Journal of Ageing and Longevity

Older adults, aged 65 years and older, develop and experience frailty at different rates. Yet, this heterogeneity is not well understood, nor are the factors, such as geographical residence, that influence different frailty trajectories and subsequent healthcare outcomes. We aim to identify factors that impact older adult frailty trajectories, skilled nursing facility (SNF) placement, and death. Medicare beneficiaries ≥ 65 years from the National Health and Aging Trend Study (2011–2021) with complete data using Fried’s frailty phenotype on ≥ 2 occasions (n = 6082) were included in the analysis. Rural/urban residence was defined using Office of Management and Budget criteria. Latent class growth analysis (LCGA) helped identify four frailty trajectories: improving, stable, mildly worsening, and drastically worsening. Cox proportional hazard analysis and logistic regression determined the association of social determinants of health (sex, race/ethnicity, education and income level, healthcare and transportation access, and social support) on death and SNF admission, respectively. The mean age was 75.12 years (SE 0.10); 56.4% female, 18.6% (n = 1133) rural residence. In the overall sample, 1094 (23.0%) older adults were classified as robust, 3242 (53.0%) as pre-frail, and 1746 (24.0%) as frail. Urban residence did not modify the relationship between frailty trajectories and SNF placement, nor did geographic residence on death. Higher income was associated with lower odds of a worse frailty trajectory, SNF admission, and a lower hazard of death, all reaching statistical significance. Future work should examine the factors that influence older adult participation in research and the impact of standardizing the definition of geographic rurality on older adult frailty and health outcomes. Full article

Blue Zones (BZs) are regions across the world associated with exceptional human longevity, where individuals routinely live into their 90s and beyond. These areas share distinct lifestyle and environmental factors that promote healthy aging. The established BZs include Sardinia, Okinawa, Ikaria, and Nicoya, while several “emerging” BZs have been reported in various parts of the globe. This study investigates an area in Sicily for similar longevity patterns. Demographic data from the Italy National Institute of Statistics and local civil registries identify the municipality of Caltabellotta, home to approximately 3000 residents, and the nearby Sicani Mountains as a potential emerging BZ. The area exhibits a significantly higher prevalence of nonagenarians and centenarians compared to national and regional averages. Between 1900 and 1924, the proportion of newborns in Caltabellotta who reached age 90 and above rose from 3.6% to 14%, with 1 out of 166 individuals during this period reaching the age of 100. Historical, dietary, environmental, and sociocultural characteristics align with known BZ traits, including adherence to the Mediterranean diet, physical activity through agrarian routines, strong social cohesion, and minimal environmental pollution. A comparative analysis with the validated Sardinia BZ supports the hypothesis that this Sicilian area may represent an emerging longevity hotspot. Further multidisciplinary investigation is warranted to substantiate these findings. Full article

As global populations age, there is increasing demand for effective, person-centered healthcare solutions that support older adults to age in place. Home healthcare has emerged as a crucial strategy to address the complex health and social needs of older adults while reducing reliance on institutional care. This umbrella review aimed to synthesize evidence from existing systematic reviews and meta-analyses on home healthcare services and interventions targeting older adults. A comprehensive search was conducted across five databases and gray literature sources, including Google Scholar, for reviews published between 2000 and 2025. The review followed the Joanna Briggs Institute methodology and PRISMA statement. Twenty reviews met the inclusion criteria, encompassing a total of over 3.1 million participants. Interventions were grouped into four categories: integrated and multidisciplinary care, preventive and supportive home visits, technological and digital interventions, and physical, transitional, and environmental support. Results indicated that many interventions led to improved health outcomes, including enhanced functional ability, reduced hospital readmissions, and increased satisfaction. However, effectiveness varies depending on the intervention type, delivery model, and population. Challenges such as caregiver burden, digital exclusion, and implementation in diverse settings were noted. This review highlights the promise of home healthcare interventions and underscores the need for context-sensitive, equitable, and scalable models to support aging populations. Full article

Aged-care services are in crisis through a combination of rising demand and increasing costs. Quality of care is often reported to be insufficient. Medical science has increased lifespans but the overmedicalisation of aged care may affect the financial sustainability and quality of care. Person-centred care was developed as a solution and is generally interpreted as being concerned with consumer choice. This study presents a human rights-based approach to a code of conduct for aged-care consumers and workers to ensure autonomy and participation in aged-care communities, which are fundamental to person-centred care. A test–retest cohort study was used to investigate the impact of a training module about a human rights-based code of conduct on the perspectives of new aged-care workers (n = 11) on a case scenario involving conflicting care priorities. Qualitative content analysis was used to categorise and count the participants’ responses. The analysis found that prior to training the majority of participants were focused on a medical and risk reduction model of care. After the training participants had a more expansive understanding of care needs and recognised the importance of client empowerment to enable clients to participate in decisions affecting their care. The results support the implementation of a human rights-based approach to worker training and client care; such an approach is consistent with person-centred care. Full article

The COVID-19 pandemic has illuminated and intensified pre-existing structural vulnerabilities among older adults living with HIV/AIDS in sub-Saharan Africa, particularly Nigeria. Within already overstretched healthcare infrastructures, these individuals faced heightened economic precarity, disrupted HIV care, and pronounced psychosocial distress. Exploring their lived experiences critically advances an understanding of resilience and informs contextually responsive interventions that can mitigate future health crises. This study employed a narrative qualitative approach to explore the lived experiences of older adults (aged 50 and above) attending the Infectious Diseases Institute (IDI) clinic in Ibadan, Nigeria, during the pandemic lockdown. Purposive sampling guided by maximum variation principles enabled the selection of 26 participants who provided detailed accounts through in-depth interviews. Reflective thematic analysis identified complex narratives illustrating intensified financial hardships, disrupted access to antiretroviral therapy (ART), and heightened psychological distress, including anxiety, depression, and profound isolation. Conversely, participants also articulated experiences of resilience, manifesting in improved medication adherence, strengthened family bonds, and introspective growth fostered by enforced isolation. These nuanced findings highlights the necessity of developing an adaptive, integrated healthcare interventions that addresses economic vulnerabilities, psychosocial wellbeing, and ART continuity, thereby better preparing resource-constrained health systems to support older adults with HIV/AIDS in future public health crises. Full article

The COVID-19 pandemic brought unprecedented challenges, particularly for older adults. They were identified as a high-risk group. While research has primarily focused on health measures, less is known about their adaptation processes during this period in the UK and Colombia. This study explores “how older adults in the UK and Colombia adapted during the health crisis after one year”. We conducted interviews with 29 participants in the UK and 32 participants in Colombia, aged 63–95, about their experiences one year after the pandemic. We analysed their anonymised transcripts using constructivist grounded theory. The pandemic highlighted older adults’ ability to learn new skills in the face of adversities. Some found new goals; others found pleasure in optimising existing skills and tasks. Some compensated for the lack of social connectivity by intensifying hobbies. We identified three broad ways older adults adapted. Cognitive adaptation included acceptance, positive reframing, and religious trust. Emotional regulation was experienced not only through deep freeze, weather impact, social support, religion, pet companionship but also emotional struggles. Finally behavioural adaptation was enacted through routine modification, use of virtual technologies, intertwined cognitive–emotional–behavioural adaptation, and previous experiences. However, adaptation varied, with some individuals struggling to adapt, highlighting that while adaptation is possible for some, it is not universal among all older adults. Full article

Background: Decision-making under risk is a crucial process for undertaking health behaviors. Although the influence of individual differences on decision-making under risk has been widely examined, there is no clear consensus yet as to how to explain this process considering both young and older adults. The main aim of this preliminary study was to examine age differences in decision-making under risk, risk propensity, sensation-seeking, and self-conscious emotions between younger and older adults. Methods: A total of 40 subjects (20 young adults and 20 older adults) participated in the present study. The young adults were aged 18–35 years (M = 23.25, SD = 2.59). The older adults were aged 65–70 years (M = 68.50, SD = 4.01). Participants completed the Risk Propensity Scale, the Sensation-Seeking Scale, the Test of Self-Conscious Affect, and the Prisoner’s Dilemma Game. Results: The results indicated that the groups showed different behaviors in sensation-seeking (p < 0.001, pη2 = 0.14). The older group showed a larger propensity to seek recreational activities and unconventional behaviors than the younger group (p < 0.0001, d = 0.78; p = 0.001, d = 0.75). Also, the older adults demonstrated a greater inclination toward pride (p < 0.01, d = 0.78), whereas younger adults exhibited a stronger tendency towards shame (p < 0.01, d = 0.76). Conclusions: These data suggest a shift in risk preferences as individuals age, potentially influenced by a variety of psychological, social, and experiential factors. The applications of this study can support psychological well-being, productivity, and quality of life in later adulthood. Full article

Falls among older adults create major damage to their quality of life. The present study explores which has a greater impact on this quality and feeling of safety in daily life—falling itself or the fear of falling. A stratified sample of 403 Israelis aged 55–80 years was recruited through a panel survey company, and self-reported questionnaires were completed. The questions included history of the number of past falls, as well as meaning and quality of life, along with the feeling of safety. Fear of falling was directly measured using a new scale as an additional measure to the feeling of safety. The research analysis was based on a theoretical model, tested by path analysis. The main findings show that fear of falling has a greater negative impact on the feeling of safety and quality of life than actually falling and is significantly influenced by subjective psychological feelings. The implications for clinical practice should be to raise awareness among the staff who care for older adults of the psychological fear of falling among the adults in their care and build both diagnosis and treatment programs for treating and reducing the fear of falling. Such programs have to be built by organizations, either in institutions or in meetings organized for community-dwelling older adults. Full article

Gait speed and grip strength are widely used measures of physical function in older adults and are predictive of disability, hospitalization, and mortality. However, there is a limited understanding of the long-term trajectories of these measures and which older adults are at the highest risk of functional decline. We used data from the National Health and Aging Trends Study (NHATS) to identify subgroups of community-dwelling older adults with distinct 10-year trajectories in gait speed and grip strength and to examine the baseline factors associated with these patterns. The sample included 4961 adults aged 65 years and older who completed gait speed and grip strength assessments in 2011 and at least one subsequent wave between 2013 and 2021. Using latent class growth analysis, we identified three trajectories for each measure: worsening, stable, and improving. More than one-third of participants were in the worsening group for at least one measure. In multinomial logistic regression models, lower income, Medicaid coverage, cognitive impairment, and multiple chronic conditions were associated with membership in worsening trajectory groups. These findings highlight the heterogeneity of physical aging and the importance of the early identification of older adults who may benefit from targeted interventions to maintain function and independence over time. Full article

Background: The 2010 Conical Model of Theoretical Framework for Mobility in Older Adults examines how various factors impact elderly mobility. A decade later, describing the model’s application in research, clinical practice, and policy is crucial. Objective: This scoping review aims to identify studies utilizing the Conical Model in older adult research, clinical practice, and policy while pinpointing implementation gaps. Methods: Seven databases (MEDLINE (PubMed), Embase, CINAHL, PsycINFO, Scopus, Web of Science, GooogleScholar) from 2010 to April 2025 with a well-defined search strategy. Pairs of reviewers independently conducted title/abstract and full-text screening, extracted data, and assessed study quality using modified Downs and Black Checklist (quantitative), Consolidated Criteria for Reporting Qualitative Research (qualitative), and Mixed Methods Appraisal Tool (mixed methods). Results: Twenty-four studies (20 cross-sectional quantitative studies, 2 mixed methods, one concept and one e-Delphi study) were included, with one advancing the Conical Model, eleven testing it, and twelve incorporating it into study development. Findings showed a consistent association between physical and social factors with mobility, although the assessment of mobility factors varied among studies. The quality of articles ranged from good (23%) to excellent (77%). Conclusion: No evidence was found on the Conical Model’s application in clinical practice or policy, despite its theoretical relevance; therefore, there is a need for further validation of the model in real-world applications. Full article

This study examines the relationship between living arrangements and depressive symptoms among community-dwelling older adults in Japan, with a particular focus on gender differences. A cross-sectional survey was conducted in Ayase City, Kanagawa Prefecture, using mailed questionnaires, and the analysis was conducted on data from 1409 participants aged 65 and older. Logistic regression analysis was performed to assess the associations between living arrangements, social networks, social participation, and depressive symptoms, adjusting for sociodemographic and health-related factors. The findings indicate that older adults living alone and those co-residing with their children are particularly vulnerable. Those living alone were more likely to be women aged 75 and older, with economic difficulties, and exhibited higher rates of depressive symptoms and care needs. Similarly, older adults living with their children had a higher prevalence of depressive symptoms and care requirements despite experiencing fewer economic hardships. This group was also characterized by lower educational attainment. Additionally, gender-specific factors were identified in the relationship between social relationships, including living arrangements, and depressive symptoms. These results underscore the necessity of interventions that consider both living arrangements and gender-specific social factors to mitigate mental health risks among older adults. Full article

The institutionalisation of older adults is often associated with negative perceptions from the past, influenced by asylums and hospices that were seen as marginalising older people. These views have contributed to a dominant social representation of residential care as undesirable, being associated with the ideas of social death, isolation and confinement. However, changes in family structures and longer life expectancies have increased the need for residential care. It is thus essential to rethink these institutions as integral parts of the community rather than isolating and marginalising them. Bridging the generation gap and integrating care institutions can help to combat negative perceptions, such as ageism, and promote a more inclusive view of elderly care. One way of involving older adults and recognising their rights and contributions is through community initiatives such as choirs. Community choirs can enhance social cohesion and music learning, offering older adults personal fulfilment, community involvement and resilience. These initiatives underscore respect for autonomy and emphasise their continuing value to society. This study explores the potential impact of community music on relieving feelings of loneliness among older adults in formal care settings. The project engaged 216 participants in singing classes held twice a week over six months. Utilising ethnographic observations and collective interviews with the participants, institutional staff, and family members, in this paper, the changes in participants’ self-perception of loneliness and perspectives from family members and staff are analysed. The findings indicate positive effects on the participants, especially in the psychological, educational and social dimensions, including increased autonomy, active participation, learning and social integration. The project engendered trust, empathy, mutual support and a sense of belonging and community, suggesting that community music contributes to mitigating loneliness and enhancing overall well-being. Full article

Background: Cognitive decline does not always occur; therefore, it is important to recognise the predictors in people over 60. The COVID-19 pandemic led to isolation to limit the spread of the virus, with older people being the most affected. Objectives: To analyse the cognitive variables of older adults in confinement during COVID-19 using tele-neuropsychology for cognitive assessment, comparing online with in-person screening. Methods: In total, 148 subjects took part in the study. Participants were assigned to the in-person or online intervention based on their preferences. A person close to the patient also participated in the study as an informant. Results: The results support the suitability of the protocol used in both modalities (face-to-face/online). Conclusions: Both assessments (face-to-face and online) are equally effective. The findings are consistent with the importance of cognitive measures and the key informant corroboration in identifying indicators of cognitive decline and implementing early intervention strategies. Full article

Shared decision making is a key part of patient-centered care and is associated with improved quality of care. The objective was to analyze associations between sociodemographic factors, health conditions, and how frequently providers ask Medicare beneficiaries about ideas to improve their own health. The 2020 Medicare Current Beneficiary Survey, a nationally representative dataset of beneficiaries aged ≥65 years, was analyzed (n = 7416). A survey-weighted multinomial logistic model was performed to analyze associations between independent variables and a three-level categorical dependent variable. Approximately 28.6%, 22.9%, and 48.5% of beneficiaries reported never (reference group), sometimes, and usually/always being asked about their own ideas for improving health, respectively. Beneficiaries aged 65–74 were more likely to usually/always or sometimes be asked for ideas about health improvement than those aged ≥75. Beneficiaries with lower than a high school education were less likely to be asked about ideas to improve their health than those with more than a high school education. Beneficiaries living alone were less likely to be asked about their health improvement ideas than those living with others. Disparities involving how often providers asked questions for shared decision making among beneficiaries were observed. Increasing provider awareness and implementation of standardized shared decision-making models may begin to mitigate these disparities. Full article

This study aimed to develop a comprehensive understanding of the decision-making process among older adults regarding leaving their homes and relocating to senior living communities (SLCs) in the United States. Specifically, it explored various aspects of the relocation experience, including the reasons behind their decision to relocate, the factors influencing their choice of destination, and the challenges encountered during the decision-making process. The study’s data were collected from 44 older adults residing in SLCs through five in-depth, semi-structured focus group discussions. The study results revealed that older adults’ decisions to relocate to an SLC were influenced by health-related factors, housing- and property-related factors, family dynamics, and socio-psychological factors. Older adults evaluated environmental and locational factors, facility attractions and amenities, and opportunities for socialization when selecting an SLC for relocation. Additionally, the study identified several barriers faced by older adults, including family-related barriers, economic constraints, socio-psychological barriers, and barriers related to knowledge and information about SLCs. Full article

Polyphenol-Rich Sugarcane Extract (PRSE), derived from Saccharum officinarum, demonstrates significant neuroprotective effects against amyloid-beta (Aβ_1–42)-induced deficits associated with Alzheimer’s disease (AD). This study utilized transgenic C. elegans expressing Aβ_1–42 to investigate PRSE’s impact on lifespan, sensory behavior, learning, memory, and amyloid fibril accumulation. Supplementation with 5 mg/mL of PRSE extended the mean lifespan of Aβ_1–42 worms by 11% (17.78 ± 0.36 days) and reduced amyloid fibril levels by 34% in aged worms compared to untreated worms. PRSE also improved sensory behavior, with a 27% increase in naïve chemotaxis at day 8. Memory deficits were mitigated, with PRSE-treated worms showing 21% and 30% reductions in short-term associative memory loss after 1 h intervals on days 8 and 12, respectively. These improvements can be associated with the polyphenolic compounds in PRSE, which aid in reducing amyloid aggregation. The findings highlight PRSE’s potential as a dietary supplement to address AD-related symptoms and pathologies. Further studies are needed to understand its mechanisms and confirm its effectiveness in mammals, supporting its potential use as a natural preventative supplement for Alzheimer’s and related neurodegenerative diseases. Full article

Antithrombotic medication is recommended for individuals who have a history of atrial fibrillation, venous thromboembolism, acute coronary events, or post-percutaneous coronary intervention. The purpose of this study was to describe the use of antithrombotics among older adults living with dementia at hospital admission and 1-month follow-up, treatments prescribed, and associated complications. The sample included 404 hospitalized older adults living with dementia, the majority of whom were White females, mean age in years of 82 (SD = 8). On admission, 69% of the patients were on at least one antithrombotic medication, and at 1-month post-discharge, this decreased to 64%. At 1-month post-discharge, the percentage of individuals on two or more antithrombotics decreased from admission at 34% to 14%. On admission, 11 (4%) of patients were admitted with adverse events from antithrombotics, and at 1-month post-discharge 5 (2%), patients were readmitted due to adverse events from antithrombotics. Given the risks and benefits of antithrombotic use among older adults living with dementia, a shared decision-making approach with patients and caregivers is recommended. This approach is the best way to help patients achieve their individual goals of care. Full article

This article explores the transformative potential of Artful Ageing as a conceptual framework for enriching experiences in later life. By synthesising Manning’s theory of minor gestures with Basting’s creative care approach, the article demonstrates how Artful Ageing fundamentally reconfigures our understanding of the ageing experience. The findings indicate that this framework transforms ageing from a narrative of decline into a dynamic process of becoming, where physical and existential spaces intertwine to create opportunities for emancipatory experiences. The transformative power emerges through what Manning terms “art-as-practice” and Basting describes as “moments of awe”—small, ephemeral encounters that carry profound potential for connection and meaning-making. This study reveals how Artful Ageing transforms conventional care environments into cultural spaces where creativity becomes embedded in everyday interactions rather than isolated to scheduled activities. The author identifies how this approach enables a shift from outcome-oriented interventions focused primarily on physical health to process-oriented engagements that honour the non-rational and in-between elements of ageing lives. The research demonstrates that when implemented, Artful Ageing transforms not only individual experiences but also relational dynamics and institutional structures, challenging biopolitical agendas embedded in current regimes of active ageing. This transformative framework ultimately offers new pathways for understanding and supporting meaningful engagement throughout later life. Full article

This review and discussion article is based on a literature review of selected materials and is devoted to the role of research agendas in linking research and policy in the field of ageing and longevity. After emphasizing the importance of research evidence in international policy frameworks on ageing and defining the main parameters of research agendas, the authors turn to describing how research agendas can play a key role in bridging research and policy on population ageing and individual longevity. Examples of international (global), regional and national research agendas are presented. Finally, the authors reflect on the benefits and current limitations of research agendas in supporting evidence-based policy and highlight the potential role of research agendas in developing appropriate and timely responses to the challenges and opportunities of population ageing and individual longevity. Full article