J. Ageing Longev., Volume 2, Issue 2 (June 2022) – 8 articles

The current paper uses comparable data to present an overview of home-based long-term care (LTC) for persons over 65 years of age in Europe. It aims to provide new insights to aid discussions on LTC policy convergence in three areas: the need for services, the extent to which these needs are met and the means employed to do so. It uses data from wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE). Four summary indicators are charted: (i) the care need: how many people need care; (ii) the care gap: the extent to which stated needs remain unmet; (iii) the care mix: how overall provision is divided into formal, informal or a mix of both; and (iv) care satisfaction based on stated preferences by recipients. Heterogeneity at individual level is explained by probit analyses, examining how individual factors (age, severity of need, gender, social networks, prosperity and others) combine with country group and country effects. Scatter plots are used to relate differences among countries to systemic variables, such as public expenditures. The key conclusions are that: (i) Once needs are defined in comparable terms, there remains a surprisingly large number of people across Europe whose needs are not addressed at all, what we call the care gap, especially among the younger group aged 65–80; this is evident everywhere and is not limited to any one type of system or group of countries; (ii) formal and informal care are both significant for the stability of an LTC provision system and for the well-being of care recipients; and (iii) recipients of care are especially sceptical about formal care, as they reward principally informal carers with whom they have personal relationships. The overwhelming finding is that the heterogeneity defies easy generalisations, whether these relate to individual characteristics or systemic effects. This (unexplained) heterogeneity is a challenge for researchers to explain, but it could also represent an untapped resource for policymakers to exploit. Full article

Most older adults desire to be as independent as possible and remain living in their ancestral home as they age. Aging-in-place maximizes the independence of older adults, enhancing their wellbeing and quality of life while decreasing the financial burden of residential care costs. However, due to chronic disease, multimorbidity, and age-related changes, appropriate conditions are required to make aging-in-place possible. Remote monitoring with smart home technologies could provide the infrastructure that enables older adults to remain living independently in their own homes safely. The health-assistive smart home shows great promise, but there are challenges to integrating smart homes on a larger scale. The purpose of this discussion paper is to propose a Design Thinking (DT) process to improve the possibility of integrating a smart home for health monitoring more widely and making it more accessible to all older adults wishing to continue living independently in their ancestral homes. From a nursing perspective, we discuss the necessary stakeholder groups and describe how these stakeholders should engage to accelerate the integration of health smart homes into real-world settings. Full article

To address the importance of family carers’ understanding of care, encompassing their own care as well as the broader care and health social systems, this paper leverages the notion of ‘care literacy’. The aim of this study is to understand the variation in care literacy and the impact of care literacy on preventive care. The empirical focus is on working family carers for older relatives in Japan, through a cross-sectional online survey that includes a novel operationalization of care literacy, an established measure of health literacy, the assessment of information used to understand care, and measures of preventive care. The participants’ (n = 281) mean age was 53, with 44% women, and an average of 8.3 h per week caring for their parent(s). The measure of care literacy is shown to be correlated, as expected, but distinct to health literacy (correlation 0.60). Based on regression analysis of care literacy, significant explanatory variables are health literacy (p < 0.001), gender (p = 0.044), number of sources of information on care (p = 0.029), and care hours (p < 0.001). In contrast, proximity in living arrangements of the carer and care receiver and severity of care needs were not significant predictors. Turning to the impact of care literacy, care literacy is a significant explanatory variable for use of preventive measures (p = 0.002), in particular as related to nutrition (p < 0.001), frailty (p = 0.028), and general home renovations (p = 0.018). The pattern of results from this cross-sectional analysis indicates the importance of understanding the potential for improved care literacy as an enabler of better care. Full article

In previous research, older adults reported they preferred enjoyable exercise programmes. The aim of this systematic review is to identify the components of enjoyable group-based physical activity interventions for older adults. Eleven electronic databases were searched in May 2021. Inclusion criteria were: Community-dwelling, ≥60 years of age, group-based physical activity, controlled intervention studies, designed to promote enjoyment, and included a measure of enjoyment or physical activity. Characteristics of the studies, intervention content, and enjoyment outcomes were extracted. Six studies, involving 1205 participants (Mean = 72.9 years old, 71.3% female, 67% European countries) were included. While enjoyment outcomes (n = 3) appeared to improve, there was wide heterogeneity in measurement tools, making it difficult to compare studies. Enjoyable group-based physical activity for older adults may consist of a supportive instructor and peers, creating a shared positive experience. Components included confidence building through competence, and courage experienced in the company of others. Within a physically supportive environment, older adults have the potential to generate social support to enjoy being physically active together. Future studies should include measures of enjoyment and device-based physical activity. Furthermore, a standardised definition of enjoyable physical activity for older adults is needed to inform the design of future interventions. Full article

People aged 50 years and over often show nutritional vulnerability in South Asia, including Bangladesh. Consequently, they present physical weakness and illness that escalate overtime. Community-focused investigations have the potential to inform healthcare interventions in Bangladesh, but current studies examine older adults’ nutrition status which are not all-encompassing (e.g., wetland communities). We, therefore, assessed the malnutrition status among wetland community-dwelling older adults aged ≥50 years in Bangladesh. A cross-sectional survey was conducted with 400 older adults living in the north-eastern wetland community of the country through simple random sampling. Demographics and general health information were collected using a structured questionnaire, and the Nestlé Mini Nutrition Assessment—Short Form was used to assess nutrition status. Respondents’ socio-demographic and health profiles were assessed, and the Pearson Chi-square test was performed to identify the associated risk factors of malnutrition. The prevalence of malnutrition and risk of malnutrition were 59.75 and 39.75 percent, respectively. The malnutrition prevalence rate was higher with increasing of age and females were more malnourished than males. Age, gender, educational status, occupation, and income were significantly associated with the participants’ malnutrition. The wetland community-dwelling people suffering from sleep disorders and having poor health condition, were found to be more malnourished. The findings confirm that the prevalence of malnutrition and risk of malnutrition are high among the wetland community-dwelling people aged ≥50 years. Our findings suggest health professionals to implement public health nutrition surveillance and clinical interventions simultaneously in wetland elderly to improve nutritional status of this cohort. Full article

Objectives: Recently, the SARC-F (Strength, Assistance for walking, Rise from a chair, Climb stairs, and Falls) questionnaire was developed to screen for the risk of sarcopenia in older patients. However, no study has investigated whether SARC-F is linked to food intake. This study aimed to evaluate the relationship between SARC-F and food intake in older hospitalized unselected cancer patients. Methods: A cross-sectional study included 53 older hospitalized unselected cancer patients. The SARC-F score was used to identify muscle function loss (SARC-F ≥ 4) or sarcopenia risk [SARC-F + calf circumference (CC) ≥ 11]. Pearson’s correlation was used to assess the relationship between SARC-F and food intake. Results: We found that 51% of patients presented with SARC-F ≥ 4 and 56.6% with SARC-F + CC ≥ 11. Although these patients had a lower calorie intake (22.4 ± 11.9 kcal/kg/day), they had an adequate distribution of macronutrients. We found a negative correlation between the SARC-F score and the calorie and macronutrient intake. However, SARC-F + CC was not correlated with calories and carbohydrates, only with lipid and protein intake. Conclusions: Approximately half of unselected cancer patients presented with muscle function loss (SARC-F ≥ 4) or sarcopenia risk (SARC-F + CC ≥ 11). In addition, we showed an inverse weak correlation between SARC-F and food intake, but not between SARC-F + CC and calories and carbohydrates, suggesting that the SARC-F questionnaire may be used with caution to screen for muscle function loss and correlation with food consumption. Full article

Introduction: Aging is directly related to sleep problems. Primary insomnia has a negative impact on the lives of elderly adults, altering cognitive and metabolic functions. Physical activity is positively related to improvement in sleep quality. The objective of this systematic review was to analyze the effects of physical activity programs in healthy elderly individuals aged 60 years or older, using the Pittsburgh Sleep Quality Index (PSQI) as a tool. Methods: The search was performed in the PubMed and Scielo databases, July 2021. Only randomized clinical trials that evaluated the role of physical exercise in the sleep quality of elderly patients were selected by two independent reviewers. Results: The result of the PSQI analysis showed that compared with the control condition, the exercise intervention was beneficial for the groups with insomnia (SMD: −0.57; 95% CI: −0.73 to −0.4; p < 0.00001; I² = 53%) and without insomnia (SMD: −0.61; 95% CI: −0.75 to −0.47; p < 0.00001; I² = 73%) and for the two groups combined (SMD: −0.59; 95% CI: −0.70 to −0.49; p < 0.0001, I² = 68%). Conclusion: The systematic and continuous practice of physical exercise significantly improves perceived sleep quality in elderly individuals. Therefore, physical activities can be used as a tool to prevent sleep disorders and improve health in general. Future studies may clarify the comparison between aerobic and resistance exercises, evaluate the dose–response relationship and include more participants. Full article

Cognitive training approaches are promising to manage the effects of normal cognitive decline for the aging adult, especially with the development and integration of computerized cognitive training. Supportive community models for older adults, such as senior centers, may provide engagement opportunities for occupation-based cognitive training programming. Fourteen older adults (n = 13 Black) from an urban older adult community center participated. This feasibility trial used a two-group, pretest-posttest design to examine differences between an occupation-based computerized cognitive training (CCT) program (n = 7) and a traditional cognitive training (TCT) program (n = 7), as assessed by participants’ perceptions of the perceived benefits, tolerance of time of sessions, and on executive functioning measures. There were no significant differences in the tolerance of time of sessions (p = 0.81) between CCT (average session time = 43.64 min) and TCT (average session time = 44.27 min). Additionally, there were no significant differences in how the two program groups perceived the training based on helpfulness (p = 1.00), positive opinions (p = 0.46), and executive functioning measurement changes. All participants reported “enjoyment” of the training. Including occupation-based CCT and TCT programming is feasible and positive within community-based programming focusing on a diverse population. Short-term improvements in executive functioning should not be expected but are worthy of longer-term observation, considering a socialization component, telehealth integrations, and expansion of supportive technology-based models. Full article