Factors Associated With Low and High Social Engagement Among Older Nursing Home Residents in Korea

Social Activity and Cognitive Decline in Older Residents of Long-Term Care Facilities: A Cohort Study

Background

Cognitive decline is a major reason for dependence and resource use in long-term care.

Objective

We explored whether social activities may prevent cognitive decline of older residents of long-term care facilities.

Methods

In a routine care cohort, 3,603 residents of long-term care facilities were assessed on average 4.4 times using the interRAI-Long-Term-Care-Facilities instrument which includes frequency of participation in social activities of long standing interest over the last 30 days and the Cognitive Performance Scale. Linear mixed models repeated measures analyses were performed corrected for age, sex, physical activity, Activities of Daily Living, mood, and health indicators.

Results

Social activity was associated with cognitive preservation over time. This association was stronger in those with no or mild cognitive impairment at baseline, relative to those with moderate to severe impairment. Participation in specific social activities such as conversing and helping others showed a similar positive association. The relation between social activity and cognitive impairment appeared to be bi-directional.

Conclusions

The protective effects of social activity offer a window of opportunity to preserve cognitive functioning in long-term care residents.

Depressive symptoms and physical function among the elderly in nursing homes during the COVID-19 pandemic in China: A cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has placed a heavy burden on global healthcare. Depressive symptoms and physical function impairment are 2 common health problems among the elderly, but the association between depressive symptoms and physical function in nursing homes have not been extensively investigated during the COVID-19 pandemic. The purpose of this study was to investigate the current status of depressive symptoms and physical function and analyze the prevalence and related factors of depression among elderly people in nursing homes during the COVID-19 pandemic in China. A cross-sectional study was conducted. 381 elderly people were included in 4 nursing homes who were 60 to 100 years old with more than 3 months' residential in Weifang City, Shandong Province using convenience cluster sampling. The Patient Health Questionnaire (PHQ-9) was performed to evaluate geriatric depression, the Barthel Index (BI) was administered to assess the activities of daily living, and a self-designed demographic data questionnaire was used to collect the demographic data. Multiple logistic regression analysis was conducted. 103 (27.0%) old residents reported depression according to PHQ-9. 279 (73.2%) old residents reported impaired self-care ability according to BI. The mean score of PHQ-9 and BI in the elderly was 3.56 ± 3.76 and 5.76 ± 7.05. The total PHQ-9 score of the elderly in nursing homes was positively correlated with the total activities of daily living score (R = 0.503, P < .01). Regression analysis showed that gender, self-care ability, more chronic diseases and medicines, especially Alzheimer's disease and cataract were risk factors for depression among elderly people in nursing homes (P < .05). Our study showed 27.0% depression rate among old residents in nursing homes in China in the context of the COVID-19 pandemic. Depression is relatively prevalent among the elderly in China, and we should pay attention to those with poor self-care ability and more chronic diseases and medicines.

Chair stand test as a proxy for physical performance and muscle strength in sarcopenia diagnosis: the Korean frailty and aging cohort study

BACKGROUND

The 5-times chair stand test (5CST) is a proxy tool for measuring physical performance and muscle strength in diagnosing sarcopenia. The Asian Working Group for Sarcopenia 2019 guidelines recommends the 5CST for evaluating gait speed, whereas the European Working Group on Sarcopenia in Older People guidelines recommend the chair stand test as a proxy for muscle strength.

AIMS

This study sought to determine whether the chair stand test correlates with handgrip strength and gait speed, and investigate sex differences in these relationships.

METHODS

We used data collected from 1416 participants (678 men and 738 women) in the 2017 Korean Frailty and Aging Cohort Study (KFACS).

RESULTS

The 5CST time had a higher correlation with gait speed (r =  - 0.470) than handgrip strength (r =  - 0.309). In addition, 5CST time predicted low gait speed (area under the curve [AUC] 0.727) better than low handgrip strength (AUC 0.641). The optimal cutoff values of the 5CST to estimate low gait speed were 10 s for men (sensitivity 62%, specificity 64%) and 11 s for women (sensitivity 68%, specificity 67%). The optimal cutoff values of the 5CST for low handgrip strength were the same as those for low gait speed (10 s for men and 11 s for women).

CONCLUSIONS

The 5-times chair stand test fits with gait speed and handgrip strength but seems to be a better proxy of gait speed than handgrip strength. The optimal cutoff values of the 5CST to estimate low gait speed and low handgrip strength were lower in men than women. Although none of the AWGS 2019 or EWGSOP guidelines present sex-specific cutoffs for the 5CST, it needs to be considered in the next guidelines.

Relationship between unmet needs for assistance and healthy aging among disabled older adults in China

Background

Although there is a growing consensus around the world that long-term care services and supports are important to help the aged population with disabilities achieve healthy aging, a misallocation of care resources and inefficiency in care delivery still exist in China. The absence or inadequate provision of long-term care services and supports among older adults with disabilities results in a range of adverse health consequences. However, the negative influence of unmet needs for assistance on healthy aging, based on functional perspectives including physiological, psychological, and societal domains, has been underestimated. This study aimed to measure healthy aging based on a person-centered approach and examine the relationship between unmet needs for assistance and healthy aging among older adults with disabilities in China.

Methods

Based on the data from the Chinese Longitudinal Healthy Longevity Survey 2018, we used the latent profile analysis with three indicators to uncover distinctive types of older adults experiencing distinct levels of healthy aging, and applied the ordered logit regression to analyze the correlation between unmet needs for assistance and different levels of healthy aging. To further address the endogeneity bias, the robust test was conducted by the two-stage least-squares instrumental variable estimation and the conditional mixed process instrumental variable estimation.

Results

Three ordered latent classes were identified: a low level of healthy aging (42.83%), a middle level of healthy aging (47.27%), and a high level of healthy aging (9.90%). Disabled older adults with unmet needs had a lower probability of achieving the higher level of healthy aging (OR = 0.57, SE = 0.04, CI = 0.48–0.66, p < 0.001).

Conclusions

This study highlights the need to increase awareness among gerontological practitioners with respect to long-term care services and supports for disabled older adults as a potential for enhancing their healthy aging, and that unmet needs could be a basis for risk assessment and a means for determining the efficacy of long-term care interventions on maintaining health.