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García-Puello F, Herazo-Beltrán Y, Pinillos-Patiño Y, Suarez-Palacio D, Longo E. Restrictions on persons with disabilities for participating in family and community activities. Rev Salud Publica (Bogota) 2023; 22:62-68. [PMID: 36753141 DOI: 10.15446/rsap.v22n1.80515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/29/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To identify the influence of functional impairments and limitations activities for persons with disabilities to particípate in family and community activities. METHODS This is a cross-sectional study with 4 044 persons with disabilities, selected using probabilistic sampling and a door-to-door active search model in 5 towns in the District of Barranquilla. The data were processed with univariate analysis and bivariate analysis to determine the relationship between the study variables. RESULTS 55.9% of the population were males, 41.6% were between 15 and 44 years of age, and 92.9% belonged to the lower socioeconomic stratum. 82.9% reported mobility limitations and 99% reported barriers to access non-formal learning activities, 98.6% to access public activities, and 97.5% to access productive activities. Individuals with that a lower limitation in exercising the power of reason, particularly thinking, can increase participation in activities with family and friends (OR, 0.8; 95% CI, 0.6-0.9), with the community (OR, 0.7; 95% CI, 0.6-0.9), religious or spiritual activities (OR, 0.8; 95% CI, 0.7-0.9). CONCLUSIONS There is a directly proportional relationship between structural impairment with the development of dependency and limited family, social, and work participation in the persons with disabilities.
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Affiliation(s)
| | - Yaneth Herazo-Beltrán
- YH: Fisioterapeuta, M. Sc. Salud Pública. Universidad Simón Bolívar. Barranquilla, Colombia.
| | - Yisel Pinillos-Patiño
- YP: Fisioterapeuta. M. Sc. Salud Pública. Universidad Simón Bolívar. Barranquilla, Colombia.
| | - Damaris Suarez-Palacio
- DS: Fisioterapeuta, M. Sc. Salud Pública. Universidad Simón Bolívar. Barranquilla, Colombia.
| | - Egmar Longo
- EL: Fisioterapeuta. M. Sc. Salud Pública. Ph. D. Discapacidad, Universidad Federal de Rio Grande do Norte-UFRN. Facisa, Brasil.
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Moving around a Large City in Latin America: The Mobility Challenges Faced by Older Adults with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412984. [PMID: 34948594 PMCID: PMC8700889 DOI: 10.3390/ijerph182412984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022]
Abstract
A growing body of research has shown that barriers in the urban environment can be disabling by reducing the ability of older people to manage independently in the community, but also because they can negatively affect health by limiting the possibilities to move outside the home. In this study, we ask how obstacles in the urban environment are associated with the need for help to go to places in the community. To respond to this question, we used the Annual Household Survey of the City of Buenos Aires, Argentina 2018, which had a specific questionnaire for people with disabilities. From this sample, we selected adults aged 65 years or older with difficulties in at least one of six domains: vision; hearing; upper and lower body mobility; cognition; self-care; and communication. The final sample consisted of 513 persons (weighted = 109,316). First, we conducted a principal component analysis identifying three factors from variables of obstacles to access and use the urban environment: transportation; outdoor spaces; and information. Second, through a logistic regression model, we observed a direct relationship between these factors and the need for help to move in the community, controlling for sociodemographic characteristics, health status, and number of disabilities. This paper provides evidence on the significance of improving urban spaces to reduce dependent mobility. In Latin America, cities still face many challenges in becoming more age-friendly.
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Cabrero Castro JE, García-Peña C, Ramírez Aldana R. Transitions of disability, disability-free life expectancy and health insurance among adults aged 50 and older in Mexico: a multistate life table analysis. BMJ Open 2021; 11:e045261. [PMID: 34353793 PMCID: PMC8344280 DOI: 10.1136/bmjopen-2020-045261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To analyse the transitions of disability onset and recovery, estimate life expectancy (LE) with and without disability and explore the relation between insurance and disability patterns in the population aged 50+ in Mexico. DESIGN Multistate life table analysis of data from a longitudinal cohort survey. SETTING Data came from the Mexican Health and Aging Study, a longitudinal and representative survey of older adults in Mexico. PARTICIPANTS 10 651 individuals aged 50+ interviewed in 2012 and 2015, including those who died between waves. PRIMARY AND SECONDARY OUTCOME MEASURES Disability is measured using the activities of daily living (ADL) scale. Transition rates between disability free, ADL disabled and death were employed to estimate total life expectancy (TLE) and disability-free life expectancy (DFLE). RESULTS 46% of the individuals who reported an ADL limitation in 2012 recover from disability by 2015. TLE at age 60 for people without ADL limitations is 30 years (95% CI 28.9 to 31), out of which 4.7 years (95% CI 4.1 to 5.4) are lived with ADL limitations, while TLE at age 60 in the initially disabled is 18.7 years (95% CI 17.3 to 20), with 9.4 years (95% CI 8.4 to 10.3) lived with disability. DFLE at age 60 in people with social security is 24.2 years (95% CI 23.3 to 25.2), in people with public insurance is 24.6 years (95% CI 23.7 to 25.4) and in uninsured people is 26.9 years (95% CI 25.9 to 27.9). CONCLUSIONS In Mexico, a substantial proportion of ADL disabled individuals recover from disability. Nevertheless, initially disabled individuals have a considerably lower DFLE regardless of age when compared with initially active individuals. There appeared to be no differences in terms of disability and LEs between the individuals with social security and public insurance.
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Affiliation(s)
- Jose Eduardo Cabrero Castro
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | - Carmen García-Peña
- Research Department, Instituto Nacional de Geriatría, Mexico City, Mexico
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Rueda-Salazar S, Spijker J, Devolder D, Albala C. The contribution of social participation to differences in life expectancy and healthy years among the older population: A comparison between Chile, Costa Rica and Spain. PLoS One 2021; 16:e0248179. [PMID: 33711063 PMCID: PMC7954322 DOI: 10.1371/journal.pone.0248179] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/19/2021] [Indexed: 11/18/2022] Open
Abstract
We study the health trajectories of the population aged over 60, comparing between one European and two Latin American countries (Spain, Chile and Costa Rica) which have similar longevity patterns. Our focus is on functional limitation and mortality risks, considering differences by gender, education and social participation. Data come from national panel surveys (EPS, CRELES, SHARE). Multistate modelling is used to estimate transition probabilities between two health states: healthy to unhealthy, unhealthy to healthy as well as the transition to death from healthy or unhealthy states, to estimate the duration of stay in a specific state (computing healthy and unhealthy life expectancies) and the effect of the selected covariates. Results show that older Costa Ricans have the smallest gender gap in life expectancy but women have a lower healthy life expectancy compared to those in Chile and Spain. Participation in social activities leads to higher healthy life expectancy among the elderly in Costa Rica and Spain, whilst there were no relevant educational differences observed in longevity in the analysed countries. To conclude: despite the different patterns observed in health transitions and survival across the three countries, social participation is associated with greater health and longevity among people of old age, with little effect coming from educational attainment. Public policies should therefore be aimed at reducing unhealthy life years and dependency at advanced ages by promoting more engagement in social activities, especially among vulnerable groups who are more likely to experience impairment from a younger age.
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Affiliation(s)
- Sarahí Rueda-Salazar
- Centre d’Estudis Demogràfics (CED), Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Jeroen Spijker
- Centre d’Estudis Demogràfics (CED), Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Daniel Devolder
- Centre d’Estudis Demogràfics (CED), Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Cecilia Albala
- Unidad de Nutrición Pública, Instituto de la Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
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Shin SM. The Influence of Pain on Frailty among the Elderly: Based on Korea Health Panel. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:2392-2399. [PMID: 34178746 PMCID: PMC8215067 DOI: 10.18502/ijph.v49i12.4825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Interests between pain and frailty have been increasing in aging or aged societies. This study aimed to identify the prevalence of pain and frailty and to find the influence of pain on frailty. Methods: Subjects were selected with aged 65 yr or older among pooled Korea Health Panel data from 2009 to 2013. The prevalence of pain was determined by combining some pain and extreme pain and also, frailty was defined when subjects had at least one of the following 6-domain frailty: physical inactivity, mobility reduction, dependence of daily life, depression, multimorbidity, and disability. Results: The prevalence of pain and frailty was 56.1% and 59.8%. It was significantly higher in female (66.1% and 65.2%) and the oldest-old (69.4% and 71.8%). After adjusting for gender, age group, spouse, illiteracy, and economic activity, odds ratios of frailty for some pain and extreme pain were 2.8 (95% CI 2.6–3.0) and 10.5 (95% CI 8.0–13.8) in total subjects. The odds ratios of each 6-domain frailty for some and extreme pain were also significant. Among them, mobility reduction was 5.1 (95% CI 4.5–5.8) and 16.5 (95% CI 13.6–20.1), and dependence of daily life was 3.9 (95% CI 3.5–4.5) and 12.4 (95% CI 10.2–15.1). Conclusion: Among the elderly, prevalence of frailty (59.8%) was somewhat higher than that of pain (56.1%). Female and oldest-old had higher prevalence of pain and frailty. In addition, some pain and extreme pain had a decisive influence on frailty and each 6-domain frailty. Therefore, pain control is essential to prevent or manage frailty.
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Affiliation(s)
- Sun Mi Shin
- Department of Nursing, Joongbu University, Geumsan-gun, Korea
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Moda Vitoriano Budri A, Moore Z, Patton D, O’Connor T, Nugent L, Mc Cann A, Avsar P. Impaired mobility and pressure ulcer development in older adults: Excess movement and too little movement—Two sides of the one coin? J Clin Nurs 2020; 29:2927-2944. [DOI: 10.1111/jocn.15316] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 03/25/2020] [Accepted: 03/29/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Aglecia Moda Vitoriano Budri
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
| | - Zena Moore
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
- Cardiff University Cardiff UK
- Fakeeh College for Medical Sciences Jeddah Saudi Arabia
- Monash University Melbourne Vic. Australia
- UGent Ghent University Ghent Belgium
| | - Declan Patton
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
- Fakeeh College for Medical Sciences Jeddah Saudi Arabia
- University of Wollongong Wollongong NSW Australia
| | - Tom O’Connor
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
- Fakeeh College for Medical Sciences Jeddah Saudi Arabia
- Lida Institute Shanghai China
| | - Linda Nugent
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
| | - Aisling Mc Cann
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
| | - Pinar Avsar
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
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Paredes-Arturo YV, Yarce-Pinzon E, Diaz-Velasquez DM, Aguirre-Acevedo DC. Factors Associated with Cognitive and Functional Performance in Indigenous Older Adults of Nariño, Colombia. J Aging Res 2019; 2019:4542897. [PMID: 31662909 PMCID: PMC6791244 DOI: 10.1155/2019/4542897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/29/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Ethnicity in Latin America is a factor of poverty and social exclusion. Like in developed countries, demographic, medical, psychosocial, global cognitive, and functional variables interact in a complex relationship on the elderly population. Such interaction should be considered to determine cognitive and functional performance using screening tests. The aim of this study was to evaluate the demographic, medical, and psychosocial factors affecting global cognitive performance as well as functional activities. METHODS The study was conducted in a Colombian elderly indigenous population which included a sample of 518 adults. This research employed a structural model of latent factors to assess the effects of demographic, medical, and psychosocial factors on cognitive and functional performance. The model was estimated by least squares and used a maximum-likelihood procedure, and it was determined RMSEA, TLI, and CFI to assess the model's goodness of fit. The categorical variables used in the model were as follows: (1) demographics, (2) psychosocial factors, (3) medical condition, (4) global cognition, and (5) functional factors. RESULTS Demographics, in addition to medical and psychosocial factors, were related to global cognition and functional factors (RMSEA = 0.051, CI 90% 0.045-0.057, CFI = 0.901, and TLI = 0.881). CONCLUSION These results provide strong evidence about the complex relationships among demographics, medical conditions, and psychosocial factors and their influence on global cognition and functional performance in Colombian indigenous elderly population.
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Affiliation(s)
| | - Eunice Yarce-Pinzon
- Mariana University Health Sciences Faculty, Occupational Therapy Program, Pasto, Colombia
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Cabrera-García V, García-Reales J, Rivera-Ensuncho M, Bermeo-Solarte L. Necesidades de acceso a servicios institucionales de familias con hijos con discapacidad intelectual. DUAZARY 2019. [DOI: 10.21676/2389783x.2970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Este artículo presenta los resultados de una investigación de enfoque cuantitativo y diseño descriptivo transversal, que tiene como propósito de identificar el nivel de acceso a los servicios que ofrecen las instituciones gubernamentales y privadas a las familias de niños en condición de discapacidad intelectual. Se contó con la participación de 82 familias de las ciudades de Bogotá D.C, Cali y Putumayo, 16 papás y 66 mamás a cargo de 54 niños y 28 niñas con edades entre dos y 17 años. Se aplicó el instrumento de FNA versión Colombia y se corrió un análisis de varianza (ANOVA). Los resultados muestran como la necesidad más alta, los servicios educativos para los hijos y como más baja, la comprensión familiar dentro de las creencias espirituales. Así mismo diferencias 1) por sexo: las familias con niños (M=3,46) presentan más necesidades que las familias con niñas (M=3,10), y 2) por edad en dos grupos: el primero con resultados más altos entre los dos a 10 años, y el segundo de 11 a 17 años muestra que las familias con hijos adolescentes (M=3,60) presentan mayor necesidad de acceso a servicios que las familias con niños y niñas (M=3,23).
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Lozano M, Manyes L, Peiró J, Montes F. Geographic conditioning in dietary, social, and health patterns in elderly population with disabilities. Nutrition 2019; 57:17-23. [DOI: 10.1016/j.nut.2018.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/11/2018] [Accepted: 05/26/2018] [Indexed: 10/28/2022]
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10
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Regional differences in the profile of disabled community-dwelling older adults: A European population-based cross-sectional study. PLoS One 2018; 13:e0208946. [PMID: 30533039 PMCID: PMC6289507 DOI: 10.1371/journal.pone.0208946] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/27/2018] [Indexed: 11/19/2022] Open
Abstract
The main objective of this work was to estimate the prevalence of disability in European community-dwelling older adults, as well as to investigate differences in the profile of disabled older adults between European regions (Northern, Central, Eastern and Southern). A cross-sectional study based on wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted. Community-dwelling participants aged 65-84 were selected (n = 33,369). Disability was defined as presenting at least one functional limitation in basic activities of daily living (BADL). Sociodemographic, health services, lifestyle and health-related variables were analyzed. Statistical analysis was carried out through the Chi-square and ANOVA tests for bivariate analysis, and Poisson regression for multivariate analysis. Overall prevalence of disability was 13.8%: 9.4% in the Northern region, 13.1% in the Southern region, 13.6% in the Central region, and 16.6% in the Eastern region. Portugal, Poland, Estonia and Belgium showed the highest prevalence of BADL limitations, while Sweden, Denmark, Greece and Switzerland showed the lowest prevalence. Besides, disabled older adults from East Europe presented the most disadvantaged health profile, followed by the Southern region. On the other hand, disabled older adults living in the Northern region showed the most advantaged characteristics of most variables, except for smoking and polypharmacy.
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Lozano M, Ramada JM, Peiró J, Frígola A, Esteve MJ. Dietary Assesment of Free-Living Elderly Spanish People with Disabilities. Ecol Food Nutr 2017; 56:277-296. [PMID: 28548585 DOI: 10.1080/03670244.2017.1323742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Nutritional research in elderly disabled is difficult in noninstitutionalized people. The dietary intake of a noninstitutionalized disabled population of the eastern region of Spain was evaluated to detect possible nutritional deviations. A total of 329 participants aged 65 and over were recruited. Most participants were overweight. Carbohydrates did not reach 50% of total Kcal/day. Insufficient micronutrient intakes and high consumption of simple carbohydrates and saturated fats (SFA) were found. A decreasing trend of water intake (p < .05) as well as an increasing trend of alcohol consumption (p < .05) with increasing age was found. The area of residence had a relevant impact on nutritional, dietary, and anthropometric characteristics of our population.
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Affiliation(s)
- M Lozano
- a Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine , University of Valencia , Burjassot , Spain
| | - J M Ramada
- b Institut Hospital del Mar d'Investigacions Mèdiques (IMIM) , Barcelona , Spain.,c CIBER de Epidemiologìa y Salud Pública (CIBERESP) , Madrid , Spain
| | - J Peiró
- d Department of Statistics and Operations Research , University of Valencia , Burjassot , Spain
| | - A Frígola
- a Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine , University of Valencia , Burjassot , Spain
| | - M J Esteve
- a Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine , University of Valencia , Burjassot , Spain
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Abajo M, Rodríguez-Sanz M, Malmusi D, Salvador M, Borrell C. Gender and socio-economic inequalities in health and living conditions among co-resident informal caregivers: a nationwide survey in Spain. J Adv Nurs 2016; 73:700-715. [PMID: 27683193 DOI: 10.1111/jan.13172] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 01/13/2023]
Abstract
AIMS To explore the associations between social determinants, caregiver's network support, burden of care and their consequences in health and living conditions of informal caregivers. BACKGROUND The socio-demographic trends regarding population ageing and changes in family models trigger an increased demand for care. DESIGN Cross-sectional study based on the 2008 edition of the National Disability, Independence and Dependency Situations Survey (DIDSS-2008) conducted by the National Statistics Institute in Spain. METHODS Analyses focused on persons identified as primary caregivers who co-reside with the dependent person. The associations between social determinants of caregivers, burden of care, support network and problems attributed to informal care (impaired health, depression, professional, economic and personal issues) were estimated by fitting robust Poisson regression models. Analyses were conducted separately for women and men. RESULTS The study sample included 6923 caregivers, 73% of women and 27% of men. Gender and socio-economic inequalities were found in assumption of responsibilities and burden of caring for dependents, which tend to fall more on women and persons of lower socio-economic level, who in turn have less access to formal support. These aspects translate into a higher prevalence of health, professional, economic and personal problems. CONCLUSIONS The study highlights gender and socio-economic inequalities in informal caregiving and its negative consequences. These findings may be useful in the design of policies and support programmes targeting the most affected groups of informal caregivers.
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Affiliation(s)
- María Abajo
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain
| | - Maica Rodríguez-Sanz
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - Davide Malmusi
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - María Salvador
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - Carme Borrell
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain.,Pompeu Fabra University, Barcelona, Spain
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Arnau A, Espaulella J, Serrarols M, Canudas J, Formiga F, Ferrer M. Risk factors for functional decline in a population aged 75 years and older without total dependence: A one-year follow-up. Arch Gerontol Geriatr 2016; 65:239-47. [PMID: 27131227 DOI: 10.1016/j.archger.2016.04.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/02/2016] [Accepted: 04/03/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES estimation of functional loss incidence and identification of risk factors associated with new disability onset in people aged 75 and older without severe dependence in a rural primary care setting. PATIENTS AND METHOD Prospective cohort study of a representative sample of people aged 75 years or older without severe dependence (Barthel Index>20 and Lawton Index>1) at a primary care center, with a 12-month follow-up. The baseline geriatric assessment recorded activities of daily living (ADL), sociodemographic information, numbers of drugs prescribed, previous hospital admissions and falls, cognitive function, hearing and visual capacity, body mass index, blood pressure, and the Short Physical Performance Battery to evaluate lower limb function. ADL was re-assessed after 12 months, defining functional loss as a fall of ≥10 points on the Barthel Index and/or ≥2 instrumental activities of the Lawton Index. Bivariate and multivariate analyses using logistic regression models were conducted to identify factors independently associated with functional loss. RESULTS Mean age was 81.7 years, 58.7% of patients were men, and 23.4% presented functional loss at the 12-month follow-up. Variables identified as independent predictors of functional loss were hospital admissions (aOR 3.92; 95%CI: 1.35-11.39), cognitive impairment (aOR 2.60; 95%CI: 1.39-4.92) and lower limbs functional limitation (aOR 2.01; 95%CI: 1.02-3.97). CONCLUSIONS Our results support the use of performance batteries in primary care for identifying elderly persons at risk of functional decline; and they also highlight the relevance of appropriate management of hospital admissions and planned discharges in order to preserve patients' functional status.
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Affiliation(s)
- Anna Arnau
- Clinical Research Unit, Althaia Xarxa Assistencial Universitària de Manresa, Dr. Joan Soler, 1-3, 08243 Manresa, Barcelona, Spain; Programa de Doctorat en Salut Pública i Metodologia de la Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Facultat de Medicina, Edifici M, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain; Department of Clinical Epidemiology, Hospitalari Universitari de Vic, Francesc Pla "El Vigatà", 1, 08500 Vic Barcelona, Spain.
| | - Joan Espaulella
- Servei de Geriatria i Cures Palliatives, Hospitalari Universitari de Vic-Hospital Universitari de la Santa Creu, Rambla Hospital, 52, 08500 Vic Barcelona, Spain
| | - Marta Serrarols
- Equip d'Assitència Primària Vic, Primary Care Center El Remei, Pla del Remei, 10-12, 08500 Vic Barcelona, Spain
| | - Judit Canudas
- Equip d'Assitència Primària Vic, Primary Care Center El Remei, Pla del Remei, 10-12, 08500 Vic Barcelona, Spain
| | - Francesc Formiga
- Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Feixa Llarga, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Montserrat Ferrer
- Programa de Doctorat en Salut Pública i Metodologia de la Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Facultat de Medicina, Edifici M, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain; Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Rodríguez López S, Montero P, Carmenate M, Avendano M. Functional decline over 2 years in older Spanish adults: evidence from the Survey of Health, Ageing and Retirement in Europe. Geriatr Gerontol Int 2013; 14:403-12. [PMID: 23844926 DOI: 10.1111/ggi.12115] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2013] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the social, educational, health and behavioral predictors of physical functional decline in older Spanish adults. METHODS A 2-year longitudinal study based on 699 community-dwelling Spanish adults aged over 65 years participating in the Survey of Health, Ageing and Retirement in Europe was carried out. Several predictors of a combined measure of functional disability were examined using logistic regressions. RESULTS A decline in function was experienced by 166 individuals. Functional decline in men was associated with an increased number of chronic diseases (OR 2.25, 95% CI 1.21-4.19) and depressive symptoms (OR 5.05, 95% CI 2.42-10.54) over a 2-year period, whereas among women it was associated with decreased numeracy score (OR 1.88, 95%CI 1.05-3.34). CONCLUSIONS Longitudinal changes in predictors are strongly associated with longitudinal changes in function between baseline and a 2-year follow up, most clearly among men. A decrease in cognitive functioning and increased depressive symptoms are associated with a decline in physical functioning, and can serve as useful clinical predictors to prevent disability in older Spanish adults.
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Cornejo-Ovalle M, Costa-de-Lima K, Pérez G, Borrell C, Casals-Peidro E. Oral health care activities performed by caregivers for institutionalized elderly in Barcelona-Spain. Med Oral Patol Oral Cir Bucal 2013; 18:e641-9. [PMID: 23524433 PMCID: PMC3731093 DOI: 10.4317/medoral.18767] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 01/04/2013] [Indexed: 12/14/2022] Open
Abstract
Objectives: To describe the frequency of brushing teeth and cleaning of dentures, performed by caregivers, for institutionalized elderly people.
Methods: A cross-sectional study in a sample of 196 caregivers of 31 health centers in Barcelona. The dependent variables were frequency of dental brushing and frequency of cleaning of dentures of the elderly by caregivers. The independent variables were characteristics of caregivers and institutions. We performed bivariate and multivariate descriptive analyses. Robust Poisson regression models were fitted to determine factors associated with the dependent variables and to assess the strength of the association.
Results: 83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents. The variables explaining the lower frequency of brushing teeth by caregivers for the elderly, adjusted for the workload, were: no training in the care of elderly persons (PRa 1.7 CI95%: 1.6-1.8), not fully agreeing with the importance of oral health care of the elderly (PRa 2.5 CI95%: 1.5-4.1) and not knowing of the existence of oral health protocols (PRa 1.8 CI95%: 1.2-2.6). The variables that explain the lower frequency of cleaning dentures, adjusted for the workload, were lack of training in elderly care (PRa 1.7 CI95%: 1.3-1.9) and not knowing of the existence of protocols (PRa 3.7 CI95%: 1.6-8.7).
Conclusion: The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons.
Key words:Institutionalized elderly, caregivers, oral hygiene, long-term care, oral health.
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Affiliation(s)
- Marco Cornejo-Ovalle
- Faculty of Dentistry, University of Chile - Service of Health Information Systems, Agència de Salut Pública de Barcelona, Barcelona, Spain.
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Darder JJT, Carvalho ZMDF. La interface del cuidado de enfermería con las políticas de atención al anciano. Rev Bras Enferm 2012; 65:721-9. [DOI: 10.1590/s0034-71672012000500002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 11/24/2012] [Indexed: 11/22/2022] Open
Abstract
Se objetivó hacer una explanación sobre la interface del cuidado de enfermería con las políticas de atención al anciano. Presenta-se el envejecimiento como una realidad mundial y una victoria de la sociedad moderna; la situación de las personas ancianas en España y las consecuencias sociales del envejecimiento en España; dependencia y necesidades de asistencia; situación de las personas ancianas en Brasil; comparación entre España y Brasil; niveles de dependencia; las soluciones que suministran las enfermeras y atención domiciliaria como base de un mejor futuro. Las consideraciones apuntadas son: La atención a la dependencia debe ser abordada de inmediato, considerar los fracasos en otros países, para no caer en los mismos errores, instar a la población mayor al mantenimiento de su independencia con promoción de la salud.
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Desafíos en la autonomía y la atención a la dependencia de la población mayor. Síntesis. GACETA SANITARIA 2011; 25 Suppl 2:1-4. [DOI: 10.1016/j.gaceta.2011.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 10/18/2011] [Indexed: 11/20/2022]
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