Walking the talk for dementia: A unique immersive, embodied, and multi-experiential initiative.

Coping with dementia requires an integrated approach encompassing personal, health, research, and community domains. Here we describe "Walking the Talk for Dementia," an immersive initiative aimed at empowering people with dementia, enhancing dementia understanding, and inspiring collaborations. This initiative involved 300 participants from 25 nationalities, including people with dementia, care partners, clinicians, policymakers, researchers, and advocates for a 4-day, 40 km walk through the Camino de Santiago de Compostela, Spain. A 2-day symposium after the journey provided novel transdisciplinary and horizontal structures, deconstructing traditional hierarchies. The innovation of this initiative lies in its ability to merge a physical experience with knowledge exchange for diversifying individuals' understanding of dementia. It showcases the transformative potential of an immersive, embodied, and multi-experiential approach to address the complexities of dementia collaboratively. The initiative offers a scalable model to enhance understanding, decrease stigma, and promote more comprehensive and empathetic dementia care and research.

Science-based policy: targeted nutrition for all ages and the role of bioactives.

Globally, there has been a marked increase in longevity, but it is also apparent that significant inequalities remain, especially the inequality related to insufficient 'health' to enjoy or at least survive those later years. The major causes include lack of access to proper nutrition and healthcare services, and often the basic information to make the personal decisions related to diet and healthcare options and opportunities. Proper nutrition can be the best predictor of a long healthy life expectancy and, conversely, when inadequate and/or improper a prognosticator of a sharply curtailed expectancy. There is a dichotomy in both developed and developing countries as their populations are experiencing the phenomenon of being 'over fed and under nourished', i.e., caloric/energy excess and lack of essential nutrients, leading to health deficiencies, skyrocketing global obesity rates, excess chronic diseases, and premature mortality. There is need for new and/or innovative approaches to promoting health as individuals' age, and for public health programs to be a proactive blessing and not an archaic status quo 'eat your vegetables' mandate. A framework for progress has been proposed and published by the World Health Organization in their Global Strategy and Action Plan on Ageing and Health (WHO (2017) Advancing the right to health: the vital role of law. https://apps.who.int/iris/bitstream/handle/10665/252815/9789241511384-eng.pdf?sequence=1&isAllowed=y . Accessed 07 Jun 2021; WHO (2020a) What is Health Promotion. www.who.int/healthpromotion/fact-sheet/en/ . Accessed 07 Jun 2021; WHO (2020b) NCD mortality and morbidity. www.who.int/gho/ncd/mortality_morbidity/en/ . Accessed 07 Jun 2021). Couple this WHO mandate with current academic research into the processes of ageing, and the ingredients or regimens that have shown benefit and/or promise of such benefits. Now is the time for public health policy to 'not let the perfect be the enemy of the good,' but to progressively make health-promoting nutrition recommendations.

Letalidad de la COVID-19: ausencia de patrón epidemiológico / Case fatality rate of COVID-19: absence of epidemiological pattern

Objetivo: Analizar un conjunto de indicadores para comprender la variabilidad de la evolución y el impacto de la epidemia de COVID-19. Método: Estudio ecológico de países con más de 200 casos notificados. Se han analizado variables demográficas, de gasto sanitario y de características de los servicios sanitarios como variables explicativas, y las tasas de incidencia, mortalidad y letalidad como variables respuesta. Se ha creado un índice de letalidad relativa. Los datos proceden de organismos internacionales. La magnitud de las asociaciones se ha estimado mediante el coeficiente de correlación de Spearman. Resultados: El número de pruebas y el número de profesionales de medicina se asocian a una mayor incidencia. La mortalidad y la letalidad no se asocian con variables demográficas, de gasto sanitario ni de los servicios sanitarios. Conclusión: Las diferencias sugieren una subestimación generalizada de la magnitud de la epidemia. Es necesario mejorar la identificación de casos y la eficacia de los sistemas de vigilancia epidemiológica. (AU)

Objective: Analyze a set of indicators to understand the variability of the evolution and impact of the COVID-19 epidemic in a set of selected countries. Method: Ecological study of a group of countries with more than 200 reported cases. Demographic variables, health expenditure variables, and variables about characteristics of health services were included as explanatory variables. and incidence, mortality and fatality rates have been analyzed as response variables. In addition, a relative fatality index has been created. Data are from international organizations. Spearman's correlation coefficient was used to estimate the magnitude of the associations. Results: Number of tests and of medical professionals are associated with a higher incidence rate. Mortality and case fatality rate are not associated with demographic, health expenditure, or health services variables. Conclusion: Differences suggest a general underestimation of the magnitude of the epidemic. Improvement of case identification and effectiveness of epidemiological surveillance systems is necessary. (AU)

[Case fatality rate of COVID-19: absence of epidemiological pattern]. / Letalidad de la COVID-19: ausencia de patrón epidemiológico.

Objective: Analyze a set of indicators to understand the variability of the evolution and impact of the COVID-19 epidemic in a set of selected countries. Method: Ecological study of a group of countries with more than 200 reported cases. Demographic variables, health expenditure variables, and variables about characteristics of health services were included as explanatory variables. and incidence, mortality and fatality rates have been analyzed as response variables. In addition, a relative fatality index has been created. Data are from international organizations. Spearman's correlation coefficient was used to estimate the magnitude of the associations. Results: Number of tests and of medical professionals are associated with a higher incidence rate. Mortality and case fatality rate are not associated with demographic, health expenditure, or health services variables. Conclusion: Differences suggest a general underestimation of the magnitude of the epidemic. Improvement of case identification and effectiveness of epidemiological surveillance systems is necessary.

Moving Toward a Global Age-Friendly Ecosystem.

The designation of "age friendly" has clearly engaged the attention of scholars and leading experts in the field of aging. A search of PubMed references citing the term produced 15 results in the 5-year period from 2006 to 2011; that number increased to 572 in the period from 2015 to 2019. The work, notably led by the World Health Organization with the initiation of age-friendly cities and age-friendly communities, has now sparked a movement for the creation of age-friendly health systems and age-friendly public health systems. Now more than ever, in an era of pandemics, it seems wise to create an ecosystem where each of the age-friendly initiatives can create synergies and additional momentum as the population continues to age. Work of a global nature is especially important given the array of international programs and scientific groups focused on improving the lives of older adults along with their care and support system and our interconnectedness as a world community. In this article, we review the historical evolution of age-friendly programs and describe a vision for an age-friendly ecosystem that can encompass the lived environment, social determinants of health, the healthcare system, and our prevention-focused public health system.

Meeting the complex challenge of health and social care provision for rapidly-ageing populations: introducing the concept of "avoidable displacement from home".

The increasing numbers of people at very old ages pose specific policy challenges for health and social care and highlight the need to rethink established models of service provision. The main objective of this paper is to introduce the concept of "avoidable displacement from home" (ADH). The study argues that ADH builds on and adds value to existing concepts, offering a holistic, person-centered framework for integrated health and social care provision for older people. It also demonstrates that this framework can be applied across different levels, ranging from macro policymaking to organizational and individual decision-making. The paper pays attention to the Brazilian context but argues that ADH is a universally applicable concept.

Longevidad y revolución digital. Contribucion de las tecnologías de la información y de la comunicacion al envejecimiento saludable / Longevity and digital revolution. The contribution of information and communication technologies to healthy aging

OBJETIVO: Sintetizar el conocimiento disponible sobre la contribución de las tecnologías de la información y de la comunicación al envejecimiento activo y saludable. METODOLOGÍA: En la primera fase de búsqueda se utilizó la base de datos GERION de la Biblioteca Virtual del Sistema Sanitario Público Andaluz (SSPA). En la segunda fase se realizó una búsqueda en Cochrane Library, PubMed, EMBASE, Medline, SciELO, MedlinePlus y ScienceDirect. Se utilizaron descriptores de lenguaje natural y lenguaje controlado. Se incluyeron estudios publicados en castellano e inglés en el período comprendido entre enero de 2013 y enero de 2018. Se realizó una metasíntesis cualitativa. RESULTADOS: Se seleccionaron 262 estudios; se excluyeron 240: por estar duplicados, por no cumplir con los criterios de inclusión, por no disponer del texto completo y por no guardar relación con el objeto de estudio. Se incluyeron 22 estudios en la síntesis cualitativa. A partir de la identificación de temas emergentes y su agrupación en categorías, se construyó un modelo conceptual que explica la relación entre envejecimiento activo y saludable e innovación tecnológica. CONCLUSIONES: Las tecnologías de la información y de la comunicación contribuyen al empoderamiento de las personas para el autocuidado; mejoran su autoeficacia y ayudan a mantener su autonomía en la toma de decisiones; favorecen su participación efectiva en los sistemas sanitarios y de cuidados, y contribuyen a la democratización de la salud. Su utilización está condicionada por el compromiso y la implicación de las personas mayores en su diseño, la adaptación a los entornos y preferencias de la persona usuaria, su simplicidad, comprensibilidad, utilidad percibida y facilidad de uso

OBJECTIVE: synthesize the available knowledge on the contribution of information and communication technologies to active and healthy ageing. METHODOLOGY: GERION database from the Virtual Library of the Public Health System of Andalusia was used in the first search phase. In the second phase, a search was performed using Cochrane Library, PubMed, EMBASE, MEDLINE, SciELO, MedlinePlus, and Science Direct. Natural language and controlled language descriptors were used. Studies published in Spanish and English in the period January 2013 to January 2018 were included. Qualitative meta-synthesis was carried out. RESULTS: 262 studies were selected; 240 were excluded due to: duplication, not meeting the inclusion criteria, missing the full text, or not related to the object of study.22 studies were included in the qualitative synthesis. From the identification of emerging issues and their grouping into categories, a conceptual model was constructed that explains the relationship between active and healthy ageing and technological innovation. CONCLUSIONS:Information and communication technologies contribute to the empowerment of people for self-care; improve their self-efficacy; help maintain their autonomy in decision-making; favor their effective participation in health and care systems; and contribute to the democratization of health. Its use is conditioned by the commitment and involvement of older people in its design, adaptation to the environments and preferences of the user, its simplicity, comprehensibility, perceived utility and ease of use

Meeting the complex challenge of health and social care provision for rapidly-ageing populations: introducing the concept of "avoidable displacement from home" / O enfrentamento do desafio complexo da prestação de serviços de saúde e sociais para populações com envelhecimento rápido: a introdução do conceito de "deslocamento residencial evitável" / Resolver el complejo desafío para la salud y atención social en poblaciones que envejecen rápidamente: introduciendo el concepto de "desplazamiento evitable desde el hogar"

Abstract: The increasing numbers of people at very old ages pose specific policy challenges for health and social care and highlight the need to rethink established models of service provision. The main objective of this paper is to introduce the concept of "avoidable displacement from home" (ADH). The study argues that ADH builds on and adds value to existing concepts, offering a holistic, person-centered framework for integrated health and social care provision for older people. It also demonstrates that this framework can be applied across different levels, ranging from macro policymaking to organizational and individual decision-making. The paper pays attention to the Brazilian context but argues that ADH is a universally applicable concept.

Resumo: O número crescente de indivíduos muito idosos cria desafios específicos para as políticas de assistência social e de saúde. Os desafios incluem a necessidade de repensar os modelos assistenciais atuais. O artigo tem como objetivo principal introduzir o conceito de "deslocamento residencial evitável" (DRE). Argumentamos que o conceito de DRE elabora e contribui para os conceitos existentes, oferecendo um arcabouço holístico e centrado na pessoa para a assistência de saúde e social para os idosos. Demonstramos que esse arcabouço pode ser aplicado em diversos níveis, desde a formulação de políticas macro até as decisões organizacionais e individuais. O artigo aborda particularmente o contexto, mas sustenta que o DRE é um conceito universalmente aplicável.

Resumen: Un número creciente de personas con edad muy avanzada plantea desafíos específicos para las políticas de salud y atención social. Esto implica la necesidad de repensar los modelos establecidos de provisión de servicios. El objetivo principal de este artículo es introducir el concepto de "desplazamiento evitable del hogar" (DEH). Nosotros planteamos que el DEH se basa y añade valor a conceptos existentes, ofreciendo un marco de trabajo holístico, centrado en la persona para la provisión integrada de salud y atención social a personas mayores. Demostramos que este marco de trabajo se puede aplicar a través de diferentes niveles, que van desde la elaboración de políticas macro a la adopción de decisiones por parte de organizaciones e individuos. Este trabajo fija su atención en particular sobre el contexto brasileño, pero plantea que el DEH es un concepto aplicable universalmente.

Letalidad del COVID-19: ausencia de patrón epidemiológico / Case fatality rate of COVID-19: absence of epidemiological pattern

OBJETIVO: Analizar un conjunto de indicadores para comprender la variabilidad de la evolución y el impacto de la epidemia de COVID-19. MÉTODO: Estudio ecológico de países con más de 200 casos notificados. Se han analizado variables demográficas, de gasto sanitario y de características de los servicios sanitarios como variables explicativas, y las tasas de incidencia, mortalidad y letalidad como variables respuesta. Se ha creado un índice de letalidad relativa. Los datos proceden de organismos internacionales. La magnitud de las asociaciones se ha estimado mediante el coeficiente de correlación de Spearman. RESULTADOS: El número de pruebas y el número de profesionales de medicina se asocian a una mayor incidencia. La mortalidad y la letalidad no se asocian con variables demográficas, de gasto sanitario ni de los servicios sanitarios. CONCLUSIÓN: Las diferencias sugieren una subestimación generalizada de la magnitud de la epidemia. Es necesario mejorar la identificación de casos y la eficacia de los sistemas de vigilancia epidemiológica

OBJECTIVE: Analyze a set of indicators to understand the variability of the evolution and impact of the COVID-19 epidemic in a set of selected countries. METHOD: Ecological study of a group of countries with more than 200 reported cases. Demographic variables, health expenditure variables, and variables about characteristics of health services were included as explanatory variables. and incidence, mortality and fatality rates have been analyzed as response variables. In addition, a relative fatality index has been created. Data are from international organizations. Spearman's correlation coefficient was used to estimate the magnitude of the associations. RESULTS: Number of tests and of medical professionals are associated with a higher incidence rate. Mortality and case fatality rate are not associated with demographic, health expenditure, or health services variables. CONCLUSIONS: Differences suggest a general underestimation of the magnitude of the epidemic. Improvement of case identification and effectiveness of epidemiological surveillance systems is necessary

Vested rights, active aging and resiliance: the importance of such concepts throughout life / Direitos adquiridos, envelhecimento ativo e resiliência: a importância desses conceitos ao longo da vida

Mostra a influência da crise econômica brasileira do ano de 2016 e da expectativa da reforma da previdência social na qualidade de vida da pessoa idosa. Orienta sobre a importância de se programar políticas públicas que abracem os princípios do Envelhecimento Ativo e suscita que a academia, as instituições da sociedade civil, o setor privado e a mídia sejam facilitadores desse processo. Conclui que os idosos são vulneráveis, mas também resilientes.

It shows the influence of the Brazilian economic crisis of 2016 and gives expectation of reform of the social offer of quality of life. This guides the importance of programming public policies that encompass the principles of Active Aging and the creation of academia, such as civil society institutions or the private sector, to facilitate the development of facilitators of this process. They concluded that the good are vulnerable but also resilient.

Making communities age friendly: state and municipal initiatives in Canada and other countries.

To promote healthy, active aging, the age-friendly community initiative has evolved in Canada, Spain, Brazil and Australia, among other countries. An age-friendly community provides accessible and inclusive built and social environments where older adults can enjoy good health, participate actively and live in security. The rapid expansion of the initiative in all states can largely be explained by common key activities undertaken by the state, municipal and -in the case of Canada- also federal, governments. These initiatives include strategic engagements and policy action in all states, and knowledge development and exchange in Canada in particular. Strategic engagements involve creating or strengthening collaborative intersectoral relationships to access multiple arenas of decision-making, and addressing all areas that constitute an age-friendly community. With variations across states, policy actions have included the following: declaring the initiative as an official policy direction; establishing model cities to be emulated by other cities; funding community projects; implementing consistent methodology; evaluating implementation, enhancing public visibility, and aligning age-friendly community policy with other state-level policy directions. To stimulate knowledge development and exchange, Canadian efforts have included the creation of a community of practice and of a research and policy network to encourage the development and translation of scientific evidence on aging-supportive communities. These activities are expected to result in a strong and durable integration of older persons' views, aspirations, rights and needs in municipal, as well as state, planning and policy.