The Cultural Context of “Successful Aging” Among Older Women Weavers in a Northern Okinawan Village: The Role of Productive Activity

Lessons Learned From Blue Zones, Lifestyle Medicine Pillars and Beyond: An Update on the Contributions of Behavior and Genetics to Wellbeing and Longevity

Blue Zones are regions of the world that have a higher number of individuals who live longer than the expected average. The current paper revisits principles previously identified to be common in Blue Zones and to be contributing to longevity (move naturally, eat wisely, improve resilience to stress, get adequate sleep, keep strong family ties, stimulate strong community support, respect for the planet and having a purpose in life'), compares these to the 6 pillars of Lifestyle Medicine (healthy eating, exercising, avoidance of smoking and other risky substances, stress management, restorative sleep, and forming and maintaining relationships) and reviews new studies investigating the association between behavioral factors and longevity. In addition to the role of behavior, the review also discusses the important role of genetics and emphasizes the importance of conducting further research to understand how behavioral and genetic factors may affect molecular pathways with consequent effects on wellbeing and longevity.

SuperAgers and centenarians, dynamics of healthy ageing with cognitive resilience

Graceful healthy ageing and extended longevity is the most desired goal for human race. The process of ageing is inevitable and has a profound impact on the gradual deterioration of our physiology and health since it triggers the onset of many chronic conditions like dementia, osteoporosis, diabetes, arthritis, cancer, and cardiovascular disease. However, some people who lived/live more than 100 years called 'Centenarians" and how do they achieve their extended lifespans are not completely understood. Studying these unknown factors of longevity is important not only to establish a longer human lifespan but also to manage and treat people with shortened lifespans suffering from age-related morbidities. Furthermore, older adults who maintain strong cognitive function are referred to as "SuperAgers" and may be resistant to risk factors linked to cognitive decline. Investigating the mechanisms underlying their cognitive resilience may contribute to the development of therapeutic strategies that support the preservation of cognitive function as people age. The key to a long, physically, and cognitively healthy life has been a mystery to scientists for ages. Developments in the medical sciences helps us to a better understanding of human physiological function and greater access to medical care has led us to an increase in life expectancy. Moreover, inheriting favorable genetic traits and adopting a healthy lifestyle play pivotal roles in promoting longer and healthier lives. Engaging in regular physical activity, maintaining a balanced diet, and avoiding harmful habits such as smoking contribute to overall well-being. The synergy between positive lifestyle choices, access to education, socio-economic factors, environmental determinants and genetic supremacy enhances the potential for a longer and healthier life. Our article aims to examine the factors associated with healthy ageing, particularly focusing on cognitive health in centenarians. We will also be discussing different aspects of ageing including genomic instability, metabolic burden, oxidative stress and inflammation, mitochondrial dysfunction, cellular senescence, immunosenescence, and sarcopenia.

Cognitive Reserve, Physical Reserve, and Cognitive Efficiency of Older People Living in the Sardinian Blue Zone. An Exploratory Study

This study mainly intended to disentangle the role played by physical reserve as a mediator of the relationship between cognitive reserve and global cognitive functioning in older people aging well. A sample of 120 67-101-year-old community-dwellers was recruited in the Sardinian Blue Zone, an area characterized by the extreme longevity of its inhabitants. Each respondent completed a battery of tests examining cognitive functioning, perceived physical health, cognitive reserve, and physical reserve (objectively assessed through accelerometric-derived measures). Significant associations were found among measures of cognitive reserve, physical reserve, perceived physical health, and cognition. Besides, two mediational analyses pointed out that physical reserve and distinct indexes of cognitive reserve explained 18% and 32% of the variance associated with global cognitive functioning. In conclusion, the combination of high cognitive reserve and more preserved motor functioning seems to contribute to the maintenance of healthy cognition in older people aging well.

Redefining Age-Friendly Neighbourhoods: Translating the Promises of Blue Zones for Contemporary Urban Environments

The longevity and healthy ageing observed in Blue Zones offer valuable insights for contemporary urban neighbourhood planning and design. This paper reviews the age-friendly features of the built environment in Blue Zones, aiming to translate these insights into actionable strategies for urban neighbourhood development. Employing a systematic literature review and Convolutional Neural Networks (CNNs) analysis of Google Street View imagery, this study assesses the built environments in Blue Zones, including housing, public spaces, and transportation systems. Key findings highlight the presence of adaptable housing, building designs that foster a connection with nature, and semi-public spaces that encourage social interaction and physical activity. A notable emphasis on walkability and limited public transport access was observed. The CNN analysis corroborated these findings, providing a quantitative view of age-friendly features. This research contributes to the academic discourse in urban planning and design by providing practical insights for developing age-friendly neighbourhoods, inspired by Blue Zones. It concludes by offering policy advice and future research directions for creating sustainable and inclusive urban environments conducive to ageing populations.

Is Cognitive Reserve a Determinant of Functional and Mental Health in Older People of the Sardinian Blue Zone? A Mediational Approach

The main purpose of this study was to examine the mediating role of cognitive reserve in the relationship between functional health (expressed through the amount and intensity of performed physical activity objectively assessed using wearable accelerometers) and psychological well-being (i.e., assessed in terms of self-reported depressive signs) of older people living in an area of exceptional longevity, the so-called Sardinian Blue Zone. A further goal was to investigate the impact of gender on the cognitive reserve and physical health of our participants, using global cognitive functioning as a covariate. A battery of tests assessing motor efficiency, cognitive reserve, global cognitive functioning, and self-reported depressive symptoms was individually presented to 120 community dwellers (Mage = 82 years, SD = 8.4 years) of the Sardinian Blue Zone. Significant associations were found between cognitive reserve, motor efficiency, and self-reported depressive signs. Moreover, three mediation analyses documented that distinct indexes of cognitive reserve and motor efficiency explain 27.2-31% of the variance in the self-reported depression condition. Following this, it was also found that people with scarce cognitive reserve tended to exhibit significant signs of depression and showed worse motor abilities. In addition, after controlling for the effect of global cognitive functioning, motor efficiency, and cognitive reserve were generally more preserved in males than in females. Overall, these findings suggest that cognitive reserve is a compensatory resource that contributes significantly to the enhancement of health-related quality of life in the last decades of life.

Effectiveness of Otago Exercise Program on Successful Aging within Older Women with Migrant Children Referring to Public Health Centers in Shiraz City, Iran

Background: Successful aging (SA) is considered an indicator of satisfaction of older people. This study aimed to evaluate the effectiveness of the Otago Exercise Program (OEP) on SA among older women. Materials and Methods: quasi-experimental research with a control group was conducted in 2021 on 120 older women in Shiraz city, south Iran. Eligible samples were selected by a three-stage cluster sampling method and were classified into two equal intervention and control groups. Eight training sessions (exercises) were conducted for the intervention group using the OEP. SA questionnaire was completed at the beginning and 2 months after the intervention. The data were analyzed using the IBM-SPSS version 26, and the effect sizes were extracted. Results: The mean age of samples in the intervention and control groups was 69.71 + 59.59 and 68.83 + 5.08 years, respectively. Although there was no significant difference in the mean scores of SA between the two groups at the beginning of the study, 2 months after the intervention implementation, the mean scores of SA increased significantly in the intervention group (t = 8.57, p ≤ .001). Conclusion: It seems that OEP is an effective strategy for supporting SA in older people.

Blue Zones: Centenarian Modes of Physical Activity: A Scoping Review

The primary aim of this scoping review was to identify the predominant modes of physical activity (PA) in each Blue Zone and to explore the influences that environment and culture have on PA. A research team of three Doctor of Physiotherapy students completed a systematic search using five online databases and cross referenced each reviewer in the study selection process. The study selection was based on eligibility criteria comprised of population autonomy/independence, > 80 years, Blue Zone resident, specified mode of physical activity, and utilized all research designs except for case studies and literature reviews. The databases retrieved a total of 236 articles, and 18 of which, met the inclusion criteria. Data synthesis revealed that 81% of the activities engaged by Blue Zone centenarians are moderate intensity activities. Blue Zone centenarians represent a significantly high physical functioning and high levels of activity through labouring occupations, outdoor hobbies and in-home activities. The most predominant mode represented through the included studies was agricultural activities. Overall, Blue Zones Centenarians are highly active, perform continuous and consistent movements daily, maintain daily hobbies, and work beyond the expected age of retirement. The key findings represent a significant effect on PA by environmental and cultural influences of each region.

Aging Well for Indigenous Peoples: A Scoping Review

As life expectancy increases for Indigenous populations, so does the number of older adults with complex, chronic health conditions and age-related geriatric syndromes. Many of these conditions are associated with modifiable lifestyle factors that, if addressed, may improve the health and wellbeing of Indigenous peoples as they age. If models of healthy aging are to be promoted within health services, a clearer understanding of what aging well means for Indigenous peoples is needed. Indigenous peoples hold a holistic worldview of health and aging that likely differs from Western models. The aims of this review were to: investigate the literature that exists and where the gaps are, on aging well for Indigenous peoples; assess the quality of the existing literature on Indigenous aging; identify the domains of aging well for Indigenous peoples; and identify the enablers and barriers to aging well for Indigenous peoples. A systematic search of online databases, book chapters, gray literature, and websites identified 32 eligible publications on Indigenous aging. Reflexive thematic analysis identified four major themes on aging well: (1) achieving holistic health and wellbeing; (2) maintaining connections; (3) revealing resilience, humor, and a positive attitude; and (4) facing the challenges. Findings revealed that aging well is a holistic concept enabled by spiritual, physical, and mental wellbeing and where reliance on connections to person, place, and culture is central. Participants who demonstrated aging well took personal responsibility, adapted to change, took a positive attitude to life, and showed resilience. Conversely, barriers to aging well arose from the social determinants of health such as lack of access to housing, transport, and adequate nutrition. Furthermore, the impacts of colonization such as loss of language and culture and ongoing grief and trauma all challenged the ability to age well. Knowing what aging well means for Indigenous communities can facilitate health services to provide culturally appropriate and effective care.

An investigation of the relationship between ageing in place and successful ageing in elderly individuals

BACKGROUND

With the increase in longevity in the world, successful ageing has become an important issue. This study aims to investigate the relationship between ageing in place and successful ageing in elderlies.

METHODS

This study, which utilised a descriptive and relational-screening model, was conducted with the participation of 370 individuals aged 65 and over who were registered in Family Health Centres in a city centre located in the eastern part of Turkey.

RESULTS

The participating elderlies' Successful Ageing Scale mean score was 54.16 ± 11.32, and the Ageing in Place Scale mean score was 54.24 ± 12.88. While there was a positive, statistically significant relationship between the Successful Ageing Scale total score, the Ageing in Place Scale total score, and living in the same environment, there was a negative, significant relationship between age and the Successful Ageing Scale total score.

CONCLUSION

Elderlies' successful ageing processes are affected positively by the increase in the duration of living in the same environment and satisfaction level about the place they lived in. Successful ageing is negatively affected by the increase in age. It is recommended that elderly people's living environments should not be changed and their social support networks should be strengthened as much as possible so they can have a successful ageing process.

Early Hour, Golden Hour: an Exploration of Slovenian Older People's Meaningful Occupations

People are occupational beings and enabling older people to engage in meaningful occupations contributes to their health and well-being. Experiences of engagement and meaning in an occupation may differ in different socio-cultural contexts. The aim of this study was to explore Slovenian older people's individual experiences of engagement in occupation, with a particular emphasis on their meaningful occupations. The study employed a phenomenological research approach. Semi-structured interviews were conducted with ten Slovenian older adults, living independently in their home environment. Interpretative Phenomenological Analysis was used to approach and analyze the data. The findings highlighted that meaningful occupations and daily rituals represented an important part of the participants' identities. The meanings they attached to their occupations were informed by Slovenian socio-cultural, historical and physical context. A range of people and places were identified as significant in generating and maintaining these meanings. Participants gave particular significance to the role of productive, health-promoting and family-related occupations. The study contributes new occupational science knowledge and the findings support the case for increased recognition of the importance of meaningful occupation for older people.

Perceptions of Successful Aging among Older Adults in Bangladesh: An Exploratory Study

To analyze older adults' definitions of successful aging in Bangladesh. The purposively selected study sample comprised twelve participants who were aged over 60. Interviews using in-depth semi-structured questionnaires were conducted based on participants' chosen mode, either face-to-face, or by phone. Findings of this study support that successful aging is multidimensional - that is - for Bangladeshis successful aging encompasses dimensions such as adaptation to an aging body, financial security, family and intergenerational care, and social participation. Older adults' emphases on all these dimensions were qualitatively different from those relevant in western societies. Bangladeshis see disease and disability as a normal part of aging and do not emphasize freedom from disease or longevity as much as North Americans and the US-focused successful aging discourses do. Family care is a key component of successful aging in Bangladesh. While in western models functional independence has been emphasized, for Bangladeshi older adults' adaptations to changing body, co-residing with children, being financially, physically, and emotionally dependent on family and receiving their care are viewed as normal and appropriate. Cross-cultural comparisons in this study suggest that what it means and entails to age well differ across cultures. This study highlights the need among health professionals to understand Bangladeshi culture, with its specific beliefs and values, as it relates to the views of aging well.

The Role of Existential Beliefs Within the Relation of Centenarians' Health and Well-Being

The purpose of this study was to explore the role of existential beliefs in mediating the influence of health on centenarians' well-being. A total of 80 centenarians (mean age 101.1; SD = 1.3; 81.3 % women) with no/minor cognitive impairment were included. The OARS questionnaire for diseases and functional capacity (ADL, IADL), the Satisfaction with Life Scale, and the existential beliefs subscale were used for data collection. The findings suggest that existential resources are a crucial element for mitigating the impact of health constraints in subjective well-being in this population. Appropriate models of intervention for very old age that recognize the importance of religion, spirituality, and meaning of life are to be considered.

What Does Successful Aging Mean? Lay Perception of Successful Aging Among Elderly Singaporeans

Objectives

We explore the culturally specific meaning of successful aging in Singapore, an ethnically diverse city-state in Asia. We aim to investigate lay perceptions of successful aging among the elderly individuals in Singapore and further examine variations of these perceptions.

Methods

We applied a mixed-method research design. Firstly, we conducted qualitative interviews with 49 elderly respondents, generating 12 main subjective components of successful aging. Next, we did a national survey with a sample of 1,540 local residents aged 50 to 69 years, in which respondents were asked to evaluate the importance of each subjective component of successful aging. We used the regression models and latent class analysis to analyze the correlatives of successful aging and to classify the elderly individuals by perception types.

Results

Among 12 components of successful aging, those related to self-sufficiency received the highest acknowledgment among the elderly individuals in Singapore. At least half of them simultaneously highlighted independence from family and dependence on family. Malays and Indians in Singapore valued more of the roles of spouse and children in successful aging, as compared with Chinese. The latent class analysis classified four groups of the elderly individuals according to their lay views on successful aging.

Discussion

As compared with the western model of successful aging, the elderly individuals in Singapore perceived successful aging with a strong focus on familism. These lay perceptions also significantly varied among these elderly individuals.

Green Mind Theory: How Brain-Body-Behaviour Links into Natural and Social Environments for Healthy Habits

We propose a Green Mind Theory (GMT) to link the human mind with the brain and body, and connect the body into natural and social environments. The processes are reciprocal: environments shape bodies, brains, and minds; minds change body behaviours that shape the external environment. GMT offers routes to improved individual well-being whilst building towards greener economies. It builds upon research on green exercise and nature-based therapies, and draws on understanding derived from neuroscience and brain plasticity, spiritual and wisdom traditions, the lifeways of original cultures, and material consumption behaviours. We set out a simple metaphor for brain function: a bottom brain stem that is fast-acting, involuntary, impulsive, and the driver of fight and flight behaviours; a top brain cortex that is slower, voluntary, the centre for learning, and the driver of rest and digest. The bottom brain reacts before thought and directs the sympathetic nervous system. The top brain is calming, directing the parasympathetic nervous system. Here, we call the top brain blue and the bottom brain red; too much red brain is bad for health. In modern high-consumption economies, life has often come to be lived on red alert. An over-active red mode impacts the gastrointestinal, immune, cardiovascular, and endocrine systems. We develop our knowledge of nature-based interventions, and suggest a framework for the blue brain-red brain-green mind. We show how activities involving immersive-attention quieten internal chatter, how habits affect behaviours across the lifecourse, how long habits take to be formed and hard-wired into daily practice, the role of place making, and finally how green minds could foster prosocial and greener economies. We conclude with observations on twelve research priorities and health interventions, and ten calls to action.

Gender, aging, and the economics of "active aging": Setting a new research agenda

The world is aging, and the percentages of older people are on a dramatic ascent. This dramatic demographic aging of human society is not gender neutral; it is mostly about older women. One of the key policy approaches to address the aging revolution is known as "active aging," crystalized by the WHO in 2002 by three pillars: participation, health, and security. The active aging policy has financial and economic aspects and affects both men and women. However, as argued in this article, a gender-based approach has not been adopted within the existing active aging framework. Therefore, a new gender-specific research agenda is needed, one that focuses on an interrelation between gender and different economic aspects of "active aging" from international, comparative, cultural, and longitudinal perspectives.

Perceptions of Successful Ageing Among Iranian Elders: Insights From a Qualitative Study

The aim of this article is to explore the perceptions of successful ageing among Iranian elderly. The data were collected in Tehran city on 60 older adults using a semistructured interview. The collected data were analyzed using directed content analysis. The findings revealed various dimensions of successful ageing among Iranian older adults. Social well-being is the most prevalent dimension of successful ageing, followed by psychological well-being, physical health, spirituality and transcendence, financial security, and an elder-friendly environmental and social context. Also, the findings from this study provide a new understanding of successful ageing in the context of Iran and contribute additional elements. This qualitative study highlights the importance of multidimensional and contextual viewpoints to successful ageing. In conclusion, to achieve multidimensional successful ageing, the interaction between all levels of successful ageing such as individual, family, and environment must be considered.

Keeping up with the caravan of life: Successful aging strategies for Iranian women

Background

Because of improving life expectancy in the world in recent times, the focus has shifted to the issue of the quality and nature of life and how to assist successful aging (SA) rather than increasing physical survival and lifespan. SA is a multidimensional, relative, and context-dependent concept with different paths and outcomes. The purpose of this qualitative study was to explore older women's strategies for SA in a specific context.

Methods

Following a grounded theory design approach, we conducted semi-structured individual interviews with 21 women between the ages of 28 and 96 years. We analyzed the data from interviews, written narratives, and field notes using the grounded theory approach.

Results

We identified four categories: prevention of threats, internal self-control against threats, coping with threats, and optimizing the passage of time according to opportunity. These described the strategies for SA when encountering with age-related changes. Utilizing these strategies, the women accompanied the caravan of life in the context of threats and opportunities.

Conclusions

The findings suggest that SA is a continuous process in confronting changes related to age. The identified strategies can help to promote SA by familiarizing older women with the threats and opportunities of life and training them in how to use these strategies.

Factors Influencing the Successful Aging of Iranian Old Adult Women

Background:

Aging is an irreversible natural process characterized by a decline in both the physical and mental status of individuals. Because of multiple factors, this process and its consequences vary greatly between individuals. A successful aging (SA) is the target of current health policies and well-being of individuals. Knowing the factors that contribute to SA and its barriers would translate in measurements that increase the quality of life of elderly and reduce health costs.

Objectives:

The aim of this study was to explore barriers and facilitators to Iranian elderly women’s SA.

Patients and Methods:

A purposive sample of 16 elderly women, aged 61 - 96 years, was recruited for this qualitative content analysis study. Study data were collected during 2012 -.2013 by conducting 16 face-to-face semi-structured in-depth interviews. We continued the data collection until reaching saturation. Study data were analyzed concurrently with data collection, by using the conventional qualitative content analysis approach.

Results:

Barriers and facilitators to Iranian elderly women’s SA fell into five main categories, including availability of support systems, state of health, personal capabilities, personality characteristics, and lifestyle.

Conclusions:

Availability of support systems, state of health, personal capabilities, personality characteristics, and lifestyle were the main interrelated factors affecting Iranian elderly women’s SA. Accordingly, providing elderly women with strong educational, emotional, financial, cultural, and social supports can help facilitate their SA.

Defining successful aging: a tangible or elusive concept?

PURPOSE OF THE STUDY

Everyone wants to age successfully; however, the definition and criteria of successful aging remain vague for laypersons, researchers, and policymakers in spite of decades of research on the topic. This paper highlights work of scholars who made significant theoretical contributions to the topic.

DESIGN AND METHODS

A thorough review and evaluation of the literature on successful aging was undertaken.

RESULTS

Our review includes early gerontological definitions of successful aging and related concepts. Historical perspectives reach back to philosophical and religious texts, and more recent approaches have focused on both process- and outcome-oriented models of successful aging. We elaborate on Baltes and Baltes' theory of selective optimization with compensation [Baltes, P. B., & Baltes, M. M. (1990a). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1-34). United Kingdom: Cambridge University Press], Kahana and Kahana's preventive and corrective proactivity model [Kahana, E., & Kahana, B. (1996). Conceptual and empirical advances in understanding aging well through proactive adaptation. In V. Bengtson (Ed.), Adulthood and aging: Research on continuities and discontinuities (pp. 18-40). New York: Springer], and Rowe and Kahn's model of successful aging [Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon Books], outlining their commonalities and differences. Additional views on successful aging emphasize subjective versus objective perceptions of successful aging and relate successful aging to studies on healthy and exceptional longevity.

IMPLICATIONS

Additional theoretical work is needed to better understand successful aging, including the way it can encompass disability and death and dying. The extent of rapid social and technological change influencing views on successful aging also deserves more consideration.

In search of the everyday life of older people in Japan: reflections based on scholarly literature

The main objective of this paper is to critically examine discourses about old age in Japan, a country with perspectives that are culturally different from the European and American perspectives that tend to dominate the scholarly discourse on ageing. We focus our inquiry on the scientific discourse as representative of a system of knowledge that has a crucial role in determining ways of thinking and perceiving old age. Our literature review is based on a study of academic articles, within the field of gerontology, about the everyday life of older people in Japan that were published in the 10-year period between 1999 and 2009. We apply a Foucauldian gerontology perspective as our analytical tool. The results of our study indicate that there is insufficient knowledge about the everyday life of older people in Japan in gerontological research. We identify a number of discursive practices applied in various research projects that present a one-sided story of old age in Japan. In the conclusion of this paper, we identify a need for interdisciplinary and qualitative studies of old age in Japan that would include voices of older people.

Productive engagement in older adults: a concept analysis

This study aimed to clarify the concept of productive engagement as it applies to older adults. The concept analysis was based on Walker and Avant's eight-step method. A literature review of articles published in English between 1990 and 2011 (n = 37) was conducted, using an electronic search of multiple sources. Results revealed that four defining attributes for productive engagement include continuing to work either paid or unpaid, caring for others, engaging in social activities, and growing spirituality. The antecedents of productive engagement are sociocultural factors as well as individual and institutional capacities. Meanwhile, the consequences are increased feelings of usefulness, improved health and well-being, aged successfully, and enhanced quality of life. Model, borderline, and contrary cases are presented to illustrate the concept's defining attributes. Defining the concept of productive engagement provides a basis for nurses and other health professionals to better understand productive engagement in older adults, thus effective strategic plans or programs for promoting productive roles among older adults can be further developed.

What does it feel like to be 100? Socio-emotional aspects of well-being in the stories of 16 Centenarians living in the United Kingdom

OBJECTIVES

The purpose of this article was to describe socio-emotional themes in the stories of 16 Centenarians living in the United Kingdom.

METHODOLOGY

Sixteen Centenarians were recruited and interviewed face-to-face by members of the research team. Participants were invited to tell the story of their lives in line with the principles of participatory action research (Koch and Kralik, 2006). The resultant story was returned to the Centenarian and their significant others for their validation and ownership. Stories were further analysed alongside verbatim interview transcripts. The first author wrote her psycho-social interpretation of the socio-emotional content in each person s life. These psycho-social interpretations were combined to provide commonalities in experience.

FINDINGS

These six common experiences or themes were: Engagement in the world, Happiness and describing a good life, Stoicism, Sources of support, Sources of frustration and Talking about death. All participants had strong interests. They reported their lives as having been 'good' or 'happy'. They were resilient in the face of stress. Their frustrations pertained to visual or mobility impairments. While they were accepting the death of spouses, siblings and significant others, they were silent about the proximity of their own. In this article, we consider these themes in the light of previous empirical findings and theories.

CONCLUSION

Centenarians indicated that life had been worth living and that it felt good to be 100 years of age. We explore the limitations of this study and discuss implications of the findings for those involved with the oldest old.

Progress in Infant Health in Okinawa, Japan

The infant mortality rate (IMR) and neonatal mortality rate (NMR) defined as the number of infant and newborn deaths per 1000 live births, respectively, are widely accepted as population indicators of the level of perinatal and postnatal health. Since the end of World War II, Japan has made substantial progress in reducing its IMR and NMR. This resulted from improving living standards and the provision of universal maternal and child health care (MCH) services. Okinawa, the island prefecture that is the furthest from mainland Japan, had the third highest IMR and the highest low-birth-weight rate (LBW) among all prefectures when its statistics were integrated into Japan in 1973. Even though the LBW rate in Okinawa has remained higher than the all-Japan average, Okinawa has shown a considerable improvement in IMR and NMR. The aim is to review the trends in IMR, NMR, and LBW in Japan and Okinawa and to discuss sociodemographic trends, economics, and the provision of health care services. The IMR and NMR in Okinawa decreased during that time from 14.8 to 2.4 and from 7.5 to 0.8, respectively. The LBW rate decreased until the mid-1980s, but since then it has increased to 11.5 (Okinawa) and 9.6 (Japan) in 2009. Okinawa’s public health and primary health care model for infants has been very successful and may be applicable to child health in island nations of the Asia-Pacific region.

Are men aging as oaks and women as reeds? A behavioral hypothesis to explain the gender paradox of French centenarians

Since the 1990s, several studies involving French centenarians have shown a gender paradox in old age. Even if women are more numerous in old age and live longer than men, men are in better physical and cognitive health, are higher functioning, and have superior vision. If better health should lead to a longer life, why are men not living longer than women? This paper proposes a hypothesis based on the differences in the generational habitus between men and women who were born at the beginning of the 20th century. The concept of generational habitus combines the generation theory of Mannheim with the habitus concept of Bourdieu based on the observation that there exists a way of being, thinking, and doing for each generation. We hypothesized that this habitus still influences many gender-linked behaviours in old age. Men, as "oaks," seem able to delay the afflictions of old age until a breaking point, while women, as "reeds," seem able to survive despite an accumulation of health deficits.

Connectedness in Community-Dwelling Older Adults

The purpose of this study was to examine the processes involved with connectedness in community-dwelling older adults, which the authors contend is quality of life from a generative perspective. Using a grounded theory approach, 12 older adults were interviewed using a semistructured interview guide. The tape-recorded interviews were transcribed verbatim, categories were created to code the data, and themes were extracted. Four processes involved with connectedness in older adults were identified: (a) having something to do, (b) having relationships, (c) having a stake in the future, and (d) having a sense of continuity. Various aspects of spirituality were also apparent in each of the four processes. This study suggests that connectedness provides older adults with a mechanism to engage life in meaningful, positive, and purposeful ways.

Social support networks and maternal mental health and well-being

The link between social networks and mental health has increasingly been recognized by public health as an important topic of interest. In this paper, we explore this association among a specific group: mothers. Specifically, we discuss how maternal mental health can be understood in the context of social networks, the influence of specific social relationships, and how the type and quality of support can mediate maternal mental health outcomes. We review interventions that foster social networks to address maternal mental health as well as other related health outcomes. Findings suggest that interventions that combine multiple treatment approaches may be more effective in addressing mental health. Also, traditional measures of social networks may not be appropriate for vulnerable populations, with qualitative, rather than quantitative, indicators of social networks being more predictive of maternal health and well-being. The implications of these findings and future research directions are discussed.