ORCID Profile
0000-0002-9977-8888
Current Organisations
University of Cambridge
,
University of Oxford
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Publisher: Cambridge University Press (CUP)
Date: 20-05-2015
DOI: 10.1017/S1041610215000708
Abstract: Many definitions of successful aging (SA) exist in the absence of an established consensus definition. There are few ex les of a priori application of SA models in real world contexts using external validation procedures. The current study aims to establish the predictive validity of an a priori, continuous model of SA with respect to service utilization. In iduals ( n = 740 64.2% female) aged 65 years and over (mean 75.9 SD 6.2), randomly selected from general practitioner registries in five sites across the United Kingdom included in the second and third combined screen and assessment waves of the Medical Research Council Cognitive Function and Aging Study (MRC CFAS a longitudinal population-based cohort study) comprised the baseline and two-year follow-up in the current study. A Successful Aging Index (SAI) was created using items identified by systematic reviews of operational definitions and lay perspectives of SA, capturing physiological and psychosocial components. Demographic data and SAI components were collected at baseline. Outcome measures, i.e. health service use, informal care use, and functional service, were captured at two years follow-up. Logistic regression revealed significant relationships between the SAI and six of eight service use outcomes in models adjusted for age, sex, education, and socio-economic status. Analysis of the area under the receiver operating characteristic (ROC) curve demonstrated sufficient predictive capabilities for all models, (range 0.65–0.86). The SAI demonstrated a strong association, and predictive accuracy, with respect to service use, providing preliminary support for the practical utility and usefulness of this measure.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.PSYCHRES.2016.12.020
Abstract: The literature regarding exercise for people with established anxiety disorders is equivocal. To address this issue, we conducted a systematic review and meta-analysis investigating the benefits of exercise compared to usual treatment or control conditions in people with an anxiety and/or stress-related disorders. Major electronic databases were searched from inception until December/2015 and a random effect meta-analysis conducted. Altogether, six randomized control trials (RCTs) including 262 adults (exercise n=132, 34.74 [9.6] years control n=130, 37.34 [10.0] years) were included. Exercise significantly decreased anxiety symptoms more than control conditions, with a moderate effect size (Standardized Mean Difference=-0.582, 95%CI -1.0 to -0.76, p=0.02). Our data suggest that exercise is effective in improving anxiety symptoms in people with a current diagnosis of anxiety and/ or stress-related disorders. Taken together with the wider benefits of exercise on wellbeing and cardiovascular health, these findings reinforce exercise as an important treatment option in people with anxiety/stress disorders.
Publisher: Springer Science and Business Media LLC
Date: 10-2014
DOI: 10.1038/514035E
Publisher: Cambridge University Press (CUP)
Date: 25-10-2016
DOI: 10.1017/S0714980816000519
Abstract: Un indice de vieillissement réussi (SA) a été capturé dans une étude de cohorte longitudinale basée sur la population des personnes de 75 ans et plus, qui a été examiné longitudinalement en utilisant la modélisation d’un mélange de croissance (MMC) pour identifier les groupes ayant des trajectoires similaires utilisant la dernière interview complète de personnes décédées et jusqu’à quatre collections de données précédentes avant la mort. MMC a identifié un modèle avec trois classes. Les classes étaient : haut fonctionnement, pas de déclin (HPD) fonctionnement élevé, baisse progressive (HBP) et un faible fonctionnement, fort baisse (FB). Les in idus de la classe HPD étaient significativement plus jeunes à la mort, et à la fin de l’examen, se composait de plus d’hommes, et plus susceptibles d’être mariées, comparativement aux in idus HBP et FB. Ces résultats démontrent différentes façons dont les in idus peuvent éprouver un vieillissement réussi à la fin de vie. Cette étude fournit le cadre pour la recherche future en ce qui concerne les processus du vieillissement pendant toute la vie, avec des implications importantes pour la politique et la pratique.
Publisher: Canadian Geriatrics Society
Date: 14-01-2015
DOI: 10.5770/CGJ.18.131
Abstract: The conceptualization of positive and negative states of aging is contentious at the inter- and intraparadigm level lack of consensus exists within and between states. Working within their respective paradigms, successful aging and frailty researchers may have lost sight of the larger picture. Are successful aging researchers describing nonfrail in iduals? Are frailty researchers describing unsuccessful aging? It is imperative that researchers are cognizant of the ways in which their perspectives are contextualized within the literature and within related paradigms, so as to be able to clearly communicate their research and to ensure they are working within the appropriate paradigm to facilitate desired outcomes. Here we discuss the similarities and differences between successful aging and frailty in terms of the scope and emphasis of their constituent components and functioning: both SA and frailty include biomedical components SA examines the high end, whilst frailty predominately examines the low end of the functioning spectrum. Frailty models emphasize the biomedical realm, whilst SA models emphasize both the biomedical and the psychosocial.
Publisher: Springer Science and Business Media LLC
Date: 16-06-2015
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.NEUBIOREV.2016.11.017
Abstract: Whilst obesity is associated with a higher risk of cognitive impairment, the influence of weight loss on cognitive function in obese/overweight people is equivocal. We conducted a meta-analysis of randomized controlled trials (RCTs) and longitudinal studies evaluating the influence of voluntary weight loss on cognitive function in obese/overweight in iduals. Articles were acquired from a systematic search of major databases from inception till 01/2016. A random effect meta-analysis of weight loss interventions (diet, physical activity, bariatric surgery) on different cognitive domains (memory, attention, executive functions, language and motor speed) was conducted. Twenty studies (13 longitudinal studies=551 participants 7 RCTs=328 treated vs. 140 controls) were included. Weight loss was associated with a significant improvement in attention and memory in both longitudinal studies and RCTs, whereas executive function and language improved in longitudinal and RCT studies, respectively. In conclusion, intentional weight loss in obese/overweight people is associated with improvements in performance across various cognitive domains. Future adequately powered RCTs are required to confirm/refute these findings.
Publisher: Cambridge University Press (CUP)
Date: 05-12-2013
DOI: 10.1017/S1041610213002287
Abstract: Half a century after the inception of the term “successful aging (SA),” a consensus definition has not emerged. The current study aims to provide a comprehensive snapshot of operational definitions of SA. A systematic review across MedLine, PsycInfo, CINAHL, EMBASE, and ISI Web of Knowledge of quantitative operational definitions of SA was conducted. Of the 105 operational definitions, across 84 included studies using unique models, 92.4% (97) included physiological constructs (e.g. physical functioning), 49.5% (52) engagement constructs (e.g. involvement in voluntary work), 48.6% (51) well-being constructs (e.g. life satisfaction), 25.7% (27) personal resources (e.g. resilience), and 5.7% (6) extrinsic factors (e.g. finances). Thirty-four definitions consisted of a single construct, 28 of two constructs, 27 of three constructs, 13 of four constructs, and two of five constructs. The operational definitions utilized in the included studies identify between % and % of study participants as successfully aging. The heterogeneity of these results strongly suggests the multidimensionality of SA and the difficulty in categorizing usual versus successful aging. Although the majority of operationalizations reveal a biomedical focus, studies increasingly use psychosocial and lay components. Lack of consistency in the definition of SA is a fundamental weakness of SA research.
Publisher: Springer Science and Business Media LLC
Date: 05-10-2017
Publisher: Springer Science and Business Media LLC
Date: 19-08-2022
DOI: 10.1007/S12062-022-09389-Z
Abstract: Canada is a relatively young, geographically- erse country, with a larger proportion of the population aged over 65 than under 15. Increasing alongside the number of ageing Canadians is the number of older adults that live with mental health challenges. Across the life course, one in five Canadians will experience a mental health disorder with many more living with subclinical symptoms. For these in iduals, their lived experience may be directly impacted by the contemporary laws and policies governing mental illness. Examining and reviewing the historical context of mental health and older adults, we provide insights into the evolving landscape of Canadian mental health law and policy, paternalistic roots in the infancy of the country, into modern foci on equity and ersity. Progressing in parallel to changes in mental health policy has been the advancement of mental health research, particularly through longitudinal studies of ageing. Although acting through different mechanisms, the evolution of Canadian mental health law, policy, and research has had, and continues to have, considerable impacts on the substantial proportion of Canadians living with mental health challenges.
Publisher: Cambridge University Press (CUP)
Date: 06-07-2017
DOI: 10.1017/S2045796017000324
Abstract: The extension of life does not appear to be slowing, representing a great achievement for mankind as well as a challenge for ageing populations. As we move towards an increasingly older population we will need to find novel ways for in iduals to make the best of the challenges they face, as the likelihood of encountering some form of adversity increases with age. Resilience theories share a common idea that in iduals who manage to navigate adversity and maintain high levels of functioning demonstrate resilience. Traditional models of healthy ageing suggest that having a high level of functioning across a number of domains is a requirement. The addition of adversity to the healthy ageing model via resilience makes this concept much more accessible and more amenable to the ageing population. Through asset-based approaches, such as the invoking of in idual, social and environmental resources, it is hoped that greater resilience can be fostered at a population level. Interventions aimed at fostering greater resilience may take many forms however, there is great potential to increase social and environmental resources through public policy interventions. The wellbeing of the in idual must be the focus of these efforts quality of life is an integral component to the enjoyment of additional years and should not be overlooked. Therefore, it will become increasingly important to use resilience as a public health concept and to intervene through policy to foster greater resilience by increasing resources available to older people. Fostering wellbeing in the face of increasing adversity has significant implications for ageing in iduals and society as a whole.
Publisher: Springer Science and Business Media LLC
Date: 10-02-2014
Publisher: Cambridge University Press (CUP)
Date: 11-10-2017
DOI: 10.1017/S0714980817000344
Abstract: As the population ages, interest is increasing in studying aging well. However, more refined means of examining predictors of biopsychosocial conceptualizations of successful aging (SA) are required. Existing evidence of the relationship between early-life education and later-life SA is unclear. The Successful Aging Index (SAI) was mapped onto the Cognitive Function and Aging Study (CFAS), a longitudinal population-based cohort ( n = 1,141). SAI scores were examined using growth mixture modelling (GMM) to identify SA trajectories. Unadjusted and adjusted (age, sex, occupational status) ordinal logistic regressions were conducted to examine the association between trajectory membership and education level. GMM identified a three-class model, capturing high, moderate, and low functioning trajectories. Adjusted ordinal logistic regression models indicated that in iduals in higher SAI classes were significantly more likely to have higher educational attainment than in iduals in the lower SAI classes. These results provide evidence of a life course link between education and SA.
Publisher: SAGE Publications
Date: 12-03-2013
Publisher: Springer Science and Business Media LLC
Date: 19-09-2015
DOI: 10.1007/S12603-015-0589-6
Abstract: Health is a multi-dimensional concept, capturing how people feel and function. The broad concept of Active and Healthy Ageing was proposed by the World Health Organisation (WHO) as the process of optimizing opportunities for health to enhance quality of life as people age. It applies to both in iduals and population groups. A universal Active and Healthy Ageing definition is not available and it may differ depending on the purpose of the definition and/or the questions raised. While the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has had a major impact, a definition of Active and Healthy Ageing is urgently needed. A meeting was organised in Montpellier, France, October 20-21, 2014 as the annual conference of the EIP on AHA Reference Site MACVIA-LR (Contre les Maladies Chroniques pour un Vieillissement Actif en Languedoc Roussillon) to propose an operational definition of Active and Healthy Ageing including tools that may be used for this. The current paper describes the rationale and the process by which the aims of the meeting will be reached.
Publisher: BMJ
Date: 06-2013
Publisher: JMIR Publications Inc.
Date: 26-06-2020
Abstract: ne of the most at-risk groups during the COVID-19 crisis is older adults, especially those who live in congregate living settings and seniors’ care facilities, are immune-compromised, and/or have other underlying illnesses. Measures undertaken to contain the spread of the virus are far-reaching, and older adults were among the first groups to experience restrictions on face-to-face contact. Although reducing viral transmission is critical, physical distancing is associated with negative psychosocial implications, such as increased rates of depression and anxiety. Promising evidence suggests that participatory digital co-design, defined as the combination of user-centered design and community engagement models, is associated with increased levels of engagement with mobile technologies among in iduals with mental health conditions. The COVID-19 pandemic has highlighted shortcomings of existing technologies and challenges in their uptake and usage however, strategies such as co-design may be leveraged to address these challenges both in the adaptation of existing technologies and the development of new technologies. By incorporating these strategies, it is hoped that we can offset some of the negative mental health implications for older adults in the context of physical distancing both during and beyond the current pandemic.
Publisher: CMA Joule Inc.
Date: 02-04-2013
DOI: 10.1503/CMAJ.121720
Publisher: Elsevier BV
Date: 2014
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.JAMDA.2015.09.004
Abstract: A core operational definition of active and healthy aging (AHA) is needed to conduct comparisons. A conceptual AHA framework proposed by the European Innovation Partnership on Active and Healthy Ageing Reference Site Network includes several items such as functioning (in idual capability and underlying body systems), well-being, activities and participation, and diseases (including noncommunicable diseases, frailty, mental and oral health disorders). The instruments proposed to assess the conceptual framework of AHA have common applicability and availability attributes. The approach includes core and optional domains/instruments depending on the needs and the questions. A major common domain is function, as measured by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). WHODAS 2.0 can be used across all diseases and healthy in iduals. It covers many of the AHA dimensions proposed by the Reference Site network. However, WHODAS 2.0 does not include all dimensions proposed for AHA assessment. The second common domain is health-related quality of life (HRQoL). A report of the AHA questionnaire in the form of a spider net has been proposed to facilitate usual comparisons across in iduals and groups of interest.
Publisher: JMIR Publications Inc.
Date: 06-05-2021
DOI: 10.2196/21864
Abstract: One of the most at-risk groups during the COVID-19 crisis is older adults, especially those who live in congregate living settings and seniors’ care facilities, are immune-compromised, and/or have other underlying illnesses. Measures undertaken to contain the spread of the virus are far-reaching, and older adults were among the first groups to experience restrictions on face-to-face contact. Although reducing viral transmission is critical, physical distancing is associated with negative psychosocial implications, such as increased rates of depression and anxiety. Promising evidence suggests that participatory digital co-design, defined as the combination of user-centered design and community engagement models, is associated with increased levels of engagement with mobile technologies among in iduals with mental health conditions. The COVID-19 pandemic has highlighted shortcomings of existing technologies and challenges in their uptake and usage however, strategies such as co-design may be leveraged to address these challenges both in the adaptation of existing technologies and the development of new technologies. By incorporating these strategies, it is hoped that we can offset some of the negative mental health implications for older adults in the context of physical distancing both during and beyond the current pandemic.
Publisher: Wiley
Date: 08-2014
DOI: 10.1111/JGS.12958
Publisher: Wiley
Date: 03-2015
DOI: 10.1111/JGS.13307
Publisher: Cambridge University Press (CUP)
Date: 11-01-2013
DOI: 10.1017/S1041610212002293
Abstract: Background: Over the last 20 years, a number of instruments developed for the assessment of health-related quality of life (HRQL) in dementia have been introduced. The aim of this review is to synthesize evidence from published reviews on HRQL measures in dementia and any new literature in order to identify dementia specific HRQL instruments, the domains they measure, and their operationalization. Methods: An electronic search of PsycINFO and PubMed was conducted, from inception to December 2011 using a combination of key words that included quality of life and dementia. Results: Fifteen dementia-specific HRQL instruments were identified. Instruments varied depending on their country of development/validation, dementia severity, data collection method, operationalization of HRQL in dementia, psychometric properties, and the scoring. The most common domains assessed include mood, self-esteem, social interaction, and enjoyment of activities. Conclusions: A number of HRQL instruments for dementia are available. The suitability of the scales for different contexts is discussed. Many studies do not specifically set out to measure dementia-specific HRQL but do include related items. Determining how best to operationalize the many HRQL domains will be helpful for mapping measures of HRQL in such studies maximizing the value of existing resources.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Theodore Cosco.