European Journal of Ageing最新文献

Hearing loss, a common age-related health condition, has been linked to adverse health outcomes, including changes in social participation and cognitive function. As subjective views of aging are influenced by changes in health and functional abilities, we hypothesized that people with poor hearing would exhibit less favorable generalized and personal Views of Aging. Additionally, we explored whether these associations varied by age. Data were analyzed from 148 participants (aged 40-84) who completed an app-based research study: Labs without Walls. Participants completed a validated, app-based hearing task, and a pure-tone average was calculated in the better-hearing ear. Generalized Views of Aging were measured using the Expectations Regarding Aging Scale (with subscales on physical health, mental health, and cognitive function). Personal Views of Aging were measured using the Self-perceptions of Aging Scale. Structural equation modeling was conducted to explore the relative contributions of hearing function to Views of Aging constructs while controlling for chronological age, sex-at-birth, sociodemographic status, loneliness, and cognition. Cross sectionally, poorer hearing was associated with negative age expectations regarding maintaining physical health and with negative self-perceptions of aging. Contrary to our hypothesis, hearing function did not predict age expectations about mental health or cognitive function. No significant age moderation effects were observed. Overall, these findings offer preliminary evidence for distinct associations between hearing and individual Views of Aging constructs and domains. The novel insight into the association between objectively measured hearing and Views of Aging highlights the importance of addressing hearing health early in the aging process to prevent negative outcomes linked to Views of Aging.

The main objective of the current study was to investigate the psychometric properties of the Oslo Social Support Scale (OSSS-3) and establish detailed normative values for older adults aged between 60 and 85 years. The representative sample analyzed consists of German residents aged between 60 and 85 living in private households (N = 1659). The analysis of the psychometric properties of the OSSS-3 involved reliability and validity testing as well as an EFA and a CFA. We provide age-specific normative data for the OSSS-3 for the German population aged between 60 and 85. The EFA resulted in a one-factor model for OSSS-3, and the CFA confirmed that this model fits the data well. In accordance with previous studies on this topic, we found that the OSSS-3 is a reliable and valid instrument for assessing perceived levels of social support among older adults. The generated percentile norms allow the direct comparison of individual scores of older adults on the OSSS-3 to an age-corresponding reference sample. Exploring the levels of perceived social support among older adults is important, given the low levels of perceived social support experienced by approximately 25% of older adults in Germany. The risk factors for social isolation and its consequences for the mental and physical health of older adults are discussed. If the population continues to age as expected, an even greater number of older adults in the future could face low levels of perceived social support.

This study investigates the unmet healthcare needs of older adults during the COVID-19 pandemic, leveraging data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the two waves of the SHARE Corona Survey (SCS) conducted in 2020 and 2021. Using latent class analysis (LCA) with covariates, we identified distinct groups based on experiences of forgoing medical treatments due to fear of infection, postponed medical appointments, and denied care, while examining socio-demographic, economic, and health-related differences in class membership. The two-wave data provide insights into patterns of unmet healthcare needs across time, highlighting groups whose situations appeared to either improve or deteriorate. Our findings reveal six distinct classes of healthcare needs: no unmet needs, high early postponement with rapid improvement, rising barriers, high early fear-based barriers, high denial with persistent postponement, and persistently high fear-based barriers. We observe significant disparities in class membership based on age, gender, living arrangements, rural/urban residence, education, employment status, financial hardship, self-rated health, changes in health, and the number of chronic conditions. High-risk groups, particularly women, those with lower education, those experiencing financial hardship, and individuals with multiple chronic conditions, were identified as especially vulnerable to unmet healthcare needs during the pandemic. Our findings offer targeted insights for intervention and policy, aiming to address healthcare access disparities among older adults during such crises.

Background: The Border Region Area lifestyle INtervention for healthy cognitive ageing in Diabetes' (BRAIN-Diabetes) trial aimed to test the feasibility of an adapted version of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multidomain intervention in cognitively healthy adults at risk of dementia living in border regions of Ireland.

Methods: BRAIN-Diabetes was a 6-month randomised controlled pilot trial involving adults living in rural border regions who were ≥ 50 years old, without existing dementia but had a diagnosis of type 2 diabetes and access to a computer. Individuals were randomised to either the multidomain intervention or the standard care control group. The intervention included diet counselling, physical exercise and computerised cognitive training which were delivered remotely and cardiometabolic risk monitoring which was delivered in person. The primary outcomes assessed feasibility of recruitment/retention and adherence to the intervention. Other outcomes explored intervention effects on cognitive, metabolic and health-related quality of life.

Results: In total, 156 individuals were assessed for eligibility, and 79 (51%) were recruited (mean age 61.6 ± 6.9 (range 60-75) years; 68% male). After 6 months, retention was 81% (72% in intervention versus 90% control). Adherence rate was high with most participants attending > 50% of the scheduled intervention sessions. There was greater improvement in diet quality (p < 0.001), daily step count (p = 0.04), triglyceride levels (p = 0.02) and health-related quality of life (p < 0.05) in the intervention group compared to control. There were no observed intervention effects on cognitive performance over 6 months.

Conclusions: The BRAIN-Diabetes pilot trial demonstrated that an adapted FINGER model was feasible to deliver and efficacious in supporting lifestyle behavioural changes among a unique at-risk rural population. There were also indicative benefits for metabolic health and health-related quality of life over a short time frame. Trial registration ClinicalTrials.gov (registration ref: NCT05304975 accepted 31st March 2022).

Retirement brings changes in daily life, which may have implications for life satisfaction and leisure-time physical activity (LTPA). This study sought to examine associations between concurrent changes in life satisfaction and LTPA across retirement, addressing gaps in understanding how life satisfaction influences physical activity in retirees. Study included 3535 public sector workers (83% women) from the Finnish Retirement and Aging study with annual surveys before and after retirement. Participants were categorized based on their Life Satisfaction Scale responses before and after retirement into Stable Low, Low-Increasing, Intermediate-Decreasing, Stable Intermediate, Intermediate-Increasing, High-Decreasing, and Stable High life satisfaction. Self-reported weekly LTPA during past 12 months was summarized as metabolic equivalent hours (METh/week). Generalized estimating equations were used to examine changes in LTPA across retirement transition among these groups, adjusting for sociodemographic and health-related factors. Compared to Stable Low, Low-Increasing life satisfaction was associated with increasing LTPA (mean difference 4.16 METh/week, 95%CI 0.85 to7.47). Compared to Stable Intermediate, Intermediate-Increasing life satisfaction was associated with increasing LTPA (mean difference 1.96 METh/week, 95%CI 0.03 to 3.88), while Intermediate-Decreasing life satisfaction was linked to decreasing LTPA (mean difference  -3 .79 METh/week, 95%CI -7.62 to 0.04). No differences were observed between Stable High and High-Decreasing life satisfaction. Changes in life satisfaction during retirement transition are associated with changes in LTPA, especially among those with low or intermediate life satisfaction before retirement. Further research is needed to assess, whether supporting life satisfaction in retirees could foster greater engagement in LTPA.

Most people with dementia (PwD) live with the support of their caregiver. Sleep issues are common among all types of dementia and increase the burden on the IC. Disturbed nights may lead to earlier admission to nursing homes. This study explored the experiences and challenges related to the sleep of PwD and IC. A qualitative study using semi-structured interviews was performed. The target groups were PwD, ICs, and care professionals. The sample comprised 20 informal caregivers, 2 PwD, and 9 care professionals. Thematic analysis was used to identify patterns within and across data concerning the experiences and challenges of participants. In total, 31 participants were interviewed in 28 sessions. Three themes were identified, namely, (a) challenges in maintaining time orientation and day/night routines, (b) irregularities and concerns of informal caregivers at night, and (c) environmental cues that support or disturb sleep. The results provide insight into the experiences of IC at home regarding their sleep and the sleep of PwD at home. Our results may guide the development of non-pharmacological interventions to support sleep and day structure with a certain balance in activities.

The growing number of people aged 80 or older living in the community has raised concerns about meeting their care needs and about socio-economic inequalities in their care use. The study examines socio-economic status (SES) patterns in informal and formal care use, as well as unmet care needs, of people aged 80 or older living in the community in Germany and England. We propose that SES patterns in care use change with the intensity of care needs. The analyses use data from the Survey of Quality of Life and Well-Being of the Very Old in North Rhine-Westphalia and the English Longitudinal Study of Ageing. Despite the differences in the long-term care systems (LTCSs) and cultural norms around filial obligations, we find a consistent pattern of association between socio-economic status (SES) and care use for older people with only few care needs in both countries. In this group, people with a higher SES have the highest likelihood of experiencing unmet care needs. For older people with many care needs, we find country-specific SES patterns that we link to cultural differences and the design of the LTCSs. In Germany, SES is negatively associated with using informal care and positively with using formal care. In England, care use shows little SES variation for older people with many care needs. The findings underscore the importance of considering the intensity of care needs when assessing inequalities in care access.

A bi-directional interaction between the cardiovascular and postural control systems has been previously reported in young adults; however, limited data exist in older populations where physiological alternations in these systems are well known. The purpose of this study was to determine: (1) the effect of slow breathing on heart rate (HR) and systolic blood pressure (SBP) responses following surface support postural perturbations in older adults and (2) the effect of slow breathing on lower limb muscle burst onset and burst amplitude during postural perturbations of the support surface in older adults. Twenty community-dwelling older adults experienced posteriorly directed accelerations of treadmill belts during quiet standing while breathing spontaneously (SPON) or breathing at 6 breaths per minute (SLOW). SBP, HR, and muscle burst onset and burst amplitude were analyzed for 7 s from each perturbation's onset. Post-perturbation comparison of SLOW and SPON showed that SBP was significantly higher during SPON over the entire analyzed time period (0-7 s) (p < 0.001), while there was no difference in HR throughout the same analysis window (0-7 s) (p > 0.05). The muscle burst onset was shortened in the SLOW compared to SPON task (p < 0.001), while muscle burst amplitude was not significantly different between SPON and SLOW (p = 0.353). Although slow breathing affected cardiovascular and muscle activation onset responses during postural perturbations in older adults, they differed from the responses in younger adults reported previously. The findings highlight the physiological adaptations that may occur to maintain postural stability in older adults.

Older adults with cognitive and/or physical limitations often face excessive health and long-term care (LTC) costs, which significantly affect their living standards. However, current measures of catastrophic health expenditure primarily focus on healthcare costs, overlooking the substantial burden of LTC costs. Our study is among the first to introduce the concept of catastrophic health and long-term care expenditures (CHLTCE) to comprehensively capture the economic burden of health and LTC costs associated with functional limitations. Drawing data from 2011, 2013, 2015, and 2018 waves of China Health and Retirement Longitudinal Study, we employed a staggered difference-in-differences approach to assess the impact of long-term care insurance (LTCI) on alleviating CHLTCE. We found that after accounting for LTC costs, both total health and LTC expenditures and CHLTCE risk significantly increased compared to when only healthcare costs were considered. Furthermore, LTCI coverage significantly reduced CHLTCE risks among older adults with cognitive and/or physical limitations. This effect was more pronounced among those with severe cognitive impairments and those with physical limitations and chronic diseases. In addition, its effectiveness in reducing CHLTCE risks for individuals with complex care needs was observed only at the high threshold, but not at lower thresholds. Our findings offer empirical contributions by incorporating both health and LTC costs into catastrophic expenditures analysis. We recommend that policymakers refine LTCI eligibility criteria and implement tiered coverage options based on various levels and dimensions of cognitive and physical function-beyond activities of daily living-to offer targeted protection for individuals with complex care needs.

Providing care to family members and friends in older age is common, but it can impact the carers' time and energy for social participation. This study explores the relationship between care and social participation in 16 European countries, considering factors like care status, care frequency, relationship to the care recipient, gender, socioeconomic status, and country care regimes. The study utilised pooled data from the Survey of Health Ageing and Retirement in Europe and the English Longitudinal Study of Ageing. Multiple regression models assessed the association between care status (non-carer, carer, and former carer) and social participation measured through volunteering frequency and group membership. The models adjusted for various demographic and socioeconomic covariates. The study found that carers, especially those doing so more frequently (daily and weekly care), were more likely to volunteer and belong to groups compared to non-carers. Furthermore, compared to non-carers individuals caring for their partner, parent, or non-relatives were more likely to engage in social participation. The association between care and social participation appeared stronger for carers in countries with supportive care regimes. The findings support the idea that care and social participation are complementary activities, where engagement in one represents an avenue for greater participation in the other.