Comprehensive 5P framework for active aging using the ecological approach: an iterative systematic review

Abstract

Background: "Active aging" is an inclusive term and has been defined from a variety of aspects in different domains throughout the literature. The aim of this review was to identify those aspects that play significant roles in building this concept using an ecological approach. Methods: In this study, seven online databases, including JSTOR, Pub-Med, Web of Science, Google Scholar, ProQuest, EBSCO, and Scopus, were searched from 2002 to 2018 for both qualitative and quantitative articles published in English. Two reviewers independently found the related articles using the search terms "active aging" and "built environment" and included both "ageing" and "aging". Results: Of 1500 records which passed the screening stage, 92 were eligible for inclusion in the review. A total of 15 subthemes were derived: (1) personal characteristics, (2) behavioral attitude, (3) land use, (4) access, (5) physical form, (6) cityscape/city image, (7) public open spaces, (8) housing, (9) social environment, (10) cultural Environment, (11) economic environment, (12) good governance, (13) physical health, (14) mental health, and (15) social health. Ecological themes of active aging can be defined as the 5P model: person, processes, place, prime, and policymaking. Conclusions: The results of this study can shed light on different aspects of active aging. Also, the results emphasized the significance of the multidimensional nature of active aging, micro (person), meso (process), and macro systems (place and policymaking), based on health (prime) environments. Moreover, the results were based on the relationships between the person and the environment at the individual, interpersonal, and environmental levels, which can be used to conduct future studies and develop policies on aging populations.

Psychosocial Determinants of Quality of Life and Active Aging. A Structural Equation Model

“…Taking into account ecological perspectives, many studies suggest that age-friendly communities (characterized by social participation, secure living, social connections, and lifelong learning) have positive effects on self-perceived health [44] and life satisfaction [45]. We obtained the same result in our model.…”

Age-Friendly Ecosystems for Community Participation: A Rapid Realist Review

“…Between 2012 and 2020 selected studies took place in Brazil, 17,18 Canada, 19 Iran, 20 Ireland, 21 Korea , 22 Netherlands, 23 Portugal, 24 UK, 25 and the USA. 26,27,28,29,30 All were peer reviewed articles with one editorial commentary.…”

“…Drawn from selected sources, ecosystems were variously described in terms of a model, framework or approach 20,24,27,28 to guide research: The Portland and Multnomah County age-friendly initiatives are useful for exploring the relationship between the World Health Organization's (WHO) age-friendly framework and the application of the ecological perspective to research and action related to a set of age-friendly initiatives co-coordinated by the initiatives' Advisory Council 28 p130-131 or as intervention : 'The AAL4ALL project has developed a conceptual architecture to support an ecosystem of integrated (collaborative) care and assistance services. The architecture follows a holistic sociotechnical approach, which is reflected in the ecosystem notion'.…”

“…There is an existing and identified need to provide support for older people. Needs can arise in relation to a critical event such as the COVID pandemic where Lak et al 20 highlight that an ecological approach to promote active ageing is required in which social, (social contact, networks, neighbourliness) civic, financial (affordable housing, services) cultural (events, activities) and spiritual (religious) needs are supported. Bettis et al 27 also identify social needs, particularly through family and friends and mental health support through counselling.…”

Fostering Well-Being in the Elderly: Translating Theories on Positive Aging to Practical Approaches

“…Older adults should be provided with the necessary support to maintain a good balance between their decreased physical ability and increased transcendence, which can be significantly enhanced by tapping personal, environmental, and social resources. This equilibrium includes physical and mental health at the micro level (personal), social well-being, and spirituality/transcendence (process) at the meso level, while living in a favorable and appropriate environment (43). Many older adults constitute a resourceful group that can contribute actively to society, realize their own potential, cope with normal stressors of life, and contribute to their community productively and fruitfully.…”