Sociodemographic Factors Associated With Changes in Successful Aging in Spain: A Follow-Up Study

Determinants and indicators of successful aging as a multidimensional outcome: a systematic review of longitudinal studies

Background

Successful aging (SA) has been coined as a term to describe the multidimensional aspects associated with achieving optimal combination of physical and mental health along with social well-being health, mental and social well-being at older age. In recent years there has been an increased interest in understanding the role of determinants of SA, such as demographic, biological, behavioral, psychological and social factors. To synthesize the recent evidence, we conducted a systematic review of longitudinal studies on a range of determinants and indicators of SA defined as a multidimensional outcome.

Methods

A systematic search of PubMed, MEDLINE and Web of Science for finding eligible papers published between August 2016 and June 2023 was conducted following the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines. The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews (Registration number: CRD42021250200). The web-based automated screening tool-Rayyan-was used for title and abstract screening. The study quality was assessed using the Quality in Prognosis Studies (QUIPS) tool.

Results

A total of 3,191 records were initially identified using the predefined search strategy. Out of 289 articles selected for full text screening, 22 were found eligible and included in the review. A variety of factors have been explored in relation to SA, ranging from socio-demographic factors, nutrition, lifestyle, biological pathways, psychological health, and well-being. Overall, the results of recent studies have confirmed the role of metabolic health, adherence to healthy dietary patterns, such as the Mediterranean diet, physical activity, non-smoking, and higher socio-economic status as main factors associated with higher odds for SA. Emerging research highlights the role of psycho-social factors and early life health as determinants of SA.

Conclusion

In summary, this review highlights the importance of healthy living and monitoring metabolic risk along with sustaining psychological well-being in adult life as major determinants of SA. Further methodological and research work on SA would pave the way toward development of adequate health promotion policies in aging societies.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021250200, CRD42021250200.

Socioeconomic position and healthy ageing: A systematic review of cross-sectional and longitudinal studies

BACKGROUND

The association between socioeconomic position (SEP) and health is well-established. However, the association between SEP and healthy ageing as a multidimensional construct is unclear.

METHODS

We conducted a systematic review of peer-reviewed cross-sectional and longitudinal studies on the associations between SEP and multidimensional healthy ageing measures. Studies were identified from a systematic search across major electronic databases from inception to February 2021.

RESULTS

Fourthy-five articles met inclusion criteria (26 cross-sectional and 19 longitudinal studies). There was no consistency in method of operationalizing healthy ageing across studies, domains included in the healthy ageing measures, or in the definition and number of levels of SEP indicators. Overall, regardless of heterogeneity between studies, a positive association between educational level (85.0 % of studies) and income/wealth (81.4 % of studies) and healthy ageing was evident. Regarding occupational position, evidence from 11 studies was inconclusive. The number of studies including home ownership, parenteral SEP, or composite SEP scores was insufficient to be able to draw a conclusion.

CONCLUSIONS

There is evidence that socioeconomic inequalities, as assessed by educational level and income/wealth, are associated with healthy ageing. These findings, and the broader evidence base on SEP and healthy ageing, highlight the importance of addressing inequality through integrated health and social policies and strategies.

Association between successful aging transitions and depressive symptoms among older Korean adults: findings from the Korean longitudinal study of aging (2006-2018)

Background

The importance of SA (Successful aging) has been emphasized in recent years, with focus shifting towards attaining healthier aging rather than longevity. However, the influence of SA and its changes on mental health such as depression remains a relatively unexplored area in gerontology. Therefore, we investigated the longitudinal association between changes in SA and depressive symptoms in Korean older adults.

Methods

This study comprised a longitudinal sample of older adults aged ≥ 45 years, drawn from the Korean Longitudinal Study of Aging (2006–2018). Changes in SA status was determined using the Rowe and Kahn model over two consecutive years. Using an adjusted generalized estimating equation model, we examined the association between changes in successful aging status, namely SA and NSA (Non-successful aging), and depressive symptoms.

Results

Compared to the SA→SA group, depressive symptom risk in the NSA→NSA and SA→NSA groups were higher in men [(OR, 1.16; 95 % CI, 1.13–1.18), (OR, 1.11; 95 % CI, 1.08–1.13), respectively] and in women [(OR, 1.15; 95 % CI, 1.13–1.18), (OR, 1.11; 95 % CI, 1.09–1.14), respectively]. Subgroup analysis of the dimensions of successful aging revealed that low or worsening criteria of successful aging status in men and women were associated with depressive symptoms.

Conclusions

Korean older adults who continuously failed to attain or maintain successful aging status had the highest risk of depressive symptoms. These results could further assist in establishing policies and interventions that promote successful aging and subsequently protect the mental health of the Korean older adult population.

Finding the Silver Lining: Aging Well Amongst Older Brazilian Women in the Post-Migration Context

STUDY BACKGROUND

The aging population in Canada has been increasing steadily over the past 40 years, however, there is limited information about the meaning of aging well amongst older Brazilian women in Canada.

METHODS

A Heideggerian interpretive phenomenology study was conducted to understand the meaning of aging well amongst older Brazilian women in the post-migration context living in the Greater Toronto Area (GTA) in Ontario, Canada.

RESULTS

Eight older Brazilian women residing in the GTA were recruited through purposive and snowball sampling and participated in individual face-to-face interviews. Through data analysis and the incorporation of Heidegger's four existentials of human existence, the themes that emerged were (a) Embracing being part of a mosaic, (b) Aging with grace, (c) Chasing your dreams and (d) Being a bridge and not a fence. The overarching theme was: Finding the silver lining: Aging well.

CONCLUSION

This study informs nursing practice, research and policy development to advance the health of older immigrant adults in Canada.

Ageing trajectories of health-longitudinal opportunities and synergies (ATHLOS) Healthy Ageing Scale in adults from 16 international cohorts representing 38 countries worldwide

BACKGROUND

Uniform international measurement tools for assessing healthy ageing are currently lacking.

OBJECTIVES

The study assessed the novel comprehensive global Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) Healthy Ageing Scale, using an Item Response Theory approach, for evaluating healthy ageing across populations.

DESIGN

Pooled analysis of 16 international longitudinal studies.

SETTING

38 countries in five continents.

SUBJECTS

International cohort (n=355 314), including 44.4% (n=153 597) males, aged (mean±SD) 61.7±11.5 years old.

METHODS

The ATHLOS Healthy Ageing Scale (including 41 items related to intrinsic capacity and functional ability) was evaluated in a pooled international cohort (n=355 314 from 16 studies) according to gender, country of residence and age group. It was also assessed in a subset of eight cohorts with ≥3 waves of follow-up assessment. The independent samples t-test and Mann-Whitney test were applied for comparing normally and skewed continuous variables between groups, respectively.

RESULTS

The ATHLOS Scale (range: 12.49-68.84) had a mean (±SD) value of 50.2±10.0, with males and individuals >65 years old exhibiting higher and lower mean scores, respectively. Highest mean scores were detected in Switzerland, Japan and Denmark, while lowest in Ghana, India and Russia. When the ATHLOS Scale was evaluated in a subset of cohorts with ≥3 study waves, mean scores were significantly higher than those of the baseline cohort (mean scores in ≥3 study waves vs baseline: 51.6±9.4 vs 50.2±10.0; p<0.01).

CONCLUSIONS

The ATHLOS Healthy Ageing Scale may be adequately applied for assessing healthy ageing across populations.

Adherence to the Mediterranean diet and healthy ageing: Current evidence, biological pathways, and future directions

With an ever-ageing population in developed countries, healthy ageing is an emerging public health priority for securing citizens' quality of life and minimizing healthcare associated costs. While adherence to the Mediterranean diet is associated with numerous health benefits and deterrence of age-related disorders, a comprehensive review of the current evidence to guide further public health interventions is lacking. This study systematically assessed, according to PRISMA guidelines, current evidence arising from observational studies regarding the potential impact of adherence to the Mediterranean diet on healthy ageing among elder adults. Of 509 initially retrieved unique items, 9 studies (including 2 cross-sectional and 7 prospective cohort studies) were reviewed. The reviewed evidence support that adherence to the Mediterranean diet during midlife was associated with 36%-46% greater likelihood of healthy ageing. Among the elderly, adherence to the Mediterranean diet was significantly associated with healthy ageing, while diets similar to that of the Mediterranean diet were associated with 269% greater likelihood of successful ageing and 33% reduction in mortality risk. Therefore, public health interventions aimed at promoting adherence to the Mediterranean diet, particularly among the elderly, may propagate healthy ageing and diminish the healthcare associated costs associated with age-related morbidity and mortality.

Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA)

BACKGROUND

Social network, loneliness, generalized anxiety disorder (GAD) and major depression disorder (MDD) are interrelated. However, as the directions of these associations are still unclear, we examined them prospectively using community-based data.

METHODS

Data on 5066 adults aged ≥50 years from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Loneliness was assessed through the UCLA loneliness scale. Social integration was measured using the Berkman-Syme Social Network Index. MDD and GAD were assessed with the Composite International Diagnostic Interview (CIDI). Logistic regression models were conducted.

RESULTS

The longitudinal association between experiencing loneliness and higher likelihood of suffering from MDD or GAD two years later is bidirectional but stronger with loneliness as origin, whereas the association between social isolation and higher likelihood of subsequent MDD or GAD as well as those between loneliness and subsequent deterioration of social integration are unidirectional.

CONCLUSION

Objective and perceived social isolation independently affect the probability of suffering from MDD or GAD whereas loneliness is a risk factor for the deterioration of social life, which highlights the need to address the subjective factors (such as loneliness) and objective factors (such as social network size) of social isolation in a complementary way in order to improve the mental health of the older adult population.

Decomposition of Mediterranean Dietary Pattern on Successful Aging, Among Older Adults: A Combined Analysis of Two Epidemiological Studies

Objective: To investigate the association of Mediterranean food group consumption with successful aging (SA), among people more than 50 years old. Method: Dietary habits, as well as several bio-clinical characteristics of the Greek participants enrolled in the ATTICA (n = 1,128 men and women from Athens metropolitan area) and the MEDIS (n = 2,221 men and women from selected Greek islands) cohort studies were investigated in relation to SA; SA was measured using a validated 10-scale index. Results: Multivariate discriminant food group analysis revealed that legumes consumption, followed by vegetables, cereals, and poultry were associated with higher levels of SA index (explained variability: 7.9%), mainly among islanders, but not among mainland participants. Further analysis revealed that alcohol consumption was positively associated with SA for mainlanders (ATTICA study) but inversely for islanders (MEDIS study; all p's < .05). Conclusion: The differential and hierarchical effect of various foods on SA and the diet-environmental interaction revealed in the present work may help health professionals to better understand the role of diet on SA, and to prioritize the nutritional needs of older people for better quality of life.

The impact of socioeconomic status on the association between biomedical and psychosocial well-being and all-cause mortality in older Spanish adults

PURPOSE

The aim of this paper was to analyze the effect of biomedical and psychosocial well-being, based on distinct successful aging models (SA), on time to mortality, and determine whether this effect was modified by socioeconomic status (SES) in a nationally representative sample of older Spanish adults.

METHODS

Data were taken from a 3-year follow-up study with 2783 participants aged 50 or over. Vital status was ascertained using national registers or asking participants' relatives. Kaplan-Meier curves were used to estimate the time to death by SES, and levels of biomedical and psychosocial SA. Cox proportional hazard regression models were conducted to explore interactions between SES and SA models while adjusting for gender, age, and marital status.

RESULTS

Lower levels of SES and biomedical and psychosocial SA were associated with low probability of survival. Only the interaction between SES and biomedical SA was significant. Biomedical SA impacted on mortality rates among individuals with low SES but not on those with medium or high SES, whereas psychosocial SA affected mortality regardless of SES.

CONCLUSIONS

Promoting equal access to health care system and improved psychosocial well-being could be a protective factor against premature mortality in older Spanish adults with low SES.