Background: Establishing cost-effective informal care services for lonely older adults living at home in developing countries can be an innovative approach for improving their well-being. This study investigated the effectiveness of an informal home care support intervention program (HoSIP) reducing the loneliness and improving quality of life of lonely community-dwelling older adults.Methods: This quasi-experimental pre-post study employed a non-randomized control group design with a 12-week intervention period and three follow-up points at the end of the HoSIP. Questionnaires were used to measure feelings of loneliness (20-item UCLA Loneliness Scale), quality of life (Control, Autonomy, Self‐Realization and Pleasure Scale), general health (12-item General Health Questionnaire), social network (six-item Lubben Social Network Scale), social support (12-item Multidimensional Scale of Perceived Social Support), and self-care ability (17-item Self-care Ability Scale for the Elderly). Repeated-measures analysis of variance was used to gauge the effect of the intervention program over time and in comparison to the control group. Data analyses were performed using the IBM SPSS Statistics software (IBM Corp.).Results: We found a significant relationship between the outcome variables, including feelings of loneliness (P<0.001) and quality of life (P<0.001), at different stages of measurement. Despite the positive feasibility results, the implementation of the HoSIP faced challenges due to a lack of facilities (e.g., place restriction for holding educational classes, educational facilities like computers, video projector, and whiteboard at daycare center) and the absence of supporting organizations.Conclusion: Utilizing the existing capabilities of older adults to provide online and face-to-face care services can be a cost-effective way to improve their quality of life and reduce loneliness. The process of facilitating such informal care services for lonely older adults should be managed by either governmental or non-governmental organizations to reduce the rate of social isolation among this vulnerable population.

Introduction. The primary objective of our study was to determine the nature of medication beliefs and their association with adherence to antiseizure medications (ASMs) among elderly epilepsy patients. Our secondary objective was to enhance the psychometric properties and factor structure parameters of the Beliefs about Medications Questionnaire (BMQ) adapted to epilepsy and affected aged subjects. Methods. A population-based survey was performed in which older adults (≥60 years of age) were invited for a free face-to-face consultation with the specialists as well as for the collection of necessary data. The eligible subjects were those who are affected with epilepsy and having epileptic seizures of any type. In addition, the participants were required to be of any sex, currently under treatment with ASMs, resident of Tehran, and able and interested to participate independently. All were carefully examined with a reasonably detailed case-history examination. Two Persian questionnaires used were Medication Adherence Rating Scale (MARS) and BMQ. Those with a MARS score of ≥6 were considered as adherent to ASMs. All data were described in descriptive terms. We did a group comparison of means and proportions for all possible independent variables between adherents and nonadherents. Then, we did a hierarchical multiple linear regression. For this, independent variables were categorized into three different blocks: (a) sociodemographic block (Block-1), (b) treatment side-effect block (Block-2), and (c) BMQ block that included ten items of the BMQ scale (Block-3). We also did a forward step-wise linear regression by beginning with an empty model. We also estimated the psychometric properties and factor structure parameters of BMQ and its two subdomains. Results. Of all (N = 123, mean age: 63.3 years, 74.0% males), 78.0% were adherent (mean score: 7.0, 95% CI 6.2–7.8) to ASMs. The MARS scores were not different between males and females. The mean BMQ score was 23.4 (95% CI 19.8–27.0) with the mean need score of 20.0 (95% CI 18.0–22.0) and mean concern score of 16.5 (95% CI 14.3–18.7). A positive need-concern differential was 20.4%. Upon hierarchical regression, the adjusted R² for Block-1 was 33.8%, and it was 53.8% for Block-2 and 92.2% for Block-3. Upon forward step-wise linear regression, we found that “ASMs disrupt my life” (ß −1.9, ES = −1.1, ) as the only belief associated with adherence. The alpha coefficient of BMQ was 0.81. Conclusions. Ours is one of the very few studies that evaluated medication beliefs and their association with adherence to ASMs among elderly epilepsy patients in a non-western context. In our context, medication beliefs are likely to have an independent role in effecting adherence to ASMs, particularly the concern that “ASMs disrupt life.” Treating physicians should cultivate good conscience about ASMs and evaluate the patient’s medication beliefs early-on to identify those who might be at the risk of becoming nonadherent.

Objectives: In order to maintain and improve older adults’ health, the integrated and comprehensive geriatric care program has been developed and run by ministry of health. The present study was conducted to evaluate the effectiveness of this program on physical and mental health of older adults in Golestan province in 2019. Methods & Materials: The present retrospective cohort study employed a multistage clustered random sampling technique to obtain 500 e-health records of older adults during 2017-2019. The data on blood pressure, depression, and BMI were extracted from e-health records. Data analysis was conducted using repeated measure anova, paired t-test and Wilcoxon tests. The SPSS statistics software v. 20 was used to perform data analysis Results: Of the 500 cases studied, were male and female, respectively. The Mean±SD age of the participants was 69.97±7.45 years. The results of inferential statistics showed that the mean score of systolic blood pressure was significantly decreased through study period (P<0.001). However, through study period depression score was significantly increased (P≤0.05). There was no significant difference in BMI index. Conclusion: The results of this study showed that the integrated and comprehensive geriatric program was effective for controlling blood pressure, however was not effective for preventing depression. Therefore, stakeholders should pay more attention towards establishing appropriate program to improve older adults' mental health.

Our aim in the present study was to estimate the psychometric properties of the full-length Adelaide driving self-efficacy scale (ADSES) for use among community-based resident older adults in Tehra...

The worldwide rise in dementia cases is creating significant pressures on healthcare systems, clinicians, and decision-makers. As dementia does not follow a single predictable pathway, individuals commonly move across different care settings as their needs evolve, requiring coordinated and integrated responses across the healthcare system rather than isolated efforts within single services. This perspective study explores service quality and underlying structural challenges throughout the dementia care pathway with a particular concentration on transitions between various stages. Key barriers to successful implementation include fragmented service delivery, short-term funding structures, weak coordination across care settings, staffing constraints, and challenges in staff retention. These challenges undermine care standards and result in avoidable emergency department and acute care utilization that contribute to increasing health systems expenditures. Strengthening integrated, person-centered, and transition-oriented care frameworks is critical to enhance outcomes and support sustainable health system responses to an increasing global impact of dementia.