Preface

Living a long and healthy life is now considered the main challenge of societies worldwide. The World Health Organization (WHO) in 2015 defined healthy aging as the "ongoing process of developing and maintaining the functional ability that enables well-being in older age." Functional ability is a central concept in this approach since it comprises the interaction between physical and mental capacities in a particular environment. Physical activity has been considered a key recommendation for developing sustainable policies and action programs for healthy aging. Increasing physical activity is a necessary condition to maintain functional and cognitive abilities as well as social activities. Currently, assisted living technologies have been given special attention since innovative information and communication technology (ICT)-based products can make a real difference in people's physical, mental, and social lives. Considering the multifaceted character of the phenomenon, all these predictors directly impact health-related quality of life.

*Geriatric Medicine and Healthy Aging* is organized into four sections and eight chapters. Section 1, "Healthy Aging: An Overview", includes an introductory chapter that introduces and defines the main concepts of this book: healthy aging, physical activity, functional fitness, cognitive function, and assisted living technologies. The chapter explains how each independent variable can explain the variance in quality of life in older people and considers the relationship between these concepts. The chapter also identifies priorities, challenges, and future research with the purpose of creating solutions in health and well-being adapted to the needs of older people.

Chapter 2, "Exercise Aging and Health: A Proposal Course for Healthcare Professionals and Physical Activity Instructors", proposes a curriculum to be taught to healthcare professionals, physical activity instructors, or other health professionals who work directly with older people. The curriculum addresses structural topics, including aspects of aging (i.e., demography, theories, and current policies on aging) and physical and functional aged-related declines, including morphological and physiological changes. Physical–psychosocial relationships are also explored, focusing on the relationships between aging, active life, cognitive function, physical activity, well-being, and health-related quality of life. Finally, the chapter presents guidelines for exercise prescription in the older population, including general guidelines for pre-exercise assessment and critical considerations for maximizing the effective development of exercise programs for older people. This curriculum is expected to support professionals with theoretical knowledge regarding exercise, aging, and health in different contexts of intervention with older people (i.e., health gyms, rehabilitation centers, elderly centers, city councils, and parish councils, among others). This course content is believed to be an essential step in improving the quality of physical activity programs for older people.

Chapter 3, "Perspective Chapter: Geriatric Care in Africa", explores the issue of geriatric care on the African continent. It presents emerging needs, identifying the most vulnerable groups and Africa's shortage of qualified geriatricians. This chapter underlines Africa's health and social problems and emphasizes several challenges that make older people prone to vulnerabilities. Another enormous problem presented is the lack of technical training for geriatricians. The conclusion is that there are few geriatricians in Africa and thus it is essential to consider partnerships between African counties and other more developed countries to find strategies for training in geriatric medicine, such as postgraduate courses, fellowships, refresher courses, and workshops.

Section 2, "Physical–psychosocial Relationships: Moving towards Healthy Aging", explores physical–psychosocial relationships and how they affect healthy aging.

Chapter 4, "Does Physical Activity Mediate the Effect of Loneliness on Inflammatory and Metabolic Processes?", clarifies the contribution of physical activity to the associations between loneliness and immune and metabolic processes and provides insights concerning the mechanism by which this social–biological connection operates. This chapter supports the idea that loneliness is associated with increased levels of inflammation. It also suggests that loneliness is associated with subsequent low metabolic regulation, as manifested by elevated concentrations in all three metabolic measures of body mass index (BMI), hemoglobin A1C (Hba1c), and serum cystatin C (CysC). In conclusion, this chapter observes an important psycho-physiological mechanism that may be present among older adults. A strong public health message to engage in physical activities in late life also mitigates the deleterious health effects of loneliness.

Directly connected with the topic of physical–psychosocial relationships, Chapter 5, "Perspective Chapter: Social Distancing and Isolation – Unintended Consequences, Concerns, and Antidotes for Older Adults", explores the consequences of social isolation, particularly in the post–COVID-19 pandemic period. This chapter stresses that opportunities for increasing the social connectedness of older adults and others who are isolated must be prioritized to decrease the impact of social isolation and loneliness on mental and physical health. In addition, it proposes recommendations for policies, programs, and other actions addressing social isolation as a determinant of healthy aging using case examples from the western region of North Carolina.

Section 3, "Novel Approaches to Prevention and Treatment of Age-Related Declines", addresses novel approaches to the prevention and treatment of age-related declines.

Chapter 6, "Perspective Chapter: The Role of Modifiable Factors, Particularly Nutritional Factors, on Age-Related Sarcopenia", explores nutrition as a modifiable factor in fighting against sarcopenia and frailty. Sarcopenia, which is defined by low muscle strength, low muscle mass, and low physical performance, has been highly correlated with poor quality of life, risk of falls, fractures, and higher healthcare costs. Despite the growing interest in treating this phenomenon, the lack of adequate knowledge underlying the multi-factorial parthenogenesis of age-sarcopenia hinders the diagnosis of effective therapeutic approaches. This chapter discusses the association between the components of sarcopenia and nutritional status in older adults and their potential effect on prevention and treatment.

**V**

Chapter 7, "Perspective Chapter: Nutraceuticals as a Therapeutic Promise in Healthy Aging and Neurocognitive Disorders", explores modern therapeutics, namely, approaches based on chemical substances belonging to classes of natural dietary origin that seem to have protective properties against some age-related diseases,

Section 4, "Assisted Living: Technology for Healthy Aging", includes Chapter 8, "Perspective Chapter: Telehealth Technologies for the Elderly People", which presents a systematic review of the literature on telemedicine tools for older adults from a perspective of empowering them to take an active role in the management of their health. The chapter also emphasizes the need for co-creation and co-design with

**Élvio Rúbio Gouveia**

University of Madeira, Madeira, Portugal

Funchal, Portugal

**Adilson Marques**

University of Lisbon, Lisbon, Portugal

**Bruna Raquel Gouveia**

University of Geneva, Geneva, Switzerland

Madeira, Portugal

Funchal, Portugal

Regional Directorate of Health,

University of Geneva, Geneva, Switzerland

Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal

Instituto de Saúde Ambiental (ISAMB),

Interactive Technologies Institute,

Department of Physical Education and Sport,

Laboratory of Robotics and Systems in Engineering and Science (LARSyS),

Center for the Interdisciplinary Study of Gerontology and Vulnerability,

Interdisciplinary Centre for the Study of Human Performance (CIPER),

Center for the Interdisciplinary Study of Gerontology and Vulnerability,

Secretary of Health of the Autonomous Region of Madeira,

Saint Joseph of Cluny Higher School of Nursing,

including neurodegenerative ones.

end users to ensure adequate technological solutions.

Chapter 7, "Perspective Chapter: Nutraceuticals as a Therapeutic Promise in Healthy Aging and Neurocognitive Disorders", explores modern therapeutics, namely, approaches based on chemical substances belonging to classes of natural dietary origin that seem to have protective properties against some age-related diseases, including neurodegenerative ones.

Section 4, "Assisted Living: Technology for Healthy Aging", includes Chapter 8, "Perspective Chapter: Telehealth Technologies for the Elderly People", which presents a systematic review of the literature on telemedicine tools for older adults from a perspective of empowering them to take an active role in the management of their health. The chapter also emphasizes the need for co-creation and co-design with end users to ensure adequate technological solutions.

**Élvio Rúbio Gouveia**

Department of Physical Education and Sport, University of Madeira, Madeira, Portugal

Laboratory of Robotics and Systems in Engineering and Science (LARSyS), Interactive Technologies Institute, Funchal, Portugal

Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland

#### **Adilson Marques**

Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal

> Instituto de Saúde Ambiental (ISAMB), University of Lisbon, Lisbon, Portugal

#### **Bruna Raquel Gouveia**

Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland

> Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, Madeira, Portugal

> > Saint Joseph of Cluny Higher School of Nursing, Funchal, Portugal

#### **Andreas Ihle**

**1**

Section 1

Healthy Aging: An Overview

Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland

> Department of Psychology, University of Geneva, Geneva, Switzerland

Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability, Life Course Perspectives, Switzerland

Section 1
