(1) Introduction: Physical activity is considered a key factor in maintaining functional health during aging; however, its relationship with objective measures of physical performance remains unclear. (2) Methods: A cross-sectional study was conducted with 63 community-dwelling older adults (70.4 ± 6.6 years; 35.7 ± 6.5% body fat). Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ), and participants were classified into activity levels. Body composition was evaluated using bioelectrical impedance analysis. Functional fitness was assessed through standardized tests, including lower-limb strength, Timed Up and Go (TUG), and the 2 min step test (2MST). Isokinetic strength of the knee extensors and flexors was measured at 60°/s and 180°/s. Non-parametric tests, Spearman correlations, and linear regression analyses were performed; (3) Results: No significant differences were observed between IPAQ categories for body fat percentage, TUG performance, lower-limb strength, or aerobic capacity (all p > 0.05). Correlations between MET values and physical or functional variables were weak (ρ ranging from −0.07 to 0.18). (4) Conclusions: Self-reported physical activity was not associated with objective measures of physical function in older adults. These findings highlight the importance of incorporating objective assessments of physical performance when evaluating functional health in this population.
Background: Malnutrition is common among older adults aged 65 years and over and is associated with physical and mental health risks. Malnutrition is a complex condition; supporting older adults in achieving healthy, sustainable dietary behaviors remains a challenge for care professionals. Assistive technologies to support malnutrition care, such as monitoring tools, social robots, or smart spoons, are often poorly adapted to real-world contexts and fail to sustain long-term engagement. Method: A design research approach was used to understand care practices better and explore design opportunities for assistive technologies. Eight in-depth, qualitative interviews were conducted with dietitians treating older adults with malnutrition. Interviews were transcribed and analyzed through thematic analysis. A five-phase patient journey was created as a visual tool to identify where assistive technologies could improve the care process and define design requirements. Results: Dietitians face challenges due to the dynamic nature of patient journeys, limited time for personalized care, difficulty in monitoring progress, and unclear collaboration with other care providers. Conclusions: This study contributed by reframing malnutrition as a dynamic, multi-actor patient journey in which assistive technology can play a supportive role at different phases, supporting collaboration, facilitating relationship-building, and involving the larger care network.
The COVID-19 pandemic accelerated telehealth adoption, but disparities in digital access hinder its potential, especially for older adults in nonmetropolitan areas. This study examined associations between sociodemographic factors and access to select digital resources among nonmetropolitan Medicare beneficiaries. This cross-sectional study used the 2022 Medicare Current Beneficiary Survey Public Use File, including 1732 Medicare beneficiaries aged ≥65 in nonmetropolitan areas. The dependent variable of digital access was categorized as (1) access to both a computer/tablet and the internet, (2) access to either, and (3) access to neither. A survey-weighted multinomial logit model was conducted to examine associations between sociodemographic factors and digital access, with no access to either a computer/tablet or the internet as the reference category. Approximately 71.7% of nonmetropolitan beneficiaries had both computer/tablet and internet access, 14.4% had one or the other, and 13.9% had neither. About one-third of study beneficiaries lacked full digital access. Older age, male, minority race/ethnicity, lower education, and lower income were associated with reduced digital access among nonmetropolitan beneficiaries. Targeted interventions to expand digital access for these at-risk populations are needed.
Reaction time (RT) is widely used as a fundamental indicator of central nervous system processing speed. Numerous studies have shown that RT increases with age, generally in-terpreted as a decline in information processing efficiency. However, most previous studies have focused on absolute RT values, and it remains unclear whether aging also alters the relative relationships between responses under different task conditions. The present study investigated whether aging affects the relative difference between inside and outside pedal reaction times in a Foot Psychomotor Vigilance Test (Foot PVT). A total of 44 participants were analyzed, including 20 younger adults (24 ± 3 years) and 24 older adults (73 ± 5 years). Participants responded to visual stimuli by pressing either the left or right pedal with the right foot. The difference between inside and outside RT (dRT) was calculated for each participant as an index of relative response structure. Group compari-sons and correlation analyses were conducted to examine associations with age, height, physical activity level (PAL), and sleep-related factors. As expected, RTs were consistently longer in older adults across conditions. In contrast, dRT did not differ significantly be-tween younger and older groups, with negligible effect sizes(|d|< 0.1). Furthermore, dRT showed no significant correlations with height, PAL, or sleep-related indices. These find-ings indicate that while aging affects the overall speed of motor responses, the relative temporal structure between response conditions is preserved. This dissociation between global slowing and stable response structure may represent a fundamental characteristic of neuromotor aging.
In ageing and built environment research, unevenness in evidence across spatial contexts constitutes a methodological condition rather than a simple coverage gap, with direct implications for how accessibility, usability and fairness are conceptualised and measured. Research on built environments for older adults has largely relied on urban evidence. Although findings from cities remain valuable, this focus influences how concepts are defined, which indicators are considered valid, and how far results can be generalised. Indicators designed for high-density urban settings often capture service availability well but have limited validity in low-density or resource-scarce environments. In such contexts, the presence of nearby services is frequently equated with accessibility, and accessibility is often assumed to imply usability. This paper synthesises review and measurement research to identify three mechanisms sustaining urban bias: urban-focused sampling, limited transferability of common indicators, and exposure definitions that assume density and reliable infrastructure. Building on this analysis, the study proposes a measurement framework that explicitly takes principles of fairness into account. This framework is organised around four analytical lenses: distribution, recognition, participation and sustainability. Matching sampling strategies, spatial classifications, measurement strategies and reporting practices to local settlement characteristics is critical to ensuring that conclusions are appropriately limited to what indicator-based evidence can validly support.
Falls among older adults are a major public health concern. Older adults living in low-income housing (LIH) are at higher risk of falls due to disadvantages linked to social determinants of health, yet remain underrepresented in research. This study aimed to assess the feasibility of a program addressing fear of falling and its consequences on activity levels among older adults living in LIH in Côte-des-Neiges (Montreal, QC, Canada). A mixed-methods pilot feasibility study was conducted using Bowen et al.’s framework, drawing on data collected through questionnaires, observation grids, attendance records, and semi-structured interviews. The program consisted of six 90 min sessions designed to enhance participants’ confidence in preventing falls while promoting engagement in activities. Fourteen older adults (mean age = 75.5 years) were recruited. Outcome data on fall-related psychological factors, activity engagement, and knowledge about falls were collected before and after the program. Moreover, older participants’ perceived benefits were assessed following program completion. Post-program interviews with older adults, facilitators, and a community field worker were conducted to further explore program feasibility, including its acceptability, implementation, and integration. The program showed strong acceptability and a high attendance rate (95%). Although no statistically significant pre-post changes were observed in the outcome variables, older participants reported several benefits at post-test, including improved knowledge about fall prevention (100%) and greater confidence in their ability to avoid falls (85%). These findings support the feasibility of implementing this culturally adapted fall prevention program in similar LIH settings and provide valuable insights for its refinement and future research. Further investigation is warranted to examine the program’s feasibility across other LIH settings and linguistic groups, as well as to assess its effectiveness.
Addressing global urbanization and demographic shifts, this study argues that urban affordance—the environment’s capacity to promote or constrain healthy activities—is the critical link missing in current ageing in place (AIP) models. The research introduces a new multidisciplinary approach bridging urbanism, statistics, and psychology to evaluate the relationship between urban space and ageing through the lens of environmental affordance. It synthesizes 47 indicators across five macro-areas (demographic, economic, healthcare, social–relational and urban–environmental) into a composite index named the index of Vulnerability for Ageing in place and Longevity (VAL index). It maps over 65 vulnerabilities related to AIP at the neighbourhood level in Bergamo, an Italian medium-sized city. The VAL index reveals critical discrepancies between objective urban determinants and subjective resident conditions (e.g., high walkability contrast with low perceived safety). In conclusion, this index reorients urban planning for ageing, leveraging an AIP approach to advance spatial justice and demographic resilience.
Despite growing recognition of holistic care in gerontology, the role of spirituality and religion in physiotherapy practice remains underexplored. This study examines Maltese physiotherapists’ perceptions and awareness of religious and spiritual care in the treatment of older persons, contributing to an untapped area in local research and adding to the limited international literature, particularly within Mediterranean and predominantly Catholic healthcare contexts. A questionnaire was distributed via SurveyMonkey to government sector physiotherapists in Malta. Findings revealed that while physiotherapists recognised the importance of incorporating spiritual and religious considerations into older persons’ care, they often viewed such care as outside their clinical responsibilities. Key barriers included limited training, insufficient knowledge, and time constraints. Notably, physiotherapists with personal religious or spiritual beliefs were more inclined to integrate these aspects into their practice compared to their atheist or agnostic counterparts. The study underlines the need for enhanced training at both undergraduate and postgraduate levels and advocates for qualitative research to deepen understanding of the barriers and facilitators to spiritual care. Addressing these gaps will promote holistic, person-centred care that respects individual beliefs, ultimately enhancing outcomes for older persons.
As men age, systemic inflammation increases, whereas grip strength (GS) and testosterone levels tend to fall. This rate of decline is known to be influenced by gut microbial health, lifestyle and diet but the role for interventions to slow this decline are less well established. This double-blind randomised controlled trial evaluated the impact, and explored the synergistic potential, of boosting phytochemical rich foods and Lactobacillus probiotics on these physical and biological markers. Two hundred and eight men with untreated early prostate cancer managed with observation only (average age 74 years) received a phytochemical rich supplement (PRS) containing concentrated broccoli, green tea, pomegranate, ginger, cranberries and turmeric (YourPhyto). In addition, they were randomised to either a 5-blend Lactobacillus probiotic (PB) capsule (YourGutplus) or a placebo (P). Average GS improved by 2.5 kg from baseline to trial completion, at 4 months in men taking PRS +P (95% CI 1.8–3.4, p < 0.001). In the PRS+PB arm, GS improved by 4.4 kg (95% CI 3.6–5.2, p < 0.001). The odds of grip strength improving was 11.8% greater (p = 0.002, OR = 1.11, 95% CI 1.04–1.20) in the PRS+PB arm. Improvements in systemic inflammation were better in the PRS+PB arm (−0.41 vs. +0.39, p = 0.04). Four-month testosterone levels were greater in the PRS+PB arms (14.75 vs. 13.02 ng/L, 95% CI 0.23 to 3.33 ng/L p = 0.046). In conclusion, boosting dietary phytochemicals was associated with improved GS. The addition of this blend of Lactobacillus further enhanced GS, and reduced markers of inflammation. These data justify longer studies exploring the synergy between phytochemicals and probiotics, on more objective markers of longevity.
Population ageing has renewed interest in the capability approach (CA) as a framework for understanding wellbeing in later life. Yet research applying the CA to ageing remains fragmented, and its empirical focus is still not well understood. This study examines how CA-based ageing research has developed and how it explains capability constraints and adaptive responses in later life. Using Web of Science Core Collection records from 2000 to 2025, we combine comparative bibliometric analysis with a focused qualitative interpretive synthesis. A general CA corpus (n = 3416) was first constructed and then refined to identify a CA-in-ageing subset (n = 142). The bibliometric results suggest that CA-in-ageing research is more problem-oriented than the broader CA literature, with health and care evaluation, as well as mobility and accessibility, emerging as particularly prominent thematic concentrations in the retrieved corpus. The qualitative synthesis of five appraised studies further shows how capability loss may be experienced in everyday life through shrinking life-space, disrupted social participation, and threats to dignity. It also identifies adaptive strategies through which older adults rebuild routines, negotiate selective support, and re-establish participation through enabling environments and services. Given the small qualitative corpus, its reliance on several COVID-19-related studies, and its Western empirical contexts, the findings should be read as an explanatory account of possible mechanisms rather than as a comprehensive representation of later-life capability loss across all ageing settings. By integrating bibliometric mapping with qualitative evidence, this study clarifies how the CA has been operationalised in ageing research and highlights the importance of environmental accessibility, service stability, and participation opportunities in sustaining wellbeing in later life.
Background/Objectives: Promoting psychological well-being is a central goal in healthy aging research. While leisure has been widely recognized as an important contributor to well-being in later life, the underlying psychological mechanisms remain insufficiently understood. This study aims to examine the relative roles of cognitive and experiential mechanisms in shaping psychological well-being among older adults. Methods: A cross-sectional survey was conducted with 200 older adults participating in community-based leisure programs in South Korea. Data were analyzed using confirmatory factor analysis and structural equation modeling. A dual-pathway model was tested, in which leisure attitude represents a cognitive mechanism and leisure satisfaction reflects an experiential mechanism. Results: Leisure attitude significantly influenced both leisure satisfaction and psychological well-being, while leisure satisfaction also had a positive but comparatively weaker effect on well-being. Mediation analysis confirmed that leisure satisfaction partially mediates the relationship between leisure attitude and psychological well-being. Notably, the direct effect of leisure attitude (β = 0.368) was substantially stronger than that of leisure satisfaction (β = 0.150), providing preliminary support for differences in the relative associations of cognitive and experiential pathways. Conclusions: These findings suggest that cognitive appraisal may play a relatively important role in psychological well-being among older adults and provide preliminary support for the relevance of cognitive mechanisms alongside experiential factors in aging research. Interventions aimed at promoting healthy aging should therefore focus not only on improving the quality of leisure experiences but also on fostering positive cognitive orientations toward leisure.
Loneliness describes a complex experience, the subjective incongruence between one’s desired and perceived social connections. The study of loneliness has increased but mostly through quantitative methods, leaving a gap in the personal experience and understanding of what it means to be lonely. The everyday language used to articulate the personal experience of loneliness remains underexamined. To address this gap, we conducted 18 semi-structured life story interviews with older adult mental health service users. Interviews were conducted via telephone and lasted on average 45 min. Participants were included on the basis of being objectively classified as lonely and ranged in age from 66 to 84. This paper provides a thematic analysis of responses to the question “What does loneliness mean to you?” Responses include subjective and objective aspects, as well as frequency, duration, and intensity, and social, emotional, and existential loneliness. Loneliness is a multidimensional, personal experience, rather than a single construct. Participants discussed loneliness alongside social isolation, depression, grief, feelings of emptiness, purpose, meaning, boredom and hopelessness. These insights are important for informing how we frame loneliness in research, policy, and practice, and for highlighting that our language needs to be sufficiently inclusive to capture the complexity of loneliness, not only for work with mental health service users but in public health.
A neighborhood’s built environment can challenge the mobility of older mobility-challenged adults (due to knee osteoarthritis and falls), reducing their participation and quality of life. The Built Environment in Falls and arthrITis (BE-FIT) study aims to understand the neighborhood influence on the mobility, participation, and psychosocial health of older adults with knee osteoarthritis and/or falls. BE-FIT comprises four work packages (WPs). WP1 quantitatively explores relationships among environmental-, social-, and person-related factors and participation outcomes of its intended population. WP2 employs qualitative methods to comprehend the relationships among WP1’s variables. Via a combination of wearable sensor technology and qualitative geospatial methods, WP3 aims to characterize its population’s movement behavior, mobility, functional activity of daily living, and lived experiences of residing in a mature neighborhood. Finally, WP4 engages crucial stakeholders to co-develop evidence-based recommendations to inform public health, urban planning, and aging policies and implementation. BE-FIT could benefit societies with rising incidence of knee osteoarthritis and falls by improving neighborhoods and lives of older mobility-challenged residents.
Older adults are particularly vulnerable to extreme heat, but evidence of the role of social factors in regional heat vulnerability remains limited. To assess the impacts of heat waves on cardiorespiratory hospitalizations and mortality, we developed a Climate Vulnerability Index by the Regional Health Department (RHD), including adults aged ≥ 60 years across 17 RHDs in São Paulo State, Brazil. Health data were obtained from national information systems, and heat wave exposure was derived from ERA5 reanalysis data, defined as periods of at least three consecutive days with daily mean temperature exceeding the seasonal climatological mean by ≥3 °C, for 2010–2019 and 2023–2024, excluding 2020–2022. Associations between heat waves and health outcomes were estimated using distributed lag non-linear models with lags of 0–15 days. Cumulative relative risks, along with sociodemographic, sanitation, and health system indicators, were integrated to construct the Index based on IPCC sensitivity and adaptive capacity domains. Heat waves were associated with increased risks of cardiorespiratory hospitalizations and mortality across all RHDs, with stronger effects observed for mortality and inland regions. Higher vulnerability was concentrated in RHDs characterized by larger older adult populations, greater heat-related risks, and weaker health system and sanitation indicators, whereas more developed regions showed lower vulnerability. Overall, the Index provides a practical tool to support territorial prioritization and targeted heat–health adaptation strategies in ageing populations.
Background: Medication adherence is essential for effective management of chronic conditions, particularly among older adults with complex chronic conditions (CCCs). The Simplified Medication Adherence Questionnaire (SMAQ) is a brief self-report instrument widely used to assess adherence; however, its psychometric properties have not been evaluated in Albanian older populations. Objective: To assess the psychometric properties of the SMAQ in Albanian older adults with CCCs. Methods: A multicenter, cross-sectional study was conducted among 727 adults aged ≥65 years with two or more chronic conditions recruited from primary healthcare centers in southern Albania. Internal consistency was assessed using Cronbach’s alpha and McDonald’s ω. Construct validity was evaluated through exploratory and confirmatory factor analyses and correlations with clinical and behavioral variables. Discriminative validity was examined using known-group approach and independent samples t-tests, and criterion validity was assessed using Spearman correlations. Results: The SMAQ demonstrated good internal consistency (α = 0.799, ω = 0.821). Factor analyses supported a unidimensional structure, with all items loading significantly onto a single factor. Model fit indices indicated acceptable fit (CFI = 0.921; SRMR = 0.051), although RMSEA suggested some misfit (0.116). Non-adherent participants had significantly higher SMAQ scores than adherent participants (p < 0.001), indicating strong discriminative validity. Conclusions: The SMAQ is a reliable and valid tool for assessing medication adherence among Albanian older adults with CCCs, supporting its use in primary healthcare and research settings.
The classic tripartite life-course model (education, work, and retirement) is under increasing pressure from rising longevity and structural labour-market change. This study examines how Millennials and Generation Z in Portugal conceptualise retirement and the life course, asking whether these cohorts adhere to a standardised, sequential logic or aspire to more fluid, multi-stage trajectories, and whether observed differences reflect generation or socioeconomic position. A cross-sectional survey of 234 participants aged 18–43 assessed perceptions of retirement, openness to non-linear life cycles, future concerns, preparation strategies, and orientations towards lifelong learning. Responses were analysed using non-parametric tests (Mann–Whitney U, Kruskal–Wallis) and multivariate linear regression, with outcomes stratified by income, education, and occupational status. Participants showed a widespread preference for greater flexibility around the tripartite sequence rather than its abandonment, the statutory retirement age persisting as a reference point. Trust in the public pension system was low and cross-cutting, with over 70% doubting its capacity to ensure an adequate retirement, while Generation Z reported significantly greater concern about losing professional purpose. Socioeconomic position was a more consistent stratifier than generation for financial preparation, which rose with income and education; distrust, by contrast, was predicted by neither socioeconomic position nor generation in multivariate models. These findings indicate that biographical deinstitutionalisation may already be underway among younger Portuguese cohorts, with structural risks increasingly individualised, carrying implications for the redesign of life-course policies and social protection systems in an era of longevity.
This study examines the determinants of subjective economic status and life satisfaction among Korean middle-aged individuals, defined as those between 45 and 57 years old. The research explores the impact of eating out expenses, clothing expenses, employment status, and physical exercise on these factors. Data is drawn from the Korean Longitudinal Study of Elderly Employment (KLoEE) for the year 2022, with a sample size of 4392 observations. To test the research hypotheses, quadratic multiple regression analysis was employed. The findings reveal that subjective economic status is significantly influenced by both eating out and clothing expenses, exhibiting an inverted-U-shaped effect. Additionally, an inverted U-shaped relationship between clothing expenses and life satisfaction was also observed. Employment had a positive effect on subjective economic status but a negative impact on life satisfaction. Furthermore, regular physical exercise was found to influence both subjective economic status and life satisfaction positively. The study concludes that subjective economic status positively affects life satisfaction among the Korean middle-aged population. This research contributes to the literature by identifying key behavioral characteristics of this demographic in Korea and discussing relevant policy implications.
Background: Language impairment is a core feature of Major Neurocognitive Disorder (MND), yet the domain-specific relationship between language functioning and everyday functional status remains insufficiently characterized. Methods: We conducted a retrospective observational study in 125 older adults diagnosed with MND according to DSM-5 criteria with mild-to-moderate cognitive impairment measured with Mini-Mental State Examination (MMSE). Language performance was assessed using semantic, phonemic verbal fluency and confrontation naming. Functional status was evaluated using basic (BADL) and instrumental activities of daily living (IADL). Ordinal logistic regression models examined associations between language domains and functional outcomes, adjusting for global cognitive status (MMSE), demographic variables, multimorbidity, and depressive symptoms. Model fit was evaluated using the Akaike Information Criterion. Results: Semantic fluency emerged as the best-performing predictor of BADL across all hierarchical models, remaining statistically significant after full adjustment for MMSE and clinical covariates (β ≈ 0.60, p < 0.05). Phonemic fluency showed the most robust association with IADL, with a stable effect across models, reaching a trend toward statistical significance in the fully adjusted analyses (β ≈ 0.22–0.27, p = 0.069). Naming ability did not influence functional outcomes. All observed associations persisted after controlling for MMSE, demographic variables, multimorbidity, and depressive symptoms. Conclusions: Language abilities showed differential associations across language domains with functional status in this sample of patients with MND. Semantic fluency was associated with basic self-care, while phonemic fluency showed a trend toward association with instrumental daily activities. These relationships remained observable after adjustment for global cognitive impairment, suggesting verbal fluency as a potentially sensitive marker of functional vulnerability.
Alkaline water is increasingly marketed for musculoskeletal and recovery benefits, yet its relevance to healthy aging, sarcopenia prevention, and functional capacity in older adults remains largely unexplored. This systematic evidence map and translational appraisal examined whether the available comparative human evidence on alkaline water is applicable to aging populations and longevity research. Following PRISMA guidance, PubMed and Scopus were searched from January 2005 to September 2025. Eligible studies were controlled or comparative observational human studies reporting muscle strength, physical performance, or recovery outcomes. Risk of bias was assessed using RoB 2, ROBINS-I, and JBI criteria; evidence certainty was judged narratively using GRADE-informed principles. Ten studies met the inclusion criteria. Most enrolled young athletic populations; only two had partial relevance to aging cohorts. Crucially, no study included participants aged 65 years or older or assessed primary sarcopenia-relevant endpoints such as appendicular lean mass, gait speed, or chair-rise performance; this total absence of data in the target demographic represents the central limitation of the current literature. Risk of bias ranged from some concerns to serious. The most consistent signals were short-term improvements in lactate clearance and perceived exertion in young male athletes. Evidence for strength, functional performance, and safety in older adults was absent or indirect. Current evidence, rated low to very low certainty for aging-relevant outcomes, does not support alkaline water as an evidence-based strategy for healthy aging or muscle preservation in older adults. Age-appropriate trials using EWGSOP2-aligned outcomes are urgently needed.
Dementia is a progressive condition that affects cognition, communication, mobility, and independence, posing growing challenges for individuals, caregivers, and healthcare systems. While traditional care models often focus on symptom management in later stages, emerging artificial intelligence (AI) technologies offer new opportunities for proactive and personalized support across the dementia trajectory. This concept paper presents the Assistive Intelligence framework, which aligns AI-powered interventions with each stage of dementia: preclinical, mild, moderate, and severe. These are mapped across four core domains: cognition, mental health, physical health and independence, and caregiver support. We illustrate how AI applications, including generative AI, natural language processing, and sensor-based monitoring, can enable early detection, cognitive stimulation, emotional support, safe daily functioning, and reduced caregiver burden. The paper also addresses critical implementation considerations such as interoperability, usability, and scalability, and examines ethical challenges related to privacy, fairness, and explainability. We propose a research and innovation roadmap to guide the responsible development, validation, and dissemination of AI technologies that are adaptive, inclusive, and centered on individual well-being. By advancing this framework, we aim to promote equitable and person-centered dementia care that evolves with individuals’ changing needs.
