Search Results (926)

Background: Loneliness and social isolation among older people are currently widespread and recognized as the foremost public health problems globally and locally. Hong Kong, which exhibits a rapid aging trend and an expanding elderly population, is inevitably facing these issues. This study explored the lived experiences of loneliness among older adults in Hong Kong. Methods: Qualitative interviews were conducted among older adults in the community aged 60 or above who were cared for by migrant domestic workers and presented varying levels of loneliness. Purposive sampling was used to select subjects for face-to-face, semi-structured individual interviews, with consent for audio recording, which led to the inclusion of 19 older adults, among whom five were male, nine lived with a spouse, and three lived with their children. Interpretative phenomenological analysis was adopted. Results: We identified a core theme, “Should I stay at home alone?”, and the following four interrelated themes: (1) experience of inadequate social support and networks, (2) altered family dynamics and support, (3) deterioration in physical functions and mobility limitations, and (4) experience of negative and complex emotions. Conclusions: Based on our investigation into the lived experience of loneliness among older adults locally, we recommend that the government, non-governmental organizations, and healthcare institutions establish appropriate strategies and integrated services to address the social, physical, familial, and emotional issues in this population to foster healthy aging, improve their quality of life, and encourage support from families and communities. Full article

Cognitive decline among older people is a growing concern worldwide since it impacts quality of life and independence. Recently, we reported that an epicatechin-enriched product improves cardiometabolic status, physical performance/mobility, and quality of life (QoL) in over-60-year-old subjects. Here, we explored the effects of an (−)-epicatechin-enriched cacao supplement on the cognitive conditions of older and sedentary individuals residing in a community center. Twelve persons with the inclusion criteria were included in this proof-of-concept study. We evaluated reasoning, memory, attention, coordination, and perception using CogniFit software, version 4.6.18. Patients received a mixture of cacao flour and 15 mg of free (−)-epicatechin twice daily for 3 months. The main results from the trial suggested a positive and significant improvement in perception, coordination, reasoning, attention, and memory. Full article

Background and Aims: Multiple genetic variants have been associated with disease prevalence and outcomes in middle-aged people with metabolic dysfunction-associated fatty liver disease (MAFLD). However, genetic studies in older adults have been lacking. We aimed to understand their clinical relevance in healthy older persons. Methods: A secondary analysis of the ASPREE (ASPirin in Reducing Events in the Elderly) randomized trial involving community-dwelling older adults ≥ 70 years without prior cardiovascular disease events or life-limiting illness at enrolment. The Fatty Liver Index (FLI) was used to identify MAFLD at baseline. We assessed the associations between six previously reported MAFLD-associated genetic variants with prevalent MAFLD at baseline, and the associations of these variants with cardiovascular disease events and all-cause mortality. Results: A total of 8756 participants with genetic data were stratified according to the FLI, with 3310 having MAFLD at baseline. The follow-up was for a median of 8.4 (IQR 7.3–9.5) years. Variants in two genes (GCKR and HSD17B13) were associated with prevalent MAFLD (p < 0.05); PNPLA3, TM6SF2, LYPLAL1, and MBOAT7 were not. PNPLA3, TM6SF2, HSD17B13, GCKR, and LYPLAL1 were not associated with major adverse cardiovascular events (MACEs) or mortality in the overall cohort or in participants with MAFLD during the follow-up (all p > 0.05). Within the MAFLD group, homozygosity for the rs641738 C > T variant in the MBOAT7 gene was associated with a reduced risk of MACEs (HR 0.68 [95% CI 0.48–0.97]), but not all-cause mortality (HR 1.14 [95% CI 0.89–1.47]). This protective association remained significant after adjusting for multiple key covariates (aHR 0.64 [95% CI 0.44–0.92]). The results were similar when using the metabolic dysfunction-associated steatotic liver disease definition rather than MAFLD. Conclusions: The rs641738 C > T variant in MBOAT7 may confer protection against MACEs in older adults with MAFLD, independent of other clinical risk factors. Further validation using external cohorts is needed. Full article

With rapid global aging, the community environment has become a critical factor influencing cognitive health in older adults. However, most existing studies focus on single environmental attributes and rely on linear analytical methods, which fail to capture the complex and synergistic effects of community features. Guided by an integrated theoretical perspective on environmental psychology, aging, and cognitive health, this study examines how multiple community environmental factors jointly affect cognitive function in elderly people. A case study was conducted among 215 older residents in Shanghai, China. An exploratory factor analysis (EFA) identified the following five key dimensions of community environment: pedestrian friendliness, blue–green spaces, infrastructure, space attractiveness, and safety. We then applied both Partial Least Squares Structural Equation Modeling (PLS-SEM) and Fuzzy Set Qualitative Comparative Analysis (fsQCA) to reveal linear and configurational relationships. The findings showed that pedestrian friendliness, blue–green spaces, and space attractiveness significantly enhance cognitive health, while fsQCA highlighted multiple pathways that underscore the non-linear and synergistic interactions among environmental features. These results provide theoretical insights into the mechanisms linking community environments and cognitive function and offer practical guidance for designing age-friendly communities. Full article

(1) Background: People living with spinal cord injury (SCI) face numerous challenges in their lives in terms of health conditions, everyday activity, and participation in society, which are not fully recognized. To address such issues, a community survey with 125 questions for people living with SCI was conducted and the response rates, population characteristics, health and functioning problems are reported. (2) Methods: The survey questionnaire comprised 125 questions on SCI characteristics, health conditions, activities, participation, and environmental and personal factors. The survey response rates were calculated, and demographics and health and functioning characteristics were analyzed. (3) Results: A total of 890 individuals responded to the survey. The median age of the participants was 48 years (interquartile range (IQR), 39–56), and 76% of the population were males. Paraplegia (60%) and complete injury (58%) were the most common injury type, and the cause was mostly traumatic (92%). More health problems and lower quality of life were more frequent with older age and in patients without paid work. (4) Conclusions: The Ko-InSCI study provides valuable information in terms of health needs and service gaps for people with SCI in the community. Full article

This paper presents a case study of the Local Care Ecosystems developed by the provincial government of Gipuzkoa (Basque Country, Spain) to strengthen coordination between social services, health services, and community-based initiatives at the municipal level. The initiative seeks to personalize care, enhance service integration, and support community-based care with the overarching goal of improving the quality of life for older adults living at home. These ecosystems incorporate social, institutional, and technological innovations aimed at supporting individuals who are frail or vulnerable throughout the care cycle. At present, 18 Local Care Ecosystems are active, providing services to 1202 people over the age of 65 and 167 families. The model addresses a growing global challenge linked to population aging, which has led to increasing demand for care and support services that are often fragmented, under-resourced, and constrained by outdated regulatory frameworks. These structural issues can compromise both the quality and efficiency of care for dependent individuals. Based on the findings, the paper offers policy recommendations to support the transfer and adaptation of this model, with the aim of improving the well-being of older adults who wish to remain in their own homes. Full article

Background: There is little information about the effectiveness of oral nutritional supplements (ONS) in combatting nutrient inadequacies in primary care, where most malnutrition exists. Aim: To examine the extent to which readymade ONS add or displace the nutrients consumed in the diet and their impact on combatting dietary inadequacies. Methods: 308 free-living people >50 years with medium + high risk of malnutrition (Malnutrition Universal Screening Tool) were randomised to receive readymade low volume (2.4 kcal/mL), liquid ONS plus dietary advice (ONS + DA) or dietary advice alone (DA). Intake was assessed at baseline (24 h recall) and 4-weekly for 12 weeks (3-day diet record). Total nutrient intake was benchmarked against UK and European dietary reference values (DRVs). The proportion of energy and nutrients from the ONS that added or displaced those from the diet (net addition/displacement) was calculated. Results: ONS + DA led to significantly greater total energy and nutritional intakes, with 25/29 nutrient intakes significantly higher than with DA alone. There were no significant differences in dietary energy and nutrient intakes from food between the groups. There was little or no displacement of nutrients from the diet, with over 90% of the energy and nutrients consumed in the ONS additive to the diet. ONS + DA more than halved the number of people with nutrient intakes that failed to meet DRVs and the number of nutrients per person that did not meet DRVs compared to DA alone. Conclusions: Supplementation with readymade, low volume (2.4 kcal/mL) liquid ONS overcomes most nutrient intake inadequacies in malnourished older people in primary care without significantly reducing intake from the diet. This makes ONS an effective way to improve nutritional intakes above dietary advice alone to improve the outcomes for the management of older people at risk of malnutrition. Full article

Background/Objectives: There is a need for randomized clinical trials with higher quality, especially for older people at high risk of falls, with interventions that consider individual needs, comprehensiveness of care, and connection with primary health care. We designed a randomized controlled trial to examine the effects of a case management intervention combined with a physical exercise protocol on risk factors for falls, falls data, adherence, satisfaction, costs, and implementation in community-dwelling older adults with high risk of falls. Methods: A minimum of 60 community-dwelling older people with high falls risk will participate in the randomized controlled assessor-blinded trial (MAGIC—v. 2). The trial will be conducted in a regional health department of São Paulo state (Brazil), which includes 6 cities. Participants will be randomized to the Intervention Group (case management intervention based on all individual risk factors for falls identified by a multidimensional assessment, over 16 weeks, once a week, by telephone calls). Both groups will perform a physical exercise protocol based on falls prevention for 16 weeks (twice a week) in Health Units. The assessment will be performed at baseline, after 16 weeks of intervention, after 6-month follow-up, and after 12-month follow-up. Primary outcome measures include falls data and potentially modifiable risk factors for falls. Discussion: This study has the potential to facilitate the future implementation of the intervention based on case management with a focus on fall prevention in the health sectors. Trial registration: Brazilian Registry of Clinical Trials (ReBEC). Full article

Older people’s social participation is being shaped by the current context of “liquid modernity,” characterized by the erosion of traditional roles and identity, fragile social ties, individualism, economic precariousness, and uncertainty. The challenges entailed by these trends can be exacerbated when a circumstance, such as being the parent of an adult with a physical disability, is combined with old age. This study aimed to explore how this dual condition influences processes of aging and community participation. This work presents the findings of a phenomenological study conducted in 2025 through semi-structured interviews with a sample of 24 elderly people with children diagnosed with spina bifida. The results show that the children’s support needs, especially when they live with their parents, but also if they have become independent, impact the parents’ aging and social participation processes. Likewise, concern for the future is identified as a recurring aspect due to the children’s lack of support from a social network. It was concluded that public administrations and non-profit organizations should develop social intervention strategies aimed at promoting social participation, guaranteeing external assistance in the home, and providing coexistence resources. Full article

The aging of China’s population has created significant challenges for the mental health of older adults. However, limited research has examined how public sports facility availability in living communities supports older adults’ mental health. To explore this association, data were extracted from the 2016 China Longitudinal Aging Social Survey, which involved 7811 respondents. The ordinary least squares model and the instrumental variable approach were employed to test the association between public sports facility availability in Chinese older adults’ living communities and their mental health. The bootstrapping method was used to estimate the mediating effect of physical activity and life satisfaction. The results indicate that public sports facility availability in living communities was significantly correlated with a decrease in depressive symptoms among older people (coefficient = −0.225; p < 0.01), which suggests that a greater availability of public sports facilities in living communities is related to the better mental health of older adults. The results of the mediation analysis show that physical activity and life satisfaction were identified as mediating mechanisms. This study suggests that increasing the availability of public sports facilities in older adults’ living communities can alleviate depression and promote better mental health. Our findings provide valuable policy implications for enhancing public sports infrastructure and promoting healthy aging. Full article

The increasing frequency and severity of bushfires in Australia, combined with an ageing population in bushfire-prone regions, creates an urgent need for targeted resilience guidance for older Australians. The outcome of this research is a developed and validated user-friendly toolkit for bushfire retrofitting, tailored to the specific needs of this vulnerable older demographic. A qualitative multi-method approach was employed, incorporating a systematic literature review (SLR) and participatory design method. Two bushfire-prone regions, Bega Valley and Noosa Shire, were used as the case study contexts for this research. Data collection in these two regions involved focus groups with participants over the age of sixty and on-site fieldwork assessments of bushfire-prone properties. Several types of data including interview transcripts, physical artefacts, documents, and archival records were collected. The data was then analysed using thematic and content analysis to identify key areas of focus for the toolkit. Findings revealed that existing bushfire retrofit resources inadequately address the implementation capabilities of older people. The adapted toolkit design therefore presents a novel approach that addresses the current gaps in the literature by providing a scalable approach to retrofitting that is tailored to varied retrofitting capabilities. By effectively integrating technical building compliance standards with age-specific design considerations, the toolkit promotes the effective implementation and adoption of retrofit measures by older people, ultimately improving individual and community resilience against bushfires. Full article

Background: After an older person moves into a nursing home, the next of kin often continues to participate in the care provided there. This participation in care may contribute valuable knowledge of the preferences and wishes of the older person, thereby helping nursing staff deliver personalised care. Objectives: The aim of this study was to explore how next of kin experience their participation in the care of older persons residing in nursing homes after educating nursing staff about participation in palliative care. Methods: This follow-up study used a qualitative design based on semi-structured interviews with 37 next of kin. A thematic analysis was applied. Results: Participation of the next of kin involved active communication and collaboration with nursing staff, expressed in three themes: striving to achieve co-created care, navigating involvement through presence, and building commitment through communication and information. The dual role of being an emotionally close next of kin and a participant in the relative’s care was challenging and became increasingly burdensome and often overwhelming when the older person’s health deteriorated. Conclusions: This study reveals the need to develop and implement a policy for the participation of next of kin in the care of older people living in nursing homes. In addition, support groups can increase well-being through dialogue with other next of kin, thereby alleviating emotional strain. Increased implementation of life stories and the use of digital communication would keep the next of kin informed about the older person’s condition, especially when they cannot be present in person. Life story is a valuable tool for person-centred care and strengthens the relationships between the next of kin, the older person, and the nursing staff. Full article

Background/Objectives: End-of-life (EOL) HIV cure research, which studies HIV persistence through pre- and post-mortem tissue collection, has focused primarily on people living with HIV (PLWH) with a prognosis of six months or less. However, the perspectives of long-term survivors (LTS) diagnosed before the advent of effective antiretroviral treatment (ART) remain underexplored. Understanding their motivations and concerns about EOL cure research is essential for creating inclusive and ethical research frameworks. Methods: Between 2023 and 2024, we conducted in-depth qualitative interviews with 16 PLWH aged 60 and older from diverse backgrounds across the United States, recruited through community-based organizations and HIV networks. We used inductive thematic analysis to explore LTS’ perspectives on EOL HIV research. Results: Participants included cisgender men (56.25%) and women (43.75%) with diverse racial identities. While participants supported EOL HIV cure research, their willingness to participate varied, influenced by awareness, logistics, and ethical concerns. Altruism-motivated participation, but misconceptions about procedures and concerns over bodily integrity represented potential barriers. Some viewed blood draws and leukaphereses as routine, while others expressed hesitancy with biopsies and post-mortem tissue retrieval. HIV stigma, historical mistrust, and cultural beliefs also played a role in willingness to participate. LTS emphasized the need for decentralized research sites, travel support, and financial safeguards. Conclusions: To include LTS in EOL HIV cure research, a community-driven approach is needed, focusing on clear communication, ethical considerations, logistical support, and linkages to EOL care. Addressing misconceptions and building trust, particularly within groups traditionally underrepresented in research, is essential to expanding participation. Full article

Background and Objectives: Sarcopenia and lower urinary tract symptoms (LUTSs) are both prevalent among older adults and may share underlying pathophysiological mechanisms. However, their association has not been systematically quantified. This systematic review and meta-analysis aimed to evaluate the association between sarcopenia and LUTSs, including the pooled estimates of prevalence and odds ratios (ORs), and to explore the influence of diagnostic definitions and study-level factors. Materials and Methods: A comprehensive literature search was conducted using PubMed and Embase for studies published between 1 January 2000 and 26 April 2025. This study adhered to PRISMA and MOOSE guidelines and was registered in PROSPERO (CRD420251037459). Eligible observational studies reported LUTS prevalence or ORs in individuals with sarcopenia, low muscle strength (LMS), low lean mass (LLM), low gait speed (LGS), or sarcopenia risk identified by SARC-F (score ≥4). Pooled ORs and prevalence rates were calculated using a random-effects model. Subgroup analyses were performed based on sarcopenia definitions—Asian Working Group for Sarcopenia (AWGS) and European Working Group on Sarcopenia in Older People (EWGSOP)—as well as LUTS subtypes and diagnostic components. Univariate meta-regression assessed associations with age, BMI, sex distribution, WHO region, and risk of bias. Results: Twenty-five studies comprising 84,484 participants were included. Sarcopenia was significantly associated with LUTSs (pooled OR = 1.78; 95% CI: 1.29–2.45; p < 0.001), with a pooled LUTS prevalence of 43.2% (95% CI: 26.9–61.0%). Stronger associations were observed in studies using AWGS diagnostic criteria (OR = 2.24; 95% CI: 1.41–3.56; p = 0.001), in those evaluating severe sarcopenia (OR = 1.66; 95% CI: 1.03–2.68; p = 0.038), and in institutionalized populations (OR = 3.68; 95% CI: 2.18–6.24; p < 0.001) compared to community-dwelling populations (OR = 1.43; 95% CI: 1.06–1.92; p = 0.018). Sarcopenia risk identified by SARC-F (score ≥4) showed the strongest association with LUTSs (OR = 3.20; 95% CI: 1.92–5.33; p < 0.001). Significant associations were also found for LLM (OR = 1.52; 95% CI: 1.19–1.95; p = 0.001) and LGS (OR = 1.37; 95% CI: 1.06–1.76; p = 0.015), but not for LMS (OR = 0.94; 95% CI: 0.47–1.89; p = 0.871). Exploratory analyses comparing LLM diagnostic modalities—including standardized criteria (ASMI, ASM/BMI), imaging-based methods (SMI, PMA), and surrogate measures (calf circumference)—revealed no significant differences (all p > 0.05). Heterogeneity was high (I² > 90%). Egger’s test indicated no evidence of publication bias (p = 0.838), and trim-and-fill analysis did not affect the pooled estimates. Conclusions: Sarcopenia—particularly in its severe forms—is significantly associated with LUTSs. Additionally, individuals who screened positive for sarcopenia using the SARC-F tool demonstrated a heightened risk of LUTSs. Subgroup analyses revealed a stronger association in institutionalized populations, suggesting that care setting may modify risk. These findings underscore the importance of assessing muscle health in older adults with urinary symptoms. Standardization of diagnostic criteria and longitudinal studies are needed to clarify causality and guide targeted interventions. Full article

Ageing is a global demographic trend that has increased the total prevalence of multimorbidity, disability and frailty, posing ever greater challenges for public health systems. For older people, ageing is often associated with a loss of quality of life, independence and well-being. This study analyses the role of urban gardens as spaces that promote active ageing and contribute to the physical, psychological and social well-being of older adults. Focusing on the urban areaof Valencia, this research adopts a qualitative approach based on in-depth semi-structured interviews with 15 older adults who regularly participate in urban gardens. The findings indicate that urban gardens contribute significantly to active ageing by providing opportunities for regular physical activity, emotional well-being, social engagement, and improved nutrition through the cultivation of food by the participants themselves. These spaces also enhance autonomy, stimulate cognitive functions, elevate mood, and offer a renewed sense of purpose following retirement. Moreover, urban gardens serve as inclusive environments that promote intergenerational interaction and reinforce community bonds. As multifunctional spaces, they hold considerable potential for enhancing the quality of life among older adults and addressing key public health challenges associated with population ageing. Consequently, their integration into urban planning frameworks should be prioritised. Full article