فصلنامه سالمند
پیاپی 71 (پاییز 1402)

The ability to safely walk up and down the stairs is an essential factor in older adults’ independence and quality of life. This study aims to investigate the effect of combined exercises on stair negotiation performance of older men. 

In this randomized controlled clinical trial, 30 older men with at least 60 years of age living in Isfahan, Iran, in 2021 were selected who had functional independence, mental health, the ability to perform daily activities without using an assistive device, and without a history of falling. They assigned randomly to two parallel groups of intervention and control groups. Participants in the intervention group completed 12 weeks of combined exercise. The center of pressure (COP) parameters were measured by a force plate, and the time of stair ascending and descending was recorded by the Qualisys motion analysis system. The stair negotiation performance was evaluated by the timed up and down stairs (TUDS) test and the stair self-efficacy (SSE) scale. Data were analyzed by mixed ANOVA in SPSS software, version 24. The significance level was set at 0.05.

The combined exercise program was effective in reducing the COP parameters during stairs ascending and descending (P<0.05). Stance time and time of ascending and descending decreased after the exercise (P≤0.034). The results of TUDS test (P≤0.002) and SSE scale (P≤0.048) showed improved performance in the intervention group compared to the control group.

The combined exercise program, by focusing on the factors such range of motion, strength, power, and balance, is effective in improving the stair negotiation performance of older men. Due to the prevalence of stair use in daily activities and its potential risk for older adults, this combined exercise program is recommended for older men.

The capacity to manage financial affairs is a multidimensional construct and includes a wide range of judgment, perceptual, and pragmatic activities, ranging from basic to higher abilities. The decline of cognitive function and the ability to manage financial affairs in the elderly can cause problems in them, their families, and society. The present study aims to design and develop a tool to measure the financial capacity of older adults in Iran.

This pilot study was conducted using Waltz’s four-step method Defining objectives, selecting a conceptual mod, blueprinting, and construction of measure (by application of procedures, item sets, and scoring rules). To check the validity of the tool, its face validity and content validity were evaluated.

The initial draft included nine main areas, 27 sub-areas, and 65 items. The questionnaire was completed through a semi-structured interview by an expert. The items in each area were scored as “yes,” “no,” and “not applicable”. By developing instructions, acceptable, unacceptable, and non-applicable answers for each item were explained. The content validity ratio and content validity index for the overall scale were 0.57 and 0.83, respectively.

The designed tool can help clinicians in Iran to make more consistent judgments and more accurately identify older adults who are no longer able to manage their financial affairs.

The provision of health care services for older adults in the form of age-friendly hospitals has been emphasized. The move towards age-friendly hospitals is one of the key issues in international politics. The present study aims to investigate the compliance of teaching hospitals of Khorasan Razavi Province of Iran with the criteria of age-friendly hospitals.

This is a cross-sectional study that was conducted in 2022 on 16 teaching hospitals in Khorasan Razavi Province. The data collection tool was the checklist of age-friendly hospitals. SPSS software, version 22 and descriptive statistics (Mean±SD, frequency, and percentage) were used for data analysis.

Regarding the physical environment, more than 40% of hospitals were in good conditions in terms of being located near the subway and bus station, lighting, access to the elevator, wide doors and corridors, the presence of ramps, and signboards. Regarding staff training and information, more than 82% of the hospitals did not have guidelines for screening and providing counselling to older patients, and the hospitals lacked trained and specialized personnel in the field of major diseases and problems of old age. In the field of management systems, more than 90% of hospitals were not in a good condition.

The teaching hospitals in Khorasan Razavi Province are in a relatively unfavorable condition regarding the compliance with the criteria of age-friendly hospital. Therefore, it is necessary that the criteria of the age-friendly hospital, especially in the areas of staff training and special programs for geriatric care, be taken into account by these hospitals.

Quality of life and subjective vitality are two important components for the elderly. This study aims to study the effect of cognitive rehabilitation and transcranial direct current stimulation (tDCS) on the quality of life and subjective vitality of older adults with mild cognitive impairment (MCI).

This is a quasi-experimental study with a pre-test/post-test/follow-up design. The study population consists of all older adults referred to the Rehabilitation Clinic of Payambaran Hospital in Tehran and diagnosed with MCI based on clinical criteria. Of these, 40 were selected using a convenience sampling method and randomly assigned to two groups of intervention and control. For the intervention group, cognitive rehabilitation plus tDCS was provided at 12 sessions. The LEIPAD quality of life questionnaire and subjective vitality scale of Ryan and Frederick were used to measure the variables. Two-way repeated measures analysis of variance was used to analyze the data in SPSS software, version 25.

There was a significant difference between the two groups in the quality of life and subjective vitality after intervention (P<0.05), indicating that the combination of cognitive rehabilitation with tDCS affected the quality of life and subjective vitality of the elderly. In the follow-up phase, the effects were stable over time.

Combining cognitive rehabilitation with tDCS can have a significant impact on the quality of life and subjective vitality of the elderly with MCI.

This study aims to identify and prioritize the educational needs of older adults in Iran as a prerequisite for developing any educational intervention for them.

In this study, the interviews and content analysis were used to identify the needs, and the Delphi method was used to prioritize them. Three target groups were experts in the fields of education and geriatrics, caregivers of older adults, and older adults. Purposive sampling was used for sampling. The final samples consisted of 45 people.

The results of content analysis by Sterberg’s method, 13 themes were extracted which were sent to the participants for prioritization using the Delphi method. Finally, after two rounds, the participants agreed by 96% on the priority of the most needs, which were: 1) Health-promoting skills, 2) Management of negative emotions and feelings, 3) Self-knowledge, 4) Sense of satisfaction, 5) Interpersonal communication skills, and 6) Self-learning.

With age, physical health and negative emotions management skills decline and with the limitation of the circle of friends and relatives due to retirement or death, social health is also at risk. Proper knowledge about old age and acquiring self-learning skills are key elements to overcome the challenges of this period. The educational centers in Iran should provide education to older adults about health-promoting skills, how to manage negative emotions, knowledge about old age and self-learning skills, and communication skills.

Today, vaccination is effective in preventing COVID-19. This study aims to determine the factors affecting the acceptance of COVID-19 vaccines by older adults in Qom, Iran, based on the theory of planned behavior (TPB).

In this correlational study, 200 older people were selected from a retirement center in Qom using a random sampling method. Data collection tools included a demographic form and a TPB-based questionnaire. The data were analyzed using descriptive statistics and structural equation modeling in SmartPLS software.

The mean age of the participants was 62.8±5.8 years; 80.1% were male, and 49.7% had received the booster dose of vaccines. There was a significant positive relationship between intention to receive the vaccine and vaccination behavior (β=0.597, P<0.05). Also, the fear of vaccine side effects (β=-0.162, P<0.05), attitude (β=0.356, P<0.05), and perceived behavioral control (β=0.171, P< 0.05) had a significant relationship with the intention to receive the vaccine. The fitness indexes of the model showed its good fit, and the TPB-based model could predict 34% of the changes in receiving COVID-19 vaccines. 

Attitude, fear of vaccine side effects, and behavioral control are the factors affecting the acceptance of COVID-19 vaccines by the elderly in Qom City. The results can be useful in developing educational programs to increase the rate of vaccination among older people.

Sleep disorders are among the most common problems in the elderly. Guided imagery is a non-pharmacological treatment that can be effective in treating these problems and improving the health of the elderly. This study aims to determine the effect of guided imagery therapy on sleep quality and general health of older adults suffering from sleep disorders.

This is an interventional study on 70 older adults aged >60 years referred to a health center in Ardabil, Iran in 2021. They were selected using a convenience sampling method and were randomly allocated to the intervention (n=35) and control (n=35) groups after obtaining informed consent. The Pittsburgh sleep quality index (PSQI) and Goldberg’s general health questionnaire (GHQ) were used before and after the intervention for data collection. The control group received the routine care, while the intervention group received the guided imagery therapy as well by listening to an audio file. Data analysis was done in SPSS software, version 22.

There was no significant difference in the mean score of PSQI and GHQ between the two groups before the intervention (P>0.05). However, a significant difference was observed in sleep quality (P≤0.001) and general health (except for severe depression and social dysfunction domains) after the intervention (P≤0.05).

Guided imagery is efficient in improving sleep quality and general health of the elderly with sleep disorders and can be used as a non-pharmacological nursing intervention.

The burden of disease analysis can be used to measure the factors that are suitable for interventions for disease control. This study aims to calculate the burden of risk factors for common cancers among the elderly in Markazi Province of Iran in 2016.

This a retrospective descriptive-analytical study. Information was collected based on age and sex groups, which included the cancer incidence rate, cancer death rate, cancer disability rate based on the GBD standard table, which were collected from the website of Statistics Centre of Iran, the latest death report and the latest cancer report in 2016. The data analyses were done in Excel and DISMOD2 applications. The disease burden calculation formula was used in this study. To ensure the validity and reliability of the data, the data with wrong or useless codes were excluded.

For skin cancer, the highest burden was related to exposure to sunlight (526.71); for stomach cancer, family history (79305.88); for colon, lack of fruit consumption (4063.18); for breast cancer, lack of marriage (6488.58); and for prostate cancer, history of previous diseases (7244.08).

Family history of cancer, smoking, obesity, and physical inactivity are common risk factors of most cancers with a same burden.

Planning for active aging to manage the conditions of old age is one of the inevitable priorities that requires knowing its facilitators and barriers from the perspectives of beneficiaries. In this regard, this study aims to identify the facilitators and barriers to active aging in Iran from the perspective of older adults and geriatric experts.

This is a qualitative study that was conducted in 2022 using the content analysis method. Participants were 20 older adults and 21 experts in geriatrics who were selected using a purposive sampling method based on the inclusion criteria. Semi-structured, in-depth interviews and focus groups were used for data collection. Data were analyzed using Graneheim and Lundman’s content analysis method. Lincoln and Guba’s criteria were used to determine the credibility, transferability, dependability, and confirmability of the data.

Four main categories were extracted for barriers to active aging (individual, family, structural, and health system-related) and four main categories for facilitators of active aging (older adults’ existential capacity, family capacity, community capacity, and health system capacity).

Health system-related barrier is one of the barriers to planning for active aging in Iran. The results of this study provide valuable information to experts in geriatrics, scholars, and elderly care centers for developing interventions to promote active aging in Iran.

Balance disorder is an important risk factor in older people while walking. Knee pain (KP) and low back pain (LBP) are the most common disorders related to aging that disturb the balance of the elderly. This study aims to investigate the relationship between chronic LBP and chronic KP with dynamic balance in the elderly.

In this analytical cross-sectional study, 79 older adults aged ≥65 years living in a nursing home in Mashhad, Iran, were selected using the census method and based on the inclusion and exclusion criteria of the study. In addition to measuring demographic information, fear of falling was assessed with the Persian version of the falls efficacy scale - international (FES-I), and the pain was assessed using the visual analog scale (VAS). To assess dynamic balance, the time up & go (TUG) test was used. Data analysis was done in SPSS software, version 23.

There was a significant difference among the three study groups of LBP, KP, and control in TUG score (P=0.050). With the increase in the FES-I score, the mean score TUG score increased significantly (P=0.01). With the increase of age, the mean score of TUG score increased significantly (P=0.006).

The elderly with chronic KP have poorer dynamic balance than the elderly with chronic LBP. Therefore, focusing on the prevention and treatment of knee injuries at younger ages can play an important role in preventing balance disorders in the elderly.