Measuring what matters to older persons for active living: part I content development for the OPAL measure across four countries.

AIMS: Many older persons do not think of themselves as "patients" but as persons wishing to live as actively as possible for as long as possible. However, most health-related quality of life (HRQL) measures were developed for use with clinical populations. The aim of this project was to fill that gap and to develop, for international use, a measure of what matters to older persons as they age and seek to remain as active as possible, Older Persons for Active Living (OPAL). METHODS: For content development, interviews about active living were conducted with older persons from Canada, USA, UK, and the Netherlands in English, French, Spanish and Dutch, respectively with subsequent thematic analysis and harmonization. RESULTS: Analyses of transcripts from 148 older persons revealed that active living was a "way of being" and not merely doing activities. Saturation was reached and a total of 59 content areas were identified. After grouping similar "ways" together and after conducting a consensus rating of importance, 19 unique and important "ways" remained. In some languages, formulating was challenging for three of the 19, resulting in changes to two English words and dropping two other words, yielding a final list of 17 "ways of being" with harmonized wording in 4 languages. CONCLUSION: This study underscores the significance of listening to older adults and highlights the importance of considering linguistic and cultural nuances in measure development.

Mediterranean Dietary Pattern for Healthy and Active Aging: A Narrative Review of an Integrative and Sustainable Approach.

The global population is on a trajectory of continuous growth, with estimates projecting an increase from 7.7 billion in 2019 to approximately 9.7 billion by 2050. Longevity is also expected to rise rapidly, with advancements in healthcare contributing to increased life expectancies and an increase in the maximum lifespan. The aging process is accompanied by different changes, often leading to a decline in daily life activities and an increased susceptibility to disease. Age-related changes can cause cellular damage and subsequent cellular death. Oxidative stress and inflammation play significant roles in this process contributing to molecular damage and mitochondrial dysfunction. Active aging has been associated with improved quality of life and a reduced risk of morbidity and premature mortality. In this context, the Mediterranean diet has emerged as a promising approach to promoting healthy aging and sustainability. The phytochemical compounds within the Mediterranean diet have been linked to a lower risk of developing cardiovascular disease, type 2 diabetes, obesity, cancer and neurodegenerative diseases. The findings of peer-reviewed articles regarding the use of the Mediterranean diet as a healthy and sustainable dietary pattern written in Portuguese, Spanish or English were included in this narrative literature review. This dietary pattern's emphasis on the consumption of fresh and local food aligns with both health and environmental sustainability goals. This work provides a comprehensive review of the benefits of the Mediterranean diet and its components in a healthy aging process and highlights the importance of this dietary pattern as a sustainable approach.

Determinants of Health Status and Life Satisfaction among Older South Koreans.

South Korea is a rapidly aging society with the lowest fertility rates among the OECD economies. It is projected to become a super-aged society in 2025, with the share of individuals older than 65 reaching twenty percent. These developments make it important to analyze the determinants of health outcomes in older individuals. In this study, we identified the determinants of subjective and objective health outcomes among senior individuals in South Korea. We used self-rated health and life satisfaction scores as the two subjective health status indicators, while the number of chronic diseases was the objective one. We ran Tobit multivariate regressions of all three indicators on a set of factors related to the older citizens' physical, economic, and social characteristics. Active employment status and willingness to work in the future were positively related to self-rated health level but were not statistically related to life satisfaction, while income positively affected both subjective health status indicators. Age did not appear to affect satisfaction with life. Active leisure activities were positively related to both self-rated health and life satisfaction. In contrast, passive leisure, such as watching TV, was negatively related to both health status indicators while being associated with an increased number of chronic diseases. Our findings suggest that older South Koreans view employment primarily as a means of financial support rather than as an opportunity for active social engagement.

Traditional Chinese medicine health literacy among rural older adults: a cross-sectional study.

Background: The purpose of this study was to understand the current status of traditional Chinese medicine (TCM) health literacy among rural older adults people and its influencing factors. Methods: This study used a random number table method to select one prefecture from Henan Province, China and used a convenience sampling method to select 200 rural older adults who met the inclusion criteria in a township in northern Henan from March to April 2023. A cross-sectional survey was conducted using a general information questionnaire and a traditional Chinese medicine health literacy questionnaire, and the influencing factors of rural older adults were analyzed using univariate analysis of variance (ANOVA) and multiple linear regression. Results: The total TCM health literacy score of 200 rural older adults people was 84.14 ± 6.709. One-way ANOVA revealed that six factors, including education level, marital status, type of occupation, presence of family members engaged in medical-related work, main economic sources, and monthly income, influenced the TCM health literacy score of rural older adults people (p < 0.05). Multiple linear regression analysis revealed that education level, occupation type, and the presence of family members engaged in medical-related work were the factors influencing the TCM health literacy of rural older adults. Conclusion: The TCM health literacy level of rural older adults people is at the lower to middle level, and health educators should strengthen the publicity and education of TCM healthcare knowledge for rural older adults people to improve their TCM health literacy level and thus enhance their quality of life.

A focus group study for the design of a web-based tool for improving problem-solving in older adults.

The development of easily accessible and usable social and cognitive enhancement trainings is becoming a priority to reduce the impact of aging on quality of life. Since most activities of daily living (e.g., making a meal) require problem-solving skills, problem-solving interventions could be used to improve and/or maintain functional abilities in aging to prolong independence. To design an effective problem-solving training and increase older adults' adherence to the training, this study examined older adults' perceptions of their challenges in activities of daily living, their skills and difficulties in using information technology (IT), and their motivations and expectations for participating in a web-based problem-solving training activity. Four focus groups (two in Italy and two in the Netherlands) were conducted with older adults aged between 65 and 84 years, a total of 27 participants. The data were analyzed using the Atlas.ti 8 software for the thematic analysis. The analysis identified five thematic areas: interests and activities, difficulties and concerns, experiences and motivations for training, expertise and resources, suggestions for the design of the new training. The results were used to develop a first prototype of a Shared, Web-based, Intelligent Flexible Thinking Training (SWIFT), adapted to future user needs. The participation of older adults in this design phase was critical to understanding their needs, motivations, and expectations regarding the implementation and use of a cognitive enhancement training.

Rethinking Health Recommender Systems for Active Aging: An Autonomy-Based Ethical Analysis.

Health Recommender Systems are promising Articial-Intelligence-based tools endowing healthy lifestyles and therapy adherence in healthcare and medicine. Among the most supported areas, it is worth mentioning active aging. However, current HRS supporting AA raise ethical challenges that still need to be properly formalized and explored. This study proposes to rethink HRS for AA through an autonomy-based ethical analysis. In particular, a brief overview of the HRS' technical aspects allows us to shed light on the ethical risks and challenges they might raise on individuals' well-being as they age. Moreover, the study proposes a categorization, understanding, and possible preventive/mitigation actions for the elicited risks and challenges through rethinking the AI ethics core principle of autonomy. Finally, elaborating on autonomy-related ethical theories, the paper proposes an autonomy-based ethical framework and how it can foster the development of autonomy-enabling HRS for AA.

Changes in Resources and Volunteering: A Longitudinal Study of Active Engagement Among Older Europeans.

BACKGROUND AND OBJECTIVES: Volunteering is an important dimension of successful aging. Although prior studies have found that personal resources such as health and financial situations are associated with volunteering, there is a lack of research exploring the relationship between resource changes and volunteering. Here, we investigated whether changes in individuals' resources were associated with volunteer engagement among older Europeans. RESEARCH DESIGN AND METHODS: Using data from the Survey of Health, Aging, and Retirement in Europe, collected in five waves between 2011 and 2020 across 19 countries (57,410 observations from 17,498 individuals aged 50 and above), we employed asymmetric fixed-effect ordinal regression models to investigate whether positive or negative resource changes were associated with the frequency of volunteering over time. We used three resource indicators: health, financial condition, and time availability (measured by engagement in paid work, grandparenting, and family care). RESULTS: Health deterioration and worsening financial condition were associated with a decreased frequency of volunteering. A transition out of weekly paid work and beginning to provide weekly grandchild care were both associated with an increased frequency of volunteering. We did not detect any further significant effects of resource changes on volunteering. DISCUSSION AND IMPLICATIONS: Our study revealed asymmetrical associations between changes in resources and volunteering, providing new insights into their interplay. The results deepen our understanding of successful aging by emphasizing the need to consider the dynamics of all resources that either facilitate or hinder active engagements among older adults.

Physical activity components associated with gait parameters in community-dwelling older adults.

OBJECTIVE: To investigate the association between components of physical activity and spatiotemporal gait parameters in community-dwelling older adults. METHODS: Cross-sectional study with 134 independent community-dwelling older adults. A questionnaire was applied to obtain information related to the components of physical activity (frequency, duration, modality, and history of physical activity in the life course) and the GAITRite System was used to quantify gait parameters. Three MANOVA models adjusted for potential confounders were conducted to identify associations between components of physical activity (predictors) and gait performance (outcome). RESULTS: Higher weekly frequency but not daily hours of physical activity and sports practice (tennis, boxing, football, volleyball, and tai chi) were significantly associated with better gait performance, specifically gait speed and stride length. CONCLUSION: Understanding the most effective components of physical activity to maintain functional capacity and independence in community-dwelling older adults, allowing for active aging, is essential for formulating more effective strategies.

Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals.

Background: Physical activity is associated with improved health and function in older adults, yet most older adults are sedentary. Loneliness is associated with decreased physical activity at the cross-section, but longitudinal studies are scarce. We examined longitudinal associations between loneliness and physical activity-and whether they were modified by marital status and network size (the number of children, relatives, and friends a person interacts with at least once a month). Methods: We analyzed data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project with a mean follow-up of 4.8 years (mean age 79.6 ± 7.7, 74.9% women). Loneliness was assessed using the de Jong Gierveld Loneliness Scale. Physical activity was assessed as the frequency with which participants engaged in five categories of activities (e.g., walking, gardening, calisthenics, bicycling, and swimming). Linear mixed effects models examined associations between baseline loneliness and change in physical activity over time after adjusting for demographics, depressive symptoms, global cognition, disability, network size, marital status, social support, and social and cognitive activities. We assessed for effect modification by marital status and network size. Results: Associations between loneliness and physical activity differed by marital status. In widowed individuals, baseline loneliness was associated with a 0.06 h/week greater decrease in physical activity per year compared to those who were not lonely (p = 0.005, CI -0.1, 0.02)-which equaled a 150% decrease in physical activity per year. Loneliness did not predict a statistically significant decrease in physical activity in married or unmarried individuals. Discussion: Loneliness is associated with decreased physical activity in widowed older adults and should be considered in the design of interventions to prevent or slow the decline in physical activity and promote healthy aging.

Correlation Between Lifestyle Patterns and Cognitive Function Among Community-Dwelling Older Chinese Adults in the Pre-Dementia Stages: A Latent Class Analysis.

Lifestyle activity engagement is a modifiable factor for cognitive decline. We aimed to identify lifestyle patterns (LPs) among community-dwelling older adults in the pre-dementia stages and to explore the links between LPs, cognitive function, and individual characteristics. 702 older Chinese adults were recruited. Three LPs were identified by latent class analysis: active aging lifestyle pattern (AALP), leisure lifestyle pattern (LLP), and work-centered lifestyle pattern (WLP). AALP refers to participation in various activities that are meaningful to individuals and benefit their well-being. LLP is the pattern of activities aimed at recreation. WLP refers to the LP where individuals are most likely to engage in work-related activities. However, only AALP is protected against mild cognitive impairment (MCI). Multinomial logistic regression models revealed the differences in individual characteristics among participants with different LPs, indicating the importance of tailored intervention strategies. As a protective factor against MCI, AALP should be highlighted in community-based care.

Is Transition to Retirement Associated With Volunteering? Longitudinal Evidence from Europe.

Studies have shown that retired older adults are more likely to volunteer than their working counterparts. However, whether the transition to retirement is associated with increased volunteering frequency and whether this varies according to material and time resources of participants is unclear. We used four waves of data from the longitudinal Survey of Health, Ageing and Retirement in Europe, collected between 2011-2018 across 19 countries (n = 12,400 person-observations from 6200 individuals over 50). Within-person (or panel fixed-effect) regression analyses revealed that transition to retirement was associated with an increased volunteering frequency over time. This association was stronger among individuals with better health, higher education, improved financial situation and in countries with higher gross domestic product per capita. Overall, transition to retirement tends to open new ways of organizing everyday life and is associated with increased frequency of volunteering.

Addressing Data Absenteeism and Technology Chauvinism in the Use of Gamified Wearable Gloves Among Older Adults: Moderated Usability Study.

BACKGROUND: Digital health technologies have the potential to improve health outcomes for older adults, especially for those recovering from stroke. However, there are challenges to developing these technologies, such as data absenteeism (where older adults' views are often underrepresented in research and development) and technology chauvinism (the belief that sophisticated technology alone is the panacea to addressing health problems), which hinder their effectiveness. OBJECTIVE: In this study, we aimed to address these challenges by developing a wearable glove integrated with culturally relevant exergames to motivate older adults to exercise and, for those recovering from stroke, to adhere to rehabilitation. METHODS: We conducted a moderated usability study with 19 older adults, of which 11 (58%) had a history of stroke. Our participants engaged in a 30-minute gameplay session with the wearable glove integrated with exergames, followed by a quantitative survey and an in-depth interview. We used descriptive analysis to compare responses to the System Usability Scale between those who had a history of stroke and those who did not. In addition, we analyzed the qualitative interviews using a bottom-up thematic analysis to identify key themes related to the motivations and barriers regarding the use of wearable gloves for rehabilitation and exercise. RESULTS: Our study generated several key insights. First, making the exergames exciting and challenging could improve exercise and rehabilitation motivation, but it could also have a boomerang effect, where participants may become demotivated if the games were very challenging. Second, the comfort and ease of use of the wearable gloves were important for older adults, regardless of their stroke history. Third, for older adults with a history of stroke, the functionality and purpose of the wearable glove were important in helping them with specific exercise movements. CONCLUSIONS: Our findings highlight the importance of providing contextual support for the effective use of digital technologies, particularly for older adults recovering from stroke. In addition to technology and usability factors, other contextual factors such as gamification and social support (from occupational therapists or caregivers) should be considered to provide a comprehensive approach to addressing health problems. To overcome data absenteeism and technology chauvinism, it is important to develop digital health technologies that are tailored to the needs of underserved communities. Our study provides valuable insights for the development of digital health technologies that can motivate older adults recovering from stroke to exercise and adhere to rehabilitation.

Physical literacy, health and interactive aging: a position paper.

Physical literacy (PL), a concept commonly associated with the early years, physical education, and youth sport development, can become a meaningful determinant of health and longevity for the adult and older adult population. A review of 55 recent publications from 2018 to 2023 that encompassed physical literacy conceptual frameworks, assessments, and intervention-based studies was undertaken through an heuristic inspired by the philosophy which gave birth to PL. With particular interest in how PL has evolved in response to the needs of an aging population, this position paper tracks a key shift in focus from the individual to the relational context. It references positive interaction and social participation in recent models as significant features of an across-the-lifespan PL perspective.The concluding position is that fostering joyful inter-action be at the heart of PL promotion, resource development and assessment practices, especially in the case of an aging population.

Public perception on active aging after COVID-19: an unsupervised machine learning analysis of 44,343 posts.

Introduction: To analyze public perceptions of active aging in China on mainstream social media platforms to determine whether the "14th Five Year Plan for the Development of the Aging Career and Older Adult Care System" issued by the CPC in 2022 has fully addressed public needs. Methods: The original tweets posted on Weibo between January 1, 2020, and June 30, 2022, containing the words "aging" or "old age" were extracted. A bidirectional encoder representation from transformers (BERT)-based model was used to generate themes related to this perception. A qualitative thematic analysis and an independent review of the theme labels were conducted by the researchers. Results: The findings indicate that public perceptions revolved around four themes: (1) health prevention and protection, (2) convenient living environments, (3) cognitive health and social integration, and (4) protecting the rights and interests of the older adult. Discussion: Our study found that although the Plan aligns with most of these themes, it lacks clear planning for financial security and marital life.

Effectiveness of blended happy age education program (B-HAEP) on active aging promotion among pre-disable community dwelling older adults in Pakistan.

BACKGROUND: Addressing aging related functional declines in older adults has become a top priority for countries around the world. The aim of this study was to investigate the effectiveness of a blended happy age education program in promoting active aging among community-based pre-disable older adults. METHODS: We conducted a two-arm trial study in Khyber Pakhtunkhwa, Pakistan. Participants were randomly assigned into two groups using a computer-generated random sequence of 150 participants. RESULTS: Blended Happy Age Education Program (BHAEP) reduced time for 3 m walk (Estimated mean 19.5 ± 3.4 to 13.7 ± 1.3, effect size ηp² = 0.98, (P < 0.001). The current level of happiness improved in B-HAEP group from 4.7 ± 1.05 scores to 7.8 ± 1.6, P < 0.001, effect size (ηp² = 0.540). Healthy lifestyle significantly improved (P < 0.001, ηp² = 0.4). CONCLUSIONS: B-HAEP can be an effective intervention strategy to promote active aging in older adults with risk for immobility.

Attitudes toward active aging and their association with social determinants and views on older adults in Japan: a cross-sectional study.

BACKGROUND: Globally, the population of older adults has greatly increased, and active aging-whereby older adults can live healthy and fulfilling lives-is considered crucial for a sustainable society. However, the concept and practice of active aging are highly debated because it is unclear how people perceive active aging. This study explored Japanese people's attitudes toward active aging (ATAA) and examined the associations between ATAA scores and sociodemographic variables, views on older adults, and self-rated life and health. METHODS: This study used data obtained from an online survey that originally targeted adults of all generations in Taiwan, South Korea, and Japan. In this study, we used only data from Japanese participants to elaborate on factors associated with ATAA in Japan. We conducted a one-way analysis of variance test and multiple linear regression analysis to evaluate the associations between the ATAA scores of 506 Japanese individuals and sociodemographic variables, views on older adults, and self-rated life and health. RESULTS: The sample comprised 171 females and 335 males. The mean (± SD) ATAA score of the 506 respondents was 138.8 (± 20.80). Females had a significantly higher ATAA score than males (144.02 versus 136.13, F = 26.29, p < 0.001). The respondents with higher education attainment, religious beliefs, better views on older adults, and better self-rated health were more likely to have a positive ATAA score (B: 3.83, 95% CI: 0.11, 7.56; B: 4.31, 95% CI: 0.93, 7.69; B: 2.07, 95% CI: 1.61, 2.53; B: 2.87, 95% CI: 0.92, 4.82, respectively). Being male, single (i.e., never married, divorced, or widowed) and other non-married marital statuses, and satisfied with one's financial condition were negatively associated with ATAA (B: -8.73, 95% CI: -12.49, -4.96; B: -5.47, 95% CI: -9.07, -1.86; B: -2.04, 95% CI: -3.99, -0.09, respectively). CONCLUSIONS: This study identified that females have more positive ATAA than males. Better views on older adults are a possible contributing factor that promotes ATAA among Japanese people. Our findings provide useful evidence that an approach towards those who are male, single, and economically satisfied is needed so that they have a positive attitude toward aging in Japan. It is necessary to address ageism and develop an environment in which individuals can expect to age actively.

Can Virtual Reality Help Improve Motor and Cognitive Function in Active Aging in Older Adults? A Scoping Review.

BACKGROUND: Active aging is considered one of the most effective methods for a healthy aging process. There are numerous clinical practice guidelines that address this model and propose multiple strategies for its achievement through the improvement of motor and cognitive function. Virtual reality is emerging as a potential tool, with various modalities focused on promoting good health maintenance in older adults. The objectives of this review were to map the potential benefits of virtual reality for active aging and delve into adaptability and adherence in older individuals. METHODS: A scoping review was conducted on studies published between 2013 and 2023 in English, Spanish, or Catalan, examining virtual reality interventions in older adults. The search was performed using the Medline, CINAHL, Scopus, and Web of Science databases. The methodological quality was assessed using CASPe and FLC 3.0 critical appraisal guidelines. The graphical data were reported narratively, grouping results based on the study characteristics and the impact of virtual reality. RESULTS: The review process resulted in the inclusion of 22 articles out of the initial 459 following the application of the selection criteria. Most articles were randomized controlled trials (45.4%; n = 10), systematic reviews (40.9%; n = 9), observational studies (9%; n = 2), and pilot studies (4.5%; n = 1). The information was organized based on the virtual reality modality (immersive, non-immersive, and 360) and application area (motor, cognitive, and mental health). CONCLUSIONS: Virtual reality (both immersive and non-immersive) is a valuable tool for promoting physical exercise in older adults, helping to prevent recurrent accidental falls. It also yields positive results for cognitive stimulation in healthy older individuals, improving memory, depression, and mental health in those with cognitive impairment. Virtual reality is generally well-received by older adults, achieving high adherence rates.

Community Building Through Place-Making Activities: Older Landscapers in a Singaporean Residential Town.

This paper explores how some older residents in B Town, a residential estate in northern Singapore, engage in community building through their 'serious leisure' and 'devotee work' participation in a resident landscaper program. Using data from ethnographic fieldwork conducted from February to November 2020 with participants aged from 60 to 81, I analyze how they built connections with each other, and the wider B Town community, through their participation. Particularly, I examine how the shared identity marker of being former farmers in now-evicted kampungs (villages) before the 1980s drew them together, and informed their continued involvement as resident landscapers. The 'kampung spirit' that they built up through the program enabled the construction of not only social connections, but also exclusionary mechanisms that prevented more older adults from engaging in the activities. These findings highlight participants' agency, and complicate static and/or monolithic conceptualizations of 'aging in place/the community' and 'active aging'.

A randomized controlled pilot study of a cognitive-behavioral video game intervention for the promotion of active aging.

Background: Due to the accessibility barriers of in-person programs for active aging, the development of programs that use innovative technologies is needed. Video games can be an engaging tool for disseminating active aging interventions. Objective: The objective of this pilot study was to analyze the feasibility of a cognitive-behavioral intervention to promote active aging administered through a video game. Methods: Fifty-five participants (63.6% women, mean age = 53.0 years) were randomly assigned to a cognitive-behavioral intervention to promote active aging administered through an interactive multimedia online video game with a complementary app (CBI-V; n = 29) or to a control group that received nonspecific online information (CG; n = 26). Results: Only 3.6% of the participants dropped out of the study (6.9% in CBI-V and 0.0% in CG; without significant differences between groups). The mean number of modules completed was 7.6 (SD = 0.9) out of 8 in the CBI-V and 7.9 (SD = 0.5) in the control group (CG), without significant between-group differences. In the CBI-V, the mean total time dedicated to the game was 516.8 min (SD = 94.3), including 143.2 min (SD = 31.6) of cognitive training tasks, and the mean of completed tasks was 206.2 (SD = 33.7) out of 259. Participants were highly engaged (M = 39.9, SD = 8.6) and satisfied (M = 25.8, SD = 4.5) with the intervention. After the intervention, the CBI-V group significantly improved on SF-36 dimensions of General Health (p = .0386), Vitality (p = .0283), Social Functioning (p = .0130), and Physical Summary Index (p = .0370) compared to the CG, with medium effect sizes (d = 0.56-0.75). Conclusions: The results demonstrate the feasibility of the video game intervention to promote active aging and encourage conducting a large-scale randomized controlled trial.

How environments can promote active aging: results from a case study of two municipalities in Quebec, Canada.

OBJECTIVES: To address global aging, a paradigm shift is needed from disease prevention and treatment towards active aging, i.e., optimizing opportunities for health, participation, and security as people age. Little is known about how age-friendly environments promote active aging. This study thus aimed to explore how (through which mechanisms and in what contexts) environments can promote active aging and, specifically, positive health, social participation, and health equity. METHODS: Using a realist approach and semi-structured focus groups, a case study was used in two Quebec municipalities known for best fostering active aging. Data also included participants' logbooks, sociodemographic questionnaires, municipalities' sociodemographic profiles, and policy documents. A conceptual framework and thematic content analysis were carried out. RESULTS: A total of 24 participants (9 older adults, 4 health professionals, 3 community-based actors, 5 municipal employees, and 3 elected officials) took part in 5 focus groups. Regarding contexts, both cases were midsize municipalities having an income and education level higher to Quebec's averages with supportive active aging policies. Two main themes explained how the environments promoted active aging: (1) by ensuring proximity through built (urban planning), social (network structures), services (variety and availability of local and outreach resources), and organizational (active listening to older adults' needs for active aging) environments; and (2) by fostering transversality through built (universal accessibility, intergenerational spaces), social (intergenerational opportunities for social participation), and political/organizational (unified and complementary policies) environments. CONCLUSION: To better promote active aging through age-friendly environments, practices should focus on fostering proximity and transversality, and act simultaneously on multiple environments.

RéSUMé: OBJECTIFS: Pour faire face au vieillissement des populations, un changement de paradigme est requis allant de la prévention et du traitement de la maladie vers la promotion d'un vieillissement actif, c.-à.-d. l'optimisation des possibilités de bonne santé, de participation sociale et de sécurité pendant l'avancement de l'âge. Peu d'informations renseignent sur comment les environnements favorisent le vieillissement actif. Cette étude visait donc à explorer comment (par quels mécanismes et dans quels contextes) les environnements favorisent le vieillissement actif et, spécifiquement, la santé positive, la participation sociale et l'équité en santé des aînés. MéTHODES: Selon une approche réaliste et des groupes de discussion semi-dirigés, une étude de cas multiples a été réalisée dans deux municipalités québécoises, reconnues pour favoriser un vieillissement actif. Les données incluaient aussi les journaux de bord et les questionnaires sociodémographiques des participants ainsi que les profils sociodémographiques des municipalités et leurs politiques municipales. Les données ont été traitées à l'aide d'un cadre conceptuel et d'une analyse de contenu thématique. RéSULTATS: Un total de 24 participants (9 aînés âgés de 65 ans ou plus, 4 professionnels de la santé, 3 acteurs communautaires, 5 employés municipaux et 3 élus) ont pris part à un des cinq groupes de discussion. Concernant les éléments de contexte, les deux municipalités étaient de taille moyenne et présentaient des revenus et un niveau de scolarité supérieurs à la moyenne québécoise ainsi que des politiques municipales favorisant un vieillissement actif. Deux thèmes principaux expliquaient comment les environnements favorisaient le vieillissement actif : 1) en assurant la proximité des environnements bâti (aménagement urbain), social (structures des réseaux sociaux), des services (ressources locales et de proximité) et politique/organisationnel (écoute active des besoins des aînés pour un vieillissement actif); et 2) en favorisant la transversalité des environnements bâti (accessibilité universelle, espaces intergénérationnels), social (opportunités intergénérationnelles) et politique/organisationnel (politiques unifiées et complémentaires). CONCLUSION: Pour mieux promouvoir le vieillissement actif grâce à des environnements conviviaux aux aînés, les pratiques doivent privilégier la proximité et les approches transversales, en plus d'agir sur plusieurs environnements simultanément.