Evaluating a healthy ageing centre in Turkiye: a mixed-methods study of clinical needs, service utilization, and psychosocial outcomes

Year 2026, Volume: 7 Issue: 1, 85 - 93, 20.02.2026

İrem Kıraç Utku , Burcu Kurnaz , Hakan Küçük , Mahmut Hakan Şahin , Büşra Aybike Kumcu , Gökmen Özceylan , Elif Aktaş , Hamide Gider , Duygu Baydere , Nezahat Müge Çatıkkaş , Tuğba Erdoğan

https://izlik.org/JA27SN53GW

Abstract

Aims: To evaluate the clinical characteristics, multidisciplinary service utilization, and psychosocial experiences of older adults receiving care from a community-based Healthy Aging Centre (YAŞAM) in Turkiye.
Methods: This mixed-methods study included adults aged ≥75 years who received services between August 2023 and August 2025. Quantitative data from 383 participants were analyzed to describe sociodemographics, Comprehensive Geriatric Assessment findings, and patterns of multidisciplinary service use. For the qualitative component, semi-structured interviews were conducted with eight purposefully selected participants and analyzed using Braun and Clarke’s thematic approach.
Results: Participants were predominantly very old adults with multimorbidity, moderate frailty, and partial dependence in daily activities. Dietitian, physiotherapy, psychology, and social work services were used more frequently by individuals with malnutrition risk, IADL dependency, frailty, depressive symptoms, or limited social support. Older age alone (≥80 years) did not predict higher service utilization. Thematic analysis revealed six key themes: satisfaction and gratitude; feelings of safety and support; feeling valued and respected; loneliness and the need for socialization; acceptance of aging; and inner change and self-awareness. Emotional security, accessible support, and respectful communication emerged as core strengths of the model.
Conclusion: The YAŞAM model meets both medical and psychosocial needs by providing integrated, community-based geriatric care, reinforcing safety, dignity, and social connectedness. These findings highlight the value of multidisciplinary, community oriented services in supporting functional and emotional well-being in aging populations.

Keywords

Healthy aging , geriatrics; frailty , community health services , activities of daily living

Ethical Statement

The study was approved by the Institutional Ethics Committee of Sancaktepe Martyr Prof. Dr. Ilhan Varank Training and Research Hospital Approval No: 2025/433.

Supporting Institution

None

Thanks

None

References

• United Nations Department of Economic and Social Affairs, Population Division. World Population Ageing 2022. New York: United Nations; 2023.
• Beard JR, Officer A, Cassels AK. The world report on ageing and health. Lancet. 2016;387(10033):2145-2154. doi:10.1016/S0140-6736(15)00516-4
• World Health Organization. Ageing and health. World Health Organization website. Available from: https://www.who.int/news-room/ fact-sheets/detail/ageing-and-health. Accessed October 1, 2025.
• Salari N, Najafi H, Rasoulpoor S, Canbary Z, Heidarian P, Mohammadi M. The global prevalence and associated factors of loneliness in older adults: a systematic review and meta-analysis. Humanit Soc Sci Commun. 2025;12:985. doi:10.1057/s41599-025-05304-x
• Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129-136. doi:10.1126/science.847460
• Borrell-Carrió F, Suchman AL, Epstein RM. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med. 2004;2(6):576-582. doi:10.1370/afm.245
• Yamada M, Arai H. Long-term care system in Japan. Ann Geriatr Med Res. 2020;24(3):174-180. doi:10.4235/agmr.20.0037
• Canadian Institute for Health Information. Home and Community Care in Canada: Trends and Practices. Ottawa: CIHI; 2021. Available from: https://www.cihi.ca/en/home-and-community-care-in-canada. Accessed December 10, 2025.
• Republic of Türkiye Ministry of Health. Healthy Ageing Centers Implementation Guide. Ankara: Ministry of Health; 2023. Available from: https://hsgm.saglik.gov.tr/depo/birimler/saglikli-yas-alma-db/dokumanlar/ Saglikli_Yas_Alma_Merkezleri_Uygulama_Rehberi.pdf. Accessed December 10, 2025.
• Courtin E, Knapp M. Social isolation, loneliness and health in old age: a scoping review. Health Soc Care Community. 2017;25(3):799-812. doi:10. 1111/hsc.12311
• Kelly ME, Duff H, Kelly S, et al. The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review. Syst Rev. 2017; 6(1):259. doi:10.1186/s13643-017-0632-2
• Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7):e1000316. doi:10.1371/journal.pmed.1000316
• Yavuz E, Şimşek Yurt N, Kadıoğlu K. Evaluation of the patient profile and services provided at the Healthy Aging Center (YAŞAM) in Samsun Province. Turk J Fam Med Prim Care. 2024;18(2):223-229. doi:10.21763/tjfmpc.1409337
• Goodwin N. Understanding integrated care: a complex process, a fundamental principle. Int J Integr Care. 2013;13:e011. doi:10.5334/ijic.1144
• Singer SJ, Burgers J, Friedberg M, Rosenthal MB, Leape L, Schneider E. Defining and measuring integrated patient care: promoting the next frontier in health care delivery. Med Care Res Rev. 2011;68(1):112-127. doi:10.1177/1077558710371485
• Borgermans L, Marchal Y, Busetto L, et al. How to improve integrated care for people with chronic conditions: key findings from EU FP-7 Project INTEGRATE and beyond. Int J Integr Care. 2017;17(4):7. doi:10. 5334/ijic.3096
• Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581-629. doi:10.1111/j.0887-378X.2004.00325.x
• Campbell H, Hotchkiss R, Bradshaw N, Porteous M. Integrated care pathways. BMJ. 1998;316(7125):133-137. doi:10.1136/bmj.316.7125.133
• Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 3rd ed. Thousand Oaks: Sage Publications; 2017.
• Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101.
• Greene JC. The generative potential of mixed methods inquiry. Int J Res Method Educ. 2005;28(2):207-211. doi:10.1080/01406720500256293
• Turkish Statistical Institute (TURKSTAT). Elderly Population Statistics 2024. Ankara: Turkish Statistical Institute; 2024. Available from: https://data.tuik.gov.tr/. Accessed December 10, 2025.
• Chen C, Lim J, Koh J, Beard J, Rowe JW; Research Network on an Aging Society. A global analysis of adaptation to societal aging across low-, middle- and high-income countries using the Global Aging Society Index. Nat Aging. 2025;5(1):113-121. doi:10.1038/s43587-024-00772-3
• Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018;14(9): 513-527. doi:10.1038/s41574-018-0062-9
• Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014;13(1):57-65. doi:10.1517/14740338. 2013.827660
• Rawle MJ, Richards M, Davis D, Kuh D. The prevalence and determinants of polypharmacy at age 69: a British birth cohort study. BMC Geriatr. 2018;18(1):118. doi:10.1186/s12877-018-0795-2
• Brañas F, Azcoaga A, García Ontiveros M, Antela A. Chronicity, ageing and multimorbidity. Enferm Infecc Microbiol Clin (Engl Ed). 2018; 36(Suppl 1):15-18. doi:10.1016/S0213-005X(18)30241-6
• Soysal P, Isik AT, Arik F, Kalan U, Eyvaz A, Veronese N. Validity of the Mini-Nutritional Assessment Scale for evaluating frailty status in older adults. J Am Med Dir Assoc. 2019;20(2):183-187. doi:10.1016/j.jamda. 2018.07.016
• Woo J. Nutrition and frailty. J Nutr Health Aging. 2018;22(9):1025-1027. doi:10.1007/s12603-018-1120-7
• König H, König HH, Konnopka A. The excess costs of depression: a systematic review and meta-analysis. Epidemiol Psychiatr Sci. 2020;29: e30. doi:10.1017/S2045796019000180
• Gedik M. Home-based social support services for elderly well-being: a qualitative study from a gerontological social work perspective. SAGE Open Aging. 2025;11:30495334251387500. doi:10.1177/ 30495334251387500
• Moody HR, Sasser JR. Aging: Concepts and controversies. 9th ed. Thousand Oaks: Sage Publications; 2020.
• Tornstam L. Gerotranscendence: a developmental theory of positive aging. New York: Springer Publishing Company; 2005.
• Baltes PB, Baltes MM, editors. Successful aging: perspectives from the behavioral sciences. Cambridge: Cambridge University Press; 1993.
• Duggan S, Deeny P, Spelman R, Vitale CT. Perceptions of older people on disaster response and preparedness. Int J Older People Nurs. 2010;5(1): 71-76. doi:10.1111/j.1748-3743.2009.00203.x
• Lafortune C, Huson K, Santi S, Stolee P. Community-based primary health care for older adults: a qualitative study of the perceptions of clients, caregivers and health care providers. BMC Geriatr. 2015;15:57. doi:10.1186/s12877-015-0052-x
• Liddle J, Stowell M, Ali M, et al. Community-based physical and social activity for older adults with mild frailty: a rapid qualitative study of a collaborative intervention pilot. BMC Geriatr. 2024;24(1):1011. doi:10. 1186/s12877-024-05604-y
• Spoorenberg SL, Wynia K, Fokkens AS, Slotman K, Kremer HP, Reijneveld SA. Experiences of community-living older adults receiving integrated care based on the chronic care model: a qualitative study. PLoS One. 2015;10(10):e0137803. doi:10.1371/journal.pone.0137803