Australasian Journal on Ageing最新文献

Objectives: Physical restraints and hand restraints are used in medical settings to provide protection and control. However, few studies have investigated their use among community-dwelling older adults. The study explored variables associated with the use of physical restraints and hand restraints among older adults receiving home care services and the reasons behind their use.

Methods: This cross-sectional study recruited 128 older adults receiving home care services and with catheters. Data were collected regarding demographic characteristics; activities of daily living (ADLs); muscle strength; family function; the use of nasogastric tubes, urinary catheters, and tracheal tubes; and the type and duration of restraint use and the reasons behind such use.

Results: Among the participants, 76% experienced the use of physical restraints, and 34% experienced the use of hand restraints. The variables related to physical restraints were ADLs (adjusted odds ratio [AOR] = 0.95, p = .02) and the presence of a paid caregiver (AOR = 3.33, p = .02). The variables related to hand restraints were ADLs (AOR = 0.93, p = .03), use of a nasogastric tube (AOR = 13.46, p = .03) and the presence of a paid caregiver (AOR = 6.38, p = .02). The primary reasons behind restraint use were to prevent fall and extubation events.

Conclusions: The use of physical restraints among older adults with catheters may be affected by their functioning in ADLs and the presence of paid caregivers to ensure their safety. Thus, implementing interventions that target functional capabilities and caregiving skills may help reduce the use of restraints.

Objectives: Dual-task walking performance is an early marker of dementia. However, there is uncertainty about which measure of the dual-task test is a better marker. The objective of this study was to determine which dual-task measure best differentiates between normal cognition, mild cognitive impairment (MCI) and dementia.

Methods: Participants (n = 116) were aged ≥60 years attending a cognitive clinic in Melbourne, Australia. Single- and dual-task gait speed were obtained using a 16 metre distance and stopwatch. The cognitive task involved reciting alternate letters of the alphabet sitting and walking. Dual-task interference in gait and cognition was calculated as: single-task-dual-task/single task × 100 and summed to obtain total interference. Multiple linear regression was used to determine differences in single and dual-task measures between those with no cognitive impairment (n = 11), MCI (n = 54) and dementia (n = 51).

Results: The mean age of the sample was 76.9 (SD 6.4) years and 48.3% (n = 56) were female. Compared to those with dementia: (a) those with MCI had a higher dual-task letter rate and lower cognitive and total interference (all indicate better performance) (p < .05) and (b) those with no cognitive impairment had a higher single- and dual-task letter rate (both indicate better performance) (p < .05). There were no differences between those with no cognitive impairment and those with MCI (all p > .05).

Conclusions: In a cognitive clinic, measurement during dual-task walking differentiated those with dementia from those with MCI or no cognitive impairment. However, differences appear to be driven by performance on the cognitive, rather than the gait task.

Objectives: The aim of this project was to evaluate the feasibility and acceptability of virtual reality (VR) as a leisure activity for people living in residential aged care. Virtual reality experiences may offer alternatives for residents with limited mobility, or during times when older people are unable to leave residential care.

Methods: The intervention used VR videos delivered via a head-mounted device. Video content was created by a local artist specifically for use with older Western Australian adults and used local content. VR sessions were videotaped for analysis. The evaluation included structured observation of video content to assess mood and engagement and post-intervention interviews with participants.

Results: Mood and engagement scores indicated overall favourable mood and considerable positive engagement with the VR experience. Interview content analysis reflected the enjoyment participants took in visiting places they had once been and the surprising ways that the experience made them feel and act as though they were actually there. Videos featuring coastal visits were the most popular and videos featuring music were the most engaging. Some participants found the head-mounted device uncomfortable. VR was considered potentially beneficial for residents with limited mobility or living with cognitive impairment.

Conclusions: Overall VR is a feasible and acceptable leisure activity for older people in residential care. The use of local content has the potential to prompt memories and generate new conversations. Future use of VR may consider different modes of video delivery and advancements in evaluation.

Objective: Given the differing cultural contexts and service needs of older persons in the west and the east, programs or policies should be thoughtfully redesigned to accommodate these diverse societies. This paper presents a systematic scoping review of ageing in place (AIP) strategies in Japan, Singapore and Thailand, emphasising how they are tailored to address the unique challenges of ageing populations in Asia.

Methods: A systematic literature search was conducted through seven databases. Empirical, peer-reviewed studies in English that discussed AIP-related programs or policies involving aged populations in the target countries were included. Themes were identified using the policy triangle framework, allowing for a comprehensive comparison of AIP across the countries.

Results: Three key components of AIP, place, support network and workforce, were identified from 44 included studies. Each country exhibits distinctive approaches to implementing these components. Japan has extensive AIP systems with comprehensive services and strong community and family support. Singapore offers innovative aged care with significant government involvement, though on a smaller scale. Thailand's localised initiatives focus on community health care and age-friendly city assessments, with a less developed AIP infrastructure.

Conclusions: The study proposes a comprehensive framework for developing ageing policies in Asia, emphasising the need for a person-centred approach in developing AIP strategies that cater to the diverse needs of ageing populations, and underscores the importance of integrating health-care services, community support and home environment modifications. The three AIP elements advocate for a person-centred approach, providing valuable insights for policymakers to effectively manage challenges of rapidly ageing populations.

Objective: This study aimed to translate previous implementation science research describing the implementation of perioperative medicine for older people undergoing surgery (POPS) services into a format that is comprehensible and relevant to clinical leaders contemplating implementing a POPS service.

Methods: We conducted a multistage expert end-user review process to design a POPS implementation guide. Our expert research team created a draft POPS service implementation guide using previous implementation science research that described the core elements and implementation of a POPS service. Next, we invited multidisciplinary (allied health, anaesthetics, geriatric medicine, nursing and surgery) clinical leaders in perioperative medicine (n = 12) from five contextually different health services to review the guide. These clinical leaders then participated in two rounds of review and refinement of the implementation guide.

Results: The first draft of the POPS service implementation guide was reviewed by clinical leaders (n = 4) with participants querying implementation science-based language and concepts, the format of the guide and its practical use. We revised the guide accordingly, and the next draft was reviewed by the second group of clinical leaders (n = 8). Feedback from the second group review was supportive of the guide's comprehensibility and relevance, and only minor changes were made to the final version of the POPS service implementation guide.

Conclusions: We used an implementation science-based approach to create a POPS service implementation guide that is comprehensible and relevant to clinical leaders in perioperative care. The next steps are to use the guide and assess its utility to support implementation of a POPS service.

Objective: To investigate the impact of retirement on marital satisfaction by gender on Koreans aged >45 years in a large, nationally representative cohort.

Methods: Retirement status and marital satisfaction data of 5867 individuals were analysed. Marital dissatisfaction was defined as a satisfaction score reduction of more than 10 points versus the previous wave. Lagged generalised estimating equation (GEE) models adjusted for demographics (age, sex, education level and household income), health-related habits (smoking and drinking status) and comorbidities (obesity, hypertension, type 2 diabetes, and depression and frailty) were used to confirm the relationship between retirement and marital dissatisfaction.

Results: The final GEE model adjusted for covariates revealed sex-specific differences in marital satisfaction after retirement. Whereas male retirees reported higher satisfaction than non-retired men, female retiree responses revealed lower satisfaction than non-retired women. Furthermore, these trends were consistent regardless of the time elapsed after retirement.

Conclusions: Marital satisfaction should be screened in women during the transition to retirement.