Can musical activities promote healthy ageing?

Background: As most of the baby boomer generation have now reached retirement age, there are increasing demands for long-term care services. Depression and psychological distress can be highly prevalent at advanced ages. Regardless of chronological age, it is important to have a decent quality of life as a human being by improving resilience. The present study aims to briefly look at the current evidence on the effects of musical activities on quality of life in older adults. Methods: A literature review was performed to explore current research evidence on different modalities of musical activities and outcomes among older adults. The search included English-language articles published in PubMed from January 1986 to May 2014. Studies were published in peer-reviewed journals and without country restriction. Supplementary searches were carried out and a – narrative synthesis was conducted. Results: Overall, musical activities such as listening to music, singing, and playing instruments can contribute to improving some aspects of quality of life in older people by increasing psychological wellbeing, life satisfaction, social health and decreasing anxiety and depression. Conclusion: There is a great potential for using musical activities as part of a cost-effective strategy to promote the well-being of healthy community-dwelling older people, as well as institutionalised older adults with dementia. Therefore, wider groups of older people with varying degrees of physical and mental capacities can be reached through more personalised musical activities. More studies using mixed methods are needed to confirm the economic benefits as well as to capture the richness of other dimensions for quality of life

Exploring the economic implications of a group-based lifestyle intervention for middle-aged adults with chronic schizophrenia and co-morbid type 2 diabetes

Objective: People with schizophrenia are at elevated risk of having type 2 diabetes, compared to the general population. Although there is a growing body of literature on the effectiveness of behavioural interventions to improve physical activity levels and healthy eating habits, there are very few economic evaluations conducted for people with severe mental illness and physical health problems. The aim of this study is to explore the cost-effectiveness of group-based lifestyle interventions for middle-aged adults with enduring long-term schizophrenia and co-morbid type 2 diabetes. Methods: Deterministic decision analytical modelling techniques are applied to explore cost-effectiveness based on the findings from a systematic review on this population. The intervention refers to a group-based lifestyle intervention, which is a combination of exercise, diet and diabetes education over 6 months. The intervention costs are estimated to reflect the UK local context. Results: From the UK National Health Service perspective, the group-based lifestyle intervention is potentially cost-effective, relative to usual care. It costs £80 to achieve an additional unit of Body Mass Index (BMI) lost and the incremental cost-effectiveness ratio is just below £700 to gain an extra Quality Adjusted Life Year, which lies well within the conventionally acceptable threshold values in the UK. Conclusions: Group based life style intervention for this population is effective and can be cost-effective in reducing BMI and improving diabetes knowledge, at least in the short-term. More co-ordinated policies among relevant sectors are required to facilitate behavioural change and better maintain an improved lifestyle. An integrated approach is needed to make this more sustainable in the long-term

The impacts of intergenerational programmes on the physical health of older adults

Background: The ageing population is growing and the dependency ratio is increasing. It is vital to promote healthy ageing of older people to relieve pressure on society. The aim of this study is to explore the effects of community-based intergenerational programmes on older adults’ physical health in terms of their general self-rated health, level of physical activity and physical functioning. Methods: A rapid literature review was performed to identify studies of intergenerational programmes for community-dwelling older adults. The search included peer-reviewed articles published in English from 1986 to 2014 with no country restriction. However, interventions for older people with dementia, as well as for anyone living in residential care were excluded. Supplementary searches were performed and a narrative synthesis was conducted. Results: Seven studies met these inclusion criteria. Intergenerational activities, including volunteering and reminiscence components, have been associated with an overall positive trend in physical health outcomes. Individuals reported having better health, as well as decreased body aches and pain. In addition, participants reported a feeling of being “more active”, with improved energy consumption, increasing the numbers of streets walked and stairs climbed. For physical functioning, older volunteers tended to show less decline in hand grip strength but inconsistent results for walking speed. Conclusion: More studies with longer time horizons and sufficient statistical power are required to determine the optimal level of participation and to address potential barriers to maximising the benefits of intergenerational programmes for socially marginalised groups. More formal evaluations of the costs and benefits of programmes are needed, taking account of broader societal benefits to inform practice and policy for active ageing

Do intergenerational activities do any good for older adults well-being?: a brief review

Introduction: With the rapid growth in the oldest old segment of the population across the world, public policy interests tend to be more directed to quality of life than quantity of life for those of advanced age. Although there is a growing body of literature on the effects of psychosocial interventions for older adults, interventions from a crossgenerational viewpoint are under-researched. This article briefly reviews the impacts on the well-being of community dwelling older people of participation in non-kin related intergenerational activities. Method: A literature review was conducted to assess current research regarding intergenerational activities and outcomes among older adults. The search included English-language publications that reported original data from January 1986 to mid-2014. Studies were published in a peer-reviewed journal and without country restriction. Supplementary searched were performed and a narrative synthesis was conducted. Intergenerational interventions involving older people with dementia were excluded. Results: Overall positive benefits from the intergenerational programmes can be seen in terms of improved cognitive functioning, as well as in the emotional and social dimensions of well-being for older adults living in the community. Conclusion: More studies with larger sample sizes and longer-time horizons are needed to confirm the optimal levels of intensity and duration that would maximize the synergistic effects for all participating generations

The effects of intergenerational programmes on children and young people

Background: Schools can provide a powerful environment for shared learning among similar age groups as well as different generations. This study aims to explore the literature on the effectiveness and economic aspects of intergenerational interventions among children and young people in terms of academic performance and psychosocial outcomes. Methods: A literature review was conducted to assess current research regarding intergenerational activities and outcomes among young people. The search included English-language publications that reported original data from January 1986 to mid-2014. Studies were published in a peer-reviewed journal with no country restriction. Supplementary searched were conducted and a narrative synthesis was performed. Intergenerational interventions involving older people with dementia were excluded. Results: There were positive trends in mental health and social aspects of the outcomes such as positive changes in attitudes towards older people shown as better mutual understanding, decreased stereotyping of older people, and more respect for them. Better psychological outcomes were found, including reduced anxiety and an improved sense of self-worth. The intergenerational programmes in non-kin relationships also promoted better family relationships. In addition, classroom behaviours were improved among children in need of fostering pro-social behaviours and there was a non-significant improvement in early literacy development. Conclusion: More studies with larger sample sizes and longer term follow-ups are needed to explore the possible transferability of the results to different country contexts. Economic modelling techniques can be more utilised to explore the generalisability of the findings from one to another setting under various scenarios. This would facilitate a more optimal allocation of scare resources by justifying the decision on whether investments in intergenerational activities at a strategic level would be worth pursuing as a public health intervention for a whole society

Evidence on financing and budgeting mechanisms to support intersectoral actions between health, education, social welfare and labour sectors

Intersectoral collaboration between the health and the social welfare, education or labour sectors can help to influence the social determinants of health. Funding such collaboration can be difficult as these sectors may be subject to very different regulatory structures, incentives and goals. This review found 51 documents on the use of various financial mechanisms to facilitate intersectoral collaboration for health promotion, involving at least two of these sectors. A systematic search of the evidence identified the approaches used, including: discretionary earmarked funding, recurring delegated financing allocated to independent bodies and mechanisms for joint budgeting between two or more sectors. Many of these examples are implemented at a regional or local, rather than national, level and factors that influence their success include organizational structures, management, culture and trust. Potential facilitators include regulatory and legislative frameworks providing incentives, clear accountability for actions and the identification of specific benefits to all participating sectors

Modelling the economic impact of reducing loneliness in community dwelling older people in England

Loneliness has been associated with poor mental health and wellbeing. In England, a 2018 national strategy on loneliness was published, and public health guidelines recommend participation in social activities. In the absence of existing economic evidence, we modelled the potential cost effectiveness of a service that connects lonely older people to social activities against no-intervention. A 5-year Markov model was constructed from a health and social care perspective. Parameters were drawn from the literature, with the intervention structure based on an existing loneliness alleviation programme implemented in several settings across England. Univariate and probabilistic sensitivity analyses were undertaken. The total expected cost per participant in the intervention group is £ 7131 compared to £ 6783 in the usual care group with 0.45 loneliness free years (LFY) gained. The incremental cost per LFY gained is £ 768; in the probabilistic sensitivity analysis the intervention is cost saving in 3.5% of iterations. Potentially such interventions may be cost-effective but are unlikely to be cost-saving even allowing for sustained effects and cumulative adverse health and social care events averted. Empirical studies are needed to determine the cost-effectiveness of these interventions, ideally mapping changes in loneliness to the quality of life, in order to allow the key metric in health economic studies, cost per quality adjusted life year to be estimated