OBJECTIVES: (1) To study the natural decline in functional capacity (FC) of healthy aging workers; (2) to compare FC to categories of workload; and (3) to study the differences in decline between men and women.DESIGN: Cross-sectional design.SETTING: A rehabilitation center at a university medical center.PARTICIPANTS: Volunteer sample of healthy workers (N=701) between 20 and 60 years of age, working at least 20 hours per week in the year prior to the study. Subjects were recruited via local press and personal networks.INTERVENTIONS: FC was measured with a 14-item Functional Capacity Evaluation. Demographics and health status were measured with a general demographic questionnaire and the RAND-36 questionnaire.MAIN OUTCOME MEASURES: Workload was expressed by the workload categories, as described by the Dictionary of Occupational Titles. Descriptive statistics were used to present FC of workers. Change in FC by age was tested with segmented regression analyses with a cutoff point at 45 years of age.RESULTS: Significant but small declines of FC under age 45 years were present in repetitive reaching, hand dexterity, and energetic capacity. Up to 45 years of age, hand and finger strength increased on average. Over 45 years of age, lifting, carrying, hand and finger strength, and coordinative tests declined more compared with the group aged less than 45 years. Work capacity of men and women working in sedentary and light work was sufficient in all age categories. There are no differences in decline between men and women.CONCLUSIONS: FC of healthy workers declines with age. This study demonstrates substantial variation in the type of FC decline among healthy workers between 20 and 60 years of age. Material handling, hand and finger strength, and hand coordination appear to decline the most in workers over age 45 years. The objective of rehabilitation is to maximize an individual's FC, particularly with respect to environmental demand. Thus, return to work programs must appreciate both FC and workplace demands in an effort to restore/enhance equilibrium between the 2.
DOCUMENT
OBJECTIVE: The prevalence of multimorbidity has risen considerably because of the increase in longevity and the rapidly growing number of older individuals. Today, only little is known about the influence of multimorbidity on cognition in a normal healthy aging population. The primary aim of the present study was to investigate the effect of multimorbidity on cognition over a 12-year period in an adult population with a large age range. METHODS: Data were collected as part of the Maastricht Aging Study (MAAS), a prospective study into the determinants of cognitive aging. Eligible MAAS participants (N = 1763), 24-81 years older, were recruited from the Registration Network Family Practices (RNH) which enabled the use of medical records. The association between 96 chronic diseases, grouped into 23 disease clusters, and cognition on baseline, at 6 and 12 years of follow-up, were analyzed. Cognitive performance was measured in two main domains: verbal memory and psychomotor speed. A multilevel statistical analysis, a method that respects the hierarchical data structure, was used. RESULTS: Multiple disease clusters were associated with cognition during a 12-year follow-up period in a healthy adult population. The disease combination malignancies and movement disorders multimorbidity also appeared to significantly affect cognition. CONCLUSIONS: The current results indicate that a variety of medical conditions adversely affects cognition. However, these effects appear to be small in a normal healthy aging population.
DOCUMENT
BACKGROUND: Older adults want to preserve their health and autonomy and stay in their own home environment for as long as possible. This is also of interest to policy makers who try to cope with growing staff shortages and increasing health care expenses. Ambient assisted living (AAL) technologies can support the desire for independence and aging in place. However, the implementation of these technologies is much slower than expected. This has been attributed to the lack of focus on user acceptance and user needs.OBJECTIVE: The aim of this study is to develop a theoretically grounded understanding of the acceptance of AAL technologies among older adults and to compare the relative importance of different acceptance factors.METHODS: A conceptual model of AAL acceptance was developed using the theory of planned behavior as a theoretical starting point. A web-based survey of 1296 older adults was conducted in the Netherlands to validate the theoretical model. Structural equation modeling was used to analyze the hypothesized relationships.RESULTS: Our conceptual model showed a good fit with the observed data (root mean square error of approximation 0.04; standardized root mean square residual 0.06; comparative fit index 0.93; Tucker-Lewis index 0.92) and explained 69% of the variance in intention to use. All but 2 of the hypothesized paths were significant at the P<.001 level. Overall, older adults were relatively open to the idea of using AAL technologies in the future (mean 3.34, SD 0.73).CONCLUSIONS: This study contributes to a more user-centered and theoretically grounded discourse in AAL research. Understanding the underlying behavioral, normative, and control beliefs that contribute to the decision to use or reject AAL technologies helps developers to make informed design decisions based on users' needs and concerns. These insights on acceptance factors can be valuable for the broader field of eHealth development and implementation.
DOCUMENT
As societies age, the development of resources and strategies that foster healthy ageing from the beginning of life become increasingly important. Social and healthcare professionals are key agents in this process; therefore, their training needs to be in agreement with societal needs. We performed a scoping review on professional competences for social and health workers to adequately promote healthy ageing throughout life, using the framework described by Arksey and O’Malley and the Joanna Briggs Institute Guidelines. A stakeholder consultation was held in each of the participating countries, in which 79 experts took part. Results show that current literature has been excessively focused on the older age and that more attention on how to work with younger population groups is needed. Likewise, not all disciplines have equally reflected on their role before this challenge and interprofessional approaches, despite showing promise, have not been sufficiently described. Based on our results, health and social professionals working to promote healthy ageing across the lifespan will need sound competences regarding person-centred communication, professional communication, technology applications, physiological and pathophysiological aspects of ageing, social and environmental aspects, cultural diversity, programs and policies, ethics, general and basic skills, context and self-management-related skills, health promotion and disease prevention skills, educational and research skills, leadership skills, technological skills and clinical reasoning. Further research should contribute to establishing which competences are more relevant to each discipline and at what level they should be taught, as well as how they can be best implemented to effectively transform health and social care systems.
DOCUMENT
For the needs analysis, an assessment of the national (and local) status quo in the area of Healthy Ageing, specifically towards Active and Healthy Lifestyles. This status quo will serve as important starting point for the exploration of a potential shared goal of the local community of practice. This needs analysis report includes generic sections towards definitions and methodologies, and an introduction towards the topics assessed. Secondly, national/ local chapters will outline the situation in the communities of Groningen (the Netherlands), Odense (Denmark), Malaga (Spain), Kaunas (Lithuania) and Cascais (Portugal). Within each local COP chapter the partners taking part of the COP are described and the shared goals illustrated. These shared goals are: COP Groningen: “stimulating a Healthy environment (physical & social) with focus on physical activity”. COP Odense: “further develop and educate professionals who work on stimulating physical activity in community dwelling older adult”’. COP Malaga: “developing, implementing and evaluating outdoor fitness” COP Kaunas: “to provide opportunities for primary school children and Kaunas district community members older than 50 more opportunities for exercising and physical activity” COP Cascais: “develop, organize for and together with the stakeholders and end users (youngsters from 12-24 years old) activities focused on healthy lifestyle (e.g., healthy cooking workshops, parent-child physical activities etc.) embedded in approach GERAÇÃO S+ “.
DOCUMENT
BACKGROUND: Global migration has increased in the past century, and aging in a foreign country is relevant to the Chinese diaspora.OBJECTIVE: With regard to migration, this study focuses on the places of aging as the context of older Chinese adults. This study aimed to describe the general health and wellbeing of this population with respect to their location.DESIGN: This study has a cross sectional design.SETTING AND PARTICIPANTS: Participants were recruited who were "aging in place" from Tianjin, China (199 participants), and "aging out of place" from the Netherlands (134 participants). Data from April to May 2019 in China and November 2018 to March 2019 in the Netherlands were aggregated.MEASUREMENTS: frailty, QoL and loneliness were used in both samples.RESULTS: T-tests and regression analyses demonstrated that social domains of frailty and QoL, as well as loneliness and frailty prevalence characterized the major differences between both places of aging. A correlation analysis and visual correlation network revealed that frailty, quality of life (QoL), and loneliness were more closely related in the aging out of place sample. Social domains of frailty and QoL, as well as the prevalence of loneliness and frailty, characterized the major differences between both places of aging.CONCLUSIONS: The findings indicate that frailty, QoL, and loneliness have a complex relationship, confirming that loneliness is a major detriment to the general wellbeing of older Chinese adults aging out of place. This study examined the places of aging of the larger Chinese population and allows a comprehensive understanding of health and wellbeing. The social components, especially loneliness, among the aging out of place Chinese community should receive more attention practice and clinical wise. On the other hand, frailty as well as its prevention is of more importance for the Chinese community aging in place.
DOCUMENT
Background: Most older adults prefer to age in place, and supporting older adults to remain in their own homes and communities is also favored by policy makers. Technology can play a role in staying independent, active and healthy. However, the use of technology varies considerably among older adults. Previous research indicates that current models of technology acceptance are missing essential predictors specific to community-dwelling older adults. Furthermore, in situ research within the specific context of aging in place is scarce, while this type of research is needed to better understand how and why community-dwelling older adults are using technology. Objective: To explore which factors influence the level of use of various types of technology by older adults who are aging in place and to describe these factors in a comprehensive model. Methods: A qualitative explorative field study was set up, involving home visits to 53 community-dwelling older adults, aged 68-95, living in the Netherlands. Purposive sampling was used to include participants with different health statuses, living arrangements, and levels of technology experience. During each home visit: (1) background information on the participants' chronic conditions, major life events, frailty, cognitive functioning, subjective health, ownership and use of technology was gathered, and (2) a semistructured interview was conducted regarding reasons for the level of use of technology. The study was designed to include various types of technology that could support activities of daily living, personal health or safety, mobility, communication, physical activity, personal development, and leisure activities. Thematic analysis was employed to analyze interview transcripts. Results: The level of technology use in the context of aging in place is influenced by six major themes: challenges in the domain of independent living; behavioral options; personal thoughts on technology use; influence of the social network; influence of organizations, and the role of the physical environment. Conclusion: Older adults' perceptions and use of technology are embedded in their personal, social, and physical context. Awareness of these psychological and contextual factors is needed in order to facilitate aging in place through the use of technology. A conceptual model covering these factors is presented.
LINK
Background. In an ageing society cognitive decline is expected to become an important health problem. Previous studies showed that a healthy lifestyle, i.e. sufficient physical activity and a healthy diet,can benefit cognitive function. In this study, we aimed to assess the (synergistic) association of physical activity and a healthy diet with cognitive functioning in 1,741 Dutch men and women aged 57-97 years.
DOCUMENT
Healthy gestational weight gain (GWG) is associated with better pregnancy outcomes and with improved health in the later lives of women and babies. In this thesis the author describes the process of developing an intervention to help pregnant women reach a healthy GWG. The need for this intervention was derived from discussions with midwives, working in primary care in the Netherlands. In this introduction, the author describes the background of the larger project “Promoting Health Pregnancy”, of which this study is a part (1.2), the problem of unhealthy GWG (1.3-1.6) and offers a brief introduction to the theoretical framework of the study and to the subsequent chapters (1.7-1.9).
DOCUMENT
Objective: Gaining too much or too little weight in pregnancy (according to Institute of Medicine (IOM) guidelines) negatively affects both mother and child, but many women find it difficult to manage their gestational weight gain (GWG). Here we describe the use of the intervention mapping protocol to design ‘Come On!’, an intervention to promote adequate GWG among healthy pregnant women. Design: We used the six steps of intervention mapping: (i) needs assessment; (ii) formulation of change objectives; (iii) selection of theory-based methods and practical strategies; (iv) development of the intervention programme; (v) development of an adoption and implementation plan; and (vi) development of an evaluation plan. A consortium of users and related professionals guided the process of development. Results: As a result of the needs assessment, two goals for the intervention were formulated: (i) helping healthy pregnant women to stay within the IOM guidelines for GWG; and (ii) getting midwives to adequately support the efforts of healthy pregnant women to gain weight within the IOM guidelines. To reach these goals, change objectives and determinants influencing the change objectives were formulated. Theories used were the Transtheoretical Model, Social Cognitive Theory and the Elaboration Likelihood Model. Practical strategies to use the theories were the foundation for the development of ‘Come On!’, a comprehensive programme that included a tailored Internet programme for pregnant women, training for midwives, an information card for midwives, and a scheduled discussion between the midwife and the pregnant woman during pregnancy. The programme was pre-tested and evaluated in an effect study.
MULTIFILE
