Archives of Gerontology and Geriatrics Plus最新文献

The leading cause of visual impairment (VI) worldwide is uncorrected refractive errors (URE). The prevalence of VI increases with age, but older adults often do not seek optometric care because they assume that, in old age, it is normal to "not see well". Between 2017–2023, several service-learning projects were developed in the city of Santiago de Compostela in which a visual care service was offered to users of gerontological centres and focused on the detection of avoidable vision loss. This study analyses the results of this service. Methodology: visual care was carried out in the collaborating centres themselves. The optometric protocol applied included: measurement of visual acuity (VA) with habitual correction and with pinhole, Hirschberg test, assessment of ocular motility, examination of pupillary size and response and biomicroscopy. Binocular VI was defined as binocular VA with standard correction < 0.5 (decimal scale). Results: a total of 242 students and 4 entities participated in the service-learning projects. 215 subjects (mean age = 80.3 ± 10 years, females = 63.7 %) completed all visual screening tests. 8.4 % had binocular VI and 41.4 % binocular VA < 0.5 in near vision. The frequency of URE reached 40.3 %. 22.2 % of the subjects with binocular VI live with URE in at least one eye. More than 40 % of the examined users have eye hygiene problems. Conclusion: the visual care service provided shows the need for visual care in a group where a significant percentage of cases of visual deficit can be solved with a simple optical correction.

Purpose

Methods

Results

Conclusion

Background

Anxiety in mid-life and later-life is highly prevalent and causes significant distress and disability. There is increasing evidence supporting the potential effectiveness of exercise interventions for reducing clinically significant anxiety. Self-directed online interventions can be scalable and thus reach more people.

Aims

The Exercise Therapy to Reduce Anxiety (ExTRA) project aims to assess the feasibility and acceptability of an 8-week web-based exercise intervention with the innovation of being self-directed, and facilitated by wearable activity monitors (WAMs) and tailored behaviour change strategies to reduce anxiety in mid-life and later-life adults with clinically significant anxiety.

Methods

ExTRA will recruit 20-30 community dwelling adults aged 40-79 years with clinically significant anxiety. The self-directed 8-week web-based exercise intervention includes information and strategies to support participants to meet Australian national physical activity guidelines. The intervention is adapted from previous face-to-face trials and includes strategies to support participants living with anxiety. Feasibility will be measured by screening and retention rates. Acceptability will be measured by website usage data, online outcome measure completion, and an evaluation questionnaire. Other outcome measures include anxiety measured by the Depression Anxiety Stress Scales, and physical activity measured by the Global Physical Activity Questionnaire and a WAM.

Results

Findings will demonstrate whether this intervention is feasible and acceptable, and provide preliminary efficacy data.

Conclusions

The findings of this pragmatic real-world study will be valuable in guiding development of future trials, including randomised controlled trials of scalable and accessible exercise interventions to reduce the distress, disability and cost of anxiety.

Purpose

Frailty and falls are two major health challenges in older adults, but little is known about their levels and interactions in community-dwelling older adults in sub-Saharan Africa. The purpose of this scoping review was to map the literature on frailty and falls with respect to their definitions, measurement methods, associated factors, and interactions in this setting.

Methods

A systematic search of eight databases and four other relevant sources was performed with no language restriction using combinations of the keywords ‘frailty’, ‘older adults’, ‘falls’ and ‘Africa’ and their synonyms.

Results

Thirty-six studies from nine countries in the sub-region met the inclusion criteria. The average age for participant inclusion in the studies was 50 years. The Frailty Phenotype and the Frailty Index were the primary assessment methods used, yielding frailty prevalence rates ranging from 5.4 % to 17.4 % and 20.6 % to 60.0 %, respectively. Fall prevalence ranged from 20.8 % to 55.1 %, while recurrent falls were reported in 11.0 % to 24.6 % of cases. Comorbidities/multimorbidity and increasing age were the most reported clinical and socio-demographic factors associated with frailty. Low functional status and being female were the primary factors associated with falls.

Conclusions and recommendations

In sub-Saharan Africa, there appears to be a high prevalence of frailty and falls in a relatively young cohort of older adults. Future studies should focus on developing frailty definitions and assessment methods that are culturally appropriate in this setting.

Background

Visual impairment(VI) is a multifaceted condition that significantly impacts mental health, notably depression. With the population ageing, the incidence of VI is expected to rise, consequently increasing depression rates. This study aims to provide a comprehensive analysis of the pathways linking VI and depression among older adults in India.

Data & methods

This study uses data from the Longitudinal Ageing Survey of India (LASI Wave-1) with a sample of individuals aged 45 years and above (n=56,353). Binary logistic regression along with causal mediation analysis was conducted to assess the roles of mediating factors and other socio-demographic factors contributing to depression among older adults in India.

Results

An association between VI and an increased likelihood of depression was observed after accounting for functional, behavioural, psychosocial mediators and other covariates (OR:1.10, 95% CI: 1.01–1.19). The overall effect of visual impairment on depression, including both direct and indirect effects shows that visual impairment has a significant total effect on depression, with a coefficient of 1.11 (95 % CI: 1.01–1.10). The natural direct effect is significant, with an OR of 1.05 (95% CI: 1.01–1.10) for functional mediators, while the natural indirect effect through functional mediators suggests that a portion of the relationship between VI and depression is mediated through functional pathways.

Conclusion

Findings highlight the importance of addressing not only the direct impact of VI on individuals' well-being but also the various indirect effects mediated through functional limitations, behavioural, and psychosocial factors. This necessitates the interventions aimed at enhancing daily functional capacity and health perception among the visually impaired elderly. Findings suggest the need for fostering strong social ties and ensuring a supportive environment for older adults experiencing visual impairments.

The microorganisms residing the oral cavity, referred to as the oral microbiome, have been reported to have an association with health and disease in older adults. In the present review the state-of-the-art methodology was applied to investigate the association of the oral microbiome to systemic diseases, frailty and ageing. The methodology includes a six-step strategy, whereas inclusion criteria were articles in English, publication period between 2015 and December 2023, clinical studies, case series, in-vitro studies, and animal studies. Results indicated that the oral microbiome's composition is crucial for older adults with systemic diseases such as diabetes, Alzheimer's, or cardiovascular disorders. Moreover, there appears to be an association between the oral microbiome and frailty in older patients. The relationship between oral microbiome and ageing is bidirectional, since older adults experience a shift in the composition of the microbiome, whereas those bacteria promote inflammation remotely and rapid ageing of the individual. Further studies investigating the exact kind of phyla and genera of oral microorganisms are essential to better understand the interaction of the oral microflora with the human body in older individuals.

Background

Several previous studies have demonstrated that brain-derived neurotrophic factor (BDNF) and oxytocin are associated with dementia, depression, and mental health. The aim of this study was to measure the serum BDNF and oxytocin levels of community-dwelling older adults and evaluate the relationship between the two biomarkers in the study cohort.

Methods

This survey was conducted between November 2016 and September 2017 in Kurokawa-cho, Imari, Saga Prefecture, Japan, and the participants were community-dwelling older adults aged ≥ 65 years old. Their blood samples were collected for the measurement of their serum BDNF and oxytocin levels using enzyme-linked immunosorbent assays. The relationship between serum BDNF and oxytocin levels was analyzed using correlation and multiple regression analyses.

Results

A total of 95 participants (25 men and 70 women; mean age: 78.24 ± 3.85 years and 77.96 ± 5.52 years, respectively) were analyzed. The results of the analyses indicated that serum BDNF level was positively associated with serum oxytocin level, even after adjusting for age, sex, and years of education.

Conclusion

The results of this study suggest that BDNF and oxytocin may interact in older adults and may be associated with maintaining good mental health among them.

The article reviews recent research on new technologies for assisting the elderly based on Artificial Intelligence: Utilities for smart houses and Ambient Assisted Living, wearable and monitoring devices, virtual and augmented reality, and assistive robotics.

These smart technological tools can reduce the isolation of older adults by assisting them in their daily activities, but without completely replacing direct interventions, and requiring human support to facilitate interaction.

In determining the effectiveness of assistive technologies, older people's perceptions of them, acceptability, and willingness to use them are key variables. Also relevant is the perception by caregivers and healthcare professionals, and the socio-cultural dimension of acceptability.

Finally, the paper presents the ethical issues related to the use of technologies with the elderly population, to ensure the autonomy, safety, and dignity of the person. Some suggestions are offered for developers of new technologies for older adults.

In conclusion, the challenges for the future of assistive technologies are highlighted, so that they can best be used to assist large and differentiated elderly populations.