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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 "Aging".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 34425

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Special Issue Editors

Dr. Myo Nyein Aung

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Guest Editor

1. Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
2. Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
Interests: healthy ageing communities

Dr. Thin Nyein Nyein Aung

E-Mail Website
Co-Guest Editor

Department of Public Health, Juntendo University, Tokyo 113-8421, Japan
Interests: ageing; NCD prevention; rehabilitation; frality

Special Issue Information

Dear Colleagues,

Population ageing is a global phenomenon. Around the world, the epidemiological burden has shifted to age-related, noncommunicable diseases, whereas long-term care for older people is not yet systematically financed in many countries. While universal access to health and long-term care is the objective of many countries, health promotion that encourages people to lead a healthy and productive life is increasingly important; however, it has yet to be addressed in many parts of the world. This Special Issue will bring together papers that focus on evidence and practices that lead to healthy ageing in the scope of public health, social policy, and several areas in gerontology.

Research that examines how older people can age healthily are urgently required. Intervention studies that assess the effectiveness of community-integrated models are required in both high- and low-income countries. Observational studies that determine the factors that influence healthy ageing and quality of life will help create policies to address the determinants of healthy ageing communities. In addition, qualitative and mixed-method studies are important to help us understand the interaction and conceptual frameworks of several determinants in different context.

Aside from health promotion, this Special Issue welcomes research that addresses health and social care in communities, the strengthening of informal care, and care prevention for the older people.

Dr. Myo Nyein Aung
Dr. Thin Nyein Nyein Aung
Guest Editors

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Keywords

community
family
care
ageing
health promotion
age-friendly environment
NCDs
dementia
frailty
policy

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Published Papers (9 papers)

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Research

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15 pages, 324 KiB

Open AccessArticle

A Descriptive Qualitative Study of Older Persons and Family Experiences with Extreme Weather Conditions in Northern Thailand

by Piyatida Junlapeeya, Thaworn Lorga, Somporn Santiprasitkul and Asawinee Tonkuriman

Int. J. Environ. Res. Public Health 2023, 20(12), 6167; https://doi.org/10.3390/ijerph20126167 - 18 Jun 2023

Cited by 4 | Viewed by 2280

Abstract

Extreme weather can cause ill health in older persons due to a direct thermal effect on the body’s thermoregulation and difficulties in maintaining a healthy lifestyle and accessing the health services they need. To understand experiences in relation to their exposures to extreme weather and how they responded to such weather conditions, including cold snaps, heat and air pollution in northern Thai communities, a descriptive qualitative study was conducted to uncover details and the essence of perspectives and experiences of older persons and family members. Three focus group discussions with 15 older persons and 15 family members occurred in three communities in Chiang Rai, a northern province of Thailand. Thematic analysis was performed. Experiences of older persons and families in relation to extreme weather conditions were described in five themes: local actions against weather changes, the double challenges, awareness and reactions to weather changes, protective and comfortable living environments, and mitigation of the impacts of weather conditions. Seasonal adaptability was key for older persons to stay safe and healthy during extreme weather changes. Heat, cold snaps, and air pollution made health and daily living routine maintenance among older persons challenging, especially among those with declining health. Older persons and families employed predictive and adaptive strategies to avoid and minimise extreme weather impacts and maximise their comfort and optimal living. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

14 pages, 357 KiB

Open AccessArticle

Person–Environment Fit in Urban Neighbourhoods in Slovenia: Challenges and Coping Strategies

by Maša Filipovič Hrast, Richard Sendi and Boštjan Kerbler

Int. J. Environ. Res. Public Health 2023, 20(6), 5139; https://doi.org/10.3390/ijerph20065139 - 14 Mar 2023

Viewed by 1793

Abstract

A poor person–environment fit may bring various negative effects to older people’s independence and physical and psychological well-being. The presented study is especially valuable as it explores the challenges of living in cities in a country located in central and eastern Europe; namely, a less researched area when it comes to the quality of life of older people dwelling in an urban environment. The research questions that were explored are (1) what environmental pressures have people identified in the urban environment in Slovenia; and (2) what strategies have they used to deal with them? The study is based on 22 interviews with older people and three focus groups, that were then analysed using a thematic analysis approach. The study results identify a number of environmental pressures, which were divided into structural housing pressures, structural neighbourhood pressures, and formal and informal pressures. The analysis shows important behavioural responses, such as strategies of using formal and informal help, moving away from environmental pressures, mobility, actively involved in changing the environment, as well as attitudinal adaptation strategies, such as acceptance, resilience, using distraction, modesty and planning for the future. We further emphasize how these coping strategies are linked to individual and community capabilities, which function as a conversion factor. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

16 pages, 1894 KiB

Open AccessArticle

Social Infrastructure and Street Networks as Critical Infrastructure for Aging Friendly Community Design: Mediating the Effect of Physical Activity

by Jiayi Jiang, Zhengwei Xia, Xiaodi Sun, Xuanxuan Wang and Shixian Luo

Int. J. Environ. Res. Public Health 2022, 19(19), 11842; https://doi.org/10.3390/ijerph191911842 - 20 Sep 2022

Cited by 3 | Viewed by 3010

Abstract

Establishing an age-friendly environment at the community level is essential for promoting healthy aging. This study focused on the relationship between older adults and the community environment through their levels of satisfaction within it. We measured their physical activity (PA) in the community environment and three variables of community-level satisfaction: community environment (SCE), community social infrastructure (SSI), and community street networks (SSN). We analyzed 108 older adult participants in Suzhou using mediation analysis and multiple linear regression to investigate the relationship between physical activity and the community environment. The results of the mediation effect model showed that SCE, SSI, and SSN all affected the physical functions of older adults via the total amount of physical activity (TPA); SSI and SSN affected older adults’ physical functions by affecting the total duration of moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA). In addition, SSI and SSN are related to the types of community facilities, street space quality, and accessibility. Our study provides valuable insights into optimizing aging-friendly neighborhoods through moderate-to-vigorous-intensity PAs at both the facility and street space levels. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

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12 pages, 349 KiB

Open AccessArticle

Factors Influencing the Willingness of Palliative Care Utilization among the Older Population with Active Cancers: A Case Study in Mandalay, Myanmar

by Aye Tinzar Myint, Sariyamon Tiraphat, Isareethika Jayasvasti, Seo Ah Hong and Vijj Kasemsup

Int. J. Environ. Res. Public Health 2021, 18(15), 7887; https://doi.org/10.3390/ijerph18157887 - 26 Jul 2021

Cited by 5 | Viewed by 3986

Abstract

Palliative care is an effective, multidisciplinary healthcare service to alleviate severe illness patients from physical, psychological, and spiritual pain. However, global palliative care has been underutilized, especially in developing countries. This cross-sectional survey aimed to examine the factors associated with older cancer patients’ willingness to utilize palliative care services in Myanmar. The final sample was composed of 141 older adults, 50-years of age and above who suffered from cancers at any stage. Simple random sampling was applied to choose the participants by purposively selecting three oncology clinics with daycare chemotherapy centers in Mandalay. We collected data using structured questionnaires composed of five sections. The sections include the participant’s socio-economic information, disease status, knowledge of palliative care, psychosocial and spiritual need, practical need, and willingness to utilize palliative care services. The study found that approximately 85% of older cancer patients are willing to receive palliative care services. The significant predictors of willingness to utilize palliative care services include place of living, better palliative care knowledge, more need for spiritual and psychosocial support, and practical support. This study can guide health policymakers in increasing the rate of palliative care utilization. The suggested policies include developing community-level palliative care services in Myanmar, especially in rural areas, promoting palliative care knowledge, applying appropriate religious and spiritual traditions at palliative treatment, and developing suitable medicines for the critically ill. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

14 pages, 555 KiB

Open AccessArticle

Typology of Family Support in Home Care for Iranian Older People: A Qualitative Study

by Soheila Shamsikhani, Fazlollah Ahmadi, Anoshirvan Kazemnejad and Mojtaba Vaismoradi

Int. J. Environ. Res. Public Health 2021, 18(12), 6361; https://doi.org/10.3390/ijerph18126361 - 11 Jun 2021

Cited by 11 | Viewed by 3701

Abstract

The world population is rapidly aging. In older people, age-related biological decline in most body systems causes functional decline, an increase in dependence, and an increased need for support, especially by their family members. The aim of this study was to explore the main aspects of family support for older parents in home care. This qualitative study was conducted using a deductive qualitative content analysis approach. Participants were 21 older parents living in their own homes, as well as four family members of some participants. Data were collected using semi-structured interviews and then were analyzed using the primary matrix developed based on the existing literature. The main aspects of family support for older parents were grouped into five predetermined categories and one new category: “instrumental support”, “financial support”, “psycho-emotional support”, “healthcare-related support”, “informational-technological support”, and “social preference support “. Family support for older people in home care is a multi-dimensional phenomenon. Family members can identify the needs of their older parents and provide them with appropriate support in collaboration with healthcare professionals to enhance their quality of life, autonomy, and satisfaction with life. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

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14 pages, 514 KiB

Open AccessArticle

Estimating Service Demand for Intermediary Care at a Community Integrated Intermediary Care Center among Family Caregivers of Older Adults Residing in Chiang Mai, Northern Thailand

by Thin Nyein Nyein Aung, Myo Nyein Aung, Saiyud Moolphate, Yuka Koyanagi, Mariko Ichikawa, Siripen Supakankunti and Motoyuki Yuasa

Int. J. Environ. Res. Public Health 2021, 18(11), 6087; https://doi.org/10.3390/ijerph18116087 - 4 Jun 2021

Cited by 5 | Viewed by 3201

Abstract

Background: Thailand’s population is currently the third most rapidly aging in the world, with an estimated 20 million ageing population by 2050. Sustainability of the family based long-term care model is challenged by the chronic burden on family caregivers and by smaller family sizes. We aimed to introduce a new service model, Community Integrated Intermediary Care (CIIC), TCTR20190412004, including free of charge intermediary care services at CIIC centers in the local community, to help older adults whose caregivers are temporarily unable to sustain care at home. Since Thai society upholds values of gratefulness, it is better to estimate willingness to use such an intermediary care service first, before introducing the service. Methods: A total of 867 pairs of senior citizens and their family caregivers were interviewed with structured-questionnaires in 2019. Descriptive analysis and binary logistic regression were applied to determine the predictors of family caregivers’ willingness to use the CIIC service, guided by Anderson’s model of health services use. Results: About 26.8% of elderly participants and 24.0% of family caregivers were willing to use an intermediary care service. The family caregiver determinants of predisposing factors (kinship: spouse caregivers, other relatives, maid or friends; job types: own business and private company staff), enabling factors (original community residents and monthly income ≤9000 baht), and need factors (caregiver burden total scores ≥24, taking leave for caregiving, and having diabetes), were found to be significantly associated with willingness to use the CIIC service. Conclusions: The baseline survey data noted that caregivers’ sociodemographic factors and burden determined their willingness to use the intermediary care service, although the dependency of care recipients was low in this study. This, nonetheless, indicated that there is need for a backup respite care to strengthen current family based long-term aging care in Thailand. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

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15 pages, 714 KiB

Open AccessArticle

Caregiver Burden and Associated Factors for the Respite Care Needs among the Family Caregivers of Community Dwelling Senior Citizens in Chiang Mai, Northern Thailand

by Thin Nyein Nyein Aung, Myo Nyein Aung, Saiyud Moolphate, Yuka Koyanagi, Siripen Supakankunti and Motoyuki Yuasa

Int. J. Environ. Res. Public Health 2021, 18(11), 5873; https://doi.org/10.3390/ijerph18115873 - 30 May 2021

Cited by 23 | Viewed by 7171

Abstract

Background: Families are the backbone of caregiving for older adults living in communities. This is a tradition common to Thailand and many low- and middle-income countries where formal long-term care services are not so available or accessible. Therefore, population aging demands more and more young people engaging as family caregivers. Informal caregiving can become an unexpected duty for anyone anytime. However, studies measuring the burden of informal caregivers are limited. We aimed to determine the caregiver burden, both from the perspective of the caregivers as well as that of their care recipients. Method: We used the baseline survey data from a cluster randomized controlled trial providing a community integrated intermediary care (CIIC) service for seniors in Chiang Mai, Thailand, TCTR20190412004. Study participants were 867 pairs of older adults and their primary family caregivers. Descriptive analysis explored the characteristics of the caregivers and binary logistic regression identified factors influencing the caregivers’ burden. Results: The mean age of family caregivers was 55.27 ± 13.7 years and 5.5% indicated the need for respite care with Caregiver Burden Inventory (CBI) scores ≥24. The highest burden was noted in the time-dependence burden domain (25.7%). The significant associated factors affecting CBI ≥24 were as follows: caregivers older than 60 years, being female, current smokers, having diabetes, and caring for seniors with probable depression and moderate to severe dependency. Conclusions: A quarter of caregivers can have their careers disturbed because of the time consumed with caregiving. Policies to assist families and interventions, such as respite service, care capacity building, official leave for caregiving, etc., may reduce the burden of families struggling with informal care chores. Furthermore, caregiver burden measurements can be applied as a screening tool to assess long-term care needs, complementing the dependency assessment. Finally, implementation research is required to determine the effectiveness of respite care services for older people in Thailand. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

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10 pages, 348 KiB

Open AccessCase Report

Health Access, Health Promotion, and Health Self-Management: Barriers When Building Comprehensive Ageing Communities

by Leticia Pérez-Saiz, Mireia Ferri Sanz, Maite Ferrando, Mirian Fernández Salido, Tamara Alhambra-Borrás, Jorge Garcés Ferrer and Rachael Dix

Int. J. Environ. Res. Public Health 2023, 20(19), 6880; https://doi.org/10.3390/ijerph20196880 - 3 Oct 2023

Cited by 2 | Viewed by 2179

Abstract

A new intervention model for promoting healthy ageing grounded on integrated value-based care was developed and tested in the city of Valencia (Spain). Its implementation raised relevant barriers for older adults in their access to health, health promotion, and health self-management linked with their health and digital literacy. This new intervention model included several aspects. On the one hand, researchers together with older adults and their informal caregivers participating in the study, designed personalized care plans, based on older adults’ specific needs, to be implemented with the support of a digital solution. On the other hand, researchers and health and social professionals implemented a series of workshops in different locations of the city to encourage a sense of community among participants, reinforcing their trust in the new care model and increasing their adherence. Social activities were at the core of the workshops to understand older people’s interaction with the health and social services provided in the neighborhood. Qualitative and quantitative methods were combined to extract information from older participants on how to engage them as active actors of their health and understand their values and preferences. In the present manuscript, we focus on the qualitative results, which show that after a post-pandemic situation, they were more concerned about social isolation and desired face-to-face contact with their professional care team; however, feelings of loneliness and/or sadness were not considered among the reasons to visit health professionals. Some of the conclusions revealed that the use of technology as a supportive tool is well received but with a stress on its role as “supportive”, and not replacing the close contact with healthcare professionals. Professionals recognized the benefits of this new approach but required more time and incentives to dedicate the effort needed. The main aim of this study was to present these barriers related to health access, health promotion, and health self-management, as well as the actions developed to face them. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

19 pages, 1631 KiB

Open AccessStudy Protocol

Mindfulness Awareness Practice (MAP) to Prevent Dementia in Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Trial and Implementation Outcomes

by Ted Kheng Siang Ng, Lei Feng, Johnson Fam, Iris Rawtaer, Alan Prem Kumar, Grishma Rane, Irwin Kee-Mun Cheah, Ratha Mahendran, Yuan Kun Lee, Ene Choo Tan, Lee Gan Goh, Ee Heok Kua and Rathi Mahendran

Int. J. Environ. Res. Public Health 2021, 18(19), 10205; https://doi.org/10.3390/ijerph181910205 - 28 Sep 2021

Cited by 7 | Viewed by 4482

Abstract

Background: With an aging population, developing non-pharmacological interventions (NPIs) to delay dementia has become critical. Apart from cognitive decline, dementia is associated with multiple pathophysiology, including increased oxidative stress, dysregulated gene expressions, cytokine, neurotrophin, and stress markers, telomere shortening, and deteriorations in brain connectivity. Although mindfulness practices have been proposed to ameliorate these biological changes, no empirical studies were conducted. We thus aimed to investigate the effects of mindfulness awareness practice (MAP) to prevent cognitive decline and improve peripheral biomarkers in community-dwelling older adults diagnosed with mild cognitive impairment (MCI). Methods/Design: This was a single-blinded and parallel-group randomized controlled trial with two arms (intervention and active control arms), conducted over nine months. A total of 60 consenting community-dwelling older adults diagnosed with MCI were planned to be randomized in a 1:1 ratio to either the MAP or the Health Education Program (HEP). Interventions were performed weekly for the initial 12 weeks, and monthly for the subsequent six months. Outcome measures were assessed at baseline, 3-month, and 9-month post-intervention by blinded assessors. Primary outcomes were neurocognitive tests, comprehensive peripheral biomarkers, and brain imaging scans. Secondary outcomes included basic health screening measures, affective symptoms, and measures of physical functions. Linear-mixed models were used to examine the effects of MAP on these outcome measures. Significance: This is the first randomized controlled trial to systematically investigate the effects of a mindfulness intervention in improving cognitive functions and various biomarkers in community-dwelling older adults diagnosed with MCI. Our findings have the potential to inform mindfulness intervention as a novel approach to delay dementia. Full article

(This article belongs to the Special Issue Healthy Ageing Commuities)

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