There is little visibility for the voices of indigenous and Afro-descendant women in Latin America and the Caribbean (LAC), meaning that few studies offer information on mental health for this group. This study takes the Living Well (Buen Vivir) approach as a basis to examine the prevalence of depressive symptoms and their associated individual physical and social/cultural dimensions. Based on a national study involving the participation of a majority of Chilean peoples, 774 women identifying as indigenous (569 Andean indigenous and 146 other indigenous people) and Afro-descendant (59) were interviewed. The findings show that Andean and Afro-descendant women are more at risk of suffering depressive symptoms and that in general terms mental health should be understood from a holistic perspective, in addition to its being underpinned by several associations. Lower levels of depression were associated with older age, having a partner, independence in activities of daily living, social support from partner and being resilient. In contrast, higher levels of depression were associated with health problems, poor-quality relationship with grandchildren and loneliness. Out of the dimensions examined, resilience had a key influence on mental health among women. The findings are discussed in the context of a comprehensive view of wellbeing among ethnic minorities.

There are limited data on chiropractic care for older adults, specifically from medically underserved communities. This study describes the characteristics, clinical management, and patient-reported outcomes of older adults with spinal pain who present for chiropractic care at a publicly funded community health centre serving marginalized populations. This retrospective analysis utilized quality assurance data from chiropractic encounters at Mount Carmel Clinic between January 2011 and June 2020 of adults aged 45 and older. Descriptive statistics summarized the study population and their self-reported pain severity scores. Student’s t-tests and repeated-measures ANOVA explored relationships between pain outcomes, age, and clinical characteristics. The sample included 240 middle-aged (45–59 years) and older adults (≥60 years) who recorded baseline and discharge pain scores following chiropractic treatment. Over half of middle-aged participants self-identified as Indigenous or as people with disabilities. Statistically and clinically important improvements in pain were noted across spinal regions and extremities for both cohorts.

One barrier to patients’ compliance in following instructions to take prescription medication is their memory of those instructions. Effective communication can be challenging with older adults, since people can use ineffective strategies to compensate for older adults’ presumed communication difficulties. The purpose of this study was to test whether older adults would benefit from gestures and/or props in hearing explanations of the appropriate use of prescription medication. Participants were 181 adults 65 years or older. They evaluated pharmacy students on their communication. Each participant watched video clips of pharmacy students explaining how to use fictional medications in three conditions: (1) speech only, (2) speech and gestures, and (3) speech and props. Participants were tested on their memory and rated the effectiveness of the communication of each pharmacy student. Participants showed no differences in memory across conditions. These findings do not support the use of gestures and/or props in effective communication with older adults.

Plant-based diets (PBD) have been found to be environmentally sustainable and beneficial for health. Observational research showed that higher plant-based diet quality improves health-related quality of life (HRQoL) in adult women, however this is unclear for older adults. This association may be due to anti-inflammatory properties of PBD. Older adults, prone to chronic inflammation, may therefore profit from PBD. We investigated the relation between PBD and HRQoL in older adults of both sexes and tested whether the effects are associated with circulating high-sensitivity C-reactive protein (hsCRP) levels. We used data of the population-based Lifelines Cohort Study (n = 6,635, mean age = 65.2 years) and a subsample in which hsCRP was measured (n = 2,251, mean age = 65.2 years). We applied a plant-based diet index measuring adherence to a healthful (hPDI) and an unhealthful (uPDI) plant-based diet based on food frequency questionnaires. The RAND-36 questionnaire was applied as measure of HRQoL, from which we derived physical and mental HRQoL. Older adults with the highest adherence to a hPDI had respectively 15% and 12% greater odds for high physical quality of life and mental quality of life. Meanwhile, higher adherence to uPDI was associated with respectively 16% and 13% lower odds for high physical and mental quality of life. An additive but no interactive effect of hsCRP on the association between PBD and HRQoL has been observed. Adherence to a healthful plant-based diet and circulating levels of inflammation are independently associated with physical and mental HRQoL. Mechanisms other than inflammation through which PBD could influence HRQoL may be explored in further research.

Loneliness is a major health concern for immigrant older adults. This study explores social influences on loneliness in neighbourhoods among immigrant older adults across five major urban centres in Ontario and Alberta, Canada. Data were collected from 435 older immigrants who participated in the Inclusive Communities for Older Immigrants (ICOI) Project. Data were analysed using multiple linear regression (MLR) to identify the influences of neighbourhood factors, family support, duration of residency in Canada, English proficiency, and gender. Results indicate that increased engagement in ethnic enclaves, not being reliant on transportation for social interactions, and perceptions of neighbourhood cohesion are associated with a significant reduction in loneliness. These associations remain significant after accounting for family support and language proficiency. This calls for further research into the interconnections among interpersonal factors, neighbourhood-level factors, and family and community-level support to address key influences on loneliness in this population.

Postprandial hypotension (PPH) is defined as a postprandial decline in systolic blood pressure (SBP) of 20 mm of Hg. Some have recommended the use of acarbose (an alpha-glucosidase inhibitor) as a potential therapy for PPH based exclusively on studies of older adults with diabetes. Using a randomized placebo-controlled design, 43 older adults (23 women, 20 men, mean age 77.1 ± 0.9 years) were recruited from geriatric medicine outpatient clinics in an academic centre. Although the average decrease in SBP during the meal test was significantly attenuated in the acarbose group (standardized β = 0.724 ± 0.286, p = 0.017), the acarbose group experienced significantly more PPH events (standardized β = 0.593 ± 0.279, p = 0.040). Although acarbose attenuated the mean decrease in SBP during the meal test, it did not reduce the actual number of PPH events recorded in a general population of older adults.

ClinicalTrials.gov ID NCT01914133.

The purpose of this retrospective population-based study of adults aged ≥50 years was to examine associations between older age, multimorbidity, and self-rated perceptions of health with frequent emergency department (ED) visits. Using Canadian Community Health Survey (CCHS) 2015–16 data, a multivariate logistic regression model was generated to evaluate associations between predictor variables and frequent ED use. The study sample included data for 57,138 participants across Canada, equating to approximately 13,091,592 when sampling weights applied. Frequent ED use was associated with older age, male sex, multimorbidity, and lower household income. Lower self-rated levels of health were most strongly associated with frequent ED use. Having a primary health care provider was not a significant predictor in univariate or multivariate analyses. Older adults who are frequent ED attenders are a distinct population whose characteristics need to be understood to target strategies for those who most need them to improve quality care and outcomes.

Sarcopenia is a skeletal muscle disease characterised by low muscle mass, strength and/or impaired physical function that is associated with a wide range of adverse outcomes including osteoporosis, falls, fractures, disability, hospitalization, loss of independence and quality of life and mortality, if left untreated.(1, 2) This is also growing evidence linking sarcopenia to many other chronic conditions, including type 2 diabetes, fatty liver disease, cognitive impairment and dementia, certain cancers (and post- treatment outcomes), cardiovascular disease and impaired immunity.(3–4) Despite its significant impact, awareness and knowledge about this disease amongst healthcare professionals (and the general public), including how to identify and treat/manage sarcopenia, remains low. There are currently no approved pharmacological agents for the treatment sarcopenia, but there is moderate-to-high level evidence informing clinical practice guidelines that multifaceted interventions incorporating resistance-based training with adequate nutrition focusing on high quality protein or multi-nutrient protein-based supplements can prevent and manage this disease.(1, 5–6) Meta-analyses of randomised controlled trials consistently demonstrate that progressive resistance training (at least twice weekly) is the most effective approach to elicit gains in muscle mass and strength (independent of age), with the provision of dietary protein or multi- nutrient protein-based supplements providing small added benefits(7). Emerging evidence also indicates that minimal dose exercise strategies (e.g., resistance/strength “snacking” activities) and limiting sedentary behaviours (breaking up prolonged sitting) may help to attenuate age-related muscle loss. With regards to nutritional factors, most guidelines for older adults recommend a protein intake of 1.2 to 1.6 g/kg/d (25-30g of protein per meal) incorporating 3-4g of leucine to support muscle health. However, the benefits of protein alone on muscle-related outcomes are modest and appear mostly limited to those with insufficient (deficient) intakes (levels) and/or who are sarcopenic, frail and/or malnourished. A wide range of other nutritional-related factors (with and without exercise) have been investigated, including β-hydroxy β-methylbutyrate (HMB), vitamin D, creatine, antioxidants, omega-3 fatty acids, and phospholipids, as well as multi-nutrient supplements and various diets (Mediterranean diet), dietary patterns and foods (dairy products). There is also growing evidence that altering the gut microbiota and the use of probiotics, prebiotics and synbiotics may enhance muscle health. This presentation will provide an update of the evidence related to these factors to help guide decision making for clinical management and provide an overview of the current criteria used to identify poor muscle health and sarcopenia, including a new muscle health monitoring and management algorithm we have developed.

Masters athletes tend to have higher intakes of calcium, magnesium, iron, and zinc when compared to Australian national population data from similar age groups(1). However, little is known about the diets of New Zealand Olympians as they get older. This study aimed to describe the micronutrient intakes of New Zealand Olympic and Commonwealth Games athletes over the age of 60 years and make comparisons with National Nutrition Survey data. Thirty-three individuals (mean age 76±8 years, n=27 male) who had represented New Zealand at an Olympic or Commonwealth Games participated in this study. Dietary intake was assessed using three 24-h diet recalls. The first recall was conducted face to face in the participant’s home and the second and third were completed over a voice or video call on non-consecutive days following this. All recalls were performed using a multiple-pass technique and entered into FoodWorks dietary analysis software (Version 9, Xyris Software Ltd., Brisbane, Australia). Mean intakes across the three recalls were used to represent the intake of each individual.This study was approved by the University of Otago Ethics Committee (Health; H23/054, April 2023).The mean intakes of iron (males 13.3±5.1 mg, females 9.9±1.9 mg) and zinc (males 10.7±4.0 mg, females 9.6±1.9 mg) in Olympians were similar to those reported in those over 70 y in the 2008/09 New Zealand Adult Nutrition Survey, but more than 60% of Olympians had intakes below the estimated average requirements for these nutrients. Intakes of calcium (males 1048±474 mg, females 810±139 mg) and selenium (males 66.7±49.1 µg, females 48.4±17.7 µg) were higher in Olympians when compared to the 2008/09 New Zealand Adult Nutrition Survey data, however 39% and 61% of Olympians still had intakes below the estimated average requirements, respectively. While this group of older New Zealand Olympians did have higher intakes of some nutrients than a representative sample of their peers, a marked number are still at risk of inadequate intakes and may benefit from a nutrition intervention to improve the overall quality and adequacy of their diet.

Frailty in older adults with cancer is complex, evolving, and often overlooked in care. This qualitative study explored how frailty is experienced and reported using patient-reported outcome measures (PROMs) and visualized over time through journey maps. Eleven participants (65+) completed the Comprehensive Frailty Assessment Instrument (CFAI) and semi-structured interviews. Individual journey maps combined CFAI scores with personal narratives to track changes in physical, mental, and social aspects of frailty over time. While PROMs showed variability in frailty severity, narratives revealed discrepancies, such as low frailty scores despite significant treatment-related challenges. Fatigue, emotional distress, and isolation were common during treatment, with lasting impacts post-treatment. Findings suggest PROMs alone may not fully capture lived experience. Integrating narrative dialogue provides a more person-centred approach to frailty assessment and care planning.

Despite consensus that quality of life (QoL) in later adulthood is multi-dimensional, scholars’ perceptions of the dimensions the construct comprises differ. Under the premise that models and measures of QoL should correspond with lay perspectives to have relevance to the targeted population, we investigated the constituents of QoL in later adulthood as perceived by middle-aged and older laypersons. We fielded a factorial design vignette experiment among 2,544 respondents aged 50+ participating in the Dutch Longitudinal Internet studies for the Social Sciences panel to assess how 11 dimensions identified from four established QoL instruments designed for older people (WHOQOL-OLD, CASP-19, OPQOL, ICECAP-O) influence QoL evaluations. The study extends prior work on lay perspectives on QoL by combining the internal validity of an experiment with the external validity of a true population sample. All dimensions considered significantly impacted the QoL ratings in the expected direction. Enjoyment and social participation had a significantly larger contribution than the other dimensions. Models stratified by age group showed a strong degree of similarity, suggesting a high level of consensus across age groups about the constituents of QoL in later adulthood. The study highlights the necessity of capturing a broad range of dimensions when conceptualizing QoL in later adulthood. Our finding that dimensions that were omitted in selected established instruments still contributed substantially to QoL evaluations arguably implies that these instruments may have suboptimal content validity. The insights gained from this study are important for developing and evaluating policies aimed at improving QoL for the ageing population.

Food insecurity (FIS) is a critical public health issue, particularly among older adults. This study investigates the association between FIS with diet quality and anthropometric indices in the US older adults. A cross-sectional analysis was conducted using NHANES data from 2017 to 2020, involving 2592 participants aged ≥ 60 years. FIS was assessed using the USDA Household Food Security Survey Module. Diet quality was assessed using the Healthy Eating Index (HEI)-2020 and adherence to Mediterranean diet (MedDiet) score. Anthropometric measures were calculated following standardised protocols. Multivariable logistic regression models, adjusted for demographic, socio-economic and behavioural factors examined the association between FIS and the higher quartile and tertile of anthropometric and diet quality indices, respectively. Of the participants, 27·4 % experienced FIS. FIS participants were younger and had lower education and income levels compared with FS individuals (P < 0·05). In the adjusted model, FIS was associated with lower adherence to both the Mediterranean Diet (OR: 0·48, 95 % CI: 0·31, 0·67) and HEI-2020 (OR: 0·61, 95 % CI: 0·37, 0·84), indicating poorer diet quality in older adults. In adjusted analyses, FIS was significantly associated with higher A Body Shape Index quartiles (Q3: OR: 1·44, 95 % CI: 1·06, 1·95; Q4: OR: 1·46, 95 % CI: 1·07, 2·01), the waist-to-hip ratio (Q4: OR: 1·44, 95 % CI: 1·01, 2·06) and the Conicity index (Q4: OR: 1·36, 95 % CI: 1·02, 1·81). FIS in older adults is associated with unfavourable diet quality and body composition patterns, particularly central obesity measures. Addressing FIS may mitigate health risks related to obesity and its complications.

As Nigeria’s aging population increases, older adults living in poverty face growing threats to their psychological well-being. This study examines the role of formal social networks such as government programs, non-governmental organizations and faith-based initiatives in alleviating mental stress, defined as persistent psychological distress characterized by anxiety, loneliness and emotional strain, distinct from clinically diagnosed mental illness. Using Social Capital Theory as a guiding framework, the review explores how bonding, bridging and linking social capital influence the ability of formal networks to reduce financial insecurity, social isolation and health-related vulnerabilities. Traditional family caregiving structures are weakening due to rapid urbanization and economic pressures, leaving many older Nigerians unsupported. Although formal initiatives like the National Social Safety Nets Project exist, their effectiveness is limited by delayed disbursements, poor coordination and cultural stigma surrounding mental health. Strengthening the National Senior Citizens Centre as a coordinating body, expanding culturally relevant community-based care and integrating informal support systems are identified as crucial steps forward. Without such reforms, the continued neglect of this population risks worsening mental health outcomes, straining public health resources, and undermining intergenerational solidarity. This review offers actionable insights for improving older adult-care systems in Nigeria and provides guidance for other low-resource settings confronting similar demographic transitions.

An increasing number of older adults require residential care. Concurrently, older adults’ alcohol use is increasing. This review explored the perspectives of all relevant stakeholders on older adults’ alcohol use within residential care settings, through a systematic review and thematic synthesis of qualitative studies. Eight databases were searched for qualitative studies focusing on older adults’ alcohol consumption (defined as aged ≥ 50) within residential care settings, sampling any involved stakeholders, published up until January 2024. Quality appraisal utilised the Critical Appraisal Skills Programme checklist and included 15 studies of mainly moderate quality across seven high-income countries, reporting data from a range of stakeholders and representing varied older adults’ alcohol histories. Three themes were identified: alcohol use by older adults is socially acceptable and purposeful in residential care settings; alcohol helps in the pursuit of an ‘ideal’ outcome; and decision-making around older adults’ alcohol use varies depending on the involvement, knowledge, skills and beliefs of the participating stakeholders, who also vary. Reports of problematic alcohol use were rare and older adults in residential care settings should be supported to exercise their own choice in determining their alcohol use. However, residential care settings face particular challenges in managing the alcohol intake of older adults with limited mental capacity and alcohol dependency; owing to a lack of guidance, front-line staff make subjective decisions. Future research should develop guidance that involves all relevant stakeholders, including family members. Limitations include lack of generalisability to low- and middle-income countries and limited availability of raw data.

Older adults have largely been excluded from health research despite bearing a disproportionate disease burden. The Community Engagement Studio (CES) model, initially developed at Vanderbilt University in 2009, allows potential research participants to help shape research to promote greater inclusion. The University of Pittsburgh adapted the CES model for older adults (OA-CES). Tailored specifically to older adults, OA-CES addresses underrepresentation in research by gathering valuable feedback that allows investigators to make research more accessible and relevant to older people. An OA-CES toolkit will help in adapting the model in other research areas to close the gap in research inclusion.