Monitoring active ageing in the Asia-Pacific region: Recommendations for future implementation of the MIPAA

Being uniquely positioned in terms of population growth and rapid ageing, the Asia-Pacific region is of high importance in ensuring that the Madrid International Plan of Action on Ageing (MIPAA) monitoring and implementation framework is accessible and attractive to member States, the majority of which are developing and have varied resources and research infrastructures. This paper reviews the current data collection processes of 14 countries in the Asia-Pacific region, and discusses the various frameworks being used to monitor active ageing in the global context. We consequently suggest how a more functional and sustainable set of metrics can be developed to maximise countries’ participation in the MIPAA implementation and to build ageing knowledge globally, in particular around developing countries. We conclude that a dashboard of indicators that both constructs the Active Ageing Index (AAI) and is aligned with the key priorities of the MIPAA should become part of the toolkit to monitor MIPAA implementation in the future, but so too this framework should incorporate Asia-Pacific indicators that reflect the region’s unique demographic context and priorities, such as the community support

Sleep disturbance in dementia or mild cognitive impairment: a realist review of general practice

Background: Sleep disturbance (SD) is a prevalent condition among people living with dementia (PLwD) or mild cognitive impairment (MCI). Its assessment and management within primary care is complex due to the comorbidities, older age and cognitive impairment typical of this patient group. Aim: This study aimed to explore how primary care clinicians assess, understand, and manage SD for PLwD or MCI; if and why such initiatives work; and how people and their carers experience SD and its treatment. Design and setting: A realist review of existing literature was conducted in 2022. Methods: Six bibliographic databases were searched. Context-Mechanism-Outcome Configurations (CMOCs) were developed and refined. Results: Sixty records were included from 1,869 retrieved hits and 19 CMOCs were developed. Low awareness of and confidence in the treatment of SD among primary care clinicians and service users, combined with time and resource constraints, meant that identifying SD was difficult and not prioritised. Medication was perceived by clinicians and service users as the primary management tool, resulting in inappropriate or long-term prescription. Rigid nursing routines in care homes were reportedly not conducive to good quality sleep. Conclusion: In primary care, SD among PLwD or MCI is not adequately addressed. Over-reliance on medication, under-utilisation of non-pharmacological strategies, and inflexible care home routines were reported due to low confidence and resource constraints. This does not constitute effective and person-centred care. Future work should consider ways to tailor the assessment and management of SD to the needs of individuals and their informal carers without overstretching services

What really is nontokenistic fully inclusive patient and public involvement/engagement in research?

Patient and public involvement and engagement (PPIE) is critically important in healthcare research. A useful starting point for researchers to understand the scope of PPIE is to review the definition from the National Institute for Health and Care Research (NIHR) as, 'research being carried out "with" or "by" members of the public rather than "to", "about" or "for" them'. PPIE does not refer to participation in research, but to actively shaping its direction. The 'Effectiveness of a decision support tool to optimise community-based tailored management of sleep for people living with dementia or mild cognitive impairment (TIMES)' study is funded through the NIHR programme grant for applied research. TIMES has thoroughly embraced PPIE by ensuring the person's voice is heard, understood, and valued. This editorial showcases how the TIMES project maximised inclusivity, and we share our experiences and top tips for other researchers. We base our reflections on the six key UK standards for public involvement; Inclusive Opportunities, Working Together, Support and Learning, Communications, Impact and Governance. We present our work, which had been co-led by our PPIE leads, academics and partners including, together in dementia everyday, Innovations in Dementia, The UK Network of Dementia Voices (Dementia Engagement & Empowerment Project) and Liverpool Chinese Wellbeing. We have a Lived Experience Advisory Forum on Sleep, which includes people with dementia, family carers, representatives of the South Asian Community and the Chinese community

The New Asian Active Ageing Index for ASEAN+3: A Comparative Analysis with EU Member States

The high speed of population ageing in ASEAN countries and in China, Japan and Korea necessitate a high-quality, comparative evidence base for policy learning. The new Asian Active Ageing Index (AAI) proposed in this paper quantifies the extent to which older people make contributions to their families and societies. The Asian AAI was calibrated to cultural norms in Asia by revisiting the choice of indicators. We also revised the aggregation methods previously used in the AAI for European Union member states. Amongst ASEAN member countries, Thailand does better than Indonesia and they both fare better than many European countries. Japan is among the top performing countries alongside Scandinavian countries. In the two ASEAN countries, Thailand and Indonesia, older persons are physically and mentally capable while their pension incomes are low, which explains the level of informal support they offer and their high employment rates, respectively. Future active ageing strategies need to prioritize active ageing among older women, particularly those who live alone.N

Developing a toolkit to monitor implementation of the Madrid International Plan of Action on Ageing in the context of the Asia-Pacific region

This report provides a critical reflection on the review and monitoring process of the MIPAA policy framework for older persons, comparing its priority policy directions with the framework of indicators and the protocols used. The report recommends that a dashboard of indicators aligned with the key priorities of MIPAA and the adoption of the concept and measure of the Active Ageing Index (AAI) can jointly serve as the toolkit to monitor MIPAA implementation in the future