OBJECTIVE: The number of older people with poor oral health diagnosed with cancer is increasing rapidly. However, integration of oral health in cancer care for older people to prevent or minimize oral health complications of cancer treatments is uncommon, except in head and neck oncology. The aim of this review is to describe the need, role of, and factors influencing the integration of oral health(care) into the treatment of older people with cancer.
METHODS: MEDLINE, CINAHL, PubMed, Scopus, and Web of Science databases were searched for papers published in the last 10 years that focus on oral health in older people diagnosed with cancer, the impact of oral health on cancer therapy, and integrated oral health in cancer treatment.
RESULTS: From 523 related papers, 68 publications were included and summarized as follows: (1) oral complications associated with cancer therapies, (2) the need for oral healthcare in older people with cancer, (3) the role of integration of oral health in cancer care, and (4) influencing factors such as ageism, interprofessional education and collaborations, oral healthcare workforce, oral health literacy, and financial considerations.
CONCLUSIONS: Integration of oral healthcare is highly recommended for the overall well-being of older people with cancer to prevent, minimize, and manage complications in cancer treatment. However, oral healthcare has not been integrated in cancer care yet, except for head and neck cancers. This review identified a notable gap in the literature, highlighting the need for research on integration of oral healthcare in geriatric oncology.

OBJECTIVE: Food insecurity has been associated with mobility difficulty (MD) in old age. However, there is a scarcity of research on this topic from low- and middle-income countries, while the bio-psychological factors underlying this association are largely unknown. We investigated the food insecurity-MD link in Ghana and explored how sleep, anxiety, loneliness, and physical activity (PA) mediate the association.
METHODS: Community-based, representative cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behavior Study were analyzed (N = 1201; Mage = 66.5; women = 63%). MD was assessed with items from the SF-36 of the Medical Outcomes Study. We assessed food insecurity with items on hunger and breakfast-skipping frequency due to lack of food and resources. Adjusted OLS and mediation models via bootstrapping technique evaluated the associations.
RESULTS: Results revealed the expected association between food insecurity and MD, such that greater food insecurity was significantly and positively associated with MD across paths (from β = 0.33 to β = 0.42, p < .001). Analyses of indirect effects showed that sleep problems (27.8%), anxiety (15.5%), loneliness (17.5%), and PA (18.0%) mediated the association between food insecurity and MD. Cross-level interactions revealed that food insecurity significantly modified the link between each mediator and MD.
CONCLUSIONS: Our data provide novel evidence that bio-psychological mechanisms may underlie the food insecurity-MD link and should, therefore, be considered relevant targets for interventions to prevent/manage MD in later life.

UNASSIGNED: Physical activity (PA) is essential following an acute cardiac event. Cardiac rehabilitation (CR) is commonly prescribed, and PA after CR is recommended. Because of age-related changes in functional ability and multi-comorbidity, many older cardiac patients struggle to continue performing PA at home after CR. Depressive symptoms and anxiety are prevalent in cardiac patients and associated with poor self-care, including lack of daily PA. Yoga has been demonstrated to improve psychological and physical health outcomes in cardiac patients, but it is unknown whether yoga, modified for older CR patients - Gentle Yoga - is beneficial in managing psychological distress and maintaining PA following phase II CR. Our specific aims are to:1) determine the feasibility and acceptability of a modified gentle yoga intervention delivered via video conferencing for older cardiac patients; 2) compare, at 3-month follow-up, the effects and determine effect sizes of a gentle yoga intervention versus control on psychological health and physical health.
UNASSIGNED: We are conducting a 2-group (intervention versus control) randomized controlled pilot study. The intervention is a 12-week gentle yoga program delivered via video conference. Short-term effects will be evaluated at 3-month.
UNASSIGNED: This study is designed to be suited for older cardiac patients who would not have access to supervised PA opportunities after facility-based CR to enhance PA. This study will provide data about the feasibility and acceptability of the protocol for older cardiac patients and will offer effect sizes to determine sample size for a fully powered randomized controlled trial.

BACKGROUND: Research examining the healthy aging trajectory of retired older adults with multimorbidity is limited, leaving uncertainties regarding the optimal physical activity (PA) intensity and frequency necessary to sustain healthy aging during retirement.
METHODS: Our study investigated the moderating effects of PA on the healthy aging trajectories of retired older adults living with multimorbidity in the United States (US). We utilized data from 1,238 retired individuals aged 50 to 102 who contributed 11,142 observations over 16 years from the Health and Retirement Study (HRS). We employed mixed effects modeling to assess the impact of various classes of multimorbidity on this group and examine how different PA, PA intensities, and PA frequencies influence the disability, physical, and cognitive functioning domains of healthy aging.
RESULTS: The results reveal that while outcomes differed significantly, retired older adults in the US attained healthy aging at baseline. However, their ability to maintain healthy aging declined over time, with multimorbidity, especially musculoskeletal and neurological conditions, accelerating this decline. Fortunately, PA, especially light to moderate intensities, is associated with improving healthy aging and moderating the impact of multimorbidity on the disability and cognitive functioning domains of healthy aging. However, the specific moderating effects of PA depend on its frequency, intensity, and chronic conditions.
CONCLUSIONS: The significant variability in healthy aging attainment among retired older adults underlies the need to consider these differences when addressing healthy aging issues in the US. Accounting for these variations would aid in evaluating the potential impact of future interventions and contribute to achieving health equity. Fortunately, our dynamic findings facilitate this objective by identifying specific frequencies and intensities of PA tailored to different aspects of multimorbidity and healthy aging. This highlights PA, especially light-to-moderate intensity, as an essential, cost-effective, and amenable strategy for alleviating the impact of multimorbidity on healthy aging.

Many physical, social, and psychological changes occur during aging that raise the risk of developing chronic diseases, frailty, and dependency. These changes adversely affect the gut microbiota, a phenomenon known as microbe-aging. Those microbiota alterations are, in turn, associated with the development of age-related diseases. The gut microbiota is highly responsive to lifestyle and dietary changes, displaying a flexibility that also provides anactionable tool by which healthy aging can be promoted. This review covers, firstly, the main lifestyle and socioeconomic factors that modify the gut microbiota composition and function during healthy or unhealthy aging and, secondly, the advances being made in defining and promoting healthy aging, including microbiome-informed artificial intelligence tools, personalized dietary patterns, and food probiotic systems.

In 2021, China became an aged society when the share of its elderly population (age 65 years and above) exceeded 14%. In China, as in other upper-middle-income and high-income countries, life expectancy gains are increasingly concentrated at older ages with below-average health and economic activity. Governments worldwide are hence actively pursuing healthy and productive aging. Healthy aging by some measures is taking place. Similar with other upper-middle-income countries, China\'s young old in their 60s are healthier than the same age group two decades ago. The picture is more complex for the older age group (70 years and above). Although there is a substantial decline in leading disease burdens such as stroke and chronic obstructive pulmonary disease, diseases such as Alzheimer\'s and other dementia are on the rise. To meet the challenge of a rapidly aging population, China\'s healthy aging agenda should improve its multipronged approach that seeks to promote healthy lifestyles, enhance the healthcare system, create age-friendly communities, and tackle socioeconomic and health disparities.

This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.

Aging is a complex and time-dependent decline in physiological function that affects most organisms, leading to increased risk of age-related diseases. Investigating the molecular underpinnings of aging is crucial to identify geroprotectors, precisely quantify biological age, and propose healthy longevity approaches. This review explores pathways that are currently being investigated as intervention targets and aging biomarkers spanning molecular, cellular, and systemic dimensions. Interventions that target these hallmarks may ameliorate the aging process, with some progressing to clinical trials. Biomarkers of these hallmarks are used to estimate biological aging and risk of aging-associated disease. Utilizing aging biomarkers, biological aging clocks can be constructed that predict a state of abnormal aging, age-related diseases, and increased mortality. Biological age estimation can therefore provide the basis for a fine-grained risk stratification by predicting all-cause mortality well ahead of the onset of specific diseases, thus offering a window for intervention. Yet, despite technological advancements, challenges persist due to individual variability and the dynamic nature of these biomarkers. Addressing this requires longitudinal studies for robust biomarker identification. Overall, utilizing the hallmarks of aging to discover new drug targets and develop new biomarkers opens new frontiers in medicine. Prospects involve multi-omics integration, machine learning, and personalized approaches for targeted interventions, promising a healthier aging population.

Many middle-aged and older adults (MAOAs) do not engage in sufficient physical activity (PA), despite its well-documented benefits for healthy aging. Existing PA interventions often fail to reach or engage the target population effectively. This study investigates MAOAs\' preferences for recruitment strategies to optimize the reach and uptake of PA interventions, thereby enhancing their impact on healthy aging and public health. Qualitative interviews were conducted with 39 MAOA participants (69% female, mean age = 69.46, SD = 7.07), guided by McGuire\'s Theory on Persuasive Communication. Factors related to the source, message content, channel, receiver characteristics and target behavior of recruitment strategies were analyzed. Our findings suggest a preference for trustworthy sources (e.g., healthcare professionals over commercial entities) and positive, non-ageist messaging. MAOAs vary in their channel preferences but emphasize the importance of personalization. Despite heterogeneity, MAOAs commonly perceive themselves as sufficiently active, indicating a need for improved knowledge on what constitutes sufficient PA, as well as easy enrollment or trying out interventions. Tailoring recruitment strategies to diverse MAOA segments based on age seems crucial for effective engagement. Future research could explore quantitative research into how communication factors relate to various target population characteristics.

BACKGROUND: Previous social prescribing work highlights a range in the types and number of outcomes used in published studies. We aimed to describe social prescribing outcome core areas and instruments to build capacity for future research and program evaluation.
METHODS: This was a modified umbrella review following standard guidelines. We registered the study and searched multiple databases (all languages and years); inclusion criteria were peer-reviewed publications containing outcomes for self-described social prescribing for adults aged 18 years and older. The last search date was 9 July 2023. From the included systematic reviews, we identified primary studies using the same inclusion criteria. For primary studies, we sorted extracted outcomes and instruments into six core areas using a published taxonomy. We located information on instruments\' description and measurement properties and conducted two rating rounds for (1) the quality of systematic reviews and (2) reporting of instruments in primary studies. We conducted a narrative synthesis of reviews, primary studies and outcomes (PROSPERO 2023 CRD42023434061).
RESULTS: We identified 10 systematic reviews and 33 primary studies for inclusion in our review. Outcomes covered most core taxonomy areas, with an emphasis on psychosocial factors (e.g. well-being) and less emphasis on cognition, physical activity, and caregivers and volunteers. We noted few studies provided detailed information on demographic data of participants or measurement properties of instruments.
CONCLUSIONS: This synthesis provides an overview and identifies knowledge gaps for outcomes and instruments used in social prescribing interventions. This work forms the basis of our next step of identifying social prescribing-related outcomes that matter most across interested parties, such as individuals providers and decision makers.
BACKGROUND: Les travaux dont on dispose sur la prescription sociale montrent une grande variété, au sein des études publiées, dans les types de résultats et leur nombre. Nous avons entrepris de décrire les grands thèmes et les instruments associés aux résultats de la prescription sociale, dans l’objectif de renforcer la capacité de recherche et d’évaluation des programmes.
UNASSIGNED: Cette étude est une métarevue modifiée, réalisée selon des lignes directrices normalisées. Nous avons enregistré l’étude et effectué des recherches dans plusieurs bases de données (toutes langues et années confondues). Les publications incluses devaient avoir été évaluées par les pairs et devaient rendre compte des résultats d’une intervention auprès d’adultes de 18 ans et plus qualifiée de prescription sociale dans la publication elle-même. La période de recherche s’étend jusqu’au 9 juillet 2023. Nous avons sélectionné, dans les revues systématiques retenues, les études primaires qui répondaient à ces mêmes critères d’inclusion. En ce qui concerne les études primaires, nous avons trié les résultats et les instruments extraits en fonction de six grands thèmes provenant d’une taxonomie publiée. Nous avons trouvé l’information relative à la description et aux propriétés de mesure des instruments et mené deux rondes d’évaluation concernant 1) la qualité des revues systématiques et 2) la présentation de données en lien avec les instruments dans les études primaires. Nous avons fait une synthèse narrative des revues, des études primaires et des résultats (PROSPERO 2023 CRD42023434061).
UNASSIGNED: Dix revues systématiques et 33 études primaires ont répondu aux critères d’inclusion de notre revue. Les résultats couvrent la plupart des grands thèmes de la taxonomie, en particulier les facteurs psychosociaux (comme le bien-être) et, dans une moindre mesure, la cognition, l’activité physique, ainsi que les aidants naturels et les bénévoles. Nous avons constaté que peu d’études fournissaient des données détaillées sur les caractéristiques sociodémographiques des participants ou sur les propriétés de mesure des instruments.
CONCLUSIONS: Notre synthèse brosse une vue d’ensemble des résultats et des instruments qui sont utilisés dans les interventions de prescription sociale et cerne également les lacunes des connaissances en la matière. Ce travail jette les bases de la prochaine étape de notre démarche : la sélection des résultats associés à la prescription sociale qui comptent le plus pour les parties intéressées, notamment les usagers, les prestataires et les décideurs.
We synthesized and categorized outcomes and instruments identified in 10 reviews and 33 primary studies for social prescribing. We highlight a range in the types and number of outcomes used in published studies. Many studies focussed on wellbeing and mental health outcomes. We noted less emphasis on use of outcomes for cognition, physical activity, and caregivers and volunteers. The field would benefit from comprehensive reporting of participants’ demographic information.
Nous avons synthétisé et catégorisé les résultats et les instruments issus de 10 revues et de 33 études primaires sur la prescription sociale. Nos travaux révèlent la variabilité des types et du nombre de résultats utilisés dans les études publiées. Les résultats associés au bien-être et à la santé mentale occupent une place prépondérante dans bon nombre d’études. Nous avons constaté une moindre utilisation des résultats concernant la cognition, l’activité physique, les aidants naturels et les bénévoles. La déclaration exhaustive des caractéristiques sociodémographiques des participants serait bénéfique dans le domaine.