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Layton N, Harper K, Hill K. Digital Capabilities of Older People and Uptake of Online Healthy Ageing Interventions: An Australian Study. Stud Health Technol Inform 2023; 306:359-363. [PMID: 37638936 DOI: 10.3233/shti230644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
The promise of digital health interventions is tempered by the realities of digital capabilities and infrastructure, especially for older persons. This paper critically examines learnings from a rapid evidence review of digital information tools along with a study evaluating the uptake of a digitally-based healthy ageing intervention by 53 older Australians. Findings suggest that digital literacy is an important precursor to engagement with digital information tools, and that digital information tools must be designed with digital literacy in mind. To achieve digital health equity and realise the potential outcomes that digital tools offer, it may well be necessary to support consumers with the basics of mastering digital platforms.
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Krishnapillai A, Kee CC, Ariaratnam S, Jaffar A, Omar MA, Sanaudi RB, Sooryanarayana R, Kiau HB, Ghazali SS, Mohd Tohit N, Zainal Abidin SI. Social Support among Older Persons and Its Association with Smoking: Findings from the National Health and Morbidity Survey 2018. Healthcare (Basel) 2023; 11:2249. [PMID: 37628448 PMCID: PMC10454005 DOI: 10.3390/healthcare11162249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Globally, the average age of the world's population of older people continues to rise and having a good social support network becomes increasingly relevant with the aging populace. Overall, in Malaysia, social support prevalence was low among older persons. This study was conducted to determine the association between social support and smoking status among the older Malaysian population. METHODS Data were obtained from the National Health and Morbidity (NHMS) 2018 survey on the health of older Malaysian adults and analyzed. This cross-sectional population-based study used a two-stage stratified random sampling design. Sociodemographic characteristics, smoking status, and social support data were collected from respondents aged 60 years and more. A validated Malay language interviewer-administered questionnaire of 11-items, the Duke Social Support Index, was utilized to assess the social support status. A multivariable logistic regression analysis was used to assess the association of social support and smoking status among the respondents. RESULTS The prevalence of good social support was significantly higher among the 60-69 years old (73.1%) compared to the ≥80 years old respondents (50%). Multivariate logistic regression analysis showed that respondents aged ≥80 years old were 1.7 times more likely to have poor social support compared to those aged 60-69 years. Respondents with no formal education were 1.93 times more likely to have poor social support compared to respondents who had tertiary education. Respondents with an income of MYR 3000. Former smokers had good social support compared to current smokers (73.6% vs. 78.7%). For current smokers, they had poor social support, which is almost 1.42 times higher than that for non-smokers. CONCLUSION There was poor social support among older people who were current smokers, had an increased age, had no formal education and had a low income. The findings obtained from this study could assist policymakers to develop relevant strategies at the national level to enhance the social support status among older smokers and aid in their smoking cessation efforts.
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de Carvalho ARB, de Sousa AR, da Silva MDF, de Freitas DRJ, Moura MEB. Global research trends related to coronavirus disease 2019 and the aged: a bibliometric analysis. SAO PAULO MED J 2023; 142:e2022662. [PMID: 37556683 PMCID: PMC10403196 DOI: 10.1590/1516-3180.2022.0662.r1.190523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/29/2023] [Accepted: 05/19/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND A bibliometric analysis covering only the production of original studies or considering world production until 2022 has yet to be conducted. The creation and advancement of vaccines have also influenced research priorities, demonstrating the need for a new approach to this subject. OBJECTIVES To analyze worldwide scientific production related to coronavirus disease 2019 (COVID-19) and the aged and to describe what has already been produced. DESIGN AND SETTING Bibliometric analysis with a quantitative approach. METHOD The search terms "COVID-19," "SARS-CoV-2," "Aged," and "Elderly" were used to retrieve articles from the Web of Science database. A total of 684 articles were included in the analysis. Data were imported into RStudio Desktop Software and linked to R Software. The Bibliometrix R package and VOSviewer software were used for analysis. RESULTS Most articles were published in 2020. These were produced by 4,937 authors and published in 379 journals. The keyword most used by the authors was "COVID-19." Publications from 77 countries were obtained. China had the highest article production ranking, and Spain collaborated the most. The articles addressed the implications of the pandemic on the aged, the relationship between vaccination in the aged, and the implications for the disease itself. CONCLUSION Further research should be conducted, mainly concerning vaccines and vaccination of the aged, owing to the need for and importance of immunization in this risk group, including assessing the long-term effects of vaccines.
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Söderman M, Bondesson A, Pettersson T, Gustafsson LK. "Intensive-Home-Rehabilitation" Intervention for Older Persons: A Follow-Up Study of Team Members' Perceptions. J Multidiscip Healthc 2023; 16:2207-2216. [PMID: 37551340 PMCID: PMC10404402 DOI: 10.2147/jmdh.s409879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/02/2023] [Indexed: 08/09/2023] Open
Abstract
Background Reablement as a concept includes a health-promoting perspective with the goal of strengthening health and the ability to perform and participate in daily activities, a broader perspective than in general home care and rehabilitation. Reablement interventions have shown to be both more effective and to a greater extent improve the function and health-related quality of life of older persons when compared to traditional home-based care. Success factors for intensive-home-rehabilitation (IHR), an intervention based on the reablement concept, have been described earlier; however, there is a lack of knowledge about why some persons do not recover despite receiving IHR. Aim The aim was to shed light on the older persons' conditions during IHR from the perspective of the rehabilitation team members and to describe obstacles to recovery. Methods Qualitative analysis of health and care records of persons (65+) who received IHR (n=19) performed by an interprofessional team. Results The analysis revealed various problematic situations, dilemmas, that occurred in the older persons' lives during IHR, as well as their consequences and the strategies employed by the older persons as a result. IHR aspects perceived as successful by the older persons also emerged, as well as differences in experiences of the physical and mental aspects of the IHR. Analysis also revealed reasons why the IHR might be experienced as broadly successful. Conclusion The older persons seemed to be satisfied with IHR and achieved their goals; however, some seemed to need more time to reach their goals. Background factors such as having additional diagnoses and living alone might affect the rehabilitation process. Implication for Practice The study provides knowledge regarding the importance of IHR for the recovery process for the increasing numbers of older persons, which might also be useful in other patient groups requiring otherwise long-term rehabilitation and recovery such as after covid-19 infection.
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Kasa AS, Drury P, Chang HCR, Lee SC, Traynor V. Cross-Cultural Adaptation, Validity, and Reliability Testing of the Tilburg Frailty Indicator (TFI) Amharic Version for Screening Frailty in Community-Dwelling Ethiopian Older People. Clin Interv Aging 2023; 18:1115-1127. [PMID: 37522070 PMCID: PMC10377638 DOI: 10.2147/cia.s416942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Frailty is a global health problem, including in African countries. Despite this, no reliable or valid frailty instruments incorporate any African language, and no research exists to cross-culturally adapt and test the validity and reliability of instruments commonly used in other countries for use within African countries. The Tilburg Frailty Indicator (TFI) is a reliable and validated instrument with the potential to be relevant for older populations living in Africa. This study aimed to develop the TFI Amharic (TFI-AM) version for use within Ethiopia. METHODS This study employed psychometric testing and the evaluation of a translated and adapted instrument. The original English language version of the TFI was translated and culturally adapted into Amharic using the World Health Organization process of translation and adaptation of an instrument. A convenience sample of ninety-six community-dwelling older people 60 years and over was recruited. Cronbach's alpha was used for the analysis of the internal consistency of the TFI Amharic (TFI-AM) version using IBM SPSS 26.0 (IBM Corp., Armonk, NY, USA). Face and content validities of the TFI-AM were determined. RESULTS The TFI-AM total mean score was 5.76 (±2.89). The internal consistency of the TFI-AM was very good with an overall Cronbach alpha value of 0.82. The physical domain showed the highest reliability with a 0.75 Cronbach's alpha value while the social domain was the lowest with a 0.68 Cronbach's alpha value. The Cronbach's alpha reliability coefficients of the instrument ranged from 0.68 to 0.75. The item content validity index value ranged from 0.83 to 1.0 and the total content validity index average for the instrument was 0.91. CONCLUSION The TFI-AM is reliable, valid, and reproducible for the assessment of frailty among community-dwelling older populations in Ethiopia. TFI-AM proved an easy-to-administer, applicable and fast instrument for assessing frailty in community-dwelling older populations.
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Pourhassan M, Cederholm T, Donini LM, Poggiogalle E, Schwab U, Nielsen RL, Andersen AL, Małgorzewicz S, Volkert D, Wirth R. Severity of Inflammation Is Associated with Food Intake in Hospitalized Geriatric Patients-A Merged Data Analysis. Nutrients 2023; 15:3079. [PMID: 37513497 PMCID: PMC10385000 DOI: 10.3390/nu15143079] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
The extent to which inflammation impacts food intake remains unclear, serving as a key risk factor for malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). To address this, we analyzed a large, merged dataset of geriatric hospitalized patients across Europe. The study included 1650 consecutive patients aged ≥65 year from Germany, Italy, Finland, Denmark, and Poland. Nutritional intake was assessed using the first item of the Mini Nutritional Assessment Short Form; C-reactive protein (CRP) levels were measured using standard procedures. In total (age 79.6 ± 7.4 year, 1047 females), 23% exhibited moderate to severe inflammation, and 12% showed severe inflammation; 35% showed moderate reductions in food intake, and 28% were considered malnourished. Median CRP levels differed significantly between patients with severe, moderate, and no decrease in food intake. Among patients with a CRP level of 3.0-4.99 mg/dL, 19% experienced a severe decrease in food intake, while 66% experienced moderate to severe decreases. Regression analysis revealed that inflammation was the most prominent risk factor for low food intake and malnutrition, surpassing other factors such as age, gender, infection, and comorbidity. A CRP level of ≥3.0 mg/dL is associated with reduced food intake during last 3 months in two thirds of hospitalized geriatric patients and therefore indicative for a high risk of malnutrition.
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Verderber S, Koyabashi U, Cruz CD, Sadat A, Anderson DC. Residential Environments for Older Persons: A Comprehensive Literature Review (2005-2022). HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:291-337. [PMID: 37078127 PMCID: PMC10328148 DOI: 10.1177/19375867231152611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND Independent noninstitutional and institutional residential long-term care environments for older persons have been the subject of significant empirical and qualitative research in the 2005-2022 period. A comprehensive review of this literature is reported, summarizing recent advancements in this rapidly expanding body of knowledge. PURPOSE AND AIM This comprehensive review conceptually structures the recent literature on environment and aging to provide conceptual clarity and identify current and future trends. METHOD AND RESULT Each source reviewed was classified as one of the five types-opinion piece/essay, cross-sectional empirical investigation, nonrandomized comparative investigation, randomized study, and policy review essay-within eight content categories: community-based aging in place; residentialism; nature, landscape, and biophilia; dementia special care units; voluntary/involuntary relocation; infection control/COVID-19, safety/environmental stress; ecological and cost-effective best practices; and recent design trends and prognostications. CONCLUSIONS Among the findings embodied in the 204 literature sources reviewed, all-private room long-term care residential units are generally safer and provide greater privacy and personal autonomy to residents, the deleterious impacts of involuntary relocation continue, family engagement in policy making and daily routines has increased, multigenerational independent living alternatives are increasing, the therapeutic role of nature and landscape is increasingly well-documented, ecological sustainability has increased in priority, and infection control measures are of high priority in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review sets the stage for further research and design advancements on this subject in light of the rapid aging of societies around the globe.
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Sturm J, Dierick A, Christianen M, van Gelder M, Wouters E. Possibilities, Patience, and Perseverance: A Preliminary Analysis of the Needs and Experiences of Ten Older Adults Regarding Their Use of Digital Health Technology. Healthcare (Basel) 2023; 11:healthcare11111612. [PMID: 37297752 DOI: 10.3390/healthcare11111612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023] Open
Abstract
The COVID-19 pandemic created the need to use digital health resources (DR), as they sometimes were the only option to receive healthcare or social interaction. The aim of this research is to provide insight into the experiences during the lockdown of older people using DR for health in general and the points of improvement they see. A qualitative study was carried out using semi-structured interviews with older persons by telephone. A total of 10 older adults participated, with a median age of 78 years, the majority having a chronic disease. The most important themes for motivation to use health-related DR were 'urgency' and 'usefulness'. Experiences with DR were related to the themes 'human contact' and 'communication', which were experienced by respondents as facilitated by DR, and 'time and energy', which was two-sided. Additionally, most older persons worried about accessibility of DR by all older persons and the support needed. In conclusion, older persons are convinced of the urgency and the usefulness of digital technology for health and healthcare. Time and energy constraints can be alleviated by using DR on the one hand, but this can also be challenging if older persons are less digitally skilled or lack digital literacy. Good and sustained human support is therefore mandatory.
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Blusi M, Lindgren H, Nilsson I. Factors to Consider when Introducing Digital Social Activities to Older Persons with Home Care. Stud Health Technol Inform 2023; 302:453-457. [PMID: 37203715 DOI: 10.3233/shti230171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Social isolation and loneliness have become everyday concerns for populations all over the world as these factors are affecting both physical and mental health in a negative way. Feelings of isolation and loneliness are increasingly acknowledged as a health risk among older persons. ICTs have been recognized as effective tools to combat social isolation among older people. The aim of this study was to explore factors of significance when introducing a tablet-based system providing digital social activities for older persons with home care. Participants were 17 persons, age 70 and older, who lived alone and had assistance from home care. This exploratory study used cross-sectional qualitative data analyzed through thematic analysis. Three themes were generated: 1) lacking vocabulary related to the context, 2) intuitive user interface may replace extensive instructions and 3) unwillingness to commit to a pre-defined measure of performance.
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Farrié AJ, Jacus JP, Cuervo-Lombard CV. Evaluation of apathy among institutionalized older persons: Its mediating role between cognitive functioning and lack of awareness. Int J Geriatr Psychiatry 2023; 38:e5917. [PMID: 37132066 DOI: 10.1002/gps.5917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 04/18/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES The main objective of this study was to determine the directions of the relationships between apathy, cognitive deficits and lack of awareness. METHODS One hundred and twenty-one older persons living in nursing homes, aged between 65 and 99 years old, participated in the study. Cognitive functioning, autonomy, depressive and anxious symptoms, general self-efficacy, self-esteem and apathy were evaluated through tests and questionnaires. Lack of awareness was calculated using the patient-caregiver discrepancy method. The sample was divided into two groups (n1 = 60, n2 = 61) depending on cognitive functioning level (Dementia Rating Scale < median score: 120). We first explored the characteristics of each group. Then, we compared the mode of evaluation of apathy. Finally, we investigated the direction of relationships by applying mediation analyses. RESULTS Older persons in the low cognitive functioning group were less autonomous, had a lower cognitive functioning level, higher caregiver-rated apathy and higher lack of awareness than the high cognitive functioning group (ps < 0.05). Evaluation differences were found only in the low cognition group. Caregiver-rated apathy totally mediated the relationship between cognitive functioning (predictor) and lack of awareness (dependent variable) for the whole sample (90%) and for the low cognitive functioning group (100%). CONCLUSIONS Cognitive deficits should be taken into account when evaluating apathy. Interventions should combine cognition training and emotion intervention to reduce lack of awareness. Future research should develop a therapy dedicated to apathy among older persons without pathologies.
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Herrmann-Lunecke MG, Figueroa-Martínez C, Olivares Espinoza B. Making Chile More Pedestrian-Friendly for Older Persons: Expert Perspectives. J Aging Soc Policy 2023; 35:486-508. [PMID: 37011133 DOI: 10.1080/08959420.2023.2196908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Walking provides numerous benefits to older persons, but its practice is hindered by social factors and the built environment. This article aims to understand the factors that encourage or discourage older people's walking behaviors, as well as the policies influencing those factors in Chile. It does so by reporting the analysis of twenty-five semi-structured interviews with Chilean policymakers and local leaders. The experts consistently represented walking as a beneficial activity for older persons that, nonetheless, occurs in adverse built environments. They asserted that the absence of older people in the public discussion and a top-down policy-making structure hamper its promotion.
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Yan E, To L, Ng HKL, Lai DWL, Bai X, Lee VWP. Trends in elder abuse and age discrimination during the COVID-19 pandemic in Hong Kong: Findings from a two-wave representative telephone survey study. Int J Geriatr Psychiatry 2023; 38:e5915. [PMID: 37096750 DOI: 10.1002/gps.5915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVES Empirical evidence about the heightened risks of elder abuse and age discrimination during the COVID-19 pandemic is scarce. This study aimed to track the changes in rates of both, and investigated their associated factors in the community-dwelling older population in Hong Kong. METHODS In this two-wave, cross-sectional telephone survey, we interviewed a population-based sample of individuals (≥55 years), and captured the situation of elder abuse and age discrimination before the COVID-19 outbreak (n = 1209, Wave 1: October-December 2019) and during the pandemic (n = 891, Wave 2: December 2020-January 2021). Participants reported their experiences of different types of abuse and discrimination, financial health, subjective well-being, satisfaction with environment, health and social services, and resilience. RESULTS Abuse was reported by 20.2% of the sample before the outbreak and 17.8% during the pandemic; while discrimination was reported by 24.6% and 29.8% at the two time points, respectively. A drop in physical abuse was observed, but it was accompanied by a rise in discrimination in the form of harassment or refusal of services. Findings of logistic regression analysis show that abuse during the pandemic was associated with younger age, poorer subjective well-being, and lower resilience; while discrimination was associated with female gender, being married, and poorer subjective well-being. CONCLUSIONS Elder abuse and discrimination were prevalent across time points. The pandemic has highlighted the marginalization of older persons in our communities. There is an urgent need for development of effective interventions to end abuse and discrimination.
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Mannheim I, Varlamova M, van Zaalen Y, Wouters EJM. The Role of Ageism in the Acceptance and Use of Digital Technology. J Appl Gerontol 2023; 42:1283-1294. [PMID: 36917039 DOI: 10.1177/07334648231163426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Technology acceptance models associate older age with lower intention to use digital technology although this assumption is often stereotypically-based and not sufficiently tested with older persons. This study investigated the association of ageism (rather than chronological age) with behavioral intention and actual use of technology within the theoretical framework of the Unified Theory of Acceptance and Use of Technology (UTAUT-2) model. 374 Dutch-speaking participants aged 50-97 completed the UTAUT-2 questionnaire, Expectations Regarding Aging, Attitudes Toward Older Adults Using Technology (ATOAUT-11) and experienced ageism scales. A path analysis found that expectations regarding aging partially mediated the association of age with negative attitudes. Mixed results were found regarding the fit of the new UTAUT-2-Ageism model. Negative ATOAUT moderated the associations of Effort Expectancy, Facilitating Conditions, and Habit with Behavioral Intention to use technology, and the explained variance increased. Further research is warranted to fully identify the potential role of ageism in technology acceptance.
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Gustafsson T, Maurin Söderholm H, Sundler AJ, Karlsson P, Lindberg E. 'Sometimes you need an eye-opener': A qualitative study on nursing assistants' experiences of developing communication skills through an educational intervention on person-centred communication. Nurs Open 2023. [PMID: 36882996 DOI: 10.1002/nop2.1702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 12/12/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
AIM To explore nursing assistants' (NAs') experiences of developing communication skills while participating in an educational intervention on person-centred communication. DESIGN A descriptive qualitative study was conducted. METHODS Data were collected from interviews and written assignments before, during and after an educational intervention on person-centred communication targeting NAs in home care services. The data were analysed using a phenomenological approach. A total of 25 NAs participated in the study. RESULTS The findings describe NAs' experiences concerning the communication skills needed for building relationships with older persons and handling emotionally challenging situations. The educational intervention increased their knowledge and awareness of the importance of communication skills and how such skills are developed and refined.
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Teerawichitchainan B, Zimmer Z, Low TQY, Toan TK. Respiratory Health Among Older Adults in Vietnam: Does Earlier-Life Military Role and War Exposure Matter? J Aging Health 2023; 35:168-181. [PMID: 35941715 DOI: 10.1177/08982643221118445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ObjectiveWe explore how earlier-life military roles and war trauma associate with later-life respiratory health in Vietnam. Method: The population-based sample aged 60+ is from the 2018 Vietnam Health and Aging Study. Poisson and binary logistic regressions investigate correlates of overall lung health, measured as total number of four conditions, and individual conditions, with focus on earlier-life wartime experiences. Results: Exposure is associated with lung conditions. Overall, a one-standard deviation increase in exposure results in 0.529 more conditions (p ≤ .001). Association varies across military roles and is partially explained by PTSD and smoking. Civilians heavily exposed to war trauma exhibit worse lung health than similarly exposed formal and informal military personnel. Discussion: Earlier-life war exposure is an important predictor of late-adulthood respiratory health in lower- and middle-income countries. Evidence calls for attention to the long-term impacts of war on health among not only formal and informal military personnel but also civilians.
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Sahril N, Chan YM, Chan YY, Ahmad NA, Kassim MSA, Shahein NA, Rezali MS, Abd Razak MA, Tahir FA, Ab Wahab N, Shamsuddin N, Adnan MAA, Khalil MKN, Liew SH. Poor Self-Rated Health and Associated Factors among Older Persons in Malaysia: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054342. [PMID: 36901351 PMCID: PMC10002035 DOI: 10.3390/ijerph20054342] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVE This study aims to determine the prevalence of poor self-rated health (SRH) in Malaysia and its association with sociodemographic characteristics, lifestyle behavior, chronic diseases, depression, and functional limitations in activities of daily living (ADLs) among older persons. DESIGN Cross-sectional. Setting, participants, and outcome measures: We used data from the National Health and Morbidity Survey 2018, a nationwide community-based study. This study was conducted using a two-stage stratified cluster sampling design. Older persons were defined as persons aged 60 years and above. SRH was assessed using the question "How do you rate your general health?" and the answers were "very good", "good", "moderate", "not good", and "very bad". SRH was then grouped into two categories; "Good" (very good and good) and "Poor" (moderate, not good, and very bad). Descriptive and logistic regression analyses were conducted using SPSS version 25.0. RESULTS The prevalence of poor SRH among older persons was 32.6%. Poor SRH was significantly related to physical inactivity, depression, and limitations in activities of daily living (ADLs). Multiple logistic regression revealed that poor SRH was positively associated with those who had depression (aOR 2.92, 95% CI:2.01,4.24), limitations in ADLs (aOR 1.82, 95% CI: 1.31, 2.54), low individual income (aOR 1.66, 95% CI:1.22, 2.26), physical inactivity (aOR 1.40, 95% CI:1.08, 1.82), and hypertension (aOR 1.23, 95% CI:1.02, 1.49). CONCLUSIONS Older persons with depression, limitations in ADLs, low income, physical inactivity, and hypertension were significantly associated with poor SRH. These findings provide information to aid health personnel and policymakers in the development and implementation of health promotion and disease prevention programs, as well as adequate evidence in planning different levels of care for the older population.
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Abdul Latiff AR, Mohd S. Transport, Mobility and the Wellbeing of Older Adults: An Exploration of Private Chauffeuring and Companionship Services in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2720. [PMID: 36768086 PMCID: PMC9915393 DOI: 10.3390/ijerph20032720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/19/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
As physical abilities and health decline with age, older adults tend to lose their driving abilities, which affects their mobility. As mobility is important to older adults' wellbeing, there is a need to explore alternative modes of transportation to increase their ability to actively participate in society. Hence, this paper aims to understand the characteristics of private chauffeuring and companionship services for older adults, and to assess their possible effects on older adults' wellbeing. We gathered the views of transport operators, government agencies, and city councils that offer private chauffeuring and companionship services for older adults. We frame the model of private chauffeuring and companionship services as alternative mobility for older adults and outline a conceptual framework for its possible effects on their wellbeing. The underlying mobility characteristics were availability, accessibility, safety, and affordability-all of which influence wellbeing. The study found that the private chauffeuring and companionship model for older adults includes an additional model of government-to-consumer services in addition to the existing peer-to-peer and business-to-consumer services. While the services are available, the services provided are not standardized, with different operators offering different services and prices, and limiting certain geographical areas. Transport operators perceived that the services they offer promote older adults' physical and mental health, improve their social participation in the community, and empower them in making their travel decisions. The findings of the paper provide insights for policy makers for future planning of alternative transportation for older adults to enhance their mobility.
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Migration and health: exploring healthy ageing of immigrants in European societies. Prim Health Care Res Dev 2023; 24:e10. [PMID: 36733211 PMCID: PMC9971849 DOI: 10.1017/s1463423623000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AIM The aim is to identify important factors for immigrants' health and well-being and for their use (or non-use) of primary health care (PHC) and other non-specialised services, and for possible ways that PHC can support healthy ageing of immigrants. BACKGROUND Older persons are an increasing share of the immigrant population in the global north, frequently in contact with various forms of health services, (PHC services most of all. Consequently, PHC services are in a particularly unique position to support healthy ageing of immigrants. METHODS The position paper builds on five international, multi-professional and cross-disciplinary small group discussions as well as an international workshop early summer. During the discussions and the workshop, topics were arrived at as to factors related to the health situation of older immigrants, their needs, and health-seeking behaviour, and to how PHC professionals could support healthy ageing in immigrants. Those main topics in turn guided search for relevant research literature and informed the selection of the main research questions of this paper. FINDINGS Several factors, in addition to culture and cultural differences, are important to for PHC professionals and decision-makers to take into consideration in encounters with older immigrants. The socio-economic position of the older immigrant and close relatives, inter-generational relationships within the immigrant communities, country-specific factors in the host country like health care expenditure, and communication skills in health professionals are all examples of factors playing an important role regarding the health and health-seeking behaviour of older immigrants.
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Yeung EK, Brown L, Kairaitis L, Krishnasamy R, Light C, See E, Semple D, Polkinghorne KR, Toussaint ND, MacGinley R, Roberts MA. Impact of haemodialysis hours on outcomes in older patients. Nephrology (Carlton) 2023; 28:109-118. [PMID: 36401820 DOI: 10.1111/nep.14133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 11/20/2022]
Abstract
AIM Previous studies report an association between longer haemodialysis treatment sessions and improved survival. Worldwide, there is a trend to increasing age among prevalent patients receiving haemodialysis. This analysis aimed to determine whether the mortality benefit of longer haemodialysis treatment sessions diminishes with increasing age. METHODS This was a retrospective cohort study of people who first commenced thrice-weekly haemodialysis aged ≥65 years, reported to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry from 2005 to 2015, included from 90 days after dialysis start. The primary outcome was all-cause mortality. Cox regression analysis was performed with haemodialysis session duration the exposure of interest. RESULTS Of 8224 people who commenced haemodialysis as their first treatment for kidney failure aged ≥65 years during this period, 4727 patients died. Longer dialysis hours per session was associated with a decreased risk of death in unadjusted analyses [hazard ratio, HR, for ≥5 h versus 4 to <4.5 h: 0.81 (0.75-0.88, p < .001)]. Patients having longer dialysis sessions were younger but had greater co-morbidity. In an adjusted model including age and other variables, the survival benefit of longer hours was only partially attenuated [HR for previous comparison: 0.75 (0.69-0.82, p < .001)], and no interaction between age and hours was demonstrated (p = .89). CONCLUSION The apparent survival benefit associated with longer haemodialysis session length appears to be preserved in patients 65 years or older. In practice, the benefit of longer dialysis hours should be carefully weighed against other factors in this patient group.
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Söderman A, Werkander Harstäde C, Hälleberg Nyman M, Blomberg K. Valuing the individual - evaluating the Dignity Care Intervention. Nurs Ethics 2023; 30:86-105. [PMID: 36206197 PMCID: PMC9902983 DOI: 10.1177/09697330221122902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Palliative care needs in older persons can endanger their dignity. To provide dignity-conserving care to older persons, the Swedish Dignity Care Intervention (DCI-SWE) can be used. The DCI-SWE is built on Chochinov's dignity model and the original version, developed and tested in UK and Scotland. AIM To describe older persons' and their relatives' experiences of dignity and dignity-conserving care when using the DCI-SWE in municipal health care. RESEARCH DESIGN A mixed method study with convergent parallel design. PARTICIPANTS AND RESEARCH CONTEXT The DCI-SWE was used and evaluated in a Swedish municipality health care context. Older persons' (n=17) dignity-related distress and quality of life were assessed after the intervention. Interviews with older persons (n=10) and their relatives (n=8) were analysed using thematic analysis. ETHICAL CONSIDERATIONS The study followed the World Medical Association Declaration of Helsinki. Ethical approval was obtained from the Regional Ethical Review Board in Uppsala, Sweden (Reg No. 2014/312) and the National Swedish Ethical Review Authority (Reg. No. Ö 10-2019). Informed consent was collected from older persons and their relatives. FINDINGS The older persons' dignity-related distress did not significantly change over time (p = 0.44) neither was their overall quality of life (p = .64). Only psychological quality of life was decreased significantly (p = 0.01). The older persons and their relatives emphasized the importance of valuing the individual. CONCLUSIONS The DCI-SWE provides a forum to talk about dignity issues, but relevant competence, continuity and resources are needed. Psychological care actions and health care professionals' communication skills training are important. To fully evaluate, the DCI-SWE a larger sample and validated instruments are necessary.
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Nkurunziza M, Mchiza ZJR, Zembe Y. Meals on Wheels: Promoting Food and Nutrition Security among Older Persons in Cape Town, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2561. [PMID: 36767923 PMCID: PMC9915356 DOI: 10.3390/ijerph20032561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Food insecurity (FI) prevails in Sub-Saharan Africa. Yet, in South Africa, although many people, including the elderly, are vulnerable to FI, little is known about the experiences of older persons (OPs) with FI and the interventions thereof. In South Africa, Meals on Wheels Community Service (MOWCS) provides readymade home meal deliveries for OPs through 209 branches across the country. Therefore, this study investigated MOWCS' role in the promotion of food security among the OPs at the Brooklyn branch, Cape Town. The study was grounded within the food security framework and focused on the availability, accessibility, utilization, and stability of food at Brooklyn MOWCS. Using qualitative research methods, 10 semi-structured interviews and one focus group discussion (N = 5) were conducted with Brooklyn MOWCS beneficiaries, in addition to three key personnel interviews conducted with staff. Data were analysed using Open Code 4.03. The findings showed Brooklyn MOWCS as a stable source of affordable and nutritious meals to OPs. The portion size satisfied hunger; occasionally, one portion sufficed for two meals. Respondents admitted the meal ingredients represented various food groups and rated them as "healthy". However, some financial challenges hindered the extension of MOWCS services to the wider community. For instance, they only had three paid employees and were overcrowded within church premises. Findings also showed race and gender disparity among respondents; 90% were White and 10% were of Mixed Ancestry, with no Black or Asian OPs represented, and only 10% were male. These outcomes are typical of the current ethnic profile of the overall Brooklyn MOWCS beneficiaries in SA. This calls, therefore, for such interventions to be extended to all South African demographic groups as an initiative to alleviate food and nutrition insecurity among all OPs.
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Gao H, Yous ML, Connelly D, Hung L, Garnett A, Hay M, Snobelen N. Implementation and impacts of virtual team-based care planning for older persons in formal care settings: A scoping review. Digit Health 2023; 9:20552076231151567. [PMID: 36714541 PMCID: PMC9880593 DOI: 10.1177/20552076231151567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/08/2022] [Indexed: 01/25/2023] Open
Abstract
Objective This scoping review aimed to summarize current knowledge about the implementation, impacts, facilitators and barriers of virtual team-based care planning for older persons in formal care settings (e.g. home and community, primary, long-term and acute care). Methods The Joanna Briggs Institute (JBI) methodology was used. The Arksey and O'Malley and Levac, Colquhoun, and O'Brien methodologies provided additional frameworks. Databases accessed included PubMed, EMBASE, CINAHL, AgeLine, PsycInfo and Scopus. Reference lists of selected articles and grey literature retrieved through Google and Google Scholar were also reviewed. Three researchers screened titles, abstracts and conducted full-text reviews. Extracted data were mapped in a table and analysed for summative themes. Older persons and family partners assisted in interpreting findings based on their lived experiences. Results A total of 27 studies were included. Virtual team-based care planning led to many positive outcomes for older persons (e.g. decreased depression, reduced falls and improved medication management) and their families (e.g. reduced caregiver stress and improved caregiving skills). Only four studies reported the involvement of older persons and/or families in virtual team-based care planning. Multiple barriers to adopting virtual team-based care planning were found including lack of education/training for older persons and families in using technology. Conclusion Despite the multiple advantages that virtual team-based care planning offers for older persons and families, it is important to ensure that this care can be offered to all. There is a need to ensure that health equity is addressed to promote access to care and respond to social determinants of health.
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Kutner NG, Zhang R. Frailty as a dynamic process in a diverse cohort of older persons with dialysis-dependent CKD. FRONTIERS IN NEPHROLOGY 2023; 3:1031338. [PMID: 37675341 PMCID: PMC10479570 DOI: 10.3389/fneph.2023.1031338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/02/2023] [Indexed: 09/08/2023]
Abstract
This study examines frailty status evolution observed in a two-year follow-up of a cohort of older persons (age ≥65) with chronic kidney disease (CKD) undergoing maintenance hemodialysis (HD) treatment. Frailty, a geriatric syndrome that connotes a state of low physiologic reserve and vulnerability to stressors, is associated with increased risk for multiple adverse health outcomes in studies of persons with CKD as well as older persons in the general population. The Fried frailty index defines frailty as the presence of 3 or more of 5 indicators-recent unintentional weight loss, slowed gait speed, decreased muscle strength, self-reported exhaustion, and low physical activity. In the seminal work by Fried and colleagues, persons who were characterized by 1-2 of the Fried index criteria were termed "pre-frail" and considered at risk for subsequently becoming frail, potentially providing insight regarding intervention targets that might slow or prevent individuals' transition from pre-frail to frail status. Other less frequently studied types of transitions may also be informative, including "recovery or reversion" (improvement) by people whose longitudinal assessments indicate movement from frailty to prefrailty or robust, or from prefrailty to robust. These status changes are also a potential source of insights relevant for prevention or remediation of frailty, but research focusing on the various ways that individuals may transition between frailty states over time remains limited, and no previous research has examined varying patterns of frailty status evolution in an older cohort of persons with dialysis-dependent CKD. In a study cohort of dialysis-dependent older persons, we characterized patterns of frailty status evolution by age, sex, race/ethnicity, and treatment vintage; by longitudinal profiles of non-sedentary behavior; and by self-report indicators relevant for dimensions emphasized in the Age-Friendly 4Ms Health System (What Matters, Mobility, Mentation). Our study suggests that strategies to promote resiliency among older persons with dialysis-dependent CKD can be informed not only by frailty status transition that indicates improvement over time but also by older adults' maintenance of (stable) robust status over time, and we concur that inclusion of both frailty and resilience measures is needed in future longitudinal studies and clinical trials.
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Farsijani S, Cauley JA, Peddada SD, Langsetmo L, Shikany JM, Orwoll ES, Ensrud KE, Cawthon PM, Newman AB. Relation Between Dietary Protein Intake and Gut Microbiome Composition in Community-Dwelling Older Men: Findings from the Osteoporotic Fractures in Men Study (MrOS). J Nutr 2023; 152:2877-2887. [PMID: 36205552 PMCID: PMC9839986 DOI: 10.1093/jn/nxac231] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/12/2022] [Accepted: 09/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Little is known about the association of specific nutrients, especially proteins, on age-related gut dysbiosis. OBJECTIVES To determine the associations between the quantity and sources (vegetable and animal) of dietary protein intake and gut microbiome composition in community-dwelling older men. METHODS We performed a cross-sectional analysis on 775 older men from the Osteoporotic Fractures in Men Study (MrOS) (age 84.2 ± 4.0 y) with available dietary information and stool samples at visit 4 (2014-2016). Protein intake was estimated from a brief FFQ and adjusted to total energy intake. The gut microbiome composition was determined by 16S (v4) sequencing (processed by DADA2 and SILVA). A total of 11,534 amplicon sequence variants (ASVs) were identified and assigned to 21 phyla with dominance of Firmicutes (45%) and Bacteroidetes (43%). We performed α-diversity, β-diversity, and taxa abundance (by Analysis of Compositions of Microbiomes with Bias Correction [ANCOM-BC]) to determine the associations between protein intake and the gut microbiome. RESULTS Median protein intake was 0.7 g/(kg body weight · d). Participants with higher energy-adjusted protein intakes had higher Shannon and Chao1 α-diversity indices (P < 0.05). For β-diversity analysis, participants with higher protein intakes had a different center in weighted and unweighted UniFrac Principal Co-ordinates Analysis (PCoA) compared with those with lower intake (P < 0.05), adjusted for age, race, education, clinical center, batch number, fiber and energy intake, weight, height, and medications. Similarly, higher protein consumptions from either animal or vegetable sources were associated with higher gut microbiome diversity. Several genus-level ASVs, including Christensenellaceae, Veillonella, Haemophilus, and Klebsiella were more abundant in participants with higher protein intakes, whereas Clostridiales bacterium DTU089 and Desulfovibrio were more abundant in participants with lower protein intake (Bonferroni corrected P < 0.05). CONCLUSIONS We observed significant associations between protein intake and gut microbiome diversity in community-living older men. Further studies are needed to elucidate the mediation role of the gut microbiome on the relation between protein intake and health outcomes in older adults.
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Hessels NR, Zhu Y, Bakker SJL, de Borst MH, Navis GJ, Riphagen IJ. Low Sodium Intake, Low Protein Intake, and Excess Mortality in an Older Dutch General Population Cohort: Findings in the Prospective Lifelines-MINUTHE Study. Nutrients 2023; 15:nu15020428. [PMID: 36678299 PMCID: PMC9865839 DOI: 10.3390/nu15020428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/17/2023] Open
Abstract
Background: Several studies have found a U-shaped association between sodium intake and mortality. The increased mortality risk of low sodium intake has raised debates and hampers widespread acceptance of public health campaigns and dietary guidelines on reducing sodium intake. Whether the excess risk can be attributed to low sodium intake alone or concomitant inadequate intake of other relevant nutrients is unknown. Objective: We investigated whether concomitant low protein intake could explain the lower part of the U-shaped association of sodium intake with all-cause mortality. Methods: We included 1603 individuals aged between 60 and 75 years old from the gender- and socioeconomic status-balanced prospective Lifelines-MINUTHE cohort study. Using multivariable Cox regression analyses, we investigated the association of sodium intake (24 h urinary sodium excretion) with all-cause mortality, including the interaction with protein intake calculated from the Maroni formula. Results: Mean intakes of sodium and protein were 3.9 ± 1.6 g/day and 1.1 ± 0.3 g/kg/day, respectively. After a median follow-up of 8.9 years, 125 individuals (7.8%) had died. The proportion of participants with insufficient protein intake (<0.8 g/kg/day) was inversely related to sodium intake (i.e., 23.3% in Q1 versus 2.8% in Q4, p < 0.001). We found an increased risk for mortality in both the highest quartile (Q4, >4.7 g/day; hazard ratio (HR) 1.74 (95% confidence interval (CI) 1.03−2.95)) and the lowest two quartiles of sodium intake (Q1, 0.7−2.8 g/day; 2.05 (1.16−3.62); p = 0.01 and Q2, 2.8−3.6 g/day; 1.85 (1.08−3.20); p = 0.03), compared with the third quartile of sodium intake (Q3, 3.6−4.7 g/day). This U-shaped association was significantly modified by protein intake (Pinteraction = 0.006), with the increased mortality risk of low sodium intake being reversed to the lowest mortality risk with concomitant high protein intake. In contrast, the increased mortality risk of low sodium intake was magnified by concomitant low protein intake. Conclusions: We found that a higher protein intake counteracts the increased mortality risk observed in subjects with a low sodium intake. In contrast, a joint low intake of sodium and protein is associated with an increased mortality risk, allegedly due to poor nutritional status. These findings support the guidelines that advocate a lower sodium intake, while highlighting the importance of recognizing overall nutritional status among older adults.
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