فصلنامه سالمند
پیاپی 69 (بهار 1402)

The present study aims to analyze the content of primary school textbooks in the Iranian educational system based on the psychological components of the elderly and how these books have reproduced the psychological components of the elderly.

The research method was descriptive-content analysis. The statistical population of the study included primary school textbooks. The statistical sample of the desirable cases purposefully included the content of all primary school textbooks in 2020. Research components included self-acceptance, autonomy, personal growth, communication with others, environment mastery, and consciousness in life, as well as a content analysis unit.

The results showed that primary school textbooks have addressed the problem of aging from a psychological perspective to some extent, but the texts and images have been at a low level in terms of content and quality of effect in primary school children, which is the period of their personality formation, and has indirectly introduced an elderly person disable and impressible. Therefore, these textbooks do not strongly reproduce the psychological characteristics of the elderly. Their presentation focuses more on the quality of communication with others and neglects other psychological components.

Iranian primary school curriculum requires a thorough review based on the psychological components of the elderly. Texts, activities, and elderly images are included in the textbook to pay more attention to the area of vitality and life expectancy. This practice creates an attitude and a sense of purposefulness in aging.

Primary care is the first main interface of health services for the elderly to maintain and improve their health. Therefore, it is essential to evaluate the appropriateness of the way to provide services for this population group, which is one of the most vulnerable classes of society. This study was conducted to explain the structural and functional challenges of comprehensive health centers in Babol City, based on the guidelines of the World Health Organization’s elderly-friendly centers to plan aging-friendly.

The current research was a descriptive qualitative study using the content analysis method with a conventional approach. This research was conducted on elderly people who were referred to comprehensive health centers and their families as well as service providers in the form of in-depth semi-structured interviews until reaching the level of data saturation. Each interview was implemented immediately after implementation, and the content analysis of the interviews was conducted by determining conceptual units, accurate coding, and continuous comparison method until the formation of subgroups and main classes.

In this study, 23 elderly people with an average age of 71.47±7.88, 5 family members, and 14 service providers participated. A total of 72 codes were extracted from all the interviews, which were divided into five main categories of structural factors, behavioral issues, educational characteristics, social support, and functional challenges during the analysis process. A total of twelve subgroups emerged for the five main classes.

Several underlying factors exist in the path of making comprehensive health centers elderly-friendly, and which will be impossible to achieve this issue without providing the conditions and eliminating the existing challenges. Therefore, the obtained components may help in identifying, and prioritizing needs, and choosing the type of interventions to adapt comprehensive health centers to the needs of the elderly.

The stagnation of mental activity in aging is associated with a decline in the function of all body systems, including cardiovascular, respiratory, genital, glandular, immune, and other organs. Cognitive disorders are also one of the most common problems in aging, which in turn exposes them at risk. Aging is associated with significant changes in memory, intelligence, perception, metacognition, recall, problem-solving, and other cognitive abilities. Therefore, this study was conducted to determine the effectiveness of cognitive rehabilitation in improving the cognitive abilities of the elderly. 

The present study was a quasi-experimental study with a pre-test-post-test design with a control group. The statistical population included elderly people living in nursing homes in Kermanshah City, Iran, from which 24 people were selected by convenience sampling method and according to the inclusion criteria and were randomly assigned to the experimental and control groups. The experimental group underwent 20 sessions of 35 minutes twice a week with the Captain Log cognitive rehabilitation program, during which time the control group did not receive any intervention. After the intervention, post-test was performed for both groups. Research tools included a cognitive rescue skills questionnaire and Captain Log rehabilitation software. Descriptive statistics and univariate and multivariate analysis of covariance were used to analyze the data using SPSS software, version 24.

The results of data analysis showed that F statistic for dependent components, including memory (F=193.57, P<0.001), selective attention (F=375.43, P<0.001), decision-making (F=39.20, P<0.001), planning (F=120.003, P<0.001), sustained attention (F=312.07, P<0.001), flexibility (F=91.44, P<0.001), and social cognition (F=4.48, P<0.05) are significant at the level of 0.05 and 0.01. Therefore, it can be concluded that the cognitive rehabilitation program has improved the cognitive abilities of the elderly.

Considering that cognitive rehabilitation has a significant effect on the neural activities of brain areas related to cognitive abilities and improves their function, it can be used as a suitable method to improve cognitive abilities.

The importance of self-care ability in the elderly to improve their physical and mental health has led to the most direct intervention in this regard to be the assessment of the status of self-care ability and its relationship with nutritional status. This study aims to determine the impact of self-care ability on the nutritional status of the elderly in Tehran City, Iran in 2019.

In this descriptive-analytical correlation study, 420 elderly people referred to the health centers of Shahid Beheshti University of Medical Sciences were studied by two-stage cluster sampling. The data collection tool in this study was a three-part questionnaire, including demographic information, a self-care ability scale for the elderly (SASE), including 40 questions, and a mini nutritional assessment (MNA), including 18 items. The inclusion criteria included a willingness to participate in the study, age 60 years and older, literacy, ability to communicate and collaborate in the study, no cognitive impairment, and the exclusion criteria included incomplete completion of the questionnaire. Data were analyzed by SPSS software version 16 using descriptive and inferential statistical tests of Spearman correlation and structural equation model via using model fit indices under EQS6/1 software.

Among the elderly people, 65.7% were at the desired level in terms of self-care ability and 34.3% were at the middle level. In terms of nutrition, 65% of the elderly people were normal, and 26.4% were exposed to malnutrition. The highest mean and SD of nutritional status and self-care status were obtained in the elderly between the ages of 70-74 and 65-69 years (21.47±3.98) (87.51±6.64). The results obtained from structural equations showed that self-care with an intensity of 71% affected the nutritional status of elderly people. The indices obtained in the model RMR and RMSEA showed less than 0.08 and other fitting indices showed 0.90 and higher.

According to the findings, considering the appropriate level of self-care ability and nutritional status of the elderly and the impact of its socio-individual factors on self-care status, purposeful planning to improve quality of life, especially nutritional quality, and self-care, is essential.

Considering the migration age pattern and the aging trend in Iran, this study aims to investigate the migration effect on the aging spatial distribution of the country during 2006-2016.

This study is a secondary and descriptive-analytical analysis. The source used is the data of the general population and housing census and the analysis unit is the counties of the country. Pearson correlation and analysis of variance in SPSS software, version 22 were used to analyze the data and geographic information system (GIS) was used to display spatial distribution maps.

The study of the migration process in the cities showed that the immigrant-first cities have gone towards aging by losing their young population, while the young cities are mostly receiver-migrant. As a result, the proportion of elder cities is increasing every year. The correlation between the net migration rate and the aging index indicates the inverse relationship (-0.363, -0.303, and -0.216) of these two variables during all periods; as the net migration rate increases, the aging index decreases. The results of the analysis of variance also showed the net migration rate at the county level is significantly different (P = 0.000). The spatial distribution also showed that immigrant-first cities in the western and northwestern regions have a higher rate of aging compared to other regions.

According to the research question, it should be said that the spatial pattern of aging in the population of Iran according to the studied indicators is scattered in clusters and the population of Iran is transitioning from middle age to old age.

The prevalence of cardiovascular risk factors is different in the elderly and middle-aged. Therefore the present study aims to compare the prevalence of risk factors affecting ST-elevation myocardial infarction (STEMI), type of treatment, and mortality rate in these two groups.

This retrospective cohort study included 1 071 elderly and middle-aged ST-elevation myocardial infarction (STEMI) patients who had referred to Kermanshah Imam Ali Hospital for 23 months from January 2017 to November 2019. Demographic information, cardiovascular risk factors, type of treatment, and mortality were examined. Data were analyzed with descriptive statistics, independent t test, and Chi-square test in Stata software version 14 with a significance level of 0.05.

In the present study, the prevalence of risk factors, including smoking, high triglyceride, overweight, and obesity in the middle-aged group was significantly more than the elderly group (P < 0.05). The low-density lipoprotein (LDL) mean (mg/dL) in the middle-aged group (99.26 ± 71.69) was significantly higher than the elderly group (96.29 ± 8.5) (P < 0.05). The rate of primary angioplasty use was higher in the middle-aged (55.31%) than in the elderly (48.52%). Other results indicated that the overall mortality rate in the elderly (15.7%) was higher than in the middle-aged (4.4%) (P < 0.001). The prevalence of myocardial infarction, stroke, hypertension, hyperlipidemia, and glomerular filtration rate (GFR) < 60 was significantly higher in the elderly group compared to the middle-aged (P < 0.05).

The prevalence of low glomerular filtration rate (GFR), hyperlipidemia, and hypertension, myocardial infarction and stroke is higher in the elderly than in the middle-aged, while the prevalence of vital risk factors, such as smoking, triglycerides, overweight, and obesity in the middle-aged group is significantly higher than the elderly. If these risk factors are planned and controlled in middle age, people will be less at risk for myocardial infarction in aging.

This study aims to investigate the relationship between the big-five personality traits (extroversion, neuroticism, agreeableness, conscientiousness, and openness to experience) and elder abuse.

In this cross-sectional study, 304 older adults (60 years old and older) were selected by convenience sampling method based on the inclusion criteria among older adults who were referred to the health centers of Marand City, Iran in 2021. To collect data, Hwalek-sengstock elder abuse screen test (HS-EAST) and 10-item personality inventory (TIPI) were used. The data were analyzed using SPSS software version 23 with t test, chi-square, and logistic regression.

The mean age of the participants was 70.5±7.7 years with almost equal gender distribution. Among the older adults studied, the prevalence of elder abuse was calculated to be 34.2%. The results of logistic regression indicated that the five-big personality traits, especially low conscientiousness, low extroversion, low agreeableness, and high neuroticism after controlling the variables of sex, age, marital status, housing status, education level, employment status, and chronic disease significantly predicts elder abuse (P<0.001, df=12, X2=76.64).

Based on the findings of the present study, it is suggested to pay more attention to the five-big personality traits in the screening and early identification programs of older adults at risk of elder abuse.

Hypertension is the most common cause of stroke and kidney failure in the elderly and medication adherence is vital in controlling complications. This study aims to determine the effect of the Johnson model-based program on medication adherence among the elderly with hypertension.

The present study was a clinical trial that was performed on the elderly with hypertension referred to the Shahid Aval comprehensive health service center in Isfahan City, Iran. Through the convenience sampling method, 70 older adults were selected and randomly divided into intervention and control groups. For the intervention group, 6 sessions of a family-based medication adherence program were performed based on the Johnson model. Demographic characteristics questionnaire and sphygmomanometer were used to collect data. Data were analyzed by SPSS version 22 statistical software using independent t test, Chi-square, and repeated measures analysis of variance (ANOVA).

No difference was observed between the two groups in terms of the distribution of demographic characteristics. Mean systolic and diastolic blood pressure before the intervention in the group were not significantly different, but immediately and three months after the intervention in the intervention group, it was significantly lower than the control group(P<0.05).

Johnson’s model-based program was effective in lowering hypertension in the elderly. Therefore, the method used in the present study is proposed to older adults and elderly care nurses as a simple, non-invasive, low-cost, and effective method of reducing hypertension.

Lifestyle is influenced by differences in societies and changes in culture, social and environmental conditions, hence this study was conducted to determine and compare healthy lifestyle and its predictors in the elderly living in Iran and Iraq.

This descriptive-analytical study was performed on 800 elderly people over 60 years old who were referred to health centers in Najaf City, Iraq, and Mashhad City, Iran in 2021. The research units were selected by cluster probability sampling. Data were collected by demographic characteristic form, healthy lifestyle questionnaire for the elderly, and questionnaire of predictors of a healthy lifestyle at the time of the presence of the elderly in the health center. Data were analyzed using SPSS software, version 23 with descriptive statistics, and the Chi-Square, Mann Whitney U, independent t test, and regression.

The Mean±SD age of the elderly in Iran and Iraq was 66.89±6.68 and 66.42±5.23 years, respectively. About 75% of the Iranian elderly and 59% of the Iraqi elderly had a moderate lifestyle. The mean and standard deviation of total lifestyle scores in Iran and Iraq were 145.75±14.97 and 152.29±13.46, respectively, and the independent t test showed a significant difference (P<0.001). Multiple linear regression tests showed that variables of age, self-assessment of health, drug abuse, income and job satisfaction, and marital status and companions had a significant relationship with a healthy lifestyle in the Iranian elderly, while in the Iraqi elderly, variables of age, sex, self-assessment of health, smoking, income, and job satisfaction, and companions had a significant relationship with a healthy lifestyle (P<0.05). Predictor factors predicted 25% of healthy lifestyle scores in Iran and 37% in Iraq.

It is recommended to improve the lifestyle of the elderly in both Iran and Iraq from the current situation to the desired level. For this purpose, health officials must pay more attention to the most effective factors for a healthy lifestyle, especially drug abuse and income satisfaction in Iran and Iraq, respectively.

In the context of family changes and population aging, changing the pattern of life arrangements of older adults has become a social and policy issue. In this regard, this article aims to investigate the patterns of living arrangements of older adults and its socio-demographic correlates.

A secondary analysis of micro-census data for 2006 and 2016 was used. The study population include people aged 60 and over living in households. Multinomial logistic regression tests and SPSS26 were used to data analysis. 

Living with a spouse and children is the dominant form of living arrangements for older adults in Iran. However, the share of this pattern has been almost stable in the decade 2006-2016, and in contrast, the share of older adults living alone has increased from 12% to 15%. The results indicated a significant gender difference in the pattern of living alone and its prevalence in elderly women (24.1%) was four times higher for older than older men (5.6%). Also, the results showed that with increasing age, the probability of living alone increases and with increasing the level of education of the older adults, the probability of living alone decreases. In addition, rural older adults are more likely to live alone than urban older adults.

Although living with a spouse and children is still the dominant pattern, the living alone of older adults is increasing. Women are more likely to live alone than older men and face more problems. Therefore, paying attention to the issues and problems of the alone elderly women should be the headline of the country’s welfare programs and policies. In addition, by creating employment in rural areas, it is possible to prevent the migration of young people to the city to some extent and reduce the possibility of living alone among rural older adults.