Health assets in older age: a systematic review

Abstract

BackgroundFinding ways to optimise health in older age is key to reducing the impact of population ageing on health and social care systems. A salutogenic approach takes into account an individual’s health assets—internal or external strengths or accessible resources which improve and preserve physical, social and mental wellness, independence and quality of life. The aim of this narrative systematic review was to provide a summary and appraisal of the evidence for factors that act as health assets within personal, social, economic and environmental domains.MethodsSystematic searches of databases were conducted for literature published in peer-reviewed journals between January 2000 and November 2016. Selection criteria included community dwelling populations aged 65 years and over and publications written in English. Data on study population, design, measures of health status, factors within the four previously stated domains and results were extracted. Study quality was independently assessed using an appraisal instrument.ResultsTwenty-three publications, including 78 422 participants, from more than 13 different countries were identified for inclusion in this review. There was strong evidence that higher scores of self-rated health, psychological well-being and life satisfaction were associated with better health in older age. Social network and contact with family and friends, and engagement in leisure and social activities were important support mechanisms. Education and financial resources consistently proved to be key economic health assets for older adults.ConclusionsImplementing an asset-based approach to health promotion uncovers the skills, knowledge, connections and potential of the individual and the community. This approach is an ideal opportunity for government health bodies and their partners to respond to the challenges faced by global ageing.Factors are often interdependent and cumulative, suggesting the potential for an instrument to measure the accumulated effect of health assets on health status in older adults.

Do the Positives Through Life Decrease Later-life Frailty?: Positive Psychosocial Resources and Health Status in Older Adult, a Prospective Cohort Study

“…20 The concept of health assets was rst developed and explored in the community setting in longitudinal studies. 9,11 The lack of impact of protective factors for those who were already frail is consistent with ndings in the community and supports that once an individual is frail, protective factors do not improve survival. 12 The Canadian Study of Health and Aging has also demonstrated that for adults aged 65 and older who were t, a higher level of self-rated health, which is a Health Asset, protected against mortality.…”

“…10 In community studies, health assets can act individually and cumulatively to improve survival and health status. 9,11 Although the protective effect of health assets in the community has been established, their impact in the hospital setting is less well characterised. 12,13 Systematic reviews have demonstrated that individual health assets can improve outcomes.…”

“…12,13 Systematic reviews have demonstrated that individual health assets can improve outcomes. 11,13 Health Assets have previously been found to moderate the impact of frailty associated outcomes. 4 An example is that two frail individuals might have different outcomes if one is able to access the community versus remaining at home.…”

Health Assets and Frailty: Positive Psychosocial Resources and Health Status in Older Adult, a Prospective Cohort Study

“…The concept of health assets was first developed and explored in the community setting in longitudinal studies. 5,7 The lack of impact of protective factors for those who were already frail is consistent with findings in the community and supports that once an individual is frail, protective factors do not improve survival. 8 The Canadian Study of Health and Aging has also demonstrated that for adults aged 65 and older who were fit, a higher level of self-rated health, which is a Health Asset, protected against mortality.…”

Prerequisites for a healthy and independent life among older people: a Delphi study

“…Moreover, the relationship between home, past life and identity created a meaningful space in which the participants emphasised the symbolic qualities of the home, often leading them to prefer a sub-optimal living environment that was familiar and reflective of self rather than practically supportive (Sixsmith et al, 2014). A recent review by Hornby-Turner et al (2017) found that older people's ability to make their own choices and their will to maintain their independence are important protective factors or 'health assets'. 'Health assets' are defined as an individual's internal or external strengths or accessible resources which enhance their ability to optimise health (Rotegård et al, 2010).…”