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2nd Edition: Active Aging

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 33598

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Dr. José Alberto Laredo-Aguilera

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Facultad de Fisioterapia y Enfermería, Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
Interests: adolescent; public health; nursing
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Prof. Dr. Juan Manuel Carmona-Torres

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1.Facultad de Fisioterapia y Enfermeria, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
2.Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
Interests: adolescent; public health; nursing
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Ana Isabel Cobo-Cuenca

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Facultad de Fisioterapia y Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha, 45005 Toledo, Spain
Interests: preventive activities and public health; physical activity and health; nursing care; women and health; quality of life; sexuality; mood; chronic diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The world’s population is aging; it is estimated that between 2015 and 2030, the number of people aged 60 and over will grow by 56% worldwide. Age is associated with increased rates of chronic diseases, poor health, functional limitations, and morbidity, resulting in a greater use of health services and health costs. This is why, in recent years, there has been increasing interest in how to respond to the irreversible phenomenon of an aging population. To respond to this issue, scientific research and policies have proliferated in this area, aimed at increasing health and participation levels in older people. For example, the European Union designated 2012 as the European Year of Active Aging and intergenerational solidarity, with the objective to find innovative solutions to the economic, social, and health problems of an aging population and to encourage the elderly to continue playing an important role in society.

This Special Issue seeks papers on new research into the phenomenon of aging, new therapies to improve the health status of older people, and epidemiological surveys concerning the problems older people face. We also welcome high-quality systematic reviews related to these matters. I would be delighted if this Special Issue serves as a trigger for elaborate policies and future health programs that improve the elderly population’s health levels, their participation in society, and that also identify solutions to mitigate the economic, social, and health effects stemming from an aging population.

Dr. José Alberto Laredo-Aguilera
Prof. Dr. Juan Manuel Carmona-Torres
Prof. Dr. Ana Isabel Cobo-Cuenca
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

aging
aged
active aging
diet and oral health
epidemiological survey for older people
lifelong learning
mental health
old-age policy
older people
participation in society
physical activity
physical and mental health
polypharmacy
programming effects
security
social support

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Published Papers (10 papers)

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12 pages, 1468 KiB

Open AccessArticle

Emotional Status, Motor Dysfunction, and Cognitive Functioning as Predictors of Quality of Life in Physically Engaged Community-Dwelling Older Adults: A Structural Equation Modeling Approach

by Inaihá Laureano Benincá, Maria Gattuso, Stefania Butti, Davide Caccia and Francesca Morganti

Int. J. Environ. Res. Public Health 2024, 21(11), 1469; https://doi.org/10.3390/ijerph21111469 - 4 Nov 2024

Viewed by 637

Abstract

The demographic transition has become a reality, and it demands public policies to promote physical and mental health in aging. Group exercise emerges as a cost-effective and accessible alternative to promote active aging on a large scale, but to optimize the effectiveness of these programs, it is crucial to understand the underlying mechanisms that improve quality of life. This study aimed to explore the associations between emotional status, cognitive functioning, motor dysfunction, and their relationship with quality of life in community-dwelling older adults participating in a group physical exercise program. Structural equation modeling was used to explore these relationships in a sample of 190 older adults. Emotional state directly predicted all domains of quality of life. Motor dysfunction predicts the physical health domain of quality of life. Motor dysfunction and cognitive functioning are strongly correlated with emotional status. The fit indices of the final model are acceptable, and it demonstrates that within group-exercise dynamics, emotional status is the main component of quality-of-life promotion. Therefore, professionals designing group physical exercise programs to promote active aging should consider not only physical fitness, but also the integration of psychosocial elements, offering a holistic approach to enhancing overall well-being. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

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17 pages, 345 KiB

Open AccessArticle

An Ethnographic Study Concerning the Implementation of Education on Ageing for Older Adults with Mild Intellectual Disability: The Perspective of the Educators

by Marianne Holmgren and Gerd Ahlström

Int. J. Environ. Res. Public Health 2024, 21(7), 953; https://doi.org/10.3390/ijerph21070953 - 21 Jul 2024

Viewed by 989

Abstract

Despite the fact that longevity in people with intellectual disability has increased at least as much as in the general population, there is a dearth of interventions related to ageing for these older people. Therefore, this study investigated educators’ implementation strategies in a new tailor-designed educational intervention with the goal of supporting the process of ageing for people with mild intellectual disability. An ethnographic research design was employed, including participant observations, field notes, and 15 ad hoc interviews with educators, spread over two years in four towns. The strategies used for facilitating learning about ageing were expressed in the two themes promoting social togetherness through everyone’s participation and learning together and from each other through recognition and consolidation. These strategies were applied to create a learning environment characterised by a good atmosphere and respectful interaction. Learning together involved consolidation through repetition, group discussions, the use of visual learning materials, and study visits. This new educational intervention about ageing is promising, but less resource-intensive interventions should also be developed and preferably integrated into the disability service. Before concluding whether this education supports the ageing process, it needs to be evaluated from the perspective of people with intellectual disability. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

10 pages, 308 KiB

Open AccessArticle

Adding Behaviour-Change Counselling to an Exercise Program for Adults Preparing for Hip and Knee Arthroplasty Improves Psychological and Physical Wellness: Focus Group Reflections

by Marie-Louise Bird, Jonathan Mulford, Andrew Daffyd Williams, Michael Cheney and Jane O’Brien

Int. J. Environ. Res. Public Health 2023, 20(20), 6960; https://doi.org/10.3390/ijerph20206960 - 23 Oct 2023

Viewed by 2518

Abstract

Purpose: To explore participant experiences for people on an arthroplasty waitlist, randomised to an exercise and behaviour-change counselling program (ENHANCE). The ENHANCE program for arthroplasty patients was led by an accredited exercise physiologist who delivered an individually tailored and structured exercise program. Included in the exercise program were up to five in-person counselling sessions, based on the Health Action Process Approach (HAPA) applied specifically to people with osteoarthritis. Nine adults (mean 69.4 years) who were on the waiting list for a total hip or knee arthroplasty and who had completed a 12-week program (ENHANCE) as part of a randomised controlled trial were recruited for this study. Methods: Two focus groups were conducted to explore participant experiences of ENHANCE. Data were analysed using inductive thematic analysis with constructs of the HAPA (motivational and volitional factors) as a framework. Results: We identified three themes (1) ‘The structured program addressed inactivity and improved feelings of wellness and preparation for the operation’. The benefits were not only physical, but psychological and were contextualised in terms of preparation for the upcoming surgery. (2) ‘People as enablers of participation’: Participants identified that the attitude, and skill of the experienced instructor were supportive and motivating, especially in tailoring the intervention. Within the program, the support of the group was considered a positive attribute (3) ‘Improved awareness changed attitudes to self-efficacy and perceived self-control’. Participants described an increased awareness of their condition and a better understanding of health expectations. They felt more control and ownership over their health journey. Conclusion: Goal setting and social support were identified factors in a behaviour-change counselling program, delivered in conjunction with structured exercise that led to a positive experience. Improved psychological and physical health were described. Participants were better prepared for their upcoming surgery, with increased self efficacy and mastery to support long-term physical-activity engagement. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

25 pages, 1319 KiB

Open AccessArticle

Knowledge, Awareness, and Attitude of Healthcare Stakeholders on Alzheimer’s Disease and Dementia in Qatar

by Pradipta Paul, Ziyad Riyad Mahfoud, Rayaz A. Malik, Ridhima Kaul, Phyllis Muffuh Navti, Deema Al-Sheikhly and Ali Chaari

Int. J. Environ. Res. Public Health 2023, 20(5), 4535; https://doi.org/10.3390/ijerph20054535 - 3 Mar 2023

Cited by 12 | Viewed by 4848

Abstract

Dementia is characterized by progressive cognitive decline, memory impairment, and disability. Alzheimer’s disease (AD) accounts for 60–70% of cases, followed by vascular and mixed dementia. Qatar and the Middle East are at increased risk owing to aging populations and high prevalence of vascular risk factors. Appropriate levels of knowledge, attitudes, and awareness amongst health care professionals (HCPs) are the need of the hour, but literature indicates that these proficiencies may be inadequate, outdated, or markedly heterogenous. In addition to a review of published quantitative surveys investigating similar questions in the Middle East, a pilot cross-sectional online needs-assessment survey was undertaken to gauge these parameters of dementia and AD among healthcare stakeholders in Qatar between 19 April and 16 May 2022. Overall, 229 responses were recorded between physicians (21%), nurses (21%), and medical students (25%), with two-thirds from Qatar. Over half the respondents reported that >10% of their patients were elderly (>60 years). Over 25% reported having contact with >50 patients with dementia or neurodegenerative disease annually. Over 70% had not undertake related education/training in the last 2 years. The knowledge of HCPs regarding dementia and AD was moderate (mean score of 5.3 ± 1.5 out of 7) and their awareness of recent advances in basic disease pathophysiology was lacking. Differences existed across professions and location of respondents. Our findings lay the groundwork for a call-to-action for healthcare institutions to improve dementia care within Qatar and the Middle East region. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

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13 pages, 2679 KiB

Open AccessArticle

Rumba Dance Combined with Breathing Training as an Exercise Intervention in the Management of Stress Urinary Incontinence in Postmenopausal Women: A Randomized Controlled Trial

by Yuting Tang, Xian Guo, Yi Wang, Zeyao Liu, Guoxia Cao, Yanbing Zhou, Mengmeng Chen, Jingying Liu, Jinhao Mu and Mengjie Yuan

Int. J. Environ. Res. Public Health 2023, 20(1), 522; https://doi.org/10.3390/ijerph20010522 - 28 Dec 2022

Cited by 7 | Viewed by 2936

Abstract

Purpose: Stress urinary incontinence (SUI) refers to involuntary leakage from the urethra, synchronous with exertion/effort, sneezing or coughing, which has a negative effect on quality of life. Studies have shown that mild-to-moderate physical activities reduce the risk of SUI by multiple mechanisms. The objective of this study was to determine whether the Rumba dance combined with breathing training (RDBT) can reduce the severity of incontinence and improve the quality of life of patients with SUI. Methods: A randomized clinical trial was conducted with women who were sedentary, were postmenopausal, reported mild-to-moderate SUI on a 1-h pad test, were not already engaged in Rumba dance and did not receive estrogen replacement therapy. The patients were randomly assigned to the RDBT group (n = 13) or the control group (n = 11). The intervention included 90 min of RDBT three times per week for 16 weeks, and the vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength and endurance, 1-h pad test, International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form (ICIQ—UI SF), and the Incontinence Quality of Life Questionnaire (I—QOL) were measured or completed at baseline and 16 weeks. None of the participants reported adverse events. Results: The mean (±SD) age of the participants was 55.75 ± 5.58 years. After 16 weeks, in the RDBT group, the urine leakage on the 1-h pad test was significantly decreased −2.91 ± 0.49 from the baseline (p = 0.000). The VRP increased from 76.00 ± 16.23 cmH₂O to 95.09 ± 18.90 cmH₂O (p = 0.000), the PFM endurance of class I (−3.15 ± 1.99% vs. −0.46 ± 0.97%, p = 0.000) and class II (−0.69 ± 0.95% vs. −0.23 ± 0.44%, p = 0.065) increased, and the grades of PFM strength of class I and class II were significantly enhanced (p < 0.01). Finally, the severity of self-reported incontinence (ICIQ—UI SF) significantly decreased from 6.12 ± 2.15 to 3.81 ± 1.68 (p = 0.000), and quality of life (I—QOL) improved from 75.73 ± 11.93 to 83.48 ± 7.88 (p = 0.005). Conclusion: A 16-week RDBT program can increase PFM strength and endurance to reduce the severity of incontinence symptoms and improve the quality of life in patients with SUI, demonstrating the feasibility of recruiting and retaining postmenopausal women with SUI into a RDBT therapeutic program. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

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14 pages, 1225 KiB

Open AccessArticle

Red Cell Distribution Width as a Predictive Factor of Celiac Disease in Middle and Late Adulthood and Its Potential Utility as Celiac Disease Screening Criterion

by Julia María Cabo del Riego, María Jesús Núñez-Iglesias, José Paz Carreira, Andrés Blanco Hortas, Tamara Álvarez Fernández, Silvia Novío Mallón, Sofía Zaera and Manuel Freire-Garabal Núñez

Int. J. Environ. Res. Public Health 2023, 20(1), 66; https://doi.org/10.3390/ijerph20010066 - 21 Dec 2022

Cited by 2 | Viewed by 2381

Abstract

Red cell distribution width (RDW) could be of interest by its potential use in the assessment of celiac disorder (CD). The main objective of this study was to evaluate the case positive rate of CD and the utility of red cell distribution width (RDW) in the CD diagnosis. This prospective study included 9.066 middle adult (≥45 years old) and elderly patients (≥60 years old) from 2012 to 2021. CD diagnosis was performed by CD antibody tests (serology and Human Leucocyte Antigen genotype (HLA)) and biopsy. Gastrointestinal and extra-intestinal manifestations as well as hematological and biochemical parameters were analyzed. CD diagnoses were confirmed in 101 patients (median (IQR) age = 62 (52.3–73); 68.32% women) by serologic tests (100%) and intestinal biopsy (88.12%), showing mainly marked or complete atrophy (76.24%, MARSH 3a–c). Anemia was the most commonly presenting extra-intestinal manifestation (28.57%). Among 8975 individuals without CD, 168 age and sex matched were included. By comparison of CD and no CD individuals, we observed that high >14.3% RDW was exhibited by 58.40% and 35.2% individuals with CD and without CD, respectively. Furthermore, high RDW is associated with CD and grade III atrophy. We suggest that RDW could be used as a CD screening criterion. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

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15 pages, 1750 KiB

Open AccessArticle

Portuguese Version of the Ageing Attitudes Questionnaire (AAQ): Validation of the Psychometric Properties

by Margarida Pedroso de Lima, Paulo Martins and António-José Gonzalez

Int. J. Environ. Res. Public Health 2022, 19(24), 16778; https://doi.org/10.3390/ijerph192416778 - 14 Dec 2022

Cited by 2 | Viewed by 1971

Abstract

The Ageing Attitudes Questionnaire—AAQ was validated for the Portuguese population to understand the importance of attitudes towards old age and their impact on the subjective well-being of older adults. A sample of 400 subjects (from 18 to 93 years) answered a socio-demographic questionnaire, and the AAQ, composed of three subscales (psychosocial losses, physical change, and psychological growth). The CFA confirmed the tri-factorial structure with very good adjustment of the model to the data, with the Cronbach alpha of the total scale scoring 0.84 and ranging from 0.65 to 0.77 for each factor. A total of nine items were omitted for poor factor loadings (<0.50), namely in factor 1 items 9-17-20, in factor 2 items 7 and 24 and, finally, in factor 3 we omitted items 4-18-19-21. Notwithstanding, three items below the criteria were maintained, as they conceptually fit into the factor. Of the final 15 AAQ items, 5 belong to the Psychosocial Loss Factor, 6 to Physical Change Factor, and 4 to Psychosocial Growth Factor. This tree factor model explained 50.1% of the total variance. In conclusion, this study supports that AAQ has acceptable validity, confirming the composite reliability and the discriminant validity, but not the convergent validity. Through multi-group analysis, the invariance of the scale was confirmed. This validation is of pivotal importance once it allows measuring attitudes towards ageing in the Portuguese population, thus facilitating the prevention of ageism and the promotion of well-being across the lifespan. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

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21 pages, 9289 KiB

Open AccessArticle

A Toolkit for Co-Designing towards Community-Based Active Ageing: Lessons Learned during Development

by Gubing Wang, Dena Kasraian, Carlijn Valk, Yuan Lu, William Hurst, Marielle Jambroes and Pieter van Wesemael

Int. J. Environ. Res. Public Health 2022, 19(23), 15591; https://doi.org/10.3390/ijerph192315591 - 24 Nov 2022

Cited by 3 | Viewed by 2497

Abstract

It is increasingly recognized that community-based interventions for active ageing are more lasting and effective, yet the tools and methods for developing these interventions are lacking. This study investigates how to co-design community-based active ageing with older adults via the development of a toolkit to support this goal. Rapid reviews were conducted to understand (i) the effective behavioural change techniques for older adults, (ii) how to co-design with older adults for community-based interventions, and (iii) how to design tools for behaviour change that are easy to use. These reviews served as the foundation for developing a toolkit to support the co-design of community-based active ageing, which was evaluated during an interdisciplinary hackathon with older adults. Quantitative data from the surveys suggested that the confidence levels of students in developing interventions for health behaviour change and in co-designing with older adults increased after the hackathon, and the enjoyment of participating in the hackathon and of using the toolkit were statistically significant factors influencing this increase. Qualitative data from interviews and observations revealed how the toolkit was (un)used by the participants and what aspects of the toolkit can be improved. We encourage future researchers and practitioners to apply and adapt our research findings to the communities of older adults that they are working with. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

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10 pages, 720 KiB

Open AccessArticle

Social Frailty among Community-Dwelling Older Adults during the COVID-19 Pandemic in Korea: A Cross-Sectional Study

by Seunghye Choi and Hana Ko

Int. J. Environ. Res. Public Health 2022, 19(19), 11963; https://doi.org/10.3390/ijerph191911963 - 22 Sep 2022

Cited by 5 | Viewed by 2309

Abstract

Social frailty among older adults has become a growing concern from a public health perspective in the context of the coronavirus disease 2019 (COVID-19) pandemic. This study’s aim was to investigate the influence of various aspects of social frailty in community-dwelling older adults during the COVID-19 pandemic. This study carried out a secondary analysis of data collected from the 2020 National Survey of Older Koreans and performed multinomial logistic regression analysis to identify the predictive factors of social frailty. The affected factors for the social frailty group were health conditions (depression), behavioral and metabolic risk factors (exercise, nutritional status, current smoking status, drinking frequency), intrinsic capacity (cognitive functions, activities of daily living), and digital literacy (use of smartphone or tablet PCs). Since multidimensional factors could affect older adults’ social frailty, comprehensive strategies are urgently needed to reduce their rate of social frailty. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

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11 pages, 1530 KiB

Open AccessSystematic Review

Nurse-Led Interventions in Chronic Obstructive Pulmonary Disease Patients: A Systematic Review and Meta-Analysis

by Alejandra Aranburu-Imatz, Juan de la Cruz López-Carrasco, Ana Moreno-Luque, José Manuel Jiménez-Pastor, María del Rocío Valverde-León, Francisco José Rodríguez-Cortés, Pedro Arévalo-Buitrago, Pablo Jesús López-Soto and Ignacio Morales-Cané

Int. J. Environ. Res. Public Health 2022, 19(15), 9101; https://doi.org/10.3390/ijerph19159101 - 26 Jul 2022

Cited by 11 | Viewed by 11218

Abstract

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, causing 3.32 million deaths in 2019. COPD management has increasingly become a major component of general and hospital practice and has led to a different model of care. Nurse-led interventions have shown beneficial effects on COPD patient satisfaction and clinical outcomes. This systematic review was conducted to identify and assess nurse-led interventions in COPD patients in terms of mental, physical, and clinical status. The review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The relevance of each manuscript was assessed according to the inclusion criteria, and we retrieved full texts, as required, to reach our conclusions. Data extraction was performed independently by two reviewers, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Forty-eight articles were included in the analysis, which focused on the management of COPD patients by hospital, respiratory and primary nursing care. Nursing management was shown to be highly effective in improving quality of life, emotional state, and pulmonary and physical capacity in COPD patients. In comparison, hospital and respiratory nurses carried out interventions with higher levels of effectiveness than community nurses. Full article

(This article belongs to the Special Issue 2nd Edition: Active Aging)

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