J. Ageing Longev., Volume 5, Issue 3 (September 2025) – 16 articles

Ageism, a pervasive form of discrimination based on age, has become a growing concern across various fields. Artificial Intelligence (AI), despite its transformative potential, may have unintentionally reinforced ageist stereotypes through flawed design, biased datasets, and implementation practices. This review delves into the complex interplay between ageism and AI, offering a thorough analysis of existing research on the subject and its consequences for older adults. It highlights significant gaps, including the underrepresentation of older individuals in datasets and the absence of age-inclusive design standards, which may perpetuate algorithmic biases. Ethical principles, policy development, and societal implications of ageist AI systems are critically assessed. Furthermore, the article proposes constructive strategies and outlines future research directions to promote equitable and inclusive AI systems. By addressing these challenges, this review aims to contribute to a fair and dignified technological landscape for all age groups. Full article

Background: Although nature exposure is recognized for its beneficial effects on psychological, cognitive, and physiological health, its impact on physical function has been underexplored. The main aim of this paper is to cover this gap. Methods: A systematic search of Cochrane, CINAHL Plus, and PubMed databases (2012–2023) was conducted using terms related to nature and physical function. Results: Eight intervention studies (total n = 209, age 25–91) met the inclusion criteria. NBIs, such as horticultural therapy and forest therapy, demonstrated generally positive effects across physical, psychosocial, and physiological outcomes, though effect size and quality varied. Study quality ranged from low to high. Conclusions: NBIs appear to promote multi-dimensional functioning in people living with physical chronic disease and offer promising complementary strategies to traditional rehabilitation. Full article

(1) Background: Alzheimer’s disease and related dementias (ADRD) are a major cause of mortality among older adults globally. The cognitive decline associated with ADRD often reduces individuals’ ability to live independently over time, increasing reliance on caregivers. Assistive and socially assistive robots offer a promising means of supporting independent living. This narrative review examined how older adults with ADRD, their caregivers, and healthcare providers perceive and experience interactions with robots. (2) Methods: Guided by the Population, Phenomenon of Interest, and Context (PICo) framework, five databases were searched. Sixteen studies met the inclusion criteria. Extracted data were summarized, and a convergent synthesis integrated qualitative and quantitative findings. (3) Results: Drawing on content analysis, the qualitative findings were organized into three domains: user perceptions and experiences, barriers to adoption, and suggestions for improvement. Quantitative results emphasized usability, usefulness, acceptance, satisfaction, feature preferences, and barriers. While most stakeholders viewed robots as beneficial, acceptance was shaped by factors such as design features, timing of introduction, familiarity with technology, and perceived need. (4) Conclusions: This review highlights priorities for future research and development, including personalization, ethical safeguards, and caregiver integration, to improve the acceptance and effectiveness of robot-assisted support for individuals with cognitive impairment. Full article

Parkinson’s disease is a progressive neurological disorder reliant on medication regime adherence to alleviate symptomology. When hospitalised, people with Parkinson’s disease have specific medication management needs which are consistently unmet. This study aims to develop, implement and evaluate solutions for improving the medication management of inpatients with Parkinson’s disease. A healthcare redesign approach was utilised, focusing on the final three phases: solutions design, implementation and evaluation. Five solutions were derived: formalise routine patient identification, provide improved staff education, develop and install automated prescriber alerts, review and amend ward PD medication stock, and develop systematic prompts for PD medications. The findings suggest that our solutions sustainably improved systems and processes that contribute to quality and safe medication management for Parkinson’s patients. Correct identification of Parkinson’s patients within an acute care hospital leads to correct prescription of medications, timeliness of medication administration and timely pharmacy review. The length of stay was not positively impacted. Full article

The Older People’s Quality of Life Questionnaire (OPQOL-35) is a validated tool used to measure quality of life in the older people in many countries. The study describes the linguistic validation, cultural adaption, and pilot testing of the Albanian version of the OPQOL-35 (AL-OPQOL-35) in older adults, confirming its internal consistency and reliability. The process of linguistic validation, cross-cultural verification and adaptation of the AL-OPQOL-35 questionnaire went through four stages: forward translation, backward translation, patient testing, and proofreading. The AL-OPQOL-35 instrument obtained after forward–backward translation was tested on a sample of 40 elderly people with chronic diseases and multimorbidity. The sample consisted of 75% females and the age group 65–74 makes up the highest percentage with 72.5%. The sample consisted of 25% with one chronic disease, while 75% had two or more chronic diseases. After the evaluation by a panel of experts and pilot testing, the AL-OPQOL-35 was found to be clear and understandable for older adults with chronic conditions and multimorbidity, showing good reliability with a Cronbach’s alpha α = 0.848. It is recommended to use the AL-OPQOL-35 instrument in a larger population and evaluate its psychometric properties. Full article

Hypertension is a major chronic condition affecting older adults in the United States. The condition imposes clinical and economic burdens. Self-efficacy, or confidence in managing health, is crucial for effective self-management of hypertension. This study explored the relationships between socio-demographics, health status, and confidence in following provider recommendations for controlling hypertension among Medicare beneficiaries. The 2021 Medicare Current Beneficiary Survey was analyzed, including responses from 5838 beneficiaries aged ≥65 years with reported hypertension. A three-level categorical dependent variable ((1) very confident/confident, (2) somewhat confident, and (3) not confident (reference group)) based on provider recommendations for lifestyle changes for hypertension control was created. A survey-weighted multinomial logit model examined associations between socio-demographics and self-reported health status and the dependent variable. Among respondents, 70.8%, 21.4%, and 7.8%, respectively, were very confident/confident, somewhat confident, and not confident in following provider recommendations for lifestyle changes to control hypertension. Beneficiaries with obesity, fair/poor general health, and limitations in basic activities of daily living or instrumental activities of daily living were less likely to report being very confident/confident. The findings of this cross-sectional study highlighted the potential need for targeted support (e.g., tailored health coaching, peer mentoring) of lifestyle changes for at-risk older adults to manage hypertension. Full article

The rising prevalence of CKD, particularly within aging populations, demands effective and accessible self-management strategies. Three middle-aged and older adult inpatients (one female, two males; mean age 58.6 years ± 23) with CKD and preserved cognitive capacity (Mini-Mental State Examination) participated. A multiple case study was conducted in a Portuguese nephrology unit between November 2024 and February 2025, utilizing baseline assessments that included the Braden, Barthel, and Morse scales, as well as the KDQOL-SF. A targeted educational program addressed key CKD management aspects: disease understanding, vascular access care, medication regimens, and dietary restrictions. Pre- and post-intervention assessments measured knowledge gains. Results indicated improvements in participants’ knowledge and self-management capabilities across several domains. These included enhanced understanding of the disease process, vascular access for hemodialysis, dietary requirements, and fluid restrictions. Participants also demonstrated improved self-assessment of support systems, coping mechanisms, and family involvement. A 15% average increase in knowledge scores post-intervention was observed. This study provides preliminary evidence supporting the efficacy of a structured educational nursing program in improving CKD self-management. The significant improvements in knowledge and self-reported confidence suggest that targeted education is a valuable component of comprehensive CKD care. Future research should incorporate larger, more diverse samples and explore the long-term impact of the intervention. Furthermore, the integration of technological tools, such as personalized learning platforms and digital health, holds a significant promise for enhancing the accessibility and effectiveness of such educational programs. Full article

Multimorbidity, or the presence of two or more co-occurring chronic medical conditions, is extremely prevalent within the United States (US), with disproportionately high incidence rates in individuals with minoritized identities. Sleep disturbances are an empirically supported risk factor contributing to disease status and maintenance throughout the lifespan. Given this, this study examines the relationship between disturbed sleep and multiple chronic conditions (MCCs) in adults using cross-sectional data from (n = 1013) participants enrolled in the Survey of Midlife Development in the US Study (MIDUS-2). Participants within this study were predominantly female (54.9%), white (93.2%), middle-aged (M_AGE = 58 years old), and experienced multimorbidity (56.6%) by having two or more (M_CHRON = 2.25) chronic health conditions in the past year. A negative binomial regression indicated that sleep disturbances significantly predict the number of chronic health conditions, with sleep-disturbed individuals reporting a 41% increase in reported health conditions (IRR = 1.407, p < 0.001). Findings suggest that disturbed sleep is significantly related to disease presence in aging populations and should be addressed through early intervention to mitigate negative health consequences. Full article

By 2040, more than 80 million Americans will be aged ≥65, yet contemporary senior living communities still operate on a hospitality-first model developed for healthier cohorts three decades ago. This commentary argues that the next generation of senior living must pivot from hotel-style amenities to person-centric health platforms that proactively coordinate medical, functional, and social support. We outline four mutually reinforcing pillars. (1) Data infrastructure that stitches together clinical, functional, and social determinants of health enables continuous risk stratification and early intervention. (2) Ambient and conversational artificial-intelligence tools can extend sparse caregiving workforces while preserving resident autonomy. (3) Value-based contractual arrangements—for example, Medicare Advantage special-needs plans embedded within senior living sites—can realign financial incentives toward prevention rather than occupancy. (4) Targeted policy levers, including low-income housing tax credits for the “forgotten middle” and outcomes-based regulatory frameworks, can catalyze adoption at scale. Ultimately, re-architecting senior living around integrated technology, value-based financing and supportive regulation can transform these communities into preventive-care hubs that delay nursing home entry, improve quality of life, and reduce total cost of care. Full article

Older adults, aged 65 years and older, develop and experience frailty at different rates. Yet, this heterogeneity is not well understood, nor are the factors, such as geographical residence, that influence different frailty trajectories and subsequent healthcare outcomes. We aim to identify factors that impact older adult frailty trajectories, skilled nursing facility (SNF) placement, and death. Medicare beneficiaries ≥ 65 years from the National Health and Aging Trend Study (2011–2021) with complete data using Fried’s frailty phenotype on ≥ 2 occasions (n = 6082) were included in the analysis. Rural/urban residence was defined using Office of Management and Budget criteria. Latent class growth analysis (LCGA) helped identify four frailty trajectories: improving, stable, mildly worsening, and drastically worsening. Cox proportional hazard analysis and logistic regression determined the association of social determinants of health (sex, race/ethnicity, education and income level, healthcare and transportation access, and social support) on death and SNF admission, respectively. The mean age was 75.12 years (SE 0.10); 56.4% female, 18.6% (n = 1133) rural residence. In the overall sample, 1094 (23.0%) older adults were classified as robust, 3242 (53.0%) as pre-frail, and 1746 (24.0%) as frail. Urban residence did not modify the relationship between frailty trajectories and SNF placement, nor did geographic residence on death. Higher income was associated with lower odds of a worse frailty trajectory, SNF admission, and a lower hazard of death, all reaching statistical significance. Future work should examine the factors that influence older adult participation in research and the impact of standardizing the definition of geographic rurality on older adult frailty and health outcomes. Full article

Blue Zones (BZs) are regions across the world associated with exceptional human longevity, where individuals routinely live into their 90s and beyond. These areas share distinct lifestyle and environmental factors that promote healthy aging. The established BZs include Sardinia, Okinawa, Ikaria, and Nicoya, while several “emerging” BZs have been reported in various parts of the globe. This study investigates an area in Sicily for similar longevity patterns. Demographic data from the Italy National Institute of Statistics and local civil registries identify the municipality of Caltabellotta, home to approximately 3000 residents, and the nearby Sicani Mountains as a potential emerging BZ. The area exhibits a significantly higher prevalence of nonagenarians and centenarians compared to national and regional averages. Between 1900 and 1924, the proportion of newborns in Caltabellotta who reached age 90 and above rose from 3.6% to 14%, with 1 out of 166 individuals during this period reaching the age of 100. Historical, dietary, environmental, and sociocultural characteristics align with known BZ traits, including adherence to the Mediterranean diet, physical activity through agrarian routines, strong social cohesion, and minimal environmental pollution. A comparative analysis with the validated Sardinia BZ supports the hypothesis that this Sicilian area may represent an emerging longevity hotspot. Further multidisciplinary investigation is warranted to substantiate these findings. Full article

As global populations age, there is increasing demand for effective, person-centered healthcare solutions that support older adults to age in place. Home healthcare has emerged as a crucial strategy to address the complex health and social needs of older adults while reducing reliance on institutional care. This umbrella review aimed to synthesize evidence from existing systematic reviews and meta-analyses on home healthcare services and interventions targeting older adults. A comprehensive search was conducted across five databases and gray literature sources, including Google Scholar, for reviews published between 2000 and 2025. The review followed the Joanna Briggs Institute methodology and PRISMA statement. Twenty reviews met the inclusion criteria, encompassing a total of over 3.1 million participants. Interventions were grouped into four categories: integrated and multidisciplinary care, preventive and supportive home visits, technological and digital interventions, and physical, transitional, and environmental support. Results indicated that many interventions led to improved health outcomes, including enhanced functional ability, reduced hospital readmissions, and increased satisfaction. However, effectiveness varies depending on the intervention type, delivery model, and population. Challenges such as caregiver burden, digital exclusion, and implementation in diverse settings were noted. This review highlights the promise of home healthcare interventions and underscores the need for context-sensitive, equitable, and scalable models to support aging populations. Full article

Aged-care services are in crisis through a combination of rising demand and increasing costs. Quality of care is often reported to be insufficient. Medical science has increased lifespans but the overmedicalisation of aged care may affect the financial sustainability and quality of care. Person-centred care was developed as a solution and is generally interpreted as being concerned with consumer choice. This study presents a human rights-based approach to a code of conduct for aged-care consumers and workers to ensure autonomy and participation in aged-care communities, which are fundamental to person-centred care. A test–retest cohort study was used to investigate the impact of a training module about a human rights-based code of conduct on the perspectives of new aged-care workers (n = 11) on a case scenario involving conflicting care priorities. Qualitative content analysis was used to categorise and count the participants’ responses. The analysis found that prior to training the majority of participants were focused on a medical and risk reduction model of care. After the training participants had a more expansive understanding of care needs and recognised the importance of client empowerment to enable clients to participate in decisions affecting their care. The results support the implementation of a human rights-based approach to worker training and client care; such an approach is consistent with person-centred care. Full article

The COVID-19 pandemic has illuminated and intensified pre-existing structural vulnerabilities among older adults living with HIV/AIDS in sub-Saharan Africa, particularly Nigeria. Within already overstretched healthcare infrastructures, these individuals faced heightened economic precarity, disrupted HIV care, and pronounced psychosocial distress. Exploring their lived experiences critically advances an understanding of resilience and informs contextually responsive interventions that can mitigate future health crises. This study employed a narrative qualitative approach to explore the lived experiences of older adults (aged 50 and above) attending the Infectious Diseases Institute (IDI) clinic in Ibadan, Nigeria, during the pandemic lockdown. Purposive sampling guided by maximum variation principles enabled the selection of 26 participants who provided detailed accounts through in-depth interviews. Reflective thematic analysis identified complex narratives illustrating intensified financial hardships, disrupted access to antiretroviral therapy (ART), and heightened psychological distress, including anxiety, depression, and profound isolation. Conversely, participants also articulated experiences of resilience, manifesting in improved medication adherence, strengthened family bonds, and introspective growth fostered by enforced isolation. These nuanced findings highlights the necessity of developing an adaptive, integrated healthcare interventions that addresses economic vulnerabilities, psychosocial wellbeing, and ART continuity, thereby better preparing resource-constrained health systems to support older adults with HIV/AIDS in future public health crises. Full article

The COVID-19 pandemic brought unprecedented challenges, particularly for older adults. They were identified as a high-risk group. While research has primarily focused on health measures, less is known about their adaptation processes during this period in the UK and Colombia. This study explores “how older adults in the UK and Colombia adapted during the health crisis after one year”. We conducted interviews with 29 participants in the UK and 32 participants in Colombia, aged 63–95, about their experiences one year after the pandemic. We analysed their anonymised transcripts using constructivist grounded theory. The pandemic highlighted older adults’ ability to learn new skills in the face of adversities. Some found new goals; others found pleasure in optimising existing skills and tasks. Some compensated for the lack of social connectivity by intensifying hobbies. We identified three broad ways older adults adapted. Cognitive adaptation included acceptance, positive reframing, and religious trust. Emotional regulation was experienced not only through deep freeze, weather impact, social support, religion, pet companionship but also emotional struggles. Finally behavioural adaptation was enacted through routine modification, use of virtual technologies, intertwined cognitive–emotional–behavioural adaptation, and previous experiences. However, adaptation varied, with some individuals struggling to adapt, highlighting that while adaptation is possible for some, it is not universal among all older adults. Full article

Background: Decision-making under risk is a crucial process for undertaking health behaviors. Although the influence of individual differences on decision-making under risk has been widely examined, there is no clear consensus yet as to how to explain this process considering both young and older adults. The main aim of this preliminary study was to examine age differences in decision-making under risk, risk propensity, sensation-seeking, and self-conscious emotions between younger and older adults. Methods: A total of 40 subjects (20 young adults and 20 older adults) participated in the present study. The young adults were aged 18–35 years (M = 23.25, SD = 2.59). The older adults were aged 65–70 years (M = 68.50, SD = 4.01). Participants completed the Risk Propensity Scale, the Sensation-Seeking Scale, the Test of Self-Conscious Affect, and the Prisoner’s Dilemma Game. Results: The results indicated that the groups showed different behaviors in sensation-seeking (p < 0.001, pη2 = 0.14). The older group showed a larger propensity to seek recreational activities and unconventional behaviors than the younger group (p < 0.0001, d = 0.78; p = 0.001, d = 0.75). Also, the older adults demonstrated a greater inclination toward pride (p < 0.01, d = 0.78), whereas younger adults exhibited a stronger tendency towards shame (p < 0.01, d = 0.76). Conclusions: These data suggest a shift in risk preferences as individuals age, potentially influenced by a variety of psychological, social, and experiential factors. The applications of this study can support psychological well-being, productivity, and quality of life in later adulthood. Full article