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People with Parkinson’s disease (PD) experience a gradual loss of functional abilities that affects all facets of their daily life. There is a lack of longitudinal studies on coping styles in relation to the disease progression among people with PD. The aim of this study was to explore how coping styles in PD evolve over a 3-year period. Data from the longitudinal project “Home and Health in People Ageing with PD” was utilized (N = 158), including baseline and 3-year follow-up assessments. Coping was captured by ratings of 13 different coping styles. A factor analysis was conducted to analyse patterns of coping styles. Stability and change were analysed for each of the 13 styles with respect to the course of the disease. The factor analysis revealed four coping patterns: pessimistic, optimistic, persistent and support-seeking. The stability of each coping style over time ranged from 75.3% to 90.5%. Those who experienced a worsening of the disease were most inclined to change their coping style (p = 0.006). The results suggest that even when facing severe challenges due to PD in daily life, coping styles remain relatively stable over time. However, a worsening in PD severity appeared to trigger a certain re-evaluation of coping styles.
This special issue focuses on aging in place in late life. Aging in place is about being able to continue living in one’s own home or neighborhood and to adapt to changing needs and conditions. It is of high concern due to the increasing number of old and very old people in all societies and challenges researchers, practitioners, and policy makers in many societal and scientific areas and disciplines. We invited authors to contribute original research papers as well as conceptually driven review papers that would stimulate the continuing efforts to understand the different aspects of aging in place in late life. The papers that were submitted came from very diverse disciplines, such as sociology, psychology, occupational therapy, nursing, architecture, public planning, and social work. Given the number and diversity of papers submitted, we can conclude that aging in place is an important concern throughout the world and that different kinds of measures are taken to come up with local, national, and international solutions that enhance aging in place. [...]
Background and Objectives: Valuation of life (VOL) represents a construct capturing individuals’ active attachment to their life. The majority of studies on VOL were conducted in North America and Europe where personal autonomy and independence are highly valued, leaving open the question about the relevance of this construct in interdependence-oriented cultures. Using a framework of cross-cultural and life-span theories, the present study compared levels and predictors of VOL between the young-old and old-old individuals from Germany and Japan.
Research Design and Methods: Two hundred fifty-seven Germans and 248 Japanese, matched by age, gender, education, and IADL, answered a 5-item VOL scale and shared information on sociodemographic, social, and health resources.
Results: Germans’ VOL levels were higher than in Japanese participants. Both culture- and age-moderated predictions of VOL: education was significant only in the young-old Japanese, and close social partners mattered in the old-old, not in the young-old. Health determined VOL irrespective of culture and age.
Discussion and Implications: The findings suggest that cultural values and aging processes should be considered to better understand how individuals value their life and to help older adults to feel that his/her life is meaningful and worth living.
Mobilität ist für ältere Menschen ein hohes Gut und wirkt sich positiv auf ihre Lebensqualität aus. Wer mobil bleibt – und sei es nur im engeren Umkreis seines eigenen Wohnquartiers –, fühlt sich wohler und bleibt gesünder. Alternsforscher analysieren individuelle Verhaltensweisen und Bedürfnisse hochbetagter Menschen (80 Jahre und älter), sie schauen aber auch in die Zukunft: Wie sieht das Mobilitätsprofil der "jungen Alten" zwischen 65 und 80 Jahren aus, und wie wird es sich entwickeln, wenn die "Baby Boomer"-Generation, also die heute Fünfzigjährigen, Rentner sind?
The present study concerns the development of a computerized tool targeting housing accessibility issues. A user-centered approach involving professionals from the housing sector and senior citizens from four European countries resulted in a fully functional prototype of a mobile application (app) including an apartment database. The app raises awareness on housing accessibility and has the potential to support decision making and strengthen all citizens regardless of functional capacity to be more active in their endeavors for a satisfying housing solution. Further refinements and additional features are needed to enhance the potential benefits; they include addressing potential challenges facing senior citizens, developing interactive features that allow users to provide input and adapting to different national contexts to make the app applicable for the European market.
Due to the increasingly heterogeneous trajectories of aging, gerontology requires theoretical models and empirical methods that can meaningfully, reliably, and precisely describe, explain, and predict causes and effects within the aging process, considering particular contexts and situations. Human behavior occurs in contexts; nevertheless, situational changes are often neglected in context-based behavior research. This article follows the tradition of environmental gerontology research based on Lawton’s Person-Environment-Interaction model (P-E model) and the theoretical developments of recent years. The authors discuss that, despite an explicit time component, current P-E models could be strengthened by focusing on detecting P-E interactions in various everyday situations. Enhancing Lawton’s original formula via a situationally based component not only changes the theoretical perspectives on the interplay between person and environment but also demands new data collection approaches in empirical environmental research. Those approaches are discussed through the example of collecting mobile data with smartphones. Future research should include the situational dimension to investigate the complex nature of person environment interactions.
The policy review is part of the project EQualCare: Alone but connected? Digital (in)equalities in care work and generational relationships among older people living alone, a three-year international project involving four countries: Finland, Germany, Latvia and Sweden. EQualCare interrogates inequalities by gender, cultural and socio-economic background between countries, with their different demographics and policy backgrounds. As a first step into empirical analysis, the policy review aims to set the stage for a better understanding of, and policy development on, the intersections of digitalisation with intergenerational care work and care relationships of older people living alone in Germany.
The policy review follows a critical approach, in which the problems policy documents address are not considered objective entities, but rather discursively produced knowledge that renders visible some parts of the problem which is to be solved as other possible perspectives are simultaneously excluded. Twenty publicly available documents were studied to analyse the processes in which definitions of care work and digital (in)equalities are circulated, translated and negotiated between the different levels of national government, regional governments and municipalities as well as other agencies in Germany.
The policy review consists of two parts: a background chapter providing information on the social structure of Germany, including the historical development of Germany after the Second World War, its political structure, information on the demographic situation with a focus on the 60+ age group, and the income of this age group. In addition, the background presents the structure of work and welfare, the organisation of care for old people, and the state of digitalisation in Germany. The analysis chapter includes a description of the method used as well as an overview of the documents chosen and analysed. The focus of this chapter is on the analysis of official documents that deal with the interplay of living alone in old age, care, and digitalisation.
The analysis identified four themes: firstly, ageing is framed largely as a challenge to society, whereas digitalisation is framed as a potential way to tackle social challenges, such as an ageing society. Secondly, challenges of ageing, such as need of care, are set at the individual level, requiring people to organise their care within their own families and immediate social networks, with state support following a principle of subsidiarity. Thirdly, voluntary peer support provides the basis for addressing digital support needs and strategies. Publications by lobby organisations highlight the important work done by voluntary peer support for digital training and the benefits this approach has; they also draw attention to the over-reliance on this form of unpaid support and call for an increase in professional support in ensuring all older people are supported in digital life. Fourthly, ageing as a hinderance to participation in digital life is seen as an interim challenge among younger old people already online.
In summary, the analysis shows that the connection between ageing and digitalisation remains a marginal topic in current politics. The focus on older people merely as a potential group at risk of being left behind implies a deficit perspective on ageing and a homogenising of a large and diverse age group. Lessons learnt from the pandemic should not be interpreted in a one-sided way, by merely acknowledging the increasing number of (older) people moving online, but by acknowledging intersecting inequalities that mitigate social participation.
RITA, the RBP‐J interacting and tubulin‐associated protein, has been reported to be related to tumor development, but the underlying mechanisms are not understood. Since RITA interacts with tubulin and coats microtubules of the cytoskeleton, we hypothesized that it is involved in cell motility. We show here that depletion of RITA reduces cell migration and invasion of diverse cancer cell lines and mouse embryonic fibroblasts. Cells depleted of RITA display stable focal adhesions (FA) with elevated active integrin, phosphorylated focal adhesion kinase, and paxillin. This is accompanied by enlarged size and disturbed turnover of FA. These cells also demonstrate increased polymerized tubulin. Interestingly, RITA is precipitated with the lipoma‐preferred partner (LPP), which is critical in actin cytoskeleton remodeling and cell migration. Suppression of RITA results in reduced LPP and α‐actinin at FA leading to compromised focal adhesion turnover and actin dynamics. This study identifies RITA as a novel crucial player in cell migration and invasion by affecting the turnover of FA through its interference with the dynamics of actin filaments and microtubules. Its deregulation may contribute to malignant progression.
Objectives: Investigate the effectiveness of a complex intervention aimed at improving the appropriateness of medication in older patients with multimorbidity in general practice.
Design: Pragmatic, cluster randomised controlled trial with general practice as unit of randomisation.
Setting: 72 general practices in Hesse, Germany.
Participants: 505 randomly sampled, cognitively intact patients (≥60 years, ≥3 chronic conditions under pharmacological treatment, ≥5 long-term drug prescriptions with systemic effects); 465 patients and 71 practices completed the study.
Interventions: Intervention group (IG): The healthcare assistant conducted a checklist-based interview with patients on medication-related problems and reconciled their medications. Assisted by a computerised decision support system, the general practitioner optimised medication, discussed it with patients and adjusted it accordingly. The control group (CG) continued with usual care.
Outcome measures: The primary outcome was a modified Medication Appropriateness Index (MAI, excluding item 10 on cost-effectiveness), assessed in blinded medication reviews and calculated as the difference between baseline and after 6 months; secondary outcomes after 6 and 9 months’ follow-up: quality of life, functioning, medication adherence, and so on.
Results: At baseline, a high proportion of patients had appropriate to mildly inappropriate prescriptions (MAI 0–5 points: n=350 patients). Randomisation revealed balanced groups (IG: 36 practices/252 patients; CG: 36/253). Intervention had no significant effect on primary outcome: mean MAI sum scores decreased by 0.3 points in IG and 0.8 points in CG, resulting in a non-significant adjusted mean difference of 0.7 (95% CI −0.2 to 1.6) points in favour of CG. Secondary outcomes showed non-significant changes (quality of life slightly improved in IG but continued to decline in CG) or remained stable (functioning, medication adherence).
Conclusions: The intervention had no significant effects. Many patients already received appropriate prescriptions and enjoyed good quality of life and functional status. We can therefore conclude that in our study, there was not enough scope for improvement.
Trial registration number: ISRCTN99526053. NCT01171339; Results.
The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden.
