European Journal of Ageing最新文献

Cognitive decline is influenced by factors such as inflammation, reduced physical activity, chronic pain, and depression. Osteoarthritis (OA), the most prevalent form of arthritis, may contribute to cognitive impairment through these mechanisms. The objectives of this study are: (1) To assess cognitive trajectories in older adults (≥ 65 years) over a 7-year period; (2) to explore the relationship between OA and cognitive decline; and (3) to investigate the potential mediating effect of depressive symptoms. Using the longitudinal dataset of Progetto Veneto Anziani (Pro.V.A), data on inflammation, and cognitive status (Mini-Mental State Examination-MMSE, Geriatric Depression Scale-GDS) were collected. OA was diagnosed based on clinical evaluations and medical records. Active follow-ups were carried out after 4.4 and 7 years from baseline. Group-based trajectory modeling identified cognitive trajectories, and multivariable logistic regression assessed factors associated with these trajectories. Structural equation modeling explored whether depressive symptoms mediated the OA-cognitive trajectories relationship. The sample included 2945 older adults (63.3% having OA). Participants with OA were older, more likely to be female, and had higher GDS and lower MMSE scores at baseline. Over 7 years, three cognitive trajectories were identified: severe cognitive decline (n = 261, 8.9%), moderate decline (n = 865, 29.3%), and stability (n = 1819, 61.8%). OA was more prevalent in participants with greater cognitive decline. Logistic regression showed that OA was significantly associated with moderate cognitive decline trajectory (OR = 1.31, 95% CI: 1.03-1.71, p = 0.039). OA influenced cognitive decline both directly and indirectly through depression, with depression mediating 30% of the total effect. OA seem to be associated with cognitive decline trajectory directly and indirectly through depression, highlighting the need to address mental health in OA management. KEY POINTS: Osteoarthritis is linked to moderate cognitive decline in older adults, with depression acting as a partial mediator.About 30% of OA's total effect on cognition is explained by depressive symptoms.Early intervention targeting both physical and psychological health may help prevent cognitive deterioration in this population.

Ageism remains a pervasive societal issue that significantly affects individuals with dementia, influencing cognitive performance, healthcare access, and social inclusion. This systematic review synthesizes existing research on the implications of ageism for people with dementia, focusing on its impact on cognitive function, stigma, and healthcare disparities. A comprehensive literature search was conducted across multiple databases, including PubMed, Cochrane, Web of Science, and Scopus, adhering to PRISMA guidelines. After screening 515 articles, 13 studies met the inclusion criteria and were analyzed for key findings on ageism's effects. Findings indicate that age-related stereotypes negatively impact cognitive assessments, often leading to misdiagnosis and unnecessary anxiety regarding cognitive decline. Studies show that exposure to negative aging stereotypes correlates with poorer cognitive performance, reinforcing stereotype threat. Additionally, ageism in healthcare settings results in differential treatment, with older adults facing delays in diagnosis and limited access to specialized care. Social stigma further compounds these challenges, contributing to social isolation and decreased well-being among individuals with dementia. Research highlights the role of intergenerational programs and public awareness campaigns in mitigating these effects, promoting inclusivity and reducing ageist attitudes. Addressing ageism requires a multifaceted approach, including policy changes, caregiver training, and societal initiatives to reshape perceptions of aging and dementia. Future research should explore long-term interventions that foster positive aging attitudes and equitable healthcare practices. This review underscores the necessity of dismantling ageist biases to enhance the quality of life and care for individuals with dementia, advocating for a more inclusive and respectful societal framework.

Retirement is a major life event that can significantly impact health and well-being in later life. In this study, we evaluated how effects of retirement on mental, physical, and cognitive health vary depending on retirement age, pre-retirement job satisfaction, and degree of voluntariness in the transition. Using nine annual measurement waves from the longitudinal population-based HEalth, Aging, and Retirement Transitions in Sweden (HEARTS) study (N = 5,913, age 60-74), we applied linear-mixed effects models to assess changes in life satisfaction, quality of life, depressive symptoms, disease burden, reasoning ability, and memory over the retirement transition. Results showed average improvements across health domains post-retirement, with more pronounced benefits among those who retired early. High pre-retirement job satisfaction and involuntary retirement increased the risk of negative changes in mental health, particularly among those who retired later. The findings illustrate how health effects of retirement are driven by push (out of work) and pull (into retirement) factors. While extended working lives can benefit those who find meaning and value in work, delaying retirement for individuals who would benefit from leaving the workforce may increase the public health burden.

Most older adults in Europe want to age in their own homes. However, this is not feasible or desirable for everyone. Limited financial resources, lack of daily support or social contact, the sudden loss of a partner, or a desire for change may result in a wish or necessity to move. Community-based housing alternatives, such as co-housing, naturally occurring retirement communities (NORCs), sheltered housing, or villages, can provide viable options. These initiatives facilitate independent living, care and support, and a sense of community. Compared to institutionalised care homes, community-based housing offers autonomy, independent living, and the opportunity to shape one's home environment. However, despite variation in how residents participate in co-producing their living environments, the role of resident involvement in shaping community-based housing has been underexplored. To address this gap, this paper proposes a conceptual framework for understanding how older residents engage in co-producing community-based housing. Bringing together literature on housing co-production and community-based housing for older adults, the framework distinguishes between community-led and community-oriented co-production. Community-led co-production refers to practices that are controlled by older residents, while community-oriented co-production describes practices that include resident input, but led by other stakeholders. By developing and discussing this framework, the paper lays the groundwork for future empirical studies and offers guidance for policymakers, practitioners, and housing providers on considering the role of residents in shaping future housing models for older adults.

Background: Behaviour-related health risk factors are associated with an increased risk of early exit from the working life, but their contribution to working life expectancy (WLE) remains unclear. We investigated the associations of obesity, alcohol intake, smoking and low levels of physical activity with WLE among adults aged 50 years and older.

Methods: Individuals working at study baseline with 18 years of follow-up data from the English Longitudinal Study of Ageing (ELSA) (n = 3233) and the Finnish Public Sector study (FPS) were included (n = 65,255). Obesity, alcohol consumption, smoking and low physical activity were self-reported at study baseline. WLE from age 50 to 70 years was estimated using a multi-state modelling, separately for men and women across occupational position categories (low, intermediate and high), with adjustment for age.

Results: Our findings suggest that individuals who were obese, smoked, had low physical activity levels and reported heavy alcohol use (only in FPS) could expect to work fewer years than those who did not have these behaviour-related health risk factors. A higher number of risk factors was associated with shorter WLE across sex and occupational position categories in both studies. The difference in WLEs between those with no behaviour-related health risk factors and those with ≥ 2 risk factors was up to 1.5 years in ELSA and less than 1 year in FPS.

Conclusion: Having multiple behaviour-related health risk factors is linked to shorter WLE after age of 50 years, a difference that may have important economic implications in societies with ageing populations.

Evidence indicates an association between wellbeing (e.g., purpose in life) and cognition over time. However, wellbeing is a multifaceted construct, and most research has focused on purpose in life and positive affect, with less research on other aspects of wellbeing. The aim of this study was to test associations between life satisfaction (LS) and hope with cognitive function and decline. Data were used from Whitehall II, a longitudinal cohort study of people employed by the British Civil Service. Measures of LS and hope were available at Wave 7, and cognitive function (phonemic/semantic verbal fluency, memory and inductive reasoning) at Waves 7, 9, 11, and 12. Linear mixed models were fitted to test associations between LS and hope with cognitive function and decline over 13 years. LS was positively associated with baseline cognitive function (overall cognition, verbal fluency, memory, and inductive reasoning) cross-sectionally but not with decline over time. Hope was positively associated with baseline overall cognition, phonemic fluency and inductive reasoning (but not semantic fluency or memory). Hope was associated with slower decline in inductive reasoning over 13 years. Findings contribute to better understanding of the temporal relationship between wellbeing and cognitive function from middle to older age. People with higher hope show lower baseline cognition and slower decline in inductive reasoning. People with lower LS show lower initial cognitive function and this difference is maintained over time. Although decline is not steeper for those with lower LS, they may reach the threshold for dementia earlier than those with higher LS.

The scientific study of psychological aging is very challenging due to the complex, multidimensional, multi-directional, and highly variable nature of change processes observed in adulthood and old age. Psychological aging encompasses phenomena that require interdisciplinary efforts to be understood. Recent advancements in technology (e.g., wearable devices, apps offering digital metrics, multimodal data collection, artificial intelligence, and big data algorithms) reconfigure the epistemology of behavioral and social sciences but can, if properly applied and analyzed, enhance our understanding of the mechanisms behind age-related within-person change. As researchers in the field of psychological aging, we must continually train in various domains and keep abreast of new methodologies, with the aim of advancing theoretical perspectives on aging. Collaborative, open, and cumulative research efforts are key to developing our knowledge of psychological aging. Additionally, as privileged observers of aging mechanisms and processes, we bear the responsibility to challenge stereotypes surrounding aging and help educate professionals in related fields who work with older populations. There is also a critical need for accurate scientific information about psychological aging to inform public and social policies, making our contributions even more valuable. This paper explores some of these challenges of psychological aging research and the opportunities they present.

The concept of active aging (AA) was defined as the process of optimizing opportunity for health, security, and social participation for older people. While several questionnaires were developed to measure AA, there is no universal consensus on how to measure it, underlining a lack of clarity about what aspects to consider in the evaluation. To contribute to fill this gap, the aims of these two studies were to provide a guide for aging care professionals to choose the most appropriate questionnaire(s) based on a scoping review of the specialist literature and on a content analysis of the questionnaire, that is, the University of Jyvaskyla Active Aging Scale (UJACAS). Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were used. We found 25 records introducing questionnaires. The content validity evaluation of the most complete questionnaire (in terms of inspected content areas), i.e., UJACAS, was conducted to obtain a complete framework of evaluated aspects. Among the selected questionnaires, heterogeneity was found regarding investigated aspects and relative terms used to describe it. Only two questionnaires were found to be validated in other languages besides the original one. The content validity evaluation of UJACAS revealed its comprehensiveness in covering various aspects of AA. Specifically, five items mainly addressed one content area, while the others encompassed more than one content area. In terms of assessed aspects and translations, the UJACAS scale could be considered the most complete questionnaire for AA evaluation. Furthermore, recognizing the heterogeneity of the terms related to the aspects investigated could help professionals in selecting assessment tools with greater precision.

The Mini-Mental State Examination (MMSE) is widely used in cognitive screening, including in primary care settings. This study evaluated the diagnostic performance of the MMSE using data from 390 community-dwelling older adults aged 65 to 98 years (M = 75.76, SD = 6.76). The MMSE's accuracy was assessed against clinical diagnoses and symptom severity levels based on the Global Deterioration Scale (GDS). Receiver operating characteristic (ROC) analysis, evaluating the ability to distinguish individuals with dementia from those without, provided an area under the curve (AUC) of .75 (95% CI: 0.67-0.84, p < .001). The optimal cutoff based on Youden Index was 21 and resulted in a sensitivity of .77 (95% CI [.728, .812]) and specificity of .65 (95% CI [.603, .697]), whereas the more conventional cutoff (24) showed lower sensitivity (.50; 95% CI [.450, .550]) but higher specificity (.82; 95% CI [.782, .858]). At the suggested cutoff, the MMSE identified all cases at the severe stage, 88% at the moderate stage, and 31% at the mild stage of dementias, as classified by the GDS. In contrast, the Quick Mild Cognitive Impairment screen (Qmci) identified nearly all cases across severity levels. Against previous dementia diagnoses, when employing a cutoff score of 24 the MMSE had a positive predictive value of .52 (95% CI [.395, .645]) and a negative predictive value of .81 (95% CI [.726, .894]), indicating modest diagnostic reliability in a primary care context. Similar results were obtained applying a cutoff score of 21. These findings highlight how base rates and test characteristics shape test accuracy and should guide decision-making. Overall, our findings highlight that the MMSE can produce a substantial number of false positives in contexts with a relatively low prevalence of dementia, such as primary care, challenging the common assumption of its low false-positive rate. More broadly, our study emphasizes the importance of considering the prevalence of the condition in a given context, as differences in prevalence can drastically affect the interpretation of results, particularly the positive predictive value, even when sensitivity and specificity remain unaffected.

The global ageing population presents growing challenges for health and social care systems, particularly during transitions from hospital to home for older adults. These high-risk periods are associated with functional decline, hospital readmissions, and reduced quality of life. This systematic review synthesised evidence from 25 randomised controlled trials (RCTs), involving 17,542 participants aged 65 and older, to evaluate the effectiveness of transitional care interventions. A comprehensive search of PubMed, CINAHL Complete, and Scopus was conducted for studies published between January 2013 and March 2024. Outcomes were categorised using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy into four domains: clinical outcomes, life impact, resource use, and death/adverse events. Most interventions were multicomponent, combining structured discharge planning, caregiver involvement, follow-up, and home-based support, typically delivered by multidisciplinary teams. Interventions were frequently associated with improvements in functional status, mood, and nutritional outcomes, as well as modest reductions in hospital readmissions and emergency department visits in the short term. Few studies assessed outcomes beyond six months, and sustained effects were uncommon. Few interventions demonstrated effects on mortality or adverse events. Caregiver engagement, particularly involving informal caregivers, and early post-discharge follow-up emerged as key enablers of success. Due to considerable heterogeneity in intervention design and outcomes, findings were synthesised narratively. This review highlights the potential of personalised, interdisciplinary transitional care models tailored to the complex needs of older adults. Future research should prioritise long-term outcomes, patient-reported experiences, and the development of scalable, context-sensitive strategies, including digital tools and caregiver-inclusive approaches.