Objectives:This study explored the mediation and moderation effects of social engagement on the relationship between hearing status and cognitive function among Mexican adults aged ≥ 50 years across a six-year period (2015-2021). Methods:Data were drawn from the nationally representative Mexican Health and Aging Study (MHAS). Social engagement was calculated by summing the number of social activities and frequencies undertaken in the past year. A global measure of cognitive function was derived by summing z-scores of verbal memory, orientation, verbal fluency, visual scanning, figure copy, and figure recall. Multilevel generalized models with lagged predictors were used to assess the mediation and moderation effects of social engagement on the association between self-reported hearing status and cognitive function over time. Results:There were 10,561 people in the analytic sample. Greater social engagement was independently associated with better cognitive function over time. Better hearing status was associated with higher cognitive functioning in the following survey wave. Fair or better hearing was significantly associated with increased social engagement. The association was attenuated when covariates were adjusted. The association between hearing difficulty and cognitive function varied across levels of social engagement. Discussion:The mediation and moderation effects of social engagement on the association between hearing difficulty and cognitive function were affected by the population's socioeconomic status among middle-aged and older adults in Mexico. Future research should investigate other unknown mediators between hearing difficulty and cognitive health of middle-aged and older adults in low- and middle-income countries.
Background:Aging is associated with decreased physical and cognitive functions, increasing the risk of balance disorders and falls in older adults. Physical performance is a key early indicator of frailty and disability, and balance disorders impair the ability to carry out daily living activities. This study aimed to determine whether sociodemographic factors modify the association between physical performance and balance disorders among older adults in Peru. Methods:A cross-sectional analytical study was conducted using secondary data from two cohorts: the CEMENA Frailty Study (n = 1896) and the ANDES-FRAIL Study (n = 453). After excluding participants with incomplete data, 2200 older adults aged ≥ 60 years were analyzed. Physical performance was measured using the Short Physical Performance Battery (SPPB), and balance disorders were assessed with the functional reach test (FRT). Crude and adjusted Poisson regression models stratified by sociodemographic variables were performed, adjusting for multimorbidity and functional dependence. Results:Of the participants, 52.09% had impaired physical performance, and 44.05% exhibited balance disorders. Impaired physical performance was significantly associated with balance disorders. Associations were observed among individuals aged ≥ 80 years (PR: 2.72; 95% CI: 2.23-3.32), men (PR: 2.59; 95% CI: 2.22-3.04), those with < 11 years of education (PR: 2.43; 95% CI: 2.00-2.95), and coastal residents (PR: 2.63; 95% CI: 2.32-2.99). The strongest associations were observed among adults aged ≥ 80 years and coastal residents after adjustment for multimorbidity and functional dependence. Conclusion:Physical performance impairment is strongly associated with balance disorders among older adults, and this relationship is influenced by sociodemographic factors. These findings suggest that sociodemographic characteristics should be considered when evaluating the relationship between physical performance and balance disorders in older adults.
Behaviour change techniques (BCTs) are recommended as core components of physical activity (PA) interventions for people with lower limb osteoarthritis (OA), and identifying effective BCTs is an emerging research priority. This systematic review aimed to evaluate the effects of combined behaviour change and exercise interventions on objectively measured total PA (primary outcome) and other device-measured activity behaviours, including moderate-to-vigorous physical activity (MVPA), steps and sedentary behaviour, in people with hip or knee OA (secondary outcomes). Five databases were searched from inception until September 2025. The titles of identified randomised controlled trials (n = 907) were screened by two reviewers, and 12 studies involving 1162 participants with OA were included. Study quality was assessed using the SIGN checklist, and certainty of evidence was evaluated using the GRADE approach. Most studies were rated as low quality, and the certainty of evidence was low to very low across all outcomes. Random-effects meta-analyses found little to no difference for the use of behaviour change and exercise interventions for our primary outcome of total PA postintervention (3 studies, n = 246; MD 21.25 min/day, 95% CI -26.11-68.61) or at 12-month follow-up (3 studies, n = 221; MD 30.52 min/day, 95% CI -25.42-86.45). A meta-analysis of four studies (n = 307) found a small increase in device-measured MVPA at short-term follow-up (MD 2.53 min/day, 95% CI 0.18 to 4.88; I 2 = 21%). No significant effects were observed for any of the other outcomes (long-term MVPA, steps or sedentary behaviour). The existing evidence is limited, and findings should be interpreted cautiously given the low to very low certainty of the evidence and the small number of studies available. This highlights the need for higher quality studies with clear BCT reporting and fidelity procedures to establish whether behaviour change combined with exercise improves PA behaviours.
Balance and lower limb muscle strength are essential factors in preventing falls in older adults. This randomized controlled trial investigated the effect of 8 weeks of dynamic neuromuscular stability (DNS) exercises on static balance, dynamic balance, and lower limb strength in older men. Thirty older men aged 61-76 years were randomly allocated to either a DNS exercise group (n = 15) or a control group (n = 15). The experimental group performed DNS exercises for 8 weeks (3 sessions/week), while the control group received no intervention. Outcomes were assessed using the Berg Balance Scale (static balance), Timed Up and Go test (dynamic balance), and Chair Stand Test (lower limb strength) at baseline and postintervention. Analysis of covariance (ANCOVA) adjusted for age revealed that the DNS intervention produced significant improvements in all outcomes. The Berg Balance Scale showed an adjusted difference of 3.79 points between groups (F (1, 27) = 38.87, p < 0.0001). The Timed Up and Go test showed an adjusted difference of -0.87 s (F (1, 27) = 10.48, p = 0.0009). The Chair Stand Test showed an adjusted difference of 1.77 repetitions (F (1, 27) = 40.95, p < 0.0001). These improvements remained significant when adjusted for baseline age differences between groups. Eight weeks of DNS exercises significantly improved static balance, dynamic balance, and lower limb strength in older men. These findings suggest that DNS may be an effective intervention for improving balance and strength in the aging population. Trial Registration: Iranian Registry of Clinical Trials (IRCT): IRCT20260417069089N2.
Objectives:To examine associations of demographic, behavioral, and clinical factors with physiological dysregulation across cardiometabolic, renal, and hepatic functions among United States (US) adults aged 45 years and older using nationally representative data. Methods:This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 prepandemic cycle (weighted N ≈ 17,219,945; analytic n = 496). Eight biomarkers representing cardiometabolic (glucose, total cholesterol, and triglycerides), renal (serum creatinine and blood urea nitrogen), and hepatic (alanine aminotransferase, aspartate aminotransferase, and total bilirubin) functions were standardized using survey-weighted z-scores. They averaged with equal weighting to construct a physiological dysregulation index (PDI). Higher PDI scores indicate greater physiological dysregulation. Survey-weighted multivariable linear regression models were used to examine associations between PDI and sociodemographic, behavioral, and clinical factors. Results:Female sex was associated with significantly lower physiological dysregulation compared with male sex (β = -0.302, SE = 0.066, p < 0.001). Physically active individuals also had lower dysregulation scores than inactive individuals (β = -0.186, SE = 0.069, p = 0.007). Overweight (β = 0.108, SE = 0.043, p = 0.012) and obesity (β = 0.191, SE = 0.087, p = 0.028) were associated with greater dysregulation than normal body mass index (BMI). Conclusions:Female sex and physical activity were associated with lower physiological dysregulation, whereas higher BMI was associated with greater dysregulation. These findings underscore the importance of sex differences and modifiable lifestyle factors, particularly physical activity and adiposity in multisystem physiological burden among older US adults.
Using a mixed-methods design, we investigated the effect of an asynchronous online group intervention for older adults with subjective cognitive difficulties on their memory self-efficacy and control beliefs, in a pre-post single group study. We hypothesized that engaging with online discussion boards would foster a sense of community amongst participants, helping improve self-reported memory self-efficacy and control beliefs. One hundred and twenty-seven community-dwelling adults aged 60-88 years, drawn from the Online Personalized Training in Memory Strategies for Everyday (OPTIMiSE) study, completed questionnaires assessing memory self-efficacy, control beliefs, sense of community and usefulness of the discussion boards. The number of discussion board posts was recorded to indicate engagement. Findings revealed significant improvements to memory self-efficacy and control beliefs postintervention. Whilst not all participants reported a strong sense of community, their opinions of the discussion boards were generally favourable, particularly in terms of normalization of memory concerns through sharing with others. Time constraints, limited quality of interactions and decreased engagement were reported to impact both the usefulness of the discussion boards and the development of a sense of community. There are promising implications for the utility of online memory interventions in promoting greater confidence and feelings of control regarding memory ability through psychoeducation, strategy training and in providing reassurance through normalization. Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12620000979954.
Background:Life-space mobility refers to the way individuals maneuver themselves in their home and community and is commonly assessed using the Life-SpaceAssessment (LSA). Before using the LSA, it is important to ensure that it demonstrates validity in the population being used, as culture, built environment, and modes of transportation in different geographical regions can influence mobility. Therefore, the purpose of this study was to assess the convergent, divergent, and known-groups validity of the LSA in community-dwelling Canadian middle-aged and older adults using data from the Canadian Longitudinal Study on Aging (CLSA). Methods:Spearman's correlation coefficients were calculated for all measures of convergent (hypothesis: r > 0.5) and divergent (hypothesis: r < 0.3) validity. Known-groups validity was assessed by determining if the LSA can differentiate between people with chronic diseases and a history of falls using measures of clinical significance (i.e., LSA score change of 5 or more points). Results:The sample (n = 24,577) had a median LSA score of 86.0. Correlations between the LSA and comparator measures of convergent validity (r = 0.10-0.29) did not meet the hypothesis; however, measures of divergent validity (r = 0.15-0.17) met the hypothesis. For known-groups validity, the LSA can be used to differentiate between those with (median score = 84; interquartile range [IQR] = 72-100) and without (median score = 90; IQR = 74-100) a history of falls among the whole sample. Further, it can be used to differentiate between those with and without chronic conditions, among males and females aged 75+ years. Conclusion:The LSA can be used to differentiate between known groups. However, there is limited evidence of its convergent validity as its relationship with other measures of actual mobility, perceived mobility, and locomotor capacity for mobility was weak. Future studies need to assess the convergent validity of the LSA against different comparator measures before its use among community-dwelling Canadians.
Sexuality in older age remains a taboo subject. Little is known about the perceptions and experiences of healthcare professionals when addressing this topic with older adults. This systematic review, registered in PROSPERO, aims to understand the perceptions, practices, and recommendations of healthcare professionals in primary and hospital care regarding the approach to sexuality and sexual health in older people. The 17 selected studies, conducted in six countries, show that physicians and nurses rarely discuss sexuality with their older patients, often assuming that they are not interested in the topic, but also due to a lack of time and willingness to address it. The studies recommend both initial and continuing education on sexuality and aging, as well as the development of protocols for assessing the sexual health of older people in healthcare settings. The absence of studies from Portugal and the passive role of professionals in promoting the sexual health of older people further reinforce the need for research in this area.
ObjectivesObjective: To investigate the association between depressive symptoms and falls in community-dwelling older adults.MethodsMethods: This is a cross-sectional study with 278 participants aged 60 or older. Information on clinical and sociodemographic data were obtained from a structured interview, depressive symptoms were assessed with the Geriatric Depression Scale (GDS), falls in the previous year were self-reported, and risk of falls was assessed with the Physiological Profile Assessment (PPA). Fallers and nonfallers were compared with Mann-Whitney and chi-squared tests. A binary logistic model was used to investigate the association between falls and GDS score, followed by a binomial negative regression model to analyze the association of GDS score and the number of falls. Finally, groups of individuals screened positive or negative for depression were compared for risk of falls and each individual's PPA test.ResultsDiscussion: Fallers presented more chronic conditions, polypharmacy, worse subjective health status and higher GDS scores. Individuals with higher GDS scores presented a higher chance of falling. The number of falls was not associated to the GDS score; however, there was an association between falls and the number of morbidities. Positive screening for depression was associated to a higher risk of falls according to the PPA, as well as to reaction time.ConclusionConclusion: Fallers presented more depressive symptoms, morbidities, polypharmacy, and worse subjective health status. Depressive symptoms do not act directly over the number of falls; nonetheless, those with depressive symptoms presented a higher chance of falling, which may be associated to slower reaction time. Psychological symptoms play an important role in falls, and should, therefore, be considered in identifying older people at risk and in developing prevention programs.
Driving is often the preferred mode of mobility for older adults in the United States, yet age-related functional declines increasingly compromise driver safety. Driver reaction time is one of the most critical factors related to accident avoidance and is particularly vulnerable to age-related decline. Maintaining a physically active, cognitively engaging lifestyle can help attenuate age-related declines in reaction time, and rhythm-based exercise programs represent one such avenue. This pilot study examined preliminary evidence on whether a 10-week Drums Alive program, a drumming-based aerobic workout program, shows sufficient promise to maintain or improve reaction time for community-dwelling older adults. Participants enrolled in the Drums Alive program were nonrandomly assigned to the intervention condition (mean age = 69.67 years, SD = 5.86). Twelve age- and sex-matched participants from a previously published study served as the stretching comparison condition (mean age = 69.35 years, SD = 5.07). Simple reaction time (releasing accelerator), movement time (moving foot to brake), and total reaction time were recorded during a simulated brake-onset task pre- and postintervention. There was a statistically significant intervention by time interaction for movement time, with Drums Alive participants showing a greater improvement (M = -0.054, SD = 0.061) compared to the stretching group (M = 0.006, SD = 0.044) and total reaction time, with Drums Alive participants showing a greater improvement (M = -0.080, SD = 0.089) compared to the stretching group (M = 0.059, SD = 0.165). No significant group differences were observed for simple reaction time. It is important to design music-based interventions for a specific purpose to support client needs, enhance engagement, and align with evidence-based practices. Our findings suggest that carefully designed music interventions that engage older adults in exercise may help maintain independence by improving driving-related reaction time.
Background:Age-related loss of muscle mass and function contributes to mobility limitations, loss of independence, and other adverse health outcomes. Structural and functional indicators characterize muscle health but may not change in parallel with advancing age. Evidence from rural populations remains limited. This study aimed to examine age-related differences in structural and functional muscle indicators among rural community-dwelling women and to determine whether age-group differences are greater in functional than in structural indicators. Methods:This cross-sectional study included 211 community-dwelling women aged 50-89 years residing in rural Asan, Korea. Participants were categorized into four age groups (50-59, 60-69, 70-79, and 80-89 years). Structural indicators included skeletal muscle index (SMI), skeletal muscle mass (SMM), thigh circumference (TC), and calf circumference (CF). Functional indicators included handgrip (HG) strength, isometric knee extensor (KE) strength, and the five-times sit-to-stand test (5×STS). Between-group differences were analyzed using one-way analysis of variance (ANOVA), and domain-level differences were further examined using a mixed-design repeated-measures ANOVA. To facilitate comparison across indicators, variables were normalized to the 50-59 age group (set to 100). Results:Structural and functional indicators showed different magnitudes of age-related change across groups. HG and KE were lower in older groups and showed larger between-group differences than the structural indicators. In contrast, 5×STS time increased across age groups, from 7.0 ± 1.75 s in the 50-59 group to 15.2 ± 6.60 s in the 80-89 group. Relative SMI decreased to 81.5% of the reference group, whereas the relative index for 5×STS (reciprocal time) decreased to 46.0% (all p < 0.001). Conclusions:Structural and functional muscle indicators showed divergent age-related patterns among rural community-dwelling women. The performance-based 5×STS demonstrated substantially greater relative differences than structural indicators, supporting the inclusion of functional assessments alongside structural measures for age-stratified evaluation in rural settings.
Background/Objective:Retirement represents a significant life transition, yet limited research exists on retirement planning among public sector employees in sub-Saharan Africa's most impoverished regions. This study investigates the retirement preparedness of local government workers in Ghana's Upper West Region, examining the factors that drive planning and readiness for retirement. Methods:A qualitative case study design was employed. Semistructured key informant interviews were conducted with 33 local government employees aged 25-45 years across five departments within all 11 metropolitan, municipal, and district assemblies of the Upper West Region. Participants were selected using purposive sampling with convenience recruitment. Data were analyzed using thematic analysis, guided by the life course perspective and theory of planned behavior. Findings:Key findings include (1) thoughts on retirement indicated that there was high awareness but age-related postponement of planning; (2) retirement aspirations were guided by financial security, homeownership, healthcare access, and family time; (3) content of retirement plans included land acquisition prioritized over financial instruments due to eroded trust in banking institutions; (4) drivers of retirement planning included personal goals, family obligations, and notably, the absence of workplace retirement education programs; (5) overall preparedness showed inadequate preparation, complicated by cultural norms of wealth secrecy as a protective strategy against envy and social obligations. Conclusion:Local government employees in Northwestern Ghana demonstrate inadequate retirement preparedness. Effective interventions require context-sensitive approaches addressing financial literacy, workplace education programs, and the cultural dynamics of savings disclosure in collectivist, resource-constrained settings.
Introduction:This study investigates how chronological age at stroke onset affects post-stroke language abilities and recovery. Using cross-sectional and retrospective data, we investigated (A) which language tasks are sensitive to age; (B) whether any age-related effects are modified by factors such as lesion size, initial severity and education and (C) whether age influences recovery from aphasia. Methods:Language abilities were assessed in 749 participants using (i) the Comprehensive Aphasia Test (CAT) at a single time point and (ii) self-reported measures of speaking, understanding, reading and writing ability both at 1 week and 1 year post-stroke. The outcomes investigated, using multiple linear regression, were (1) CAT language scores and (2) self-reported recovery scores at 1 year post-stroke. Lesion size, initial severity, sex, handedness, pre-stroke education and time post-stroke were controlled. Bayesian statistics assessed the strength of evidence for observed effects. Results:(A) Irrespective of lesion or symptom severity, older age at stroke onset was associated with worse performance across multiple language domains, including overall language ability, nonword and word repetition, semantic and letter fluency, object naming and comprehension of spoken and written words and sentences. Effect sizes were strongest for nonword repetition (β = -0.258) and weakest for written word comprehension (β = -0.061). (B) The disadvantage of older age was heightened in participants with the largest lesions and most severe initial aphasia, but (C) there was no evidence that older age hindered language recovery in any subgroup. Conclusion:Older age at stroke onset significantly worsened language outcomes, highlighting the sensitivity of aphasia assessments to age-related differences in post-stroke language abilities. This disadvantage was greatest in participants with both large lesions and severe initial symptoms. Considering age when interpreting assessment scores would optimise diagnosis and prognostic accuracy.
Objectives:The present study was conducted to examine the effects of a 1-year multicomponent exercise training (MCET) program on the physical function and sarcopenia status of community-dwelling older adults with probable sarcopenia. Methods:Data of 132 Brazilian community-dwelling older adults with probable sarcopenia were examined. The MCET program was performed twice a week over 1 year. Physical performance evaluations included (i) timed "up-and-go" (TUG), (ii) one-leg stand, (iii) walking speed (WS) at normal pace and fast pace, (iv) 5-time sit-to-stand (5STS) test, and (v) isometric handgrip strength (IHG). Results:MCET significantly increased TUG (-7.0%), balance (53.0%), 5STS (-10.0%), and WS at normal pace (13.0%). Furthermore, a significant decrease in the prevalence of IHG-based probable sarcopenia was observed (88.6% vs. 67.4%). Conclusions:Findings of the present study indicate that a 1-year intervention program based on an MCET strategy significantly improved multiple physical performance measures and enhanced sarcopenia status in community-dwelling older adults. These improvements may significantly lower the risk of developing adverse outcomes, such as falls, disability, hospitalization, and death. Therefore, the MCET program tested in this study shows promise as a primary care strategy to reduce the burden of physical decline in community-dwelling older adults.
Purpose:To analyze the correlation between spontaneous physical activity (PA) and sedentary behavior (SB) objectively measured using wearable devices and frailty syndrome (FS) in older adults. Methods:The PubMed/Medline, Web of Science, and Cochrane Library databases were used as sources of information. The search equation used was "(accelerometer OR physical activity) AND (elderly OR 'older adult' OR older) AND (frailty) AND ('nursing home' OR institutionalized)." Results:Twenty-three studies were included. Of these, 14 studies examining PA were eligible for meta-analysis. A random effects correlation analysis of these 14 studies revealed a significant inverse correlation between PA and FS (r = -0.48, 95% CI = [-0.5585, -0.3560], Z = -8.39, p < 0.0001), indicating statistically significant between-study variance and high heterogeneity (I 2 = 84%). Regarding SB, 11 of the 16 studies were meta-analyzed. Random-effects meta-analysis showed that 8 of the 11 analyzed studies presented a significant positive association between SB and FS (r = 0.334, CI = [0.2233; 0.4259], Z = 6.67, p < 0.0001), with statistically significant between-study variance and high heterogeneity (I 2 = 86.9%). Sensitivity analysis revealed that removing one study increased the inverse correlation coefficient between PA and FS from -0.33 to -0.46 and increased the positive correlation coefficient between SB and FS from 0.22 to 0.39. Conclusion:Lower PA and high SB time are significantly associated with high FS incidence among older people. These findings highlight the importance of promoting PA and reducing SB to prevent FS and its complications in later life.
Background:Frailty is a predictor of adverse outcomes in older adults, yet contemporary Portuguese-language tools for standardized frailty assessment remain limited. We translated, culturally adapted, and evaluated the updated clinical frailty scale (CFS, v2.0) for Brazilian Portuguese. Objectives:To assess inter- and intrarater reliability and convergent validity of the updated CFS in hospitalized older adults. Methods:This cross-sectional psychometric study included patients aged 65 years or older admitted for elective surgery. Following a standardized cross-cultural adaptation process, two independent examiners administered the updated Brazilian Portuguese CFS 60 min apart to assess inter-rater reliability. Intrarater reproducibility was evaluated after 24 h. Participants also completed the SF-36 quality-of-life questionnaire to examine convergent validity. Results:Ninety-four hospitalized older adults were included. Inter-rater reliability was excellent (ICC[2, 1] = 0.92, 95% CI 0.88-0.95). Weighted Cohen's kappa indicated almost perfect ordinal agreement (κw = 0.96, 95% CI 0.83-1.00). Measurement error was low (SEM = 0.44; MDC95 = 1.22). Convergent validity was strong, demonstrating a significant monotonic association between CFS scores and SF-36 domains (Spearman's ρ = -0.786, p < 0.01). Exploratory descriptive analyses were conducted to illustrate the clinical context of frailty classification in this sample. These observations were not intended to assess predictive validity or support confirmatory inference. Conclusion:The updated Brazilian Portuguese version of the CFS demonstrates excellent reproducibility and strong convergent validity in hospitalized older adults. These results support its use as a reliable clinical and research tool for frailty assessment in hospitalized older adults, within the scope of the measurement properties evaluated.
Background and Purpose:Food insecurity and activity limitations impact the overall health-related quality of life (HRQOL) of older adults. This cross-sectional study investigates the relationship between food security and functional limitation on the QOL life among older adults in New York City. Methodology:A total of 378 participants aged 60 years and older were assessed using the USDA 6-Item Household Food Security Survey, and the Eastern Cooperative Oncology Group (ECOG) scale was used to assess overall functional status and activity limitation and the CDC's HRQOL-4 questionnaires. Results:Results indicated that 19.1% of the participants were food insecure, 56.9% reported fully active, and 33.9% reported very good or excellent overall health. Participants who experienced food insecurity were more likely to rate their overall health as poor or fair (p = 0.031) and report 12 or more days that their physical or mental health kept them from doing their usual activities (p = 0.001) compared to those who were food secure. Similarly, older adults with more functional limitations or disabilities were strongly associated with poorer HRQOL (p < 0.001) in all domains of the HRQOL-4. Conclusion:These results show the impact of food insecurity and functional limitations and HRQOL in older adults. The results emphasize the urgent need for addressing food insecurity and promote healthy aging among older adults in New York City.
IntroductionMany municipalities in Sweden offer group exercises for older persons at meeting places, i.e., senior centres. However, it is unclear whether older persons experience group exercises as in accordance with their needs and wishes.AimThe aim was to explore older persons' experiences of participating in group exercises held at meeting places in municipalities from a person-centred perspective.MethodsIndividual interviews were conducted with 18 persons aged 65 and over who participated in group exercises at meeting places in six different municipalities. The interview guide was based on a person-centred framework. The data were analysed using content analysis, first deductively and then inductively.FindingsThe findings were presented in two main categories. The first concerned incentives for older persons to continue exercising in groups, which were held at meeting places. Such incentives were the encouragement they felt from the power of the group and the fact that the group exercises made them feel good. They also felt a sense of worth from having time and effort invested in them. The second main category included mixed feelings about the interaction between the older persons and the stakeholders, primarily the exercise leader. On the one hand, the older persons felt a strong trust in the exercise leaders, but on the other, they felt ambivalent and had ambiguous feelings regarding their own opportunities to influence the group exercises.ConclusionsTo conclude, the group exercises held at meeting places contribute to meaningful relationships and a sense of social belonging and togetherness. The intervention not only promotes physical and mental health but also counters loneliness and social isolation, and therefore needs to be scaled up even more. This study highlights the need to make group exercises more person-centred and to introduce processes that include the needs and wishes of older persons in the design of such interventions.
Objectives:Loneliness and social isolation are associated with significant negative impacts on physical and mental health. Living alone increases one's risk for loneliness and social isolation. Many older adults live alone, including individuals with mild cognitive impairment (MCI) and subjective memory decline. Living alone with a diagnosis of MCI or subjective memory decline adds greater complexity, stress, and difficulty in navigating daily life due to loneliness, social isolation, and negative mental and physical health outcomes. Despite these concerns, there is a dearth of support interventions for older adults who live alone with memory decline. Home Alone is a new support program created for this unique population of older adults in continuing to live independently and safely while engaging in social and meaningful activities. This pilot study evaluated the feasibility of the novel Home Alone support program. Methods:Home Alone is a seven-session psychosocial and psychoeducational intervention that provides one-on-one, tailored coaching in person or via telehealth. Home Alone focuses on promoting home safety strategies and modifications and encouraging personally meaningful activity and social engagement through behavioral activation-based tasks. Fifteen older adults who live alone and have MCI or subjective memory decline enrolled in the 3-month feasibility study to evaluate the initial program and inform its refinement. Mixed methods data were collected from 1- and 3-month follow-up surveys. Additional qualitative data on participants' experiences of the Home Alone intervention were collected at post-intervention interviews. Results:Results demonstrated preliminary feasibility, utility, and acceptance of Home Alone. Qualitative analyses of participant interviews identified useful aspects of the intervention, including home safety, meaningful activity, and socialization, as well as recommendations for program refinement. Discussion:The Home Alone program was well-received and viewed as valuable by participants. Participant feedback and recommendations were incorporated to further improve the intervention. The refined Home Alone intervention is now being evaluated in a larger pilot trial. Trial Registration: ClinicalTrials.gov identifier: NCT05746390.
As global populations age, active aging and lifelong learning have become critical policy objectives. In Taiwan, the Ministry of Education (MOE) promotes Older Adults’ Self-Guided Learning Groups (OASLGs); however, the sustainability of these groups relies heavily on volunteer leaders. This study investigates the motivations and management processes of “Excellent Leaders” in OASLGs using a qualitative approach. Drawing on Bronfenbrenner’s ecological systems theory, we analyzed semistructured interviews with Eight Excellent leaders who agreed to be interviewed. The findings reveal that leadership motivations, specifically altruism, self-growth, and expectancy value, are deeply embedded within the microsystem of personal fulfillment and the Mesosystem of community interaction. Key management processes identified include “learning by doing,” resource mobilization, and the cultivation of peer-based trust. This study extends the ecological understanding of senior volunteering by demonstrating how the Exosystem (policy-structured training) functions not merely as a distant backdrop but as an essential scaffolding that actively sustains the Microsystem (individual leadership agency). Implications for policy include the necessity of continuous, structured training and the fostering of local support networks to sustain volunteer engagement in aging societies.
