Non-pharmacological interventions in caregivers over 65 years of age. Scoping review of analytical studies and reviews

Non-pharmacological interventions in caregivers over 65 years of age. 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Scoping review of analytical studies and reviews Alba Peraza Delgado, Yurena María Rodríguez Novo, Miguel López Martínez, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9074136/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Introduction : Population aging has increased the number of people over 65 years of age who assume the role of informal caregivers, affecting their own active aging process. Objectives : (1) to identify and categorize the main intervention domains described in recent literature (lifestyle, psychoeducation, and emotional support) and (2) to classify the strategies found according to the standardized Nursing Interventions Classification (NIC) taxonomy, in order to facilitate their application in clinical practice. Method : A scoping review was conducted using the PubMed, Cumulative Index to Nursing & Allied Health Literature (CINAHL), and Web of Science (WOS) databases. Inclusion criteria were articles published between 2014 and 2025; in Spanish and English; publications with full-text access; and focusing on a population over 65 years of age. Review and analytical studies were included, focusing on individuals over 65 years of age and addressing the emotional, physical, social, and economic burden on caregivers, as well as interventions aimed at improving their situation. Results : Forty-nine articles were reviewed, and 12 non-pharmacological interventions were identified according to the Nursing Interventions Classification taxonomy, designed to promote active aging. The analysis identified three main intervention domains: 1) Lifestyle modification (physical activity and nutrition); 2) Psychoeducational interventions (empowerment and care management); and 3) Emotional support. Evidence suggests that multicomponent physical exercise is effective in reducing caregiver burden and improving health-related quality of life. Factors such as resilience and social support act as key protective factors against burnout. Conclusions : There is a great need for public policies that integrate coordinated social and healthcare services. Interventions should be personalized considering the advanced age of the caregiver, promoting their own autonomy and self-care to ensure the sustainability of care at home. active aging informal caregiver and caregiver overload Figures Figure 1 1. Introduction According to the World Health Organization (WHO), active aging is defined as the process of optimizing opportunities for health, participation, and security in order to enhance quality of life as people age 1 , 2 . This approach not only seeks to reduce the prevalence of disease but also to promote a balance between physical and mental health, functional independence, social participation, and economic autonomy 3 , 4 . To achieve active and healthy aging, older adults must make an active commitment to their family and community, engaging in cultural, social, and leisure activities 3 , 4 . Over time, this concept has gained increasing relevance in society due to increased longevity. According to data collected by the Spanish National Institute of Statistics (INE), as of January 1, 2024, the population over 65 years of age in Spain reached almost 10 million people. This situation is mainly due to the increase in life expectancy in the last decade and the fact that the annual mortality rate has remained stable (except for 2020) 5 . However, this population aging entails an increase in the prevalence of chronic diseases (heart failure, diabetes, high blood pressure, etc.), which leads to physical and mental decline that increases functional dependence and the need for long-term care 6 – 8 . Informal care has traditionally been provided by the family 9 . However, increased longevity and women's entry into the workforce have led to a growing number of primary caregivers over 65 years of age (spouses or older children) 8 , 10 , 11 . This population subgroup faces a “double vulnerability,” as they must manage the physical and emotional burden of caregiving (stress, anxiety, depression, social isolation) while also coping with their own challenges inherent to aging 9 , 12 , 13 . Recent studies in Spain indicate that a significant percentage of these caregivers experience considerable health problems, sometimes neglecting their medication due to lack of time, thus exacerbating their own health conditions 14 . Hence the importance of determining the level of caregiver burden and its repercussions on their quality of life, through various questionnaires such as the Zarit Burden Interview 15 , which assesses caregiver burden, or the COOP/Wanca questionnaire 16 , which evaluates quality of life. One way to assess these two aspects is by evaluating the social support perceived by the caregiver, as this helps to determine the perceived needs aimed at resolving and/or reducing the level of burden and stress, and therefore, improving quality of life 17 . According to authors such as Bustillo L et al 18 and Lourenco T et al 19 , informal caregivers present significantly higher levels of anxiety and depression than non-caregivers, especially when the caregiver is elderly. The increase in life expectancy has generated an emerging demographic phenomenon: the “aging of the caregiver.” Unlike middle-aged caregivers, caregivers over 65 face a double vulnerability, as they must manage the burden inherent in caring for a dependent person while coping with their own physiological decline and the need to maintain active aging. While previous reviews exist on interventions for caregivers in general 20 , 21 , the literature lacks a specific synthesis that isolates and analyzes strategies aimed exclusively at older caregivers, a sub-group that requires a differentiated approach focused not only on reducing overload but also on promoting their health assets. Due to the diversity of existing interventions and the dispersion of evidence in this age group, there is a need to conduct a comprehensive review that maps and synthesizes the available literature. In this context, this study aims to answer the question: What are the non-pharmacological interventions designed to promote active aging in people over 65 who act as caregivers? With this purpose in mind, the objectives of this work are: (1) to identify and categorize the main intervention blocks described in the recent literature (lifestyle, psychoeducation and emotional support) and (2) to classify the strategies found according to the standardized taxonomy of the Nursing Interventions Classification (NIC), in order to facilitate their application in clinical practice. 2. Methods 2.1 Design A scoping review was conducted following the methodological framework of Arksey and O’Malley 22 and the guidelines of the Joanna Briggs Institute (JBI). The PRISMA framework for scoping reviews (PRISMA-ScR) was applied 23 . Given the exploratory nature of the study and the evolution of the research question during the process, a prospective protocol was not registered in public databases such as PROSPERO or OSF. However, a pre-established work plan was followed to ensure transparency and reproducibility. 2.2 Search strategy The literature search was conducted between December 2024 and February 2025 in three electronic databases: Medline (via PubMed), the Cumulative Index to Nursing & Allied Health Literature (CINAHL), and Web of Science (WOS). The search strategy was structured following the PICO acronym: Population (population over 65 years of age who act as caregivers); Intervention (non-pharmacological interventions and the caregiver's role); Comparison (not established); and Outcome (active or healthy aging). The research question was: What are the non-pharmacological interventions aimed at promoting active aging in people over 65 years of age who act as caregivers? Health Sciences (DeCS) and Medical Subject Headings (MeSH) descriptors were used, combined with Boolean operators (AND, OR), resulting in the search strategies summarized in Table 1 . Table 1 Strategies, databases and number of references found Date Base Search strategy Identified references Included articles 10/02/2025 Pubmed “cuidador* informal” 4 1 10/02/2025 Pubmed “Envejecimiento activo” OR “envejecimiento saludable” 181 14 10/02/2025 Pubmed "cuidador* informal" OR "Sobrecarga del cuidador*" 5 0 10/02/2025 Pubmed ("envejecimiento activo" OR “envejecimiento saludable”) AND "cuidador* informal" 0 0 10/02/2025 Pubmed ("active aging" OR “healthy aging”) AND "caregiver" 42 8 13/02/2025 WoS “cuidador* informal” 54 7 13/02/2025 WoS “Envejecimiento activo” OR “envejecimiento saludable”” 161 9 13/02/2025 WoS "cuidador* informal" OR "Sobrecarga del cuidador*" 105 5 13/02/2025 WoS ("envejecimiento activo" OR “envejecimiento saludable”) AND "cuidador* informal" 0 0 13/02/2025 WoS ("active aging" OR “healthy aging”) AND "caregiver" 35 3 14/02/2025 CINAHL “cuidador* informal” 11 0 14/02/2025 CINAHL “Envejecimiento activo” OR “envejecimiento saludable” 32 1 14/02/2025 CINAHL "cuidador* informal" OR "Sobrecarga del cuidador*" 25 0 14/02/2025 CINAHL ("envejecimiento activo" OR “envejecimiento saludable”) AND "cuidador* informal" 0 0 14/02/2025 CINAHL ("active aging" OR “healthy aging”) AND "caregiver" 19 1 674 49 2.3 Eligibility criteria In order to ensure a thorough review of the evidence, inclusion criteria were established based on study design, incorporating secondary syntheses and meta-analyses, systematic reviews, literature reviews, and narrative studies, as well as primary analytical and experimental studies, including randomized controlled trials (RCTs), cohort studies, case-control studies, quasi-experimental and quantitative pre-experimental designs, and quantitative cross-sectional and analytical studies. Opinion pieces or editorials without empirical data, studies in which the sample of caregivers over 65 years of age was not disaggregated, and publications outside the 2014–2025 period or written in languages ​​other than Spanish or English were excluded. 2.4 Data extraction The repositories of the Canary Islands Health Service's virtual library and the University of La Laguna's Q point repository were used to retrieve the full texts. This was supplemented by a manual search in the Spanish Institute for the Elderly and Social Services (IMSERSO), INE, and the World Health Organization (WHO). 2.5 Selection of sources and control of biases A cross-checking protocol was established to control for information bias: primary individual studies already included and analyzed within the selected systematic reviews were identified and removed. This ensured that the cumulative evidence was not biased by the duplication of data from the same sample. The extraction of relevant data was performed by pairs using a standardized form. Any discrepancies or mismatches in the extracted information were submitted to the evaluation and consensus of a third reviewer. Variables including authorship, method, summary of results, and methodological quality were extracted from each article. The Critical Appraisal Skills Programme (CASP) tool 24 was used as a quality filter (> 5 points), and the evidence was classified according to the Scottish Intercollegiate Guidelines Network (SING) criteria 25 . 2.6 Synthesis and classification of interventions In order to organize and structure the results analysis, the data were collected and categorized into three main blocks: Lifestyle modifications: this includes healthy habits (physical activity, diet, etc.) and prevention of caregiver burnout (emotional and physical exhaustion). Psychoeducational interventions: this is focused on empowering caregivers and the appropriate management of medication and complex care. Emotional support interventions: this encompasses strategies for accompaniment, counseling, and strengthening social support networks. Subsequently, to ensure standardized and reproducible clinical language, interventions aimed at promoting active aging were identified and classified according to the NIC (Nursing Interventions Classification) taxonomy 26 . The coded diagnostic labels were: Physiological/Basic: 1100 Nutrition management; 0200 Exercise promotion; 1806 Self-care assistance: Transfer. Safety: 6490 Fall prevention; 2380 Medication management; 6486 Environmental management: Safety. Behavioral and Family: 5510 Health education; 7300 Advance care planning; 7040 Primary caregiver support; 5370 Role enhancement. Communication/Psychological: 4920 Active listening; 6576 Physical accompaniment. The results were structured by evaluating compliance and the characteristics of these interventions identified in the literature. 3. RESULTS 3.1 Description of the selected studies The search and selection process is shown in the flowchart (Figure 1). The initial search of databases and other sources identified a total of 679 records. After removing duplicates and screening by title and abstract, 82 full-text articles were evaluated. Of these, 33 were excluded for not presenting disaggregated empirical data on the role of the caregiver in the population over 65 years of age or for not meeting the established quality criteria. Finally, 49 studies were included in the review. The mapped evidence presented methodological heterogeneity, which justified the scoping review approach. The final sample addresses a combination of secondary and primary evidence, shown in Tables 2 and 3 respectively: Secondary evidence (Table 2): Systematic reviews, meta-analyses, and literature/narrative reviews were included. Primary evidence (Table 3): Randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies were included. 3.2 Summary of results Content analysis identified three main intervention domains to improve active aging in the study population: 3.3.1 Domain: Lifestyle Modification This area grouped interventions aimed at reducing physical deterioration and managing the burden inherent in care: Determinants of burden and barriers to self-care: Cross-sectional and cohort studies indicated that burden was not homogeneous, being greater among spouses and caregivers with fair self-perceived health, and tending to increase proportionally to the hours dedicated to caregiving. Specifically, caring for people with neuropsychiatric syndromes such as dementia or Alzheimer's was associated with the greatest burden, with up to a third of caregivers reporting severe restrictions on their social life and self-care due to the time demands 7,8 . Physical activity (NIC: 0200 Exercise Promotion): The literature indicates that progressive muscle loss reduces the ability to perform caregiving tasks such as transfers or hygiene 27 . Systematic reviews and primary studies agree that regular exercise, adapted to age and comorbidities, reduces oxidative damage and chronic inflammation 28–31 . Relevant gender differences were identified: in men, agility and speed exercises (walking) benefit bone health, while in women, balance exercises stood out 32,33 . Activities such as yoga or Pilates were reported as good alternatives for older caregivers, due to their low impact and adaptability 34,35 . Likewise, strength training, aerobic exercise, and resistance training positively influence the reduction of fall rates, frailty, and cognitive decline, as well as the improvement of balance, cardiorespiratory capacity, and sleep quality 12,36–39 . Cohort studies confirmed that physical inactivity was correlated with a worse quality of life in this population group 40 . Nutritional Management (NIC: 1100 Nutrition Management): Adherence to the Mediterranean diet (rich in protein, healthy fats, and antioxidants) was identified as a protective factor for muscle mass and cardiovascular health 41–43 . However, a critical barrier was found: the lack of time resulting from the burden of caregiving leads caregivers to neglect their own nutrition, resorting to diets high in saturated fats 38 . The evidence suggests the need for professional interventions to educate caregivers on healthy cooking techniques and ensure the intake of micronutrients (Vitamins A, C, D, and E) 38,44 . 3.3.2 Domain: Psychoeducational Interventions and Safety These interventions aim to empower the caregiver to manage the complexity of care and ensure their own safety and that of the patient. Risk and fall prevention (NIC 6490/6486): Training in body mechanics for patient mobilization (NIC 1806) is essential for elderly caregivers, as many of them presented physical frailty 6 . Likewise, adapting the environment (handrails, removal of rugs) was identified as a key strategy for preventing falls in the caregiver-patient binomial. Medication management (NIC 2380): A high risk of medication errors was reported due to age-related cognitive or visual limitations of the caregiver 27 . Effective interventions included simplifying guidelines, using organizers (pill organizers), and reminders via Information Technologies, although the use of the latter may present adaptation barriers in this population 45–47 . Health Education (NIC 5510): Training programs improved caregiver self-efficacy and competence, reducing uncertainty and stress associated with a lack of knowledge about the progression of the disease 44,48 . Furthermore, caregivers over 65 years of age showed greater vulnerability due to aging, the continuous demands of the role, and the sole responsibility for care, a situation exacerbated by the limited availability of resources 10,44,49,50 . 3.3.3 Domain: Emotional support, environment and support networks: This block grouped the interventions with the greatest effect on mental health and resource management, highlighting the need for personalized approaches according to the geographical and social context. Psychosocial support and mental health (NIC 7040/4920): Social isolation and loneliness were identified as predictors of burden, anxiety, and depression, especially in elderly caregivers 11,51,52 . Emotional support interventions, such as mutual support groups, cognitive-behavioral therapies, and mindfulness techniques, have been shown to be effective in reducing stress and improving emotional well-being 9,18,53 . Inequalities and environment (NIC 5370): Relevant structural barriers were observed; caregivers in rural areas faced greater economic difficulties and limited access to services than those in urban areas 10,21,54 . The literature emphasized the need for interventions that strengthen family and community support networks, promoting shared responsibility in caregiving and access to respite resources (day centers, home care) to prevent burnout 20,55 . Salutogenic approach and good practices: Systematic and bibliographic reviews emphasize that interventions should not be purely technical. Adopting a salutogenic and intersectoral approach in public policies was recommended 13,56,57 . “Good practices” in home care were defined not only by procedural competence, but also by the integration of human values, quality relationships, and effective coordination between the family and health services—key factors in sustaining the caregiver's role without compromising their own aging 58,59 . Table 2: Study selection, quality, level of evidence, and grade of recommendation (SIGN). Results of articles from reviews (systematic, narrative, and meta-analyses). Title Authors, year Method Results CASP 1 SIGN 2 STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs Seppala LJ, Petrovic M, Ryg J, Bahat G, 2021 Meta-analysis The panelists agreed on 14 drug classes to include in STOPPFall, primarily psychotropic medications. Eighteen differences were noted between drug subclasses with respect to properties that increase the risk of falls. 8/10 1+/A The care in the prevention of falls in elderly people: Meta-summary of qualitative articles Abad-Corpa E, Lidón-Cerezuela B, Meseguer Liza C, 2021 Meta-analysis Four topics: precipitating factors, preventive models, feelings and decision-making process related to fall prevention. 8/10 1+/A The influence of informal caregivers on the rehabilitation of the elderly in the postoperative period of proximal femoral fracture Rocha SA, Avila MA, Bocchi SC. 2016 Systematic review Falls resulting in fractures lead to dependency and, consequently, an increased burden on caregivers. Furthermore, both older adults and their caregivers demonstrated a need for support during the rehabilitation process. 7/10 1+/A Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials. Pazan F, Petrovic M, Cherubini A, 2021 Systematic review Ten pharmacological interventions improved physical performance, muscle strength, or body composition using alfacalcidol, teriparatide, piroxicam, testosterone, recombinant human chorionic gonadotropin, or capromorelin. 6/10 2++/A Impact of Foods and Dietary Supplements Containing Hydroxycinnamic Acids on Cardiometabolic Biomarkers: A Systematic Review to Explore Inter-Individual Variability. Martini D, Chiavaroli L, González-Sarrías A, 2019 Systematic review Plant-based diets rich in bioactive compounds such as polyphenols positively modulate the risk of cardiometabolic diseases (CM). 8/10 1+/A Residual Effects of Physical Exercise After Periods of Training Cessation in Older Adults: A Systematic Review With Meta-Analysis and Meta-Regression Buendía-Romero Á, Vetrovsky T, Hernández-Belmonte A, 2025 Systematic review Evidence suggests that exercise-based interventions, regardless of modality and intensity, are highly effective in preventing functional decline. 8/10 1+/A Post-informal caregiver's perspectives and experiences of the support network: a systematic literature review and meta-synthesis Afonso CIC, Madeira ACS, Magalhães, SPLVT. 2024 Systematic review The experiences of informal post-caregivers reveal the need for support in personal development, managing the impact of the care legacy, and formal and informal resources for the future. 8/10 1+/A Informal caregivers for dependent elderly people: A revision of psychological interventions over the last ten Bustillo ML, Gómez-Gutiérrez M, Guillén AI, 2018 Systematic review The most common interventions: cognitive-behavioral, psychoeducational, coping strategies, interventions that use the problem-solving intervention model, and interventions based on mindfulness programs. 7/10 1+/A Nursing interventions to reduce the overload on informal caregivers. Systematic review of clinical trials Tinoco-Camarena JM, Hidalgo-Blanco MA, Daifuku-Sansano N, 2022 Systematic review Effectiveness in reducing symptoms such as stress, anxiety, depression, or unmet needs. The most effective interventions for reducing caregiver burden are home visits and psychoeducational interventions. 7/10 1+/A Towards a healthy aging: a systematic review about music and physical exercise as modulating factors Diaz Abrahan V, Maximiliano, JN. 2019 Systematic review The population over 65 is growing rapidly; it is estimated that by 2050 there will be 114 million people with dementia. The combination of music and physical activity has a positive effect on healthy aging. 7/10 1+/A The Male Face of Caregiving: A Scoping Review of Men Caring for a Person With Dementia Robinson, CA, Bottorff, JL; Pesut, B, 2014 Systematic review Linking research on male caregivers with gender relations and men's health offers strategies to improve their health and well-being. 7/10 1+/A Assumptions of good practices in home care for the elderly: a systematic review Rodrigues RAP, Bueno AA, Casemiro FG, 2019 Systematic review Good practices in home care for the elderly depend not only on technical procedures, but also on values, human relationships, and cultural contexts. 7/10 1+/A Physical activity and exercise: Strategies to manage frailty Angulo J, El Assar M, Álvarez-Bustos A, 2020 Literature review Physical exercise can counteract physical decline in the elderly, as it improves mitochondrial function, chronic inflammation, and insulin sensitivity. 8/10 1+/B Effect of Physical Activity/Exercise on Oxidative Stress and Inflammation in Muscle and Vascular Aging El Assar M, Álvarez-Bustos A, Sosa P, 2022 Literature review The functional state for healthy aging is improved with physical activity, which reduces oxidative stress and promotes mitochondrial biogenesis. 8/10 1+/B Obesity and Bone Health: A Complex Relationship Piñar-Gutierrez A, García-Fontana C, García-Fontana B, 2022 Literature review In obese elderly patients, fat redistribution and sarcopenia increase the risk of falls and fractures, as do chronic inflammation, altered adipokines, vitamin D deficiency, insulin resistance, and reduced mobility. 7/10 2++/C Frailty as a phenotypic manifestation of underlying oxidative stress El Assar M, Angulo J, Rodríguez-Mañas L., 2020 Literature review Inadequate lifestyle habits, along with genetic vulnerability and chronic diseases, promote oxidative damage and reduce resilience. 8/10 1+/B Health promotion and disease prevention for active aging that preserves quality of life Aliaga-Díaz E, Cuba-Fuentes S, Mar-Meza M. 2016 Literature review Older adults face health problems related to physical, cognitive, social, and family factors. Prevention should address disease risks, functional impairments, and common conditions (frailty, falls, etc.). 7/10 2+/C Elder abuse: research, practice, and health policy. The 2012 GSA Maxwell Pollack award lecture Dong X. 2014 Literature review One in ten older adults suffer some form of abuse, and only a fraction of these cases are reported. It is associated with significant morbidity and premature mortality. 7/10 2+/C Healthy aging and salutogenic approach Faúndez-Pino LF. 2023 Literature review Establish comprehensive strategies in socio-health public policies to address aging in an intersectoral manner, focusing on health needs. 6/10 2+/C Caracterización de los determinantes sociales de la salud del envejecimiento activo en estudios enfocados a la calidad de vida: mapeo sistemático. Campos-Tapia, AP; Meda-Lara, RM ; Corona-Figueroa, BA, 2022 Literature review The growing older adult population is accompanied by unfavorable socioeconomic and health conditions. This situation can be addressed through the framework of active aging. The WHO identifies six social determinants of health as contributing factors to active aging. 8/10 1+/B Nutrients associated with diseases related to aging: a new healthy aging diet index for elderly population Lozano M, Manyes L, Peiró J, Ramada JM 2018 Literature review There are associations between various diseases and nutrients, such as cardiovascular disease, cancer, diabetes, osteopenia, sarcopenia, and cognitive impairment. 6/10 2+/C Polypharmacy in older adults and impact on their quality of life. Literature review Sánchez-Rodríguez JR, Escare-Oviedo CA, Castro-Olivares VE, 2019 Literature review Polypharmacy is more common in women, people with low levels of education, and those with unfavorable socioeconomic factors. A percentage of these individuals experience negative effects related to medication use, both in terms of the number of medications and the number of doctors consulted. 7/10 1+/B Self-Care of the Informal Caregiver of the Elderly in Some Latin American Countries: Descriptive Review Guato-Torres P, Mendoza-Parra S. 2022 Literature review Four key areas: concepts of care, caregiver, and types of caregivers; the health of informal caregivers; self-care theory; and the implementation of programs to support caregivers. Self-care among caregivers is diminished, which negatively impacts their health. 6/10 2+/C Daily life of informal caregivers: perspectives from occupational therapy Seguel Albornoz, F. M., Rosas Tripailaf, J. A., Caucaman Provost, M. F., 2023 Narrative review This has repercussions in the area of self-care, manifested as overload, multiple roles, and mood and sleep disorders. Leisure time is reduced due to work and the health situation, making it impossible to maintain a balance in their routines. 5/10 2+/C Digital Inclusion as a contributory alternative to active aging Arroyave Zambrano PM, Ocampo Arias J, Sánchez Velásquez SP,2020 Narrative review Aging, despite being a biological process, should not be seen as a situation of incapacity or loss of condition, but as an environment with new demands, relationships and interests, where ICTs can contribute to the quality of life. 6/10 2+/C Resilience as a protective factor in the successful aging process Fernández-Infante A, Gómez-Mendoza OC., León DA, Blanco-Pérez Á 2023 Narrative review Resilience is a protective factor that facilitates successful and healthy aging. It highlights interventions that develop coping skills, social support, and emotional well-being. 6/10 2+/C Older Adult: Aging, Disability, Care, and Day Centers. A Review Pinilla Cárdenas MA, Ortiz Álvarez MA, Suárez-Escudero JC 2021 Narrative review Day centers offer an alternative to institutionalization, promoting activities, recreation and support for caregivers. 6/10 2+/C 1 Critical Assessment Skills Program (CASP) checklist. 2 Scottish Intercollegiate Guidelines Network (SIGN). Table 3: Selection of studies, quality, level of evidence, and grade of recommendation SIGN. Results of primary studies (experimental and observational). Title Authors, year Method Results CASP 1 SIGN 2 Power-oriented resistance training combined with high-intensity interval training in pre-frail and frail older people: comparison between traditional and cluster training set configurations on the force-velocity relationship, physical function and frailty. Baltasar-Fernandez I, Alcazar J, Martín-Braojos S, 2024 Randomized controlled trial Both training methods were equally effective in improving Pmax, physical function, and reducing frailty in pre-frail and frail older adults. 9/11 1+/B Effects of a Mindfulness-Based Intervention versus Health Self-Management on Subclinical Anxiety in Older Adults with Subjective Cognitive Decline: The SCD-Well Randomized Superiority Trial Marchant NL, Barnhofer T, Coueron R, 2021 Randomized controlled trial Mindfulness-based intervention is an effective strategy for improving emotional state and reducing mild anxiety in this population, although some effects may require further research to confirm their durability and scope. 7/11 1+/B Comprehensive Older Adult and Caregiver Help (COACH): A person-centered caregiver intervention prevents elder mistreatment Gassoumis ZD, Martinez JM, Yonashiro-Cho J, 2024 Randomized controlled trial The COACH program is effective in preventing abuse of the elderly by empowering and supporting informal caregivers. 8/11 1+/C Effects of a home-based exercise program on mental health for caregivers of relatives with dementia: a randomized controlled trial Madruga M, Gozalo M, Prieto J, 2021 Randomized controlled trial The intervention showed a positive impact on the subjective burden of caregivers and the risk of depression, with functional independence and area of residence being key predictors. 7/11 1+/C Adherence to the Mediterranean diet assessed by a novel dietary biomarker score and mortality in older adults: the InCHIANTI cohort study Hidalgo-Liberona N, Meroño T, Zamora-Ros R, 2021 Cohort The Mediterranean diet was associated with lower mortality and cardiovascular disease, but not with cancer mortality. 8/12 2+/C Associations between Physical Fitness, Bone Mass, and Structure in Older People. Moradell A, Gómez-Cabello A, Gómez-Bruton A, 2020 Cohort 35 men and 94 women aged 65 years or older (76.2 ± 5.4 years) Agility and walking speed have a greater influence on bone mass and structure in men, while balance was associated with bone mineral density in women. 8/12 2+/C Taiwanese middle-aged and older caregivers' need for life safety instruction and its association with attitudes toward aging and proactive coping. Sun, J.-H.A 2020 Cohort Middle-aged and older caregivers showed a low psychological assessment of aging, with a strong need to learn about safety. 7/12 2+/C Prevalence and impact of neuropsychiatric symptoms in normal aging and neurodegenerative syndromes: A population-based study from Latin America Rodriguez Salgado AM, Acosta I, Kim DJ, Zitser J, 2023 Cohort Neuropsychiatric disorders (NPDs) were the biggest contributors to caregiver burden. Approximately 34.3%, 56.1%, and 61.2% of participants had parkinsonism, dementia, or three or more NPDs, respectively. 7/12 2+/C Aging, Gender and Quality of Life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults Campos AC, Ferreira e Ferreira E, Vargas AM, Albala C. 2014 Cohort Older adults with higher levels of education, good health, and no depression or family dysfunction showed a better quality of life, with retirement being a positive factor for men, while lack of physical activity negatively affected quality of life. 9/12 2+/C Healthy aging profile in octogenarians in Brazil Campos AC, Ferreira EF, Vargas AM, 2016 Cohort Women (62.1%), aged 80-84 (50.4%), widowed (53.4%), illiterate (59.1%), with lower monthly income (59.1%), retired (85.7%), living with their partner (63.8%), without a caregiver (60.3%), with two or more children (82.7%), and two or more grandchildren (78.8%). Active aging is associated with age, marital status, and having a caregiver. 9/12 2+/C Effect of Familial Longevity on Frailty and Sarcopenia: A Case-Control Study Belenguer-Varea A, Avellana-Zaragoza JA, Inglés M. 2023 Case-control The cases had a higher percentage of robust patients (31.8% vs. 15.9%), lower percentages of frailty (9.1% vs. 21.6%) and pre-frailty (59.1% vs. 62.5%) (p = 0.001), and lower IL-6 levels (p = 0.044) than the controls. Family longevity was also associated with less obesity, insomnia, pain, and polypharmacy, and with a higher level of education and higher levels of total cholesterol and low-density lipoprotein cholesterol. 8/11 2+/C Effectiveness of a health education program for people with dementia and their family caregivers: An intervention by nurse practitioners Huang HL, Shyu YL, Hsu WC 2024 Case-control Educator training improved health education and access to services. 9/11 2+/C Oxidative stress among informal caregivers Ramos, N; Vasconcelos, I; Marco, P; 2019 Case-control Caregivers were predominantly female. 9.4% reported being very dissatisfied and 53.1% dissatisfied with their health. 43.8% rated their quality of life as poor and 12.5% as very poor. 7/11 2+/C Evaluation of the effectiveness of an intervention program in family caregivers of dependent persons, in the primary health care system Ortiz-Mallasén, V; Claramonte-Gual, E ; Cervera-Gasch, A , 2021 Quasi-experimental study 73.3% presented with low back pain, with an average level of 5.13 +/- 2.56, and moderate disability (41.7%). 50% received little social support and experienced a significant impact on their health-related quality of life, especially in terms of pain and anxiety. 8/11 2+/C Changes in anthropometric parameters and physical fitness in older adults after participating in a 16-week physical activity program Valdés-Badilla P, Guzmán-Muñoz E, Ramírez-Campillo R, 2020 Quantitative pre-experimental study Significant reductions in PC and improvements in the following tests: sitting up from a chair (p<0.001), elbow flexions (p<0.001), two minutes of walking (p<0.001), trunk flexion in chair (p=0.018) and clasping hands behind the back (p=0.014). 9/11 2+/C La actividad física organizada en las personas mayores, una herramienta para mejorar la condición física en la senectud Gómez-Cabello A, Vila-Maldonado S, Pedrero-Chamizo R, 2018 Quantitative, cross-sectional and analytical study Lack of participation in organized physical activity increased the risk of low levels of physical fitness, with differences between sexes; women who performed more than two hours per week showed better performance in several physical areas. 9/12 2+/C Financial and Health Barriers and Caregiving-Related Difficulties Among Rural and Urban Caregivers Bouldin ED, Shaull L, Andresen EM 2018 Quantitative, cross-sectional and analytical study Rural caregivers faced more financial barriers than urban caregivers (38.1% vs. 31.0%, P = .0001), but the prevalence of health barriers was similar (43.3% vs. 40.6%, P = .18). Rural caregivers were less likely to report their problems. 7/12 2+/C Clinical validation of the NANDA-I "caregiver role strain" nursing diagnosis in the context of palliative care Lourenço TMG, Abreu-Figueiredo RMS, Sá LO. 2021 Cross-sectional, quantitative, descriptive and analytical study. Ineffective coping, depressive mood, frustration, and fatigue showed a greater association with caregiver burden, with an overall score of 0.68. 7/12 2+/C The Social Cost of Providing Care to Older Adults With and Without Dementia Patterson SE, Tate AM, Hu YL, 2023 Quantitative, cross-sectional and analytical study 1/3 of caregivers of elderly people with dementia reported restrictions due to caregiving, (33.3% vs 16.0%; p < 0.001). 8/12 2+/C Physical, emotional and social burden of elderly patients' informal caregivers Mendes PN, Figueiredo ML, Santos AM 2019 Quantitative, cross-sectional and analytical study Caregiver burden was related to marital status, degree of kinship, age of the caregiver, hours spent on care, and the presence of comorbidities and pain, being higher in spouses and caregivers with regular health. 9/12 2+/C Duelo anticipado y afrontamiento al estrés en cuidadores informales de personas de la tercera edad Aponte-Daza, V. C., Ponce, F., Pinto, B 2022 Quantitative, cross-sectional and analytical study Anticipatory grief is influenced by different coping styles, the type of care, and the age of the caregiver, with supportive coping and emotional avoidance being associated with greater emotional pain and loss. 9/12 2+/C General state of health and psychosocial profile of healthy or exceptional elderly of Santander, Colombia Quintero-Mantilla, MS, & Cerquera-Córdoba, AM. Quantitative, cross-sectional and analytical study The high biopsychosocial profile of older adults with high longevity suggests the possibility of aging successfully, maintaining health and quality of life. 7/12 2+/C Burden and types of support for family caregivers serving patients with chronic disease Campos MS, Durán EY, Rivera R, Páez N, 2019 Quantitative, cross-sectional and analytical study 19.35% of caregivers experienced severe burden, with daily care hours and knowledge being determining factors. Severe burden is associated with 0% psychological and social support. 7/11 2+/C 1 Critical Assessment Skills Program (CASP) checklist. 2 Scottish Intercollegiate Guidelines Network (SIGN). As a summary of the results, Table 4 associates the risk factors detected in the literature with the nursing interventions (NIC) 26 and the level of available evidence, according to the SIGN criteria 25 . Twelve priority interventions were identified. Table 4. Recommended interventions related to the Nursing Interventions Classification Risk factors Recommended intervention SING 1 NIC 2 Nutritional deficiency - Determine the patient's nutritional status and their ability to meet their nutritional needs. - Educate the patient about their nutritional needs (discuss dietary guidelines and food pyramids). - Provide an optimal environment for eating (e.g., clean, well-ventilated, relaxed, and free of strong odors). 2++/B 1100 Nutrition management Physical activity deficit Decreased tolerance to activity - Provide guidance on the type of exercise appropriate for their health level, in collaboration with their healthcare professional and/or physiotherapist. - Muscle strengthening exercises (psoas, quadriceps). - Scheduled walking exercises (indoors and outdoors) if possible (15 minutes twice a day). - Yoga or Pilates exercises. 2+/B 0200 Exercise promotion -Perform strengthening exercises such as knee bends, light weightlifting, or abdominal exercises 2-3 times per week. 2+/C Risk of injury -Posture recommendations: Get up slowly in two stages (first sit down, then stand up), raise the head from the bed for a while before standing, and always use a rolling position. - Identify environmental features that increase the risk of falls (slippery floors, rugs, stairs without handrails). 2+/B 6490 Fall prevention Polypharmacy -Avoid using questionable or unproven medications. - Try to reduce doses, if possible; educate patients on the correct use of sedatives and hypnotics (avoid alcohol, interactions with other drugs, and ensure proper adherence). - Regularly consult with the patient and/or their family about the types and dosages of medications they are taking. 2++/B 2380 Medication management -Use ICT for medication management and other areas of care 2-/D Hazardous environment Dependent on daily activities Difficulties with transfers (bed-chair, chair-toilet) - Determine safety needs based on physical, emotional, and cognitive function. - Use protective devices (physical restraints, railings, closed doors, fences, and gates) to physically limit mobility or access to hazardous situations. - Delegate responsibilities when possible and ensure they have time for themselves. - Train both the patient and their family and/or caregivers on proper techniques for transferring from one area to another (from bed to chair, from wheelchair to vehicle). 2++/B 5510 Health education 6486 Environmental management: safety 1806 Self-care assistance: transfer Stress, anxiety -Assess the patient's needs, desires, and values in relation to their medical care. - Inform them about the different resources available for assistance and financial aid. - Provide psychological support throughout the process. 2+/B 7300 Advance care planning 4920 Active listening Loneliness - Assess the caregiver's acceptance of the role. - Determine their level of knowledge, skills, and limitations. - Provide information about the care recipient's condition, treatment, and care according to their preferences. - Teach stress management techniques and strategies for maintaining health care. 2+/C 7040 Support for the primary caregiver 6576 Physical accompaniment 5370 Role enhancement. 1 Scottish Intercollegiate Guidelines Network (SIGN). 2 Nursing Interventions Classification (NIC). Discussion In response to the research question, 12 scientifically validated non-pharmacological interventions were identified, aimed at promoting active aging in the population over 65 years of age who act as caregivers. The results here indicate that, beyond institutional support, lifestyle modification (especially multi-skilled exercise and nutrition) is the most strongly supported strategy (sign level 1 + and 2 + + evidence) for maintaining the functional capacity of older caregivers. However, the literature reveals a paradox: although the theoretical efficacy of these interventions is known, their practical implementation is low due to the inherent time constraints of the caregiver role. Interventions that combine physical training with health education (NIC 5510) and environmental management (NIC 6486) appear to offer the best cost-effectiveness for preventing frailty in this binomial. The “double vulnerability” of the elderly caregiver The “double vulnerability” is a recurring finding in the included studies. Caregivers over 65 years of age not only face the external burden stemming from the dependency of the person being cared for (especially in cases of dementia, where the demand exceeds 100 hours per month), but also struggle against their own biological senescence 8 . The reviewed literature strongly associates the caregiver role in old age with an accelerated risk of sarcopenia and osteoarticular deterioration, exacerbated by neglect of self-care 13, 51. This validates the relevance of the NIC interventions identified in the safety domain, such as fall prevention (NIC 6490) and assistance with self-care: transfers (NIC 1806). Unlike a younger caregiver, when an older caregiver performs an incorrect transfer, the risk of disabling injury is bidirectional, as it can affect both the person being cared for and the caregiver, potentially precipitating the institutionalization of both 4 , 44 , 53 . Active aging has been addressed theoretically for decades, but the findings suggest that practice falls far short of the ideal. As Campos-Tapia et al. 2 point out, society tends to influence the role of older adults, normalizing their sacrifice, which leads to extreme situations of neglect. The evidence is alarming: it is estimated that one in ten older adults suffer or have suffered some form of abuse, and only a small percentage of cases are reported, resulting in serious consequences of morbidity and premature mortality 60 . Therefore, it is not only a matter of preventing physical accidents, but also of protecting caregivers from an environment of structural neglect. Gender gaps and territorial inequality. Increased longevity, coupled with a scarcity of formal resources, has forced a "re-familiarization" of caregiving under precarious conditions. At present, it is estimated that 27.6% of older adults receive care from individuals of the same age range (13.6% of men and 14% of women over 65) 1 , 6 . This situation directly impacts the determinants of active aging (behavioral, personal, physical, social, economic, and social and health services) 2 , which are negatively affected in the caregiver, increasing the likelihood of pathological aging. Gender analysis reveals that this burden is not equitable. Viana Campos et al. 4 state that this situation is significantly more frequent among women, exacerbated by the fact that many live alone, which limits their support network. Other studies indicate that female caregivers tend to have worse mental and physical health indicators than men 13 , 37 , 61 . In addition, there is the territorial gap; older caregivers living in rural areas face greater financial and accessibility barriers than those living in urban areas 10 , 21 , 54 . This suggests that interventions may fail if they are not adapted to the geographical context. While technological tools and “virtual coaching” are proposed as emerging solutions (grade D), the results suggest caution, since the digital divide among those over 80 years of age and in rural areas can turn these solutions into new barriers to exclusion if they are not accompanied by face-to-face training 45 – 47 . 4.3 Implications for nursing practice Classifying the findings according to the NIC taxonomy facilitates their direct transfer to clinical practice. It has been demonstrated that addressing active aging in caregivers does not require inventing new resources, but rather systematizing existing ones. The evidence supports a paradigm shift towards a salutogenic approach 13 , 56 , 57 , where the nurse not only treats the "burden" (pathogenesis), but also prescribes health assets (protein nutrition, social support networks, sleep hygiene) to preserve the caregiver's functional reserve. Limitations and strengths The study's limitations relate to language restrictions, the established time period, and the heterogeneity of the studies. The included articles were published in English and Spanish. However, this limitation is mitigated by the universality of both languages ​​and the fact that most of the scientific information found is in English or Spanish. It is also acknowledged that the protocol was not prospectively recorded. Nevertheless, the main strength lies in the rigor of the screening and in having made visible, through recent epidemiological data, the hidden reality of abuse and precarious care among peers. Another limitation is that only articles published between 2014 and 2025 were selected, and there may be relevant articles with earlier references. This is offset by the abundance of works published during this period, the inclusion of quality criteria after critical appraisal, and the reference search. On the other hand, the population represented is not entirely homogeneous, varying from one study to another, as does the time period studied, the design of the works, the analytical methods used, the results, and the conclusions drawn from each. This heterogeneity also hinders quantitative synthesis. Despite this, the burden experienced by caregivers remains alarming, reflecting the importance of promoting strategies aimed at fostering active aging among the population over 65 years of age who are currently fulfilling the role of caregiver. Conclusions The increase in longevity and dependency among older adults has negatively impacted the dimensions of the concept of active aging for the population that acts as caregivers. Despite efforts to improve the quality of life of caregivers, a significant gap remains in the design and implementation of specific interventions for this group. Predominant interventions in this field focus on improving emotional well-being and reducing caregiver burden, with cognitive-behavioral approaches such as problem solving and coping strategies, being particularly prominent. However, to be effective, these interventions must be personalized, taking into account social determinants such as gender, digital literacy, and, crucially, whether the environment is rural or urban. Furthermore, given the growing number of older caregivers and the impact this role has on their health and quality of life, it is especially important that future research addresses active aging among caregivers aged 65 and over. Declarations Ethics approval and consent to participate Human Ethics and Consent to Participate declarations: not applicable. This study is a scoping review based exclusively on previously published literature and did not involve human participants or animals. Clinical trial number: not applicable Consent for publication: not applicable Availability of data and materials : All data analyzed in this study are derived from previously published articles and are available in the cited references. Competing interests: the authors declare no conflict of interest. Funding: this research received no external funding. Author Contributions: conceptualization, A.P.-D., N.R-N. and M.N.-M.; methodology, A.P.-D. and N.R-N.; software, A.P.-D. and M.L.-M.; validation, Y.M.R.-N., N.R-N. and M.N.-M.; formal analysis, M.H.-R., N.R-N. and Y.M.R.-N.; investigation, A.P.-D. and M.L.-M.; resources, N.R-N. and M.N.-M.; data curation, N.R-N. and A.P.-D.; writing—original draft preparation, A.P.-D. and N.R-N.; writing—review and editing, M.N.-M. and N.R-N.; visualization, M.H.-R., M.L.-M.; supervision, N.R-N.,Y.M.R.-N. and M.N.-M.; project administration, A.P.-D. and M.N.-M. All authors have read and agreed to the published version of the manuscript. Acknowledgments: the authors wish to thank the translator from the College of Nursing for their contribution. References Organización Mundial de la Salud. Envejecimiento activo: un marco político. Rev Esp Geriatr Gerontol [Internet]. 2002 [citado el 24 de diciembre de 2025];37(S2):74-105. 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Adherence to the Mediterranean diet assessed by a novel dietary biomarker score and mortality in older adults: the InCHIANTI cohort study. BMC Med [Internet]. 2021 [citado el citado el 9 de enero de 2026];19(1):280. Disponible en: https://doi.org/10.1186/s12916-021-02154-7 Lozano M, Manyes L, Peiró J, Ramada JM. Nutrients associated with diseases related to aging: a new healthy aging diet index for elderly population. Nutr Hosp [Internet]. 2018 [citado el 9 de enero de 2026];35(6):1287-97. Disponible en: https://doi.org/10.20960/nh.1946 Martini D, Chiavaroli L, González-Sarrías A, Bresciani L, Palma-Duran SA, Dall’Asta M, et al. Impact of foods and dietary supplements containing hydroxycinnamic acids on cardiometabolic biomarkers: a systematic review to explore inter-individual variability. Nutrients [Internet]. 2019 [citado el 9 de enero de 2026];11(8):1805. Disponible en: https://doi.org/10.3390/nu11081805 Tinoco-Camarena JM, Hidalgo-Blanco MA, Daifuku-Sansano N, Lluch MT, Raigal-Aran L, Puig-Llobet M. Intervenciones enfermeras para disminuir la sobrecarga de cuidadores informales: revisión sistemática de ensayos clínicos. Enferm Glob [Internet]. 2022 [citado el 9 de enero de 2026];21(68):240-52. Disponible en: https://dx.doi.org/10.6018/eglobal.502351 Sánchez-Rodríguez JR, Escare-Oviedo CA, Castro-Olivares VE, Robles-Molina CR, Vergara-Martínez MI, Jara-Castillo CT. Polypharmacy in older adults and impact on their quality of life. Literature review. Rev Salud Publica (Bogota) [Internet]. 2019 [citado el 9 de enero de 2026];21(2):271-7. Disponible en: https://doi.org/10.15446/rsap.V21n2.76678 Seppala LJ, Petrovic M, Ryg J, Bahat G, Topinkova E, Szczerbinska K, et al. STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs. Age Ageing [Internet]. 2021 [citado el 9 de enero de 2026];50(4):1189-99. Disponible en: https://doi.org/10.1093/ageing/afaa249 Arroyave Zambrano PM, Ocampo Arias J, Sánchez Velásquez SP, Vega OA. Inclusión digital como opción aportante al envejecimiento activo. e-Ciencias de la Información [Internet]. 2020 [citado el 9 de enero de 2026];10(2). Disponible en: https://doi.org/10.15517/eci.v10i2.39522 Huang HL, Shyu YIL, Hsu WC, Liao YT, Huang HL, Hsieh SH. Effectiveness of a health education program for people with dementia and their family caregivers: An intervention by nurse practitioners. Arch Psychiatr Nurs [Internet]. 2024 [citado el 10 de enero de 2026];50:147-59. Disponible en: https://doi.org/10.1016/j.apnu.2024.03.018 Sun JH. Taiwanese middle-aged and older caregivers’ need for life safety instruction and its association with attitudes toward aging and proactive coping. Educ Gerontol [Internet]. 2020 [citado el 10 de enero de 2026];46(12):715-30. Disponible en: https://doi.org/10.1080/03601277.2020.1800069 Abad-Corpa E, Lidón-Cerezuela B, Meseguer Liza C, Arredondo-Gónzalez CP, de la Cuesta-Benjumea C. The care in the prevention of falls in elderly people: meta-summary of qualitative articles. Aten Primaria [Internet]. 2021 [citado el 10 de enero de 2026];53(7):102067. Disponible en: https://doi.org/10.1016/j.aprim.2021.102067 Campos de Aldana MS, Durán Niño EY, Rivera Carvajal R, Páez Esteban AN, Carrillo Gonzales GM. Burden and types of support for family caregivers serving patients with chronic disease. Rev Cuid [Internet]. 2019 [citado el 10 de enero de 2026];10(3):e649. Disponible en: https://doi.org/10.15649/cuidarte.v10i3.649 Cerquera Córdoba AM, Pabón Poches DK. Resiliencia y variables asociadas en cuidadores informales de pacientes con Alzheimer. Rev Colomb Psicol [Internet]. 2016 [citado el 10 de enero de 2026];25(1):33-46. Disponible en: https://doi.org/10.15446/rcp.v25n1.44558 Marchant NL, Barnhofer T, Coueron R, Wirth M, Lutz A, Arenaza-Urquijo EM, et al. Effects of a mindfulness-based intervention versus health self-management on subclinical anxiety in older adults with subjective cognitive decline: the SCD-Well randomized superiority trial. Psychother Psychosom [Internet]. 2021 [citado el 10 de enero de 2026];90(5):341-50. Disponible en: https://doi.org/10.1159/000515669 Bouldin ED, Shaull L, Andresen EM, Edwards VJ, McGuire LC. Financial and Health Barriers and Caregiving-Related Difficulties Among Rural and Urban Caregivers. J Rural Health [Internet]. 2018 [citado el 10 de enero de 2026];34(3):263-74. Disponible en: https://doi.org/10.1111/jrh.12273 Afonso CIC, Madeira ACS, Magalhães SPLVT. Post-informal caregiver's perspectives and experiences of the support network: a systematic literature review and meta-synthesis. Rev Esc Enferm USP [Internet]. 2024 [citado el 10 de enero de 2026];58:e20240047. Disponible en: https://doi.org/10.1590/1980-220X-REEUSP-2024-0047en Faúndez-Pino LF. Envejecimiento saludable y enfoque salutogénico. Rev Mex Med Fam [Internet]. 2023 [citado el 10 de enero de 2026];10(1):1-5. Disponible en: https://doi.org/10.24875/rmf.22000090 Rodrigues RAP, Bueno AA, Casemiro FG, da Cunha AN, de Carvalho LPN, Almeida VC, et al. Assumptions of good practices in home care for the elderly: a systematic review. Rev Bras Enferm [Internet]. 2019 [citado el 10 de enero de 2026];72(Suppl 2):302-10. Disponible en: https://doi.org/10.1590/0034-7167-2018-0445 Gassoumis ZD, Martinez JM, Yonashiro-Cho J, Mosqueda L, Hou A, Han SD, et al. Comprehensive Older Adult and Caregiver Help (COACH): A person-centered caregiver intervention prevents elder mistreatment. J Am Geriatr Soc [Internet]. 2024 [citado el 10 de enero de 2026];72(1):246-57. Disponible en: https://doi.org/10.1111/jgs.18597 Vasconcelos NRI, Dátilo GMPA, Chies AB, Chagas EFB, Vasconcelos TJQ, Barbosa PMK. Oxidative stress among informal caregivers. Rev Bras Geriatr Gerontol [Internet]. 2019 [citado el 10 de enero de 2026];22(4):110-9. Disponible en: https://doi.org/10.1590/1981-22562019022.190037 Dong X. Elder abuse: research, practice, and health policy. The 2012 GSA Maxwell Pollack award lecture. Gerontologist [Internet]. 2014 [citado el 10 de enero de 2026];54(2):153-62. Disponible en: https://doi.org/10.1093/geront/gnt139 Robinson CA, Bottorff JL, Pesut B, Oliffe JL, Tomlinson J. The male face of caregiving: a scoping review of men caring for a person with dementia. Am J Mens Health [Internet]. 2014 [citado el 10 de enero de 2026];8(5):409-26. Disponible en: https://doi.org/10.1177/1557988313519671 Additional Declarations No competing interests reported. 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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. \u003cem\u003eBMJ\u003c/em\u003e. [Internet]2021[cited 30th December 2025];372:n71. Available at: https://doi.org/10.1136/bmj.n71\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9074136/v1/a73c776f66f0954779608bd7.png"},{"id":104812929,"identity":"bc5f27a1-348a-4d0d-8d7d-16f11b154dc7","added_by":"auto","created_at":"2026-03-17 13:05:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1279436,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9074136/v1/a4cc2db7-7225-46d3-99e8-4ea3d44a45bd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Non-pharmacological interventions in caregivers over 65 years of age. Scoping review of analytical studies and reviews","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eAccording to the World Health Organization (WHO), active aging is defined as the process of optimizing opportunities for health, participation, and security in order to enhance quality of life as people age\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. This approach not only seeks to reduce the prevalence of disease but also to promote a balance between physical and mental health, functional independence, social participation, and economic autonomy \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. To achieve active and healthy aging, older adults must make an active commitment to their family and community, engaging in cultural, social, and leisure activities\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOver time, this concept has gained increasing relevance in society due to increased longevity. According to data collected by the Spanish National Institute of Statistics (INE), as of January 1, 2024, the population over 65 years of age in Spain reached almost 10\u0026nbsp;million people. This situation is mainly due to the increase in life expectancy in the last decade and the fact that the annual mortality rate has remained stable (except for 2020)\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. However, this population aging entails an increase in the prevalence of chronic diseases (heart failure, diabetes, high blood pressure, etc.), which leads to physical and mental decline that increases functional dependence and the need for long-term care\u003csup\u003e\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eInformal care has traditionally been provided by the family\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. However, increased longevity and women's entry into the workforce have led to a growing number of primary caregivers over 65 years of age (spouses or older children)\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. This population subgroup faces a \u0026ldquo;double vulnerability,\u0026rdquo; as they must manage the physical and emotional burden of caregiving (stress, anxiety, depression, social isolation) while also coping with their own challenges inherent to aging\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Recent studies in Spain indicate that a significant percentage of these caregivers experience considerable health problems, sometimes neglecting their medication due to lack of time, thus exacerbating their own health conditions\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHence the importance of determining the level of caregiver burden and its repercussions on their quality of life, through various questionnaires such as the Zarit Burden Interview\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e, which assesses caregiver burden, or the COOP/Wanca questionnaire\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e, which evaluates quality of life. One way to assess these two aspects is by evaluating the social support perceived by the caregiver, as this helps to determine the perceived needs aimed at resolving and/or reducing the level of burden and stress, and therefore, improving quality of life\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. According to authors such as Bustillo L et al\u003csup\u003e18\u003c/sup\u003e and Lourenco T et al\u003csup\u003e19\u003c/sup\u003e, informal caregivers present significantly higher levels of anxiety and depression than non-caregivers, especially when the caregiver is elderly.\u003c/p\u003e \u003cp\u003e The increase in life expectancy has generated an emerging demographic phenomenon: the \u0026ldquo;aging of the caregiver.\u0026rdquo; Unlike middle-aged caregivers, caregivers over 65 face a double vulnerability, as they must manage the burden inherent in caring for a dependent person while coping with their own physiological decline and the need to maintain active aging. While previous reviews exist on interventions for caregivers in general\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, the literature lacks a specific synthesis that isolates and analyzes strategies aimed exclusively at older caregivers, a sub-group that requires a differentiated approach focused not only on reducing overload but also on promoting their health assets.\u003c/p\u003e \u003cp\u003eDue to the diversity of existing interventions and the dispersion of evidence in this age group, there is a need to conduct a comprehensive review that maps and synthesizes the available literature. In this context, this study aims to answer the question: What are the non-pharmacological interventions designed to promote active aging in people over 65 who act as caregivers?\u003c/p\u003e \u003cp\u003eWith this purpose in mind, the objectives of this work are: (1) to identify and categorize the main intervention blocks described in the recent literature (lifestyle, psychoeducation and emotional support) and (2) to classify the strategies found according to the standardized taxonomy of the Nursing Interventions Classification (NIC), in order to facilitate their application in clinical practice.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Design\u003c/h2\u003e \u003cp\u003eA scoping review was conducted following the methodological framework of Arksey and O\u0026rsquo;Malley\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e and the guidelines of the Joanna Briggs Institute (JBI). The PRISMA framework for scoping reviews (PRISMA-ScR) was applied\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. Given the exploratory nature of the study and the evolution of the research question during the process, a prospective protocol was not registered in public databases such as PROSPERO or OSF. However, a pre-established work plan was followed to ensure transparency and reproducibility.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Search strategy\u003c/h2\u003e \u003cp\u003eThe literature search was conducted between December 2024 and February 2025 in three electronic databases: Medline (via PubMed), the Cumulative Index to Nursing \u0026amp; Allied Health Literature (CINAHL), and Web of Science (WOS). The search strategy was structured following the PICO acronym: Population (population over 65 years of age who act as caregivers); Intervention (non-pharmacological interventions and the caregiver's role); Comparison (not established); and Outcome (active or healthy aging). The research question was: What are the non-pharmacological interventions aimed at promoting active aging in people over 65 years of age who act as caregivers?\u003c/p\u003e \u003cp\u003eHealth Sciences (DeCS) and Medical Subject Headings (MeSH) descriptors were used, combined with Boolean operators (AND, OR), resulting in the search strategies summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStrategies, databases and number of references found\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBase\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSearch strategy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIdentified references\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIncluded articles\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePubmed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ldquo;cuidador* informal\u0026rdquo;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePubmed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ldquo;Envejecimiento activo\u0026rdquo; OR \u0026ldquo;envejecimiento saludable\u0026rdquo;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePubmed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\"cuidador* informal\" OR \"Sobrecarga del cuidador*\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePubmed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\"envejecimiento activo\" OR \u0026ldquo;envejecimiento saludable\u0026rdquo;) AND \"cuidador* informal\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePubmed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\"active aging\" OR \u0026ldquo;healthy aging\u0026rdquo;) AND \"caregiver\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWoS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ldquo;cuidador* informal\u0026rdquo;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWoS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ldquo;Envejecimiento activo\u0026rdquo; OR \u0026ldquo;envejecimiento saludable\u0026rdquo;\u0026rdquo;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWoS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\"cuidador* informal\" OR \"Sobrecarga del cuidador*\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWoS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\"envejecimiento activo\" OR \u0026ldquo;envejecimiento saludable\u0026rdquo;) AND \"cuidador* informal\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWoS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\"active aging\" OR \u0026ldquo;healthy aging\u0026rdquo;) AND \"caregiver\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCINAHL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ldquo;cuidador* informal\u0026rdquo;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCINAHL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ldquo;Envejecimiento activo\u0026rdquo; OR \u0026ldquo;envejecimiento saludable\u0026rdquo;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCINAHL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\"cuidador* informal\" OR \"Sobrecarga del cuidador*\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCINAHL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\"envejecimiento activo\" OR \u0026ldquo;envejecimiento saludable\u0026rdquo;) AND \"cuidador* informal\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14/02/2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCINAHL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\"active aging\" OR \u0026ldquo;healthy aging\u0026rdquo;) AND \"caregiver\"\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e674\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Eligibility criteria\u003c/h2\u003e \u003cp\u003eIn order to ensure a thorough review of the evidence, inclusion criteria were established based on study design, incorporating secondary syntheses and meta-analyses, systematic reviews, literature reviews, and narrative studies, as well as primary analytical and experimental studies, including randomized controlled trials (RCTs), cohort studies, case-control studies, quasi-experimental and quantitative pre-experimental designs, and quantitative cross-sectional and analytical studies. Opinion pieces or editorials without empirical data, studies in which the sample of caregivers over 65 years of age was not disaggregated, and publications outside the 2014\u0026ndash;2025 period or written in languages ​​other than Spanish or English were excluded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Data extraction\u003c/h2\u003e \u003cp\u003eThe repositories of the Canary Islands Health Service's virtual library and the University of La Laguna's Q point repository were used to retrieve the full texts. This was supplemented by a manual search in the Spanish Institute for the Elderly and Social Services (IMSERSO), INE, and the World Health Organization (WHO).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Selection of sources and control of biases\u003c/h2\u003e \u003cp\u003e A cross-checking protocol was established to control for information bias: primary individual studies already included and analyzed within the selected systematic reviews were identified and removed. This ensured that the cumulative evidence was not biased by the duplication of data from the same sample.\u003c/p\u003e \u003cp\u003eThe extraction of relevant data was performed by pairs using a standardized form. Any discrepancies or mismatches in the extracted information were submitted to the evaluation and consensus of a third reviewer. Variables including authorship, method, summary of results, and methodological quality were extracted from each article. The Critical Appraisal Skills Programme (CASP) tool\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e was used as a quality filter (\u0026gt;\u0026thinsp;5 points), and the evidence was classified according to the Scottish Intercollegiate Guidelines Network (SING) criteria\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Synthesis and classification of interventions\u003c/h2\u003e \u003cp\u003eIn order to organize and structure the results analysis, the data were collected and categorized into three main blocks:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eLifestyle modifications: this includes healthy habits (physical activity, diet, etc.) and prevention of caregiver burnout (emotional and physical exhaustion).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePsychoeducational interventions: this is focused on empowering caregivers and the appropriate management of medication and complex care.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eEmotional support interventions: this encompasses strategies for accompaniment, counseling, and strengthening social support networks.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eSubsequently, to ensure standardized and reproducible clinical language, interventions aimed at promoting active aging were identified and classified according to the NIC (Nursing Interventions Classification) taxonomy\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. The coded diagnostic labels were:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePhysiological/Basic: 1100 Nutrition management; 0200 Exercise promotion; 1806 Self-care assistance: Transfer.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSafety: 6490 Fall prevention; 2380 Medication management; 6486 Environmental management: Safety.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eBehavioral and Family: 5510 Health education; 7300 Advance care planning; 7040 Primary caregiver support; 5370 Role enhancement.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eCommunication/Psychological: 4920 Active listening; 6576 Physical accompaniment.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe results were structured by evaluating compliance and the characteristics of these interventions identified in the literature.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. RESULTS","content":"\u003cp\u003e\u003cstrong\u003e3.1 Description of the selected studies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe search and selection process is shown in the flowchart (Figure 1). The initial search of databases and other sources identified a total of 679 records. After removing duplicates and screening by title and abstract, 82 full-text articles were evaluated. Of these, 33 were excluded for not presenting disaggregated empirical data on the role of the caregiver in the population over 65 years of age or for not meeting the established quality criteria. Finally, 49 studies were included in the review.\u003c/p\u003e\n\u003cp\u003eThe mapped evidence presented methodological heterogeneity, which justified the scoping review approach. The final sample addresses a combination of secondary and primary evidence, shown in Tables 2 and 3 respectively:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eSecondary evidence (Table 2): Systematic reviews, meta-analyses, and literature/narrative reviews were included.\u003c/li\u003e\n \u003cli\u003ePrimary evidence (Table 3): Randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies were included.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Summary of results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eContent analysis identified three main intervention domains to improve active aging in the study population:\u003c/p\u003e\n\u003cp\u003e3.3.1 Domain: Lifestyle Modification\u003c/p\u003e\n\u003cp\u003eThis area grouped interventions aimed at reducing physical deterioration and managing the burden inherent in care:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eDeterminants of burden and barriers to self-care: Cross-sectional and cohort studies indicated that burden was not homogeneous, being greater among spouses and caregivers with fair self-perceived health, and tending to increase proportionally to the hours dedicated to caregiving. Specifically, caring for people with neuropsychiatric syndromes such as dementia or Alzheimer\u0026apos;s was associated with the greatest burden, with up to a third of caregivers reporting severe restrictions on their social life and self-care due to the time demands\u003csup\u003e7,8\u003c/sup\u003e.\u003c/li\u003e\n \u003cli\u003ePhysical activity (NIC: 0200 Exercise Promotion): The literature indicates that progressive muscle loss reduces the ability to perform caregiving tasks such as transfers or hygiene\u003csup\u003e27\u003c/sup\u003e. Systematic reviews and primary studies agree that regular exercise, adapted to age and comorbidities, reduces oxidative damage and chronic inflammation\u003csup\u003e28\u0026ndash;31\u003c/sup\u003e. Relevant gender differences were identified: in men, agility and speed exercises (walking) benefit bone health, while in women, balance exercises stood out\u003csup\u003e32,33\u003c/sup\u003e. Activities such as yoga or Pilates were reported as good alternatives for older caregivers, due to their low impact and adaptability\u003csup\u003e34,35\u003c/sup\u003e. Likewise, strength training, aerobic exercise, and resistance training positively influence the reduction of fall rates, frailty, and cognitive decline, as well as the improvement of balance, cardiorespiratory capacity, and sleep quality\u003csup\u003e12,36\u0026ndash;39\u003c/sup\u003e. Cohort studies confirmed that physical inactivity was correlated with a worse quality of life in this population group\u003csup\u003e40\u003c/sup\u003e.\u003c/li\u003e\n \u003cli\u003eNutritional Management (NIC: 1100 Nutrition Management): Adherence to the Mediterranean diet (rich in protein, healthy fats, and antioxidants) was identified as a protective factor for muscle mass and cardiovascular health\u003csup\u003e41\u0026ndash;43\u003c/sup\u003e. However, a critical barrier was found: the lack of time resulting from the burden of caregiving leads caregivers to neglect their own nutrition, resorting to diets high in saturated fats\u003csup\u003e38\u003c/sup\u003e. The evidence suggests the need for professional interventions to educate caregivers on healthy cooking techniques and ensure the intake of micronutrients (Vitamins A, C, D, and E)\u003csup\u003e38,44\u003c/sup\u003e.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e3.3.2 Domain: Psychoeducational Interventions and Safety\u003c/p\u003e\n\u003cp\u003eThese interventions aim to empower the caregiver to manage the complexity of care and ensure their own safety and that of the patient.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eRisk and fall prevention (NIC 6490/6486): Training in body mechanics for patient mobilization (NIC 1806) is essential for elderly caregivers, as many of them presented physical frailty\u003csup\u003e6\u003c/sup\u003e. Likewise, adapting the environment (handrails, removal of rugs) was identified as a key strategy for preventing falls in the caregiver-patient binomial.\u003c/li\u003e\n \u003cli\u003eMedication management (NIC 2380): A high risk of medication errors was reported due to age-related cognitive or visual limitations of the caregiver\u003csup\u003e27\u003c/sup\u003e. Effective interventions included simplifying guidelines, using organizers (pill organizers), and reminders via Information Technologies, although the use of the latter may present adaptation barriers in this population\u003csup\u003e45\u0026ndash;47\u003c/sup\u003e.\u003c/li\u003e\n \u003cli\u003eHealth Education (NIC 5510): Training programs improved caregiver self-efficacy and competence, reducing uncertainty and stress associated with a lack of knowledge about the progression of the disease\u003csup\u003e44,48\u003c/sup\u003e. Furthermore, caregivers over 65 years of age showed greater vulnerability due to aging, the continuous demands of the role, and the sole responsibility for care, a situation exacerbated by the limited availability of resources \u003csup\u003e10,44,49,50\u003c/sup\u003e.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e3.3.3 Domain: Emotional support, environment and support networks: This block grouped the interventions with the greatest effect on mental health and resource management, highlighting the need for personalized approaches according to the geographical and social context.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003ePsychosocial support and mental health (NIC 7040/4920): Social isolation and loneliness were identified as predictors of burden, anxiety, and depression, especially in elderly caregivers\u003csup\u003e11,51,52\u003c/sup\u003e. Emotional support interventions, such as mutual support groups, cognitive-behavioral therapies, and mindfulness techniques, have been shown to be effective in reducing stress and improving emotional well-being\u003csup\u003e9,18,53\u003c/sup\u003e.\u003c/li\u003e\n \u003cli\u003eInequalities and environment (NIC 5370): Relevant structural barriers were observed; caregivers in rural areas faced greater economic difficulties and limited access to services than those in urban areas\u003csup\u003e10,21,54\u003c/sup\u003e. The literature emphasized the need for interventions that strengthen family and community support networks, promoting shared responsibility in caregiving and access to respite resources (day centers, home care) to prevent burnout \u003csup\u003e20,55\u003c/sup\u003e.\u003c/li\u003e\n \u003cli\u003eSalutogenic approach and good practices: Systematic and bibliographic reviews emphasize that interventions should not be purely technical. Adopting a salutogenic and intersectoral approach in public policies was recommended\u003csup\u003e13,56,57\u003c/sup\u003e. \u0026ldquo;Good practices\u0026rdquo; in home care were defined not only by procedural competence, but also by the integration of human values, quality relationships, and effective coordination between the family and health services\u0026mdash;key factors in sustaining the caregiver\u0026apos;s role without compromising their own aging\u003csup\u003e58,59\u003c/sup\u003e.\u003c/li\u003e\n\u003c/ul\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 981px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2:\u0026nbsp;\u003c/strong\u003eStudy selection, quality, level of evidence, and grade of recommendation (SIGN). Results of articles from reviews (systematic, narrative, and meta-analyses).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTitle\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAuthors, year\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 416px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCASP\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSIGN\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eSTOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eSeppala LJ, Petrovic M, Ryg J, Bahat G, 2021\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eMeta-analysis\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eThe panelists agreed on 14 drug classes to include in STOPPFall, primarily psychotropic medications. Eighteen differences were noted between drug subclasses with respect to properties that increase the risk of falls.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eThe care in the prevention of falls in elderly people: Meta-summary of qualitative articles\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eAbad-Corpa E, Lid\u0026oacute;n-Cerezuela B, Meseguer Liza C, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eMeta-analysis\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eFour topics: precipitating factors, preventive models, feelings and decision-making process related to fall prevention.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eThe influence of informal caregivers on the rehabilitation of the elderly in the postoperative period of proximal femoral fracture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eRocha SA, Avila MA, Bocchi SC. 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eFalls resulting in fractures lead to dependency and, consequently, an increased burden on caregivers. Furthermore, both older adults and their caregivers demonstrated a need for support during the rehabilitation process.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eCurrent evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePazan F, Petrovic M, Cherubini A, 2021\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eTen pharmacological interventions improved physical performance, muscle strength, or body composition using alfacalcidol, teriparatide, piroxicam, testosterone, recombinant human chorionic gonadotropin, or capromorelin.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e6/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2++/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eImpact of Foods and Dietary Supplements Containing Hydroxycinnamic Acids on Cardiometabolic Biomarkers: A Systematic Review to Explore Inter-Individual Variability.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eMartini D, Chiavaroli L, Gonz\u0026aacute;lez-Sarr\u0026iacute;as A, 2019\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003ePlant-based diets rich in bioactive compounds such as polyphenols positively modulate the risk of cardiometabolic diseases (CM).\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eResidual Effects of Physical Exercise After Periods of Training Cessation in Older Adults: A Systematic Review With Meta-Analysis and Meta-Regression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eBuend\u0026iacute;a-Romero \u0026Aacute;, Vetrovsky T, Hern\u0026aacute;ndez-Belmonte A, 2025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eEvidence suggests that exercise-based interventions, regardless of modality and intensity, are highly effective in preventing functional decline.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003ePost-informal caregiver\u0026apos;s perspectives and experiences of the support \u0026nbsp; \u0026nbsp; \u0026nbsp;network: a systematic literature review and meta-synthesis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eAfonso CIC, Madeira ACS, Magalh\u0026atilde;es, SPLVT. 2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eThe experiences of informal post-caregivers reveal the need for support in personal development, managing the impact of the care legacy, and formal and informal resources for the future.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eInformal caregivers for dependent elderly people: A revision of \u0026nbsp; \u0026nbsp; \u0026nbsp;psychological interventions over the last ten\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eBustillo ML, G\u0026oacute;mez-Guti\u0026eacute;rrez M, Guill\u0026eacute;n AI, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eThe most common interventions: cognitive-behavioral, psychoeducational, coping strategies, interventions that use the problem-solving intervention model, and interventions based on mindfulness programs.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNursing interventions to reduce the overload on informal caregivers. \u0026nbsp; Systematic review of clinical trials\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eTinoco-Camarena JM, Hidalgo-Blanco MA, Daifuku-Sansano N, 2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eEffectiveness in reducing symptoms such as stress, anxiety, depression, or unmet needs. The most effective interventions for reducing caregiver burden are home visits and psychoeducational interventions.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eTowards a healthy aging: a systematic review about music and physical exercise as modulating factors\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eDiaz Abrahan V, Maximiliano, JN. 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eThe population over 65 is growing rapidly; it is estimated that by 2050 there will be 114 million people with dementia. The combination of music and physical activity has a positive effect on healthy aging.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eThe Male Face of Caregiving: A Scoping Review of Men Caring for a Person With Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eRobinson, CA, \u0026nbsp;Bottorff, JL; Pesut, B, 2014\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eLinking research on male caregivers with gender relations and men\u0026apos;s health offers strategies to improve their health and well-being.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eAssumptions of good practices in home care for the elderly: a systematic review\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eRodrigues RAP, Bueno AA, Casemiro FG, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSystematic review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eGood practices in home care for the elderly depend not only on technical procedures, but also on values, human relationships, and cultural contexts.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/A\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003ePhysical activity and exercise: Strategies to manage frailty\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eAngulo J, El Assar M, \u0026Aacute;lvarez-Bustos A, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003ePhysical exercise can counteract physical decline in the elderly, as it improves mitochondrial function, chronic inflammation, and insulin sensitivity.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eEffect of Physical Activity/Exercise on Oxidative Stress and Inflammation in Muscle and Vascular Aging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eEl Assar M, \u0026Aacute;lvarez-Bustos A, Sosa P, 2022\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eThe functional state for healthy aging is improved with physical activity, which reduces oxidative stress and promotes mitochondrial biogenesis.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eObesity and Bone Health: A Complex Relationship\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePi\u0026ntilde;ar-Gutierrez A, Garc\u0026iacute;a-Fontana C, Garc\u0026iacute;a-Fontana B, 2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eIn obese elderly patients, fat redistribution and sarcopenia increase the risk of falls and fractures, as do chronic inflammation, altered adipokines, vitamin D deficiency, insulin resistance, and reduced mobility.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2++/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eFrailty as a phenotypic manifestation of underlying oxidative stress\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eEl Assar M, Angulo J, Rodr\u0026iacute;guez-Ma\u0026ntilde;as L., 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eInadequate lifestyle habits, along with genetic vulnerability and chronic diseases, promote oxidative damage and reduce resilience.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eHealth promotion and disease prevention for active aging that preserves quality of life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eAliaga-D\u0026iacute;az E, Cuba-Fuentes S, Mar-Meza M. 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eOlder adults face health problems related to physical, cognitive, social, and family factors. Prevention should address disease risks, functional impairments, and common conditions (frailty, falls, etc.).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eElder abuse: research, practice, and health policy. The 2012 GSA Maxwell Pollack award lecture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eDong X.\u0026nbsp;2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eOne in ten older adults suffer some form of abuse, and only a fraction of these cases are reported. It is associated with significant morbidity and premature mortality.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eHealthy aging and salutogenic approach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eFa\u0026uacute;ndez-Pino LF. 2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eEstablish comprehensive strategies in socio-health public policies to address aging in an intersectoral manner, focusing on health needs.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e6/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eCaracterizaci\u0026oacute;n de los determinantes sociales de la salud del envejecimiento activo en estudios enfocados a la calidad de vida: mapeo sistem\u0026aacute;tico.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eCampos-Tapia, AP; Meda-Lara, RM ; Corona-Figueroa, BA, 2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eThe growing older adult population is accompanied by unfavorable socioeconomic and health conditions. This situation can be addressed through the framework of active aging. The WHO identifies six social determinants of health as contributing factors to active aging.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e8/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNutrients associated with diseases related to aging: a new healthy aging diet index for elderly population\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eLozano M, Manyes L, Peir\u0026oacute; J, Ramada JM 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eThere are associations between various diseases and nutrients, such as cardiovascular disease, cancer, diabetes, osteopenia, sarcopenia, and cognitive impairment.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e6/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003ePolypharmacy in older adults and impact on their quality of life. Literature review\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eS\u0026aacute;nchez-Rodr\u0026iacute;guez JR, Escare-Oviedo CA, Castro-Olivares VE, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003ePolypharmacy is more common in women, people with low levels of education, and those with unfavorable socioeconomic factors. A percentage of these individuals experience negative effects related to medication use, both in terms of the number of medications and the number of doctors consulted.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eSelf-Care of the Informal Caregiver of the Elderly in Some Latin American Countries: Descriptive Review\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eGuato-Torres P, Mendoza-Parra S. 2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eLiterature review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eFour key areas: concepts of care, caregiver, and types of caregivers; the health of informal caregivers; self-care theory; and the implementation of programs to support caregivers. Self-care among caregivers is diminished, which negatively impacts their health.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e6/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eDaily life of informal caregivers: perspectives from occupational \u0026nbsp; therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eSeguel Albornoz, F. M., Rosas Tripailaf, J. A., Caucaman Provost, M. F., 2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNarrative review\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eThis has repercussions in the area of self-care, manifested as overload, multiple roles, and mood and sleep disorders. Leisure time is reduced due to work and the health situation, making it impossible to maintain a balance in their routines.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e5/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eDigital Inclusion as a contributory alternative to active aging\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eArroyave Zambrano PM, Ocampo Arias J, S\u0026aacute;nchez Vel\u0026aacute;squez SP,2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNarrative review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eAging, despite being a biological process, should not be seen as a situation of incapacity or loss of condition, but as an environment with new demands, relationships and interests, where ICTs can contribute to the quality of life.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e6/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eResilience as a protective factor in the successful aging process\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eFern\u0026aacute;ndez-Infante A, G\u0026oacute;mez-Mendoza OC., Le\u0026oacute;n DA, Blanco-P\u0026eacute;rez \u0026Aacute; 2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNarrative review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eResilience is a protective factor that facilitates successful and healthy aging. It highlights interventions that develop coping skills, social support, and emotional well-being.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e6/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003eOlder Adult: Aging, Disability, Care, and Day Centers. A Review\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePinilla C\u0026aacute;rdenas MA, Ortiz \u0026Aacute;lvarez MA, Su\u0026aacute;rez-Escudero JC 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNarrative review\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 416px;\"\u003e\n \u003cp\u003eDay centers offer an alternative to institutionalization, promoting activities, recreation and support for caregivers.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e6/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003e Critical Assessment Skills Program (CASP) checklist. \u003csup\u003e2\u003c/sup\u003e\u0026nbsp; \u0026nbsp;Scottish Intercollegiate Guidelines Network (SIGN).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 981px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3:\u0026nbsp;\u003c/strong\u003eSelection of studies, quality, level of evidence, and grade of recommendation SIGN. Results of primary studies (experimental and observational).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTitle\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAuthors, year\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCASP\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSIGN\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003ePower-oriented resistance training\u003c/p\u003e\n \u003cp\u003ecombined with high-intensity interval training in pre-frail and frail older\u003c/p\u003e\n \u003cp\u003epeople: comparison between traditional and cluster training set configurations on the force-velocity relationship, physical function and frailty.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eBaltasar-Fernandez I, Alcazar J, Mart\u0026iacute;n-Braojos S, 2024\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eRandomized controlled trial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eBoth training methods were equally effective in improving Pmax, physical function, and reducing frailty in pre-frail and frail older adults.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eEffects of a Mindfulness-Based Intervention versus Health Self-Management on Subclinical Anxiety in Older Adults with Subjective Cognitive Decline: The SCD-Well Randomized Superiority Trial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMarchant NL, Barnhofer T, Coueron R, 2021\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eRandomized controlled trial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eMindfulness-based intervention is an effective strategy for improving emotional state and reducing mild anxiety in this population, although some effects may require further research to confirm their durability and scope.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eComprehensive Older Adult and Caregiver Help (COACH): A person-centered caregiver intervention prevents elder mistreatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eGassoumis ZD, Martinez JM, Yonashiro-Cho J, 2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eRandomized controlled trial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eThe COACH program is effective in preventing abuse of the elderly by empowering and supporting informal caregivers.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eEffects of a home-based exercise program on mental health for caregivers of relatives with dementia: a randomized controlled trial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMadruga M, Gozalo M, Prieto J, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eRandomized controlled trial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eThe intervention showed a positive impact on the subjective burden of caregivers and the risk of depression, with functional independence and area of residence being key predictors.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eAdherence to the Mediterranean diet assessed by a novel dietary biomarker score and mortality in older adults: the InCHIANTI cohort study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eHidalgo-Liberona N, Mero\u0026ntilde;o T, Zamora-Ros R, 2021\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCohort\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eThe Mediterranean diet was associated with lower mortality and cardiovascular disease, but not with cancer mortality.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eAssociations between Physical Fitness, Bone Mass, and Structure in Older People.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMoradell A, G\u0026oacute;mez-Cabello A, G\u0026oacute;mez-Bruton A, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCohort\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003e35 men and 94 women aged 65 years or older (76.2 \u0026plusmn; 5.4 years) Agility and walking speed have a greater influence on bone mass and structure in men, while balance was associated with bone mineral density in women.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eTaiwanese middle-aged and older caregivers\u0026apos; need for life safety instruction and its association with attitudes toward aging and proactive coping.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eSun, J.-H.A 2020\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCohort\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eMiddle-aged and older caregivers showed a low psychological assessment of aging, with a strong need to learn about safety.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003ePrevalence and impact of neuropsychiatric symptoms in normal aging and neurodegenerative syndromes: A population-based study from Latin America\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eRodriguez Salgado AM, Acosta I, Kim DJ, Zitser J, 2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCohort\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eNeuropsychiatric disorders (NPDs) were the biggest contributors to caregiver burden. Approximately 34.3%, 56.1%, and 61.2% of participants had parkinsonism, dementia, or three or more NPDs, respectively.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eAging, Gender and Quality of Life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eCampos AC, Ferreira e Ferreira E, Vargas AM, Albala C. 2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCohort\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eOlder adults with higher levels of education, good health, and no depression or family dysfunction showed a better quality of life, with retirement being a positive factor for men, while lack of physical activity negatively affected quality of life.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eHealthy aging profile in octogenarians in Brazil\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eCampos AC, Ferreira EF, Vargas AM, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCohort\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eWomen (62.1%), aged 80-84 (50.4%), widowed (53.4%), illiterate (59.1%), with lower monthly income (59.1%), retired (85.7%), living with their partner (63.8%), without a caregiver (60.3%), with two or more children (82.7%), and two or more grandchildren (78.8%). Active aging is associated with age, marital status, and having a caregiver.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eEffect of Familial Longevity on Frailty and Sarcopenia: A Case-Control Study\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eBelenguer-Varea A, Avellana-Zaragoza JA, Ingl\u0026eacute;s M. 2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCase-control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eThe cases had a higher percentage of robust patients (31.8% vs. 15.9%), lower percentages of frailty (9.1% vs. 21.6%) and pre-frailty (59.1% vs. 62.5%) (p = 0.001), and lower IL-6 levels (p = 0.044) than the controls. Family longevity was also associated with less obesity, insomnia, pain, and polypharmacy, and with a higher level of education and higher levels of total cholesterol and low-density lipoprotein cholesterol.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eEffectiveness of a health education program for people with dementia and their family caregivers: An intervention by nurse practitioners\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eHuang HL, Shyu YL, Hsu WC 2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCase-control\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eEducator training improved health education and access to services.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eOxidative stress among informal caregivers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eRamos, N; Vasconcelos, I; Marco, P; 2019\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCase-control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eCaregivers were predominantly female. 9.4% reported being very dissatisfied and 53.1% dissatisfied with their health. 43.8% rated their quality of life as poor and 12.5% as very poor.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eEvaluation of the effectiveness of an intervention program in family caregivers of dependent persons, in the primary health care system\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eOrtiz-Mallas\u0026eacute;n, V; Claramonte-Gual, E ; Cervera-Gasch, A , 2021\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuasi-experimental study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003e73.3% presented with low back pain, with an average level of 5.13 +/- 2.56, and moderate disability (41.7%). 50% received little social support and experienced a significant impact on their health-related quality of life, especially in terms of pain and anxiety.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eChanges in anthropometric parameters and physical fitness in older adults after participating in a 16-week physical activity program\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eVald\u0026eacute;s-Badilla P, Guzm\u0026aacute;n-Mu\u0026ntilde;oz E, Ram\u0026iacute;rez-Campillo R, 2020\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuantitative pre-experimental study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eSignificant reductions in PC and improvements in the following tests: sitting up from a chair (p\u0026lt;0.001), elbow flexions (p\u0026lt;0.001), two minutes of walking (p\u0026lt;0.001), trunk flexion in chair (p=0.018) and clasping hands behind the back (p=0.014).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eLa actividad f\u0026iacute;sica organizada en las personas mayores, una herramienta para mejorar la condici\u0026oacute;n f\u0026iacute;sica en la senectud\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eG\u0026oacute;mez-Cabello A, Vila-Maldonado S, Pedrero-Chamizo R, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuantitative, cross-sectional and analytical study\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eLack of participation in organized physical activity increased the risk of low levels of physical fitness, with differences between sexes; women who performed more than two hours per week showed better performance in several physical areas.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eFinancial and Health Barriers and Caregiving-Related Difficulties Among Rural and Urban Caregivers\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eBouldin ED, Shaull L, Andresen EM 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuantitative, cross-sectional and analytical study\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eRural caregivers faced more financial barriers than urban caregivers (38.1% vs. 31.0%, P = .0001), but the prevalence of health barriers was similar (43.3% vs. 40.6%, P = .18). Rural caregivers were less likely to report their problems.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eClinical validation of the NANDA-I \u0026quot;caregiver role strain\u0026quot; nursing diagnosis in the context of palliative care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eLouren\u0026ccedil;o TMG, Abreu-Figueiredo RMS, S\u0026aacute; LO. 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eCross-sectional, quantitative, descriptive and analytical study.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eIneffective coping, depressive mood, frustration, and fatigue showed a greater association with caregiver burden, with an overall score of 0.68.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eThe Social Cost of Providing Care to Older Adults With and Without Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003ePatterson SE, Tate AM, Hu YL, 2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuantitative, cross-sectional and analytical study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003e1/3 of caregivers of elderly people with dementia reported restrictions due to caregiving, (33.3% vs 16.0%; p \u0026lt; 0.001).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003ePhysical, emotional and social burden of elderly patients\u0026apos; informal \u0026nbsp; \u0026nbsp; \u0026nbsp;caregivers\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMendes PN, Figueiredo ML, Santos AM 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuantitative, cross-sectional and analytical study\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eCaregiver burden was related to marital status, degree of kinship, age of the caregiver, hours spent on care, and the presence of comorbidities and pain, being higher in spouses and caregivers with regular health.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eDuelo anticipado y afrontamiento al estr\u0026eacute;s en cuidadores informales de personas de la tercera edad\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eAponte-Daza, V. C., Ponce, F., Pinto, B 2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuantitative, cross-sectional and analytical study\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eAnticipatory grief is influenced by different coping styles, the type of care, and the age of the caregiver, with supportive coping and emotional avoidance being associated with greater emotional pain and loss.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e9/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eGeneral state of health and psychosocial profile of healthy or exceptional elderly of Santander, Colombia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eQuintero-Mantilla, MS, \u0026amp; Cerquera-C\u0026oacute;rdoba, AM.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuantitative, cross-sectional and analytical study\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003eThe high biopsychosocial profile of older adults with high longevity suggests the possibility of aging successfully, maintaining health and quality of life.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003eBurden and types of support for family caregivers serving patients with chronic disease\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eCampos MS, Dur\u0026aacute;n EY, Rivera R, P\u0026aacute;ez N, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003eQuantitative, cross-sectional and analytical study\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 406px;\"\u003e\n \u003cp\u003e19.35% of caregivers experienced severe burden, with daily care hours and knowledge being determining factors. Severe burden is associated with 0% psychological and social support.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7/11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 981px;\"\u003e\n \u003cp\u003e\u003csup\u003e1\u003c/sup\u003e Critical Assessment Skills Program (CASP) checklist. \u003csup\u003e2 \u0026nbsp;\u003c/sup\u003e Scottish Intercollegiate Guidelines Network (SIGN).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAs a summary of the results, Table 4 associates the risk factors detected in the literature with the nursing interventions (NIC)\u003csup\u003e26\u0026nbsp;\u003c/sup\u003eand the level of available evidence, according to the SIGN criteria\u003csup\u003e25\u003c/sup\u003e. Twelve priority interventions were identified.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eRecommended interventions related to the Nursing Interventions Classification\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRecommended intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSING\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNIC\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003eNutritional deficiency\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e- Determine the patient\u0026apos;s nutritional status and their ability to meet their nutritional needs.\u003c/p\u003e\n \u003cp\u003e- Educate the patient about their nutritional needs (discuss dietary guidelines and food pyramids).\u003c/p\u003e\n \u003cp\u003e- Provide an optimal environment for eating (e.g., clean, well-ventilated, relaxed, and free of strong odors).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2++/B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e1100 Nutrition management\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 129px;\"\u003e\n \u003cp\u003ePhysical activity deficit\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eDecreased tolerance to activity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e- Provide guidance on the type of exercise appropriate for their health level, in collaboration with their healthcare professional and/or physiotherapist.\u003c/p\u003e\n \u003cp\u003e- Muscle strengthening exercises (psoas, quadriceps).\u003c/p\u003e\n \u003cp\u003e- Scheduled walking exercises (indoors and outdoors) if possible (15 minutes twice a day).\u003c/p\u003e\n \u003cp\u003e- Yoga or Pilates exercises.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0200 Exercise promotion\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e-Perform strengthening exercises such as knee bends, light weightlifting, or abdominal exercises 2-3 times per week.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003eRisk of injury\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e-Posture recommendations: Get up slowly in two stages (first sit down, then stand up), raise the head from the bed for a while before standing, and always use a rolling position.\u003c/p\u003e\n \u003cp\u003e- Identify environmental features that increase the risk of falls (slippery floors, rugs, stairs without handrails).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e6490 Fall prevention\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 129px;\"\u003e\n \u003cp\u003ePolypharmacy\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e-Avoid using questionable or unproven medications.\u003c/p\u003e\n \u003cp\u003e- Try to reduce doses, if possible; educate patients on the correct use of sedatives and hypnotics (avoid alcohol, interactions with other drugs, and ensure proper adherence).\u003c/p\u003e\n \u003cp\u003e- Regularly consult with the patient and/or their family about the types and dosages of medications they are taking.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2++/B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 119px;\"\u003e\n \u003cp\u003e2380 Medication management\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e-Use ICT for medication management and other areas of care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2-/D\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003eHazardous environment\u003c/p\u003e\n \u003cp\u003eDependent on daily activities\u003c/p\u003e\n \u003cp\u003eDifficulties with transfers (bed-chair, chair-toilet)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e- Determine safety needs based on physical, emotional, and cognitive function.\u003c/p\u003e\n \u003cp\u003e- Use protective devices (physical restraints, railings, closed doors, fences, and gates) to physically limit mobility or access to hazardous situations.\u003c/p\u003e\n \u003cp\u003e- Delegate responsibilities when possible and ensure they have time for themselves.\u003c/p\u003e\n \u003cp\u003e- Train both the patient and their family and/or caregivers on proper techniques for transferring from one area to another (from bed to chair, from wheelchair to vehicle).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2++/B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e5510 Health education\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6486 Environmental management: safety\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1806 Self-care assistance: transfer\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003eStress, anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e-Assess the patient\u0026apos;s needs, desires, and values in relation to their medical care.\u003c/p\u003e\n \u003cp\u003e- Inform them about the different resources available for assistance and financial aid.\u003c/p\u003e\n \u003cp\u003e- Provide psychological support throughout the process.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2+/B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e7300 Advance care planning\u003c/p\u003e\n \u003cp\u003e4920 Active listening\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003eLoneliness\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 281px;\"\u003e\n \u003cp\u003e- Assess the caregiver\u0026apos;s acceptance of the role.\u003c/p\u003e\n \u003cp\u003e- Determine their level of knowledge, skills, and limitations.\u003c/p\u003e\n \u003cp\u003e- Provide information about the care recipient\u0026apos;s condition, treatment, and care according to their preferences.\u003c/p\u003e\n \u003cp\u003e- Teach stress management techniques and strategies for maintaining health care.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2+/C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e7040 Support for the primary caregiver\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6576 Physical accompaniment\u003c/p\u003e\n \u003cp\u003e5370 Role enhancement.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eScottish Intercollegiate Guidelines Network (SIGN).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eNursing Interventions Classification (NIC).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eIn response to the research question, 12 scientifically validated non-pharmacological interventions were identified, aimed at promoting active aging in the population over 65 years of age who act as caregivers. The results here indicate that, beyond institutional support, lifestyle modification (especially multi-skilled exercise and nutrition) is the most strongly supported strategy (sign level 1\u0026thinsp;+\u0026thinsp;and 2\u0026thinsp;+\u0026thinsp;+\u0026thinsp;evidence) for maintaining the functional capacity of older caregivers. However, the literature reveals a paradox: although the theoretical efficacy of these interventions is known, their practical implementation is low due to the inherent time constraints of the caregiver role. Interventions that combine physical training with health education (NIC 5510) and environmental management (NIC 6486) appear to offer the best cost-effectiveness for preventing frailty in this binomial.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eThe \u0026ldquo;double vulnerability\u0026rdquo; of the elderly caregiver\u003c/h2\u003e \u003cp\u003eThe \u0026ldquo;double vulnerability\u0026rdquo; is a recurring finding in the included studies. Caregivers over 65 years of age not only face the external burden stemming from the dependency of the person being cared for (especially in cases of dementia, where the demand exceeds 100 hours per month), but also struggle against their own biological senescence\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. The reviewed literature strongly associates the caregiver role in old age with an accelerated risk of sarcopenia and osteoarticular deterioration, exacerbated by neglect of self-care 13, 51. This validates the relevance of the NIC interventions identified in the safety domain, such as fall prevention (NIC 6490) and assistance with self-care: transfers (NIC 1806). Unlike a younger caregiver, when an older caregiver performs an incorrect transfer, the risk of disabling injury is bidirectional, as it can affect both the person being cared for and the caregiver, potentially precipitating the institutionalization of both\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eActive aging has been addressed theoretically for decades, but the findings suggest that practice falls far short of the ideal. As Campos-Tapia et al.\u003csup\u003e2\u003c/sup\u003e point out, society tends to influence the role of older adults, normalizing their sacrifice, which leads to extreme situations of neglect. The evidence is alarming: it is estimated that one in ten older adults suffer or have suffered some form of abuse, and only a small percentage of cases are reported, resulting in serious consequences of morbidity and premature mortality\u003csup\u003e\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e\u003c/sup\u003e. Therefore, it is not only a matter of preventing physical accidents, but also of protecting caregivers from an environment of structural neglect.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eGender gaps and territorial inequality.\u003c/h2\u003e \u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIncreased longevity, coupled with a scarcity of formal resources, has forced a \"re-familiarization\" of caregiving under precarious conditions. At present, it is estimated that 27.6% of older adults receive care from individuals of the same age range (13.6% of men and 14% of women over 65)\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. This situation directly impacts the determinants of active aging (behavioral, personal, physical, social, economic, and social and health services)\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e, which are negatively affected in the caregiver, increasing the likelihood of pathological aging.\u003c/p\u003e\u003cp\u003eGender analysis reveals that this burden is not equitable. Viana Campos et al.\u003csup\u003e4\u003c/sup\u003e state that this situation is significantly more frequent among women, exacerbated by the fact that many live alone, which limits their support network. Other studies indicate that female caregivers tend to have worse mental and physical health indicators than men\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e. In addition, there is the territorial gap; older caregivers living in rural areas face greater financial and accessibility barriers than those living in urban areas\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e\u003c/sup\u003e. This suggests that interventions may fail if they are not adapted to the geographical context. While technological tools and \u0026ldquo;virtual coaching\u0026rdquo; are proposed as emerging solutions (grade D), the results suggest caution, since the digital divide among those over 80 years of age and in rural areas can turn these solutions into new barriers to exclusion if they are not accompanied by face-to-face training\u003csup\u003e\u003cspan additionalcitationids=\"CR46\" citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Implications for nursing practice\u003c/h2\u003e \u003cp\u003eClassifying the findings according to the NIC taxonomy facilitates their direct transfer to clinical practice. It has been demonstrated that addressing active aging in caregivers does not require inventing new resources, but rather systematizing existing ones. The evidence supports a paradigm shift towards a salutogenic approach\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e,\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e\u003c/sup\u003e, where the nurse not only treats the \"burden\" (pathogenesis), but also prescribes health assets (protein nutrition, social support networks, sleep hygiene) to preserve the caregiver's functional reserve.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and strengths\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThe study's limitations relate to language restrictions, the established time period, and the heterogeneity of the studies. The included articles were published in English and Spanish. However, this limitation is mitigated by the universality of both languages ​​and the fact that most of the scientific information found is in English or Spanish.\u003c/p\u003e \u003cp\u003eIt is also acknowledged that the protocol was not prospectively recorded. Nevertheless, the main strength lies in the rigor of the screening and in having made visible, through recent epidemiological data, the hidden reality of abuse and precarious care among peers.\u003c/p\u003e \u003cp\u003eAnother limitation is that only articles published between 2014 and 2025 were selected, and there may be relevant articles with earlier references. This is offset by the abundance of works published during this period, the inclusion of quality criteria after critical appraisal, and the reference search.\u003c/p\u003e \u003cp\u003eOn the other hand, the population represented is not entirely homogeneous, varying from one study to another, as does the time period studied, the design of the works, the analytical methods used, the results, and the conclusions drawn from each. This heterogeneity also hinders quantitative synthesis. Despite this, the burden experienced by caregivers remains alarming, reflecting the importance of promoting strategies aimed at fostering active aging among the population over 65 years of age who are currently fulfilling the role of caregiver.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003e The increase in longevity and dependency among older adults has negatively impacted the dimensions of the concept of active aging for the population that acts as caregivers. Despite efforts to improve the quality of life of caregivers, a significant gap remains in the design and implementation of specific interventions for this group.\u003c/p\u003e \u003cp\u003ePredominant interventions in this field focus on improving emotional well-being and reducing caregiver burden, with cognitive-behavioral approaches such as problem solving and coping strategies, being particularly prominent. However, to be effective, these interventions must be personalized, taking into account social determinants such as gender, digital literacy, and, crucially, whether the environment is rural or urban.\u003c/p\u003e \u003cp\u003eFurthermore, given the growing number of older caregivers and the impact this role has on their health and quality of life, it is especially important that future research addresses active aging among caregivers aged 65 and over.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate declarations:\u0026nbsp;\u003c/strong\u003enot applicable. This study is a scoping review based exclusively on previously published literature and did not involve human participants or animals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e: All data analyzed in this study are derived from previously published articles and are available in the cited references.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003ethe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003ethis research received no external funding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u0026nbsp;\u003c/strong\u003econceptualization, A.P.-D., N.R-N. and M.N.-M.; methodology, A.P.-D. and N.R-N.; software, A.P.-D. and M.L.-M.; validation, Y.M.R.-N., N.R-N. and M.N.-M.; formal analysis, M.H.-R., N.R-N. and Y.M.R.-N.; investigation, A.P.-D. and M.L.-M.; resources, N.R-N. and M.N.-M.; data curation, N.R-N. and A.P.-D.; writing\u0026mdash;original draft preparation, A.P.-D. and N.R-N.; writing\u0026mdash;review and editing, M.N.-M. and N.R-N.; visualization, M.H.-R., M.L.-M.; supervision, N.R-N.,Y.M.R.-N. and M.N.-M.; project administration, A.P.-D. and M.N.-M. All authors have read and agreed to the published version of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u0026nbsp;\u003c/strong\u003ethe authors wish to thank the translator from the College of Nursing for their contribution.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOrganizaci\u0026oacute;n Mundial de la Salud. Envejecimiento activo: un marco pol\u0026iacute;tico. Rev Esp Geriatr Gerontol [Internet]. 2002 [citado el 24 de diciembre de 2025];37(S2):74-105. Disponible en: https://www.elsevier.es/es-revista-revista-espanola-geriatria-gerontologia-124-articulo-envejecimiento-activo-un-marco-politico-13035694 \u003c/li\u003e\n\u003cli\u003eCampos-Tapia AP, Meda-Lara RM, Corona-Figueroa BA. 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Disponible en: https://doi.org/10.24875/rmf.22000090\u003c/li\u003e\n\u003cli\u003eRodrigues RAP, Bueno AA, Casemiro FG, da Cunha AN, de Carvalho LPN, Almeida VC, et al. Assumptions of good practices in home care for the elderly: a systematic review. Rev Bras Enferm [Internet]. 2019 [citado el 10 de enero de 2026];72(Suppl 2):302-10. Disponible en: https://doi.org/10.1590/0034-7167-2018-0445\u003c/li\u003e\n\u003cli\u003eGassoumis ZD, Martinez JM, Yonashiro-Cho J, Mosqueda L, Hou A, Han SD, et al. Comprehensive Older Adult and Caregiver Help (COACH): A person-centered caregiver intervention prevents elder mistreatment. J Am Geriatr Soc [Internet]. 2024 [citado el 10 de enero de 2026];72(1):246-57. Disponible en: https://doi.org/10.1111/jgs.18597\u003c/li\u003e\n\u003cli\u003eVasconcelos NRI, D\u0026aacute;tilo GMPA, Chies AB, Chagas EFB, Vasconcelos TJQ, Barbosa PMK. Oxidative stress among informal caregivers. 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Disponible en: https://doi.org/10.1177/1557988313519671\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-geriatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bgtc","sideBox":"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bgtc/default.aspx","title":"BMC Geriatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"active aging, informal caregiver and caregiver overload","lastPublishedDoi":"10.21203/rs.3.rs-9074136/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9074136/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e: Population aging has increased the number of people over 65 years of age who assume the role of informal caregivers, affecting their own active aging process.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e: (1) to identify and categorize the main intervention domains described in recent literature (lifestyle, psychoeducation, and emotional support) and (2) to classify the strategies found according to the standardized Nursing Interventions Classification (NIC) taxonomy, in order to facilitate their application in clinical practice.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e: A scoping review was conducted using the PubMed, Cumulative Index to Nursing \u0026amp; Allied Health Literature (CINAHL), and Web of Science (WOS) databases. Inclusion criteria were articles published between 2014 and 2025; in Spanish and English; publications with full-text access; and focusing on a population over 65 years of age. Review and analytical studies were included, focusing on individuals over 65 years of age and addressing the emotional, physical, social, and economic burden on caregivers, as well as interventions aimed at improving their situation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Forty-nine articles were reviewed, and 12 non-pharmacological interventions were identified according to the Nursing Interventions Classification taxonomy, designed to promote active aging. The analysis identified three main intervention domains: 1) Lifestyle modification (physical activity and nutrition); 2) Psychoeducational interventions (empowerment and care management); and 3) Emotional support. Evidence suggests that multicomponent physical exercise is effective in reducing caregiver burden and improving health-related quality of life. Factors such as resilience and social support act as key protective factors against burnout.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: There is a great need for public policies that integrate coordinated social and healthcare services. Interventions should be personalized considering the advanced age of the caregiver, promoting their own autonomy and self-care to ensure the sustainability of care at home.\u003c/p\u003e","manuscriptTitle":"Non-pharmacological interventions in caregivers over 65 years of age. 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