Prioritizing Patient Perspectives When Designing Intervention Studies for Homeless Older Adults

2021 ◽  
pp. 104973152199555
Author(s):  
Sarah L. Canham ◽  
Harvey Bosma ◽  
Anita Palepu ◽  
Scott Small ◽  
Chris Danielsen
Keyword(s):  
Older Adults ◽  
Older People ◽  
Intervention Studies ◽  
Research Process ◽  
Participant Recruitment ◽  
Research Teams ◽  
Vulnerable Patient ◽  
Trauma Informed ◽  
Patient Groups ◽  
Peer Researchers

Purpose: Medical respite provides postacute care to people experiencing homelessness upon hospital discharge if they are too sick to recover on the streets or in a traditional shelter. The current study examined the feasibility of conducting a study to test the effectiveness of a medical respite intervention for older people experiencing homelessness. Methods: Fifteen patient and 11 provider participants were interviewed between July and November 2018. Results: Participants’ considerations for how to design a program of research included (1) desired qualities of researchers; (2) preferences for study design; (3) mechanisms for participant recruitment and retention; (4) what, where, and how to collect data; and (5) barriers and motivations to participation. Conclusions: Findings from this study build on an emerging research base on how to appropriately engage vulnerable patient groups, including older people experiencing homelessness, in trauma-informed research by including peer researchers on research teams to serve as advisors throughout the research process.

Physical Activity and Inactivity Impacts on Cognitive and Emotional Functioning in Later Life

2018 ◽  
Author(s):  
Patrick D. Gajewski ◽  
Michael Falkenstein
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
Intervention Studies ◽  
Cognitive Activity ◽  
Well Being ◽  
Positive Effects ◽  
Brain Physiology ◽  
The Impact

Healthy aging is associated with changes in sensory, motor, cognitive, and emotional functions. Such changes depend on various factors. In particular, physical activity not only improves physical and motor but also cognitive and emotional functions. Observational (i.e., associations) and cross-sectional studies generally show a positive effect of regular physical exercise on cognition in older adults. Most longitudinal randomized controlled intervention studies also show positive effects, but the results are inconsistent due to large heterogeneity of methodological setups. Positive changes accompanying physical activity mainly impact executive functions, memory functions, and processing speed. Several factors influence the impact of physical activity on cognition, mainly the type and format of the activity. Strength training and aerobic training yield comparable but also differential benefits, and all should be used in physical activities. Also, a combination of physical activity with cognitive activity appears to enhance its effect on cognition in older age. Hence, such combined training approaches are preferable to homogeneous trainings. Studies of brain physiology changes due to physical activity show general as well as specific effects on certain brain structures and functions, particularly in the frontal cortex and the hippocampus, which are those areas most affected by advanced age. Physical activity also appears to improve cognition in patients with mild cognitive dysfunction and dementia and often ameliorates the disease symptoms. This makes physical training an important intervention for those groups of older people. Apart from cognition, physical activity leads to improvement of emotional functions. Exercise can lead to improvement of psychological well-being in older adults. Most importantly, exercise appears to reduce symptoms of depression in seniors. In future intervention studies it should be clarified who profits most from physical activity. Further, the conditions that influence the cognitive and emotional benefits older people derive from physical activity should be investigated in more detail. Finally, measures of brain activity that can be easily applied should be included as far as possible.

scholarly journals The Importance of Risk and Subgroup Analysis of Nonparticipants in a Geriatric Intervention Study

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Elizabeth Rosted ◽  
Ingrid Poulsen ◽  
Carsten Hendriksen ◽  
Lis Wagner
Keyword(s):  
Randomized Controlled Trial ◽  
Older People ◽  
Intervention Studies ◽  
Controlled Trial ◽  
Randomized Study ◽  
University Hospital ◽  
Randomized Controlled ◽  
Emergency Department Stay ◽  
Geriatric Intervention ◽  
Patient Groups

Background. A major concern in intervention studies is the generalizability of the findings due to refusal of intended participants to actually take part. In studies including ill older people the number of those declining to participate may be large and the concern is therefore relevant.Objectives. To compare patients characteristics, rates of acute readmission, and mortality after one and six months among older persons who agreed and those who declined to participate in a randomized controlled trial and to describe subgroups of nonparticipants.Design. Comparative study based on a randomized controlled trial.Setting. University hospital in the Capital Region of Denmark.Participants. Patients ≥70 years discharged home after a short Emergency Department stay. 399 were requested to participate; 271 consented, whereas 128 refused.Results. Refusers were more likely to be readmitted (p<0.001) or die (p=0.006). The largest subgroup of refusers described as “too ill” had the highest risk of readmission (OR = 3.00, 95% CI = 1.61–5.47,p=0.001) and of mortality within six months (OR = 3.50, 95% CI = 1.64–7.49,p=0.002). However, this seems not to have affected the results of our randomized study.Conclusion. We recommend that intervention studies among older people or other fragile patient groups include analysis of relevant risk and subgroup analyses of refusers.

scholarly journals INTERNET USE AND LONELINESS OF OLDER ADULTS OVER TIME: THE MEDIATION EFFECT OF SOCIAL CONTACT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S194-S194
Author(s):  
Kexin Yu ◽  
Kexin Yu ◽  
Shinyi Wu ◽  
Iris Chi
Keyword(s):  
Older Adults ◽  
Older People ◽  
Internet Use ◽  
Social Contact ◽  
Total Effect ◽  
Mediation Effect ◽  
Health And Retirement Study ◽  
Longitudinal Association ◽  
Retirement Study ◽  
Over Time

Abstract Internet is increasingly popular among older adults and have changed interpersonal interactions. However, it remains controversial whether older people are more or less lonely with internet use. This paper tests the longitudinal association of internet use and loneliness among older people. One pathway that explains the association, the mediation effect of social contact, was examined. Data from the 2006, 2010 and 2014 waves of Health and Retirement Study was used. Hierarchical liner modeling results showed internet use was related to decreased loneliness over 12-year period of time (b=-0.044, p&lt;.001). Internet use was associated with more social contact with family and friends overtime (b=0.261, p&lt;.001), social contact was related to less perceived loneliness longitudinally (b=0.097, p&lt;.001). The total effect of internet use on loneliness is -0.054 and the mediated effect is -0.025. The findings imply that online activities can be effective for reducing loneliness for older people through increased social contact.

scholarly journals Forgiveness Interventions for Older Adults: A Review

2021 ◽  
Vol 10 (9) ◽  
pp. 1866
Author(s):  
Javier López ◽  
Maria Inés Serrano ◽  
Isabel Giménez ◽  
Cristina Noriega
Keyword(s):  
Older Adults ◽  
Intervention Studies ◽  
Satisfaction With Life ◽  
Meta Analysis ◽  
Specific Treatment ◽  
Community Dwelling ◽  
Group Treatments ◽  
Receive Treatment ◽  
Community Dwelling Older Adults

A meta-analysis of the efficacy of forgiveness interventions in older adults was conducted. International databases (Medline, PsycINFO, Scopus, Web of Science) were searched for studies published from 1990 to 2020 that attempted to promote forgiveness in older adults. Most intervention studies are group treatments targeted towards community-dwelling older adults. Participants in these studies are mainly women. The intervention objectives and contents vary widely and often criteria are not well-defined. Participants that received forgiveness interventions reported significantly higher levels of forgiveness than participants that did not receive treatment. Additionally, forgiveness interventions resulted in more changes in depression, stress and anger than no intervention conditions. Forgiveness treatment also enhances positive states (satisfaction with life, subjective happiness, and psychological wellbeing). The reported effects are moderate. The specific treatment model (e.g., Enright’s, Worthington’s) and format (e.g., group-based interventions and individually delivered programs) do not differentially predict better outcomes. In conclusion, future intervention studies should include more male participants and utilize a broader range of follow-up periods. Caution must be exercised because of the limited number of studies developed to date; researchers must be cautious when generalizing the results.

scholarly journals Reference values and factors associated with hand grip strength among older adults living in southeastern Poland

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Agnieszka Wiśniowska-Szurlej ◽  
Agnieszka Ćwirlej-Sozańska ◽  
Justyna Kilian ◽  
Natalia Wołoszyn ◽  
Bernard Sozański ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Reference Values ◽  
Handgrip Strength ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Normative Values ◽  
Dominant Hand ◽  
Cross Sectional ◽  
Factors Associated

AbstractHandgrip strength (HGS) is used as a biomarker for the state of health of older people, but the number of research publications containing the normative values of HGS in older adult populations is limited. The aim of the study was to define reference values and factors associated with HGS in older adults living in southeastern Poland. A cross-sectional study including 405 participants aged 65 and older was conducted. Handgrip strength for the dominant hand was assessed by the average of three trials using a JAMAR dynamometer. The sample was categorized into the following age groups: 65–69 years, 70–74 years, 75–79 years, 80–84 years, 85 and over. The average HGS was 19.98 kg (16.91 kg for women and 26.19 kg for men). There was a decrease in handgrip strength across the age range in both sexes. The average handgrip strength of the older people was 17.97 kg (14.47 kg for women and 25.66 kg for men) for those aged 80–85 and 16.68 kg (13.51 kg for women and 21.77 kg for men) in the group over 85 years old. In both sexes, marital status was an independent factor associated with reduced handgrip strength. In conclusion, this study described, for the first time, handgrip strength values for the southeastern Polish population aged ≥ 65 years according to age and gender.

The ‘loneliness pandemic’: implications for gerontological nursing

2021 ◽  
Vol 30 (11) ◽  
pp. 652-655
Author(s):  
Carlos Laranjeira
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older People ◽  
Chronic Diseases ◽  
Old Age ◽  
Social Isolation ◽  
Social Relationships ◽  
Vulnerable Groups ◽  
Negative Consequences ◽  
Gerontological Nursing

The COVID-19 pandemic compelled states to limit free movement, in order to protect at-risk and more vulnerable groups, particularly older adults. Due to old age or debilitating chronic diseases, this group is also more vulnerable to loneliness (perceived discrepancy between actual and desired social relationships) and social isolation (feeling that one does not belong to society). This forced isolation has negative consequences for the health of older people, particularly their mental health. This is an especially challenging time for gerontological nursing, but it is also an opportunity for professionals to combat age stereotypes reinforced with COVID-19, to urge the measurement of loneliness and social isolation, and to rethink how to further adjust interventions in times of crisis, such as considering technology-mediated interventions in these uncertain times.

scholarly journals The media image of Chinese older people: From stigmatic stereotype to diverse self-representation

2021 ◽  
pp. 205943642110125
Author(s):  
Kun Li
Keyword(s):  
Older Adults ◽  
Older People ◽  
Old Age ◽  
Media Studies ◽  
Positive Attitude ◽  
Media Image ◽  
Past Life ◽  
The Media ◽  
Leisure And Recreation ◽  
Chinese Older People

From the perspective of communication and media studies, this article explores a comparison between the image of older adults presented on media and online self-representation facilitated by the use of smartphones. The qualitative textual analysis was conducted with a sample (228 posts, from 1 January to 31 December,2019) selected from a representative WeChat Public Account targeting at older adults in China. The results demonstrate that leisure and recreation is the most frequently mentioned topic (58%) with memories of past life receiving the least references (3%). The striking features of popular posts among older people include a highly emotional tone, bright colours and multimedia. Sentiment analyses shows 68.42%, 13.16% and 18.42% of positive, neutral and negative emotions, respectively. A generally positive attitude of self-representation is in a sharp contrast with the stigmatic media image of older adults. The article concludes that the visibility of Chinese older people may help to reduce the stigma surrounding old age in China.

scholarly journals Body mass index and mild cognitive impairment among rural older adults in China: the moderating roles of gender and age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yemin Yuan ◽  
Jie Li ◽  
Nan Zhang ◽  
Peipei Fu ◽  
Zhengyue Jing ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Older People ◽  
Older Women ◽  
Older Men ◽  
Gender And Age ◽  
Low Bmi ◽  
Rural Older Adults

Abstract Background Evidence concerning the association between body mass index (BMI) and cognitive function among older people is inconsistent. This study aimed to investigate gender and age as moderators in association between BMI and mild cognitive impairment (MCI) among rural older adults. Methods Data were derived from the 2019 Health Service for Rural Elderly Families Survey in Shandong, China. In total, 3242 people aged 60 years and above were included in the analysis. Multilevel mixed-effects logistic regression was used to examine the moderating roles of gender and age, then further to explore the relationship between BMI and MCI. Results There were 601 (18.5%) participants with MCI. Compared with normal BMI group, low BMI group had a higher risk of MCI among older people [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.26–3.44], women (aOR = 2.06, 95% CI: 1.35–3.12), or the older elderly aged ≥75 years old (aOR = 3.20, 95% CI: 1.34–7.45). This effect remained statistically significant among older women (aOR = 3.38, 95% CI: 1.69–6.73). Among older men, elevated BMI group had a higher risk of MCI (aOR = 2.32, 95% CI: 1.17–4.61) than normal BMI group. Conclusions Gender and age moderated the association between BMI and MCI among Chinese rural older adults. Older women with low BMI were more likely to have MCI, but older men with elevated BMI were more likely to have MCI. These findings suggest rural community managers strengthen the health management by grouping the weight of older people to prevent the risk of dementia.

Understanding Exercise Challenges and Barriers for Older Adults with Mobility Disabilities

2020 ◽  
Vol 64 (1) ◽  
pp. 1297-1301
Author(s):  
Qiong Nie ◽  
Lyndsie M. Koon ◽  
Madina Khamzina ◽  
Wendy A. Rogers
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Older People ◽  
Health Outcomes ◽  
Quantitative Evaluation ◽  
Exercise Barriers ◽  
Depth Interview ◽  
Physical Limitations ◽  
Barriers And Challenges ◽  
Depth Interviews

Interventions to address exercise challenges in older people have been the focus of recent research, given the importance of exercise for health outcomes. However, exercise challenges for older adults with mobility disabilities have received little attention. We investigated participation of exercise among older adults with mobility disabilities to understand exercise barriers and challenges experienced by this population. We conducted a needs assessment using two archival datasets: a quantitative survey with 1,137 respondents and a qualitative in-depth interview with 23 participants. The quantitative evaluation revealed low participation of walking and less engagement of vigorous activities, and significant correlates of health status and lack of energy with vigorous activities. The in-depth interviews showed exercise challenges were attributed to difficulties with physical limitations, accessibility, and environmental limitations. Individuals with mobility disabilities may face unique challenges and barriers, affordable and effective supports to promote exercise engagement for them should be adapted to such needs.

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