Iranian community-dwelling older adults' perceptions of prosociality: A qualitative study.

BACKGROUND: The world population is aging at an accelerating rate, and prosociality aspects increase in people with age. This study aimed to explore Iranian community-dwelling older adults' perspectives of the prosociality concept. MATERIALS AND METHODS: This qualitative study was conducted among older adults aged 60 years and older in Qom City, Iran. A purposive sampling method was used to collect data between July and October 2022. Semi-structured interviews were conducted with 25 older adults engaged in various types of prosocial activities. Data were analyzed applying a directed content analysis approach. All interviews were audio recorded, transcribed verbatim, and coded using MAXQDA 20 software. RESULTS: Overall, 5 main categories and 19 subcategories emerged from the content data analysis. The two emerged categories were related to the predetermined dimensions of the prosociality concept, namely, "prosocial behaviors" and "prosocial dispositions." The remaining three newly emerged categories included "egocentric motives," "facilitators," and "barriers" to prosocial behaviors. As participants reported, "informal spontaneous helping" was the most prevalent subcategory of prosocial behaviors. "Prosocial norms" and "social reward-seeking" were identified as the most common subcategories of prosocial dispositions and egocentric motives, respectively. Likewise, participants mentioned "religious and metaphysic beliefs" and "social distrust" as important facilitators and barriers, respectively. CONCLUSIONS: The results of this qualitative study provide a new understanding of the prosociality concept among older adults in the context of Iran. In conclusion, to improve prosocial behaviors in this population, the interaction between all factors that influence it such as motives, facilitators, and barriers must be considered.

The Concept of Prosociality in Later Life and Its Dimensions: A Scoping Review.

Objective: The aim of this study was to clarify various aspects and dimensions of the prosociality concept in later life as an important concept that gains significance in people as they age. This concept has been expressed through a variety of dimensions in different studies. Method : This is a scoping review of the relevant literature on the concept of prosociality and its dimensions in later life, including quantitative and qualitative studies. The required data were collected from Web of Science, Scopus, PubMed, ProQuest, and Google Scholar databases between the years 1987 and 2022. Results: First, 877 articles were identified, and after the screening phase, 57 eligible studies were reviewed. Two main categories, prosocial dispositions and prosocial behaviors, and seven subcategories were extracted. The subcategories of prosocial dispositions include empathy, prosocial norms, innate tendencies, and generative desires. Prosocial behaviors subcategories include informal spontaneous helping, formal planned helping, and pro-environmental behaviors. Conclusion: The various aspects and dimensions of the prosociality concept in later life identified in this study can be used as a basis for assessing and planning the promotion of prosociality among older adults.

The Role of Childhood Circumstances on Social Conditions and Health of Middle-Aged and Older Adults: Ardakan Cohort Study on Aging (ACSA).

Some studies suggest that childhood can affect some later outcomes. This cross-sectional study of the first phase of the Ardakan Cohort Study on Aging (ACSA) on 5,197 individuals examined the effects of childhood socioeconomic and health on aging well. Childhood socioeconomic status (SES) was measured using parents' education and self-expressed family's financial status. Quality of Life (SF-12), Satisfaction with Life Scale (SWLS), WHO well-being scale, and self-reported health questionnaire were used. All data, including childhood experiences, was collected at a single time point. Poor childhood health was associated with lower well-being, life satisfaction, and mental quality of life (OR: .53, p = .032, OR: 0.49, p = .019, and ß: -3.51, p = .008, respectively). The family's financial status during childhood was associated with the mental and physical quality of life, satisfaction, well-being, and health (all p < .05). Fathers and mothers who had some level of education increased the odds of being healthy by 1.20 and 1.49 times, respectively. Childhood circumstances affect older adults' health and social conditions. Policies to improve childhood health and SES should be prioritized.

Impact of COVID-19 on Lifestyle: A Sample of Iranian Older Adults.

The COVID-19 pandemic and prolonged quarantine affect the health behaviors of older adults. We investigated the changes in older adults' lifestyles during the pandemic in a sample of 1020 people aged 60 years old and over in Tehran. The results revealed that the COVID-19 pandemic had a positive impact on nutritional behaviors and social support while having a negative impact on physical activity and anxiety in older adults. Due to the greater deterioration of health behaviors among unmarried older adults, low socio-economic status, and COVID-19 inpatients, policymakers must pay attention to interventions to promote healthy lifestyles.

Association between long COVID, functional activity, and health-related quality of life in older adults.

BACKGROUND: Older adults experience persistent symptoms post-COVID-19, termed as Long COVID, affecting their physical and mental health. This study aimed to evaluate the effects of Long COVID, level of physical activity, and functional decline on older adults' health-related quality of life post-COVID-19. METHODS: This cross-sectional study was conducted on 121 older adults with 60 to 90 years old post-coronavirus infection. The standardized metrics used in the study were Fatigue Severity Scale, Physical Activity Elderly, SF12, Post-COVID-19 functional status scale, and COVID-19 Yorkshire rehabilitation screening scale. The severity of coronavirus infection was evaluated by changes in chest CT scan images and O2 saturation at hospital admission. Data were analyzed using linear regression analyses. RESULTS: The results of regression analysis revealed six factors to be predictors of physical health at 6 months post-COVID-19 (F = 9.046, P < 0.001; explained variance 63%), which the significant factors were fatigue, level of physical activity, worsened pain, difficulties in activities of daily living and cognitive-communication problems. Among these factors, greater fatigue and worsened pain intensity were the strongest predictors. Mental health was associated with days of hospitalization and cognitive-communication problems (F = 2.866, P < 0.001; explained variance 35%). CONCLUSIONS: Considering the negative impact of fatigue, pain, low physical activity, and cognitive-communication problems on health-related quality of life, early and accurate evaluation and management are required for recovered older adults post-COVID-19.

Translation, Cultural Adaption, and Validation of the Persian Version of the Pediatric Eating Assessment Tool.

INTRODUCTION: The Pediatric Eating Assessment Tool (PediEAT) is a parent-report tool to assess feeding problems in children aged 6 months to 7 years. This study aimed to translate and adapt the PediEAT to Persian and determine its psychometric properties. METHODS: The PediEAT was translated and culturally adapted the following guidelines for health-related instruments. Face and content validity was assessed using an expert panel. This study also aimed to evaluate psychometric properties using a sample of 160 children without feeding problems and 43 children with diagnosed feeding problems. Known-groups validation was used to compare PediEAT scores between children with and without feeding problems. In criterion validity, pediatricians' opinions were used as a criterion. To calculate internal consistency, Cronbach's alpha was used. After 2 weeks, temporal stability was assessed with 40 parents who repeated the PediEAT. RESULTS: Face and content validity showed that all tool items had CVI and kappa coefficients higher than 0.8. Known-group validity showed that the total and subscale scores significantly differed between children with and without feeding problems (p < 0.001). Criterion validity showed that criterion measurements correlated with questionnaire measurements. All four subscales and the total scale showed acceptable internal consistency reliability (Cronbach's alpha > 0.74). Test-retest reliability was acceptable (ICC = 0.987, p < 0.001). CONCLUSIONS: The PediEAT-Persian version is a valid and reliable tool for assessing symptoms of problematic feeding in Persian children aged 6 months to 7 years.

The intergenerational relationship patterns between aging parents and their adult children.

Background: Older parent-child relations and their impact on the elderly's lives are of importance; thus, the present study aimed to investigate the patterns of the intergenerational relationships between aging parents and their adult children. Methods: The current cross-sectional study was conducted on 463 elderly men and women, aged ≥60 years who were residing in Tehran City, Iran. The study participants were selected using the stratified cluster sampling method. The Bai's (2017) 13-item Intergenerational Relationship Quality Scale for Aging Parents (IRQS-AP) was used to evaluate the patterns of intergenerational relationships among the study subjects. The obtained data were analyzed in SPSS. The significance level of the tests was set at P ≥ 0.05. The logistic regression model was employed to investigate the factors related to the patterns of intergenerational relationships. Results: The mean ± SD age of the explored aging parents was 67.93 ± 7.0 years. Besides, the mean ± SD number of children in the study participants was 3.55 ± 1.80. The mean ± SD scores of solidarity (structural, associational, consensual, affectual, functional, and normative) and conflict were measured to be (58.95 ± 17.55) and (64.10 ± 20.92), respectively. Furthermore, the mean ± SD score of the ambivalence pattern was calculated as (51.46 ± 21.61). The mean score of conflict was higher than those of solidarity and ambivalence. Additionally, the mean score of consensual-normative solidarity was higher than those of other dimensions of solidarity. The obtained data suggested a significant difference between age and the patterns of intergenerational relationships (p ≤ 0.05). Moreover, the mean scores of solidarity and conflict in the examined female elderly and their adult children were higher than those of their male counterparts and their adult children; however, the mean score of ambivalence in the male elderly and their adult children was higher than that in their female counterparts. Logistic regression analysis results indicated that aging parents who were literate (OR = 1.5), those who lived alone (OR = 1.2), and those who assessed their general health status as good (OR = 4), reported high levels of solidarity with their adult children. Conclusion: The present research results demonstrated that the level of conflict between aging parents and their adult children exceeded the solidarity level, indicating the intergenerational gap. Therefore, the necessary implications should be adopted to promote intergenerational relationships within the family by providing family counseling. Further research is recommended to consider the essential role of predictive factors, such as age, gender, educational level, occupational status, living arrangements, health status, and socioeconomic status of aging parents concerning the intergenerational relationships between aging parents and their adult children.

Representation of Aging in Elementary School Textbooks in Iran.

The attitude toward older adults is developed from childhood. School textbooks are one of the most important sources of shaping attitude in children. So, the present study aimed to analyze the visual and textual content of the aging concept in elementary school textbooks after the Irans's Islamic Revolution (1979). The method of the present study was content analysis, and 112 textbooks were reviewed. The analysis unit included 118 images and 91 subset of texts pertaining to aging concept. The results showed that aging concepts are classified into two positive and negative stereotypes categories. The positive stereotype included social interaction, authority and respect, wisdom, spirituality, positive traits, and independence. Social interaction was the most frequent of them. Negative stereotypes included abuse, negative personality traits, illness, and disability, of which the negative personality traits were the most frequent. In addition, the results suggested that 87.7% of the concepts of aging in the textbooks were positive. Although the positive stereotypes were more frequent in textbooks, the active older adults were presented in low-status jobs, and the ethnic minorities and older women were less considered. Accordingly, policymaking through the textbooks and from childhood is necessary for developing successful aging and decreasing ageism in society.

Dimensions of Preparation for Aging: A Systematic Review.

Background: A deeper understanding of the dimensions of preparation for aging at the personal level may provide new perspectives for healthy aging promotion policies. Therefore, the present study was conducted to investigate the dimensions of preparation for old age and retirement. Methods: This was a systematic review. The search was performed in the following databases: PubMed, Embase, Scopus, Web of Science, PsycINFO, and Google Scholar up to June 2020. This search was done based on the following keywords: "prepare*", "preparation", "plan* ", "Aged", "Ageing", "Aging", "older people", "senior", "retirement", "older adults", and "elderly" through the AND/OR operators. In the preliminary search, 2032 papers were identified. After removing the duplicated articles and screening the title and abstract, the full text of 141 papers were investigated. Finally, 42 papers were eligible for inclusion in the systematic review. Results: The results indicated that preparation for aging is propounded in the 6 dimensions: (1) health preparation; (2) psychological preparation; (3) financial preparation; (4) housing; (5) social preparation; and (6) active leisure. Conclusion: The findings of the present study indicated that planning for aging requires coverage of all dimensions of old age preparations to achieve healthy aging. The preparation planning should be performed before later life and during the young or middle-age years.

Psychometric properties of the Persian version of the "Intergenerational relationship quality scale for aging parents and their children".

BACKGROUND: Investigating the status of intergenerational relationships of elderly parents with their adult childen is very important in examining issues related to the status of the elderly such as well being and quality of life and other aspects of elderly life. Giveeen the significance of the topic, the current study aimed to examine the psychometric properties of the Persian version of "Intergenerational Relationship Quality Scale for Aging Parents and Their Children" (IRQS-AP). MATERIALS AND METHODS: A total of 463 community-dwelling elders (aged 60 years or older) in Tehran participated in this study through multistage cluster sampling method. To investigate reliability, the construct and convergent validity of the IRQS-AP, confirmatory factor analysis (CFA), and interclass correlation coefficient were done. RESULTS: The content validity index was 0.84 for the entire tool. In the CFA, we found the instrument had a four-factor structure and adequate internal consistency. The scale had a significant and positive correlation with the two measures of loneliness and depression. Furthermore, Cronbach's alpha was estimated at 0.77, and the high value of the interclass correlation was 0.82. CONCLUSION: The IRQS-AP is a valid and reliable scale that can be used to examine the status of intergenerational relationship quality in Iranian elder population.

Psychometric Properties of the Persian Version of the UCLA Geriatrics Attitudes Scale (UCLA-GAS).

AIMS: The attitudes toward older patients are considered the main factor in providing health services. BACKGROUND: There is a lack of proper short scale to measure attitudes toward older patients among healthcare professionals. OBJECTIVE: The present study was to assess the psychometric properties of the UCLA Geriatric Attitude scale (UCLA-GAS) among a sample of Iranian healthcare professionals. METHODS: The method of this study was cross-sectional for psychometric evaluation. The sample included 232 healthcare professionals in Mazandaran city. Study participants were selected by cluster random sampling technique. Psychometric evaluation of the UCLA-GAS assessed through content and construct validity. Content validity was evaluated based on the content validity index (CVI) and construct validity was investigated using exploratory and confirmatory factor analysis. Also, convergent validity was assessed using the Kogan's Attitudes Toward Older People Scale (KAOPS) questionnaire. Cronbach's alpha was used to evaluate internal consistency reliability and stability was assessed using test-retest. RESULTS: Regarding the content validity, CVI and modified Kappa statistic for all items were >0.79 and showed all items relevant to the UCLA-GAS in the Iranian context. The three dimensions of the UCLA-GAS extracted from factor analysis were labeled: 1- medical/economic burden (6 items) 2- appreciate attitude (5 items), 3- resource allocation (3 items). CFA revealed that the UCLA-GAS structure model was a validated model (CMIN = 2.312, GFI = 0.913, CFI = 0.902, RMSEA = 0.075). The scale had a significant and positive correlation with KAOPS questionnaire. Also, The Cronbach's alpha of the scale was 0.78 and intra-class correlation coefficient (ICC) for total instrument was reported as 0.93 (95% CI: 0.87-0.98) and demonstrated good reliability of the instrument. CONCLUSION: The result shows the UCLA-GAS is a valid and reliable scale for measuring attitudes toward older patients among healthcare professionals. This study recommends using Iranian UCLA-GAS in future research and policy-making.

Perspectives on healthy aging in middle age: Evidence for health promotion interventions.

CONTEXT: Understanding how middle-aged people perceive healthy aging and what they need to do to stay healthy as they age can help public policy planning to enhance the lifestyles of middle-aged and elderly people. AIMS: The purpose of this study was to clarify the concept of healthy aging and strategies to achieve it from the perspective of middle-aged people in Tehran, Iran. SETTING AND DESIGN: This qualitative study was performed on 21 middle-aged people aged 45-59 years of Tehran in 2019. SUBJECTS AND METHODS: The data collection was carried out through semi-structured and in-depth interviews; the interviews were audiotaped, transcribed. Sampling was carried out gradually until data saturation through purposive sampling was achieved. STATISTICAL ANALYSIS USED: Data collection and analysis were performed simultaneously. Data were analyzed using conventional content analysis. To establish the reliability and validity of findings, Graneheim and Landman criteria were considered. RESULTS: The middle-aged perspective on healthy aging was included in four main themes: having good physical and mental health, having financial well-being, having social support. Strategies for achieving healthy aging were included in five themes: future financial planning, promoting physical health, promoting psychological health, maintaining and improving communication. CONCLUSION: From the middle-aged perspective, healthy aging and strategies to achieve it are multidimensional. Planning for promotional interventions to have a healthy old age should be including all dimensions and done from the years before old age.

Development and validation of the geriatrics health behavior questionnaire (GHBQ).

BACKGROUND: Considering the importance of health behaviors in health outcomes, it is necessary to assess health behaviors precisely. This study aimed to develop and validate The Geriatrics Health Behavior Questionnaire among Iranian older adults. METHODS: This cross-sectional and methodological study was conducted on 420 community older adults (age ≥ 60) through random multi-stage sampling. The initial questionnaire has been developed with 22 items and seven subscales based on an extensive literature review, evaluation of related questionnaires, and experts' opinions. Face and content validity were evaluated by interviewing 10 older adults and 18 specialists. The construct validity was evaluated via Known-groups validity and convergent validity. The reliability of the questionnaire was calculated by internal consistency, test-retest, and absolute reliability. RESULTS: The face validity was conducted by using interviews with older adults and gathering the specialists' opinions. The items were grammatically and lexically corrected accordingly. Two items were deleted due to CVR < 0.44. Modified Kappa statistic (K*) and I-CVI for all items were higher than 0.88. The average content validity index (S-CVI/Ave) value was 0.94. Three items were deleted to improve the internal consistency; the final GHBQ consisted of 17 items with Cronbach α = 0.72. Acceptable convergent validity was approved by a significant correlation between GHBQ and SF8™ health survey (r = 0.613, P value< 0.001). Independent t-test showed that older adults with education level ≥ high school have significantly higher health behavior scores than those with education level < high school (11.93 ± 2.27 vs. 9.87 ± 2.35, t = - 9.08, p < 0.001). Intra-class correlation coefficient (ICC) for the total questionnaire was 0.92 (95% CI =0.84 to 0.96). Standard Error Measurement (SEM) and Minimal Detectable Change (MDC95) were 0.71 and 1.98, respectively. CONCLUSION: The present study results showed that the Geriatrics Health Behavior Questionnaire had suitable validity and reliability among Iranian older adults. It is recommended to consider its comprehensiveness and yet its briefness in other populations after passing validation.

Middle-aged preparation for healthy aging: a qualitative study.

BACKGROUND: Preparing for aging is investing resources in preparing to cope with the challenges that are expected to happen in older age. This will lead to an increase in the quality and well-being in aging. The present study was conducted to elucidate the preparation of the middle-aged people for healthy older age in Tehran, Iran. METHODS: The present study was performed with a qualitative approach and using semi-structured interviews with 23 Iranian middle-aged people (45 to 59 years old), selected by purposive sampling, and the interviews continued until theoretical saturation. Data were analyzed using the content analysis technique with MAXQDA 10 software. RESULTS: The preparation of the middle-aged people was examined in four main categories including staying healthy, financial perspective for the future, outlook on aging, and planning for use time productively. The middle-aged people paid more attention to Staying healthy than other dimensions and the saw their future financially as very dark. Outlook on aging and planning for use time productively dimensions were less considered by the subjects. DISCUSSION: Preparing for healthy aging is a multidimensional concept. The results of the study showed that the middle-aged studied in Iranian society rarely had the necessary preparation and planning to have healthy aging, also preparation is outside the individual behavioral factors and is more affected by the economic situation of the society. So, interventions and the country's macro-policy are needed to plan for healthy aging these people.

The Influence of Providing and Receiving Social Support on Older Adults' Well-being.

Introduction: Social support is a leading contributing factor for older adults' well-being. The present study aimed to compare the impact of two-way (providing and receiving) social support on the well-being of Iranian older adults. Methods: The present cross-sectional study was conducted on 1280 community-dwelling older adults in Tehran, Iran, 2020. The researcher used the clustered sampling method and the 2-way Social Support Scale (SSS) to collect samples and measure social support, respectively. The well-being was measured by the self-reported World Health Organization-Five Well-Being Index (WHO-5). Bivariate and hierarchical linear regression analyses were performed to compare the effects of social support aspects on well-being. Data were analyzed using SPSS 20.0. A significance level of p≤0.05 was considered statistically significant. Results: The mean age of the respondents was 70.90 (SD=8.07), and about 70% of the sample was married. The mean scores of taking and providing social support were 20.70 ±7.52 and 17.71 ±7.82, respectively. The hierarchical regression analysis revealed that providing social support is significantly associated with the well-being of older adults beyond and over receiving social support and possible contributing factors (∆F=30.25; ∆R2= 0.39, p<0.05). Conclusion: The results showed that providing social support is more important than receiving it. Older adults should participate in social activities to provide social support.

Facing double jeopardy: Experiences of driving cessation in older adults during COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic is a multidimensional phenomenon whose consequences can be detected in various economic, social, cultural, and political areas. Driving cessation in older adults is one of the areas affected by the social consequences of this crisis. This study aimed to explain the concept of facing the double jeopardy of the COVID-19 pandemic and driving cessation in older adults. METHODS: This qualitative study was conducted using a thematic analysis approach. Fifteen older adults aged 60 years and above who lived in a community-based setting of Shiraz, Iran were selected based on purposive sampling. The data were collected using semi-structured interviews. RESULTS: The findings indicated two themes, namely dualization of common challenges and fitness with limitations, and nine sub-themes, which showed the experiences of older adults regarding the main theme of facing the double jeopardy of the COVID-19 pandemic and driving cessation. DISCUSSION: Facing the double jeopardy created unique challenges for older adults, as the combined adverse effects of the two sources simultaneously put them at a greater risk. This double jeopardy endangered the health of older adults in various dimensions. This can be the beginning of a new era in older adults' life and care. In this context, application of telecommunication technology and home-based applications increases the flexibility of older adults as well as their ability to cope with stress to meet their mental, social, and physical health needs.

Prevalence and Determinant Factors of Diabetes Distress in Community-Dwelling Elderly in Qom, Iran.

BACKGROUND: Diabetes distress (DD) is common among the patients with type 2 diabetes (T2D), but few studies investigated this problem and its related factors in the elderly population. This study has focused on the prevalence rate of DD and its determinants in community-dwelling elderly in Qom, Iran. METHODS: This study was cross-sectional. A total of 519 subjects community-dwelling with T2D participated in the study. Collected data contained sociodemographic information, some clinical variables (body mass index and duration of diabetes) knowledge, attitude, and self-efficacy. Participants' distress was measured via diabetes distress scale (DDS). The cut of 3 (≥3) was considered as the presence of distress. Also, the attitude, self-efficacy, and knowledge about diabetes were measured by questioner. Multiple logistic regression analysis was applied to detect predictors of DD. RESULTS: The mean age of the participants was 68.38 ± 6.78 and 53.6% were female. Among the participants, 48.6% were identified with positive DD. According to the results of logistic regression analysis, being female (odds ration [OR] = 1.688, P = 0.009), being widowed or divorced (OR = 1.629, P = 0.027), being over-weight or obese (OR = 1.627, P = 0.027), and having less than 10 years in disease duration (OR = 1.721, P = 0.029), attitude (OR = 0.590, P < 0.001), and self-efficacy (OR = 0.658, P = 0.009) were identified as the independent predictors of DD. No significant association was found between DD and age, occupational status, education level, and knowledge (P > 0.05). CONCLUSIONS: The prevalence of DD is considerable among the elderly in Qom. It seems that more attention should be paid to the mental aspects of the patients with T2D specially in high risk groups.

Investigating the effect of social support, social capital, and coping on the positive state of mind of Iranian older people with human immunodeficiency virus/acquired immunodeficiency syndrome.

BACKGROUND: Social resources help to adapt to stress and might positively affect the well-being of individuals with severe conditions like human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The present study investigates the effect of social support, social capital, and coping in a positive state of mind of Iranian older people with HIV/AIDS. MATERIALS AND METHODS: This cross-sectional study was conducted on 160 older people with HIV referred to AIDS clinics in Tehran in 2019. Samples were randomly selected from patients aged 50 years and older. Data were collected using a questionnaire, a positive state of mind, social capital, coping, social support, and a checklist of demographical variables. Data analysis was performed using SPSS software version 21. RESULTS: A significant positive correlation was found between social support, social capital, coping, education, and a positive state of mind. A significant negative correlation was also found between age, several chronic diseases of the patient, and a positive state of mind. The linear regression results showed that social support, social capital, coping, and education improved the positive state of mind. CONCLUSIONS: Based on our findings, we believe that social and psychological interventions effectively enhance patients' positive state of mind with HIV and ultimately, improve their quality of life.

Prevalence of frailty and associated socio-demographic factors among community-dwelling older people in southwestern Iran: a cross-sectional study.

OBJECTIVES: This community-based cross-sectional study aimed to identify the frailty prevalence and associated socio-demographic factors among older adults in five cities of the south west of Iran. METHODS: We selected a random sample of adults aged 60 years and above from five Southwest cities in Iran. Data for this study were retrospectively collected from 540 community-dwelling older adults. To measure frailty, we utilized the frailty index of cumulative deficit (FICD). Data were collected from medical records and socio-demographic factors, including gender, age, marital status, education level, lifestyle, income, and job status. The chi-square test and Spearman's correlation coefficient test were used to assess the relationship between the demographic variables and frailty status (SPSS version 22). Also, multiple binary logistic regression models were used to estimate the effects of demographic characteristics on the frailty recurrence. RESULTS: The overall frailty prevalence was as follows: 77 (14.3%) frail, 139 (25.7%) pre-frail, and 324 (60%) not frail. The findings showed that all variables except education level and marital status are significantly associated with frailty status (P < 0.05). Multiple ridge logistic regression model indicated that age, gender, marital status, job status have significant, and education level, living arrangement, and economic status have no considerable effect on the frailty. CONCLUSIONS: This study has shown that age and gender significantly contributed to the frailty process in older adults. The research also has shown the syndrome's occurrence affected by the aging process, and it supports the biological characteristics of frailty.

Drug injection and associated factors among the elderly living with HIV/AIDS in Tehran, Iran.

Background: Injection of drugs is one of the most serious health problems among Iranian living with HIV/AIDS. The injection of drugs, accounting for the transmission of more than two-thirds of HIV infections. HIV remains a major concern around the world and is expected to be the third leading cause of mortality worldwide. Thus, the aim of this study was to explore the predictors of injection drug use in the elderly patients living with HIV/AIDS. Methods: This was a cross-sectional study executed in Tehran City, Iran, in 2018. A total of 160 individuals aged 60 years and older with HIV from different counseling centers were selected by convenience sampling. Data were collected using questionnaires including a positive state of mind, coping, social support, and a checklist of demographical variables. Bivariate analysis and multiple logistic regression using SPSS software version 21.0 were employed to determine factors associated with drug injection. The statistical tests were performed with a significance level of 5% (p≥0.05). Results: The study participants' mean(SD) age was 65.6(±6.6) years. In total, 33 people (20.6%) of the samples reported injection drug use. The frequency of injection drug use was greater among men (AOR: 2.28, 95% CI 2.2-22.8; p=0.010), those reporting a monthly income of ≥30000000 Rials (AOR: 31.56, 95% CI 2.95-338; p=0.004), subjects with past experience of drug use (AOR: 7.11, 95% CI 2.18-23.2; p=0.001), those with ≥2 years past from their HIV diagnosis (AOR: 4.04, 95% CI 1.12-14.58; p=0.033), and those living with more than two people in one residential place (Household size AOR: 5.9, 95% CI 1.64-21.24; p=0.007). Conclusion: It seems that the design and implementation of harm reduction programs among the elderly with HIV/AIDS who inject drugs are essential and should be considered as an agenda of policymakers and health professionals.