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Background: Musculoskeletal pain alters physiological function, which may be evidenced as early as middle age. Previous research has concluded that middle-aged adults are a high-risk group for musculoskeletal pain and report functional limitations similar to older adults. However, few studies have examined the relationships between musculoskeletal pain and physical function, using objective performance measures in a sample of racially and socioeconomically diverse adults. Thus, this study examined musculoskeletal pain in relation to physical function in middle-aged (30-64 years) White and Black adults and investigated whether the relationship varied by sociodemographic characteristics., Methods: This cross-sectional examination incorporated data from the Healthy Aging in Neighborhoods of Diversity across the Life-Span Study. Participants (n = 875) completed measures of musculoskeletal pain and objective measures of physical performance (ie, lower and upper body strength, balance, and gait abnormalities). Physical performance measures were standardized to derive a global measure of physical function as the dependent variable., Results: Approximately, 59% of participants identified at least 1 pain sites (n = 518). Multivariable regression analyses identified significant relationships between greater musculoskeletal pain and poorer physical function (β = -0.07, p = .031), in mid midlife (β = -0.04, p = .041; age 40-54) and late midlife (β = -0.05, p = .027; age 55-64)., Conclusions: This study observed that musculoskeletal pain was associated with poorer physical function within a diverse group of middle-aged adults. Future research should longitudinally explore whether chronic musculoskeletal pain identified at younger ages is associated with greater risk for functional limitation and dependence in later life., (Published by Oxford University Press on behalf of The Gerontological Society of America 2020.)

ABSTRACTGiven Canada's aging population, the demand for home care is expected to increase significantly. To date, little is known about home care for older adults in Canada such as characteristics of home care recipients, gaps in services, or interventions designed to support home care client needs. Consequently, we conducted a systematic review of seven electronic databases for the years 2000-2016 to examine the current knowledge of home care services for Canada's older adults. This synthesis examined four main themes in the literature: older adult client-level predictors; unmet care needs; interventions; and issues and challenges in home care. This review found significant knowledge gaps on home care for older adults across the country, as over half of the studies were focused primarily in Ontario. Although promising strategies were evident, more research and evaluation of interventions, and outcomes are required to effectively support Canada's home care system now and over time.

This study examines life expectancy (LE) and healthy life expectancy (HLE) in India longitudinally over the period 2007 to 2020, providing projections into the future. Specifically, the Indian Healthy Life Expectancy Projection model was developed based on epidemiological data (mortality, disability rates) obtained from the World Health Organization and the Government of India. The current model contributed to 4 key findings: decreases in mortality but not in all age and gender groups; increasing disability in the Indian population over time; increase in LE and HLE into the future in all age and gender groups; and the largest gains in LE and HLE are in the older age bands starting from the 70+ age band in women and 65+ age band in men. This study sheds some light on the population health measures needed to improve the understanding of the determinants of health for the efficient allocation of resources and to inform policy in the planning of health and social services.

The purpose of this study was to describe the longitudinal (10 yr) decline in aerobic power [maximal O(2) uptake (Vo(2 max))] and anaerobic threshold [ventilatory threshold (T(Ve))] of older adults living independently in the community. Ten years after initial testing, 62 subjects (34 men, mean age 73.5 +/- 6.4 yr; 28 women, 72.1 +/- 5.3 yr) achieved Vo(2 max) criteria during treadmill walking tests to the limit of tolerance, with T(Ve) determined in a subset of 45. Vo(2 max) in men showed a rate of decline of -0.43 ml.kg(-1).min(-1).yr(-1), and the decline in Vo(2 max) was consequent to a lowered maximal heart rate with no change in the maximum O(2) pulse. The women showed a slower rate of decline of Vo(2 max) of -0.19.ml.kg(-1).min(-1).yr(-1) (P < 0.05), again with a lowered HR(max) and unchanged O(2) pulse. In this sample, lean body mass was not changed over the 10-yr period. Changes in Vo(2 max) were not significantly related to physical activity scores. T(Ve) showed a nonsignificant decline in both men and women. Groupings of young-old (65-72 yr at follow-up) vs. old-old (73-90 yr at follow-up) were examined. In men, there were no differences in the rate of Vo(2 max) decline. The young-old women showed a significant decline in Vo(2 max), whereas old-old women, initially at a Vo(2 max) of 19.4 +/- 3.1 ml.kg(-1).min(-1), showed no loss in Vo(2 max). The longitudinal data, vs. cross-sectional analysis, showed a greater decline for men but similar estimates of the rates of change in women. Thus the 10-yr longitudinal study of the cohort of community-dwelling older adults who remained healthy, ambulatory, and independent showed a 14% decline in Vo(2 max) in men, and a smaller decline of 7% in women, with the oldest women showing little change over the 10-yr period.

Social interaction and physical activity are critical components in supporting health among older adults, yet rates of activity are low in rural communities. There is significant merit in exploring the relationship between these interrelated concepts. A scoping review was conducted to synthesize existing literature. Search results identified 26 studies meeting inclusion criteria. Findings indicated that social interaction and physical activity were important for many older adults to maintain health; however, not all older adults preferred the social aspect of group-based exercise. Opportunities for physical activity and social interaction were limited based on geographical location and other socioeconomic factors. This was evident in rural communities where populations were lower and education and income levels varied. Differences on the defining role and meaning of physical activity also emerged. Increasing physical activity and social interaction must account for negative associations to address the lower rates of participation among rural older adults. [ABSTRACT FROM AUTHOR]

In the context of an aging population, both the need for home care services and its complexity of care have increased in many high-income countries. Yet, the definition of what constitutes complex care is largely elusive. This systematic review examined the conceptual definition of complex care within the home care environment using several social and health science databases for research published from 2000 to 2017. Of the 25 articles and reports identified, only 16 addressed complex care specifically and included older adults, aging, and/or home care. The results showed that complex care for older adults is primarily defined from a biomedical approach focusing on chronic disease and management and less commonly from the perspective of the social determinants of health. Future studies should consider the importance of the continuum of care needs from both the biomedical and the social determinants to adequately plan and provide care for older adults. [ABSTRACT FROM AUTHOR]

This qualitative study examined the falls and fall-related injury experiences of community-dwelling rural seniors. 42 senior men and women living in two rural areas in Saskatchewan, Canada were recruited, and in-depth interviews were conducted. Analysis revealed three main themes among responses: nature of falls and injuries, causes of falls and injuries, and consequences of falls and injuries. Men and women expressed a fear of falling, which led to activity limitations; however, women were more reflective on their potential to fall and showed an increased level of preparedness compared to men. The causes of falls included activities at the time of a fall, functional limitations, chronic diseases, and personal factors such as type shoes worn. While men and women downplayed the seriousness of their falls or injuries, indicating a level of hardiness, this trend was stronger among men. None of the participants discussed the role of health care professionals or the health care system in relation to fall risk and ways of preventing falls, despite reporting adaptations to prevent and deal with consequences of falls. Overall, these findings may allude to the scarcity of health care services provided in rural communities, highlighting a need to focus on falls prevention for community-dwelling rural seniors. [ABSTRACT FROM AUTHOR]

To date, initiatives to support healthy aging in place have focused primarily on the views of policy makers, researchers, and health professionals. This article explored the meanings, experiences, and perceptions of healthy aging in place among rural older adults. Guided by a community-based participatory research approach, this study sheds light on the perspectives of rural seniors themselves. Through semistructured interviews with 40 rural older adults, the study found that rural older adults' conceptualization of healthy aging in place consisted of factors that policy makers and health professionals would not necessarily consider. In contrast to biomedical approaches, the rural older adults situated healthy aging in place within a more holistic context of health, ranging from social interaction to maintaining an optimistic mental outlook. If policy makers and researchers are to develop more effective interventions that support rural healthy aging in place, then the importance of rural older adults' perspectives, experiences, and input must be recognized. [ABSTRACT FROM PUBLISHER]

This study was performed to compare the effects of creatine supplementation (CR) before vs. after supervised resistance training (RT) in healthy older adults. Participants were randomized to one of two groups: CR-Before (0.1g•kg−1creatine before + 0.1g•kg−1placebo [rice flour] after RT,n = 11) or CR-After (placebo before + creatine after RT,n = 11). Resistance training (RT) was performed 3 days/week, on nonconsecutive days, for 12 weeks. Prior to and following the study, measures were taken for body composition, maximum strength, muscle protein catabolism, and kidney function. Over the 12-week training period, both groups experienced a significant increase in whole-body lean tissue mass, limb muscle thickness, and upper and lower body strength and a decrease in muscle protein catabolism (p < 0.001), with no differences between groups. There was no change in kidney function over time. Changes in muscle mass or strength are similar when creatine is ingested before or after supervised resistance training in older adults. [ABSTRACT FROM PUBLISHER]

Purpose: To examine the key determinants that support healthy aging in rural communities. Sample: Forty- two participants aged 65 and older were recruited from two rural communities in Saskatchewan, Canada. Methods: Using an ethnographic methodological approach, data was collected through semi-structured interviews, field notes and participant observation notes. Cantor's (1989) Social Care Model was used as the theoretical framework for exploring the supports that facilitate rural healthy aging. Findings: Healthy aging among rural seniors extends significantly beyond access to physicians and formal health care. Eight key themes related to healthy aging were identified: housing; transportation; healthcare; finances; care giving; falls; rural communities; and support systems. Conclusions: While there is evidence of poor health among rural seniors, little research has examined healthy aging or the determinants that facilitate healthy aging in rural communities. In addressing rural seniors' health needs, this study provides a fundamental basis for developing effective interventions and innovative public policy options to support rural healthy aging. [ABSTRACT FROM AUTHOR]