A social health services model to promote active ageing in Mexico: design and evaluation of a pilot programme

Age-friendly initiatives: Mexico

While the implementation of these initiatives varies globally and continues to face low uptake in the global south, it is crucial to underscore key ongoing efforts, particularly in developing nations. This allows us to have knowledge about progress and identify areas that require more effective strategies to advance the cause of global healthy aging. The aim of this mini-review was to describe some of the key age-friendly initiatives made in Mexico through Governmental and Non-Governmental entities to promote healthy aging, at different levels of health and social institutions, covering the healthcare systems, community, and education.

Effectiveness of Theory-Based Physical Activity and Nutrition Interventions in Aging Latino Adults: A Scoping Review

In the United States (US), Latino individuals older than 50 years face health disparities compared to their White counterparts. Considering the rising life expectancy and the projected increase of older Latino adults in the US, this scoping review aimed to determine the effectiveness of theory-based and culturally relevant strategies that promote healthy aging in Latinos. Web of Science and PubMed databases were searched between December 2022 and February 2023 for peer-reviewed articles assessing healthy aging interventions tailored to community-dwelling aging Latino adults. We included nine studies describing the effects of seven interventions on physical activity- or nutrition-related outcomes. Although not always statistically significant, interventions had a beneficial impact on well-being indicators. The most commonly used behavioral theories were Social Cognitive Theory and Attribution Theory. Latino cultural elements in these studies included partnering with community organizations that serve Latinos (such as Catholic churches), delivery of in-person bilingual group sessions by trusted community members (such as promotoras or Latino dance instructors), and incorporating values such as family and religion into the health curriculum, among others. Future strategies that promote healthy aging in Latino adults should proactively culturally adapt the theoretical foundations and the design, recruitment, and implementation processes to ensure their relevance and effectiveness.

Essential factors and key features in designing active aging programs and their outcomes: A narrative review study

With an increase in the older adult population, many countries have designed programs to promote active aging. Thus, knowledge of the factors and features of these programs is necessary to design a comprehensive active aging program. This study aimed to review the active aging programs focusing on the extraction of essential factors, key features, and outcomes of these programs. This narrative review was carried out to examine the conducted active aging programs. Through systematic searches of databases within the time limit of 2002-2021, articles were identified and assessed against inclusion and exclusion criteria. Using the findings, three sections were developed: (1) essential factors in designing programs that consist of older adults' participation, health maintenance and, promotion, leisure time, and technology use; (2) key features of the program, include affordability, voluntary participation, intergenerational consideration, social networks and government support, lifelong learning and teaching, cross-sectoral and inter-professional collaboration, and an enabling-supportive environment; (3) the program outcomes, include increasing awareness and knowledge, activities and participation, quality of life, life satisfaction in various psychological dimensions of well-being, and physical, mental, cognitive, and behavioral health in older adults. Some gaps were identified. Consequently, future planners are recommended to address older adults' sexual health, community culture, and gender in addition to other key features and essential factors in designing active aging programs to promote older adults' health.

Instrument development and validation of the comprehensive ability of older people assessment scale

Aim

The study is aimed to develop and psychometrically test the Comprehensive Ability of Older People Assessment scale and classify the ability grades.

Design

A cross‐sectional design was used for instrument development.

Method

The Comprehensive Ability of Older People Assessment scale was developed by a sample of 971 older people from 4 long‐term care institutions in China. The data were collected between April 2018 and March 2020. One‐way analysis of variance and multiple regression analysis was used to screen scale items, while focus group interviews were used to integrate the subjective and objective items. Confirmative factor analysis and expert judgment were applied to explore construct validity. Reliability was explored through internal consistency estimation using Cronbach's alpha and homogeneity evaluation using corrected item‐total correlations. Cluster analysis and discriminant analysis were used to segment the comprehensive ability assessment scores and discriminant function was established to determine the boundary value of each segment, using correlation analysis to perform reverse verification.

Results

Factor analysis yielded 40 items with six dimensions, including “mentation and cognitive,” “perception and communication,” “emotional problems,” “mental and behavioural problems,” “daily life and social participation,” and “skin and oral status.” The Cronbach's α was 0.951, while the dimensions showed Cronbach's α values ranging from 0.760–0.946. The rationality and scientificity of this scale were proved by the correlation analysis of reverse validation.

Conclusion

The 4‐grade Comprehensive Ability of Older People Assessment scale is proved to be with good validity and reliability and should be considered for institutional assessors.

Impact

Assessors can accurately evaluate older people's health status and nursing needs through this scale in long‐term care institutions, communities and hospitals, so as to provide accurate and high‐quality nursing services. It will become a scientific basis for the government to offer accurate pension subsidies, purchase pension services scientifically for older people and establish third‐party objective evaluation and supervision.

Double-task exercise programmes to strengthen cognitive and vascular health in older adults at risk of cognitive decline: protocol for a randomised clinical trial

INTRODUCTION

Cognitive and physical declines are frequent causes of disability among older adults (OAs) in Mexico that imposes significant burden on the health system and OAs' families. Programmes to prevent or delay OAs' cognitive and physical decline are scarce.

METHODS AND ANALYSIS

A double-blind randomised clinical trial will be conducted. The study will aim to evaluate two 24-week double-task (aerobic and cognitive) square-stepping exercise programmes for OAs at risk of cognitive decline-one programme with and another without caregiver participation-and to compare these with an aerobic-balance-stretching exercise programme (control group). 300 OAs (100 per group) affiliated with the Mexican Institute of Social Security (IMSS) between 60 and 65 years of age with self-reported cognitive concerns will participate. They will be stratified by education level and randomly allocated to the groups. The intervention will last 24 weeks, and the effect of each programme will be evaluated 12, 24 and 52 weeks after the intervention. Participants' demographic and clinical characteristics will be collected at baseline. The outcomes will include: (1) general cognitive function; (2) specific cognitive functions; (3) dual-task gait; (4) blood pressure; (5) carotid intima-media thickness; (6) OAs' health-related quality of life; and (7) caregiver burden. The effects of the interventions on each outcome variable will be examined using a repeated-measures analysis of variance (ANOVA), with study groups as the between-subjects variable and time as the within-subject variable.

ETHICS AND DISSEMINATION

The study was approved by the IMSS Ethics and Research Committees (registration number: 2018-785-095). All participants will sign a consent form prior to their participation. The study results will be disseminated to the IMSS authorities, healthcare providers and the research community.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov (NCT04068376).

Identifying contemporary early retirement factors and strategies to encourage and enable longer working lives: A scoping review

AIM

Accelerating population ageing is raising concern in many countries now in relation to the availability of workers for essential work roles and responsibilities. A scoping research literature review was done to identify factors currently associated with early retirement and contemporary strategies to encourage and support longer working lives.

METHODS

Using the PRISMA-ScR Checklist, we searched the Directory of Open Access Journals and EBSCO Discovery Service for published 2013-2018 research articles using the keyword/MeSH term "early retirement"; 54 English-language articles in peer-review journals were reviewed.

RESULTS

Seven early retirement factors were revealed: Ill health, good health, workplace issues, the work itself, ageism, social norms and having achieved personal financial or pension requirement criteria. Six suggested solutions, none proven effective, were identified: Occupational health programmes, workplace enhancements, work adjustments, addressing ageism, changing social norms and pension changes.

CONCLUSIONS

The evidence base on early retirement prevention is not strong, with qualitative investigations needed for in-depth understandings of early retirement influences and mixed-methods studies needed to test early retirement prevention solutions for their effects.

IMPLICATIONS FOR PRACTICE

Until more evidence is available, every organisation should perform an early retirement risk assessment and identify current versus needed policies and programmes to encourage and enable more middle-aged and older people to work longer.

Community Gerontology Model for Healthy Aging Developed in Mexico Framed in Resilience and Generativity

BACKGROUND

The aims of this paper are to present the evolutionary development of the Community Model of Healthy Aging (CMHA) and to show the main results of the community gerontology studies framed in each of the stages of the CMHA.

METHOD

The study employs a qualitative community-based participatory research approach. We also measured several biochemical parameters, social support networks, and indicators of physical and cognitive functioning.

RESULTS

We identified three stages in the development of the CMHA. The first stage was informative (CMHA-I, 1994-2000) with more than 70% of the older adults participating in self-care programs for health. The second stage was formative (CMHA-F, 2001-2015) with more than 80% of older adults participating in self-care, mutual aid, and self-management programs. The third stage was emancipatory (CMHA-E, 2016-2018). In this last stage, we added resilience and generativity as basic elements to strengthen and enhance human capacities during aging, and more than 90% of older adults made optimal use of social support networks as a key strategy.

CONCLUSION

Our findings suggest that the addition of resilience and generativity in the CMHA contributed to the active participation of older adults in the maintenance of functioning and the prevention and control of diseases linked to aging.

Influence of the Self-Perception of Old Age on the Effect of a Healthy Aging Program

It has been shown that health programs are useful for the prevention and control of chronic diseases in community-dwelling older people; however, a negative self-perception of old age could have an effect on the results. Therefore, our aim was to evaluate the effect of a healthy aging program linked to self-perception of old age in Mexican community-dwelling older people. A pre-test/post-test single-group design study was conducted in a convenience sample of 64 older people who undertook the entire healthy aging program workshop (five months’ duration). We measured self-perception of old age, efficacy of self-care, blood glucose concentration, anthropometric measures, and blood pressure before and after the workshop. A statistically significant decrease in blood glucose concentration was observed (baseline 136 ± 50 vs. post-intervention, 124 ± 45 ± 29 mg/dL, p < 0.01), LDL (baseline 153 ± 47 vs. post-intervention, 130 ± 36 mg/dL, p < 0.01), systolic blood pressure (130 ± 20 vs. 119 ± 11 mm/Hg, p < 0.001), and diastolic blood pressure (75 ± 9 vs. 72 ± 7 mm/Hg, p < 0.05) after community intervention. However, when we analyzed the data regarding self-perception, we found that this difference was only maintained in the subgroup of older adults with a positive self-perception of old age. Our findings suggest that the self-perception of old age influences the effect of healthy aging programs on the health of community-dwelling older people.

Comprehensive Gerontological Development: A Positive View on Aging

Human aging can only be understood within its social and historical contexts. It is largely determined by the complex interrelation of biological, cultural, social, political, and economic factors. Furthermore, the phenomenon of population aging can be considered as a social and economic burden or as an invaluable social asset if understood within the perspective of the enormous potential of our aging populations. This article is based on the tenet that aging can be an enriching and productive stage marked by a lifelong process of personal growth and development. That is, in our perspective, ageing should become a process oriented toward the improvement and promotion of the individual’s physical, psychological, and social potentialities to achieve the highest quality of life. The purpose of this article is to introduce the concept and practice of Comprehensive Gerontological Development that underlie current research at the Gerontological Research Unit of the Zaragoza Campus of the National Autonomous University of Mexico.