The perspectives of successful ageing among older adults aged 75+: a systematic review with a narrative synthesis of mixed studies

Abstract Older adults 75 and above are a fast-growing segment of the population. However, few studies have investigated what it means to age successfully from their perspective. This group of older adults face challenges that might characteristically differ from younger older adults. Therefore, the aim of this study was to conduct a systematic review of the perspectives of older adults aged 75 and above regarding what it means to age successfully and to summarise the findings through a narrative synthesis. We also aimed to provide a snapshot of inhibitors and facilitators to achieve successful ageing. A systematic review of the 75+ older adults’ perspectives was conducted across PubMed, CINAHL, Scopus, Web of Science and PsycINFO. Qualitative, quantitative and mixed-methods original peer-reviewed studies were included. After reviewing 4,661 articles, 15 articles met the inclusion criteria and 15 themes were identified. They ranged from biomedical components such as physical functioning to psychosocial components such as relationships, reflections on life and past experiences, preparations for death and environmental factors. The findings revealed that as people age, their definition of successful ageing changes, expanding the current conceptualisation of successful ageing by including additional factors that can act as facilitators and/or inhibitors, such as death and environmental factors. The findings also highlight the need for further research on theory development by considering age-related differences and the perspectives of under-studied populations.

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The Association Between Sarcopenia and Postoperative Outcomes Among Older Adults With Hip Fracture: A Systematic Review

Journal of Applied Gerontology ◽

10.1177/07334648211006519 ◽

2021 ◽

pp. 073346482110065

Author(s):

Ming-Hsiu Chiang ◽

Yi-Jie Kuo ◽

Yu-Pin Chen

Keyword(s):

Systematic Review ◽

Older Adults ◽

Hip Fracture ◽

Postoperative Mortality ◽

Clinical Event ◽

High Morbidity ◽

Adverse Health Outcomes ◽

Age Related ◽

Study Selection ◽

And Function

Hip fracture is a serious clinical event with high morbidity and mortality. Sarcopenia is characterized by age-related loss of muscle mass and function, leading to several adverse health outcomes. In this systematic review, no limitation criteria were used for study selection and 327 studies were identified in the initial search. Of these, 11 studies comprising a total of 2,314 patients were selected. The overall proportion of older adults with hip fracture having sarcopenia was 44%, with a disparity of approximately 10% between men and women. Most studies have indicated that older adults with sarcopenia had poorer postoperative functional recovery than those without sarcopenia; the association between sarcopenia and high postoperative mortality or long hospital stay was heterogeneous. Well-organized studies with longer follow-up periods are warranted.

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Clinical Evidence in the Treatment of Obstructive Sleep Apnoea with Oral Appliances: A Systematic Review

International Journal of Dentistry ◽

10.1155/2021/6676158 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Andrea Rossi ◽

Antonino Lo Giudice ◽

Camilla Di Pardo ◽

Alberto Teodoro Valentini ◽

Francesca Marradi ◽

...

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnoea ◽

Assessment Tool ◽

Sleep Apnoea ◽

Common Finding ◽

Control Group ◽

Oral Appliances ◽

Inclusion Criteria ◽

Obstructive Sleep ◽

Definition Of

Background. Recent clinical guidelines have extended indications for oral appliances to subjects affected by moderate-to-severe obstructive sleep apnoea (OSA). The aim of this systematic review covering this important issue for public health is twofold: updating and summarizing the best available scientific evidence by selecting RCTs of quality only, and identifying the therapeutic pathways that can be transferred to the current clinical practice. Methods. All the abstracts which were published before February 18, 2019, have been identified in three electronic databases (PubMed, Web of Science, and Cochrane). The Cochrane Collaboration’s tool for assessing risk of bias was used as an assessment tool in order to evaluate the quality of the selected studies. Results. The search strategy yielded 2,260 studies. After removing duplicates and studies that did not comply with the inclusion criteria, 32 full-text articles were assessed for eligibility, and 17 RCTs were finally included in the qualitative synthesis. The 17 selected studies were very heterogeneous in the type of included RCTs in terms of patient inclusion criteria, sample size, distribution of the two genders in the various groups, duration of treatment, and definition of primary and secondary outcomes, without any restriction on the definition of the control group. A common finding was the positive responsiveness of oral appliance treatment in subjects affected by mild-to-moderate OSA with some evidence for cases of severe OSA. Conclusion. Higher-quality studies are needed in order to provide additional useful guidelines for dental clinicians for OSA management.

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Neurobiological findings associated with high cognitive performance in older adults: a systematic review

International Psychogeriatrics ◽

10.1017/s1041610218000431 ◽

2018 ◽

Vol 30 (12) ◽

pp. 1813-1825 ◽

Cited By ~ 2

Author(s):

Wyllians Vendramini Borelli ◽

Lucas Porcello Schilling ◽

Graciane Radaelli ◽

Luciana Borges Ferreira ◽

Leonardo Pisani ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Performance ◽

Anterior Cingulate ◽

Control Group ◽

High Performing ◽

High Performers ◽

Positron Emission ◽

Definition Of ◽

Molecular Brain

ABSTRACTObjectives:to perform a comprehensive literature review of studies on older adults with exceptional cognitive performance.Design:We performed a systematic review using two major databases (MEDLINE and Web of Science) from January 2002 to November 2017.Results:Quantitative analysis included nine of 4,457 studies and revealed that high-performing older adults have global preservation of the cortex, especially the anterior cingulate region, and hippocampal volumes larger than normal agers. Histological analysis of this group also exhibited decreased amyloid burden and neurofibrillary tangles compared to cognitively normal older controls. High performers that maintained memory ability after three years showed reduced amyloid positron emission tomography at baseline compared with high performers that declined. A single study on blood plasma found a set of 12 metabolites predicting memory maintenance of this group.Conclusion:Structural and molecular brain preservation of older adults with high cognitive performance may be associated with brain maintenance. The operationalized definition of high-performing older adults must be carefully addressed using appropriate age cut-off and cognitive evaluation, including memory and non-memory tests. Further studies with a longitudinal approach that include a younger control group are essential.

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Rate of normal lung function decline in ageing adults: a systematic review of prospective cohort studies

BMJ Open ◽

10.1136/bmjopen-2018-028150 ◽

2019 ◽

Vol 9 (6) ◽

pp. e028150 ◽

Cited By ~ 15

Author(s):

Elizabeth T Thomas ◽

Michelle Guppy ◽

Sharon E Straus ◽

Katy J L Bell ◽

Paul Glasziou

Keyword(s):

Systematic Review ◽

Lung Function ◽

Cohort Studies ◽

Lung Disease ◽

Prospective Cohort ◽

Normal Lung ◽

Prospective Cohort Studies ◽

Age Related ◽

Disease Definition ◽

Definition Of

ObjectiveTo conduct a systematic review investigating the normal age-related changes in lung function in adults without known lung disease.DesignSystematic review.Data sourcesMEDLINE, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for eligible studies from inception to February 12, 2019, supplemented by manual searches of reference lists and clinical trial registries.Eligibility criteriaWe planned to include prospective cohort studies and randomised controlled trials (control arms) that measured changes in lung function over time in asymptomatic adults without known respiratory disease.Data extraction and synthesisTwo authors independently determined the eligibility of studies, extracted data and assessed the risk of bias of included studies using the modified Newcastle–Ottawa Scale.ResultsFrom 4385 records screened, we identified 16 cohort studies with 31 099 participants. All included studies demonstrated decline in lung function—forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) with age. In studies with longer follow-up (>10 years), rates of FEV1decline ranged from 17.7 to 46.4 mL/year (median 22.4 mL/year). Overall, men had faster absolute rates of decline (median 43.5 mL/year) compared with women (median 30.5 mL/year). Differences in relative FEV1change, however, were not observed between men and women. FEV1/FVC change was reported in only one study, declining by 0.29% per year. An age-specific analysis suggested the rate of FEV1function decline may accelerate with each decade of age.ConclusionsLung function—FEV1, FVC and PEFR—decline with age in individuals without known lung disease. The definition of chronic airway disease may need to be reconsidered to allow for normal ageing and ensure that people likely to benefit from interventions are identified rather than healthy people who may be harmed by potential overdiagnosis and overtreatment. The first step would be to apply age, sex and ethnicity-adjusted FEV1/FVC thresholds to the disease definition of chronic obstructive pulmonary disease.PROSPERO registration numberCRD42018087066.

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AGE-BASED STEREOTYPE THREAT: A SYSTEMATIC REVIEW OF PRIMING TECHNIQUES AND THEIR EFFECTS

Innovation in Aging ◽

10.1093/geroni/igz038.1705 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S455-S456

Author(s):

Francesco Vailati Riboni ◽

Francesco Pagnini

Keyword(s):

Systematic Review ◽

Older Adults ◽

Stereotype Threat ◽

Functional Performance ◽

Later Life ◽

Experimental Methods ◽

Experimental Manipulation ◽

Older Individuals ◽

Negative Stereotypes ◽

Age Related

Abstract Age-based stereotype threat (ABST) occurs when older adults are influenced by negative stereotypes about age-related decline and functional losses and ironically behave in disengaging and self-defeating ways that confirm the stereotype (Steele & Aronson, 1995). Aging stereotypes are found to be strong predictors of health and illness outcomes in later life, and are associated with performance in specific areas, mainly in cognitive and physical domains. The current study reviewed the experimental methods and their reported effects previously published in the literature to determine if there were different ABST methods were associated with different types of age-related outcomes. We conducted a systematic review, screening the scientific literature for papers that included experimental manipulation of age-related stereotypes as an independent variable, focusing on samples of older adults (1113 articles, most published after 2003). Through a classification of the common and distinctive characteristics of the different stereotype manipulation techniques, we were able to identify three specific types of experimental methods: by instruction, tests, and interpersonal exposure. Although the mechanism by which stereotypes are associated with functional outcomes in older adults remains unclear, our review suggests it is possible to experimentally control the activation of the stereotype by manipulating its specific characteristics and the way older participants are exposed to it. Findings also highlight the possibility that specific experimental methods used to induce ABST in older individuals may lead to unique and different consequences on functional performance variation.

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The Gut Microbiome, Aging, and Longevity: A Systematic Review

Nutrients ◽

10.3390/nu12123759 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3759

Author(s):

Varsha D. Badal ◽

Eleonora D. Vaccariello ◽

Emily R. Murray ◽

Kasey E. Yu ◽

Rob Knight ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Gut Microbiota ◽

Gut Microbiome ◽

Oldest Old ◽

Amino Acid Synthesis ◽

Old Adults ◽

Age Related ◽

Functional Features ◽

Functional Pathways

Aging is determined by complex interactions among genetic and environmental factors. Increasing evidence suggests that the gut microbiome lies at the core of many age-associated changes, including immune system dysregulation and susceptibility to diseases. The gut microbiota undergoes extensive changes across the lifespan, and age-related processes may influence the gut microbiota and its related metabolic alterations. The aim of this systematic review was to summarize the current literature on aging-associated alterations in diversity, composition, and functional features of the gut microbiota. We identified 27 empirical human studies of normal and successful aging suitable for inclusion. Alpha diversity of microbial taxa, functional pathways, and metabolites was higher in older adults, particularly among the oldest-old adults, compared to younger individuals. Beta diversity distances significantly differed across various developmental stages and were different even between oldest-old and younger-old adults. Differences in taxonomic composition and functional potential varied across studies, but Akkermansia was most consistently reported to be relatively more abundant with aging, whereas Faecalibacterium, Bacteroidaceae, and Lachnospiraceae were relatively reduced. Older adults have reduced pathways related to carbohydrate metabolism and amino acid synthesis; however, oldest-old adults exhibited functional differences that distinguished their microbiota from that of young-old adults, such as greater potential for short-chain fatty acid production and increased butyrate derivatives. Although a definitive interpretation is limited by the cross-sectional design of published reports, we integrated findings of microbial composition and downstream functional pathways and metabolites, offering possible explanations regarding age-related processes.

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Lower-Limb Factors Associated with Balance and Falls in Older Adults: A Systematic Review and Clinical Synthesis

Journal of the American Podiatric Medical Association ◽

10.7547/19-143 ◽

2019 ◽

Vol 110 (5) ◽

Cited By ~ 1

Author(s):

Christopher Neville ◽

Hung Nguyen ◽

Kim Ross ◽

Mariana Wingood ◽

Elizabeth Walker Peterson ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Lower Limb ◽

Fall Risk ◽

Community Dwelling ◽

Sufficient Evidence ◽

Cochrane Library ◽

Direct Link ◽

Age Related ◽

Falls In Older Adults

Background Despite sufficient evidence to suggest that lower-limb–related factors may contribute to fall risk in older adults, lower-limb and footwear influences on fall risk have not been systematically summarized for readers and clinicians. The purpose of this study was to systematically review and synethesize the literature related to lower-limb, foot, and footwear factors that may increase the risk of falling among community-dwelling older adults. Methods We searched PubMed, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and AgeLine. To describe the trajectory toward increasing risk of falls, we examined those articles that linked age-related changes in the lower limb or footwear to prospective falls or linked them to evidenced-based fall risk factors, such as gait and balance impairment. Results This systematic review consisted of 81 articles that met the review criteria, and the results reflect a narrative review of the appraised literature for eight pathways of lower-limb–related influences on fall risk in older adults. Six of the eight pathways support a direct link to fall risk. Two other pathways link to the intermediate factors but lack studies that provide evidence of a direct link. Conclusions This review provides strong guidance to advance understanding and assist with managing the link between lower-limb factors and falls in older adults. Due to the lack of literature in specific areas, some recommendations were based on observational studies and should be applied with caution until further research can be completed.

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Consumer and carer leadership in palliative care academia and practice: A systematic review with narrative synthesis

Palliative Medicine ◽

10.1177/0269216319854012 ◽

2019 ◽

Vol 33 (8) ◽

pp. 959-968 ◽

Cited By ~ 4

Author(s):

Brett Scholz ◽

Alan Bevan ◽

Ekavi Georgousopoulou ◽

Aileen Collier ◽

Imogen Mitchell

Keyword(s):

Systematic Review ◽

Decision Making ◽

Palliative Care ◽

Service Planning ◽

Data Sources ◽

Health Policies ◽

Narrative Synthesis ◽

Inclusion Criteria ◽

Systemic Decision Making ◽

Synthesis Approach

Background: Contemporary health policies call for consumers to be part of all aspects of service planning, implementation, delivery and evaluation. The extent to which consumers are part of the systemic decision-making levels of palliative care appears to vary between and within services and organisations. Aim: The aim of this systematic review is to develop understandings about consumer and carer leadership in palliative care. Design: A systematic, narrative synthesis approach was adopted due to the heterogeneity of included studies. The review was registered on PROSPERO prospectively (PROSPERO 2018 CRD42018111625). Data sources: PubMed, Scopus and PsycINFO were searched for all studies published in English specifically focusing on consumers’ leadership in palliative care organisations and systems. Articles were appraised for quality using a modified JBI-QARI tool. Results: Eleven studies met the inclusion criteria and quality assessment. Consumers are currently involved in leadership of palliative care teaching, research and services. Findings highlight the benefits of consumer leadership in palliative care including more relevant, higher-quality services, teaching and research. Across the included studies, it was not clear the extent to which consumer leaders had influence in relation to setting agendas across the palliative care sector. Conclusion: The findings suggest that more could be done to support consumer leadership within palliative care. Academics and clinicians might improve the relevance of their work if they are able to more meaningfully partner with consumers in systemic roles in palliative care.

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Effect of Sleep Quality on the Prevalence of Sarcopenia in Older Adults: A Systematic Review with Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm8122156 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2156 ◽

Cited By ~ 5

Author(s):

Jacobo Á. Rubio-Arias ◽

Raquel Rodríguez-Fernández ◽

Luis Andreu ◽

Luis M. Martínez-Aranda ◽

Alejandro Martínez-Rodriguez ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Sleep Quality ◽

Sleep Duration ◽

Meta Analysis ◽

Cochrane Library ◽

Short Sleep Duration ◽

Related Condition ◽

Age Related ◽

Inadequate Sleep

Sarcopenia is an age-related condition. However, the prevalence of sarcopenia may increase due to a range of other factors, such as sleep quality/duration. Therefore, the aim of the study is to conduct a systematic review with meta-analysis to determine the prevalence of sarcopenia in older adults based on their self-reported sleep duration. Methods: Three electronic databases were used—PubMed-Medline, Web of Science, and Cochrane Library. We included studies that measured the prevalence of sarcopenia, divided according to sleep quality and excluded studies (a) involving populations with neuromuscular pathologies, (b) not showing prevalence values (cases/control) on sarcopenia, and (c) not including classificatory models to determine sleep quality. Results: high prevalence values in older adults with both long and short sleep duration were shown. However, prevalence values were higher in those with inadequate sleep (<6–8 h or low efficiency) (OR 0.76; 95% CI (0.70–0.83); Q = 1.446; p = 0.695; test for overall effect, Z = 6.01, p < 0.00001). Likewise, higher prevalence levels were shown in men (OR 1.61; 95% CI (0.82–3.16); Q = 11.80; p = 0.0189) compared to women (OR 0.77; 95% CI (0.29–2.03); Q = 21.35; p = 0.0003). Therefore, the prevalence of sarcopenia appears to be associated with sleep quality, with higher prevalence values in older adults who have inadequate sleep.

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Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B6 and B12, with advancing older age: a systematic review

British Journal Of Nutrition ◽

10.1017/s0007114520004249 ◽

2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

N. Gillies ◽

D. Cameron-Smith ◽

S. Pundir ◽

C. R. Wall ◽

A. M. Milan

Keyword(s):

Systematic Review ◽

Older Adults ◽

Community Dwelling ◽

B Vitamins ◽

Cross Sectional ◽

Longitudinal Changes ◽

Dietary Adequacy ◽

Metabolism Regulation ◽

Age Related

Abstract Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).

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