A social health services model to promote active ageing in Mexico: design and evaluation of a pilot programme

Ricardo Pérez-Cuevas, Svetlana V Doubova, Laura Angélica Bazaldúa-Merino, Hortensia Reyes-Morales, David Martínez, Roberto Karam, Carlos Gamez, Onofre Muñoz-Hernández, Ricardo Pérez-Cuevas, Svetlana V Doubova, Laura Angélica Bazaldúa-Merino, Hortensia Reyes-Morales, David Martínez, Roberto Karam, Carlos Gamez, Onofre Muñoz-Hernández

Abstract

The objective of the study was to design and evaluate a pilot programme aimed at promoting the active ageing of older adults at the Mexican Institute of Social Security. The study was conducted in three stages: (a) design; (b) implementation; and (c) before-after evaluation through analysis of changes in functional status, occupational functioning and health-related quality of life. To overcome the limitations of the study design, we evaluated the effect of 80 per cent adherence to the programme on the outcome variables using the generalised linear regression models (GLM). Two hundred and thirty-nine older adults agreed to participate, of whom 65 per cent completed the programme. Most were women; the average age was 77 years. Adherence to the programme was higher than 75 per cent for the group who completed active ageing services and less than 60 per cent for the drop-out group. Overall, 46 per cent of older adults reached an adherence level of 80 per cent or higher. Adherence was significantly associated with improved quality of life total score (coefficient 2.7, p<0.0001) and occupational functioning total score (coefficient 2.2, p<0.0001). Participation of older adults in an active ageing programme may improve their health-related quality of life and occupational functioning. It is necessary to identify the potential barriers and to implement strategies to improve the recruitment and retention rates during the intervention.

Keywords: active ageing; health-related quality of life; occupational functioning; pilot programme.

Figures

Figure 1.
Figure 1.
Flow of participants.

References

    1. Angevaren M., Aufdemkampe G., Verhaar H. J., Aleman A. and Vanhees L. 2008. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database of Systematic Reviews, 2, CD005381.
    1. Arbesman M. and Mosley L. J. 2012. Systematic review of occupation- and activity-based health management and maintenance interventions for community-dwelling older adults. American Journal of Occupational Therapy, 66, 3, 77–83.
    1. Arean P. and Gallagher-Thompson D. 1996. Issues and recommendations for the recruitment and retention of older ethnic minority adults into clinical research. Journal of Consulting and Clinical Psychology, 64, 5, 875–80.
    1. Ashworth N. L., Chad K. E., Harrison E. L., Reeder B. A. and Marshall S. C. 2005. Home versus center based physical activity programs in older adults. Cochrane Database of Systematic Reviews, 1, CD004017.
    1. Atchison K. A. and Dolan T. A. 1990. Development of the Geriatric Oral Health Assessment Index. Journal of Dental Education, 54, 11, 680–7.
    1. Beaman S. R., Bearman P. E., Garcia-Pela C., Villa M. A., Heres J., Córdova A. and Jagger C. 2004. Validation of a modified version of the Mini-Mental State Examination (MMSE) in Spanish. Aging, Neuropsychology, and Cognition, 11, 1, 1–11.
    1. Beswick A. D., Rees K., Dieppe P., Ayis S., Gooberman-Hill R., Horwood J. and Ebrahim S. 2008. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet, 371, 9614, 725–35.
    1. Boudini K. 2013. Active ageing: from empty rhetoric to effective policy tool. Ageing & Society, 33, 6, 1077–98.
    1. Burns R., Nichols L. O., Martindale-Adams J. and Graney M. J. 2000. Interdisciplinary geriatric primary care evaluation and management: two-year outcomes. Journal of the American Geriatrics Society, 48, 1, 13.
    1. Campo-Arias A., Urruchurtu-Mendoza Y. and Solano-Morales T. 2008. Internal consistency and exploratory factorial analysis of the Yesavage Geriatric Depression Scale (GDS-15) in Cartagena (Colombia). Revista Salud Uninorte, 24, 1, 1–9.
    1. Caplan G. A., Williams A. J., Daly B., Abraham K. 2004. A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the emergency department – the DEED II study. Journal of the American Geriatrics Society, 52, 9, 1417–23.
    1. Dahan-Oliel N., Gélinas I. and Mazer B. 2008. Social participation in the elderly: what does the literature tell us? Critical Reviews in Physical and Rehabilitation Medicine, 20, 2, 159–76.
    1. Deakin University's Centre for Physical Activity and Nutrition Research 2012. Identifying Effective Strategies to Increase Recruitment and Retention in Community-based Health Promotion Programs. Centre for Physical Activity and Nutrition Research, Deakin University, Geelong, Australia.
    1. Diaz Veiga P. 1987. Evaluación del apoyo social In Fernández-Ballesteros R. (ed.), El ambiente. Análisis psicológico. Pirámide, Madrid, 125–49.
    1. Douketis J. D., Paradis G., Keller H. and Martineau C. 2005. Canadian guidelines for body weight classification in adults: application in clinical practice to screen for overweight and obesity and to assess disease risk. Canadian Medical Association Journal, 172, 8, 995–8.
    1. Eakin E. G., Bull S. S., Riley K., Reeves M. M., Gutierrez S. and McLaughlin P. 2007. Recruitment and retention of Latinos in a primary care-based physical activity and diet trial: the Resources for Health Study. Health Education Research, 22, 3, 361–71.
    1. Economic Commission for Latin America and the Caribbean (ECLAC) and the United Nations Population Fund (UNFPA) 2003. Social Networks for Older People in Latin America and the Caribbean. ECLAC and UNFPA, New York.
    1. Ellis G., Whitehead M. A., Robinson D., O'Neill D. and Langhorne P. 2011. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials. British Medical Journal, 343, d6553.
    1. Fletcher B., Gheorghe A., Moore D., Wilson S. and Damery S. 2012. Improving the recruitment activity of clinicians in randomised controlled trials: a systematic review. BMJ Open, 2, 1, e000496.
    1. Forsman A. K., Nordmyr J. and Wahlbeck K. 2011. Psychosocial interventions for the promotion of mental health and the prevention of depression among older adults. Health Promotion International, 26, supplement 1, i85–107.
    1. Gillespie L., Robertson M., Gillespie W., Lamb S., Gates S., Cumming R. and Rowe B. 2010. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 10, CD007146.
    1. Glass T. A., Mendes de Leon C., Marottoli R. A. and Berkman L. F. 1999. Population based study of social and productive activities as predictors of survival among elderly Americans. British Medical Journal, 319, 7208, 478–83.
    1. Gonzales-Celis A. L. and Padilla A. 2006. Calidad de vida y estrategias de afrontamiento ante problemas y enfermedades en ancianos de Ciudad de México. Universitas Psychologica Bogotá (Colombia), 5, 3, 501–9.
    1. Guigoz Y. 2006. The Mini Nutritional Assessment (MNA) review of the literature – what does it tell us? Journal of Nutrition, Health & Aging, 10, 6, 466–85.
    1. Huenchuan S. 2010. Ageing, Human Rights and Public Policies. Economic Commission for Latin America and the Caribbean (ECLAC), Santiago, Chile.
    1. Huenchuan S. and Rodríguez-Piñero L. 2011. Module 3. The national and regional standards and policies on older people In The Rights of Older Persons. Study Materials and Outreach. Latin American and Caribbean Demographic Centre (CELADE) – Population Division of Economic Commission for Latin America and the Caribbean (ECLAC), Santiago, Chile.
    1. Jacobs T. 2005. Being Old, Feeling Old. Between Autonomy and Dependency in the Area of ‘Active Ageing’. University of Antwerp, Antwerp, Belgium.
    1. Jancey J., Howat P., Lee A., Clarke A., Shilton T., Fisher J. and Iredell H. 2006. Effective recruitment and retention of older adults in physical activity research: PALS study. American Journal of Health Behaviour, 30, 6, 626–35.
    1. Kielhofner G. 2008. Model of Human Occupation: Theory and Application. Fourth edition, Lippincott Williams & Wilkins, Philadelphia, Pennsylvania.
    1. Lawton M. P. and Brody E. M. 1969. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 3, 179–86.
    1. Liang K. Y. and Zeger S. L. 1986. Longitudinal data analysis using generalized linear models. Biometrika, 73, 1, 13–22.
    1. Liu C. J. and Latham N. K. 2009. Progressive resistance strength training for improving physical function in older adults. Cochrane Database of Systematic Reviews, 3, CD002759.
    1. Lloyd-Sherlock P. and Redondo N. 2009. Institutional care for older people in developing countries: the case of Buenos Aires, Argentina. Population Ageing, 2, (1,2), 41–56.
    1. Mahoney F. I. and Barthel D. W. 1965. Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 61–5.
    1. McMahon S., Talley K. M. and Wyman J. F. 2011. Older people's perspectives on fall risk and fall prevention programs: a literature review. International Journal of Older People Nursing, 6, 4, 289–98.
    1. Mendoza-Nuñez V. M. and Martinez-Maldonado M. L. 2013. Model of social and community networks to maintain health in old age In Montes de Oca Zavala V. (ed.), Envejecimiento en América Latina y el Caribe. Enfoques en investigación y docencia de la Red Latinoamerica de Investigación en Envejecimiento (LARNA). Instituto de Investigaciones Sociales, UNAM, México DF, 453–80.
    1. Mendoza-Núñez V. M., Martínez-Maldonado M. L. and Correa-Muñoz E. 2009. Implementation of an active aging model in Mexico for prevention and control of chronic diseases in the elderly. BMC Geriatrics, 9, 40.
    1. Mexican Institute of Social Security 2007. Report to the President and Congress of the Union on the Financial Situation and the Risks of the Mexican Institute of Social Security 2006–2007. Mexican Institute of Social Security, México DF.
    1. Ministry of Health of the Nation 2007. National Program for Active Aging and Health for Older Adults. Ministry of Health of the Nation, Buenos Aires.
    1. Ministry of Labour and Social Affairs, IMSERSO and Secretary of State for Social Services, Families and Disability 2004. Caring for People in Situations of Dependency in Spain. White Paper. Ministry of Labour and Social Affairs, Spain: Available online at .
    1. National Institute of Public Health 2012. National Survey of Health and Nutrition 2012. National Results. National Institute of Public Health, Cuernavaca, Mexico: Available online at .
    1. National Population Council 2006. Population Projections in Mexico. National Population Council, México DF.
    1. National Research Council 2001. Preparing for an Aging World: The Case for Cross-national Research, Panel on a Research Agenda and New Data for an Aging World. Committee on Population and Committee on National Statistics, Division of Behavioral and Social Sciences and Education, National Academy Press, Washington DC.
    1. Noerholm V., Groenvold M., Watt T., Bjorner J. B., Rasmussen N. A. and Bech P. 2004. Quality of life in the Danish general population – normative data and validity of WHOQOLBREF using Rasch and item response theory models. Quality of Life Research, 13, 2, 531–40.
    1. Nyman S. R. and Victor C. R. 2012. Older people's participation in and engagement with falls prevention interventions in community settings: an augment to the Cochrane systematic review. Age and Ageing, 41, 1, 16–23.
    1. O'Neill T., Marsden D., Silman A. and Group at EVOS. 1995. Differences in the characteristics of responders and non-responders in a prevalence survey of vertebral osteoporosis. Osteoporos International, 5, 5, 327–34.
    1. Orellano E., Colón W. I. and Arbesman M. 2012. Effect of occupation- and activity-based interventions on instrumental activities of daily living performance among community-dwelling older adults: a systematic review. American Journal of Occupational Therapy, 66, 3, 292–300.
    1. Organisation for Economic Co-operation and Development (OECD) 2009. Pensions at a Glance 2009: Retirement Income Systems in OECD Countries. Online Country Profiles, Including Personal Income Tax and Social Security Contributions. OECD, Paris.
    1. Parkinson S., Forsyth K. and Kielhofner G. 2006. The Model of Human Occupation Screening Tool (MOHOST) (Version 2.0). The Model of Human Occupation Clearinghouse, Department of Ocupational Therapy, College of Applied Health Sciences, University of Illinois, Chicago.
    1. Paskulin L. M. and Molzahn A. 2007. Quality of life of older adults in Canada and Brazil. West Journal of Nursing Research, 29, 1, 10–26.
    1. Rodríguez-Guevara C. and Lugo L. H. 2012. Validity and reliability of Tinetti Scale for Colombian people. Revista Colombiana de Reumatología, 19, 4, 218–33.
    1. Stuck A. E., Siu A. L., Wieland D., Adams J. and Rubenstein L. Z. 1993. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet, 342, 8878, 1032–6.
    1. Tinetti M. E. 1986. Performance-oriented assessment of mobility problems in elderly patients. Journal of American Geriatrics Society, 34, 2, 119–26.
    1. United Nations 2002. Report of the Second World Assembly on Ageing, Madrid, 8–12 April 2002. United Nations, New York.
    1. Van Craen K., Braes T., Wellens N., Denhaerynck K., Flamaing J., Moons P., Boonen S., Gosset C., Petermans J. and Milisen K. 2010. The effectiveness of inpatient geriatric evaluation and management units: a systematic review and meta-analysis. Journal of the American Geriatrics Society, 58, 1, 83–92.
    1. Wang H. X., Karp A. and Winblad B. 2002. Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen Project. American Journal of Epidemiology, 155, 12, 1081–7.
    1. World Health Organization 1996. WHOQOL-BREF. Introduction, Administration, Scoring and Generic Version of the Assessment. World Health Organization, Geneva.
    1. World Health Organization 2002. Active Aging: A Policy Framework. A Contribution of the World Health Organization to the Second United Nations World Assembly on Ageing. World Health Organization, Madrid: Available online at .
    1. World Health Organization 2010. Global recommendations on physical activity for health. World Health Organization, Geneva.

Source: PubMed

3
Subskrybuj