[Dietary diversity, anthropometric status and biochemical profile of centenarians of the Nicoya Peninsula, Costa Rica, and their offspring]. / Diversidad dietética, estado antropométrico y perfil bioquímico de centenarios de la Península de Nicoya, Costa Rica, y su descendencia.

BACKGROUND AND OBJECTIVE: Social relationships, physical activity and diet have been proposed as responsible for longevity; however, many of these conditions have changed in modern societies. The objective of this study was to identify if the anthropometric status, biochemical profile and diet of Nicoyan centenarians is different from that of their decency and if the quality and diversity of the diet of these Costa Ricans differs from that of adults from urban areas of the same country. MATERIALS AND METHODS: Anthropometric, biochemical and dietary assessments were carried out on 120 adults residing in the Nicoya Peninsula, including centenarians, their children and grandchildren. The data were analyzed using descriptive and inferential statistics. RESULTS: There is a significantly lower percentage of excess weight, central adiposity and blood lipids in Nicoyan centenarians compared to their children and grandchildren. The consumption of «Dairy¼ and «Other fruits¼ is higher in centenarians than in their descendants. Centenarians showed a higher dietary diversity index (DDI) compared to other age categories, and they also showed a higher DDI and a significantly more diverse diet than the urban population of Costa Rica. CONCLUSION: Nicoyan centenarians presented a better lipid and glycemic profile than their offspring, they have lower weight and a better quality and diversity of diet than their relatives and than adults from the urban area of Costa Rica.

Protocol for a feasibility randomized controlled trial of gentle yoga in older patients discharged from phase II cardiac rehabilitation.

Background: Physical activity (PA) is essential following an acute cardiac event. Cardiac rehabilitation (CR) is commonly prescribed, and PA after CR is recommended. Because of age-related changes in functional ability and multi-comorbidity, many older cardiac patients struggle to continue performing PA at home after CR. Depressive symptoms and anxiety are prevalent in cardiac patients and associated with poor self-care, including lack of daily PA. Yoga has been demonstrated to improve psychological and physical health outcomes in cardiac patients, but it is unknown whether yoga, modified for older CR patients - Gentle Yoga - is beneficial in managing psychological distress and maintaining PA following phase II CR. Our specific aims are to:1) determine the feasibility and acceptability of a modified gentle yoga intervention delivered via video conferencing for older cardiac patients; 2) compare, at 3-month follow-up, the effects and determine effect sizes of a gentle yoga intervention versus control on psychological health and physical health. Methods: We are conducting a 2-group (intervention versus control) randomized controlled pilot study. The intervention is a 12-week gentle yoga program delivered via video conference. Short-term effects will be evaluated at 3-month. Conclusion: This study is designed to be suited for older cardiac patients who would not have access to supervised PA opportunities after facility-based CR to enhance PA. This study will provide data about the feasibility and acceptability of the protocol for older cardiac patients and will offer effect sizes to determine sample size for a fully powered randomized controlled trial.

Food insecurity and mobility difficulty in middle-aged and older adults: The importance of bio-psychosocial factors.

OBJECTIVE: Food insecurity has been associated with mobility difficulty (MD) in old age. However, there is a scarcity of research on this topic from low- and middle-income countries, while the bio-psychological factors underlying this association are largely unknown. We investigated the food insecurity-MD link in Ghana and explored how sleep, anxiety, loneliness, and physical activity (PA) mediate the association. METHODS: Community-based, representative cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behavior Study were analyzed (N = 1201; Mage = 66.5; women = 63%). MD was assessed with items from the SF-36 of the Medical Outcomes Study. We assessed food insecurity with items on hunger and breakfast-skipping frequency due to lack of food and resources. Adjusted OLS and mediation models via bootstrapping technique evaluated the associations. RESULTS: Results revealed the expected association between food insecurity and MD, such that greater food insecurity was significantly and positively associated with MD across paths (from ß = 0.33 to ß = 0.42, p < .001). Analyses of indirect effects showed that sleep problems (27.8%), anxiety (15.5%), loneliness (17.5%), and PA (18.0%) mediated the association between food insecurity and MD. Cross-level interactions revealed that food insecurity significantly modified the link between each mediator and MD. CONCLUSIONS: Our data provide novel evidence that bio-psychological mechanisms may underlie the food insecurity-MD link and should, therefore, be considered relevant targets for interventions to prevent/manage MD in later life.

Unlocking the biochemical secrets of longevity: balancing healthspan and lifespan.

In an era of rising global life expectancies, research focuses on enhancing the quality of extended years. This review examines the link between mitochondrial function and aging, highlighting the importance of healthspan alongside lifespan. This involves significant human and economic challenges, with longer lifespans often accompanied by reduced well-being. Addressing mitochondrial decline, exploring targeted interventions, and understanding the complexities of research models are vital for advancing our knowledge in this field. Additionally, promoting physical exercise and adopting personalized supplementation strategies based on individual needs can contribute to healthy aging. The insights from this Perspective article offer a hopeful outlook for future advances in extending both lifespan and healthspan, aiming to improve the overall quality of life in aging populations.

Necessity and influencing factors for integrating oral health in cancer care for older people: a narrative review.

PURPOSE: The number of older people with poor oral health diagnosed with cancer is increasing rapidly. However, integration of oral health in cancer care for older people to prevent or minimize oral health complications of cancer treatments is uncommon, except in head and neck oncology. The aim of this review is to describe the need, role of, and factors influencing the integration of oral health(care) into the treatment of older people with cancer. METHODS: MEDLINE, CINAHL, PubMed, Scopus, and Web of Science databases were searched for papers published in the last 10 years that focus on oral health in older people diagnosed with cancer, the impact of oral health on cancer therapy, and integrated oral health in cancer treatment. RESULTS: From 523 related papers, 68 publications were included and summarized as follows: (1) oral complications associated with cancer therapies, (2) the need for oral healthcare in older people with cancer, (3) the role of integration of oral health in cancer care, and (4) influencing factors such as ageism, interprofessional education and collaborations, oral healthcare workforce, oral health literacy, and financial considerations. CONCLUSION: Integration of oral healthcare is highly recommended for the overall well-being of older people with cancer to prevent, minimize, and manage complications in cancer treatment. However, oral healthcare has not been integrated in cancer care yet, except for head and neck cancers. This review identified a notable gap in the literature, highlighting the need for research on integration of oral healthcare in geriatric oncology.

Association between possible sarcopenia and domain-specific cognitive impairment in middle-aged and older adults: Insights from the Gan-Dau Healthy Longevity Plan.

BACKGROUND: Given the established association between sarcopenia and cognitive impairment was mainly in the older and oldest-old population or people with relatively limited education, this study extends the investigation to community-dwelling middle-to-old age adults in urban communities, emphasizing the need for preventive intervention for muscle health and healthy longevity. METHODS: Data of 712 participants from the Gan-Dau Healthy Longevity Plan were retrieved for analysis, and all participants were stratified by age (50-64, 65-74 and 75+ years old). Possible sarcopenia was defined by 2019 consensus report of the Asian Working Group for Sarcopenia (AWGS). This study used four neuropsychological tests for analysis, i.e., Mini-Mental Status Examination (MMSE), California Verbal Learning Test II (CVLT-SF), Digital Symbol Substitution Test (DSST) and Verbal fluency (VF) for global and domain-specific cognitive function. Multivariate generalized linear models (GLMs) were employed to investigate the associations between possible sarcopenia and cognitive function in each age-specific groups. RESULTS: The prevalence of possible sarcopenia increased with age, with 31.8 %, 37.7 %, and 55.6 % in participants aged 5064, 65-74 and, 75+ years, respectively. On the other hand, cognitive performance declined with age. In particular, among participants aged 75+ years with possible sarcopenia, their cognitive performance were poorer than robust counterparts, including MMSE (26.6 [3.4] vs. 27.4 [2.6]), CVTL-SF (total score: 21.5 [5.4] vs. 23.8 [5.5]; 30-second delayed recall: 6.0 [1.7] vs. 6.5 [1.6]), DSST (32.8 [14.3] vs. 41.3 [18.7]), and VF (12.8 [5.1] vs. 14.8 [4.9]). Multivariate generalized linear model indicated that possible sarcopenia was associated with lower MMSE (ß: -0.70, p = 0.014) and lower DSST (ß: -7.00, p = 0.010) in those aged 50-64 years. Moreover, possible sarcopenia was associated with lower CVLT-SF (total score ß:-1.90, p = 0.028), lower DSST (ß: -6.45, p < 0.001), and lower VF (ß: -1.64, p=0.026) in 75+ years group. CONCLUSIONS: An association exists between possible sarcopenia and cognitive impairment, encompassing global cognition, delayed memory, verbal fluency, and executive function, among community-dwelling adults of mid-to-old age. Future research is warranted to explore the temporal alterations in this association and the potential effects of interventions aimed at fostering healthy longevity.

"I Don't Believe in Age; I Believe in Staying Enthusiastic": An Exploratory Qualitative Study into Recruitment Strategies Stimulating Middle-Aged and Older Adults to Join Physical Activity Interventions.

Many middle-aged and older adults (MAOAs) do not engage in sufficient physical activity (PA), despite its well-documented benefits for healthy aging. Existing PA interventions often fail to reach or engage the target population effectively. This study investigates MAOAs' preferences for recruitment strategies to optimize the reach and uptake of PA interventions, thereby enhancing their impact on healthy aging and public health. Qualitative interviews were conducted with 39 MAOA participants (69% female, mean age = 69.46, SD = 7.07), guided by McGuire's Theory on Persuasive Communication. Factors related to the source, message content, channel, receiver characteristics and target behavior of recruitment strategies were analyzed. Our findings suggest a preference for trustworthy sources (e.g., healthcare professionals over commercial entities) and positive, non-ageist messaging. MAOAs vary in their channel preferences but emphasize the importance of personalization. Despite heterogeneity, MAOAs commonly perceive themselves as sufficiently active, indicating a need for improved knowledge on what constitutes sufficient PA, as well as easy enrollment or trying out interventions. Tailoring recruitment strategies to diverse MAOA segments based on age seems crucial for effective engagement. Future research could explore quantitative research into how communication factors relate to various target population characteristics.

Precision nutrition impact on metabolic health and quality of life in aging population after a 3-month intervention: A randomized intervention.

OBJECTIVES: Innovative precision dietary procedures are required to promote healthy aging. This study aimed to evaluate the effects of a personalised strategy based on the inclusion of individualised foods and digital tools on overall health status and quality of life within a follow-up of 3 months in older adults with overweight or obesity. METHODS: 127 men and women aged between 50 and 80 years with overweight/obesity participated in the study-between January 2020 and September 2020 at the Center for Nutrition Research-University of Navarra and IMDEA-ALIMENTACIÓN-and were randomly assigned to a usual-care group (standard recommendations) or precision group (precision nutrition strategy based on the inclusion of individualised foods and a mobile application). Anthropometry, body fat percentage, biochemical parameters, diet, and quality of life (SF-36 Health Survey) were assessed at baseline and after 3 months. RESULTS: Both strategies were found to improve overall metabolic health; however, the precision approach demonstrated significantly better outcomes. The precision strategy reduced body weight at 3 months (-4.3 kg; p < 0.001) with significant improvements in body fat percentage, blood pressure and general metabolic health (glycated haemoglobin; alanine aminotransferase; aspartate aminotransferase; hepatic steatosis index) in comparison with the standard recommendations. The precision approach significantly enhanced the quality of life (SF-36) of individuals, with additional improvements in emotional well-being (p = 0.024) and vitality (p = 0.008). Adherence to the Mediterranean diet was significantly associated with a higher quality of life and vitality. CONCLUSION: These results support the benefit of precision nutrition approaches for promoting healthy aging and emotional well-being, enhancing the quality of life in aging populations, during the COVID-19 pandemic.

Trend analysis and influencing factors of healthy aging in middle-aged population in China: a longitudinal study based on the China Health and Retirement Longitudinal Study.

OBJECTIVES: This study aimed to assess the trends of healthy aging and investigate its determinants in the middle-aged population. STUDY DESIGN: This was a longitudinal study. METHODS: The sample comprised 3043 participants aged 45-59 years from the China Longitudinal Study of Health and Retirement 2011-2018. We plotted the prevalence across four waves and used ordered logistic models to investigate the determinants of cumulative times of healthy aging. RESULTS: We enrolled 3043 middle-aged people in our study. The prevalence of healthy aging is 28.2% at baseline but subsequently decreased to 19.72% at wave 4. Active socializing consistently ranked the lowest among the five dimensions. Participants with older age (odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.94-0.97), low monthly income (OR = 0.82, 95% CI: 0.69-0.97) or lived in urban (OR = 0.81, 95% CI: 0.70-0.94) were less likely to have per time increase in healthy aging. Participants with more than primary school degree (OR = 1.79, 95% CI: 1.31-2.46), high life satisfaction (OR = 2.38, 95% CI: 1.86-3.06), and good self-report health (OR = 1.97, 95% CI: 1.66-2.34) were more likely to have healthy aging. CONCLUSION: The number of middle-aged individuals in China who achieved healthy aging is declining and eventually less than one in five, which was far from ideal. Particular attention should be paid to older, women, urban dwellers, individuals with low income, low life satisfaction or poor self-report health. It is urgent to develop public health policies to improve the health and well-being of the middle-aged population.

Myricanol prevents aging-related sarcopenia by rescuing mitochondrial dysfunction via targeting peroxiredoxin 5.

Aging is a process that represents the accumulation of changes in organism overtime. In biological level, accumulations of molecular and cellular damage in aging lead to an increasing risk of diseases like sarcopenia. Sarcopenia reduces mobility, leads to fall-related injuries, and diminishes life quality. Thus, it is meaningful to find out novel therapeutic strategies for sarcopenia intervention that may help the elderly maintain their functional ability. Oxidative damage-induced dysfunctional mitochondria are considered as a culprit of muscle wasting during aging. Herein, we aimed to demonstrate whether myricanol (MY) protects aged mice against muscle wasting through alleviating oxidative damage in mitochondria and identify the direct protein target and its underlying mechanism. We discovered that MY protects aged mice against the loss of muscle mass and strength through scavenging reactive oxygen species accumulation to rebuild the redox homeostasis. Taking advantage of biophysical assays, peroxiredoxin 5 was discovered and validated as the direct target of MY. Through activating peroxiredoxin 5, MY reduced reactive oxygen species accumulation and damaged mitochondrial DNA in C2C12 myotubes. Our findings provide an insight for therapy against sarcopenia through alleviating oxidative damage-induced dysfunctional mitochondria by targeting peroxiredoxin 5, which may contribute an insight for healthy aging.

Effect of Modifiable Lifestyle Factors on Biological Aging.

Biological age is a concept that uses bio-physiological parameters to account for individual heterogeneity in the biological processes driving aging and aims to enhance the prediction of age-related clinical conditions compared to chronological age. Although engaging in healthy lifestyle behaviors has been linked to a lower mortality risk and a reduced incidence of chronic diseases, it remains unclear to what extent these health benefits result from slowing the pace of the biological aging process. This short review summarized how modifiable lifestyle factors - including diet, physical activity, smoking, alcohol consumption, and the aggregate of multiple healthy behaviors - were associated with established estimates of biological age based on clinical or cellular/molecular markers, including Klemera-Doubal Method biological age, homeostatic dysregulation, phenotypic age, DNA methylation age, and telomere length. In brief, the available studies tend to show a consistent association of lifestyle factors with physiological measures of biological age, while findings regarding molecular-based metrics vary. The limited evidence highlights the need for further research in this field, particularly with a life-course approach.

Special Report from the CDC: Evaluating the dissemination of CDC's MyMobility Plan: Findings and lessons learned.

INTRODUCTION: Age-related changes (e.g., cognitive, physiologic) can affect an individual's mobility and increase risks for falls and motor-vehicle crashes, which are leading causes of injuries and injury deaths among older Americans. To address this issue, CDC developed MyMobility Plan (MMP) products to help older adults make plans to reduce injury risks and promote safe mobility. In 2019, MMP products were disseminated to older adults and partner organizations. Dissemination strategies consisted of digital and print distribution and partner outreach. METHODS: To assess dissemination efforts, a process (or implementation) evaluation was conducted from January to June 2019. Data were collected for 17 indicators (e.g., counts of webpage visits, product downloads, social media posts). Key informant interviews were conducted with partners, and qualitative analyses of interview data were undertaken to identify key themes related to their dissemination experiences. RESULTS: Findings showed the dissemination resulted in 13,425 product downloads and print copy orders and reached almost 155,000 individuals through email subscriber lists, websites, webinars, and presentations. It is unknown what proportion of these individuals were older adults. Social media metrics were higher than expected, and 58 partners promoted products within their networks. Partner interviews emphasized the need for guidance on dissemination, collaboration with local partners, and integration of the products within a program model to ensure broader reach to and use by older adults. CONCLUSIONS: The evaluation of the dissemination campaign identified strategies that were successful in creating exposure to the MMP and others that could improve reach in the future. Those strategies include meaningful and early partner engagement for dissemination. PRACTICAL APPLICATIONS: Building in evaluation from the start can facilitate development of appropriate data collection measures to assess project success. Engaging partners as active disseminators in the planning stages can help increase the reach of public health tools and resources.

A Most Significant Change evaluation of a new co-designed tool to measure holistic well-being in consumers of community aged care services.

OBJECTIVES: To evaluate a Wellbeing Check-in tool and process for use with BlueCare's home care package (HCP) clients by care and well-being practitioners. The tool had been co-designed with HCP clients and trialled with 15 clients. METHODS: The Most Significant Change (MSC) methodology was used to gather stories from five practitioners, five HCP staff and seven clients. A workshop with senior staff was held to determine themes and whether the tool met its aims. RESULTS: Out of 22 MSC stories, 18 were judged in scope by workshop participants. Eight themes were then identified. Four themes reflected the content of the narratives (i.e. what was discussed): Isolation and connection; Grief; Faith/explicit spirituality; and Client preference. The other four themes reflected the process (i.e. what the discussions meant to participants): Being there/Meaningful conversations; Impact on significant others; New insight; and Purpose of the check-in. These eight themes largely reflected the aims of the Wellbeing Check-in tool in terms of providing a means to optimise connectedness, well-being and spiritual care in accordance with the client's needs, goals and preferences. Unanticipated findings included its benefits for family members and uncertainty about the aim or value of the tool, which highlighted the need for BlueCare to be clear about the purpose of the tool in promoting it to clients and their informal carers. CONCLUSIONS: The Wellbeing Check-in tool was found to be fit for purpose. A tool used flexibly to prompt discussion about well-being can be helpful to clients and pastoral care staff.

The link between exposure to violence and psychological distress among middle-aged Muslims in Israel: the role of gender.

Introduction: To date, it is still unclear if exposure to violence affects psychological distress in middle-aged adults and if the effects are gender specific. This age group is of special interest as it is at the onset of the aging process and is often overlooked or understudied in scholarly research. Specifically, targeted research on middle-aged Muslims living in Israel, a unique population exposed to increasing violence, is lacking. Methods: We examined the relationship between exposure to violence and psychological distress in a cohort of 363 middle-aged adults (223 women) from three Muslim villages in northern Israel, collecting data on violence exposure (Screen for Adolescent Violence Exposure (SAVE) questionnaire), psychological distress (Kessler 6 Psychological Distress questionnaire), and other demographic characteristics including education level and socioeconomic status. We used this data to answer two questions: (1) is exposure to violence a predictor of psychological distress in middle-aged Muslims, and (2) does the relationship between exposure and distress differ between men and women? Results: We revealed a positive link between exposure to violence and psychological distress (ß = 0.145, p = 0.017) when controlling for gender, age, education level, and socioeconomic level. Discussion: Despite previous evidence of gender-based differences in this interplay in younger cohorts, we did not find a significant interaction between gender and the violence exposure-psychological distress interplay. Our findings are some of the first to focus on middle-aged individuals and show that both men and women exhibit connections between exposure to violence and psychological distress when considering covariates. This research provides insights that can be used when planning community-wide interventions and treatment schemes to support healthy aging.

Effects of Peer- or Professional-Led Support in Enhancing Adherence to Wearable Monitoring Devices Among Community-Dwelling Older Adults: Systematic Review of Randomized Controlled Trials.

BACKGROUND: Despite the well-documented health benefits associated with wearable monitoring devices (WMDs), adherence among community-dwelling older adults remains low. By providing guidance on the purpose and benefits of using WMDs, facilitating goal-setting aligned with the device's features, promoting comprehension of the health data captured by the device, and assisting in overcoming technological challenges, peers and health care professionals can potentially enhance older adults' adherence to WMDs. However, the effectiveness of such support mechanisms in promoting adherence to WMDs among older adults remains poorly understood. OBJECTIVE: The aims of this systematic review were to examine the effects of peer- or professional-led intervention programs designed to improve adherence to WMDs among community-dwelling older adults and to identify the intervention components that may positively influence the effects of the intervention. METHODS: We conducted a comprehensive search across 7 electronic databases (Cochrane Central Register of Controlled Trials [CENTRAL], PubMed, EMBASE, PsycINFO, British Nursing Index, Web of Science, and CINAHL) to identify articles published between January 1, 2010, and June 26, 2023. We specifically targeted randomized controlled trials that examined the impact of peer- or professional-led interventions on enhancing adherence to WMDs among individuals aged 60 years and older residing in the community. Two independent reviewers extracted data from the included studies and assessed the potential risk of bias in accordance with the Cochrane Risk of Bias tool for randomized trials, version 2. RESULTS: A total of 10,511 studies were identified through the database search. Eventually, we included 3 randomized controlled trials involving 154 community-dwelling older adults. The participants had a mean age of 65 years. Our review revealed that increasing awareness of being monitored and implementing the SystemCHANGE approach, a habit change tool focusing on personal goals and feedback, were effective strategies for enhancing adherence to WMDs among older adults. All of the included studies exhibited a low risk of bias. CONCLUSIONS: By collaboratively designing specific goals related to WMDs with health care professionals, including nurses and physicians, older adults exhibited a higher likelihood of adhering to the prescribed use of WMDs. These goal-setting tools provided a framework for structure and motivation, facilitating the seamless integration of WMDs into their daily routines. Researchers should prioritize interventions that target awareness and goal-setting as effective approaches to enhance adherence to WMDs among older adults, thereby maximizing the realization of associated health benefits.

Reciprocal and Differential Influences of Mediterranean Diet and Physical Activity on Adiposity in a Cohort of Young and Older than 40 Years Adults.

Translational research has documented the conjoint beneficial relationships between dietary and physical activity habits concerning weight maintenance. However, the precise interplay between diet and exercise impacting body composition remains unclear, challenging personalized interventions. This study aimed to explore potential interactions and effect modifications of these factors affecting the body mass index (BMI) within an online adult cohort. Data from 11,883 NUTRiMDEA cohort participants were analyzed in this cross-sectional study, categorizing individuals by age, sex, and BMI using linear regression models to assess the interactions between lifestyle factors and adiposity. Significant differences emerged in anthropometry, lifestyle, and health-related quality of life (HRQoL) across categories. The combined effect of diet and physical activity had a greater impact on BMI than physical activity or Mediterranean diet adherence alone, with lower BMI as physical activity levels increased (ß: -0.5) and adherence to the Mediterranean diet decreased, where a modification effect between them was identified (ß: -0.28). Participants with lower Mediterranean diet adherence displayed superior BMI when physical activity was low, but when activity levels were higher, their BMI aligned with those with healthier dietary habits. An interaction link between lifestyle factors and BMI was found, showing the differential effects of the Mediterranean diet and physical activity combination concerning adiposity.

Outcomes and instruments used in social prescribing: a modified umbrella review. / Résultats et instruments utilisés dans les interventions de prescription sociale : une métarevue modifiée.

INTRODUCTION: Previous social prescribing work highlights a range in the types and number of outcomes used in published studies. We aimed to describe social prescribing outcome core areas and instruments to build capacity for future research and program evaluation. METHODS: This was a modified umbrella review following standard guidelines. We registered the study and searched multiple databases (all languages and years); inclusion criteria were peer-reviewed publications containing outcomes for self-described social prescribing for adults aged 18 years and older. The last search date was 9 July 2023. From the included systematic reviews, we identified primary studies using the same inclusion criteria. For primary studies, we sorted extracted outcomes and instruments into six core areas using a published taxonomy. We located information on instruments' description and measurement properties and conducted two rating rounds for (1) the quality of systematic reviews and (2) reporting of instruments in primary studies. We conducted a narrative synthesis of reviews, primary studies and outcomes (PROSPERO 2023 CRD42023434061). RESULTS: We identified 10 systematic reviews and 33 primary studies for inclusion in our review. Outcomes covered most core taxonomy areas, with an emphasis on psychosocial factors (e.g. well-being) and less emphasis on cognition, physical activity, and caregivers and volunteers. We noted few studies provided detailed information on demographic data of participants or measurement properties of instruments. CONCLUSION: This synthesis provides an overview and identifies knowledge gaps for outcomes and instruments used in social prescribing interventions. This work forms the basis of our next step of identifying social prescribing-related outcomes that matter most across interested parties, such as individuals providers and decision makers.

Analysis of the life course effects of the disability dilemma among rural older adults in China.

Objective: To analyse whether the accumulation of early adverse experiences among individuals of different generations has an impact on disabilities and evaluate the cumulative effects of disadvantages in rural older adults in China. Methods: A Binary Logit Model was used to analyse the life course effects of the disability dilemma among rural older adults. Results: Regarding Activities of Daily Life (ADLs), there was no significant difference between older adults that experienced 1 adverse events and the control group. The probability of older adults experiencing difficulties in 2, 3, 4, or more types of ADLs was 1.486 times, 2.173 times, and 3.048 times higher than that of the control group, respectively. Regarding Instrumental Activities of Daily Life (IADLs), there was no significant difference between the population that experienced 1 or 2 adverse events and the control group. The probability of experiencing difficulties in 3, 4, or more types of IADLs was 1.527 times and 1.937 times higher than that of the control group, respectively. Early adverse events had a cumulative disadvantageous effect on disability in older adults. The longer the duration of adverse experiences, the higher the risk of disability in old age. Education had a significant mitigating effect on health risks. Conclusion: Pay attention to early factors in the life course, strengthen the promotion of health prevention concepts, and pay attention to the moderating and relieving effects of education on health. We should also gradually improve the rural disability care system and family health security capabilities in China's rural areas.