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Park NS, Jang Y, Chung S, Chiriboga DA, Haley WE. Relationship of Living and Eating Arrangements to Mental Distress Among Older Korean Immigrants: Gender Difference in the Mediating Role of Loneliness. Res Aging 2024; 46:153-166. [PMID: 37820385 DOI: 10.1177/01640275231206482] [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] [Indexed: 10/13/2023]
Abstract
This study examined how different living/eating arrangements were associated with loneliness and depressive symptoms among older Korean immigrants. We examined gender differences considering: (1) patterns of living/eating arrangements and their relations with loneliness and mental distress and (2) indirect effect of living/eating arrangements on mental distress through feeling lonely. Data were drawn from the Study of Older Korean Americans that surveyed older; Korean immigrants during 2017-2018 (N = 2150). Living/eating arrangements were classified in the combination of four categores. Using the PROCESS macro, we tested gender differences in the mediation effect of loneliness on the relationship between living/eating arrangements and mental distress while controlling for background/health characteristics and social connectedness-related variables. The mediating role of loneliness was manifested differentially between men and women. By administering simple measures of living/eating arrangements, practitioners could potentially identify key targets to improve social and mental well-being, particularly among older immigrants with limited resources.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, California, CA, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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Demir ZG, Yılmaz M. Loneliness, Psychological Well-being, Depression, and Social Participation in the Older Persons: Rural and Urban Differences. Curr Aging Sci 2024; 17:247-261. [PMID: 38638048 DOI: 10.2174/0118746098297063240409070531] [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: 01/12/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION The purpose of this study is to compare the loneliness, psychological well- being, depression, and social participation of elderly people living in Turkish society between rural and urban areas. The sample group of the study, in which a correlational survey model was used, consisted of 610 elderly adults. METHOD The study population consists of two groups: the first group consists of individuals over 65 years of age living in the city (Istanbul) (n= 291), and the second group consists of individuals over 65 years of age living in rural areas (rural areas of Ordu) (n= 319). Socio-demographic Information Form, Loneliness in the Elderly Scale, Geriatric Depression Scale, Psychological Well-Being in the Elderly Scale, and Social Inclusion Scale were applied online. Statistical analyses of the study were conducted using SPSS 27.00, and the Independent Samples t-test and ANOVA test were used. RESULTS According to the findings of this study, statistically significant results were found in psychological well-being, social inclusion, social relations, loneliness and depression, and place of residence. It was observed that the social isolation and social acceptance levels of those living in urban areas were higher than those living in rural areas. Social, loneliness, and depression scores of those living in the village/town were found to be higher than those living in the city centre. Furthermore, the social relationship scores of those living in the village/town were found to be higher than those living in the city centre. CONCLUSION The increasing elderly population worldwide has become an issue that requires global measures. Place of residence is one of the factors thought to affect older people's health and well- being. It is thought that the study data will contribute to new policies that will ensure the protection and promotion of elderly health and those working in this field. In addition, the study, which provides information about Turkish culture, will also enable intercultural comparisons.
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Affiliation(s)
| | - Mahmut Yılmaz
- Specialised Clinical Psychologist, Istanbul Aydın University, Istanbul, Turkey
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Devkota R, Cummings G, Hunter KF, Maxwell C, Shrestha S, Dennett L, Hoben M. Factors influencing emotional support of older adults living in the community: a scoping review protocol. Syst Rev 2023; 12:186. [PMID: 37794514 PMCID: PMC10548654 DOI: 10.1186/s13643-023-02346-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 09/07/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Emotional support is key to improve older adults' subjective health, and psychological, social and emotional well-being. However, many older adults living in the community lack emotional support, increasing the risk for loneliness, depression, anxiety, potentially avoidable healthcare use and costs, and premature death. Multiple intersecting factors may influence emotional support of older adults in the community, but these are poorly understood. Studies have focused on specific populations (e.g., older adults with depression, cancer). Although relevant, these studies may not capture modifiable factors for the wider and more diverse population of older adults living in the community. Our scoping review will address these important gaps. We will identify and synthesize the evidence on factors that influence emotional support of older adults in the community. METHODS We will use the Johanna Briggs Institute updated methodological guidance for the conduct of scoping reviews to guide our review process. We will search MEDLINE, EMBASE, APA Psycinfo, CINAHL, Dissertations and Theses Global, and Scopus from inception. We will include studies published in English, examining factors influencing emotional support of older adults residing in community, without restrictions on the study design or year of publication. We will also include gray literature (dissertations and reports). Two independent reviewers will conduct title, abstract, and full-text screening, as well as risk of bias assessment, using validated quality appraisal tools based on study designs. Discrepancies will be resolved by consensus. The primary reviewer will extract the data from all studies, and the second reviewer will check the extractions of all the studies. We will use descriptive statistics and narrative synthesis for analysis. Family/friend caregivers and older adults involved as an advisory group will help with explaining the findings in terms of whether associations observed reflect their experiences and reality. We will analyze the discussion and generate themes, and summarize in a narrative form. DISCUSSION This scoping review may identify factors that could be modified or mitigated to improve emotional support provision for older adults residing in community. The knowledge will inform the development of tailored interventions directed to older adults and their caregivers. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/4TAEB (associated project link: osf.io/6y48t).
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Affiliation(s)
- Rashmi Devkota
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
| | - Greta Cummings
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Colleen Maxwell
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Shovana Shrestha
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Liz Dennett
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Matthias Hoben
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
- School of Health Policy and Management, Faculty of Health, York University, Toronto, ON, Canada
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Hussain B, Mirza M, Baines R, Burns L, Stevens S, Asthana S, Chatterjee A. Loneliness and social networks of older adults in rural communities: a narrative synthesis systematic review. Front Public Health 2023; 11:1113864. [PMID: 37255758 PMCID: PMC10225733 DOI: 10.3389/fpubh.2023.1113864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Loneliness has significant impacts on the health of older adults. Social networks help to improve psychosocial and quality of life outcomes among older adults. A fifth of older adults live in rural communities, where geographic isolation poses challenges to health. The dynamics of social networks of older adults in rural communities has not been explored. Objective To synthesize the literature related to loneliness and social networks of older adults in rural settings. Methods A mixed-methods systematic review was conducted through searching six bibliographic databases to retrieve peer-reviewed literature with no time limits. We performed a methodological assessment of each study using a mixed method quality assessment tool. Findings are synthesized thematically. Results A total of 50 studies (32 quantitative, 15 qualitative, and 3 mixed methods) were included in this review. Studies were conducted in 17 different countries, the majority from China (n = 12), the UK (n = 9), and USA (n = 9). Findings revealed that social networks of older adults consist of family, friends and neighbors and continue to be developed through participation in various physical and social activities such as walking groups and participation in religious events. Social networks offer informational, functional, psychological and social support to older adults. Through their social networks, older adults feel socially connected and cared for. Successful interventions to improve social networks and address loneliness were those developed in groups or one-on-one with the older adults. The key ingredient to the positive impact of these interventions on reducing social isolation and loneliness was the formation of a social connection and regular engagement with the older adults. However, the review did not find any explicitly reported theory or model on which these interventions are based. Conclusion The prevalence of loneliness among older adults in rural areas needs urgent attention. Social network theory and methods can help in developing interventions to address social isolation and loneliness among older adults in rural communities.
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Affiliation(s)
- Basharat Hussain
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Mahrukh Mirza
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Rebecca Baines
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Lorna Burns
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | | | - Sheena Asthana
- Plymouth Institute of Health and Care Research (PIHR), Plymouth, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Centre for Coastal Communities, University of Plymouth, Plymouth, United Kingdom
| | - Arunangsu Chatterjee
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- School of Medicine, University of Leeds, Leeds, United Kingdom
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Jung Y, Choi S. Trajectories of Preventive Health Care Utilization Among Older Koreans: The Role of Social Relationships. HEALTH EDUCATION & BEHAVIOR 2022; 50:382-393. [PMID: 36412206 DOI: 10.1177/10901981221135505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Receiving timely health screening is associated with important public health benefits among older adults. By focusing on the role of social relationships, the present study was aimed at examining longitudinal trajectories of health screening use among older adults in Korea, whose universal health care system provides free-of-charge health screening. Methods A nationally representative sample of 3,575 individuals aged 65 or older from wave one of the Korean Longitudinal Study of Aging (2006) was followed for 10 years (up to Wave 6, 2016). Mixed-effect logit models were used to investigate how an older adult’s social relationship characteristics (i.e., household composition, financial support from family, social group participation, and the frequency of contact with friends or relatives) were associated with their trajectories of participation in the national health screening program. Results Despite the low financial burden, only 49.7% of older adults in Korea reported receiving the recommended health screening at the baseline. Although the probability of receiving recommended health screening increased over the 10-year study period, the trajectories were significantly different by an older adult’s social relationship characteristics. All four social relationship characteristics were significantly associated with receiving health screening. However, those with more frequent social contacts and those who participated in social groups showed steeper increases in the probability of receiving health screening (i.e., significant interaction with time). Conclusions This study highlights the importance of social relationships and intervention approaches that accommodate socially isolated older adults to facilitate their timely receipt of recommended preventive care.
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Affiliation(s)
| | - Sunha Choi
- Seoul National University of Science & Technology, Seoul, Republic of Korea
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Satsanasupint P, Daovisan H, Phukrongpet P. Enhancing active ageing in later life: Can community networks enhance elderly health behaviours? Insights from a bracketing qualitative method. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2022. [DOI: 10.1002/casp.2628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Panarat Satsanasupint
- Faculty of Nursing Science Saint Theresa International College Nakhon Nayok Thailand
| | - Hanvedes Daovisan
- Human Security and Equity Research Unit, Chulalongkorn University Social Research Institute Chulalongkorn University Bangkok Thailand
| | - Pimporn Phukrongpet
- Department of Sociology and Anthropology, Faculty of Humanities and Social Sciences Mahasarakham University Maha Sarakham Thailand
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Ma Y, Liang C, Yang X, Zhang H, Zhao S, Lu L. The Effect of Social Media Use on Depressive Symptoms in Older Adults with Self-Reported Hearing Impairment: An Empirical Study. Healthcare (Basel) 2021; 9:1403. [PMID: 34828450 PMCID: PMC8625068 DOI: 10.3390/healthcare9111403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 02/07/2023] Open
Abstract
Older people with hearing impairment are more likely to develop depressive symptoms due to physical disability and loss of social communication. This study investigated the effects of social media on social relations, subjective aging, and depressive symptoms in these older adults based on the stimulus-organism-response (S-O-R) framework. It provides new empirical evidence to support improving the mental health and rebuilding the social relations of older people. A formal questionnaire was designed using the Wenjuanxing platform and distributed online through WeChat; 643 valid questionnaires were received from older people with self-reported hearing impairments, and SmartPLS 3.28 was used to analyze the data. The results show that (1) social media significantly impacts the social relations of older people with hearing impairment (social networks, β = 0.132, T = 3.444; social support, β = 0.129, T = 2.95; social isolation, β = 0.107, T = 2.505). (2) For these older people, social isolation has the biggest impact on their psychosocial loss (β = 0.456, T = 10.458), followed by the impact of social support (β = 0.103, T = 2.014); a hypothesis about social network size was not confirmed (β = 0.007, T = 0.182). Both social media (β = 0.096, T = 2.249) and social support (β = 0.174, T = 4.434) significantly affect the self-efficacy of hearing-impaired older people. (3) Both subjective aging (psychosocial loss, β = 0.260, T = 6.036; self-efficacy, β = 0.106, T = 3.15) and social isolation (β = 0.268, T = 6.307) significantly affect depressive symptoms in older people with hearing impairment. This study expands the theories of social media aging cognition, social support, and social networks and can provide practical contributions to the social media use and mental health of special persons 60 years and older.
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Affiliation(s)
- Yiming Ma
- The School of Management, Hefei University of Technology, Hefei 230009, China; (Y.M.); (X.Y.); (S.Z.); (L.L.)
| | - Changyong Liang
- The School of Management, Hefei University of Technology, Hefei 230009, China; (Y.M.); (X.Y.); (S.Z.); (L.L.)
| | - Xuejie Yang
- The School of Management, Hefei University of Technology, Hefei 230009, China; (Y.M.); (X.Y.); (S.Z.); (L.L.)
| | - Haitao Zhang
- The School of Management, Jilin University, Changchun 130012, China;
| | - Shuping Zhao
- The School of Management, Hefei University of Technology, Hefei 230009, China; (Y.M.); (X.Y.); (S.Z.); (L.L.)
| | - Liyan Lu
- The School of Management, Hefei University of Technology, Hefei 230009, China; (Y.M.); (X.Y.); (S.Z.); (L.L.)
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Wu F, Sheng Y. Social isolation and health-promoting behaviors among older adults living with different health statuses: A cross-sectional study. Int J Nurs Sci 2021; 8:304-309. [PMID: 34307779 PMCID: PMC8283714 DOI: 10.1016/j.ijnss.2021.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/26/2021] [Accepted: 05/24/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives To describe the characteristics and relationships of social isolation and health promoting behaviors of Chinese older adults with different health statuses. Methods Totally 485 older adults were recruited. They were divided into three groups based on their health status: healthy group (n = 72), group with one disease (n = 183) and group with multimorbidity (n = 230). Lubben Social Network Scale-6 and Health-Promoting Lifestyle Profile II were used to measure their social isolation and health-promoting behaviors, respectively. Results Among the aged with one disease or multimorbidity, 30.6% (56/183) and 31.7% (73/230) were socially isolated, respectively, based on the score of the Lubben Social Network Scale-6. The three groups differed significantly in health-promoting behaviors and scores on several subscales. The group with multimorbidity exhibited more social isolation and fewer health-promoting behaviors than other groups. Social isolation was among the factors adversely affecting health-promoting behaviors in older adults. Conclusions Health care providers should help older adults with multimorbidity preserve the remaining abilities to improve health-promoting behaviors. Meanwhile, it is important to support healthy older adults to increase self-responsibility to achieve healthy aging.
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Affiliation(s)
- Fan Wu
- College of Medicine and Health Science, Wuhan Polytechnic University, Hubei, China
| | - Yu Sheng
- School of Nursing, Peking Union Medical College, Beijing, China
- Corresponding author.
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Eating Alone or Together among Community-Living Older People-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073495. [PMID: 33801775 PMCID: PMC8036467 DOI: 10.3390/ijerph18073495] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/04/2021] [Accepted: 03/25/2021] [Indexed: 12/30/2022]
Abstract
Research on healthy aging commonly concerns problems related to loneliness and food intake. These are not independent aspects of health since eating, beyond its biological necessity, is a central part of social life. This scoping review aimed to map scientific articles on eating alone or together among community-living older people, and to identify relevant research gaps. Four databases were searched, 989 articles were identified and 98 fulfilled the inclusion criteria. In the first theme, eating alone or together are treated as central topics of interest, isolated from adjoining, broader concepts such as social participation. In the second, eating alone or together are one aspect of the findings, e.g., one of several risk factors for malnutrition. Findings confirm the significance of commensality in older peoples' life. We recommend future research designs allowing identification of causal relationships, using refined ways of measuring meals alone or together, and qualitative methods adding complexity.
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da Silva ACS, Ansai JH, Cezar NODC, Carvalho Vale FA, dos Santos JG, de Andrade LP. Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study. Dement Neuropsychol 2020; 14:394-402. [PMID: 33354293 PMCID: PMC7735049 DOI: 10.1590/1980-57642020dn14-040010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 06/25/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Clinical follow-up studies are necessary for a better understanding of the evolution of cognitive impairment as well as the development of better assessment and intervention tools. OBJECTIVE To investigate whether older people with preserved cognition (PC), mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) show differences in clinical outcomes and interventions after a 32-month period. METHODS One hundred twenty-four community-dwelling older people were included and classified in one of three groups (PC, MCI and mild AD). Information on clinical outcomes (deaths, new diagnoses, falls, need for assistance or changes in routine and hospitalizations) and interventions (increased use of medication, physiotherapeutic intervention, practice of physical exercise, etc.) in the 32-month period were collected by telephone or during a home visit on a single day. RESULTS Ninety-five participants (35 with PC, 33 with MCI and 27 with AD) were reevaluated after 32 months. The need for assistance/changes in routine was significantly higher in the AD group, especially with regard to basic activities of daily living. Unlike the other groups, the PC group did not show "other diagnoses" (urinary incontinence, prolapse, change in vision or autoimmune disease). No significant differences were found regarding other variables. CONCLUSIONS Older people with and without cognitive impairment exhibited differences in some clinical outcomes after 32 months, such as need for assistance or changes in their routine and new diagnoses of specific diseases. Therefore, the multidimensionality of geriatric patients should be considered when planning assessments and interventions.
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Affiliation(s)
| | - Juliana Hotta Ansai
- Gerontology Department, Universidade Federal de São Carlos – São Carlos, SP, Brazil
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Hu C, Chung PK, Zhang CQ, Gan Y, Hu R. Understanding of Resilience of Older Adults in Hong Kong: A Qualitative Investigation. Gerontol Geriatr Med 2020; 6:2333721420966904. [PMID: 33195741 PMCID: PMC7597569 DOI: 10.1177/2333721420966904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/12/2020] [Accepted: 09/26/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose: Resilience is an important trait for older adults facing adversity. This qualitative study aimed to identify the characteristics that contribute to resilience in a group of community-dwelling older adults in Hong Kong. Methods: Twenty-five Chinese older adults were invited. Interviews were conducted to collect information about the adverse events in their lives, their attitudes towards adversity and the beliefs underlying their approaches to overcoming adversity. The transcripts were analyzed using qualitative content analysis. Results: Seven themes emerged from the interviews: equanimity, positive attitudes towards life; meaningfulness, self-reliance, social support, environmental support, and spirituality and faith. Conclusion: Our qualitative analysis found that resilience among older adults in Hong Kong is characterized by internal, external and existential factors. The results may be useful for the development of proactive interventions aimed at assisting older adults to enhance the positive experiences in their lives.
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Affiliation(s)
- Chun Hu
- Northwestern Polytechnical University, Shanxi, China
| | | | - Chun-Qing Zhang
- Hong Kong Baptist University, Hong Kong SAR, China.,Sun Yat-Sen University, Guangdong, China
| | | | - Rui Hu
- Administrative Committee of Educational Science College, Wuhan Polytechnic, Hubei, China
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12
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Gender differences in the association between social relationships and loneliness among older adults in Singapore. JOURNAL OF POPULATION RESEARCH 2020. [DOI: 10.1007/s12546-020-09242-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Dowgiałło-Wnukiewicz N, Janik MR, Lech P, Major P, Pędziwiatr M, Kowalewski PK, Walędziak M, Wysocki M, Michalik M. Outcomes of sleeve gastrectomy in patients older than 60 years: a multicenter matched case-control study. Wideochir Inne Tech Maloinwazyjne 2020; 15:123-128. [PMID: 32117495 PMCID: PMC7020714 DOI: 10.5114/wiitm.2019.81450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 11/27/2018] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The prevalence of obesity is increasing according to the World Health Organization. Furthermore, global aging is increasing, especially in developed countries in Europe. Whether bariatric surgery should be performed in elderly people is still controversial. AIM To determine the clinical outcomes of sleeve gastrectomies (SG) in older central European patients. We compared the safety and efficacy of SG in patients older than 60 years with younger patients. MATERIAL AND METHODS Eighty-nine patients older than 60 years, who underwent SG, were included in the study. Eighty-nine younger patients (aged 18-40 years) were matched according to body mass index (BMI) and comorbidities. The analyzed data included age, sex, total body weight, BMI, length of hospital stay, 30-day complications and improvement in comorbidities. RESULTS There was no significant difference in the complication rate between the 2 age groups (p = 0.59). An improvement in hypertension was observed in 73.1% of older patients and in 69.2% of younger patients (p = 0.67). There was improvement in diabetes mellitus in 40% of older patients and in 31.1% of younger patients (p = 0.25). The ΔBMI after 12, 24 and 36 months was significantly lower in older patients than in younger patients (p = 0.002, p = 0.001; p = 0.043, respectively). Percent excess BMI loss (%EBMIL) after 12, 24, and 60 months was significantly lower in older than in younger patients (p = 0.001, p = 0.001, p = 0.028, respectively). CONCLUSIONS Better weight loss is achieved in younger than in older patients, while maintaining a similar effect on the risk of complications and improvement in comorbidities. Therefore, SG is safe and effective in older people.
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Affiliation(s)
| | - Michal R. Janik
- Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Pawel Lech
- Department of General, Minimally Invasive and Elderly Surgery, University of Warmia and Mazury, Olsztyn, Poland
| | - Piotr Major
- 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland
| | - Michał Pędziwiatr
- 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland
| | - Piotr K. Kowalewski
- Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Maciej Walędziak
- Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Michał Wysocki
- 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland
| | - Maciej Michalik
- Department of General, Minimally Invasive and Elderly Surgery, University of Warmia and Mazury, Olsztyn, Poland
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Dixon P, Round J. Caring for Carers: Positive and Normative Challenges for Future Research on Carer Spillover Effects in Economic Evaluation. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:549-554. [PMID: 31104733 PMCID: PMC6524130 DOI: 10.1016/j.jval.2018.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/04/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Many individuals rely on family and friends to provide care outside of the formal healthcare sector. The need for caring is driven by many factors, including government policies toward health and social care, and increased prevalence of chronic and comorbid conditions. Informal care may give rise to "spillover" effects from the health of a cared-for individual to the health of carers. Spillover effects are rarely reflected in economic evaluations, in spite of growing research interest in this area, and recommendations from bodies such as the National Institute for Health and Care Excellence (NICE) and the Second Panel on Cost-Effectiveness that effects of this type be included in cost-effectiveness analysis. OBJECTIVE We explore the positive and normative issues to which the inclusion of carer spillover effects in economic evaluation may give rise and how future research might begin to address these challenges. RESULTS Positive challenges include the identification of causal rather than coincidental impacts on carers, selection into caring, and the measurement and treatment of spillover effects. The normative issues are related to these challenges, and particularly include impacts on equity, and spillovers that improve rather than reduce the health of carers. CONCLUSIONS We argue that challenges including spillover effects in economic evaluation are considerable. Avenues for future research and possible solutions to these challenges include a re-orientation of analytic perspectives so that the impacts of caring on carers are accounted for where appropriate, and the design of studies to collect robust evidence to inform debate and guidance development in this area.
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Affiliation(s)
- Padraig Dixon
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England, UK.
| | - Jeff Round
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK
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