The influence of physical and mental health on life satisfaction is mediated by self-rated health: A study with Brazilian elderly

Impact of family communication on self-rated health of couples who visited primary care physicians: A cross-sectional analysis of Family Cohort Study in Primary Care

Introduction

Self-rated health (SRH) is a subjective health measurement that predicts mortality and morbidity and reflects mental health and socioeconomic status. Since a couple’s relationship can influence the health status of the individuals involved, poor family communication can negatively influence the health status of its members. The aim of this study was to investigate the factors affecting SRH among married couples in primary care and evaluated the effect of family communication on SRH.

Material and methods

In this cross-sectional analysis of Family Cohort Study in Primary Care, 469 couples (938 participants) were analyzed to evaluate the relationship between SRH and family communication. Participants answered questionnaires on demographic characteristics and lifestyle factors. The Korean version of the Family Communication Scale of Family Adaptation and Cohesion Evaluation Scale-IV was used to assess family communication, and a 5-point scale of SRH questions was used to assess the SRH status. Multivariate logistic regression analyses were performed in order to evaluate the relationship between family communication and SRH and identify associated factors for good SRH.

Results

Wives with a high family communication level had higher OR for good SRH. When the husband and wife both reported high family communication levels, the OR for good SRH increased in wives; however, the relationship between family communication and SRH was not significant in husbands. In the multi-adjusted model, the OR for good SRH of husbands increased in those with >12 years of education, moderate drinkers and decreased in current smokers. The OR for good SRH of wives increased in those with age of 60 to 69, those with >12 years of education, and those who participated in vigorous physical activity, and decreased in those with diabetes and depressive mood.

Conclusions

Our results indicate that improvement in family communication may contribute to better SRH.

Prediction of future cognitive impairment among the community elderly: A machine-learning based approach

The early detection of cognitive impairment is a key issue among the elderly. Although neuroimaging, genetic, and cerebrospinal measurements show promising results, high costs and invasiveness hinder their widespread use. Predicting cognitive impairment using easy-to-collect variables by non-invasive methods for community-dwelling elderly is useful prior to conducting such a comprehensive evaluation. This study aimed to develop a machine learning-based predictive model for future cognitive impairment. A total of 3424 community elderly without cognitive impairment were included from the nationwide dataset. The gradient boosting machine (GBM) was exploited to predict cognitive impairment after 2 years. The GBM performance was good (sensitivity = 0.967; specificity = 0.825; and AUC = 0.921). This study demonstrated that a machine learning-based predictive model might be used to screen future cognitive impairment using variables, which are commonly collected in community health care institutions. With efforts of enhancing the predictive performance, such a machine learning-based approach can further contribute to the improvement of the cognitive function in community elderly.

Effects of changes in family social capital on the self-rated health and family life satisfaction of older adults in Taiwan: A longitudinal study

AIM

The present study assessed the effect of family social capital on self-rated health and family life satisfaction among older adults aged ≥50 years.

METHODS

A logistic regression model was used to analyze the longitudinal data of 1243 older adults from the Panel Study of Family Dynamics in Taiwan.

RESULTS

The findings show that, compared with having a poor relationship with parents, respondents who were getting along with their parents have a higher likelihood of reporting good health. Frequent interaction with kin significantly promotes respondents' family life satisfaction. With regard to parental control, there is no evidence of its effect on either health or family life satisfaction.

CONCLUSIONS

The results suggest that the quality of relationships has limited effect on the health of older adults, whereas frequent interaction with kin contributes to the promotion of their family life satisfaction. Policies aiming to improve health-related quality of life should take into account the importance of a reciprocal relationships and the need to maintain family-focused networks in Chinese culture. Geriatr Gerontol Int 2019; 19: 228-232.

Factors associated with poor balance ability in older adults of nine high-altitude communities

INTRODUCTION

Poor balance ability in older adults result in multiple complications. Poor balance ability has not been studied among older adults living at high altitudes. In this study, we analysed factors associated with poor balance ability by using the Functional Reach (FR) among older adults living in nine high-altitude communities.

MATERIAL AND METHODS

Analytical cross-sectional study, carried out in inhabitants aged 60 or over from nine high-altitude Andean communities of Peru during 2013-2016. FR was divided according to the cut-off point of 8 inches (20.32 cm) and two groups were generated: poor balance ability (FR less or equal than 20.32 cm) and good balance ability (greater than 20.32 cm). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor balance ability. Prevalence ratio (PR) with 95% confidence intervals (95CI%) are presented.

RESULTS

A total of 365 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-91 years), and 180 (49.3%) participants had poor balance ability. In the adjusted Poisson regression analysis, the factors associated with poor balance ability were: alcohol consumption (PR = 1.35; 95%CI: 1.05-1.73), exhaustion (PR = 2.22; 95%CI: 1.49-3.31), gait speed (PR = 0.67; 95%CI: 0.50-0.90), having had at least one fall in the last year (PR = 2.03; 95%CI: 1.19-3.46), having at least one comorbidity (PR = 1.60; 95%CI: 1.10-2.35) and having two or more comorbidities (PR = 1.61; 95%CI: 1.07-2.42) compared to none.

CONCLUSIONS

Approximately a half of the older adults from these high-altitude communities had poor balance ability. Interventions need to be designed to target these balance issues and prevent adverse events from concurring to these individuals.

Motives to practice exercise in old age and successful aging: A latent class analysis

PURPOSE

The aim was to classify motives for exercising trying to find sets of related cases that share common motivations, and to relate these latent classes to markers of successful aging.

METHODS

725 old adult aged 55 to 97 years were sampled in several Spanish towns.

INSTRUMENTS

Successful Aging Inventory (SAI), International Physical Activity Questionnaire (IPAQ), Health Survey SF-8, Satisfaction with Life Scale (SWLS), and motives to practice exercise, were used. Latent Class Analyses (LCAs) were estimated. The classes obtained were compared on markers of successful aging.

RESULTS

Three latent classes were deemed optimal. Significant differences for several markers of successful aging were found.

CONCLUSION

A main conclusion derived from the results is that not all old people do exercise for the same motives, and the class of motives you are in had an impact/relation on markers of successful aging. Motives related to internal rather than external pressures should be promoted in the old age.

Funcionalidade familiar de idosos brasileiros residentes em comunidade

Resumo Objetivo Avaliar a funcionalidade familiar de idosos brasileiros; testar a influência de fatores determinantes. Métodos Estudo transversal com 2.052 idosos, a partir de dados coletados da linha base referente ao estudo “Aging, Gender and Quality of Life (AGEQOL)”, responderam questionários sobre funcionamento familiar; atividades básicas e instrumentais de vida diária (AVD e AIVD); estado cognitivo; e características sociodemográficas. Modelos multivariados de regressão ordinal e análise de correspondência múltipla identificaram fatores associados à boa funcionalidade familiar. Resultados A maior parte dos idosos gozava de boa funcionalidade familiar (76,3%), era casada e vivendo com cônjuge (55,5%), tinha mais de seis filhos e netos (85,4% e 76,7%, respectivamente) e independente para AIVD (71,5%). Análise de correspondência resultou em três grupos: alta, moderada e baixa funcionalidade familiar e perfil de idosos com distintas condições socioeconômicas. Conclusão Infere-se dos resultados implicações para a prática e política de atenção à família com membros idosos segundo seu funcionamento e distintas condições de vida e saúde das pessoas idosas.

Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model

INTRODUCTION

Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status.

OBJECTIVE

To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults.

MATERIALS AND METHODS

We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health.

RESULTS

A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20).

CONCLUSIONS

A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.

Improvement in lower urinary tract symptoms across multiple domains following ventriculoperitoneal shunting for idiopathic normal pressure hydrocephalus

AIMS

The purpose of this study was to evaluate the change in lower urinary tract symptoms following ventriculoperitoneal shunting in patients with idiopathic normal pressure hydrocephalus (iNPH).

METHODS

Lower urinary tract symptoms in patients with new-onset iNPH were prospectively evaluated using validated questionnaires from the International Consultation on Incontinence to assess overactive bladder (ICIq-OAB), incontinence (ICIq-UI), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale, prior to and following ventriculoperitoneal shunting for iNPH. Sub-analysis was performed based on gender, age, and medical comorbidities.

RESULTS

Twenty-three consecutive patients with new-onset iNPH were evaluated prior to, and following, surgical intervention for iNPH via ventriculoperitoneal shunting. Shunting resulted in a significant improvement in urinary urgency, urge incontinence, ability to perform physical activities, and overall quality of life. Women had improvement across more domains than men following shunting, particularly in terms of urinary urgency and overall quality of life. Younger patients experienced significant improvement in scores following shunting as compared to older patients. Patients with two or more medical comorbidities, as well as those with fewer than two comorbidities, reported a significant improvement in overall quality of life.

CONCLUSIONS

Surgical intervention for iNPH results in significant improvement in urinary symptoms, specifically in terms of urinary urgency and urge incontinence as well as overall quality of life, particularly in women and younger patients.

The impact of neighborhood social capital on life satisfaction and self-rated health: A possible pathway for health promotion?

Neighborhood social capital has repeatedly been linked to favorable health-outcomes and life satisfaction. However, it has been questioned whether it's impact on health has been over-rated. We aim to investigate relationships between neighborhood social capital and self-rated health (SRH) and life satisfaction (LS) respectively, both directly and indirectly mediated via Sense of Coherence and self-esteem. Based on a cross-sectional population-survey (N=865) in a medium size Norwegian municipality, we specified a structural equation model (SEM) including the above-listed variables, while controlling for gender, age, education, income, and employment status. The applied model explains more variance in LS (46%) than in SRH (23%). Social capital has a stronger impact on life satisfaction than on health. The indirect pathway via SOC had the highest impact on life satisfaction, but no significant relationship to SRH. Self-rated health was more tightly linked to personal background variables. Enhancing social capital in the neighborhood might be a beneficial strategy to promote life satisfaction, as well as strengthening sense of coherence even in healthy communities.

Characterization of lower urinary tract symptoms in patients with idiopathic normal pressure hydrocephalus

AIMS

The purpose of this study was to evaluate lower urinary tract symptoms (LUTS) in idiopathic normal pressure hydrocephalus (iNPH).

METHODS

Patients with new-onset iNPH were prospectively evaluated for LUTS via detailed history and physical, and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), overactive bladder (ICIq-OAB), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale. All patients with moderate-to-severe LUTS were offered urodynamic testing. Sub-analysis was performed based on gender, medical comorbidities, and age.

RESULTS

Fifty-five consecutive patients with iNPH completed the initial evaluation and surveys. Total urinary incontinence score was mild to moderate (8.71 ± 0.64: 0-21 scale) with 90.9% experiencing leakage and 74.5% reporting urge incontinence. The most common OAB symptom was nocturia (2.2 ± 0.14: 0-4 scale) with urge incontinence the most bothersome (3.71 ± 0.44: 0-10 scale). Quality-of-life impact was moderate (4.47 ± 0.4: 0-10 scale) and American Urological Association Symptom Score bother scale was 2.89 ± 0.22 (0-6 scale). Urodynamics testing revealed 100% detrusor overactivity and mean bladder capacity of 200 mL. Several differences were identified based on gender, medical comorbidities, and age.

CONCLUSIONS

Patients with iNPH present with mild-moderate incontinence of which nocturia is the most common symptom, urge incontinence the most bothersome, with 100% of patients having detrusor overactivity. Younger patients experienced greater bother related to LUTS. To our knowledge, this is the only prospective evaluation of urinary symptoms in patients with new-onset iNPH.