Search

Introduction: The gerontological literature suggests that external housing-related control beliefs (HCB) influence activities of daily living (ADL) among older people, but knowledge is scarce for people with Parkinson's disease (PD). This longitudinal study aimed to explore the directions of the relationship between external HCB and ADL among people with PD. Methods: Baseline (T1) and 3-year follow-up data (T2) were collected from 154 people with PD (mean age = 68 years, T1). Two regression analyses were applied, where dependent (T2 values) and independent (T1 values) variables—external HCB score and PD specific ADL (PADLS)—were switched, adjusting for age, disease severity, cognitive functioning, and accessibility problems. Results: There was a significant effect of ADL on external HCB (β = 3.07, p <.001, CI [1.28, 4.85]), but no effect in the reverse direction. The proportion with moderate-extreme ADL difficulties increased over time (from 20.8% to 32.5%, p =.006). Discussion: ADL difficulties seem to lead to higher external HCB, but not the other way around, which contradicts assumptions in environmental gerontology theories. This new knowledge can promote theory development. While additional studies are required to verify whether this is a disease-specific finding, this indicates the importance of targeting ADL if the purpose is to influence external HCB among people with PD. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess seasonal and age-related variations in sleep quality using Fitbit data and offer lifestyle recommendations for enhancing winter sleep quality. Methods: Fitbit sleep and activity data of 51 participants randomly recruited from members of the Association for Research in Supporting System of Chronic Disease, a nonprofit organization in the Yamanashi Prefecture of Japan, were collected and retrospectively analyzed from July to December 2022. Sleep stage targets were set at 10% to 25% for deep sleep, 50% to 60% for shallow sleep, and 20% to 25% for REM sleep. Participants were categorized into improved, unchanged, and worsened groups based on sleep stage unit changes between August and December. Results: The median (interquartile range) age was 71 (68–74) years old. There were eight participants in the improved group, 23 in the unchanged group, and nine in the worsened group. The improved group showed significantly more steps (990 ± 1,102 steps/day, p =.039) in December than in August, while the worsened group showed fewer steps (−507 ± 1,638 steps/day, p =.38). Conclusion: Increasing step count in winter may improve sleep quality, as assessed by sleep stage. Further research considering potential confounders and factors affecting winter sleep is needed to support and extend these findings. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has significantly impacted the daily lives of older adults. Three case reports illustrate how individuals have coped with loss, maintained routines, and faced emotional challenges. Understanding these experiences can guide efforts to promote the well-being and resilience of older adults during this time. Interview questions included "What was your daily routine and any leisure activities you participated in before COVID-19? During the height of social distancing?" to explore the impact of this pandemic on older adults' daily routines and the effects on their mental and physical health. [ABSTRACT FROM AUTHOR]

One dementia prevention strategy that is effective for older adults is frequent participation in leisure time physical activity. However, research gaps exist in our understanding of the longitudinal relationship between different levels of leisure time physical activity participation and the cognitive function of older adults with mild cognitive impairment. Thus, we investigated this relationship using Health and Retirement Study data from 2012 to 2020. Results from Repeated Measures Multivariate Analysis of Covariance indicated that both the mid (Mean Difference = −0.45) and high level (Mean Difference = −0.82) leisure time physical activity groups showed higher levels of memory function compared to the low-level leisure time physical activity group. Additionally, the mid (Mean Difference = −0.21) and high level (Mean Difference = −0.37) leisure time physical activity groups reported better working memory function, and the mid (Mean Difference = −0.02) and high level (Mean Difference = −0.02) leisure time physical activity groups showed higher levels of attention and processing speed than the low-level leisure time physical activity group. These findings suggest that older adults with mild cognitive impairment who engage either vigorously or moderately in leisure time physical activity (more than three times a week) experience improvements in cognitive function compared to those who do not. This study provides valuable insights for clinicians on the optimal level of leisure time physical activity required to mitigate cognitive decline in older adults with mild cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Loneliness in the elderly is of public health importance as it is a risk factor for adverse consequences. There is lack of data on loneliness among the elderly population of India, especially those residing in a rural community. Aim: To estimate loneliness and its association with depression and caregiver abuse. Materials and Methodology: A cross-sectional study was conducted in a rural health clinic in North India. 125 elderly persons were evaluated on the UCLA Loneliness Scale, Patient Health Questionnaire-15, Geriatric Depression Rating Scale‑30 (GDS), and Caregiver Abuse Screening (CASE) scale. Results: 67.6 years was the mean age of the study's subjects, with a mean number of years of education of 2.9. Most were female, married, and from lower socioeconomic status and belonged to a non-nuclear family. The prevalence of loneliness was 66.4%. Regarding specific features, subjects reported a lack of companionship (64.8%), being left out in life (45.2%), and being isolated from others (52.8%). The severity of depression, somatization, psychological and physical abuse, neglect abuse, and caregiver abuse had a significant positive association with loneliness. Those with a presence of loneliness scored higher on GDS and CASE than those without. Those who were single at the time of the study reported significantly more loneliness than married ones. Those from nuclear families and middle socioeconomic status reported a significantly higher level of loneliness. Conclusion: Loneliness among the elderly rural population is significantly high. The severity of loneliness is associated with higher severity of depression, somatization, and caregiver abuse. [ABSTRACT FROM AUTHOR]

Summary: This qualitative, phenomenological study explored the lived experience of the intersectionality of ageism and racism among older adults, with a focus on interpersonal experiences. Fifteen participants 60+ years of age (M = 67, SD = 7.45) in the U.S. Mountain West identifying as Black, Latino(a), Asian-American/Pacific Islander, or Indigenous engaged in a 1-hour interview. A three-cycle, inductive coding process involved five coders who independently coded interviews and engaged in critical discussion to resolve disagreements. An audit trail, member checking, and peer debriefing enhanced credibility. Findings: The results detail four umbrella themes and nine subthemes. The subthemes demonstrate experiences of the intersectionality of ageism with racism reflected through (1) increased disrespect, (2) cultural differences in respect for elders, (3) tokenization, (4) physical appearance, (5) being ignored or discriminated against due to others' discomfort, (6) intersecting experiences of pity, hate, and violence, (7) unspoken bias (including racial profiling), (8) microaggressions: questioning intelligence/ability, and (9) microaggressions: slurs. Multiple themes highlighted how ageism may be racialized through stereotypes related to mental (in)capability. Applications: Social work practitioners and researchers can apply the findings from this study to explore interventions aimed at reducing interpersonal, racialized ageist microaggressions related to mental incapability. At the community level, anti-racism and anti-ageism initiatives should collaborate by applying an enhanced understanding of the ways ageism and racism intersect through pity, hate, and violence particularly in public settings such as shopping centers. The findings from this study can also help shape policies aimed at reducing racial profiling and hate crimes toward older adults of color. [ABSTRACT FROM AUTHOR]

The study investigates temporal aspects of home care in Sweden, as experienced and interpreted by older care users. Data consists of 34 interviews with 36 care users and 15 participant observations during home visits by care staff. By focusing on care users' recalibration of time and events, the analysis identifies a form of interpreted experience – here termed 'home care time' – that comprises two governing sublogics – care users' understanding of themselves as part of the home care organisation, and care users' empathetic understanding for care staff – where each sublogic evolved from several approaches where care users expressed time empathy, tried to increase time efficiency, or adapted to other care users. Some care users described attempts to take control and influence temporal aspects. Such attempts resulted in adjustments to services at the individual care user's request, but they were also associated with the risk of conflict between care users and care workers. The study addresses the gap in the literature, which mostly studies and theorises care from a care provider perspective. The logic of home care time identified in the study can explain why older people may say they are satisfied with services though poorly performed due to time shortages. This explanation is a corrective to stereotypes that portray older care users as docile and grateful. [ABSTRACT FROM AUTHOR]

Over the last 20 years, ageing has been studied through the lens of an active ageing perspective, which considers older adults as responsible for their own conditions. However, the COVID-19 health emergency has highlighted its limits. Drawing on a sample of semi-structured interviews – collected before and during the pandemic – with people aged 65 years and above who are self-sufficient and live in Turin, Italy, this article explores the representations and perceptions of ageing, to highlight the possible effects of the COVID-19 emergency. The results show that representations of ageing revolve around two fundamental viewpoints: one considers older adults as a cost for the community because of their unproductiveness; the other overlaps the loss of self-sufficiency with a definition of 'real' old age. Furthermore, the interviews introduce a distinction between those who – considered productive despite their age – were called to provide a service to the community during the lockdown, and those who were judged vulnerable because of their age. Such ambiguous messages have raised new questions about an active and successful ageing imperative. [ABSTRACT FROM AUTHOR]

Background: Examining the distribution of biochemical and haematological tests in different age groups of rural population is necessary to ensure that health care facilities are equipped to address the prevalent health conditions and manage age-related illness effectively. Hence, this study is aimed at seeing the distributions of blood biochemical and haematological parameters in rural population. Methods: This cross-sectional study investigated the distribution of 26 different haematological and biochemical parameters in longitudinal cohort study (Srinivaspura Aging, NeuoSenescence and COGnition - SANSCOG), from the villages of Srinivaspura, Kolar district, India. A total of 2592 participants (1240 males and 1352 females), aged ≥45 years who are cognitively healthy were included for the analysis. Mean, 2.5th, 5th, 25th, 50th, 75th, 95th and 97.5th percentiles were calculated for the entire sample. Additionally, median and percentiles were determined for both gender and age categories (45-54, 55-64, 65-74, and ≥75 years). Results: We observed the distinct distributions of various haematological and biochemical parameters, with elevated levels of glycaemic, lipid, liver, and thyroid parameters. Conclusion: Findings revealed the notable variations from the established reference ranges, indicating the potential undiagnosed cases and highlighting the gaps in health awareness and health seeking behaviour. [ABSTRACT FROM AUTHOR]

Purpose: Our study explores cancer care disruption among different demographic subgroups. It also investigates these disruptions' impacts on cancer survivors' mental and physical well-being. Design: Pooled cross-sectional survey data. Setting: Health Information Trends Survey for Surveillance Epidemiology and End Results, HINTS-SEER. Participation: n = 1234 cancer survivors participated in the study and completed the survey. Measures: Outcome variables were treatment disruption in cancer care, mental health and physical health perceptions, age, race, education, income, and sexual orientation. Analysis: Multiple imputations were used to address missing data. Descriptive statistics were conducted to understand the perceptions of care disruption. Partial least squares structural equation models were employed for data analysis, adjusted for socio-demographics. Results: COVID-19 impacted cancer treatment and follow-up appointments (69.45%), routine cancer screening (60.70%), and treatment plans (73.58%), especially among elderly patients. It changed the interactions with health care providers (HCP) for 28.03% of the participants. Older adults were 2.33 times more likely to experience treatment appointment disruptions. People who thought their contact with their doctors changed during COVID-19 were more likely to be older adults (65 or more) (OR = 3.85, P =.011), white (OR >1, P =.002), and with higher income (OR = 1.81, P =.002). The changes to cancer treatment and follow-up medical appointments negatively impacted the well-being of the patients (mental: β = −.006, P =.043; physical: β = −.001, P =.006), routine screening and preventative care visits (mental: β = −.029, P =.031; physical: β = −.003, P =.008), and cancer treatment plans (mental: β = −.044, P =.024; physical: β = −.021, P =.040). Conclusions: Our findings underscore the crucial requirement for implementing focused interventions aimed at alleviating the discrepancies in the accessibility of cancer care across diverse demographic groups, particularly during times of emergency, in order to mitigate any potential disruptions in care. [ABSTRACT FROM AUTHOR]

Purpose: Increasing the perceived need for CRC screening can facilitate undertaking CRC screening. This study aims to identify factors associated with the need for CRC screening in rural populations. Design: A cross-sectional online survey. Setting: The survey was conducted in June - September 2022 in the rural areas of Alaska, Idaho, Oregon, and Washington, US. Subjects: The subjects of this study were 250 adults (completion rate: 65%) aged 45-75 residing in rural Alaska, Idaho, Oregon, and Washington. Measures: Perceived need for CRC screening, internet usage for health purposes, demographics, and intrapersonal, interpersonal, community, and environmental characteristics. Results: Perceived need for CRC screening were negatively associated with patient-provider miscommunication (β = −.23, P <.001) and perceived discrimination (β = −.21, P <.001), cancer fatalism (β = −.16, P <.05), individualism (β = −.15, P <.05), and dependence on community (β = −.11, P <.05), but positively with compliance with social norms (β =.16, P <.05), trust in health care providers (β =.16, P <.05), knowledge about colorectal cancer (β =.12, P <.05). Conclusions: Our study showed potential individual and situational characteristics that might help increase colorectal cancer screening. Future efforts might consider addressing discrimination in health care settings, improving patient-provider communication, and tailoring messaging to reflect the rural culture. [ABSTRACT FROM AUTHOR]

Purpose: To examine the relative importance of social cognitive predictors (ie, performance accomplishment, vicarious learning, verbal persuasion, affective state) on health promotion self-efficacy among older adults during COVID-19. Design: Cross-sectional. Setting: Data collected online from participants in British Columbia (BC), Canada. Subjects: Seventy-five adults (n = 75) aged ≥65 years. Measures: Health promotion self-efficacy was measured using the Self-Rated Abilities for Health Practices Scale. Performance accomplishment was assessed using the health directed behavior subscale of the Health Education Impact Questionnaire; vicarious learning was measured using the positive social interaction subscale of the Medical Outcomes Survey - Social Support Scale (MOS-SSS); verbal persuasion was assessed using the informational support subscale from the MOS-SSS; and affective state was assessed using the depression subscale from the Depression Anxiety Stress Scale (DASS-21). Analysis: Multiple linear regression was used to investigate the relative importance of each social cognitive predictor on self-efficacy, after controlling for age. Results: Our analyses revealed statistically significant associations between self-efficacy and performance accomplishment (health-directed behavior; β =.20), verbal persuasion (informational support; β =.41), and affective state (depressive symptoms; β = −.44) at P <.05. Vicarious learning (β = −.15) did not significantly predict self-efficacy. The model was statistically significant (P <.001) explaining 43% of the self-efficacy variance. Conclusion: Performance accomplishment experiences, verbal persuasion strategies, and affective states may be the target of interventions to modify health promotion self-efficacy among older adults, in environments that require physical and social distancing. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the relationships among motor function, physical activity, and the characteristics of chronic pain (the number of pain sites, pain intensity, and pain-type). Design: Cross-sectional study. Setting: An ongoing community-based prospective study conducted in Itoshima, Japan. Subjects: Community-dwelling Japanese aged 65-75 years (n = 805; 401 men, 404 women). Measures: Chronic pain subtypes were examined in terms of the number of pain sites, pain intensity, and pain type. Motor function was evaluated by handgrip strength, walking speed, and the 5 Times Stand-up and Sit Test (FTSST). Locomotive activity, non-locomotive activity, and sedentary time were evaluated by a tri-axial accelerometer as physical-activity parameters. Analysis: Multiple regression model adjusting for age, sex, education level, employment status, subjective economic status, body mass index, cognitive function, comorbidity, current tobacco use, current alcohol consumption, and regular exercise. Results: In a multivariate analysis, the subjects' walking speed was negatively associated with multisite, moderate-to-severe, and neuropathic-like pain. The FTSST was positively associated with single-site, moderate-to-severe, and neuropathic-like pain. There was no significant association between handgrip strength and any chronic pain subtypes. Locomotive activity was negatively related to multisite, moderate-to-severe, and neuropathic-like pain, but there was no clear association between the amount of non-locomotive activity, sedentary time, and chronic pain subtypes. Conclusion: Severe chronic pain was associated with decreased locomotion-related motor function and physical activity. [ABSTRACT FROM AUTHOR]

Background: Gallstone pancreatitis (GSP) is common in elderly patients and carries worse outcomes. Laparoscopic cholecystectomy (LC) is recommended for prevention of recurrent GSP. In frail populations, an endoscopic retrograde cholangiopancreatography with sphincterotomy (ERCP-s) is an alternative. Management guidelines of GSP in the elderly are lacking. This study aimed to investigate and compare management strategies for GSP in the elderly. Materials and methods: A retrospective comparison of outcome of patients aged ≥65 years with first presentation of GSP treated either with (1) LC only, (2) ERCP-s, (3) ERCP-S followed by LC, or (4) no intervention. Results: 216 patients were included. Median age was 76 years (interquartile range 70-83). Most (80%, n = 172) had mild pancreatitis, whilst 12% (n = 26) had severe disease. 24% (n = 55) were treated with ERCP-s; 40% (n = 87) underwent LC alone; 11% (n = 23) had ERCP-s followed by LC; and 25% (n = 55) received no intervention. Patients without intervention were older (P < .001) and frailer (P < .001). The LC-only group had lower post-procedure re-admission rates of 6% (n = 5) compared to 27% (n = 14) for ERCP-s, 33% (n = 7) for ERCP-S + LC, and 31% (n = 17) for the no intervention group (P = .0001). Biliary cause mortality was highest in the no intervention group (n = 11, 20%). Conclusion: Laparoscopic cholecystectomy represents the gold standard for elderly patients with GSP. [ABSTRACT FROM AUTHOR]

Objective: To examine the effect of concurrent physical and cognitive demands as well as age on indicators of muscle fatigue at the wrist. Background: There are few studies examining risk indicators for musculoskeletal disorders associated with work-related physical and cognitive demands that often occur simultaneously in the workplace. Methods: Twenty-four gender-balanced older and 24 gender-balanced younger (mean age 60 and 23 years) participants performed four 30 min dual tasks. Tasks differed by the muscular load level during force tracking: 5% and 10% of maximum voluntary contraction force (MVC) and concurrent cognitive demands on the working memory: easy and difficult. Muscle fatigue was assessed by MVC decline and changes in surface electromyography (increased root mean square: RMS, decreased median frequency: MF) at the extensor digitorum (ED) and extensor carpi ulnaris (EU). Results: A decline in MVC was found in all participants when tracking was performed at 10% MVC (mean ± SD: 137.9 ± 49.2 – 123.0 ± 45.3 N). Irrespective of age, muscular, or cognitive load, RMS increased (ED 12.3 ± 6.5 – 14.1 ± 7.0% MVE, EU 15.4 ± 7.6 – 16.9 ± 8.6% MVE) and MF decreased (ED 85.4 ± 13.6 – 83.2 ± 12.8 Hz, EU 107.2 ± 17.1 – 104.3 ± 16.7 Hz) in both muscles. However, changes in MF of EU tended to be more pronounced in the older group at higher cognitive and lower muscular load, without reaching statistical significance. Conclusion: Maximum voluntary contraction indicated no interaction between muscle fatigue, cognitive load, or age. However, the tendencies toward altered muscle activity due to an increase in cognitive load and older age suggest muscular adaptations while maintaining tracking performance during the onset of fatigue signs in the sEMG signal. Application: If the tendencies in muscle activity are confirmed by further studies, ergonomic assessments in industrial workplaces should consider cognitive load and age when describing the risk of musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Background: Due to the rapid growth of the world´s oldest population, the number of older persons with stroke is expected to rise. Knowledge of stroke etiology is essential to offer personalized and equal health care across age groups. The present systematic review aimed to investigate the prevalence of etiological subtypes of ischemic and hemorrhagic stroke in older compared to younger people. Methods: MEDLINE, Embase, Cochrane, Epistemonikos, and Cinahl were systematically searched for studies regarding etiological classification in people ≥80 years compared to those <80 years with ischemic or hemorrhagic stroke. Results: Out of 28 441 identified articles, eight met the inclusion criteria. In total, 8223 individuals were included in meta-analyses, of whom 2997 were 80 years or older. We demonstrated a higher prevalence of cardioembolic stroke in people ≥80 years OR 1.68 (95% CI, 1.12-2.53). Small vessel disease was significantly less common in older people OR.64 (95% CI,.50-.81). Regarding large vessel disease, no statistically significant difference between the two groups was shown OR 1.05 (95% CI,.77-1.43). Conclusion: In people ≥80 years, cardioembolic stroke is more common, and small vessel disease less common compared to people <80 years. Overall, the results have to be interpreted with caution due to few studies. Large studies using validated classification systems are needed. [ABSTRACT FROM AUTHOR]

Background: Studies have shown apolipoprotein E (APOE) genotype disclosure to be safe and well-tolerated in cognitively unimpaired (CU) older adults. This study aimed to examine the effect of the disclosure process on decisions about future directives and health behaviors in community-dwelling CU older adults from the Butler Alzheimer's Prevention Registry (BAPR). Methods: CU APOE E4 non-carriers (n = 106) and carriers (n = 80) aged 58-78 completed in-person psychological readiness screening to undergo APOE disclosure. Follow-up assessments were completed online 3 days, 6 weeks, and 6 months post-disclosure. The primary outcomes were future directives, dietary habits, and physical activity scores. Results: Disclosure was associated with decision making on future directives in E4 carriers (t = 3.59, P =.01) at 6 months compared to baseline, but not non-carriers. Family history of memory impairment, SCD endorsement, and education consistently predicted scores on future directives. A significant interaction between E4+ and SCD endorsement on future directive scores was noted (OR = 163.06, 9.5-2,799.8). E4 + carrier status was associated with physical activity (W = 60,148, P =.005) but not dietary habits scores. Conclusions: Our findings indicate that disclosure led to a change in future directives but not protective health behaviors, specifically in E4 carriers. Future work will explore whether pairing disclosure with education about the role of lifestyle factors in AD risk and providing guidelines on making risk-lowering lifestyle modifications as an intervention approach leads to positive change. [ABSTRACT FROM AUTHOR]

Background: Intranasal trigeminal function is important in detecting environmental stimuli. The impact of age-associated chemosensory dysfunction upon taste and olfaction is well described, but an understanding of trigeminal loss (chemesthesis) is lacking. Objective: The goal of this study was to characterize trigeminal function in a cohort of older adults and explore potential impacts. Methods: Twenty-eight participants over 50 years of age were recruited from the community as part of an aging cohort study. This nested cohort completed chemosensory questionnaires, patient-reported outcome measures (PROMs), and psychophysical testing for taste (taste strips), olfaction (Sniffin' Sticks), and trigeminal function (eucalyptol lateralization). Data were analyzed for associations between trigeminal function, olfactory, and taste psychophysical performance, patient-reported metrics, and demographic risk factors. Results: Patient-reported trigeminal impairment is less severe than other chemosensory loss, with mean visual analog scores (VAS, rated 0-100 from least to most severe) for smell (32.9 ± 34.2), taste (20.6 ± 28.4), and trigeminal sensation (9.5 ± 12.8). Despite low VAS scores, psychophysical trigeminal dysfunction was present in 10 (35.7%) subjects. Psychophysical olfactory and taste dysfunction were present in 16 (57.1%) and eight (28.6%) participants respectively. Hypercholesterolemia was associated with psychophysical trigeminal dysfunction (mean lateralization performance in hypercholesterolemia 57.7% ± 17.1 vs. 74.1% ± 10.4, p =.008). Conclusion: Intranasal trigeminal impairment is present in nearly one-third of aging adults when assessed by psychophysical methods but is under-recognized. Hyperlipidemia may be associated with trigeminal impairment. Future inquiries should better characterize these findings in larger and prospective cohorts. [ABSTRACT FROM AUTHOR]

This rapid review aimed to present a comprehensive overview of barriers, facilitators, and effective interventions that promote vaccination uptake by older adults in the Asia-Pacific region. Rapid review methodology was applied, using two databases (PubMed, Embase). Articles were included if studies were conducted in Australia, Singapore, Indonesia, and the Philippines; included human population ≥50 years of age, and was published from 2016 to August 2022. Related articles were not found from Indonesia and Philippines. A total of 23 articles met the inclusion criteria, with 19 reporting on barriers and facilitators, whereas, four articles reported effective interventions to promote vaccination uptake. Among the 19 studies that identified barriers and facilitators to vaccination uptake, the more common factors were social influences (n = 8/19), perceived benefits of vaccine (n = 7/19), and perceived vaccine safety (n = 6/19). Interventions that focused on supporting clinicians were found to be effective in leading them to recommend vaccinations among older adults, such as creating awareness on the low baseline vaccination rates among older adults, provision of structured health assessment, and nurse reminders. More studies are needed to ascertain the barriers and facilitators to uptake, as well as to identify effective interventions influencing vaccine uptake among older adults in the Asia-Pacific region. [ABSTRACT FROM AUTHOR]

Objective: Given the importance of advance care planning (ACP) in the context of a pandemic, we aimed to assess current adherence to local policy recommending ACP in all hospitalised adult patients with suspected or proven COVID-19 at Liverpool Hospital, Sydney, Australia. Design: A retrospective cohort study. Setting: A tertiary referral and teaching hospital. Participants: A select sample of adult patients admitted to Liverpool Hospital in 2019-2021 with suspected or proven COVID-19. Main outcome measures: Proportion of patients with documented ACP and format of ACP. Results: Amongst 209 patients with proven or suspected COVID-19 hospitalised between March 2019 through to September 2021, median frailty score was 3, the median Charlson Comorbidity Score was 4, median age of the patients was 71 years, and median length of hospital stay was 5 days (range 0-98 days). Almost all patients were tested for COVID-19 (n = 207, 99%) of which 15% (31) were positive. Fewer than a quarter of the patients had documented ACPs (50, 24%) and 17 patients had existing formal advance care directives. Patients who had ACP were older, more likely to be frail and more likely to have higher rates of comorbidity compared to those without ACP. ACP was more commonly discussed with family members (41/50) than patients (25/50) and others (5/50). Conclusion: Adherence to the local ACP policy mandating such discussions was low. This reinforces the need for prioritising ACP discussions, especially for unwell patients such as those with COVID, likely involving further input to improve awareness and rates of formal documentation. [ABSTRACT FROM AUTHOR]

Due to the growing concerns of mass incarceration, coupled with the recent global pandemic of COVID-19, parole is in the spotlight as an avenue for early release. At the start of COVID-19, the elderly incarcerated population received attention due to their vulnerabilities. In this article, the likelihood of parole release and the amount of time candidates must wait postdenial are examined by accounting for the COVID-19 period and a parole candidate's elderly status. Data come from a U.S. state parole board's written decisions issued between 2017 and 2022 for individuals sentenced to life with the possibility of parole. While logistic regression models showed COVID-19 and elderly status did not influence the likelihood of release, ordinary least squares (OLS) models found that having a hearing after the onset of the pandemic was significantly associated with shorter interval term lengths. The article concludes with implications for replicating similar studies to understand discretionary release outcomes. [ABSTRACT FROM AUTHOR]

Objective: Previous studies suggest older patients with multiple health conditions and medications may experience adverse interactions, leading to negative outcomes. However, there's limited research on this in older adults receiving home medical care. This study assesses whether polypharmacy is linked to falls or other clinical outcomes. Methods: The study population included 217 participants, aged ≥65 years, receiving home medical care, who consented to participate in the Osaka Home Care Registry (OHCARE) study in Japan. The survey examined the association between polypharmacy and clinical outcomes. We defined "polypharmacy" as six or more medications taken regularly. Results: Of the participants, 135 (62.6%) had polypharmacy and were significantly more likely to have hypertension or diabetes. Common medications included those for hypertension, diabetes, and mental disorders. Participants with polypharmacy experienced significantly more falls. Multivariate analysis showed an association between polypharmacy and falls (odds ratio: 2.81, 95% confidence interval [1.34, 5.92]). Conclusion: Even in older patients receiving home health care, the use of six or more medications poses a risk of falls. Careful observations and life support by medical stuffs are necessary to prevent falls in older patients with polypharmacy receiving home medical care. [ABSTRACT FROM AUTHOR]

Hyponatremia, characterized by serum sodium <135 mEq/L, poses a significant health concern, particularly among the elderly. This case report explores chronic hyponatremia, with a focus on the Tea and Toast Syndrome, prevalent in individuals with atypical dietary habits. We present a 69-year-old female presenting with chronic hyponatremia, revealing dietary factors as key contributors. Thorough diagnostic workup ruled out common causes, emphasizing the importance of meticulous approaches. The patient's adherence to recommended dietary changes resulted in significant improvement, showcasing the pivotal role of targeted nutritional interventions. Pathogenetic mechanisms, such as reduced water-excretory capacity and solute excretion, were explored, with differentiation between AVP-mediated and non-AVP-mediated hyponatremia highlighted. The case underscores the intricate interplay between dietary habits, aging, and chronic hyponatremia, emphasizing the need for adjusted interventions in this vulnerable population. Addressing the nutritional aspects of chronic hyponatremia emerges as a crucial aspect, offering an opportunity for targeted management and improved patient care, especially in the aging demographic. [ABSTRACT FROM AUTHOR]

Ageism refers to stereotypes, prejudice, and discrimination directed towards individuals based on their age, such as perceptions that someone is "too old" for certain activities. Ageism directed at older people is prevalent; over 90% of older people in the United States report that they regularly experience ageism, such as when others assume they are forgetful or need assistance because of their age. Experiencing ageism is associated with poorer health outcomes, reduced cognitive performance, and increased healthcare costs. Reducing ageism requires a multifaceted approach, including strengthening anti-ageism laws and reframing societal narratives about what it means to grow older. Growing older should not be presented as a problem but as a fundamental part of the human journey. Ageism can also be reduced through positive intergenerational interactions and educational initiatives. Reducing ageism can promote healthier aging trajectories. [ABSTRACT FROM AUTHOR]

Associative memory declines with age, and this decline is thought to stem from a decreased ability to form new associations or bind information together. However, a growing body of work suggests that (a) the binding process itself remains relatively intact with age when tested implicitly and (b) older adults form excessive associations (or "hyper-bind") because of a decreased ability to control attention. In this article, we review evidence for the hyper-binding hypothesis. This work shows that older adults form more nontarget associations than younger adults, which leads to increased interference at retrieval and forgetting, an effect that may extend to others with poor attentional control, such as children and people with attention-deficit disorder. We discuss why hyper-binding is apparent only under implicit test conditions and how it affects memory for everyday events. Although hyper-binding likely contributes to forgetting, it may also confer certain advantages when seemingly irrelevant associations later become relevant. [ABSTRACT FROM AUTHOR]

While the literature is well represented in accounting for how aging influences segmental properties of speech, less is known about its influences on suprasegmental properties such as lexical tones. In addition, foreign language learning is increasingly endorsed as being a potential intervention to boost cognitive reserve and overall well-being in older adults. Empirical studies on young learners learning lexical tones are aplenty in comparison with older learners. Challenges in this domain for older learners might be different due to aging and other learner-internal factors. This review consolidates behavioural and neuroscientific research related to lexical tone, speech perception, factors characterising learner groups, and other variables that would influence lexical tone perception and learning in older adults. Factors commonly identified to influence tone learning in younger adult populations, such as musical experience, language background, and motivation in learning a new language, are discussed in relation to older learner groups and recommendations to boost lexical tone learning in older age are provided based on existing studies. [ABSTRACT FROM AUTHOR]

Objective: To describe implementation of the Pathways to Community Living Initiative (PCLI) within an Older People's Mental Health (OPMH) service. Method: A retrospective observational study was conducted. Implementation comprised partnership with a specialist Residential Aged Care Facility (RACF). Data were obtained from Clinical Advisory Committee (CAC) discussion and minutes, the PCLI database, and consumer medical records. Results: Eighteen consumers were accepted onto the program between April 2019 and March 2023. Their PCLI and rating scale outcomes alongside interventions facilitating placements are described. Interventions included OPMH case management, wide-reaching liaison, and inservices. Challenges included communication, confusion regarding roles, and differing views on capacity to accommodate complex consumers. Solutions included streamlining communication, including clinical updates in the CAC, facility appointment of a lead PCLI-nurse, and targeted RACF education. Conclusions: Considered interventions strengthened the OPMH and specialist RACF partnership over time. Clarification of professional roles and intersection with other services was crucial. Successful placement for PCLI consumers required consideration of personalised needs and existing resident mix, liaison with stakeholders, and targeted staff training. These strategies may apply to other health services implementing similar initiatives supporting community placements for OPMH consumers with complex needs. [ABSTRACT FROM AUTHOR]

Ciliated muconodular papillary tumor (CMPT) is a rare pulmonary tumor, typically occurring in middle-aged and elderly individuals. The molecular mutation spectrum of CMPT remains insufficiently explored. Commonly known driver gene alterations include KRAS, BRAF, EGFR, and ALK rearrangement. This report details the clinicopathological features of 2 patients presenting with CMPT as pulmonary nodules during clinical examinations. Microscopic analysis revealed tumors with glandular or papillary structures, consisting of mucinous cells, ciliated columnar cells, and basal cells. Notably, both patients exhibited STRN::ALK fusion, a finding not previously associated with CMPT. STRN::ALK fusion serves as a target for therapy in various tumors, including non-small cell lung cancer, thyroid cancer, and colon cancer. Consequently, we conducted a review of relevant literature, summarizing the clinicopathological and molecular characteristics of CMPT to facilitate further research. Our insights enhance the understanding of this uncommon tumor and contribute to the expansion of its molecular alteration spectrum. [ABSTRACT FROM AUTHOR]

Introduction: In-person cognitive behavioral therapy (CBT) can reduce self-reported anxiety in older adults. However, studies are limited for remote CBT. We assessed the effectiveness of remote CBT in mitigating self-reported anxiety in older adults. Methods: We conducted a systematic review and meta-analysis based on a literature search of PubMed, Embase, PsycInfo, and Cochrane databases up to March 31, 2021, for randomized controlled clinical trials comparing the effectiveness of remote CBT versus non-CBT controls on mitigating self-reported anxiety in older adults. We calculated within-group pre-to-post-treatment standardized mean difference using Cohen's d, obtained the difference between a remote CBT group and a non-CBT control group as our effect size for cross-study comparison, and conducted a random-effects meta-analysis. Changes in scores on self-reported anxiety symptoms (Generalized Anxiety Disorder-7 item Scale, Penn State Worry Questionnaire, or Penn State Worry Questionnaire – Abbreviated), and self-reported depressive symptoms (Patient Health Questionnaire-9 item Scale or Beck Depression Inventory) were primary and secondary outcomes, respectively. Results: Six eligible studies, containing 633 participants with a pooled mean age of 66.6 years, were included in the systematic review and meta-analysis. There was a significant mitigating effect of intervention on self-reported anxiety, favoring remote CBT over non-CBT controls (between-group effect size: −0.63; 95% CI: −0.99 to −0.28). We also found a significant mitigating effect of intervention on self-reported depressive symptoms (between-group effect size: −0.74; 95% CI: −1.24 to −0.25). Discussion: Remote CBT is more effective in reducing self-reported anxiety and depressive symptoms than non-CBT control in older adults. [ABSTRACT FROM AUTHOR]

Objectives: The progressive and unpredictable course of heart failure (HF) has made the provision of palliative care (PC) services to older adults with HF a serious challenge. This study aimed to explain the barriers and facilitators of PC in older adults with HF. Methods: This qualitative study was conducted using the content analysis approach. A sample of 15 participants, including 6 patients, 2 family caregivers, and 7 healthcare team members (4 nurses, a psychiatric nurse, a nutritionist, and a PC physician) were selected by purposive sampling over 10 months (November 21, 2020 to September 1, 2021). The data were collected using semistructured in-person interviews until data saturation and analyzed with conventional qualitative content analysis. Results: The findings revealed the main category of "neglecting the provision of PC," with 4 subcategories of "weak organizational structure," "poor social support," "older adults' and healthcare teams' poor knowledge," and "limited financial resources" as the barriers of PC and the main category of "enjoying support potentials" with 3 subcategories of "the cooperation of the government, benefactors, and nongovernmental organizations," "empathy from the family and relatives," and "benefiting from the presence of healthcare workers" as PC facilitators. Conclusions: The findings of this study explained the barriers and facilitators of PC in older adults with HF. Removing the barriers and supporting the facilitators give older adults with HF better access to PC. Therefore, to expand PC centers for older adults with HF, health system officials, and policy-makers should pay attention to organizational infrastructures and remove the barriers at organizational, social, educational, and economic levels with the cooperation of governmental organizations, benefactors, and nongovernmental organizations. [ABSTRACT FROM AUTHOR]

For older people, physical inactivity increases fall risk as well as other preventable health conditions. Despite the well-documented benefits of physical activity, uptake and adherence continue to challenge efforts aimed at increasing physical activity and reducing falls. Nested within a randomized controlled trial, this study reports on the factors influencing the physical activity behavior of people, aged between 70 and 90 years, engaged in StandingTall, a home-based balance exercise program proven to reduce falls in the community. The perception of aging, physical activity in older age, and the delivery of exercise were identified as major themes, with the perception of aging an overarching theme influencing both preferences for physical activity in older age and exercise delivery. Findings demonstrate the importance of considering the role of aging, the influence aging has on physical activity and exercise behavior, and how aging influences the delivery and design of exercise programs including falls prevention activities for older people. [ABSTRACT FROM AUTHOR]

Background/Objective: Senile pruritus (SP) is a prevalent disease that occurs in elderly individuals over the age of 60 and is characterized by the primary symptom of pruritus. The disease's pathogenesis is complex, and clinical practice mainly uses symptomatic treatment drugs. YGZ223 is a traditional Chinese medicine currently in clinical trials for treatment of SP. However, its chemical composition and pharmacological mechanism remain unclear. The purpose of this inquiry is to investigate the workings of YGZ223 in managing SP using network pharmacology, UPLC-MS, and molecular docking. Materials and Method: This investigation employs network pharmacology to anticipate the mode of operation of YGZ223 in alleviating SP, and UPLC-MS is applied to identify the chemical constituents. Molecular docking provides the binding strengths between principal constituents and targets, while animal experiments are performed to validate the antipruritic activity of YGZ223. Results: The compound prescription for SP contains formononetin and erysodienone as effective ingredients. These ingredients have the potential to impact pathways related to cancer, endocrine resistance, and the PI3K/AKT signaling pathway by regulating targets such as AKT1, EGFR, and mTOR. Formononetin and erysodienone have a considerable binding capacity with various targets, the former displaying the strongest binding with AKT1. Animal test results show that the YGZ223 group can significantly reduce the number of tickles in mice compared to the 4-Aminopyridine induced model group, and has a good anti-itch effect. Conclusion: This study demonstrates that YGZ223 has potential anti-SP activity due to multiple constituents, targets, and pathways, and thus lays the groundwork for development of novel therapeutic approaches for SP. [ABSTRACT FROM AUTHOR]

More than half of older people in long-term care facilities have dementia. Little is currently known about the methods and instruments which can be used to capture the perspectives of older people, including those with dementia, regarding the quality of care provided in such facilities. The main aims of this scoping review were two-fold. Firstly, to identify quality of care instruments that have been applied in long-term care settings. Secondly, to evaluate how these instruments have been developed and validated, particularly in terms of their applicability among older people with dementia. Seven databases (Medline, Web of Science, Scopus, ProQuest, Ageline, CINHAL and google scholar) were searched for relevant literature without any date limit. We used quality criteria adapted from COSMIN (Consensus-based Standards for the selection of health status Measurement Instruments) guidelines to assess the psychometric properties of the instruments. The search identified 16 quality of care instruments which had been used in long-term care settings. Of which, two (12.5%) were specifically designed for older people with dementia, and three instruments (18.7%) were modified for use with older people with mild to moderate dementia. A variety of methods were used to develop the identified instruments including literature reviews, qualitative interviews, expert panel reviews, pre-testing and piloting with older people. None of the identified instruments had been subjected to comprehensive psychometric assessment. Most instruments for assessing quality of care in long term care settings lack alternative communication techniques tailored to people with dementia. This review highlights the need for more rigorous psychometric testing of existing instruments for assessing quality of care in long-term care settings. Several existing measures show promise and may be taken forward for further testing and development for widespread application with older people, including those living with dementia, in long term care settings. [ABSTRACT FROM AUTHOR]

Older adults report high emotional well-being, but age-comparative studies of emotion regulation strategies have not identified systematic age differences. We propose that emotion regulation tactics may be more promising. Emotion regulation tactics involve strategy implementation in a specific situation, and have features shared across strategies involving positive or negative elements (objects/thoughts) in the environment that may be approached or receded from in the regulation attempt (i.e., a valence dimension about the environmental element, and a direction dimension indicating movement toward or away from it). Across several studies, older adults used more positive-approaching than negative-receding tactics. Positive-approaching tactics may also be more effective at regulating mood. We consider implications for aging, as well as group differences in emotion regulation behavior generally. [ABSTRACT FROM AUTHOR]

The global growth of an aging population is expected to coincide with an increase in aging-related pathologies, including those related to brain health. Thus, the potential for accelerated cognitive health declines due to adverse aging is expected to have profound social and economic implications. However, the progression to pathological conditions is not an inevitable part of aging. In fact, engaging in activities that improve cardiovascular fitness appears to be a means that offers the benefits of maintaining and/or improving cognitive health in older age. However, to date, the underlying mechanisms responsible for improved central nervous system health and function with exercise are not yet fully elucidated. Consequently, there is considerable interest in studies aimed at understanding the neurophysiological benefits of exercise on aging. One such area of study suggests that the improvements in brain health via exercise are, in part, driven by the recovery of inhibitory processes related to the neurotransmitter gamma-aminobutyric acid (GABA). In the present review, we highlight the opposing effects of aging and exercise on cortical inhibition and the GABAergic system's functional integrity. We highlight these changes in GABA function by reviewing work with in vivo measurements: transcranial magnetic stimulation (TMS) and magnetic resonance spectroscopy (MRS). We also highlight recent and significant technological and methodological advances in assessing the GABAergic system's integrity with TMS and MRS. We then discuss potential future research directions to inform mechanistic GABA study targeted to improve health and function in aging. We conclude by highlighting the significance of understanding the effects of exercise and aging, its influence on GABA levels, and why a better understanding is crucial to allow for more targeted and effective interventions aimed to ultimately improve age-related decline in aging. [ABSTRACT FROM AUTHOR]

As the number and proportion of older adults living in the U.S. increases, growing evidence shows that people are entering late life with more functional disability than in previous generations. Using data from the 2020 Behavioral Risk Factor Surveillance System survey, we sought to identify the contributions of demographic variables and health conditions to functional disability. Specifically, we tested the associations among age, sex, race, chronic physical health conditions, depression, and functional ability among 243,693 adults, ages 45 years and older. Model testing, implemented in AMOS 29.0.0, resulted in an acceptable fit of the model to the data, Χ2 (DF = 18, N = 243,693) = 19,512.64, p <.001; CFI = 0.909; TLI = 0.774; RMSEA = 0.066; R 2 Function =.267. The findings from the present study replicate previous research that age, sex, and racial background differences influence functional disability. We extend the literature to examine physical and emotional health as potential pathways to intervene in midlife. [ABSTRACT FROM AUTHOR]

The population of Hispanic older adults is growing along with the burden of chronic diseases. This cross-sectional study aims to assess the factors associated with frailty among community-dwelling Hispanic women aged ≥60 years (n = 357) enrolled in the Panama Aging Research Initiative—Health Disparities study of cognitive-functional health of older persons in Panama. Cognitive function was assessed with a neuropsychological test battery. Depression was measured with the Geriatric Depression Scale. Frailty was defined using the Fried criteria and participants were classified as non-frail, pre-frail or frail. A subsample (n = 281) provided fasting blood samples for quantification of protein biomarkers. Associations were examined using hierarchical multiple linear regressions. 59.4% and 9.0% of participants (M = 69.2 years, SD = 6.3) were pre-frail and frail, respectively. Having more depression (β =.28, p <.001) was significantly associated with frailty, even after covariate adjustment. Cognitive function was not associated with frailty. Higher pTau181 levels were associated with increased frailty (β =.13, p =.039), whereas higher α2M levels were associated with decreased frailty (β = −.16, p =.004). These findings advance the search for health indicators and biomarkers of frailty and warrant further studies to decrease the burden of frailty among older Hispanic women. [ABSTRACT FROM AUTHOR]

Electrical heated clothing (EHC) is a revolutionary concept that combines garment with electrical technology to create garments capable of actively regulating and providing warmth to the wearer, especially for the elderly. To develop an EHC for the elderly with both aesthetics and functionality, the technique of knitted Jacquard is employed for fabrics and Bluetooth module is applied to realize user interaction (UI) design. Firstly, 16 different heated fabrics were fabricated by choosing different silver-coated yarns and knitted Jacquard patterns. The heating temperatures of the fabrics were simulated, and the actual heating performance was observed through infrared thermal image. Suitable materials and patterns were selected to produce the EHC. Secondly, in order to meet the demands for the elderly, a prototype was developed by combining the characteristics of the elderly clothing design and UI design. After the design of a Bluetooth module with a PCBA, the heating temperature and heating time of the clothing can be adjusted through the WeChat mini-program on the mobile phone. It has been verified that the developed prototype meets the heating requirements. This study can serve as an excellent guide for the advancement of EHC and electrical wearables. [ABSTRACT FROM AUTHOR]

Malnutrition is a multifactorial problem affecting older adults especially in developing countries like Nigeria. Eighty-five subjects which comprise 55 older adults and 30 controls were recruited. Total protein, Albumin, Calcium, Vitamin-C and Vitamin D were estimated using Biuret's method, Bromo-Cresol Green method, O-Cresolphthalein-Complexone, High performance liquid chromatography, and ELISA methods respectively. Cognitive and nutritional status information were obtained using Mini-Cog test and MNA-short form. Data were analyzed at p <.05. Activities of daily living (ADL) was observed to be associated with nutritional status in older adults. The prevalence of older adults at risk of malnutrition was found to be 58.2%. Blood pressure, albumin and total protein were significantly higher in older adults (p <.05) compared to the younger adults. Total protein was significantly higher in older female subjects (p <.05) compared to older male subjects. It was also significantly higher in non- institutionalized older adults than in those who were institutionalized. Calf circumference was significantly lower (p <.05) in those with poor cognitive status. BMI and calcium were significantly lower in the malnourished older adults. It is concluded that older adults who are dependent, most of which are institutionalized may be more exposed to malnutrition, frailty and cognitive impairment. [ABSTRACT FROM AUTHOR]

This study examined the association between healthcare access and quality of life (QOL) among senior citizens in Pampanga, Philippines. We conducted a cross-sectional study among 410 community-dwelling senior citizens aged 60 and above. Using validated scales, we assessed both healthcare access and QOL. Descriptive statistics were employed to characterize the senior citizens, and multiple linear regression was used to examine the association between healthcare access and QOL. Senior citizens, averaging 69 years old, were predominantly women, single/widowed, and with comorbidities. They reported high healthcare access (mean = 120.13) and moderate QOL (mean = 70.79). Environmental health scored highest in QOL domains, while social relationships scored lowest. Overall healthcare access was positively associated with overall QOL (B [unstandardized beta] =.22, 95% CI [confidence interval] 0.10, 0.33) and its domains. Significant associations with overall QOL were observed for accessibility (B = 1.95, 95% CI 0.98, 2.91) and affordability (B = −1.60, 95% CI −2.46, −0.74). Filipino senior citizens in Pampanga demonstrated high healthcare access and moderate QOL. The study highlights the importance of healthcare access in enhancing senior citizens' QOL, particularly regarding accessibility and affordability. Further research is needed to explore the nuanced relationships between healthcare access subscales and specific QOL domains. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) significantly contributes to sepsis, with patients suffering from both conditions exhibiting greater severity and higher mortality rates compared to those with sepsis alone. Elderly individuals in the intensive care unit (ICU) are particularly prone to these comorbidities. A nomogram prediction model was developed to accurately assess prognosis and guide treatment for elderly patients with sepsis and T2DM. Methods: Data from 1489 patients with sepsis and T2DM in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were analyzed and categorized into 28-days survival (n = 1156) and 28-days death groups (n = 333). The dataset's clinical characteristics were employed to create a nomogram predicting 28-days mortality in elderly ICU patients with sepsis and T2DM. The least absolute shrinkage and selection operator (LASSO) regression identified candidate predictors, followed by a multivariate logistic regression analysis incorporating variables with p <.05 into the final model. A nomogram was then constructed using these significant risk predictors. The model's discriminatory power was evaluated through a receiver operating curve (ROC) and the area under the curve (AUC). Additionally, model performance was assessed using a calibration plot and the Hosmer-Lemeshow goodness-of-fit test (HL test), and clinical utility was examined via decision curve analysis (DCA). Results: Risk factors incorporated into the nomogram included age, ICU length of stay, mean blood pressure (MBP), metastatic solid tumor, Sequential Organ Failure Assessment (SOFA) score, Logistic Organ Dysfunction System (LODS) score, blood urea nitrogen (BUN), and vasopressor use. The predictive model demonstrated robust discrimination, with an AUC of 0.802 (95% CI 0.768–0.835) in the training dataset and 0.753 (95% CI 0.697–0.809) in the validation set. Calibration was confirmed with the HL test (p >.05), and DCA indicated clinical usefulness. Conclusion: This new nomogram serves as a practical tool for predicting 28-days mortality among elderly ICU patients with sepsis and T2DM. Optimizing treatment strategies based on this model could enhance 28-days survival rates for these patients. [ABSTRACT FROM AUTHOR]

Background: The population in Latin America and Caribbean (LAC) has experienced a major demographic transition with increased numbers of older adults (OA). This change brings opportunities in the public health sector to implement health prevention interventions and delay the onset of geriatric syndromes. Micronutrients play an important role in the maintenance of biological function which contributes to longevity. Micronutrient deficiencies (MD) in OA increase the risk for onset of chronic comorbidities and geriatric syndromes. Aim: To review and summarize the existing data on micronutrient status in OA in the LAC region and discuss the gaps and challenges in public health approaches to address deficiencies. Methods: Literature review in Medline for records describing nutritional biomarkers in older adults (≥ 60y) from community dwelling and population-based studies in LAC. Results: Few countries (including Chile, Ecuador, Costa Rica, Brazil, and Mexico) have documented one or more nutritional deficiencies for OA in national health surveys, however across the entire region, evidence of micronutrient levels is scarce. Some surveys have documented a high prevalence and large heterogeneity in the prevalence of vitamin D followed by B12 deficiency, being the 2 MDs most studied due their effects on cognition, frailty, and bone mineral density in the OA population. Other MD including C, E, A, copper, zinc, iron, and selenium have also been reported. Conclusion: Information on the micronutrient status in OA from LAC is poorly documented. Research and capacity building initiatives in the region are crucial to develop tailored strategies that address the specific nutritional needs and challenges faced by the ageing population in Latin America. Plain language title: Micronutrients Deficiencies in Older Adults in Latin American Plain language summary: For the first time, there are more older adults (OA) than children worldwide. In the Latin America and Caribbean (LAC) region, OA represents 13.2% of the population, and it is projected to increase to 30% (220 millions) by 2030. This demographic shift represents an opportunity in the public health sector to implement health prevention strategies and public health policies to delay the onset of geriatric syndromes in the younger generation. Vitamins and minerals (micronutrients) are necessary in our body to maintain biological function. Deficiencies in older ages have been associated with the onset of geriatric syndromes (such as sarcopenia, frailty, cognitive impairment, and falls, among others). Therefore, it is relevant to understand the magnitude and distribution of micronutrient deficiencies in OA in the LAC region. This will help to inform decision-makers to further implement early actions to maintain good nutrition and health status in the population. In this narrative review, we highlight that few countries in the LAC region documented one or more nutritional deficiencies for OA in their national health surveys. Across the entire region, evidence of micronutrient levels in OA is scarce. Vitamin D and vitamin B12 are the 2 most reported micronutrients in the OA population. Research and capacity-building in the region are crucial to develop tailored strategies to address specific nutritional needs and challenges faced by the aging population in Latin America. [ABSTRACT FROM AUTHOR]

Geographical mobility may have a powerful influence on sexual change. The sexual dimension of migration has mostly been studied in reference to its role in shaping aspiration for mobility. It has been documented how the promise of an erotically desirable future plays often an important role in many migration subcultures. Mobility, moreover, has been recognized as one of the ways in which many types of sexual minorities have escaped repression or pursued greater autonomy. In this paper, we argue that the same phenomena may be observed in the migration of older people. For some mature persons, particularly women, migration provides an alternative to de-sexualization and stigmatization. In many of these cases, however, the subjective process of sexual change is triggered indirectly, and sometimes serendipitously, by the experience of geographical dislocation. In fact, the experience of re-sexualization may be utterly independent from any pre-emigration aspiration to change one's sexual Self. The paper – on the basis of two longitudinal research projects on the women pioneers of the Eastern European migration to Italy – explores the role played in their settlement by the discovery that, in the new environment, their age did not disqualify them from romance. The different reactions to these opportunities have created a strong differentiation among migratory trajectories. For the women pioneers who have decided to explore it, this unexpected lovescape has made possible to draw some crucial social boundaries and to trigger the birth of a distinctive sexual field. [ABSTRACT FROM AUTHOR]

Cognitive impairment and older age are major risk factors for postoperative delirium. Professional societies have advocated preoperative screening to identify at-risk individuals for implementation of interventions, which have moderate effectiveness in preventing delirium. However, it remains unclear from the guidelines whether screening should be completed routinely for all older individuals or targeted, and also which specific screening tool is preferred. In addition, the responsibility for screening remains undesignated in the guidelines provided. We reviewed the benefits and risks of routine screening. We also performed a cost-benefit analysis of routine screening (versus no screening). Furthermore, we summarised the sensitivities and specificities of commonly used screening tools and reviewed evolving screening tools that may have an increasing role in future practice. We concluded that routine screening is useful and appears to be cost-effective for reducing postoperative delirium, with a cost-benefit ratio of 2.89 (adjusted ratio of 2.34), and has additional advantages over other approaches such as targeted screening or routine intervention. [ABSTRACT FROM AUTHOR]

Background: Recent studies suggested that persons with migraine might be at higher risk of structural brain changes, including cerebral small vessel disease and atrophy. However, findings in the literature are inconsistent, with variations observed in the direction, magnitude, and population characteristics of reported effects, and large-scale population-based evidence remains scarce. Hence, we investigated the association of migraine with structural brain changes in a middle-aged and elderly population. Methods: Within the population-based Rotterdam Study, lifetime history of migraine was assessed using a validated questionnaire between 2006 and 2011. Magnetic resonance imaging of the brain was performed in 4920 participants (median age 61.7 [IQR 45.5, 97.5] years, 55.4% female) to assess imaging markers of cerebral small vessel disease and brain atrophy. We used linear and logistic regression models to examine the cross-sectional association of migraine with brain volumes (total grey and white matter volumes in mL) and cerebral small vessel disease markers (white matter hyperintensity volume in mL, presence of lacunes and cerebral microbleeds). Adjustments were made for age, sex, intracranial volume and cardiovascular variables. Analyses were also stratified by sex and presence of aura. Results: The lifetime prevalence of migraine was 15.3% (752/4920). In multivariable adjusted regression models, we found no statistically significant differences between participants with and without migraine in terms of total brain volume (mean difference [MD]: 2.21 mL, 95% confidence interval [CI]: −0.38 ; 4.81), grey matter volume (MD: 0.38 mL, 95% CI: −1.98 ; 2.74), white matter volume (MD: 2.19 mL, 95% CI: −0.56 ; 4.93), log white matter hyperintensity volume (MD: −0.04 mL, 95% CI: −0.10 ; 0.02), presence of lacunes (odds ratio [OR]: 0.82, 95% CI: 0.58–1.15), and presence of cerebral microbleeds (OR: 0.95, 95% CI: 0.76–1.18). Conclusion: In this study, we found that middle-aged and elderly participants with migraine were not more likely to have structural brain changes on magnetic resonance imaging. [ABSTRACT FROM AUTHOR]

Socioecological crises, such as the climate crisis, place a heavy burden on young and future generations. However, these generations have less influence on political and economic decisions. Older generations will be less affected by most socioecological crises but have a greater impact in terms of contribution and resolution. Therefore, young and future generations depend on older generations to act in solidarity. In a preregistered online survey study, we examined the political solidarity of older adults with young people in three countries (US, N = 399; Germany, N = 401; and Brazil, N = 403). Results show that affinity with young people and legacy motivation directly explained intergenerational political solidarity in all three countries. In the US and Brazil, quantity and quality of intergenerational contact with young people indirectly explained political solidarity through affinity. These findings suggest that increasing the closeness between generations may be a promising lever for intergenerational solidarity. [ABSTRACT FROM AUTHOR]

Age is a commonly used criterion in social work, whether for entry and exit or for decisions about the appropriate measures for clients. This study introduces the concept of age logics in social work and investigates the use of age in 'wet' eldercare facilities. Wet eldercare facilities are harm reduction arrangements open to people over the age of 50 with long-term substance misuse. No treatment is provided, and residents can continue to consume alcohol and other substances for the rest of their lives. At wet eldercare facilities, age is used to mark a shift in ambition: earlier efforts to treat are replaced by attempts to provide care and dignity. The article uses wet eldercare facilities as the example with which to (i) introduce age logics as an analytical tool for critical studies of age in social work; (ii) understand how age logics are used in harm reduction arrangements for older people; and (iii) propose a method to increase age awareness and identify and challenge problematic uses of age in social work. The empirical data consists of interviews with 31 residents, 11 caseworkers and 12 staff members at two Swedish wet eldercare facilities. The analysis identifies four types of age logics linking chronological age with its meanings: (a) the logic of changeability; (b) the logic of lifestyle; (c) the logic of function; and (d) the logic of administrative fit. Together they construct an ideal type of the 'older addict', which justified existing arrangements. [ABSTRACT FROM AUTHOR]

Introduction: The aim was to identify whether cardiovascular telerehabilitation programs (CV-T-REHAB) can improve functional capacity, cardiorespiratory fitness and quality of life (QoL) to the same extent of presential rehabilitation (CV-P-REHAB) in older adults, by meta-analysis of previous studies. Methods: Literature search was conducted in October 2020 in four databases to select controlled trials of CV-T-REHAB effects on functional capacity (six-minute walk test [6MWT]), cardiorespiratory fitness (maximal oxygen consumption [ V ˙ O2max]), and QoL in older adults (> 50 years) and included new articles in April 2022. Results: CV-T-REHAB improved 6MWT (11.14 m [CI95% = 8.03; 14.26], p < 0.001), V ˙ O2max (1.18 ml/kg/min [CI95% = 0.70; 1.66], p < 0.001), and QoL (standardized mean difference [SMD] = 0.36 [CI95% = 0.05; 0.67], p = 0.02). CV-T-REHAB increased V ˙ O2max to a greater extent than CV-P-REHAB (1.08 ml/kg/min [0.39; 1.76], p = 0.002). Although the 6MWT and V ˙ O2max analyses proved consistent and homogeneous, the QoL analysis showed considerable inconsistency (I 2 = 92.90%), suggesting the need for studies exploring the effect of CV-T-REHAB on QoL in this population. Part of the heterogeneity was explained by age differences, as CV-T-REHAB improved QoL in adults >65 years, but not in adults <64 years. Conclusion: CV-T-REHAB improved cardiorespiratory fitness to a level equal to or higher than CV-P-REHAB and improved functional capacity and QoL; being mainly effective for QoL in older adults >65 years. Thus, CV-T-REHAB can be a good alternative, when not the best option and might be considered especially for individuals with limited access to participate in face-to-face programs. [ABSTRACT FROM AUTHOR]

Objective: Depression in later life is associated with a two-fold increased risk of dementia. It is not clear to what extent potentially modifiable risk factors account for this association. Method: Older adults (age 50 +) with objective health measures (n = 14,014) from the Canadian Longitudinal Study on Aging were followed for a mean duration of 35 months. Linear regression analyses were used to determine if clinically significant depression (Centre for Epidemiologic Studies Depression scale score (CESD) ≥ 10) was associated with global cognitive decline, assessed with a neuropsychological battery during follow-up, and if modifiable risk factors mediated this association. Results: Depression was associated with an excess of risk factors for cognitive decline including: vascular disease, hypertension, diabetes, apnoea during sleep, higher body mass index, smoking, physical inactivity and lack of social participation. In regression analyses depression remained independently associated with cognitive decline over time (beta −0.060, P = 0.038) as did cerebrovascular disease (beta −0.197, P < 0.001), HbA1C (beta −0.059, P < 0.001), visual impairment (beta −0.070, P = 0.007), hearing impairment (beta −0.098, P < 0.001) and physical inactivity (beta −0.075, P = 0.014). In mediation analyses, we found that cerebrovascular disease (z = −3.525, P < 0.001), HbA1C (z = −4.976, P < 0.001) and physical inactivity (z = −3.998, P < 0.001) partially mediated the association between depression and cognitive decline. Conclusions: In this large sample of Canadian older adults incorporating several objective health measures, older adults with depression were at increased risk of cognitive decline and had an excess of potentially modifiable risk factors. Clinicians should pay particular attention to control of diabetes, physical inactivity and risk factors for cerebrovascular disease in older adults presenting with depression as they can contribute to accelerated cognitive decline and may be addressed during routine clinical care. [ABSTRACT FROM AUTHOR]

The current study investigated how perceived social support was associated with personality trait development in a Swedish longitudinal sample (n = 3914; mean age = 63.09 years) with six waves of data on individuals' Big Five personality traits, and perceived support from family, friends, and a special someone. We employed random intercept cross-lagged panel models to consider the between- and within-person associations for these constructs over time. First, in almost all cases, between-person associations were found between the levels for personality traits and support variables. Moreover, findings did not differ much depending on the source of the relationship. Second, again in almost every model, significant within-person covariances were evidenced, suggesting that when individuals increased on support relative to their typical level at a given wave, they also tended to report higher levels than they typically do on these traits. Finally, however, little evidence was found for cross-lagged effects in either direction. Across models, only one cross-lagged association even reached significance. In sum, our findings support the close connection between personality and perceived social support in older adulthood, and they motivate future directions into when and why such associations occur using more proximal measurements. Plain language summary: In older adulthood, social relationships take on new meanings and importance compared to earlier in the lifespan. However, work is needed to understand how social relationships may shape the kind of person we are, or our personalities, in older adulthood. The current study examined whether older adults' personality changed in tandem with their social support levels. Older adults were asked to report on their personality and how much they felt supported six times, one year apart. Our findings suggest that when older adults feel more or less supported by others, it often coincides with changes in their personality. [ABSTRACT FROM AUTHOR]