Week 8: The Concept of Healthy Aging Flashcards
Health (WHO)
“A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
Healthy Aging definition
“the process of developing and maintaining the functional ability that enables wellbeing in older age”
- life with FULL CAPACITY, not just without disease
What constitutes remaining physically/socially/mentally healthy?
(BBL? Call Me.)
- Be mobile
- Build and maintain relationships
- Learn, grow, and make decisions
- Contribute to society
- Meet basic needs
What is a large proportion of differences in capacity in older age is due to?
cumulative (life course) impacts of advantage and disadvantage across people’s lives
T or F: Healthy aging starts in old age
F: starts @birth
4 key considerations in healthy aging
(DINQ)
- DIFFERENCES in capacity = due to the cumulative life course impacts (+ , -) across people’s lives
- relationships w environment (shaped by SDH) - INTERVENTION is possible
- big picture
- identify harmful factors & target - NO typical older person
- goal = improve functional ability of all - QOL is focus of improvement, not only lengthening life
Rank the following on individual, societal, and policymaker levels
- Healthy Aging
- Successful Aging
- Aging Well
Successful Aging: Individual Health
Healthy Aging: Society
Aging Well: policymakers
Successful aging = low _________ & high _________
- Low chance of chronic conditions and disability
- High mental, physical, and social functioning
Indicators of healthy aging
(Frank Pls Stop Pressuring Carl)
Functioning and disability
Physical activity
Social engagement and contribution
Prevalence of chronic diseases and multi-morbidity
Cognitive capability
what is aging in place
a policy to keep established social connection, continuous use of resources, no need to (many) additional direct individual-based interventions
- Older adults strive to live in their family home unless forced to move
T or F: aging in place includes adaptations needed as situations (health, financial, family) change
T: ex. redesigning bathrooms and kitchens
what order does design/evaluation of an intervention occur in
- effectiveness studies
- efficacy studies
- dissemination & implementation studies
- determinant studies
- determinant studies
(lack of walkable places = determinant of inactivity) - efficacy studies
(experiment to see walkable places influence activity) - effectiveness studies
(are walkable places rly helpful @population level?) - dissemination & implementation studies
a. translation to policy
b. adaption to various populations
Why don’t some interventions work?
- evidence = wrong
- implementation = wrong
- modifications = wrong
- “experts” thinking they’re better than science
Characteristics of a good intervention
- Clear and specific goals
- Focuses on a particular sub-population of elderly
- Intervention is clearly defined
- Outcome is measurable
Core principles of social/behavioral aspects on aging that have implications on aging interventions
(HAAT)
- Heterogeneity of the older population
- variability in health & function, experiences & exposures
- Aging as a life course phenomenon
- No single chronological marker of old age
- Aging and the social context
- How one grows old depends what country they’re in
(industrialized, prosperous) - unique age cohorts have common defining experiences
- How one grows old depends what country they’re in
- The potential for intervention
- “never too late” to make changes that can influence
ones life trajectory
- “never too late” to make changes that can influence
Almeida County Study’s 5 practices generally associated with longer/healthier lives
- Avoiding smoking
- Exercising regularly
- Maintaining a healthy body weight
- Sleeping between 7-8 hours nightly
- Limiting consumption of alcoholic drinks
T or F: healthy aging interventions aim at lengthening remaining years of life
F: Quality of remaining years of life
What is one of the most salient risk factors for health and longevity, linked to onset and progression of most chronic conditions
Physical Activity
Why are elderly (on average) the least physically active of any age group
stereotypes that exercise is harmful, has fewer benefits, they’re unwilling or unable to change lifestyle habits
Essential elements needed for successful programs
- Social support
- Self-efficacy
- Active choices
- Health contracts
- Regular performance feedback
- Positive reinforcement
There is an importance of SDH for understanding variance in health across populations/settings, what is a key risk factor?
ZIP code
Walking environment @macro and micro/meso levels
Macro level: principles associated with population benefits
- supporting mixed land use
- creating walkable neighborhoods
- attractive communities with sense of pride
- variety of transportation options
Micro/Meso level: modifiable environmental designs to influence neighborhood walkability
- Access to services, aesthetics, traffic hazards, crime
- Safety + cohesion = major factor in walkability
what 2 things are associated with walking for exercise
Functional capacity & environmental demands
Research has turned towards ____ studies to identify the impact of interventions
efficacy
Continuum in research translation
problem identification and risk factor correlation → testing/creating interventions → dissemination and scalability → sustainability of intervention effort
4 fundamental Qs guiding research translation based on existing evidence
- Types & levels of lifestyle behaviors related to the problem of interest?
- Health benefits/consequences of these lifestyle behaviors ?
- Interventions have been created/ tested that have been proven to work? Criteria used to evaluate their success?
- Factors most effective in ensuring successful translation and broader dissemination of programs with demonstrated efficacy and effectiveness?
The _____ movement is used to promote/deliver/embed evidence-based programs in communities (USA)
Evidence-based
What 2 factors are being introduced as critical, making the biopsychosocial model no longer sufficient?
genetics & environment
what is the silo approach
researchers tend to specialize on one component, not collaborating with each other
Evidence-based programs have 2 components @macro level: therapeutic element & the delivery mechanism, explain
Therapeutic elements: focus on behavioral risk factors (exercise, diet, stress reduction, smoking cessation)
Delivery mechanism: means by which elderly are motivated to implement/maintain appropriate health practices
______ of interventions is necessary to disseminate known benefits to new populations/settings
- Make necessary modifications to content/format to meet new objectives while maintaining essential elements from original program needed for success
Translation
Successfully translated intervention =
capable of achieving same outcomes as original intervention while also yielding new information
what is precision health
have therapeutic elements but are tailored to better align with needs/beliefs/values of target population
Treatment fidelity
degree that an intervention is delivered in the way it was originally intended
- ensures intervention outcomes observed are a result of the intervention model and its implementation
Lack of fidelity
= effectiveness is questionable, outcomes may be due to external factors
Program drift
- how this can happen in a + or - way
slight modifications (intentional or unintentional) that result in less than perfect replication and program delivery
- Occurs when intervention is delivered over a period of time or in multiple settings
(+) when program developers attempt to scale up their dissemination efforts
(-) health professional facilitates and modifies content because they “know better” than program manual
scalability
Increasing # of people served by a program (scaling up)
Only a certain # of individuals can be served by a given intervention given specified budget - strategies to enhance scalability?
- Reduce/eliminate content deemed unnecessary for program success, retaining only essential elements
- Change participant by having each individual have a certain demographic characteristic, health status, or reside within a geographic location
- Help ensures those who will benefit most will be enrolled
while others are not actively recruited
Community-based participatory research (CBPR)
= strong strategy for planning initial program and long-term sustainability
- Way of engaging community organizations/stakeholders to understand context and climate of program
- help identify and meet community priorities by selecting appropriate interventions
Strategies to enhance sustainability:
- Identify an innovative partner who can help advance intervention delivery within community
- ex. program targeting elderly delivered in senior centers - leverage: funds, target populations, referrals
- budget can go further when enhanced with partnerships vs subjected to additional competition
- Participants should be shared and served collectively
- Avoid wasting funds on duplicated services by relying on community partners
conquer silo approach by facilitating _______ integration
community-clinical
ex. After clinical-based intervention, patients can be referred to community-based fall-prevention programs
Major concern with policy = whether we can can IMPLEMENT what is known to work … how to conquer?
- Design intervention with end user in mind
- Community participatory approach w stakeholders involved - Secure funding stream to support intervention after initial testing and first-phase dissemination
T or F: typically quick from discovery to wide-spread dissemination
F: Long lag time between discovery and wide-spread dissemination
