•The uptake of PPSV23 in older adults was negatively associated with incident dementia who required daily living care.•Such associations were observed regardless of the follow-up period or influenza ...vaccination.•The uptake of IIV was not associated with incident dementia, regardless of the follow-up period or PPSV23.•PPSV23 was independently associated with incident dementia, whereas the IIV was not.
It is unclear whether inactivated influenza vaccination (IIV) or pneumococcal vaccination are associated with the risk of dementia; however, both types of vaccination are recommended for older adults. Studies have shown that the IIV is negatively associated with incident dementia; however, the uptake of pneumococcal vaccinations has not been considered. We investigated the independent associations of IIV and 23-valent pneumococcal polysaccharide vaccine (PPSV23) with incident dementia in older adults.
Health-related information on older Japanese adults was obtained through a baseline survey conducted in 2013 (baseline survey). The uptake of IIV and PPSV23 was determined in a second survey conducted in 2016 (second wave). Both surveys were conducted among independent Japanese older adults aged ≥ 65 years at the two surveys and who had not been certified as needing long-term care (LTC). In the second wave, 9,865 participants were followed up for 3.5 years (short-term follow-up), and 6,995 participants were followed up for six years and five months (long-term follow-up) until they required LTC due to dementia onset (incident dementia). A competing risk model with stabilized inverse probability weighting (SIPW) was constructed to calculate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of incident dementia.
PPSV23 uptake was negatively associated with incident dementia among participants in both the short- and long-term follow-up periods after SIPW (short-term follow-up: HR: 0.77, 95 % CI: 0.63 – 0.95; long-term follow-up: HR: 0.83, 95 % CI: 0.70 – 0.97). Conversely, IIV uptake was not associated with incident dementia among participants in either follow-up group (short-term follow-up: HR: 0.86, 95 % CI: 0.63–1.16; long-term follow-up: HR: 0.99, 95 % CI: 0.76–1.29). The PPSV23 uptake was negatively associated with incident dementia in participants without the IIV uptake (short-term follow-up: HR: 0.44, 95 % CI: 0.24 – 0.81; long-term follow-up: HR: 0.47, 95 % CI: 0.29 – 0.76). Conversely, the IIV uptake was not associated with incident dementia regardless of the PPSV23 status (short-term follow-up: HR: 0.87, 95 % CI: 0.62 – 1.23; long-term follow-up: HR: 1.00, 95 % CI: 0.74 – 1.35).
Our results suggest that the PPSV23 uptake was independently associated with the incidence of dementia. However, the IIV uptake was not associated with the incidence of dementia.
The COVID-19 pandemic has created a new reality for consumers all around the globe. To cope, users of digital technologies have faced the necessity of adopting and using specific technologies ...practically overnight. They are doing this under the condition of social isolation, all while facing the fear of catching the disease. The purpose of the paper is to study the way unexpected circumstances cause disruptions in existing theoretical models and their implications for the post-COVID-19 era. Therefore, the paper examines the unified theory of acceptance and use of technology (UTAUT) model under the circumstances of the COVID-19 pandemic and social isolation, and it identifies herd behavior as a possible new mechanism affecting behavioral intention under these unique decision-making circumstances. Behavioral intention toward online shopping was analyzed using data from 420 individuals aged 60 and older who present an increasingly important potential market for electronic commerce and who are particularly affected by COVID-19. The main results show that performance expectancy still has the most important influence on behavioral intention, whereas the impact of social influence was not supported under these conditions. Rather, herd behavior was identified as particularly influential for behavioral intention. Based on the study results, the option to reconsider the social influence factor in the UTAUT model and its possible complementary mechanisms are discussed.
•Online shopping adoption among older adults during the pandemic was reviewed.•Social influence does not have a major role in behavioral intention to adopt online shopping.•Contrary to our expectations, COVID-19 fear does not influence behavioral intention to adopt online shopping.•Herd behavior importantly influences behavioral intention in the pandemic situation.•Complementary mechanisms to social influence in UTAUT are discussed.
Background and Purpose
Exercise interventions are effective at preventing falls in community‐dwelling older adults, especially before disability is present. Gait speed below 1.0 m/s is a strong ...predictor for falls in the elderly. However, evidence is sparse for gait speed alone being sufficient to identify individuals at a high risk of falling. This study aimed to describe the prevalence of fall risk factors among community‐dwelling older adults in their late 70s and to investigate the associations between these risk factors and low gait speed in this population.
Methods
This cross‐sectional cohort study comprised 108 elderly living in a small Norwegian municipality, born between 1936 and 1938. Exclusion criteria were living in residential care, inability to walk 4 m, and severe cognitive impairment. Measurements included gait speed, depressive symptoms, executive functions, fear of falling, vision function, fall history, body mass index, medications, and comorbidity. Gait speed was dichotomized using a cut‐off of 1 m/s, and associations between different risk factors and low gait speed was explored using logistic regression analysis.
Results
Mean gait speed was 1.0 ± 0.3 m/s. In 44.4% of the participants, gait speed was below 1.0 m/s, indicating increased fall risk. Low gait speed was significantly associated with a history of multiple falls (odds ratio OR = 3.70, 95% CI 1.18, 11.65), low educational level (OR = 3.58, 95% CI 1.10, 11.66), higher number of medications (OR = 4.28, 95% CI 1.63, 11.2), and higher number of depressive symptoms (OR = 1.31, 95% CI 1.09, 1.58). We found no significant associations between gait speed and comorbidity, sex, vision, executive functions, or fear of falling.
Conclusion
Our results indicate that gait speed with cut‐off 1.0 m/s could represent a useful tool for identifying individuals who are vulnerable but not yet disabled and could benefit from fall‐preventive exercise. However, extended assessment is probably needed to personalize interventions.
Previous research has demonstrated a dose-response relationship between exposure to adverse childhood experiences (ACEs) and adverse outcomes in adulthood. Despite widely known associations, previous ...reviews have primarily focused on outcomes in younger and middle-aged adults exposed to ACEs to the exclusion of older adults and do not consider the potential role of resilience for understanding outcomes in older adulthood.
The present scoping review aimed to examine the extent and nature of existing literature on the influence of ACEs and resilience on the cognitive, physical, mental, and social health outcomes among older adults.
We conducted a search of five electronic databases (CINAHL, MEDLINE, PsycINFO, AgeLine, Scopus) using the following keywords: adversity, resilience, aging, and older adults. We limited our inclusion criteria to works published in English or French after 1998 as Felitti et al. published the first study describing ACEs in this year.
Of the 4926 studies screened, 27 studies met the inclusion criteria. Overall, results from the included studies indicated that exposure to adversity during childhood was associated with worse outcomes in older adulthood. Additionally, we found that resilience and resiliency-related factors (e.g., problem-focused coping strategies) mitigated or reduced harms associated with ACEs to improve outcomes in older adulthood.
Exposure to ACEs is associated with reduced functioning in later adulthood. Findings from this review indicate a need for further exploration into the role of ACEs, and the potential effects of resilience, on health outcomes in older adults to develop better individual- and population-level interventions for this group.
The 2015 American Geriatrics Society (AGS) Beers Criteria are presented. Like the 2012 AGS Beers Criteria, they include lists of potentially inappropriate medications to be avoided in older adults. ...New to the criteria are lists of select drugs that should be avoided or have their dose adjusted based on the individual's kidney function and select drug–drug interactions documented to be associated with harms in older adults. The specific aim was to have a 13‐member interdisciplinary panel of experts in geriatric care and pharmacotherapy update the 2012 AGS Beers Criteria using a modified Delphi method to systematically review and grade the evidence and reach a consensus on each existing and new criterion. The process followed an evidence‐based approach using Institute of Medicine standards. The 2015 AGS Beers Criteria are applicable to all older adults with the exclusion of those in palliative and hospice care. Careful application of the criteria by health professionals, consumers, payors, and health systems should lead to closer monitoring of drug use in older adults.
Objective: Stroke rehabilitation is clinically and economically complex and requires a long-term commitment from patients and their support systems. Therefore, there is a need for an intervention ...that addresses the cost and accessibility needs of stroke survivors and their caregivers. This study aimed to gain expert consensus on the feasibility of Brunnstrom Movement Therapy (BRS) telerehabilitation for older adult patients with post-stroke mild cognitive impairment. Methods: A Delphi study was conducted to provide a BRS telerehabilitation programme for older adult patients with post-stroke mild cognitive impairment. The stages involved were literature review, items-modelling, expert review, and video modelling of the consented items. The feasibility of the video was tested among selected patients. Results: Consensus on the structure and content of the BRS telerehabilitation with and without tDCS was achieved in three rounds. The final telerehabilitation programme comprised eight exercise regimens, including repetition and progression of the exercise programme. The programmes had a good feasibility score among the study participants. The USE questionnaire data revealed high scores for the telerehabilitation programme, with usefulness at 89.28%, ease of use at 88.52%, ease of learning at 93.25%, and satisfaction at 89.80%. When combined with tDCS, the programme's usefulness increased to 93%, ease of use to 90%, ease of learning remained high at 92%, and retention was at 91%. Conclusion: The BRS telerehabilitation programme was developed for older adult patients with post-stroke mild cognitive impairment, with experts’ consensus that it is feasible to use among older adult patients with post-stroke mild cognitive impairment.
The COVID-19 pandemic imposed a psychological burden on people worldwide, including fear and anxiety. Older adults are considered more vulnerable during public health emergency crises. Therefore, the ...aim of the present study was to investigate the psychological response of older adults during the acute phase of the pandemic in Greece.
This cross-sectional study was part of a larger three-day online survey. A total of 103 participants over the age of 60 fulfilled inclusion criteria. The survey included sociodemographic questions and six psychometric scales: the Fear of COVID-19 Scale (FCV-19S), the Brief Patient Health Questionnaire (PHQ-9) depression scale, the Generalized Anxiety Disorder scale (GAD-7), the Athens Insomnia Scale (AIS), the Intolerance of Uncertainty Scale (IUS-12), and the De Jong Gierveld Loneliness Scale (JGLS).
A significant proportion of the participants reported moderate to severe depressive symptoms (81.6%), moderate to severe anxiety symptoms (84.5%), as well as disrupted sleep (37.9%). Women reported significantly higher levels of COVID-19-related fear, more severe depressive symptoms and sleep disturbances, as well as higher levels of intolerance of uncertainty. Participants living alone showed higher levels of loneliness. Intolerance of uncertainty was shown to modulate levels of loneliness.
During the quarantine, attention was promptly drawn upon the risks related with older people's loneliness. Studies identifying factors that may contribute to loneliness during a public health emergency facilitate the implementation of supportive interventions. Preparedness to address and manage older people's loneliness may limit this deleterious emotional response during the pandemic, as well as at the post-COVID-19 phase.
Objectives: Current tobacco use (CTU) and secondhand smoke (SHS) exposure among older adults in India (≥60 years) are prevalent in India and indicate the importance of addressing associated factors. ...Methods: Pooled Global Adult Tobacco Survey India 2009–2010 and 2016–2017 data (n = 17,299) for older adults examined prevalence of CTU and SHS exposure at home and/or in public places and associated socioeconomic and demographic correlates. Results: CTU among older adults in India was 44.6%, and SHS exposure at home and public places were 20.0% and 30.0%, respectively. Men, younger age-group, rural, lower education, lower wealth index, and lower knowledge were independently associated with CTU. Men, rural, lower education, lower wealth index, CTU, and lower knowledge were independently associated with SHS exposure at home. Men, younger age, and rural residence were associated with SHS exposure in public places. Conclusion: CTU and SHS exposure among older adults in India suggest targeted interventions to address associated social and demographic factors.
•Urinary incontinence creates both physical and mental burdens that need adaptation.•Identifying barriers is critical first step to building successful adaptation.•Being neglected is a main barrier ...for older women in adapting to urinary incontinence.•Beliefs formed in older women led them to remain silent about urinary incontinence.
Urinary incontinence affects the physical, psychological, social and well-being of older adult women and requires adaptation. This study aimed to explain the inhibiting factors of adaptation to urinary incontinence in community-dwelling older adult women. A qualitative content analysis approach was adopted. Participants were 15 older women with urinary incontinence, three family members, and three healthcare team members. Data were collected by individual, in-depth semistructured interviews and analysed using the Graneheim and Lundman approach. The data analysis yielded the theme of neglecting urinary incontinence and the older adult, with four categories of “s silence-inducing beliefs”, “worthlessness for the family”, “non-adaptation of urban spaces”, and “deficiencies in the healthcare service structure”. Elucidating the inhibiting factors for older women's adaptation to urinary incontinence will lead to a change in the attitude of social policymakers and healthcare officials. This changes will then facilitate the establishment and adjustment of the necessary infrastructure to overcome these barriers.
The COVID-19 pandemic has affected many aspects of people's lives. Lockdown measures to reduce the spread of COVID-19 have been more stringent for those aged over 70, at highest risk for the disease. ...Here, we examine whether home garden usage is associated with self-reported mental and physical wellbeing in older adults, during COVID-19 lockdown in Scotland. This study analysed data from 171 individuals (mean age 84 ± 0.5 years) from the Lothian Birth Cohort 1936 study who completed an online survey approximately two months after lockdown commenced (May/June, 2020), and reported having access to a home garden. The survey also included items on garden activities (gardening, relaxing), frequency of garden usage during lockdown, and measures of self-rated physical health, emotional and mental health, anxiety about COVID-19, and sleep quality. Ordinal regression models were adjusted for sex, living alone, education, occupational social class, anxiety and depressive symptoms, body mass index, and history of diabetes and cardiovascular disease. Neither gardening nor relaxing in the garden were associated with health outcomes. However, higher frequency of garden usage during lockdown was associated with better self-rated physical health (P = 0.005), emotional and mental health (P = 0.04), sleep quality (P = 0.03), and a composite health score (P = 0.001), after adjusting for covariates. None of the garden measures were associated with perceived change in physical health, mental and emotional health, or sleep quality, from pre-lockdown levels. The results of the current study provide support for positive health benefits of spending time in a garden—though associations may be bidirectional—and suggest that domestic gardens could be a potential health resource during the COVID-19 pandemic.
•Covid-19 restrictions have had adverse impacts on wellbeing in older people.•An online health survey was conducted among an ageing cohort in Scotland.•Spending more time in a home garden associated with greater subjective wellbeing.•Potential benefits include better physical and mental health, and sleep quality.•During lockdowns, home gardens may be a potential health resource in older people.
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