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The products that we use in our living environment greatly assist us in maintaining health and independence as we age. Much research has been conducted on the physical ergonomic needs in product design for older people, overlooking an understanding of the 'softer' functionality that domestic products offer. Through an ethnographic case study of older peoples' cooking and heating product needs (N=40), this paper presents 1) a theoretical framework which supports the need for designers to consider social and emotional connections when designing domestic products for older people and 2) practical implications and requirements for future designers to consider when designing these products. In this paper, I encourage designers to consider the reflective and visceral connections domestic products hold and how products can both inhibit and increase social inclusion. [ABSTRACT FROM AUTHOR]

This paper extends our understanding of employment and gendered rural ageing by examining the latent benefits of paid work for mid-life women in rural Ireland. Existing social gerontology literature deals extensively with manifest financial reasons to work, consequences of gendered pay and pension inequalities, work-related health concerns and the negative impacts to an extended working life for women. However, there is much less focus on the latent non-financial positive contributions that work provides for the older woman, especially within a rural context. Findings from this study show how mid-life women, even if in lower-paid, precarious work or in poorer health may choose to continue working into older age. Paid work provides not only financial autonomy, but also temporal structure, life purpose, personal agency, social connectivity and a self-identity that most women are reluctant to relinquish to retirement. Meaningful work plays a critical role in the ageing experience of older rural women. A qualitative study of 25 women aged 45–65 in Connemara, Ireland was undertaken from a lifecourse perspective and analysed using constructivist grounded theory to allow rich, novel narrative to emerge. Narrative from seven, who best represent all participants, are utilised in this paper. Conclusions suggest that the latent benefits of paid work are at least as, if not more important than financial gain for rural mid-life women. [ABSTRACT FROM AUTHOR]

Major transitions in older people's lives can give rise to multifaceted forms of social exclusion, with subsequent impacts for later life health and well-being. With place now a central concept within policy on ageing and community care, there is the potential that it may offer new pathways to support older people undergoing these critical life transitions (CLTs). However, how policy and practice stakeholders working with and on behalf of these population groups understand, conceptualise and capitalise on the involvement of place in CLTs has not been investigated. This paper aims to address this deficit and explores the perspectives of key national and local actors on three CLTs-dementia, bereavement and forced migration-and their relationship with place and exclusion. The analysis involved 18 semi-structured interviews with stakeholders from policy, practice and advocacy spheres related to the CLTs and ageing in general. Interviews highlighted the differences across stakeholders in perceived exclusionary impacts, and the different degrees to which place is conceptualised in relation to these transitions. Findings illustrate the lack of a holistic policy approach to the needs of older people experiencing CLTs that impedes our capacity to truly harness place in supporting older people. The article concludes by arguing for a more nuanced reconstruction of place and its meanings in the context of CLTs., (© 2020 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)

There is emerging consensus that older opiate treatment patients have specific health and social care needs and also evidence of a particular stigma associated with opiate maintenance treatment. Yet, very little is known about the stigma experienced by individuals who have been interacting with methadone treatment services over a prolonged period. Conducted in Ireland and drawing on data from a qualitative study of 25 long-term clients of methadone treatment, this paper examines the stigma narratives of patients who are growing older as MMT patients. More than two-thirds were over the age of 40 and 16 had first accessed methadone treatment more than 20 years prior to taking part in the research. The findings reveal the omnipresence of stigma in participants' lives, which was experienced at institutional and public levels, leading many to attempt to conceal clinic attendance. Treatment-related stigma intersected strongly with the process of growing older on methadone; an ageing effect that was particularly apparent in participants' accounts of public and private shame. The disabling effects of multiple intersecting stigmas were perhaps most apparent in participants' narratives of internalized stigma, which uncovered private worlds characterized by isolation and seclusion. The findings presented reflect the marginal position of addiction treatment within the wider healthcare system in Ireland and a failure to normalize methadone treatment. [ABSTRACT FROM AUTHOR]

Background: The 2008 financial crisis exacerbated an already mounting workforce challenge faced by most health services in the western world, namely the recruitment and retention of qualified nurses. Aim: This paper examines two additional challenges of relevance to workforce planning in health care, an ageing nursing workforce and reliance upon migrant nurses to solve short‐term workforce issues. Methods: Using Ireland as a case exemplar of these issues, this paper argues that policy makers and service providers should seek not only to address the challenge of retaining trained newly qualified and younger nurses but also focus on supporting older nurses and migrant nurses to remain within the workforce. Findings: The findings of this paper highlight the need for workforce planners, policy makers and service providers to take account of an ageing nursing workforce and reliance on foreign‐trained nurses as a solution to short‐term planning difficulties. Conclusion: Failure to address this need is likely to lead to significant workforce difficulties for health services into the future and undermine current efforts to increase the number and long‐term retention of qualified nursing staff. Implications for Nursing Policy: Policy makers and service providers should focus on the retention of trained older nurses as an important element of workforce planning. [ABSTRACT FROM AUTHOR]

Drawing primarily upon data from the various censuses conducted in Ireland after the Act of Union in 1800, this paper seeks to elucidate the changing position of older people in Ireland during the Victorian period. Following the Great Famine of 1845–1849, it is argued, Ireland was transformed from a young, growing country to one that, by the end of the 19th century, had become ‘prematurely’ old. By the end of Victoria's reign, not only had Ireland grown ‘old’, but its older population were more likely to be identified as paupers. Later-life expectancy decreased and sickness and infirmity among the over-60 s increased. By employing a stricter form of ‘less eligibility’ in the drafting and implementation of the Irish Poor Law, proportionately more older people received indoor relief than outdoor relief compared with the rest of the British Isles. Not until the Old Age Pensions Act in 1908 did these disparities begin to change, by which time many of these ‘other’ Victorians had passed away. [ABSTRACT FROM PUBLISHER]

Aims and Objectives: This paper aims to explore how GMS drug costs depend on age, gender, income, health status, community drug scheme coverage rates and whether they display significant differences across regions of Ireland. We also aim to find out whether the GMS drug costs of high and low income cohorts respond similarly to changes in their health status. The paper projects GMS drug costs in 2026 and examines the separate cost of population ageing and population growth over the period. We also aim to simulate the estimated model to show how much giving free prescription drugs to all persons aged 'under 5' would add to 2026 GMS drug costs, and also how much giving universal GMS coverage to all persons in 2026 would add to 2026 GMS drug costs.Methods: We construct a multivariate logistic regression model of GMS community drug costs in Ireland. We progress the methodology used in earlier studies by explicitly modelling how regional incomes and regional health status interact in determining GMS drug costs in Ireland. An age cohort and region breakdown of the simulated GMS drug costs, of both projected demographic trends and public policy measures that have been adopted or are under consideration, are also investigated.Findings: We find that GMS drug costs depend on age-but not gender-on income, health status, community drug scheme coverage rates, and they are significantly lower for all age cohorts in Donegal and the North West region. The GMS drug costs of high income cohorts tend to increase as their health status improves, whereas they tend to decrease as the health status of low income cohorts improves. A uniform 1% gain in health status has little impact on total GMS prescribing costs. Similarly, if the health status of all Irish regions improved to match that of the East region in 2010 it would only have reduced public prescription costs by around 32 € million of the 1.8 € billion GMS drugs bill. We find that giving free prescription drugs to all persons aged 'under 5' in 2010 would have only a minor impact on 2010 GMS drug costs, whereas giving universal GMS coverage to all persons would have doubled public prescription costs from 1.8 € billion to circa 3.6 € billion. [ABSTRACT FROM AUTHOR]

Purpose -- This paper aims to explore, for the first time, community perceptions of the relationship between age and social exclusion in rural areas of the Republic of Ireland and Northern Ireland. Design/methodology/approach -- The paper builds on learning from a previous baseline cross-border rural ageing study and draws its methodology from a broader ecological multi-level approach. The research was conducted through focus groups with community stakeholders, which were undertaken in ten communities in different rural settings (village, near-urban, island, dispersed, and remote) in both the Republic of Ireland and Northern Ireland. Findings -- In total, four interconnecting thematic areas emerged as important in determining exclusion or inclusion for older people living in rural areas: place, economic circumstances, social provision, and social connectedness. Within these themes, various tipping points emerged as important for pathways into and out of exclusion, most notably local systems of social support and the mindset of older people themselves in relation to participation. Originality/value -- This research lays the foundations for understanding the lived experiences of older people on the island of Ireland and the pathways for their inclusion and exclusion in diverse rural areas, as seen through the lens of community stakeholders. [ABSTRACT FROM AUTHOR]

Background: Adults with an intellectual disability (ID) have much lower rates of employment than their counterparts without intellectual disability, which increases their risk of poverty and social exclusion. Differential treatment of people with intellectual disability in welfare and training policies suggests an expectation they will be passive welfare recipients rather than productive employees. Methods: This paper aims to examine occupational activities by older people with intellectual disability in Ireland, exploring factors influencing outcomes using data from the IDS‐TILDA study (n = 708). Results: Most people were unemployed but engaged in regular occupational activity. Occupational activity was associated with better emotional/mental health. Activities of Daily Living (ADL) functioning was associated with an active occupational status, while social supports most strongly predicted high occupational engagement across a range of activities. Conclusions: A focus on the individual meaning derived from a broad range of engagement may better support people with intellectual disabilities to benefit from regular occupational activity. [ABSTRACT FROM AUTHOR]

Background Frailty is a common, multi-factorial, age-related syndrome commonly observed in people with diabetes. Although older diabetics are prone to adverse healthcare outcomes and diabetes increases the risk of developing frailty, little is known about the effects of frailty on diabetes. This paper examines the association between diabetes, frailty, and mortality in Europeans aged ≥50 years. Methods Data were included from The Survey of Health, Ageing and Retirement in Europe (SHARE) waves one and six. A participant's first interview was taken as the baseline and subsequent waves were used for mortality follow-up (time and cause). Frailty and pre-frailty were measured using established cut-offs using the Physical Phenotype (SHARE-FI) and a 55-item Frailty Index (FI-55). Kaplan-Meier survival analysis was used to assess the relationship between frailty and mortality in people with diabetes and significance tested using log-rank test. Cox regression was used to adjust for potential confounders (age, sex, education, income, employment, alcohol use, smoking, hypertension, hypercholesterolaemia, myocardial infarction, stroke, metastatic cancer, chronic lung disease, polypharmacy, self-perceived health and depression). Results Data from 8,954 diabetics aged 50-99 years were included with 1,598 deaths (17.8%). According to the SHARE-FI, 1,971 (22.0%) were frail, 4,183 (46.7%) pre-frail and 2,800 (31.3%) robust. According to the Kaplan-Meier log-rank test survival varied significantly across frailty strata according to both indexes (p<0.001). At 10-year follow-up, adjusting for confounders SHARE-FI frailty and pre-frailty were significantly associated with mortality, adjusted Hazard Ratio (HR) 2.19, (95% CI:1.66-2.89), and 1.38 (95% CI:1.09-1.74), respectively. Results were similar using the FI-55, HR for frailty 1.66 (95% CI:1.09-2.54). Causes of mortality were significantly different according to frailty status (p<0.05). Conclusion Frailty and pre-frailty are independent risk factors for mortality in diabetics. The identification of frailty is important for the risk-stratification and management of middle aged and older patients with diabetes and should be included in the routine assessment of these high-risk individuals. [ABSTRACT FROM AUTHOR]

Background With the arrival of a super-ageing society, the use of technologies in social care is not only necessary but inevitable. However, there is a dearth of evidence to demonstrate how assistive technologies (AT) can improve standards of care while improving the working conditions of care professionals and care givers. Furthermore, little is known about users' perceptions of such technologies. The objectives of this paper are: first, to test the effects of an integrated AT system on users (both care recipients and staff) in a residential care home; and second, to understand their perceptions of such technologies. Methods We combined an infrared monitoring camera with communicative robots and a sheet-shaped body vibrometer. A 4-week pre/post intervention study was conducted, during which the evaluation was carried out before, during and after the intervention. Twenty care recipients (average age of 89.5) and 15 care professionals participated in the study. In order to measure the effectiveness of the integrated system, the care recipients' quality of life was examining using the interRAI method. Regarding the impact on professionals, stress levels were examined during night shifts. Perceptions towards use of the system were also explored by the system usability scale (SUS) and semi-structured interviews. Results After the system was introduced, the number of unnecessary visits by care professionals during the night was dramatically reduced (by 8.2 times per person on average), and staff's stress levels were also reduced. The SUS and interview data show mixed results in terms of the perceptions of care recipients and staff towards using the technologies. Conclusion Overall, the use of integrated assistive technologies yielded positive results. However, some issues were identified with regard to future implementation of such technologies in a residential care home. This study was financially supported in part by the Japanese Council of Senior Citizens Welfare Services. [ABSTRACT FROM AUTHOR]

Background Aimed to compare the prevalence, characteristics, and associated mortality risk of frailty in Northern Ireland (NI) and the Republic of Ireland (ROI). Methods Secondary analysis of the first wave of two nationally representative cohorts, the Northern Ireland Cohort for the Longitudinal Study of Ageing or NICOLA study (N  = 8504) and the Irish Longitudinal Study on Ageing or TILDA study (N  = 8504). Frailty was assessed using a harmonized accumulation deficits frailty index (FI) containing 30 items. FI scores classified individuals as non-frail (<0.10), pre-frail (0.10–0.24) and frail (≥0.25). Linkage to respective administrative data sources provided mortality information with a follow-up time of 8 years. Results The prevalence of frailty was considerably higher in NI compared with the ROI (29.0% compared with 15.0%), though pre-frailty was slightly lower (35.8% and 37.3%, respectively). Age, female sex, and lower socio-economic status were consistently associated with a higher likelihood of both pre-frailty and frailty. In the pooled analysis, both frailty and pre-frailty were higher in NI (RR = 2.68, 95% CIs 2.45, 2.94 and RR = 1.30, 95% CIs 1.21, 1.40, respectively). Frailty was associated with an increased mortality risk in both cohorts, even after full adjustment for all other characteristics, being marginally higher in TILDA than in NICOLA (HR = 2.43, 95% CIs 2.03, 2.91 vs. HR = 2.31, 95% CIs 1.90, 2.79). Conclusions Frailty is a major public health concern for both jurisdictions. Further research and monitoring are required to elucidate why there is a higher prevalence in NI and to identify factors in early life that may be driving these differences. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the relationship between the age-friendliness of local environments and self-reported loneliness for a representative sample of community-dwelling adults aged 55+ in Ireland. Design/methodology/approach: Data were from the Healthy and Positive Ageing Initiative Age friendly Cities and Counties Survey (n=10,540) (2016). Several age friendly indicators, as proposed by World Health Organisation, were included in this study: outdoor spaces and buildings; access to social services; social participation; respect and social inclusion; and transport. Loneliness was measured using five items from the UCLA Loneliness Scale. Informed by an ecological approach to ageing, multi-level negative binomial regression models were used to investigate the association between each age friendly indicator and social loneliness. Models were adjusted for known demographic, socio-economic and health correlates of loneliness. Findings: Average loneliness scores were significantly higher for those in poorer health, who lived alone, were materially deprived and those never or formerly married. Lower ratings and poorer outcomes for several interrelated age friendly place-based factors were significantly associated with higher loneliness scores: difficulty with transport, difficulty accessing social services, barriers to community activities, lower social engagement, and experiences and perceptions of ageism in the community; however, the effect sizes were small. Originality/value: This study identified several modifiable age friendly features of local environments that are associated with loneliness in this older population. The results of this study can inform coordinated local and national efforts to enhance the age-friendliness of local environments and reduce the risk and experience of loneliness among the ageing population in Ireland. [ABSTRACT FROM AUTHOR]

Abstract: Background: The UN Convention on the Rights of Persons with Disabilities (CRPD) provides the benchmark for assessing human rights and citizenship for people with disabilities. This emphasises autonomy, choice, independence, equality and participation for individuals as its fundamental guiding principles. Methods: This paper explores the exercise of human rights and citizenship for older adults with intellectual disabilities (ID) in Ireland, including choice‐making, advocacy and political participation. Cross‐sectional data (n = 701) is drawn from wave 2 of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing. Rates of participation are reported, along with bivariate associations across a range of demographic, personal and social variables, while factors associated with level of choice‐making and voting are explored. Results: We found very low rates of choice‐making, advocacy and political participation amongst this population. Two factors of choice were explored: key life choice and everyday choice. Some commonalities were identified between the two factors, yet key differences were also noted. Type of residence was the strongest predictor of key life choice yet not significant in everyday choice, while the reverse was true for functioning in activities of daily living. Other factors were also significant in determining choice, including level of ID, contact with family, functional limitation, literacy, age, having friends and respondent type. Conclusions: Low rates of participation reported here impinge on the rights of older adults with ID under the principles of the UN CRPD. Choice‐making emerged as a multi‐factorial phenomenon, with different factors important depending on the type of choice involved. This encourages a nuanced and personalised response from policy and support services to overcome individual challenges to participation as equal citizens. The significance of respondent type also highlights the difficulty of including self‐report, supported and proxy participants in ID research. [ABSTRACT FROM AUTHOR]

Background: As adults with intellectual disability (ID) in Ireland move to the community from residential settings, the changed environment is intended to increase opportunities for occupational engagement, autonomy and social relationships. It is important to consider how increased resources and opportunities available within the community can be optimized to promote engagement and quality of life. Aims: This paper investigates if and how ADL and IADL performance of people ageing with ID is related to place of residence. Methods: ADL and IADL performance of adults with ID in Ireland across different living situations was analyzed using descriptive and bivariate analysis of data collected from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS TILDA). Results: Greater ability to perform ADL and IADL was noted in those living in independent or community group home settings when compared to traditional residential settings. Place of residence was strongly related to ADL and IADL performance. Conclusion and significance: Given that people with ID will likely require physical and social supports to complete ADL and IADL when transitioning to community living from residential settings, an occupational justice perspective can inform occupational therapists working with people with ID, facilitating successful transitions to community living. [ABSTRACT FROM AUTHOR]

Purpose -- Recognition of potential for greater all-Ireland cooperation, pooling of expertise, and sharing of knowledge led to the establishment of the Centre for Ageing Research and Development in Ireland (CARDI) in 2007. This paper seeks to outline the development of CARDI and in particular the delivery of its grants programme as a model for supporting ageing research to work across disciplines, sectors and borders. Design/methodology/approach -- Using CARDI as a case study, this paper charts the organisation's development and in particular focuses on the development and learning from its grants programme, established to support ageing research in Ireland, north and south. Findings -- CARDI has promoted and helped support the development of a community of researchers on ageing across Ireland via its grants programme, networking events and communication's strategy. There is growing momentum, interest and potential in an all-Ireland approach to research on ageing and older people. Originality/value -- Research can and must play a vital role in informing future policies and services for our ageing population. This paper explores the development of ageing research in Ireland, illustrating a model for working across disciplines, sectors and borders when supporting and communicating research on ageing in Ireland, north and south, to the benefit of researchers, policy makers and older people. [ABSTRACT FROM AUTHOR]

Background: This paper aimed to develop a short version of the 32-item Ageing Perceptions Questionnaire (APQ), a multi-dimensional measure based on Leventhal's self-regulation model. Ageing perceptions are a key area of interest for large-scale surveys of ageing populations. As these studies capture a broad range of health and social variables, included instruments need to be as concise as possible., Methods: Data from the Irish Longitudinal Study of Ageing (TILDA), a representative sample of community-dwelling individuals aged 50+ (n = 6,718), was used to revise the scale. Items for exclusion were identified by examining conceptual content, descriptive statistics, and by detecting sources of poor model fit using confirmatory factor analysis (CFA). Potential combinations of dimensions were also tested using CFA. Finally, we identified any dimensions that could be excluded without limiting the conceptual coverage and coherence of the scale. Model modifications were done sequentially and with regard to theoretical considerations. Internal consistency and construct validity of the concise scale were compared with the longer version., Results: Initially, 11 items were excluded on the basis of conceptual and empirical overlap with other items. CFA indicated that the negative-control and negative-consequences dimensions could be combined, allowing us to exclude a further item from this dimension. The 5-item timeline-cyclical dimension was also excluded, as it was less well-established conceptually and empirically than the other dimensions. The final 17-item, 5-dimension model was consistent with the original conceptual model and fit the data well (chi-sq = 1433.54, df(109), p < 0.01, RMSEA = 0.04, CFI = 0.97, TLI = 0.96)., Conclusions: The Brief-APQ (B-APQ) is a concise, multi-dimensional measure of ageing perceptions, which is psychometrically valid for use with the Irish population aged 50+. The concise version preserved the internal consistency and construct validity of the original. Its brevity makes it particularly suitable for use with large-scale adult population surveys. The psychometric analysis supports the application of the self-regulation model to ageing perceptions, but also the existence of distinct "physical decline" and "ongoing development" dimensions of perceptions.

This paper analyses the fictional representation of ageing, dementia and migrant home care in Ireland in Oona Frawley's debut novel Flight (2014) and how the tropes of in/difference and silence best befit this representation. Drawing upon the tenets of literary gerontology and the Irish perspectives on ageing and dementia the analysis focuses on the multiple individual and community challenges the novel depicts – those of patients' and onlookers' perspectives, the fourth age and demise. Accordingly, the novel becomes the site of denunciation and interrogation of social and institutional responses to ageing and migrant home care. The analysis concludes that Frawley's fiction represents the potential of individual stories of ageing and care to envisage new futures within a global Irish society that is constantly changing. Ultimately, these stories are directly related to a wider social, historical, economic and political context in contemporary Ireland that enforces silence and in/difference. [ABSTRACT FROM AUTHOR]

Background: some cohort studies of ageing and health supplement questionnaire-based surveys with in-home measurements of biological parameters and others have required respondents to attend assessment centres. Centre-based assessments facilitate detailed measurements and novel technologies, but may differentially influence participation. The aim of this paper is to compare the characteristics of participants who attended a centre with those who chose a home assessment and those who did not have a health assessment., Methods: trained field workers administered a computer-assisted personal interview (CAPI) to a random sample of community-dwelling people aged 50 and over in the participants' homes. All questionnaire respondents were invited to attend an assessment centre for a comprehensive physical assessment. Participants who refused or were unable to attend a centre were offered a home assessment., Results: of the 291 participants who completed the CAPI, 176 had a health assessment: 138 in an assessment centre and 38 in their own home. The centre, home and no visit respondents differed in demographic characteristics, behavioural factors, physical functioning and health. Lower socio-economic status, physical inactivity and current smoking were the most robust predictors of non-participation in the health assessment. Home respondents had the highest levels of physical disability and were much weaker (grip strength) and slower (walking speed) than centre respondents., Conclusion: home and centre physical assessments are required to avoid systematically over-representing healthier and wealthier respondents.

Interest in older prisoners is gaining momentum, and this is reflected in research undertaken in the USA and the UK over the past decade. Studies on this sub-population of prisoners have focused on prevalence, profile, specific health and social needs, and raised questions about how different sectors of the criminal justice sector should be adjusting policy and practice in response. Attention has also been directed to what probation/social work has to offer to older prisoners and their specific needs. This paper presents a review of the literature relating to older male prisoners alongside key findings from a research study undertaken in an Irish prison in 2011. The research study was conducted using a mixture of quantitative and qualitative methods, and sought to provide a preliminary description of ageing male prisoners and their specific needs in Ireland. The implications of these findings for social work/probation policy and practice are considered, and directions for future service provision are recommended. Further insights into the circumstances of older men imprisoned in Ireland are offered to the various professionals (including Probation Service/social work staff) working in the criminal justice system who strive towards providing 'prisoner well-being' and a 'duty of care'. [ABSTRACT FROM AUTHOR]

Elder abuse is a significant social issue in society. Although this area has generated an increasing research base, there is scant literature on elder abuse viewed through the lens of ageism and its sway on human rights and citizenship. These three perspectives on the topic allow for a meaningful and equitable benchmark from which elder abuse may be considered. Ageism influences the way human rights and citizenship are articulated for older people and is conceptualised as stereotypical views of older people leading to prejudiced attitudes, actions and societal marginalisation. Such attitudes function to both disadvantage and devalue older people providing a covert basis for societal tolerance of elder abuse. This paper reviews pertinent literature in the area of elder abuse, human rights, citizenship and ageism, and argues that although society aspires to certain ideals in terms of equality and valuing the human individual, these aspirations may often be questionable in terms of older people and abuse.

Social relationships are central to the health and well-being of older adults. Evidence exploring the association of physical activity (PA) with social isolation and loneliness is limited. This study uses a path analysis to investigate the longitudinal association between loneliness and social isolation with PA using the Irish Longitudinal Study on Ageing. Higher levels of social isolation measured using the Berkman–Syme Social Network Index were directly and indirectly associated with lower levels of walking, moderate PA, and vigorous PA over 6 years. Additionally, higher levels of walking were associated with lower levels of loneliness measured using a modified version of the University of California, Los Angeles loneliness scale over a 3-year period. Future interventions should target individuals who are more socially isolated and explore the effects of different types of PA on loneliness over time. [ABSTRACT FROM AUTHOR]

The intellectual disability (ID) population in Ireland is ageing and the number of older persons with the dual disability of ID and dementia is increasing. In spite of these demographic trends, as in other countries adequate policy and service provision for this population are lacking. This paper draws upon data available on the population with ID and dementia, reviews both generic and ID specific literature, considers the policy context and argues for a specific model of service provision. A service model is proposed for the development of multidisciplinary specialist teams within ID, delivered through mobile regional ID dementia clinics.

Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men's health, with men tending to be seen as largely 'irresponsible' towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting 'irresponsibly' was what defined participants as 'real men'. The implications of these findings for men's health policy are discussed with specific reference to the recent publication of Ireland's National Men's Health Policy. [ABSTRACT FROM AUTHOR]

The successful implementation of the ongoing roll-out of free GP care for all private patients in Ireland, begun in 2015, requires an estimate of its impact on GP utilisation. However, estimates of this impact vary widely. For example, a recent study based on administrative records of six GP practices, predicts an extra 4.4 million GP visits. This paper argues that little reliance should be placed on this estimate due to methodological and sample selection issues, as well as the use of demonstrably inappropriate assumptions. Instead, more reliance should be placed on estimates derived from retrospective self-reporting surveys (e.g. Growing Up in Ireland, the Irish Longitudinal Study on Ageing) which suggest that extending free GP care to all private patients is likely to result in an increase of around 2.5 million GP visits. The increase in demand for GP services occasioned by free GP care feeds into the wider debate about the enhanced role of primary care in Ireland and the corresponding increase in funding. [ABSTRACT FROM AUTHOR]

Background The label 'faller' and the associated stigma may reduce healthcare-seeking behaviours. However, falls are not inevitably progressive and many drivers are modifiable. This observational study described the 8-year longitudinal trajectories of self-reported falls in The Irish Longitudinal Study on Ageing (TILDA) and studied associations with factors, including mobility, cognition, orthostatic hypotension (OH), fear of falling (FOF) and use of antihypertensive and antidepressant medications. Methods Participants aged ≥50 years at each wave were categorised by whether they averaged ≥2 falls in the previous year (recurrent fallers) or not (≤1 fall). Next-wave transition probabilities were estimated with multi-state models. Results 8,157 (54.2% female) participants were included, of whom 586 reported ≥2 falls at Wave 1. Those reporting ≥2 falls in the past year had a 63% probability of moving to the more favourable state of ≤1 fall. Those reporting ≤1 fall had a 2% probability of transitioning to ≥2 falls. Besides older age and higher number of chronic conditions, factors that increased the risk of transitioning from ≤1 fall to ≥2 falls were lower Montreal Cognitive Assessment score, FOF and taking antidepressants. Conversely, male sex, higher timed up and go time, the presence of OH and being on antidepressants reduced the probability of improving from ≥2 falls to ≤1 fall. Conclusion The majority of recurrent fallers experienced favourable transitions. Improvements in cognitive and psychological status, psychotropic prescribing, mobility and OH may help improve trajectories. Findings may help combat stigma associated with falling and promote preventative healthcare-seeking behaviours. [ABSTRACT FROM AUTHOR]

International evidence shows that people approaching end of life (EOL) have high prevalence of polypharmacy, including overprescribing. Overprescribing may have adverse side effects for mental and physical health and represents wasteful spending. Little is known about prescribing near EOL in Ireland. We aimed to describe the prevalence of two undesirable outcomes, and to identify factors associated with these outcomes: potentially questionable prescribing, and potentially inadequate prescribing, in the last year of life (LYOL). We used The Irish Longitudinal Study on Ageing, a biennial nationally representative dataset on people aged 50+ in Ireland. We analysed a sub-sample of participants with high mortality risk and categorised their self-reported medication use as potentially questionable or potentially inadequate based on previous research. We identified mortality through the national death registry (died in <365 days versus not). We used descriptive statistics to quantify prevalence of our outcomes, and we used multivariable logistic regression to identify factors associated with these outcomes. Of 525 observations, 401 (76%) had potentially inadequate and 294 (56%) potentially questionable medications. Of the 401 participants with potentially inadequate medications, 42 were in their LYOL. OF the 294 participants with potentially questionable medications, 26 were in their LYOL. One factor was significantly associated with potentially inadequate medications in LYOL: male (odds ratio (OR) 4.40, p =.004) Three factors were associated with potentially questionable medications in LYOL: male (OR 3.37, p =.002); three or more activities of daily living (ADLs) (OR 3.97, p =.003); and outpatient hospital visits (OR 1.03, p =.02). Thousands of older people die annually in Ireland with potentially inappropriate or questionable prescribing patterns. Gender differences for these outcomes are very large. Further work is needed to identify and reduce overprescribing near EOL in Ireland, particularly among men. [ABSTRACT FROM AUTHOR]

BreastCheck is Ireland's breast screening service which offers biennial mammograms to women aged 50–69. Practicing regular breast self-examination (BSE) enhances women's awareness and increases their perception of their susceptibility to the risk of breast cancer, possibly increasing their likelihood of attending a screening programme which reduces breast cancer mortality. Research is needed to identify the promotors and barriers to both attending breast cancer screening and practicing BSE. The aim of this study was to determine the promotors and barriers associated with attending breast cancer screening and practicing BSE in Irish women. Data from the participants of TILDA wave 3 (2014–2015) was used, the participant population included females only (≥50 years old), a total of 3575 women. Bivariate analysis was used to identify variables that were significantly associated with having had a mammogram since the last interview (wave 2) or regularly checking their breasts for lumps (BSE). Regression analysis was then used to determine the effect the significant variables had on predicting the likelihood of participants attending breast screening or practicing BSE. Over half (55%) of all women over the age of 50 had a mammogram since wave 2 was completed (2012) and two thirds reported practicing regular BSE. The factors associated with having attended for breast cancer screening were: having private health insurance (OR = 1.86, 95%CI = 1.45–2.380), and practicing BSE (OR = 1.683, 95%CI = 1.344–2.107). The factors found to be associated with practicing regular BSE were: higher quality of life (OR = 1.035, 95%CI = 1.015–1.057), higher BMI (OR = 1.118, 95%CI = 1.020–1.226), being married (OR = 1.436, 95%CI = 1.190–1.732) and attending mammogram screening (OR = 1.691, 95%CI = 1.353–2.114). Regular participation in mammography screening reduces breast cancer mortality. Women eligible for BreastCheck were significantly more likely to attend screening. BSE is associated with increased attendance at screening. Health-care professionals should encourage BSE in order to increase screening uptake. [ABSTRACT FROM AUTHOR]

This study used a mixed methods approach to understand the ways in which religion and quality of life (QoL) are associated in later life in Ireland. Longitudinal quantitative data from 2112 Christian women aged 57 and over at baseline (2009–10) participating in the Irish Longitudinal Study on Ageing (TILDA), as well as qualitative data from semi-structured interviews from 11 Christian women aged 65 and over in 2018, were used. The quantitative data showed an association between lower religiosity and lower QoL. Qualitative data supported an effect of religious involvement on QoL although certain aspects of being religious in Ireland were accompanied by distress. The data suggested that the relationship between religious attendance and higher QoL could be driven by multifactorial pathways, including psychological, social, and practical benefits. [ABSTRACT FROM AUTHOR]

There is increased emphasis on adopting positive health and aging policy goals for heterogeneous older populations, and recognition of the role that participatory research approaches can play in supporting their implementation. However, questions remain about how to represent the marginalized experiences of some older populations within such processes. With a focus on older Irish ethnic Travelers and older homeless adults as two vulnerable populations in Ireland, this article presents and critically discusses a participatory approach developed to integrate marginalized older adult perspectives on positive health and aging in a multistakeholder research and development process. The qualitative methodology is first detailed, incorporating methods that harness collaboratively derived views and individual narratives (e.g., focus groups; consultation forums; in-depth interviews). Critical reflections on research implementation and specific considerations relevant to these populations are presented (e.g., trust building; one-to-one facilitation), with lessons then drawn for the design of multistakeholder participatory approaches with marginalized older populations. [ABSTRACT FROM AUTHOR]

Background: Longitudinal study of people with intellectual disability and other difficult to reach populations requires specific recruitment and retention strategies to be successful.Aims: This paper provides a case study of participant recruitment and retention for a longitudinal study of ageing among older adults with intellectual disability in Ireland.Methods and Procedures: Development and implementation of strategies to recruit and retain participants with intellectual disability aged 40+ years, for a longitudinal study comprising four data collection waves over more than a decade, are reported. Recruitment and retention outcomes are assessed alongside factors of successful implementation.Outcomes and Results: A nationally representative sample of 753 individuals with intellectual disability was recruited for wave 1 of the study. Multiple retention strategies aimed to reduce barriers to participation and create a project community and study bond, underpinned by a Values Framework and commitment to PPI. After four waves over 11 years, 87.1 % of surviving participants were retained.Conclusions and Implications: Successful recruitment and retention of people with intellectual disabilities in longitudinal studies is possible when the approach taken is personal, flexible, and innovative; participant burden is minimised; the research team is skilled and sensitive to needs of participants; and where involvement of the study population guides development and implementation of specific and bespoke strategies. [ABSTRACT FROM AUTHOR]

Despite policy commitments to support ageing in place, we know very little about the everyday realities and experiences of older people living in different environmental circumstances, with varying personal capabilities. This paper: 1) examines the valued place-based functionings of older people through the use of geo-spatial and in-situ methods, where functionings are defined as states of being and doing, and place-based functionings are defined as places, activities, interactions, routes, and routines that support these beings and doings; and 2) demonstrates the utility of a capability approach by amalgamating the interconnected concepts 'ageing in place' and 'ageing well'. Three in-depth individual experiences of ageing at home in a Dublin (Ireland) suburb show how differing health and mobility challenges are managed, and illustrate how conceptions of ageing well in place can be identified from geographically-grounded lifeworlds. Participants' place-based functionings are identified by combining qualitative and geo-spatial approaches through the use of annotated maps, using data obtained from traditional interviews, go-along interviews, and mapping exercises. Results demonstrate the diversity of place-based functionings valued by each individual, and how functionings are negotiated depending on different needs, wishes, and health or mobility challenges. Results also highlight the importance of supportive environments and social supports in enabling older people to realise their most valued functionings over time, which include being able to get out and about, engage and connect with others, carry out daily tasks and errands confidently, and remain independent. By paying attention to subjectively valued place-based functionings, as well as the specific supports required to sustain them, we can facilitate older people to not just age in place, or age well, but to age - as well as they can - in place. • This article considers ageing well in place through a Capability Approach lens. • Geo-spatial and qualitative methods can illustrate place-based functionings. • Older people should be supported to age – as well as they can – in place. [ABSTRACT FROM AUTHOR]

Background There are no prospective studies on the association between multimorbidity and urinary incontinence (UI), while mediators in this association are unknown. Thus, we aimed to (i) investigate the longitudinal association between multimorbidity and UI in a large sample of Irish adults aged ≥50 years and (ii) investigate to what extent physical activity, polypharmacy, cognitive function, sleep problems, handgrip strength and disability mediate the association. Methods Data on 5,946 adults aged ≥50 years old from the Irish Longitudinal Study on Aging were analysed. The baseline survey was conducted between 2009 and 2011 and follow-up after 2 years was conducted. Information on self-reported occurrence of UI in the past 12 months and lifetime diagnosis of 14 chronic conditions were obtained. Multivariable logistic regression and mediation analysis were conducted. Results After adjustment for potential confounders, compared to having no chronic conditions at baseline, having three (odds ratio [OR] = 1.79; 95% confidence interval [CI] = 1.30–2.48) and four or more (OR = 1.86; 95% CI = 1.32–2.60), chronic conditions were significantly associated with incident UI. Mediation analysis showed that polypharmacy, sleep problems and disability explained 22.7, 17.8 and 14.7% of the association between multimorbidity (i.e. two or more chronic conditions) and incident UI, respectively. Conclusion A greater number of chronic conditions at baseline were associated with a higher risk for incident UI at 2-year follow-up among adults aged ≥50 years in Ireland. Considering the effects of different medications on UI and improving sleep quality and disability among people aged ≥50 years with multimorbidity may reduce the incidence of UI. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization published updated Environmental Noise Guidelines in 2018. Included are recommended limit values for environmental noise exposure based on systematic reviews for a range of health outcomes, including cognitive impairment. There is emerging evidence in the literature that chronic exposure to road traffic noise may affect cognitive function in older adults, but this relationship is not well established. This study spatially linked nationally representative health microdata from The Irish Longitudinal Study on Ageing to building-level modelled noise data for two cities in the Republic of Ireland. This was used to investigate associations between exposure to road traffic noise and cognitive function in a sample of older adults, independent of a range of socio-demographic and behavioural characteristics, as well as exposure to air pollution.Methods: We used the Predictor-LimA Advanced V2019.02 software package to estimate noise originating from road traffic for the cities of Dublin and Cork in Ireland according to the new common noise assessment methodology for the European Union (CNOSSOS-EU). Noise exposure values were calculated for each building and spatially linked with geo-coded TILDA microdata for 1706 individuals aged 54 and over in the two cities. Ordinary least squares linear regression models were estimated for eight standardised cognitive tests including noise exposure as an independent variable, with standard errors clustered at the household level. Models were adjusted for individual sociodemographic, behavioural and environmental characteristics.Results: We find some evidence that road traffic noise exposure is negatively associated with executive function, as measured by the Animal Naming Test, among our sample of older adults. This association appears to be accounted for by exposure to air pollution when focusing on a sub-sample. We do not find evidence of an association between noise exposure and memory or processing speed.Conclusions: Long term exposure to road traffic noise may be negatively associated with executive function among older adults. [ABSTRACT FROM AUTHOR]

Background: Several kinds of motor dysfunction can predict future cognitive impairment in elderly individuals. However, the ability of the fine motor index (FINEA) and gross motor index (GROSSA) to predict the risk of cognitive impairment has not been assessed.Objective: We investigated the associations between FINEA/GROSSA and cognitive impairment.Methods: The data of 4,745 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). We first assessed the correlation between the FINEA/GROSSA and MMSE in a cross-sectional study. Then, we further investigated the predictive role of the incidence of cognitive impairment in a prospective cohort study.Results: We found that both FINEA and GROSSA were negatively correlated with MMSE in both the unadjusted (FINEA: B = -1.00, 95%confidence intervals (CI): -1.17, -0.83, t = -11.53, p < 0.001; GROSSA: B = -0.85, 95%CI: -0.94, -0.76, t = -18.29, p < 0.001) and adjusted (FINEA: B = -0.63, 95%CI: -0.79, -0.47, t = -7.77, p < 0.001; GROSSA: B = -0.57, 95%CI: -0.66, -0.48, t = -12.61, p < 0.001) analyses in a cross-sectional study. In a prospective cohort study, both high FINEA and high GROSSA were associated with an increased incidence of cognitive function impairment (FINEA: adjusted odds ratios (OR) = 2.35, 95%CI: 1.05, 5.23, p = 0.036; GROSSA adjusted OR = 3.00, 95%CI: 1.49, 6.03, p = 0.002) after 2 years of follow-up.Conclusion: Higher FINEA and GROSSA scores were both associated with an increased incidence of cognitive impairment. FINEA or GROSSA might be a simple tool for identifying patients with cognitive impairment. [ABSTRACT FROM AUTHOR]

Background 'Wish to Die' (WTD) involves thoughts of or wishes for one's own death or that one would be better off dead. Objective To examine the prevalence, longitudinal course and mortality-risk of WTD in community-dwelling older people. Design Observational study with 6-year follow-up. Setting The Irish Longitudinal Study on Ageing, a nationally representative cohort of older adults. Subjects In total, 8,174 community-dwelling adults aged ≥50 years. Methods To define WTD, participants were asked: 'In the last month, have you felt that you would rather be dead?' Depressive symptoms were measured using the CES-D. Mortality data were compiled by linking administrative death records to individual-level survey data from the study. Results At Wave 1, 3.5% of participants (279/8,174) reported WTD. Both persistent loneliness (OR 5.73 (95% CI 3.41–9.64)) and depressive symptoms (OR 6.12 (95% CI 4.33–8.67)) were independently associated with WTD. Of participants who first reported WTD at Wave 1 or 2, 72% did not report WTD when reassessed after 2 years, and the prevalence of depressive symptoms (−44%) and loneliness (−19%) was more likely to decline in this group at follow-up. Fifteen per cent of participants expressing WTD at Wave 1 died during a 6-year follow-up. Conclusions WTD amongst community-dwelling older people is frequently transient and is strongly linked with the course of depressive symptoms and loneliness. An enhanced focus on improving access to mental health care and addressing social isolation in older people should therefore be a public health priority, particularly in the current context of the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Friendship is important to quality of life, yet people with intellectual disability have more restricted social networks and fewer friends outside family and support staff. Method: Data from a nationally representative longitudinal study of older adults with intellectual disability (aged >40) examined rates and types of friends. Factors associated with having a best friend and friendship quality were explored. Results: A large majority (92.4%) had friends but just over half (52%) had a best friend. Co‐resident friends (71.8%) were more common than non‐resident friends (62%), while staff friendships (62.5%) were important. The majority of best friends were peers with intellectual disability (63.2%), carer/service providers (15.9%) or family (8.4%). Challenging behaviour and communication difficulty were associated with reduced likelihood of having a best friend. A best friend with intellectual disability was associated with lower friendship quality scores. Conclusion: Limited choice and social opportunity may result in a precarious form of friendship for older people with intellectual disability that undermines their quality of life. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship between loneliness and cognitive functioning, and whether depressive and anxiety symptoms have intermediate roles therein. Methods: Information about 7,433 participants of the Irish Longitudinal Study on Ageing (a prospective, representative cohort study), aged over 50, was collected at three time-points two years apart, and analysed using Structural Equation Modelling to assess whether depressive and anxiety symptoms mediate the relationship between loneliness and cognitive functioning. Cognitive functioning was measured as a latent factor, with four indicators: measures of immediate and delayed word recall, verbal fluency, and a global measure (the MMSE). Loneliness was measured using the UCLA Loneliness scale, depressive symptoms using the CES-D-ML scale, and anxiety symptoms using the HADS-A scale. Results: Loneliness at time-point 1 predicted cognitive functioning at time-point 3, β = −0.103, p < 0.001, and depressive (β = 0.426, p < 0.001) and anxiety (β = 0.410, p < 0.001) symptoms at time-point 2. Depressive (β = −0.020, p = 0.001) but not anxiety (β = −0.000, p = 0.658) symptoms mediated the relationship between loneliness and cognitive functioning, total effect: β = −0.123, p < 0.001. Conclusion: The relationship between loneliness and cognitive functioning is in part explained by its relationship with depressive symptoms. Statistically, the mediation model helps us understand possible mechanisms through which loneliness impacts cognitive functioning. Results have implications for cognitive functioning interventions for older adults, and imply that loneliness is also a worthwhile target for intervention. [ABSTRACT FROM AUTHOR]

Objective In the present paper, we examine the association between manual work, resultant functional limitations and reduced ability to carry out daily activities of living (ADL), in older age. We hypothesise that manual workers as opposed to non-manual workers suffer, in older age, functional limitations and reduced ability to carry out ADL. This study is of great importance owing to our ageing Irish population and an ailing health service. Methods A 10 year follow up study was conducted on a cohort of the general population (59–80 year olds) in the Republic of Ireland. Specific data on physical measurements, marital status, educational attainment, work history, functional status and ADL was collected on 357 study participants. Work history data focused on the job the participant had done for the longest period of time, paid or unpaid. Each participant was then asked if they described this work as manual or non-manual. Functional limitations and ADL were assessed using validated scales. Results Just over half the sample were female (53%) with 44% (n=150) retired (median=9 (5.14) years). Over 60% of the participants were, or had been engaged in manual work with this percentage higher in males, albeit non-significant (68% vs 58%, p=0.08). 20% of the total sample had complete function with a higher proportion of non-manual as opposed to manual workers (p=0.07) with no limitations. Almost three quarters of the sample had functional limitations and less than one fifth were classified as having an ADL disability. Using linear regression, manual workers were significantly more likely to have functional limitations even after adjustment (B=0.85, SE=0.30, p=0.01) for socio-demographic factors. When stratified by age, manual work remained significantly associated with functional limitations in the 60–69 year olds (B=0.66, SE=0.34, p=0.05) and in the 70–80 year olds (B=1.13, SE=0.50, p=0.03). For the older age group, males had a decreased risk of functional limitations independent of work type (B=−1.06, SE=0.47, p=0.03). There was no significant association between manual work and reduced activities of daily living either in the unadjusted or adjusted model. Discussion Functional limitations, in an older population, are related to the type of work they carried out. Good health surveillance for manual workers at a young age can identify limitations early. Initiatives such as work organisation, education and promotion of best work practices with regard to manual work can reduce functional limitations in older age. [ABSTRACT FROM PUBLISHER]

Background: Exposures to life events are associated with emotional, psychological and behavioural problems in those with intellectual disability (ID). Older adults with ID may experience different life events given differences in living circumstances, cognitive decline, greater dependency on others and less autonomy. This study examines the relationship of life events and mental ill health in an older ID population in Ireland. Methods: The study was part of 'The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing'. The frequency of life events was assessed using a 20‐item checklist, and the level of stress experienced was assessed using a three‐point Likert scale measuring the burden of the life event. The associations of life events with factors associated with mental ill health were measured using a variety of self‐report and proxy completed questionnaires. Results: For the study population, 88.1% had been exposed to at least one life event in the preceding 12 months and 64.5% to two or more life events. Frequency and burden of life events were significantly higher in individuals living in institutional settings and in individuals with any current psychiatric condition, increased depressive and anxiety symptoms, challenging behaviour and reported poorer self‐rated mental and physical health. More life events were significantly associated with new psychiatric diagnoses as well as initiation and increased dosage of mood stabilising, hypnotic and sedative medications. Conclusions: Life events are significantly associated with mental ill health in the older ID population. Service providers must focus on limiting the exposure to these events and, in situations where they cannot be avoided, should support and manage individuals compassionately and effectively, prioritising their mental and physical well‐being. [ABSTRACT FROM AUTHOR]

Objectives This study assessed the association between sexual activity, mismatches in the importance attributed to sex within couples, and relationship quality in older Irish adults. Method We used data from the Irish Longitudinal Study on Ageing (TILDA) to derive a scale of subjective relationship strain in married or cohabiting individuals. Negative binomial regression was used to assess the association between relationship strain and sexual activity. Separate models assessed the associations with importance of sex and within-couple mismatch in the importance attributed to sex and whether these associations were independent from sexual activity. Age interactions were tested. Results Sexual activity and within-couple mismatch in the importance attributed to sex were associated with relationship strain. The frequency of sexual activity was consistently associated with less relationship strain for men, but less so for women when the importance attributed to sex was accounted for. Results were largely consistent across age groups for men, but sexual activity and importance of sex varied with age in women. Discussion Frequent sexual activity was associated with less strain within-intimate relationships. For women, this association was weakened when accounting for the importance attributed to sex. Within-couple mismatch in the importance attributed to sex was associated with relationship strain, independent from frequency of sexual activity, for both men and women at all ages. [ABSTRACT FROM AUTHOR]

Objective: Act-Belong-Commit is the world's first population-wide, community-based mental health promotion campaign. We assessed the associations between baseline indicators of Act-Belong-Commit behavioral domains and wellbeing at 2-year follow-up in a population-based sample of Irish older adults. Methods: Data from 2 waves of the Irish Longitudinal Study on Ageing were analyzed. The sample consisted of 6098 adults. Outcomes were quality of life (QoL), life satisfaction (LS) and self-rated mental health (SRMH). Multivariable regression analyses were conducted. Results: The adjusted model showed that each increase in the number of social/recreational activities (Act) predicted better QoL and SRMH, but the positive association with LS did not reach statistical significance. Both social network integration (Belong) and frequency of participation in social/recreational activities (Commit) significantly promoted QoL, LS, and SRMH. These associations were apparent regardless of baseline common mental disorders. Conclusion: Act-Belong-Commit indicators are shown to promote wellbeing among Irish older adults, providing further support for the campaign's potential. [ABSTRACT FROM AUTHOR]

Introduction As life expectancy grows so does the need for mental health services for older people. Occupational science and therapy literature demonstrates how occupation supports older adults' wellbeing, but there has been little research into the relationship between occupation and health for those with anxiety and depression. The aim of this study was to understand the occupational experience of Irish older adults with anxiety and depression so as to inform therapeutic programmes. Method A qualitative research design with a phenomenological framework was adopted. A total of five community-dwelling people with diagnoses of anxiety and/or depression were purposively selected to participate in semi-structured interviews. The interviews were analysed using thematic analysis. Findings The themes which emerged – ‘Occupation as a marker for wellness’ and ‘Sustaining a sense of occupational identity’ – support existing literature and reveal new information about interactions between occupational identity crisis and mental health. Personally meaningful occupation which connects a person to their life worlds and sense of self has the potential to consolidate recovery from anxiety and depression. Conclusion The study contributes to knowledge on how occupation supports an older person's wellbeing and identity in the face of life changes, and has implications for occupational therapists working with older adults. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that item responses and total scores on depression screening scales follow characteristic distribution patterns in the United States and Japanese general populations. However, the degree to which these findings, especially in terms of item responses, can be generalized to a European population is unknown. Thus, we analyzed the item responses and total score distribution for the Center for Epidemiologic Studies Depression Scale (CES-D) in a representative Irish cohort from a large, recent study—the Irish Longitudinal Study on Ageing (TILDA). Methods: We used CES-D data from the 2009–2011 TILDA (8504 individuals). Responses for the 16 depressive symptoms included “rarely,” “some of the time,” “occasionally,” and “all of the time.” Item response patterns and total score distribution across these 16 depressive symptom items were examined using graphical analyses and exponential regression modeling. Results: Lines for item responses followed the same pattern across the 16 items. These lines were characterized by intersections in the vicinity of a single point between “rarely” and “some of the time” and parallel patterns from “some of the time” to “all of the time” on a log-normal scale. Total scores for the 16 items exhibited an exponential pattern, except for at the lower end of the distribution. Conclusions: The present findings suggest that item responses and total scores on depression screening scales among the general population follow the same characteristic patterns across populations from multiple nations. [ABSTRACT FROM AUTHOR]

Abstract: Medications use in adults ageing with Down syndrome (DS) has not been studied extensively. People with DS are at increased risk of hypothyroidism, seizures, and dementia. It is possible that this pattern of multimorbidity is associated with polypharmacy. The aim of this study is to describe the patterns of medical disorders, symptoms, and medications, variation with age and residential setting, and utilization of health screening in an ageing cohort with DS. Data were obtained from wave one (2009/2010) of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing. Information on disorders, symptoms, health screening, and medications was gathered using preinterview questionnaires and face to face interviews with participants and/or caregivers. Of the 721 participants answering the questions about medication use and cause of intellectual disability, 20% had DS (n = 144). Descriptive statistics describe the prevalence of disorders and medications and proportion of participants attending health screening for disorders commonly associated with DS. The most commonly reported disorders were eye disease (61.8%), thyroid dysfunction (38.2%), constipation (34.7%) high cholesterol (32.6%), pain (32.1%), and emotional/psychiatric/nervous disorder (25%). The most commonly reported medications were thyroid hormones (43.8%), laxatives (27.1%), pain relievers (27.1%), and lipid modifying agents (26.4%). Polypharmacy, excessive polypharmacy, and multimorbidity were more prevalent among the older group compared to the younger group (37.3% vs. 14.3%; 13.4% vs. 7.8%; 73.1% vs. 58.4%, respectively). Uptake of memory assessments (32.9%), hearing tests (23.8%), and bone density screening (9.2%) was poor, particularly among those living independently, yet general practitioner visits were frequent and extensive. Polypharmacy and excessive polypharmacy are prevalent in this population, yet the provision of health care screening is inadequate. Medications review is needed since the risks posed by multiple medications use have not yet been quantified. As people with DS age, support is necessary for health care professionals, people with DS and their carers to help them optimize the use of medications. [ABSTRACT FROM AUTHOR]

This case study examines the role of philanthropic funding in building capacity for aging research in Ireland, and how this investment has addressed the lack of evidence to support planning for an aging population. The funding has supported a range of initiatives including the national longitudinal study on aging (TILDA), the creation of three professorships/chairs, and the establishment of four new research centers. Important potential outcomes are emerging across other domains including research-informed policy development and the generation of health benefits. The efforts of academic researchers to ensure that their findings are readily accessible to end users and to forge robust working relationships with all stakeholders have helped to enhance the use of research findings. Overall, philanthropy has played a pivotal role in building capacity, infrastructure, and expertise in academic settings in Ireland. Moreover, this work provides an excellent example of how such efforts can begin to inform effective planning and service provision. [ABSTRACT FROM AUTHOR]

Objectives Cardiovascular disorders are recognized as important modifiable risk factors for falls. However, the association between falls and orthostatic hypotension ( OH) remains ambivalent, particularly because of poor measurement methods of previous studies. The goal was to determine for the first time to what extent OH (and variants) are risk factors for incident falls, unexplained falls ( UF), injurious falls ( IF) and syncope using dynamic blood pressure ( BP) measurements in a population study. Design Nationally representative longitudinal cohort study-The Irish Longitudinal Study on Ageing ( TILDA)-wave 1 (2009-2011) with 2-year follow-up at wave 2 (2012-2013). Setting Community-dwelling adults. Participants Four thousand one hundred twenty-seven participants were randomly sampled from the population of older adults aged ≥50 years resident in Ireland. Measurements Continuous BP recordings measured during active stands were analyzed. OH and variants (initial OH and impaired orthostatic BP stabilization OH(40)) were defined using dynamic BP measurements. Associations with the number of falls, UF, IF, and syncope reported 2 years later were assessed using negative binomial and modified Poisson regression as appropriate. Results Participants had a mean age of 61.5 (8.2) years (54.2% female). OH(40) was associated with increased relative risk of UF ( RR: 1.52 95% CI: 1.03-2.26). OH was associated with all-cause falls ( IRR: 1.40 95% CI: 1.01-1.96), UF( RR: 1.81 95% CI: 1.06-3.09), and IF( RR: 1.58 95% CI: 1.12-2.24). IOH was not associated with any outcome. Conclusion With the exception of initial orthostatic hypotension, beat-to-beat measures of impaired orthostatic BP recovery (delayed recovery OH (40) or sustained orthostatic hypotension OH) are independent risk factors for future falls, unexplained falls, and injurious falls. [ABSTRACT FROM AUTHOR]