Health care in future community: innovatively discover and respond to the needs of today's seniors.

Introduction: In the context of the digital economy, the emergence and application of emerging technologies have accelerated the integration of traditional social structures with new technologies, leading to the inception of the "Future Community" as an innovative urban unit. With an aging population's rapid and sustained rise, integrating health care for older adults with modern information technology is gradually moving towards holistic governance. This approach utilizes the Future Community as a medium and aims for quality enhancement and increased efficiency, which instrumentally addresses the diversified health care needs of China's aging era. Methods: In this study, we employed a questionnaire survey method that covered 11 communities in Tianjin City to understand better the current status and characteristics of their health care services. Results: The survey results show that the means of community health care for older adults are gradually being upgraded, and the demands are shifting. Then, we arrive at three conclusions: firstly, technological innovation and smart approaches have the potential to positively influence the quality of health care in these communities. Secondly, allocating health care resources within communities can have a salutary effect on the psychological well-being of seniors. Thirdly, actively involving seniors in community life and governance can elevate their self-worth. Discussion: At last, in conjunction with current challenges, we think that deepening multi-party collaboration, educating specialized talents, and bridging the "digital gap" would be effective ways to establish a future community for seniors.

Measuring music engagement in older adults: the UNE music in aging wellness scale (MAWS).

OBJECTIVES: Engagement with music (i.e. listening, moving to the beat, joining in, performance) is documented to enhance cognition, mood, socialization, and a host of other wellness indicators in advancing age. A number of comprehensive scales measure this engagement, but a brief, accessible scale designed for general use with older adults is lacking. This project was undertaken to create and offer preliminary validation of the 7-item Music in Aging Wellness Scale (MAWS). METHOD: Seven items reflecting aspects of music engagement (ME) were developed by expert opinion (e.g. 'I always tap my foot or sway my body to good music') for completion on a 1-7, strongly disagree to strongly agree, Likert scale. These were subject to exploratory factor analysis (EFA) (n = 349 cases) along with a set of six experimental items on ageism. It was hypothesized these items would cluster by content, thus showing separation into distinct factors. RESULTS: This was achieved and the resulting measure showed sound internal consistency (0.82), split-half reliability (0.71), and one-year test-retest (0.83). The MAWS total score was found to correlate significantly in expected directions with common gerontological measures. High scorers reported less depression, more mastery, less loneliness, and larger social networks. No association was found for worry-based anxiety and self-reported cognitive decline. CONCLUSION: This preliminary reliability and validity study suggests that the MAWS may be an appropriate outcome and tracking measure for older adults involved in music-wellness interventions. Future research will further validate MAWS characteristics and associations with other established measures in this important field.

Promoting older adult mental health through integrated care.

The prevalence of behavioral health conditions among older adults continues to rise while the number of specialty providers remains low. Nurses caring for aging populations across care settings have opportunities to integrate behavioral healthcare into their practice with adults to promote wellness and avoid negative outcomes. Priority issues for integrated behavioral health among older adults include depression, substance use disorders, and neurocognitive conditions. Connections to professional organizations, timely continuing education, and integration of evidenced-based clinical protocols are vital for nurses to provide effective integrated care.

Oral administration of an integrative supplement (CogniCaps®) improves cognitive scores in aging dogs with canine cognitive dysfunction for at least two months: An open-label investigation in 10 dogs.

Background: Canine cognitive dysfunction (CCD), the dog analog of human Alzheimer's disease (AD), is a progressive neurodegenerative condition that presents many treatment challenges. There are few effective drugs with acceptable side effects for AD/CCD, which has prompted investigation into non-drug options, collectively termed nutraceuticals. Nutraceutical supplements are conceptually divided into conventional (Western) and non-conventional (Eastern) ingredients. Many of these individual supplements have shown in vitro and/or in vivo efficacy in ameliorating neuronal damage in rodent models, and some have demonstrated positive effects on cognition in rodent models and clinical trials in dogs and humans with cognitive impairment. Aim: The purpose of this open-label clinical trial was to investigate the effect of an oral integrative (combination of conventional nutraceuticals and Chinese herbals) supplement (CogniCaps®) on cognitive scores when administered to aging dogs with CCD over a 2-month period. Methods: Ten aging (>9-year-old) dogs with moderate (16-33) cognitive scores were recruited and administered oral CogniCaps® for two months. No additional drugs or nutraceuticals directed at improving cognitive function were allowed during the study period. Baseline cognitive scores were compared with those procured at 30 and 60 days. Cognitive scores for baseline, 30- and 60-days post-treatment were compared. Results: Cognitive scores improved at 30 days (38% reduction) and 60 days (41% reduction) post-treatment (p = 0.002). Scores did not differ between 30- and 60-day assessments (p = 0.7). Conclusion: The results of this small preliminary study suggest that the integrative supplement CogniCaps® might improve cognitive scores in dogs with CCD within the first 30 days of administration and that this improvement is sustained at 60-day follow up.

Associations between physical activity and cognitive dysfunction in older companion dogs: results from the Dog Aging Project.

Canine cognitive dysfunction (CCD) is a form of dementia that shares many similarities with Alzheimer's disease. Given that physical activity is believed to reduce risk of Alzheimer's disease in humans, we explored the association between physical activity and cognitive health in a cohort of companion dogs, aged 6-18 years. We hypothesized that higher levels of physical activity would be associated with lower (i.e., better) scores on a cognitive dysfunction rating instrument and lower prevalence of dementia, and that this association would be robust when controlling for age, comorbidities, and other potential confounders. Our sample included 11,574 companion dogs enrolled through the Dog Aging Project, of whom 287 had scores over the clinical threshold for CCD. In this observational, cross-sectional study, we used owner-reported questionnaire data to quantify dog cognitive health (via a validated scale), physical activity levels, health conditions, training history, and dietary supplements. We fit regression models with measures of cognitive health as the outcome, and physical activity-with several important covariates-as predictors. We found a significant negative relationship between physical activity and current severity of cognitive dysfunction symptoms (estimate = - 0.10, 95% CI: - 0.11 to - 0.08, p < 0.001), extent of symptom worsening over a 6-month interval (estimate = - 0.07, 95% CI: - 0.09 to - 0.05, p < 0.001), and whether a dog reached a clinical level of CCD (odds ratio = 0.53, 95% CI: 0.45 to 0.63, p < 0.001). Physical activity was robustly associated with better cognitive outcomes in dogs. Our findings illustrate the value of companion dogs as a model for investigating relationships between physical activity and cognitive aging, including aspects of dementia that may have translational potential for Alzheimer's disease. While the current study represents an important first step in identifying a relationship between physical activity and cognitive function, it cannot determine causality. Future studies are needed to rule out reverse causation by following the same dogs prospectively over time, and to evaluate causality by administering physical activity interventions.

Drawing compared to writing in a diary enhances recall of autobiographical memories.

Drawing at encoding has been shown to improve later recall of to-be-remembered words, pictures, and academic terms, compared to when one simply writes out the target information. Here we examined whether drawing in a diary, compared to writing in it, differentially improved later memorability of personal autobiographical events, and whether aging influenced the magnitude of this effect. Thirty younger and thirty older adults were given a diary booklet, and instructed to use it to reminisce about a random daily event of their choosing, on 12 days within a two-week period. They recorded the event on each day in one of two ways, counterbalanced within-subject: by writing about or by drawing a picture of the event. Participants also generated a keyword descriptor for each event. After the two-week period, participants were cued using their keyword descriptors to recall each autobiographical memory by writing it down. Self-reported match accuracy, between reminisced and recalled events was tabulated. Across age groups, match accuracy was significantly higher for those drawn than written during the reminiscing phase. In addition, we compared the word count, level of detail, visual imagery, and point of view of the recalled memories. Self-reports of the level of detail in the recalled memory were better maintained for events drawn compared to written during the reminiscing stage, and better maintained in older than younger adults. Our findings suggest the use of drawing, while reminiscing within a diary format, enhances accuracy and quality of later recollections.

Trait Mindfulness and Physical Health among Chinese Middle-Older Adults: The Mediating Role of Mental Health.

Few studies have focused on the specific effects of trait mindfulness on physical health status, especially from a resilient aging perspective. This study examined the mediating role of mental health in the association between trait mindfulness and physical health status among middle-older adults in urban China. The participants included 188 individuals who were recruited from a community senior university and five community senior care centers. The findings reveal: (1) trait mindfulness has a strong effect on two physical health indicators (self-rated physical health and subjective sleep quality); (2) mental health is a significant mediator in the relationship between trait mindfulness and physical health status; and (3) the mediation role of mental health is more evident in the self-rated physical health model (24.15%) than subjective sleep quality (18.10%). This study improves our knowledge of how trait mindfulness can lead to a better physical health in middle-older adults and can lead to the development of social value communication and effective prevention.

Association of multi-morbidity, social participation, functional and mental health with the self-rated health of middle-aged and older adults in India: a study based on LASI wave-1.

Self-rated health (SRH) is a well-established measure in public health to administer the general health of an individual. It can also be used to assess overall health status' relationship with the social, physical, and mental health of a person. In this study, we examine the association of SRH and various socio-economic & health-related factors such as multi-morbidity status, mental health, functional health, and social participation. Data used in this paper is collated from the first wave of Longitudinal Ageing Study in India (LASI) 2017-18. A total of 65,562 older adults aged 45 or above are considered in our study. Various indices (multimorbidity, social participation, functional and mental health) have been created to measure factors influencing the SRH of an individual. Overall, in the study population, around 18.4% of people reported poor SRH. Dominance Analysis results show that the contribution of multimorbidity in predicting poor SRH is highest, followed by functional health, mental health, and social participation. In a developing country like India, there is a dire need for policies having a holistic approach regarding the health and well-being of the older population.

Analyzing Successful Aging and Longevity: Risk Factors and Health Promoters in 2020 Older Adults.

Geriatric syndromes (GSs) and aging-associated diseases (AADs) are common side effects of aging. They are affecting the lives of millions of older adults and placing immense pressure on healthcare systems and economies worldwide. It is imperative to study the factors causing these conditions and develop a holistic framework for their management. The so-called long-lived individuals-people over the age of 90 who managed to retain much of their health and functionality-could be holding the key to understanding these factors and their health implications. We analyzed the health status and lifestyle of the long-lived individuals and identified risk factors for GSs. Family history greatly contributes to the health and prevention of cognitive decline in older adults. Lifestyle and certain socioeconomic factors such as education, the age of starting to work and retiring, job type and income level, physical activity, and hobby were also associated with certain GSs. Moreover, the levels of total protein, albumin, alpha-1 globulins, high-density lipoprotein, free triiodothyronine, and 25-hydroxyvitamin D were direct indicators of the current health status. The proposed mathematical model allows the prediction of successful aging based on family history, social and economic factors, and life-long physical activity (f1 score = 0.72, AUC = 0.68, precision = 0.83 and recall = 0.64).

Expectativas en salud de las personas mayores que acuden a la atención primaria / Health expectations of older people attending primary care

INTRODUCCIÓN: Desde la última década se ha evidenciado el aumento de la población de personas mayores en Chile. Muchos de ellos son usuarios regulares del sistema público de salud el cual se caracteriza por entregar una atención de tipo integral. En este sentido, resulta relevante conocer los requerimientos en salud desde la perspectiva de las experiencias de las personas mayores con respecto al uso de este servicio. OBJETIDO: El objetivo de este estudio fue identificar las expectativas de las personas mayores que asisten a los centros de APS. MATERIAL Y MÉTODOS: Este es un estudio cualitativo, descriptivo, donde la muestra fue de 13 personas mayores de 65 años y más, autovalentes, de tres centros APS, los cuales fueron entrevistados mediante instrumento semiestructurado, con análisis cualitativo de datos método que incluyó codificación abierta y focalizada. RESULTADOS: Las expectativas de las personas mayores fueron categorizadas como requerimiento de una atención profesional integral, oportunidad de atención, accesibilidad de la atención, promoción de salud sobre el autocuidado, explicación de cambios en el envejecimiento con enfoque biológico y alfabetización en salud. CONCLUSIONES: Las expectativas de las personas mayores en este estudio dan cuenta de una atención profesional integral poco efectiva, además de la necesidad de un trato especializado al grupo poblacional específico, no sólo de los profesionales, sino también del personal administrativo de los centros de APS, considerándolos una barrera en la calidad de la atención.

INTRODUCTION: Since the last decade there has been evidence of an increase in the population of older people in Chile. Many of them are regular users of the public health system (PHS) which is characterized by providing comprehensive care. In this sense, it is relevant to know the health requirements from the perspective of the experiences of the older people regarding the use of this health service. OBJECTIVE: The objective of this study was to identify the needs and expectations of older people attending PHS centers. MATERIAL AND METHODS: It were a qualitative and descriptive study. The sample was compounded by 13 people over 65 years and over, self-sufficient, from three PHS centers. It was used a semi-structured instrument. RESULTS: The main needs of the elderly were categorized as a requirement for comprehensive professional care, the opportunity for care, accessibility of care, health promotion on self-care, explanation of changes in aging with a biological focus and health literacy. CONCLUSIONS: The needs and expectations of the older people in this study account for an ineffective comprehensive professional care, in addition to the need for specialized treatment of the specific population group, not only of professionals but also of the administrative staff of the centers of PHS, considering them a barrier in the quality of care.

Age-related alterations to working memory and to pyramidal neurons in the prefrontal cortex of rhesus monkeys begin in early middle-age and are partially ameliorated by dietary curcumin.

Layer 3 (L3) pyramidal neurons in aged rhesus monkey lateral prefrontal cortex (LPFC) exhibit significantly elevated excitability in vitro and reduced spine density compared to neurons in young subjects. The time-course of these alterations, and whether they can be ameliorated in middle age by the powerful anti-oxidant curcumin is unknown. We compared the properties of L3 pyramidal neurons from the LPFC of behaviorally characterized rhesus monkeys over the adult lifespan using whole-cell patch clamp recordings and neuronal reconstructions. Working memory (WM) impairment, neuronal hyperexcitability, and spine loss began in middle age. There was no significant relationship between neuronal properties and WM performance. Middle-aged subjects given curcumin exhibited better WM performance and less neuronal excitability compared to control subjects. These findings suggest that the appropriate time frame for intervention for age-related cognitive changes is early middle age, and points to the efficacy of curcumin in delaying WM decline. Because there was no relationship between excitability and behavior, the effects of curcumin on these measures appear to be independent.

Prospective Memory Training for Healthy Older Adults: A Systematic Review.

OBJECTIVES: This review systematically synthesizes existing evidence of prospective memory training for healthy older adults (> 55 years). Existing prospective memory training include strategy-based, process-based and combined regimens. Strategy-based training focuses on different mnemonics to compensate for aging declines in prospective memory. Process-based training aims to restore related cognitive processes to support prospective memory. Combined training utilizes both strategy-based and process-based regimens to enhance prospective memory performance. METHODS: A total of 349 studies were identified from the Cochrane Library, EBSCO, PsycINFO and PubMed databases. RESULTS: Using predefined inclusion and exclusion criteria, 11 studies were included in the review. There were six studies of strategy-based training, two studies of process-based training and three studies of combined training. CONCLUSIONS: Overall, strategy-based training appears to facilitate prospective memory for healthy older adults. However, it is impossible to draw conclusions for process-based and combined training due to the preliminary nature of current evidence. CLINICAL IMPLICATIONS: Mental imagery or the use of external aids can be useful strategy-based approaches to facilitate prospective memory in older adults. Strategy-based training should target multiple prospective memory phases simultaneously to encourage transfers. Further studies will be required to draw conclusions on the effectiveness of process-based and combined training.

An experimental study of mindfulness and acceptance-based skills for internalized ageism in older adults and college students.

OBJECTIVES: Older adults (OA; 65+) can become cognitively fused with negative attitudes and stereotypes. Given the verbal nature of ageist stereotypes, mindfulness and acceptance-based practices (MABPs) may help the impact of negative aging attitudes by increasing non-judgmental awareness, cognitive defusion, and acceptance. As part of a larger study, this project examined whether an Acceptance and Commitment Therapy (ACT) consistent MABP would reduce negative aging attitudes using an experimental design. We hypothesized that assignment to the MABP condition would be associated with lower negative aging attitudes for both OAs and university undergraduates (18-25). METHOD: Both OAs (N = 60) and undergraduate student (N = 60) participants were assigned to the experimental or comparison condition (MABP vs. sit-and-think task) and were then presented negative ageist stereotypes assessed with two ageism measures. RESULTS: Following the MABP, undergraduates who received a MABP had significantly lower ageism scores than did undergraduates who did not, while OAs endorsed higher scores on ageism after receiving the MABP (vs comparison group; ps < .05). There was no significant condition by age sample interaction effect. CONCLUSION: Results suggest that undergraduates and OAs may have different strategies for recontextualizing ageist attitudes, with OAs possibly employing different strategies when confronted with ageism in an experimental context. Overall, aging education, OA experimental research, and evidence-based interventions for negative beliefs about aging are needed. Limitations and future directions are discussed.

Multidimensional wellness for people aging with mental health conditions: A proposed framework.

OBJECTIVE: This project aimed to develop a synthesized framework of multidimensional wellness for people aging with serious mental health conditions (SMHC) using existing frameworks to serve as a guide for policy and interventions to address the unique needs, experiences, and strengths of the population. METHOD: A concept analysis compared a widely used wellness approach (Swarbrick, 1997) for people with SMHC and one for older adults (Fullen, 2019) to synthesize into a practical framework for people aging with SMHC. RESULTS: Nine dimensions were proposed for conceptualizing the wellness of this population including: (a) Developmental, (b) Intellectual/Cognitive, (c) Physical, (d) Emotional, (e) Social, (f) Occupational, (g) Spiritual, (h) Environmental, and (i) Financial. Practical suggestions for implementation are identified. CONCLUSIONS AND IMPLICATION FOR PRACTICE: People aging with SMHC require rehabilitation services that address their unique perspectives, strengths, and challenges. The proposed adapted wellness framework offers a guide to comprehensively address well-being in people aging with SMHC. Placing the model in the context of external factors of resources and supports available, and the impact of societal perspectives about each dimension, further delineates a holistic model of wellness that considers well-being and successful living. This model can offer structure and practical application for services, and consideration of future needs of people aging with SMHC to support psychiatric rehabilitation services, as well as offer strategies to encourage positive aging and recovery. Future work should explore the impact of multidecade experiences of mental health conditions and the mental health system to better support individual recovery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Nutrition, Physical Activity, and Other Lifestyle Factors in the Prevention of Cognitive Decline and Dementia.

Multiple factors combined are currently recognized as contributors to cognitive decline. The main independent risk factor for cognitive impairment and dementia is advanced age followed by other determinants such as genetic, socioeconomic, and environmental factors, including nutrition and physical activity. In the next decades, a rise in dementia cases is expected due largely to the aging of the world population. There are no hitherto effective pharmaceutical therapies to treat age-associated cognitive impairment and dementia, which underscores the crucial role of prevention. A relationship among diet, physical activity, and other lifestyle factors with cognitive function has been intensively studied with mounting evidence supporting the role of these determinants in the development of cognitive decline and dementia, which is a chief cause of disability globally. Several dietary patterns, foods, and nutrients have been investigated in this regard, with some encouraging and other disappointing results. This review presents the current evidence for the effects of dietary patterns, dietary components, some supplements, physical activity, sleep patterns, and social engagement on the prevention or delay of the onset of age-related cognitive decline and dementia.

Spike Activity in the Ventromedial Nucleus of Rat Hypothalamus during Aging.

Spike activity of neurons in the ventromedial nucleus (VMN) of the hypothalamus in adult (6-8 months) and aged (2 years) male rats was studied by the in vivo extracellular method using stereotaxic insertion of microelectrodes. In all animals, firing frequency of most VMN neurons increased in response to glucose administration. However, in aged rats, the mean baseline and glucose-induced spike frequencies of VMN neurons were lower than in adult animals. These results support the hypothesis that aging is associated with a decrease in the functional activity of hypothalamic neurons.

Co-treatment of vitamin D supplementation with enriched environment improves synaptic plasticity and spatial learning and memory in aged rats.

RATIONALE AND OBJECTIVE: Environmental enrichment (EE) has been shown in old rats to improve learning and memory. Vitamin D (VitD) has also been shown to modulate age-related, cognitive dysfunction. As both EE and VitD could work to improve cognition via enhancement of neurotrophic factors, their effects might occlude one another. Therefore, a clinically relevant question is whether noted cognition-promoting effects of EE and VitD can co-occur. METHODS: Aged rats were housed for 6 weeks in one of three housing conditions: environmentally enriched (EE), socially enriched (SE), or standard condition (SC). Further, a 4th group was co-treated with VitD supplementation (400 IU kg-1 daily, 6 weeks) under EE conditions (EE + VitD). RESULTS: Treatment with VitD and EE housing were associated with higher score on measures of learning and memory and exhibited lower anxiety scores compared to EE alone, SE or SC as assayed in the elevated plus maze, Morris water maze, passive avoidance, and open field tasks. Additionally, in the EE + VitD group, mRNA expression levels of NGF, TrkA, BDNF, Nrf2, and IGF-1 were significantly higher compared to expression seen in the EE group. Furthermore, field potential recordings showed that EE + VitD resulted in a greater enhancement of hippocampal LTP and neuronal excitability when compared to EE alone. CONCLUSIONS: These findings demonstrate that in aged rats exposure to EE and VitD results in effects on hippocampal cognitive dysfunction and molecular mechanisms which are greater than effects of EE alone, suggesting potential for synergistic therapeutic effects for management of age-related cognitive decline.

State mindfulness and affective well-being in the daily lives of middle-aged and older adults.

Contemporary conceptualizations of mindfulness refer to paying attention to the present moment with an open and nonjudgmental attitude. Empirical research is increasingly focusing on mindfulness as a dynamic and multifaceted state that can fluctuate across situations and time. The present study aimed to extend existing knowledge by using experience-sampling methodology to examine state-level mindfulness, pleasant/unpleasant event occurrence, and affective well-being in the everyday lives of middle-aged and older adults. A community-based sample of 157 participants aged 53-86 (M = 69.36, SD = 5.80) was recruited in May-June 2020. Participants completed assessments of multidimensional state mindfulness, hassle and uplift occurrence, and positive and negative affect on their smartphones, four times a day over 10 consecutive days. (Total observations: 4,761; M = 30.32, SD = 8.78.) Multilevel models indicated that the state mindfulness-facets present-moment attention and nonjudgmental acceptance were predictive of greater affective well-being in older adulthood. Furthermore, nonjudgmental acceptance appeared to buffer affective reactivity to daily hassles, and importantly, this effect was stronger at older ages. Mindful states did not appear to provide any further boost to uplift-related mood. The findings suggest that occasions characterized by relatively high present-moment attention and nonjudgmental acceptance may contribute to enhanced emotional well-being in later adulthood. Furthermore, adopting a nonevaluative and accepting orientation toward momentary experiences may be a psychological strategy that has particular utility for mitigating emotional reactivity to daily stressors with increasing age. Future research should investigate multidimensional state mindfulness and affective well-being for middle-aged and older adults participating in mindfulness-based interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Attachment: the mediating role of hope, religiosity, and life satisfaction in older adults.

BACKGROUND: Attachment and support from family and friends are core to the experiences of ageing for older adults. The purpose of this study is to examine the relationships between attachment styles and hope, religiosity, and life satisfaction and provide new knowledge that may assist future planning for a rapidly ageing global population. METHODS: In this cross-sectional study, 504 Iranian older adult participants from Qazvin province were recruited between December 2015 and April 2016. They completed a questionnaire that included the Revised Adult Attachment Scale, the Life Satisfaction Index-Z, and the Herth Hope Index. RESULTS: Participants in the study had a mean age of 66.20 years (SD: 5.76) and most of them were women (57.5%). A mediation model testing the direct relationships between attachment, hope, religiosity, and life satisfaction showed a positive relationship between close attachment and religiosity (ß = .226, p < .001) and a negative relationship between anxiety attachment and religiosity (ß = - .229, p < .001). Religiosity was positively related to hope (ß = .384, p < .01) and hope was related to life satisfaction (ß = .448, p < .001). Religiosity and hope mediated the relationship between close attachment (ß = .119, p < .001) and anxiety attachment (ß = - .056, p < .01) with life satisfaction. More specifically, while religiosity and hope fully mediated the relationship between close attachment and life satisfaction, they partially mediated the attachment anxiety-life satisfaction link. CONCLUSIONS: Findings of the study provide insight into only a narrow perspective of life satisfaction and attachment given the many and varied variables that influence these constructs. Future research is needed whereby other related variables are introduced into the model to be examined further.