Background The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. Objective This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias. Methods A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework–Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. Results A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted. Conclusions Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

Purpose: PRISMA is an innovative co-ordination-type Integrated Service Delivery System developed to improve continuity and increase the efficacy and efficiency of services, especially for older and disabled populations. Description:The mechanisms and tools developed and implemented by PRISMA include: (1) co-ordination between decision-makers and managers, (2) a single entry point, (3) a case management process, (4) individualised service plans, (5) a single assessment instrument based on the clients' functional autonomy, and (6) a computerised clinical chart for communicating between institutions for client monitoring purposes. Preliminary results:The efficacy of this model has been tested in a pilot project that showed a decreased incidence of functional decline, a decreased burden for caregivers and a smaller proportion of older people wishing to be institutionalised. Conclusion:The on-going implementation and effectiveness study will show evidence of its real value and its impact on clienteles and cost. Keywords health services for the aged, integrated service delivery systems, frail elderly, programme evaluationAlthough the problem of continuity applies to and is significant for all health care and services, it is particularly acute at the present time in regard to the frail elderly. Many factors-demographic (accelerated ageing of the population), social (break-up of families, children moving away to find work), economic (low income women living alone), health (increased life expectancy, high incidence of disabilities) and financial (reduced health care budgets)-are putting strong pressure on both the demand for and the supply of services for this clientele. Functional decline generates an increased need, for both the dependent individuals and their families, for evaluation, treatment, rehabilitation, psychological and social support, help to remain at home, and temporary or permanent longterm care facilities w1x. These multiple needs can also change quickly over time due to the biological, psychological and social vulnerability of this frail clientele. In terms of supply, a wide range of resources and services involving numerous practitioners and partners have been developed over the past twenty years to try to meet these needs. However, continuity-related problems compromise both service accessibility and the efficiency of health care services. For example: multiple entry points, service delivery which is influenced by the resource contacted rather than the user's need, numerous redundant evaluations of clienteles not using standardised tools, inappropriate use of costly resources (e.g. hospitals, emergency services), waiting time for services, inadequate transmission of information, and the piecemeal response to needs w2-4x. In a situation where resources are scarce and the demand for services is increasing, it is essential to ensure that the services meet the users' needs, without duplication and as efficiently as possible. Therefore, there is an urgent need to provide managers and decision-maker...

Background: This study aimed at evaluating face and content validity, feasibility and reliability of process quality indicators developed previously in the United States or other countries. The indicators can be used to evaluate care and services for vulnerable older adults affected by cognitive impairment or dementia within an integrated service system in Quebec, Canada.

R É S U M É L'objectif de cette étude vise à évaluer l'efficacité d'un nouveau réseau de services intégré (RSI) pour les personnes âgées vulnérables en milieu semi-urbain. Une étude quasi-expérimentale avec mesures avant (T0) et après à chaque 12 mois (T1, T2, T3), de 1997 à 2000; auprès d'une cohorte initiale de 482 personnes dont 272 dans le groupe expérimental et 210 dans le groupe témoin. Les analyses ont été faites en employant des tests statistiques paramétriques et non-paramétriques, modèle linéaire généralisé et régression de Cox pour les analyses de survie. Une tendance à la baisse de l'hébergement a été observée et le désir d'être hébergé était plus faible dans le groupe expérimental. Quand le suivi sans détérioration était analysé en fonction de l'autonomie, le RSI avait des effets positifs à T1 et qui tendaient à se maintenir à T2 chez les personnes en plus grande perte d'autonomie. Le fardeau des aidants était moindre à T1 et T2 dans le groupe expérimental. Le RSI a eu peu d'effet sur l'utilisation des services de santé. Le RSI a effectivement produit des effets jugés importants pour une population âgée.The aim of this study was to examine the effectiveness of a new, integrated service delivery (ISD) network of health and social services for frail elderly living in a semi-urban community. A quasi-experimental study was conducted from 1997 to 2000, with measures taken before implementation (T0) and every 12 months after implementation for a 3-year period (T1, T2, T3); 482 people aged 75 years or older from 2 communities, 272 in the experimental and 210 in the control group, were followed. Analyses were conducted using parametric and non-parametric statistics, a generalized linear model, and Cox regression for survival analysis. A declining trend in institutionalization was observed and the desire to be institutionalized was lower in the study group. When absence of deterioration on follow-up was analysed in terms of the level of autonomy, the ISD network produced positive effects on the frailer clientele at T1, effects that tended to be maintained at T2. In regard to caregivers' burden, the ISD network seemed to have been effective, with caregivers' burden being less at T1 and T2. The ISD network did not have a marked effect on the utilization of services.