Marc-Dan Blajovan, Simona-Alina Abu-Awwad, Mirela-Cleopatra Tomescu
et al.
<b>Background/Objectives</b>: Inflammatory sarcopenia, characterized by muscle weakness exacerbated by chronic systemic inflammation, has emerged as a critical factor in fall risk among older adults. While previous studies have examined sarcopenia and inflammation independently, few have investigated their combined impact on mobility impairments and fall susceptibility, particularly in immunocompromised individuals. This study aimed to assess the role of inflammatory sarcopenia in increasing fall risk by comparing functional performance, muscle strength, and inflammatory biomarkers across three groups: healthy older adults, individuals with non-inflammatory sarcopenia, and those with inflammatory sarcopenia. A secondary objective was to evaluate fall incidence in immunocompromised versus non-immunocompromised individuals. <b>Methods</b>: A prospective observational study was conducted on 250 adults aged ≥65 years, categorized based on inflammatory status and muscle health. Functional assessments included handgrip strength, the Timed Up and Go (TUG) test, and fall frequency analysis. Inflammatory status was determined by measuring C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Multivariate regression models were used to identify predictors of fall risk. <b>Results</b>: Participants with inflammatory sarcopenia exhibited significantly higher CRP and IL-6 levels, greater muscle weakness, poorer mobility performance, and a fourfold increase in fall incidence compared to controls (<i>p</i> < 0.001). Immunocompromised individuals had nearly double the fall risk of their non-immunocompromised counterparts (<i>p</i> < 0.001). TUG test performance was the strongest fall predictor. <b>Conclusions</b>: Our findings highlight the importance of integrating fall prevention strategies that not only focus on muscle-strengthening programs but also include regular screening for inflammatory markers. Given the strong association between systemic inflammation, muscle weakness, and fall risk, identifying and managing chronic inflammation may play a crucial role in reducing mobility impairments and improving outcomes in older adults.
Abstract Background This study investigated the relationship between sleep disturbance, obstructive sleep apnea (OSA), and osteoporosis in older adults. Methods This cross-sectional study involved 326 older adults (mean age: 83.46 years) in elder care institutions in Taiwan. The presence of osteoporosis was assessed using dual-energy X-ray absorptiometry, while sleep quality and OSA risk were evaluated using the Pittsburgh Sleep Quality Index and STOP-Bang questionnaire, respectively. Heart rate variability (HRV) was measured to assess autonomic function. Logistic regression models, adjusted for age, body mass index (BMI), and comorbidities, were used to examine the associations among sleep duration, OSA risk, and osteoporosis. Results Osteoporosis was more prevalent in females and those with lower BMI and neck circumference, and less common in individuals with knee osteoarthritis. Intermediate-to-high OSA risk was associated with the male sex, higher BMI, higher neck circumference, and cardiovascular comorbidities. Short sleep duration (< 4 h) was initially correlated with a higher osteoporosis risk, but this association disappeared after adjusting for covariates. However, after adjusting for covariates, intermediate-to-high OSA risk was significantly associated with osteoporosis. HRV showed no significant difference in assessing osteoporosis or OSA risk in this study. Conclusion Short sleep duration (< 4 h) and intermediate-to-high OSA risk were associated with a higher prevalence of osteoporosis among older adult participants, compared to those with 6–7 h of sleep or low OSA risk. Further research is required to explore the relationship between sleep and osteoporosis in older adults.
Szabolcs Garbóczy, András Mohos, Anikó Égerházi
et al.
Background: Dementia is a significant health issue worldwide. Mild cognitive impairment (MCI) can transform into dementia over time. General practitioners (GPs) may be the first to notice the cognitive deficit; therefore, it is crucial for them to have access to a screening test that can be administered quickly and efficiently. We explored the Hungarian version of the Test Your Memory self-administered dementia screening test in general practice for the early detection of dementia and cognitive impairment. Methods: In the four Hungarian cities with medical universities, 368 patients over the age of 50 attending GPs filled out the questionnaire within the framework of our cross-sectional study. Results: The total scores of the test showed a significant correlation with education and type of occupation and a significant negative correlation with age. The results of this research showed that the clock drawing and recall subtest scores deteriorate at the earliest age. Conclusion: The test can be filled out in a GP’s office easily and two of its subtests can raise the possibility that patients may need further assessment, especially if they have symptoms, at an earlier age than the other subtests.
Marieke Geerars-van der Veen MSc, PT, Judith Ballemans MSc, PT, Anna M. Bongers MSc, PT
et al.
Background and Purpose: Patients with COPD-induced malnutrition and muscle wasting are often frail. Consequently, traditional rehabilitation may be even counterproductive due to energy costs and there is a need for specialized rehabilitation programs, which are lacking for these patients. We developed such a program, which includes resistance training, following Nonlinear Periodized Exercise principles and physical energy management, in combination with a restriction of physical activities. The purpose of the study was to investigate the feasibility and the potential effects of this program. Methods: Patients who are eligible for the program are those with COPD gold III/IV and a fat free mass index below standard. We conducted a qualitative feasibility study and interviewed both patients and healthcare professionals (HCPs), using a deductive approach. The open interviews were qualitatively analyzed focussing on six areas of Bowens’ feasibility model: acceptability, demand, implementation, practicality, limited efficacy, and integration. Results and discussions: Seven patients and seven HCPs were interviewed. For patients, key factors that helped to adhere to the program were knowledge about energy management, alternative skills to cope with COPD, and social support. They found the program beneficial. However, several patients considered a limitation of walking and ADL activities challenging. HCPs considered the program feasible and beneficial especially for those patients who accept they need a behavior change and who adhere to the program. For HCPs, key factors were the consistent approach and coaching skills of the multidisciplinary team members, and the monitoring role of the nurses. The limitation of physical activity and endurance training deviates from existing geriatric rehabilitation programs which propagate functional activity and training. Still, evidence from the current study suggests that our tailored approach for these patients might be more appropriate and also potentially effective without harm for physical function. Conclusions: Our novel, multidisciplinary rehabilitation program is considered feasible and clinically relevant by both patients and healthcare professionals. The next step is to explore its effects on muscle strength, physical functioning, and quality of life.
Abstract Background The growing population of older adults worldwide is associated with an extended life expectancy and an increasing proportion of older adults with dynapenia. Most research on dynapenia has involved only populations of older adults living in the community; little research has examined the effects of risk factors on sleep quality among older adults with dynapenia residing in assisted living facilities. Aim This study examined the relationships among physical function, nutrition, cognitive function, depression, and sleep quality among older adults with dynapenia residing in assisted living facilities. Methods In this cross-sectional study, data on physical function, nutrition, cognitive function, depression, and sleep quality was collected from 178 older adults with dynapenia residing in assisted living facilities, who were selected using purposive sampling. Descriptive statistical analysis, independent-sample t tests, chi-squared tests, and logistic regression analysis were performed using SPSS 25.0. Results The statistical analyses revealed correlations between sleep quality and age (t = 2.37, p < 0.05), level of education (χ 2 = 3.85, p < 0.05), grip strength (t = 3.40, p < 0.01), activities of daily living (t = 4.29, p < 0.001), instrumental activities of daily living (t = 2.23, p < 0.001), calf circumference (t = 2.89, p < 0.01), Mini Nutritional Assessment scores (t = 2.29, p < 0.05), Mini Mental State Exam (MMSE) scores (t = 4.50, p < 0.001), and Geriatric Depression Scale (GDS) scores (t = − 4.20, p < 0.001). Calf circumference (OR = 0.8, 95% CI = 0.650.97, p < 0.05), GDS score (OR = 1.42, 95% CI = 1.05–1.92, p < 0.05), and MMSE score (OR = 0.85, 95% CI = 0.73–0.97, p < 0.05) were related to sleep quality among the sample population. Conclusion Physical function, nutrition, cognitive function, and depression affect the sleep quality of older adults with dynapenia residing in assisted living facilities. Facility nurses must regularly assess these aspects of their patients to ensure that facility-dwelling older adults can maintain their physical function and improve their health to improve the quality of their sleep.
Objective To study the effect and mechanism of berberine (BBR) on the lung metastasis of mouse breast cancer via epithelial-mesenchymal transition (EMT). Methods CCK-8 and Transwell migration assays were utilized to investigate the proliferation and migration properties of breast cancer 4T1 cells after BBR treatment.Mouse 4T1-Luc cells were injected into mice under the fourth mammary fat pad, and the mice were then randomly divided into the control and BBR groups.The mice in the BBR group received daily intraperitoneal injections of BBR working solution and those in the control group were continuously intraperitoneally injected with the same volume of the solvent used to dissolve BBR powder.Tumor metastasis in the lungs of living mice was detected by using an in vivo imaging system.After 42 days of administration, lung metastasis was measured via microscopy and HE staining.Western blot analysis was used to examine the effects of BBR on the expression of EMT-related proteins (Vimentin and Snail) as well as the activation of the Akt and ERK signaling pathways. Results BBR significantly promoted 4T1 cell migration (P < 0.05).In vivo experiments showed that the number of lung metastases in the BBR group had significantly increased compared with that in control group (P < 0.05) as observed under microcopy and histological staining.Compared with the control group, BBR upregulated the expression levels of Vimentin and Snail as well as the phosphorylated levels of p-Akt and p-ERK (P < 0.05). Conclusion BBR may promote EMT and lung metastasis of breast cancer 4T1 cells by activating the expression of proteins in the p-Akt and p-ERK pathways.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Antibody‒drug conjugates (ADCs), which combine the advantages of monoclonal antibodies with precise targeting and payloads with efficient killing, show great clinical therapeutic value. The ADCs’ payloads play a key role in determining the efficacy of ADC drugs and thus have attracted great attention in the field. An ideal ADC payload should possess sufficient toxicity, low immunogenicity, high stability, and modifiable functional groups. Common ADC payloads include tubulin inhibitors and DNA damaging agents, with tubulin inhibitors accounting for more than half of the ADC drugs in clinical development. However, due to clinical limitations of traditional ADC payloads, such as inadequate efficacy and the development of acquired drug resistance, novel highly efficient payloads with diverse targets and reduced side effects are being developed. This perspective summarizes the recent research advances of traditional and novel ADC payloads with main focuses on the structure–activity relationship studies, co-crystal structures, and designing strategies, and further discusses the future research directions of ADC payloads. This review also aims to provide valuable references and future directions for the development of novel ADC payloads that will have high efficacy, low toxicity, adequate stability, and abilities to overcome drug resistance.
Sara Tookey, Caroline V. Greaves, Jonathan D. Rohrer
et al.
Abstract Introduction Carers of people with frontotemporal dementia (FTD) experience greater challenges than carers of people with other dementias due to the younger age of onset and the challenging presentation of symptoms. The aim of the present study was to explore experiences of spousal carers of people with bvFTD, including those with the familial form of the disease (fFTD). Method Fourteen qualitative interviews were analysed using an inductive approach to Thematic Analysis to understand experiences of spousal carers of people with bvFTD including those with fFTD. Results Five main themes were identified including: a) The “Constant Battle” – A journey toward an FTD diagnosis, b) Shock, Relief and Fear – Challenges persist post diagnosis, c) The “Life Altering” impact – The loss of the spousal relationship and shifting roles, d) Adapting, Managing Symptoms and Receiving Carer Support, e) Lack of General Knowledge – Barriers to support. Conclusions Healthcare professionals should be educated on the initial presentations of FTD, to enable carers and families receive timely diagnosis and appropriate support. Future research should investigate the impact of fFTD on carers and families, to explore positive or meaningful experiences in caring, as well as theory-driven research to identify helpful coping strategies for carers of people with FTD.
Spinocerebellar ataxia (SCA) is a hereditary neurodegenerative disorder that presents as ataxia. Due to the decline in balance, patients with SCA often experience restricted mobility and a decreased quality of life. Thus, many studies have emphasized the importance of physiotherapies, including gait training, in SCA patients. However, few studies have examined the effectiveness of robotic gait training in SCA. Here, we report the therapeutic outcomes of exoskeleton-assisted gait training in a patient with SCA. A 23-year-old woman with SCA participated in a gait training program using a powered lower-limb robotic exoskeleton, ANGELLEGS. The 8-week training program consisted of standing training, weight-shifting exercises, and gait training. Several measures of general function, balance, gait, and cardiopulmonary function were applied before, after, and 4 weeks after the program. After the program, overall improvements were found on scales measuring balance and gait function, and these improvements remained at 4 weeks after the program. Cardiopulmonary function was also improved 4 weeks after the program. Robotic exoskeleton gait training can be a beneficial option for training balance, gait, and cardiopulmonary function in SCA.
Background: This study aims to investigate whether certain demographic factors of patients receiving home healthcare (HHC) interventions have any positive impact on mortality. Methods: the study included all patients who were enrolled in the HHC program in a referred medical complex, Jeddah, Saudi Arabia between the years 2017 and 2020 (593 patients). Results: A total of 6548 HHC visits were received during the study period. From the total number of visits, 3592 (54.9%) HHC visits were scheduled in the year 2020 compared to 157 (2.4%) scheduled HHC visits in 2017 (<i>p</i> < 0.001). The most successful HHC visits were provided in 2020 compared with the year 2017 (2193 vs. 132; <i>p</i> < 0.001). The cancelled HHC visits were observed to be the lowest (194) in 2019. Three explanatory variables of mortality [age, having a major diagnosis (diabetes mellitus, cerebrovascular diseases, and bedridden), and having more cancelled visits] made a statistically significant contribution to the logistic regression model after controlling for other variables. Suffering from cerebrovascular diseases and/or bedridden were the strongest predictor of death in patients receiving HHC. Conclusions: During the 2020 pandemic, there was a sharp increase in HHC compared to previous years. Three significant explanatory variables of mortality [age, having a major diagnosis (diabetes mellitus, cerebrovascular diseases, and bedridden), and having more cancelled visits] were reported.
The editors of <em>OBM Geriatrics</em> would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2020. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal's editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recognition directly from our submission system. Additionally, reviewers can sign up to the service Publons (https://publons.com) to receive recognition. Of course, in these initiatives we are careful not to compromise reviewer confidentiality. Many reviewers see their work as a voluntary and often unseen part of their role as researchers. We are grateful to the time reviewers donate to our journals and the contribution they make.
Abstract Background Older people living with HIV (OPLWH) are expected to live longer in the era of antiretroviral treatment, but at the same time, they are at risk for developing various health complications as a consequence of a life with the infection, exposure to medications that carry their own toxicity and side effects, and the natural effects of aging on the immune system. Because senescence is an inherent process that can be accelerated by HIV, it is important to identify strategies that can modify this phenomenon. Emerging data suggests that while physical activity and exercise may not have a positive impact on viral replication and on the immune system of people living with HIV, it can elicit improvements in cardiorespiratory fitness, strength, body composition, and overall quality of life. The purpose of this study is to map out empirical evidence on the effects of physical activity and exercise in OPLWH. Methods The scoping review methods will be guided by the framework proposed by the Joanna Briggs Institute guidelines. Literature searches will be conducted in the following electronic databases (from inception onwards): PubMed/MEDLINE, Cochrane Library, and Google Scholar. Peer-reviewed journal papers will be included if they are written in English, involved human participants aged 50 years, and older with HIV and described a measure for physical, mental, or functional status of physical activity/exercise and/or the recommendations in OPLWH. Quantitative, qualitative, and mixed-method studies will be included in order to consider different aspects of measuring the effects of physical activity and exercise (e.g., quality of life, functional status, activities of daily living). Two reviewers will screen all citations and full-text articles. We will abstract data, organize them into themes and sub-themes, summarize them, and report the results using a narrative synthesis. The study methodological quality (or bias) will be appraised using a Mixed Methods Appraisal Tool. Discussion The evidence gathered from the selected studies will be discussed in relation to the research questions using a narrative to identify and explore emergent themes. The review will provide a baseline of evidence on exercise and physical activity interventions for OPLWH. It will highlight gaps regarding the use of exercise and physical activity and contribute to the design of an effective intervention approach to the rehabilitation of OPLWH. Systematic review registration Open Science Framework ( https://osf.io/728kp/ ).
Background This study explored the effects of aging on the expression of angiogenic and muscle protein synthesis factors, as well as the number of satellite cells affecting sarcopenia in naturally aged rat skeletal muscles. Methods We divided 16 Sprague-Dawley rats into young (12 weeks old, n=8) and old (24 months old, n=8) groups and compared muscle and body weight (BW) between them. We also analyzed the expression levels of angiogenic and muscle growth proteins in soleus (slow-twitch) and extensor digitorum longus (EDL; fast-twitch) muscles by western blotting and assessed the number of skeletal muscle satellite cells and myonuclei and mean fiber cross-sectional area (CSA) using by immunofluorescence staining. Results EDL/BW was significantly lower in old rats than in young rats (p=0.002). The vascular endothelial growth factor level in soleus muscles was significantly lower in old rats than in young rats (p=0.001). Hypoxia-inducible factor 1-alpha and fetal liver kinase 1 levels in EDL muscles were lower in old rats than in young rats (p=0.001). The mammalian target of rapamycin (mTOR), p70S6K, and 4E-BP1 levels were significantly lower in the soleus muscles of old rats than in those of young rats (p<0.01). Similarly, insulin growth factor-1, Akt, mTOR, and p70S6K levels were significantly lower in EDL muscles of old rats than in those of young rats (p<0.01). Additionally, myonuclei/fiber, Pax7/fiber, and mean fiber CSAs in both muscle types were significantly lower in old rats than in young rats (p<0.01). Conclusion These data suggest different regulation of indices of angiogenic and muscle growth with aging in different muscle types.
In this article I explore ideas of the good and meaningful life in older age, based on ethnographic research with older Japanese in the city of Osaka. Some of my interlocutors and friends in the field spoke about the approaching end of their life. When speaking about the time remaining, many expressed their sense that the future ‘will somehow turn out [all right]’ (nantonaku). This statement of quiet hope acknowledged change and encapsulated a desire to support others; it also shifted emphasis away from the future. This is not to say that the experience was for my interlocutors primarily marked by an orientation towards the past: by reminiscing and recollection. Inhabiting the moment was equally important. While reminiscing and narrating past events clearly relate to meaning-making, then, what is the role of dwelling in the moment for maintaining a meaningful existence? I will argue that dwelling in the moment allows for the cultivation of an attitude of gratitude, which lends meaning to a life. This attitude of gratitude binds together both reflection on the past and attention to the present moment in its fullness. It also, I suggest, opens up space for a particular kind of hope, grounded in the moment. Thus, the sense of the good and meaningful life that my older friends conveyed encapsulates an attitude of gratitude as a way of inhabiting the present, rather than dwelling in the past or leaping towards the future.
Fabiana Pavan Viana, Anapaula Castro de Lorenzo, Érika Felipe de Oliveira
et al.
Resumo O acidente vascular encefálico (AVE) é uma das maiores causas de seqüelas permanentes que geram a incapacidade funcional. O objetivo deste estudo foi avaliar, por meio da Medida de Independência Funcional (MIF), as atividades de vida diária em idosos com AVE. Para isto, 14 idosos com seqüela de AVE do Complexo Gerontológico Sagrada Família de Goiânia foram avaliados por meio da MIF. A MIF é um instrumento que avalia a capacidade funcional e cognitiva em relação a seis dimensões: autocuidados, controle de esfíncteres, transferências, locomoção, comunicação e cognição social. Os resultados para o domínio motor foram 43,0±0,8, para domínio cognitivo, 17,0±1,3, e a MIF total, 60,0±0,9. Os resultados demonstraram que 57,1% dos indivíduos com seqüela de AVE apresentaram dependência modificada – assistência de até 50%, e 21,4% dependência modificada – assistência de até 25% e 21,4% de independência completa. Pode-se concluir que a maioria dos idosos possui dependência significativa para a realização das AVDs, resultante de uma baixa performance funcional. Desta forma, esses idosos necessitam de acompanhamento e orientações direcionadas que possibilitem uma maior independência.
Singapore has experienced rapid development in the past 50 years. This has presented unique challenges with regard to land space and a rapidly ageing population. The role of extrinsic factors in successful ageing is well documented, and places a degree of responsibility on the state and healthcare systems. Singapore has taken many proactive measures to meet this responsibility by implementing policy changes across multiple domains including housing, transport, education and research. One hospital in the north east of Singapore has undertaken a frailty screening program that aims to identify, prevent and reverse frailty at an early stage. This paper provides a review of these national and regional measures.
R. Turner Goins, Mark Schure, Paul N. Jensen
et al.
Abstract Background More than six million American Indians live in the United States, and an estimated 1.6 million will be aged ≥65 years old by 2050 tripling in numbers since 2012. Physical functioning and related factors in this population are poorly understood. Our study aimed to assess lower body functioning and identify the prevalence and correlates of “good” functioning in a multi-tribe, community-based sample of older American Indians. Methods Assessments used the Short Physical Performance Battery (SPPB). “Good” lower body functioning was defined as a total SPPB score of ≥10. Potential correlates included demographic characteristics, study site, anthropometrics, cognitive functioning, depressive symptomatology, grip strength, hypertension, diabetes mellitus, heart disease, prior stroke, smoking, alcohol use, and over-the-counter medication use for arthritis or pain. Data were collected between 2010 and 2013 by the Cerebrovascular Disease and Its Consequences in American Indians Study from community-dwelling adults aged ≥60 years (n = 818). Results The sample’s mean age was 73 ± 5.9 years. After adjustment for age and study site, average SPPB scores were 7.0 (95% CI, 6.8, 7.3) in women and 7.8 (95% CI, 7.5, 8.2) in men. Only 25% of the sample were classified with “good” lower body functioning. When treating lower body functioning as a continuous measure and adjusting for age, gender, and study site, the correlates of better functioning that we identified were younger age, male gender, married status, higher levels of education, higher annual household income, Southern Plains study site, lower waist-hip ratio, better cognitive functioning, stronger grip strength, lower levels of depressive symptomatology, alcohol consumption, and the absence of hypertension, diabetes mellitus, and heart disease. In our fully adjusted models, correlates of “good” lower body functioning were younger age, higher annual household income, better cognitive functioning, stronger grip, and the absence of diabetes mellitus and heart disease. Conclusions These results suggest that “good” lower body functioning is uncommon in this population, whereas its correlates are similar to those found in studies of other older adult populations. Future efforts should include the development or cultural tailoring of interventions to improve lower body functioning in older American Indians.
Hirofumi Nagayama,1 Norikazu Kobayashi,2 Yu Ishibashi,2 Ryuji Kobayashi,2 Chika Murai,3 Keita Yamauchi4 1Department of Occupational Therapy, Kanagawa University of Human Services, Yokosuka, Japan; 2Division of Occupational Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Arakawa, Japan; 3Department of Occupational Therapy, Ishikawa Prefectural Takamatsu Hospital, Kahoku, Japan; 4Graduate School of Health Management, Keio University, Fujisawa, Japan Purpose: The purpose of this pilot study was to determine the effectiveness and costs of the occupation-based practice for community dwelling frail elderly. Design: Pilot pre-post design without a control group. Setting: A care management center involving 37 local elderly. Subject: The final analysis included 26 frail elderly in a community dwelling center. Intervention: The intervention was occupation-based practice involving setting of client-centered goals, observation of real living situations, and provision of advice on the individual problem of real occupation. Outcome: The outcome was the Frenchay Activities Index (FAI), which is used to evaluate the instrumental activities of daily living (IADL). Additionally, the frequency, duration, and cost of the intervention were calculated. Results: Regarding the FAI score before and after the interventions, there were significant improvements in all items except work (P<0.05, effect size [r]: 0.67–0.93). A total of 15 people out of 26 (57.7%) showed improvement in activities of daily living. The frequency of interventions was 3.7 (95% confidence interval [CI]: 2.83–4.48), and the duration was 7.4 weeks (95% CI: 5.27–9.42). The average intervention cost was $258 (95% CI: 200.4–317.4). Conclusion: The results of this study showed that occupation-based practice has a potential to improve IADL in frail elderly, with low frequency of intervention, within a short-term, and direct cost reduction. We believe that this pilot study will contribute to future clinical studies for frail elderly, and the findings can be easily applied to daily clinical intervention. A well-designed prospective randomized-controlled trial is necessary to verify these results. Keywords: activities of daily living, Frenchay Activities Index, frail elderly, occupational therapy, cost saving
Abstract Objective: the present study aimed to identify patterns of social participation in old age and the theories used to explain them. Method: A systematic review was performed using the Medical Literature Analysis and Retrieval System Online (MEDLINE / PUBMED), Scientific Electronic Library Online (Scielo) and Web of Science (ISI Web of Knowledge) databases. The keywords used were: social participation, social engagement, social involvement and social activities; combined with seniors, the elderly, older adults, older people and aging. Research was performed between January and February. Results: thirty-one longitudinal studies on social participation among old and healthy middle-aged adults were included for analysis. In three studies social engagement levels increased, especially at the beginning of old age (up to 75 years). Twenty-one studies presented results that described the reduction of social engagement levels in old age, and five studies found that there was no change in levels of social involvement. The most used theories were: the activity theory, the social disengagement theory, the continuity theory and the theory of socioemotional selectivity. Conclusion: the results point to the need for reflection on what is envisioned and what is practiced in terms of policies and practices aimed at achieving successful aging. Future attempts should include not only incentives to remain active, but a description of factors that influence the social disengagement associated with poor adaptation in old age.