scholarly journals A Multi-Level Analyses of Charges and Cost of Fall-Related Hospitalizations Among Older Adults: Individual, Hospital, and Geospatial Variation

2020 ◽  
pp. 1-22 ◽  
Author(s):  
Samuel D Towne ◽  
Matthew Lee Smith ◽  
Yajuan Li ◽  
Diane Dowdy ◽  
SangNam Ahn ◽  
...  
Keyword(s):  
Older Adults ◽  
Multi Level ◽  
Individual Hospital

scholarly journals Older Adults-Friendly Multi-Modal Touch-Screen Platform Measures for Bilingual Cognitive Interventions

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 816-816
Author(s):  
W Quin Yow ◽  
Tharshini Lokanathan ◽  
Hui-Ching Chen
Keyword(s):  
Older Adults ◽  
Cognitive Performance ◽  
Older Adult ◽  
Cognitive Training ◽  
Touch Screen ◽  
Cognitive Intervention ◽  
Cognitive Interventions ◽  
Multi Level ◽  
Poor Comprehension ◽  
Touch Screen Devices

Abstract There is an increasing interest in using touch-screen devices to conduct cognitive training and collect measurements of cognitive performance. However, older adults often have concerns such as anxiety about using these systems and poor comprehension of language instructions (Czaja & Lee, 2007). Given that Singapore is a multilingual society, we examined the deployment of an age-friendly multi-modal touch-screen platform (a game-based application on a tablet) in a cognitive intervention research. After modification of the platform to include features such as simplified instructions, multi-level prompts with a local accent, and four different instructional languages (including local dialects), participants were less reliant on the researchers and reported fewer difficulties in comprehending the instructions. The integrity and reliability of the data collected improved as a result. In sum, multilingual age-friendly touch-screen platform can be a novel yet effective method to study cognitive interventions in the Asian older adult populations.

Facing “Double Jeopardy”? Depressive Symptoms in Left-Behind Elderly in Rural China

2016 ◽  
Vol 29 (7) ◽  
pp. 1182-1213 ◽  
Author(s):  
Qian Song
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Living Arrangements ◽  
Rural China ◽  
Migrant Children ◽  
Left Behind ◽  
Multi Level ◽  
Traditional Patterns ◽  
Poverty Levels

Objective: When examining the depressive symptoms of left-behind elderly, this article goes beyond a focus on disruption to traditional patterns of living arrangements and investigates the heterogeneities in the patterns of migration distance, as well as the role of community contexts in buffering the loss of migrant children’s support. Method: This study uses the first wave of the China Health and Retirement Longitudinal Survey, and employs random effects multi-level modeling. Results: Having migrant children is associated with increased depressive symptoms among older adults, above and beyond living arrangements. Having their migrant children all live outside the province further puts older adults in disadvantaged mental conditions. This disadvantage can be further compounded by residence in impoverished communities. Discussion: In assessing depression among rural older adults in China, examination of living arrangements may be insufficient. It may be necessary to reference to children’s migration status as well as community poverty levels.

scholarly journals Age-related changes in human emotional egocentricity: evidence from multi-level neuroimaging

2019 ◽  
Author(s):  
Federica Riva ◽  
Melanie Lenger ◽  
Martin Kronbichler ◽  
Claus Lamm ◽  
Giorgia Silani
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Life Span ◽  
Emotional State ◽  
Effective Connectivity ◽  
Age Related ◽  
Somatosensory Cortices ◽  
Egocentric Bias ◽  
Multi Level ◽  
Age Related Changes

AbstractEmotional egocentric bias (EEB) occurs when, due to a partial failure in self-other distinction, empathy for another’s emotions is influenced by our own emotional state. Recent studies have demonstrated that this bias is higher in children, adolescents and older adults than in young adults. In the latter, overcoming emotional egocentrism has been associated with significant activity in the right supramarginal gyrus (rSMG), as well as increased connectivity between rSGM and somatosensory and visual cortices. Investigations on the neural correlates of EEB in adolescents and older adults are missing. We filled this gap, by asking female participants from three different age groups (adolescents, young adults and older adults, N=92) to perform a well-validated EEB task (Silani et al., 2013) in an MRI scanner. A multi-level analysis approach of MRI data including functional segregation, effective connectivity and structural analyses was adopted. Results revealed higher EEB in older compared to young adults and a comparable EEB in adolescents and young adults. Age-related differences in EEB were associated with differences in task-related rSMG connectivity with somatosensory cortices, especially with S2, which acted as a partial mediator between age and EEB. These findings provide further evidence for the crucial role of the rSMG in self-other distinction in the emotional domain, and suggest that the age-related decline in overcoming EEB is best explained by changes in rSMG connectivity rather than decreased regional activity in that area. This advocates a more systematic investigation of task-related connectivity in studies on aging and life-span development of social-cognitive phenomena.Significance StatementEmpathy comprises both the ability to identify and share another’s emotional state, and the ability to disentangle one’s own from the other’s emotional state. When self- and other-related emotions are conflicting, empathy might be negatively influenced by egocentric tendencies. This phenomenon is referred to as emotional egocentric bias (EEB), with previous research showing that its extent changes across the life-span. Here, we provide evidence that age-related differences in EEB are mainly associated with age-related changes in rSMG effective connectivity, and in particular that higher EEB in older adults is associated to lower rSMG effective connectivity with somatosensory cortices. These findings suggest the importance, particularly in aging, of intact functional connectivity for optimal socio-cognitive functioning.

scholarly journals Political participation of older adults in Scandinavia - the civic voluntarism model revisited? A multi-level analysis of three types of political participation

2013 ◽  
Vol 8 (1) ◽  
pp. 65-96 ◽  
Author(s):  
Mikael Nygård ◽  
Gunborg Jakobsson
Keyword(s):  
Older Adults ◽  
Political Participation ◽  
Older People ◽  
Resource Model ◽  
Political Activities ◽  
Multi Level ◽  
Level Analysis

This article examines political participation among older adults in österbotten, Finland, and Västerbotten, Sweden. Two specific hypotheses are tested. First, we anticipate that older adults are loyal voters but less avid in engaging in politics between elections. Second, we expect individuallevel resources to explain why older people participate in politics. The article offers two contributions to the literature on political participation of older adults. First, it corroborates earlier findings by showing that older adults indeed have a higher inclination to vote than to engage in political activities between elections, but it also shows that the latter engagement is more diversified than one could expect. Second, although the findings largely support the resource model, they suggest that we need to consider also other factors such as the overall attitude towards older people.

scholarly journals Integrated Primary Care and Social Services for Older Adults With Multimorbidity in England: A Scoping Review

2021 ◽  
Author(s):  
Hajira Dambha-Miller ◽  
Glenn Simpson ◽  
Lucy Hobson ◽  
Paul Roderick ◽  
Paul Little ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Integrated Care ◽  
Population Health ◽  
Social Services ◽  
Scoping Review ◽  
Integrated Primary Care ◽  
Integration Of Services ◽  
Multi Level ◽  
Sector Integration

Abstract Background: As the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the range of physical and social needs of the population. The aim of this study is to describe and summarise current evidence, clinical provision and progress towards integrated primary care and social services for older adults with multimorbidity in an English context. Methods: A scoping review was conducted which included a systematic electronic search of Medline, EMBASE, The Cochrane Library, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, Science and Social Science Citation Indices and Opengrey from data inception until the 16th June 2020. Articles were screened and extracted in duplicate by two independent reviewers. Data were extracted onto a charting sheet and thematic synthesis used to summarise findings.Results: Our search yielded 7656 papers of which 84 papers were included. Three themes were identified: (1) diverse focus on individual level services rather than multi-level or multi-sector integration, with an increasing emphasis on the need to consider broader determinants of population health as critical to integrated care in multimorbidity; (2) time was needed for integration to embed to allow new structures and relationships to develop and mature; and (3) we identified inherent tension between top-down and bottom-up driven approaches to integrated care that requires a whole-systems structure while allowing for local flexibilities.Conclusions: There is limited evidence of multi-level and multi-sector integration of services for older adults with multimorbidity in an English context. The literature increasingly acknowledges wider determinants of population health that are likely to require integration beyond primary care and social services. Improving clinical care in one or two sectors may not be as effective as simultaneously improving the organisation or design across services as one single system of provision. This may take time to establish and will require local input.

scholarly journals Integrated primary care and social services for older adults with multimorbidity in England: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hajira Dambha-Miller ◽  
Glenn Simpson ◽  
Lucy Hobson ◽  
Paul Roderick ◽  
Paul Little ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Integrated Care ◽  
Population Health ◽  
Social Services ◽  
Scoping Review ◽  
Integrated Primary Care ◽  
Integration Of Services ◽  
Multi Level ◽  
Sector Integration

Abstract Background As the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the physical and psycho-social needs of this cohort. This study describes and summarises current evidence, clinical provision and progress towards integrated primary care and social services for older adults with multimorbidity in England. Methods A scoping review was conducted involving systematic searches of a range of electronic academic and policy databases. Articles were screened and extracted in duplicate by two independent reviewers. Data were extracted onto a charting sheet and thematic synthesis was used to summarise findings. Articles were included if published in English and related to primary care, social care and multimorbidity in older adults in England. Conceptually, the review was framed using the Rainbow Model of Integrated Care. Results The search yielded 7656 articles of which 84 were included. Three themes were identified: (1) a focus on individual level services rather than multi-level or multi-sector integration, with an increasing emphasis on the need to consider broader determinants of population health as critical to integrated care for older adults with multimorbidity; (2) the need for policymakers to allow time for integration to embed, to enable new structures and relationships to develop and mature; and (3) the inherent tension between top-down and bottom-up driven approaches to integrated care requires a whole-systems structure, while allowing for local flexibilities. Conclusions There is limited evidence of multi-level and multi-sector integration of services for older adults with multimorbidity in England. The literature increasingly acknowledges wider determinants of population health that are likely to require integration beyond primary care and social services. Improving clinical care in one or two sectors may not be as effective as simultaneously improving the organisation or design across services as one single system of provision. This may take time to establish and will require local input.

scholarly journals Promoting Physical Activity Among Older Adults Using Community-Based Participatory Research With an Adapted PRECEDE-PROCEED Model Approach: The AEQUIPA/OUTDOOR ACTIVE Project

2020 ◽  
pp. 089011712097487
Author(s):  
Karin Bammann ◽  
Carina Recke ◽  
Birte Marie Albrecht ◽  
Imke Stalling ◽  
Friederike Doerwald
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Participatory Research ◽  
Ecological Model ◽  
Community Based Participatory Research ◽  
Target Group ◽  
Community Based ◽  
Community Stakeholders ◽  
Starting Point ◽  
Multi Level

Purpose: The PRECEDE-PROCEED model (PPM) is a community-based participatory research (CBPR) framework for health promotion, yet the direct application of the PPM into practice is unclear. This paper describes how the PPM was adapted for the development and application of a pilot intervention study to promote outdoor physical activity (PA) in older adults (OUTDOOR ACTIVE). We illustrate the steps and adaptations we applied to put the PPM into practice and present the developed interventions. Design: The PPM was adapted by incorporating a socio-ecological model. This ensured the design of any resultant intervention would explicitly address multi-level determinants of physical activity. The list of possible program components to select from for the design of an intervention was also extended. Setting: Bremen, Germany. Participants: Participants in the intervention development were 924 noninstitutionalized older adults, aged 65-75 years (response: 25.2%), living in Bremen-Hemelingen, Germany. For implementation of the intervention and to ensure sustainability, several groups of stakeholders were involved throughout the process. Methods: A mixed method design was employed (e.g., focus groups, quantitative survey) to identify determinants. A round table and participatory workshops were held to involve the target group and community stakeholders in the design of an intervention using the adapted PPM model. Results: A conceptual model was developed illustrating the integration of a socio-ecological model into the PPM. The model received ecological validity, as it was affirmed by community stakeholders as an appropriate method for designing a community-level PA intervention. Target goals to address PA determinants were selected by target group members. An intervention to meet the goals was developed and implemented with target group input. Conclusion: The adapted PPM is a promising starting point for developing multi-level interventions. Steps should be taken to ensure all social groups are participating in the process and all levels of determinants are addressed.

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