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15 pages, 346 KiB

Open AccessArticle

Age Friendly Characteristics and Sense of Community of an Italian City: The Case of Macerata

by Paola Monachesi

Int. J. Environ. Res. Public Health 2023, 20(10), 5847; https://doi.org/10.3390/ijerph20105847 - 17 May 2023

Cited by 3 | Viewed by 1518

Abstract

The paper presents a study about the city of Macerata, as a representative case of an urban community in the Marche Region, Italy. The aim of this paper is to assess the level of its age-friendliness by means of a quantitative analysis based [...] Read more.

The paper presents a study about the city of Macerata, as a representative case of an urban community in the Marche Region, Italy. The aim of this paper is to assess the level of its age-friendliness by means of a quantitative analysis based on a questionnaire that relies on the well-established eight AFC domains proposed by the WHO. In addition, the sense of community (SOC) is investigated and how the older residents relate to it. Studies that analyze age-friendly Italian cities in relation to elder outcomes are limited. The paper contributes to fill this gap, and the findings reveal that the elderly respondents are not particularly satisfied about the services and the urban infrastructure of the city but show nevertheless a sense of community. It might be the combination of urban and rural features that contributes to the longevity and strong sense of community of the city despite its poor infrastructure and average services. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

12 pages, 477 KiB

Open AccessArticle

Deprescribing as an Opportunity to Facilitate Patient-Centered Care: A Qualitative Study of General Practitioners and Pharmacists in Japan

by Kenya Ie, Reiko Machino, Steven M. Albert, Shiori Tomita, Mio Kushibuchi, Masanori Hirose, Takahide Matsuda, Chiaki Okuse and Yoshiyuki Ohira

Int. J. Environ. Res. Public Health 2023, 20(4), 3543; https://doi.org/10.3390/ijerph20043543 - 17 Feb 2023

Cited by 9 | Viewed by 2560

Abstract

Deprescribing has recently been applied to address polypharmacy, particularly among older adults. However, the characteristics of deprescribing that are likely to improve health outcomes have not been well studied. This study explored the experiences and perspectives of general practitioners and pharmacists with regard [...] Read more.

Deprescribing has recently been applied to address polypharmacy, particularly among older adults. However, the characteristics of deprescribing that are likely to improve health outcomes have not been well studied. This study explored the experiences and perspectives of general practitioners and pharmacists with regard to deprescribing in older adults with multimorbidity. A qualitative study was conducted involving eight semi-structured focus group interviews with 35 physicians and pharmacists from hospitals, clinics, and community pharmacies. Thematic analysis was applied to identify themes using the theory of planned behavior as a guide. The results illustrated a metacognitive process, as well as influencing factors, through which healthcare providers commit to shared decision making for deprescribing. Healthcare providers acted on the basis of their attitudes and beliefs on deprescribing, the influence of subjective norms, and perceived behavioral control for deprescribing. These processes are influenced by factors such as drug class, prescribers, patients, deprescribing experience, and environment/education. Healthcare providers’ attitudes, beliefs, and behavioral control (along with deprescribing strategies) evolve in a dynamic interplay with experience, environment, and education. Our results can serve as a foundation for the development of effective patient-centered deprescribing to improve the safety of pharmaceutical care for older adults. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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11 pages, 342 KiB

Open AccessArticle

Socialisation Agents’ Use(fulness) for Older Consumers Learning ICT

by Torgeir Aleti, Bernardo Figueiredo, Diane M. Martin and Mike Reid

Int. J. Environ. Res. Public Health 2023, 20(3), 1715; https://doi.org/10.3390/ijerph20031715 - 17 Jan 2023

Cited by 2 | Viewed by 1906

Abstract

This research investigates the socialisation agents older consumers use to learn about information and communication technologies (ICT). We surveyed 871 older consumers in Victoria, Australia, about whom they would most likely turn to for advice (i.e., their preferred socialisation agents) if they needed [...] Read more.

This research investigates the socialisation agents older consumers use to learn about information and communication technologies (ICT). We surveyed 871 older consumers in Victoria, Australia, about whom they would most likely turn to for advice (i.e., their preferred socialisation agents) if they needed help using or fixing an ICT device. They were asked to identify the most and second most likely source of advice. Participants were also asked to assess the usefulness of the advice received from their preferred agents and to estimate their level of ICT knowledge. The findings reveal that older consumers tend to rely on younger family members. Still, the agency they receive from non-familial sources is essential when preparing for a digital consumer role. Surprisingly, ICT knowledge is determined by the socialisation agency received by older adults’ second advice option—which is less likely to be their own adult children. This research expands current knowledge about how older consumers perceive various ICT socialisation agents. Consumer socialisation theory suggests that socialisation agents impact how consumers function in the marketplace. Although the first choice of socialisation agent may be perceived as beneficial for older adults, the advice given does not relate to marketplace functioning regarding improved ICT knowledge. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

17 pages, 1242 KiB

Open AccessArticle

Healthy Aging at Family Mealtimes: Associations of Clean Cooking, Protein Intake, and Dining Together with Mental Health of Chinese Older Adults amid COVID-19 Pandemic

by Shuai Zhou, Xiangying Ding and Janet Tsin Yee Leung

Int. J. Environ. Res. Public Health 2023, 20(3), 1672; https://doi.org/10.3390/ijerph20031672 - 17 Jan 2023

Cited by 7 | Viewed by 2314

Abstract

The present study aims to examine whether multiple dietary factors affect the mental health of older adults amid the COVID-19 pandemic. It proposes an integrative dietary framework that highlights environmental, nutritional, and social aspects of diet for healthy aging. Based on a sample [...] Read more.

The present study aims to examine whether multiple dietary factors affect the mental health of older adults amid the COVID-19 pandemic. It proposes an integrative dietary framework that highlights environmental, nutritional, and social aspects of diet for healthy aging. Based on a sample of 7858 Chinese older adults, the associations between diet and depressive symptoms, along with the rural–urban divide, were examined using zero-inflated negative binomial regression. Overall, protein intake (incidence-rate ratio [IRR] = 0.89, p < 0.001), frequency of family dining together (IRR = 0.98, p < 0.001), and using tap water for cooking (IRR = 0.92, p < 0.01) were associated with lower incidence rates of depressive symptoms among older adults. Among rural older adults, frequency of family dining together (IRR = 0.97, p < 0.001) and tap water use (IRR = 0.89, p < 0.001) were associated with fewer depressive symptoms. However, urban residents who had a higher frequency of family dining together (IRR = 0.98, p < 0.05) and protein intake (IRR = 0.81, p < 0.001) exhibited fewer depressive symptoms. The findings revealed multifaceted dietary pathways towards healthy aging, which call for policies and interventions that improve diet quality for community-dwelling older adults. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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16 pages, 353 KiB

Open AccessArticle

Impact of Sociodemographic Factors on Use of Formal Social Services in an Older Swedish Population

by Emilie Stroh, Anna Axmon, Connie Lethin, Gunilla Carlsson, Agneta Malmgren Fänge and Kristoffer Mattisson

Int. J. Environ. Res. Public Health 2022, 19(19), 12526; https://doi.org/10.3390/ijerph191912526 - 30 Sep 2022

Cited by 3 | Viewed by 1572

Abstract

Background: In Sweden, societal support for older people is the responsibility of the municipalities. However, due to Sweden’s current aging-in-place policy for older people, there is a need to assess how the use of such services varies based on sociodemographic factors. The aim [...] Read more.

Background: In Sweden, societal support for older people is the responsibility of the municipalities. However, due to Sweden’s current aging-in-place policy for older people, there is a need to assess how the use of such services varies based on sociodemographic factors. The aim of this study was to describe the use of different forms of social services and institutional long-term care (ILTC) in an older population and to evaluate the impact of sociodemographic factors. Methods: This was a cross-sectional register-based study, including all individuals aged 65 years and older in two Swedish municipalities in 2010, 2015, and 2019. The study analyzed the use of social services and ILTC in relation to sex, place of birth, cohabitation status, and type of housing. Results: Women, those born in Sweden, and those living in an apartment were more likely to receive assistance than men, those born abroad, or living in single family houses, respectively. People living alone were consistently more likely to have assistance, as well as ILTC. Conclusions: There may be a discrepancy between the individual’s need and the assistance provided from the municipality in certain sociodemographic groups in the older population in Sweden. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

13 pages, 1134 KiB

Open AccessArticle

Weaving Social Connectivity into the Community Fabric: Exploring Older Adult’s Relationships to Technology and Place

by Belinda Paulovich, Sonja Pedell, Erica Tandori and Jeanie Beh

Int. J. Environ. Res. Public Health 2022, 19(14), 8500; https://doi.org/10.3390/ijerph19148500 - 12 Jul 2022

Cited by 1 | Viewed by 2528

Abstract

The wellbeing of older adults is positively impacted by ease of access to social networks and opportunities. In urban fringe communities, longer geographical distances, combined with mobility and health issues, can lead to decreased access to community life. Technology can facilitate socialisation opportunities [...] Read more.

The wellbeing of older adults is positively impacted by ease of access to social networks and opportunities. In urban fringe communities, longer geographical distances, combined with mobility and health issues, can lead to decreased access to community life. Technology can facilitate socialisation opportunities for older adults living in more geographically isolated locations, but we need to work with communities to better understand how technology can fit into their existing social tapestry and community infrastructure. We conducted an explorative, qualitative study consisting of in-depth semi-structured interviews with members of an urban fringe community (n = 2), and a community mapping focus group (n = 14). Transcripts and mapping materials were analysed thematically, and also the method’s suitability explored. The community mapping proved suitable to uncover the complexity of technology use to support social connectivity. We found that while technology was perceived as valuable by our participants, there were also significant fears and concerns surrounding its use related to the abstract concept of online friendship and the steep learning curve required to master some platforms. Inclusive communities connected by technology require tailored and customised community-led technology initiatives in order to accommodate for the unique social and geographical contexts in which they live. We outline the next steps for future research on technology-supported social connectivity within urban fringe communities. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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14 pages, 736 KiB

Open AccessArticle

Perceived Gap of Age-Friendliness among Community-Dwelling Older Adults: Findings from Malaysia, a Middle-Income Country

by Chee-Tao Chang, Xin-Jie Lim, Premaa Supramaniam, Chii-Chii Chew, Lay-Ming Ding and Philip Rajan

Int. J. Environ. Res. Public Health 2022, 19(12), 7171; https://doi.org/10.3390/ijerph19127171 - 11 Jun 2022

Cited by 3 | Viewed by 3224

Abstract

Background: The United Nations predicts that the global population aged 65 years or above will double from 703 million in 2019 to 1.5 billion by 2050. In Malaysia, the older population has reached 2.4 million, accounting for nearly 8% of the population. This [...] Read more.

Background: The United Nations predicts that the global population aged 65 years or above will double from 703 million in 2019 to 1.5 billion by 2050. In Malaysia, the older population has reached 2.4 million, accounting for nearly 8% of the population. This study aimed to evaluate the perceptions of the elderly on the importance and availability of the age-friendly features in eight domains specified by the Global Network of Age-Friendly City and Communities. Methods: This was a cross-sectional study conducted by structured face-to-face and or telephone interviews. Gap score analysis was performed for 32 items of the 8 age-friendly domains. The gap scores were categorized as follows: 0 = not important OR important and element available; 1 = important but unsure whether the element is available; 2 = important but element not available. The gap scores were then dichotomized into “yes” and “no”, and multivariate logistic regression analysis was subsequently performed. Results: From the 1061 respondents, the housing (55.4%) and transportation (50.7%) domains reported the highest mean perceived gap scores. Out of the 32 elements, the highest mean gap percent scores were observed in elderly priority parking bays (83.8%), home visits by healthcare professionals (78.9%), financial assistance for home modification and purchase (66.3%), and affordable housing options (63.6%). Respondents in the city center reported higher gap scores for modified restrooms, parks, volunteer activities, and the internet; respondents in the non-city center reported higher gap scores for nursing homes, healthcare professionals, and cultural celebrations. Age, location, marital status, income, duration of stay, physical exercise, internet access, and intention to continue working were found to be associated with a higher perceived gap in specific domains. Conclusion: The most significant unmet needs were detected in the housing, transportation, and employment opportunities domains. Considerable disparities in the perceived gap were detected between the older population in the city center and non-city center. To address shortcomings in the local age-friendly setting, coordinated municipal policies, political commitment, and benchmarking of existing age-friendly cities are warranted. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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12 pages, 385 KiB

Open AccessArticle

Suggesting Indicators of Age-Friendly City: Social Participation and Happiness, an Ecological Study from the JAGES

by Kazushige Ide, Seungwon Jeong, Taishi Tsuji, Ryota Watanabe, Yasuhiro Miyaguni, Hirotaka Nakamura, Miyako Kimura and Katsunori Kondo

Int. J. Environ. Res. Public Health 2022, 19(9), 5096; https://doi.org/10.3390/ijerph19095096 - 22 Apr 2022

Cited by 19 | Viewed by 3759

Abstract

Ascertaining progress in building age-friendly cities (AFCs) requires community diagnostic indicators. This study examines the relationship between social participation and happiness at the municipal level. The data from the Japan Gerontological Evaluation Study (JAGES) from 2013, 2016, and 2019, comprising 442,079 older people [...] Read more.

Ascertaining progress in building age-friendly cities (AFCs) requires community diagnostic indicators. This study examines the relationship between social participation and happiness at the municipal level. The data from the Japan Gerontological Evaluation Study (JAGES) from 2013, 2016, and 2019, comprising 442,079 older people from 289 municipalities, are used. We also employ linear mixed-effects models to evaluate the association between social participation and happiness. In these models, we adjust for seven variables as potential confounders. This study reveals that the higher the social participation, except for neighborhood association, the higher the state of happiness (B = 0.14–0.30). Our study suggests that social participation is useful, as a community diagnostic indicator, for monitoring the progress of building AFCs, developing strategies, and creating evidence. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

10 pages, 350 KiB

Open AccessArticle

Association between Increasing Social Capital and Decreasing Prevalence of Smoking at the Municipality Level: Repeated Cross-Sectional Study from the JAGES

by Hiroki Takeuchi, Kazushige Ide, Ryota Watanabe, Yasuhiro Miyaguni and Katsunori Kondo

Int. J. Environ. Res. Public Health 2022, 19(8), 4472; https://doi.org/10.3390/ijerph19084472 - 8 Apr 2022

Cited by 5 | Viewed by 2957

Abstract

As smoking cessation is crucial for both individual and public health, this study aimed to elucidate the association between changes in social capital and in terms of smoking at the level of municipal units in Japan. Using repeated cross-sectional data from the Japan [...] Read more.

As smoking cessation is crucial for both individual and public health, this study aimed to elucidate the association between changes in social capital and in terms of smoking at the level of municipal units in Japan. Using repeated cross-sectional data from the Japan Gerontological Evaluation Study, we analyzed data from adults aged 65 years or older from 69 municipal units that participated in two survey waves. We received valid responses from 91,529 and 86,403 older people in 2013 and 2019, respectively, and aggregated all variables by municipal units. For the dependent variable, we used the units’ prevalence of smoking for both years. The independent variables were the percentages of social capital indicators, such as social participation, social cohesion, and reciprocity for each of the 69 municipal units. The mean prevalence of smoking increased from 9.7% in 2013 to 10.2% in 2019. Multiple regression analysis revealed that increases in the percentages of sports group participation, receiving emotional and instrumental social support, and reciprocity were significantly associated with decreased prevalence of smoking, after we adjusted for confounding variables. This study indicates that building social capital might be useful in promoting smoking cessation and that its indicators could be useful in monitoring efforts. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

13 pages, 946 KiB

Open AccessArticle

Perceived Environmental Attributes: Their Impact on Older Adults’ Mental Health in Malaysia

by Teck Hong Tan

Int. J. Environ. Res. Public Health 2022, 19(6), 3595; https://doi.org/10.3390/ijerph19063595 - 18 Mar 2022

Cited by 6 | Viewed by 3036

Abstract

In Malaysia, the population of older adults will increase in the coming years. In this context, there is a requirement to build an age-friendly environment to enable the elderly to age healthily. Many studies have shown that a built environment that allows older [...] Read more.

In Malaysia, the population of older adults will increase in the coming years. In this context, there is a requirement to build an age-friendly environment to enable the elderly to age healthily. Many studies have shown that a built environment that allows older adults to age in place improves their mental health. However, person-environment analysis that considers mental well-being has remained rare for older adults living in Malaysia. This study examines the relationship between Malaysian seniors’ perceptions of their surroundings at home and in the neighborhood and their mental health. Using stratified sampling, 510 seniors aged 60 and over were interviewed. The results showed that accessibility (p-value 0.033, 95% CI for coefficients 0.006, 0.146), environmental qualities (0.015, 0.014, 0.129) and neighborhood problems (0.000, −0.299, −0.146) were significant determinants of elderly people’s mental health. With respect to respondents’ socio-demographic characteristics, female elderly (0.000, 0.616, 0.782), older adults with an elementary education (0.000, 0.263, 0.685) or a college degree (0.026, 0.019, 0.294), being married (0.005, 0.047, 0.259), the ability to drive (0.000, 0.993, 1.315), the number of dependents in the family (0.003, −0.060, −0.012), and homeownership (0.000, −0.602, −0.271) were significantly related to mental well-being. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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9 pages, 318 KiB

Open AccessArticle

What Should Be Considered When Evaluating the Quality of Home Care? A Survey of Expert Opinions on the Evaluation of the Quality of Home Care in Japan

by Seungwon Jeong, Yusuke Inoue, Yasuyuki Arai, Hideki Ohta and Takao Suzuki

Int. J. Environ. Res. Public Health 2022, 19(4), 2361; https://doi.org/10.3390/ijerph19042361 - 18 Feb 2022

Cited by 3 | Viewed by 2409

Abstract

Intending to obtain scientific evidence to use in developing indicators for evaluating the quality of home care, we surveyed doctors, nurses, and other home care professionals to determine the points they consider to be essential in evaluating home care. We investigated all 901 [...] Read more.

Intending to obtain scientific evidence to use in developing indicators for evaluating the quality of home care, we surveyed doctors, nurses, and other home care professionals to determine the points they consider to be essential in evaluating home care. We investigated all 901 clinics registered to the National Association of Medical Institutions Supporting Home Care and a random sample of 600 Visiting Nurse Service stations registered to the National Association for Visiting Nurse Service in Japan. A total of 539 questionnaire responses were received (response rate: 35.9%). In this study, a factor analysis revealed four factors to be considered when evaluating the quality of home care: (1) patients’ and family members’ level of satisfaction, (2) home care process, (3) structure of home care, and (4) medical outcomes. The factor of the satisfaction of patients and family members identified in the present study was not considered in previous studies for evaluating the quality of care in Japan. Satisfaction is the point of difference in goals between hospital-based care and home care, and it requires different measurement indicators. Home care professionals expect to help relieve the physical and psychological burden felt by the patient and their family. Thus, on the evaluation indicators of quality of home care, their perspectives from the present study are valuable. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

23 pages, 3001 KiB

Open AccessArticle

A Policy Framework for Producing Age-Friendly Communities from the Perspective of Production of Space

by Jianbo Han, Edwin H. W. Chan, Esther H. K. Yung, Queena K. Qian and Patrick T. I. Lam

Int. J. Environ. Res. Public Health 2022, 19(4), 2031; https://doi.org/10.3390/ijerph19042031 - 11 Feb 2022

Cited by 8 | Viewed by 4786

Abstract

Given various hindrances in the macro context, how to efficiently develop age-friendly community policies requires further research. Currently, such kinds of frameworks are lacking. This paper aims to develop a policy framework to minimise cost and resolve conflict of interest between different generations [...] Read more.

Given various hindrances in the macro context, how to efficiently develop age-friendly community policies requires further research. Currently, such kinds of frameworks are lacking. This paper aims to develop a policy framework to minimise cost and resolve conflict of interest between different generations in age-friendly community development. The study adopted a scientometric method to review the theoretical development of age-friendly community studies. Firstly, with a search for the keywords “age-friendly” and “community” on Web of Science, 72 English academic papers were found containing explicit theories. Most of the studies were conducted in the Global North. Then, a mixed analytical method was used to find a suitable theory, “the production of space”, to develop the policy framework. Lastly, a policy framework was developed to overcome barriers to age-friendly community development strategically. Echoing previous studies, this paper proposes a way to counter financial austerity in age-friendly initiative investment and balance the consideration for older and younger populations in urban development. For practice, the policy framework can provide a reference for more efficient age-friendly community policymaking in different regions. For future research, the framework provides a model for more empirical studies considering the social dynamics in age-friendly community development. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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13 pages, 359 KiB

Open AccessArticle

Socioeconomic Classes among Oldest-Old Women in South Korea: A Latent Class Analysis

by Chiyoung Lee and Jee-Seon Yi

Int. J. Environ. Res. Public Health 2021, 18(24), 13183; https://doi.org/10.3390/ijerph182413183 - 14 Dec 2021

Cited by 7 | Viewed by 3009

Abstract

Oldest-old women are known to live at the intersection of multiple socioeconomic disadvantages in South Korean society. This study classified oldest-old Korean women into several socioeconomically homogeneous classes based on various socioeconomic status (SES) risks and compared health characteristics among the identified classes. [...] Read more.

Oldest-old women are known to live at the intersection of multiple socioeconomic disadvantages in South Korean society. This study classified oldest-old Korean women into several socioeconomically homogeneous classes based on various socioeconomic status (SES) risks and compared health characteristics among the identified classes. This cross-sectional study utilized the 2019 Korean Community Health Survey, including data from 11,053 women (≥80 years). Latent class analysis determined the number of underlying socioeconomic classes based on nine selected SES variables. Four distinct socioeconomic classes were identified: “Urban, living alone, recipient of NBLSS, moderate education, leisure activity” (Class 1), “Rural, traditional house, living with others, not financially deprived, low education, employed” (Class 2), “Urban, living with family, financially affluent, not employed, no barriers to healthcare” (Class 3), “Rural, traditional house, living alone, financially deprived, uneducated, employed, barriers to healthcare” (Class 4). Depressive symptoms, subjective stress, and the prevalence of sleep disorder and diabetes were higher in Class 1 compared to other classes. Health-related quality of life, perceived health, and self-rated oral health were the poorest in Class 4. Class 3 reported the best health status. Understanding the intersecting SES risk factors in this group can aid in developing targeted interventions. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

15 pages, 1496 KiB

Open AccessArticle

The Influences of Community-Enriched Environment on the Cognitive Trajectories of Elderly People

by Shuyang Yu and Meng Wei

Int. J. Environ. Res. Public Health 2021, 18(16), 8866; https://doi.org/10.3390/ijerph18168866 - 23 Aug 2021

Cited by 7 | Viewed by 3267

Abstract

To examine the influences of community-enriched environment on the cognitive trajectories of the elderly in China, using panel data of 10,057, 3994, 2387, and 1749 older persons aged 65–104 years of the 2005, 2008, 2011, and 2014 waves from the Chinese Longitudinal Health [...] Read more.

To examine the influences of community-enriched environment on the cognitive trajectories of the elderly in China, using panel data of 10,057, 3994, 2387, and 1749 older persons aged 65–104 years of the 2005, 2008, 2011, and 2014 waves from the Chinese Longitudinal Health Longevity Survey (CLHLS) and a growth curve model, the authors analyzed the changing trend of elderly people’s cognitive abilities with age. The influences of community-enriched environments on cognitive abilities were also investigated. Results show that when all the factors are out of consideration except age, for an older person aged 82.5 years, as he/she grows one year older, his/her cognitive abilities will be reduced by 0.139 points, while for one aged 92.5 years, they will be reduced by 0.199 points, which means cognitive abilities decline rapidly as the individuals grow older. The elderly people from communities with enriched environments have higher cognitive levels and slower declining speeds of cognitive abilities than the other elderly people, proving the long-term ability of such environments to facilitate cognitive abilities. An increase in the stimulation of the enriched environment is needed to prevent or slow down the degeneration of cognitive abilities. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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13 pages, 328 KiB

Open AccessArticle

Active Aging in ASEAN Countries: Influences from Age-Friendly Environments, Lifestyles, and Socio-Demographic Factors

by Sariyamon Tiraphat, Vijj Kasemsup, Doungjai Buntup, Murallitharan Munisamy, Thang Huu Nguyen and Aung Hpone Myint

Int. J. Environ. Res. Public Health 2021, 18(16), 8290; https://doi.org/10.3390/ijerph18168290 - 5 Aug 2021

Cited by 16 | Viewed by 4614

Abstract

Active aging is a challenging issue to promote older population health; still, there is little clarity on research investigating the determinants of active aging in developing countries. Therefore, this research aimed to examine the factors associated with the active aging of the older [...] Read more.

Active aging is a challenging issue to promote older population health; still, there is little clarity on research investigating the determinants of active aging in developing countries. Therefore, this research aimed to examine the factors associated with the active aging of the older populations in ASEAN’s low and middle-income countries by focusing on Malaysia, Myanmar, Vietnam, and Thailand. The study is a cross-sectional quantitative research study using multi-stage cluster sampling to randomize the sample. The sample consists of 2031 older people aged 55 years and over, including 510 Thai, 537 Malaysian, 487 Myanmar, and 497 Vietnamese. We collected a quantitative questionnaire of age-friendly environmental scale and active aging scale based on the World Health Organization (WHO) concept. The predictors of active aging include age-friendly environments, lifestyles, and socioeconomic factors; the data are analyzed by using multiple logistic regression. After adjusting for other factors, we found that older people living in a community with higher levels of age-friendly environments are 5.52 times more active than those in lower levels of age-friendly environments. Moreover, the older population with healthy lifestyles such as good dietary intake and high physical activity will be 4.93 times more active than those with unhealthy lifestyles. Additionally, older adults with partners, higher education, and aged between 55 and 64 years will be 1.70, 2.61, and 1.63 times more active than those with separate/divorce/widow, primary education, and age at 75 years or higher, respectively. Our results contribute considerable evidence for ASEAN policy-making to promote active aging in this region. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

13 pages, 318 KiB

Open AccessArticle

WHO’s Global Age-Friendly Cities Guide: Its Implications of a Discussion on Social Exclusion among Older Adults

by Soondool Chung, Miri Kim, Erica Y. Y. Auh and Nan Sook Sook Park

Int. J. Environ. Res. Public Health 2021, 18(15), 8027; https://doi.org/10.3390/ijerph18158027 - 29 Jul 2021

Cited by 8 | Viewed by 3815

Abstract

This study analyzed the World Health Organization’s (WHO) Global Age-Friendly Cities Guide to observe its role in embodying social inclusion of older adults in attempts to prevent social exclusion. Social exclusion refers to the marginalization of individuals and groups from important economic and [...] Read more.

This study analyzed the World Health Organization’s (WHO) Global Age-Friendly Cities Guide to observe its role in embodying social inclusion of older adults in attempts to prevent social exclusion. Social exclusion refers to the marginalization of individuals and groups from important economic and social opportunities in the society. Many aging societies are implementing social inclusion of older adults as one of their key policy agendas to create a more sustainable and healthy society, in recognition that age functions as one of the essential factors accelerating social exclusion and declining physical and mental health of those affected. In order to explore the pertinence of the WHO guidelines to social inclusion of older adults, content analysis was conducted on each checklist item in the WHO guideline to identify its relation to the four dimensions of social exclusion, which are social interaction, production, consumption, and political engagement. The results showed comprehensive coverage of each dimension by the guideline, although the relative importance of each dimension was unequal. Additional insights were suggested to promote further social inclusion of older adults in the context of an age-friendly environment. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

12 pages, 343 KiB

Open AccessArticle

The Psychometric Properties of the Meaning of Home and Housing-Related Control Beliefs Scales among 67–70 Year-Olds in Sweden

by Yadanuch Boonyaratana, Eva Ekvall Hansson, Marianne Granbom and Steven M. Schmidt

Int. J. Environ. Res. Public Health 2021, 18(8), 4273; https://doi.org/10.3390/ijerph18084273 - 17 Apr 2021

Cited by 10 | Viewed by 2349

Abstract

Background: The housing environment is important for health and well-being among older people, and it is important to consider both physical and perceived aspects of housing. Psychometrically sound scales are necessary to assess perceived housing. This study evaluated the psychometric properties of two [...] Read more.

Background: The housing environment is important for health and well-being among older people, and it is important to consider both physical and perceived aspects of housing. Psychometrically sound scales are necessary to assess perceived housing. This study evaluated the psychometric properties of two instruments that measure perceived aspects of housing among a younger cohort of older adults in Sweden. Methods: A random sample of 371 participants aged 67 to 70 years (mean 67.9 (SD = 0.98)) was used. Participants lived in ordinary housing in the south of Sweden. Data on perceived aspects of housing were collected with the Meaning of Home Questionnaire (MOH) and the Housing-Related Control Beliefs Questionnaire (HCQ). Internal consistency, corrected item–total correlations, floor and ceiling effects, and construct validity were analyzed. Results: Cronbach’s alphas for all four subscales of MOH and two of three subscales of HCQ had acceptable levels (α > 0.50). Some items from both scales had low item–total correlations. All subscales, except for one from HCQ, had good construct validity. Conclusion: While both instruments had some limitations, all subscales with one exception had adequate psychometric properties. When used in different national contexts, further development may be necessary to achieve conceptual equivalence. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

18 pages, 1319 KiB

Open AccessArticle

Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)

by Haixia Liu, Xiaojing Fan, Huanyuan Luo, Zhongliang Zhou, Chi Shen, Naibao Hu and Xiangming Zhai

Int. J. Environ. Res. Public Health 2021, 18(8), 3886; https://doi.org/10.3390/ijerph18083886 - 7 Apr 2021

Cited by 40 | Viewed by 5541

Abstract

Depression amongst the elderly population is a worldwide public health problem, especially in China. Affected by the urban–rural dual structure, depressive symptoms of the elderly in urban and rural areas are significantly different. In order to compare depressive symptoms and its influencing factors [...] Read more.

Depression amongst the elderly population is a worldwide public health problem, especially in China. Affected by the urban–rural dual structure, depressive symptoms of the elderly in urban and rural areas are significantly different. In order to compare depressive symptoms and its influencing factors among the elderly in urban and rural areas, we used the data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7690 participants at age 60 or older were included in this study. The results showed that there was a significant difference in the prevalence estimate of depression between urban and rural elderly (χ² = 10.9.76, p < 0.001). The prevalence of depression among rural elderly was significantly higher than that of urban elderly (OR_-unadjusted = 1.88, 95% CI: 1.67 to 2.12). After adjusting for gender, age, marital status, education level, minorities, religious belief, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities and having income or not, the prevalence of depression in rural elderly is 1.52 times (OR = 1.52, 95% CI: 1.32 to 1.76) than that of urban elderly. Gender, education level, self-reported health, duration of sleep, chronic diseases were associated with depression in both urban and rural areas. In addition, social activities were connected with depression in urban areas, while minorities, marital status and having income or not were influencing factors of depression among the rural elderly. The interaction analysis showed that the interaction between marital status, social activities and urban and rural sources was statistically significant (divorced: coefficient was 1.567, p < 0.05; social activities: coefficient was 0.340, p < 0.05), while gender, education level, minorities, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities having income or not and urban and rural sources have no interaction (p > 0.05). Thus, it is necessary to propose targeted and precise intervention strategies to prevent depression after accurately identifying the factors’ effects. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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14 pages, 796 KiB

Open AccessArticle

How to Improve the Public Trust of the Intelligent Aging Community: An Empirical Study Based on the ACSI Model

by Tuochen Li and Siran Wang

Int. J. Environ. Res. Public Health 2021, 18(4), 1971; https://doi.org/10.3390/ijerph18041971 - 18 Feb 2021

Cited by 8 | Viewed by 2856

Abstract

In order to enhance social trust in intelligent aging services, the formation mechanism of public trust in the intelligent aging community was studied. Based on the classic American Customer Satisfaction Index (ACSI) model, this paper establishes the public trust formation model of the [...] Read more.

In order to enhance social trust in intelligent aging services, the formation mechanism of public trust in the intelligent aging community was studied. Based on the classic American Customer Satisfaction Index (ACSI) model, this paper establishes the public trust formation model of the intelligent aging community by proposing relevant assumptions. Using 306 questionnaires from China’s intelligent aging care model community as the original data, the model is empirically tested through structural equation modeling. The empirical results show that: firstly, the public satisfaction with the intelligent aging community directly determines the formation of public trust, and the key to improving public trust in the intelligent aging community is to improve customer satisfaction. Secondly, perceived quality, perceived ease of use, perceived risk, and perceived cost economical directly affect public satisfaction and indirectly affect the formation process of public trust in the intelligent aging community. Public satisfaction serves as a complete intermediary in this process. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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Review

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27 pages, 1764 KiB

Open AccessReview

Age-Friendly Community Interventions for Health and Social Outcomes: A Scoping Review

by Andy Hong, Jessie Welch-Stockton, Ja Young Kim, Sarah L. Canham, Valerie Greer and Michelle Sorweid

Int. J. Environ. Res. Public Health 2023, 20(3), 2554; https://doi.org/10.3390/ijerph20032554 - 31 Jan 2023

Cited by 14 | Viewed by 3801

Abstract

To address the numerous challenges associated with aging, increased attention has been given to the development of age-friendly cities and communities (AFCC) to promote healthy aging and social participation. However, limited evidence exists for addressing both health and social needs through the AFCC [...] Read more.

To address the numerous challenges associated with aging, increased attention has been given to the development of age-friendly cities and communities (AFCC) to promote healthy aging and social participation. However, limited evidence exists for addressing both health and social needs through the AFCC framework. We address this gap by conducting a scoping review of the interventions that target both health and social outcomes within the purview of the AFCC framework. The results showed that many of the successful interventions used a partnership model and behavioral change theories to inform the program design and implementation. The results also indicated that social participation and engagement played a key role in making the interventions successful. However, the results revealed that the literature is dominated by person-focused approaches. Future research should focus more on evaluating environmental-focused interventions and develop a holistic framework that combines both person- and environment-based approaches to healthy aging. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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25 pages, 1183 KiB

Open AccessReview

The World Health Organization (WHO) Integrated Care for Older People (ICOPE) Framework: A Narrative Review on Its Adoption Worldwide and Lessons Learnt

by Grace Sum, Lay Khoon Lau, Khalid Abdul Jabbar, Penny Lun, Pradeep Paul George, Yasmin Lynda Munro and Yew Yoong Ding

Int. J. Environ. Res. Public Health 2023, 20(1), 154; https://doi.org/10.3390/ijerph20010154 - 22 Dec 2022

Cited by 16 | Viewed by 6790

Abstract

The World Health Organization (WHO) recently published guidelines on the implementation of a new Integrated Care for Older People (ICOPE) framework in 2017–2019. It is an integrated care framework for the screening, assessment, and management of intrinsic capacity (IC) declines. We aimed to [...] Read more.

The World Health Organization (WHO) recently published guidelines on the implementation of a new Integrated Care for Older People (ICOPE) framework in 2017–2019. It is an integrated care framework for the screening, assessment, and management of intrinsic capacity (IC) declines. We aimed to examine where the early adopters of ICOPE are across the world, how these study teams and sites plan to apply the framework or have applied it, and the lessons learnt for future adopters. We systematically searched electronic medical and social sciences databases and grey literature published between 31 October 2017 and 31 March 2022. Records were systematically selected using precise inclusion criteria. There were 18 ICOPE study teams and sites across the 29 selected records. Of the 18 study teams and sites, seven were in the development stage, seven conducted feasibility studies, and four have commenced implementation of interventions that applied the ICOPE framework. Future ICOPE adopters may need to make certain decisions. These include whether to adopt ICOPE in the community setting or other settings, whether to adopt only Step 1 on IC screening or additional ICOPE Steps, whether the ICOPE IC screening tool requires modifications, and whether to use digital health technology. We propose the key factors needed to make these decisions and future research needed. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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17 pages, 733 KiB

Open AccessReview

A Scoping Review of Psychological Sense of Community among Community-Dwelling Older Adults

by Thomas D. Buckley

Int. J. Environ. Res. Public Health 2022, 19(14), 8395; https://doi.org/10.3390/ijerph19148395 - 9 Jul 2022

Cited by 10 | Viewed by 3302

Abstract

Psychological sense of community (PSOC) is an important construct for health and well-being outcomes for community-dwelling older adults. Drawing on the Ecological Theory of Aging and the Age-Friendly Cities (AFC) framework, this scoping review explored how PSOC has been used in research with [...] Read more.

Psychological sense of community (PSOC) is an important construct for health and well-being outcomes for community-dwelling older adults. Drawing on the Ecological Theory of Aging and the Age-Friendly Cities (AFC) framework, this scoping review explored how PSOC has been used in research with community-dwelling older adults. This study examined antecedents, correlates, and outcomes of PSOC, with a focus on relevance to theory and practice. Databases were searched between 1986 and 2021 for peer-reviewed journal articles. Searches identified 582 unique articles, and 28 were included in the final sample. Three primary themes emerged in the synthesis: relevance to the AFC framework, PSOC as a predictor of health and well-being outcomes, and the role of PSOC in relocation. Findings from this review show that PSOC serves as a mechanism that links the social and physical AFC environments with health and well-being outcomes. This review also presents mechanisms for how features of the environment relate to PSOC. These findings demonstrate the role of PSOC as a resource to improve person–environment fit. Results from this review can be used to guide future research and inform theory, policy, and practice. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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19 pages, 1866 KiB

Open AccessReview

A Methodological Quality Evaluation of Meta-Analyses on Nursing Home Research: Overview and Suggestions for Future Directions

by In-Soo Shin, Juh-Hyun Shin, Dong-Eun Jang and Jiyeon Lee

Int. J. Environ. Res. Public Health 2022, 19(1), 505; https://doi.org/10.3390/ijerph19010505 - 3 Jan 2022

Viewed by 2192

Abstract

(1) Background: The nursing home (NH) research field lacks quality reporting about meta-analyses (MAs), and most gradings of MA evidence are biased on analyzing the effectiveness of independent variables in randomized control trials. (2) Objectives: This study aimed to perform a critical methodological [...] Read more.

(1) Background: The nursing home (NH) research field lacks quality reporting about meta-analyses (MAs), and most gradings of MA evidence are biased on analyzing the effectiveness of independent variables in randomized control trials. (2) Objectives: This study aimed to perform a critical methodological review of MAs in the NH research field. (3) Methods: We searched the articles from four databases (PubMed, MEDLINE, CINAHL, and PsycINFO) until 15th January 2021. We reviewed a total of 41 published review articles in the NH research field. (4) Results: The studies primarily fell into the following categories: medicine (17/41), nursing (7/41), and psychiatry or psychology (6/41); 36.6% of the reviewed studies did not use any validated MA guidelines. The lowest correctly reported PRISMA 2000 guideline item was protocol and registration (14.6%), and more than 50% of articles did not report risk of bias. Moreover, 78.0% of studies did not describe missing reports of effect size formula. (5) Discussion: NH researchers must follow appropriate and updated guidelines for their MAs in order to provide validated reviews, as well as consider statistical issues such as the complexity of interventions, proper grouping, and scientific effect-size calculations to improve the quality of their study. Future quality review studies should investigate more diverse studies. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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Other

Jump to: Research, Review

32 pages, 7031 KiB

Open AccessSystematic Review

The Effect of Human Settlement Pedestrian Environment on Gait of Older People: An Umbrella Review

by Changzheng Xuan, Bo Zhang and Xiaohu Jia

Int. J. Environ. Res. Public Health 2023, 20(2), 1567; https://doi.org/10.3390/ijerph20021567 - 14 Jan 2023

Cited by 2 | Viewed by 2786

Abstract

Older people are limited by the pedestrian environment in human settlements and are prone to travel difficulties, falls, and stumbles. Furthermore, we still lack systematic knowledge of the pedestrian environment affecting the gait of older people. The purpose of this review is to [...] Read more.

Older people are limited by the pedestrian environment in human settlements and are prone to travel difficulties, falls, and stumbles. Furthermore, we still lack systematic knowledge of the pedestrian environment affecting the gait of older people. The purpose of this review is to synthesize current evidence of effective human settlement pedestrian environments interfering with gait in older people. The systematic effects of the human settlement pedestrian environment on gait in older people are discussed. Databases such as Web of Science, Medline (via PubMed), Scopus, and Embase were searched for relevant studies up to June 2022. The literature was screened to extract relevant evidence from the included literature, assess the quality of the evidence, and analyze the systematic effects of the pedestrian environment on gait in older people. From the 4297 studies identified in the initial search, 11 systematic reviews or meta-analysis studies were screened, from which 18 environmental factors and 60 gait changes were extracted. After removing duplicate elements and merging synonymous features, a total of 53 relationships between environmental factors and gait change in older people were extracted: the main human settlement pedestrian environmental factors affecting gait change in older people in existing studies were indoor and outdoor stairs/steps, uneven and irregular ground, obstacles, walking path turns, vibration interventions, mechanical perturbation during gait, and auditory sound cues. Under the influence of these factors, older people may experience changes in the degree of cautiousness and conservatism of gait and stability, and their body posture performance and control, and muscle activation may also be affected. Factors such as ground texture or material, mechanical perturbations during gait, and vibration interventions stimulate older people’s understanding and perception of their environment, but there is controversy over the results of specific gait parameters. The results support that human settlements’ pedestrian environment affects the gait changes of older people in a positive or negative way. This review may likely contribute evidence-based information to aid communication among practitioners in public health, healthcare, and environmental construction. The above findings are expected to provide useful preference for associated interdisciplinary researchers to understand the interactions among pedestrian environments, human behavior, and physiological characteristics. Full article

(This article belongs to the Special Issue Toward Healthy Aging and Age-Friendly Communities: Advances in Methods, and Challenge for Implementation Research)

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