European Journal of Ageing最新文献

Purpose: Dementia and chronic pain (CP) are prevalent among older adults. However, no study has systematically reviewed the association between dementia and CP. Therefore, we performed this study to gather evidence about the potential relationship between the two.

Methods: Two authors independently searched PubMed, Embase, and Web of Science to identify all records published up to 1 September 2022 that explored the association between CP and dementia. The methodological quality of the studies was assessed using the Newcastle Ottawa Scale (NOS). A fixed or random-effects model was used to pool the risk estimates.

Results: Among the initial 3296 articles retrieved, 19 were included in the review (1 cross-sectional, and 18 cohort). The pooled result showed the risk of dementia was 1.42 times higher in CP patients (HR = 1.42, 95% CI 1.23-1.64, P < 0.001). dementia and CP subtypes, gender, and age did not significantly affect the results.

Conclusion: Our study shows that people who suffered from CP are at an increased risk of developing dementia, regardless of gender, age, and dementia and CP subtypes.

In old age, walking difficulty may reduce opportunities to reach valued activity destinations. Walking modifications, e.g., slower pace or using a walking aid, may enable individuals to continue going where they wish, and hence postpone the consequences of the onset of walking difficulties. We studied visited activity destinations (type, distance) among older people with varying degrees of walking limitations. Community-dwelling 75-85-year-old people living in Jyväskylä (N = 901) were asked to state whether they had no difficulty walking 2 km, had modified their walking, or had difficulty walking. On a digital map, participants located physical exercise, attractive, and regular destinations they had visited during the past month. Destination counts and median distance to destinations from home were computed. Participants with intact walking reported higher counts of physical exercise (IRR = 1.45, 95% CI [1.31, 1.61]) and attractive destinations (IRR = 1.23, 95% CI [1.10, 1.40]) than those with walking difficulty and also visited these destinations further away from home than the others (b = 0.46, 95% CI [0.20, 0.71]). Those with walking modifications reported higher counts of physical exercise destinations than those with walking difficulty (IRR = 1.23, 95% CI [1.09, 1.40]). Counts of regular destinations and distance traveled were not associated with walking limitations. Walking modifications may help people with walking difficulty reach destinations further away from home, potentially contributing to their sense of autonomy. For those with walking difficulty, a low count of destinations other than regular destinations, e.g., shops or healthcare facilities, may signal their abandonment of recreational activities and a decrease in their life space, potentially leading to reduced well-being.

This paper proposes comparative research on support provided outside the household by older adults in Europe. In studying social support, the network perspective is widely used, investigating, in particular, the ego-centered support networks of individuals. The analysis is based on data from Wave 7 of the Survey of Health Ageing and Retirement in Europe (SHARE). It examines the characteristics of ego-support networks of individuals aged 65 and over in 12 European countries, which are grouped into a novel welfare regime typology. Through Multiple Correspondence Analysis, we jointly looked into the categorical variables describing the recipients (alters) of the support provided by older adults and the welfare regime classification. As a main result, countries grouped in "High degree of familialism by default" category specialized in supporting family-related alters, particularly with childcare or personal care. In contrast, the elders in countries belonging to "High degree of de-familialisation" typology provided a more varied but less demanding support, to non-relatives alters and less oriented to care. The analyses show that the SHARE provides a solid opportunity to face the topic.

Polypharmacy (PP) use is very common in older people and may lead to drug-drug interactions (DDIs) and anticholinergic burden (ACB) that may affect cognitive function. We aimed to determine the occurrence of PP, potential DDIs and ACB and their role in cognitive outcomes in an older population. Cross-sectional data from 636 community-dwelling adults (73.2 ± 6.0 SD, 58.6% women) participating in the NutBrain study (2019-2023) were analyzed. Participants were asked about their medication use, and data on potential DDIs and ACB were extracted. The associations of PP (≥ 5 drugs/day), potential DDIs, and ACB with mild cognitive impairment (MCI) and specific cognitive domains were assessed using logistic regression adjusted for confounders. Sex-stratified analysis was performed. Overall, 27.2% of the participants were exposed to PP, 42.3% to potential DDIs and 19% to cumulative ACB. Women were less exposed to PP and more exposed to ACB than men. In multivariate analysis, the odds of having MCI (24%) were three times higher in those with severe ACB (≥ 3) (OR 3.34, 95%CI 1.35-8.25). ACB was positively associated with poor executive function (OR 4.45, 95%CI 1.72-11.49) and specifically with the Frontal Assessment Battery and neuropsychological tests of phonological and semantic fluency. In sex-stratified analysis, ACB was statistically significantly associated with MCI and executive function in women and with memory in men. PP, potential DDIs and anticholinergics use are very common in community-dwelling older people. ACB exposure is associated with MCI, particularly with poor executive function. Clinicians are encouraged to be vigilant when prescribing anticholinergics.Trial registration: Trial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).

New technologies can help older persons age in place and support their caregivers. However, they need to be accepted by the end-users to do so. Technology acceptance models, such as TAM and UTAUT and their extensions, use factors like performance expectancy and effort expectancy to explain acceptance. Furthermore, they are based on quantitative methods. Our qualitative study investigates factors fostering and hindering acceptance among older persons and their caregivers for a variety of assistive technologies, including wearables, ambient sensors at home with and without cameras and social companion robots. The goal of this paper is twofold: On the one hand, it investigates the factors of technology acceptance models in a qualitative setting. On the other hand, it informs these models with aspects currently overlooked by them. The results reveal that performance expectancy and effort expectancy are relevant for acceptance. We also find that reliability, anxiety around technology and different social aspects have an influence on acceptance of assistive technology in aged care for all end-user groups. Our findings can be used to update current technology acceptance models and provide in-depth knowledge about the currently used factors.

WHOQOL-AGE is a promising quality of life (QOL) tool that has not been fully validated in Asia. The present study aimed to verify its factor structure and psychometric properties among community-dwelling older adults in Singapore. This study was cross-sectional and used data (N = 593) from the Community Health and Intergenerational study that interviewed older adults between 2018 and 2021. Confirmatory factor analysis (CFA) was used to examine the factor structure of the WHOQOL-AGE, and Cronbach's alpha coefficients were employed to examine internal consistency. Spearman's rho correlations coefficients between WHOQOL-AGE and other related scales (Satisfaction with Life and the Friendship) examined convergent validity. A Pearson's correlation coefficient between WHOQOL-AGE and compassion scale examined discriminant validity. An independent t test was used to demonstrate known-groups validity, examining differences in QOL scores between individuals with and without chronic medical conditions. Findings supported a bifactor model with more satisfactory goodness-of-fit indices than the original two-factor model and the two-correlated factor model. WHOQOL-AGE showed adequate internal consistency (Cronbach's alpha coefficients > .70). Good convergent validity was demonstrated by moderate-to-large correlations between WHOQOL-AGE and satisfaction with life (r_s = .54) as well as social connectedness (r_s = .33). Discriminant validity was shown by low correlations between WHOQOL-AGE and compassion (r = .19). Findings also indicated good known-groups validity (p < 0.01). The WHOQOL-AGE showed promising psychometric properties using an Asian convenience sample and can be useful in large-scale studies or busy clinical settings.

Objective: Adequate sleep is closely related to people's health. However, with increasing age, the quality of sleep worsens. At the same time, among elderly individuals, frailty is also a disturbing factor, which makes elderly individuals more vulnerable to negative factors. To explore the relationship between the two, we conducted this study.

Methods: In this paper, independent genetic variations related to insomnia, sleep duration and daytime sleepiness were selected as IVs, and related genetic tools were used to search published genome-wide association studies for a two-sample Mendelian randomization (TSMR) analysis. The inverse-variance weighted (IVW) method was used as the main Mendelian randomization analysis method. Cochran's Q test was used to test heterogeneity, MR‒Egger was used to test horizontal pleiotropy, and the MR-PRESSO test was used to remove outliers.

Results: According to our research, insomnia (OR = 1.10, 95% CI 1.03-1.17, P = 2.59e-97), long sleep duration (OR = 0.66, 95% CI 0.37-1.17, P = 0.02), short sleep duration (OR = 1.30, 95% CI 1.22-1.38, P = 2.23e-17) and daytime sleepiness (OR = 1.49, 95% CI 1.25-1.77, P = 0.96e-4) had a bidirectional causal relationship with frailty.

Conclusions: Our research showed that there is a causal relationship between sleep disturbances and frailty. This result was obtained by a TSMR analysis, which involves the use of genetic variation as an IV to determine causal relationships between exposure and outcome. Future TSMR studies should include a larger sample for analysis.

Emotions are processed in the brain through a cortical route, responsible for detailed-conscious recognition and mainly based on image High Spatial Frequencies (HSF), and a subcortical route, responsible for coarse-unconscious processing and based on Low SF (LSF). However, little is known about possible changes in the functioning of the two routes in ageing. In the present go/no-go online task, 112 younger adults and 111 older adults were asked to press a button when a happy or angry face appeared (go) and to inhibit responses for neutral faces (no-go). Facial stimuli were presented unfiltered (broadband image), filtered at HSF and LSF, and hybrids (LSF of an emotional expression superimposed to the HSF of the same face with a neutral expression). All stimuli were also presented rotated on the vertical axis (upside-down) to investigate the global analysis of faces in ageing. Results showed an overall better performance of younger compared to older participants for all conditions except for hybrid stimuli. The expected face-inversion effect was confirmed in both age groups. We conclude that, besides an overall worsening of the perceptual skill with ageing, no specific impairment in the functioning of both the cortical and the subcortical route emerged.

Retirement reduces sleep problems, but changes in life satisfaction during the retirement transition are multifactorial and partly unknown. The aim of this prospective cohort study was to examine whether changes in sleep problems are associated with changes in total and domain-specific life satisfaction during the retirement transition (on average 0.5 years before and 0.5 years after retirement). The study population consisted of Finnish public sector employees (n = 3518) from the Finnish Retirement and Aging (FIREA) study who responded to annual surveys before and after transition to statutory retirement. Sleep problems were measured with Jenkins Sleep Problem Scale questionnaire and participants were grouped into four sleep problem groups depending on the state of their sleep problems during the retirement transition: 'Never,' 'Decreasing,' 'Increasing,' and 'Constant' sleep problems. Life satisfaction was measured with the Life Satisfaction Scale questionnaire including four domains (interestingness, happiness, easiness, togetherness). We found that the improvement in total life satisfaction was greatest for participants in the 'Decreasing' (0.17, 95% CI 0.11-0.23, SMD 0.27) and 'Constant' (0.12, 95% CI 0.07-0.18, SMD 0.19) sleep problem groups. Of the specific life satisfaction domains, similar findings were observed only for the easiness domain. It seems that decreasing or constant sleep problems are associated with improved life satisfaction during the retirement transition, especially in the feeling of easiness of life. This may be due to the fact that as the demands of working life are removed, sleep problems are alleviated or it becomes easier to live with them, which improves life satisfaction.

The COVID-19 pandemic has changed the supply of formal and informal home care to older adults in many countries across the world. This study aims to compare the initial picture of how the supply of formal and informal home care to older adults in European countries and Israel changed during the first pandemic year (from mid-2020 to mid-2021) and to examine the changes that these countries made in the provision of adequate care to older adults. Using data from the two COVID-19 waves of SHARE, we show that the provision of formal home care services improved in the investigated period, as in 2021 the share of those who reported difficulties in receiving formal home care dropped significantly compared to the previous year. By contrast, informal care provision patterns experienced a growing polarization, with some countries continuing in reporting a strong support from this source, and others moving towards a remarkable reduction in the help coming from informal networks. These findings can serve as a basis for the development of evidence-based recommendations that can inform future care policies at the national level and to implement more sustainable models for older adults living in the community.