Healthy ageing in a multi-ethnic population: A descriptive cross-sectional analysis from the HELIUS study.

OBJECTIVE: We investigated ethnic health disparities in the Healthy Life in an Urban Setting multi-ethnic cohort using the multidimensional Healthy Ageing Score. STUDY DESIGN: We conducted a cross-sectional analysis of the study baseline data (2011-2015) collected through questionnaires/physical examinations for 17,091 participants (54.8 % women, mean (SD) age = 44.5 (12.8) years) from South-Asian Surinamese (14.8 %), African Surinamese (20.5 %), Dutch (24.3 %), Moroccan (15.5 %), Turkish (14.9 %), and Ghanaian (10.1 %) origins, living in Amsterdam, the Netherlands. MAIN OUTCOME MEASURES: We computed the Healthy Ageing Score developed in the Rotterdam Study, which has seven biopsychosocial domains: chronic diseases, mental health, cognitive function, physical function, pain, social support, and quality of life. That score was used to discern between healthy, moderate, and poor ageing. We explored differences in healthy ageing by ethnicity, sex, and age group using multinomial logistic regression. RESULTS: The Healthy Ageing Score [overall: poor (69.0 %), moderate (24.8 %), and healthy (6.2 %)] differed between ethnicities and was poorer in women and after midlife (cut-off 45 years) across ethnicities (all p < 0.001). In the fully adjusted models in men and women, poor ageing (vs. healthy ageing) was highest in the South-Asian Surinamese [adjusted odds ratios (95 % confidence intervals)] [2.96 (2.24-3.90) and 6.88 (3.29-14.40), respectively] and Turkish [2.80 (2.11-3.73) and 7.10 (3.31-15.24), respectively] vs. Dutch, in the oldest [5.89 (3.62-9.60) and 13.17 (1.77-98.01), respectively] vs. youngest, and in the divorced [1.48 (1.10-2.01) and 2.83 (1.39-5.77), respectively] vs. married. Poor ageing was inversely associated with educational and occupational levels, mainly in men. CONCLUSIONS: Compared with those of Dutch ethnic origin, ethnic minorities displayed less healthy ageing, which was more pronounced in women, before and after midlife, and was associated with sociodemographic factors.

Effectiveness of Theory-Based Physical Activity and Nutrition Interventions in Aging Latino Adults: A Scoping Review.

In the United States (US), Latino individuals older than 50 years face health disparities compared to their White counterparts. Considering the rising life expectancy and the projected increase of older Latino adults in the US, this scoping review aimed to determine the effectiveness of theory-based and culturally relevant strategies that promote healthy aging in Latinos. Web of Science and PubMed databases were searched between December 2022 and February 2023 for peer-reviewed articles assessing healthy aging interventions tailored to community-dwelling aging Latino adults. We included nine studies describing the effects of seven interventions on physical activity- or nutrition-related outcomes. Although not always statistically significant, interventions had a beneficial impact on well-being indicators. The most commonly used behavioral theories were Social Cognitive Theory and Attribution Theory. Latino cultural elements in these studies included partnering with community organizations that serve Latinos (such as Catholic churches), delivery of in-person bilingual group sessions by trusted community members (such as promotoras or Latino dance instructors), and incorporating values such as family and religion into the health curriculum, among others. Future strategies that promote healthy aging in Latino adults should proactively culturally adapt the theoretical foundations and the design, recruitment, and implementation processes to ensure their relevance and effectiveness.

Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000-2010.

OBJECTIVES: To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less-educated white Americans during the first decade of the twenty-first century. METHODS: This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (i) change in age-specific mortality rates; and (ii) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). RESULTS: Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. In contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less-educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages. DISCUSSION: Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less-educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

"We Are Like Any Other People, but We Don't Cry Much Because Nobody Listens": The Need to Strengthen Aging Policies and Service Provision for Minorities in Canada.

BACKGROUND AND OBJECTIVES: This study explores the aging experiences and needs of immigrant Muslim communities in an urban center in Alberta, Canada. Over one million Muslims live in Canada, with the majority being immigrants and visible minorities. Aging-focused policies and services have yet to address the needs of this population as larger cohorts begin to enter older age. RESEARCH DESIGN AND METHODS: A community-based participatory research approach was adopted with a community advisory committee co-leading all aspects of the research process. Sixty-seven older adults and stakeholders from diverse ethnocultural immigrant Muslim communities participated in either individual interviews or one of the seven focus groups (2017-2018). Data were transcribed verbatim and thematically analyzed with a focus on factors that support or hinder positive aging experiences in this population. RESULTS: Participants not only described the benefits of growing old in Canada but also identified unique challenges stemming from their social positioning as religious minorities, immigrants, and older adults. We highlight these experiences in three themes: (a) aging while living across places, (b) negotiating access to aging-supportive resources in a time of scarcity, and (c) re-envisioning Islamic approaches to eldercare. DISCUSSION AND IMPLICATIONS: Immigrant Muslim communities report inequities experienced by older community members. There is a need for an in-depth analysis of the ways aging and migration policies intersect to influence the resources that immigrant minorities have access to as they grow old in Canada.

Association between improved adherence to the Japanese diet and incident functional disability in older people: The Ohsaki Cohort 2006 Study.

BACKGROUND & AIMS: Although it has been reported that the Japanese dietary pattern is associated with a lower risk of incident functional disability among older people, the potential benefits of improving adherence to the Japanese diet remain unclear. The aim of the present study was to evaluate the association between 12-year change in adherence to the Japanese diet and the subsequent risk of incident functional disability in older people in Japan. METHODS: We analyzed 10-year follow-up data from a cohort study of 2923 Japanese older adults (age ≥65 years) in 2006. We collected dietary information using a validated 39-item food frequency questionnaire at two time points (1994 and 2006). Adherence to the Japanese diet (high intake of rice, miso soup, seaweeds, pickles, green and yellow vegetables, fish, green tea; low intake of beef and pork, and coffee) was assessed using the Japanese Diet Index (JDI), which ranges from 0 to 9. Participants were categorized into five groups according to changes in the JDI score at these two time points. Data on incident functional disability from December 2006 to November 2016 were retrieved from the public long-term care insurance database. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident functional disability. RESULTS: During 22,466 person-years of follow-up, 1093 cases of incident functional disability were documented. Compared with participants in the group with the largest decrease in the JDI score (≤-2), the multivariate-adjusted HR (95% CI) of incident functional disability was 0.77 (0.61-0.98) for those in the largest increase group (≥+2). CONCLUSIONS: Improved adherence to the Japanese diet was associated with a significantly lower risk of incident functional disability in older people in Japan.

The social determinants of healthy ageing in the Canadian Arctic.

A better knowledge of the social determinants of health (SDH) promoting healthy ageing in Inuit communities is needed to adapt health and social policies and programs. This study aims to identify SDH associated with healthy ageing. Using the 2006 Aboriginal Peoples Survey (n = 850 Inuit aged ≥50 years), we created a holistic indicator including multiple dimensions of health and identified three groups of participants: those in 1) good 2) intermediate and 3) poor health. Sex and age-adjusted multinomial regression models were applied to assess the associations between this indicator and SDH measured at the individual, household and community scales. In comparison to APS respondents in the "Poor health" profile, those in the "Good health" profile were more likely to have a higher individual income, to participate in social activities, and to have stronger family ties in the community ; those in the "Intermediate health" profile were less likely be in a relationship, more likely to live in better housing conditions, and in better-off communities. Results indicate that SDH associated with the "Good health" profile related more to social relationships and participation, those associated with the "Intermediate health" profile related more to economic and material conditions.

Efficacy and challenges of a culturally relevant intervention to improve attitudes to aging.

OBJECTIVES: Attitudes to aging have been linked with important health outcomes. It is unclear whether interventions to improve attitudes to aging are effective across cultural contexts. This study investigated the efficacy of an intervention among women of either Australian or Chinese backgrounds. METHODS: Among 96 women who provided baseline measures, 86 attended a single, 90-min group session on either healthy aging or healthy diet. Measures of three domains of attitudes to aging were collected at baseline, then immediately and 8 weeks after the intervention. RESULTS: The intervention improved attitudes in the psychological growth domain, but not the physical change or psychosocial loss domains. Cultural identification did not moderate intervention efficacy. DISCUSSION: The findings suggest that brief, culturally inclusive interventions may be partially effective at improving attitudes to aging. Furthermore, research is needed to investigate if the intervention would be more effective when baseline attitudes to aging are less positive.

Disparities in social determinants of health outcomes and behaviours between older adults in Alaska and the contiguous US: evidence from a national survey.

Few studies have focused on understanding how sociodemographic factors impact healthy ageing in the rapidly growing population of Alaskan older adults. Therefore, the objectives of this study are to compare the health of Alaskan older adults to those in the contiguous US, and determine how the associations differ between older adults in Alaska and the contiguous US. We abstracted 165,295 respondents age 65+ from the 2016 Behavioral Risk Factor Surveillance System. We used generalised linear models to assess the associations between sociodemographic factors and six health outcomes accounting for confounders and complex sampling. In the contiguous US, females were less likely than males to be obese (OR 0.96, 95%CI 0.96-0.97), while in Alaska, females were more likely to be obese (OR 1.24, 95%CI 1.19-1.29). In the contiguous US, Alaska Natives/American Indians were more likely than respondents of other races to be smokers (OR 1.62, 95%CI 1.60-1.63), while in Alaska, the association between race and smoking was not significant (OR 1.00, 95%CI 0.94-1.06). These differences between Alaska and the contiguous US results suggest that programs designed to reduce disparities and promote healthy behaviours may need to be tailored to meet the unique needs and challenges of older adults living in Alaska.

Challenges and adjustments in maintaining health and well-being of older Asian immigrants in New Zealand: An integrative review.

OBJECTIVE: There is a paucity of health-related research on older Asian immigrants in New Zealand. The aim of this review was to critically examine literature on the health and well-being of this population group. METHODS: An integrative literature review was conducted from December 2017 to February 2018. Online databases searched were Scopus, MEDLINE, CINAHL and the Australia/New Zealand Reference Centre. RESULTS: Two themes were identified: Firstly, the "challenges stemming from an unfamiliar environment" faced by older Asian immigrants, and secondly, their "strategies for adjusting to a new home." These themes suggested how participation in community and leisure activities, as well as adapting their outlook on life, contributed to these older migrants' health and well-being within a New Zealand context. CONCLUSION: A multitude of challenges in maintaining health and well-being confronted these older Asian immigrants; nevertheless, they created strategies to respond and positively influence their health following later-life migration.

Changes in Physical Activity Barriers among American Indian Elders: A Pilot Study​.

The objective of the present study was to assess whether selfreported physical activity barriers could be reduced among American Indian elders who participated in a 6-week randomized physical activity trial that compared the use of a pedometer only to that of pedometers with step-count goal setting. Elders (N = 32) were compared on the Barriers to Being Physically Active Quiz after participating in a pilot physical activity trial. Elders were classified into high- and low-barrier groups at baseline and compared on self-reported physical activity, health-related quality of life, pedometer step counts, and 6-minute walk performance. At the conclusion of the 6-week trial, only the lack of willpower subscale significantly decreased. The low-barrier group reported significantly higher physical activity engagement and improved mental health quality of life than the high-barrier group. The groups did not differ on daily step counts or 6-minute walk performance. Additional research is needed with a larger sample to understand relevant activity barriers in this population and assess whether they can be modified through participation in structured physical activity and exercise programs.

Ethnic and Gender Differences in Preferred Activities among Maori and non-Maori of Advanced age in New Zealand.

This study explored active aging for older Maori and non-Maori by examining their self-nominated important everyday activities. The project formed part of the first wave of a longitudinal cohort study of aging well in New Zealand. Maori aged 80 to 90 and non-Maori aged 85 were recruited. Of the 937 participants enrolled, 649 answered an open question about their three most important activities. Responses were coded under the World Health Organization's International Classification of Functioning, Disability and Health (ICF), Activities and Participation domains. Data were analyzed by ethnicity and gender for first in importance, and all important activities. Activity preferences for Maori featured gardening, reading, walking, cleaning the home, organized religious activities, sports, extended family relationships, and watching television. Gendered differences were evident with walking and fitness being of primary importance for Maori men, and gardening for Maori women. Somewhat similar, activity preferences for non-Maori featured gardening, reading, and sports. Again, gendered differences showed for non-Maori, with sports being of first importance to men, and reading to women. Factor analysis was used to examine the latent structural fit with the ICF and whether it differed for Maori and non-Maori. For Maori, leisure and household activities, spiritual activities and interpersonal interactions, and communicating with others and doing domestic activities were revealed as underlying structure; compared to self-care, sleep and singing, leisure and work, and domestic activities and learning for non-Maori. These findings reveal fundamental ethnic divergences in preferences for active aging with implications for enabling participation, support provision and community design.

Nurturing spiritual well-being among older people in Australia: Drawing on Indigenous and non-Indigenous way of knowing.

AIM: The meaning of spiritual well-being as a health dimension is often contested and neglected in policy and practice. This paper explores spiritual well-being from both an Indigenous and a non-Indigenous perspective. METHOD: We drew on Indigenous and non-Indigenous methodologies to explore the existing knowledge around spiritual well-being and its relationship with health. RESULTS: The Indigenous perspective proposed that spiritual well-being is founded in The Dreaming, informs everyday relationships and can impact on health. The non-Indigenous perspective suggested that spiritual well-being is shaped by culture and religion, is of increased importance as one ages, and can improve coping and resilience stressors. CONCLUSIONS: Situating these perspectives side by side allows us to learn from both, and understand the importance of spirituality in people's lives. Further research is required to better address the spiritual well-being/health connection in policy and practice.