The COVID-19 pandemic is novel corona virus infection outbreak that has gone global in 2020. Current prevention policies consist of hand hygiene and social distancing. Emergencies overloaded health services and shocked the logistics chains in many countries, especially Italy and China. Having more than a quarter of its population being elderly, Japan is at high risk for COVID-19 induced morbidity and mortality. This situation cancelled schedules of all routine group exercise activities for the seniors in Japan. While the outbreak is ongoing, staying at home is safe. However, successive days of being house-ridden and limited movement can lead to excessive physical inactivity. Some elderly who are not moving much can lose a significant amount of muscle strength, flexibility and aerobic capacity. It can accelerate the frailty and dependency of the seniors, and subsequently, claiming of care and health services. Moreover, existing and new evidences showed that physical activity can promote antiviral immunity. An alternative to usual group exercise activities is crucial to keep seniors active without affecting social distancing. While staying at home for long, functional exercises maintaining basic level of physical activity and movements are urgently required to be introduced to the seniors in Tokyo and around the world to prevent functional decline. Home exercise is a practical option. Therefore, we made a home-version of the functional training exercise video with different sets of 10minutes exercise for 7 days a week. This breakthrough alternative may sustain health promotion for the elderly persons to preserve their active aging and maintain optimal health.
Background: Families are the backbone of caregiving for older adults living in communities. This is a tradition common to Thailand and many low- and middle-income countries where formal long-term care services are not so available or accessible. Therefore, population aging demands more and more young people engaging as family caregivers. Informal caregiving can become an unexpected duty for anyone anytime. However, studies measuring the burden of informal caregivers are limited. We aimed to determine the caregiver burden, both from the perspective of the caregivers as well as that of their care recipients. Method: We used the baseline survey data from a cluster randomized controlled trial providing a community integrated intermediary care (CIIC) service for seniors in Chiang Mai, Thailand, TCTR20190412004. Study participants were 867 pairs of older adults and their primary family caregivers. Descriptive analysis explored the characteristics of the caregivers and binary logistic regression identified factors influencing the caregivers’ burden. Results: The mean age of family caregivers was 55.27 ± 13.7 years and 5.5% indicated the need for respite care with Caregiver Burden Inventory (CBI) scores ≥24. The highest burden was noted in the time-dependence burden domain (25.7%). The significant associated factors affecting CBI ≥24 were as follows: caregivers older than 60 years, being female, current smokers, having diabetes, and caring for seniors with probable depression and moderate to severe dependency. Conclusions: A quarter of caregivers can have their careers disturbed because of the time consumed with caregiving. Policies to assist families and interventions, such as respite service, care capacity building, official leave for caregiving, etc., may reduce the burden of families struggling with informal care chores. Furthermore, caregiver burden measurements can be applied as a screening tool to assess long-term care needs, complementing the dependency assessment. Finally, implementation research is required to determine the effectiveness of respite care services for older people in Thailand.
Background and Objectives While governments are building age-friendly environments, community-based social innovation (CBSI) provides opportunities for older community residents to interact. Common CBSIs in Japan are in the form of group exercise activities or social cultural activities, such as reading, writing, poetry, chorus, calligraphy, card game, knitting, planting trees and cooking, etc. In this study, an age-friendly environment in Japan was assessed quantitatively and qualitatively through the perceptions of community residents and their interaction with the environment. Research Design and Methods A cross-sectional survey of 243 participants and multiple in-depth interviews were carried out. Quantitative study applied the WHO framework of 20 age-friendly environmental factors with analysis applying a structural equation model. Qualitative study applied focus-group meetings and in-depth interviews to conduct thematic analysis of Japanese community residents’ activities according to the WHO scope of CBSI for healthy ageing. Results This age-friendly environment in Japan has provided pathways for the older people to sustain their social network, which promotes civic participation and engagement in peer group activities leading to active ageing. CBSIs are the factors that lead to an age-friendly environment resulting in a sustainable quality of life. Discussion and Implications It is important to sustain CBSIs in the era of COVID-19 pandemic as those are the paths leading to healthy ageing communities and quality of older residents’ life. The lessons learnt about how physical environment and social participation result in healthy, active quality of life for older adults in Japan may be applicable to other contexts around the world.
Background The new coronavirus outbreak originated in Wuhan, China, started in January 2020 is escalating as a pandemic across the globe in March 2020. It causes unprecedented morbidity and shocked health systems and the supply chains in new epicenters such as Italy, Spain, and the USA, claiming thousands of lives. Meanwhile, the pandemic is reaching swiftly and silently to low-income countries where international media cover less. How likely health outcomes among the countries with different economies may differ during the pandemic has not been reported yet. Methodologically, we conducted an analysis of COVID-19 deaths comparing case fatality rate (CFR) among countries with different income categories, applying COVID-19 global data from the European Centre for Disease Control including 199 countries’ data as of 31 March 2020, in the early phase of the pandemic. We categorized countries into high-income countries (HIC), upper-middle-income countries (UMIC), lower-middle-income countries (LMIC), and low-income countries (LIC) according to World Bank classification by income as of 2020. Finding Statistically, countries in different income groups are significantly different in terms of new cases identified in the last 2 weeks and the case fatality rate (MANOVA, P value < 0.001). New tests and detected case numbers shot up in HICs where CFR shot up in LMICs and LICs. The results of this analysis pointed out an important gap among countries with different economic status during the ongoing pandemic. Conclusion In the HIC, contact tracing, testing capacity, and outbreak response, as well as clinical services, are strong. In the LICs, there is a low capacity of outbreak response which is reflected by the significantly lower number of diagnostic tests. Consequently, the reported number of COVID-19 cases in LICs may not reflect the actual burden of the pandemic. Without effective prevention, the pandemic can readily break into the weak health system and over-burden the hospitals and clinical services in poor countries. This finding is showing health inequality between the rich and the poor being amplified by the COVID-19 pandemic. Addressing such a gap through the local governance and integrated global responses will not only prevent unprecedented deaths, but also preserve the momentum towards Sustainable Development Goals (SDGs).
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