Leader: Alessandra Buja (UNIPD); Other collaborator(s): Giulia Grotto, Sohail Akhtar, Mark Herbert Ebell, Stefania Lopatriello (UNIPD)
To solve the challenges of an ageing population, it is necessary to work with a community-based approach to address the full range of factors influencing a person's overall health and well-being, including interventions that extend care beyond the care setting and reach the entire target population with health promotion and prevention activities and not just a small group of potential beneficiaries.
The activities of this task will be focused on the production of tools tailored to promote health and well-being in older adults, adapting and building a favorable environment, communities, and social context, and defining preventive actions with a population approach, also with the use of new Information and Communication Technologies.
Brief description of the activities and of the intermediate results
A systematic literature review was conducted to assess the effectiveness of using information and communication technologies (ICT) in increasing vaccination rates for vaccines recommended for older adults (influenza, pneumococcal, COVID-19 and shingles). Overall, more than half of the included studies found some level of effectiveness of ICT strategies in increasing vaccination rates, while a quarter of the included studies were partially effective (for specific vaccines or population subgroups) and another quarter reported no significant effect. The results showed that prevention programmes using ICT tools can be effective in promoting vaccination among older adults.
Main policy, industrial and scientific implications
Acceptance and rejection of vaccines are highly context-dependent and are influenced by ‘local vaccine cultures’, as well as social, cultural, historical and political factors. Despite the use of ICT communication methods, which are particularly new when considering non-phone-based studies, most interventions appeared to be effective in older adults, similar to what was observed in another study that looked at different ages. This could be partly due to their acceptance of commonly used technologies and the fact that patients with greater difficulties in using ICT can provide a close relative as a contact through the healthcare system. Overall, ICT tools may be an additional strategy to be used in health promotion campaigns to improve vaccine uptake in older adults by providing information directly to people at a relatively low cost.
Brief description of the activities and of the intermediate results
A systematic review was conducted to examine the impact of religion and spirituality on the longevity of older adults and most of the studies showed a reduction in mortality risk, particularly among those engaged in religious activities with an active social component. Results showed that the link between religiosity and longevity could be mediated by social support from the religious community, better health behaviour and mental health. However, most studies found a reduction in all-cause mortality even after adjusting for these mediating factors, indicating that other mechanisms might be involved.
Main policy, industrial and scientific implications
Most studies conducted among older adults have supported the protective role of religiosity or spirituality on longevity, particularly for religious activities with an active social component. The link between religiosity and longevity could be mediated by the beneficial effects of social support and improved health behaviour that often characterise religious persons. However, since most studies have found a reduction in all-cause mortality even after adjusting for these confounding variables, other mechanisms not yet understood may be involved. These results highlighted the importance of allowing older people to attend their religious community and maintain their spirituality.
Brief description of the activities and of the intermediate results
A scoping review was conducted to evaluate the effectiveness of mHealth interventions (healthcare interventions delivered via smartphone or tablet) in improving sleep quality among older persons suffering from primary insomnia. All five included studies reported improvements in subjective sleep quality after the application of mHealth interventions. Two studies also conducted objective assessments of sleep outcomes using actigraphy and reported improvements in some of the variables
Main policy, industrial and scientific implications
mHealth interventions have shown promise for improving sleep health in the elderly by reaching a wide audience, being easily accessible and cost-effective, offering flexibility to patients and requiring less time from specialists. Furthermore, the incorporation of special tools such as animations, multimedia content, dynamic feedback, interactivity and social networking can improve compliance and increase the perceived value of the intervention. Over the past decades, mobile technology has been widely used worldwide and mHealth has developed in parallel with it. This method offers the advantages of greater availability of medical services everywhere, quick access and greater simplicity. The use of mHealth and telemedicine has become increasingly important for healthcare professionals, especially in view of the COVID-19 pandemic, with greater importance for older, more vulnerable adults with limited mobility.
Brief description of the activities and of the intermediate results
A systematic review was performed to evaluate digital health interventions’ effect on physical activity levels among community-dwelling older adults. Twelve studies were included. Four main conceptually distinctive types of intervention were identified: motivational reminders (messages and reminders aimed at promoting and sustaining participants’ active behaviors, sent exclusively through automated tools, either individually or to the entire intervention group); dynamic exercise programs (tailored physical activity schedules made by a automated software using physical activity data gathered through a digital device, such as pedometers or accelerometers), self-monitoring of physical activity goals (digital versions of a personal diary to record and monitor over time, with or without automatic data collection via digital device and peer support, the amount of physical activity performed and/or goals achieved), physical activity digital coaching (automated tools that provide instruction and guidance on performing physical exercises without the need for a human instructor available during training sessions). For the “motivational reminders” category, a positive effect was reported by three low-quality studies. For the “dynamic exercise programs” category results were mixed, with a positive effect reported by one high-quality study with a high sample size versus two contrasting low-quality studies. For “digital physical activity coaching,” no positive effect was reported by one high-quality and one low-quality study. For the “self-monitoring of physical activity goals” category no positive effect was reported by three low quality studies versus one contrasting medium quality study. The results showed that additional support provided in daily life by motivational reminders, alongside exercise prescription, can be effective in promoting physical activity. Also, well-designed interventions leveraging wearable devices for automated goal setting and tracking could significantly enhance physical activity levels in older adults.
Main policy, industrial and scientific implications
Motivational reminders and dynamic exercise programs appeared to be more effective in increasing physical activity in older adults than other interventions and should be more embedded in structured public health programs. As digital devices become increasingly accessible to older adults, policymakers should consider evaluating this diverse array of digital health interventions to identify and implement the most evidence-based, effective health promotion interventions tailored to this demographic.