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Older adults in long-term care (LTC) homes experience complex nutrition-related challenges and care staff are central to supporting nutrition care, eating assistance, and positive mealtime experiences. However, nutrition care education is often inconsistently addressed in staff training. This scoping review mapped the scope, characteristics, and reported the outcome measures of nutrition care education and programs for LTC staff. This review followed JBI methodology and was reported according to PRISMA-ScR guidelines. Four databases (MEDLINE, CINAHL, Scopus, and PsycINFO) were searched from May to October 2024, with an updated search in September 2025. Grey literature and reference lists were also searched. Sixteen studies met the eligibility criteria. Programs varied in content, delivery format, duration, target staff groups, implementation supports, and outcomes. Common outcomes included staff knowledge, confidence, attitudes, eating assistance practices, mealtime environment, feasibility indicators, and selected resident nutrition outcomes. Future research should improve reporting, follow-up, outcome definitions, implementation, feasibility, and continuity.
This chapter advances the premise that one way in which racism impacts health and developmental outcomes is through the experiences of the finite resource of time. Although all humans experience the same twenty-four hours in a given day, how those hours are allocated, how much agency over how those hours are spent, and the lived experiences of that time are stratified by structural systems such as racism. Taking a lifecourse perspective, we describe how human development is shaped as much by social factors as biological influences, using time as an example. Ultimately, stratified experiences of time set the stage for racism to shape even the most fundamental of human experiences. We call upon the field to deepen our study of the connections between time, racism, and health inequities, and offer a few recommendations for future research.
This study examines the representation of aging hikikomori in Japanese language media through qualitative content analysis of 188 sources (2019–2024), including news articles and personal blogs. Using deductive and inductive coding, the research reveals disparities between institutional media portrayals and personal narratives. Findings demonstrate that Japanese media frames aging hikikomori through medical and social welfare lenses, emphasizing social burden and family crisis narratives, while self-authored blogs reveal intersectional identities encompassing disability, sexuality, and regional marginalization. This paper provides the first English-language empirical analysis of Japanese media representations of aging hikikomori, demonstrating how blogosphere self-representation functions as counter-discourse to medicalized framings.
People living with dementia are at risk of going missing. The goal of this project was to develop case scenarios for health service providers, service recipients, and care partners to facilitate dialogues about managing risks related to going missing. This paper presents 10 case scenarios, based in real events, created to describe factors related to missing incidents of people living with dementia. Scenarios were developed following qualitative analysis of dementia-related missing incident reports from 515 MedicAlert Foundation Canada® hotline call summary notes, 1760 missing incident reports from three Canadian police departments and one search and rescue unit, and the experiences of two families. The case scenarios were reviewed by five participants for comprehensibility and validity. The case scenarios are an educational tool for health service providers, first responders, care partners, and persons living with dementia to use when discussing ways to manage risks of going missing.
This cross-sectional study examinee health and social concerns among community-dwelling older people, the resources they sought, and factors related to these concerns.
Methods
A convenience sample of 222 Nova Scotians aged 65 or over completed a semi-structured interview using the ACT® Assess, which assess 53 common health and social issues across six domains. Each item was linked to a database of corresponding local resources.
Findings
Over 40% of participants reported loneliness, moderate or greater pain, sleep problems, and/or bereavement – all within the Mental Health domain. However, only 32% sought Mental Health resources, compared to over 60% who sought resources for Accommodation and Finances. Participants receiving care showed greater challenges in activities of daily living and mobility.
Discussion
Findings suggest a high level of concern, even among a relatively healthy sample, and indicate a progression of concerns from psychosocial and home maintenance issues to mobility and functional challenges.
We undertook a qualitative descriptive study to explore participants’ perceptions of whether marital status shapes how functional social support (FSS) relates to memory.
Methods
Semi-structured interviews were conducted with 18 community-dwelling middle-aged and older people representing various marital status categories. Each interview was audio-recorded, transcribed verbatim, and thematically analyzed.
Findings
Participants did not perceive marital status to shape the FSS–memory relationship. Three themes emerged to explain this view: learning to cope – participants used alternatives besides a spouse to deal with memory challenges; context matters – factors such as marital satisfaction must be considered; and doing more harm than good – some spouses may provide excessive support, reducing participants’ autonomy to stimulate their own cognitive processes.
Discussion
These themes highlight that marital relationships are complex and that contextual factors such as marital quality and support adequacy should be considered to provide a comprehensive understanding of how social and marital dynamics shape cognitive trajectories in aging populations.
Receiving a dementia diagnosis is a complex experience that can provide clarity about symptoms but often creates uncertainty. Support during and after diagnosis is essential to help individuals navigate living with dementia. This qualitative descriptive study examined experiences during and after diagnosis among people with dementia and care partners in New Brunswick, Ontario, and Quebec.
Methods
Interviews with 5 people with dementia and 15 care partners were conducted and then analysed using qualitative content analysis to identify barriers, facilitators, and contextual influences related to a positive experience.
Results
Barriers included limited resources, poorly coordinated care, disorganized diagnostic pathways, and stigma. Facilitators included access to information, person-centred care, support networks, recognition of personhood, and structured care navigation. The COVID-19 pandemic further shaped experiences.
Conclusion
Findings highlight the importance of compassionate care, accessible information, and coordinated services while underscoring systemic gaps, stigma, and the impact of the pandemic.
Les interventions basées sur la pleine conscience (IBPC) sont reconnues comme des approches pertinentes auprès de personnes vieillissantes à risque de déclin cognitif. Toutefois, peu d’études ont exploré l’expérience vécue de participants présentant un déclin cognitif accompagné de symptômes anxiodépressifs. Cette étude qualitative vise à comprendre l’expérience de 13 adultes de 55 ans et plus ayant participé à une IBPC de groupe. Des entrevues semi-dirigées menées après l’intervention ont été analysées selon une approche inductive pour dégager les thèmes émergents. Les résultats révèlent une trajectoire expérientielle en trois temps : une surprise initiale face aux pratiques, une évolution progressive de leur vécu, tant individuel qu’interpersonnel, notamment grâce au groupe, puis un sentiment d’élucidation et de satisfaction à l’égard du programme. L’analyse met en lumière des processus individuels et relationnels importants, soulignant la nécessité de considérer divers facteurs dans l’étude des mécanismes et effets des IBPC auprès des personnes vieillissantes.
This research note assessed the relationship between health status and union dissolution in middle and later life in the Canadian context.
Methods
Data were drawn from four waves (2014–2020) of the Canadian Longitudinal and International Study of Adults aged 45 and older. Logistic regression analyses examined the effects of stability and changes in self-rated health (SRH) and psychological distress on subsequent marital and cohabiting union dissolution.
Findings
Unlike those whose SRH declined over time, those who experienced continuing fair/poor SRH had a greater likelihood of subsequent union dissolution compared to those experiencing continuing good/very good/excellent or improved SRH. In contrast, those reporting increased psychological distress were more likely to experience union dissolution later on.
Discussion
Policies and interventions that limit poor physical and mental health of individuals as they age may also serve to reduce the occurrence of union dissolution and its implications.
Older refugees often navigate complex health care needs while aging in resettlement contexts. For Syrian refugees in the Greater Toronto Area and surrounding regions, barriers within the Canadian health care system may shape how care is accessed, coordinated, and supplemented through transnational practices.
Objective
This study examines how older Syrian refugees aging in the Greater Toronto Area and surrounding regions navigate health care and construct hybrid health care pathways across local and transnational contexts.
Methods
A qualitative interpretive descriptive design was used. In-depth interviews were conducted with 20 Syrian refugees aged 55–63. Data were analyzed using reflexive thematic analysis to identify patterns in participants’ experiences of accessing, coordinating, and supplementing health care.
Findings
Participants described persistent linguistic barriers, long wait times, and limited access to culturally aligned services within the Canadian health care system. In response, they developed hybrid health care pathways that combined Canadian health care with transnational practices, including consultations with clinicians abroad, cross-border medication use, family support, traditional remedies, and digital technologies. Digital tools played a central role in bridging language and geographic gaps and supporting care coordination. While these hybrid pathways enhanced autonomy, continuity of care, and perceived control, they also introduced risks related to medication safety, fragmented care, informal decision-making, and digital inequities.
Discussion
The findings show that older Syrian refugees’ health care navigation extends beyond formal Canadian health services and is shaped by transnational relationships, cultural knowledge, digital access, and prior health system experiences. Hybrid health care pathways can support continuity and culturally meaningful care, but they also require careful attention to safety, communication, and equity. Health systems should develop culturally responsive and digitally inclusive models that recognize transnational care practices while supporting safer integration with local care.
Immigrant and racialized Canadians constitute an increasing percentage of the older adult population. Attention is needed to the role of municipalities and their key partners in creating urban environments that are supportive of aging in place.
Objective/Methods
We conducted a qualitative descriptive sub-study of policy partners’ perceptions of age-friendly policies and initiatives as part of a larger community-based participatory project in Edmonton (Alberta, Canada).
Findings/Discussion
Nineteen participants, including elected municipal representatives, city administrators, advisory committee volunteers and seniors-serving organization staff, took part in semi-structured interviews, which was followed with a reflexive thematic analysis of the data. Participants described high levels of awareness about inequities faced by immigrant and racialized older adults. Advocacy and policy efforts, however, were constrained by insufficient funding, lack of capacity for sustainable initiatives, unclear jurisdictional boundaries and competing priorities.
Mobility limitations due to chronic musculoskeletal pain are a major contributor to disability in older adults, yet current pharmacological treatments often have limited efficacy and increase the risk of polypharmacy. Omega (ω)-3 PUFA, particularly EPA and DHA, have demonstrated anti-inflammatory and analgesic properties, but are under-consumed among older USA adults. Krill oil, a marine-derived source of EPA and DHA with enhanced bioavailability compared with typical fish oils and additional bioactive compounds such as astaxanthin and choline, may offer a promising nutritional intervention. This pilot study will assess the feasibility and acceptability of a 3-month randomised, double-blind, placebo-controlled trial of krill oil supplementation (4 g/d: 1288 mg EPA + DHA, 0·45 mg astaxanthin, 320 mg choline) v. placebo (mixed vegetable oils) in forty community-dwelling adults aged ≥ 60 years with chronic musculoskeletal pain. Primary outcomes include feasibility (recruitment, retention and adherence) and acceptability (participant satisfaction). Secondary outcomes include changes in the omega-3 index, ω-6/ω-3 ratio and inflammation (high-sensitivity C-reactive protein), as well as exploratory changes in pain intensity and functional interference, and physical function (Short Physical Performance Battery, 6-Minute Walk Test). Findings will inform the design of future fully powered trials that may ultimately contribute to the evidence for omega-3 supplementation as a non-pharmacological strategy to support healthy aging and functional independence in older adults.
This chapter first discusses age composition, that is, how a population is divided among children, young and middle-aged adults, and older adults. Aging is a biological process, but there are many social expectations associated with certain ages, referred to as age-grading. There are minimum ages, for example, for starting school; for obtaining a driver’s license; for voting; and for qualifying for Social Security and Medicare. The US Constitution specifies minimum ages for members of Congress, and the presidency. People of the same age tend to have much in common because they have had similar experiences at similar ages. This chapter focuses specifically on the definition and measures of age and age distribution, the concepts of age heaping and age dependency, and population pyramids. It then turns attention to some of the issues posed by aging populations, including healthy aging, and lastly to the concepts of cohort and generation.
Pulse pressure (PP) calculated as systolic minus diastolic blood pressure is a surrogate measure of arterial stiffness that may affect executive function; however, this relationship could be moderated by age and genetic risk for Alzheimer’s disease (AD). We therefore examined relationships among PP, age, AD risk (i.e., APOE genotype) and executive function measured by the NIH Toolbox Cognition Battery (NIHTB-CB) in older adults.
Methods:
PP was determined in 216 older adults without dementia (mean age: 77.5 ± 7.9 years, education: 16.8 ± 2.4 years, 55% women, 34.8% APOE ϵ4+) who were tested with the NIHTB-CB as part of the Advancing Reliable Measurement of Alzheimer’s Disease and Cognitive Aging (ARMADA) study.
Results:
Multiple linear regression revealed PP × Age × APOE genotype interaction effects for List Sorting Working Memory (β = 0.04; p = .007) and Picture Sequence Memory (β = 0.04; p = .006); higher PP was associated with worse scores in younger APOE ϵ4+ older adults (same pattern for fluid and total cognition composite scores). Higher PP was associated with lower Picture Vocabulary scores in ApoE ϵ4+ (PP X APOE interaction: β = −0.19; p = .022). Higher PP was associated with lower Flanker Inhibitory Control scores (β = −0.13; p = .005) across all participants.
Conclusions:
Arterial stiffness measured by PP in older adults is associated with worse performance on NIHTB-CB tests of executive function, working memory, and episodic sequence memory, particularly in younger APOE ϵ4 carriers. Arterial stiffness and AD risk may work synergistically in an age dependent manner to adversely affect cognition.
To develop regression-based normative data for a set of widely used neuropsychological tests and to provide a freely accessible normative data calculator for use in Buenos Aires, Argentina.
Methods:
Participants were drawn from a large clinical dataset and selected to reflect preserved global cognition, intact memory performance, and functional independence. Regression-based norms were developed for the Rey Auditory Verbal Learning Test, Verbal Fluency, Trail Making Test, and Digit Span tasks. For each model, predictors included age, sex, and years of education, as well as polynomial terms and interaction effects; final models were obtained via stepwise backward elimination procedures. Model assumptions were evaluated, and predictive performance was estimated using 10-fold cross-validation.
Results:
393 participants met inclusion criteria. Age was negatively associated with verbal memory, fluency, and executive function, whereas higher educational attainment was associated with better performance. Women outperformed men in verbal memory and phonological fluency. Demographic variables explained between 2% and 23% of variance across tests. An open-access calculator was developed to facilitate individualized normative estimation in clinical settings.
Conclusions:
This study provides locally developed, regression-based norms for neuropsychological assessment in Buenos Aires – Argentina, addressing the lack of culturally relevant norms and limitations of traditional methods.
There is an increase in life expectancy in the Nordic countries. Research in health promotion is vital in the fields of aging and health to address present and emerging opportunities and challenges. This scoping review of doctoral theses with a health promotion focus was conducted by the ‘healthy ageing’ research group, which is part of the Nordic Health Promotion Research Network. The overall aim was to explore how research about older adults under the label ‘health promotion’ was undertaken in doctoral theses in a Nordic context, with a specific focus on the theoretical framework, and on participation, and empowerment – the guiding principles for health promotion. A scoping review following the guidelines of The Joanna Briggs Institute was carried out. Relevant databases in Denmark, Finland, Norway, and Sweden were searched for theses published between 2011 and 2021. In total 28 theses were included in the results. The results revealed that the number of theses identified with the word ‘health promotion’ in the title, as a keyword, or in the abstract varied considerably between the Nordic countries. Qualitative and quantitative methods were used, and data was collected mainly from healthy older adults living at home. Theoretical perspectives differed, and definitions of health promotion varied across the theses and were sometimes absent. In conclusion, doctoral theses within the field of healthy aging research could benefit from being more specific about the meaning and use of the concept of health promotion.
This study examines how intensive caregivers in Nova Scotia who receive the provincial government’s Caregiver Benefit interpret and experience the program, particularly in the context of its ambiguous goals.
Methods
A qualitative descriptive methodological design was used to ensure that the reporting of findings remained close to participants’ own words and to emphasize the practicality of findings. Twenty family caregivers with experience receiving the Caregiver Benefit participated in a semi-structured interview.
Findings
Our analysis captured four themes: (a) caregiving intensity shaping perceptions of the Benefit, (b) financial relief provided by the Benefit, (c) systemic barriers to access, and (d) policy problems.
Discussion
To our knowledge, this is the first study to explore the firsthand accounts of caregivers’ experiences with the Caregiver Benefit in Nova Scotia.
Creatine monohydrate (CrM) is a widely used supplement to improve physical performance and strength. Recent studies suggest it may also benefit cognitive function and depression treatment. However, data on its effects in older adults are scarce, highlighting the need for further research in this population. This study is a randomised, double-blind, placebo-controlled trial assessing 5 weeks of CrM supplementation combined with physical training in older adults (≥ 75 years). Participants will be divided into four groups: placebo (PL), placebo with multicomponent training (PL + MT), creatine monohydrate supplementation (CrM) and creatine monohydrate with multicomponent training (CrM + MT). Evaluations will be conducted before, during and after the intervention and again after a 5-week washout period. The training programme includes supervised sessions twice a week over 4 weeks, focusing on resistance, cardiovascular, balance, reaction and agility exercises. Functional capacity and fall risk will be measured, alongside physical tests such as handgrip strength and one-repetition maximum (1RM) tests for leg press, bench press, seated row and leg extension. Cognitive and emotional assessments will also be conducted during the intervention. The results of this study aim to increase our understanding of the effects of CrM supplementation in older adults. This study is expected to generate valuable information on the impact and safety of this nutrition and exercise strategy, and its application can be extended to a variety of health conditions. CLINICAL TRIALS: https://clinicaltrials.gov/study/NCT06677359.
Older refugees are often depicted in deficit-oriented terms in policy and scholarly discourse, leading to limited recognition of their capacities, agency, and social contributions.
Objective
This study examines the sociocultural roles and contributions of older African refugees in Calgary, Canada.
Methods
Drawing on qualitative storytelling and diagramming, with 11 older African refugees serving as co-researchers, to illuminate how they support younger generations and strengthen community resilience.
Findings
The results demonstrate that older refugees actively contribute through cultural and linguistic transmission, moral and civic mentorship, financial guidance, and culturally grounded support. Co-researchers described themselves as heritage keepers safeguarding language, culture, and identity amid perceived cultural risks in the host society. These contributions challenge prevailing assumptions of older refugees as passive or dependent and highlight the importance of recognizing their community influences.
Discussion
The study underscores the need for strength-based policies and services that acknowledge older refugees’ sociocultural roles in supporting intergenerational well-being and community integration.
A study using a waitlist control group pre–post design evaluated a new 13-week, peer-delivered Frailty Coach Program that was adapted from two prior self-management interventions involving persons with type 2 diabetes (2019) and other chronic conditions (2022). The intervention included teaching participants to use three Self-Management support strategies and providing education and encouragement to incorporate the Canadian Frailty Network AVOID (Activity, Vaccinate, Optimize medication, Interact, and Diet & nutrition) strategies into their lives. Results showed that over half the study participants made significant changes and had returned to lower levels of frailty as measured by the Clinical Frailty Scale. Other self-reported outcome measures that included eight subscales of the RAND 36-item Health Survey showed improved physical functioning, improved emotional well-being, and improved their impression of general health. At the end of the project, the program was approved for ongoing funding by the provincial Ministry of Health.