A multilevel model of life satisfaction among old people: individual characteristics and neighborhood physical disorder

Physical and social neighborhood disorder in Latin American cities: a scoping review

Neighborhood disorder is an important aspect that may influence the health of residents in urban areas. The aims of this study were to map and systematize methods for measuring physical and social neighborhood disorder in studies conducted in Latin American cities. By means of a scoping review, articles published from 2000 in English, Spanish, and Portuguese with the following descriptors were mapped: neighborhood, physical disorder, and social disorder. Searches were conducted in MEDLINE (PubMed), LILACS (Virtual Health Library), Scopus, Web of Science, and Cochrane Library. Information on authorship, year, study type, locality, data source, target population, outcome, dominion, indicator, method, geographic unit, and unit of analysis was extracted. Variables from the disorder-related studies were extracted and grouped by similarity of content and themes. A total of 22 articles were identified, all published between 2012 and 2022, the majority in Brazil (n = 16). The perception of the individual was the most used method. The most frequent theme addressed in the physical disorder dominion was public streets (n = 20) and security (n = 15), in the social disorder dominion. A lack of consensus in the literature regarding variables used to measure physical and social neighborhood disorder in Latin American cities was detected. In addition to the need for standardization of the theme, studies to verify the sustainability of proposed measurement methods relevant to dynamically classify and compare urban neighborhoods and health impacts based on levels of exposure to physical and social disorder, are recommended.

The Associations between Physical Activity, Functional Fitness, and Life Satisfaction among Community-Dwelling Older Adults

Previous studies showed physical activity had benefits for older adults’ life satisfaction, but the mechanism was unclear. This study aimed to investigate whether older adults with more physical activity had better functional fitness and life satisfaction, and whether functional fitness mediated the relationship between physical activity and life satisfaction. A cross-sectional study design was employed, and 623 older adults (73.71 ± 5.91 years) were recruited. Physical activity, functional fitness, life satisfaction, and demographic characteristics were collected. Compared with older adults with low physical activity, those with high (B = 0.41, p = 0.025) and moderate (B = 0.40, p = 0.041) physical activity had better life satisfaction; those with high physical activity had better lower limb muscle strength (B = 1.71, p = 0.001), upper (B = 2.91, p = 0.032) and lower (B = 3.12, p = 0.006) limb flexibility, cardiorespiratory endurance (B = 6.65, p = 0.008), and dynamic balance ability (B = −1.12, p < 0.001). Functional fitness did not mediate the relationship between physical activity and life satisfaction. Promoting physical activity may be useful for increasing older adults’ functional fitness and life satisfaction, but the effects on functional fitness only occurred at a high level of physical activity, and the effect of physical activity on life satisfaction was not mediated by functional fitness.

Perceived neighborhood and fall history among community-dwelling older adults living in a large Brazilian urban area: a multilevel approach

Few studies have examined the neighborhood features related to falls in the older population in low-and-middle-income countries, including Brazil. This study aimed to evaluate if perceived neighborhood features are related to falls among older Brazilian adults living in a large urban area. This cross-sectional study was conducted using data from 834 participants (≥60 years) from a multistage household survey in Belo Horizonte, Brazil. The association between fall history in the previous year and perceived neighborhood features (quality of services, physical and social disorder, and safety) was examined using multilevel logistic regression. The fall prevalence was 13.6%. Older adults living in neighborhoods with a higher physical disorder were more likely to report fall in the previous year, even after controlling for demographic, clinical and social variables (OR = 2.59; 95% CI = 1.14-5.87). The other neighborhood features investigated were not associated with a fall history. Our findings suggest that improving the physical environment represents an important strategy to prevent falls in the Brazilian urban older population.

Comparative Study of the Effects of Tai Chi and Square Dance on Immune Function, Physical Health, and Life Satisfaction in Urban Empty-Nest Older Adults

Objective: To compare the effects of Tai Chi and Square dance on immune function, physical health, and life satisfaction in urban, empty-nest older adults.

Methods: This cross-sectional study included 249 older adults (60–69 years) who were categorized into Tai Chi (n = 81), Square dance (n = 90), and control groups (n = 78). We evaluated immunoglobulin G (IgG) and interleukin-2 (IL-2) levels by enzyme-linked immunosorbent assay (ELISA), natural killer (NK) cell cytotoxicity by MTT assay, physical health indices by physical fitness levels, and life satisfaction by Life Satisfaction Index A (LSIA) scores.

Results: Immune function, physical health, and life satisfaction in older adults in the Tai Chi and Square dance groups were significantly better than those in the control group (P < 0.05). Regarding immune function and physical health, the Tai Chi group exhibited significantly higher levels of IgG (15.41 ± 0.26 g/L vs. 11.99 ± 0.35 g/L, P < 0.05), IL-2 (4.60 ± 0.20 ng/mL vs. 4.45 ± 0.21 ng/mL, P < 0.05), and NK cell cytotoxicity (0.28 ± 0.02 vs. 0.22 ± 0.02, P < 0.05) than the square dance group, significantly lower waist-to-hip ratio (0.87 ± 0.02 vs. 0.89 ± 0.02, P < 0.05), resting pulse (78.4 ± 4.6 beats/min vs. 81.0 ± 3.1 beats/min, P < 0.05), systolic blood pressure (132.0 ± 5.2 mmHg vs. 136.2 ± 3.2 mmHg, P < 0.05), diastolic blood pressure (80.0 ± 2.6 mmHg vs. 83.0 ± 2.7 mmHg, P < 0.05), and significantly higher vital capacity (2978.0 ± 263.0 mL vs. 2628.3 ± 262.8 mL, P < 0.05) and duration of one-leg standing with eyes closed (16.2 ± 1.9 s vs. 12.0 ± 1.7 s). However, there was no significant difference in LSIA scores between the Tai Chi and Square dance groups (12.05 ± 1.96 vs. 13.07 ± 1.51, P > 0.05). Further, there was a significant correlation between LSIA scores and immune function (r = 0.50, P = 0.00) and physical health (r = 0.64, P = 0.00).

Conclusion: (1) Both Tai Chi and square dance practitioners had better health outcomes, compared with sedentary individuals; (2) Tai Chi practitioners had better physical health and immune function than Square dance practitioners. (3) Tai Chi and Square dance exercises had similar effects on life satisfaction among urban empty-nest older adults.

Suggestions: For urban empty-nest older adults who want to have better physical health and immune function, long-term Tai Chi exercise may be a better choice; however, those who are concerned about life satisfaction can choose either Tai Chi or Square dance exercise.

Association of Regular Leisure-Time Physical Activity with Happiness among Middle-Aged and Older Adults in Taiwan

The aim of the present study was to clarify the relationship between regular LTPA (i.e., 150-300 min of moderate-intensity or 75-150 min of high-intensity physical activity) and happiness among middle-aged and older adults in Taiwan. The cross-sectional study data were obtained from the Taiwan National Physical Activity Survey, a nationally representative survey of the Taiwanese population. A total of 12,687 middle-aged and older adults (45-108 years) were ultimately enrolled in this study. The questionnaire data obtained through this national telephone survey included sociodemographic characteristics, self-reported health status, self-evaluations (comprising height, body weight, and happiness), and zip code of residence. The results suggest a significant positive relationship between regular LTPA and happiness scores; that is, the middle-aged adults who engaged in more LTPA may report higher happiness occurrence than others. This study suggests that regular LTPA is an essential factor influencing happiness. LTPA is an essential form of physical activity that helps middle-aged and older people to relax.

Acculturation and Subsequent Oral Health Problems Among Foreign-Born Older Chinese Americans: Does Neighborhood Disorder Matter?

OBJECTIVES

To investigate the relationship between acculturation and subsequent oral health problems in older Chinese Americans and to further test the moderating role of neighborhood disorder in such a relationship.

METHODS

The working sample included 2,706 foreign-born community-dwelling older Chinese Americans aged 60 years or older who participated in the Population Study of Chinese Elderly in Chicago at baseline between 2011 and 2013 and the 2-year follow-up between 2013 and 2015. Stepwise Poisson regressions with lagged dependent variable were conducted.

RESULTS

Behavioral acculturation was protective against subsequent oral health problems, and the protective role was stronger among individuals reporting lower levels of neighborhood disorder. Residence in Chinatown was associated with an increase in the risk of subsequent oral health problems.

DISCUSSION

To reduce oral health symptoms and related burdens, it is important to consider, in practice and policy, the role of acculturation and the neighborhood on subsequent oral health outcomes.

Factors Associated With Positive Self-Rated Health: Comparing Older Adults in Brazil and in Portugal

Introduction: Self-rated health is a multidimensional health indicator and a predictor of adverse events in old age. Answers to this assessment are influenced by social, cultural and personality factors. Aim: Exploring common and distinctive characteristics of Brazilian and Portuguese older adults aged 70 and over regarding positive self-rated health according to sociodemographic variables, to functional capacity, to independent performance of basic activities of daily living and to neuroticism, as well as analyzing associations between positive self-rated health and these variables. Methods: The present paper is a comparative and cross-sectional study based on secondary data contained in the databases of the FIBRA (Frailty in Brazilian Older Adults) follow-up study, with 418 Brazilian older adults, and of the DIA (From Disability to Activity: The Challenge of Aging) study, with 380 Portuguese older adults. Both samples had higher percentages of women: 68.4% for Portugal and 69.9% for Brazil. The Brazilian sample had a higher average age (80.31 ± 4.67) than the Portuguese sample (76.80 ± 5.28). Results: The Portuguese older adults had better overall cognition scores, higher handgrip strength and higher neuroticism values than the Brazilian older adults. In the simple and multiple logistic regression analyses, it was found that among Brazilian older adults, subjects with higher scores in the MMSE (OR 1.16; 95% CI 1.08-1.24), regardless of ADL performance (OR 2.13; 95% CI 1.31-3.47) and with scores 24-29 (OR 1.92; 95% CI 1.07-3.43) or 11-23 (OR 2.09; 95% CI 1.15-3.79) in neuroticism were more likely to assess their health as very good/good. On the other hand, the Portuguese older adults with intermediate 24-9 (OR 2.38; 95% CI 1.31-4.33) or low 11-23 (OR 5.31; 95% CI 2.69-10.45) scores in neuroticism were more likely to evaluate their health as very good/good. Conclusion: Based on the findings of the present study and on the existing literature, it may be said that it is possible for people to age while keeping a positive perception of their own health, even in advanced old age; comparisons between the above-mentioned countries, however, point to the need for investments in healthcare systems so that older adults may enjoy greater physical independence and improved mental health.

Factors associated with successful aging in Brazilian community-dwelling older adults: When physical health is not enough

OBJECTIVES

To determine the main factors (physical, psychological, social and spiritual) associated with successful aging in community-dwelling older adults.

METHODS

A cross-sectional study of older adults was conducted evaluating successful aging (Successful Aging Scale-SAS) and its associated factors (sociodemographics, resilience, religiosity/spirituality, meaning in life, quality of life, social support, self-reported diseases, mental health, medications used, among others) using regression models.

RESULTS

A total of 534 older adults were assessed. Linear regression models showed an association of higher SAS score with greater resilience (Beta = 0.371, p < 0.001), spiritual well-being - meaning (Beta = 0.174, p < 0.001) and quality of life - physical (Beta=0.203, p < 0.001), fewer diseases (Beta=-0.128, p < 0.001), greater meaning in life (Beta=0.116, p = 0.001), less loneliness (Beta=-0.133, p = 0.001), lower tobacco use (Beta=0.080, p = 0.013), greater quality of life - environment (Beta=-0.092, p = 0.013) and more frequent religious attendance (Beta=0.068, p = 0.035).

CONCLUSION

The study results suggested that physical factors, although relevant, were not the main factors associated with successful aging.

Physical Disorders and Poor Self-Rated Health in Adults Living in Four Latin American Cities: A Multilevel Approach

Considering that urban environments may affect self-rated health through behavioral and psychosocial mechanisms, the aim of this study was to investigate the association between self-rated health and perceived urban environment characteristics among adults living in four Latin American cities. Data is from a population-based survey by Development Bank of Latin America, encompassing adults between 20 and 60 years old in Buenos Aires, Lima, Mexico City, and Panama City. Self-rated health was measured using a single question and the response options were categorized as poor and good. The explanatory variables were empirical Bayes estimates of self-reported area physical disorder, social disorder, access to services, and access to leisure spaces derived from the survey. The covariates were: individual age, sex, education, wealth index, and length of residency in the neighborhood; and an area social environment index. Multilevel logistic regressions with two levels (individual and sub-city areas) were fitted. Poor self-rated health was reported by 34.73% (95% CI: 33.17 to 36.29) of the participants and was associated with physical disorder (OR = 1.16 per SD; 95% CI: 1.02 to 1.32). Our findings suggest that public policies to promote population health should consider area urban environment factors, especially those associated with disorder.

Creating a Healthy Environment for Elderly People in Urban Public Activity Space

According to statistics, the global, population aging problem is severe and growing rapidly. The aging problem is most obvious in some European countries, and most of them are developed countries, such as Japan, Italy, Germany, France, etc. The current internal and external environments of parks in China are complex. The inefficient utilization of space in urban parks is a prominent problem. The design of public spaces that only considers the visual experience is incomplete. Based on the optimization of urban park space planning principle, this study examined a new measure of the acoustic environment in elderly public activity space and designed a new elderly healthy urban park environment. Methods: Using the main parks in Shenyang (Zhongshan Park, Nanhu Park, Youth Park, and Labor park) as the study sites, this study analyzed problems in the acoustic environmental data through on-site inspection, questionnaire survey, and physical data collection. By using general linear regression and multiple regression methods, this study analyzed the impacts of plant density, site elevation, structure enclosure, functional mixing degree on the acoustic environment, and elderly population activities. Based on the acoustic environment, we propose improvements and construction ideas, as well as technical methods, for urban elderly public activity space planning. The utility of the “elderly public activity space planning principle” was also considered. Results: Elderly activity space in urban parks was affected by three main factors—plant density, degree of structural enclosure, and function mixing degree. These factors should be optimized to construct healthy acoustic environments and attract different types of people. Discussion: Compared to past studies, the new influencing factors of the planning principle for elderly public activity space found in this study, would benefit the urban park environment for the elderly and support sustainable development of cities. Conclusions: This study proposes three optimizations to the elderly urban park space planning principle and builds four healthy models of elderly urban space activity.

Causal assessment in demographic research

Causation underlies both research and policy interventions. Causal inference in demography is however far from easy, and few causal claims are probably sustainable in this field. This paper targets the assessment of causality in demographic research. It aims to give an overview of the methodology of causal research, pointing out various problems that can occur in practice. The “Intervention studies” section critically examines the so-called gold standard in causality assessment in experimental studies, randomized controlled trials, and the use of quasi-experiments and interventions in observational studies. The “Multivariate statistical models” section deals with multivariate statistical models linking a mortality or fertility indicator to a series of possible causes and controls. Single and multiple equation models are considered. The “Mechanisms and structural causal modelling” section takes into account a more recent trend, i.e., mechanistic explanations in causal research, and develops a structural causal modelling framework stemming from the pioneering work of the Cowles Commission in econometrics and of Sewall Wright in population genetics. The “Assessing causality in demographic research” section examines how causal analysis could be further applied in demographic studies, and a series of proposals are discussed for this purpose. The paper ends with a conclusion pointing out, in particular, the relevance of structural equation models, of triangulation, and of systematic reviews for causal assessment.

The Relationships between Physical Activity and Life Satisfaction and Happiness among Young, Middle-Aged, and Older Adults

Physical activity has benefits on physical and psychological health. The aims of this study were to investigate (1) the relationships between physical activity and life satisfaction and happiness in young, middle-aged, and older adults while controlling for demographic characteristics, and (2) the relationships between age and life satisfaction and happiness for different physical activity levels. A total of 2345 healthy adults were recruited. Demographic characteristic, physical activity, life satisfaction, and happiness were collected. Participants were divided into young, middle-aged, and older adult groups based on age, and physical activity was categorized as high, moderate, and low. After controlling for demographic characteristics, participants with high and moderate activity levels had significantly higher life satisfaction and happiness than those with a low activity level across the total population and the three age groups. Age squared was a significant predictor of a positive curvilinear between age and life satisfaction and happiness. Physical activity was significantly related to life satisfaction and happiness in young, middle-aged, and older adults. In addition, life satisfaction and happiness increased with increasing age. The results support the promotion of physical activity.