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Approximately 30% of older adults (≥65) fall annually, yet community delivery of evidence-based fall prevention exercise remains poorly understood. This qualitative study explores fall prevention exercise service delivery from the perspective of exercise providers in Ontario.
Methods
We conducted semi-structured interviews with 20 exercise providers, guided by the Consolidated Framework for Implementation Research, and analyzed data thematically.
Findings
While providers valued evidence-based balance and functional training, those in large-group settings struggled with exercise tailoring and progression. Instead, many prioritized building trust, creating safe environments, and facilitating socialization.
Barriers were highly contextual
kinesiologists lacked resources, independent providers lacked networking, and municipal/non-profit staff faced low pay and organizational competition.
Discussion
To enhance implementation of fall prevention exercise services, support must address unique contextual barriers while balancing clinical tailoring with participant adherence. Our insights suggest that leveraging existing community services and focusing on provider-specific supports are essential for effective implementation of fall prevention exercise services in Ontario.
Behavioral and psychological symptoms of dementia (BPSD) are common in hospitalized older people and challenge acute care delivery.
Objective
This study sought to identify available quality indicators (QIs) for BPSD, establish priorities, and explore perceived facilitators and barriers to their use.
Methods
We conducted a cross-sectional electronic survey among physicians, nurses, and administrators in Quebec acute care hospitals (January–February 2025). The survey included open-ended questions analysed using Donabedian’s structure–process–outcome model.
Findings
Fifty-five respondents generated 677 responses, yielding 59 themes, 44 deemed priorities. Key QIs included delirium screening, restraint and antipsychotic use, length of stay, adverse events, and resource availability. Participants emphasized the need for standardized, clinically meaningful QIs. Reported barriers included staffing shortages, fragmented technological systems, and limited institutional prioritization, while facilitators included leadership commitment, interdisciplinary support, and structured training.
Discussion
Embedding standardized QIs into electronic health records may enhance benchmarking, guide improvement, and promote safer dementia care.
Early-onset frontotemporal dementia (EO-FTD) presents before age 65 and is frequently misdiagnosed as psychiatric or behavioural disorders, delaying care.
Objective
This scoping review synthesizes research on EO-FTD’s earliest cognitive symptoms from patients, companions (family and friends), healthcare professionals, and cognitive tests to promote early detection.
Methods
A systematic search of six databases (Medline, Embase, CINAHL, PsycInfo, Scopus, and Proquest Dissertations and Theses) identified 2197 studies of which 16 met inclusion criteria, encompassing 663 EO-FTD participants.
Findings
A total of 35 unique cognitive symptoms were identified. Memory, attention, and executive dysfunction were most frequently reported. Symptom terminology varied widely, often mirroring cognitive test phrasing, limiting clinical applicability. Many studies relied on cognitive test scores rather than detailed symptom descriptions, with patient and companion reports underrepresented.
Discussion
The findings underscore the need for standardized nomenclature, improved assessment tools, and greater inclusion of patient and companion perspectives to enhance EO-FTD early diagnosis and intervention strategies.
This study assessed the construct validity, predictive validity, and responsiveness of the 4-metre walk test (4MWT) in community-dwelling older Canadians.
Methods
Baseline and 3-year follow-up data from the Canadian Longitudinal Study on Aging were examined, including participants ≥ 65 years with 4MWT assessments. Secondary outcomes included physical and self-report measures and healthcare utilization (e.g., hospitalization and emergency department visits).
Results
Baseline data on 12,433 and follow-up data on 10,107 participants were analysed. For construct validity, low-to-high correlations with the comparator measures (rho = 0.25 [with the Life Space Assessment] to 0.72 [with the Timed-Up and Go]) and known-groups differences of 0.15 m/s (assistive device use) and 0.04 m/s (falls) were found. For predictive validity, areas under the curve ranged from 0.51 to 0.59 for healthcare utilization, indicating poor prediction. For responsiveness, low-to-moderate correlations between change scores were found (rho = 0.01–0.44).
Conclusions
Findings demonstrated partial support for construct validity and responsiveness and no support for predictive validity.
This study engages with the experiences and challenges reported by Punjabi family carers of older adults from one census metropolitan city in Canada.
Objective
Our focus was on understanding carers’ interpretations of family and public responsibilities for supporting older adults.
Methods
We interviewed eight Punjabi carers in one Canadian city who provide any form of unpaid help to an older adult living at home, about their experiences and ideas for advocacy. The interviews were analyzed through abductive thematic analysis, using politicization as a sensitizing concept.
Findings
While participants identified ideas for changes in public policy, their underlying mistrust of formal care systems often seemed to reinforce familial responsibility for care and restrict advocacy efforts to local family systems.
Discussion
These truncated networks of support contributed to alienating conditions for carers and limited opportunities for inclusive collective action to improve the current social organization of care for older people at home in Canada.
The objective was to identify, critically appraise, and synthesize evidence on the effectiveness of dance interventions on quality of life (QoL) for adults aged 60+ living in long-term care (LTC).
Methods
A systematic review, initiated and co-led by patient partners, was conducted following a search across eight electronic databases. Eligible studies included randomized controlled trials, quasi-experimental, and observational designs reporting QoL or health-related QoL outcomes. Reviewers independently completed title/abstract and full-text screening. Data extraction included study characteristics, intervention details, outcome measures, use of theory, proposed mechanisms of action, and intervention effectiveness.
Findings
Seven studies involving 429 participants were included. Six studies reported improvements in QoL or health-related QoL. Five studies used a dance intervention targeted to a specific country or cultural group. Two studies identified potential mechanisms of action.
Discussion
Dance interventions may improve QoL in older adults living in LTC. Research with more theory-driven, mixed methods, and/or co-created designs is needed.
This review examines the role glycerophospholipids (PL) in dairy cow health, with specific focus on phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylinositol (PI) and phosphatidylserine (PS). Increasing parity of cows is associated with lower concentrations of plasma PL that contain very long-chain omega-3 fatty acids, including docosahexaenoic acid and eicosapentaenoic acid, which are precursors for prostaglandin synthesis, and have anti-inflammatory roles. Low concentrations of these PL could plausibly contribute to the increased risk of disease, reproductive failure and mortality in older cows. The bioavailability and metabolism of fatty acids may differ among supplements that are predominately neutral lipids, such as triacylglycerol-rich oils, and those bound to PL including pasture, whole or ground oilseeds and fish meal. Hepatic lipidosis can occur during the transition period if there is insufficient very-low density lipoproteins (VLDL) production in the liver to transport lipids into blood circulation. The PC are the primary PL of VLDL and are produced by two main pathways in the liver, the cytidine diphosphate-choline pathway that uses choline as a substrate, and the PE N-methyltransferase pathway that uses PE and methyl-donors as substrates. Co-supplementation strategies that target both pathways may increase PC production over a one-pathway supplementation strategy. The PIs are phosphoinositides precursors, which have broad physiological roles including regulating inflammatory processes and may offer targets for novel treatment and management of disease. Both the PI and PE are precursors to endocannabinoids, important regulators of energy metabolism, immune function and reproduction in mammals. Early findings on the endocannabinoid system in transition dairy cows yielded results that diverge from non-ruminant models. The PS expression on cytoplasmic membranes signals apoptosis, coagulation and contributes to sperm–oocyte recognition. As lipidomic diagnostics become increasingly available, understanding the metabolism of PL will continue to develop and promises to offer novel strategies for optimising cattle health and longevity.
Research concerning the variety of close relationships adults maintain, initiate, cease, and lose during middle and later adulthood has been fast growing in recent decades. Much of the theoretical and empirical work in this field has aimed to overcome views of older age as a time of loss and decline, both individually and socially. Moreover, recent trends have focused on the increasingly diverse experiences of the aging population. This includes not only extended life expectancy – and, importantly, extended healthy life expectancy – but also demographic changes, including larger proportions of racial/ethnic minorities attaining older age; new cohorts of openly LGBTQ adults entering mid and later life, many of whom represent the first generation of same-sex married couples; and the phenomenon of “gray divorce” and romantic repartnering in the years beyond age 50. This chapter will cover both the history and foundations of research on close relationships in middle and later life, as well as these recent trends in the field, finishing with an eye toward future directions as both the aging population and our perceptions of it continue to change.
This study investigates the relationship between bilingualism, language use, aging, and interference control using the Color–Word Stroop test task. We examined 158 highly proficient Basque–Spanish bilinguals and 84 Spanish monolinguals (aged 30–80 years) to test whether interference control declines with age and whether bilingual adaptations depend on language use frequency. Language experience was assessed using an adapted Language and Social Background Questionnaire and Color–Word Stroop test interference scores were analyzed by regression models. Results showed that interference control declines with age. Group-level differences between bilinguals and monolinguals were not significant once education was included as a covariate, although a small marginal advantage for bilinguals emerged when using education-adjusted T-scores. Within the bilingual group, higher use of the minority language (Basque) in social contexts was associated with significantly better interference control. Social language use showed a stronger relationship with interference control than home use. These findings highlight that bilingual advantages are not uniform but depend on language use frequency and context, contributing to understanding how bilingual experience shapes cognitive control across the lifespan.
We study private equity involvement (or lack thereof) in the long-term care (LTC) sector and its recent developments in the United States, Ireland and Poland. Based on the similarities and differences across these countries’ LTC systems, which can be treated as ideal types of the variety in typical models of LTC systems, we develop a systematic approach to the analysis of private equity engagement in the sector. Specifically, we define the comparison criteria as follows: the debates about the role and place of private equity in LTC; the extent of private equity investments in LTC; the reasons for private equity entry into the LTC sector; the business strategies of private equity firms; the regulations relative to private equity in LTC. Our case study comparison demonstrates that policy responses to population aging and care needs are deeply political processes, leading to a variety of solutions shaped by institutional legacies, cultural contexts, and the power dynamics between states, markets, and civil society.
People with schizophrenia develop more chronic diseases at a younger age and die younger than people in the general population. It has been hypothesized that this excess morbidity and mortality could be partially due to accelerated aging in schizophrenia. If true, this would motivate the development of ‘gero-protective’ interventions to reduce chronic disease burden in schizophrenia. However, it has been difficult to test this hypothesis, in part, due to the limited ability to measure aging in samples of people with schizophrenia.
Methods
We utilized a novel neuroimaging biomarker of the longitudinal pace of aging, DunedinPACNI, to test for accelerated whole-body aging in schizophrenia across four neuroimaging datasets (total N = 2,096, 48% female) accessed through the Lieber Institute for Brain Development, the University of Bari Aldo Moro, and the North American Prodrome Longitudinal Study – 3.
Results
We found consistent evidence of faster DunedinPACNI in schizophrenia compared with controls. In contrast, youth at clinical-high risk for psychosis did not have faster DunedinPACNI compared to controls. Unaffected siblings of patients also did not have faster DunedinPACNI than controls. Faster DunedinPACNI in schizophrenia was not explained by tobacco smoking or antipsychotic medication use.
Conclusions
The results support the hypothesis that schizophrenia is accompanied by accelerated aging. Results were inconsistent with some of the most obvious explanations for accelerated aging in schizophrenia (familial risk, smoking, and iatrogenic medication effects). Research should aim to uncover why people who have schizophrenia age rapidly, as well as the utility of early disease-risk monitoring and anti-aging interventions in schizophrenia.
When his manager stole most of his wealth, Cohen was forced to go back out on the road at the age of seventy-three. The result was the beginning of a triumphant last chapter in his storied career. While rockers in the 1960s often proclaimed that they couldn’t imagine themselves continuing into their fifties or sixties, many have continued well beyond that. The Rolling Stones, of whom the youngest remaining member is seventy-four, just completed a well-received tour of the United States. But the Stones and most other older performers do not present themselves as old. Mick Jagger continues to prance around the stage with almost as much energy as he exhibited in his twenties. Cohen, on the contrary, performed on these late tours honestly and gracefully as a septuagenarian. Some of this is consistent with the persona he has displayed since the 1960s, for example dressing in the style of the previous generation. But the new Cohen was not just conservatively dressed. He directly confronted the limitations of age in his stage patter, and his songs, which had always taken account of death, now took on a new resonance, as it was apparent that the singer’s days were numbered. Where other old rockers seem to assume that they deserve the audience’s adoration, Cohen was humble and grateful for the renewed interest in his work. This chapter explores what it means for a rock star to present himself as an old man, a persona that challenges some of the fundamental assumptions about what a rock star is.
Effective strategies are needed to increase the healthy lifespan and prevent age-related diseases in aging populations. Using senescence marker protein 30 knockout (SMP30 KO) mice—models that mimic human vitamin C (vitC) deficiency and exhibit accelerated aging—we investigated the effects of bioactive ceramic processed water (BCP) compared to natural mineral water (MW) and MW supplemented with vitamin C (MW-vitC) on gut microbial communities and hepatic metabolism. Due to pooled fecal sampling (n=1 composite library per group), microbiome results represent descriptive trends in diversity and composition. BCP was associated with discernible shifts in gut microbiota, including increased abundances of beneficial genera, such as Akkermansia, Lactobacillus, and Allobaculum, and the Muribaculaceae family. PICRUSt2 functional analysis suggested an enrichment in secondary metabolite biosynthesis, vitamin (e.g., retinol) metabolism, and xenobiotic biodegradation pathways. Furthermore, BCP was associated with significantly higher levels of activated hepatic AMP-activated protein kinase (AMPK), a key energy metabolism regulator, compared to control groups. Although microbiome findings are descriptive due to the study design, these results suggest BCP as a potential dietary intervention to help mitigate age-related metabolic decline and promote healthy ageing.
Individuals with mild cognitive impairment (MCI) and dementia often engage in self-regulatory driving behaviours, but less is known about individuals with subjective cognitive impairment (SCI), who perceive cognitive decline without objective evidence of it.
Objective and Methods
This study describes the driving status and habits of older Canadians in the COMPASS-ND data set (n = 955) across cognitive groups: cognitively unimpaired (CU), SCI, MCI, and dementia.
Findings
Most participants reported having a driver’s license without restrictions, including over half of the Dementia group, who differed from the other groups by driving less often, shorter distances, and with greater restrictions. Interestingly, on driving frequency and restriction measures, the SCI group showed greater similarity to the MCI than the CU group. Females reported driving less frequently, shorter distances, and with more restrictions than males across cognitive groups.
Discussion
Results suggest that cognitive status and sex influence the driving habits of older adults, with potential implications for autonomy and independent mobility.
This study explored the motivations of Catalan older people to engage in political organizations. The sample consisted of 192 people aged 65 and over who were active members of three types of political organizations: neighborhood associations, political parties/trade unions, and single-issue organizations. Their answers to an open-ended question were content analyzed, and a series of Chi-square tests were run to assess the association of the resulting categories with the type of organization in which participants were active. The results show that the motives for engaging in political organizations were mainly focused on introducing changes in the community, although the scope of the changes desired tended to vary. While some participants expressed idealistic motivations, others stated that they become involved in order to stand up for a cause in which they believed. One in six participants was motivated by self-interest, either related to personal growth or to self-protective needs. Motives for participating were related to the type of organization in which participants were active, suggesting that organizations should consider the influence of their own particular context and characteristics in developing recruitment and retention strategies.
This paper investigates the effect of volunteering on quality of life (QoL) in 50+ populations across European countries and Israel. We analyzed data from the Survey of Health, Aging and Retirement in Europe (SHARE). Using the Kendall tau-b correlation coefficients, we show that the extent of effect volunteering has on quality of life is nonlinearly related to the prevalence of volunteering in a given country. The relationship follows an inverted-U-shaped curve. In countries where volunteering is the most popular (Denmark, Switzerland, and Belgium) and in countries with the lowest rates (Poland, Greece, the Czech Republic, and Spain), the correlation between volunteering and one’s quality of life is low. The correlation is high in countries with medium levels of volunteering (Austria, Italy, and Israel). Moreover, volunteering affects more internal than external domains of QoL. These new insights extend the discussion started by Haski-Leventhal (Voluntas Int J Volunt Nonprofit Organ 20:388–404, 2009). Our study is correlational, and we do not claim causality.
Many older adults living in a seniors’ residence (SR), especially those living with dementia, will have to be relocated in long-term care (LTC) despite the negative impact of these care transitions on physical and psychological well-being. Using a living lab methodology and focus group methods, a care approach was co-developed in collaboration with a SR and public home care services, to promote aging-in-place and delay relocations in LTC. Outcomes were assessed using Interrupted Time Series Analysis. Integrating best practices like staff training, care reorganization, personalized care based on the residents’ life stories, and stronger collaborations with the home care services, this approach allowed older adults with higher assistance needs to remain within their home. Relocations to LTC were delayed by approximately 3 months. Ultimately, aging-in-place was found to be relevant in providing evolving care to older adults living in a SR, though further studies are needed to document its financial impact.
The Interplay of Genes and Environment across Multiple Studies (IGEMS) is a consortium of 21 twin studies from 5 countries (Australia, Denmark, Finland, Sweden, and United States) established to explore the nature of gene–environment interplay in cognitive, physical, and emotional health across the adult lifespan. The combined data from over 145,000 participants (aged 18 to 108 years at intake) has supported multiple research projects over the three phases of development since its inception in 2010. Phases 1 and 2 focused on launching and growing the consortium and supported important developments in data harmonization, analyses of data pooled across multiple studies, incorporation of linkages to national registries and conscription data, and integration of molecular genetic and classical twin designs. IGEMS Phase 3 focuses on developing appropriate infrastructure to maximize utilization of this large twin consortium for aging research.
Maintaining appetite in older adults is important for preventing malnutrition. Previous studies have shown seasonal variations in dietary intake, suggesting that appetite itself may vary with the seasons. Nevertheless, few studies have directly examined seasonal changes in appetite in older adults, particularly those living alone, who are at higher risk of malnutrition. Thus, the purpose of the present study was to identify when appetite declines throughout the year in older adults living alone and with others. Of the 60 adults aged 65 and older who participated in the study, 57 completed the longitudinal study over four seasons. Appetite for each season was assessed using the Simple Nutritional Appetite Questionnaire (SNAQ) and the visual analogue scale for hunger, satiety, and expectation of food intake. Nutritional status was assessed using the Mini Nutritional Assessment and the Food Frequency Questionnaire. The living arrangements of the participants were determined based on whether they were living alone or with others. The stratified analysis revealed seasonal changes in SNAQ scores exclusively among individuals living alone (p = 0.029, effect size = 0.280), who exhibited diminished appetite during summer compared to winter (p = 0.026, 95% CI: 0.076–1.258). No seasonal variation in appetite or nutritional status was observed in those living with others (p > 0.05). These findings highlight the importance of an approach that considers living arrangement and seasonality to ensure that older people maintain adequate appetite status throughout the year.
While early-life adverse experiences have been linked to late-life cognitive decline, few studies have explored war exposure. Paradoxically, one study even indicated a late-life cognitive advantage of early-childhood war exposure. In the present study, we explored these associations.
Methods:
We examined older adults exposed to World War II (1940–1944; n = 1179) and the subsequent Civil war (1946–1949; n = 962) in Greece during early and middle childhood with a comprehensive neuropsychological assessment and for ApoE-ε allele status, including demographic information and medical history.
Results:
Higher cognitive performance in language tasks predicted middle childhood, relative to early childhood, WWII-exposure group membership (B = .316, p = .038, OR:1.372, 95%CI:1.018–1.849), primarily for men, while higher attention/speed (B = .818, p = .002, OR:2.265, 95%CI:1.337–3.838) and total cognitive score (B = .536, p = .040, OR:1.709, 95%CI:1.026–2.849) were predictors of belonging to the middle-childhood group, only in men. Individuals who did not meet criteria for Mild Cognitive Impairment (MCI)/dementia were more likely to belong to the middle-childhood war-exposure group. Similarly, for the Civil war, higher cognitive scores and reduced likelihood to meet criteria for MCI/dementia were predictors of middle, relative to early childhood war exposure group membership (visuospatial score: B = .544, p = .001, OR:1.723, 95%CI:1.246–2.381, MMSE: B = .134, p = .020, OR:1.143, 95%CI:1.021–1.297), primarily for women. Results remained consistent when adjusting for multimorbidity, sex, education, current age, depression, and anxiety.
Conclusion:
The present findings suggest that better cognitive performance and lower likelihood of MCI or dementia were associated with being exposed to significant hardships, such as war, during middle childhood, regardless of potentially confounding factors. Further studies are needed to shed light on this relationship.