Safety Evaluation of Natural Drugs in Chronic Skeletal Disorders: A Literature Review of Clinical Trials in the Past 20 years

Chronic skeletal disorders (CSDs), including degenerative diseases such as osteoporosis (OP) and autoimmune disorders, have become a leading cause of disability in an ageing society, with natural drugs being indispensable therapeutic options. The clinical safety evaluation (CSE) of natural drugs in CSDs has been given priority and has been intensively studied. To provide fundamental evidence for the clinical application of natural drugs in the elderly population, clinical studies of natural drugs in CSDs included in this review were selected from CNKI, Web of Science, PubMed, Science Direct and Google Scholar since 2001. Seventeen randomized controlled trials (RCTs) met our inclusion criteria: four articles were on OP, seven on osteoarthritis (OA), four on rheumatoid arthritis (RA) and two on gout. Common natural drugs used for the treatment of OP include Epimedium brevicornu Maxim [Berberidaceae], Dipsacus asper Wall ex DC [Caprifoliaceae] root, and Phalaenopsis cornu-cervi (Breda) Blume & Rchb. f[ Orchidaceae], which have been linked to several mild adverse reactions, such as skin rash, gastric dysfunction, abnormal urine, constipation and irritability. The safety of Hedera helix L [Araliaceae] extract, Boswellia serrata Roxb [Burseraceae] extract and extract from perna canaliculus was evaluated in OA and upper abdominal pain, and unstable movements were obsrerved as major side effects. Adverse events, including pneumonia, vomiting, diarrhoea and upper respiratory tract infection, were reported when RA was treated with Tripterygium wilfordii, Hook. F [Celastraceae][TwHF] polyglycosides and quercetin (Capsella bursa-pastoris (L.) Medik [Brassicaceae]). The present review aimed to summarize the CSE results of natural drugs in CSDs and could provide evidence-based information for clinicians.

Access to healthcare during COVID-19 among ageing population in Latvia

Medical staff has worked tirelessly throughout the COVID-19 pandemic to test and treat coronavirus patients. However, the focus on the virus has caused huge disruption to healthcare services, resulting in delayed treatment for patients with other serious conditions. Additionally, the reasons for forgoing or abstaining healthcare could also relate to individual decisions. We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE), where the respondents aged 50 and older of the Wave 8, version 0, were asked to answer, among other, questions on delayed, postponed or denied healthcare services during the first wave of COVID-19 pandemic in Latvia. For comparative reasons also Estonian and Lithuanian data were included in the study with 2 473 627 valid weighted cases in total. Due to the large sample size, in order to evaluate statistically significant result for Pearson’s chi-square test, strength of association (f) was provided. The results show that 12.7% of the respondents forwent and 14% postponed medical treatment in Latvia. Appointment was denied to 5.5% of the respondents. Generally, older people in Latvia had better access to health care services compared to the average in the Baltic countries. We found significant age and gender differences, but they varied depending on the type of treatment and reason for not receiving it. However, further studies are necessary to analyse how limited access to the healthcare for other reasons has affected health of the ageing population. Also, more knowledge is needed about how to maintain public health and wellbeing for the growing part of the ageing society.

Promising best practices implemented in long-term care homes during COVID-19 pandemic to address social isolation and loneliness: a scoping review protocol

IntroductionPrior to the COVID-19 pandemic, social isolation and loneliness (SIL) affected at least one-third of the older people. The pandemic has prompted governments around the world to implement some extreme measures such as banning public gatherings, imposing social distancing, mobility restrictions and quarantine to control the spread and impact of the novel coronavirus. Though these unprecedented measures may be crucial from a public health perspective, they also have the potential to further exacerbate the problems of SIL among residents in long-term care homes (LTCHs). However, some LTCHs have developed promising best practices (PBPs) to respond to the current situation and prepare for future pandemics. Key aspects of such practices revolve around maintaining and strengthening social connections between residents and their families which helps to reduce SIL. This scoping review looks at existing PBPs that have been implemented to reduce SIL among LTCH residents during the most recent pandemics.Methods and analysisWe will follow Arksey and O’Malley’s framework of scoping review, further developed by Levac et al. In addition, we will also apply the Joanna Briggs Institute Reviewers’ ‘Methodology for Scoping Reviews’. Ten electronic databases and grey literature will be searched for articles published from January 2003 to March 2021 in either English or French. Two reviewers will independently screen titles and abstracts and then full texts for final inclusion. Data will be extracted using a standardised form from ‘Evidence for Policy and Practice Information’. The results will be presented in a tabular form and will be summarised and interpreted using a narrative synthesis.Ethics and disseminationFormal ethical approval is not required as no primary data are collected. Findings will be used to develop a solid knowledge corpus to address the challenges of SIL in LTCHs. Our findings will help to identify cutting edge practices, including technological interventions that could support health services in addressing SIL in the context of LTCHs and our ageing society.

The consequences of ageing for the Polish economy

The ageing of population, as well as the expected decline resulting from the demographic changes, may have a negative effect on the economy, burdening national budgets. Poland has been among 30 demographically old countries in the world for years, and the ageing of the population has already begun in the early 1970s (Majdzińska A., 2015). The subject of the study is the economic effects of ageing society in Poland. The aim of the article is to present the economic consequences of ageing in Poland. The data from the Central Statistical Office on the demographic situation in Poland are used in the article. The ageing of the population is perceived as the dominant demographic process reflecting changes in the age structure of the population and the growth in the general elderly population. Therefore, the task of the state policy is to ensure the most optimal development for ageing population. The ageing of society imposes many tasks for social policy, including pension deficits, increase in healthcare service costs and care for the elderly, as well as slowing down in economic growth in the context of increasing social costs (P. Błędowski, 2012). Human ageing is a natural process, and at the same time, it has become a subject of interest among researchers working in various scientific environments. Therefore, it is necessary to regularly observe changes and undertake extensive discussions in this regard. It goes without saying that the course of aging process and its consequences require increased attention from experts and politicians. It is necessary to take up-to-date actions that will mitigate the negative effects in the future.

Racial disparities in hospitalization expenditures of older adults in Singapore

The World Population Prospects 2019 reports that the proportion of people who aged 65 and above takes up 9 per cent globally in 2019, reaching up to 16 per cent by 2050. Asia has the fastest rise: from 1 in 9 people aged 65 and above to 1 in 4 in 2050. Rapid growth in older adults has strong implications for diseases and healthcare expenditure. For Singapore, the transition from ‘ageing society’ (7% seniors) in 1999 to ‘super-aged society’ (20% seniors) in 2026 is projected to take 27 years, much faster than Japan’s 36 years. We used the Singapore Multi-Ethnic Cohort (MEC) of 14,465 subjects aged 21 to 94, and the Future Elderly Model (FEM) microsimulation model to project disease burden and hospitalization expenditures to 2050. We found that Chinese females had the highest life expectancy of 86.0 years, followed by Indian and Malay females with 80.4 and 75.6 years respectively. In all racial groups, women lived longer than men by 5-7 years. Cumulative hospitalization expenditures of older adults aged 51+ was US$69,500 for Chinese, US$67,600 for Malays and US$86,100 for Indians; US$71,200 for males and US$70,700 for females. The increased hospitalization spending for all three ethnic groups was due to the underlying manifestation of chronic diseases, including diabetes, hypertension, heart disease and stroke. Variations in environmental risk factors such as diet, cigarette smoking and physical activity across ethnic groups may contribute to racial differences in chronic diseases and disability. Therefore, targeted interventions are needed to reduce racial disparities.

A new old age?: Exploring the values, attitudes and expectations of baby boomers and their implications for policy and practice in an ageing society

<p>As a large age cohort, baby boomers needs, attitudes and behaviour can have a substantial impact on society. Despite international predictions that older boomers will behave in very different ways to current generations of older people little scholarly research has to date been done to explore „kiwi boomers‟ attitudes to ageing or the underlying values that may predispose them to behave in a particular manner as older workers, consumers, voters and family members. This study explores boomers views about their own ageing and considers how their expectations, attitudes and beliefs and underlying values may influence their behaviour as they age. Policy implications are then considered. Discourse analysis reveals prevailing paradigms and the degree of disparity or congruence with boomers‟ views is considered. Eleven focus groups were held in urban and semi-rural settings around New Zealand with boomers born 1946 – 1965, to explore participants' views on ageing, their expected lifestyle in future years, what forms of assistance they expected to give or receive, and what attitudes and values they felt baby boomers typically had that may influence their behaviour in older age. Results are triangulated with existing data on boomers in New Zealand. Where possible comparisons are drawn with boomers in other countries and with older and younger generations in New Zealand. Results indicate these boomers have a sense of common identity. Many articulated and appeared to have internalised common discourses about the boomer generation, although differences between older and younger, urban and provincial, socio-economic and ethnic groups were apparent. Most believed they would age differently to current generations of older people. These boomers are interested in new forms of work, more flexible, creative lifestyles and more supportive living arrangements. They have a strong work ethic, but they value work/life balance, choice, freedom and autonomy in decision-making. They anticipate working longer, but on their own terms. They believe they should provide for their families, but the state has a responsibility to reduce inequities and support those in need. Like their parents they value self-reliance and independence, but also inter-dependence and inter-generational care responsibilities. There was a desire for more innovative intra-cohort care and support. Despite areas of commonality, a key feature of the boomer cohort is their diversity and this presents a major challenge for policy and service development. Boomers accept their status as change agents. They anticipate drawing on previous experience to collectively influence policy. While it remains unclear on which issues they may converge, findings suggest the boomer cohort has the potential and inclination to advocate for social change. Processes of policy development will need to adapt to effectively work, with and not against this cohort.</p>

A new old age?: Exploring the values, attitudes and expectations of baby boomers and their implications for policy and practice in an ageing society

<p>As a large age cohort, baby boomers needs, attitudes and behaviour can have a substantial impact on society. Despite international predictions that older boomers will behave in very different ways to current generations of older people little scholarly research has to date been done to explore „kiwi boomers‟ attitudes to ageing or the underlying values that may predispose them to behave in a particular manner as older workers, consumers, voters and family members. This study explores boomers views about their own ageing and considers how their expectations, attitudes and beliefs and underlying values may influence their behaviour as they age. Policy implications are then considered. Discourse analysis reveals prevailing paradigms and the degree of disparity or congruence with boomers‟ views is considered. Eleven focus groups were held in urban and semi-rural settings around New Zealand with boomers born 1946 – 1965, to explore participants' views on ageing, their expected lifestyle in future years, what forms of assistance they expected to give or receive, and what attitudes and values they felt baby boomers typically had that may influence their behaviour in older age. Results are triangulated with existing data on boomers in New Zealand. Where possible comparisons are drawn with boomers in other countries and with older and younger generations in New Zealand. Results indicate these boomers have a sense of common identity. Many articulated and appeared to have internalised common discourses about the boomer generation, although differences between older and younger, urban and provincial, socio-economic and ethnic groups were apparent. Most believed they would age differently to current generations of older people. These boomers are interested in new forms of work, more flexible, creative lifestyles and more supportive living arrangements. They have a strong work ethic, but they value work/life balance, choice, freedom and autonomy in decision-making. They anticipate working longer, but on their own terms. They believe they should provide for their families, but the state has a responsibility to reduce inequities and support those in need. Like their parents they value self-reliance and independence, but also inter-dependence and inter-generational care responsibilities. There was a desire for more innovative intra-cohort care and support. Despite areas of commonality, a key feature of the boomer cohort is their diversity and this presents a major challenge for policy and service development. Boomers accept their status as change agents. They anticipate drawing on previous experience to collectively influence policy. While it remains unclear on which issues they may converge, findings suggest the boomer cohort has the potential and inclination to advocate for social change. Processes of policy development will need to adapt to effectively work, with and not against this cohort.</p>

Transport and Mobility Needs for an Ageing Society from a Policy Perspective: Review and Implications

The world population is ageing, and many countries in the world are confronted by significant challenges in adapting their health and social systems to meet the requirements of this demographic change. It is well-accepted that mobility is often closely linked to a person’s independence, wellbeing and quality of life. Interest has increased across the world with regard to how the mobility needs of an ageing society can be addressed, since an ageing population is confronting nations across the globe and poses long-term challenges on a nation’s many aspects, including transport. Questions of how future policies can better respond to the mobility needs of an ageing population and how these policies can be delivered have emerged as major concerns for transport planners, operators and decision-makers. This review explores the way in which implemented policies have addressed the mobility needs of an ageing society, focusing on the provision of accessible, safe and affordable transport. More specifically, the paper reviews legislative and institutional approaches of addressing the mobility needs of an ageing population. The paper discusses the outcomes of these approaches and the remaining challenges in this policy area that relate to elderly people’s mobility and provides future research directions. Based on the discussion, clear conclusions about the effectiveness of particular policies are difficult to make. Alternative approaches (e.g., technological innovations) need to be considered in addressing older people’s mobility needs.

Let’s Walk It: Mobility and the Perceived Quality of Life in Older Adults

European policy and the research and development landscape put forward a number of arguments in favor of implementing “Active Assisted Living” (AAL) for older adults: it will improve older adults’ quality of life, allow them to age in place, and keep costs for an ageing society down by exploiting new technology markets. The idea is that older adults who are supported by AAL and make use of assistive technologies will enjoy more freedom, autonomy, and mobility and also improved social integration and better communication. Yet, despite a history of more than 10 years of European research and development, the use of AAL applications is not as widespread as expected. To examine older adults’ attitudes to assistive technologies, we conducted a study in Vienna (Austria) between 2018 and 2020 questioning 245 older adults aged 61–93 years (M = 74.27 SD = 6.654) who lived at their private homes and had different support needs (ranging from “no support” to “everyday visit of social and/or care organizations”). The three goals of the study encompassed: (1) examination of their quality of life, (2) their attitudes and use of assistive technologies, and (3) the way they perceive their own and others’ life-course and getting older. AAL as a concept links “ageing in place” and “quality of life”. However, “mobility” is also of major importance here. In this paper, we aim to investigate the relation between the independent variables “Quality of life” and “Mobility” and their possible associations with the following dependent variables: cohabitation, social integration, self-rated health, sportive activities, locomotion, home well-being and safety, physical limitations, falls, and self-perception of their own ageing (compared to others). We calculated multivariate models regressing on these explaining and confounding variables. We found a positive correlation between mobility and quality of life. In detail, our results show a significant positive association between QOL and mobility regarding self-rated health and self-perception. Experiencing vertigo, walking difficulties, and balance problems significantly and negatively influence self-rated health and self-perception compared to others. Our findings can also be read as a clear message that there is a need to improve both health and the culture of ageing and to facilitate positive attitudes toward ageing as an efficient way to enhance the Quality of life of older adults.