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It has been found that people with disabilities remain at the margin as far as the different aspects of their lives are concerned. This paper tests the hypothesis that disability leads to lower quality of life among older adults in low and middle-income countries. The data from the Study on Global Ageing and Adult Health (SAGE) was used in this study which was conducted in Ghana, China, India, Russia, South Africa and Mexico. The disability scores have been made utilising Item Response Theory, Partial Credit Model and are centered on eight functioning and health areas. Bivariate analysis, binary logistic regression and pooled regression analysis have been used to fulfil the objectives of the paper. The findings reveal that disability acts as a hindrance in attaining a high quality of life (HQOL) amongst the older adults in the above mentioned low and middle-income countries. The older adults with disability are as much as 60% less likely to enjoy an HQOL with respect to the older adults without disability. Better socio-economic development like improved health care for disabled older adults with disability enhanced living standards for both abled and disabled, efficient pension schemes for older adults with disability and effective social service schemes would be very much essential to improve overall QOL among older adults. [ABSTRACT FROM AUTHOR]

Outdoor thermal comfort (OTC) has considerable impacts on the health and life of different groups of people. Older people are one of the most vulnerable groups to climate-related diseases. Heat-related deaths are likely to increase due to an increasing proportion of adults aged 65 and over in the total population. Reviewing literature shows that very few studies have investigated OTC for older people compared to indoor environments. This paper aims to present a comprehensive literature review of the recent literature that discusses differences in OTC sensations and preferences between older people and other age groups. Also, this research reviews effective parameters that should be considered during the planning of outdoor places. These parameters are mainly categorized into two groups of environment-and human-based parameters. Existing comfort models are not fully developed to consider the effects of both environment and human-based parameters for OTC assessment for older people. It is important that the ageing aspects of the OTC being taken into account to shed light on the complex factors of OTC studies. Therefore, holistic agendas and comprehensive masterplans can facilitate communication between policy-making entities, scientific institutions, and urban planners to present healthier urban development for the elderly. [ABSTRACT FROM AUTHOR]

Retirement is a psycho social process. It refers to the phase of life when a person leaves his job and withdraws from active working life. Proper optimization of retirement is only possible when a person has pre planned his life with proper finances and saving or the government is providing him with a lot of social security benefits. However, such conditions rarely occur as a person is preoccupied in his pre retirement phases. But proper optimization of retirement can also take place when a person has high social intelligence which affects physical and mental health. Hence, this paper is an endeavor to look into the relevance of social intelligence which helps the people in their retirement process in the people. Thus, a survey was done to find the level of Social Intelligence in the people who are ageing and are going to be retired soon. Around 252 people between 55 to 70 years were studied from Delhi and NCR. The result indicated that middle aged and just retired people had high social intelligence as compared to older adults and the former were also able to optimize their retirement effectively for successful ageing. The older adults were not able to cope up with the various issues of retirement due to low social intelligence. Hence, further studies can be carried out to design proper training for enhancement of social intelligence in aged people for their effective optimization of retirement. [ABSTRACT FROM AUTHOR]

Studies on the association between population ageing and health spending are inconclusive. Though per capita health spending has a strong age gradient, evidence from the developed countries attributes increasing health expenditure to high spending in terminal year of life. In India, though studies have examined the level, trends and determinants of health care spending, no attempt has been made on association of population ageing and per capita health spending across the districts of India. The objective of this paper was to examine the spatial dependencies and heterogeneities of population ageing and per capita health spending across 640 districts of India. Data from the Census of India (2011) and the consumption expenditure rounds of the National Sample Survey Organisation (NSSO) (2009–10 and 2011–2012) were used in the analysis. Univariate and bivariate LISA analysis, ordinary least square regression, and spatial error model were used to decipher the spatial pattern of population ageing and health spending in the districts of India. Results suggest that per capita health expenditure is positively associated with the proportion of the older adults (aged 60 years and above) in the districts of India. Districts with less than 5% older adults have an annual per capita health expenditure of ₹629 compared to ₹2432 in districts with older adults 12% or more. Districts of India also exhibit large spatial heterogeneity in household health spending. Bivariate Moran's I statistic of proportion of older adults and per capita annual health expenditure was 0.48, suggesting spatially association of the share of the older adults and the per capita annual health expenditure in India. Results of the spatial error model confirmed that share of urban population, mean wealth score, and mean household size are significant predictors of per capita annual health expenditure in India. This study is important to monitor the progress of universal health coverage across the disadvantaged districts and to integrate age component in universal health coverage programmes. [ABSTRACT FROM AUTHOR]

Changing family structure from joint to nuclear posits a challenge among older people. Increasing prevalence of nuclear family promotes household headship among older adults but leaves them vulnerable as they have to live alone at older ages. Therefore, the study aims to estimate the trends and determine the factors associated with household headship among older adults from 1992-93 to 2015–16. The analysis of this paper is based on four rounds of the National Family Health Survey, which were conducted during the periods between 1992-93, 1998–99, 2005–06, and 2015–16, respectively. The study carried out bivariate and multivariate analysis to observe the association between outcome and independent variables. Results found that household headship among older adults had increased from 59.5% in 1992–93 to 67.8% in 2015–16. Further, the study found a rise in the proportion of nuclear families and household headship among older adults from 1992-93 to 2015–16. In older ages, household headship was more among older women than older men. The likelihood of household headship among older adults in a joint family is low as compared to household headship in a nuclear family. While the rise in household headship among older adults may be attributable to a variety of socio-economic influences, it has been noted that household headship among older adults has varied between men and women and by type of family structure. Moreover, there was a clear relationship between headship and wealth status of a household. [ABSTRACT FROM AUTHOR]

Working with people living with dementia in residential facilities for older adults can be challenging, and this is exacerbated when staff have a limited understanding of dementia. However, the relationship between knowledge of dementia and strain in caring for people with dementia among residential facility staff is unclear. This cross-sectional study investigated the relationship between dementia knowledge and strain in caring for people with dementia. A questionnaire containing the Dementia Knowledge Assessment and Strain in Dementia Care Scales was administered in 2017 and 2019 to 141 staff in three southern Australian residential facilities for older adults. Bivariate and hierarchical regression analysis examined inter-scale relationships and the power of dementia strain to explain knowledge variance. It was found that staff had substantial gaps in dementia knowledge (mean score 32/50) and low strain in dementia care (mean score 4/16). A positive relationship was found between higher dementia knowledge and greater strain in dementia care (rs = 0.319, p <.001), particularly with feeling that residents are not receiving appropriate care from colleagues (Factor 1 Frustrated Empathy; rs = 0.392, p <.001). Frustrated Empathy explained a significant amount of variance in dementia knowledge beyond demographic variables. The findings suggest that more comprehensive dementia knowledge is associated with higher strain in care of people with dementia, particularly in the context of perceived lapses in the quality of care provided by colleagues. Arguably, organisational-wide dementia education to address identified gaps should be supported by facilitating staff enaction of their knowledge to improve care. [ABSTRACT FROM AUTHOR]

India's traditional kinship behavior have undergone certain fundamental changes due to recent development and functioning of Indian society. Of all, the most dominant change is in the form of co-residence of children with their parents in old age. Without familial support, falling or no income and poor health, today, older adults are the most vulnerable population sub-group in the total population. Therefore, by using the India Human Development Survey-II, 2011-12 data we study the relevant association of living arrangement on health status of the older adults. Our results indicate that older adults living alone have significant and strong association with adverse health conditions such as Cataract, Hypertension, and Heart Disease. On the backdrop of health variations of older adults, it is understood that among other socio-economic conditions, living arrangement have serious implications on the health status of the older adults. Thus, we strongly support the notion that older adults with proper family care and support are more likely to be in a better health position as compared to those deprived of it. [ABSTRACT FROM AUTHOR]

Naturally occurring retirement communities (NORCs) are unplanned communities with a high proportion of residents aged 65 years and older. Oasis is a Canadian aging in place model that combines health and supportive community services for adults aged 65 years and older within NORCs. The aims of this study were to explore how physical distancing restrictions during the COVID-19 pandemic impacted older adults living in a NORC (Oasis members) and to investigate whether Oasis served as a context for social connection and well-being during the COVID-19 pandemic. An interpretive description methodology guided this study. Semi-structured interviews were conducted with nine Oasis members (aged 66–77 years) and two Oasis site coordinators. The Oasis members also completed a social network mapping activity guided by the hierarchical mapping technique. Three overarching themes related to the impact of physical distancing on Oasis members during the COVID-19 pandemic were identified: (1) unintended consequences of physical distancing restrictions on participants' wellbeing; (2) face-to-face interactions are important for social connection; and (3) family, friend, healthcare provider, and community support mitigated the impact of physical distancing restrictions during the COVID-19 pandemic. In addition, two of Oasis' core pillars were found to support participants: strengthening social connectivity and connection to pre-existing community services. Findings illustrate that community programs like Oasis acted as a source of resilience during the COVID-19 pandemic and advance our understanding of the impact of aging in place models on community dwelling older adults' experience of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The loss of family-based support services along with the preference of the older adults to age-in-place, have increased the importance of neighbourhood and community based support services for the older adults in India. This study first proposes a framework for identification of the neighbourhood-based support services, which are perceived by the older adults to contribute to their overall QoL, by understanding the concerns and perception of overall QoL of older adults living in Kolkata, India. The quality and type of available services also vary considerably based on the different classes of cities in India. This study, through analysis of data collected from structured interviews with older adults living in Kolkata and Midnapore in India, also proposes a framework that can help in exploring if living in different classes of cities impacts upon on the prioritisation of the support services by the older adults. In the process of identification of the support services, the initial list was first identified from literature and interviews with caregivers and beneficiaries of non-governmental organizations providing older adults care services, and the final list of support services were selected on the basis of researchers' judgement. The importance or prioritisation of support services was determined using RIDIT analysis. Considering the limitations of funds for social support services in a developing country like India, the proposed framework of identification and prioritisation can be utilised by future policy makers for formulation of policies and programs catering to essential support services, based on the class of city and the socio-economic and cultural background of the city residents. [ABSTRACT FROM AUTHOR]

Indian population is ageing at a higher pace coupled with the increase in life expectancy, and the prevalence of cognitive impairment, dementia, and comorbidities increase dramatically with age. Such cognitive and physical changes are intimately linked with declines in everyday functioning that include loss of decision-making skills. The present study explored the relationship between socioeconomic and health status of older adults and their role in household decision making. The study used data from the "Building a Knowledge Base of Population Ageing in India" (BKPAI) survey conducted in 2011 (n = 9181). Descriptive statistics along with multivariate negative binomial and binary logistic regression analyses were conducted. A proportion of 29.7% of older adults had no or partial involvement in household decision making and 26.5% of older adults reported that they had witnessed a decline in their role as decision-maker. The involvement of older adults in household decision making was 1.51 times lower among those who did not contribute money in household expenditure (incidence rate tatio (IRR):1.51; 95% confidence interval (CI): 1.24, 1.84) than those who contributed. Respondents who had low cognitive ability (IRR: 1.22; 95% CI: 1.09, 1.37) or had more than one disability (IRR: 1.27; 95%CI: 1.09, 1.47) were significantly 1.22 and 1.27 times less likely to have involvement in household decision making, respecctively. Older adults who reported low self-rated health (adjusted odds rati (aOR): 1.4; 95% CI: 1.21, 1.61), low general health (aOR: 2.85; 95% CI: 2.46, 3.31), low subjective wellbeing (aOR: 2.29; 95% CI: 1.99, 2.64) and low IADL (aOR: 1.49; 95% CI: 1.31, 1.69) were significantly more likely to report a decline in the role as a decision maker compared to their healthy counterparts. Along with the poor socioeconomic characteristics, the negative effects of cognitive and health markers of ageing further diminish the role of older adults in household decision making. Further research in the field of familial role and importance of older adults in different family settings is required in tackling a wide range of issues related to the wellbeing of the aged population. [ABSTRACT FROM AUTHOR]

To cross-culturally adapt and validate the original English version of the Short Falls Efficacy Scale-International (SFES-I) to the Igbo culture and environment. The study was a cross-cultural adaptation and validation study that employed the guidelines for cross-cultural adaptation by the American Academy of Orthopedic Surgeons. The SFES-I was translated, adapted and validated. The English (E-SFES-I) and Igbo (I-SFES-I) versions of the SFES-I, and the Modified Falls Efficacy Scale were administered to purposively recruited 109 consenting older adult residents (53.2% females; mean age = 73.75 ± 7.63 years) of Nnewi community, South-east Nigeria. Descriptive statistics and graphs were used to summarize participants' socio-demographic and questionnaire data. Mann Whitney-U test, Spearman rank order test, principal component analysis and Cronbach's alpha were used to analyze data at alpha level of 0.05. All the seven items on the E-SFES-I were retained on the I-SFES-I. There was no significant difference between the scores on the E-SFES-I and the I-SFES-I (p > 0.05). The I-SFES-I showed evidence of excellent known-group validity (ρ = 0.96–1.00) in all the item and total scores. The I-SFES-I also demonstrated excellent convergent validity (rho = 0.93) and internal consistency (α = 0.96). The I-SFES-I is a valid and reliable fear of falling tool, and can be used as an outcome measure for Igbo-speaking older adults. [ABSTRACT FROM AUTHOR]

High prevalence of uncontrolled blood pressure in older adults is a major health concern, and mostly results from poor medication adherence. The study assessed blood pressure profile and factors that influence medication adherence in older persons. Association of adherence factors with systolic and diastolic blood pressure was also determined. Cross-sectional and retrospective survey were conducted among 310 out-patients of ≥ 65 years of age in two hospitals. A pretested questionnaire measured medication adherence factors on a 5-point Likert scale. Data on last blood pressure and medications of study participants were retrospectively obtained from case notes. Descriptive analysis and Chi-square were performed using SPSS version 25. (P ≤ 0.05). A total of 300 patients participated in the study. The study noted slightly high mean systolic and diastolic blood pressure (147.65 ± 20.607 and 92.82 ± 15.137) among respondents, however, diastolic hypertension was prevalent 171 (57.0%). Average mean score for respondents' reported medication-related and attitude-related adherence factors were 2.40 ± 1.09 and 2.66 ± 1.24, respectively. Systolic and diastolic blood pressure were statistically significant with; number of pills (p = 0.008 and p = 0.003 respectively) and dosing regimen (p = 0.000 and p = 0.052, respectively). Systolic blood pressure was statistically significant with; frequency of dosing (p = 0.011), non-availability or scarcity of prescribed medicines (p = 0.027), pharmacists' attitude (p = 0.000), physician's attitude (p = 0.000) and phobia for medicines (p = 0.002). Forgetfulness was statistically associated with diastolic blood pressure (p = 0.011). Diastolic hypertension was prevalent, and several factors of adherence significantly influenced systolic and diastolic blood pressure in older adults. Improved medication counselling is required for maximum benefits in older persons. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the effects of exergaming and resistance training on reaction time in older adults and to investigate intraindividual variability in reaction time. Thirty-six participants (62.1 ± 7.1 years), randomly assigned to exergaming (n = 17) or resistance training (n = 19) groups, underwent two protocols of physical training carried out three times a week for 13 weeks. The exergaming program was based on games from Kinect Sports and Kinect Adventures collections using a console Xbox 360 Kinect. In the resistance-training program, each session consisted of ten full-body exercises using free weights and weight machines. Outcomes were reaction time in simple (finger-press test) and complex (Stroop test) tasks and intraindividual variability. A mixed model analysis of variance was conducted, and effects sizes were calculated. Interactions effects revealed no significant differences between groups before and after 13 weeks of training. Regarding the main effects, only the exergaming group showed a significant (p = 0.041) and relevant decrease in reaction time in a complex task (neutral test) when compared to the pre- (1854 ± 732 ms) and post-tests (1530 ± 521 ms). The resistance-training group showed a trend (relevant effect size) of improvement in intraindividual variability in reaction time. These results suggest that both interventions could benefit the cognitive function of older adults. Exergaming improves the reaction time in a complex task, and resistance training improves the intraindividual variability. However, exergaming was not superior to resistance training in any of the outcomes. Trial Registration: Brazilian Clinical Trials Registry (RBR-7fh22d/) on 06/07/2019, retrospectively registered. [ABSTRACT FROM AUTHOR]

Amidst a rapidly aging population, living alone is considered as a living arrangement with various disadvantages. The study aimed to assess the association between older adults living in one-person-households (OPH) and their socio-economic status along with associated inequalities. The data for the present study was utilized from National Family Health Survey, 2015–16 (n = 146, 657). Descriptive, bivariate along with multivariable analysis was used to fulfil the aim of the present study. For assessing socio-economic differentials in OPH, concentration index along with Wagstaff decomposition analysis was used. It was revealed that poor older adults had a higher proportion of OPH (12.7%) than older adults from the non-poor category (3.8%). The value of concentration index was -0.38 indicating the concentration of OPH among poor older adults. Manipur had the highest value of concentration index (-0.614). The highest percentage of poor OPH among older adults was in Kerala (30.7%) and whereas it was lowest among older adults in Bihar (5.9%). About 33.6% of socio-economic status related-inequality was explained by the marital status of older adults followed by older adults' place of residence (30.9%) and gender (29.3%). Older adults who are poor, women, never married, and living in rural areas need greater attention from both governmental and non-governmental organizations. In addition, policies should be designed by differentiating between older adults who live alone by choice and those who are forced by circumstances to map the vulnerabilities effectively. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the social factors affecting the frequency of going out, and social isolation related to the frequency of daily conversation, stratified by gender. Method: The participants comprised 1,016 community-dwelling older Japanese adults, who were categorized into four groups: those who are (1) not isolated socially and go out every day, (2) not isolated socially and do not go out every day, (3) socially isolated and go out every day, and (4) socially isolated and do not go out every day. We performed a logistic regression analysis to assess the relationship between the frequency of daily conversation and the four groups. Results: Our multivariable logistic regression analysis (reference, group 1) showed that the coexistence of poor social factors significantly affected men (group 2: odds ratio [OR] 2.13 [1.10 to 4.12]; group 3: OR 2.92 [1.70 to 5.00]; and group 4: OR 4.28 [2.43 to 7.54]). For women, the frequency of going out was related to daily conversation only with social isolation group (group 2: OR 1.51 [0.77 to 2.98]; group 3: OR 2.42 [1.25 to 4.68]; and group 4: OR 3.81 [2.08 to 7.00]). Conclusion: Our findings suggest that promoting daily conversations of community-dwelling older adults can help prevent related health adversities. [ABSTRACT FROM AUTHOR]

Physical frailty has been described as a complex geriatric syndrome. Independent of frailty, older people have been showing an increased health care services utilization. The objective is to assess an interaction effect between frailty and education on the association with the use of health services in community-dwelling older Brazilians. This is a cross-sectional study. The study was conducted with community-dwelling older Brazilian individuals. The sample had 5,473 older adults derived from the FIBRA Study. The definition of frailty was made using the physical frailty phenotype. The level of education was assessed by complete years of schooling. The use of health services was assessed by the occurrence of hospitalization, for individuals receiving home visits and having attended four or more medical consults in the past 12 months. The robust Poisson regression model with a robust error variance was used to estimate the prevalence ratio (PR) and its 95% confidence intervals to set the association between frailty and use of health services, considering the interaction between frailty and education in final model. Considering all sample, 16.4% were hospitalized, 14.1% received home visits, and 48.2% attended four or more medical consults. The interaction term between frailty and education was statistically significant only for hospitalization, showing a higher prevalence of health services utilization among pre-frail (PR1.68 95% CI 1.15–2.47) and frail (PR1.77 95% CI 1.08–2.90) older individuals with low education compared to non-frail highly educated peers. Low-educated and frail older people were more likely to be hospitalized and should be carefully looked after by health professionals. [ABSTRACT FROM AUTHOR]

Sarcopenia is one of the several syndromes that affect older adults individuals, being a growing area in the number of scientific productions. To compare the presence of sarcopenia among sedentary and active older adults, practitioners of different models of physical training. 115 individuals, aged 60 years or older, were evaluated for the presence of sarcopenia, according to the recommendations of the European Working Group on Sarcopenia in Older People. The subjects were divided into 3 groups: a group of 47 sedentary older adults (CON), a group with 30 older adults practicing physical training with emphasis on resistance (RES), and a group of 38 older adults practicing physical training with aerobic emphasis (AER). Individuals still responded to the Wide Geriatric Anamnesis. The prevalence of sarcopenia was lower in RES (p < 0.001). Of the sarcopenia indicators, the skeletal muscle mass was the only one that did not present significant difference. However, strength and performance showed a statistically significant difference in favor of the resistance group (p < 0.001 and p = 0.006, respectively). The total prevalence of sarcopenia was 37.4%, being 46.8% in CON, 6.6% in RES and 37.3% in AER. Resistance training is effective on the counterattack and control of sarcopenia among the subjects assessed, with no difference in the presence of sarcopenia among training practitioners with emphasis aerobic, or sedentary. [ABSTRACT FROM AUTHOR]

Life in a community is marked by a social fabric that gives meaning to one's life. Older adults shifting to institutional living face the problem of an abrupt change in their social environment, often paired with a loss of social identity that had been constructed within the social fabric. In many Asian countries, including India, a considerable number of older adults shift to institutions for reasons other than the need for medical support. Traditional research on older adults living in institutions focuses on the role loss and psychological discomforts of institutional living. The current study is a counter-narrative on how the social fabric of the institutions serve as a platform in which older adults form ties and relationships to construct a new meaningful identity. The research has employed a mixed methodology approach and a sequential exploratory design, sampling 62 older adults from two randomly selected institutions for seniors in Ernakulam, Kerala. The findings suggest that older adults experience a role loss and identity crisis during the initial transfer to institutions, which is gradually compensated to an extent through networking and identifying oneself as a member of the institutional family. In-degree centrality from fellow residents and out-degree centrality towards fellow residents and professionals in the institution significantly impact the 'Satisfaction with Life' of the respondents. The findings suggest that institutionalised older adults rely on reciprocal ties and relationships to rediscover their roles and identity, which in turn help them age successfully. [ABSTRACT FROM AUTHOR]

The article discusses on the aging population in Poland, where the percentage of older adults in the population is projected to reach over 40 percent by 2050. The study examines functional fitness, which is defined as the ability to perform normal everyday activities without undue fatigue, and its impact on the elderly population's independence. The research suggests that physical activity plays a crucial role in maintaining physical fitness.

The living arrangement is an essential social support mechanism affecting older adults' health and well-being. As the Indian family structure changes over time, India's older population needs detailed investigation for its well-being due to living arrangements. This study investigates the association between the change in living arrangements after reaching age 60 years with subjective well-being and psychological health among older adults in India. We used the survey data "Building Knowledge Base on Population Ageing" in India conducted in 2011. The effective sample size for the study was 9231 older adults. Descriptive and bivariate analysis was done to present sample distribution and unadjusted estimates, respectively. Ordered logistic regression analysis was performed to understand the association between the living arrangements of the older adults and their psychological health. The outcome variables were ordered as 0 "best", 1 "good", and 2 "worst". The results showed that older adults with a change in living arrangement after turning 60 years had a higher prevalence of poor psychological health (27.5%) and low subjective well-being (36%). It was found that older adults with change in living arrangement after turning old had 84% and 54% higher likelihood to report worst psychological health [AOR: 1.84; CI: 1.48–2.27] and worst subjective well-being [AOR: 1.54; CI: 1.22–1.93] compared to older adults who did not change their living arrangement after turning old. A change in old-age living arrangements is associated with older adults' psychological health and subjective well-being in India. Older adults with a change in living arrangements need special policy attention. [ABSTRACT FROM AUTHOR]

Population aging is particularly pronounced in Italy. Recently, home-care services emerged as one of the desirable strategy when dealing with such situations of fragility. In this framework, we present the evaluation of a home-care service which was experimentally implemented by Fondazione Sacra Famiglia and Casa di Cura Ambrosiana in the 2017–2018 biennium. The service consisted of a twice-weekly nursing visit intended to monitor patient health conditions and to gather data constantly supervised by a geriatrician. The eligible population consisted of the users of San Carlo Hospital Emergency Department (91 individuals). Twenty of these individuals had access to the experimental home-care service. The results show the smaller probability of mortality for the treatment group compared to the control group, but similar probabilities in admissions to ER and in hospitalizations. These findings suggest that health home-care policies could reduce mortality by lessening the negative effects of relational isolation. [ABSTRACT FROM AUTHOR]

A cross-sectional survey study was conducted to examine older adults hip surgery patients' post-surgery quality of life, and to study the causal relationships that directly and indirectly influence it. A total of 447 patients who met the inclusion criteria were recruited from eight tertiary care hospitals and four universities in Thailand' using convenience sampling. The results revealed that post-discharge quality of life in older adults patients following hip surgery was at a moderate level ( X ¯ = 79.40, SD = 12.41). The results of the final model fit well with the empirical data of all variables (X2 = 12.24, df = 15, p =.661, RMSEA =.000, GFI =.99, CFI = 1.00, X2/df =.816). The final model accounted for 16% of the total variance in QoL, 25% of the variance in self-management, and 3% of the variance in physical function recovery. Age, pain, comorbidity, family caregiver support and health service system factors had indirect effects on self-management through physical function recovery and quality of life. Self-management had a direct effect on physical function recovery. Comorbidities and health service system also had direct effects on quality of life. The findings suggest that appropriate health service system factors should be performed to help support self-management, including follow-up services with home or telephone visiting, in order to promote physical function recovery, particularly for female older adults hip surgery patients. This will improve patients' quality of life. [ABSTRACT FROM AUTHOR]

Adequate protein consumption in amount, food sources, and meals is important to maintain muscle mass and reduce the risk of sarcopenia in older adults. This study aimed to assess protein intake in terms of the amount consumed, food sources, and meals in a sample of 295 community-dwelling older adults in a city in southeastern Brazil. Protein intake was assessed in grams/day and the amount consumed per meal and food sources were calculated using the total value and relative contribution. Adequate protein consumption was considered 0.66 g/kg/day (Estimated Average Requirement-EAR) and amount per meal 25 g, as recommended by the PROT-AGE Study Group. Descriptive analysis was based on central trend and dispersion measures. Average protein intake was 67 g and 1.05 g/kg, with an 8.5% prevalence of inadequacy. The meal that provided the largest protein contribution was lunch and 98% of the group showed insufficient intake at breakfast. Concerning food sources, the greatest contribution came from the meat group (47.3%). The results indicated that median intake was at the lower end of the range recommended by PROT-AGE, with about 50% of subjects consuming less than 1.0 g/kg/day. Protein distribution among meals showed a high prevalence of adequate consumption, breakfast being the most critical meal. Strategies to optimize protein intake should consider the amount, quality, and distribution of protein consumed at meals that form part of a balanced healthy diet, in addition to dietary techniques and supplementation, to achieve maximum protein synthesis capacity. [ABSTRACT FROM AUTHOR]

The current study explores the interaction effect of adversities and self-efficacy at baseline on quality of life (QoL) at follow-up among middle-aged and older Chinese women. 531 women were interviewed in 2008 and 226 of them were re-interviewed a year later using Quality of Life Ladder (QoLL), General Self-Efficacy Scale (GSE), List of Threatening Experiences (LTE), Somatic Complaint Scale, and self-rated health. Respondents' mean age at baseline was 55.7 (SD = 4.7, range: 50–78). Over a year's time, respondents had a decline in quality of life and self-rated health (p <.001), experienced more life-threatening events (p <.05) and somatic complaints. The hierarchical multiple regression model, employed in the study, identifies three predictors of future quality of life after adding the interaction term 'Previous LTE × Previous GSE × Previous household income' — previous quality of life (β =.492, p <.001), previous LTE (β = -.292, p <.001), and the interaction term (β =.221, p <.05). This model explains 34.1% of the variance of future quality of life (Adjusted R2 =.341, p <.001). The findings suggests that respondents' good self-appraisal of coping resources could moderate the impact of adversities on their future quality of life. Interventions for promoting positive psychological growth among middle-aged and older adults should cover four domains, i.e. event-related factors, environmental factors, personal factors, and cognitive and coping responses. Traditional Chinese wisdom emphasizes the importance of understanding the bad ('Yin'—the shady side) and the good ('Yang'—the sunny side) aspect of life events. Future research may explore the Yin Yang perspective on life-threatening experiences and its applications in cross-cultural quality of life studies in the era of globalization. [ABSTRACT FROM AUTHOR]

Household age-sex composition in India is changing fast due to persistently declining fertility and improvement in life expectancy, rural–urban migration and change in family orientation. Under such circumstances healthcare of older adults is expected to be affected as they mostly depend on other household members. Keeping this in view the present study attempts to answer the question 'How does the change in household age-sex composition affect out of pocket healthcare expenditure of older adults in India?'. Household age-sex composition and healthcare expenditure for rounds of National Sample Survey Organaization (NSSO) conducted in 1993, 1999–00 and 2007–08 are used for the study. Considerable shift in the share of older adults over period of time is noticed and the change in household age-sex composition is found to have significant effect on healthcare expenditure of older adults. More specifically the share of consumption by older adults above 60 years has increased substantially over time with the increase in their composition. The study provides empirical evidence to support the need for public policies to respond to the growing challenges of the changing age structure of India's population. [ABSTRACT FROM AUTHOR]

The proportion of older adults are increasing at a much higher rate than ever expected in both developing and developed countries, and India is no exception. High health care expenditure is attributed to deteriorating health condition among older adult following disability in later life stages and also due to the presence of chronic diseases, and multi-morbidity among them as life expectancy has substantially increased in last few decades. Data for the analysis was used from the National Sample Survey Organization conducted during the 71st (2014) and 75th round (2017-18). Descriptive statistics, bivariate analysis, and linear regression were used for the study. It was found that mean OOPE for older adults was high if the household head was an older adult in case of both men and women. Older adults from higher socio-economic status incurred high OOPE. Moreover, older adults who were financially independent incurred high OOPE compared to those who were partially or fully economically dependent. More interestingly, financially independent women incur higher OOPE than financially independent men. In most states, it was observed that mean OOPE was high for men compared to women, which depicts clear gender differentials. The findings of this study are significant and provide new information on discrepancies between older men and women in health-care spending. Older men were found to have slightly higher health care costs relative to women in this nationally representative survey, after adjusting for confounding factors. [ABSTRACT FROM AUTHOR]

The practice of physical activity (PA) is an alternative to promote healthy aging. However, the index of physical inactivity of this population is high, being important to investigate factors that can influence this behavior. Thus, this study aimed to analyze associations between PA and sociodemographic, antropometric, functional and psychosocial factors, and to identify the most significant psychosocial predictors for the practice of PA in older adults. A quantitative cross-sectional study was performed with a random sample of 208 older adults (69.9 years ± 6.48 years and 55.3% men). Validated instruments were used to assess PA, functional capacity, self-efficacy, social support and perceived benefits and barriers for PA. There were significant associations between PA and education (r = 0.33), self-efficacy (r = 0.56), social support from friends (r = 0.58) and family (r = 0.25), perceived benefits (r = 0.52) and barriers (r = -0.45). Self-efficacy was the most significant psychosocial predictor for PA in older adults (β = 0.346), followed by perceived barriers (β = 0.152), social support from friends (β = 0.019), perceived benefits (β = 0.118) and social support from family (p = 0.019). This study suggests the importance of psychosocial aspects for the promotion of active aging. [ABSTRACT FROM AUTHOR]

As a result of increasingly senior populations worldwide, healthy ageing is becoming an important factor that can help reduce the burden of disease and disability and related healthcare costs. Previous research has shown that physical activity (PA) is crucial for healthier ageing and a better quality of life. This study sought to measure the PA and health-related quality of life (HRQoL) of people 55 years old or more. A sample of 202 senior adults completed a survey that comprised the EQ-5D-5L and other items assessing PA and activities of daily living (ADL) performance. Descriptive statistical analyses were carried out to characterise the sample and define its HRQoL. Non-parametric tests were used to compare the respondents' HRQoL according to sociodemographic variables and PA and ADL performance. The level of agreement between HRQoL and ADL scores was assessed using Spearman's rho. Sample subgroups were compared according to their age (i.e. nearly senior and senior) and sport and leisure time activities. Results show that HRQoL is lower for respondents with at least one diagnosed disease. Senior adults who take part in sport and leisure activities overall have a higher HRQoL, which is also impacted by the presence of at least one diagnosed disease and individuals' natural age-related issues. The results show the importance of preventing disease by helping senior adults engage in some level of PA given its impact on HRQoL. This research also confirmed that the EQ-5D-5L is a valid tool for measuring senior people's HRQoL. [ABSTRACT FROM AUTHOR]

The rate of strokes in Africa, particularly among lower socio-economic classes, is increasing. The impact on long-term, informal caregivers of stroke patients is not known, as most research has focused on acute and discharge care. This study reports on the findings from a study of in-depth qualitative interviews with 20 caregivers to family members with stroke diagnoses in Lomé, Togo. Findings show that social, structural, and relational forces greatly impact the lives of informal caregivers. This study offers an understanding of the caregivers' challenges through an intersectional framework which can be used to inform socio-economic, emotional, and health system supports for caregivers. [ABSTRACT FROM AUTHOR]

The outdoor environment offers an important platform for engaging older adults from a variety of social, cultural and ethnic orientations for the purpose of improving or maintaining their physical and mental health as well as facilitating their social and cultural connections. Using a multidisciplinary lens, this study looks at the requirements and potential of a more inclusive landscape design that acknowledges different modes of health, recovery and rehabilitation, drawing from both the past and the future and providing suggestions on how more efficient and culturally appropriate ways of maintaining health and social connectivity can be achieved in later life. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the effect of social determinants and socio-demographic factors on driving among older adults living in Tehran, Iran. This cross-sectional study was conducted on 1280 older adults in Tehran in 2020. The participants were randomly selected from people aged 60 years and above. Data were collected using a questionnaire. Multiple logistic regression was employed to estimate the effects of socio-demographic characteristics on driving status among older persons. Data analysis was performed by SPSS 23.0. The driving among older adults was found to be 33.3% while it was 70.6% among the older adults with a driver's license. There was a significant relationship between internet use, gender, health status, education level, loneliness and driving status (p < 0.05). The results also revealed that male participants (OR = 19.51, 95% CI: 13.10–29.06), those with good (AOR = 6.06, p < 0.001) or fair (AOR = 2.34, p < 0.051) health status, those with diploma degree (AOR = 2.46, p < 0.021), high education (AOR = 2.14, p < 0.033), internet users (AOR = 2.44, p < 0.001), and being married (AOR = 2.28, p < 0.001) were more likely to report driving. According to the results, driving was found to be low among older adults and gender gaps regarding car use are much wider in this group. On the other hand, there is a significant association between driving with well-being, loneliness, and internet use by older persons. Therefore, it is suggested that policies be designed and implemented to motivate them to drive. [ABSTRACT FROM AUTHOR]

Primary objective of the study was to assess health-related quality of life and associated factors (gender, age, education, income, marital status and expenses) that affect quality of life among senior citizens in Islamabad, Pakistan. A community-based cross-sectional study was designed to assess the health-related quality of life among senior citizens in the territory of Islamabad, Pakistan. Convenient sampling technique was used to collect the data from 385 participants. A pre-validated tool SF-36 was used to collect the data. Data was clean coded and analyzed by SPSS. The overall health-related quality of life score (55.79) was poor. Females had less quality-of-life score (50.84) as compared to males (59.74). Uneducated had a poor score (46.54) than educated (64.70). Age group (60-70 years) had a good quality of life score (60.07) as compared to the elder age groups (47.16). Married participants had a better quality of life score (57.67) than unmarried, divorced and widowed participants (53.58, 46.85, and 47.39 respectively). Participants with low monthly income showed low quality of life score (46.99) which was increased to (63.95) with an increment in monthly income. Participants who were financially independent had a better health-related quality of life score (59.44) as compared to those who were dependent on family (53.05) or government annuity (41.16). These findings suggested the requirement for effective health promotion strategies to improve overall health status among the elderly. The health systems needed to be aligned to meet the needs of older people. Retirement age should be extended to 65 year of age. [ABSTRACT FROM AUTHOR]

The Active Aging Index (AAI) is a tool for detecting and tracking active aging in the older population. The proportion of the aging population is growing very fast, from 6.4% in 2020 to around 20.0% in 2041, in Bangladesh. But the country does not have a calculated AAI to know its active aging situation or to make a global comparison. Objective: The objective of the study was to calculate and compare AAI for Bangladesh with a European AAI approach. Method: Secondary analysis was conducted based on the data from Bangladesh Bureau of Statistics (BBS), General Economic Division, Ministry of Planning, Department of Population Sciences, and the United Nations (UN) study to calculate the individual indicators of the four domains of AAI. Results: For Bangladesh, 15 out of 22 indicators of AAI were available from the analysis. The result of the study shows that the AAI value for Bangladesh is 30.1. Among the four domains of the AAI, the 'capacity and enabling environment' domain scored the best (59.9) and the participation domain scored the second highest (40.3). The score of the 'independent, healthy and secure living' domain was poor (28.2) and the score in the employment domain was very poor (3.3). Conclusion: Policy-makers should pay special attention immediately to improve each of the individual indicators of AAI for better active aging of the seniors. At the same time, policy-makers should focus on the immediate initiative for the generation of data for the missing 7 indicators for AAI. The study findings would be a basic reference case for Bangladesh to know the situation of active aging and what to do for the betterment of the upcoming huge number of seniors of the country and also possible to compare with other countries. [ABSTRACT FROM AUTHOR]

In Alzheimer's disease (AD), attention and executive dysfunction occur early in the disease. However, little is known about the relationship between these disorders and behavioral and psychological symptoms of dementia (BPSD). This study investigated the relationship between BPSD and attention and execution functions. Twenty-five patients with mild cognitive impairment (MCI) and early AD were included. Neuropsychological tests, mini-mental state examination (MMSE), Raven's colored progressive materials (RCPM), and trail making test (TMT) were conducted for patients with dementia. The dementia behavior disturbance scale (DBD) was used for psychological and behavioral evaluations of patients with dementia. The AD group showed significantly lower MMSE, DBD, and TMT-B scores than the MCI group. Multiple regression analyses revealed a significant correlation between DBD score, MMSE, and TMT-B.Conclusion: BPSD is associated with cognitive function severity in patients with MCI and early AD, suggesting that attentional and executive functions are independent risk factors for these neural substrates. [ABSTRACT FROM AUTHOR]

Older adults historically have been excluded from biomedical research, especially in low-and middle-income countries (LMICs). This study aims to assess the scientific production of older adults-related publications (OARPs) in Ecuador and uncover research gaps to inform health and aging policy. A Scopus search was performed to retrieve OARPs published from 2008 to 2018. Bibliometric indicators studied included the number of publications per year, study design, research focus, and research lines. A total of 121 OARPs were retrieved. Sixty-four articles (~ 53%) were excluded. Overall, the most common study designs were cross-sectional and case–control studies, 84.2% (n = 48) and 8.8% (n = 5), respectively. The primary research focus was in the clinical-surgical area (~ 51%), and the most prevalent research lines were in the epidemiology of older-related diseases (35%) and causes of older-related diseases (26.3%). Across the analyzed period, we were not able to find studies related with aging policy, and we found only one OARP dedicated to diagnosis/treatment and provision of geriatric services, respectively. Ecuadorian OARPs were scarce during the last decade, providing limited evidence to address health priorities of the local older population and to inform health policy making. Improving research on the older population would provide valuable inputs to key stakeholders to perform evidence-based policy development that ultimately will improve quality of life and long-term health outcomes in Ecuador and other LMICs. [ABSTRACT FROM AUTHOR]

The psychosocial model of social exclusion postulates that age identity of older persons induce and sustain perceived and enacted discrimination, resulting in psychosocial disability and social exclusion. These propositions were tested by using a cross-sectional survey of 573 older persons, aged 65 years and above. The variables were measured by standardized rating scales. The results reveal age identity significantly influenced perceived (β =.762; p <.001), enacted discrimination (β =.514; p <.001), psychosocial disability (β =.588; p <.001) and social exclusion (β =.389; p <.001). Perceived discrimination significantly increased enacted discrimination (β =.314; p <.001) and enacted discrimination influenced psychosocial disability (β =.279; p <.001) and psychosocial disability increased social exclusion (β =.090; p <.05). Perceived discrimination significantly mediated the negative effect of age identity on enacted discrimination (b =.211; p <.001), psychosocial disability (b =.219; p <.001) and social exclusion (b =.073; p <.05). The conceptual model showed good data model-fit, giving evidence to conclude that this model was useful in explaining process and outcomes of social exclusion of older persons. [ABSTRACT FROM AUTHOR]

The percentage of older persons in India is projected to rise to 11 percent of the total population by 2025 and to 19 percent by 2050. Available literature suggests that life satisfaction of older persons depends extensively on their social network. Young people in urban areas have a busy lifestyle and little time for older family members. The present study aims to explore the role of social networking and the support from these networks on life satisfaction of the older people in India. Primary data from 530 households were collected between November 2014 and March 2015. Descriptive statistics, chi square test and Berkman's theoretical model were partially used. Structural equation modelling (SEM) was applied to examine the association between the social network and life satisfaction, arbitrated by different types of social support. Different types of social network act differently on the perception of life satisfaction among the older person. Findings show that networks with family, neighbours, friends and close ones were significantly associated with life satisfaction of the older people in urban area. Support derived from different social networks is important for life satisfaction at later ages. Having a strong confidant social network is significant in promoting life satisfaction among older persons. The main characteristic of this network support is trust between the support provider and old people. [ABSTRACT FROM AUTHOR]

This study aimed at exploring the mediating role of oral health in the relationships between personality traits and psychosocial impact of dental aesthetics among the elderly. The sample included 119 older adults (Mage = 68.89 SD = 9.75, 51 males) who were assessed through a self-report measure evaluating personality traits, the self-perceived impact of oral health on well-being and quality of life, and the self-perceived impact of dental aesthetics on daily living. Descriptive statistics, bivariate correlations and path coefficients were computed. Findings showed the mediating role of self-perceived oral health, given the positive indirect effects of neuroticism on social and psychological impact and aesthetic concern, and the negative indirect effects of conscientiousness on social impact and aesthetic concern. The interrelationships between personality traits and oral health in predicting psychosocial impact of dental aesthetics in elderly underline the usefulness of a patient-centered approach that clinicians should adopt to improve a healthcare system. [ABSTRACT FROM AUTHOR]