Improving quality of life for older people in the community: findings from a local Partnerships for Older People Project innovation and evaluation

Factors associated with older persons' physical health in rural Uganda

Introduction

The proportion of older persons in developing countries is increasing with no clear evidence of improvement in physical health. The aim of this paper was to examine the factors associated with older persons’ physical health in rural Uganda.

Methods

This paper is based on a cross-sectional study of 912 older persons age 60 years and older across four major regions of Uganda. The study was conceptualized basing on World Health Organization quality of life BREF (WHOQOL-BREF). Analysis was done at three levels, that is, frequency distributions were generated to describe background characteristics of respondents and cross-tabulations were done to determine associations between dependent and each of the independent variables. Ordinal logistic regression was used to determine the predictors of physical health.

Results

The likelihood of good physical health is high among older persons (Ops) who controlled their household assets (OR = 3.64; CI = 1.81–7.30) or the household assets controlled by their spouses (OR = 4.44; CI = 1.91–10.32) relative to those whose household assets were controlled by their children. There is high likelihood of good physical health among those who engage in physical activities (OR = 2.28; CI = 1.52–3.43) compared to those who do not.

Conclusion

The findings have various policy implications, including creating an enabling environment and building capacities of older persons to remain in control of their household assets. Interventions focusing on deepening sensitization of older persons about importance of physical exercises could be a viable strategy for improving physical health of older persons.

Health-related quality of life among healthy elderly Iranians: a systematic review and meta-analysis of the literature

Background

Health-related quality of life (HRQoL) measurement in elderly people can provide appropriate information for an optimal management of physical/mental conditions. The main objective of the present study was to quantitatively assess the HRQoL among healthy elder Iranian individuals as measured by the Short-Form 36 (SF-36) questionnaire, both overall and at the level of each its single component/domain.

Methods

This study was designed as a systematic review and meta-analysis, following the "Preferred Reporting Results of Systematic Reviews and Meta-Analyses" (PRISMA) guidelines. Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, and Iranian databases such as MagIran, SID and Irandoc were mined from inception up to 1st September 2017. Also the grey literature (via Google Scholar) was mined. Two reviewers independently screened titles/abstracts, assessed full-text articles, extracted data, and appraised their quality using the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) checklist.

Results

Twenty five studies were included. Mean overall HRQoL was 54.92 [95%CI 51.50–58.33], lower than the value found by studies done in other countries, especially in those economically developed. The sensitivity analysis indicated stability and reliability of results. Pooled scores of each HRQoL domain/sub-scale of the SF-36 questionnaire ranged from 49.77 (physical role functioning) to 63.02 (social role functioning).

Conclusions

HRQoL among healthy elder Iranian individuals is generally low. Health policy-makers should put HRQoL among the elderly as a priority of their agenda, implementing ad hoc programs and providing social, economic and psychological support, as well as increasing the participation of old people in the community life and use their experiences.

Electronic supplementary material

The online version of this article (10.1186/s12955-018-0845-7) contains supplementary material, which is available to authorized users.

The Value of a Gardening Service for the Frail Elderly and People With a Disability Living in the Community

Little is known about the significance of gardening services for frail elderly people. This study explored the value of a gardening service for frail older people and people with a disability living in the community. Using qualitative and quantitative data collected from pre-gardening (n = 38) and post-gardening service delivery interviews (n = 35) and the Housing Enabler, the value of a gardening service was examined. Findings suggest that the service had a positive impact on the independence and emotional well-being of frail aged people and younger people with a functional disability, with little impact on physical health. Results indicate that gardening services should be fundamental to planning for these populations to remain or return to living in the community.

Health Promotion and Education: A Study of the Effectiveness of Programs Focusing on the Aging Process

Considering the population aging and the failure of biologistic and hospital-based treatment model, health promotion programs based on scientific evidence are necessary. A comprehensive review of literature was performed, aiming to identify and analyze health promotion and education experiments focused on the aging process. Papers published in eight databases, together with the database of the Pan-American Health Organization, were selected based on review of titles and abstracts, followed by a full text review conducted by two independent reviewers. A total of 22 studies were included, the majority of which adopted a quantitative approach, with a sample larger than 100 elderly or pre-retirement individuals. The majority of studies reported positive results in terms of health promotion and education. One study obtained minimum improvement and one reported that no statistically significant improvement had occurred. The positive effects most indicated by authors were: general or self-perceived improvement in physical health, improvement in psychosocial aspects and in relation to the aging process, improvement in adherence to preventative actions and in healthy conduct and lifestyle, increase in level of physical activity, improvement in quality of life and/or physical well-being, and improvement in activities of daily living or reduction of the risk of developing disabilities.

Urinary incontinence in institutionalized elderly: prevalence and impact on quality of life

AbstractIntroduction Urinary incontinence is a geriatric syndrome that generates strong economic and social impacts as well as emotional changes and negative consequences for the health of the elderly.Objective The objective of this work was to identify the prevalence of urinary incontinence and its associated factors, as well as its impact on quality of life of institutionalized elderly.Materials and methods A cross-sectional study was conducted herein, with 10 long-term institutions for the elderly of the municipality of Natal (Northeast Brazil). The Minimum Data Set was completed by caregivers to determine the presence of incontinence, and the Short Form of the International Consultation on Incontinence Questionnaire was answered by the elderly, to assess the frequency and amount of urinary leakage, the impact on quality of life, and the type of incontinence. The chi-square test and Fisher’s exact test were applied in the bivariate analysis, and logistic regression was utilized for multivariate analysis.Results The prevalence of urinary incontinence was 42.7% (95% CI: 34.8–50.8). The impact of this condition on daily life was mild in 46.5% of cases, moderate for 29.3% of cases, and severe in 24.1% of cases. The condition was associated with functional impairment (p < 0.001; RP: 4.13).Final considerations The prevalence of urinary incontinence in this sample, which presented cognitive ability to answer questionnaires, was over 40% with a high degree of severity. Approximately half of the incontinents referred a moderate-severe impact of incontinence. Control measures for this geriatric syndrome within the institutions are important to delay the decline of health and improve the quality of life of the residents.

Prevalence of fecal incontinence (FI) and associated factors in institutionalized older adults

The objective of this work is to determine the prevalence of FI and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December 2013, in 10 nursing homes (NHs) of the city of Natal (Northeast Brazil). Individuals over the age of 60 were included in the study, while those hospitalized or in terminal phase were excluded. Data collection included sociodemographic information, FI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). FI was verified through the Minimum Data Set (MDS) 3.0, which was also used to assess toileting programs. The Chi-square test and the linear Chi-square test were performed for bivariate analysis, as well as logistic regression for multivariate analysis. The final sample consisted of 321 elderly, mostly females, with mean age of 81.5 years. The prevalence of FI was 42.68% (CI 95%, 37.39-48.15). Most residents presenting FI were always incontinent (83.9%) and the most frequent incontinence type was total FI (solid and liquid stools). Incontinence control measures were applied only to 9.7% of the residents. The final model revealed a statistically significant association between FI and functional and cognitive impairments. It is concluded that FI is a health issue that affects almost half of the institutionalized elderly, and is associated with functional and cognitive disability.

Prevalence of urinary incontinence and associated factors in nursing home residents

AIMS

To determine the prevalence of urinary incontinence (UI) and associated factors in the institutionalized elderly.

METHODS

A cross-sectional study is presented herein, conducted between October and December 2013, in 10 nursing homes in the city of Natal (Northeast Brazil). Individuals over the age of 60, who reside in institutions, were included. Hospitalized individuals and those at end of life were excluded. Data collection included sociodemographic information, UI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity, and Pfeiffer test for cognitive status). UI was verified through the Minimum Data Set (MDS) version 3.0, which was also used to assess urinary devices and UI toileting programs. The Chi-square test (or Fisher's exact test), the linear Chi-square test, and logistic regression were utilized to model associations.

RESULTS

The final sample consisted of 321 elderly, mostly females, with a mean age of 81.5 years. The prevalence of UI was 58.88% (CI 95%: 53.42-64.13) and the final model revealed a statistically significant association between UI and white race, physical inactivity, stroke, mobility impairment, and cognitive decline. The most frequent UI type was functional UI and toileting programs (prompted voiding) were only applied to approximately 8% of residents.

CONCLUSIONS

It is concluded that UI is a health issue that affects more than half of the institutionalized elderly, and is associated with white race, physical inactivity, stroke, and other geriatric syndromes such as immobility and cognitive disability.