Adoption Quarterly

Physical exercise interventions to prevent falls for older adults at risk of falling are widespread in many countries; however, there is insufficient knowledge of the impact of long-term exercise on the fall discriminating ability of existing fall-prediction indicators. This study measured physical and cognitive indicators of the fall risk, including the timed up and go (TUG), walking speed (WS), and plantar tactile threshold (PTT), in 124 community-dwelling older adults with care needs who were continuing an exercise program. Logistic regression analyses were used to determine factors associated with falls in the 87 participants who could adhere to the exercise continuously for 12 months. The PTT was significantly higher in fallers, while the TUG and WS did not differ significantly between fallers and non-fallers. The only index significantly associated with falls was the PTT ( OR = 1.20). The fall identification ability was better for PTT (AUC = 0.63), whereas TUG (AUC = 0.57) and WS (AUC = 0.52) were lower than previously reported scores. In conclusion, long-term exercise was found to improve scores on the fallprediction indicators by physical performance, but to decrease their ability to identify future falls. PTT may complement the ability to identify falls in such elderly populations.

COVID-19 has affected the daily activities of people worldwide. Recommendations introduced to reduce the spread of the virus led to increased use of Information and Communication Technologies (ICT) to meet everyday needs. Such rapid digitalization had not been seen previously and not been possible to study before. Hence, this study aimed to identify and describe self-reported changes in usage of and attitudes toward ICT among three generations in Sweden during the early phase of the COVID-19 pandemic. Additionally, it aimed to identify whether and how belonging to a specific generation was related to these changes. A national cross-sectional survey was conducted in June 2020 with a final sample of N = 3,000, stratified into three generations (30–39, 50–59, and 70–79-year-old persons). A majority reported using digital technology more often than before the pandemic. Compared to the youngest generation, the oldest and middle-aged generations reported that they used digital technology more often than before the pandemic. Our results show which technologies were considered essential for different generations during the early phase of the pandemic. This information can be used to guide policy makers based on knowledge concerning the needs and demands for digital technologies in everyday life among people of different ages.

This qualitative study aimed to gain insight into the impact of COVID-19 on Home Care Workers (HCWs). During COVID-19 HCWs provided a lifeline for home care clients to support older people remaining living in their own homes. With a high-risk client base, HCWs were one of the few (Health and Social Care Professional) HSCPs to continue providing home-based care throughout COVID-19. Despite these contributions HCWs provided for aging in place during COVID-19, a paucity of research exists in relation to the challenges and impact of the pandemic on HCWs. Three in-person focus groups were conducted ( n = 23). Two main themes were produced guided by a Reflexive Thematic Analysis approach to enable the researchers to best represent the participants experiences: Challenges and concerns to the personal and private lives of HCWs and Navigating home-based complexities of HCWs workplace during COVID-19. health care challenges to minimize impact to HCWs issues to create a safe workplace for HCWs.

Purpose: Patients and surgeons may be reluctant on spinal surgery over 80 years old, fearing medical complications despite the possible improvement on quality of life. However, fewer reservations for lower limb prosthetic surgery (LLPS) seem to be arisen in this population. Is spinal surgery after 80 years-old responsible of more complications than lower limb surgery? Methods: The consecutive files of 164 patients over 80 years that had spinal surgery or LLPS were analyzed. The data collected pre-operatively were demographic, clinical and post-operatively the number and types of medical complications and length of stay. Results: The mean number of medical complications was 1.11 ± 0.6 [0–6] for spinal surgery and 1.09 ± 1.0 [0–3] for LLPS, ( p = 0,87). The length of stay in orthopedic unit was comparable between the two groups: 10.7 ± 4.9 days [2–36] for SS and 10.7 ± 3.0 days [5–11] for LLPS ( p = 0,96). Conclusion: The global rate of peri-operative complications and the length of hospital stay were similar between spinal surgery and lower limb prosthetic surgery. These results may be explained by the rising cooperation between geriatric specialist and surgeons and the development of mini-invasive surgical technics, diminishing the early post-operative complication rates.

This study examined the feasibility of using tailored text messages to promote adherence to longitudinal protocols and determined what facets of text message tone influence motivation. Forty-three older adults ( Mage = 73.21, SD = 5.37) were recruited to engage in video-game-based cognitive training for 10 consecutive days. Participants received encouraging text messages each morning that matched their highest or lowest ranking reasons for participating in the study, after which they rated how effective each message was in motivating them to play the games that day. After 10 days, participants rated all possible messages and participated in semi-structured interviews to elicit their preferences for these messages. Results showed that messages matching participants’ reasons for participating were more motivating than mismatched messages. Further, participants preferred messages that were personalized (i.e., use second person voice) and in formal tones. Messages consistent with these preferences were also rated as more motivating. These findings establish the feasibility of using message tailoring to promote adherence to longitudinal protocols and the relevance of tailoring messages to be personal and formal.

Malnutrition is a significant issue among elderly individuals in 24-hour care facilities, leading to increased morbidity. The aim of the study was to compare the nutritional status before and after nutritional intervention based on selected indicators of nutritional status among residents of a 24-hour care institution. The study included a group of 104 people aged 65 to 97 years. Nutritional status was assessed before and after the nutritional intervention based on indicators: levels of prealbumin, albumin, transferrin, total lymphocyte count, BMI, and MNA scale. The nutritional intervention consisted of administering oral nutritional supplements (ONS) to patients, regardless of nutritional status. The method of retrospective analysis of patients' medical records was used. Statistical analysis was performed using IBM SPSS Statistics 24 for Windows. Improvements in nutritional status occurred among patients with malnutrition based on MNA and prealbumin indices, and in groups of patients with moderate or mild malnutrition as determined by transferrin, prealbumin and albumin. The mean levels of nutritional indices significantly increased: MNA ( p = .001), BMI ( p = .001), prealbumin ( p = .001), and albumin ( p < .001). The use of ONS resulted in better nutritional status parameters based on MNA, albumin and prealbumin. These indices may be predictors of reducing the risk of various disorders among the elderly.

Purpose: Assisted Living (AL) residents are embedded in “care convoys” comprised of a dynamic network of formal and informal care partners. Using the convoys of care model—a multi-level framework connecting care convoy properties to resident outcomes—we examined healthcare management and communication between convoy members. We recommend strategies to engage primary care in supporting collaboration, communication, and consensus-building for older adults and their convoys. Methods: Data were collected from the longitudinal study, Convoys of Care: Developing Collaborative Care Partnerships in AL. Fifty residents and their care convoy members ( N = 169) were followed in eight AL homes in Georgia over 2 years. Original data were analyzed using Grounded Theory Methods of qualitative data, including formal and informal interviewing, participant observation, and record review. Results: The convoys of care model provide an innovative perspective that will assist providers in supporting AL residents and their care partners to achieve better care outcomes. Findings demonstrate the utility of understanding the structure and function of social resources and implications for improving healthcare outcomes. Conclusion: This research informs the work of physicians and mid-level providers with patients in AL by providing strategies to uncover specific social determinants of health. Recommendations for use in patient encounters are enumerated.

This qualitative study explores the experiences of elderly beggars who transitioned from a life of homelessness to a hopeful life through rehabilitation programs. The aim is to gain insights into their lived experiences, challenges faced during their homeless phase, and the transformative effects of rehabilitation interventions. The study employs Case study approach applying thematic analysis to capture the narratives of elderly individuals who have undergone rehabilitation. The data was collected directly from the elderly using purposive sampling method. The in-depth interview guide was used to collect data from 30 elderly people in Atchayam Beggars Rehabilitation centre at Erode. From the findings, it was clear that homeless phase is characterized by extreme poverty, social exclusion, health issues, and a lack of basic necessities. The elderly beggars face numerous challenges, including stigma, discrimination, and a sense of hopelessness. The study documents the transformative journey of the elderly beggars, highlighting the positive changes they experience after rehabilitation. These changes include improved physical and mental well-being, restored self-esteem, regained social connections, and the acquisition of new skills. The elderly experience a renewed sense of hope, dignity, and empowerment as they move from vulnerability to independence and self-sufficiency. The study also highlights the significance of destigmatization efforts and community involvement in fostering the successful reintegration of elderly beggars into society. The study also contributes to the existing literature by shedding light on the possibilities for positive change and the journey from homeless life to a hopeful life among this vulnerable population.

Food insecurity impacts the lives of 7.6 million U.S. adults aged 60 and older and is linked to numerous life challenges. This study examined the nature of food insecurity among community-based participants ≥65 years in a north Florida county and conceptualized food insecurity as encompassing the lack of food and individual adaptability. Thus, food insecurity was measured using three dependent variables: (1) worrying that food would run out, (2) cutting meal size or skipping meals, and (3) food not lasting. Logistic regression revealed that older participants, those with better-perceived health status, and those who were confident that they could find solutions to their problems had lower odds of reporting food insecurity. However, respondents who lived in low-income, low-access zip codes and those who received food assistance were more likely to report food insecurity. To improve outcomes and reduce healthcare disparities, solutions to food insecurity must vary in focus and approach.

This study investigated the behavioral intention of Filipino older adults toward using telemedicine and the pivotal role of initial trust in influencing this intention. A cross-sectional method was employed, involving a questionnaire administered to 180 participants using convenience sampling. The structural model test results indicate that subjective norm, attitude, and notably, initial trust positively impact the behavioral intention to use telemedicine, whereas perceived behavioral control does not significantly affect intention. This underscores the significance of subjective norm and attitude in shaping behavioral intention, consistent with the Theory of Planned Behavior (TPB), while the extended construct of initial trust played a crucial role in influencing the attitude and intention of older adults, highlighting its importance in technology adoption. The study aligns with the trend of increased telemedicine adoption during the COVID-19 pandemic, emphasizing the need for trust in sensitive healthcare contexts. Establishing initial trust is vital for successful telemedicine implementation among Filipino older adults, enhancing healthcare accessibility and well-being.

As global population ages, “Aging in Place” is prioritized as the top aging strategy for many of the older adults worldwide. India, being a nation that is expected to hold the maximum share of the older adult population in the near future, has a huge responsibility vested in it to take care of the needs of older adults. The social structure of the nation has emphasized the importance of older adults to age in place, experiencing all the independence and autonomy at their own dwelling places for as long as possible. This study aims to provide a profound understanding of the meaning, attitude, and perceptions of older adults toward aging in place. Using a qualitative research design, in-depth interviews were conducted among 15 community-dwelling older adults who chose aging in place in Kerala, India. Following the interviews, thematic network analysis was done, inspired by Jennifer Attride-Stirling. Three global themes were derived, which include the older adults’ perspectives on (1) determinants of aging in place, (2) challenges of aging in place, and (3) strategies for successful aging in place. The study evokes in-depth exploration of the experiences of older adults aging in place, which inform future evidence-based practices and policy-level implications.

Mild Cognitive Impairment (MCI) affects 15% of adults 50 years old and over. Individuals living with MCI have shown decreased social participation, a critical activity as it may delay cognitive decline. Depression may be a key factor in limiting participation. This study is a secondary data analysis of 30 older adults living with MCI, looking for associations with participation. Participation was examined using the Patient Reported Outcomes Measurement Information System (PROMIS®) Satisfaction with Participation in Social Roles Computer Adaptive Test (CAT) form. Depressive symptoms were reported using the PROMIS Quality of Life in Neurological Disorders Depression CAT form and the Patient Health Questionnaire (PhQ-9) form. Results showed that demographics (age, sex) were not significantly associated with participation, but depressive symptoms were significantly associated. This suggests that adults living with MCI who have higher levels of depressive symptoms may be a uniquely vulnerable population who benefit from interventions that support participation.

The study objective was to assess the feasibility of the Patient Benefit Assessment Scale (P-BAS), a digital tool designed to enable older outpatients (≥70 years) to elucidate at home their individual goals regarding their current medical issue. Several digital tools are developed to assist older people in identifying their goals, thereby facilitating the process of shared decision making. However, studies on the feasibility of these digital tools, especially in older patients, are limited. Data were collected from 36 older patients. The study comprised three stages. In stage I and II, cognitive interviews were conducted to strengthen the feasibility of the P-BAS. In stage III, 80% of the patients completed the P-BAS independently at home. The cognitive interviews provided insight into patients’ interpretation and individual understanding of the digital visual P-BAS and associated opportunities for improvement, which were subsequently implemented. One conclusion is that the digital visual P-BAS might be of added value for patients and contributes to the process of shared decision making, assuring that the goals of the patient will be into account in treatment options. Findings are useful for researchers interested in technological tools that contribute to shared decision making.

In this study, based on the 2022 National Health and Aging Trend Study ( N = 5,593, age 65+), we examined direct associations between moderate and vigorous physical exercise (PE) and depressive/anxiety symptoms as well as bothersome pain and sleep problems. We then examined if the association between PE and depressive/anxiety symptoms would be partially mediated by the effects of PE on bothersome pain and sleep problems. Results from a path model showed that controlling for sociodemographic and health statuses, PE was negatively associated with depressive/anxiety symptoms and bothersome pain, but it was not significantly associated with sleep problems. The mediation analysis showed that 10% of the total effects of PE on depressive/anxiety symptoms was indirect effects of PE on bothersome pain. This study is important as it examined the associations among PE, pain, sleep, and depression/anxiety in community-dwelling older adults in their natural environments. Healthcare and social service providers for older adults need to emphasize the importance and benefits of PE for older adults’ physical and mental health. Easy access to venues for PE is also important.

Background: This mixed methods systemic review synthesizes the evidence about nursing home risks for COVID-19 infections. Methods: Four electronic databases (PubMed, Web of Science, Scopus, and Sage Journals Online) were searched between January 2020 and October 2022. Inclusion criteria were studies reported on nursing home COVID-19 infection risks by geography, demography, type of nursing home, staffing and resident’s health, and COVID-19 vaccination status. The Mixed Methods Appraisal Tool (MMAT) was used to assess the levels of evidence for quality, and a narrative synthesis for reporting the findings by theme. Results: Of 579 initial articles, 48 were included in the review. Findings suggest that highly populated counties and urban locations had a higher likelihood of COVID-19 infections. Larger nursing homes with a low percentage of fully vaccinated residents also had increased risks for COVID-19 infections than smaller nursing homes. Residents with advanced age, of racial minority, and those with chronic illnesses were at higher risk for COVID-19 infections. Discussion and implications: Findings suggest that along with known risk factors for COVID-19 infections, geographic and resident demographics are also important preventive care considerations. Access to COVID-19 vaccinations for vulnerable residents should be a priority.