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van der Ploeg T, Gobbens RJJ. Disability transitions in Dutch community-dwelling older people aged 75 years or older. Arch Gerontol Geriatr 2024; 116:105165. [PMID: 37639841 DOI: 10.1016/j.archger.2023.105165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/10/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Recent world population predictions show that the world population aged >=65 years will increase from 10% in 2022 to 16% in 2050. Population aging is accompanied by an increase in people with disability. It is important to pay special attention to people with disability, as these people are at high risk of adverse outcomes. Our study aimed to investigate the transitions of disability among Dutch community-dwelling older people aged 75 years or older, using a follow-up of nine years. We used socio-demographic factors gender, age, marital status, education, and income, but also lifestyle, diseases, and life events to predict the disability transitions over time. METHODS We used a sample of 484 people that was randomly drawn from the municipality of Roosendaal (the Netherlands), a municipality with 78,000 inhabitants. A subset of people who completed part A of the Tilburg Frailty Indicator (TFI) at baseline and the Groningen Activity Restriction Scale (GARS) questionnaires was used with a nine-year follow-up. Paired Wilcoxon tests were used to compare the consecutive measurements. Socio-demographic factors gender, age, marital status, education, and income, but also lifestyle, diseases, and life events were included to predict the disability transitions over time. For the univariable and multivariable analysis of the measurements over time with the predictor variables, we used generalized estimation equations (GEE). A p-value <0.05 was considered significant. R version 3.4.4 was used for all analyses. RESULTS Of the participants, 65% were younger than 80 years, 50% were married or cohabiting, 87% reported a healthy lifestyle, and 63% had no diseases or chronic disorders. Each year, more participants changed from status not disabled to disabled than vice versa. The GEE analyses showed that lifestyle ('not healthy') and diseases or chronic disorders ('two or more') were significant in the multivariable analysis for the disability score and only diseases or chronic disorders ('two or more') was significant in the multivariable analysis for the dichotomous disability score. CONCLUSIONS The transition of the disability score is strongly influenced by lifestyle and diseases or disorders. This applies to a lesser extent to the dichotomous disability score. There, only diseases or disorders are an important predictor. For health care professionals our study provides starting points for interventions focused on the prevention of worsening disability and for community-dwelling older people >= 75, the most important recommendation is: live healthy!
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Affiliation(s)
- Tjeerd van der Ploeg
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands.
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands; Zonnehuisgroep Amstelland, Amstelveen, The Netherlands; Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Tranzo, Tilburg University, Tilburg, The Netherlands
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Xiang H, Feng X, Lin L, Luo S, Liu X, Chen D, Qin K, Guo X, Chen W, Guo VY. Association between healthy lifestyle factors and health-related quality of life among Chinese adolescents: the moderating role of gender. Health Qual Life Outcomes 2023; 21:119. [PMID: 37904152 PMCID: PMC10617140 DOI: 10.1186/s12955-023-02201-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND To examine the associations of the independent and combined healthy lifestyle factors with health-related quality of life (HRQOL) in adolescents, and to test the moderating role of gender. METHODS This cross-sectional study included 5125 adolescents aged between 11 and 20 years. They provided self-reported data on six healthy lifestyle factors, including never smoking, never drinking, good sleep quality, sufficient sleep duration, appropriate Internet use, and adequate physical activity. Adolescents' HRQOL was evaluated using the Pediatric Quality of Life Inventory version 4.0. Linear regression models were conducted to explore the association of individual and combined healthy lifestyle factors with adolescents' HRQOL. We further performed stratified analyses and likelihood ratio test to explore the moderating role of gender in these associations. RESULTS Of the included adolescents, the proportions with 0-2, 3, 4, and 5-6 healthy lifestyle factors were 13.6%, 26.4%, 44.3%, and 15.7%, respectively. Compared to adolescents with composite healthy lifestyle scores of 0-2, those with scores of 3, 4, or 5-6 had significantly higher HRQOL scores across all dimensions, summary scales, and total scale in both unadjusted and adjusted models. Specifically, adolescents with 5-6 healthy lifestyle factors had a total scale score that was 19.03 (95%CI: 17.76 to 20.30) points higher than their counterparts who only had 0-2 healthy lifestyle factors. Significant dose-response patterns were also observed in aforementioned associations. Gender was a significant moderator in the associations between composite healthy lifestyle groups and HRQOL scores, except for the social functioning dimension. CONCLUSIONS Our results confirmed that combined healthy lifestyle factors were associated with improved HRQOL among adolescents, with a stronger association observed in girls. These findings underscore the necessity for education and healthcare authorities to design health-promoting strategies that encourage multiple healthy lifestyle factors in adolescents, with the objective of enhancing their overall health outcomes.
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Affiliation(s)
- Hongyu Xiang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Xiuqiong Feng
- Department of Public Health, Guangzhou Huangpu District Center for Disease Control and Prevention, Guangzhou, Guangdong, 510530, China
| | - Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Shengyu Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Xinxia Liu
- Zhongshan Third People's Hospital, Nanlang Town, Zhongshan, Guangdong, 528451, China
| | - Dezhong Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Kang Qin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Xun Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China.
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Chen D, Lin L, Li C, Chen W, Zhang Y, Ren Y, Guo VY. Maternal adverse childhood experiences and health-related quality of life in preschool children: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2023; 17:19. [PMID: 36747212 PMCID: PMC9903527 DOI: 10.1186/s13034-023-00570-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The intergenerational association between maternal adverse childhood experiences (ACEs) and their children's health-related quality of life (HRQOL) is underexplored. This study aimed to examine such association in Chinese preschool children and to test the moderation role of children's sex. METHODS A cross-sectional study was conducted among 4243 mother-child dyads who attended randomly selected preschools. Mothers self-reported their experience of 12 forms of ACEs, including emotional abuse, physical abuse, emotional neglect, physical neglect, intimate partner violence, substance abuse in the household, incarcerated household member, mental illness in household, parental death, parental separation or divorce, bullying, and community violence. Children's HRQOL was evaluated through mother report of the Pediatric Quality of Life Inventory version 4.0. Linear regression models were established to estimate the associations between maternal ACEs and their children's HRQOL sub-scores and total scores. Stratified analysis and test for interaction were further conducted to evaluate whether the associations were moderated by children's sex. RESULTS Of the included mothers, 85.8% (n = 3641) had reported exposure to at least one ACE, and 22.3% (n = 948) were exposed to three or more ACEs. Compared to children of mothers without any ACE exposure, those of mothers with 1, 2, or ≥ 3 ACEs all had significantly lower scores of physical, social, and school functioning, as well as lower psychosocial health summary score and total scale score in both crude and adjusted models. However, only children of mothers with two or more ACEs had significantly poorer emotional functioning when compared to their counterparts whose mothers had no ACE exposure. A significant dose-response pattern was also observed between the number of maternal ACEs and children's HRQOL sub-scores and total scores. Stratified analysis revealed sex-specific pattern between maternal ACEs and their children's HRQOL. Nonetheless, children's sex was not a significant moderator. CONCLUSIONS Our study showed that preschool children of mothers who had any experience of ACEs were at risk of poorer HRQOL. Our findings indicated that screening maternal ACEs in young children and promoting targeted interventions might be a feasible way to mitigate or stop the potential negative intergenerational health and wellbeing implications of ACEs.
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Affiliation(s)
- Dezhong Chen
- grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Second Road, Guangzhou, 510080 Guangdong China
| | - Li Lin
- grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Second Road, Guangzhou, 510080 Guangdong China
| | - Chunrong Li
- grid.54549.390000 0004 0369 4060Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Weiqing Chen
- grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Second Road, Guangzhou, 510080 Guangdong China
| | - Yuying Zhang
- Department of Child Healthcare, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Yan Ren
- grid.54549.390000 0004 0369 4060Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Second Road, Guangzhou, 510080, Guangdong, China.
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van der Ploeg T, Gobbens RJJ, Salem BE. Bayesian Techniques in Predicting Frailty among Community-Dwelling Older Adults in the Netherlands. Arch Gerontol Geriatr 2023; 105:104836. [PMID: 36343439 DOI: 10.1016/j.archger.2022.104836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 12/13/2022]
Abstract
Background Frailty is a syndrome that is defined as an accumulation of deficits in physical, psychological, and social domains. On a global scale, there is an urgent need to create frailty-ready healthcare systems due to the healthcare burden that frailty confers on systems and the increased risk of falls, healthcare utilization, disability, and premature mortality. Several studies have been conducted to develop prediction models for predicting frailty. Most studies used logistic regression as a technique to develop a prediction model. One area that has experienced significant growth is the application of Bayesian techniques, partly due to an increasing number of practitioners valuing the Bayesian paradigm as matching that of scientific discovery. Objective We compared ten different Bayesian networks as proposed by ten experts in the field of frail elderly people to predict frailty with a choice from ten dichotomized determinants for frailty. Methods We used the opinion of ten experts who could indicate, using an empty Bayesian network graph, the important predictors for frailty and the interactions between the different predictors. The candidate predictors were age, sex, marital status, ethnicity, education, income, lifestyle, multimorbidity, life events, and home living environment. The ten Bayesian network models were evaluated in terms of their ability to predict frailty. For the evaluation, we used the data of 479 participants that filled in the Tilburg Frailty indicator (TFI) questionnaire for assessing frailty among community-dwelling older people. The data set contained the aforementioned variables and the outcome "frail". The model fit of each model was measured using the Akaike information criterion (AIC) and the predictive performance of the models was measured using the area under the curve (AUC) of the receiver operator characteristic (ROC). The AUCs of the models were validated using bootstrapping with 100 repetitions. The relative importance of the predictors in the models was calculated using the permutation feature importance algorithm (PFI). Results The ten Bayesian networks of the ten experts differed considerably regarding the predictors and the connections between the predictors and the outcome. However, all ten networks had corrected AUCs >0.700. Evaluating the importance of the predictors in each model, "diseases or chronic disorders" was the most important predictor in all models (10 times). The predictors "lifestyle" and "monthly income" were also often present in the models (both 6 times). One or more diseases or chronic disorders, an unhealthy lifestyle, and a monthly income below 1800 euro increased the likelihood of frailty. Conclusions Although the ten experts all made different graphs, the predictive performance was always satisfying (AUCs >0.700). While it is true that the predictor importance varied all the time, the top three of the predictor importance consisted of "diseases or chronic disorders", "lifestyle" and "monthly income". All in all, asking for the opinion of experts in the field of frail elderly to predict frailty with Bayesian networks may be more rewarding than a data-driven forecast with Bayesian networks because they have expert knowledge regarding interactions between the different predictors.
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Affiliation(s)
- Tjeerd van der Ploeg
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands.
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands; Zonnehuisgroep Amstelland, Amstelveen, the Netherlands; Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Tranzo, Tilburg University, Tilburg, the Netherlands
| | - Benissa E Salem
- School of Nursing, University of California, Los Angeles, USA
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Junca E, Pino M, Santamaría-García H, Baez S. Brain, cognitive, and physical disability correlates of decreased quality of life in patients with Huntington's disease. Qual Life Res 2023; 32:171-182. [PMID: 35978062 PMCID: PMC9829572 DOI: 10.1007/s11136-022-03220-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Following a case-control design, as a primary objective, this study aimed to explore the relationship between quality of life (QoL) scores and gray matter (GM) volumes in patients with Huntington's disease (HD). As a secondary objective, we assessed the relationship between QoL scores and other important behavioral, clinical and demographical variables in patients with HD and HD patients' caregivers. METHODS We recruited 75 participants (25 HD patients, 25 caregivers, and 25 controls) and assessed their QoL using the World Health Organization Quality of Life scale-Brief Version (WHOQOL-BREF). Participants were also assessed with general cognitive functioning tests and clinical scales. In addition, we acquired MRI scans from all participants. RESULTS Our results showed that patients exhibited significantly lower scores in all four QoL domains (physical health, psychological wellbeing, social relationships, and relationship with the environment) compared to caregivers and controls. Caregivers showed lower scores than controls in the physical health and the environmental domains. In HD patients, lower scores in QoL domains were associated with lower GM volumes, mainly in the precuneus and the cerebellum. Moreover, in HD patients, physical disability and GM volume reduction were significant predictors of QoL decrease in all domains. For caregivers, years of formal education was the most important predictor of QoL. CONCLUSIONS HD patients exhibit greater GM volume loss as well as lower QoL scores compared to caregivers and controls. However, caregivers displayed lower scores in QoL scores than controls, with years of education being a significant predictor. Our results reflect a first attempt to investigate the relationships among QoL, GM volumes, and other important factors in an HD and HD caregiver sample.
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Affiliation(s)
| | - Mariana Pino
- Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Hernando Santamaría-García
- Pontificia Universidad Javeriana. PhD program of Neuroscience, Bogotá, Colombia
- Centro de Memoria y Cognición intellectus, Bogotá, Colombia
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Norden P, Lyndon M, Krägeloh CU, Henning M, Medvedev O. Longitudinal investigation of the stable and dynamic components of the World Health Organization Quality of Life Measure (WHOQOL-BREF) using generalizability theory. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02474-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Koponen S, Nykänen I, Savela RM, Välimäki T, Suominen AL, Schwab U. Inadequate Intake of Energy and Nutrients Is Common in Older Family Caregivers. Nutrients 2021; 13:nu13082763. [PMID: 34444923 PMCID: PMC8400852 DOI: 10.3390/nu13082763] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 12/28/2022] Open
Abstract
The aim of this study was to investigate the nutritional status, determinants of nutritional status, and adequacy of energy and nutrient intake of older family caregivers (FC). Nutritional status was measured using the Mini Nutritional Assessment (MNA), plasma albumin, plasma pre-albumin, and blood hemoglobin concentrations. Dietary intake was assessed with a three-day food record. Comorbidity (B −0.283, 95% CI: −0.492, −0.073), quality of life (B 0.045, 95% CI: 0.018, 0.072) and energy intake (B 0.001, 95% CI: 0.000, 0.002) were significantly associated with the MNA scores of the older FCs (n = 125). It was common for FCs to have lower than recommended intakes of energy and several nutrients, independent of the risk of malnutrition assessed by the MNA. Over half of the FCs had inadequate intake of protein, vitamin A, folate, and fiber, and 25–40% of the FCs had a low intake of vitamin D, vitamin E, thiamine, magnesium, iron, and selenium. It is important to follow both the nutritional status and dietary intake of older FCs regularly to find those with lower than recommended nutrient intake and to avoid poor nutritional status and its adverse effects hampering their ability to serve as FCs.
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Affiliation(s)
- Sohvi Koponen
- Institution of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (I.N.); (U.S.)
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 Kuopio, Finland
- Correspondence:
| | - Irma Nykänen
- Institution of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (I.N.); (U.S.)
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (R.-M.S.); (T.V.)
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (R.-M.S.); (T.V.)
| | - Anna Liisa Suominen
- Institution of Dentistry, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland;
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, P.O. Box 100, FI-70029 Kuopio, Finland
| | - Ursula Schwab
- Institution of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (I.N.); (U.S.)
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 Kuopio, Finland
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