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Aims: This longitudinal study investigated the prevalence of and risk factors for loneliness among older new informal caregivers, long-term informal caregivers, former informal caregivers and non-caregivers in selected regions of Finland and Sweden over 5 years.

Methods: A longitudinal sample of 5083 respondents from the Gerontological Regional Database (GERDA) survey data in 2016 and 2021 was used. Bivariate correlation tests and multivariate logistic regression analyses were performed.

Results: Loneliness prevalence rates varied between 6% and 8% in 2016 and increased in all groups, although not significantly among new informal caregivers. In 2021, the prevalence of loneliness varied between 8% and 14%. Among the baseline variables, reporting loneliness, single/unmarried/bereaved civil status, infrequent contact with friends and neighbours, poor self-rated health, depressive symptoms, living in Finland and financial strain increased the likelihood of reporting loneliness in 2021. Among the change variables, being a long-term caregiver, a negative change in civil status, a reduced number of confidants, a negative change in self-rated health and depressive symptoms increased the likelihood of reporting loneliness.

Conclusions: Loneliness increased among all four groups of comparison. Being a long-term caregiver was a significant risk factor for reporting loneliness over time (odds ratio 2.00, 95% confidence interval 1.20–3.35), when controlling for several other social and health-related variables. To develop effective support, future research could address risk factors for loneliness among distinct groups of informal caregivers based on whether the care recipients have neurological or functional health limitations and examine the availability of support measures.

Background: Changes in marital status are major life transitions that may affect older adults’ physical and mental health, support network, and coping behaviors such as alcohol use. This study examined the effects of baseline and longitudinal marital status on alcohol use, gender interaction, and whether depressive symptoms and loneliness mediate these associations.

Methods: Data from the GERDA study in Northern Sweden and Western Finland included 5,071 adults aged 65-85 years (53.6% women; 77.4% partnered) surveyed in 2016 and 2021. Transitions were categorized as partnered (stable/entered partnership) or unpartnered (stable/divorced/widowed). Alcohol use in 2021 was assessed using AUDIT-C (non-drinker, low-risk, and hazardous drinking and binge drinking). Multinomial and binary logistic regressions assessed associations between marital status and alcohol use, adjusting for baseline sociodemographic, psychosocial, and health factors. Gender-stratified causal mediation analyses tested indirect effects via depression and loneliness. Inverse probability weights adjusted for attrition.

Results: Being unpartnered at baseline were associated with higher odds of abstaining versus partnered (aRRR=1.39, 95%CI=1.06-1.83 and aRRR=1.47, 95%CI=1.14-1.91 respectively). No associations with hazardous or binge drinking were found. Between 2016 and 2021, unpartnered individuals had higher odds of abstaining. Partnered women were less likely than partnered men to drink at hazardous level (aRRR=0.36, 95%CI=0.28-0.47) and unpartnered women had even lower odds (interaction aRRR=0.56, 95% CI = 0.33-0.95). No significant mediation via depression or loneliness was found. Among women, being unpartnered directly predicted lower odds of hazardous and binge drinking.

Conclusions: Older unpartnered adults are more likely to abstain and no mediation via depression loneliness was found. Alcohol use in later life appears shaped more by partnership status than by psychological distress after marital loss.

Key messages:

• In later life, drinking is shaped more by social dynamics within partnerships than emotional distress after relationship loss. Prevention should target social drinking norms, especially among women.
• Future studies should improve causal inference by using repeated measures over time and address selection bias through strategies like inverse probability weighting based on baseline factors.

Background: Physical activity and exercise are promoted worldwide as effective interventions for healthy ageing. Various exercise initiatives have been developed and evaluated for their efficacy and effectiveness among older populations. However, a deeper understanding of participants’ experiences with these initiatives is crucial to foster long-term activity and exercise among older persons.

Methods: A constructivist grounded theory study was conducted to explore the experiences of older persons participating in a supervised group supramaximal high-intensity training (HIT) programme. Four focus groups were held, involving 28 persons aged 65 to 78. The focus groups were analysed inductively, followed by an iterative process of abstraction, abduction, and theory generation using a constant comparative method. A conceptual framework comprising three theoretical concepts—stereotype embodiment, ageist practices, and self-efficacy—was employed during the abductive phase as an analytical lens.

Results: The core category of our grounded theory, Negotiating a physically active life in tune with ageing, encapsulates the complex processes and actions influencing older persons as they engage in physical activities in their daily lives and in relation to HIT. This core category was created from the conceptual framework and the four categories: Grit in the moment and overall life, Empowered by the training group, Navigating one’s physically active self, and Committing to exercise for duty and pleasure. Participants reported feeling invigorated by the exercise, enjoying the challenge, and valuing the group setup for its social connectedness and structure. The generated theory illustrates how participants’ engagement with physical activity and exercise is shaped by various perspectives accumulated over their lifespan. The findings provide a plausible explanation of how participation in HIT groups can challenge negative age stereotypes and ageist practices while enhancing self-efficacy for high-intensity exercise.

Conclusions: Our grounded theory underscores that physical activity and exercise should be regarded as multifaceted processes, which must be considered when promoting physical activity initiatives for older persons. By considering the older person and societal norms and values, we can gather knowledge to design physical exercise interventions that are not only effective but also enjoyable and capable of transforming how individuals perceive themselves as exercising persons.

Rapporten är ett resultat av ett samverkansprojekt mellan Umeå kommun och Umeå Universitet. Syftet är att ta reda på vilka förhållanden som kan främja äldre invånares möjligheter att bo kvar hemma i eget boende och samtidigt möjliggöra förutsättningar till ett aktivt deltagande i samhällslivet, ökad självständighet och ett förlängt steg till vård- och omsorg.

 Rapporten innehåller en narrativ litteraturöversikt, där målsättningen är att sammanfatta och diskutera empiriska och teoretiska studier på ett område där det saknas en etablerad översikt och kunskapsläget är oklart. Översikten genomfördes i fyra faser: 1) Inledande litteratursökning, 2) Fokuserad litteratursökning, 3) Översiktlig analys av identifierade publikationer, samt 4) Kompletterande sökning och slutlig analys. För att identifiera relevanta publikationer gjordes datorbaserade sökningar i vetenskapliga databaser och etablerade sökmotorer. Det empiriska materialet består av 99 publikationer som slutligen valdes ut och analyserades systematiskt i fem steg.

Resultaten presenteras i fem kapitel: 1) Förhållanden relaterade till den egna personen, 2) Social delaktighet, sociala relationer och nätverk, 3) Boende och bostaden, 4) Digital teknik, 5) Fysisk omgivning. Resultaten visar att för att äldre ska kunna bo kvar hemma krävs ett holistiskt perspektiv som inkluderar både bostaden och den sociala och fysiska miljön utanför. Viktiga faktorer inkluderar självständighet, trygghet och säkerhet inom hemmet, samt att ta hänsyn till äldres egna uppfattningar om stöd och service. Det finns begränsat med forskning med fokus på att främja äldres boende i eget hem, och i rapporten betonas att det är en komplex fråga som kräver insatser från olika discipliner och sektorer. Att se de äldre som individer med varierande behov, och att använda ett personcentrerat förhållningssätt är centralt, trots att många insatser ofta utformas utifrån en homogen bild av äldre.

Baserat på resultaten diskuteras i det sista kapitlet tre huvudteman: Proaktiv bostads- och samhällsplanering, Social delaktighet och tredje rum, samt Digital teknik i den äldres vardag. Där belyses även bristen på studier som tar ett helhetsgrepp kring främjande av äldres vardag och självständighet i olika livssituationer.

To understand health and well-being in later life, it is vital to consider the meaning of subjective aging. This study aimed to explore how perceived health, self-perceptions of aging, and participation in social activities relate to each other among older persons in the Bothnia region and Åland islands in Finland. Data were analyzed using Spearman’s and polychoric correlation and multinomial logistic regression analyses. The perceived good health and the younger physical, psychological, and social dimensions of subjective age were found to be associated with each other and with participation in social activities outside one's home.

Background: Eliciting and understanding older persons’ descriptions of their resources for healthy ageing and the interaction of these resources with alcohol use and alcohol problems can facilitate health promotion. It can also inform clinicians when identifying areas of recovery capital that present risks and strength for older people seeking alcohol treatment. The objective of this study was to illuminate the experiences and perspectives of older persons on ageing, alcohol use, treatment, and recovery from alcohol problems, as well as their understanding of healthy ageing.

Methods: Eight men and two women, aged 61 to 73 years, with moderate drinking as a treatment goal and treated at an outpatient alcohol clinic in Sweden, participated in semi-structured audio-recorded virtual interviews. A qualitative content analysis examined the transcribed interviews.

Results: Three themes were identified: “Tipping the balance”, “Staying behind a veil” and “Lifting the vail”. First, participants understood healthy ageing as a personal and multidimensional process that involved actively expanding, maintaining or adjusting to the resources needed to lead an active and meaningful life while preserving autonomy, dignity and independence for as long as possible. Second, most participants viewed moderate alcohol use as a contributor to healthy ageing. They sought treatment when their drinking became unsustainable and an immediate threat to their healthy ageing resources. Stigma, ambivalence and a lack of treatment options, however, contributed to delayed treatment. Third, the participants responded to treatment approaches that elicited their concern, incorporated their expertise and treatment and life goals, appreciated their autonomy and agency, and considered them partners in goal setting and decision making. Reduced drinking helped participants regain their agency and improved their healthy ageing capital which in turn catalyzed continuing recovery.

Conclusions: Older persons in non-abstinent recovery perceive healthy ageing and alcohol recovery as personal and interacting multidimensional processes involving their agency to improve biopsychosocial functioning. Treatment approaches that recognize older persons’ desire for healthy ageing, incorporate their treatment goals and respect their autonomy are likely to be acceptable and effective.

Unit of analysis: Individual

Population: Older people aged between 61 and 73 years who have sought treatment for alcohol at a specialist outpatient clinic in a metropolitan city in Sweden.

Time Method: Cross-section

Sampling procedure: Non-probability: Purposive

The study participants were purposefully recruited from a specialist outpatient alcohol treatment clinic located in a Swedish metropolitan city. To be eligible for the study, participants had to be 55 years or older, had to self-report a history of problematic alcohol use and treatment for alcohol use after the age of 50. Individuals who were unable or unwilling to provide informed consent or participate in the interview via Zoom, Skype, or telephone were excluded from the study.

Time period(s) investigated: 2021-12 – 2022-04

Number of individuals/objects: 10

Data format / data structure: Text

Background: In Sweden and in many other countries, the proportion of older people will increase dramatically over the next ten years. Resources such as residential care will not be sufficient for the needs within the target group to the same extent as today. Organizations responsible for care needs to initiate new solutions to promote older people’s independence, active participation to extend the age of onset for elderly care interventions. This societal challenge was investigated through a scoping review with an overarching research question: What needs must be met for older people to be able to stay at home longer?

Review: Sub-questions were designed informed by Maslow’s hierarchy of needs. Which conditions make it possible for older people to stay at home longer regarding: 1) the person her/himself?, 2) the housing?, 3) the social relations?, 4) the surroundings? Several databases and search engines were used to search for a range of literature published 2000-2021, in English and Scandinavian languages. The search resulted in approx. 2500 abstracts of which 386 publications were selected.

Results: A preliminary assessment indicates that:

- the research area is heterogeneous (many different disciplines, target groups, questions, designs and theories).

- the publications include person-related factors (73%), environment-related factors (19%) and housing factors (8%).

- person-related factors include physical conditions (35%), psychological conditions (24%) and social relationships (13%).

We will present a compilation of preconditions that enable older people to stay at home longer, as well as demonstrate a model of how these preconditions are interrelated.

The study examined changes in active ageing among 65/66- and 75/76-year-olds in northern Sweden and western Finland. Data were retrieved from a repeated cross-sectional survey conducted in 2005 and 2016. Logistic regression was used to estimate the probability of ageing actively in terms of employment, social and political participation, confidence in healthcare, economic situation, self-rated health and social contacts. The results showed no significant changes in employment, social participation or economic situation. However, the level of political participation and self-rated good health was significantly higher in 2016 compared with 2005, whereas confidence in healthcare and social contacts was lower. Considering that the implementation of active ageing policies relies heavily on municipal and/or regional level in our study region, our results could be used as a framework for regional policymaking.

Objectives: The present study aimed to identify multidimensional typologies of harmful alcohol use based on the Swedish Addiction Severity Index (ASI) assessment data on individuals aged 50 years and above.

Methods: Latent class analysis examined 11 indicators from ASI data on 1747 individuals (men = 1255, women = 492) who reported they were troubled by alcohol problem at least one day in the past 30 days before their assessment. The discriminative validity of the classes was assessed by comparing other measures of individual characteristics and problem severity of other ASI dimensions.

Results: Five subtypes of harmful alcohol use were identified. Two classes with alcohol problems varying in psychosocial functioning, age composition and ages of onset of both regular and heavy drinking. Two with psychiatric comorbidity but varying in violence, criminality, gender composition and ages of onset of regular and heavy drinking. One with high prevalence of concurrent use of other substances, psychiatric, legal, and employment problems.

Conclusions: The analysis identified, in a national sample, heterogeneous risk groups of older adults with harmful alcohol use. These findings suggest a need for healthcare providers to assess older adults not only for their substance use but also for associated problems and needs. Given these findings, the Addiction Severity Index is a valuable assessment tool for older adults with harmful alcohol use.