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Klöppel S, Brill E, Frisoni GB, Aarsland D, Klusmann-Weißkopf V. Value-based motivational strategies combined with technology to encourage a lifestyle that helps to prevent dementia. THE LANCET. HEALTHY LONGEVITY 2024; 5:e443-e446. [PMID: 38824958 DOI: 10.1016/s2666-7568(24)00069-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 06/04/2024] Open
Abstract
Lifestyles aimed at reducing dementia risk typically combine physical and cognitive training, nutritional adaptations, and, potentially, an augmentation in social interactions. Interventions at the population level are essential but should be complemented by individual efforts. For efficacy, lasting changes to an individual's lifestyle are needed, necessitating robust motivation and volition. Acting in accordance with one's values is assumed to be rewarding, leading to improved motivation and volition, and produces stable behaviour-outcome relationships. To this end, future preventive endeavours might first evaluate an individual's extant lifestyle, preferences, and values, including considerations of age-related changes to ensure these values remain a motivational source. Digital technology can support lifestyle goals and be targeted to support an individual's values. A digital platform could implement situation-specific, sensing-based feedback to alert users to a target situation (eg, opportunity for exercise) coupled with (smartphone-based) feedback on the extent of accomplished behavioural change to support individually set goals and facilitate their adjustment depending on whether these goals are achieved. This use of the motivational impetus of values, coupled with interpersonal techniques, such as motivational interviewing and SMART goal setting, in combination with sensor technology and just-in-time adaptive interventions, is assumed to hold high potential for dementia prevention.
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Affiliation(s)
- Stefan Klöppel
- University Psychiatric Services Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern Switzerland.
| | - Esther Brill
- University Psychiatric Services Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern Switzerland
| | - Giovanni B Frisoni
- Memory Center, University of Geneva and University Hospitals, Geneva, Switzerland
| | - Dag Aarsland
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Hennecke M, Fuths S. Levels of goal adjustment in late adulthood. Curr Opin Psychol 2024; 55:101730. [PMID: 38006625 DOI: 10.1016/j.copsyc.2023.101730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/27/2023]
Abstract
In this review, we argue that in late adulthood adults adjust their goals at three levels to cope with age-related challenges: At the highest level, they narrow their goal systems by selectively pursuing fewer goals from important life domains that are mutually supportive, by abandoning goals, and by focusing on agency protection. At the mid-level of individual goals, older adults show changes in goal content, goal importance, goal orientation, and goal focus, indicating, for example, a relative increase in intrinsic goals. Finally, but worthy of future investigation, older adults may show adjustments on the level of means and strategies for goal pursuit. Individual differences in such adaptations also contribute to differences in goal commitment, well-being, and psychopathology in late adulthood.
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Affiliation(s)
- Marie Hennecke
- Department of Psychology, Ruhr-Universität Bochum, Universitätsstr. 150, 44780 Bochum, Germany.
| | - Sabrina Fuths
- Department of Psychology, Ruhr-Universität Bochum, Universitätsstr. 150, 44780 Bochum, Germany.
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Sonnauer F, Frewer A. Trojan technology in the living room? Ethik Med 2023. [DOI: 10.1007/s00481-023-00756-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
Abstract
Definition of the problem
Assistive technologies, including “smart” instruments and artificial intelligence (AI), are increasingly arriving in older adults’ living spaces. Various research has explored risks (“surveillance technology”) and potentials (“independent living”) to people’s self-determination from technology itself and from the increasing complexity of sociotechnical interactions. However, the point at which self-determination of the individual is overridden by external influences has not yet been sufficiently studied. This article aims to shed light on this point of transition and its implications.
Arguments
The identification of this “tipping point” could contribute to analysis of familiar issues of conflict between the ethical principles of beneficence and respect for autonomy. When using technology in the living spaces of older adults, relationships, among other factors, may play a crucial role in older adult’s self-determination. We find the tipping point to occur subjectively and variably. To this end, the article combines theoretical ethical considerations with two examples from a qualitative study illustrating the perspective of older adults aged 65–85 years.
Conclusion
The study of the tipping point underscores the importance of perceiving an older person’s perspective. Particularly at the tipping point, this might be the only way to effectively identify whether the individual concerned perceives their self-determination as externally overridden. In conceptualizing the tipping point itself as well as its variability, we might create the basis for a normative call to shift the tipping point to promote self-determination and prevent overriding the will of older adults. We highlight individual, relational, and societal implications of our findings.
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Menassa M, Stronks K, Khatmi F, Roa Díaz ZM, Espinola OP, Gamba M, Itodo OA, Buttia C, Wehrli F, Minder B, Velarde MR, Franco OH. Concepts and definitions of healthy ageing: a systematic review and synthesis of theoretical models. EClinicalMedicine 2023; 56:101821. [PMID: 36684393 PMCID: PMC9852292 DOI: 10.1016/j.eclinm.2022.101821] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Healthy ageing (HA) has been defined using multiple approaches. We aim to produce a comprehensive overview and analysis of the theoretical models underpinning this concept and its associated normative terms and definitions. METHODS We conducted a systematic review of peer-reviewed HA models in Embase.com, Medline (Ovid), Cochrane CENTRAL, CINAHL, PsycINFO, and Web of Science until August 2022. Original theoretical papers, concept analyses, and reviews that proposed new models were included. Operational models/definitions, development psychology theories and mechanisms of ageing were excluded. We followed an iterative approach to extract the models' characteristics and thematically analyze them based on the approach of Walker and Avant. The protocol was registered in PROSPERO (CRD42021238796). FINDINGS Out of 10,741 records, we included 59 papers comprising 65 models/definitions, published in English (1960-2022) from 16 countries in Europe, Asia, and America. Human ageing was described using 12 normative terms, mainly (models (%)): successful (34 (52%)), healthy (eight (12%)), well (five (8%)), and active (four (6%)). We identified intrinsic/extrinsic factors interacting throughout the life course, adaptive processes as attributes, and outcomes describing ageing patterns across objective and subjective dimensions (number of models/definitions): cognitive (62), psychological (53), physical (49), social (49), environmental (19), spiritual (16), economic (13), cultural (eight), political (six), and demographic (four) dimensions. Three types of models emerged: health-state outcomes (three), adaptations across the life course (31), or a combination of both (31). Two additional sub-classifications emphasized person-environment congruence and health promotion. INTERPRETATION HA conceptualizations highlight its multidimensionality and complexity that renders a monistic model/definition challenging. It has become evident that life long person-environment interactions, adaptations, environments, and health promotion/empowerment are essential for HA. Our model classification provides a basis for harmonizing terms and dimensions that can guide research and comparisons of empirical findings, and inform social and health policies enabling HA for various populations and contexts. FUNDING MM, ZMRD, and OI are supported by the European Union's Horizon 2020 Marie Skłodowska-Curie grant No 801076, and MM is also supported by the Swiss National Foundation grant No 189235.
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Affiliation(s)
- Marilyne Menassa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Corresponding author. Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Farnaz Khatmi
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Community Medicine Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Zayne Milena Roa Díaz
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Octavio Pano Espinola
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Magda Gamba
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Oche Adam Itodo
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Chepkoech Buttia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Faina Wehrli
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Beatrice Minder
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Public Health and Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | - Minerva Rivas Velarde
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Public Health, Julius Center for Health Science and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands
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Klusmann V, Gow AJ, Robert P, Oettingen G. Using Theories of Behavior Change to Develop Interventions for Healthy Aging. J Gerontol B Psychol Sci Soc Sci 2021; 76:S191-S205. [PMID: 34515775 DOI: 10.1093/geronb/gbab111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Indexed: 12/28/2022] Open
Abstract
Healthy aging requires people to adopt and maintain beneficial behaviors in all stages of the life span. Supporting behavior change, including via the motivation to make and maintain those changes, is therefore important for the promotion of healthy aging. The aim of this overview is to introduce theoretical frameworks from the psychology of motivation that lend themselves to the development of effective interventions promoting behavior change conducive to healthy aging. We discuss theoretical frameworks referring to the determinants, properties, and functionality of goals aimed at behavior change, and consider the implications of the various theories for designing interventions to support healthy aging. We first consider theories that focus on beliefs and attitudes as determinants of goals, then we address theories that focus on the structure and content as important properties of goals, and, finally, we examine theories drawing on conscious and nonconscious processes underlying the functionality of these goals. We will present if-then planning and mental contrasting, as well as nudging and boosting, that is, novel strategies of behavior change that support the creation of scalable interventions for healthy aging across the life span. Against this background, new perspectives emerge for modern, state-of-the-art, and individually tailored interventions with the aim of enhancing older people's healthy living.
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Affiliation(s)
- Verena Klusmann
- Department of Psychology, University of Konstanz, Germany.,Department of Psychology and Human Movement Science, University of Hamburg, Germany
| | - Alan J Gow
- Centre for Applied Behavioural Sciences and Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, UK
| | - Philippe Robert
- CoBTEK Lab, IA Association, University Côté d'Azur, Nice, France
| | - Gabriele Oettingen
- Department of Psychology and Human Movement Science, University of Hamburg, Germany.,Department of Psychology, New York University, USA
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