Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

A multidisciplinary journal on gaming and gamification for health education/promotion, teaching and social change.

The built environment is essential for well-being at old age. The theory of salutogenesis, focusing on health, rather than the disease itself, provides evidence that space contributes to health and well-being. This has influenced healthcare architecture through facilities designed to support well-being. So, increasingly healthcare facilities aim to look like hotels to improve user experience. This retains conceptual and usage gaps between hospitality and healthcare but supports cross-fertilization of best practice. This paper explores possibilities of synergies between healthcare facilities and hospitality industry. Appropriate services and well-being across the lifespan is the ultimate objective, and the physical environment is critical in that provision. Examining the architectural typology of the dementia village as case study, it explores healthcare–hospitality hybrids. Learning from both domains can contribute to silver economy while providing the aging population with enhanced environment. Aging population and stakeholders in this ecosystem can benefit from these synergies.

Non-communicable chronic diseases (NCCDs) are the main cause of morbidity and mortality globally. Demographic aging has resulted in older populations with more complex healthcare needs. This necessitates a multilevel rethinking of healthcare policies, health education and community support systems with digitalization of technologies playing a central role. The European Innovation Partnership on Active and Healthy Aging (A3) working group focuses on well-being for older adults, with an emphasis on quality of life and healthy aging. A subgroup of A3, including multidisciplinary stakeholders in health care across Europe, focuses on the palliative care (PC) model as a paradigm to be modified to meet the needs of older persons with NCCDs. This development paper delineates the key parameters we identified as critical in creating a public health model of PC directed to the needs of persons with NCCDs. This paradigm shift should affect horizontal components of public health models. Furthermore, our model includes vertical components often neglected, such as nutrition, resilience, well-being and leisure activities. The main enablers identified are information and communication technologies, education and training programs, communities of compassion, twinning activities, promoting research and increasing awareness amongst policymakers. We also identified key ‘bottlenecks’: inequity of access, insufficient research, inadequate development of advance care planning and a lack of co-creation of relevant technologies and shared decision-making. Rethinking PC within a public health context must focus on developing policies, training and technologies to enhance person-centered quality life for those with NCCD, while ensuring that they and those important to them experience death with dignity.

Context and aim The spread of the new coronavirus SARS-CoV-2 is challenging many health and care systems around the globe [1]. Its onset constitutes a critical issue, especially for older and/or vulnerable people and patients with preexisting medical conditions being at risk for severe outcomes [2]. This new challenge puts care systems in need of answers: how can vulnerable populations be protected

Background: Under conditions of high demand for primary care services in a setting of low financial resources, there is need for brief, easily administered cognitive screening tools for use in the primary care setting, especially in rural areas. However, interpretation of these cognitive tests’ results requires knowledge on their susceptibility to cultural, educational and demographic patient characteristics. Objectives: To assess the clinical validity of the ‘Test Your Memory’ (TYM) and ‘General Practitioner assessment of Cognition’ (GPCog) which was specifically designed for primary care practice, in a rural primary care setting in Greece, utilizing the ‘Mini Mental State Examination’ (MMSE) as a reference standard. Methods: The MMSE, TYM, and GPCog were administered to a random sample of 319 community dwelling Greek adults aged 60 to 89 years in 11 rural Primary Healthcare Centres of the Prefecture of Heraklion on the island of Crete, Greece. Analyses examined (a) The association of each instrument with demographic factors and MMSE and (b) optimal cut-off scores, sensitivity and specificity against MMSE-based cognitive impairment risk using ROC analyses with the MMSE 23/24 point cut-off as a reference standard. Results: We found a sensitivity of 80% and a specificity of 77% for TYM (35/36 or 38/39 cut-off, depending on education). Corresponding values were 89% and 61% for GPCog (7/8 cut-off), respectively. Conclusion: The TYM and GPCog instruments appear to be suitable for routine use in the primary care setting as tools for cognitive impairment risk detection in elderly rural populations.