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Active/Healthy Ageing and Quality of Life

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Guest Editor
1. National Centre of Epidemiology, Institute of Health Carlos III, REDISSEC, Monforte de Lemos 5, Pabellón 12, 28029 Madrid, Spain
2. Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Institute of Health Carlos III, Madrid, Spain
Interests: patient reported outcomes; multimorbidity; older adults; quality of life; comorbidity
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Guest Editor
National School of Public Health, Carlos III Institute of Health and REDISSEC, 28029 Madrid, Spain
Interests: psychometrics; older adults; active and healthy ageing; quality of life; multimorbidity; patient reported outcomes

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on the association between active/healthy aging and quality of life and wellbeing as a public health issue in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph

We will accept scientific works focusing on conceptual issues of active/healthy ageing, literature reviews, measurement and assessment of active/healthy ageing, determinants of active/healthy ageing and its impact on quality of life and wellbeing of the older population. We are also interested in psychosocial, community interventions, public health, and environmental interventions that aim at maintaining and increasing the quality of life and wellbeing of older adults. Finally, the importance of the built environment in active/healthy aging will also be displayed in this Issue. The built environment, including neighborhoods, public spaces, parks, housing, and transportation systems, may affect public health through individual transportation choices (e.g., using active modes instead of a car), activity patterns (e.g., promoting social participation), and environmental exposure. Research, both in cities and rural areas, and in both developing and developed countries, can offer a critical guide for policy efforts and planning for public health.

This Special Issue is open to any subject area related to the impacts of the built environment on public health. The listed keywords suggest just a few of the many possibilities.

Dr. Maria João Forjaz
Dr. Carmen Rodriguez-Blazquez
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • Built environment
  • Ageing in place
  • Public health
  • Health geography
  • Sense of community
  • Quality of life
  • Wellbeing
  • Physical activity
  • Walkability
  • Social participation
  • Leisure
  • Health
  • Loneliness
  • Social support

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Published Papers (19 papers)

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12 pages, 340 KiB  
Article
Scaling Down the PGCM Scale to Assess Views on Ageing More Efficiently: Finding a New Alternative
by Tomáš Doseděl, Tereza Menšíková and Lucie Vidovićová
Int. J. Environ. Res. Public Health 2020, 17(24), 9414; https://doi.org/10.3390/ijerph17249414 - 15 Dec 2020
Viewed by 2271
Abstract
The aim of the study is to present a new and efficient way of measuring the quality of life among older populations, with special attention to morale, positive outlook on life and ageing. The measure is based on the Philadelphia Geriatric Center Morale [...] Read more.
The aim of the study is to present a new and efficient way of measuring the quality of life among older populations, with special attention to morale, positive outlook on life and ageing. The measure is based on the Philadelphia Geriatric Center Morale Scale (PGCM), originally consisting of 22 items. The growing numbers and proportions of older people among European populations has increased the need to obtain more reliable data on their needs, values, life experiences and overall quality of life. Using data from six surveys conducted in the Czech Republic, we have formulated a three-item positive outlook on life and ageing (POLA) scale. Our analyses are divided into three steps: (1) constructing the scale and testing its internal consistency; (2) testing the scale’s external validity using mean comparisons and correlation coefficients; and (3) determining the factors affecting a positive outlook on later life, such as gender and education. We have confirmed that the three-item approach to measuring positive outlook on ageing as a part of morale is highly applicable to surveys, producing compelling results in assessing important quality-of-life sub-concepts, such as subjective health, subjective age, and loneliness. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
10 pages, 1055 KiB  
Article
Anxiety, Depression and Quality of Life in Older Adults: Trajectories of Influence across Age
by Oscar Ribeiro, Laetitia Teixeira, Lia Araújo, Carmen Rodríguez-Blázquez, Amaia Calderón-Larrañaga and Maria João Forjaz
Int. J. Environ. Res. Public Health 2020, 17(23), 9039; https://doi.org/10.3390/ijerph17239039 - 4 Dec 2020
Cited by 62 | Viewed by 6218
Abstract
This study focuses on the influence of anxiety and depression on individual trajectories of quality of life in old age through a longitudinal approach. A representative sample of adults aged 50+ living in Portugal and participating in wave 4 (W4) and wave 6 [...] Read more.
This study focuses on the influence of anxiety and depression on individual trajectories of quality of life in old age through a longitudinal approach. A representative sample of adults aged 50+ living in Portugal and participating in wave 4 (W4) and wave 6 (W6) of the Survey of Health, Ageing and Retirement in Europe (SHARE) project was considered. Participants, 1765 at baseline (W4) and 1201 at follow up (W6), were asked about their quality of life (CASP-12) and emotional status (Euro-D scale; five items from the Beck Anxiety Inventory). Linear Mixed Effects models were performed to identify factors associated with changes in quality of life across age. Increasing age was found to have a significant negative effect on quality of life. Lower education and higher levels of depression and anxiety at baseline were also associated with worse quality of life; 42.1% of the variation of CASP-12 across age was explained by fixed and random effects, being depression followed by anxiety as the factors that presented with the highest relative importance. Both depression and anxiety play an important role in quality of life in older adults and must be acknowledged as important intervention domains to foster healthy and active aging. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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11 pages, 330 KiB  
Article
A Study on the Influence of Social Leisure Activities on the Progression to the Stage of Frailty in Korean Seniors
by AlChan Kim, Eunsurk Yi, Jiyoun Kim and MunHee Kim
Int. J. Environ. Res. Public Health 2020, 17(23), 8909; https://doi.org/10.3390/ijerph17238909 - 30 Nov 2020
Cited by 8 | Viewed by 2510
Abstract
In this study, we performed a logistic regression analysis according to the frequency of participation in social leisure activities (education, clubs, social groups, volunteer activities, religious activities, and senior citizens’ welfare center use) by men and women aged ≥ 65 years. We investigated [...] Read more.
In this study, we performed a logistic regression analysis according to the frequency of participation in social leisure activities (education, clubs, social groups, volunteer activities, religious activities, and senior citizens’ welfare center use) by men and women aged ≥ 65 years. We investigated the frequency of participation in social leisure activities and their association with the level of frailty (health vs. pre-frailty, health vs. frailty, pre-frailty vs. frailty). This study included 10,297 older adults (men: 4128, women: 6169) who participated in the 2017 National Survey of Older Koreans, and were divided into three groups (healthy, pre-frailty, and frailty). Five frailty index components were used to measure the frailty level. There was a positive relationship between the elderly’s religious activities, four times a week, from the healthy stage to the frailty stage, from the healthy stage to the pre-frailty stage, and from the pre-frailty stage to the frailty. In addition, positive associations emerged in leisure activities and club activities, respectively, from the healthy stage to the frailty stage (once a week, respectively). Positive association also emerged from the healthy stage to the pre-frailty and from the pre-frailty stage to the frailty stage (once a month to once in a two-week period). Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
14 pages, 703 KiB  
Article
Are Loneliness and Social Isolation Associated with Quality of Life in Older Adults? Insights from Northern and Southern Europe
by Giorgi Beridze, Alba Ayala, Oscar Ribeiro, Gloria Fernández-Mayoralas, Carmen Rodríguez-Blázquez, Vicente Rodríguez-Rodríguez, Fermina Rojo-Pérez, Maria João Forjaz and Amaia Calderón-Larrañaga
Int. J. Environ. Res. Public Health 2020, 17(22), 8637; https://doi.org/10.3390/ijerph17228637 - 20 Nov 2020
Cited by 48 | Viewed by 6780
Abstract
Purpose: Loneliness and social isolation have detrimental effects on health in old age; however, the prospective associations with quality of life (QoL) remain unclear. Furthermore, despite the existence of a European north-south gradient in the distribution of loneliness and social isolation, little is [...] Read more.
Purpose: Loneliness and social isolation have detrimental effects on health in old age; however, the prospective associations with quality of life (QoL) remain unclear. Furthermore, despite the existence of a European north-south gradient in the distribution of loneliness and social isolation, little is known whether the associations are context-specific. We investigated the relationships between loneliness, social isolation and QoL of older adults residing in the North (Sweden) and South (Spain) of Europe. Methods: Study sample consisted of 2995 Swedish and 4154 Spanish older adults who participated in waves six and seven of the Study on Health, Aging and Retirement in Europe (SHARE). Loneliness and social isolation were measured at the baseline, and QoL was measured at the baseline and follow-up using CASP-12. Prospective associations were assessed via multivariate linear regression. Results: In Sweden, subjects with higher vs. lower loneliness had 1.01 (95% CI: −1.55, −0.40) units lower QoL, while every standard deviation increase in social isolation was associated with a 0.27 (95% CI: −0.42, −0.09)-unit decrease in QoL. In Spain, every standard deviation increase in social isolation was associated with a 0.66 (95% CI: −1.11, −0.22)-unit decrease in QoL. The association was stronger in subjects aged ≤65 years old and those with no chronic diseases. The association with loneliness was not statistically significant in Spain. Conclusion: Loneliness and social isolation are prospectively associated with decreased QoL among older adults, yet the associations are contextually bound. Future interventions should target both exposures, among others, in order to increase QoL in this group. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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21 pages, 1072 KiB  
Article
Older Adult Segmentation According to Residentially-Based Lifestyles and Analysis of Their Needs for Smart Home Functions
by Jiyeon Yu, Angelica de Antonio and Elena Villalba-Mora
Int. J. Environ. Res. Public Health 2020, 17(22), 8492; https://doi.org/10.3390/ijerph17228492 - 16 Nov 2020
Cited by 10 | Viewed by 2785
Abstract
Globally, the percentage of older people in the general population is growing. Smart homes have the potential to help older adults to live independently and healthy, improving their quality of life, and relieving the pressure on the healthcare and social care systems. For [...] Read more.
Globally, the percentage of older people in the general population is growing. Smart homes have the potential to help older adults to live independently and healthy, improving their quality of life, and relieving the pressure on the healthcare and social care systems. For that, we need to understand how older adults live and their needs. Thus, this study aims to analyze the residentially-based lifestyles (RBL) of older adults and segment them to compare and analyze the real needs of smart home functions for each group. To identify a person’s RBL, a questionnaire was designed to include questions about activities at home, social events, quality of life, etc. This study surveyed 271 older Koreans. As a result of the survey on RBL, five groups with different characteristics were clustered. Finally, each groups’ features and the differences in their needs for smart home functions were compared and analyzed. The priority of needed functions for each group was found to be significantly different. In a total of 26 smart home functions, there were meaningful differences in the needs for 16 functions among the groups. This study presents the results in South Korea, according to older adults’ RBL and their smart home needs. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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15 pages, 766 KiB  
Article
The Influence of Physical Activity, Anxiety, Resilience and Engagement on the Optimism of Older Adults
by Alfonso Martínez-Moreno, Ricardo José Ibáñez-Pérez, Francisco Cavas-García F and Francisco Cano-Noguera
Int. J. Environ. Res. Public Health 2020, 17(21), 8284; https://doi.org/10.3390/ijerph17218284 - 9 Nov 2020
Cited by 11 | Viewed by 4140
Abstract
The purpose of this study was to learn how physical activity, anxiety, resilience and engagement can influence optimism in older adults. An observational, quantitative, descriptive and transversal design was used with non-probabilistic sampling. A descriptive statistical analysis of the sample, Cronbach’s alpha test [...] Read more.
The purpose of this study was to learn how physical activity, anxiety, resilience and engagement can influence optimism in older adults. An observational, quantitative, descriptive and transversal design was used with non-probabilistic sampling. A descriptive statistical analysis of the sample, Cronbach’s alpha test of internal consistency and linear correlation using Pearson’s correlation coefficient (r) were performed. In addition, a t-Student test, analysis of variance (ANOVA), Kolmogorov–Smirnov test of normality and Levene test of homogeneity, as well as a multivariate linear regression model, were conducted. Participants who had not engaged in physical activity showed an increased total anxiety and significantly greater decrease in concentration compared to those who had engaged in physical activity. The Revised Life Orientation Test (LOT-R), Utrecht Work Engagement Scale (UWES) and resilience of participants who had not engaged in physical activity were significantly lower than those of the participants who had engaged in physical activity. Those with a partner showed significantly lower decreases in concentration compared to single women. Regarding UWES, the current scores and dedication of couples were significantly higher than singles, as for resilience. In addition, the levels of pessimism in participants living on the coast were significantly higher compared to those living inland; in addition, a greater number of days with less anxiety is seen in those who performed physical activity. A multivariate linear regression model, F(7, 349) = 30.6, p < 0.001, explained 38% of the variance of LOT-R; those attending a public center had a lower LOT-R than those who did not, and high values of anxiety were associated with low levels of LOT-R, while high values of resilience were associated with high values of LOT-R. The results from the study provide support for future programs for older adults, in order to be able to determine in a much more precise way the objectives of programs intended for users of this age group. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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11 pages, 512 KiB  
Article
Examining Older Adults’ Perspectives on the Built Environment and Correlates of Healthy Aging in an American Age-Friendly Community
by Kathy Black and Dylan J. Jester
Int. J. Environ. Res. Public Health 2020, 17(19), 7056; https://doi.org/10.3390/ijerph17197056 - 27 Sep 2020
Cited by 11 | Viewed by 3914
Abstract
Population aging has led to an increased focus on the environmental context in which we age. While researchers have identified significant health benefits associated with built community features such as housing, transportation and outdoor spaces and buildings, less attention has focused on the [...] Read more.
Population aging has led to an increased focus on the environmental context in which we age. While researchers have identified significant health benefits associated with built community features such as housing, transportation and outdoor spaces and buildings, less attention has focused on the correlates of healthy aging and other characteristics via the perspective of community-dwelling older adults. This study utilized cluster analysis to examine health-related subgroups of older adults (n = 598) in an age-friendly community located in the United States, of which nearly half of its residents are age 60 and older. Linear regression was used to associate the health clusters with perceptions of built environmental features and socio-demographics. Four distinct profiles were identified, with the greatest preference for housing and transportation found among those reporting poorer health compared to those reporting excellent health across multi-dimensional healthy aging measures. Perceptions on the importance of built environmental features were also found to vary by age, income and home accessibility status. Findings suggest that older adults’ perceptions about built environmental features differ across health and home status as well as age and income, underscoring opportunities for public health action to better reach and engage older adults by life-course trajectories in age-friendly communities. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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10 pages, 865 KiB  
Article
Daily Physical Activity and Sedentary Time Assessed by Acceleration Based on Mean Amplitude Deviation among Older People
by Ying Gao, Timo Rantalainen, Taija Finni, Erja Portegijs, Johanna Eronen, Taina Rantanen and Merja Rantakokko
Int. J. Environ. Res. Public Health 2020, 17(18), 6887; https://doi.org/10.3390/ijerph17186887 - 21 Sep 2020
Viewed by 3016
Abstract
Accelerometer-derived estimates of physical activity (PA) and sedentary time have been an important methodological focus. However, little is known about the daily activities among older people during their normal lives. Furthermore, some older individuals would like to be more active, yet experience an [...] Read more.
Accelerometer-derived estimates of physical activity (PA) and sedentary time have been an important methodological focus. However, little is known about the daily activities among older people during their normal lives. Furthermore, some older individuals would like to be more active, yet experience an unmet PA need, which is defined as the desire to engage in more PA but without the opportunity to act on the desire. This study examined the intensity of daily PA and sedentary behavior measured with accelerometers among older people, and whether PA differs between weekdays and weekends and those with and without the experience of unmet PA need, measured with self-reports. A total of 174 community-dwelling older people (64% female) aged 75 to 90 years used an accelerometer for 7 consecutive days during waking hours, and the results were classified for sedentary behavior (thresholds of 0.0167 g), light activity (0.091 g), and moderate-to-vigorous activity (MVPA, 0.414 g) based on mean amplitude deviation (g). We found that during weekdays, older people engaged slightly more in light activity and had less sedentary time than during weekends. In total, 7.6% of the participants perceived an unmet PA need. Accordingly, those with unmet PA needs spent less time in MVPA, especially during weekdays, and they might benefit from PA-enabling interventions. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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15 pages, 2022 KiB  
Article
Understanding Aging Policies in China: A Bibliometric Analysis of Policy Documents, 1978–2019
by Yan Nan, Tieying Feng, Yuqun Hu and Xinzhu Qi
Int. J. Environ. Res. Public Health 2020, 17(16), 5956; https://doi.org/10.3390/ijerph17165956 - 17 Aug 2020
Cited by 26 | Viewed by 4401
Abstract
Aging poses a big challenge in all aspects of social governance in China. A coherent and focused aging policy response that spans multiple sectors of government has been undertaken to achieve the goal of “Healthy Aging”. From an historical perspective, this paper uses [...] Read more.
Aging poses a big challenge in all aspects of social governance in China. A coherent and focused aging policy response that spans multiple sectors of government has been undertaken to achieve the goal of “Healthy Aging”. From an historical perspective, this paper uses a bibliometric analysis method to probe into the evolution of Chinese aging policies from 1978 to 2019, and the roles of core government agencies in policy-making. We obtained 226 Chinese aging policies from the PKULaw Database and the websites of the government departments. Co-word analyses and network analyses were applied in mapping the topics of aging policies and collaboration among the agencies. Gephi software was used to visualize the most frequently used keywords and their network graphs. Findings are as follows. Firstly, the development of the aging policy system in China has undergone two phases, from focusing on basic security to emphasizing the rights and health of the elderly. Secondly, the network structure of aging policy-making departments presents a distinct edge-core layer. More and more government agencies have become involved in the formulation of aging policies. But collaboration among the agencies is insufficient. Thirdly, pilot promotion is the main tool for implementing aging policies. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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17 pages, 879 KiB  
Article
Associations of City-Level Active Aging and Age Friendliness with Well-Being among Older Adults Aged 55 and Over in Taiwan
by Hui-Chuan Hsu
Int. J. Environ. Res. Public Health 2020, 17(12), 4304; https://doi.org/10.3390/ijerph17124304 - 16 Jun 2020
Cited by 12 | Viewed by 3572
Abstract
This study aims to identify the typology of city-level active aging and age-friendliness across cities in Taiwan and examine their effects on well-being in terms of life satisfaction (aged 55 and over) and health-related quality of life (HRQoL) (aged 65 and over) among [...] Read more.
This study aims to identify the typology of city-level active aging and age-friendliness across cities in Taiwan and examine their effects on well-being in terms of life satisfaction (aged 55 and over) and health-related quality of life (HRQoL) (aged 65 and over) among older adults. The data were from the 2017 Taiwan Senior Citizen Condition Survey. Available indicators of Taiwan’s Active Aging Index and city age-friendliness were selected, and mixed linear models were analyzed. Active aging cities were classified into four categories—content, developed, participatory, and pioneer—and age-friendly cities into insecure, infrastructural, and tranquil. Life satisfaction was rated higher in content and participatory cities compared with the pioneer city, and related to individuals’ active aging status. Physical HRQoL was rated higher in infrastructural and tranquil cities, compared with insecure cities. City types of active aging and age-friendliness have different effects on well-being, but the effects are weaker than those of individuals’ characteristics. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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12 pages, 289 KiB  
Article
Factors Associated with Successful Aging among Community-Dwelling Older Adults Based on Ecological System Model
by Hye-Young Jang
Int. J. Environ. Res. Public Health 2020, 17(9), 3220; https://doi.org/10.3390/ijerph17093220 - 6 May 2020
Cited by 32 | Viewed by 6200
Abstract
This study was conducted to identify the factors associated with successful aging in older adults based on the ecological system model. Data from the 2017 National Survey of the Living Conditions of Korean Elderly were used. Participants comprised 10,074 older adults. The three [...] Read more.
This study was conducted to identify the factors associated with successful aging in older adults based on the ecological system model. Data from the 2017 National Survey of the Living Conditions of Korean Elderly were used. Participants comprised 10,074 older adults. The three principal components in the successful aging model developed by Rowe and Kahn, “absence of disease and disease-related disability,” “maintenance of high mental and physical function,” and “continued engagement with life,” were used to determine successful aging. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, and logistic regression. The study results showed that the correlation factors were age, sex, educational level, economic status, heavy drinking, subjective health status, and health screening in the individual system; living arrangement, satisfaction with spouse, and frequency of contacting family, siblings, and relatives in the family system; and the frequency of contacting neighbors and friends, number of close neighbors and friends, and accessibility of neighborhood facilities in the community system. This study is significant because it confirms that individual characteristics and the environmental systems surrounding older adults should be considered for successful aging; it is necessary to develop and apply healthcare intervention programs that consider both of these aspects. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
15 pages, 996 KiB  
Article
The Study of Health-Related Fitness Normative Scores for Nepalese Older Adults
by Jung Kyu Kim, Won Il Son, Ye Jung Sim, Ju Sung Lee and Kamala Oli Saud
Int. J. Environ. Res. Public Health 2020, 17(8), 2723; https://doi.org/10.3390/ijerph17082723 - 15 Apr 2020
Cited by 6 | Viewed by 3523
Abstract
Physical fitness tests are important to maintain and promote the health status of people. The purpose of this study was to develop health-related fitness evaluation norms according to the age and gender of Nepalese older adults. One thousand nine subjects (449 males, 560 [...] Read more.
Physical fitness tests are important to maintain and promote the health status of people. The purpose of this study was to develop health-related fitness evaluation norms according to the age and gender of Nepalese older adults. One thousand nine subjects (449 males, 560 females) above 60 years, residing in 19 wards (rural and urban) of Dhangadhi Sub-Metropolitan City participated in this study. The test included the PAR-Q (Physical Activity Readiness Questionnaire), social aspects questionnaire, blood pressure test, height, weight, BMI (body mass index), percent body fat, and four physical fitness components (grip strength, 1-minute sit-to-stand, sit and reach, and 2-minute step tests). Mean, SD, and fitness evaluation norms for each component were obtained after the main test and statistical analyses. This study showed higher BMI and percent body fat in female age groups than in male age groups. Grip strength, relative grip strength, sit-to-stand, and 2-minute steps scores were better in male age groups than in female age groups, but in contrast, flexibility was better in female age groups. This study may help the related sectors to assess physical fitness, identify fitness levels, and develop appropriate physical activities or exercise programs for older adults based on age. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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17 pages, 589 KiB  
Article
Prevalence and Characterization of Specific Phobia Disorder in People over 65 Years Old in a Madrid Community Sample (Spain) and its Relationship to Quality of Life
by Berta Ausín, Manuel Muñoz, Miguel Ángel Castellanos and Sara García
Int. J. Environ. Res. Public Health 2020, 17(6), 1915; https://doi.org/10.3390/ijerph17061915 - 15 Mar 2020
Cited by 12 | Viewed by 4338
Abstract
The prevalence of anxiety disorders over the last year among seniors ranged from 3.6% to 17.2%. The most prevalent disorders are specific phobias. Data are needed concerning the consequences of specific phobia disorder on the level of functioning and quality of life of [...] Read more.
The prevalence of anxiety disorders over the last year among seniors ranged from 3.6% to 17.2%. The most prevalent disorders are specific phobias. Data are needed concerning the consequences of specific phobia disorder on the level of functioning and quality of life of older people, the age of onset of specific phobia disorder, and the duration of episodes. In total, 555 community-dwelling people aged between 65 and 84 years who lived in Madrid (Spain) were assessed (Composite International Diagnostic Interview for people over 65 years (CIDI65+), WHO Disability Assessment Schedule (WHODAS II), Health of the Nation Outcome Scales for Older Adults (HoNOS65+), World Health Organization Quality of Life Brief (WHOQOL-BREF). Prevalence rates and odds ratio, t-tests, binary logistic regression, and point-biserial correlations were calculated. A total of 12.07% of the sample suffered a specific phobia disorder over the last year. The average age at onset of the specific phobia was 38.78 (sd = 21.61) years. The mean duration of the phobia was approximately 20 (sd = 20) years. A significant effect of the specific phobia was found for the current levels of functioning and quality of life: WHOQOL-BREF total score (p < 0.05), WHODAS II overall score (p < 0.01), and HoNOS65+ total score (p < 0.001). Having specific phobia disorder decreased the level of functioning and negatively affected the quality of life. These data suggest the need for primary healthcare professionals to include the detection of specific phobia disorders in their protocols because people do not receive treatment for this problem, and they might carry it throughout their lives. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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10 pages, 334 KiB  
Article
Satisfaction with Life, Subjective Well-Being and Functional Skills in Active Older Adults Based on Their Level of Physical Activity Practice
by María Antonia Parra-Rizo and Gema Sanchis-Soler
Int. J. Environ. Res. Public Health 2020, 17(4), 1299; https://doi.org/10.3390/ijerph17041299 - 18 Feb 2020
Cited by 56 | Viewed by 5966
Abstract
Studies about the influence of physical activity on life satisfaction, functional ability and subjective well-being in physically active older adults without cognitive impairment are very few for the moment. Therefore, the aim of this research was to evaluate the life satisfaction, functional skills [...] Read more.
Studies about the influence of physical activity on life satisfaction, functional ability and subjective well-being in physically active older adults without cognitive impairment are very few for the moment. Therefore, the aim of this research was to evaluate the life satisfaction, functional skills and subjective well-being of physically active older adults based on the level of activity practiced. The IPAQ (International Physical Activity), CUBRECAVI and LSIA (Life Satisfaction Index) scales were tested for a sample of 397 Spanish older adults between 61 and 93 years of age (M = 69.65; SD = 4.71). The results showed that those who performed high physical activity obtained higher scores in functional skills (p < 0.01) and in the activities of daily living (p < 0.01). In addition, subjective well-being (p < 0.01) and the functional autonomy of older adults (p < 0.01) were related to the level of physical activity that they practiced. In conclusion, it could be said that the older adults with a high level of physical activity have more functional skills and less difficulties performing the activities of daily living, and that they value their autonomy and health better. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
12 pages, 304 KiB  
Article
The Association between Loneliness and Health Related Quality of Life (HR-QoL) among Community-Dwelling Older Citizens
by Siok Swan Tan, Irene N. Fierloos, Xuxi Zhang, Elin Koppelaar, Tamara Alhambra-Borras, Tasos Rentoumis, Greg Williams, Tomislav Rukavina, Rob van Staveren, Jordi Garces-Ferrer, Carmen B. Franse and Hein Raat
Int. J. Environ. Res. Public Health 2020, 17(2), 600; https://doi.org/10.3390/ijerph17020600 - 17 Jan 2020
Cited by 35 | Viewed by 5552
Abstract
Background: This study aimed to assess the association between loneliness and Health-Related Quality of Life (HR-QoL) among community-dwelling older citizens in five European countries. We characterize loneliness broadly from an emotional and social perspective. Methods: This cross-sectional study measured loneliness with [...] Read more.
Background: This study aimed to assess the association between loneliness and Health-Related Quality of Life (HR-QoL) among community-dwelling older citizens in five European countries. We characterize loneliness broadly from an emotional and social perspective. Methods: This cross-sectional study measured loneliness with the 6-item De Jong Gierveld Loneliness Scale and HR-QoL with the 12-Item Short-Form Health Survey. The association between loneliness and HR-QoL was examined using multivariable linear regression models. Results: Data of 2169 citizens of at least 70 years of age and living independently (mean age = 79.6 ± 5.6; 61% females) were analyzed. Among the participants, 1007 (46%) were lonely; 627 (29%) were emotionally and 575 (27%) socially lonely. Participants who were lonely experienced a lower HR-QoL than participants who were not lonely (p ≤ 0.001). Emotional loneliness [std-β: −1.39; 95%-CI: −1.88 to −0.91] and social loneliness [−0.95; −1.44 to −0.45] were both associated with a lower physical HR-QoL. Emotional loneliness [−3.73; −4.16 to −3.31] and social loneliness [−1.84; −2.27 to −1.41] were also both associated with a lower mental HR-QoL. Conclusions: We found a negative association between loneliness and HR-QoL, especially between emotional loneliness and mental HR-QoL. This finding indicates that older citizens who miss an intimate or intense emotional relationship and interventions targeting mental HR-QoL deserve more attention in policy and practice than in the past. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
9 pages, 1887 KiB  
Article
Domain-Specific and Total Sedentary Behavior Associated with Gait Velocity in Older Adults: The Mediating Role of Physical Fitness
by Mario Kasović, Lovro Štefan and Martin Zvonař
Int. J. Environ. Res. Public Health 2020, 17(2), 593; https://doi.org/10.3390/ijerph17020593 - 16 Jan 2020
Cited by 18 | Viewed by 3435
Abstract
Although it has been well-documented that older adults spend a significant amount of time being sedentary and have slower gait velocity, little is known of how physical fitness mediates the association between them. The main purpose of this study was to explore whether [...] Read more.
Although it has been well-documented that older adults spend a significant amount of time being sedentary and have slower gait velocity, little is known of how physical fitness mediates the association between them. The main purpose of this study was to explore whether objectively measured physical fitness mediates the association between domain-specific and total sedentary behavior and gait velocity. We recruited 120 older adults aged ≥ 60 years. Sedentary behavior was assessed by the Measure of Older Adults’ Sedentary Time questionnaire. We used a Zebris pressure platform to assess gait velocity. To assess the level of overall physical fitness, we summed the z-scores of seven tests: (1) waist circumference, (2) chair stand in 30 s, (3) arm curl in 30 s, (4) 2-min step test, (5) chair sit-and-reach test, (6) back scratch test, and (7) 8-foot up-and-go test. Overall physical fitness was obtained by summing up all physical test z-scores. Gait velocity was significantly associated with all domain-specific and total sedentary behavior (β = −0.04 to −0.35, p < 0.05). Overall physical fitness was significantly associated with all domain-specific and total sedentary behavior (β = −0.21 to −1.24, p < 0.001) and gait velocity (β = 0.23 to 0.24, p < 0.001). When physical fitness was put as the mediator, significant direct effects between sedentary behavior and gait velocity disappeared. Results indicate that physical fitness fully mediates the association between sedentary behavior and gait velocity in older adults. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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Review

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34 pages, 762 KiB  
Review
Environmental and Psychosocial Interventions in Age-Friendly Communities and Active Ageing: A Systematic Review
by Diego Sánchez-González, Fermina Rojo-Pérez, Vicente Rodríguez-Rodríguez and Gloria Fernández-Mayoralas
Int. J. Environ. Res. Public Health 2020, 17(22), 8305; https://doi.org/10.3390/ijerph17228305 - 10 Nov 2020
Cited by 30 | Viewed by 7241
Abstract
Background: The academic literature contains little information regarding the interventions that create age-friendly cities and communities in order to promote active ageing. Objectives: A systematic review was carried out to determine the available empirical evidence in relation to the characteristics, content and effectiveness [...] Read more.
Background: The academic literature contains little information regarding the interventions that create age-friendly cities and communities in order to promote active ageing. Objectives: A systematic review was carried out to determine the available empirical evidence in relation to the characteristics, content and effectiveness of interventions aimed at improving environmental and psychosocial risk factors for older people, from the perspective of age-friendly communities and the promotion of active ageing. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the studies retained in this review were identified through a systematic search of the academic literature in selected electronic databases including Web of Science and Scopus. Independent critical appraisal and data extraction were conducted by two reviewers. The checklist was used to assess the quality of the articles. Findings: The search identified 1020 potentially eligible documents, of which 11 satisfied the established criteria. Non-exhaustive practices prevailed over rigorous investigations, with a high proportion of studies observed to be of low methodological quality and at high risk of bias. This reflected the predominance of uncontrolled interventions. Environmental interventions were focused on reducing risk and adapting the everyday environmental setting, while psychosocial interventions prioritised social strategies (behavioural changes, promotion of participation) and training. Interventions were more effective in certain domains of age-friendly cities and communities such as transportation and housing, followed by increased participation as a lifestyle-related behavioural change. The inferred changes were associated with providing information and enhancing skills; modifying access, barriers, exposures, and opportunities; enhancing services and support; continuity and effectiveness of changes over time; and modifying policies based on the bottom-up approach of age-friendly cities and communities (AFCC). Discussion and conclusion: Interventions focused on personal and organisational aspects might have positive effects in the longer term. However, fewer changes would be observed in interventions revolving around changing lifestyles owing to the impact of complex multi-causal factors. The relative effectiveness in terms of health calls into question the design of interventions and the supposed “friendliness” of certain communities. There is a need to encourage sound longitudinal research aimed at providing key knowledge for the implementation and evaluation of public policies, and to encourage age-friendly community programmes to promote active ageing. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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Other

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7 pages, 332 KiB  
Brief Report
Proximity to Facilities and Its Association with the Health-Related Habits of Functionally Independent Older Adults
by Mónica Machón, Kalliopi Vrotsou, Isabel Larrañaga and Itziar Vergara
Int. J. Environ. Res. Public Health 2020, 17(22), 8677; https://doi.org/10.3390/ijerph17228677 - 23 Nov 2020
Cited by 4 | Viewed by 2918
Abstract
The aim was to examine how proximity to facilities, as a component of community determinants, is associated with the health-related habits of functionally independent community-dwelling older adults. This was a cross-sectional study. Data were collected by face-to-face interviews. Participants were >65 years old, [...] Read more.
The aim was to examine how proximity to facilities, as a component of community determinants, is associated with the health-related habits of functionally independent community-dwelling older adults. This was a cross-sectional study. Data were collected by face-to-face interviews. Participants were >65 years old, living in 15 municipalities of Gipuzkoa (Basque Country, Spain). Proximity to park-green spaces, cultural-sport centers, market-food stores, retirement associations, religious centers, primary care centers and hospitals was explored. Sociodemographic variables and health-related habits (diet, physical activity and self-perceived social life) were collected. Logistic regression models were performed. The sample comprised of 634 individuals (55% women; mean age: 74.8, SD 6.7 years). Older age (odds ratio-OR: 0.94, 95% CI: 0.91–0.97) was associated with lower physical activity, while being male (OR: 1.71, 95% CI: 1.08–2.68) and proximity to park-green spaces (OR: 1.64, 95% CI: 1.03–2.61) were related to more physical activity. Individuals with good self-perceived health (OR: 3.50, 95% CI: 1.82–6.74) and religious centers within walking distance (OR: 2.66, 95% CI: 1.40–5.04) had higher odds of a satisfactory social life. Encouraging the creation of park-green spaces and leisure centers near residential areas can assist in promoting physical activity and improving the social life of older adults. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
9 pages, 481 KiB  
Commentary
Towards Inclusive Healthcare Delivery: Potentials and Challenges of Human-Centred Design in Health Innovation Processes to Increase Healthy Aging
by Catharina Thiel Sandholdt, Jason Cunningham, Rudi G.J. Westendorp and Maria Kristiansen
Int. J. Environ. Res. Public Health 2020, 17(12), 4551; https://doi.org/10.3390/ijerph17124551 - 24 Jun 2020
Cited by 15 | Viewed by 4915
Abstract
National healthcare systems need to adjust services and operations to accommodate the needs of complex, aging populations living with multimorbidity and polypharmacy. This paper suggests the use of a human-centred design as a method to engage older adults and key professionals in innovation [...] Read more.
National healthcare systems need to adjust services and operations to accommodate the needs of complex, aging populations living with multimorbidity and polypharmacy. This paper suggests the use of a human-centred design as a method to engage older adults and key professionals in innovation processes aiming to design person-centred healthcare services and improve quality of life in older adults. We outline three innovation phases and highlight how such processes can create engagement and new insights on how life experiences of older adult’s shape preferences, beliefs, and habits. It is important to incorporate these insights into the design of successful strategies for ensuring age-friendly healthcare services. Our viewpoint is contextualised through a small-scale case study focusing on polypharmacy in older adults. From this case study, we extracted three challenges to producing co-designed health research: recruitment, time and resources, and funding. We discuss how to address these challenges. We argue for the involvement of older adults and professional stakeholders at an early stage in the design process to align expectations and to increase the likelihood of successful implementation of healthcare innovations that improve the quality of life for older adults. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
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