Abstract Background and Objectives Healthy aging among older adults with cognitive impairment requires preserving physical, cognitive, and psychosocial functioning to sustain their independence and quality of life. However, existing interventions vary in design, delivery format, and composition, and evidence regarding their effectiveness across these three core domains remains inconsistent. This study aimed to identify the most effective intervention types for specific domains of healthy aging. Research Design and Methods Five electronic databases were searched for studies published from October 2015 to June 2026. Randomized controlled trials reporting at least two outcomes—among physical capability, cognitive function, or psychosocial well-being—were reviewed. Risk of bias was assessed using the Cochrane Risk-of-Bias 2 tool. A dependency-aware multilevel random-effects meta-analysis with trial-clustered robust inference was conducted in R, supplemented by moderator tests, prediction intervals, sensitivity analyses, reporting-bias assessments, and GRADE evaluations. Results Multicomponent interventions were associated with beneficial effects on cognitive and psychosocial outcomes, whereas group-based interventions showed beneficial effects across all three domains and a significantly greater effect on cognitive function than individually delivered interventions. Despite substantial heterogeneity and wide prediction intervals, these findings were generally robust across sensitivity analyses. Discussion and Implications The observed advantages of group-based delivery, particularly for cognitive function, and multicomponent approaches for cognitive and psychosocial outcomes highlight the domain-specific nature of intervention effects. These findings support tailoring intervention delivery and component configuration to the targeted domain rather than applying a uniform approach to healthy aging among older adults with cognitive impairment.
Abstract Background and Objectives Extreme climate events can threaten older adults’ health. The purpose of this study was to summarize existing literature on older adults’ climate health literacy, defined as their ability to find and access, understand, and act upon information related to climate-related health threats. Research Design and Methods A scoping review was conducted in the bibliographic databases Embase, Medline and Scopus and grey literature sources Cornell Initiative for Research on Climate and Aging and Climate Change and Human Health Literature portals with searches updated January 2026. English language studies of community-dwelling adults aged 60 years and older were included if they reported at least one aspect of climate health literacy. Quantitative data were reported as median percentages, and qualitative themes were categorized. Results Fifty-nine studies, including 22,992 records for 20,296 unique participants, were included. Most recognized the health risks of extreme climate events but did not identify personal vulnerability. Television was the most cited source of information and hydration, clothing and environment modification, and activity adjustment were the most utilized adaptive actions. Barriers to adaptive actions included financial constraints, limited mobility and lack of supports. The effectiveness of studied interventions was mixed, influenced by intervention type and study design. Discussion and Implications Despite access to information and awareness of climate-related health threats, gaps remain in personal risk perception and translation of knowledge into actions. Improving climate health literacy among older adults requires public health messaging, engagement of trustworthy authorities, and interventions addressing social and structural barriers.
Abstract Background and Objectives Young adults are the caregivers of tomorrow. However, it remains unclear what stereotypes about informal caregiving for older adults they have learned. This study aimed to test and validate a first of its kind scale to measure public caregiver stigma as perceived among young adults without prior care experiences. Research Design and Methods Participants aged 18 to 35 years, collected from the community (sample 1) and university students (sample 2) in Canada answered a self-reported online survey on public caregiver stigma (Public Caregiver Stigma Scale, Warmth-Competence-Scale) and their sociodemographic background. Exploratory (EFA) and Confirmatory Factor analyses (CFA) were conducted, and the resulting scale was tested for content and concurrent validity and reliability. Results : The EFA performed on sample 1 resulted in a two-factor model with correlated factors that was confirmed by a CFA in sample 2, demonstrating excellent model fit. Content and concurrent validity were supported by the study’s findings and internal consistency of the two scales varied between acceptable and good. Young adults showed moderately high positive and negative public caregiver stigma, which were associated with their sociodemographic characteristics. Discussion and implications The study confirmed a new quantitative measure of public caregiver stigma targeting unpaid caregiving for older adults, reflecting negative (e.g., isolation, invisibility) and positive (e.g., admiration) stereotypes, emotional, and behavioral reactions. In addition to new insights into younger adults’ perspectives of care, it provides a promising new instrument to investigate society’s expectations of informal caregiving for the aging population.
Abstract Background and Objectives This study investigates how health status shapes the age trajectories of informal caregiving for spouses and older parents in England. Research Design and Methods The data came from five waves (2012–2023) of the English Longitudinal Study of Ageing (ELSA). We analysed 41,997 person-wave observations from 12,420 individuals aged 50+. We derived a latent health construct via hierarchical confirmatory factor analysis, integrating functional, mental, physical, and cognitive domains. Dynamic random-effects models were employed to examine the influence of prior health on consequent caregiving, and initial condition adjustment was made to correct estimation bias. Results Among those with a spouse, parents, or parents-in-law, healthier individuals demonstrated steeper increases in caregiving probability over time, while those in poor health showed flatter or declining caregiving trajectories. For spousal caregiving, better health was associated with a lower likelihood of caregiving at age 50, but this relationship turned positive from age 70 onwards. For parental caregiving, better health was associated with a higher likelihood of caregiving from age 53 onwards. Discussion and Implications Overall the research findings are consistent with the healthy caregiver hypothesis, particularly in later life. Good health facilitates the provision of informal care, whereas poor health compromises caregiving capability and constitutes a barrier to taking on a caregiving role. A healthier older population not only means lower care needs but also has greater capacity to provide care.
Abstract Background and Objectives The aim of this study was to evaluate whether a balance-focused multimodal exercise programme improves balance and reduces falls for people with mild cognitive impairment. Research Design and Methods A single-blind randomised controlled trial (n = 128, before withdrawals), with 6-month intervention, followed by 6-month maintenance period. The intervention, Balance on the Brain, consisted of three exercise programmes: walking, Balance Yourself and Clock Yourself. Results Data from 126 adults with mild cognitive impairment were included in the study (median age = 76, 63% female). The study did not meet the required sample size to be fully powered for either falls or balance primary outcomes. Therefore, the lack of significant between-group differences for the primary outcomes of falls or balance at 6 and 12-months remains inconclusive, due to insufficient power. Fifty-nine percent (n = 38) of intervention participants were identified as adherers. Adherers’ balance improved significantly compared to low-adherers/controls at 6 and 12-months and intervention adherers fell less than low-adherers/controls, although the difference was not significant. However, the adherers data were exploratory and need to be used with caution. Discussion and Implications Balance on the Brain was underpowered and as such the non-significant primary balance and falls outcomes should be interpreted as inconclusive for people living with mild cognitive impairment in the community. Those who adhered demonstrated improved balance, and reduced falls compared to low-adherers/controls, however these data should be interpreted as exploratory and with caution.
