To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge-org.demo.remotlog.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Prior research indicates that both structural and functional networks are compromised in older adults experiencing depressive symptoms. However, the potential impact of abnormal interactions between brain structure and function remains unclear. This study investigates alterations in structural–functional connectivity coupling (SFC) among older adults with depressive symptoms, and explores how these changes differ depending on the presence of physiological comorbidities.
Methods
We used multimodal neuroimaging data (dMRI/rs-fMRI) from 415 older adults with depressive symptoms and 415 age-matched normal controls. Subgroups were established within the depressive group based on the presence of hypertension, hyperlipidemia, diabetes, cerebrovascular disease, and sleep disorders. We examined group and subgroup differences in SFC and tracked its alterations in relation to symptom progression.
Results
Older adults with depressive symptoms showed significantly increased SFC in the ventral attention network compared with normal controls. Moreover, changes in SFC within the subcortical network, especially in the left amygdala, were closely linked to symptom progression. Subgroup analyses further revealed heterogeneity in SFC changes, with certain physiological health factors, such as metabolic diseases and sleep disorders, contributing to distinct neural mechanisms underlying depressive symptoms in this population.
Conclusions
This study identifies alterations in SFC related to depressive symptoms in older adults, primarily within the ventral attention and subcortical networks. Subgroup analyses highlight the heterogeneous SFC changes associated with metabolic diseases and sleep disorders. These findings highlight SFC may serve as potential markers for more personalized interventions, ultimately improving the clinical management of depression in older adults.
While ageing in place emphasises autonomy and the preference of older adults to remain in familiar environments, and ageing and place shifts attention to their movement across multiple locations, both frameworks have paid insufficient attention to the role of social networks in shaping the spatial practices of ageing. In this article, we propose ageing in networks as a complementary approach that foregrounds relationality. Rather than supplanting place-based models, ageing in networks highlights how older adults navigate spaces—both near and far—through their social ties, and how these ties mediate access to emotional and practical support. Drawing on original survey data from 1,199 residents aged 60–92 in two Singaporean public housing areas (Hougang and Taman Jurong), we examine how older adults mobilise both strong and weak ties—including friends, co-workers, and digitally mediated contacts—across everyday sites such as hawker centres, markets, malls, and churches. These connections often span neighbourhoods, suggesting that older adults are not merely attached to their residential areas but are actively sustaining dispersed, networked geographies of care and companionship. Crucially, we find that expansive social ties can buffer the challenges of living alone. We argue that social isolation, more than spatial isolation, poses the greater risk to older adults’ well-being.
The body acquires knowledge through interactions with the world. This knowledge resides in the body and shapes our physical, social and emotional experiences. Older adults possess extensive embodied knowledge, but its expression can be suppressed by environmental and social change, such as relocating to a residential care home (RCH). Dancing is more than movement; it is an embodied activity that involves complex interactions among the body, space, time and other people. Dance has been shown to benefit older adults, yet existing research often focuses on physical and cognitive outcomes, with limited attention to dance as an embodied lived experience, especially in an RCH context. This study explores six older adults’ lived experiences of dancing. Its interpretative phenomenological analysis reveals that participants possessed a vast reserve of embodied knowledge which emerged when they participated in synchronised seated dance. Two superordinate themes – embodied musicality and rekindled connections to the lifeworld – detail how older adults expressed embodied knowledge during dance, becoming connected with their body, space, time and others, nurturing a sense of self. Dancing also helped participants navigate the changes in their body and environment, enriching their living experience in an RCH. The findings contribute to the broader field of dance research, demonstrating how seated dance facilitates accessing and expressing embodied knowledge later in life, and to the limited research on dance in RCHs, positioning dance as a meaningful mode of self-expression and continuity for older adults, supporting their transition to these settings with rich emotional experiences.
Recent literature has shown that appetite loss during ageing can lead to negative health outcomes in older adults, particularly malnutrition and mortality. However, its association with functional decline and the mechanisms driving this relationship are not well explored. This review summarises the current evidence regarding the potential effects of appetite loss on frailty and functional outcomes. Despite the limitations due to heterogeneous methodologies, including study designs, population characteristics and appetite assessments, most studies indicate that older adults with poor appetite tended to exhibit poor physical performance and increased functional limitations. Furthermore, the simultaneous weight loss in individuals experiencing appetite loss was associated with a higher risk of functional impairments. Finally, emerging evidence connects reduced appetite to biomarkers of ageing, including epigenetic alterations, chronic inflammation and the upregulation of GDF-15. Therefore, loss of appetite is a potential earlier marker of loss of function that deserves further investigation. Adopting a geroscience perspective may enhance our understanding of appetite loss during ageing and foster the development of effective interventions.
Cognitive and behavioral factors contribute to the mitigation of stress-related health outcomes in later life. Given that stress management interventions for older adults are an important target for healthcare, there is a need for a relatively short and standardized assessment tool to comprehensively measure stress and coping in later adulthood while minimizing the burden on participants. The Stress Assessment Inventory (SAI), a 123-item measure designed to assess stress and coping resources in younger adults.
Objective
The objective of this study was to examine the psychometric properties of the SAI in 294 older adults.
Methods
The SAI was evaluated on its dimensionality, reliability, and validity.
Findings
A shortened SAI is proposed for older adults, with good internal consistency and criterion validity. The Revised SAI was found to have a three-factor model that captures Adaptive Cognitive Resources, Maladaptive Behavioral and Cognitive Habits, and Adaptive Health Habits.
Discussion
The current study supports the use of the Revised SAI in community-dwelling older adult populations as a comprehensive tool to assess stress and coping for use by researchers and healthcare professionals.
We evaluated performance-based differences in neuropsychological functioning in older adults (age 65+) across the dementia continuum (cognitively intact, mild cognitive impairment, and dementia) according to recent cannabis use (past six months).
Method:
A sample of 540 older adults from a well-characterized observational cohort was included for analysis. Participants completed a standardized questionnaire assessing cannabis use in the six months prior to the study visit and completed a comprehensive neuropsychological assessment. We used traditional cross-sectional analyses (multivariate, univariate) alongside causal inference techniques (propensity score matching [PSM]) to evaluate group differences according to recent cannabis use status. We also examined whether cannabis-related problem severity, a risk factor for cannabis use disorder (CUD), was associated with cognitive outcomes among those reporting recent cannabis use.
Results:
Approximately 11% of participants reported using cannabis in the prior six months, with the median user consuming cannabis two to four times per month. Participants with recent cannabis use performed similarly across all five domains of neuropsychological functioning compared to those with no cannabis use. Among older adults reporting recent cannabis use, those with elevated risk for CUD demonstrated lower memory performance.
Conclusions:
These preliminary results are broadly consistent with other findings indicating that low-frequency cannabis use among older adults, including those along the dementia continuum, is generally well tolerated from a cognitive perspective. However, among older adults who used cannabis, elevated symptoms of CUD may negatively impact memory performance. Future research should explore how variations in cannabis use patterns, individual characteristics, and clinical phenotypes influence cognitive outcomes.
This study aimed to assess the relationship between selected parameters of nutritional status and the occurrence of frailty syndrome in older adults by analysing clinical and socio-demographic factors. Methods: The study included 150 community-dwelling participants aged > 60 years who were qualified in the medical centre. The following research tools were used: activity of daily living, instrumental activities of daily living, survey of health, aging, and retirement in Europe, geriatric depression scale, mini mental state examination (MMSE), anthropometric measurements, mini nutritional assessment (MNA), body composition measurements, and biochemical blood tests. Results: The study included 150 people over 60 years of age (mean age 76.2/SD 4.9), including 104 women and 46 men. Participants in the frail group were significantly older (KW-H: P < 0.001) and had a higher level of depression (P = 0.008), whereas on the MMSE scale, they achieved a lower result (P < 0.001) than those in the non-frail and pre-frail groups. People in the frail group had significantly lower levels of nutritional status (P < 0.001) according to the MNA scale, assessment of basic activities in everyday life (P = 0.005), complex activities of everyday life (P < 0.001), hand grip strength of the right hand (P = 0.038) and left hand (P = 0.028), and energy drop (P < 0.001). They were also characterised by difficulties walking (P < 0.001), less frequent physical activity (P < 0.001), loss of appetite (P < 0.001), and weight loss more often (P < 0.05). Conclusion: Advanced age, a greater number of diseases, worse functional and mental performance, and differences in nutritional status and body composition were observed in people with frailty syndrome.
This study aimed to identify the associations between possible sarcopenia (p-sarcopenia) and fall risk, depression, and quality of life (QOL) in middle-aged (age ≥ 45 years) and older (age ≥ 65 years) adults. In this study, we analyzed a total of 10,181 men and women aged 45–85 years from the initial survey sample of the 2006 Korean Longitudinal Study of Aging. Among middle-aged men (women) adults, fall risk and depression were 4.09 (1.34) and 2.25 (2.05) times higher in the p-sarcopenia group than in the non-possible sarcopenia (np-sarcopenia) group, respectively (p < 0.05). Middle-aged and older men and women all showed low QOL-related scores, especially middle-aged men and women in the p-sarcopenia group (p < 0.05). Therefore, adequate management of sarcopenia is necessary in both older and middle-aged adults to reduce its burden as a public health concern.
Digitalisation has given rise to concerns about the future effectiveness of older adult grassroots organisations in enabling group-based participation in later life. Despite this, these organisations and their potential role in securing a just digital transition has featured in neither research debates nor policy and innovation agendas. It is essential that this absence is addressed to ensure future citizenship rights across civic, social and political spheres within digitalising ageing societies. The aim of this article is to explore the impact of digital transformations on the capacity of older adult grassroots organisations to support group-based multifaceted engagement in later life. Focusing on an Irish national voluntary membership-based organisation, and its network of local groups, this analysis draws on data from a multi-level mixed-methods study design. Data collection involved: European expert interviews (n = 4); social media analysis (X); organisational-level interviews (n = 11); an older adult member survey (n = 464); follow-up lifecourse interviews (n = 40); and a Translational Forum involving participants from all research strands to validate findings and agree key messages (n = 13). The analysis demonstrates the transitional nature of digital communication for these groups, and the need to and difficulties in addressing the diverse preferences and digital literacies of grassroots membership. The analysis also shows that the most significant challenges are systemic and structural in nature. An assets-based, capability-orientated approach that is supported by state-level leadership and resourcing is required to equip ageing societies for an equitable digital transition.
Multimorbidity is increasingly common among older adults in Sub-Saharan Africa (SSA), yet the role of social determinants in shaping its prevalence and outcomes remains underexplored.
Objectives
This review aimed to (a) identify the prevalence, types, and patterns of multimorbidity among older adults in SSA; (b) examine the influence of social determinants such as income, education, healthcare access, and geographic location; (c) evaluate current approaches for prevention and management; and (d) propose directions for future research.
Methods
A systematic search of six databases (PubMed, EMBASE, PsycINFO, Google Scholar, CINAHL, and Global Index Medicus) was conducted to identify quantitative studies published between 2000 and 2024 on adults aged 50 and above. Of 841 records screened, 16 studies met inclusion criteria and passed quality appraisal. The review protocol was registered in PROSPERO (CRD42024607875).
Results
Multimorbidity ranged from 5.4% in Botswana to 71% in Nigeria. Cardiometabolic conditions often co-occurred with infectious and mental disorders. Poverty and low education significantly increased risk (OR: 1.44–7.44). Rural residents faced limited healthcare access, while urban dwellers had higher risks from lifestyle factors. Obesity and food insecurity further heightened vulnerability, especially among women and older adults.
Significance of Results
Findings indicate that social determinants critically shape multimorbidity risk and outcomes in SSA. Integrated care models, targeted interventions, and policies addressing structural inequalities are urgently needed. Future research should apply longitudinal and qualitative approaches to clarify causal pathways and inform context-sensitive strategies.
This study compared red meat, white meat and vegetable consumption before, during and after COVID-19 pandemic among older adults in regional China. Data were collected from urban individuals aged 60+ years in Nanjing municipality in 2018, 2021 and 2023. Differences in food intake frequencies between participants and survey years were examined. Logistic regression models were employed to identify influencing factors of meat, and vegetable consumption. Totally, 13 792 participants were analysed, with 4355, 4622 and 4815 from 2018, 2021 and 2023 surveys, respectively. The mean weekly intake frequency (sd) in 2018, 2021 and 2023 was, separately, 3·85 (sd 2·83), 3·21 (sd 2·90) and 4·71 (sd 3·94) for red meat; 1·38 (sd 1·21), 2·08 (sd 1·90) and 2·73 (sd 2·55) for white meat; and 10·98 (sd 4·84), 10·00 (sd 5·04) and 10·34 (sd 5·04) for vegetable. Moreover, 23·2, 32·6 and 52·3 % of participants met the recommendation for meat intake, while 53·7, 46·8 and 49·6 % reached vegetable intake recommendation before, during and after COVID-19 pandemic, respectively. Meat intake was positively associated with education, marital status and drinking, but negatively associated with age. Additionally, education and marital status were in negative relation to vegetable consumption, while smoking and drinking were positively associated with vegetable intake. The older residents consumed less red meat and vegetable but more white meat during COVID-19 pandemic, and their consumption levels of meat and vegetable went up after the pandemic. These findings highlight the need for targeted interventions to support older adults’ dietary habits during emergency events.
Social isolation and loneliness have been linked to adverse health outcomes such as depression in old age. However, limited data exist on the association of loneliness and social isolation with probable depression (PD) in low- and middle-income countries (LMICs), while psychosocial mediators are largely unknown. This study investigates the individual and joint associations of social isolation and loneliness with PD among older adults in Ghana. It quantifies the extent to which psychosocial factors mediate the associations. Cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behaviour Study were analyzed. PD was defined as moderate to severe depressive symptoms with the Center for Epidemiologic Studies Depression (CES-D-9) scale. Loneliness and social isolation were assessed with the University of California, Los Angeles 3-item loneliness scale and the Berkman-Syme Social Network Index, respectively. Multivariable logistic models and PROCESS macro bootstrapping mediation analyses were performed. Among the 1,201 adults aged ≥50 years (Mage = 66.1 ± 11.9 years, 63.3% women), 29.5% PD cases were found. The prevalence of social isolation and loneliness was 27.3% and 17.7%, respectively. Loneliness (OR = 3.15, 95% CI = 3.26–5.28) and social isolation (OR = 1.24, 95% CI = 1.10–1.41) were independently associated with higher odds of PD. The loneliness and PD association was modified by spatial location (Pinteraction = 0.021); thus, the association was more pronounced in rural areas (OR = 7.06) than in urban areas (OR = 3.43). Psychosocial factors (e.g. sleep problems) mediated the loneliness/social isolation and PD association. Loneliness and social isolation were independently associated with a higher likelihood of PD, and psychosocial factors mediated the associations. Interventions to reduce PD in later life should also consider addressing loneliness and social isolation, as well as sleep problems.
The global population is ageing rapidly, emphasising the need to understand the decision-making processes of older adults regarding potential care transitions. Gerontological research has focused on healthcare decisions, with less information on living situation choices of older adults. This review explored older adults’ experiences with their involvement in decision-making processes related to transitioning into care facilities in the United Kingdom. From a systematic search of articles, nine were reviewed using thematic narrative synthesis. Four themes with nine subthemes were identified: Involvement in decision-making (Exclusion of older adults, Usefulness of involvement), The necessity of moving (Triggers for moves, The role of family), Timely planning (Helpfulness of planning, Planning avoidance), and Factors for choosing a care home (Non-quality factors, Quality factors, Continuity of life). These themes highlighted the issue of inadequate involvement of older adults in decision-making, often resulting in negative consequences like regret and difficulty settling into new care settings. The necessity of moving arose from sudden events or increased support needs. Some older adults acknowledged the necessity due to declining health or to spare family burden, while relatives grappled emotionally, postponing the choice. Timely planning was found to be beneficial practically and emotionally, facilitating smoother transitions. However, participants would rarely plan and discuss such matters early. Older adults focused on personal experiences and trusted sources rather than publicly available information when considering Factors for choosing a care home. The findings show the need for greater inclusion of older adults in decisions related to their care and the importance of early planning and providing preferred types and formats of information to aid decisions. Future research should focus on a better understanding of older adults’ preferences for successful involvement in care decisions, with support and guidance for others involved in the decisions.
There is little visibility for the voices of indigenous and Afro-descendant women in Latin America and the Caribbean (LAC), meaning that few studies offer information on mental health for this group. This study takes the Living Well (Buen Vivir) approach as a basis to examine the prevalence of depressive symptoms and their associated individual physical and social/cultural dimensions. Based on a national study involving the participation of a majority of Chilean peoples, 774 women identifying as indigenous (569 Andean indigenous and 146 other indigenous people) and Afro-descendant (59) were interviewed. The findings show that Andean and Afro-descendant women are more at risk of suffering depressive symptoms and that in general terms mental health should be understood from a holistic perspective, in addition to its being underpinned by several associations. Lower levels of depression were associated with older age, having a partner, independence in activities of daily living, social support from partner and being resilient. In contrast, higher levels of depression were associated with health problems, poor-quality relationship with grandchildren and loneliness. Out of the dimensions examined, resilience had a key influence on mental health among women. The findings are discussed in the context of a comprehensive view of wellbeing among ethnic minorities.
We developed a clinical care pathway for the detection and management of frailty for older adults living in long-term care (LTC) homes.
Methods
We utilized a modified Delphi with residents of LTC homes experiencing frailty, their caregivers, and care providers. The pathway was created using existing literature and input from key LTC experts.
Findings
Fifty-two panelists completed round one of the Delphi, and 55.8% of these respondents completed round two. Both rounds had high agreement and ratings. We added six new statements following analysis of round two, and 15 statements were modified/updated to reflect panelist feedback. The final pathway included 28 statements and promotes a resident-centered approach that highlights caregiver involvement and inter-professional teamwork to identify and manage frailty, as well as initiate palliative care earlier.
Conclusion
Implementing this pathway will allow health care providers to adopt screening measures and adapt care to a resident’s frailty severity.
There are limited data on chiropractic care for older adults, specifically from medically underserved communities. This study describes the characteristics, clinical management, and patient-reported outcomes of older adults with spinal pain who present for chiropractic care at a publicly funded community health centre serving marginalized populations. This retrospective analysis utilized quality assurance data from chiropractic encounters at Mount Carmel Clinic between January 2011 and June 2020 of adults aged 45 and older. Descriptive statistics summarized the study population and their self-reported pain severity scores. Student’s t-tests and repeated-measures ANOVA explored relationships between pain outcomes, age, and clinical characteristics. The sample included 240 middle-aged (45–59 years) and older adults (≥60 years) who recorded baseline and discharge pain scores following chiropractic treatment. Over half of middle-aged participants self-identified as Indigenous or as people with disabilities. Statistically and clinically important improvements in pain were noted across spinal regions and extremities for both cohorts.
One barrier to patients’ compliance in following instructions to take prescription medication is their memory of those instructions. Effective communication can be challenging with older adults, since people can use ineffective strategies to compensate for older adults’ presumed communication difficulties. The purpose of this study was to test whether older adults would benefit from gestures and/or props in hearing explanations of the appropriate use of prescription medication. Participants were 181 adults 65 years or older. They evaluated pharmacy students on their communication. Each participant watched video clips of pharmacy students explaining how to use fictional medications in three conditions: (1) speech only, (2) speech and gestures, and (3) speech and props. Participants were tested on their memory and rated the effectiveness of the communication of each pharmacy student. Participants showed no differences in memory across conditions. These findings do not support the use of gestures and/or props in effective communication with older adults.
Plant-based diets (PBD) have been found to be environmentally sustainable and beneficial for health. Observational research showed that higher plant-based diet quality improves health-related quality of life (HRQoL) in adult women, however this is unclear for older adults. This association may be due to anti-inflammatory properties of PBD. Older adults, prone to chronic inflammation, may therefore profit from PBD. We investigated the relation between PBD and HRQoL in older adults of both sexes and tested whether the effects are associated with circulating high-sensitivity C-reactive protein (hsCRP) levels. We used data of the population-based Lifelines Cohort Study (n = 6,635, mean age = 65.2 years) and a subsample in which hsCRP was measured (n = 2,251, mean age = 65.2 years). We applied a plant-based diet index measuring adherence to a healthful (hPDI) and an unhealthful (uPDI) plant-based diet based on food frequency questionnaires. The RAND-36 questionnaire was applied as measure of HRQoL, from which we derived physical and mental HRQoL. Older adults with the highest adherence to a hPDI had respectively 15% and 12% greater odds for high physical quality of life and mental quality of life. Meanwhile, higher adherence to uPDI was associated with respectively 16% and 13% lower odds for high physical and mental quality of life. An additive but no interactive effect of hsCRP on the association between PBD and HRQoL has been observed. Adherence to a healthful plant-based diet and circulating levels of inflammation are independently associated with physical and mental HRQoL. Mechanisms other than inflammation through which PBD could influence HRQoL may be explored in further research.
Loneliness is a major health concern for immigrant older adults. This study explores social influences on loneliness in neighbourhoods among immigrant older adults across five major urban centres in Ontario and Alberta, Canada. Data were collected from 435 older immigrants who participated in the Inclusive Communities for Older Immigrants (ICOI) Project. Data were analysed using multiple linear regression (MLR) to identify the influences of neighbourhood factors, family support, duration of residency in Canada, English proficiency, and gender. Results indicate that increased engagement in ethnic enclaves, not being reliant on transportation for social interactions, and perceptions of neighbourhood cohesion are associated with a significant reduction in loneliness. These associations remain significant after accounting for family support and language proficiency. This calls for further research into the interconnections among interpersonal factors, neighbourhood-level factors, and family and community-level support to address key influences on loneliness in this population.