Active Aging and Public Health: Evidence, Implications, and Opportunities

Dogra, Shilpa; Dunstan, David W.; Sugiyama, Takemi; Stathi, Afroditi; Gardiner, Paul A.; Owen, Neville

doi:10.1146/annurev-publhealth-052620-091107

Cited by 106 publications

(52 citation statements)

References 137 publications

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“…In our study, in the well-above-average level of active aging group indicts the participants were more independent and had fewer depressive symptoms. It is consistent with the results found in an annual review report ( 43 ).…”

Section: Discussionsupporting

confidence: 93%

The mediation and interaction of depressive symptoms in activities of daily living and active aging in rural elderly: A cross-sectional survey

Fu¹,

Su²,

Zeng³

et al. 2022

Front. Public Health

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BackgroundCompared with urban areas, old adults in rural areas have limited access to medical and health resources in China. Active of daily living ability (ADL) decline and depressive symptoms are common in rural older adults. In particular, the depressive symptoms of the elderly in rural areas are often ignored. Thus, it is difficult to realize high-level active aging at the individual level. In order to explore the effects of ADL and depressive symptoms on the active aging of rural elderly, we conducted a survey and analyzed the mediation and interaction effects of depressive symptoms of ADL on active aging.MethodsFrom July to November 2019, a cross-sectional study of 945 elderly rural individuals was conducted in three townships in Xiangtan County, China. Active aging, ADL, and depressive symptoms were assessed using the positive aging questionnaire (PAEQ), ADL scale, and depression in old age scale (DIA-S), respectively. PROCESS macro program model 4 and logistic regression were used to explore the mediation and interaction between ADL and depressive symptoms on active aging.ResultsThe proportions of rural elderly with an active aging level were 23.5% (well above average), 50.9% (above average), 24.1% (below average), 1.5% (well below average), respectively. The rates of ADL decline and depressive symptoms were 44.7 and 19.7%, respectively. Mediated effect analysis showed that the relationship between ADL and active aging could be partly mediated by depressive symptoms (ab = −0.2382, boot SE = 0.0437), and the 95% confidence interval was [−0.3311, −0.1584]. The mediating effect proportion of the total effect was 30.7%. Logistic regression showed that ADL and depressive symptoms have an interactive additive effect on active aging. The relative excess risk of interaction (RERI), the attributable proportion due to interaction (API), and the synergy index (SI) scores were 13.109, 0.621, and 2.871, respectively. Older adults with ADL decline and depressive symptoms had higher (OR = 21.115) odds of well-below-average active aging compared with older adults with ADL decline (OR = 3.258) or only depressive symptoms (OR = 5.749).ConclusionThe findings suggest that the association between ADL and active aging is persistent and partly mediated by depressive symptoms, and comorbid depressive symptoms and ADL decline have an additive effect on active aging. Maintaining independence is an important factor for realizing active aging. However, for the rural elderly with ADL decline and low-level active aging, we can promote the realization of high-level active aging at the individual level through the prevention and treatment of depressive symptoms based on multidisciplinary care.

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Section: Discussionsupporting

confidence: 93%

The mediation and interaction of depressive symptoms in activities of daily living and active aging in rural elderly: A cross-sectional survey

Fu¹,

Su²,

Zeng³

et al. 2022

Front. Public Health

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“…The growth of the elderly population is a stimulating aspect for the advancement and diversity of novel biomaterials. A United Nations report indicates that the population over 60 years of age is expected to increase from 302 million in 2019 to 366 million in high-income countries in 2030 [1]. This information is consistent with the increase in this group even in countries whose socioeconomic structure is different.…”

Section: Introductionmentioning

confidence: 60%

Evaluation of Microstructure and Mechanical Properties of a Ti10Mo8Nb Alloy for Biomedical Applications

Capellato

Vilela

Fontenele

et al. 2022

Metals

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The growth of the elderly population is urging for more suitable biomaterials to allow the performance of better surgical and implant procedures and accelerate the patient’s healing because the elderly are more vulnerable to orthopedic and dental problems. β-phase Ti alloys can improve the mechanical properties of implants by reducing their elastic modulus and, consequently, the effects of stress shielding within bones. Therefore, the objective of this article is to study a novel ternary β-phase alloy of Ti10Mo8Nb produced by an electric arc furnace and rotary forge. The microstructure and mechanical properties of the Ti10Mo8Nb alloy were investigated in order to evaluate its suitability for biomedical applications and compare its characteristics with those present in Ti-alloys commerced or widely researched for prosthetic purposes. A tensile test, Vickers microhardness test, use of microstructure of optical microscopy for examination of microstructure, X-ray diffraction and hemolysis analysis were carried out. Thus, the Ti10Mo8Nb alloy showed suitable properties for biomedical applications, as well as having the potential to reduce the possibility to occur stress shielding after prosthetic implantations, especially for orthopedics and dentistry.

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“…Since ARFIs may be the result of multi-system pathophysiological changes, 55 active and healthy aging should focus on the prevention of multiple function impairments as a whole. 56 By preventing and delaying ARFIs, the goal of healthy longevity not merely prolongs life expectancy but also reduces disability among older adults. 57 In clinical practice, diagnosis of a single function impairment may also imply other dysfunctions that are worth attention, thus helping in the early detection of other ARFIs and identification of individuals at higher mortality risk.…”

Section: Discussionmentioning

confidence: 99%

Progression and trajectory network of age-related functional impairments and their associations with mortality: a two-decade prospective study

Chen

Wang

et al. 2022

Preprint

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Objective: To characterize the progression and trajectory network of age-related functional impairments and assess their associations with mortality. Design: Prospective cohort study. Setting: The Health and Retirement Study (HRS, 2000-2020). Participants: A total of 17 914 HRS participants aged from 51 to 90 years in 2000. Main outcome measure: Age-related functional impairments including visual impairment, hearing impairment, cognitive impairment, physical frailty, restless sleep, and depression, all measured using structural questionnaires biennially or quadrennially. All-cause mortality was ascertained from multiple sources. Results: During follow-up (median=12 years), the incidence rates of visual impairment (59.3 cases/1000 person years), hearing impairment (52.1 cases/1000 person years), physical frailty (31.7 cases/1000 person years), and cognitive impairment (42.5 cases/1000 person years) increased exponentially with age (P-trend <0.001), while those of restless sleep (75.6 cases/1000 person years) and depression (35.6 cases/1000 person years) increased relatively slowly. We detected bidirectional associations among all ARFIs (P <0.001). Overall, each additional ARFI was associated with 13% (11%-15%) higher risk of mortality, with independent associations observed for physical frailty (hazard ratio: 1.59, 95% confidence interval: 1.49-1.69), depression (1.38, 1.30-1.46), visual impairment (1.19, 1.13-1.26), and cognitive impairment (1.13, 1.06-1.21). Conclusions: ARFIs were highly interconnected as a network and were associated with mortality, which highlighted the importance of integrated strategies to monitor and manage the ARFIs to achieve healthy longevity.

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Active Aging and Public Health: Evidence, Implications, and Opportunities

Cited by 106 publications

References 137 publications

The mediation and interaction of depressive symptoms in activities of daily living and active aging in rural elderly: A cross-sectional survey

The mediation and interaction of depressive symptoms in activities of daily living and active aging in rural elderly: A cross-sectional survey

Evaluation of Microstructure and Mechanical Properties of a Ti10Mo8Nb Alloy for Biomedical Applications

Progression and trajectory network of age-related functional impairments and their associations with mortality: a two-decade prospective study

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