نشریه سالمندشناسی
سال هفتم شماره 4 (پیاپی 27، زمستان 1401)

Ageism is a serious international concern that negatively affects older people. But most people in society do not have enough information about this concept and the overcoming strategies for it. Therefore, this study was conducted to investigate the concept of ageism and overcoming strategies for it in the elderly.

This narrative review study focuses on ageism studies and overcoming strategies of it in the elderly. To access articles, a comprehensive search was conducted in PubMed, Embase, Scopus, Google Scholar, and Cochrane databases from 2001 to 2022. The search was conducted in Persian and English. The keywords used for the search were Age discrimination, elderly, older adult, ageism, and overcoming strategies. After reviewing the titles and abstracts of the articles, articles that met the inclusion criteria were selected. The result of the primary search was 40 articles, then based on the inclusion criteria, 27 articles were included in this study.

Ageism is carried out in two ways, individually, by individuals, and institutionally by the policy or organizational structure of an institution. Age discrimination has two aspects, explicit and implicit; explicit or conscious ageism is the discrimination and hatred of older people that is reflected through immediate behavior and action. Age discrimination can be corrected through intergenerational programs, intergenerational service learning, education about aging, positive contact with older adults, and other appropriate interventions.

The concept of ageism is a multidimensional structure. It has three cognitive, emotional, and behavioral dimensions and is divided into two types, individual and organizational. Ageism also has two explicit and implicit aspects. Based on this, it has relational, dynamic, and social aspects. Therefore, informing society about this concept seems necessary. On the other hand, interventions can be done to reduce age discrimination in various area, therefore, it is suggested those interventions will be implemented by gerontologists to reduce discriminatory behaviors toward the older adults.

Chronic musculoskeletal pain, including Chronic Knee pain is one of the most common problems in old age that if not controlled, leads to reduced activity of Daily Living. The aim of this study was to determine the effect of Dry Cupping Therapy on Knee pain and Activities of Daily Living in elderly women.

Methods & Materials:

 The current research is a clinical trial study in which two centers out of four daily care centers for the elderly in Qazvin city were randomly selected. From each center, 25 elderly women who were qualified to enter the study, a total of 50 elderly women, were randomly selected and entered the study after obtaining written consent. In the second stage, random allocation was done to place the samples in two control and intervention groups. After filling in the personal information form, the "VAS" and "ADL" questionnaires were completed for both groups. For the intervention group, twice a week for four weeks and during eight intervention sessions, dry blower therapy was performed using 3 Cupping for 5-10 minutes on points SP10, SP9, and ST36. No intervention was done for the control group. One week after the last intervention, pain intensity and daily life activities were measured and recorded using VAS and ADL questionnaires in both intervention and control groups. Finally, the data was analyzed using SPSS software version 26 and using statistical tests.

There was no significant difference between the intervention and control groups before the intervention regarding the level of chronic pain (p=0.11) and the level of daily activities (p=0.541). But after the intervention, the results showed that in the intervention group, chronic pain decreased (p<0.001) and daily activities increased significantly (p<0.001) compared to the control group.

Dry Cupping therapy is effective in reducing chronic knee pain and increasing daily activities of elderly women. It is recommended as a non-invasive, affordable and accessible method to help improve activities of daily living and reduce chronic knee pain which as a result increases the quality of life in the elderly.

Knee osteoarthritis (KOA) is associated with decreased muscle strength, muscle activity, and impaired knee range of motion (ROM). This study aimed to investigate the effect of Swedish massage on pain, the flexion of knee joint ROM, the electrical activity of the quadriceps muscles, and their co-contraction with the hamstring muscles during walking in women with medial compartment KOA.

30 patients with KOA participated in this randomized clinical trial study. Patients were randomly assigned to two intervention and control groups. The intervention group received the massage intervention for four weeks. The patient's pain, the electrical activity of muscles around the knee, and the knee joint ROM were measured in pre-and post-tests. For data analysis, SPSS software was used.

The level of pain (p=0.008) and the flexion range of motion (p=0.033) of the patients showed a significant improvement in the post-test. The electrical activity of the vastus medialis and vastus lateralis muscles increased after the test, but the electrical activity of the semitendinosus and biceps femoris muscles did not show a significant change. Also, the co-contraction ratio of the vastus lateralis-biceps femoris muscles also showed a significant improvement (p=0.020), but the ratio between the vastus medialis-semitendinosus muscles didn’t show a significant decrease (p=0.091).

Considering the improvement of the symptoms and consequences of KOA following the application of massage intervention in this study, it seems that using this intervention along with other medical and therapeutic interventions is beneficial for patients with KOA.

When it comes to migration, the migration of young people comes to mind and the migration of the older adults is ignored. While, migration after retirement is an important and increasing phenomenon. The reasons and destinations of migration of the older persons are different from those of the young. Young people usually migrate to urban destinations and further distances with more job opportunities, while the elderly choose closer destinations and rural areas with good climate. This essay study internal elderly migration, patterns and differences between various socio –demographic groups in Iran during period of 2011-2016.

This article examines the migration of older adults and its socio-demographic correlates in the period of 2011-2016 using the secondary analysis of the 2016 micro-census data. The sample includes 140,159 aged 55 and over in 31 provinces of the country, both urban and rural areas. Binary logistic regression was used in SPSS26 software for data analysis.

The results of multivariable analysis showed that elderly men 13 percent are more likely to migrate than elderly women. The relationship between age and migration for elderly men was U-shaped, which means that the probability of migration is high at the age immediately after retirement, then gradually decreases with age and finally increases again at the age of over 85 years. Also, the possibility of migration among the unmarried older adults is 36 percent higher than married older adults. In addition, with the increase in the level of education, the possibility of migration of the elderly increases. The probability of migration of the elderly with university education was 2.3 times that of uneducated elderly.

Based on the results of census 2011-2015 in Iran, it is expected that the migration of the elderly will increase in the future with the increase in the education level of the elderly and changes in living arrangements. Therefore, it is important to pay attention to the migration of the older adults and its drivers in social policy making.

The present study reviews published studies on the effects of antipsychotic use in the treatment of delirium in the elderly in order to determine the effect of antipsychotic drugs on the prevention and treatment of delirium in the elderly admitted to the intensive care unit and the possible side effects of these drugs in this group of patients.

The present review article was conducted in the year1399-1400 by searching relevant keywords in English and Persian in national and international databases. 70 studies were included in the study in the first phase. After deleting duplicate and unrelated studies, 48 studies remained, and finally 19 studies were excluded due to problems such as the lack of eligible criteria for this study, and the remaining 29 studies in this article were reviewed.

Haloperidol, dexmedetomidine, risperidone, olanzapine, quetiapine, promazine, and clozapine are some of the common antipsychotic drugs used to treat delirium in the elderly. Although in some cases the use of these drugs can reduce the symptoms of delirium, but it can also cause side effects that include increased cerebrovascular complications, increased blood pressure and heart rate, dizziness, myocardial infarction, increased QT interval, tachycardia sinus, T-wave reversal, increased ST-segment elevation, ventricular atrial block, metabolic problems, sodium deficiency, hyperglycemia, pneumonia, and deep vein thrombosis.

According to the evidence obtained from the articles, the use of antipsychotics in the prevention and treatment of delirium in the elderly is not recommended, and in some cases it seems that the risk of using antipsychotics in the treatment of delirium in the elderly outweighs the benefits of using it. Therefore, due to the lack of sufficient evidence for the beneficial role of these drugs in the prevention and treatment of delirium in the elderly, it is recommended to pay more attention to preventive measures against delirium in this group of patients.

Disturbance in maintaining balance and controlling posture is one of the consequences of aging, which, with changes in standing and walking patterns, causes a decrease in functional readiness in the elderly, which leads to a decrease in the sense of balance, loss of coordination, and muscle weakness in these people. As a result, it causes many problems such as frequent falls while standing or walking in this group of people. Therefore, it is very important to design sports exercises in order to improve functional readiness and prevent loss of balance. Therefore, the purpose of this study was to investigate and analyze the effect of core stability exercises on the static and dynamic balance of older men.

This study is a cross-sectional, comparative, quasi-experimental research with a pre-test and post-test design with a control group. Thirty healthy elderly men between 60 and 70 years old were selected through purposive, convenience sampling method. They were randomly divided into two groups: core stability exercises and control group in equal numbers. The experimental group received a 45-mintue training program three sessions per week for 6 weeks, while the control group went about their daily lives. The participants were evaluated using Romberg and Sharpendromberg balance tests for static balance and FRT and TUG balance tests for dynamic balance before and after 6-week training program. To analyze the data, descriptive statistics, paired T-test and One-way ANOVA test were used at the alpha significance level (P ≤0.05) using SPSS software (version 26).

The results showed that by performing 6 weeks of core stability exercises, the mean post-test scores were significantly different from the pre-test scores of the experimental group in all 4 tests (P=0.001). Moreover, the findings revealed that the core stability exercises have a significant effect on static balance (P=0.001) and dynamic balance (P=0.001), in the post-test scores of the experimental group compared to the control group.

It can be concluded that in order to improve balance and reduce the risk of falling in the elderly, core stability exercises can be used. Due to the ease of doing these exercises, it is recommended for sports coaches and people who work with the elderly to use core stability exercises to improve the static and dynamic balance of the elderly

The social isolation caused by the pandemic of Covid-19 affected all aspects of life and different groups of society, one of which was the elderly affected by the disease. The purpose of this study was to investigate the effect of gender and physical activity on the quality of life and sleep of the elderly in Kurdistan province after one year of the beginning of the pandemic of Covid-19.

The current research method is causal-comparative. 184 people (>60 years) participated in the study in a clustering method and proportion to the population of Kurdistan's cities. Baecke Physical Activity, Pittsburgh Sleep Quality, and Leiden-Padua questionnaires were used to collect information on physical activity, sleep, and quality of life, respectively. Multivariate analysis of variance (MANOVA) was used to analyze the research data.

The results showed that gender had no significant effect on sleep quality but had a significant effect on the quality of life on the scales of depression and anxiety, and sexual performance (P=0.001). However, physical activity has a significant effect on both sleep quality (P=0.02) and quality of life (P<0.001).

The results of the present study showed that physical activity can reduce sleep problems in the elderly, especially problems caused by sleep latency, subjective sleep quality, and sleep disturbances. Findings also showed Physical activity plays a key role in increasing the quality of life of the elderly in terms of physical, social, and sexual performance, and also self-care. Results also showed, that physical activity has a positive effect on the quality of sleep and life of the elderly and can be useful in reducing complaints caused by related problems. It also showed that in stressful conditions, women suffer from depression and anxiety, and sexual problems more than men and experience a lower quality of life.

The phenomenon of increasing elderly population is one of the most important economic, social and health challenges in the 21st century. Currently, Iran's population is not structurally elderly, but soon, the elderly population in Iran will form a significant part of the country's population structure.

The purpose of this research was to investigate the quality of sports and entertainment facilities in Mashhad municipality with the approach of an elderly-friendly city. The statistical population included two parts: spatial and human. Using Cochran's sampling method, and according to the total population of people 60 years and older living in Mashhad (22481 people), the sample size was determined to be 378 people (15).. Then, by using a pilot project in some sports and recreational places, the attitude of the elderly towards the services provided by the Mashhad municipality was investigated.
The criteria for entering the study include the ability to do sports, the absence of sensory and motor disabilities, not taking anti-depressants, not suffering from Alzheimer's disease and physical illness or the history of any specific disease that may endanger a person's health by doing sports (16). The exclusion criteria included unwillingness to continue cooperation in the research. Demographic profile questionnaires, socio-economic status questionnaire (17) and service quality measurement questionnaire of Parasuraman et al. (1988), were used to collect data. 0.88 (18). Finally, 352 questionnaires were collected for statistical analysis.
One-Sample Kolmogorov Smirnov statistical test was used to determine the normality of the data obtained from the demographic variables. Non-parametric tests such as Wilcoxon statistical tests, Friedman's ranking, repeated measurement and Ben-Froni's post hoc test were used to determine the quality of sports services in the thirteen districts of Mashhad Municipality. The probability value of α=0.05 was used to analyze the results in the SPSS-25 software environment. The research design of the present study was approved by the ethics committee of the Islamic Azad University of Mashhad with the code IR-IAU-MSHD.REC.1397.027.

Based on One-Sample Kolmogorov Smirnov’s results, the null hypothesis was rejected, so non-parametric tests such as Wilcoxon statistical tests, Friedman's ranking, measurement Repeated and Ben-Ferroni post hoc test were used for data analysis.
The findings demonstrated that among the five dimensions of the SEROQUEL model, the assurance dimension with the highest score (3.735 ± 0.707) ranks first. Dimensions of tangibles (3.717±0.734), reliability (3.692±0.603), responsiveness (3.476±0.839) and empathy (3.326±1.087) were placed in the second to fifth ranks respectively. Also, perceptions-expectations difference scores of the elderly regarding the quality of municipal sports facilities compared, results showed in all dimensions, the score of perceptions of the existing situation was significantly lower than their expectations which showed a negative gap in all five dimensions. The largest negative gap (-0.747) was related to the dimension of assurance. The smallest negative gap was related to the responsiveness dimension.
In interpreting the results of Will-Coxon's test to understand the difference between the current and desired conditions of the quality of sports services provided by Mashhad Municipality for the elderly, the value of Z, which is significant at the error level of less than 0.001, It confirms that there is a significant difference in the level of perception-expectation. The negative gap indicates the amount and direction of these differences.
In compare the average data among dimensions of service quality, by repeated measure, results showed there is a significant difference between the score of service quality dimensions in the perception section (P≥0.05), but the results of Bonferroni's post-hoc test showed that the only significant difference in current situation is located between the score of the reliability dimension and other four dimensions of quality (P≥0.05). difference between the other four dimensions (tangibles, assurance, responsiveness and empathy) were not significant.
In examining the expectations of the elderly regarding the quality of municipal sports facilities, it was observed that the mean score of expectations in all dimensions is higher than perception. The results of the Friedman ranking test showed a significant difference between the scores of these dimensions (Table 6). According to the significance of Friedman's test, the chi-square value obtained for the average perceptions was equal to 36.661, which is at the error level of less than 0.05.

According to the results of the present research, in measuring the quality of sports facilities in Mashhad Municipality from the perspective of the elderly, in the perception section, the dimension of assurance with the highest score and the dimensions of tangibles, reliability, responsiveness and empathy were ranked in the second to fifth ranks, respectively. Also, in the expectations section of the assurance dimension, tangibles, reliability, responsiveness and empathy were ranked first to fifth respectively. In all dimensions, the scores of seniors' perceptions of service quality were significantly lower than their expectations, and in other words, there was a negative gap in all five dimensions. The biggest negative gap was related to the dimension of assurance, reliability, tangibles, empathy in the next categories and the least was related to the dimension of accountability. The following researchers also reported a negative gap in the evaluation of the quality of services in university sports facilities, sports clubs and recreational sports facilities in all dimensions, which were in line with the results of the present study (11,12,19,20) The existence of a negative gap in all dimensions of quality indicates the existence of problems in service provision and makes it necessary to pay attention to the quality-of-service provision and improve it.
Compared to the results of foreign research results showed that the quality of public sports services has an average level (31). Unfortunately, no positive gap was found in any of the dimensions of service quality in the present study and other internal studies, which indicates the low and unacceptable quality of services provided at the level of sports facilities in the country.