cohorts across 25 years. Two longitudinal cohorts, the Religious Orders Study and the Rush Memory and Aging Project, with autopsy data from 1997 to 2022 with up to 27 years follow-up were analyzed. Deceased individuals with complete postmortem neuropathology evaluations were included, and 177 individuals with most distant (<1905) or recent (>1930) years of birth were excluded. Four categories of year of birth: 1905-1914, 1915-1919, 1920-1924, and 1925-1930. Outcomes included pathologic diagnosis of Alzheimer disease (AD), global AD pathology, amyloid load, tau tangles, neocortical Lewy bodies, limbic-predominant age-related TDP-43 encephalopathy neuropathological change, atherosclerosis, arteriolosclerosis, gross chronic infarcts, and chronic microinfarcts. For comparison, pathologies in each birth epoch were age-standardized to age distribution of the cohorts. χ2 Tests were used for categorical outcomes, and analysis of variance was used to compare means across birth epochs. Overall, 1554 participants were examined (510 [33%] male; median [range] age at death, 90 [66-108] years). Participants were distributed fairly evenly across birth epochs (1905-1914: n = 374; 1915-1919: n = 360; 1920-1924: n = 466; 1925-1930: n = 354). Across year of birth groups, no differences were found in prevalence of pathologic AD diagnosis; age-standardized prevalence fluctuated between 62% and 68% in the birth cohorts (χ2 test: P = .76 across birth epochs). Similarly, no differences were found in mean levels of global AD pathology, although there was greater density specifically of tau tangles in later birth cohorts (eg, age-standardized mean [SD], 1.53 [1.20] years for the 1905-1914 cohort and 1.87 [1.47] years for the 1925-1930 cohort; analysis of variance test: P = .01 across birth cohorts). There were no differences over time in other neurodegenerative pathologies. In contrast, atherosclerosis and arteriosclerosis were dramatically lower over time; for example, age-standardized prevalence of moderate to severe atherosclerosis ranged from 54% among those born from 1905-1914 to 22% for 1925-1930 (χ2 test: P < .001 across birth epochs). In this study, few differences in neurodegenerative pathologies were found, but there may be worse levels of tau tangles across birth cohorts over 25 years. This indicates that any improvements over time in clinical dementia observed by cohorts are likely in part associated with improved resilience to pathology rather than reduced AD pathology. Finally, vessel pathologies were markedly lower over birth cohorts, indicating the assocation with brain health of populationwide improvements in several vascular risk factors.

National Care Experts and Public Daughters: Navigating Publicly Funded Eldercare Jobs in South Korea and the United States

AbstractBoth the United States and South Korea have implemented publicly funded long-term care programs intended to cope with the rapid aging of their populations. These programs provide market-based solutions that depend on cheap labor supplied by women from marginalized groups. Drawing upon comparative ethnographic data collected in Los Angeles’ Koreatown and Seoul, this study illuminates the mechanisms by which publicly funded long-term care programs systematically devalue care through a combination of state policy and racialized labor markets. These programs not only sort and channel marginalized women into the low-paid care sector through targeted forms of recruitment, but they also do so by promoting an idealized care worker subject. However, workers do not passively accept their subjectivation. Instead, they selectively choose to embody some aspects of the imposed idealized care worker subject to help navigate their precarious working conditions. In doing so, they give meaning to their work and thus empower themselves.

The critical role of physical frailty and function on depressive symptoms among community-dwelling older adults in China: A cross-sectional study.

With rapid population aging in China, geriatric depression has imposed a heavy burden on public health and society. This study aimed to investigate the prevalence and influencing factors of depressive symptoms among community-dwelling older adults in China. The findings of this study will contribute to the early detection and effective interventions for older adults with depressive symptoms. A cross-sectional study was conducted among people aged ≥65 years old in urban communities in Shenzhen, China, in 2021. This study assessed depressive symptoms (Geriatric Depression Scale-5, GDS-5), physical frailty (FRAIL Scale, FS), and physical function (Katz index of independence in the Activities of Daily Living, ADL). Multiple linear regression was used to examine potential predictors of depressive symptoms. A total of 576 participants aged 71.73 ± 6.41 years were included in the analysis. More than half of them were females (53.0%). The average score of GDS-5 was 0.57 ± 1.11, with 78 (13.61%) participants with depressive symptoms (≥2). The mean scores of FS and ADL were 0.80 ± 1.08 and 9.49 ± 1.67, respectively. The final regression model indicated that those who were living alone, less satisfied with their personal life, frailer, and with worse abilities in ADL had a higher level of depression symptoms (R2 = 0.406, p < 0.001). The prevalence of depressive symptoms is high in this urban community-dwelling older adults in China. Given the critical role of frailty and ADL on depressive symptoms, specific attention to psychological support should be paid to older adults who are living alone and with poor physical conditions.

Intergenerational Esthetic Co-Creation Program for Promotion of Community Creative Aging

The world is facing rapid global aging. Global countries are concerned about the development of aging societies and related topics ranging from successful, healthy, and active aging in the past to the current creative aging (CA) perspective. However, in-depth research on applying esthetics to promote community CA in Taiwan is lacking. To address this deficiency, the Hushan community in Douliu City, Yunlin County was selected as the research area, and the CA perspective was adopted to promote community CA through multi-stage intergenerational esthetic co-creation (IEC) workshops. A model for applying IEC workshops to promote CA was constructed. Using the action research approach, community CA enabled the elderly to identify with their inherent values, opening new possibilities for the provision of elderly social care. This study explored the psychological impacts of implementing IEC workshops on the elderly, analyzed their interactions with peers and youth, helped the elderly review their lives, analyzed relevant data to construct a practical model for applying IEC workshops to promote CA, and provided the data collected during the multi-stage applications of CA and an IEC model for promoting CA as a reference for future researchers, thereby opening new possibilities for sustainable care in aging societies.

Healthy Ageing: A Decision-Support Algorithm for the Patient-Specific Assignment of ICT Devices and Services.

In response to rapid population ageing, digital technology represents the greatest resource in supporting the implementation of active and healthy ageing principles at clinical and service levels. However, digital information platforms that deliver coordinated health and social care services for older people to cover their needs comprehensively and adequately are still not widespread. The present work is part of a project that focuses on creating a new personalised healthcare and social assistance model to enhance older people's quality of life. This model aims to prevent acute events to favour the elderly staying healthy in their own home while reducing hospitalisations. In this context, the prompt identification of criticalities and vulnerabilities through ICT devices and services is crucial. According to the human-centred care vision, this paper proposes a decision-support algorithm for the automatic and patient-specific assignment of tailored sets of devices and local services based on adults' health and social needs. This decision-support tool, which uses a tree-like model, contains conditional control statements. Using sequences of binary divisions drives the assignation of products and services to each user. Based on many predictive factors of frailty, the algorithm aims to be efficient and time-effective. This goal is achieved by adequately combining specific features, thresholds, and constraints related to the ICT devices and patients' characteristics. The validation was carried out on 50 participants. To test the algorithm, its output was compared to clinicians' decisions during the multidimensional evaluation. The algorithm reported a high sensitivity (96% for fall monitoring and 93% for cardiac tracking) and a lower specificity (60% for fall monitoring and 27% for cardiac monitoring). Results highlight the preventive and protective behaviour of the algorithm.

Potential of Microalgae as Functional Foods Applied to Mitochondria Protection and Healthy Aging Promotion

The rapid aging of the Western countries’ populations makes increasingly necessary the promotion of healthy lifestyles in order to prevent/delay the onset of age-related diseases. The use of functional foods can significantly help to achieve this aim, thanks to the contribution of biologically active compounds suitable to protect cellular and metabolic homeostasis from damage caused by stress factors. Indeed, the excessive production of reactive oxygen species (ROS), favored by incorrect eating and behavioral habits, are considered causal elements of oxidative stress, which in turn favors tissue and organism aging. Microalgae represent a convenient and suitable functional food because of their extraordinary ability to concentrate various active compounds, comprising omega-3 polyunsaturated fatty acids, sterols, phenolic compounds, carotenoids and others. Within cells, mitochondria are the cellular organelles most affected by the accumulation of molecular damage produced by oxidative stress. Since, in addition to producing the chemical energy for cellular metabolism, mitochondria control numerous cell cycle regulation processes, including intrinsic apoptosis, responses to inflammatory signals and other biochemical pathways, their dysfunction is considered decisive for many pathologies. Among these, some degenerative diseases of the nervous system, cardiovascular system, kidney function and even cancer are found. From this viewpoint, bioactive compounds of microalgae, in addition to possessing high antioxidant properties, can enhance mitochondrial functionality by modulating the expression of numerous protective factors and enzymes, which in turn regulate some essential biochemical pathways for the preservation of the functional integrity of the cell. Here, we summarize the current knowledge on the role played by microalgal compounds in the regulation of the mitochondrial life cycle, expression of protective and reparative enzymes, regulation of intrinsic apoptosis and modulation of some key biochemical pathways. Special attention was paid to the composition of some cultivable microalgae strains selected for their high content of active compounds suitable to protect and improve mitochondrial functions.

Whole-brain radiotherapy associated with structural changes resembling aging as determined by anatomic surface-based deep learning.

Brain metastases are the most common intracranial tumors in adults and are associated with significant morbidity and mortality. Whole-brain radiotherapy (WBRT) is used frequently in patients for palliation, but can result in neurocognitive deficits. While dose-dependent injury to individual areas such as the hippocampus has been demonstrated, global structural shape changes after WBRT remain to be studied. We studied healthy controls and patients with brain metastases and examined MRI brain anatomic surface data before and after WBRT. We implemented a validated graph convolutional neural network model to estimate patient's "brain age". We further developed a mixed-effects linear model to compare the estimated age of the whole brain and substructures before and after WBRT. 4220 subjects were analyzed (4148 healthy controls and 72 patients). The median radiation dose was 30 Gy (range 25-37.5 Gy). The whole brain and substructures underwent structural change resembling rapid aging in radiated patients compared to healthy controls; the whole brain "aged" 9.32 times faster, the cortex 8.05 times faster, the subcortical structures 12.57 times faster, and the hippocampus 10.14 times faster. In a subset analysis, the hippocampus "aged" 8.88 times faster in patients after conventional WBRT versus after hippocampal avoidance (HA)-WBRT. Our findings suggest that WBRT causes the brain and its substructures to undergo structural changes at a pace up to 13x of the normal aging pace, where hippocampal avoidance offers focal structural protection. Correlating these structural imaging changes with neurocognitive outcomes following WBRT or HA-WBRT would benefit from future analysis.

The prevalence of anxiety and its key influencing factors among the elderly in China.

With the rapid aging population, the mental health of older adults is paid more and more attention. Anxiety is a common mental health illness in older adults. Therefore, the study aimed to explore the current situation of anxiety and its factors among the elderly in China. Based on the data from 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a total of 10,982 respondents aged 60 and above were selected. Generalized Anxiety Disorder (GAD-7) scale was used to assess the anxiety. Univariate and multivariate analysis were used to analyze the influencing factors of anxiety. Random forest was established to rank the importance of each influencing factors. The results showed that the prevalence of anxiety among the elderly was 11.24%. Anxiety was mainly associated with 14 factors from five aspects: sociodemographic characteristics, health status, psychological state, social trust and social participation, among which loneliness related to psychological status was the most important factor. The revelation of this study is that the present situation of anxiety among the elderly cannot be ignored, and it is necessary to take measures to prevent and control it from many aspects.

The perception and utilization of community care services by older persons in the new urban areas of Beijing, China: A cross-sectional study.

In recent years, Beijing, similar to many other large cities in China, has experienced rapid urbanization in many new areas. These have often been locations of population aging but have not had concomitant development of required community care services for older persons. This study aims to understand the perception and utilization of newly developed community care services by the older persons living in this region for providing knowledge to improve the services. Applying Andersen's behavior model, this study used binary logistic regression of the factors influencing the perception and utilization of community care services and analyzed data collected by questionnaires to 301 older persons in the new urban areas of Beijing. Education, income, activities of daily living, instrumental activities of daily living, mental health, and economic needs are statistically significant factors affecting older persons' perception of community care services. Age, perception of community care services, income, neighborhood relationships, mental health, and emotional needs are significant factors affecting older persons' utilization of community care services. Demographic characteristics, health status, social support, and care needs were significant factors in the perception and utilization of community care services, after controlling for many variables. Improving older persons' perceptions of community care services is likely to promote their access to the services, which should help meet the challenges of rapid population aging in providing community care services to support aging in place in the new urban areas of Beijing, China.

Ultrastructure and Physiological Characterization of Morchella Mitospores and Their Relevance in the Understanding of the Morel Life Cycle.

Morels, which belong to the Ascomycete genus Morchella, are highly valued edible fungi treasured by gourmet chefs worldwide. Some species are saprotrophic and others are able to form facultative mycorrhizal-like associations with plant roots without establishing true ectomycorrhizal symbioses. In general, it is considered that the formation of asexual spores, or mitospores, is an important step in the life cycle of morels. However, ultrastructure characterization and physiological attributes of morel mitospores have received little attention. In this contribution, the mitospores of M. sextelata were successfully induced under laboratory conditions and their ultrastructure, occurrence, germination, physiological characteristics and mating type gene structure were studied. Mitospore production was closely related to aeration, nutrition and humidity conditions. The average germination rate of mitospores on different media and under various induction stimuli was very low, with an average of 1/100,000. Based on the ultrastructure characterization, low germination rate, growth rate decline, rapid aging and mating genotyping, it was concluded that the mitospores of M. sextelata had lost their conventional function as conidia and might act more as mate sperm-like (gamete) structures. Thus, this study contributed to a deeper understanding of the life cycle of the economically and ecologically important morel fungal group.

Family companionship and elderly suicide: Evidence from the Chinese Lunar New Year

Mental health problems among the elderly have attracted increasing attention. The most serious mental health problems may result in suicide, and lack of family companionship is often speculated to be a major cause. In this paper, we use high-frequency suicide rate data and utilize a novel temporal variation in the lunisolar calendar to provide evidence on the protective effects of the Chinese Lunar New Year (when the elderly people receive unusually high level of family companionship) on elderly suicide. We find that elderly suicide rate decreases by 8.7% during the Chinese Lunar New Year, and the protective effects are stronger in counties where the typical level of daily family companionship for the elderly is lower. In addition, the dynamic effects are different for men and for women, and men are more sensitive to the shock of the Chinese Lunar New Year. We consider a variety of alternative mechanisms, and conclude that family companionship is an important channel. Our study calls for greater attention to the mental health status and suicide problem of the elderly, especially with the rapid population aging and increasing prevalence of the “empty-nest” elderly in developing countries.

Anti-aging effect of methylurolithin A and its amide derivatives on nematode Caenorhabditis elegans

At present, the global irreversible rapid population aging will cause serious social healthcare burden and economic downward pressure for many countries or regions. Urolithin A (UA) has received extensive attention and research due to its role in inducing mitophagy and improving muscle capacity. Methylurolithin A (mUA) and its nine amide derivatives were synthesized in this study in order to find potential drugs with better anti-aging effects. The anti-aging and biosafety of the synthesized compounds were evaluated using Caenorhabditis elegans (C. elegans). The results showed that among mUA and its nine amide derivatives, Cpd. 6 had the best anti-aging effect, and had good biosafety in the growth, reproduction and motility of C. elegans. Therefore, we believe that Cpd. 6 is most suitable to be considered as a potential anti-aging drug for further development and investigation.

Changes in executive function in the Canadian longitudinal study on aging over 3-years: A focus on social determinants of health.

Maintaining executive functions, including planning, inhibition, and decision-making skills, is important for autonomy and activities of daily living. There is a growing body of evidence linking social determinants and cognitive aging, but less is known about the potential role of social determinants in changes in executive functioning over time. Using data from the Canadian Longitudinal Study on Aging (CLSA), a large cohort of mid-aged and older adults, we examined changes in executive function over a 3-year period. Specifically, we focused on the role of social determinants (i.e., social positioning, social support, education) in explaining these changes. Executive function was measured at baseline and follow-up 3 years later using the Mental Alteration Test (MAT). We computed a reliable change index (RCI) and used a multiple linear regression model to examine the associations between known correlates and change in executive function over the 3-year period (n = 29,344). Older age, higher household income, and greater educational attainment predicted declines in executive function. Health factors (e.g., depression symptoms, physical activity levels) and many social determinants (sexual orientation, gender identity, race, and perceived social standing) were not associated with change in executive function. These results suggest that social determinants of health may be related to initial differences in cognitive functioning (i.e., cross-sectional differences) rather than more rapid cognitive aging.