Strengthening Active Aging through Older People’s Association and Economic Activity of the Older People in Nepal

Aging is a natural lifelong process ending in death. Many older people are living in poverty. Older people are generally considered dependent on others as they grow older. The purpose of this article is to explore the entrepreneurship activities of Nepalese older adults. Data for this study were collected from the project Help Age International (HAI) implemented in Nepal. Qualitative data observations and interviews were used to collect data. The findings of this study show the formation of the Older People’s Association (OPA) has supported many older people to participate outside the home in various social activities. Moreover, regular deposits through OPAs offer little help. OPAs support older people in their need of financial support to implement minor entrepreneurship. Older people who received support were pleased and were actively involved in their activities and also regularly deposited money in them. Subsequently, older people’s participation in social activities has increased and also helped to lower elderly abuse, loneliness, and depression. Local governments should promote such activities which will help with healthy aging.

Advance care planning readiness for Chinese older people:An integrative review and conceptual framework

Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration.Readiness for advance care planning is a patient's preparedness to engage in advance care planning.This review aims to develop the conceptual framework for advance care planning readiness for Chinese older people.The current knowledge from the published studies was identified and synthesized by an integrative review.The conceptual framework was developed based on the social-ecological model and the theory of planned behavior.The factors from the social environment/community,health care professionals,and individual/family layers were defined.These factors may influence an individual's medical decision-making,which in turn triggers individual behavioral mechanisms that arise from interactions between motivations,attitudes,and beliefs.Relevant factors should be considered when assessing the behavior of personnel engaged in advance care planning or formulating appropriate intervention measures to improve advance care planning par ticipation in China.This framework can be used to guide studies that explore how the social/familial/individual factors predict the readiness for advance care planning among Chinese older people,and to design intervention studies to test the effect of family function on the readiness for advance care planning.

Aging Experiences among Older People in Conakry/Guinea: Towards an Age-Friendly City and Community

Older people are a demographically significant group, who represent a vulnerable layer within conditions for active and healthy aging that may be lacking in both urban and rural areas. Objective: To identify the main barriers and opportunities for the establishment of age-friendly cities and communities in a low-income country. Methods: This was a qualitative study that involved focus group discussions with older people, and service providers (health and social services) in the city of Conakry. The older people were purposively selected with the support of older people associations, and men and women were equally represented in the sample. Results: The analysis focused on the experience of old age as well as the barriers and opportunities for active healthy aging specific to the sub-Saharan context. The results indicate that a good quality of life for older adults boils down to the acquisition of good health and decent housing. Other concerns frequently reported were food and education problems for their children and security. Conclusion: This study contributes to strengthening the understanding of the age-friendly cities and communities’ approach in the context of sub-Saharan African countries.

Living Arrangement of Older People: A Study of Community Living Elderly from Nepal

Background: Aging has caused changes in the structure of families that raises reflections on the sustainability of the traditional models of family care for older adults. The aim of this article is to analyze the situation of living arrangements of Nepalese older people. Methods: This study is a secondary analysis of structured interview data collected by the Central Department of Population Studies at Tribhuvan University (TU) via a cross-sectional survey of community-dwelling persons aged 60+ in the Pharping area of Kathmandu. For this study, there were 1326 valid responses. Results: Findings show over four-fifths of respondents (81.3%) were living with family members, far more than with a spouse only (11.6%), alone (6.2%), and others (0.9%). The proportion of Populace residing alone tends to increase with the increase in age of respondents;more widowers tend to live alone compared to those in marital unions;more elderly males without living children tend to live alone compared to those who have at least one living child. The sex of the respondents, marital status, ethnicity, income situation, and feeling of insecurity have significant differences in the living arrangement of older people in this study. Conclusion: Traditionally, Nepalese older adults are contented to live with their family members. The government of Nepal should promote the traditional living arrangements of older people through some incentives providing for family members taking care of their senior citizens.

Cancer risk in older people receiving statin therapy： a meta-analysis of randomized controlled trials

Background Although statins are well tolerated by most aged people, their potential carcinogenicity is considered as one of the big-gest factors limiting the use of statins. The aim of the present study was to determine the risk of cancer in people aged over 60 years receiving statin therapy. Methods A comprehensive search for articles published up to December 2015 was performed, reviews of each randomized controlled trials （RCTs） that compared the effects of statin mono-therapy with placebo on the risk of cancer in people aged 〉 60 years were conducted and data abstracted. All the included studies were evaluated for publication bias and heterogeneity. Pooled odds ratios （OR） estimates and 95% confidence intervals （CIs） were calculated using the random effects model. Results A total of 12 RCTs, involving 62,927 patients （31,517 in statin therapy group and 31,410 in control group）, with a follow-up duration of 1.9-5.4 years, contributed to the analysis. The statin therapy did not affect the overall incidence of cancer （OR = 1.03, 95% CI： 0.94-1.14, P = 0.52）; subgroup analyses showed that neither the variety nor the chemical properties of the statins accounted for the incidence of cancer in older people. Conclusions Our meta- analysis findings do not support a potential cancer risk of statin treatment in people over 60 years old. Further targeted researches with a longer follow-up duration are warranted to confirm this issue.

Physical activity in older people with cardiac co-morbidities

The World Health Organisation （WHO） launched a global action plan on physical activity to provide a frame- work of policy actions to increase physical activity in June 2018. Physical activity is an effective intervention for pre- vention and management of non-communicable diseases including cardiac disease, regardless of age. We hoped this letter would remind readers of the importance of physical activity in older people, particularly those with cardiac co-morbidities.

The Effect of Brain Gym on Global Cognitive Function of Institutionalized Older People

Cognitive function of older adults is influenced by several factors such as age,sex,education,and physical activity so that it can impact the decrease in progressive cognitive function.It is necessary to implement cognitive training in old people’s care to prevent or delay the onset of age-related cognitive decline.Brain gym is a series of simple motion exercises and is an alternative therapy that stimulates the brain.This study aims to evaluate the effect of brain gym as a cognitive training intervention on global cognitive functioning of institutionalized older population.The study is a non-randomized quasi-experimental one using pre-and post-test control group design.The participants of the study were 65 years old or older who had been part of gerontological centers from a local community.They were divided into two groups:control and intervention,each one with 15 people.Mini-Mental State Examination was applied to the sample before and after the cognitive training.The brain gym training consists of bi-weekly group meeting for 12 weeks,lasting 50 min each.The treated group had a significantly better global cognitive function.Recalling(memory),orientation and language skills were the domains with the most significant changes(p<0.05).On the other hand,no significant changes were found in the participants of control groups during post test.Our results suggest that cognitive training based in brain gym improves global cognitive function of institutionalized older people lease type your abstract here.Abstract of a research paper is typically 200 to 400 words in length,and 150 to 300 words for a review paper.Abstract shall be running continuously(not structured)and shall not include reference citations.Abbreviations that appear only once in the abstract should be defined in full.If abbreviations appear more than once,the full definitions should be provided first before they can be used elsewhere.

Nail Selenium Level and Diabetes in Older People in Rural China

This cross-sectional study aimed to examine the association between selenium levels and diabetes in an older population with life-long natural exposure to selenium in rural China. A total of 1856 subjects aged 65 years or older from four Chinese rural counties with different environmental selenium levels were evaluated. Analysis of covariance models and logistic regression models were used to examine the relationship between nail selenium levels and serum glucose, serum insulin, insulin resistance [using the Homeostatic Model Assessment for Insulin Resistance （HOMA-IR）], and the risk of diabetes. The mean nail selenium level was 0.461μg/g and the prevalence rate of diabetes was 8.3% in this population. The mean nail selenium level was significantly higher in the group with diabetes than in the group without diabetes （P〈0.0001）. The adjusted odds ratios for diabetes were 2.65 （95% Cl： 1.48 to 4.73）, 2.47 （95% CI： 1.37 to 4.45）, and 3.30 （95% Cl： 1.85 to 5.88） from the second selenium quartile to the fourth quartile, respectively, compared with the first quartile group. The mean serum glucose and HOMA-IR in the higher selenium quartile groups were significantly higher than those of the lowest quartile group. However, no significant differences in insulin were observed among the four quartile groups. A long-term, higher level of exposure to selenium may be associated with a higher risk of diabetes. Future studies are needed to elucidate the association between selenium and insulin resistance.

A Feasibility Study of an Individualized Voiding Program in Japan to Improve the Sense of Control in Older People with Functional Urinary Incontinence

Purpose: This study intended to assess the feasibility of an individualized voiding program in Japan aimed at improving the sense of micturition control in older people with functional urinary incontinence. Method: Following the interview guide, FGIs were conducted in two groups (4 - 6 participants) consisting of nurses and care workers with more than 5 years of experience as practitioners of urination care. Data were analyzed using a qualitative descriptive approach. Results: We determined that the program purpose is to “enable caregivers to work as a well-coordinated team to humanely facilitate excretion independence in older people, which is essential for living with dignity”, as this confirmed the importance of maintaining the sense of micturition control in older people for their well-being. In the program outline, we extracted the following five categories: 1) setting selection criteria for recipients considering the status of micturition induction, 2) careful collection of information and assessment of lower urinary tract symptoms in older people in case of environmental changes, 3) examination of methods used for assessing lower urinary tract symptoms according to the facility environment, 4) confirmation of the recipient’s micturition habits and request for assistance, and 5) conducting necessary examination for setting the intervention period and evaluation period according to the target condition. The feedback on the program guide was summarized in the statement—specific successful cases help frame and implement the micturition induction plan. Conclusion: We confirmed the feasibility of the micturition induction plan for improving the sense of control in older people with functional urinary incontinence. Upon evaluating the program guide, we deemed that referring to specific successful cases helps frame and implement the micturition induction plan. It is extremely important to verify the effectiveness of the program going forward.

Use of Asymmetric Models to Adjust the Vitamin Intake Distribution Data for Older People

One of the main interests in the nutrition field is to estimate the distribution of usual nutrient in-take. Data from vitamin intake generally present high asymmetry mainly to the presence of outliers. This can occur due to the variability of the diet and, in this case, robust estimation to get the distribution of the data can be required. Then, the aim of paper is to propose an alternative approach for estimating usual intake through asymmetric distributions with random effects applied to data set 10 vitamins obtained from a dietetic survey for 368 older people from Botucatu city, S?o Paulo, Brazil. In general, these asymmetric distributions include parameters related to mean, median, dispersion measures and such parameters provide good estimates for the intake distribution. In order to make some comparisons, a model fitted by National Cancer Institute (NCI) method with only for amount of nutrient intake was established using Akaike Information Criteria (AIC). NCI method is based on a Box-Cox transformation coupled with normal distribution but in case of asymmetric data, this transformation can be not useful. It was observed that, in the presence of outliers, the asymmetric models provided a better fit than the NCI method in the major of the cases. Then, these models can be an alternative method to estimate the distribution of nutrient intake mainly because a transformation for the data is no necessary and all the information can be obtained directly from the parameters.

Association between Clinical Characteristics and Quality of Life in Older People with Stroke at Hospital Discharge

Objective: The number of people with stroke increases worldwide. The stroke survivors live with disabilities and those influence their quality of life (QOL). This study was aimed to investigate the association between clinical characteristics and QOL of the older people with stroke at discharge from the hospital. Methods: This is a cross-sectional study. The participants were 113 stroke survivors aged 60 years and older admitted to the stroke unit. Quality of life was the study’s outcome which measured by using the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF). Primary clinical characteristics were measured by the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), and Modified Rankin Scale (mRS). Potential confounding factors were age, sex, education levels, marital status, current occupation, and comorbidity (hypertension, diabetes mellitus, dyslipidemia, and heart disease). Multiple linear regression was used for data analysis. Results: The main effects of clinical outcomes were high BI Score that had a significant difference association with QOL (β = 0.312, 95% CI = 0.042, 0.296, P = 0.009), lower mRS score also had significant difference association with QOL (β= -0.371, 95%CI = -5.394, -1.162, P = 0.003) after all adjusting. Additional risk factor in this study was marital status (currently married) (β= 0.155, 95% CI = 0.226, 8.666, P = 0.039). Conclusion: Low function status and severe stroke disability as the clinical characteristics were associated with QOL in older people with stroke at hospital discharge. An additional factor was marital status (currently married).

Effect of auricular plaster for primary hypertension in older people:A meta-analysis

BACKGROUND Hypertension is a critical public health problem globally.Antihypertensive drugs can create an extra burden on hypertension patients'self-regulation leading to an imbalance of blood supply and demand.This study aimed to evaluate the effect of auricular plaster therapy combined with western medicine to treat primary hypertension in older people.AIM To carry out a systematic review and meta-analysis for the effect of auricular plaster in elderly hypertension patients.METHODS Multiple databases like PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature on Disc,China National Knowledge Infrastructure,Wan Fang and Chinese Science and Technology Periodical Database were used to search for the relevant studies and full-text articles involved in the evaluation of auricular plaster combined with western medicine and western medicine alone for primary hypertension in older people.All included articles were quality assessed and the data analysis was conducted with the Review Manager(5.4).Forest plots,sensitivity analysis and funnel plots were also performed on the included articles.RESULTS In this analysis,fourteen(14)relevant studies were included.The Meta-analysis showed a significant difference in the effective ratio(OR=3.62;95%CI,2.46 to 5.33;P<0.00001),diastolic blood pressure change(5.68 mmHg;95%CI,3.49 to 7.87;P<0.00001),systolic blood pressure change(MD=8.78 mmHg;95%CI,5.04 to 12.53;P<0.00001)and symptom score(MD=3.20;95%CI,1.23 to 5.18;P=0.001)between auricular plaster combined with western medicine group and western medicine alone group.One bias was detected as selection bias and another two in reporting bias.Sensitivity analysis fulfilled the stability of the results.CONCLUSION Our study suggested that auricular plaster combined with western medicine improved primary hypertension better than western medicine alone.Limited by the quality of included studies,further studies should be performed to confirm our findings.

Validation of a FFQ （Food Frequency Questionnaire） for Older People

Nutrition data for older adults is an area that has few studies mainly in Brazil. Due to the importance to know the behavior of this age group, the aim of this study was to develop and validate a frequency food questionnaire （FFQ） for older people in Brazil. It was considered a sample of 73 subjects from the city of Avar6, Sao Paulo, Brazil, and it was applied three 24-hour recalls and a FFQ developed for adults. Data from the three 24-hour recalls were transformed in nutrient intake as well as the data from FFQ. Statistical analysis was performed in order to get correlations between data from the mean of three 24-hour recalls and FFQ for some nutrients. It was found high correlations among them, concluding that the FFQ is valid to get nutrient intakes for older people.

Study on Medical Expenditure Burden of Older People in China

Differences in level of medical expenditures and compensation ratio of medical expenditure among various subgroups in the older population according to age, gender, education, income and area have important public policy implications. This paper discusses these topics by data based on two waves of social surveys, a baseline in 2000 and a follow-up in 2006 named ＂The Sample Survey on Aged Population in Urban/Rural China （SSAPUR）＂. During the six years, the increasing speed of medical expenditure is rapid. The payout of medical expenditure of older people in 2000 was more conservative than that in 2006. Gender and urban-rural differences were also evident with regard to the compensation ratio of medical expenditure; older males and all urban older people had higher compensation ratios than elderly females and the rural older people, respectively. Compensation ratio also increased at age, as well as at education and income levels. Inequalities increased over the six-year period between surveys except when analyzed by area of residence and income levels. A comparison of factors affecting medical expenditure showed that the differences in medical expenditure between 2000 and 2006 had increased, though the influencing factors seemed to have become more reasonable.

Why Is Case Management Effective? A Realist Evaluation of Case Management for Frail, Community-Dwelling Older People: Lessons Learned from Belgium

Despite many attempts to evaluate the effectiveness of case management for frail older people, systematic reviews including experimental designs show inconsistent results. Starting from the view that case management is a complex intervention occurring in multilayered realities, we conducted a realist evaluation of case management in Belgium, where this type of intervention is new. Realist approaches are particularly well suited to evaluate complex interventions as they seek to investigate iteratively the literature and empirical data to uncover mid-range theories underpinning the intervention under study. As such, realist evaluations are works in progress which provide tools to describe how, why and for whom an intervention is supposed to work. In this paper, we describe two mid-range theories that can explain why case management can help frail older people to remain at home, through the lens of capacity and social support.

Prevalence of Inadequacy Intake for Older People:The Use of National Cancer Institute (NCI) Method

A purpose of dietary assessment is to evaluate the dietary intake of a group or a population. In Brazil few studies have been carried out to identify dietary intake of older people population. Then, the aim of this work is to estimate the distribution as well as estimate the prevalence of inadequacy of the usual intake in a representative sample of older population from Botucatu city, S?o Paulo, applying the NCI method. A sample of 365 older was used and some instruments to evaluate quality of life, activities of daily living and instrumental of daily living were applied as well as three 24-hour recalls. Data from the recalls were transformed in consumption of macro and micronutrients using NDSR software and were analyzed using NCI method in order to estimate the inadequacy prevalence. The energy and macronutrients intake of the studied population agree with their needs, however, the consumption of minerals and vitamins were below the recommendation even after including the covariates. This can reflects a monotone intake that is characteristic of this age and this inadequateness can be a serious public health problem that can carry on development of chronic diseases. Also, it is important to highlight that NCI method provides a good estimate of the usual intake.

Exploring the Care Experience of a Comprehensive Geriatric Assessment Team in the Management of Debilitating Syndromes in Older People

This study was conducted to investigate the clinical effects of applying the integrated geriatric assessment team approach on the care of elderly patients with debilitating syndromes.This study was conducted in Xi’an Jiaotong University hospital from January 2021 to January 2022.Around 50 patients with the geriatric debilitating syndrome were selected and retrospectively were analyzed,and psychiatrists,geriatric nurses,pharmacists,medical specialists,physiotherapists,and dieticians were selected to form a comprehensive geriatric assessment team.The patients were then assessed,a treatment plan was developed,and care was provided according to the actual situation,and the effectiveness of the clinical intervention was analyzed.This study demonstrated that,of the 50 patients in this study,the longest hospital stay was 15 days,while the shortest was 4 days,and the average length of stay was 10.23±4.37 days.Around 40 of the patients were able to eat on their own and consume food as prescribed,with a compliance rate of 80%,showing the effectiveness rate of the geriatric assessment team.In summary,the use of a comprehensive geriatric assessment team to treat and care for patients with debilitating syndromes in the elderly is an effective way,and this can significantly improve the life quality of the patients.

The Relationship Between Social Isolation, Psychological Resilience, and Psychological Well- Being Among Older People in the Community

Objective:To explore the relationship between social isolation,psychological resilience,and psychological well-being in community-dwelling older adults.Methods:A questionnaire survey was conducted with 265 community-dwelling older adults using the Social Isolation Scale for the Elderly(C-SIS),the 10-item Brief Psychological Resilience Scale,and the Comprehensive Happiness Questionnaire(MHQ).The results were statistically analyzed using SPSS 27.0.Results:The highest score on the Social Isolation Scale for Community Elderly was 23,with a mean entry score of 2.36±0.62.A score of 14 was the cut-off point,with scores of≤14 classified as social isolation.There were 136 cases with scores below 14,resulting in a social isolation incidence rate of 51.3%.The median(P50)psychological resilience score was 27,indicating a higher level of resilience.The total score on the Psychological Well-being Scale was 161,suggesting a moderate to slightly higher level of well-being.Social isolation had a direct negative effect on psychological well-being,while psychological resilience had a positive effect.Conclusion:Older adults should be supported in reducing the incidence of social isolation and increasing psychological resilience to enhance psychological well-being and promote successful aging.

Cancer statistics in Chinese older people,2022:current burden,time trends,and comparisons with the US,Japan,and the Republic of Korea

Largely due to population ageing,the cancer burden from older people has been rising,which imposed considerable pressure on current Chinese healthcare system.We provide comprehensive information about cancer burden of Chinese older people based on the most recent data from National Central Cancer Registry of China.The logarithmic linear regression was used to project the current cancer burden in 2022,and Joinpoint regression was used for temporal trend analysis from 2000 to 2017.We also estimated cancer statistics of older people in the US,Japan and the Republic of Korea for comparisons.It is estimated that 2.79 million cases and 1.94 million deaths occur for Chinese older people,representing 55.8%and 68.2%of cases and deaths in all population in 2022.The overall cancer incidence rate gradually increased among older women,while the mortality rates declined for both sexes.Notably,approximately 10.0%of all cases and 17.7%of all deaths are from people aged over 80 years,and cancer incidence and mortality in this age group showed upward trends for women.Lung cancer and digestive cancers are the leading cancer types for Chinese older people.Compared with other countries,China has lower incidence rates but higher mortality rates for older people.The rapidly growing burden of prostate cancer,breast cancer,colorectal cancer,and declines in esophageal cancer,stomach cancer,and liver cancer among older people indicate the cancer pattern in China is being in a transition stage to that in developed countries.Our findings imply that it should be the national health priority to meet the growing demands for cancer diagnosis,treatment and care services from the older people as the rapid population ageing in next few decades.

Bowel preparation experiences and needs before follow-up colonoscopy in older adult postoperative colorectal cancer patients: A qualitative study

BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.