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New Advances in Health of Older Adults
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New Advances in Health of Older Adults

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 21477

Special Issue Editors

Dr. Ewa Zasadzka

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Guest Editor
Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
Interests: geriatrics; problems of older people; physiotherapy; occupational therapy
Prof. Dr. Katarzyna Hojan

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Guest Editor
Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
Interests: cancer; problems of older people; physiotherapy; occupational therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As life expectancy increases, we are met with increasing challenges for medicine and public health, and science and technology are continually trying to meet these growing obstacles. This is also the case in the health and care of older people. Important areas related to the health of the elderly are prevention and treatment of large geriatric syndromes (geriatric giants), comprehensive geriatric assessment, difficulties in meeting standards of physical activity—especially during the COVID-19 pandemic—as well as characteristic diseases and problems related to old age. It is also particularly important to apply new technologies to the assessment and therapy of older people. We are seeking submissions that discuss a new approach to this type of problem and present the latest discoveries in fields related to the health of the elderly.

Dr. Ewa Zasadzka
Prof. Dr. Katarzyna Hojan
Guest Editors

Manuscript Submission Information

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

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • physical activity
  • diseases of the elderly
  • physiotherapy
  • occupational therapy
  • new technologies
  • comprehensive geriatric evaluation
  • sarcopenia
  • frailty syndrome
  • geriatric giants
  • COVID-19 pandemic

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Published Papers (6 papers)

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Research

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17 pages, 2430 KiB  
Article
ADL+: A Digital Toolkit for Multidomain Cognitive, Physical, and Nutritional Interventions to Prevent Cognitive Decline in Community-Dwelling Older Adults
by Justin Chew, Zhiwei Zeng, Toh Hsiang Benny Tan, Pamela Chew, Noorhazlina Ali, Hao Wang, Melissa Ong, Roslyn Raymond, Kalene Pek, Di Wang, Liang Zhang, Zhiqi Shen, Cyril Leung, Jing Jih Chin, Wee Shiong Lim and Chunyan Miao
Int. J. Environ. Res. Public Health 2025, 22(1), 42; https://doi.org/10.3390/ijerph22010042 - 31 Dec 2024
Cited by 1 | Viewed by 1481
Abstract
Background: Current research highlights the importance of addressing multiple risk factors concurrently to tackle the complex etiology of dementia. However, limited evidence exists on the efficacy of technology-driven, multidomain community-based interventions for preventing cognitive decline. Objectives: To evaluate the efficacy of ADL+, an [...] Read more.
Background: Current research highlights the importance of addressing multiple risk factors concurrently to tackle the complex etiology of dementia. However, limited evidence exists on the efficacy of technology-driven, multidomain community-based interventions for preventing cognitive decline. Objectives: To evaluate the efficacy of ADL+, an artificial intelligence (AI)-enabled digital toolkit integrating cognitive assessments and multidomain interventions, on outcomes of cognitive function, activity levels, and quality of life in older adults at risk of cognitive decline. Adherence and usability were also evaluated. Methods: We conducted a quasi-experimental study including community-dwelling older adults aged 60 years and above without dementia, but with subjective memory complaints (AD8 score ≥ 2). Participants received a six-month intervention (app-based cognitive training, personalized nutritional, physical, and social activities recommendations) or a control group treatment (cognitive health educational package). The primary outcome was a change in neuropsychological test battery (NTB) Z-scores (NTB composite and its individual domains: attention, processing speed, memory, and executive function). Secondary outcomes were activity levels (Frenchay Activities Index, FAI), and quality of life (EQ-5D). Outcomes were assessed at the end of the intervention and three months post-intervention using linear mixed-effects models. Results: 96% of participants in the intervention and 89% in the control group completed the study. At six months, the intervention group showed a significant NTB composite score improvement (mean change: 0.086 (95% CI 0.020 to 0.15)), with a between-group difference of 0.17 (95% CI 0.071 to 0.27). Significant differences in attention, processing speed, and memory domains were observed, with benefits sustained in the processing speed domain at nine months. The control group’s FAI scores declined at six months (mean change: −1.04 (95% CI −1.83 to −0.26)), while the intervention group’s scores remained stable. The intervention group’s EQ-5D visual analogue scale (VAS) scores improved at both six and nine months, with between-group differences of 4.06 (95% CI 0.23 to 7.90) at six months and 5.12 (95% CI 0.81 to 9.43) at nine months. Adherence was high, while average usability scores were obtained. Conclusions: The ADL+ toolkit shows potential beneficial effects on cognitive function, activity levels, and quality of life for older adults at risk of cognitive decline. Findings will guide future randomized controlled trials and implementation efforts. Full article
(This article belongs to the Special Issue New Advances in Health of Older Adults)
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39 pages, 2304 KiB  
Article
“Health Outcomes of Grandparents Caring for Double Orphans in South Africa”: What Are the Determinants?
by Salmon Likoko, Monica Ewomazino Akokuwebe, Godswill Nwabuisi Osuafor and Erhabor Sunday Idemudia
Int. J. Environ. Res. Public Health 2023, 20(24), 7158; https://doi.org/10.3390/ijerph20247158 - 8 Dec 2023
Cited by 2 | Viewed by 2777
Abstract
In the 21st century, grandparenthood is a significant phenomenon in the fields of demography, gerontology, and sociology. It is mainly explored in the context of ageing, as it is poised to become one of the most significant demographic phenomena and social issues in [...] Read more.
In the 21st century, grandparenthood is a significant phenomenon in the fields of demography, gerontology, and sociology. It is mainly explored in the context of ageing, as it is poised to become one of the most significant demographic phenomena and social issues in contemporary South Africa. Therefore, this study examined the determinants associated with grandparents who are parenting as caregivers and the health challenges they are exposed to as caregivers. The National Income Dynamics Study (NIDS) Wave 5 dataset was utilised, and a total of 302,476 grandparents aged 25 years and older, who were reported to be primary caregivers of double orphans, were included in the analysis. Both bivariate and multivariate binary logistic regressions were performed to determine the predictors of the determinants of grandparents parenting as caregivers and their health challenges in South Africa. Estimated odds ratios (ORs) with 95% confidence intervals (CIs) were used, and the threshold for statistical significance was established at ρ < 0.05. A majority of the male and female grandparent caregivers were aged 24–34 years, were Black Africans (69.8%), had secondary education (46.9%), reported health challenges (HC) (59.7%), with 26.4% reporting headaches in the last 30 days. Logistic regression revealed that grandparent caregivers aged 55–64 years were 8.9 times more likely to report health challenges compared to those aged 25–34 years. Non-Black African grandparent caregivers were found to be 0.61 times less likely to report health challenges, compared to Black African grandparent caregivers. Those with perceived poor health status were 3.3 times more likely to report health challenges, compared to those with excellent perceived health status. Therefore, there is an urgent need to redesign health interventions to address these health burdens among grandparent caregivers and to take cognisance of providing economic and social support for these vulnerable populations. Full article
(This article belongs to the Special Issue New Advances in Health of Older Adults)
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18 pages, 1549 KiB  
Article
Improving Sleep Quality, Daytime Sleepiness, and Cognitive Function in Patients with Dementia by Therapeutic Exercise and NESA Neuromodulation: A Multicenter Clinical Trial
by Esther Teruel-Hernández, José Antonio López-Pina, Sonia Souto-Camba, Aníbal Báez-Suárez, Raquel Medina-Ramírez and Antonia Gómez-Conesa
Int. J. Environ. Res. Public Health 2023, 20(21), 7027; https://doi.org/10.3390/ijerph20217027 - 6 Nov 2023
Cited by 4 | Viewed by 6695
Abstract
Dementia is a progressive decline in cognitive functions caused by an alteration in the pattern of neural network connections. There is an inability to create new neuronal connections, producing behavioral disorders. The most evident alteration in patients with neurodegenerative diseases is the alteration [...] Read more.
Dementia is a progressive decline in cognitive functions caused by an alteration in the pattern of neural network connections. There is an inability to create new neuronal connections, producing behavioral disorders. The most evident alteration in patients with neurodegenerative diseases is the alteration of sleep–wake behavior. The aim of this study was to test the effect of two non-pharmacological interventions, therapeutic exercise (TE) and non-invasive neuromodulation through the NESA device (NN) on sleep quality, daytime sleepiness, and cognitive function of 30 patients diagnosed with dementia (non-invasive neuromodulation experimental group (NNG): mean ± SD, age: 71.6 ± 7.43 years; therapeutic exercise experimental group (TEG) 75.2 ± 8.63 years; control group (CG) 80.9 ± 4.53 years). The variables were evaluated by means of the Pittsburg Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Mini-Cognitive Exam Test at four different times during the study: at baseline, after 2 months (after completion of the NNG), after 5 months (after completion of the TEG), and after 7 months (after 2 months of follow-up). Participants in the NNG and TEG presented significant improvements with respect to the CG, and in addition, the NNG generated greater relevant changes in the three variables with respect to the TEG (sleep quality (p = 0.972), daytime sleepiness (p = 0.026), and cognitive function (p = 0.127)). In conclusion, with greater effects in the NNG, both treatments were effective to improve daytime sleepiness, sleep quality, and cognitive function in the dementia population. Full article
(This article belongs to the Special Issue New Advances in Health of Older Adults)
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15 pages, 390 KiB  
Article
An Integrated Patient-Centred Medical Home (PCMH) Care Model Reduces Prospective Healthcare Utilisation for Community-Dwelling Older Adults with Complex Needs: A Matched Observational Study in Singapore
by Grace Sum, Silvia Yu Hui Sim, Junxing Chay, Soon Hoe Ho, Mimaika Luluina Ginting, Zoe Zon Be Lim, Joanne Yoong and Chek Hooi Wong
Int. J. Environ. Res. Public Health 2023, 20(19), 6848; https://doi.org/10.3390/ijerph20196848 - 27 Sep 2023
Cited by 1 | Viewed by 2437
Abstract
The global ageing population is associated with increased health service use. The PCMH care model integrates primary care and home-based care management to deliver comprehensive and personalised healthcare to community-dwelling older adults with bio-psycho-social needs. We examined if an integrated PCMH reduced healthcare [...] Read more.
The global ageing population is associated with increased health service use. The PCMH care model integrates primary care and home-based care management to deliver comprehensive and personalised healthcare to community-dwelling older adults with bio-psycho-social needs. We examined if an integrated PCMH reduced healthcare utilisation burden of older persons in Singapore. We compared the healthcare utilisation between the intervention group and coarsened exact matched controls for a follow-up of 15 months. Baseline matching covariates included socio-demographics, health status, and past healthcare use. We accounted for COVID-19 social distancing effects on health-seeking behaviour. The intervention group consisted of 165 older adults with complex needs. We analysed national administrative healthcare utilisation data from 2017 to 2020. We applied multivariable zero-inflated regression modelling and presented findings stratified by high (CCI ≥ 5) and low disease burden (CCI < 5). Compared to controls, there were significant reductions in emergency department (β = −0.85; 95%CI = −1.55 to −0.14) and primary care visits (β = −1.70; 95%CI = −2.17 to −1.22) and a decrease in specialist outpatient visits (β = −0.29; 95%CI = −0.64 to 0.07) in the 3-month period immediately after one-year enrolment. The number of acute hospitalisations remained stable. Compared to controls, the intervention group with high and low comorbidity burden had significant decreases in primary care use, while only those with lower comorbidity burden had significant reductions in utilisation of other service types. An integrated PCMH appears beneficial in reducing healthcare utilisation for older persons with complex needs after 1 year in the programme. Future research can explore longer-term utilisation and scalability of the care model. Full article
(This article belongs to the Special Issue New Advances in Health of Older Adults)

Review

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55 pages, 1617 KiB  
Review
Comprehensive Gerontological Assessment: An Update on the Concept and Its Evaluation Tools in Latin America and the Caribbean—A Literature Review
by Rafael Pizarro-Mena, Elena S. Rotarou, Diego Chavarro-Carvajal, Patrick Alexander Wachholz, María Fernanda López, Cristina Perdomo Delgado, Solange Parra-Soto, Isabel Barrientos-Calvo, Felipe Retamal-Walter and Gloria Riveros-Basoalto
Int. J. Environ. Res. Public Health 2024, 21(12), 1697; https://doi.org/10.3390/ijerph21121697 - 19 Dec 2024
Cited by 1 | Viewed by 1868
Abstract
In recent decades, Latin America and the Caribbean region have experienced accelerated aging. However, despite the significant progress of gerontology in the region, the number of geriatricians and professionals trained in the field is low; a notable gap in the training related to [...] Read more.
In recent decades, Latin America and the Caribbean region have experienced accelerated aging. However, despite the significant progress of gerontology in the region, the number of geriatricians and professionals trained in the field is low; a notable gap in the training related to the assessment of older adults can also be observed. Therefore, in this literature review, we update the concept of Comprehensive Gerontological Assessment (CGA) for its application in the region. We compile the characteristics, validity, and reliability of CGA tools, and their usage in government documents across countries in the region. We also analyze the adaptations made to CGA during the COVID-19 pandemic, and discuss challenges related to CGA administration, academic training, research, innovation, and management. This study is particularly relevant as it proposes lines of action for decision-makers, academics, researchers, university students, and the general community, which will allow for more tailored interventions aimed at meeting the needs of older adults, their families, and caregivers. Such actions will positively impact functionality, autonomy, and quality of life, while promoting healthy, active, and successful aging in the region. Full article
(This article belongs to the Special Issue New Advances in Health of Older Adults)
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16 pages, 1211 KiB  
Review
Food Delivery Apps and Their Potential to Address Food Insecurity in Older Adults: A Review
by Sangchul Hwang, Cassandra M. Johnson, Joni Charles and Lesli Biediger-Friedman
Int. J. Environ. Res. Public Health 2024, 21(9), 1197; https://doi.org/10.3390/ijerph21091197 - 10 Sep 2024
Cited by 2 | Viewed by 4694
Abstract
The proportion of older adults is increasing globally, yet many of them experience food insecurity. Technological innovations, such as increased access to internet- and mobile-based food delivery apps (FDAs), may help mitigate food insecurity. However, this topic has been understudied. This scoping review [...] Read more.
The proportion of older adults is increasing globally, yet many of them experience food insecurity. Technological innovations, such as increased access to internet- and mobile-based food delivery apps (FDAs), may help mitigate food insecurity. However, this topic has been understudied. This scoping review searched for publications and online technical reports from around the world using interdisciplinary databases like ScienceDirect and internet sources like government websites, respectively. Eligible references were published recently (2019–present) and focused on general technology use, including apps, among older adults (≥50 years) or FDAs for food insecurity or nutritional health generally or specifically among older adults. The search identified 19 studies from 10 countries and extracted relevant information for summary tables. A limited number of studies supported the idea that FDAs can help address food insecurity, but there are important equity considerations for older adults living in rural areas or with constrained physical abilities. Consistently, customized app features and functions increased the intention to use FDAs. In addition, FDAs may have health and environmental impacts, such as food waste and increased access or promotion of ultraprocessed foods. Additional research is needed to elucidate the potential of FDAs to address food insecurity generally and specifically among older adults. Full article
(This article belongs to the Special Issue New Advances in Health of Older Adults)
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