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Movahedi S, Eliyas S, Fisher N. Early years postgraduate learning and training in prosthodontic dentistry: 2019 and beyond. Br Dent J 2019; 226:801-806. [DOI: 10.1038/s41415-019-0317-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Longobucco Y, Benedetti C, Tagliaferri S, Angileri VV, Adorni E, Pessina M, Zerbinati L, Cicala L, Pelà G, Giacomini V, Barbolini M, Lauretani F, Maggio MG. Proactive interception and care of Frailty and Multimorbidity in older persons: the experience of the European Innovation Partnership on Active and Healthy Ageing and the response of Parma Local Health Trust and Lab through European Projects. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:364-374. [PMID: 31125023 PMCID: PMC6776195 DOI: 10.23750/abm.v90i2.8419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 01/03/2023]
Abstract
According to the 2018 European Union Ageing Report, the demographic profile of the European population is projected to be older. Aging cannot be considered a homogeneous process, and only in certain cases is “successful”, with maintained functional ability, which is determined by intrinsic capacity, the environment, and their interaction. When intrinsic capacity is lost, elders with chronic diseases develop frailty, a condition with high-risk of disability. Old-age dependency-ratio is projected to increase from 29.6% to 51.2% in the EU in 2070: thus, the need of new approaches targeting the prevention of disability. Numerous studies are conducted in the European Innovation Partnership on Active and Healthy Ageing and addressing identification, treatment, coordination and integration of care in frail older subjects. SUNFRAIL is aimed at developing a model, good practices and tools to improve the identification, prevention and care of frailty and management of multimorbidity. SPRINTT is testing the effectiveness of a multi-component treatment able to treat frailty and sarcopenia. VIGOUR, a project aimed at strengthening integrated-care in different contexts of European Countries, verifies enablers and obstacles encountered in the real world by these good practices. Through the creation of Parma-Lab and Frailty-Team in the Academic-Hospital of Parma combined with the contribution of Parma Health-Trust in the “Community Health-Centers”, the Projects were translated into Health Services Arena. This response bridging European Studies and clinical practice, aims to early detecting and caring 75-year older citizens with frailty and multimorbidity, living in the community, not institutionalized and at risk of hospitalization and mobility ADL-disability. (www.actabiomedica.it)
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203
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Lee KE, Lee Y, Kim J, Ki SK, Chon D, Jung EJ. Five-year survival rate among older adults participating in the national geriatric screening program: A South Korean population-based cohort study. Arch Gerontol Geriatr 2019; 83:179-184. [PMID: 31071534 DOI: 10.1016/j.archger.2019.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/12/2019] [Accepted: 04/26/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to assess the health benefits of a geriatric screening program comprising of physical function tests, screening questionnaires for depression and cognitive impairment, and bone mineral density measurements for women as a part of the National Screening Program for Transitional Ages (NSPTA). We compared the all-cause mortality between subjects who did and did not participate in the screening program. METHODS This was a nationwide longitudinal study with a 5-year follow-up based on a 10% sample of the National Health Insurance beneficiaries aged 60 years and older. Mortality records were obtained from the qualification dataset in the elderly cohort database of 2005-2013 provided by the National Health Insurance Service. A Cox proportional hazards model was used to analyze the mortality risk. We sampled 11,986 subjects each in the screened (intervention) and non-screened (control) groups after exact matching using propensity score. RESULTS After adjusting for demographic and socioeconomic characteristics (age, sex, household income, smoking, alcohol drinking, physical activity, body mass index, and the Charlson Comorbidity Index), all-cause mortality rates were found to be significantly lower (a) in the intervention group compared to the control group (hazard ratio = 0.73; 95% confidence interval: 0.65, 0.82) and (b) among women compared to men (hazard ratio = 0.50; 95% confidence interval: 0.44, 0.56). Lower hazard ratios were also observed among those with a higher body mass index, fewer comorbidities, and higher income. CONCLUSION A nationwide geriatric screening program might be helpful in reducing the incidence of premature deaths among older people.
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Affiliation(s)
- Kyung-Eun Lee
- Jungbu Area Epidemiologic Investigation Team, Occupational Safety, and Health Research Institute, Incheon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Yunhwan Lee
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea; Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
| | - Jinhee Kim
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea; Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seung Kook Ki
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Doukyoung Chon
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea; Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Eun-Joo Jung
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Hansung Institute of Industrial Medicine, Gunpo, Republic of Korea
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Edvardsson D, Baxter R, Corneliusson L, Anderson RA, Beeber A, Boas PV, Corazzini K, Gordon AL, Hanratty B, Jacinto A, Lepore M, Leung AYM, McGilton KS, Meyer J, Schols JMGA, Schwartz L, Shepherd V, Skoldunger A, Thompson R, Toles M, Wachholz P, Wang J, Wu B, Zúñiga F. Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life. Gerontol Geriatr Med 2019; 5:2333721419842672. [PMID: 31106240 PMCID: PMC6506925 DOI: 10.1177/2333721419842672] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/07/2019] [Indexed: 12/20/2022] Open
Abstract
To support the development of internationally comparable common data elements
(CDEs) that can be used to measure essential aspects of long-term care (LTC)
across low-, middle-, and high-income countries, a group of researchers in
medicine, nursing, behavioral, and social sciences from 21 different countries
have joined forces and launched the Worldwide Elements to Harmonize Research in
LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop
a common data infrastructure for international use across the domains of
organizational context, workforce and staffing, person-centered care, and care
outcomes, as these are critical to LTC quality, experiences, and outcomes. This
article reports measurement recommendations for the care outcomes domain,
focusing on previously prioritized care outcomes concepts of well-being, quality
of life (QoL), and personhood for residents in LTC. Through literature review
and expert ranking, we recommend nine measures of well-being, QoL, and
personhood, as a basis for developing CDEs for long-term care outcomes across
countries. Data in LTC have often included deficit-oriented measures; while
important, reductions do not necessarily mean that residents are concurrently
experiencing well-being. Enhancing measurement efforts with the inclusion of
these positive LTC outcomes across countries would facilitate international LTC
research and align with global shifts toward healthy aging and person-centered
LTC models.
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Affiliation(s)
- David Edvardsson
- Umeå University, Umeå, Sweden.,La Trobe University, Victoria, Australia
| | | | | | | | - Anna Beeber
- The University of North Carolina at Chapel Hill, NC, USA
| | | | | | | | | | | | | | | | | | | | | | - Lindsay Schwartz
- American Health Care Association/National Center for Assisted Living, Washington, DC, USA
| | | | | | | | - Mark Toles
- The University of North Carolina at Chapel Hill, NC, USA
| | | | | | - Bei Wu
- New York University, New York City, USA
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205
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Agahi N, Fors S, Fritzell J, Shaw BA. Smoking and Physical Inactivity as Predictors of Mobility Impairment During Late Life: Exploring Differential Vulnerability Across Education Level in Sweden. J Gerontol B Psychol Sci Soc Sci 2019; 73:675-683. [PMID: 27449220 DOI: 10.1093/geronb/gbw090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 07/05/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives To test whether older adults from high and low educational groups are differentially vulnerable to the impact of smoking and physical inactivity on the progression of mobility impairment during old age. Methods A nationally representative sample of older Swedish adults (n = 1,311), aged 57-76 years at baseline (1991), were followed for up to 23 years (2014). Multilevel regression was used to estimate individual trajectories of mobility impairment over the study period and to test for differences in the progression of mobility impairment on the basis of smoking status, physical activity status, and level of education. Results Compared to nonsmokers, heavy smokers had higher levels and steeper increases in mobility impairment with advancing age. However, there were only small and statistically nonsignificant differences in the impact of heavy smoking on mobility impairment in high versus low education groups. A similar pattern of results was found for physical inactivity. Discussion Differential vulnerability to unhealthy behaviors may vary across populations, age, time-periods, and health outcomes. In this study of older adults in Sweden, low and high education groups did not differ significantly in their associations between heavy smoking or physical inactivity, and the progression of mobility impairment.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
| | - Stefan Fors
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
| | - Johan Fritzell
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
| | - Benjamin A Shaw
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, Rensselaer, New York
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206
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Geerse C, van Slobbe C, van Triet E, Simonse L. Design of a Care Pathway for Preventive Blood Pressure Monitoring: Qualitative Study. JMIR Cardio 2019; 3:e13048. [PMID: 31758790 PMCID: PMC6834208 DOI: 10.2196/13048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/30/2019] [Accepted: 02/03/2019] [Indexed: 01/26/2023] Open
Abstract
Background Electronic health (eHealth) services could provide a solution for monitoring the blood pressure of at-risk patients while also decreasing expensive doctor visits. However, a major barrier to their implementation is the lack of integration into organizations. Objective Our aim was to design a Care Pathway for monitoring the blood pressure of at-risk patients, in order to increase eHealth implementation in secondary preventive care. Methods A qualitative design study was used in this research. Data were collected by conducting visual mapping sessions including semistructured interviews with hypertension patients and doctors. The data were transcribed and coded and thereafter mapped into a Care Pathway. Results Four themes emerged from the results: (1) the current approach to blood pressure measuring has disadvantages, (2) risk and lifestyle factors of blood pressure measuring need to be considered, (3) there are certain influences of the at-home context on measuring blood pressure, and (4) new touchpoints between patients and health professionals need to be designed. These in-depth insights combined with the visualization of the current blood pressure process resulted in our Care Pathway design for monitoring the blood pressure of at-risk patients as secondary preventive care. Conclusions The Care Pathway guides the implementation of eHealth devices for blood pressure self-measurement. It showcases the pathway of at-risk patients and increases their involvement in managing their blood pressure. It serves as a basis for a new service using eHealth.
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Affiliation(s)
- Carlijn Geerse
- Product Innovation Management Department, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Cher van Slobbe
- Product Innovation Management Department, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Edda van Triet
- Product Innovation Management Department, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Lianne Simonse
- Product Innovation Management Department, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Suriastini W, Buffardi AL, Fauzan J. What Prompts Policy Change? Comparative Analyses of Efforts to Create Age-Friendly Cities in 14 Cities in Indonesia. J Aging Soc Policy 2019; 31:250-270. [DOI: 10.1080/08959420.2019.1589889] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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208
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Spoorenberg SL, Reijneveld SA, Uittenbroek RJ, Kremer HP, Wynia K. Health-Related Problems and Changes After 1 Year as Assessed With the Geriatric ICF Core Set (GeriatrICS) in Community-Living Older Adults Who Are Frail Receiving Person-Centered and Integrated Care From Embrace. Arch Phys Med Rehabil 2019; 100:2334-2345. [PMID: 30986412 DOI: 10.1016/j.apmr.2019.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/31/2018] [Accepted: 02/13/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the prevalence, severity, and change in health-related problems in a sample of older adults who received individual care and support from Embrace, for the whole sample, per subgroup based on complexity of care needs and frailty, and for those who had at baseline a health-related problem. DESIGN A pretest-posttest study with assessments at baseline and after 12 months. SETTING Community. PARTICIPANTS Older adults aged 75 years and older (N=136) who are frail (n=56) or who have complex care needs (n=80). INTERVENTION Participants received care and support by Embrace, a person-centered and integrated care service for community-living older adults supporting them to age in place. A multidisciplinary team provided care and support, with intensity depending on the older adults' risk profile. MAIN OUTCOME MEASURE Health-related problems as perceived by older adults and measured with the Geriatric International Classification of Functioning, Disability and Health Core Set. RESULTS Health-related problems were related to 6 coherent clusters: (1) Mental Functions; (2) Physical Health; (3) Mobility; (4) Personal Care; (5) Nutrition; and (6) Support. The most prevalent and most severe problems at baseline were related to Mental Functions and Mobility. Changes in the prevalence of problems after 12 months varied. Severity scores decreased or remained stable, except for Mobility items which showed a varying changing pattern in participants with complex care needs. Prevalence and severity of problems for those with a problem at baseline decreased after 12 months. Frail participants with a problem had higher baseline severity scores than those with complex care needs experiencing a problem, but differences in changes between individuals who are frail and those with complex care needs were small. CONCLUSIONS The results are encouraging and may indicate that individual, person-centered and integrated care and support from Embrace offers a route to counteracting the decline in physical, cognitive and social functioning associated with aging.
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Affiliation(s)
- Sophie L Spoorenberg
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen
| | - Sijmen A Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen
| | - Ronald J Uittenbroek
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen
| | - Hubertus P Kremer
- University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, the Netherlands
| | - Klaske Wynia
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen; University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, the Netherlands.
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209
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Amorim CA, De Souza LP, Moreira JP, Luiz RR, De V Carneiro AJ, De Souza HSP. Geographic distribution and time trends of esophageal cancer in Brazil from 2005 to 2015. Mol Clin Oncol 2019; 10:631-638. [PMID: 31086670 DOI: 10.3892/mco.2019.1842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/05/2019] [Indexed: 12/18/2022] Open
Abstract
The purpose of the present study was to investigate the geographical distribution and time trends of the incidence and lethality of esophageal cancer (EC) in Brazil. The present study conducted an ecological study of EC using records from January 2005 to December 2015 in the Health Informatics Department of the Brazilian Ministry of Health (DATASUS) registry. In addition to demographical data on the population, EC incidence and lethality rates were estimated from hospitalizations and in-hospital mortalities and were adjusted by total available hospital beds. The adjusted EC rates per 100,000 increased from 9.1 in 2005 to 12.1 in 2015. The prevalence among males increased from 69 to 78%, while the female rates remained stable over the same period. Although EC was the most common in South and Southeast Brazil, the rates increased proportionately more in the other regions of the country, especially among males. Geographical analysis revealed higher rates of EC in more urbanized areas, with a coast-to-inland gradient. While rates increased in people older than 50 years, they decreased among people below this age. However, the lethality rates remained stable and high during the study period, overlapping with hospital admission rates. The recent increasing trend in the EC incidence, with shifts from the south towards the north and from more urbanized towards rural areas, suggests that environmental factors are crucial in EC pathogenesis. The concentration of EC in South Brazil may reflect the presence of major environmental factors in association with a possible genetic predisposition. The unchanging high mortality associated with EC in the rapidly aging population suggests that EC will continue to impose a significant social and economic burden in the future.
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Affiliation(s)
- César Augusto Amorim
- Department of Internal Medicine, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Lucila Perrota De Souza
- Department of Internal Medicine, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Jessica P Moreira
- Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Ronir R Luiz
- Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Antonio José De V Carneiro
- Department of Internal Medicine, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Heitor S P De Souza
- Department of Internal Medicine, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.,D'Or Institute for Research and Education (IDOR), Rio de Janeiro 22281-100, Brazil
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210
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Purtle J, Nelson KL, Yang Y, Langellier B, Stankov I, Diez Roux AV. Urban-Rural Differences in Older Adult Depression: A Systematic Review and Meta-analysis of Comparative Studies. Am J Prev Med 2019; 56:603-613. [PMID: 30777704 DOI: 10.1016/j.amepre.2018.11.008] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 12/15/2022]
Abstract
CONTEXT Depression among older adults (aged 60 years or older) is a problem that could be exacerbated by global trends in urbanization and population aging. The study purpose was to assess whether urban, relative to rural, residence is associated with depression among older adults and whether associations differ in countries with developed versus developing economies. EVIDENCE ACQUISITION In 2017, the authors identified and extracted information from comparative studies of urban-rural depression prevalence among older adults. Studies were identified in PubMed, PsychINFO, and Web of Science and limited to English language articles published after 1985. Eighteen studies met inclusion criteria. Random effects meta-analysis was conducted to produce weighted pooled ORs estimating the association between urban-rural residence and depression for all study participants (N=31,598) and sub-analyses were conducted for developed (n=12,728) and developing (n=18,870) countries. EVIDENCE SYNTHESIS Depression prevalence was significantly higher among urban residents in ten studies and significantly higher among rural residents in three studies (all three conducted in China). Associations between urban-rural residence and depression generally remained significant after adjusting for covariates. In developed countries, the odds of depression were significantly higher among urban than rural residents (pooled OR=1.44, 95% CI=1.10, 1.88). However, in developing countries, this association was not observed (pooled OR=0.91, 95% CI=0.46, 1.77). CONCLUSIONS Converging trends of urbanization and population aging could increase the global burden of depression among older adults. The pathways through which urban-rural residence influences depression risk among older adults might differ by country context. Future research should focus on measuring variation in these contexts.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Yong Yang
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee
| | - Brent Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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211
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Kutsuna T, Hiyama Y, Kusaka S, Kusumoto Y, Tsuchiya J, Umeda M, Takahashi T. The effect of short-term health promotion intervention on motor function in community-dwelling older adults. Aging Clin Exp Res 2019; 31:475-481. [PMID: 29971630 DOI: 10.1007/s40520-018-0994-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 06/29/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Slow walking speed as one indicator of physical frailty has been found to be associated with deterioration of the health status. Although many reports have shown that exercise training improves motor function, it is unclear whether a group-based and short-term health promotion intervention will improve motor function in older adults. AIMS This study aimed to examine the effectiveness of a short-term health promotion intervention on motor function in community-dwelling older adults. METHODS A 6-month middle-term and moderate-intensity programme (MTMIP) and a 6-week short-term high-intensity programme (STHIP) were conducted. There were 28 and 29 subjects selected for the MTMIP and STHIP, respectively. The difference in motor function test outcomes was compared by assessment of comfortable walking speed, maximal walking speed, a sit-to-stand test (STS), and a timed up-and-go test (TUG). RESULTS Comfortable walking speed, maximum walking speed, STS and TUG were significantly improved at end of the programme in the STHIP group (p = 0.02, p = 0.03, p < 0.001 and p = 0.002). Multiple regression analysis revealed that implementation of STHIP had a significant effect on end-of-programme comfortable walking speed (β = 0.19, p = 0.006, 95% CI 0.06 to 0.32). DISCUSSION It was assumed that the training content of the STHIP, with its emphasis on high intensity and physical performance, was the main factor in improved walking speed. CONCLUSIONS Our results demonstrated the effectiveness of STHIP on motor function. These findings could help support development of more effective intervention methods in community-dwelling older adults.
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Affiliation(s)
- Toshiki Kutsuna
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo, 144-8535, Japan.
| | - Yoshinori Hiyama
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo, 144-8535, Japan
| | - Satomi Kusaka
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo, 144-8535, Japan
| | - Yasuaki Kusumoto
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo, 144-8535, Japan
| | - Junko Tsuchiya
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo, 144-8535, Japan
| | - Masaru Umeda
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo, 144-8535, Japan
| | - Tetsuya Takahashi
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, Tokyo, 144-8535, Japan
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212
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Rishworth A, Elliott SJ. Global environmental change in an aging world: The role of space, place and scale. Soc Sci Med 2019; 227:128-136. [DOI: 10.1016/j.socscimed.2018.07.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/07/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
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213
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Tao D, Yuan J, Qu X. Effects of presentation formats on consumers' performance and perceptions in the use of personal health records among older and young adults. PATIENT EDUCATION AND COUNSELING 2019; 102:578-585. [PMID: 30318383 DOI: 10.1016/j.pec.2018.10.007] [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: 04/19/2018] [Revised: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine the effects of presentation formats on consumers' performance and perceptions in the use of personal health records (PHRs) and to compare the effects between older and young adults. METHODS A two-factor, mixed design experiment was conducted, where 36 older and 36 young participants were presented with hypothetical PHRs. The PHRs were randomly presented by six presentation formats: three tables and three line graphs, varying by visual cues. Participants' performance and perceptions in the use of PHRs were measured. RESULTS Presentation formats affected participants' performance and perceptions. Visual cue-enhanced line graphs and tables yielded less time and fewer errors, were considered easier and more useful in information comprehension, and resulted in higher confidence in correct comprehension of PHRs (all p's < 0.01), compared with their basic counterparts. There were age-related differences in task performance (all p's < 0.05), while young and older adults had similar perceptions for the six formats. Line graph with colored background was most preferred by both groups. CONCLUSION Visual cue-enhanced presentation formats appear effective in facilitating comprehension and eliciting favorable perceptions of PHRs for both young and older adults. PRACTICE IMPLICATIONS Consumer-facing displays of PHRs could use visual cue-enhanced presentation formats to facilitate comprehension.
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Affiliation(s)
- Da Tao
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China
| | - Juan Yuan
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China
| | - Xingda Qu
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China.
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214
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Solanki G, Kelly G, Cornell J, Daviaud E, Geffen L. Population ageing in South Africa: trends, impact, and challenges for the health sector. SOUTH AFRICAN HEALTH REVIEW 2019; 2019:175-182. [PMID: 34671174 PMCID: PMC8525465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
With more South Africans living past the age of 60, the country faces a growing chronic disease burden. Further research and action are needed for the health system to address the budgetary and social strains of this phenomenon effectively.
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Affiliation(s)
- Geetesh Solanki
- Health Systems Research Unit, South African Medical Research Council
- Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town
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Gardner M, Shepperd S, Godfrey M, Mäkelä P, Tsiachristas A, Singh-Mehta A, Ellis G, Khanna P, Langhorne P, Makin S, Stott DJ. Comprehensive Geriatric Assessment in hospital and hospital-at-home settings: a mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2019. [DOI: 10.3310/hsdr07100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundThe Comprehensive Geriatric Assessment (CGA) is a multidisciplinary process that determines a frail older person’s medical, functional, psychological and social capability to ensure that they have a co-ordinated plan for treatment and follow-up.ObjectivesTo improve our understanding of the effectiveness, cost-effectiveness and implementation of the CGA across hospital and hospital-at-home settings.MethodsWe used a variety of methods. We updated a Cochrane review of randomised trials of the CGA in hospital for older people aged ≥ 65 years, conducted a national survey of community CGA, analysed data from three health boards using propensity score matching (PSM) and regression analysis, conducted a qualitative study and used a modified Delphi method.ResultsWe included 29 trials recruiting 13,766 participants in the Cochrane review of the CGA. Older people admitted to hospital who receive the CGA are more likely to be living at home at 3–12 months’ follow-up [relative risk (RR) 1.06, 95% confidence interval (CI) 1.01 to 1.10] (high certainty). The probability that the CGA would be cost-effective at a £20,000 ceiling ratio for quality-adjusted life-years (QALYs), life-years (LYs) and LYs living at home was 0.50, 0.89, and 0.47, respectively (low-certainty evidence). After PSM and regression analysis comparing CGA hospital with CGA hospital at home, we found that the health-care cost (from admission to 6 months after discharge) in site 1 was lower in hospital at home (ratio of means 0.82, 95% CI 0.76 to 0.89), in site 2 there was little difference (ratio of means 1.00, 95% CI 0.92 to 1.09) and in site 3 it was higher (ratio of means 1.15, 95% CI 0.99 to 1.33). Six months after discharge (excluding the index admission), the ratio of means cost in site 1 was 1.27 (95% CI 1.14 to 1.41), in site 2 was 1.09 (95% CI 0.95 to 1.24) and in site 3 was 1.70 (95% CI 1.40 to 2.07). At 6 months’ follow-up (excluding the index admission), there may be an increased risk of mortality (adjusted) in the three hospital-at-home cohorts (site 1: RR 1.09, 95% CI 1.00 to 1.19; site 2: RR 1.29, 95% CI 1.15 to 1.44; site 3: RR 1.27, 95% CI 1.06 to 1.54). The qualitative research indicates the importance of relational aspects of health care, incorporating caregivers’ knowledge in care planning, and a lack of clarity about the end of an episode of health care. Core components that should be included in CGA focus on functional, physical and mental well-being, medication review and a caregiver’s ability to care.LimitationsThe risk of residual confounding limits the certainty of the findings from the PSM analysis; a second major limitation is that the research plan did not include an investigation of social care or primary care.ConclusionsThe CGA is an effective way to organise health care for older people in hospital and may lead to a small increase in costs. There may be an increase in cost and the risk of mortality in the population who received the CGA hospital at home compared with those who received the CGA in hospital; randomised evidence is required to confirm or refute this. Caregiver involvement in the CGA process could be strengthened.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Mike Gardner
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sasha Shepperd
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mary Godfrey
- Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Petra Mäkelä
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Amina Singh-Mehta
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Graham Ellis
- Monklands Hospital, NHS Lanarkshire, Glasgow, UK
| | | | - Peter Langhorne
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stephen Makin
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - David J Stott
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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216
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López MJ, Lapena C, Sánchez A, Continente X, Fernández A. Community intervention to reduce social isolation in older adults in disadvantaged urban areas: study protocol for a mixed methods multi-approach evaluation. BMC Geriatr 2019; 19:44. [PMID: 30777022 PMCID: PMC6380012 DOI: 10.1186/s12877-019-1055-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 01/31/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The proportion of older people has dramatically increased in recent decades. Moreover, social and demographic trends show a global increase of older people at risk of loneliness and lack of social relationships. The objective of this study was to evaluate the process, the effectiveness and the cost-effectiveness of a planned 22 weekly group sessions called School of Health for Older People to reduce social isolation. METHODS This is a mixed methods multi-approach evaluation that includes: 1) A qualitative evaluation among coordinators and participants taking part in the intervention, through in depth-interviews and focus groups, respectively. The main topics covered will be positive and negative aspects of the intervention, suggestions for its improvement, opinions on different aspects of the intervention, and perceived benefits; 2) A quantitative quasi-experimental design, comparing a group of individuals taking part in the intervention with another group with similar characteristics not receiving the intervention. Data will be collected at the beginning and at the end of the intervention. Social support will be measured through questions drawn from the Medical Outcomes Study and the National Social Life, Health, and Aging Project questionnaires. Psychological morbidity will be measured through Goldberg's General Health Questionnaire, and Health-related Quality of Life will be measured through the EuroQoL questionnaire. Information on visits to the primary care center in the years before and after the intervention will be obtained from the electronic records of the primary care centers; 3) A cost-utility analysis, which will be conducted from a health system (primary care) perspective, including direct costs of the program and the primary care health services used. The effects of the intervention will be measured on quality-adjusted life years. DISCUSSION There is an urgent need for studies assessing the effectiveness and the efficiency of potential interventions to reduce social isolation among older persons. The results of this study will help to fill the knowledge gap in this area and might be especially useful for the development of social and public health policies and programs for older people in disadvantaged neighborhoods in urban areas. TRIAL REGISTRATION NCT03142048 retrospectively registered (April 11, 2017).
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Affiliation(s)
- María José López
- Public Health Agency of Barcelona, Lesseps, 1, 08023 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Carolina Lapena
- Centre d’Atenció Primària Sanllehy, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Barcelona, Spain
- Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès Spain
| | - Alba Sánchez
- Preventive Medicine Department, University Hospital of Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Continente
- Public Health Agency of Barcelona, Lesseps, 1, 08023 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Ana Fernández
- Public Health Agency of Barcelona, Lesseps, 1, 08023 Barcelona, Spain
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Niedermeier M, Dremetsikas V, Herzog S, Kopp-Wilfling P, Burtscher M, Kopp M. Is the Effect of Physical Activity on Quality of Life in Older Adults Mediated by Social Support? Gerontology 2019; 65:375-382. [PMID: 30759438 DOI: 10.1159/000496103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/09/2018] [Indexed: 11/19/2022] Open
Abstract
Increasing evidence suggests positive associations between physical activity, social support, and quality of life in later life. However, the role of physical activity and social support in the influence on quality of life is unclear. In this viewpoint, definitions of central terms and key research findings on factors influencing quality of life in older adults are provided. We highlight the importance of both a physically active lifestyle and high social support in positively influencing quality of life. However, we question the direct effect of physical activity on quality of life and present data of a cross-sectional study to support the assumption that the effect of physical activity on quality of life might be influenced by perceived social support. In this cross-sectional study, self-reported physical activity, social support, and quality of life were assessed in a nonclinical sample of 100 adults aged between 60 and 80 years. Statistical analyses included correlation analyses and covariate-controlled mediation analyses. The results confirmed the research findings on positive correlations between all domains of quality of life and both physical activity and social support. Mediation analyses indicated that the effect of physical activity on all domains of quality of life was at least partially mediated by social support, when controlled for covariates. Based on the findings of published evidence and this cross-sectional study, a socially and physically active lifestyle is recommended for older adults to positively influence quality of life. However, the well-documented effect of physical activity on quality of might be an at least partially mediated effect by perceived social support. Practical and research-related implications of a potential indirect effect are discussed. Further prospective research is warranted to clarify the relationship between the variables.
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Affiliation(s)
- Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria,
| | | | - Simone Herzog
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Prisca Kopp-Wilfling
- Clinical Health Psychology Unit, Department of Psychiatry and Psychotherapy, Medical University of Innsbruck, Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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218
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Menichetti J, De Luca L, Dordoni P, Donegani S, Marenghi C, Valdagni R, Bellardita L. Making Active Surveillance a path towards health promotion: A qualitative study on prostate cancer patients' perceptions of health promotion during Active Surveillance. Eur J Cancer Care (Engl) 2019; 28:e13014. [PMID: 30761643 DOI: 10.1111/ecc.13014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 10/18/2018] [Accepted: 01/17/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Health promotion is a key aspect for health outcomes of prostate cancer (PCa) patients. However, it has been poorly explored among patients following monitoring programmes, for example Active Surveillance (AS). This study aimed to explore PCa patients' perceptions of health promotion during AS. METHODS An explorative qualitative research design was adopted. Four focus groups were used to collected data from 24 men enrolled in the Prostate Cancer Research International: AS (PRIAS) protocol. A thematic analysis with an inductive approach was performed. RESULTS Participants described promoting health during AS as challenged by mental, age-related, informational and organisational issues. It was reported as an effort to stay in the present with a positive outlook, despite the worries for the future ("the mental theme"). It was perceived as impacted by being older and having to manage physical and mental struggles related to age ("the life-course theme"). It depended, in their accounts, on obtaining reliable information and personalised education ("the educational theme"). Finally, it was related on taking responsibility on the care process ("the organisational theme"). CONCLUSION This study suggested ways of promoting health during AS that can help healthcare professionals and organisations building a "health-promoting AS," able to improve overall health outcomes.
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Affiliation(s)
- Julia Menichetti
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Letizia De Luca
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Paola Dordoni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Simona Donegani
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Cristina Marenghi
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Riccardo Valdagni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy.,Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy.,Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, Milano, Italy
| | - Lara Bellardita
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
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Mansfield L, Kay T, Anokye N, Fox-Rushby J. Community Sport and the Politics of Aging: Co-design and Partnership Approaches to Understanding the Embodied Experiences of Low-Income Older People. FRONTIERS IN SOCIOLOGY 2019; 4:5. [PMID: 33869332 PMCID: PMC8022756 DOI: 10.3389/fsoc.2019.00005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 01/22/2019] [Indexed: 06/12/2023]
Abstract
The promotion of physical activity for older people is dominated by biomedically informed polices emphasizing the prescription of exercise as medicine and a universal approach to the promotion of active aging in later life. Yet, more recent research recognizes that being physically active in later life is complex and contested, shaped by the intersections of biological, psychological, and sociological experiences, and requires differentiated responses that address this complexity. There is a disconnect between research, policy, and the physical activity experiences of older people which leads to over-generalized policy and practice in the promotion and delivery of community sport to older people. This paper presents findings from a complex community sport project employing a coproduction framework with low income older age people. Participatory community approaches including focus group discussions, and extended observations and informal conversations throughout the project develop understanding of the complexities of aging and community sport engagement among older people with limited income. Three themes are identified and discussed: (1) lived experience, aging bodies, and the changing dynamics of involvement in sport and exercise in the life course, (2) embodying aging-moving beyond practical barriers for understanding aging, lived experience and being physically active, and (3) corporeal pleasures of older sporting bodies. The paper concludes that there is a need to explore the significance of locally specific public knowledge from older people which directly addresses the complexity and inequalities of individuals' everyday lives in their communities; lived experiences likely to impact on preferences for, engagement in, and enjoyment of physical activity.
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Affiliation(s)
- Louise Mansfield
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Tess Kay
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Nana Anokye
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Julia Fox-Rushby
- Department of Primary Care and Public Health Sciences, King's College London, London, United Kingdom
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220
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Dias RD, Barros JVD. Burden of hospitalisation among older people in the Brazilian public health system: a big data analysis from 2009 to 2015. J Epidemiol Community Health 2019; 73:537-543. [PMID: 30728202 DOI: 10.1136/jech-2018-210783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 12/09/2018] [Accepted: 01/14/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND The world's population is progressively ageing, and this trend imposes several challenges to society and governments. The aim of this study was to investigate the burden generated by the hospitalisation of older (>60 years) compared with non-older population, as well as the epidemiology of these hospital admissions. METHODS Using the Brazilian Unified Health System (known as 'Sistema Único de Saúde' (SUS)), an analysis of all hospital admissions of adult patients in the SUS from 2009 to 2015 was undertaken. The following indicators were used: hospital admission rate, intensive care unit (ICU) admission rate, average length of hospital and ICU stay, hospital mortality and average reimbursement per hospitalisation. RESULTS A total of 61 958 959 admissions during the 7-year period, were analysed, encompassing 17 893 392 (28.9%) older patients. Elderly represent 15% (n=21 294 950) of the Brazilian adult population, but are responsible for 29% (n=17 893 392) of hospitalisations, 52% (n=1 731 299) of ICU admissions and 66% (n=1 885 291) of hospital mortality. Among the adults, elderly represents 39% of the total reimbursement made related to admission/hospitalisation. For 2009 to 2015, while the older population increased 27%, ICU admission rate increased 20%; the average length of ICU stay was 12% higher in 2015 (6.5 days) compared with 2009 (5.8 days); and the hospital mortality increased from 9.8% to 11.2%. CONCLUSION These findings illustrate the current panorama of the burden due to hospitalisation of older people in the Brazilian public health system, and evidence the consolidation of the epidemiological transition toward the predominance of non-communicable diseases as the main cause of hospitalisation among the elderly in Brazil.
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Affiliation(s)
- Roger Daglius Dias
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA.,STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, MA, USA
| | - Jacson Venancio de Barros
- Department of Information Technology, Hospital das Clínicas of the University of São Paulo Medical School, Sao Paulo, Brazil
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221
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Cowdell F. Role of nurses in promoting the skin health of older people in the community. Nurs Stand 2019; 35:61-66. [PMID: 31468854 DOI: 10.7748/ns.2019.e11394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 11/09/2022]
Abstract
Why you should read this article: The skin is the largest organ of the body and provides protection for the vital organs, as well as having a significant role in processes such as temperature regulation. However, the ageing process involves degenerative changes such as reduced cell replacement and less efficient barrier function. These changes have physical and psychosocial consequences for older people such as increased susceptibility to skin damage and lowered self-esteem. This article details the age-associated changes that affect the skin, explores the self-reported skin concerns of older people living in the community, and examines the role of primary care nurses in promoting older people's skin health.
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Affiliation(s)
- Fiona Cowdell
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, England
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222
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Evaluating the Effectiveness of the Health Management Program for the Elderly on Health-Related Quality of Life among Elderly People in China: Findings from the China Health and Retirement Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16010113. [PMID: 30609852 PMCID: PMC6338948 DOI: 10.3390/ijerph16010113] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/28/2018] [Accepted: 12/28/2018] [Indexed: 12/17/2022]
Abstract
The world’s rapidly aging population brings serious challenges which could be addressed by changes in behaviour and policy that promote good health in older age. However, these cheap and simple interventions are not available in many countries. China is one of the fastest-ageing countries in the world. The health management programs for the elderly in basic public health services was introduced by the government to promote the health of the elderly in China and address the challenges related to ageing. However, the effectiveness of the program is uncertain. So, we use a propensity score matching difference-in-difference (PSM-DID) model to analyse the causal effect of the health management program for the elderly in basic public health services on the health-related quality of life (HRQoL) of the elderly in China. The result shows that the program has improved the physical health of the elderly but has had no significant impact on mental health. Expanding the program to cover mental health could further benefit the HRQoL of the elderly. The program is a cost-effective approach to tackle the challenges of ageing and is a good example for other developing countries facing the same ageing challenges.
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223
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Derhun FM, Scolari GADS, Castro VCD, Salci MA, Baldissera VDA, Carreira L. The coexistence center for elderly people and its importance in the support to the family and the Health Care Network. ESCOLA ANNA NERY 2019. [DOI: 10.1590/2177-9465-ean-2018-0156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To know the perception of relatives of elderly people about the coexistence center and its importance in supporting the Health Care Network. Methodology: A qualitative study carried out with 14 relatives of elderly people participating in a coexistence center. Data collection took place in January 2016 through individual interviews, which were recorded, transcribed and submitted to content analysis. The results were discussed in the light of the theoretical referential of health promotion. Results: The elderly's participation in the coexistence center was an alternative to support care and institutionalization, provided time for self-care and to maintain or engage in the formal labor market and positively influenced the family relationships. Conclusion: The coexistence center was set up as a health promotion institution, being jointly responsible for the care of the elderly with the Health Care Network and the families.
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224
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Dreyer K, Steventon A, Fisher R, Deeny SR. The association between living alone and health care utilisation in older adults: a retrospective cohort study of electronic health records from a London general practice. BMC Geriatr 2018; 18:269. [PMID: 30514225 PMCID: PMC6280341 DOI: 10.1186/s12877-018-0939-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 10/08/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In 2016, one in three older people in the UK were living alone. These patients often have complex health needs and require additional clinical and non-clinical support. This study aimed to analyse the association between living alone and health care utilisation in older patients. METHODS We conducted a retrospective cohort study of 1447 patients over the age of 64, living in 1275 households who were registered at a large general practice in South East London. The utilisation of four different types of health care provision were examined in order to explore the impact of older patients living alone on health care utilisation. RESULTS After adjusting for patient demographics and clinical characteristics, living alone was significantly associated with a higher probability of utilising emergency department and general practitioner services, with odds ratios of 1.50 (95% confidence interval [CI] 1.16 to 1.93) and 1.40 (95% CI 1.04 to 1.88) respectively. CONCLUSIONS Living alone has an impact on health care service utilisation for older patients. We show that general practice data can be used to identify older patients who are living alone, and general practitioners are in a unique position to identify those who could benefit from additional clinical and non-clinical support. Further research is needed to understand the mechanism driving higher utilisation for those patients who live alone.
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Affiliation(s)
- Kathryn Dreyer
- The Health Foundation, 90 Long Acre, London, WC2E 9RA UK
| | - Adam Steventon
- The Health Foundation, 90 Long Acre, London, WC2E 9RA UK
| | - Rebecca Fisher
- The Health Foundation, 90 Long Acre, London, WC2E 9RA UK
| | - Sarah R. Deeny
- The Health Foundation, 90 Long Acre, London, WC2E 9RA UK
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Salathé CR, Melloh M, Crawford R, Scherrer S, Boos N, Elfering A. Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review. Global Spine J 2018; 8:872-886. [PMID: 30560041 PMCID: PMC6293434 DOI: 10.1177/2192568218765483] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
STUDY DESIGN Systematic review. OBJECTIVES To review the current literature on the treatment efficacy, clinical utility, and cost-effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) for patients suffering from persistent (nonspecific) lower back pain (LBP) in relation to pain intensity, disability, health-related quality of life, and work ability/sick leave. METHODS We carried out a systematic search of Web of Science, Cochrane Library, PubMed Central, EMBASE, and PsycINFO for English- and German-language literature published between January 2010 and July 2017. Study selection consisted of exclusion and inclusion phases. After screening for duplication, studies were excluded on the basis of criteria covering study design, number of participants, language of publication, and provision of information about the intervention. All the remaining articles dealing with the efficacy, utility, or cost-effectiveness of intensive (more than 25 hours per week) MBR encompassing at least 3 health domains and cognitive behavioral therapy-based psychological education were included. RESULTS The search retrieved 1199 publications of which 1116 were duplicates or met the exclusion criteria. Seventy of the remaining 83 articles did not meet the inclusion criteria; thus 13 studies were reviewed. All studies reporting changes in pain intensity or disability over 12 months after MBR reported moderate effect sizes and/or p-values for both outcomes. The effects on health-related quality of life were mixed, but MBR substantially reduced costs. Overall MBR produced an enduring improvement in work ability despite controversy and variable results. CONCLUSIONS MBR is an effective treatment for nonspecific LBP, but there is room for improvement in cost-effectiveness and impact on sick leave, where the evidence was less compelling.
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Affiliation(s)
| | - Markus Melloh
- Zurich University of Applied Sciences, Winterthur, Switzerland
- Curtin University, Bentley, Western Australia, Australia
- The University of Western Australia, Perth, Western Australia,
Australia
| | | | | | - Norbert Boos
- Prodorso Centre for Spinal Medicine, Zurich, Switzerland
| | - Achim Elfering
- University of Bern, Bern, Switzerland
- University of Geneva, Geneva, Switzerland
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226
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Framing the Shades of Sustainability in Health Care: Pitfalls and Perspectives from Western EU Countries. SUSTAINABILITY 2018. [DOI: 10.3390/su10124439] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Sustainability is momentous for the appropriate functioning of health care systems. In fact, health and sustainability are two strictly related values, which could not be separately sought. While studies discussing the contextualization of this issue with respect to the distinguishing attributes of health care systems are rapidly blooming, there is still little agreement about what is ultimately meant by sustainability in the health care arena. On the one hand, attention is primarily focused on the proper use of available financial resources; on the other hand, people engagement and empowerment are gradually arising as a crucial step to enhance the viability of the health care system. This paper tries to identify, from a conceptual point of view inspired by the European integrative movement, the different shades of sustainability in health care and proposes a recipe to strengthen the long-term viability of health care organizations. The balanced mix of financial, economic, political, and social sustainability is compelling to increase the ability of health care organizations to create meaningful value for the population served. However, the focus on a single dimension of sustainability is thought to engender several side effects, which compromise the capability of health care organizations to guarantee health gains at the individual and collective levels. From this standpoint, further conceptual and practical developments are envisioned, paving the way for a full-fledged understanding of sustainability in the health care environment.
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Murray CJL, Callender CSKH, Kulikoff XR, Srinivasan V, Abate D, Abate KH, Abay SM, Abbasi N, Abbastabar H, Abdela J, Abdelalim A, Abdel-Rahman O, Abdi A, Abdoli N, Abdollahpour I, Abdulkader RS, Abebe HT, Abebe M, Abebe Z, Abebo TA, Abejie AN, Aboyans V, Abraha HN, Abreu DMX, Abrham AR, Abu-Raddad LJ, Abu-Rmeileh NME, Accrombessi MMK, Acharya P, Adamu AA, Adebayo OM, Adedeji IA, Adekanmbi V, Adetokunboh OO, Adhena BM, Adhikari TB, Adib MG, Adou AK, Adsuar JC, Afarideh M, Afshin A, Agarwal G, Agesa KM, Aghayan SA, Agrawal S, Ahmadi A, Ahmadi M, Ahmed MB, Ahmed S, Aichour AN, Aichour I, Aichour MTE, Akanda AS, Akbari ME, Akibu M, Akinyemi RO, Akinyemiju T, Akseer N, Alahdab F, Al-Aly Z, Alam K, Alebel A, Aleman AV, Alene KA, Al-Eyadhy A, Ali R, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Allebeck P, Almasi A, Alonso J, Al-Raddadi RM, Alsharif U, Altirkawi K, Alvis-Guzman N, Amare AT, Ammar W, Anber NH, Andrei CL, Androudi S, Animut MD, Ansari H, Ansha MG, Antonio CAT, Appiah SCY, Aremu O, Areri HA, Arian N, Ärnlöv J, Artaman A, Aryal KK, Asayesh H, Asfaw ET, Asgedom SW, Assadi R, Atey TMM, Atique S, Atteraya MS, Ausloos M, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Ayele Y, Ayer R, Ayuk TB, Azzopardi PS, Babalola TK, Babazadeh A, Badali H, Badawi A, Bali AG, Banach M, Barker-Collo SL, Bärnighausen TW, Barrero LH, Basaleem H, Bassat Q, Basu A, Baune BT, Baynes HW, Beghi E, Behzadifar M, Behzadifar M, Bekele BB, Belachew AB, Belay AG, Belay E, Belay SA, Belay YA, Bell ML, Bello AK, Bennett DA, Bensenor IM, Bergeron G, Berhane A, Berman AE, Bernabe E, Bernstein RS, Bertolacci GJ, Beuran M, Bhattarai S, Bhaumik S, Bhutta ZA, Biadgo B, Bijani A, Bikbov B, Bililign N, Bin Sayeed MS, Birlik SM, Birungi C, Biswas T, Bizuneh H, Bleyer A, Basara BB, Bosetti C, Boufous S, Brady OJ, Bragazzi NL, Brainin M, Brazinova A, Breitborde NJK, Brenner H, Brewer JD, Briant PS, Britton G, Burstein R, Busse R, Butt ZA, Cahuana-Hurtado L, Campos-Nonato IR, 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A, Kassa DH, Kassa GM, Kassa TD, Kassa ZY, Kassebaum NJ, Kastor A, Katikireddi SV, Kaul A, Kawakami N, Karyani AK, Kebede S, Keiyoro PN, Kemp GR, Kengne AP, Keren A, Kereselidze M, Khader YS, Khafaie MA, Khajavi A, Khalid N, Khalil IA, Khan EA, Khan MS, Khang YH, Khanna T, Khater MM, Khatony A, Khazaeipour Z, Khazaie H, Khoja AT, Khosravi A, Khosravi MH, Kibret GD, Kidanemariam ZT, Kiirithio DN, Kilgore PE, Kim D, Kim JY, Kim YE, Kim YJ, Kimokoti RW, Kinfu Y, Kinra S, Kisa A, Kivimäki M, Kochhar S, Kokubo Y, Kolola T, Kopec JA, Kosek MN, Kosen S, Koul PA, Koyanagi A, Krishan K, Krishnaswami S, Krohn KJ, Defo BK, Bicer BK, Kumar GA, Kumar M, Kumar P, Kumsa FA, Kutz MJ, Lad SD, Lafranconi A, Lal DK, Lalloo R, Lam H, Lami FH, Lang JJ, Lanksy S, Lansingh VC, Laryea DO, Lassi ZS, Latifi A, Laxmaiah A, Lazarus JV, Lee JB, Lee PH, Leigh J, Leshargie CT, Leta S, Levi M, Li S, Li X, Li Y, Liang J, Liang X, Liben ML, Lim LL, Limenih MA, Linn S, Liu S, Lorkowski S, Lotufo PA, Lozano R, Lunevicius R, Mabika CM, Macarayan ERK, Mackay MT, Madotto F, Mahmood TAE, Mahotra NB, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malik MA, Mamun AA, Manamo WA, Manda AL, Mangalam S, Mansournia MA, Mantovani LG, Mapoma CC, Marami D, Maravilla JC, Marcenes W, Marina S, Martins-Melo FR, März W, Marzan MB, Mashamba-Thompson TP, Masiye F, Mason-Jones AJ, Massenburg BB, Mathur MR, Maulik PK, Mazidi M, McGrath JJ, Mehata S, Mehendale SM, Mehndiratta MM, Mehrotra R, Mehrzadi S, Mehta KM, Mehta V, Mekonnen TC, Meles HG, Meles KG, Melese A, Melku M, Memiah PTN, Memish ZA, Mendoza W, Mengesha MM, Mengistu DT, Mengistu G, Mensah GA, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezgebe HB, Miangotar Y, Miazgowski B, Miazgowski T, Miller TR, Miller-Petrie MK, Mini GK, Mirabi P, Mirica A, Mirrakhimov EM, Misganaw AT, Moazen B, Mohammad KA, Mohammadi M, Mohammadifard N, Mohammadi-Khanaposhtani M, Mohammed MA, Mohammed S, Mokdad AH, Mola GD, Molokhia M, Monasta L, Montañez JC, Moradi G, Moradi M, Moradi-Lakeh M, Moradinazar M, Moraga P, Morgado-Da-Costa J, Mori R, Morrison SD, Mosapour A, Moschos MM, Mousavi SM, Muche AA, Muchie KF, Mueller UO, Mukhopadhyay S, Muller K, Murphy TB, Murthy GVS, Musa J, Musa KI, Mustafa G, Muthupandian S, Nachega JB, Nagel G, Naghavi M, Naheed A, Nahvijou A, Naik G, Naik P, Najafi F, Naldi L, Nangia V, Nansseu JR, Nascimento BR, Nawaz H, Ncama BP, Neamati N, Negoi I, Negoi RI, Neupane S, Newton CRJ, Ngalesoni FN, Ngunjiri JW, Nguyen G, Nguyen LH, Nguyen TH, Ningrum DNA, Nirayo YL, Nisar MI, Nixon MR, Nomura S, Noroozi M, Noubiap JJ, Nouri HR, Shiadeh MN, Nowroozi MR, Nyandwi A, Nyasulu PS, Odell CM, Ofori-Asenso R, Ogah OS, Ogbo FA, Oh IH, Okoro A, Oladimeji O, Olagunju AT, Olagunju TO, Olivares PR, Olusanya BO, Olusanya JO, Ong SK, Ortiz A, Osgood-Zimmerman A, Ota E, Otieno BA, Otstavnov SS, Owolabi MO, Oyekale AS, P A M, Pakhale S, Pakhare AP, Pana A, Panda BK, Panda-Jonas S, Pandey AR, Park EK, Parsian H, Patel S, Patil ST, Patle A, Patton GC, Paturi VR, Paudel D, Pedroso MM, Peprah EK, Pereira DM, Perico N, Pesudovs K, Petri WA, Petzold M, Pierce M, Pigott DM, Pillay JD, Pirsaheb M, Polanczyk GV, Postma MJ, Pourmalek F, Pourshams A, Poustchi H, Prakash S, Prasad N, Purcell CA, Purwar MB, Qorbani M, Quansah R, Radfar A, Rafay A, Rafiei A, Rahim F, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rahman MS, Rahman MHU, Rahman MA, Rahman SU, Rai RK, Rajati F, Rajsic S, Ram U, Ranabhat CL, Ranjan P, Rawaf DL, Rawaf S, Ray SE, Razo-García C, Reiner RC, Reis C, Remuzzi G, Renzaho AMN, Resnikoff S, Rezaei S, Rezaeian S, Rezai MS, Riahi SM, Rios-Blancas MJ, Roba KT, Roberts NLS, Roever L, Ronfani L, Roshandel G, Rostami A, Rubagotti E, Ruhago GM, Sabde YD, Sachdev PS, Saddik B, Saeedi Moghaddam S, Safari H, Safari Y, Safari-Faramani R, Safdarian M, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi HS, Salahshoor MR, Salam N, Salama JS, Salamati P, Saldanha RDF, Saleem Z, Salimi Y, Salimzadeh H, Salomon JA, Salvi SS, Salz I, Sambala EZ, Samy AM, Sanabria J, Sanchez-Niño MD, Santos IS, Santric Milicevic MM, Sao Jose BP, Sardana M, Sarker AR, Sarmiento-Suárez R, Saroshe S, Sarrafzadegan N, Sartorius B, Sarvi S, Sathian B, Satpathy M, Sawant AR, Sawhney M, Saxena S, Schaeffner E, Schelonka K, Schneider IJC, Schwebel DC, Schwendicke F, Seedat S, Sekerija M, Sepanlou SG, Serván-Mori E, Shabaninejad H, Shackelford KA, Shafieesabet A, Shaheen AA, Shaikh MA, Shakir RA, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Sharafi H, Sharafi K, Sharif M, Sharif-Alhoseini M, Sharma J, Sharma R, She J, Sheikh A, Shi P, Shibuya K, Shigematsu M, Shiri R, Shirkoohi R, Shiue I, Shokraneh F, Shukla SR, Si S, Siabani S, Sibai AM, Siddiqi TJ, Sigfusdottir ID, Sigurvinsdottir R, Silpakit N, Silva DAS, Silva JP, Silveira DGA, Singam NSV, Singh JA, Singh NP, Singh V, Sinha DN, Sliwa K, Soares Filho AM, Sobaih BH, Sobhani S, Soofi M, Soriano JB, Soyiri IN, Sreeramareddy CT, Starodubov VI, Steiner C, Stewart LG, Stokes MA, Strong M, 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Widecka J, Widecka K, Wijeratne T, Winkler AS, Wiysonge CS, Wolfe CDA, Wu S, Wyper GMA, Xu G, Yamada T, Yano Y, Yaseri M, Yasin YJ, Ye P, Yentür GK, Yeshaneh A, Yimer EM, Yip P, Yisma E, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Yousefifard M, Yu C, Zadnik V, Zaidi Z, Zaman SB, Zamani M, Zare Z, Zeleke MM, Zenebe ZM, Zerfu TA, Zhang X, Zhao XJ, Zhou M, Zhu J, Zimsen SRM, Zodpey S, Zoeckler L, Lopez AD, Lim SS. Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1995-2051. [PMID: 30496106 PMCID: PMC6227915 DOI: 10.1016/s0140-6736(18)32278-5] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. METHODS We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10-54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10-14 years and 50-54 years was estimated from data on fertility in women aged 15-19 years and 45-49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. FINDINGS From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4-52·0). The TFR decreased from 4·7 livebirths (4·5-4·9) to 2·4 livebirths (2·2-2·5), and the ASFR of mothers aged 10-19 years decreased from 37 livebirths (34-40) to 22 livebirths (19-24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3-200·8) since 1950, from 2·6 billion (2·5-2·6) to 7·6 billion (7·4-7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15-64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9-1·2) in Cyprus to a high of 7·1 livebirths (6·8-7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07-0·09) in South Korea to 2·4 livebirths (2·2-2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3-0·4) in Puerto Rico to a high of 3·1 livebirths (3·0-3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. INTERPRETATION Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. FUNDING Bill & Melinda Gates Foundation.
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Bosch-Farré C, Garre-Olmo J, Bonmatí-Tomàs A, Malagón-Aguilera MC, Gelabert-Vilella S, Fuentes-Pumarola C, Juvinyà-Canal D. Prevalence and related factors of Active and Healthy Ageing in Europe according to two models: Results from the Survey of Health, Ageing and Retirement in Europe (SHARE). PLoS One 2018; 13:e0206353. [PMID: 30372472 PMCID: PMC6205806 DOI: 10.1371/journal.pone.0206353] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 10/11/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Active and Healthy Ageing (AHA) is the process of optimizing opportunities related to health, participation, and safety in order to improve quality of life. The approach most often used to measure AHA is Rowe and Kahn's Satisfactory Ageing model. Nonetheless, this model has limitations. One of the strategic objectives of the WHO Global Strategy and Action Plan (2016) is to improve Healthy Ageing measurement. Our objectives were to compare two models of assessing AHA and further compare the results by country and sociodemographic variables. METHODS This was a cross-sectional, observational analysis of a representative sample of the general population aged 50 years and older in Europe. The data analysed were obtained by the Study of Health, Ageing and Retirement in Europe (SHARE). The dependent variable was AHA and its dimensions, measured using the Rowe and Kahn AHA model (AHA-B) and the authors' model based on the WHO definition (AHA-BPS). A descriptive analysis and multivariate models of binary logistical regression were developed. RESULTS The sample consisted of 52,641 participants (mean age 65.24 years [SD = 10.18; Range = 50-104], 53.2% women). Healthy Ageing prevalence in the AHA-B model was 23.5% (95%CI = 23.1%-23.9%). In the AHA-BPS model, this prevalence was 38.9%. In both models, significant variations were observed between countries, and were distributed along a north-western to south-eastern gradient. The sociodemographic variables associated with the absence of AHA were advanced age, female sex, death of spouse, low educational level, lack of employment, and low financial status. Comparing the two models, the strength of association between absence of AHA and advanced age (85 years and older) was four times greater in the AHA-B model. CONCLUSIONS Our results showing differences between these two models provide evidence that the AHA-BPS model does not penalize older age and is more likely to characterize AHA from a health promotion perspective.
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Affiliation(s)
- Cristina Bosch-Farré
- Health and Healthcare Research Group, University of Girona, Girona, Catalonia, Spain
- Nursing Department, University of Girona, Girona, Catalonia, Spain
| | - Josep Garre-Olmo
- Girona Biomedical Research Institute (IDIBGI), Salt, Catalonia, Spain
- Healthcare Institute (IAS), Salt, Catalonia, Spain
- Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
| | | | - Maria Carme Malagón-Aguilera
- Health and Healthcare Research Group, University of Girona, Girona, Catalonia, Spain
- Nursing Department, University of Girona, Girona, Catalonia, Spain
| | | | - Concepció Fuentes-Pumarola
- Health and Healthcare Research Group, University of Girona, Girona, Catalonia, Spain
- Nursing Department, University of Girona, Girona, Catalonia, Spain
| | - Dolors Juvinyà-Canal
- Health and Healthcare Research Group, University of Girona, Girona, Catalonia, Spain
- Nursing Department, University of Girona, Girona, Catalonia, Spain
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Lucena ADF, Argenta C, Almeida MDA, Moorhead S, Swanson E. Validation of Nursing Outcomes and Interventions to Older Adults Care with Risk or Frail Elderly Syndrome: Proposal of Linkages Among NOC, NIC, and NANDA‐I to clinical practice. Int J Nurs Knowl 2018; 30:147-153. [DOI: 10.1111/2047-3095.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Amália de Fátima Lucena
- School of NursingUniversidade Federal do Rio Grande do Sul and Hospital de Clínicas de Porto Alegre Rio Grande do Sul Brazil
| | - Carla Argenta
- School of NursingUniversidade Federal do Rio Grande do Sul and Hospital de Clínicas de Porto Alegre Rio Grande do Sul Brazil
| | - Miriam de Abreu Almeida
- School of NursingUniversidade Federal do Rio Grande do Sul and Hospital de Clínicas de Porto Alegre Rio Grande do Sul Brazil
| | - Sue Moorhead
- College of NursingUniversity of Iowa Iowa City Iowa
| | - Elizabeth Swanson
- School of NursingUniversidade Federal do Rio Grande do Sul and Hospital de Clínicas de Porto Alegre Rio Grande do Sul Brazil
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Rivera-Almaraz A, Manrique-Espinoza B, Ávila-Funes JA, Chatterji S, Naidoo N, Kowal P, Salinas-Rodríguez A. Disability, quality of life and all-cause mortality in older Mexican adults: association with multimorbidity and frailty. BMC Geriatr 2018; 18:236. [PMID: 30286727 PMCID: PMC6172837 DOI: 10.1186/s12877-018-0928-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 09/24/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Multimorbidity and frailty are relevant conditions among older adult population. There is growing evidence about their association with poor health outcomes like disability, worst quality of life, and death. Nonetheless, the independent associations of both conditions have been studied, and few evidence exists about an interaction between them. Our aims were to assess the association of frailty and multimorbidity with the disability, quality of life and all-cause mortality as well as to analyze a potential interaction between these conditions. METHODS Analytical samples included 1410 respondents for disability and quality of life, and 1792 for mortality. We performed a longitudinal analysis with older Mexican adults aged 50, using data collected from the WHO's Study on global AGEing and Adult Health Waves 1 and 2. Disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and quality of life using the WHOQOL (WHO Quality of Life) instrument. All-cause mortality was determined by reviewing death certificates. Associations of frailty and multimorbidity with disability, quality of life and mortality were estimated using linear regression and Cox proportional hazards models. RESULTS Multimorbidity assessed through three patterns (cardiopulmonary, vascular-metabolic, and mental-musculoskeletal) was associated with the three outcomes in this study. Cardiopulmonary and mental-musculoskeletal patterns increased the WHODAS mean score (β = 5.05; p < 0.01 and β = 5.10; p < 0.01, respectively) and decreased WHOQOL score (β = - 1.81; p < 0.01 and β = - 2.99; p < 0.01, respectively). Vascular-metabolic was associated with mortality (HR = 1.47; p = 0.04), disability (β = 3.27; p < 0.01) and quality of life (β = - 1.30; p = 0.02). Frailty was associated with mortality (pre-frail: HR = 1.48; p = 0.02 and frail: HR = 1.68; p = 0.03), disability (pre-frail: β = 5.02; p < 0.01; frail: β = 13.29; p < 0.01) and quality of life (pre-frail: β = - 2.23; p < 0.01; frail: β = - 4.38; p < 0.01). Interaction terms of frailty and multimorbidity were not statistically significant. CONCLUSIONS Multimorbidity and frailty are important predictors of poor health outcomes. These results highlight the importance of carrying out health promotion and prevention actions as well as specific interventions aimed at older adults who suffer from multimorbidity and frailty, in such a way that deleterious effects on health can be avoided.
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Affiliation(s)
- Ana Rivera-Almaraz
- National Institute of Public Health, Avenida Universidad #655, Colonia Santa María Ahuacatitlán, ZC, 62100 Cuernavaca, Morelos Mexico
| | - Betty Manrique-Espinoza
- National Institute of Public Health, Avenida Universidad #655, Colonia Santa María Ahuacatitlán, ZC, 62100 Cuernavaca, Morelos Mexico
| | - José Alberto Ávila-Funes
- Department of Geriatrics, Salvador Zubirán National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Somnath Chatterji
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Nirmala Naidoo
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Paul Kowal
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
- University of Newcastle Research Centre on Gender, Health and Ageing, Newcastle, Australia
- Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Aarón Salinas-Rodríguez
- National Institute of Public Health, Avenida Universidad #655, Colonia Santa María Ahuacatitlán, ZC, 62100 Cuernavaca, Morelos Mexico
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231
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Pattern of tyrosine hydroxylase expression during aging of mesolimbic pathway of the rat. J Chem Neuroanat 2018; 92:83-91. [DOI: 10.1016/j.jchemneu.2018.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/24/2018] [Accepted: 05/25/2018] [Indexed: 12/13/2022]
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232
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The synergic effects of frailty on disability associated with urbanization, multimorbidity, and mental health: implications for public health and medical care. Sci Rep 2018; 8:14125. [PMID: 30237508 PMCID: PMC6148070 DOI: 10.1038/s41598-018-32537-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/05/2018] [Indexed: 01/16/2023] Open
Abstract
Frailty is garnering increasing interest as a potential target in disability prevention. Since it is uncertain how frailty interacts with multimorbidity, urbanization, and mental health to affect disability, we investigated the epidemiology of frailty and its synergies with these factors. The study enrolled 20,898 participants aged 65 and older living in New Taipei city. All participants received face to face interview to assess frailty, multimorbidity, urban or rural residence, and mental health. Individual versus combined effects of risk factors were evaluated using the Rothman synergy index. Prevalence of frailty was 5.2% overall, 7.2% in multimorbid participants, 9.6% in rural residents, and 20.8% in those with mental disorders. Logistic regression, adjusted for age and sex, showed significant associations between disability and frailty (OR 8.5, 95% CI 6.4–11.2), multimorbidity (OR 1.3, 95% CI 1.0–1.6), urbanization (OR 1.3, 95% CI 1.0–1.7), and mental disorders (OR 7.3, 95% CI 5.6–9.5); these factors had a significant synergic effect on disability. Frailty is common in older adults and associated with disability, and was synergetic with multimorbidity, mental disorders, and residing rurally. Targeting frailty prevention and intervention needs a special attention on those vulnerable groups.
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233
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Amosun SL, Harris F. "What next now that you are sixty?" - Preliminary exploration of the self-reported aspirations of community-dwelling older persons in the Western Cape Province, South Africa within the active aging framework. Physiother Theory Pract 2018; 36:791-798. [PMID: 30118636 DOI: 10.1080/09593985.2018.1508262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Future aspirations of older persons should interest professionals involved in health promotion services in view of World Health Organization's Active Aging Framework. With the South African government's plan to raise life expectancy to 70 years by 2030, there is likelihood that life expectancy at 60 years will increase. Future aspirations give motivations for living, with short and long-term goals to work toward. As part of a larger study exploring the profile of members of 35 Service Centers for Older Persons in the Western Cape Province, selected using stratified random sampling, this manuscript reports on the qualitative responses relating to the self-determined future aspirations of the members. Thematic analysis was utilized to explore the aspirations of 625 members, aged 60-100 years. The aspirations were classified into two, namely aspirations with and without possible future-oriented behavior. Separate six and three themes were identified respectively in the first and second categories of aspirations. Being members of centers meant to provide programs to enhance their future, an awareness of the future aspirations of older persons should inform the services provided to encourage older persons identify something to live for.
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Affiliation(s)
- Seyi Ladele Amosun
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town , Observatory, Republic of South Africa
| | - Fahmida Harris
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town , Observatory, Republic of South Africa
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234
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Maiers M, Agaoglu M, Brown R, Cassirer C, DaSilva K, Lystad RP, Mohammad S, Wong JJ. Chiropractic in Global Health and wellbeing: a white paper describing the public health agenda of the World Federation of Chiropractic. Chiropr Man Therap 2018; 26:26. [PMID: 30026909 PMCID: PMC6048707 DOI: 10.1186/s12998-018-0194-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/21/2018] [Indexed: 12/28/2022] Open
Abstract
The World Federation of Chiropractic supports the involvement of chiropractors in public health initiatives, particularly as it relates to musculoskeletal health. Three topics within public health have been identified that call for a renewed professional focus. These include healthy ageing; opioid misuse; and women's, children's, and adolescents' health. The World Federation of Chiropractic aims to enable chiropractors to proactively participate in health promotion and prevention activities in these areas, through information dissemination and coordinated partnerships. Importantly, this work will align the chiropractic profession with the priorities of the World Health Organization. Successful engagement will support the role of chiropractors as valued partners within the broader healthcare system and contribute to the health and wellbeing of the communities they serve.
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Affiliation(s)
- Michele Maiers
- Northwestern Health Sciences University, 2501 W 84th St, Bloomington, MN 55431 USA
| | - Mustafa Agaoglu
- Bahçeşehir University Health Sciences School of Chiropractic, No:10, Gayrettepe, 34353 Beşiktaş, Istanbul, Turkey
| | - Richard Brown
- World Federation of Chiropractic, 160 Eglinton Avenue East Suite 601, Toronto, ON M4P 3B5 Canada
| | - Christopher Cassirer
- Northwestern Health Sciences University, 2501 W 84th St, Bloomington, MN 55431 USA
| | - Kendrah DaSilva
- Chiropractic Association of South Africa, Crossway Office Park, 240 Lenchen Ave, Centurion, Pretoria, 0157 South Africa
| | - Reidar P. Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Sarkaw Mohammad
- Hillcrest Spinal Centre, 174 Cambridge Road Hillcrest Hamilton, Hamilton, 3216 New Zealand
| | - Jessica J. Wong
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON M2H 3J1 Canada
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235
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Lima-Costa MF, de Andrade FB, Souza PRBD, Neri AL, Duarte YADO, Castro-Costa E, de Oliveira C. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design. Am J Epidemiol 2018; 187:1345-1353. [PMID: 29394304 PMCID: PMC6031009 DOI: 10.1093/aje/kwx387] [Citation(s) in RCA: 161] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/21/2017] [Indexed: 12/17/2022] Open
Abstract
Brazil is experiencing among the world’s fastest demographic aging worldwide. This demographic transition is occurring in a context of few resources and great social inequalities. The Brazilian Longitudinal Study of Aging (ELSI-Brazil) is a nationally representative study of 9,412 people aged 50 years or older, residing in 70 municipalities across the 5 Brazilian regions. ELSI-Brazil allows investigations of the aging process, its health, psychosocial and economic determinants, and societal consequences. The baseline examination (2015–2016) included detailed household and individual interviews and physical measurements (blood pressure, anthropometry, grip strength, and timed walk and balance tests). Blood tests and sample storage were performed in a subsample of study participants. Subsequent waves are planned for every 3 years. The study adopts a conceptual framework common to other large-scale longitudinal studies of aging in the world, such as the Health and Retirement Study, allowing cross-national comparisons. The goal of ELSI-Brazil is not only to build an understanding of aging in a large, Western, middle-income country in a rapid demographic transition but also to provide scientific data to support and study policy changes that may affect older adults. We describe the methodology of the study and some descriptive results of the baseline survey.
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Affiliation(s)
| | | | | | | | | | - Erico Castro-Costa
- Instituto de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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236
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Affiliation(s)
- Terje A Eikemo
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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237
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Lu J, Duan X, Zhao W, Wang J, Wang H, Zhou K, Fang M. Aged Mice are More Resistant to Influenza Virus Infection due to Reduced Inflammation and Lung Pathology. Aging Dis 2018; 9:358-373. [PMID: 29896425 PMCID: PMC5988592 DOI: 10.14336/ad.2017.0701] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/01/2017] [Indexed: 12/24/2022] Open
Abstract
Immune responses are a double-edged sword. Effective and appropriate immune responses capable of controlling viral infection while also largely preserving tissue integrity, are critical for host survival. Too strong immune responses might result in immune pathology, while too weak immune responses might cause viral persistence. Physiologic ageing is accompanied with a decline in the normal functioning of the immune system, which is termed as "immunosenescence". We show that aged mice (16-19 months old) are more resistant to influenza A virus (IAV) infection than the young mice. Strong immune responses in the young mice after IAV infection result in faster clearance of virus, but also cause severe lung injury and higher mortality rate. While in the aged mice, the delayed and milder immune responses contribute to reduced pulmonary damage, and are still capable to clear the infection even with a slower kinetics, displaying a more resistant phenotype during IAV infection. Hence, our work demonstrates that moderate immune responses as a decline with ageing in the aged mice balance the immune pathology and viral clearance, might be beneficial for the host during certain circumstances. Our results provide important insight to our basic knowledge of immunosenescence and immune defenses to invading pathogens. Further, our results indicate that age factors should be considered when investigating the vaccination and therapeutic strategies for severe IAV infection.
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Affiliation(s)
- Jiao Lu
- 1CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China.,2University of Chinese Academy of Sciences, Beijing, China
| | - Xuefeng Duan
- 1CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Wenming Zhao
- 1CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Jing Wang
- 1CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China.,2University of Chinese Academy of Sciences, Beijing, China
| | - Haoyu Wang
- 3Institute of Health Sciences, Anhui University, Hefei, China.,1CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Kai Zhou
- 1CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Min Fang
- 1CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China.,4International College, University of Chinese Academy of Sciences, Beijing, China
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238
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Yuan L, Zhai L, Qian L, Huang D, Ding Y, Xiang H, Liu X, Thompson JW, Liu J, He YH, Chen XQ, Hu J, Kong QP, Tan M, Wang XF. Switching off IMMP2L signaling drives senescence via simultaneous metabolic alteration and blockage of cell death. Cell Res 2018; 28:625-643. [PMID: 29808012 DOI: 10.1038/s41422-018-0043-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 04/19/2018] [Accepted: 04/25/2018] [Indexed: 12/31/2022] Open
Abstract
Cellular senescence is a fundamental cell fate playing a significant role throughout the natural aging process. However, the molecular determinants distinguishing senescence from other cell-cycle arrest states such as quiescence and post-mitotic state, and the specified mechanisms underlying cell-fate decisions towards senescence versus cell death in response to cellular stress stimuli remain less understood. Employing multi-omics approaches, we revealed that switching off the specific mitochondrial processing machinery involving the peptidase IMMP2L serves as the foundation of the senescence program, which was also observed during the mammalian aging process. Mechanistically, we demonstrate that IMMP2L processes and thus activates at least two substrates, mitochondrial metabolic enzyme glycerol-3-phosphate dehydrogenase (GPD2) and cell death regulator apoptosis-inducing factor (AIF). For cells destined to senesce, concerted shutdown of the IMMP2L-GPD2 and IMMP2L-AIF signaling axes collaboratively drives the senescent process by reprogramming mitochondria-associated redox status, phospholipid metabolism and signaling network, and simultaneously blocking cell death under oxidative stress conditions.
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Affiliation(s)
- Lifeng Yuan
- Graduate Program in Molecular Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA.,Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Linhui Zhai
- Chemical Proteomics Center and State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Lili Qian
- Chemical Proteomics Center and State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - De Huang
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Yi Ding
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Handan Xiang
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Xiaojing Liu
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - J Will Thompson
- Proteomics and Metabolomics Shared Resource, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Juan Liu
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Yong-Han He
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China
| | - Xiao-Qiong Chen
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China
| | - Jing Hu
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Qing-Peng Kong
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China
| | - Minjia Tan
- Chemical Proteomics Center and State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Xiao-Fan Wang
- Graduate Program in Molecular Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA. .,Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA.
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239
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Bolzetta F, Wetle T, Besdine R, Noale M, Cester A, Crepaldi G, Maggi S, Veronese N. The relationship between different settings of medical service and incident frailty. Exp Gerontol 2018; 108:209-214. [PMID: 29730329 DOI: 10.1016/j.exger.2018.04.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/18/2018] [Accepted: 04/26/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Some studies have reported a potential association between usual source of health care and disability, but no one has explored the association with frailty, a state of early and potential reversible disability. We therefore aimed to explore the association between older persons' self-reported usual source of health care at baseline and the onset of frailty. METHODS Information regarding usual source of health care was captured through self-report and categorized as 1) private doctor's office, 2) public clinic, 3) Health Maintenance Organization (HMO), or 4) hospital clinic/emergency department (ED). Frailty was defined using the Study of Osteoporotic Fracture (SOF) index as the presence of at least two of the following criteria: (i) weight loss ≥5% between baseline and any subsequent follow-up visit; (ii) inability to do five chair stands; and (iii) low energy level according to the SOF definition. Multivariable Cox's regression analyses, calculating hazard ratios (HRs) with 95% confidence intervals (CIs), were undertaken. RESULTS Of the 4292 participants (mean age: 61.3), 58.7% were female. During the 8-year follow-up, 348 subjects (8.1% of the baseline population) developed frailty. Cox's regression analysis, adjusting for 14 potential confounders showed that, compared to those using a private doctor's office, people using a public clinic for their care had a significantly higher risk of developing frailty (HR = 1.56; 95%CI: 1.07-2.70), similar to those using HMO (HR = 1.48; 95%CI: 1.03-2.24) and those using a hospital/ED (HR = 1.76; 95%CI: 1.03-3.02). CONCLUSION Participants receiving health care from sources other than private doctors are at increased risk of frailty, highlighting the need for screening for frailty in these health settings.
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Affiliation(s)
- Francesco Bolzetta
- Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima", Dolo-Mirano District, Italy
| | - Terrie Wetle
- School of Public Health, Brown University, Providence, RI, USA
| | - Richard Besdine
- School of Public Health, Brown University, Providence, RI, USA; Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Marianna Noale
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Alberto Cester
- Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima", Dolo-Mirano District, Italy
| | - Gaetano Crepaldi
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy; Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy; Primary Care Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima", Dolo-Mirano District, Italy.
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240
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Jocelyn Chew H, Thiara E, Lopez V, Shorey S. Turning frequency in adult bedridden patients to prevent hospital-acquired pressure ulcer: A scoping review. Int Wound J 2018; 15:225-236. [PMID: 29243356 PMCID: PMC7949701 DOI: 10.1111/iwj.12855] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/07/2017] [Accepted: 10/11/2017] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to identify current research on turning frequencies of adult bed-bound patients and inform future turning practices for hospitals based on evidence-based practice. We undertook a scoping review framework that provided a transparent and systematic methodology using 8 electronic databases (CINAHL, PubMed, Cochrane Library, ScienceDirect, PsycINFO, Scopus, ProQuest, and Web of Science) to identify articles published from 2000 to 2016. Articles were included if they focused on the prevention of hospital-acquired pressure ulcers related to the frequency of turning or repositioning of bed-bound patients. Literature search and data extraction were performed independently by 3 authors. The study followed the PRISMA guidelines. In total, 911 articles were identified, of which 10 were eligible. Of the eligible articles, 8 studies could not reach a conclusion on the effective frequency of turning and duration for repositioning patients to prevent the development of pressure ulcers. Only 2 studies found significant differences among the intervention and control groups. Results regarding turning and repositioning schedules are inconclusive; however, the topic needs further exploration to improve the outdated guidelines surrounding pressure ulcer prevention. This may, in turn, make the work of nurses more efficient and make treatment cost-effective for both the patients and the hospitals.
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Affiliation(s)
- H‐S Jocelyn Chew
- The Nethersole School of NursingChinese University of Hong KongChina
| | - Emelia Thiara
- Paediatric Intensive Care UnitNational University HospitalSingapore
| | - Violeta Lopez
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of Medicine, National University of SingaporeSingapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of Medicine, National University of SingaporeSingapore
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241
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Enhancing Physical Activity as Lifestyle Behavior in Older Persons: The Rome Statement. J Aging Phys Act 2018; 26:345-351. [DOI: 10.1123/japa.2017-0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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242
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Cocco F, Campus G, Strohmenger L, Ardizzone VC, Cagetti MG. The burden of tooth loss in Italian elderly population living in nursing homes. BMC Geriatr 2018; 18:76. [PMID: 29558907 PMCID: PMC5859729 DOI: 10.1186/s12877-018-0760-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 03/06/2018] [Indexed: 12/29/2022] Open
Abstract
Background This survey aims to evaluate the prevalence and severity of tooth loss in the Italian elderly population living in nursing homes and to associate the oral data with demographic, socioeconomic factors, the Mini-Mental State Examination (MMSE), the Body Mass Index (BMI) and the Mini Nutritional Assessment (MNA) scores. Methods A cluster sample method was performed using each nursing home as a cluster. Twenty-three nursing homes located in the five areas of the Italy (North-West, North-East, Centre, South and Islands) were selected. An informed consent to participate was distributed by the personnel of the selected nursing homes and signed directly by subjects/caregivers; 2114 forms were distributed, 1998 forms signed and finally 1976 subjects were examined. Chewing ability was scored as good (≥10 functional units (FUs)), sufficient (7–10 FUs), and insufficient (< 7 FUs). The presence of prosthetic dental restorations was summarized as: absent of prosthesis, fixed prosthesis, removable prosthesis, combined prosthesis. Age, gender, socioeconomic status, MMSE, BMI and MNA were obtained from medical charts. Results Almost three quarters of the subjects were ≥ 80 years old (74.37%) and women (74.04%). The prevalence of edentulism was 42.10% with a large variation among the five areas of Italy (from 34.43% in Centre to 53.46% in North-West). Insufficient presence of FUs was preeminent in each age group (prevalence 42.10%) and statistically associated to age and to female gender (p < 0.01). Overweight/obese (7.47%) subjects showed the highest FUs. Area of living, MMSE (both < 0.01), BMI (p = 0.01) were statistically significant associated to the type of prosthetic dental restorations in the oldest group. Subjects with no mental impairment showed the highest percentage of prosthetic dental restorations (32.36%). Conclusions More than half of the sample has an insufficient number of functional units for chewing and this is more pronounced in females. The presence and the type of prosthetic dental restorations are linked to cognitive impairment: the higher is the mental impairment the higher is the number of subjects with absence of prosthetic restorations. The findings of this national survey highlight the need for public health policy, aiming to increase awareness regarding oral health though health education. Electronic supplementary material The online version of this article (10.1186/s12877-018-0760-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fabio Cocco
- Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy. .,WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.
| | - Guglielmo Campus
- Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy.,WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy
| | - Laura Strohmenger
- WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Viviana Cortesi Ardizzone
- WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy
| | - Maria Grazia Cagetti
- WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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O'Caoimh R, Kennelly S, O'Shea D. Can the Geriatric Day Hospital Act As a Hub for Services for Older People across the Spectrum of Ageing from Active Ageing to Advanced Frailty? Front Med (Lausanne) 2018; 5:23. [PMID: 29552560 PMCID: PMC5840151 DOI: 10.3389/fmed.2018.00023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 01/23/2018] [Indexed: 01/10/2023] Open
Affiliation(s)
- Rónán O'Caoimh
- Clinical Sciences Institute, National University of Ireland, Galway, Galway, Ireland.,National Clinical Programme for Older People, Royal College of Physicians of Ireland, Dublin, Ireland
| | - Siobhán Kennelly
- National Clinical Programme for Older People, Royal College of Physicians of Ireland, Dublin, Ireland.,Department of Medicine for the Elderly, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | - Diamuid O'Shea
- National Clinical Programme for Older People, Royal College of Physicians of Ireland, Dublin, Ireland.,Department of Geriatric Medicine, St Vincent's University Hospital, Dublin, Ireland
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244
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Shou J, Du Z, Wang H, Ren L, Liu Y, Zhu S. Quality of life and its contributing factors in an elderly community-dwelling population in Shanghai, China. Psychogeriatrics 2018; 18:89-97. [PMID: 29409153 DOI: 10.1111/psyg.12288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 06/16/2017] [Accepted: 07/17/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND We aimed to investigate the relationship between quality of life and the factors that may influence it in an elderly community-dwelling population in Shanghai. METHODS From August to October 2014, elderly individuals were enrolled from three randomly selected communities in Shanghai. Participant information was collected from responses to a general questionnaire and to the Lubben Social Network Scale-6, Cumulative Illness Rating Scale for Geriatrics, Patient Health Questionnaire, and the 12-item Short Form Health Survey. The factors influencing quality of life were explored in a multivariate stepwise linear regression model. RESULTS Physical and mental component summary scores for the elderly in Shanghai communities were 50.1 ± 10.1 and 47.3 ± 7.9, respectively. Physical component summary scores in the rural area were higher than those in the urban-rural intersection area (a place where urban and rural transitions are taking place) (52.32 ± 9.81 vs 49.63 ± 9.33, P < 0.05) and the urban area (52.32 ± 9.81 vs 47.34 ± 10.18, P < 0.05). Additionally, mental component summary scores in the rural area were higher than those in the urban-rural intersection area (52.63 ± 9.28 vs 48.43 ± 9.42, P < 0.05) and the urban area (52.63 ± 9.28 vs 48.13 ± 10.69, P < 0.05). CONCLUSIONS Depression, self-care ability, and medical care burden were found to be significantly associated with the quality of life of elderly individuals in Shanghai, China. Therefore, more attention should be paid to the mental health of this elderly population.
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Affiliation(s)
- Juan Shou
- General Practice Department, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhaohui Du
- Pudong Weifang Community Health Center, Fudan University, Shanghai, China
| | - Haitang Wang
- Pudong Shanggang Community Health Center, Shanghai, China
| | - Limin Ren
- General Practice Department, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yao Liu
- General Practice Department, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shanzhu Zhu
- General Practice Department, Zhongshan Hospital, Fudan University, Shanghai, China
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245
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Iavicoli I, Leso V, Cesari M. The contribution of occupational factors on frailty. Arch Gerontol Geriatr 2018; 75:51-58. [DOI: 10.1016/j.archger.2017.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 11/14/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022]
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246
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247
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Paterson JL, Reynolds AC, Dawson D. Sleep Schedule Regularity Is Associated with Sleep Duration in Older Australian Adults: Implications for Improving the Sleep Health and Wellbeing of Our Aging Population. Clin Gerontol 2018; 41:113-122. [PMID: 28990882 DOI: 10.1080/07317115.2017.1358790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The National Sleep Foundation (NSF) recommends 7 to 9 hours of sleep per night for adults ≥ 65 years of age. Sleep duration below 7h per night has been associated with negative health consequences, so enabling older adults to obtain at least 7 hours per night is important for health and wellbeing. However, little is known about behavioral factors that support sleep duration (≥ 7h/24h) in this group. Our aim was to determine factors associated with sleep duration in older adults, and evaluate the utility of sleep schedule regularity in particular, given the relationship between lifestyle regularity (of which sleep is an important component) and health in this population. METHODS A sample of 311 Australian adults (≥ 65 years old; 156 male, 155 female) completed a telephone survey assessing sleep history over the prior 24 hours, sleep schedule regularity, demographic and health factors as part of a larger study of the Australian population. RESULTS Sleep schedules with variability in bed and rise times of > 60 minutes were associated with increased odds of reporting sleep duration below 7 hours per night (< 7h/24h; OR = 2.38, CI = 1.26-4.48, p = .007). No other behaviors were associated with meeting sleep duration recommendations. CONCLUSIONS Sleep schedule regularity may be associated with sleep duration (≥ 7h/24h) in older adults. CLINICAL IMPLICATIONS Empowering older adults to maintain sleep schedule regularity may be a practical and efficacious strategy to support sleep durations that are in line with recommendations (≥ 7h/24h).
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Affiliation(s)
- Jessica L Paterson
- a Central Queensland University , Appleton Institute , Adelaide , Australia
| | - Amy C Reynolds
- a Central Queensland University , Appleton Institute , Adelaide , Australia
| | - Drew Dawson
- a Central Queensland University , Appleton Institute , Adelaide , Australia
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248
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Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, Cooper C, Martin FC, Reginster JY, Vellas B, Beard JR. Evidence for the Domains Supporting the Construct of Intrinsic Capacity. J Gerontol A Biol Sci Med Sci 2018; 73:1653-1660. [DOI: 10.1093/gerona/gly011] [Citation(s) in RCA: 219] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Indexed: 01/16/2023] Open
Affiliation(s)
- Matteo Cesari
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, France
- Université de Toulouse III Paul Sabatier, France
- Geriatric Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milano, Italy
- Department of Clinical Sciences and Community Health, Università di Milano, Italy
| | | | | | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
| | - Finbarr C Martin
- Division of Health and Social Care Research, King’s College, London, United Kingdom
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liege, Belgium
| | - Bruno Vellas
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, France
- Université de Toulouse III Paul Sabatier, France
| | - John R Beard
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
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249
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Lourenco J, Serrano A, Santos-Silva A, Gomes M, Afonso C, Freitas P, Paul C, Costa E. Cardiovascular Risk Factors Are Correlated with Low Cognitive Function among Older Adults Across Europe Based on The SHARE Database. Aging Dis 2018; 9:90-101. [PMID: 29392084 PMCID: PMC5772862 DOI: 10.14336/ad.2017.0128] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/28/2017] [Indexed: 12/24/2022] Open
Abstract
Increased life expectancy is associated with a high prevalence of chronic, non-communicable diseases including cognitive decline and dementia. The purpose of this study was to evaluate the prevalence of cognitive impairment using three cognitive abilities (verbal fluency, numeracy and perceived memory) and their association with cardiovascular risk factors in seniors across Europe. Data from participants in wave 4 of the SHARE (Survey of Health, Ageing, and Retirement in Europe) database was used. Cognitive performance in perceived memory, verbal fluency and numeracy was evaluated using simple tests and a memory complaints questionnaire. Clinical and sociodemographic variables were also studied for potential associations. Standardised prevalence rates of cognitive impairment based on age and gender were calculated by country. The prevalence of cognitive impairment was 28.02% for perceived memory, 27.89% for verbal fluency and 20.75% for numeracy throughout the 16 evaluated countries. Years of education, being a current or former smoker, number of chronic diseases, diabetes or hyperglycemia, heart attack and stroke were all independent variables associated with impairment in the three studied cognitive abilities. We also found independent associations between physical inactivity and verbal fluency and numeracy impairment, as well as hypertension and perceived memory impairment. Lower performance in the evaluated cognitive abilities and higher memory complaints are highly prevalent, have a heterogeneous distribution across Europe, and are associated with multiple factors, most of which are potentially preventable or treatable, especially cardiovascular risk factors.
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Affiliation(s)
- Joana Lourenco
- 1Family Health Unit of Pedras Rubras, Maia, Portugal.,2Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,3Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | | | - Alice Santos-Silva
- 4UCIBIO, REQUIMTE and Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Marcos Gomes
- 4UCIBIO, REQUIMTE and Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Claudia Afonso
- 2Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Paula Freitas
- 5Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Porto, Portugal.,6Faculty of Medicine, University of Porto, Porto, Portugal
| | - Constanca Paul
- 3Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.,7Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Elisio Costa
- 4UCIBIO, REQUIMTE and Faculty of Pharmacy, University of Porto, Porto, Portugal
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250
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Ronzi S, Orton L, Pope D, Valtorta NK, Bruce NG. What is the impact on health and wellbeing of interventions that foster respect and social inclusion in community-residing older adults? A systematic review of quantitative and qualitative studies. Syst Rev 2018; 7:26. [PMID: 29382375 PMCID: PMC5789687 DOI: 10.1186/s13643-018-0680-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 01/12/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many interventions have been developed to promote respect and social inclusion among older people, but the evidence on their impacts on health has not been synthesised. This systematic review aims to appraise the state of the evidence across the quantitative and qualitative literature. METHODS Eligible studies published between 1990 and 2015 were identified by scanning seven bibliographic databases using a pre-piloted strategy, searching grey literature and contacting experts. Studies were included if they assessed the impact (quantitatively) and/or perceived impact (qualitatively) of an intervention promoting respect and social inclusion on the physical or mental health of community-residing people aged 60 years and older. Titles and abstracts were screened for eligibility by one reviewer. A second reviewer independently screened a 10% random sample. Full texts were screened for eligibility by one reviewer, with verification by another reviewer. Risk of bias was assessed using standardised tools. Findings were summarised using narrative synthesis, harvest plots and logic models to depict the potential pathways to health outcomes. RESULTS Of the 27,354 records retrieved, 40 studies (23 quantitative, 6 qualitative, 11 mixed methods) were included. All studies were conducted in high and upper middle-income countries. Interventions involved mentoring, intergenerational and multi-activity programmes, dancing, music and singing, art and culture and information-communication technology. Most studies (n = 24) were at high or moderate risk of bias. Music and singing, intergenerational interventions, art and culture and multi-activity interventions were associated with an overall positive impact on health outcomes. This included depression (n = 3), wellbeing (n = 3), subjective health (n = 2), quality of life (n = 2), perceived stress and mental health (n = 2) and physical health (n = 2). Qualitative studies offered explanations for mediating factors (e.g. improved self-esteem) that may lead to improved health outcomes and contributed to the assessment of causation. CONCLUSIONS Whilst this review suggests that some interventions may positively impact on the health outcomes of older people, and identified mediating factors to health outcomes, the evidence is based on studies with heterogeneous methodologies. Many of the interventions were delivered as projects to selected groups, raising important questions about the feasibility of wider implementation and the potential for population-wide benefits. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42014010107.
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Affiliation(s)
- S. Ronzi
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - L. Orton
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - D. Pope
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - N. K. Valtorta
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
| | - N. G. Bruce
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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