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Objectives: This study aims to evaluate the gender inequalities in accelerometer-based physical activity (PA) across different age groups using data from 5 Pelotas (Brazil) cohorts. Methods: The data come from 4 birth cohort studies, covering all live births in the urban area of Pelotas for each respective year (1982, 1993, 2004, and 2015), and the Como vai? cohort study focusing on 60 years and above. Raw accelerometry data were collected on the nondominant wrist using GENEActive/ActiGraph devices and processed with the GGIR package. Overall PA was calculated at ages 1, 2, 4, 6, 11, 15, 18, 23, 30, and 60+ years, while moderate to vigorous PA was calculated from 6 years onward. Absolute (difference) and relative (ratio) gender inequalities were calculated and intersectionality between gender and wealth was also evaluated. Results: The sample sizes per cohort ranged from 965 to 3462 participants. The mean absolute gender gap was 19.3 minutes (95% confidence interval, 12.7–25.9), with the widest gap at 18 years (32.9 min; 95% confidence interval, 30.1–35.7) for moderate to vigorous PA. The highest relative inequality was found in older adults (ratio 2.0; 95% confidence interval, 1.92–2.08). Our intersectionality results showed that the poorest men being the most active group, accumulating around 60 minutes more moderate to vigorous PA per day compared with the wealthiest women at age 18. Conclusions: Men were more physically active than women in all ages evaluated. PA gender inequalities start at an early age and intensify in transition periods of life. Relative inequalities were marked among older adults. [ABSTRACT FROM AUTHOR]

Background: Engaging in active transport will enable individuals across the life course to increase their habitual levels of physical activity. The aim of this study was to engage citizen scientists (CS) to identify factors that influence active transport in their community. Methods: The Our Voice citizen science methodology developed at Stanford University was employed. CS completed a "discovery walk," taking photos of things that help or hinder active transport. Three groups were recruited: children aged 10–12 years (n = 11), adults (n = 12), and older adults >65 years (n = 10). CS rated each photo and provided a narrative explaining their reason for taking the photo. Once all CS in a specific age group had completed the walk, they met for a group discussion. The CS worked together to analyze the data, arranging them into themes and identifying priority actions. Two CS representatives from each age group presented their findings to the local council decision makers. Results: Children highlighted the need for safer crossings, especially from their school to the local park, and suggested zebra crossings as a solution. The adults highlighted that road signs prioritized vehicles, not pedestrians, and requested that this be reversed. Older adults noted that the poor condition of the pavements made it harder for people in wheelchairs to navigate. The CS recommendations have informed the council's walking and cycling network program. Conclusion: Engaging with citizen science provided the community with an opportunity to advocate for meaningful yet realistic improvements in the built environment that could promote neighborhood active transport and physical activity across the lifespan. [ABSTRACT FROM AUTHOR]

Background: Cognitively stimulating sedentary behavior (SB) may positively impact cognition. This study aimed to (1) describe participation across types of SB among older adults with and without cognitive impairment and (2) examine how baseline SB participation impacts cognition, longitudinally. Methods: We used National Health and Aging Trends Study data from rounds 6 to 11 for cross-sectional and longitudinal analyses. Participants were 2244 community-dwelling older adults who were selected for the SB module in round 6. The SBs were categorized as active (eg, hobbies) and passive (eg, television). Participants were also categorized as having intact or impaired orientation, memory, and executive function based on tests of orientation, recall, and the clock-drawing test. We calculated descriptive statistics characterizing SB by cognitive status. Aim 2 involved competing risks proportional hazard models of participants with intact cognition (n = 1574) to identify associations between baseline SB and changes in cognition, moves to institutional care, and death over 6 years. Results: Participants (40% ≥ 80 years, 55% female, 77% White non-Hispanic) averaged 8.75 (SD = 4.42) hours of daily SB, including 4.05 (SD = 2.32) hours of passive SB and 4.75 (SD = 3.13) hours of active SB. Active SB >3 hours per day was associated with a lower risk of impaired orientation (subdistribution hazard models = 0.60; P =.048) and memory (subdistribution hazard models = 0.62; P =.02). Baseline participation in passive SB did not impact the risk of having a change in cognition during rounds 7 to 11. Conclusion: Cognitive decline was lower among older adults who participated in more active SB. Thus, type of SB should be considered in examining the impact on cognition. [ABSTRACT FROM AUTHOR]

Background: Pickleball has grown tremendously in recent years, yet little evidence exists regarding pickleball-related injuries. This scoping review extends current work on pickleball participation by identifying positive and negative health effects associated with the sport. We summarize how pickleball impacts the health and well-being of adult participants. Methods: Searches were conducted on MEDLINE, CINAHL, ProQuest Nursing, ERIC, SPORTDiscus, PsycINFO, Scopus, CBCA Complete, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ProQuest Dissertations and Theses. Selected studies considered aspects of health and/or well-being of adult pickleball participants. Using the population/concept/context framework, participants were healthy, able-bodied adults 18 years of age or over, who had played pickleball at least once. The positive and negative outcomes of pickleball on participants' health and well-being (concept) within the context of pickleball participation were examined. Full-text articles written in English since 2013 were included. Extracted data were tabulated, and a descriptive summary with thematic analysis was completed. Results: This scoping review comprised 27 articles that met the inclusion criteria. Pickleball is promising as an exercise intervention for all adults, and there is evidence of positive social and psychological effects, and health and fitness benefits to participating in pickleball by older adults. Conclusions: Although we are still in the early stages of studying pickleball, there have been some documented health benefits of using the sport as a physical exercise intervention for adults. More research is needed on the types, prevalence, and severity of pickleball injuries and the sport's impact on younger players. [ABSTRACT FROM AUTHOR]

Purpose: To identify the prevalence of and factors associated with total edentulism in the older Brazilian population and to verify whether edentulism influences self-perception of oral health and difficulty in eating. Materials and Methods: This cross-sectional, population-based study used the database of the National Health Survey conducted in Brazil. Chi-square test was initially used for data analysis. Subsequently, a multivariate analysis of Poisson multiple regression type was performed to verify the adjusted prevalence ratios. Results: A total of 43,554 older adults participated in the study, of whom 32% had completely lost their teeth. This total edentulism, based on the multivariate analysis, was associated with female gender, advanced age, illiteracy, smoking, and lack of health insurance or dental insurance (P < .001 for all). Total edentulism had an impact on better self-perception of oral health (P < .001) and greater difficulties in eating (P = .001). Conclusions: Total edentulism in older adults is associated with worse socioeconomic conditions and a worse lifestyle. This condition has a negative impact on diet and positively affects self-perception of oral health. [ABSTRACT FROM AUTHOR]

Background: Walking activity has been associated with reduction in the development of chronic disease, cognitive and physical function impairment, disability, and mortality. The objective of this study was to examine the relationship between walking activity and physical function over 9 years of follow-up among Mexican Americans aged 78 years and older. Methods: Participants (N = 998) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2007–2016). Measures included walking activity duration and frequency, socio-demographics, body mass index, medical conditions, pain, depressive symptoms, limitation in activities of daily living, and the Mini-Mental State Examination. Low physical function was defined as scoring <7 on the Short Physical Performance Battery. At baseline, participants were grouped into nonwalkers (n = 653), walked <150 minutes/week (n = 144), and walked 150 minutes/week or more (n = 201). A Generalized Estimating Equation model was used to estimate the odds ratio and 95% CI of low physical performance as a function of walking activity status. Results: Compared with nonwalkers, participants walking < 150 minutes/week had lower odds (odds ratio = 0.66, 95% CI, 0.51–0.86) of low physical function over time, after controlling for all covariates, as did those walking ≥ 150 minutes/week (odds ratio = 0.54, 95% CI, 0.41–0.71). Conclusions: Mexican American older adults who engage in any walking activity are at reduced risk of low physical function, even those with disability. Interventions at the individual and community level are recommended to reduce physical function impairment, even in those with preexisting medical conditions or disability. [ABSTRACT FROM AUTHOR]

Introduction: The growing ability to provide online services has enabled the proliferation of exercise-based telehealth interventions; however, adoption in older adults may be impacted by low digital literacy and "technophobia." Objectives: The aim of this study was to explore the experience of community and aged-care dwelling older adults following exercise-based telehealth services to provide insights that could guide future telehealth exercise delivery. Design: Semi-structured interviews for qualitative analysis. Methods: Participants (age ≥60) who had completed at least one online exercise session from a registered health professional were recruited through a combination of purposeful and snowball sampling methods via their exercise facility or provider. A semi-structured interview guide was used by 2 interviewers to investigate participants' experiences and a "critical friends" approach used to identify common themes. Results: Thirteen interviews with 21 participants were conducted from 2 different facilities. Analysis identified meaning units within 3 themes and subthemes. Technology subthemes related to digital confidence prior to telehealth and changes during interventions, as well as the usability of technology for telehealth. Clinical practice subthemes described the different motivations to exercise, perceived benefits of telehealth, important implications for practitioners, and perceptions of safety. The social connection theme related to the social benefits of telehealth. Conclusions: Older adults in our sample were technologically confident and capable of performing exercise sessions delivered via telehealth. They notice benefits from this form of exercise delivery however, prefer face-to-face exercise delivery. [ABSTRACT FROM AUTHOR]

Falls are very serious health concerns among older adults. Providing additional cutaneous and proprioceptive feedback to older adults may enhance their balance control and therefore reduce the incidents of falls. This study aimed to investigate the acute and acclimated effect of wearing waist-to-above-ankle compression garments (CGs) on balance control in community-dwelling older adults. Thirty-one older adults participated in the study. The Timed Up and Go, Berg Balance Scale, and the Fall Risk Test of the Biodex Balance System were used in a random order to examine balance control in three testing sessions 1 week apart. Results indicated wearing CGs had a significant impact on the Timed Up and Go test (p <.001), Berg Balance Scale (p =.001), and the Fall Risk Test (p =.001). For the Timed Up and Go test, participants exhibited significant improvement in both the acute (8.68 vs. 7.91 s) and acclimated effect (7.91 vs. 7.41 s) of wearing CGs. For the Berg Balance Scale, participants showed significant improvement after wearing CGs for 1 week in comparison to the no CGs condition (55.77 vs. 55.39 points). For the Fall Risk Test, participants showed a significant improvement in the acute effect of wearing CGs in comparison to the no CGs condition (1.55° vs. 1.31°). This exploratory study showed that wearing waist-to-above-ankle CGs provided a positive impact on balance control in healthy community-dwelling older adults. It lays the foundation for future studies with a larger sample size to investigate the potential benefits of wearing CGs in individuals with balance control deficits and/or other comorbidities. [ABSTRACT FROM AUTHOR]

A systematic review and meta-analysis of brain hyperscanning research suggests that interbrain synchrony (IBS) can be used as an objective measure of teamwork. The study found that factors like familiarity and stress levels among team members facilitate IBS. It also showed that IBS is correlated with teamwork behaviors and affective states, and predicts team performance to some extent. While there are limitations to the technology used, the researchers concluded that brain hyperscanning is a promising tool for studying teamwork. Additionally, a collection of articles explores topics related to physical activity and exercise, including factors influencing physical activity in adults with overweight or obesity, the impact of mindfulness-based activities during high-intensity interval training, negative messages directed at athletes on social media, the effects of fitness center closures on physical activity in older adults during the COVID-19 pandemic, and the impact of fitfluencer captions on body image and exercise intentions in adolescents. These articles provide valuable insights and emphasize the need for further research and support in promoting physical activity and well-being. [Extracted from the article]

Inclusive design considers usability first: to design with the needs of everyone to decrease the mismatch between the end-user and the design object. In advertising, the mismatch may be in the opportunity to process an advertisement due to design strategies (i.e., executional ad cues). Based on the Motivation-Opportunity-Ability model of information processing, we focus on legibility as an important but underexplored encoding issue that can enhance consumers' opportunity to process ads based on visual clarity and lead to perceptual fluency effects. Visual acuity declines with age, so legibility is particularly important for older adults and those with vision loss. In line with recommended accessibility guidelines, we manipulated two advertising design factors believed to impact legibility—color contrast and font style—in the supers of a video advertisement for a pharmaceutical drug and tested the communication outcomes (cognition, persuasion). Across three studies with three different-aged populations, we show that legibility was positively related to awareness of information in the supers and to positive perceptions of the advertisement. In line with accessibility guidelines, legibility was rated the highest for most people in the high-color contrast sans serif font supers. Implications for theory, accessibility and older people, and public policy are discussed. [ABSTRACT FROM AUTHOR]

The need to be connected to a client's personal and business network is a key to better serving the client's needs. Do you have a relationship with the client's executor(trix), the person who holds a durable power of attorney, friends and neighbors who could provide a wellness check on elderly clients, and other members of the professional team (CPA, estate attorney, etc.)?. [ABSTRACT FROM AUTHOR]

Catherine Bertini, a leader in addressing global hunger, discusses the challenges of achieving zero hunger by 2030. Currently, 800 million people are food-insecure due to poverty, conflicts, climate issues, and the COVID-19 pandemic. The goal of reaching net-zero greenhouse gas emissions by 2050 poses a challenge, as agriculture contributes a quarter of all emissions. Efforts are being made to develop climate-resilient African crops and reduce negative impacts from the agricultural industry. The text emphasizes the importance of proactive measures to mitigate the effects of climate change on food security, investing in pre-mitigation efforts, and supporting local food systems. It also highlights the role of women in food and climate issues and the recent recognition of food's importance in climate discussions. The text concludes by discussing the food situation in Gaza and the need for an end to war to ensure food delivery to the region. [Extracted from the article]

Whether visuomotor plasticity of postural control is a trainable feature in older age remains an open question despite the wealth of visually guided exercise games promising to improve balance skill. We asked how aging affects adaptation and learning of a visual feedback (VF) reversal during visually guided weight shifting and whether this skill is modulated by explicit knowledge. Twenty-four older (71.43 + 2.54 years) and 24 young (24.04 1 0.93 years) participants were exposed to a 180° VF reversal while tracking a horizontally moving target by voluntarily weight shifting between two force platforms. An explicit strategy was available to half of the participants with detailed instruction to counter the VF rotation. Individual error data were fitted to an exponential function to assess adaptation. Fewer older (12/24) than younger (21/24) participants adapted to the VF reversal, displaying error curves that fitted the exponential function. Older adults who adapted to the VF reversal (responders. n= 12) reached an asymptote in performance in the same weight shifting cycle and displayed a similar mean asymptotic error compared with young participants. Young but not older responders exhibited an aftereffect when the VF reversal was removed. Instruction did not influence spatial error modulations regardless of age. The large individual variations within the older adults' group during early adaptation suggest age-specific limitations in using explicit cognitive strategies when older adults are exposed to an abrupt mirror feedback reversal that requires a change in weight shifting direction during whole-body postural tracking. [ABSTRACT FROM AUTHOR]

Background: There is a scarcity of studies on the association between physical multimorbidity and lower levels of physical activity among older adults from low- and middle-income countries, while the potential mediating variables in this association are largely unknown. Methods: Cross-sectional, community-based, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Data on 11 chronic physical conditions were collected. Scoring <150 minutes of moderate- to high-intensity physical activity per week was considered low physical activity. Multivariable logistic regression and mediation analysis were done to assess associations and quality of life measures which might influence these associations. Results: Data on 14,585 people aged ≥65 years were analyzed (mean [SD] age 72.6 (11.5) y, maximum age 114 y; 55.0% women). After adjustment for potential confounders, compared with no chronic conditions, ≥3 conditions were associated with a significant 1.59 to 2.42 times higher odds for low physical activity. Finally, mobility mediated the largest proportion of the association between ≥3 chronic physical conditions and low physical activity (mediated percentage 50.7%), followed by activities of daily living disability (30.7%), cognition (24.0%), affect (23.6%), and pain/discomfort (22.0%). Conclusions: Physical multimorbidity was associated with higher odds for low physical activity among older adults residing in low- and middle-income countries. Mobility, disability, cognition, affect, and pain/discomfort explained the largest proportion of this association. Given the universal benefits of regular and sustained participation in physical activity, it would be prudent to implement interventions among older people with physical multimorbidity to increase levels of physical activity. Future studies should assess the impact of addressing the identified potential mediators among people with multimorbidity on physical activity levels. [ABSTRACT FROM AUTHOR]

Solo agers--the millions of Americans without a biological child or the traditional family structure that is the foundation of informal long-term services and supports for older adults, particularly those age 80 and older-- have both advantages and challenges from being child-free. The independence and freedom to pursue career, economic, and lifestyle aspirations afforded by the absence of child-rearing responsibilities also result in increased responsibilities for caregiving and related costs for married couples, widows and widowers, and unmarried individuals. Those living alone at advanced age are particularly at risk unless they have done considerable advance planning as well for financial security, caregiving support, and social connectedness. Ideally, this includes adequate guidance and advice from financial professionals aware of and responsive to their long-term needs. [ABSTRACT FROM AUTHOR]

Background: Few programs assess for outcomes once translated into practice. The Physical Activity for Lifelong Success program was developed as a center-based public health intervention and shown to improve walking speed and distance among older adults with type 2 diabetes. We adapted the program for community-based delivery by lay leaders to physically inactive older adults. Methods: We followed the Replicating Effective Programs framework to identify community stakeholders, adapt, implement, and evaluate fidelity of delivery in community settings, and plan for maintenance and evolution. Sixteen community sites enrolled 184 adults (mean age 73.5 y, 85% female, 93% White) in 21 workshops. Baseline and postworkshop measures assessed participants' health-related quality of life, physical function, and physical fitness. Data were analyzed using Fisher exact tests, Student t test, and paired linear regression with fixed effects. Results: Fidelity testing indicated leader training was sufficient to maintain key elements with delivery. Data from 122 participants showed improvements in chair stands (P <.001), arm curls (P <.001), 2-minute step test (P <.001), sit-and-reach (P =.001), 8-foot up-and-go (P <.001), and 10-m walk (P <.001). Conclusions: Adaptation of Physical Activity for Lifelong Success for implementation by community organizations for physically inactive older adults demonstrates that fidelity and effectiveness can be maintained after program translation. [ABSTRACT FROM AUTHOR]

Background: Little investigation of accelerometry assessed movement behaviors and physical inactivity was carried out in middle-aged and older adults in low-middle-income countries. Objective: Describe accelerometry-measured movement behaviors and prevalence of physical inactivity in middle-aged and older adults. Methods: We collected raw accelerometry data during the third visit (2017–2019) of ELSA-Brasil, a large-scale multicenter Brazilian cohort. Participants wore an ActiGraph wGT3X-BT on the waist for 24 hours for 7 days and documented sleep in a diary. Results: Nine thousand two hundred and seventy-nine participants had valid data (73.4% of the eligible cohort). Overall activity was higher for men (11.82mg; 95% confidence interval [CI], 11.7 to 11.93) than women (10.69mg; 95% CI, 10.6 to 10.77) and lower in older groups—women (−0.12mg/y; 95% CI, −0.13 to −0.11), men (−0.16mg/y; 95% CI, −0.17 to −0.14). Participants were more active from noon to midnight. Distribution of movement behaviors varied with sex and age, and sleep duration was longer in older individuals. Overall, 14.4% (95% CI, 13.7 to 15.1) were inactive, with inactivity being more frequent in women (16.4%; 95% CI, 15.4 to 17.4) than men (12.2%; 95% CI, 11 to 13). Higher rates were observed in the oldest. Retirement was associated with a higher prevalence of physical inactivity in both sexes. Conclusion: Women were less active than men. Older individuals showed a high prevalence of physical inactivity, probably related to transition into retirement. These findings strengthen evidence for public policies promoting physical activity by emphasizing the need to target women, older individuals, and those transitioning to retirement to improve and/or maintain physical activity levels throughout the course of their lives. [ABSTRACT FROM AUTHOR]

Group physical activity can provide physical and social benefits; however, social barriers or a lack of social support may affect participation. This study examined social-support needs and barriers among older adults who were not participating in group physical activities. Using interpretive description, semistructured interviews were conducted with 38 older adults (M = 70.9 years; 81.6% women). Themes were grouped into two categories. Category 1, expectations and initial impressions, consisted of the following: (a) Groups cannot meet everyone's expectations or interests, (b) groups are intimidating to join, and (c) the need for inclusive programming. Category 2, social processes within group physical activity, consisted of (a) modeling physical activity behaviors, (b) sharing information and suggestions about physical activity opportunities, and (c) encouragement and genuine interest. Outreach to this population should aim to address these barriers and utilize these supportive behaviors to reduce feelings of intimidation and promote participation among older adults. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the kinematic changes in obstacle avoidance and prehension tasks performed simultaneously by older adults with a history of falls at different levels of task difficulty. Twenty-six older adults were divided into faller and nonfaller groups. The experimental protocol was divided into two different tasks: walking with obstacle avoidance and walking with obstacle avoidance combined with a reach-to-grasp task. Two types of sensors (Kinect v2 and Leap Motion Controller, respectively) were used to analyze gait and grasp. Fallen; presented kinematic changes associated with the grasping task during obstacle avoidance, such as a decrease in the velocity of the center of mass and the step length, an increase in the step width, a decrease in toe-obstacle horizontal distance, and an increase in vertical foot clearance distance, and an increase in movement time in the grasping task compared with nonfallers. To cope with the obstacle avoidance demands of both walking and grasping, fallers turned to a specific sequencing strategy. While slowing down, they attended first to the grasping task and then to crossing the obstacle on the floor. [ABSTRACT FROM AUTHOR]

Aims and Objectives Methodological Design and Justification Ethical Issues and Approval Research Methods Results Study Limitations Conclusion To describe first‐line managers' (FLMs) views of the challenges faced by staff when encountering older people's existential concerns in home and residential care.This cross‐sectional study uses a combination of qualitative and quantitative methods.The study was approved by the Swedish Ethical Review Authority (ref. number 2014/652 ) and followed the guidelines of the Helsinki Declaration.FLMs in home and residential care were randomly selected and invited to participate. A self‐administered questionnaire was distributed online to 467 managers, 136 (29%) of whom completed it.About 80% of the FLMs reported that their staff members sometimes or frequently had conversations with the older people in their care about existential concerns, including the following topics: thoughts and feelings about meaning in life; losses and longing for meaningful relations; death, fears and uncertainty and supporting meaningful everyday life. About 75% of the managers also reported that their staff sometimes or often had conversations about existential concerns with one another. Major hindrances to existential conversations were reportedly cognitive impairment and aphasia among the older people and insecurity and unwillingness among the staff. Most managers (73%) reported that their staff received support when encountering existential concerns, mostly as individual support from managers or registered nurses.The main limitation of this study is its low response rate, which is common for digital surveys. Nevertheless, the sample is considered to be representative; therefore, the study holds exploratory value.Regular conversations among staff, improved conversational skills and the ability to listen reflect on and perceive older people's perspective and life world are needed when encountering older people's existential concerns. FLMs play a crucial role in emphasising and planning staff support on a regular basis. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) often remains undiagnosed, and it independently raises the risk of ischemic stroke, which is largely reversible by oral anticoagulation. Although randomized trials using longer term screening approaches increase identification of AF, no studies have established that AF screening lowers stroke rates. To address this knowledge gap, the GUARD-AF (Reducing Stroke by Screening for Undiagnosed Atrial Fibrillation in Elderly Individuals) trial screened participants in primary care practices using a 14-day continuous electrocardiographic monitor to determine whether screening for AF coupled with physician/patient decision-making to use oral anticoagulation reduces stroke and provides a net clinical benefit compared with usual care. GUARD-AF was a prospective, parallel-group, randomized controlled trial designed to test whether screening for AF in people aged ≥70 years using a 14-day single-lead continuous electrocardiographic patch monitor could identify patients with undiagnosed AF and reduce stroke. Participants were randomized 1:1 to screening or usual care. The primary efficacy and safety outcomes were hospitalization due to all-cause stroke and bleeding, respectively. Analyses used the intention-to-treat population. Enrollment began on December 17, 2019, and involved 149 primary care sites across the United States. The COVID-19 pandemic led to premature termination of enrollment, with 11,905 participants in the intention-to-treat population. Median follow-up was 15.3 months (Q1-Q3: 13.8-17.6 months). Median age was 75 years (Q1-Q3: 72-79 years), and 56.6% were female. The risk of stroke in the screening group was 0.7% vs 0.6% in the usual care group (HR: 1.10; 95% CI: 0.69-1.75). The risk of bleeding was 1.0% in the screening group vs 1.1% in the usual care group (HR: 0.87; 95% CI: 0.60-1.26). Diagnosis of AF was 5% in the screening group and 3.3% in the usual care group, and initiation of oral anticoagulation after randomization was 4.2% and 2.8%, respectively. In this trial, there was no evidence that screening for AF using a 14-day continuous electrocardiographic monitor in people ≥70 years of age seen in primary care practice reduces stroke hospitalizations. Event rates were low, however, and the trial did not enroll the planned sample size.(Reducing Stroke by Screening for Undiagnosed Atrial Fibrillation in Elderly Individuals [GUARD-AF]; NCT04126486) [ABSTRACT FROM AUTHOR]

The older adult population is growing gradually. The demographic structure is changing with the increasing elderly population. Changing demographic structure may lead to changes in the patient profile that nurses will provide care for. Nurses need to adapt to changing environments, and the quality of care they provide must reflect this. Simulating situations experienced by older adults allows future nurses to gain experience that may help raise awareness without having to face the changing patient profile. There is a need for valid and reliable measurement tools intended to evaluate simulation experiences about aging. The purpose of this study was to adapt the Aging Simulation Experience Scale into Turkish and determine its validity and reliability. A methodological and cross-sectional design was employed. Data were collected between May and June 2023. The validity of the scale was determined using language, content, and construct validity. Cronbach’s alpha coefficient and item analysis were used to determine the reliability of the scale. The content validity index of the scale items ranged from 0.80 to 0.95. Item-total correlations of the items ranged from 0.413 to 0.713. Cronbach's alpha reliability coefficient was 0.91 for the perception toward older adults dimension and 0.83 for the simulation experiences dimension. In conclusion, the Turkish form of the Aging Simulation Experience Scale was found valid and reliable. [ABSTRACT FROM AUTHOR]

With advancements in science, technology, and healthcare, senior citizens today face extended retirement periods of 15–35 years. However, many experience challenges such as declining physical and mental functions, which often lead to depression and reduced self-esteem. This study aims to explore the design elements and needs of older adult toys by integrating older adult learning theories to promote successful, healthy, and active aging. Using both qualitative and quantitative research methods, we analyzed expert interviews and applied multivariate statistical techniques, including descriptive statistics and independent sample t-tests, to assess the physical, psychological, and lifestyle needs of older adults. Additionally, we examined older adults’ attitudes and behaviors toward toys, leading to the identification of key design criteria and preferences. Based on these insights, we developed guidelines for designing toys that support the aging process and proposed a model to predict future market trends. The findings offer valuable guidance for the toy industry in fostering innovation and sustainable development. [ABSTRACT FROM AUTHOR]

Housing conditions and quality are well-established structural or social determinants of health. Poor quality housing also has the potential to affect care needs, but there is much less research on the topic, particularly on nonspecialist housing. Based on analysis of in-depth interviews with 44 people aged 65 and older living in England, their unpaid carers (N = 22), or as a carer-care recipient dyad (N = 6), (total N = 72), this study sought to explore the perceived relationship between people’s housing conditions and characteristics and their care needs. Findings indicate three key themes within this relationship: condition of home (cold and damp; state of repair; cleanliness and clutter); space and design (space, access); and legal relationship with the home (ability to carry out remedial work; precarity). There was variation in how and whether housing affected care needs by housing tenure, financial resources, and the type and level of care need. Care needs can increase requirement for warmer, less damp homes and be a barrier to improving homes. In turn, housing has a role to play in preventing the occurrence or worsening of care needs. Improving housing through policy and practice actions could reduce care needs and improve the lives of older people now and in the future. [ABSTRACT FROM AUTHOR]

Introduction: Although a well-established component of bone metabolism, the efficacy and safety of vitamin D supplementation for the prevention of fractures in elderly healthy individuals is still unclear. Purpose: To perform a meta-analysis comparing vitamin D supplementation with placebo and its contributions on fracture incidence. Methods: This meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO), under protocol CRD42023484979. We systematically searched PubMed, Embase, and Cochrane Central databases from inception to November 2023 for randomized controlled trials (RCTs) comparing vitamin D supplementation versus placebo in individuals with 60 years of age or more and without bone related medical conditions such as cancer and osteoporosis. Results: Seven RCTs with 71,899 patients were included, of whom 36,822 (51.2%) were women. There was no significant difference in total fracture incidence (RR 1.03; 95% CI 0.93–1.14; p = 0.56; I2 = 58%) between groups or subgroups. However, women had an increased risk for hip fractures (164 vs. 121 events; RR 1.34; 95% CI 1.06–1.70; p = 0.01; I2 = 0%). There was no significant difference in non-vertebral fractures, osteoporotic fractures development, or falls (RR 1.02; 95% CI 0.94–1.12; p = 0.6; I2 = 47%; RR 0.97; 95% CI 0.87–1.08; p = 0.63; I2 = 0%; RR 1.01; 95% CI 0.97–1.04; p = 0.66; I2 = 55%, respectively). Conclusion: Vitamin D supplementation does not reduce the total fracture development rate in the elderly healthy population, and it may increase the incidence of hip fractures among elderly healthy women. This finding suggests refraining from prescribing high intermittent doses of vitamin D, without calcium, to individuals aged 60 or older with unknown vitamin D serum concentration or osteoporosis status and inadequate calcium intake. [ABSTRACT FROM AUTHOR]

Background: The aging global population is increasing the attention to cognitive decline in older individuals. Objective: This study sought to examine the potential link between the neutrophil percentage-to-albumin ratio (NPAR) and cognitive function. Methods: We analyzed data from the National Health and Nutrition Examination Survey 2011–2014 using multivariate logistic regression and smooth curve fitting, to investigate the correlation between NPAR and cognitive performance. Restricted cubic spline analysis assessed the linear relationship with high-risk cognitive dysfunction, while piecewise linear regression identified thresholds. Subgroup analyses confirmed the consistency and reliability of our findings. Results: Our study included data from 2759 individuals aged >60 years. NPAR showed a significant correlation with Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word learning score, CERAD delayed recall score, total z-score and a high risk of cognitive dysfunction. Furthermore, there were statistically significant trends in the changes in CERAD word learning, digit symbol substitution test, and CERAD delayed recall scores as the NPAR quartile increased, these trends were inverted U-shaped. When the NPAR exceeded 14.57, there was a positive association with the likelihood of a high risk of cognitive impairment. The link between NPAR and cognitive performance was notably stronger in individuals with moderate body mass index and those aged 73–80 years. Conclusions: A strong link was observed between the NPAR and cognitive function. NPAR may serve as a tool to identify individuals at increased risk of cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Effect of education attainment and nutritional status on the development of cognitive impairment in Chinese elderly has not been reported. Objective: To investigate the role of education and nutrition in preventing cognitive impairment in the hospitalized Chinese elderly. Methods: Cognitive function was examined using the scoring system of Mini-Mental State Examination (MMSE) domains performed under instruction of Physicians of Geriatrics. Generalized linear mixed-effect regression was used for analyzing the association of demographic factors (age and gender), socioeconomic factors (education attainment and monthly income), as well as health-related factors (nutritional status, comorbidity, anxiety, and depression) and MMSE scores. Results: Total 246 hospitalized Chinese elders were enrolled into this study. Of them, 96 participants were 60–70 years old, 65 participants were 71–80 years old, and 85 of them were 81 years or older. Of the examined factors, we found that age, education attainment, and nutritional status were significantly associated with the outcome of MMSE scores, while monthly income and health condition (comorbidity, anxiety, and depression) were not significantly associated with MMSE score. Furthermore, education attainment was significantly associated with majority of the MMSE domains, including orientation, registration, attention and calculation, recall, and most of language sub-domains. Conclusion: Education attainment and nutritional status were significantly associated with MMSE scores in the hospitalized Chinese elderly. Higher education and better nutritional status are protective factors for the development of cognitive impairment in the hospitalized elderly Chinese population. [ABSTRACT FROM AUTHOR]

Background: Plasma biomarkers have recently emerged for the diagnosis, assessment, and disease monitoring of Alzheimer's disease (AD), but have yet to be fully validated in preclinical AD. In addition to AD pathologic plasma biomarkers (amyloid-β (Aβ) and phosphorylated tau (p-tau) species), a proteomic panel can discriminate between symptomatic AD and cognitively unimpaired older adults in a dementia clinic population. Objective: Examine the added value of a plasma proteomic panel, validated in symptomatic AD, over standard AD pathologic plasma biomarkers and demographic and genetic (apolipoprotein (APOE) ɛ4 status) risk factors in detecting preclinical AD. Methods: 125 cognitively unimpaired older adults (mean age = 66 years) who completed Aβ PET and plasma draw were analyzed using multiple regression with Aβ PET status (positive versus negative) as the outcome to determine the best fit for predicting preclinical AD. Model 1 included age, education, and gender. Model 2 and 3 added predictors APOE ɛ4 status (carrier versus non-carrier) and AD pathologic blood biomarkers (Aβ42/40 ratio, p-tau181), respectively. Random forest modeling established the 5 proteomic markers from the proteomic panel that best predicted Aβ PET status, and these markers were added in Model 4. Results: The best model for predicting Aβ PET status included age, years of education, APOE ɛ4 status, Aβ42/40 ratio, and p-tau181. Adding the top 5 proteomic markers did not significantly improve the model. Conclusions: Proteomic markers in plasma did not add predictive value to standard AD pathologic plasma biomarkers in predicting preclinical AD in this sample. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are prevalent in older adults with cancer but are often undertreated. Older adults are also at increased risk of chemotherapy toxicity (CT). This study evaluated the impact of depression and anxiety symptoms on severe CT risk in older adults with cancer. Methods: This is a secondary analysis of a randomized trial (2:1) evaluating geriatric assessment–driven intervention (GAIN) versus standard of care (SOC) to reduce grade 3+ CT in older adults with cancer. Mental health was assessed via the Mental Health Inventory 13. CT was graded by National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results: A total of 605 patients enrolled (402 GAIN; 203 SOC). Overall, 35% were depressed and 47% were anxious. Patients with depression had increased CT in the SOC arm (70.7% vs. 54.3%; p =.02) but not in the GAIN arm (54.3% vs. 48.5%; p =.27). CT was more likely in SOC patients with depression (odds ratio [OR], 2.03; 95% CI, 1.10–3.72). This association persisted after adjusting for Cancer and Aging Research Group toxicity score (OR, 1.98; 95% CI, 1.07–3.65) and for demographic, disease, and treatment factors (OR, 2.00; 95% CI, 1.03–3.85). Depression and CT were not associated in the GAIN arm (OR, 1.26; 95% CI, 0.84–1.91). Anxiety and CT were not associated in either arm. Conclusions: Elevated depression symptoms are associated with increased risk of severe CT in older adults with cancer, which was mitigated with GAIN. This suggests that treating depression symptoms may lower toxicity risk. Future studies are needed to confirm and investigate the impact of depression‐specific interventions on outcomes. Depression symptoms are associated with increased risk of severe chemotherapy toxicities in older adults with cancer. This risk is mitigated in those who receive geriatric assessment–driven interventions. [ABSTRACT FROM AUTHOR]

To explore the relationship between adverse childhood experiences and falls in older adults, and the mediating effects of depression on such associations. This is a prospective study used survey data from the China Health and Retirement Longitudinal Study. Twelve expanded ACEs obtained from the 2014 Life History Survey. Depression levels were assessed using the Centre for Epidemiologic Studies Depression Scale-10. Self-reported outcomes of falling evaluated based on "Have you fallen down since the last survey?" and "How many times have you fallen down seriously enough to need medical treatment?" Logistic regression models were used to explore the relationship between ACEs with falls and recurrent falls. Poisson regression models were used to explore the relationship between ACEs and number of severe falls. Besides, mediation analysis was used to explore whether depression mediates the relationship between ACEs and falls in older adults. The more adverse childhood experiences experienced, the higher the risk of fall and recurrent falls, and the more severe the falls. Additionally, depression partially mediated the relationship between adverse childhood experiences and falls. Besides, middle-aged individuals were more susceptible to the impact of adverse childhood experiences on falls than older individuals, especially males. Exposure to adverse childhood experiences is associated with falls in older adults, and depression partially mediates this association. Middle-aged adults were more susceptible to the impact of adverse childhood experiences on falls. These offer important information for clinical practice and public health interventions to prevent falls and reduce fall-related injuries among older adults. [Display omitted] • Are ACEs associated with falls in older adults and does depression mediate such an association? • Exposure to more ACEs was associated with higher risk of falls, recurrent falls, and more severe falls. • Depression partially mediated the effect of ACEs on falls. • Middle-aged adults were more susceptible to the impact of ACEs on falls than older adults. [ABSTRACT FROM AUTHOR]

Loneliness is a powerful stressor for depression in older adults, and resilience and social support may mediate this relationship, while the evidence is limited. Hence, our study aims to explore the mediating role of social support and resilience between loneliness and depression and to test possible moderators. We searched 12 databases without language and publish time restrictions and obtained the correlation coefficients. This review constructed two-stage meta-analytical structural equality modeling (MASEA) to test the mediating effect of social support and resilience. Additionally, use one-stage MASEA to test the moderator effect of women proportion, published year, and country of study. This study included 53 studies and 40, 929 older adults. Loneliness directly affected depression (β = 0.28, 95 % CI: 0.20, 0.36). Social support (β = 0.06, 95 % CI: 0.02, 0.09) and resilience (β = 0.15, 95 % CI: 0.12, 0.18) mediated the relationship. The proportion of women in the sample was moderator (χ 2 (5) = 11.10, p = 0.05). When the proportion exceeded 60 %, the path coefficient of loneliness and social support (β = −0.45, SE = 0.055) was larger than that of the subgroup below 60 % (β = −0.32, SE = 0.041). It was indefinite whether the evidence would be supported in longitudinal designs. Influenced by the original research data, it is impossible to calculate the model parameters of gender discrepancy. Health aging policy-makers adopting social support and resilience intervention will help strengthen the coping skills of older adults confronting loneliness and reduce the risk of depression. • Loneliness is positively associated with depression in older adults. • Social support and resilience play a mediating role in loneliness and depression. • Pay attention to gender differences when implementing social support intervention. [ABSTRACT FROM AUTHOR]

The physiological and functional changes from aging affect the systemic and swallowing muscles. While ultrasound is used to examine muscle characteristics, no previous studies have examined the relationship between age and perioral and trunk muscle characteristics, including stiffness. This study aimed to investigate the relationship between age and the characteristics of perioral and trunk muscles, including quality, quantity, and stiffness, using ultrasound. A total of 215 participants were recruited for this cross-sectional study: 98 younger adults (20–64 years) and 117 older adults (≥ 65 years). Muscle characteristics were assessed along with data on age, sex, body mass index, and number of teeth. The correlation between age and muscle characteristics was examined. Multiple linear regression was performed with muscle characteristics as dependent variables and age, body mass index, and number of teeth as explanatory variables. We found that only trunk muscle stiffness was associated with age, with a stronger correlation in quality and quantity than perioral muscles. Masseter muscle quality and quantity showed a higher correlation with age than those of the geniohyoid muscle. In conclusion, characteristics of the trunk and perioral muscles exhibit differences in age-related changes, highlighting the importance of maintaining both trunk and perioral muscle activity in older adults to prevent functional decline. [ABSTRACT FROM AUTHOR]

Delayed marriage and childbirth often result in individuals becoming grandparents in middle and older age, coinciding with significant physical transitions. This study examines the relationship between the intensity of grandparental childcare, measured in terms of time-commitment over the last year, and relative handgrip strength among South Korea adults aged 45–84. Data from 3,742 participants with grandchildren were analyzed using the 2008–2010 waves of the Korean Longitudinal Study of Aging. After applying propensity score matching, a final sample of 286 participants was analyzed with multivariate logistic regression model. Results showed that grandparents who provided childcare for an average of less than 40 h per week (Odds Ratio [OR] = 3.62) were more likely to have lower handgrip strength compared to those without caregiving experience. Additionally, those over the age of 65 showed a similar trend (OR = 2.76). Conversely, grandparents with positive self-rated health were less likely to exhibit lower handgrip strength than those rating their health as moderate (OR = 0.28). Grandparents who provided care for more than half the year were also less likely to have lower handgrip strength than those who provided less frequent care (OR = 0.26). This study highlights grandparental childcare as both a vital family support mechanism and a factor influencing physical health. Findings on caregiving intensity, particularly the role of moderate weekly childcare hours and longer terms involvement, underscore the importance of aligning caregiving commitments with grandparents' health perceptions and capacities. Developing guidelines for optimal childcare duration and recommending physical activities tailored to support grandparents' well-being would further promote healthy aging within a family-centered caregiving system. [ABSTRACT FROM AUTHOR]

There is a critical need to understand how aging visual systems contribute to age-related increases in vehicle accidents. We investigated the potential contribution of age-related detriments in steering based on optic flow, a source of information known to play a role in navigation control. Seventeen younger adults (mean age: 21.1 years) and thirteen older adults (mean age: 57.3 years) performed a virtual reality steering task. The virtual environment depicted movement at 19 m/s along a winding road. Participants were tasked with maintaining a central lane position while experiencing eight repetitions of each combination of optic flow density (low, medium, high), turn radius (35, 55, 75 m), and turn direction (left, right), presented in random order. All participants cut corners, but did so less on turns with rotational flow from distant landmarks and without proximal optic flow. We found no evidence of an interaction between age and optic flow density, although older adults cut corners more on all turns. An exploratory gaze analysis revealed no age-related differences in gaze behavior. The lack of age-related differences in steering or gaze behavior as a function of optic flow implies that processing of naturalistic optic flow stimuli when steering may be preserved with age. [ABSTRACT FROM AUTHOR]

Background: Access to equal health services is a key issue in most European countries. In the coming years, immigrants will constitute an increasing proportion of older adults in Europe, and their need for healthcare services will likely increase. Healthcare services must prepare for such encounters to make them equitable. Older immigrants' hospitalization experiences require elucidation. Their patient experiences can provide important knowledge when the healthcare system is working toward equal and equitable healthcare services. Methods: This study employed an exploratory qualitative design. Data were collected through narrative interviews with a purposive sample of eight older adult immigrants, aged 61–79 years. Patient narratives were analyzed using thematic analysis with a reflexive approach, as outlined by Braun and Clarke. Results: The analysis created three themes that shed light on older adult immigrants' experiences as hospital patients. The themes conveyed experiences related to challenging involvement and interaction, notions of what an ideal patient should be like, and participants not feeling valued as a person. Conclusion: The findings indicate that communication between healthcare professionals and older adult immigrant patients is deficient: older immigrants in this study did not make their voices heard nor were they invited to participate by healthcare professionals. This contributes to limited involvement in assessment, treatment, and care. The older immigrants felt that they were not valued nor met as unique individuals. The findings indicate that health policy goals regarding patient participation and person-centered care are not met when older immigrants are patients. Consequently, the experiences of older adult immigrants in this study indicate that equal health services are at risk. [ABSTRACT FROM AUTHOR]

Aim Background Methods Results Conclusion Implications for nursing practice and policy To understand the role adaptation process of nurses caring for older adult patients with terminal diseases in Chinese geriatric hospitals.The Chinese government has been encouraging the conversion of secondary general hospitals and some tertiary hospitals into specialized geriatric hospitals; however, research on nurses’ adaptation to caring for older adult patients with terminal diseases in these hospitals is lacking.Individual in‐depth interviews were conducted with 13 registered nurses with a minimum of two years of experience caring for older adults with terminal diseases. Following Glaserian grounded theory, open, selective, and theoretical coding were conducted for data analysis. The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.“Guards of the shining sunset” emerged as the core category. Participants experienced three stages: “chaotic me,” “rational me,” and “inclusive me.” They highlighted two causes, three contexts, two intervention conditions, three strategies, and two consequences.The study shows that nurses play a key role in “guarding the shining sunset” of older adult patients with terminal diseases. The observed role adaptation process provides theoretical support for interventions to assist nurses in becoming inclusive “guards of the shining sunset.”Nurses play a unique role as guardians protecting the end‐of‐life quality of elderly patients. Their role needs to be expanded and strengthened via effective coping strategies and comprehensive legal, education, welfare, and professional promotion support policies. The substantive theory offered by this study may be applied by nurses, department leaders, geriatric hospital managers, and national‐level institutions to underpin future interventions and improve role adaptation. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions Sarcopenia's high prevalence in older adults with cardiovascular disease (CVD) suggests that the risk of comorbidity in sarcopenia might also be increased during the at‐risk phase of CVD. However, the relationship between CVD risk and sarcopenia has not been elucidated. Therefore, the purpose of this cross‐sectional study was to investigate the association between CVD risk and sarcopenia in community‐dwelling Japanese older adults.The participants in this cross‐sectional study included 14 923 community‐dwelling Japanese older adults (mean age 73.2 ± 5.6 years). The present study estimated the CVD risk using the revised World Health Organization risk chart, and classified CVD risk into “low” (<10%) and “mid‐high” (≥10%). Assessments of sarcopenia, muscle mass, muscle strength and gait speed were measured based on the clinical definitions.Among the participants, 654 people (4.4%) had sarcopenia, and 4857 (32.6%) had CVD mid‐high risk. A multiple logistic model showed that the CVD mid‐high risk was associated with sarcopenia (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.28–1.89). In addition, CVD mid‐high risk was associated with low muscle mass (OR 1.74, 95% CI 1.50–2.01), low muscle strength (OR 1.25, 95% CI 1.14–1.37) and slow gait speed (OR 1.17, 95% CI 1.07–1.27) in the adjusted model.Among community‐dwelling older adults, high or moderate CVD risk was associated with an increased risk of sarcopenia. Our findings could help identify older adults with a future high risk for sarcopenia. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

As populations age, women's workforce participation grows and AI advances, understanding attitudes towards care technologies becomes increasingly important. This study examines attitudes towards robot caregivers for older adults across 28 European countries, using 2017 Eurobarometer data from working-age adults (20–59; n = 13,839). We investigate how individual characteristics (gender, education, occupation) and local-level factors (GDP, female labour participation, over 65s as % of the population, spending on old age) are associated with comfort levels with domestic care robots. The results show that men, individuals with higher levels of educational attainment, and those in professional or managerial occupations report greater comfort with robot caregivers. Additionally, local context plays a significant role. Those living in local communities with higher female employment rates and lower spending on old-age support demonstrate higher acceptance of robotic care solutions. These findings highlight the dual influence of individual and community factors in shaping attitudes towards automated care technologies. [ABSTRACT FROM AUTHOR]

Objectives: To examine healthcare provider-related perceptions toward deprescribing inappropriate medications among older adults. Methods: A cross-sectional, correlational study used a convenience sample of outpatient older adults to measure their perception toward deprescribing using a Patient's Perceptions of Deprescribing (PPoD), which include 57 multiple-choice questions related to patients' sociodemographic data, health, medicines, healthcare providers, and experience of care provided by the clinic. Data were collected by a graduate nursing student from one pharmacy in a public hospital, five days per week, via in-person interviews. Results: Data were analyzed for 200 participants. The level of patient collaboration with their primary care providers (PCPs) is linked to their trust in PCPs, beliefs about medication use, PCP knowledge, and medication concerns (p <.0001). Patient involvement in medication deprescribing decision-making is also associated with trust in PCPs and willingness to stop a medication (p <.0001). Additionally, trust in PCPs is related to patient involvement in decision-making, PCP knowledge, general health, collaboration with PCPs, and receiving conflicting information about a medicine (p =.010). Lastly, PCP medication knowledge is associated with trust in PCPs, views on the importance of medicines, medication concerns, seeking help with medicines, interactions with clinical pharmacists, and being advised by a clinical pharmacist to discontinue medication (p <.0001). Conclusions: The study found that older adults' trust in their PCP, collaboration with their PCP, involvement in the decision-making of deprescribing, and knowledge about medication are associated with clinical and medicine-related factors. Therefore, PCPs should discuss the benefits of deprescribing inappropriate medications to prevent long-term side effects. Future studies should focus on the effectiveness of evidence-based deprescribing protocols for older adults. [ABSTRACT FROM AUTHOR]