Vulnerable Elderly People Research Articles

Pay more attention to vaccination to protect the health of the elderly

Vaccination has been implemented as a priority measure to control infectious diseases worldwide. The aging of the global population continues to intensify, and the process and level of aging in China are more prominent. As age increases, the immune function of people gradually declines, and the consequences of infectious diseases such as influenza, pneumococcal disease, and shingles are more severe in the elderly, which can exacerbate existing underlying diseases, leading to higher medical costs. In the process of achieving healthy aging, it is very necessary to protect vulnerable elderly people through vaccination. Despite the undeniable protective effects of the influenza, pneumococcal, and shingles vaccines for the elderly, coupled with excellent safety and significant health economic benefits, the current vaccination rates for these vaccines among the elderly in China remain low. Some factors, such as insufficient awareness of the necessity of vaccination, concerns about vaccine adverse reactions, lack of systematic and effective recommendations, and imperfect accessibility of vaccination services, affect the popularization of preventive vaccination among the elderly in China. This situation urgently calls for the attention of society as a whole, in order to maximize the role of vaccines in safeguarding the health of the elderly.

Criminal Law Mechanisms for Ensuring the Safety of the Older Adults

The paper analyzes the current state and features of the implementation of the mechanism for ensuring the safety of the older adults by the means of criminal law. The purpose of the study is to develop theoretical provisions aimed at improving the institution of criminal law protection of the rights of the older adults. The paper draws attention to the causes of the public danger of crimes against this social group, as well as the problems of legislative consolidation and practical implementation of this institution at the present stage. Methodologically, the study is based on the dialectical method of cognition, as well as a set of general scientific (analysis, synthesis, induction, abstraction), private scientific (statistical) and special legal (formal legal, method of interpretation of legal norms, historical and legal) methods. The author concludes that the level of public danger of crimes committed against the older adults cannot be determined unambiguously due to the individual characteristics of the victims. Qualifying a criminal act against an older adult person is considered fair in connection with the indication of the signs of «helpless» or «defenseless» state, which determines that there is no need to change the criminal law. Taking into account the ambiguity of judicial practice, the author defines criteria that contribute to the substantiation of the presented features in order to differentiate criminal liability for crimes against vulnerable elderly people.

Self-Perception of Mental Health and Exacerbated Social Inequalities Among Vulnerable Older Adults During the COVID-19 Pandemic in Brazil (2021-2023).

This study analyzes the self-perception of mental health of socially vulnerable elderly people during the COVID-19 crisis in Brazil. Conducted across all state capitals from February 2021 to October 2023, it included 366 participants living in various conditions such as camps, street situations, slums, and communities. The average age was 66.7 years, with a majority being male (59.0%), of Black or Brown race/color (62.3%), and earning below one minimum wage (36.6%). Findings revealed that older adults in street situations, experiencing psychological manifestations like sleep disturbances due to the pandemic, tended to assess their mental health more negatively. In contrast, older men of white race/color without such manifestations, and those practicing strategies like physical activity or relaxation, were less likely to perceive their mental health as poor. Addressing housing, implementing health strategies, and recognizing sample and regional complexities are crucial interventions for older adults in street situations.

Exercise at home program “DomiGym” contributes to the prevention of falls in vulnera-ble elderly people

Background Eighty-eight thousand fall accidents occur each year in Switzerland among people aged 65 and over, which cause a lot of personal suffering and economic costs Beratungsstelle für Unfallverhütung BFU, 2019). The exercise at home program “DomiGym - Bewegungsangebot zu Hause” (in short: DomiGym) of Pro Senectute Switzerland aims to maintain mobility, counteract the risk of falls and promote social contacts as well as social participation and psychosocial health. Vulnerable, elderly people enjoy with DomiGym an adapted, regular training program focused on strength and balance, in their own homes or in their neighborhoods. Methodology The implementation and effects of the DomiGym offers in the cantons of Zug and Zurich were evaluated using various methodological approaches: tests of strength (Chair-Stand-Test; Mehmet et al., 2019), of balance (Modified Romberg; Agrawa et al., 2011) and of functional mobility (Timed-Up-and-Go-Test; Marks, 2016) as well as written surveys of participants (based on standardized scales used in the Swiss Health Survey). Results On average participants reduced fall risk and improved functional mobility and leg strength (p < 0.05). In a subsample of the canton of Zug, the Timed-Up-and-Go-Test (functional mobility and fall risk) improved by an average of 2.3 seconds (p < 0.005) and the balance test (Romberg) improved by 1.8 seconds (p = 0.005). Over the course of a training series the reduction in fall risk proved clinically relevant in both cantons. Scores on the Timed-Up-and-Go-Test fell on average below the threshold of 13.5 seconds discriminating between fallers and non-fallers. Chair-stand test: Participants improved on average from an initial very high fall risk to an increased fall risk (below 15 seconds). In fact the subsample of canton Zug improved by an average of 3.96 seconds (clinically relevant with regard to the reduction of falls) and the subsample of canton Zurich improved by an average of 2.17 seconds (approximately clinically relevant; threshold value 2.3 seconds; Meretta et al., 2006). DomiGym improved the general health (67%) of most participants and either maintained the original walking level (80%) or even improved it (15%). The majority of DomiGym participants do gymnastic exercises at least weekly outside of DomiGym training. DomiGym participants positively change their movement behavior in everyday life. Conclusions Pro Senectute’s DomiGym reaches older people who cannot or do not want to attend out-of-home physical activity programs. The implementation of DomiGym improves the physical functions of leg strength, functional mobility, and balance, as well as the risk of falls in vulnerable elderly people. It can be assumed that DomiGym reduces the frequency of falls in the long term, contributes to the preservation of mobility and independence in everyday life, including a longer stay in their own homes.

It is a relay not a sprint! Evolving co-design in a digital and virtual environment: neighbourhood services for elders

There is an emerging body of research on the co-design of public services, including co-design with vulnerable adults. However, what has been less explored has been the impact of digital technology and virtual environments upon the co-design process in this context. This paper analyses the contingencies of virtual co-design through a case study of a project to develop supportive local communities for vulnerable elderly people. This project was initially planned to use traditional co-design methods within a face-to-face environment, in the context of the local public service ecosystem. The CoVid-19 pandemic made this impossible. Consequently, an innovative approach to co-design was developed that shifted the process from a face-to-face to a virtual environment. This exploratory paper reports and evaluates this approach and its implications for the future of the theory and practice of the co-design of public services for vulnerable adults. Theoretically the paper evolves a model of co-design in a virtual space that is embedded within a public service ecosystem framework of value creation. At a practice level, the paper provides insight into the strategic and operational management of co-creation in a virtual space. It evolves the ‘Relay’ model of asynchronous co-creation across time and considers it key contingencies.

A year-assessment of the suitability of a green façade to improve thermal performance of an affordable housing

The urban green infrastructure has been increasingly used for sustainable design and resilient cities. Despite its many benefits, such as aesthetic enhancement, improvement of the physical and mental health of residents, especially for vulnerable youth and elderly people, or creating opportunities for social cohesion and climate regulation, green infrastructure has not been used in low-income housing in subtropical Brazil, where the temperature can reach over 40 °C along the summer. This study evaluated a full-scale, low-cost green façade over a year to assess its effect on the thermal performance of an eco-friendly affordable housing located in humid subtropical climate. Aiming to be eco-friendly and keep its cost low, the house was built with materials such as unplastered hollow soil-cement bricks, not having very good thermal performance. The Wisteria floribunda, a deciduous vine, was used in the green façade installed on a west-facing wall, adjacent to a bare wall, which was also evaluated enabling to establish the thermal difference between the shaded wall and the bare wall. In the winter, the shaded and bare walls' amplitudes were remarkably close, due to leaf shedding, a desirable feature to improve temperatures within the house. The benefits of the green façade were clearer during spring and summer when the external surface temperature of the shaded wall was reduced by up to 9 °C compared to the bare wall, and its thermal amplitude varied by 8.4 °C, while the amplitude of the bare wall was more than double this value. The plant layer diminished the heat flux through the external wall by up to 22.3 W/m2 during the summer, and 8 W/m2 during the winter. These results show the potential of a low-cost green façade to improve the thermal comfort of green affordable housing projects.

Measuring the discomfort of energy vulnerable elderly people. Recommendations for solutions

Energy poverty remains today one of the most important problems for a truly just urban energy transition. In addition, older people living alone are one of the main target groups of this problem. In this research, 525 households have been monitored of which 155 were potentially in fuel poverty in the city of Valencia, Spain. In the latter, the presence in the dwelling, temperature and humidity were monitored throughout the year. We reviewed the literature and compared different comfort standards with the data collected. None of the 155 dwellings meet the comfort requirements on a regular basis. That is, their inhabitants are too often at risk to their health because of low or high temperatures and humidity. A survey was conducted to find the causes of the vulnerability of these families and to quantify their importance. In addition to the expected causes: low income, high energy prices and poor housing quality, we found elements related to habits, low energy literacy, the digital divide and others. Our findings can inform policy development for an inclusive urban energy transition that does not leave behind older people living alone.

Elderly People's Perceptions of Heat Stress and Adaptation to Heat: An Interview Study.

Objectives: Heatwaves are having a disproportionate impact on the elderly population, as demonstrated by pronounced mortality and morbidity. The present study aimed to explore elders’ subjective experiences of heat impacts and adaptive strategies. Methods: Semi-structured interviews with 19 elderly Swedes were conducted, focusing on their experiences of the extremely hot summer of 2018. Results: Most informants suffered during the heatwave, although some found it pleasant. The readiness to implement adaptive measures was generally high among the healthiest, who were able to avoid excessive heat and adjust their daily routines. In contrast, those highly dependent on care from others had limited options for avoiding the heat, and little capacity to take up adaptive measures. Discussion: With heat becoming an increasing problem, it is important to adjust elderly care so that the most vulnerable elderly people can avoid excessive heat exposure.

Assessing sexual consent capacity in cognitively impaired older adults: What place and tools for the psychologist?

Résumé Les capacités décisionnelles des personnes âgées présentant une démence comptent parmi les problématiques sociétales et éthiques les plus importantes dans le champ du vieillissement. La question est particulièrement épineuse lorsqu'il s'agit d'aborder la capacité de consentement sexuel chez ces personnes. En effet, des travaux montrent que les personnes âgées institutionnalisées (atteintes ou non de démences) conservent des intérêts et besoins sexuels similaires à ceux des personnes âgées vivant à domicile. Néanmoins, les personnes âgées cognitivement ou physiquement vulnérables constituent également un groupe à risque d'agressions et/ou de victimisation sexuelles, en particulier celles atteintes de démence sévère. Cet article s'intéresse à la place du psychologue et à la démarche qu'il peut développer pour évaluer la capacité de consentement sexuel chez le sujet âgé présentant une vulnérabilité cognitive. Abstract Decision-making capacities of older people with cognitive disorders are among the most important societal and ethical issues in the field of aging. The question is particularly thorny when it comes to addressing the issue of sexual consent capacity among these people. Indeed, research shows that institutionalized elderly people (with or without dementia) maintains sexual interests and needs similar to those of elderly people living at home. Nevertheless, cognitively or physically vulnerable elderly people also constitute a group at risk of sexual assault and/or victimization, and especially with people with severe dementia. This article examines the place of the psychologist and the approach he can develop to assess the capacity of sexual consent in the elderly subject with cognitive vulnerability. Following the recommendations of the American Bar Association/American Psychological Association for the assessment of capacity in older adults with diminished capacity, we make some propositions to assess psychological and neuropsychological functions implicated in sexual consent.

Vulnerability and quality of life of older persons in the community in different situations of family care.

to correlate socio-contextual aspects, physical vulnerability and quality of life of older persons in the community in different situations of family care. epidemiological, a cross-sectional and analytical study, with elderly people in the community (n=769), with application of the instruments: Vulnerable Elders Survey-13 (VES-13), World Health Organization Quality of Life for Older Persons (WHOQOL-OLD) and the World Health Organization Quality of Life (WHOQOL-BREF); and socio-contextual data questionnaire. the population assessed presented an average of regular quality of life in both the WHOQOL-BREF and the WHOQOL-OLD. Older non-vulnerable persons (62.2%) and those with close family contact (82.6%) have a better quality of life than the vulnerable (p<0.0001). lower quality of life scores and more distant families are related to vulnerable elderly people; thus, the assessment of family proximity and physical vulnerability of older persons is shown to be an important factor in improving quality of life.

Literature Review on the Establishment of a Community Care System: For some Vulnerable Groups in Busan

Objectives: This study presented a community care model for the vulnerable(elderly people with dementia, mobility difficulties, and severe diseases). Methods: Comparison with existing community care programs operated at home and abroad and literature review were used. Results: It is necessary to establish a community care model that complements manpower shortage and effectiveness. Conclusions: For the successful operation of community care, support for community-based integrated care services must be carried out as a project according to the strategic stage that must be promoted after active interest from local governments and related human infrastructure. In addition, the interest of local governments is the most important for the promotion of community care programs, and specific consultations should be prioritized on what is needed for project promotion.

Two Sides of the Same Coin: Fluid Intelligence and Crystallized Intelligence as Cognitive Reserve Predictors of Social Cognition and Executive Functions Among Vulnerable Elderly People.

The concept of cognitive reserve –CR– postulates two forms that prevent cognitive impairment: neural reserve and neural compensation. Both have been primarily linked to the protective role played by genetic factors, educational level, occupation or socioeconomic status. Though it is true that it has been related to executive functions, so far very little attention has been paid to its predictive capacity with other variables more related to social cognition and psychosocial adaptation. Considering socially vulnerable contexts with reduced cultural capital and educational levels, the neural reserve function would be the most relevant and best predictor of aspects related to social cognition and executive functions. We suggest that variables such as fluid and crystallized intelligence influence social cognition and executive functions. This study included a sample of 27 participants over 60 years old from varied contexts of social vulnerability. The procedure included data collection using various cognitive measures. Results show that elderly people with high intelligence—mainly fluid intelligence—have better executive functions, emotional recognition and theory of mind. These results focus on cognitive reserve and its importance because they show that elderly people in vulnerable contexts who strengthen these aspects protect themselves against the deterioration of cognitive skills. This study is the first preliminary research to present a relationship between cognitive reserve and social cognition factors in elderly subjects. Fluid intelligence functions as a highly related factor to protect the performance of executive functions, along with other social-cognitive factors relevant to facilitating the conditions of social adaptation.

219 The role of Neutrophil Extracellular Traps in chronic wound healing

Chronic wound healing is a common disease, striking mostly vulnerable population, elderly people and people with diabetes. In chronic wounds, neutrophils together with macrophages set inadequate inflammation and sustain it. The involvement of Neutrophil extracellular traps (NETs) in this mechanism is not fully understood. Thus, the aim of the study to reveal neutrophil and NETs role in wound healing, which signal to macrophages and regulate further fate of inflammation resolution. We used the full thickness wound healing model in wildtype and diabetic mice to analyse spatiotemporal structure.

The Social Policy Response to COVID-19 \u2013 The Failure to Help Vulnerable Children and Elderly People

Norway’s handling of COVID-19 has been seen as a success. Vulnerable groups among young and elderly people, have however, not been part of this success. Their interests have been defocused in two ways. First, they have not been prioritized in the big picture, because the precautionary principle and health concerns, in particular the capacity questions, have dominated. Second, the more specific social policy measures have been indirect and not particular targeted vulnerable children, youths and old people, and had negative effects for them, such as social isolation and lack of daily support and services, resulting in increasing problems.

Polarized nature of the COVID-19 pandemic in Japan: associations with population age structure and behaviours

BackgroundAlthough the scale of the coronavirus disease (COVID-19) pandemic was relatively small in Japan compared with the rest of the world, the polarisation of areas into high- and low-COVID-19-incidence areas was observed among the 47 prefectures. The aims of this study were not only identifying the factors associated with the polarised COVID-19 pandemic in Japan but also discussing effective preventive measures.MethodsThis was an ecological study using online survey data which was cross-sectionally conducted by the author. A total of 6000 respondents who resided in 10 low- and 10 high-COVID-19 incidence prefectures, with a wide gap in terms of COVID-19 incidence, in Japan were recruited. Data on COVID-19 cases and geodemographic information were obtained from official government sites. Statistical analyses were conducted to compare variables between the two areas and age groups.ResultsThis study revealed that that age influenced people’s behaviours and perceptions, except one behaviour of ‘wearing facemasks’. The major factors significantly associated with the cumulative number of COVID-19 cases per 100,000 people were ‘commuting by private automobile’ (adjusted odds ratio [AOR], 0.444; 95% confidence interval [CI], 0.394–0.501), ‘commuting by public transportation’ (AOR, 6.813; 95% CI, 5.567–8.336), ‘washing hands’ (AOR, 1.233; 95% CI, 1.005–1.511), ‘opening windows regularly’ (AOR, 1.248; 95% CI, 1.104–1.412), ‘avoiding crowded places (AOR, 0.757; 95% CI, 0.641–0.893), ‘non-scheduled visits to drinking places’ (AOR, 1.212; 95% CI, 1.054–1.392) and ‘perceived risk of contracting COVID-19’ (AOR, 1.380; 95% CI, 1.180–1.612). These factors were strongly associated with age groups.ConclusionsEffective preventive measures for COVID-19 transmission can be developed by understanding the characteristics of populated areas, such as public transportation infrastructure and younger people’s movements and behaviours in relation to the population age structure to contain the current epidemic and protect the most vulnerable elderly people.

Vulnerabilidade e fatores de risco associados para Covid-19 em idosos institucionalizados

Objetivo: Identificar a associação de fatores de risco para COVID-19 com a vulnerabilidade em pessoas idosas residentes em instituições de longa permanência. Métodos: Trata-se de um estudo descritivo, exploratório, com abordagem quantitativa, realizado em oito Instituições de Longa Permanência para Idosos (ILPI) na região metropolitana de Natal, Rio Grande do Norte, Brasil. Foram incluídos idosos com idade igual ou superior a 60 anos, que estivessem presentes na instituição durante a coleta das informações. Na obtenção dos dados foi utilizado o protocolo de identificação do idoso vulnerável inserido na Caderneta de Saúde da Pessoa Idosa. Para análise utilizou-se o software SPSS versão 21.0 e aplicados testes Qui-quadrado de Pearson e Razão de Chance. Resultados: Verificou-se que houve associação do número de itens de vulnerabilidade (até 3 itens) nos idosos que apresentaram até 3 fatores de risco para COVID-19 (p=0,008), com razão de chance de 2,2. Conclusão: A predominância de fatores de risco para COVID-19 indica maior vulnerabilidade à evolução da forma grave da COVID-19, associada ao maior risco de mortalidade, o que evidencia necessidade do monitoramento da saúde dos idosos.

EMERGENCE OF SECOND WAVE OF SARS-COV-2 INFECTIONS DURING THE ONGOING COVID-19 PANDEMIC: A MINI REVIEW

The COVID-19 outbreak originated from Wuhan, China has spread over the world, causing a “Global Pandemic”. We analyzed daily confirmed cases and deaths from different countries to understand the progression of the ongoing pandemic in different parts around the world. The data indicated that the pandemic is in different stages in different countries, where they are either at the end of the second wave or middle or early phase of it or still in the middle of the first wave of infection, and they can be divided into four groups. Type 1 countries such as UK, France, Spain, and the Netherlands are currently witnessing the second wave of infection with an exponential increase in daily cases. Countries such as Australia, United States, Japan, and Poland are currently in the declining stage of second-wave, grouped as Type 2 countries. Type 3 countries such as Germany, Italy, Belgium, and Russia are recently seeing the second wave with slowly rising of confirmed cases. Type 4 countries including India, Brazil, Argentina, and Mexico are currently fighting against the first wave of COVID-19. These countries have a chance to learn from the countries which have overcome the second wave successfully. To be ahead of the epidemic curve and preventing it, countries need to make future plans on family, hospital, and community levels. Isolation of the highly vulnerable elderly people and young children, preventing social or public gathering, following the guidelines of COVID-19 prevention including wearing face masks regularly can save countries from devastating effects of the second wave of pandemic COVID-19.

A bi-objective optimization framework for designing an efficient fuel supply chain network in post-earthquakes

Earthquakes are the most sudden and unpredictable natural disaster which can cause serious damages in terms of deaths, injuries, and property loss. When an earthquake occurs, it is very important to respond immediately to peoples’ emergency needs through proper distribution of critical resources such as medical care, water, food, shelters, etc. Fuel is also one of the most critical needs which must be provided without delay to the population affected by the earthquake, especially the vulnerable children and elderly people. This paper develops a nonlinear bi-objective optimization framework for operating an efficient and effective fuel supply chain network in earthquake-hit areas. The objective functions include minimizing the penalties due to unsatisfied and/or lost fuel demands and minimizing the difference between the satisfied demands in different damaged areas. Some assumptions and constraints, such as the existence of multiple central depots, limited vehicle capacities, time available to respond to the incident, are also considered in the modeling. Two multi-objective evolutionary algorithms (MOEAs), including a non-dominated sorting genetic algorithm (NSGA-II) and a multi-objective particle swarm optimization (MOPSO), are proposed to solve the optimization problem. Since the performance of these algorithms is significantly dependent on their parameters, a Taguchi method is used to tune the algorithms’ parameters. In addition, four performance metrics are defined to evaluate and compare the performance of the algorithms. A hypothetical earthquake with actual dimensions and realistic data in Yazd province of Iran is presented as a case study, and finally, helpful managerial insights are provided through conducting a sensitivity analysis.

Empirically based spatial projections of US population age structure consistent with the shared socioeconomic pathways

Spatially-explicit population projections by age are increasingly needed for understanding bilateral human–environment interactions. Conventional demographic methods for projecting age structure experience substantial challenges at small spatial scales. In search of a potentially better-performing alternative, we develop an empirically based spatial model of population age structure and test its application in projecting US population age structure over the 21st century under various socioeconomic scenarios (SSPs). The model draws on 40 years of historical data explaining changes in spatial age distribution at the county level. It demonstrates that a very good model fit is achievable even with parsimonious data input, and distinguishes itself from existing methods as a promising approach to spatial age structure modeling at the global level where data availability is often limited. Results suggest that wide variations in the spatial pattern of county-level age structure are plausible, with the possibility of substantial aging clustered in particular parts of the country. Aging is experienced most prominently in thinly populated counties in the Midwest and the Rocky Mountains, while cities and surrounding counties, particularly in California, as well as the southern parts of New England and the Mid-Atlantic region, maintain a younger population age structure with a lower proportion in the most vulnerable 70+ age group. The urban concentration of younger people, as well as the absolute number of vulnerable elderly people can vary strongly by SSP.

Recognizing elderly women with sleep problems and falls from information on comorbidites and medications in a continuous use

Geriatric syndromes represent new, comprehensive concepts, which can help identifying vulnerable elderly people with multimorbidity. There is also a problem in using the result in a general practice working environment. We suggest fast audit as a method for conducting research on a small scale. The aim of this study was to find out the specific characteristics that can be used for a fast recognition of elderly women who have sleep problems and are susceptible to falls. We conducted a survey on a sample of 105 elderly women (age range 60-80 years, average 68.7±5.1 SD), in a general practice setting, in the town of Osijek, eastern Croatia. The sleep disturbance was identified using the standard Pittsburgh Sleep Quality Index, while information on falls were taken from electronic health records (eHRs) and patient interviews. We used a multi-item questionnaire for socio-demographic characteristics and lifestyle habits. EHRs were used to diagnose problems associated with sleep disturbances and falls, as well as for the use of medication that affect mental functions. We found out that 74.2% of examined women had sleep problems, and 25.7% of them experienced falls in the past two years. Diagnoses that distinguished women with and those without sleep problems included dyspepsia and urinary tract infections (50% vs. 23.1%). Women with sleep problems, compared to those without them, more commonly used two or more medications, usually antidepressants, analgesics and anxiolytics. Lower back pain and osteoporosis were used as screening tools for women susceptible to falls, compared to women without reports of falling. (81.5% vs 61.5% and 22.2% vs. 5.1%). Women with falls had a higher degree of overlapping with sleep disorders (81.5%). Anxiolytics application could be a link between sleep disorders and falls (the overlapping ratio 68%).