فصلنامه سالمند
پیاپی 74 (تابستان 1403)

Following the emergence of population aging phenomenon in the world, “successful aging” as a quality concept has recently attracted the attention of many researchers and policy makers; yet it seems that there is no single and clear definition of it presented in the literature. This study aims to analyze the concept of successful aging.

The study was conducted with Walker and Avant’s 8-step approach. For this purpose, articles meeting the inclusion criteria were selected through searching the SID, Magiran, Noormags, ISI, Pubmed, Scopus and Proquest databases and using the keywords of aging, successful aging and related concepts during the years 2000-2022. Then they were analyzed using Graneheim and Lundman's content analysis method to extract the successful aging concept's applications, characteristics, antecedents and consequences.

The content analysis of 83 selected articles revealed the characteristics of successful aging in the following seven categories: 1) "manageable process", 2) "multi-dimensional and comprehensive", 3) "socio-cultural context-bounded", 4) "enjoyment of physical, psychological and social health", 5) "non-dependence on others", 6) "happiness", and 7) "continuity and active participation in different fields of life".

A comprehensive definition of successful aging was presented using the identified characteristics, antecedents and consequences, which can help to better understand this concept, recognize its various dimensions, and ultimately, plan for its realization.

Given the increase in aged population and the challenges and problems associated with aging, planning and policy-making to improve the quality of life of older adults is of crucial importance. This study aims to investigate the mediating role of resilience in the relationship between religiosity and psychological well-being in Iranian older adults.

This is a correlational and cross-sectional study that was conducted in 2022 in Mianeh county in East Azerbaijan province, Iran. Participants were 319 older adults (aged ≥60 years) who were selected using a convenient sampling method and based on inclusion criteria. The tools used to collect data included the Glock and Stark’s religiosity scale, the Connor-Davidson resilience scale, and Ryff psychological well-being scale. The collected data were analyzed using correlation test and path analysis in SPSS software, version 26 and LISREL software, version 2.10 applications.

The mean scores of religiosity, resilience, and psychological well-being were 56.90±26.42, 86.16±16.46, and 76.04±10.81, respectively. All correlation coefficients were significant (P<0.05 or P<0.01) and revealed that high levels of religiosity and resilience are associated with higher level of psychological well-being. Furthermore, based on the path analysis results and the obtained t values (≥1.96), all paths were significant, except for the indirect path between the “consequences” component of religiosity and psychological well-being. Therefore, the proposed model showed that the belief, emotional, and practice dimensions of religiosity had a indirect and significant relationship with psychological well-being through the of resilience. There was a positive and significant relationship between the dimensions of religiosity and resilience, as well as between resilience and psychological well-being.

The findings emphasize the mediating role of resilience in the relationship between religiosity and psychological well-being of Iranian older adults. It is recommended that authorities in Iran should pay attention to the effect of religiosity, resilience, and their education to promote the psychological well-being of older adults.

Falling can have significant negative consequences on the health and quality of life of older adults. This study aims to assess the effect of online self-care education on the knowledge, attitude and practice of older adults in preventing falls at home.

This is a quasi-experimental study with a pre-test/post-test/follow-up design that was conducted on 120 people aged ≥65 years referring to comprehensive health centers in the south of Tehran, Iran, in 2021. A researcher-made questionnaire was completed by the participants before, immediately after, and three months after the intervention. The intervention was a virtual self-care educational program for fall prevention at home. Data analysis was done in SPSS software, version 26 using descriptive statistics (such as Mean±SD) and analytical tests including independent t-test, Mann-Whitney U test, and chi-square test.

About 22% of the elderly had a history of falling in the past year. Immediately after the intervention, the mean scores of knowledge, attitude, and practice were 18.39±2.86, 14.99±2.51, and 13.76±3.1, respectively, which were significantly higher than the pre-test scores (P<0.001). Three months after the intervention, the mean scores of knowledge, attitude, and practice were 18.18±1.14, 14.91±1.57, and 9.06±2.78, respectively, which were significantly higher than the pre-test scores (P<0.001).

Online self-care education for fall prevention at home can significantly increase the knowledge, attitude, and practice of the elderly and reduce the risk of falling.

The COVID-19 pandemic was a stressful event, especially for the elderly. This study aims to determine the relationship between resilience and general health of Iranian older adults during the COVID-19 pandemic.

This is a descriptive-analytical study with a cross-sectional design that was conducted in 2021 on 271 older adults aged >60 years referred to the health centers in Ahar county, East Azerbaijan Province, Iran, who were selected using a random cluster sampling method. After recording their demographic characteristics, the general health questionnaire and the Connor-Davidson resilience scale were completed by them. The collected data were analyzed in SPSS software, version 23 using descriptive statistics and chi-square, Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation test.

The mean total scores of resilience and general health were 64.38±16.42 and 24.56±10.05, respectively. There was a significant relationship between resilience and general health (r=0.25, P<0.001). There total score of resilience was higher in older adults with higher educational level (P<0.05).The general health and its dimensions of somatic symptoms and social dysfunction were higher in older adults who were living with others (P<0.05).

There was a significant relationship between resilience and general health in Iranian older adults during the COVID-19 pandemic. It is important to pay attention to these areas in them. Therefore, it is recommended to evaluate the resilience of older people during providing routine elderly care for improving their general health. It is also recommended to design appropriate educational programs during pandemics to increase resilience and general health of older adults.

Population aging is accompanied by an increase in the elderly's demand for long-term care, which is mainly provided by family caregivers. Providing quality elderly care, while maintaining the health of caregivers, requires recognition of facilitators and the educational needs. Therefore, this study aims to investigate facilitators of elderly care at home and the educational needs of the family caregivers of older adults in the south of Tehran, Iran.

This is a qualitative study using the conventional content analysis method. To collect data, we conducted semi-structured telephone interviews. Seventeen family caregivers aged ≥18 years with at least one month of caregiving experience and at least six hours of caregiving per week were selected using purposive and snowball sampling methods until data saturation from January to April 2021. After transcribing the recorded interviews, the data were entered into the MAXQDA 2018 software and analyzed.

Personal factors included personal characteristics of caregivers, Capability in caregiving, perceived benefits of caregiving, and self-care activities of caregivers. Interpersonal factors included proper relationship with older adults, older adults’ partial  dependence on caregivers, cooperation and support of family members, and receiving others’ support. Supportive environments included physical environment, receiving support from work environments and organizations providing elderly care services. The most important educational needs of family caregivers were the needs to learn how to prepare nutritious foods for the elders, the way to nourish older adults with dysphagia, and how to move the physically disabled older adults.

Family caregivers of older adults in the south of Tehran should have access to affordable elderly care and home care services based on their educational needs that require planned support from service providers.

One of the most common problems in old age is chronic pain. The present study aims to investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) in reducing the pain intensity of older women.

This is a randomized controlled clinical trial with a pretest/posttest/one-month follow-up design. The study population consists of all women aged ≥60 in Isfahan, Iran, in 2023. From this population, 30 women were selected using a convenience sampling method and based on the entry criteria. They were randomly assigned into two groups of intervention and control. The research tool was the short form of the McGill Pain Questionnaire. The intervention group received the MBCT in eight two-hour sessions, while the control group was put on the waiting list. The data were analyzed by repeated measure analysis of variance in SPSS software, version 25.

The mean age of women was 64.07±3.37 years in the intervention group and 64.20±3.57 in the control group. The mean total score of pain intensity in the intervention and control groups was 22.67 and 35.13 respectively in the post-test phase and 23.60 and 35.07 in the follow-up phase, respectively. The results showed a significant difference between the mean of the three assessment phases  in all subscales and the total score (P<0.01). The results of the Bonferroni test indicated the effectiveness of the intervention in the post-test and follow-up phases for all subscales compared to the control group (P≤0.05).

The MBCT can reduce the pain intensity of older women.

The rate of population aging in Iran is higher than the regional and global levels and Iran will enter the aging phase by 2040s. Considering the importance of the changes that population aging will create in Iranian society, this study aims to investigate the challenges and drivers of population aging in the next three decades in Iran.

The is a futures study using the scenario analysis method. Data were collected from different sources to understand the possible challenges of the population aging. Then, the obtained information was analyzed based on experts’ opinions, structural analysis, cross-impact balance analysis, and scenario development. The data were analyzed using Mic-Mac and Scenario Wizard applications.

The main drivers of population aging in the future will be governance variables in the field of old age, pension funds, health costs at micro and macro levels, distribution of welfare, fertility and household size, insurance coverage & pension. These variables will affect the geriatric workforce, intergenerational relationships, social participation, and the lifestyle and quality of life of older adults (outcomes). The possible scenarios for the future of population aging in 2050 were “Risky ageing”, “ Twilight ageing”, “Dawn of ageing”, and “Prosperous ageing”. 

To achieve the desired scenario, i.e., “ prosperous ageing” in Iran, we need a smart governance with a forward-looking view in the field of aging, equal welfare distribution, win-win pension funds, active economic and social participation of older adults, and fertility rate above the replacement level.

Empty nest syndrome (SEN) in Iranian older adults is becoming an important social phenomenon. Although it is not a clinical disorder, it can affect a person’s life and lead to depression, alcoholism, marital conflicts, and identity crisis. This study aims to explore the lived experiences of older adults with SEN in Iran.

This is a qualitative phenomenological study. Participants were 17 older adults with a mean age of 65.7 years (6 males and 11 females) suffering from ENS in Tehran, Iran, in 2022. Sampling was done purposefully and until reaching theoretical saturation. Semi-structured interviews were used to collect data regarding lived experiences.

Six main themes (existential crisis, emotional turmoil, cognitive disorientation, functional decline, disruption in interpersonal relationships, and satisfaction with the transition period) and 23 sub-themes were extracted.

Understanding of Iranian older adults’ experiences of ENS can provide valuable insights to gerontologists and practitioners in fields of psychology, counseling, and social work to develop future interventions for these older adults and enhance their quality of life.

The most important reason for considering hypertension as a major health problem, especially in older adults, is its severe complications. This study aims to investigate the prevalence of hypertension complications and identify the related factors among older adults in Semnan, Iran.

This cross-sectional study was conducted on 400 older adults with hypertension in Semnan, in January-February 2023. The data collection tool was a researcher-made questionnaire, whose content validity was confirmed based on the opinion of 10 experts (CVR=0.95 and CVI=0.98) and internal consistency was conmfired using Cronbach's alpha (α=0.895). Descriptive statistics (mean, standard deviation, frequency, and percentage) were used to present the data. The statistical difference in hypertension complications based on the demographic and contextual factors was investigated using chi-square test. All the statistical analyses were performed in SPSS software, version 27 and P<0.05 was considered statistically significant

The mean age of participants was 68.35±5.23 years, ranged 60-94. Participants were 196 men (49%) 204 women (51%). The prevalence of hypertension complications was 26.75% in overall (95% CI: 22.42%-31.08%). Also, the prevalence of heart failure was 14.3% (95% CI:11.13%-17.47%), the prevalence of retinopathy was 7.5% (95% CI:4.92%-10.08%), the prevalence of renal failure was 5.5% (95% CI:3.27%-7.73%), the prevalence of heart attack was 4% (95% CI:2.08%-5.92%), and the prevalence of stroke was 1.5% (95% CI:0.31%-2.65%). Moreover, the prevalence of hypertension complications had a statistical relationship with age, marital status, educational level, time elapsed since the initial diagnosis, interval between the initial diagnosis and the start of treatment, the disease control, no history of receiving the necessary treatment, and receiving financial aid to cover medical expenses (P≤0.05). 

Most of older adults in Semnan suffer from serious complication of hypertension, which is related to several demographic and contextual factors. The results can help managers and policymakers in the health sector in Iran to make correct decisions and develop effective interventions for the hyspetensive elderly.

This study aims to assess the effect of a forward and backward walking training program on some inflammatory markers and physical function of older women.

Twenty-four older women (aged 60-75 years) were divided into three groups of walking forward, walking backward, and control. Two groups of walking forward and walking backward, performed training three times a week for eight weeks with an exertion rate of 14-15 according to Borg’s scale. Before and after the training, anthropometric factors (age, body height, body weight, and body mass index) and the muscle strength and muscle endurance were measured and blood sampling (for biochemical analysis) was conducted. Repeated measures ANOVA was used to compare the means in SPSS software, version 23, and the significance level was set at 0.05.

The results showed that backward walking training significantly increased muscle strength and muscle endurance compared to the control and forward walking groups, but the program did not cause a significant change in the levels of tumor necrosis factor-alpha, transforming growth factor-beta, or vitamin D binding protein.

It seems that backward walking training can have a greater effect on physical function in older women compared to forward walking, and lead to a healthier life for them.