Editorial: Geriatrics in the 21st Century

Health-promoting behaviors in older adulthood and intrinsic capacity 10 years later: the HUNT study

BACKGROUND

With the global population growing older, there is a need for more knowledge of how to improve and/or maintain functional capacities to promote healthy ageing. In this study we aimed to assess the effect of several known health-promoting behaviors in old age with intrinsic capacity ten years later.

METHODS

This was a prospective cohort study looking at participants that were ≥ 65 years at the time of the third wave of the Trøndelag Health Study (HUNT3, 2006-2008) who also took part in the 70 + sub-study of the fourth wave (HUNT4 70+, 2017-2019). Self-reported behavior data from short questionnaires, including diet and physical activity, were collected in HUNT3, and data on the five domains of intrinsic capacity defined by the World Health Organization were collected in HUNT4 70+. A composite index was created for both healthy life and intrinsic capacity, awarding points for how well participants adhered to guidelines for healthy living and their level of functional impairment, respectively. Ordinal logistic regression was used to assess the relationship between health-promoting behaviors and intrinsic capacity.

RESULTS

Of 12,361 participants in HUNT3 ≥ 65 years, 4699 (56.5% women) also participated in HUNT4 70+. On the health-promoting behaviors, lowest adherence to healthy living guidelines were seen for fruit and vegetables intake (47.2%), milk intake (46.7%) and physical activity (31.1%). On intrinsic capacity domains, highest impairment was seen in the domains of locomotion (29.7%), hearing (11.1%) and vitality (8.3%). A higher adherence to guidelines for healthy living was associated with higher intrinsic capacity 10 years later. A one-point increase in the healthy life index was associated with a 1.15 (95% confidence interval 1.10-1.21) times increased odds of being in a higher intrinsic capacity category.

CONCLUSION

Health-promoting behaviors in old age are associated with better intrinsic capacity ten years later. In clinical settings assessment of health-promoting behaviors could potentially be done using short questionnaires.

Cross-cultural adaptation of the PEAK 2.0 instrument for the measurement of satisfaction and quality of care for institutionalized older adults

OBJECTIVE: To perform the Brazilian Portuguese cross-cultural adaptation of scales of satisfaction, quality of care, and quality of service constructed by the Promoting Excellent Alternatives in Kansas (PEAK 2.0) program for the measurement of person-centered care practices in the context of institutionalized older persons. METHODS: Cross-cultural adaptation was performed according to the following steps: translation; back translation; semantic, idiomatic, experiential, and conceptual equivalence; validation by an expert panel; and pre-test. This is an instrument with 32 individual items grouped into 4 subscales: overall satisfaction, quality of life, quality of care, and quality of service. RESULTS: The highest disagreement between experts was observed regarding verb conjugation and/or agreement aspects, which were adjusted. The pre-test, performed with 10 residents of long-term care facilities for older adults, showed that the “quality of life” and “quality of care” items had low levels of satisfaction. Although the residents demonstrated increased concern with the objective aspects of care, such as security and cleanliness, subjective aspects such as spirituality showed the lowest satisfaction levels. CONCLUSION: After cross-cultural adaptation, the overall satisfaction, quality of life, quality of care, and quality of service instruments of the PEAK 2.0 program were well understood by older adults and interviewers. The pre-test assessment showed that these instruments have a quick and easy application and can be used in Brazilian institutions.