Explore the vast range of titles available.

\"The study of aging is not fundamentally about how old people are. It is about people's capabilities and their disabilities. In the field of population aging, measurements have generally been made with instruments devised many decades ago. Those measurements systems did not take the changing characteristics of older people into account. Using them 65-year-olds with a remaining life expectancy of 5 years could not be distinguished from 65-year-olds with a remaining life expectancy of 25 years. Although, in the past, those instruments did help us see better, it is now clear that there is a great deal that they did not allow us to see. Prospective Longevity provide a new view of who is old, how healthy people are in old age, the gender gap in survival at older ages, differences in patterns of survival across Russian regions and United States, the effects on the pace of population aging of medical breakthroughs that allow people to live much longer lives, and how an intergenerationally equitable pension age should change as life expectancy increases\"-- Provided by publisher.

Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Bill & Melinda Gates Foundation.

Heatwaves have become more frequent and intense due to anthropogenic global warming and have serious and potentially life-threatening impacts on human health, particularly for people over 65 years old. While a range of studies examine heatwave exposures, few cover the whole globe and very few cover key areas in Africa, South America, and East Asia. By using global gridded climate reanalysis, population, and demographic data, this work analyses trends in change in exposure of vulnerable populations to heatwaves, providing global and per-country aggregate statistics. The difference between the global mean of heatwave indexes and the mean weighted by vulnerable population found that these populations are experiencing up to five times the number of heatwave days relative to the global average. The total exposures, measured in person-days of heatwave, highlight the combined effect of increased heatwaves and aging populations. In China and India, heatwave exposure increased by an average of 508 million person-days per year in the last decade. Mapping of changes per country highlighted significant exposure increases, particularly in the Middle East and in South East Asia. Major disparities were found between the heatwave exposures, country income group, and country health system capacity, thus highlighting the significant inequalities in global warming impacts and response capacities with respect to health across countries. It is therefore of prime importance that health development and response are coordinated with climate change mitigation and adaptation work.

Leukocyte telomere length(LTL) has been associated with age, self-reported race/ethnicity, gender, education, and psychosocial factors, including perceived stress, and depression. However, inconsistencies in associations of LTL with disease and other phenotypes exist across studies. Population characteristics, including race/ethnicity, laboratory methods, and statistical approaches in LTL have not been comprehensively studied and could explain inconsistent LTL associations. LTL was measured using Southern Blot in 1510 participants from a multi-ethnic, multi-center study combining data from 3 centers with different population characteristics and laboratory processing methods. Main associations between LTL and psychosocial factors and LTL and race/ethnicity were evaluated and then compared across generalized estimating equations(GEE) and linear regression models. Statistical models were adjusted for factors typically associated with LTL(age, gender, cancer status) and also accounted for factors related to center differences, including laboratory methods(i.e., DNA extraction). Associations between LTL and psychosocial factors were also evaluated within race/ethnicity subgroups (Non-hispanic Whites, African Americans, and Hispanics). Beyond adjustment for age, gender, and cancer status, additional adjustments for DNA extraction and clustering by center were needed given their effects on LTL measurements. In adjusted GEE models, longer LTL was associated with African American race (Beta(β)(standard error(SE)) = 0.09(0.04), p-value = 0.04) and Hispanic ethnicity (β(SE) = 0.06(0.01), p-value = 0.02) compared to Non-Hispanic Whites. Longer LTL was also associated with less than a high school education compared to having greater than a high school education (β(SE) = 0.06(0.02), p-value = 0.04). LTL was inversely related to perceived stress (β(SE) = -0.02(0.003), p<0.001). In subgroup analyses, there was a negative association with LTL in African Americans with a high school education versus those with greater than a high school education(β(SE) = -0.11(0.03), p-value<0.001). Laboratory methods and population characteristics that differ by center can influence telomere length associations in multicenter settings, but these effects could be addressed through statistical adjustments. Proper evaluation of potential sources of bias can allow for combined multicenter analyses and may resolve some inconsistencies in reporting of LTL associations. Further, biologic effects on LTL may differ under certain psychosocial and racial/ethnic circumstances and could impact future health disparity studies.

Background Effective education for health volunteers plays a pivotal role, considering their contribution to promoting community health. Given the aging population and its associated challenges, it is crucial to develop effective and low-cost programs to enhance the knowledge and attitudes of health volunteers and improve the quality of life for older adults. Aim This study investigated the effect of active aging education on the knowledge and attitudes of health volunteers. Methods This study was conducted from November 2023 to February 2024 on 86 health volunteers at comprehensive health centers in Shiraz City. The volunteers were randomly divided into two groups: intervention and control. The data collection tool was a questionnaire. Following the pre-test, the content was delivered in six training sessions. Post-tests were administered to both groups immediately after the intervention and two months later. The data were analyzed using SPSS version 23, employing frequency analysis, the Chi-square test, the t-test, and repeated measures tests. A significance level of 0.05 was considered. Results The findings revealed that health volunteers' knowledge significantly increased after the educational intervention. There was a statistically significant difference in the mean knowledge score in the intervention group at the three-time points (before, immediately after, and two months after the intervention) based on the repeated measures test ( P  < 0.001). Additionally, the attitude of health volunteers improved significantly following the educational intervention ( P  < 0.001). Conclusion Trained volunteers can effectively convey critical health and cultural messages, make informed decisions, and enhance the local population's access to primary healthcare. The results of this study demonstrate that the active aging educational intervention improved the knowledge and attitudes of health volunteers. Therefore, leveraging the potential of health volunteers to teach active aging can improve the health and well-being of the elderly population.

ABSTRACTBackgroundLongitudinal studies predictably experience non-random attrition over time. Among older adults, risk factors for attrition may be similar to risk factors for outcomes such as cognitive decline and dementia, potentially biasing study results. ObjectiveTo characterize participants lost to follow-up which can be useful in the study design and interpretation of results. MethodsIn a longitudinal aging population study with 10 years of annual follow-up, we characterized the attrited participants (77%) compared to those who remained in the study. We used multivariable logistic regression models to identify attrition predictors. We then implemented four machine learning approaches to predict attrition status from one wave to the next and compared the results of all five approaches. ResultsMultivariable logistic regression identified those more likely to drop out as older, male, not living with another study participant, having lower cognitive test scores and higher clinical dementia ratings, lower functional ability, fewer subjective memory complaints, no physical activity, reported hobbies, or engagement in social activities, worse self-rated health, and leaving the house less often. The four machine learning approaches using areas under the receiver operating characteristic curves produced similar discrimination results to the multivariable logistic regression model. ConclusionsAttrition was most likely to occur in participants who were older, male, inactive, socially isolated, and cognitively impaired. Ignoring attrition would bias study results especially when the missing data might be related to the outcome (e.g. cognitive impairment or dementia). We discuss possible solutions including oversampling and other statistical modeling approaches.

Healthy cognitive ageing is a societal and public health priority. Cerebrovascular risk factors increase the likelihood of dementia in older people but their impact on cognitive ageing in younger, healthy brains is less clear. The UK Biobank provides cognition and brain imaging measures in the largest population cohort studied to date. Here we show that cognitive abilities of healthy individuals (N = 22,059) in this sample are detrimentally affected by cerebrovascular risk factors. Structural equation modelling revealed that cerebrovascular risk is associated with reduced cerebral grey matter and white matter integrity within a fronto-parietal brain network underlying executive function. Notably, higher systolic blood pressure was associated with worse executive cognitive function in mid-life (44–69 years), but not in late-life (>70 years). During mid-life this association did not occur in the systolic range of 110–140 mmHg. These findings suggest cerebrovascular risk factors impact on brain structure and cognitive function in healthy people. Cerebrovascular risk factors reduce cognitive performance via changes in the integrity of a frontoparietal brain network in ageing. Modification of blood pressure, with antihypertensive treatment in mid-life, mitigates against cognitive decline over a specific blood pressure range.

Background Assessing and monitoring intrinsic capacity (IC) is an effective strategy to promote healthy ageing by intervening early in high-risk populations. This review systematically analyzed the global detection rates of IC deficits and explored variations across diverse populations and data collection methods. Methods This study was preregistered with PROSPERO, CRD42023477315. In this systematic review and meta-analysis, we systematically searched ten databases from January 2015 to October 2023, for peer-reviewed, observational studies or baseline survey of trials that assessed IC deficits among older adults aged 50 and above globally following the condition, context and population approach. The main outcome was intrinsic capacity deficits which could be assessed by any tools. Meta-analyses were performed by a random-effect model to pool the detection rates across studies and subgroup analyses were conducted by populations and data collection methods. Results Fifty-six studies conducted in 13 countries were included in the review and 44 studies with detection rates of IC were included in the meta-analysis. The pooled detection rate of IC deficits was 72.0% (65.2%-78.8%) and deficits were most detected in sensory (49.3%), followed by locomotion (40.0%), cognition (33.1%), psychology (21.9%), and vitality (20.1%). Variations in detection rates of IC deficits were observed across studies, with higher rates observed in low- and middle-income countries (74.0%) and hyper-aged societies (85.0%). Study population and measurement tools also explained the high heterogeneity across studies. Conclusion IC deficits are common among older adults, while heterogeneity exists across populations and by measurement. Early monitoring with standardized tools and early intervention on specific subdomains of IC deficits are greatly needed for effective strategies to promote healthy ageing.

Object To analyze the trend of the coupling and coordination of the supply and demand of healthcare resources between the elderly population and healthcare resources in China during the period of 2012–2022, to reveal the impact of the growth of the elderly population on the relationship between the supply and demand of healthcare resources, and to put forward suggestions to improve the coupling and coordination between the supply and demand of healthcare resources and the elderly population, in order to cope with the challenges of an aging society. Methods By obtaining relevant data from authoritative data sources such as China Statistical Yearbook, Health and Health Statistics Yearbook, and the Chinese government website from 2012 to 2022, we constructed a comprehensive measurement index for the three systems of elderly population, healthcare resource supply, and healthcare resource demand; Using the entropy value method to assign weights to the indicators, combined with the coupling coordination degree model, to reveal the changes of the elderly population change and the supply and demand of medical and health resources; using ArcGIS technology, to study the spatial characteristics of the elderly population change and the supply and demand of medical and health resources. Results From 2012 to 2022, the supply and demand of healthcare resources and the variation of the elderly population in China show a continuous growth trend, and the comprehensive development level of the system gradually climbs from a low level to a high level. The fluctuation of coupling degree and coordination degree rises, although the coordination degree has always been lower than the coupling degree, but the distance between the coordination degree and the coupling degree gradually narrows with the passage of time. The coordination degree between population aging and medical and health resources development shows spatial heterogeneity in China, with the eastern region significantly higher than the western region/. Conclusions The coupling degree between population aging and healthcare resource supply and demand in China from 2012 to 2022 shows a general upward trend from low coupling to medium-high coupling, but it is worth noting that even though the degree of coupling increases, the degree of coordination is still relatively lagging behind, suggesting that the government and relevant departments need to pay more attention to coordinated allocation and management of healthcare resources. At the same time, the spatial differences in the degree of coordination among provinces suggest that future policymakers should take regional differences into full consideration in policymaking and sustainable development.

Abstract   Extending working lives is a timely and policy-relevant topic across Europe due to population aging and increased old age dependency ratio. Several individual, workplace, and societal factors are associated with longer working lives. Health is shown to be a key determinant of work participation with advancing age, and thus, public health is strongly interconnected to the goals of extending working careers. This symposium highlights ongoing research from three Nordic countries in regards to different aspects of public health, namely, health behaviors, health and functional capacity, as well as labor market transitions with advancing age. The presentations also demonstrate different statistical methods to analyze transitions between different states over time (e.g., work, retirement, and disability). The first presentation by Dr. Saana Myllyntausta from University of Turku, Finland, will show how health behavioral factors, especially physical activity and sleep, predict working life expectancy at the age 50 based on Finnish data. Next, the presentation by Dr. Bjørn Heine Strand from the Norwegian Institute of Public Health and Dr. Ellen Melbye Langballe from Norwegian National Centre for Ageing and Health, will share findings from the HUNT study and the Tromsø study showing how physical, mental, and cognitive health, as well as functional capacity, determine capacity to work between ages 60 and 70. Finally, Dr. Brian Beach from Karolinska Institutet, Sweden, will analysis of the Swedish policy context showing the complexity of labor market transitions after age 65, using population-based register data. The three presentations are followed by discussion by Dr. Kristin Farrants from Karolinska Institutet, Sweden, who will provide a synthesis of the presentations and highlight avenues for future work. The last part of the workshop will be devoted to interactive discussion among the presenters, discussant and audience. Key messages • Health is a key determinant of work participation with advancing age, which highlights the importance of public health policies in supporting sustainable working life. • Modern statistical methods enable modelling the complexity of labor market transitions and exits among older working adults.