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Physical activity levels during skilled nursing facility (SNF) rehabilitation fall far below what is needed for successful community living and to prevent adverse events. This feasibility study's purpose was to evaluate the feasibility, acceptability, and preliminary effectiveness of an intervention designed to improve physical activity in patients admitted to SNFs for short-term rehabilitation. High-Intensity Rehabilitation plus Mobility combined a high-intensity (i.e., high weight, low repetition), progressive (increasing in difficulty over time), and functional resistance rehabilitation intervention with a behavioral economics-based physical activity program. The behavioral economics component included five mobility sessions/week with structured goal setting, gamification, and loss aversion (the idea that people are more likely to change a behavior in response to a potential loss over a potential gain). SNF physical therapists, occupational therapists, and a mobility coach implemented the High-Intensity Rehabilitation plus Mobility protocol with older Veterans (n = 18) from a single SNF. Participants demonstrated high adherence to the mobility protocol and were highly satisfied with their rehabilitation. Treatment fidelity scores for clinicians were ≥95%. We did not observe a hypothesized 40% improvement in step counts or time spent upright. However, High-Intensity Rehabilitation plus Mobility participants made clinically important improvements in short physical performance battery scores and gait speed from admission to discharge that were qualitatively similar to or slightly higher than historical cohorts from the same SNF that had received usual care or high-intensity rehabilitation alone. These results suggest a structured physical activity program can be feasibly combined with high-intensity rehabilitation for SNF residents following a hospital stay. [ABSTRACT FROM AUTHOR]

Background/Objectives: Engagement in sport offers the potential for improved physical and psychological well-being and has been shown to be beneficial for promoting healthy aging. Opportunities for older adults to (re)engage with sport are limited by a paucity of age-appropriate introductory sports intervention programs. As such, the study evaluated the efficacy of a newly designed 8-week badminton training program (Shuttle Time for Seniors) on markers of healthy aging and the lived experiences of participation. Methods: Forty-three older adults assigned to a control (N = 20) or intervention group (N = 23) completed pre–post assessment of physical and cognitive function, self-efficacy for exercise, and well-being. Focus groups were conducted for program evaluation and to understand barriers and enablers to sustained participation. Results: Those in the intervention group increased upper body strength, aerobic fitness, coincidence anticipation time, and self-efficacy for exercise. Objectively improved physical and cognitive functions were corroborated by perceived benefits indicated in thematic analysis. Shuttle Time for Seniors was perceived as appropriate for the population, where the age-appropriate opportunity to participate with likeminded people of similar ability was a primary motivator to engagement. Despite willingness to continue playing, lack of badminton infrastructure was a primary barrier to continued engagement. Conclusion: Shuttle Time for Seniors offered an important opportunity for older adults to (re)engage with badminton, where the physical and psychosocial benefits of group-based badminton improved facets important to healthy aging. Significance/Implications: Age-appropriate introductory intervention programs provide opportunity for older adults to (re)engage with sport. However, important barriers to long-term engagement need to be addressed from a whole systems perspective. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine factors associated with participation of community-dwelling older Australians (≥65 years) in the Exercise Right for Active Ageing program, consisting of 12 low- to moderate-intensity group exercise classes, delivered weekly, in person or online, by accredited exercise scientists and physiologists across Australia. Out of 6,949 participants recruited, 6,626 (95%) attended one or more classes and were included in the primary analysis, and 49% of participants attended all 12 classes. Factors associated with higher class attendance included participation in yoga/flexibility/mobility classes, attendance at a free trial class (adjusted incidence rate ratio [95% confidence interval]: 1.05 [1.03, 1.08]), and attending online classes (1.19 [1.11, 1.26]). Factors associated with lower class attendance included state of residence, living in inner regional areas (0.95 [0.93, 0.98]), and having two or more comorbidities (0.97 [0.95, 0.99]). High class attendance suggests that the Exercise Right for Active Ageing program was well received by older Australians, particularly in states less impacted by COVID-19 lockdowns. [ABSTRACT FROM AUTHOR]

Despite the well-known benefits of physical activity, less than half of adults aged 55–75 years participate in sufficient physical activity. Short bouts of vigorous intermittent lifestyle physical activity (VILPA) accumulated throughout the day can contribute toward the recommended volume of physical activity. A rich characterization of the barriers and facilitators to participation in VILPA is needed to develop targeted interventions. This scoping review aimed to identify barriers and facilitators to participation in different components of VILPA in adults aged 55–75 years, and to map barriers and facilitators to the Theoretical Domains Framework. Within the 18 eligible studies, the most prevalent barriers were related to a person's skills, environmental context, and social influences. Most facilitators were related to a person's goals, social influences, and environmental context. Interventions to promote VILPA should test the effectiveness of behavioral change measures related to the unique barriers and facilitators in this age group. [ABSTRACT FROM AUTHOR]

We tested if a dance trial yielded improvements in physical function and cardiorespiratory fitness (CRF) in middle-aged/older Latino adults. Physical activity was assessed using the Community Healthy Activities Model Program for Seniors, physical function with the Short Physical Performance Battery (SPPB) protocol, and estimated CRF with the Jurca nonexercise test model. Multivariate analysis of covariance models found significant change in SPPB protocol total scores, F(1, 329) = 4.23, p =.041, and CRF, F(1, 329) = 5.16, p =.024, between the two study arms in favor of the dance group. Mediation models found moderate- to vigorous-intensity physical activity to mediate to mediate between group and SPPB scores (β = 0.054, 95% confidence interval [0.0142, 0.1247]). Moderate- to vigorous-intensity physical activity and total physical activity were found to partially mediate between group and CRF (β = 0.02, 95% confidence interval [−0.0261, 0.0751]), with the direct pathway no longer being significant (p >.05). This provides support for Latin dance programs to have an effect on SPPB protocol and CRF. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate the extent to which motivational regulations influence physical activity behavior through role identity among people 55 years or older. Participants (N = 409; Mage = 66.29 years [SD = 7.06]) completed online questionnaires to measure motivational regulations, role identity, and the frequency of physical activity in a typical week and in the past month. Mediation analysis using ordinary least squares path analysis revealed that autonomous forms of motivational regulation (positively) and controlled forms of motivational regulation (negatively) influenced role identity, which then positively influenced physical activity behavior. Bootstrap confidence intervals (95%) for the indirect effects (a × b) based on 5,000 bootstrap samples were entirely above or below zero. These findings point to future experimental evaluations of interventions aiming at both increasing and decreasing autonomous and controlled motivational regulations, respectively, to promote physical activity behavior through role identity. [ABSTRACT FROM AUTHOR]

The onset of retirement and children leaving the family home may offer a "window of opportunity" for individuals to influence regular moderate- to vigorous-intensity physical activity; therefore, this study examines the feasibility of a moderate- to vigorous-intensity physical activity intervention among recently retired participants (RET) and parents (P) with children who recently left the family home. A total of 46 inactive RET and nine inactive P were randomized to a 10-week web intervention (n = RET = 25/P = 4) or waitlist control (n = RET = 21/P = 5). Intervention techniques followed the multiprocess action control framework. Enrollment (37.5% for P; 40% for RET), retention (89% for P; 83% for RET), and satisfaction were high. One hundred percent of intervention-sectioned participation increased moderate- to vigorous-intensity physical activity compared with 52% of controls; large effect size differences were observed for key multiprocess action control constructs. Participants were highly satisfied with the intervention; however, recruitment challenges of P support moving to a randomized controlled trial for only the RET group. [ABSTRACT FROM AUTHOR]

Physical activity is a leading determinant of health and well-being in older adults; however, participation is low. Social support can significantly influence physical activity uptake and maintenance; however, most research is cross-sectional and does not differentiate among types of support. The current study assessed four types of social support for physical activity reported over 9 years by adults aged 60–65 at baseline (n = 1,984). Data were collected using a mail survey at four time points. Data were analyzed using linear mixed models. The most common type of support was emotional, with 25% of participants reporting this often/very often. Total support for activity declined by 16% across the 9 years (p <.001). Companionship had the greatest decline among types (17%–18%, p <.001). More work is needed to understand the factors contributing to the decline in support and how to enable access to support for physical activity in older adults. [ABSTRACT FROM AUTHOR]

Aim: To explore the healthcare experiences and needs of older adults living with HIV in Sweden. Design: A phenomenological study using qualitative thematic analysis. Methods: Data were gathered through semistructured qualitative interviews and analysed using thematic analysis. A purposive sample of individuals ageing and living with HIV was recruited for this study. Results: A total of 22 participants aged 65 years and older, with a mean age of 75 years, participated in the study. Living with HIV meant a need to rely on consistent healthcare and treatment over the course of one's lifetime. The experiences of older adults were described under four themes: relying on access to health care, desiring involvement and shared decision‐making, the importance of trust and confidentiality and experiences of stigma in healthcare visits. Conclusion: Living and ageing with HIV involved recurring exposure and vulnerability in healthcare encounters, and experiences of being exposed to HIV‐related stigma, especially outside HIV clinics. Continuity and being seen as a person in healthcare encounters were important. Enhancing HIV knowledge alongside fostering supportive attitudes and approaches of healthcare professionals is critical for ensuring high‐quality and nondiscriminating health care. Implications for the Profession and/or Patient Care: Meeting the needs of older adults living with HIV requires a person‐centred approach, including active involvement and shared decision‐making between patients and healthcare providers. Impact: This study describes the healthcare experiences and needs of older adults, aged 65 years and older, living with HIV, a population that is not typically investigated in qualitative research. Living and ageing with HIV means a vulnerability where the attitudes of professionals and the active involvement of the patient become significant for quality care. The findings can help with the implementation of policies and practices for the care of older adults living with HIV. Reporting Method: The Consolidated Criteria for Reporting Qualitative Studies (COREQ) was used. Patient and Public Contribution: Patient representatives were involved in discussions on data collection and the development of the interview guide. [ABSTRACT FROM AUTHOR]

Loneliness has become a significant public health issue among community‐dwelling older adults particularly those with multimorbidity. Family caregivers are crucial care resources for dependent older adults living in the community before transitioning to institutional services. However, understanding of their perceptions in supporting older adults with multimorbidity to cope with loneliness is limited. This qualitative study aimed to elucidate on the experiences of caring and explore the experiences and perceptions of family caregivers in supporting older community‐dwelling adults with multimorbidity to cope with loneliness. Eleven family caregivers, aged 51–93 years old, with at least 2 years of caregiving experience were purposively recruited and interviewed individually. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was utilised to report the study. Three key themes were generated from the inductive analysis: (1) recognising older adults' loneliness through the expression of unusual emotions, behaviour/s, social network alteration and speech; (2) variations in perceptions and responses to loneliness among different family caregiving relationships; and (3) challenges in addressing loneliness. Positive feedback from cared‐for older adults was appreciated by their family caregivers which in turn motivated further actions to alleviate loneliness. The findings emphasised the importance of developing specific patients and family caregivers centred interventions, such as communication skills training to enhance effective communications. Cultural values and norms of individuals should be respected in those interventions, ensuring that emotional expression is facilitated in a comfortable way for both older patients and family caregivers. [ABSTRACT FROM AUTHOR]

Aim: Machine learning techniques have demonstrated success in predictive modeling across various clinical cases. However, few studies have considered predicting the use of multisectoral health and social services among older adults. This research aims to utilize machine learning models to detect high-risk groups of excessive health and social services utilization at early stage, facilitating the implementation of preventive interventions. Methods: We used pseudonymized data covering a four-year period and including information on a total of 33,374 senior citizens from Southern Finland. The endpoint was defined based on the occurrence of unplanned healthcare visits and the total number of different services used. Input features included individual's basic demographics, health status and past usage of healthcare resources. Logistic regression and eXtreme Gradient Boosting (XGBoost) methods were used for binary classification, with the dataset split into 70% training and 30% testing sets. Results: Subgroup-based results mirrored trends observed in the full cohort, with age and certain health issues, e.g. mental health, emerging as positive predictors for high service utilization. Conversely, hospital stay and urban residence were associated with decreased risk. The models achieved a classification performance (AUC) of 0.61 for the full cohort and varying in the range of 0.55–0.62 for the subgroups. Conclusions: Predictive models offer potential for predicting future high service utilization in the older adult population. Achieving high classification performance remains challenging due to diverse contributing factors. We anticipate that classification performance could be increased by including features based on additional data categories such as socio-economic data. [ABSTRACT FROM AUTHOR]

The current study uses socioemotional selectivity theory (SST; Carstensen in Psychology and Aging. 7(3):331–338,1992,10.1037/0882-7974.7.3.331) as a framework to examine the experiences of older adults during COVID-19 in Aotearoa/New Zealand. SST posits that when time horizons are perceived as limited—such as with increasing age, or during times of medical uncertainty—people selectively focus on spending time with emotionally close others and in personally fulfilling activities. This may be the case particularly when uncertainty is experienced by older people. Aotearoa/New Zealand instigated an elimination strategy early in the pandemic (prior to widespread vaccine availability), employing a series of lockdowns that further challenged older adults' perceptions of future horizons, their ability to maintain social connections with loved ones, and engagement in pleasurable activities. This study used thematic analysis to analyze existing qualitative COVID-19-related data drawn from the experiences of 510 older adults who participated in the 2021 Health, Work, and Retirement study (HWR). Participants ranged in age from 56 to 87 (Mage = 69.73); 15.9% identified as Māori, and 76.2% identified as female. Two broad themes were revealed: Social Connection and Anticipating the Future. Although most participants expressed comparatively more positive than negative experiences, some also expressed frustration and anxiety about health directive-related divisions in relationships, and the inability to share in important life events (such as weddings, births, and funerals). Findings highlight the complex impact of COVID-19 on older adults' perceptions of time horizons, and the opportunities presented by the pandemic for reassessment of social relationships and activities. [ABSTRACT FROM AUTHOR]

Introduction: This narrative inquiry study aimed to explore older adults' stories about how they have coped to maintain occupational engagement, despite living with age-related vision loss (ARVL). Methods: Six older adults, ≥ 60 years of age with ARVL participated in three interviews each, which were analyzed using thematic analysis. Results: Coping was grouped into three overarching themes namely psychological, social, and behavioral coping strategies. Conclusion: Results from this study have identified how older adults with ARVL cope to maintain participation in occupations. Findings highlight the need for increased healthcare support, including occupational therapists, to help older adults aging with vision loss identify and integrate adaptive coping strategies to enhance their occupational lives. [ABSTRACT FROM AUTHOR]

Aims: The aim of this systematic review was to investigate the efficacy of perturbation-based balance training in the older adults to reduce risk and number of falls. Methods: Multiple databases were searched for articles published between 2012-2021. The inclusion criteria were 1) patients ≥65 years of age, 2) land-based perturbation training, 3) randomized controlled trials (RCTs), 4) PBT intervention group, 5) controlled intervention group, 5) written in English, and 6) articles scoring 6/10 ("good") or higher on the PEDro scale. Results: Six articles met the inclusion criteria with a PEDro scale range of 6-8/10. A total of 793 subjects were included across the studies. Conclusions: PBT can be effective in improving various deficits predictive of falls. The effect was most pronounced in reactive balance control, balance confidence, and gait kinematics of recovery steps with mild effect in overall fall risk. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association between five dietary trajectories over 21 years and frailty in Norwegian older adults. Methods: This study used data from three surveys of the Tromsø Study. Diet was measured using food frequency questionnaires at baseline (Tromsø4, 1994–95), after 7 years (Tromsø5, 2001) and at the end of follow-up (Tromsø7, 2015–16). Survey-specific diet scores were constructed based on the Nordic Nutrition Recommendations 2023 and group-based trajectory modelling was used to derive dietary trajectories. At follow-up, frailty was assessed with a 41-item frailty index. Linear regression analysis was performed to assess the associations between dietary trajectories and frailty, adjusted for baseline variables. Results: Among the 715 participants, 55% were women, with an average age of 54 years at baseline and 74 years at follow-up. The dietary trajectories 'moderately healthy' and 'healthy increase' were associated with a lower frailty index score at follow-up (β = −0.02, 95% confidence interval (CI) = −0.04, −0.002, β = −0.03, 95% CI = −0.06, −0.007), compared with the 'unhealthy' trajectory. Conclusion: Our findings suggest that maintaining a moderately healthy to very healthy diet from mid-life into older age is associated with a lower risk of frailty and supports the promotion of a healthy diet from adulthood to facilitate healthy ageing. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effects of far-infrared (FIR) heat on quality of life (QOL) in older adults. Participants were assigned to either a convective heat group (CON) or a convective and FIR group. Participants received six, 30-min heat sessions over the course of three weeks. Pre- and post-assessments included physical measures such as range of motion, gait speed, Timed Up and Go, and hand grip strength. Standardized questionnaires were used to determine pain severity and its interference with daily life, and the impact pain had on overall QOL. Pain severity was significantly reduced (from 3.31 to 2.5, p <.05) in the FIR group from pre-to-post, and pain interference was significantly reduced (from 1.26 to 0.43, p <.05) in the CON group from pre-to-post testing. Findings suggest that heat therapy was successful in reducing pain over time. [ABSTRACT FROM AUTHOR]

Understanding the intricate interplay between demographic shifts and the profound influence of social networks on the mental health of older adults is crucial amid our rapidly aging global population. As societies evolve, the significance of social connections intensifies, directly impacting the well-being of older individuals. This empirical research, encompassing 50 individuals aged 60 years and above from urban and rural areas in equal proportions, aims to comprehend sociodemographic characteristics, assess social network resilience, evaluate mental health, and investigate how sociodemographic factors shape mental well-being. Utilizing Chi-Square tests, correlation coefficients, independent samples t-tests, and frequency tables, the study reveals nuanced insights into the complex relationship between social network strength and demographic variables among older adults. The research methodology employs a comprehensive set of tools, including a self-prepared interview schedule for socio-demographic details, the Lubben Social Network Scale (LSNS-R), and the Mental Health Inventory (MHI). These instruments, recognized for their reliability and validity, offer a thorough assessment of social networks and mental health. The study's outcomes emphasize the necessity of tailored approaches that consider diverse sociodemographic factors in addressing the mental health needs of older adults. In conclusion, this research contributes significantly to the understanding of how social networks influence the mental health of older adults within the context of demographic shifts, underscoring the imperative of personalized strategies to effectively cater to the diverse mental health needs of this population in view of social work practice. [ABSTRACT FROM AUTHOR]

Objectives: To examine how change in benzodiazepine (BZD) use is linked to changes in depressive symptoms intensity, worry intensity, and sleep quality over 16 months. Method: Data come from a larger randomised controlled trial (RCT) named the 'Programme d'Aide du Succès au SEvrage (PASSE-60+)' study (NCT02281175). Seventy-three participants age 60 years and older took part in a 4-month discontinuation programme and were assessed four times over 16 months. Change in BZD use was defined as the difference in reported mg/day between two assessments. Control variables were RCT discontinuation group; BZD use at T1; and either depressive symptoms, worry intensity, or sleep quality at T1. Hierarchical multiple regressions were used to analyse data. Results: In the short term, right after the discontinuation programme, sleep quality worsened with lower BZD use. This link was no longer significant at the 3- and 12-month follow-up. In the long term, depressive symptoms lowered with lower BZD use. No change was found in worry intensity in relation to BZD use at all measurement times. Conclusion: Discontinuation may improve depressive symptoms. Our study also questions the long-term effectiveness of BZD use, since long-term discontinuation was not linked with change in worry intensity and sleep quality. [ABSTRACT FROM AUTHOR]

Objectives: Social isolation and loneliness pose significant public health risks, especially among older adults experiencing age-related cognitive decline (ACD). This mixed methods feasibility study explored the potential of an online mindfulness-based dance/movement therapy (M-DMT) program to alleviate loneliness, enhance psychological well-being, and promote physical activity among older adults experiencing ACD during the COVID-19 pandemic. Method: Sixteen participants engaged in a 12-week online group M-DMT program. Feasibility was assessed via enrollment and retention rates, attendance, adverse events, credibility/expectancy, participant perceptions, and satisfaction. Qualitative data were collected to capture participants' perspectives on the intervention's usefulness and perceived benefits. The intervention's preliminary impact on loneliness, depression, positive affect, psychological well-being, and physical activity was also examined. Results: The study met all feasibility criteria, with 65% reporting post-intervention improvement. Significant reductions in loneliness and depression, along with enhanced positive affect and psychological well-being, were observed. Though physical activity increased, statistical significance was not achieved. Qualitative feedback highlighted improved social connectedness, overall quality of life, body awareness, kinematic strategy, and satisfaction with the program. Conclusion: Online M-DMT holds promise in addressing well-being and loneliness challenges in older adults experiencing ACD. Further research is necessary to validate and expand upon these promising findings. [ABSTRACT FROM AUTHOR]

The purpose of this study is to assess to what extent environmental justice indicators have relationships with community-level COVID-19 vaccination rates among older populations in the United States. This ecological study explores the relationship between the COVID-19 vaccination rates and the Environmental Justice Index (EJI) on a spatial level. Multiple publicly available datasets, including COVID-19 vaccinations rates and EJI indicators obtained from the Centers for Disease Control and Prevention, were linked and merged into a single dataset used for all analyses. Correlational analyses and multivariate regression models were conducted to analyze the associations between environmental and social indicators of EJI and the vaccination rates. Results showed that both the Social Vulnerability Module (SVM) and Environmental Burden Module (EBM) of the EJI had predictive relationships with the COVID-19 vaccination rates (β = − 3.86 and β = − 1.54, respectively). Among these domains, the vaccination rates had the strongest associations with the built environment (β = − 4.32) within EBM and the socioeconomic status (β = − 3.49) within SVM. The following indicators showed the strongest associations with vaccination rates: air toxic cancer risks (β = − 5.47), broadband access (β = − 5.19), recreational parks (β = − 4.87), education (β = − 4.75), civilian with disability (β = − 4.17), walkability (β = − 3.71), and poverty (β = − 3.67). This study provides empirical evidence supporting the use of environmental justice indicators as a standardized tool for evaluating public health outcomes. By understanding and addressing the intersection of social vulnerabilities and environmental factors, public health efforts can strive towards achieving equitable access to vaccination and improving overall community health outcomes. [ABSTRACT FROM AUTHOR]

Background: To describe the societal costs during one year of follow-up among older adults seeking chiropractic care due to a new episode of low back pain (LBP), and to determine what factors predict high societal costs in this population. Methods: Prospective cohort study, within chiropractic private practices (n = 38) in the Netherlands. 223 people ≥ 55 years of age with a new episode of LBP seeking chiropractic care participated. The primary outcome was total societal costs. High societal costs were defined as patients with costs in the top 20th percentile. The final prediction models were obtained using forward selection. Results were presented for the total population and stratified for retirement status. The model's prognostic accuracy (Hosmer–Lemeshow X2, Nagelkerke's R2) and discriminative ability [area under the receiver operating curve (AUC)] were assessed, and the models were internally validated using bootstrapping. Results: The mean total annual societal cost per patient was €5297 [95% confidence interval (CI): 4191–6403]. The biggest cost driver was presenteeism (65% of total costs), and costs were higher among non-retired participants (€7759; 95% CI 6047–9470) than retired participants (€1892; 95% CI 1088–2695). In the total population, younger age [odds ratio (OR): 0.87 for each additional year; 95% CI 0.80–0.95], being male instead of female (OR 2.96; 95% CI 1.19–7.44), less alcohol intake (OR 0.49; 95% CI 0.20–1.19), working instead of retirement (OR 9.37; 95% CI 1.83–48.04), and more disability at baseline (OR 1.08; 95% CI 1.00–1.16) were found to be predictive of high societal costs. Working was found to be the strongest predictor for high societal costs. After internal validation, the model's fit was good, it's explained variance was moderate (28%) and their AUCs could be interpreted as moderate (0.85). For non-pensioners, the same predictive factors were identified as for the entire population. The costs for the retired participants showed too little variation to be able to predict high costs. Conclusions: This study estimated the mean total annual societal cost of older adults seeking chiropractic care due to a new episode of LBP at €5297 (95% CI 4191–6403).These costs were mainly due to high levels of presenteeism, and extensively differed based upon work status. [ABSTRACT FROM AUTHOR]

Background: Advance care planning (ACP) is pivotal in mitigating end-of-life suffering and ensuring healthcare congruence with the values of older adults and dignity in death. Despite its paramount importance, the current readiness for ACP among community-dwelling older adults and the intricate influencing factors have yet to be explored. Objective: To review the literature focusing on ACP readiness among community-dwelling older adults and the influencing factors. Methods: A scoping review conducted using the Arksey and O'Malley (2005) framework. Electronic databases (PubMed, CINAHL, Cochrane, Web of Science, PsycINFO), as well as grey literature databases (OpenGrey and GreyLit.org) were searched to identify studies published in English between January 2012 and March 2023. Results: 19 studies were selected, comprising 3 qualitative, 13 quantitative, 2 mixed-methods, and 1 review article. The study evaluated the readiness of older adults for ACP by examining their knowledge and attitudes. It categorizes influencing factors into intrinsic and extrinsic levels. This review revealed that the knowledge about ACP among older adults across all settings was limited. However, they had positive attitudes toward it. In addition, intrinsic factors including sociodemographic characteristics, psychological factors, and family relationships, along with extrinsic factors including health care professionals' attitudes and experience, as well as policies and laws, influenced the ACP readiness among older adults. Conclusions: This study established the groundwork for future ACP intervention trials, providing a theoretical framework to guide their design and implementation. operationalization. [ABSTRACT FROM AUTHOR]

Secondhand smoking may contribute to cognitive decline, but evidence on this subject is limited in the working economically active older adults. This study aimed to investigate the association between cognitive decline and exposure to secondhand smoke at work in economically active adults aged 65 years or above. Cross-sectional study using nationwide data. Data were from the 2022 Korea Community Health Survey. Chi-squared test was used to perform descriptive statistics. The association between cognitive decline and exposure to secondhand smoke at work was analysed using multivariable logistic regression analysis. Subgroup analysis was performed based on to exposure status to secondhand smoke at home and diabetes mellitus. Of a total of 28,197 adults, 8767 (28.5%) individuals reported cognitive decline. Compared to individuals without exposure to passive smoking at work, those with such exposure were more likely to report cognitive decline (odds ratio: 1.30, 95% confidence interval: 1.14–1.47). This association was particularly strong in individuals with exposure to passive smoking at both work and home and in those diagnosed with diabetes mellitus. Exposure to secondhand smoking at work is associated with a higher likelihood of cognitive decline in older-aged economically active individuals. The findings infer the importance of monitoring passive smoking and implementing public health measures to reduce workplace secondhand smoke exposure. [ABSTRACT FROM AUTHOR]

Purpose: Older adults may abandon or discontinue the use of assistive products due to low levels of satisfaction. Only few studies have examined need and satisfaction related to the use of assistive products for this group in China. As such, research is needed to improve satisfaction with assistive products and related services. Method: This study used technology acceptance theory to examine the self-reported need for, and ownership of, assistive products among older adults in China, as well as to examine the association between services and satisfaction with assistive products; the underlying mechanism of this association was also assessed. The current study used the rapid assistive technology assessment (rATA) questionnaire designed by the World Health Organization (WHO) for stratified and cluster sampling. A total of 2,158 older adults living in China were interviewed. The multiple regression analysis was used to examine the independent and interactive associations between services and satisfaction. Heterogeneity and robustness tests were also undertaken. Results: The self-reported need for assistive products pertained mainly to vision, and together with ownership, the need gap has not yet been addressed. Both pre-sale (β = 0.600, p < 0.01) and follow-up services (β = 0.270, p < 0.01) were positively correlated with satisfaction, which in turn shows heterogeneity when it comes to the types of assistive products. Conclusion: Providing accessible services, especially follow-up services, will help older adults be more satisfied with their assistive products, thus ultimately ensuring the continued use of products. IMPLICATIONS FOR REHABILITATION: There is a huge demand for assistive products among older adults in China, but the awareness of these adults' needs is low. This study's findings confirm the results of earlier research, i.e. that satisfactory services are important for overall satisfaction with assistive products among older adults. Easy-to-access services may help to improve product satisfaction through service. Environmental factors are also important indicators of satisfaction with assistive products. [ABSTRACT FROM AUTHOR]

Background: Gait performance can provide valuable insights into cognitive functioning in older adult and may be used to screen for cognitive impairment. However, the optimal test condition and spatiotemporal parameter for accuracy have not yet been determined. This study aims to determine the gait measure with the highest accuracy identifying cognitive decline. Methods: A total of 711 participants were recruited, including 332 cognitively healthy individuals, 264 with mild cognitive impairment (MCI), and 115 with dementia, with a mean age of 72 years (interquartile range 69–76), and 43% (n = 307) of women. The participants underwent gait assessment in three different conditions, including a single task and dual tasks of counting backward by ones and naming animals. Results: Gait performance was deteriorated as cognitive impairment progressed. The gait test performed during naming animals condition was the most accurate in differentiating between cognitive groups. Specifically, the naming animals gait speed was more accurate in discriminating control participants from those with cognitive impairment (area under the curve [AUC] = 76.9% for MCI and 99.7% for people with dementia with control group as reference). The coefficient of stride length variability while naming animals was the most effective parameter in discriminating between MCI and dementia groups (AUC = 96.7%). Conclusions: The naming animals dual‐task gait test can be a valuable assessment for screening cognitive impairment in older adults, regardless of their cognitive abilities. The test is useful in clinical settings for subjects with a range of cognitive profiles. [ABSTRACT FROM AUTHOR]

Background: Current guidelines for the diagnosis and treatment of pericarditis refer to the general adult population. Few and fragmentary data regarding recurrent pericarditis in older adults exist. Objective of the Study: Given the absence of specific data in scientific literature, we hypothesized that there might be clinical, laboratory and outcome differences between young adults and older adults affected by idiopathic recurrent pericarditis. Materials and Methods: We performed an international multicentric retrospective cohort study analyzing data from patients affected by recurrent pericarditis (idiopathic or post‐cardiac injury) and referring to tertiary referral centers. Clinical, laboratory, and outcome data were compared between patients younger than 65 years (controls) and patients aged 65 or older. Results: One hundred and thirty‐three older adults and 142 young adult controls were enrolled. Comorbidities, including chronic kidney diseases, atrial fibrillation, and diabetes, were more present in older adults. The presenting symptom was dyspnea in 54.1% of the older adults versus 10.6% in controls (p < 0.001); pain in 32.3% of the older adults versus 80.3% of the controls (p < 0.001). Fever higher than 38°C was present in 33.8% versus 53.5% (p = 0.001). Pleural effusion was more prevalent in the older adults (55.6% vs 34.5%, p < 0.001), as well as severe pericardial effusion (>20 mm) (24.1% vs 12.7%, p = 0.016) and pericardiocentesis (16.5% vs 8.5%, p = 0.042). Blood leukocyte counts were significantly lower in the older adults (mean + SE: 10,227 + 289/mm3 vs 11,208 + 285/mm3, p = 0.016). Concerning therapies, NSAIDS were used in 63.9% of the older adults versus 80.3% in the younger (p = 0.003), colchicine in 76.7% versus 87.3% (p = 0.023), corticosteroids in 49.6% versus 26.8% (p < 0.001), and anakinra in 14.3% versus 23.9% (p = 0.044). Conclusions: Older adults affected by recurrent pericarditis show a different clinical pattern, with more frequent dyspnea, pleural effusion, severe pericardial effusion, and lower fever and lower leukocyte count, making the diagnosis sometimes challenging. They received significantly less NSAIDs and colchicine, likely due to comorbidities; they were also treated less commonly with anti‐IL1 agents, and more frequently with corticosteroids. [ABSTRACT FROM AUTHOR]

Objective: Frailty is one of the most significant challenges to healthy ageing. Aboriginal Australians experience some of the highest levels of frailty worldwide, and despite this, no studies have explored frailty from an Aboriginal perspective. This is important because Aboriginal understandings and priorities in frailty may differ from Western/mainstream frailty frameworks. Furthermore, this lack of research severely hampers healthcare planning and service delivery. As a starting point, this study aims to understand the experiences, attitudes, and perceptions that Aboriginal older adults hold regarding frailty. Design: A qualitative study that utilized the Indigenous research method of Yarning for data collection as a culturally appropriate process for engaging Aboriginal peoples. Yarning circles and one-on-one yarns with 22 Aboriginal adults aged 45+ years living in one Australian capital city took place online and over the phone to explore the views that Aboriginal adults hold around frailty. Data were analysed thematically by Aboriginal researchers. Results: Seven key thematic areas were identified: (1) Keep in with culture; (2) Physical markers of frailty; (3) Frailty throughout the life course; (4) Social, cultural, and psychological understandings of frailty; (5) We want information about frailty; (6) Appropriate and positive wording; (7) Frailty assessment. Conclusions: There was interest and engagement in the concept of frailty by Aboriginal older adults and approaches to frailty that extend beyond the physical to address cognitive, psychosocial, cultural and spiritual domains are likely to be more acceptable to this population. Culture and community connectivity are essential elements in preventing and alleviating frailty and have wider positive implications for Aboriginal health and wellbeing. Existing tools in practice to assess frailty are not aligned with Aboriginal cultural norms. Culturally appropriate frailty assessment methods co-designed with the community which incorporate holistic and multidimensional approaches are urgently needed. [ABSTRACT FROM AUTHOR]

Objective: Understanding the characteristics of falls among older adults is necessary to prevent them. These characteristics include questions such as when (month and time), where (places), who (age), what (injury), why (trigger), and how (direction) the falls occur. The objective of this study was to identify the characteristics of falls in individuals aged 65–74 years (young‐old), 75–84 years (old‐old), and ≥85 years (oldest‐old). Methods: We conducted an observational mail survey among community‐dwelling older adults in Japan and collected detailed information on the incidence of falls over the past 3 years. The month, time, location, trigger, direction, and resulting trauma of each fall were analyzed and compared across the different age groups (young‐old, old‐old, and oldest‐old). Results: A total of 1695 falls among 1074 community‐dwelling older adults were analyzed in this study. Falls were frequent during May and October as well as during the winter season from December to February, especially between 10:00 a.m. and 11:00 a.m. These fall characteristics were consistent across all the age groups. There was a higher incidence of outdoor falls among relatively young older adults, which were typically caused by tripping or slipping. However, as one progresses with age, there is a higher incidence of falls indoors, typically due to loss of balance or leg entrapment. Approximately 60% of older fallers experience some form of injury due to falls, with fractures considered the most serious, occurring in ≈10% of all falls. Conclusion: We clarified the characteristics of falls including the "when, where, who, what, why, and how" of the fall. A future challenge is to use this valuable information to develop effective fall prevention programs for older populations worldwide. Geriatr Gerontol Int 2024; 24: 1181–1188. [ABSTRACT FROM AUTHOR]

Aim: Previous studies have shown that chronic diseases are strongly linked to the development of sarcopenia. Few studies have assessed the relationship between multimorbidity patterns and sarcopenia. This study aimed to investigate the impact of multimorbidity patterns on sarcopenia transitions in Chinese older adults. Methods: A total of 3842 older adults (aged 66.7 ± 6.2 years) with complete data at baseline and at least one follow‐up record (2 years) were included from the China Health and Retirement Longitudinal Study. Multimorbidity patterns were identified using latent class analysis. Sarcopenia was determined by the Asian Working Group for Sarcopenia 2019 criteria. Multistage Markov modeling was used to explore the association of multimorbidity patterns with sarcopenia transitions after controlling for covariates in demographic features, health status and health‐related behaviours. Results: Four multimorbidity patterns were identified at baseline: respiratory (17.73%), osteoarthritis‐hypertension (22.23%), digestive‐osteoarthritis (26.78) and cardiometabolic (33.27%). Participants with non‐sarcopenia had 1‐year transition probability of developing possible sarcopenia (10.1%) or sarcopenia (5.4%). Compared with the group without chronic diseases, the presence of cardiometabolic pattern increased the risk of progression from non‐sarcopenia to possible sarcopenia (HR 1.43, 95% CI 1.05–2.95). The presence of the osteoarthritis‐hypertension pattern (HR 1.55, 95% CI 1.00–2.41) and the digestive‐osteoarthritis pattern (HR 1.78, 95% CI 1.20–2.66) were associated with the transition toward sarcopenia from non‐sarcopenia. Conclusions: Sarcopenia is a dynamic condition in older adults. To address sarcopenia in older adults, tailored interventions should be targeted at populations with different multimorbidity patterns. Geriatr Gerontol Int 2024; 24: 1137–1143. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to identify the prevalence and predisposing factors of frailty and social inclusion among community‐dwelling older adults. Design: The study was conducted using a cross‐sectional design. Sample: The target population consisted of older adults registered in five family health centers in a city in Turkey. The study was completed with 600 older adults. Measurements: The Tilburg frailty indicator (TFI) and the social inclusion scale were used to collect data. Results: The prevalence of frailty in older adults was 60.5%. Multiple logistic regression analysis indicated that the risk of frailty was found to be higher in older adults aged 75 and over (2.5 times), those with low education level (5.8 times), those who were single (2 times), those with chronic diseases (1.8 times), those with unhealthy lifestyle (2.8 times), and those who were dissatisfied with their home living environment (5.9 times). It was found that age, education level, marital status, income, presence of chronic disease, lifestyle, satisfaction with their home living environment, and frailty explained 50% of the variance in social inclusion. Conclusion: The study concluded that most community‐dwelling older adults were frail, and social inclusion was lower in those frail. Age, education level, marital status, lifestyle, presence of chronic disease, and satisfaction with their home living environment were found to be predisposing factors for both frailty and social inclusion. Public health nurses could develop strategies to prevent frailty in older adults and increase activities that encourage participation in social life. [ABSTRACT FROM AUTHOR]

Background: Ways to help older adults overcome barriers to performing regular exercise is a challenge to nurses. Objective: The study evaluated the acceptability of a portable exercise bike for arm/foot pedaling among older patients with cardiovascular diseases (CVDs). Methods: Participants reported their physical activity levels using the International Physical Activity Questionnaire (short form) and thereafter performed two 6-minute-long arm/foot pedal biking sessions using a portable exercise bike. Participants provided qualitative feedback (one open-ended question) on the bike while exercising and completed the quantitative Acceptability Use Questionnaire following the two exercise sessions. Results: Twenty-five older adults (52% male and 48% female), with a mean (SD) age of 70 (6.4) years and a body mass index of 30 (7.4), completed the study. Most participants performed moderate to light physical activity at home with a daily mean (SD) sitting/sedentary time of 8 (3.4) hours. The mean scores from the Acceptability Use Questionnaire and the participants' comments alluded to the bike's multitasking utility and acceptability. Three broad themes derived from the qualitative analysis were: (1) the acceptability of the bike with participants who had musculoskeletal problems; (2) the ability to operate and use the bike for aerobic exercise engaging both arms and legs; and (3) the importance of overall utility, ease of use, and cost of the bike. Conclusions: The portable exercise bike was found acceptable in a group of older adults with CVDs. The bike has the potential to be applied in home-based exercise interventions. [ABSTRACT FROM AUTHOR]

Background: Using cohort analysis to examine the effects of sleep quality on loneliness among older adults from the life course perspective. Methods: The hierarchical age‐period‐cohort growth curve model was used to analyze the data from the 2005–2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Results: (1) Loneliness has a 'U' curve relationship with age, but with the rate of increase gradually slowing down. (2) There were significant differences in loneliness across birth cohorts, with younger cohorts having higher predicted loneliness than older cohorts at the same age. (3) The influence of different sleep quality on loneliness showed a trend of increasing with age. (4) There were no significant differences in the impact of sleep quality on loneliness in different cohorts. Conclusions: This study has identified heterogeneity in loneliness, emphasising the need for a diversified intervention approach. Sleep quality has a protective effect on loneliness and is easy to assess, making it an important intervention tool. In addition, it is imperative to account for the influences of age and cohort effects when formulating intervention strategies. [ABSTRACT FROM AUTHOR]

Kidney disease and its comorbidities disproportionately affect older persons. Kidney disease modifying therapy is underutilized in older adults, as guidelines lack consensus on approaching diagnosis and treatment in older adults. This review aims to highlight the challenges presented by, and opportunities for, identifying and treating CKD in older adults. [ABSTRACT FROM AUTHOR]

Introduction: As of 2019, the United States houses 5.3 million Chinese Americans (CA), with 689,000 being older adults. The purpose of this study was to examine the relationships between social determinants of health (SDOH) and acculturation on quality of life in CA older adults, an underresearched area. Methods: Using a quantitative correlational descriptive design, CA older adults (n = 110) in NYC with chronic pain were examined. Data were collected by utilizing the PRAPARE Screening Tool, Asian American Acculturation Scale, and SF-12 Questionnaire. Results: Regression revealed a negative correlation between SDOH and quality of life (p =.001). The acculturation's impact was nonsignificant (p =.647). Discussion: While SDOH significantly impacted the quality of life, acculturation did not significantly predict the quality of life for older Chinese American adults with chronic pain. Further research is warranted to explore the nuanced dynamics between acculturation, SDOH, and quality of life in this population. [ABSTRACT FROM AUTHOR]

Summary: Designing appropriate diagnostic and treatment methods to reduce fall risk and improve quality of life, as well as reduce the cost of care in elderlies. Our findings have potential for early diagnosis of those with a high probability of falling based on fairly simple clinical measures of hyperkyphosis, forward head, and lordosis. Introduction: Poor balance is an underlying cause of falling in the elderly, for which a change in the natural curvature of the spine plays a major role. Little is known about the relationship between spinal curvatures and fall incidence in this population. We primarily aimed to investigate the relationship between sagittal plane spinal curvatures and fall incidence over 1 year among nursing facility residents. Secondarily, we aim to determine associations of sagittal plane spinal curvatures with participants' perception of fall risk and balance capability. Methods: Participants (100 residents mean age 70.17 ± 6.01 years) underwent standing measures of sagittal plane spinal curvatures (flexible ruler technique) and forward displacement of the head relative to the cervical spine. The Tinetti Performance Oriented Mobility Assessment (POMA) and Fall Efficacy Scale assessed participants' perception of balance and fear of falling. Incident falls were self-reported monthly and tracked across 1 year. Spearman's correlations and logistic regression evaluated associations between fall incidence and spinal curvature. Predictive performance of spinal curvature and fall risk was determined by the corresponding ROC for defining a cut-off for variables of spinal curvature and fall risk indicators. Results: Predictive performance of spinal curvature and fall risk factors indicated 84% and 77% of participants were correctly classified using models of kyphosis and head angle, respectively. Conclusions: Our study adds new data on spinal curvatures and incident falls among nursing facility residents. Efforts are needed to intervene to counter progression of spinal curvatures and improve fall prevention practices. [ABSTRACT FROM AUTHOR]

Summary: Associations between different sarcopenia definitions and the risk of injurious falls were investigated in 75–80-year-old women in the Swedish SUPERB cohort. Only sarcopenia according to the Sarcopenia Definitions and Outcomes Consortium (SDOC) definition was associated with incident injurious falls with and without fractures in older women. Purpose: To investigate the association between three commonly used sarcopenia definitions and the risk of injurious falls in a population of older Swedish women. Methods: A total of 2,883 75–80-year-old women with complete data on relevant sarcopenia definitions from the Swedish SUPERB cohort were studied. Sarcopenia was defined based on the Sarcopenia Definitions and Outcomes Consortium (SDOC: low handgrip strength and gait speed), revised European Working Group on Sarcopenia in Older People (EWGSOP2: low appendicular lean mass index (ALMI, dual-energy X-ray absorptiometry (DXA)-derived), appendicular lean mass (kg)/height (m2), hand grip strength (kg), or low chair stand time (s)), and Asian Working Group for Sarcopenia (AWGS: low ALMI and hand grip strength (kg) or low gait speed (m/s)). Questionnaires captured the occurrence of falls in the past 12 months. Incident injurious falls were identified using national registers. Cox regression (hazard ratios (HR) and 95% confidence intervals (CI)) analyses were performed without adjustment and after adjustment for age, body mass index, previous falls, and the Charlson comorbidity index. Results: During a median (IQR) follow-up time of 7.06 (6.2–7.9) years, there were 491 injurious falls without fracture and 962 injurious falls when also including falls resulting in a fracture. Sarcopenia according to EWGSOP2 and AWGS was not associated with an increased risk of injurious falls. Individuals with sarcopenia defined by SDOC had a higher risk of injurious falls with and without fracture (HR 2.11; 95% CI, 1.63–2.73 and HR, 2.16; 95% CI, 1.55–3.02, respectively). Conclusion: Sarcopenia definitions confined to muscle function and strength such as SDOC, rather than including DXA-determined ALMI (EWGSOP2 and AWGS), are associated with incident injurious falls with and without fractures in older women. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors related to preoperative anxiety in older adults with sensory impairment. Design: Descriptive quantitative research design. Methods: Study participants were 120 older adults admitted to a tertiary hospital in Seoul, South Korea to undergo eye or ear surgery. Data were collected from 11 February to 30 April 2023. The collected data were analysed using descriptive statistics, t‐tests, ANOVA, and multiple regression analysis using SPSS 28.0. The study was reported following the STROBE checklist. Results: Preoperative anxiety differed significantly according to gender (p =.002), average monthly household income (p <.001), subjective health status (p =.003), subjective vision loss (p =.004), one‐sided or both‐sided eye discomfort (p =.002), use of glasses (p =.010), subjective hearing loss (p =.022) and anxiety coping mechanisms (p <.001). The results of a multiple regression analysis on the significant variables identified that gender (β =.178, p =.036) and anxiety coping mechanisms (β =.336, p <.001) had the most significant effect on preoperative anxiety, with an explanatory power of 34.5%. Conclusion: The development and practical application of tailored nursing interventions catering to specific genders and anxiety coping mechanisms would contribute to reducing preoperative anxiety and providing efficient nursing care for older adults with sensory impairment. [ABSTRACT FROM AUTHOR]

Background: Unhealthy alcohol use has been considered a coping strategy related to stressful and traumatic life events such as relationship loss. Yet, the effects of marital status on health behaviors are generally studied cross-sectionally or over one transition. We explored associations between the frequency and quantity of alcohol use with the number of episodes and duration of separation/divorce events across adulthood among English adults in mid to later life. Methods: This study used life history data from wave 3 (2006/07) of the English Longitudinal Study of Aging to compute marital sequences based on marital status at each year of age from 18 years of 6,355 adults aged 50–80 years. These sequences were used to compute the portion of adulthood spent separated/divorced and the number of episodes of divorce. These variables were used as predictors in logistic regressions predicting unhealthy alcohol use, while also controlling for current marital status. Results: We found that the number of episodes of separation/divorce increased the odds of drinking ≥5 days/week and binge drinking (≥6 drinks/occasion for women; ≥8 drinks/occasion for men), whereas the portion of adulthood spent divorced was not associated with drinking frequency or binge drinking. Some nuances by gender were also noted. Conclusions: Recurrent transitions into separation/divorce over adulthood appears to increase risk of unhealthy alcohol use in mid to later life beyond the risks associated with current marital status. [ABSTRACT FROM AUTHOR]

Background: Despite reported physical and functional improvements with aerobic and sprint interval training (SIT) protocols in individuals with intellectual disability (ID), it is not known if these interventions' effectivity would promote improvements in cardiac autonomic modulation. This study aimed to investigate if a 6‐month SIT or a continuous aerobic programme could enhance physical performance and cardiac autonomic modulation at rest, during physical activity (PA) and after it in older adults with an ID. Methods: This is a randomised control trial. Participants with ID (age: 50.58 ± 7.25) were allocated to one of three groups [multicomponent aerobic training group (MATG), multicomponent interval sprint training group (MISTG) and control group (CG)]. The programmes lasted 24 weeks, with three sessions/week, 75–90 min per session. The HRV was analysed at rest and recovery, the delta of heart rate (HR) was analysed during 6MWT, and the HR t‐off kinetics was analysed in recovery after 6MWT. Results: There were not found differences between groups, moments, or interaction for cardiac autonomic modulation at rest and recovery. During exercise, only MSITG showed a significant increase of HR between rest and the first 30 s of exercise (P < 0.05). Physical performance increased only in MSITG (P < 0.05), while CG showed a significant reduction (P < 0.01). Conclusions: The MSITG improved the physical performance and the vagal withdrawal at the beginning of the submaximal exercise. These findings suggest that high‐intensity exercise may positively impact baroreflex function, mitigating the decline in autonomic reflex response capacity associated with aging in individuals with ID. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acute care hospitalization has been associated with older adult home falls after discharge, but less is known about the effects of hospital- and patient-related factors on home fall risk. OBJECTIVES: This study compares the effects of hospital length of stay, medical condition, history of falls, and home health care on period rates of home falls after discharge from acute care hospitalization. METHODS: This was a retrospective cohort study comparing period rates of home injury falls among older adults (age ≥ 65) occurring after discharge from an acute care hospitalization. Data were collected from state health care utilization administrative records between January 1, 2016, and December 31, 2018. We used log-linear Poisson regression to model post-discharge injury fall incidence rates as a function of days since discharge and patient-level covariates. RESULTS: A total of 736,230 older adults were included in the study cohort. Absolute risk for post-discharge home falls was 7%. Fall rates were highest the first week after discharge at 0.05 per 100 person-days, with a period incidence rate 74.29 times higher than the >90-day discharge period. Fall risk increased with age, with the highest risk in the ≥85 age group. Fall risk increased for a 2-day hospital stay but decreased for 5- to 30-day stays, compared to a 1-day length of stay. Discharge to home health care and history of falls were associated with increased risk. CONCLUSIONS: Older adults are at highest risk for a home fall the first 7 days after discharge from acute care hospitalization. These findings describe patient-related risk factors that acute care hospitals can use to develop geriatric-specific discharge guidelines intended to reduce home fall risk during the early care transition to home. [ABSTRACT FROM AUTHOR]

Older adults have a strong desire for emotional connectivity and those who lack such social connectedness would be easily taken advantage of and experience fraud. We aimed to examine the association between loneliness and fraud victimization and further investigate the causal relationship through experimental manipulation. Fifty younger adults (aged 18–29, ${M_{age}}$ M age = 26.62), 43 middle-aged adults (aged 32–53, ${M_{age}}$ M age = 40.84) and 54 older adults (aged 60–88, ${M_{age}}$ M age = 68.31) were randomly assigned to induced loneliness or control conditions by a complete randomized design and then were asked to rate the credibility and purchase intention for nine misleading advertisements. Middle-aged and older adults, but not younger adults, showed higher susceptibility to fraud after loneliness manipulation. The present experiment confirmed that loneliness could lead to higher fraud victimization for middle-aged and older adults, suggesting future interventions should target those lonely middle-aged and older adults to prevent potential fraud. [ABSTRACT FROM AUTHOR]

Polypharmacy, commonly described as the use of five or more prescribed medications, is a prevalent health issue among seniors because of the potential adverse side effects due to medication interactions. The main purpose of this study was to investigate the association between dietary patterns and number of medications used. We hypothesized that a plant-based diet and healthy lifestyle choices decreases morbidities and number of medications taken. Data on 328 participants, aged 60 years or older, were collected through questionnaires and measurements at the Loma Linda University Drayson Center in Loma Linda, CA, between 2015 and 2016. The dependent variable was the number of pills taken, used as counts, and the main exposure was the type of diet adopted. Negative binomial regression was used for analysis. Results suggest that a vegan diet reduces the number of pills by 58% compared to non-vegetarian (IRR=.42 [95% CI:.25-.70]), even after adjusting for covariates. Increases in age, body mass index (BMI), and presence of disease suggest an increased number of pills taken. A vegan diet showed the lowest amount of pills in this sample. Body mass index also had a significant positive association with the number of pills. [ABSTRACT FROM AUTHOR]

Background/Objectives: Volunteering has been widely recognized as beneficial to the well-being of older adults, providing health benefits, increased social engagement, and a sense of purpose. This study aimed to explore the associations between volunteering and physical and mental health measures among older adults in Japan. Methods: Using an online survey conducted during the COVID-19 pandemic, 500 participants aged 65 and older were divided into volunteer and non-volunteer groups. Demographic, lifestyle, and health characteristics were comprehensively assessed using a series of reliable and validated instruments. Logistic regression analysis was used to explore the associations between volunteering and health outcomes. Results: The findings revealed that while there were no significant differences in physical health indicators and undertreatment of most diseases (with the exception of cataracts), volunteers reported significantly lower levels of depression and loneliness compared to non-volunteers. The volunteer group also showed greater engagement in social activities and hobbies, which may have contributed to their improved mental health outcomes. Conclusions: The results of this study add to the growing body of evidence suggesting that volunteering may be an effective, low-cost intervention for promoting mental health and social engagement among older adults. [ABSTRACT FROM AUTHOR]

Background/Objective: Frailty is a significant health concern in the aging population, particularly in Japan's super-aging society. Community-based interventions show promise in frailty prevention; however, their effectiveness requires further investigation. This study aimed to evaluate the impact of a continuous municipal rehabilitation program on frailty status and physical function in older adults living in suburban Japan. Methods: This prospective observational study included 52 participants aged ≥ 65 years (13 males and 39 females) who underwent assessments at baseline and after six months. Participants were divided into Pre-old (65–74 years) and Older (≥75 years) groups. Frailty was assessed using the Kihon checklist (KCL), and physical function was evaluated using the New Physical Fitness Test. Changes in frailty status, physical function, and KCL subcategories were analyzed. Results: Frailty prevalence decreased significantly from baseline to 6 months (21.2% to 7.7%, p = 0.018). In the Pre-old group, significant improvements were observed in the sit-up (p = 0.035) and six-minute walking (p = 0.017) scores. The Older group showed significant improvements in KCL lifestyle (p = 0.023) and physical function (p = 0.018). Seven of ten initially frailty participants transitioned to a non-frailty status after 6 months. Conclusions: The Co-Creative Well-being System was associated with a reduction in frailty prevalence and improvements in physical function, with age-specific benefits observed. This community-based approach presents a promising strategy for addressing frailty in aging populations. [ABSTRACT FROM AUTHOR]

Background. Social connections not only contribute to psychological and emotional well-being but also positively impact physical health, with social isolation and loneliness linked to early mortality and detrimental health outcomes. Objectives. This study aims to evaluate an online Awareness, Courage, and Love (ACL) group intervention designed to enhance social connectedness and subjective well-being while reducing loneliness, depression, and anxiety among older adults. Methods. This randomised controlled trial (RCT) will involve an intervention group receiving a 2 h ACL session via videoconferencing. Eligible participants selected after screening will be assigned randomly to either a treatment or waitlist-control group. Participants in both conditions will complete the assessments at three time points, including baseline, post-intervention, and one-month follow-up. Tools for assessing the concerned variables include the Inclusion of Other in the Self Scale, de Jong Gierveld Loneliness Scale, Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder 2-item (GAD-2) Scale, and World Health Organisation—Five Well-Being Index (WHO-5). Conclusions. This study will offer a robust framework for investigating the impact of the online ACL intervention on loneliness and social connectedness among Chinese older adults. The result of this study will reach theoretical, empirical, practical, and teaching significance on mental health care strategies for Chinese older adults. [ABSTRACT FROM AUTHOR]

Objectives: The Republic of Korea is progressively becoming a super-aged society, emphasizing the need for regular physical activity among older adults because it has physical, psychological, and social benefits. Recently, increasing depression and suicide rates have been reported among older adults living alone. However, research that considers older adults' living situations is limited. Therefore, this study aimed to analyze the relationship between health-promoting behaviors (HPB), physical self-efficacy (PSE), exercise adherence, and sports commitment among older adults aged ≥ 65 years who participated in sports activities and investigate the influence of their living situation. Methods: The participants were 452 individuals aged ≥ 65 who lived in the metropolitan areas of Chungcheong-do, Jeolla-do, and Gwangju Provinces, Republic of Korea, and who regularly participated in sports activities (men = 283, women = 169). This study was conducted from January to May 2024. Data were collected using a structured and validated questionnaire, and the collected data were analyzed using descriptive statistics, correlation analysis, structural equation modeling, and multi-group analysis. Results: Structural equation modeling showed that the research model was appropriate, and all five paths showed statistical significance. The identity of the model was verified in the multi-group analysis, but path coefficients differed between older adults living alone and those living with family members. HPB significantly affected PSE, exercise adherence, and sports commitment among both groups of older adults. However, the impact of PSE on exercise adherence and sports commitment was not statistically significant among older adults living alone. Conclusions: The results highlight the need to consider older adults' living situations when establishing regular physical activity. Efforts should also be made to promote regular exercise participation among older adults living alone. [ABSTRACT FROM AUTHOR]

Objective: Both structural (e.g., ageism) and personal (e.g., stigma) barriers hinder older adults' access to and engagement with mental health care. These barriers are particularly problematic for those vulnerable to interpersonal violence and abuse (e.g., due to social isolation). This study presents a quality improvement program aimed at older adults who have experienced significant stressful events, particularly elder mistreatment, within a larger trauma specialty clinic. Leveraging home-based telemedicine, the clinic provides evidence-based psychotherapy tailored to the needs of older adults. Methods: From 2021 through 2023, the authors retrospectively examined treatment initiation, engagement, completion, and clinical outcomes among 231 older adults age 60+ who reported trauma that met DSM-5 criterion A criteria for post-traumatic stress disorder, depression, or other mental health comorbid conditions related to their traumatic event. The clinic uses an automated measurement-based care approach that facilitates Quality Improvement projects, allowing the tracking of treatment initiation, engagement, completion, and clinical outcomes for all patients. Results: The results indicated high treatment completion, high engagement with telemedicine-delivered interventions, and, most importantly, significant changes in clinical outcomes. Conclusion: These findings highlight the importance of expanding telemedicine-based mental health services for older adults, challenging ageist norms, and prioritizing older adults' mental health needs by providing tailored services to this patient population. [ABSTRACT FROM AUTHOR]

Objectives: This study has three objectives: A) To investigate the relationship of ageism on older adults' civic activities; B) To analyze the influence of ageism on mental health; and C) To explore the impact of civic participation on older adults' mental health. Method: This qualitative study included 782 older people from three different nationalities (Portuguese, Brazilian, and English) ranging in age from 65 to 88. All the interviews went through the process of content analysis. Results: For the first objective, the findings encompass one high-level theme (Social and individual incompetence), which included social rejection (86%), reduced competence (84%), expectations of failure (83%), and not being able to contribute (77%). For the second objective, findings indicated two overarching categories: Perceived inability, including frustration and impotence (89%), incompetence (77%) and irrelevance (71%); and Perceived distress, including anger (81%), feelings of anxiety (68%); and emotional bursts (63%). For the third objective, the following two high-level themes emerged: Ego-oriented resources, which comprised the development of a sense of purpose (81%), learning cognitive skills (71%), and (A3) practising sense of agency (67%); and Social-oriented resources, encompassing feeling socially integrated (80%); and expressing emotionally (54%). Findings indicated that the most verbalized themes for the three objectives were the same across the three nationalities. Conclusions: Ageism made it difficult for people to participate in civic life, which has been linked to better mental health. These findings emphasize the need to encourage inclusive civic involvement to improve older individuals' mental health. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the relationship between muscle strength, working memory, and activities of daily living (ADL) in older adults. Additionally, it seeks to clarify the pathways and effects of working memory in mediating the relationship between muscle strength and ADL. Methods: Using a cross-sectional study design, we recruited 245 older adults individuals from nursing homes. We collected data on grip strength, the 30-s sitto-stand test, the N-back task, and ADL. The data were analyzed using independent sample t-tests, χ2 tests, correlation analysis, and structural equation modeling. Results: Grip strength significantly influenced ADL (effect size  = −0.175, 95% CI: −0.226 to −0.124). Grip strength also had a significant direct effect on ADL (effect size  = −0.114, 95% CI: −0.161 to −0.067). The 1-back task correct rate significantly mediated the relationship between grip strength and ADL (effect size  =  0.054, 95% CI: −0.084 to −0.029). The 30-s sit-to-stand test significantly impacted ADL (effect size  = −0.280, 95% CI: −0.358 to −0.203). It also had a significant direct effect on ADL (effect size  = −0.095, 95% CI: −0.183 to −0.007). The 1-back task correct rate significantly mediated the relationship between the 30-s sit-to-stand test and ADL (effect size  = −0.166, 95% CI: −0.236 to −0.106). Conclusion: There exists a strong correlation between muscle strength, working memory, and ADL. Increased muscle strength leads to better ADL performance and improved working memory tasks. Low cognitive load working memory tasks can mediate the relationship between muscle strength and ADL. Regular physical exercise can enhance muscle strength, slow down the decline of working memory, thereby maintaining or improving ADL in older adults. [ABSTRACT FROM AUTHOR]

Background: Older adults with lower socioeconomic status are less likely to be physically active than those with higher socioeconomic status. To inform future intervention development, this review explored: [i] how effective are physical activity interventions at increasing levels of physical activity amongst older adults with lower socioeconomic status?; [ii] what factors are associated with the acceptability of physical activity interventions amongst older adults with lower socioeconomic status?; [iii] what are the implications for developing physical activity interventions for older adults with lower socioeconomic status? Methods: This mixed methods systematic review followed PRISMA guidelines. MEDLINE, CENTRAL, Embase, Scopus, Web of Science, PsycINFO, CINAHL, ASSIA and Sports Medicine and Education Index were searched up to May 2023, to identify quantitative, qualitative and mixed methods primary research studies measuring the effectiveness of and/or experiences of physical activity interventions for older adults (aged ≥ 65 years) with lower socioeconomic status. No limits on country were applied. Included studies were assessed for methodological quality using the Mixed Methods Appraisal Tool. Results were synthesised using a results-based convergent synthesis approach with narrative synthesis of quantitative findings and thematic synthesis of qualitative findings. Results: Thirty studies were included. Mixed effects were found for the effectiveness of physical activity interventions, with positive effects for increases in utilitarian walking (i.e. for transport) but not for leisure, mixed effects for objectively measured physical activity and no effects for self-reported total physical activity or muscle strengthening and flexibility activities. Engaging in physical activity interventions was perceived as offering many benefits, social familiarity was important to intervention acceptability and interventions were seen as more acceptable when they were compatible with the lifestyles of older adults with lower socioeconomic status. Conclusions: Future development of physical activity interventions for older adults with lower socioeconomic status should foster social connections, emphasise health benefits of physical activity, hold interventions in locations that are accessible and familiar to older adults with lower socioeconomic status, minimise costs to participants, employ individuals who share participant characteristics to lead interventions, and combine physical activity with other activities older adults with lower socioeconomic status already do to make more efficient use of time. Trial registration: PROSPERO CRD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312. [ABSTRACT FROM AUTHOR]