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Joghataie G, Hundal S, Mushtaque A, Tator CH, Tartaglia MC. Critical gap in practice-lack of attention to falls and possible fall-related post-concussion symptoms in older adults and individuals with neurodegenerative disease. GeroScience 2024:10.1007/s11357-024-01312-y. [PMID: 39207649 DOI: 10.1007/s11357-024-01312-y] [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: 01/06/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
Falls in older adults and those with neurodegenerative disease (ND) are a current public health hazard and the primary cause of sustaining a mild traumatic brain injury (mTBI)/concussion. Little is known regarding how post-concussion symptoms present in older adults and patients with ND, even though they are the demographic at highest risk. A combination of under-reporting of falls and a lack of awareness regarding potential consequences of falls, results in the underdiagnosis of post-fall issues and concussions in this population. Our aim was to conduct a quality assessment survey to assess physician practice regarding falls and their general knowledge of concussion symptoms. We sent surveys through email to 1400 North American physicians, mostly those working at university affiliated hospitals, who specialized in seeing older adults and patients with ND. One hundred forty-one physicians completed the survey. 71.4% of all responding physicians either never inquired or inquired in less than 5% of their patients with ND or older adult patients, about history of falls. Over half of the physicians (51.8%) either never ask or do not consider it necessary to ask about concussion symptoms post-fall. The majority of physicians (92%) recognized that concussions can have lasting effects on patients, particularly on mood and demonstrated good knowledge of post-concussion symptoms by correctly identifying them. Additionally, more than 70% of responding physicians believed that patients with ND or older adults can fully recover from a concussion with the same probability as any other age group if treated. Only 50% of physicians felt confident in managing post-concussion symptoms themselves, 53.9% of physicians did not know of, or did not have nearby concussion clinics to refer patients to. The gaps in practice are clearly reflective of the gaps in the literature regarding falls and concussions in older adults and ND patients. There is a very low rate of physician inquiry about history of falls and concussion symptoms in older patients and those with NDs. Failure to recognize a concussion, can lead to missed opportunities for targeted interventions to address reversible symptoms. Additionally, the misattribution of post-concussion symptoms to disease progression in older patients or those with NDs may delay and hinder appropriate management.
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Affiliation(s)
- Goldin Joghataie
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Canadian Concussion Centre, Toronto Western Hospital Krembil Brain Institute, 60 Leonard Avenue, 6th Floor, 6KD-407, Toronto, ON, M5T 0S8, Canada
| | - Sabrina Hundal
- Canadian Concussion Centre, Toronto Western Hospital Krembil Brain Institute, 60 Leonard Avenue, 6th Floor, 6KD-407, Toronto, ON, M5T 0S8, Canada
| | - Asma Mushtaque
- Canadian Concussion Centre, Toronto Western Hospital Krembil Brain Institute, 60 Leonard Avenue, 6th Floor, 6KD-407, Toronto, ON, M5T 0S8, Canada
| | - Charles H Tator
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Canadian Concussion Centre, Toronto Western Hospital Krembil Brain Institute, 60 Leonard Avenue, 6th Floor, 6KD-407, Toronto, ON, M5T 0S8, Canada
- Department of Surgery and Division of Neurosurgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - M Carmela Tartaglia
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Canadian Concussion Centre, Toronto Western Hospital Krembil Brain Institute, 60 Leonard Avenue, 6th Floor, 6KD-407, Toronto, ON, M5T 0S8, Canada.
- Department of Neurology, University Health Network Memory Clinic, Toronto, ON, Canada.
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Lach HW, Salas J, Scherrer JF. Changes in Emergency Department and Inpatient Encounters for Falls after the Onset of the COVID-19 Pandemic. J Appl Gerontol 2024:7334648241266434. [PMID: 39030725 DOI: 10.1177/07334648241266434] [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: 07/21/2024] Open
Abstract
OBJECTIVE This study investigates changes in clinical encounters due to falls before and after the onset of the COVID-19 pandemic. METHODS De-identified health record data from a large mid-western health system was used to examine the frequency of emergency department (ED) and inpatient (IP) encounters for falls by month among adults age 50+ (N = 485, 886 patients) using joinpoint regression analysis. Also, overall rates before and during the pandemic were compared using log-binomial models. RESULTS Fall rates increased following the onset of the COVID-19 pandemic for IP encounters but not for ED encounters. There were no differences by age, gender, race, or nSES. Monthly IP fall rates increased by 0.68% per month both before and after the onset of the COVID-19 pandemic. CONCLUSION Pandemics may occur in the future, and interventions are needed to prevent falls in older adults during the next public health emergency.
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Affiliation(s)
- Helen W Lach
- Trudy Busch Valentine School of Nursing, Saint Louis University, St. Louis, USA
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
- The Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Jeffery F Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
- The Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, USA
- Department of Psychiatry and Behavioral Neuroscience, School of Medicine, Saint Louis University, St. Louis, MO, USA
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Cavadino A, Te Ao B, Kerse N, Kool B, Parsons J, Hikaka J. Ethnic variation in access to publicly funded care for unintentional injuries in older adults in Aotearoa New Zealand: a retrospective study. Inj Prev 2024:ip-2023-045168. [PMID: 38768980 DOI: 10.1136/ip-2023-045168] [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: 11/05/2023] [Accepted: 04/19/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Māori (the Indigenous people of Aotearoa New Zealand (NZ)) are more likely to experience injury than non-Māori, but less likely to have effective access to publicly funded injury care services. It is unknown if this pattern extends into older age. This retrospective study analysed Accident Compensation Corporation (ACC; national no-fault injury compensation scheme) claims data to investigate ethnic variation in unintentional injury claims and related costs for older adults (≥50 years). METHODS Injury claims data for older adults residing in two regions of NZ between January 2014 and December 2018 were reviewed. Age-standardised claims rates (per person year) standardised rate ratios were calculated and compared between Māori and non-Māori. ACC claim costs (medical treatment; earning-related compensation) were estimated, with total and average costs per claim compared between the two groups. RESULTS There were 149 275 ACC claims (18 369 Māori; 130 906 non-Māori) among 64 238 individuals (9284 Māori; 54 954 non-Māori). The age-standardised rate of ACC claims for unintentional injury was 46% higher among non-Māori (95% CI 44% to 48%) than Māori. The ACC spend for non-Māori was NZ$155 277 962 compared with NZ$30 446 673 for Māori. Māori had a significantly higher average cost per claim (NZ$1658 vs NZ$1186, p<0.001). CONCLUSIONS Results of this study highlight differences in the manner in which different groups of older adults access injury compensation in NZ, indicating the need to invest in injury prevention initiatives that target older Māori, as well as initiatives supporting improved ACC access for older Māori.
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Affiliation(s)
- Alana Cavadino
- Epidemiology & Biostatistics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Braden Te Ao
- The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Ngaire Kerse
- General Practice and Primary Health Care, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Bridget Kool
- Epidemiology & Biostatistics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - John Parsons
- Exercise Sciences, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - Joanna Hikaka
- General Practice and Primary Health Care, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
- Te Kupenga Hauora Māori, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
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Chen K, Qiu J, Wang W, Hu Q, Qiao H. Analysis of health risk factors for older adults living alone in China and establishment and evaluation of a nomogram prediction model. Front Public Health 2024; 12:1309561. [PMID: 38566800 PMCID: PMC10986849 DOI: 10.3389/fpubh.2024.1309561] [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: 10/08/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Objective To understand the health status of older adults living alone in China and analyze the influencing factors, so as to provide reference for improving the health status of older adults living alone. Methods Based on CGSS data from China General Social Survey (2017), the influencing factors of health status of older adults living alone were analyzed by unconditional Logistic regression, and the R software was used to develop a nomogram for predicting the risk of self-assessed unhealthy adverse outcomes. Results Gender, annual income, mandarin listening level and participation in medical insurance were the influencing factors of self-rated health of older adults living alone. Age and annual income are the influencing factors of physiological health. Annual income and Internet use were influential factors for mental health. C-Statistic of nomogram prediction model was 0.645. The calibration curve showed that goodness of fit test (χ2 = 58.09, p < 0.001), and the overall prediction ability of the model was good. Conclusion The health status of older adults living alone in the home-based older adults care is worrying, and it is affected by various factors. We should pay more attention to older adults living alone, improve the ability of listening and distinguishing mandarin and the use of health information platforms for older adults living alone, and further implement medical insurance policies and health services. Announcing the solution to promote healthy home-based care for older adults living alone.
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Affiliation(s)
- Kexin Chen
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Jiangwei Qiu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Wenlong Wang
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Qi Hu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Hui Qiao
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
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Pomeroy ML, Cudjoe TKM, Cuellar AE, Ihara ES, Ornstein KA, Bollens-Lund E, Kotwal AA, Gimm GW. Association of Social Isolation With Hospitalization and Nursing Home Entry Among Community-Dwelling Older Adults. JAMA Intern Med 2023; 183:955-962. [PMID: 37486647 PMCID: PMC10366946 DOI: 10.1001/jamainternmed.2023.3064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/19/2023] [Indexed: 07/25/2023]
Abstract
Importance Social isolation is associated with adverse health outcomes, yet its implications for hospitalization and nursing home entry are not well understood. Objective To evaluate whether higher levels of social isolation are associated with overnight hospitalization, skilled nursing facility stays, and nursing home placement among a nationally representative sample of community-dwelling older adults after adjusting for key health and social characteristics, including loneliness and depressive symptoms. Design, Setting, and Participants This observational cohort study included 7 waves of longitudinal panel data from the Health and Retirement Study, with community-dwelling adults aged 65 years or older interviewed between March 1, 2006, and June 30, 2018 (11 517 respondents; 21 294 person-years). Data were analyzed from May 25, 2022, to May 4, 2023. Main Outcomes and Measures Social isolation was measured with a multidomain 6-item scale (range, 0-6, in which a higher score indicates greater isolation). Multivariate logistic regressions were performed on survey-weighted data to produce national estimates for the odds of self-reported hospitalization, skilled nursing facility stays, and nursing home placement over time. Results A total of 57% of this study's 11 517 participants were female, 43% were male, 8.4% were Black, 6.7% were Hispanic or Latino, 88.1% were White, 3.5% were other ("other" includes American Indian or Alaska Native, Asian or Pacific Islander, and other race, which has no further breakdown available because this variable was obtained directly from the Health and Retirement Study), and 58.2% were aged 65 to 74 years. Approximately 15% of community-dwelling older adults in the US experienced social isolation. Higher social isolation scores were significantly associated with increased odds of nursing home placement (odds ratio, 2.01; 95% CI, 1.21-3.32) and skilled nursing facility stays (odds ratio, 1.16; 95% CI, 1.06-1.28) during 2 years. With each point increase in an individual's social isolation score, the estimated probability of nursing home placement or a skilled nursing facility stay increased by 0.5 and 0.4 percentage points, respectively, during 2 years. Higher levels of social isolation were not associated with 2-year hospitalization rates. Conclusions and Relevance This cohort study found that social isolation was a significant risk factor for nursing home use among older adults. Efforts to deter or delay nursing home entry should seek to enhance social contact at home or in community settings. The design and assessment of interventions that optimize the social connections of older adults have the potential to improve their health trajectories and outcomes.
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Affiliation(s)
- Mary Louise Pomeroy
- Roger C. Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center for Equity in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Thomas K. M. Cudjoe
- Roger C. Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Alison E. Cuellar
- Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, Virginia
| | - Emily S. Ihara
- Department of Social Work, College of Public Health, George Mason University, Fairfax, Virginia
| | - Katherine A. Ornstein
- Roger C. Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center for Equity in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Evan Bollens-Lund
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, Mount Sinai Health System, New York, New York
| | - Ashwin A. Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Gilbert W. Gimm
- Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, Virginia
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Maier JA, Andrés V, Castiglioni S, Giudici A, Lau ES, Nemcsik J, Seta F, Zaninotto P, Catalano M, Hamburg NM. Aging and Vascular Disease: A Multidisciplinary Overview. J Clin Med 2023; 12:5512. [PMID: 37685580 PMCID: PMC10488447 DOI: 10.3390/jcm12175512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Vascular aging, i.e., the deterioration of the structure and function of the arteries over the life course, predicts cardiovascular events and mortality. Vascular degeneration can be recognized before becoming clinically symptomatic; therefore, its assessment allows the early identification of individuals at risk. This opens the possibility of minimizing disease progression. To review these issues, a search was completed using PubMed, MEDLINE, and Google Scholar from 2000 to date. As a network of clinicians and scientists involved in vascular medicine, we here describe the structural and functional age-dependent alterations of the arteries, the clinical tools for an early diagnosis of vascular aging, and the cellular and molecular events implicated. It emerges that more studies are necessary to identify the best strategy to quantify vascular aging, and to design proper physical activity programs, nutritional and pharmacological strategies, as well as social interventions to prevent, delay, and eventually revert the disease.
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Affiliation(s)
- Jeanette A. Maier
- Department of Biomedical and Clinical Sciences, Università di Milano, 20157 Milano, Italy;
- VAS-European Independent foundation in Angiology/Vascular Medicine, 20157 Milano, Italy; (M.C.); (N.M.H.)
| | - Vicente Andrés
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Sara Castiglioni
- Department of Biomedical and Clinical Sciences, Università di Milano, 20157 Milano, Italy;
| | - Alessandro Giudici
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, 6229 ER Maastricht, The Netherlands;
- GROW School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Emily S. Lau
- Division of Cardiology Massachusetts General Hospital, Boston, MA 02114, USA;
| | - János Nemcsik
- Health Service of Zugló (ZESZ), Department of Family Medicine, Semmelweis University, Stáhly u. 7-9, 1085 Budapest, Hungary;
| | - Francesca Seta
- Vascular Biology Section, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA;
| | - Paola Zaninotto
- UCL Research Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK;
| | - Mariella Catalano
- VAS-European Independent foundation in Angiology/Vascular Medicine, 20157 Milano, Italy; (M.C.); (N.M.H.)
- Inter-University Research Center on Vascular Disease, Università di Milano, 20157 Milano, Italy
| | - Naomi M. Hamburg
- VAS-European Independent foundation in Angiology/Vascular Medicine, 20157 Milano, Italy; (M.C.); (N.M.H.)
- Vascular Biology Section, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA;
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Yuan L, Yibo W, Yuqian D, Haiye R, Jiaxin L, Liping Z. The relationship between fall and loneliness among older people in China: the mediating role of personality trait. Front Psychiatry 2023; 14:1204544. [PMID: 37614652 PMCID: PMC10442840 DOI: 10.3389/fpsyt.2023.1204544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023] Open
Abstract
Aims We aimed to explore the role of personality traits between fall and loneliness. Methods A questionnaire survey was used to investigate falls, the big five personality traits, and loneliness among older people (≥ 60 years old) in China mainland. Results A total of 4,289 older people participated in the survey. There are significant differences in age, marital status, education level, residence, solitariness, and fall in relation to loneliness among older people. Falls, especially when they occurred one time increase the loneliness of older people. Agreeableness, conscientiousness, and neuroticism were significant mediating effects between falls and loneliness. Conclusion This study implied that agreeableness, conscientiousness, and neuroticism were meditating factors between falls and loneliness. In the future, we should consider the big five personality traits more to understand loneliness and offer older people interventions for reducing their loneliness. The study design was cross-sectional, so the temporal precedence of mediators and causality could not be tested. Because the data were collected retrospectively, current loneliness is likely to have confounding effects on retrospective recall.
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Affiliation(s)
- Luo Yuan
- School of Nursing, Capital Medical University, Beijing, China
| | - Wu Yibo
- School of Public Health, Peking University, Beijing, China
| | - Deng Yuqian
- Xiang Ya Nursing School, Central South University, Changsha, Hunan Province, China
| | - Ran Haiye
- Xiang Ya Nursing School, Central South University, Changsha, Hunan Province, China
| | - Liu Jiaxin
- Xiang Ya Nursing School, Central South University, Changsha, Hunan Province, China
| | - Zhao Liping
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan Province, China
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Bally ELS, Ye L, van Grieken A, Tan SS, Mattace-Raso F, Procaccini E, Alhambra-Borrás T, Raat H. Factors associated with falls among hospitalized and community-dwelling older adults: the APPCARE study. Front Public Health 2023; 11:1180914. [PMID: 37457268 PMCID: PMC10344358 DOI: 10.3389/fpubh.2023.1180914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023] Open
Abstract
Background Falls are a leading cause of disability. Previous studies have identified various risk factors for falls. However, contemporary novel research is needed to explore these and other factors associated with falls among a diverse older adult population. This study aims to identify the factors associated with falls among hospitalized and community-dwelling older adults. Methods Cross-sectional data from the 'Appropriate care paths for frail elderly people: a comprehensive model' (APPCARE) study were analyzed. The study sample consisted of hospitalized and community-dwelling older adults. Falling was assessed by asking whether the participant had fallen within the last 12 months. Multivariable logistic regression models were used to evaluate associations between socio-demographic characteristics, potential fall risk factors and falls. Results The sample included 113 hospitalized (mean age = 84.2 years; 58% female) and 777 community-dwelling (mean age = 77.8 years; 49% female) older adults. Among hospitalized older adults, loneliness was associated with an increased risk of falls. Associations between female sex, secondary education lever or lower, multimorbidity, a higher score on limitations with activities of daily living (ADL), high risk of malnutrition and falling were found among community-dwelling participants. Conclusion The results of this study confirm the multi-factorial nature of falling and the complex interaction of risk factors. Future fall prevention programs could be tailored to the needs of vulnerable subpopulations at high risk for falls.
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Affiliation(s)
- Esmée L. S. Bally
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Lizhen Ye
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Amy van Grieken
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Siok Swan Tan
- Research Group City Dynamics, InHolland University of Applied Sciences, Rotterdam, Netherlands
| | - Francesco Mattace-Raso
- Division of Geriatric Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Elena Procaccini
- Funded Project Office, Local Health Authority n.2 Treviso, Treviso, Italy
| | | | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
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Ooi LL, Liu L, Roberts KC, Gariépy G, Capaldi CA. Social isolation, loneliness and positive mental health among older adults in Canada during the COVID-19 pandemic. Health Promot Chronic Dis Prev Can 2023; 43:171-181. [PMID: 37043546 PMCID: PMC10111573 DOI: 10.24095/hpcdp.43.4.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
INTRODUCTION Social isolation and loneliness are associated with poorer mental health among older adults. However, less is known about how these experiences are independently associated with positive mental health (PMH) during the COVID-19 pandemic. METHODS We analyzed data from the 2020 and 2021 cycles of the Survey on COVID-19 and Mental Health to provide estimates of social isolation (i.e. living alone), loneliness and PMH outcomes (i.e. high self-rated mental health, high community belonging, mean life satisfaction) in the overall older adult population (i.e. 65+ years) and across sociodemographic groups. We also conducted logistic and linear regressions to separately and simultaneously examine how social isolation and loneliness are associated with PMH. RESULTS Nearly 3 in 10 older adults reported living alone, and over a third reported feelings of loneliness due to the pandemic. When examined separately, living alone and loneliness were each associated with lower PMH. When assessed simultaneously, loneliness remained a significant independent factor associated with all three PMH outcomes (overall and across all sociodemographic groups), but living alone was only a significant factor for high community belonging in the overall population, for males and for those aged 65 to 74 years. CONCLUSION Overall, social isolation and loneliness were associated with poorer wellbeing among older adults in Canada during the pandemic. Loneliness remained a significant factor related to all PMH outcomes after adjusting for social isolation, but not vice versa. The findings highlight the need to appropriately identify and support lonely older adults during (and beyond) the pandemic.
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Affiliation(s)
- Laura L Ooi
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Li Liu
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Geneviève Gariépy
- Public Health Agency of Canada, Montréal, Quebec, Canada
- Département de médecine sociale et préventive, École de santé publique, Université de Montréal, Montréal, Quebec, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Quebec, Canada
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Brunzini A, Caragiuli M, Massera C, Mandolini M. Healthy Ageing: A Decision-Support Algorithm for the Patient-Specific Assignment of ICT Devices and Services. SENSORS (BASEL, SWITZERLAND) 2023; 23:1836. [PMID: 36850433 PMCID: PMC9963385 DOI: 10.3390/s23041836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
In response to rapid population ageing, digital technology represents the greatest resource in supporting the implementation of active and healthy ageing principles at clinical and service levels. However, digital information platforms that deliver coordinated health and social care services for older people to cover their needs comprehensively and adequately are still not widespread. The present work is part of a project that focuses on creating a new personalised healthcare and social assistance model to enhance older people's quality of life. This model aims to prevent acute events to favour the elderly staying healthy in their own home while reducing hospitalisations. In this context, the prompt identification of criticalities and vulnerabilities through ICT devices and services is crucial. According to the human-centred care vision, this paper proposes a decision-support algorithm for the automatic and patient-specific assignment of tailored sets of devices and local services based on adults' health and social needs. This decision-support tool, which uses a tree-like model, contains conditional control statements. Using sequences of binary divisions drives the assignation of products and services to each user. Based on many predictive factors of frailty, the algorithm aims to be efficient and time-effective. This goal is achieved by adequately combining specific features, thresholds, and constraints related to the ICT devices and patients' characteristics. The validation was carried out on 50 participants. To test the algorithm, its output was compared to clinicians' decisions during the multidimensional evaluation. The algorithm reported a high sensitivity (96% for fall monitoring and 93% for cardiac tracking) and a lower specificity (60% for fall monitoring and 27% for cardiac monitoring). Results highlight the preventive and protective behaviour of the algorithm.
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Affiliation(s)
| | | | | | - Marco Mandolini
- Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, Via Brecce Bianche 12, 60131 Ancona, Italy
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Ogliari G, Ryg J, Andersen-Ranberg K, Scheel-Hincke LL, Collins JT, Cowley A, Di Lorito C, Howe L, Robinson KR, Booth V, Walsh DA, Gladman JRF, Harwood RH, Masud T. Association of pain and risk of falls in community-dwelling adults: a prospective study in the Survey of Health, Ageing and Retirement in Europe (SHARE). Eur Geriatr Med 2022; 13:1441-1454. [PMID: 36227460 PMCID: PMC9722814 DOI: 10.1007/s41999-022-00699-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/12/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To investigate the longitudinal associations between pain and falls risks in adults. METHODS Prospective cohort study on data from 40,636 community-dwelling adults ≥ 50 years assessed in Wave 5 and 6 in the Survey of Health, Ageing and Retirement in Europe (SHARE). Socio-demographic and clinical information was collected at baseline (Wave 5). At 2-year follow-up (Wave 6), falls in the previous 6 months were recorded. The longitudinal associations between pain intensity, number of pain sites and pain in specific anatomic sites, respectively, and falls risk were analysed by binary logistic regression models; odds ratios (95% confidence intervals) were calculated. All analyses were adjusted for socio-demographic and clinical factors and stratified by sex. RESULTS Mean age was 65.8 years (standard deviation 9.3; range 50-103); 22,486 (55.3%) participants were women. At follow-up, 2805 (6.9%) participants reported fall(s) in the previous 6 months. After adjustment, participants with moderate and severe pain at baseline had an increased falls risk at follow-up of 1.35 (1.21-1.51) and 1.52 (1.31-1.75), respectively, compared to those without pain (both p < 0.001); mild pain was not associated with falls risk. Associations between pain intensity and falls risk were greater at younger age (p for interaction < 0.001). Among participants with pain, pain in ≥ 2 sites or all over (multisite pain) was associated with an increased falls risk of 1.29 (1.14-1.45) compared to pain in one site (p < 0.001). CONCLUSIONS Moderate, severe and multisite pain were associated with an increased risk of subsequent falls in adults.
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Affiliation(s)
- Giulia Ogliari
- Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karen Andersen-Ranberg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Lasse Lybecker Scheel-Hincke
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Jemima T. Collins
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Alison Cowley
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claudio Di Lorito
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Louise Howe
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Katie R. Robinson
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Vicky Booth
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - David A. Walsh
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK
| | - John R. F. Gladman
- Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Applied Research Collaboration—East Midlands, Nottingham, UK
| | - Rowan H. Harwood
- Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire UK
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Tahir Masud
- Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- NIHR Applied Research Collaboration—East Midlands, Nottingham, UK
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12
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Perceived neighbourhood environment and falls among community-dwelling adults: cross-sectional and prospective findings from the Survey of Health, Ageing and Retirement in Europe (SHARE). Eur J Ageing 2022; 19:1121-1134. [PMID: 36692742 PMCID: PMC9729615 DOI: 10.1007/s10433-022-00685-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 01/26/2023] Open
Abstract
We investigated the association between perceived neighbourhood characteristics and falls in community-dwelling adults, using data from Wave 5 and 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). We included 25,467 participants aged 50 to 103 years (mean age 66.2 ± 9.6, 58.5% women), from fourteen European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Israel, Italy, Luxembourg, Slovenia, Spain, Sweden, Switzerland). At baseline, we recorded individual-level factors (socio-demographic, socio-economic and clinical factors), contextual-level factors (country, urban versus rural area, European region) and perceived neighbourhood characteristics (vandalism or crime, cleanliness, feeling part of neighbourhood, helpful neighbours, accessibility to services) for each participant. We recorded falls in the six months prior to the baseline and 2-year follow-up interviews. The associations between neighbourhood characteristics and falls were analysed by binary logistic regression models; odds ratios (95% confidence intervals) were calculated. Participants reporting-versus not reporting-vandalism or crime had an increased falls risk of 1.16 (1.02-1.31) at follow-up, after full adjustment; lack of cleanliness, feeling part of the neighbourhood, perceiving neighbours as helpful and difficult accessibility to services were not associated with falls. Vandalism or crime was consistently associated with increased falls risks in women, adults without functional impairment and urban areas residents. In conclusion, adverse neighbourhood environments may account for inequality in falls risk among middle-aged and older adults and could be added to fall risk stratification tools. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-022-00685-3.
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13
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Smith KJ, Victor C. The Association of Loneliness With Health and Social Care Utilization in Older Adults in the General Population: A Systematic Review. THE GERONTOLOGIST 2022; 62:e578-e596. [PMID: 34875042 DOI: 10.1093/geront/gnab177] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Loneliness is proposed to be linked with increased service use. This review examined the association of loneliness and health and social care utilization (HSCU) in older adults from the general population. RESEARCH DESIGN AND METHODS Four databases were screened for studies that examined the association of loneliness (predictor) with HSCU (outcome) in older adults (defined as the majority of sample 60 or older). Study quality was assessed with the National Institutes for Health scale for observational cohorts and cross-sectional studies. RESULTS We identified 32 studies, of which 9 prospective studies were evaluated as being good or good-fair quality. Two good-fair quality studies found that loneliness at baseline was associated with subsequent admission to a residential care home. There was emerging evidence that loneliness was associated with emergency department use (n = 1) and cardiovascular disease-specific hospitalization (n = 1). Once adjusted for confounders, the highest quality studies found no association of baseline loneliness with physician utilization, outpatient service utilization, skilled nursing facility use, and planned or unplanned hospital admissions. The remaining studies were cross-sectional, or of fair to poor quality, and inadequate to reliably determine whether loneliness was associated with a subsequent change in HSCU. DISCUSSION AND IMPLICATIONS There was heterogeneity in study design, measurement, and study quality. This generated an inconsistent evidence base where we cannot determine clear inferences about the relationship between loneliness and HSCU. Only one consistent finding was observed between 2 good-fair quality studies regarding care home admission. To determine clinical implications and make reliable inferences, additional good quality longitudinal research is needed.
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Affiliation(s)
- Kimberley J Smith
- School of Psychology, Faculty of Health and Medicine, University of Surrey, Guildford, UK
| | - Christina Victor
- Department of Health Sciences, Brunel University London, Uxbridge, UK
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14
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Diagnostic accuracy of linked administrative data for dementia diagnosis in community-dwelling older men in Australia. BMC Geriatr 2022; 22:858. [PMCID: PMC9664614 DOI: 10.1186/s12877-022-03579-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Routinely collected health administrative data can be used to estimate the prevalence or incidence of dementia at a population level but can be inaccurate. This study aimed to examine the accuracy of hospital and death data for diagnosing dementia compared with a clinical diagnosis in community dwelling older men in Australia.
Methods
We performed a retrospective analysis of the Concord Health and Ageing in Men Project (CHAMP) in Sydney, Australia. Of the 1705 men aged ≥70 years in the CHAMP study, 1400 had available linked administrative data records from 1 year prior to 1 year post the date of clinical dementia diagnosis. The primary outcome was the accuracy of dementia diagnosis using linked administrative data records compared to clinical dementia diagnosis. The linked data diagnosis was based on hospital and death records for the 1 year pre and post the clinical diagnosis. Clinical dementia diagnosis was a two-stage process with initial screening, followed by clinical assessment for those meeting a validated cut-off. A final clinical diagnosis of dementia based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria was reached by a consensus panel.
Results
Administrative data identified 28 participants as having dementia, compared to 88 identified through clinical assessment. Administrative data had a sensitivity of 20% (95% CI: 13–30%, 18/88), specificity of 99% (95% CI: 99–100%, 1301/1312), positive predictive value (PPV) of 62% (95% CI: 44–77%), negative predictive value of 95% (95% CI: 94–95%), positive likelihood ratio of 24.4 (95% CI: 11.9–50.0) and negative likelihood ratio of 0.80 (0.72–0.89).
Conclusions
Administrative hospital and death data has limited accuracy for dementia diagnosis with poor sensitivity and PPV. The prevalence of dementia is likely underestimated using hospital and deaths data.
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15
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Pai N, Vella SL. The physical and mental health consequences of social isolation and loneliness in the context of COVID-19. Curr Opin Psychiatry 2022; 35:305-310. [PMID: 35787541 DOI: 10.1097/yco.0000000000000806] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Social isolation and loneliness are known contributors to all-cause mortality as well as a range of physical and mental health conditions. Therefore, this article reviews current literature pertaining to the effects of social isolation and loneliness on physical and mental health during the current COVID-19 pandemic. RECENT FINDINGS Social isolation and loneliness contribute to a myriad of physical and mental health conditions. Specifically social isolation and loneliness contribute to the development of cardiovascular disease, diabetes mellitus, and cancer. However, most research indicated that poor lifestyle factors explained most of the association. Social isolation and loneliness are also associated with cognitive problems including dementia, immune system problems, and mental health conditions. Further social isolation and loneliness also spur behavioral issues that significantly affect physical and mental health. SUMMARY Evidence suggests that social isolation and loneliness have significant consequences on the physical and mental health of the individual and that the move toward ending all protections against COVID-19 has significant implications for the vulnerable. Further the similarities between the effects of social isolation and loneliness are compared to some of the conditions evident in long-COVID.
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Affiliation(s)
- Nagesh Pai
- Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong
- Illawarra Health and Medical Research Institute
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Shae-Leigh Vella
- Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong
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16
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The onset of falls and its effects on perceived social exclusion and loneliness. Evidence from a nationally representative longitudinal study. Arch Gerontol Geriatr 2022; 100:104622. [DOI: 10.1016/j.archger.2022.104622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/19/2021] [Accepted: 01/15/2022] [Indexed: 12/11/2022]
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Abell JG, Steptoe A. Why is living alone in older age related to increased mortality risk? A longitudinal cohort study. Age Ageing 2021; 50:2019-2024. [PMID: 34304269 PMCID: PMC8675439 DOI: 10.1093/ageing/afab155] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Living alone has been associated with increased mortality risk, but it is unclear whether this is a result of a selection effect or the impact of stressful life changes such as widowhood or divorce leading to changes in living arrangements. We therefore examined the association between living alone, transitions in living arrangements and all-cause mortality. METHOD We analysed data from 4,888 individuals who participated in both wave 2 (2004-2005) and wave 4 (2008-2009) of the English Longitudinal Study of Ageing. Transitions in living arrangements over this period were identified. Mortality status was ascertained from linked national mortality registers. Cox proportional hazards analysis was used to examine the association between living alone and mortality over an average 8.5 year follow-up period. RESULTS An association was found between living alone at wave 4 and mortality (hazard ratio (HR): 1.20, 95% CI 1.04-1.38) in a model adjusted for multiple factors including socioeconomic status, physical health, health behaviours and loneliness. We also found that participants who moved to living alone after divorce or bereavement had a higher risk of mortality compared with those who lived with others at both time points (HR: 1.34, 95% CI 1.01-1.79), while those who moved to living alone for other reasons did not show an increased mortality risk. CONCLUSIONS The relationship between living alone and mortality is complicated by the reasons underlying not living with others. A greater understanding of these dynamics will help to identify the individuals who are at particular health risk because of their living arrangements.
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Affiliation(s)
- Jessica G Abell
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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18
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Zhang Y, Zhang L, Zhang X, Sun J, Wang D, Chen G. Fall Injuries and Depressive Symptoms Among Older Adults and the Mediating Effects of Social Participation - China, 2011-2018. China CDC Wkly 2021; 3:837-841. [PMID: 34659864 PMCID: PMC8500800 DOI: 10.46234/ccdcw2021.207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 01/02/2023] Open
Abstract
What is already known on this topic? Prior studies found that fall events were associated with a higher level of depressive symptoms and a lower level of social functioning and social participation. In addition, social participation has also been significantly associated with better conditions of depressive symptoms. What is added by this report? This article implemented the literature in three ways. First, it examined the mechanisms of social participation in the association between fall injuries and depressive symptoms among older adults in China. Second, it specified the fall-injured older adults group from those who merely experienced fall events. Third, it compared the results between rural and urban China and discussed policy implications for both groups. What are the implications for public health practice? Based on the findings of this study, future policies could consider boosting social participation at both the household and community level while taking into account the challenges of mobilities and social capabilities after fall injuries. Meanwhile, it is essential to accelerate the construction of aging-friendly communities to improve the accessibility of social participation and broaden social services to health management and monitoring.
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Affiliation(s)
- Yalu Zhang
- Institute of Population Research, Peking University, Beijing, China
| | - Lei Zhang
- Institute of Population Research, Peking University, Beijing, China
| | - Xinhui Zhang
- Institute of Population Research, Peking University, Beijing, China
| | - Jingjing Sun
- Institute of Population Research, Peking University, Beijing, China
| | - Dongmin Wang
- Department of Physical Education, Peking University, Beijing, China
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing, China
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Araújo R, Matos N, Mariano T, Medved I, Santos S, Pinheiro H. Functional capacity, risk of falling and chronic pain in older adults during the COVID-19 pandemic: a telemonitoring study. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.53886/gga.e0210065] [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
OBJECTIVE: To compare active and sedentary older adults regarding functional capacity, risk of falling, and chronic pain in a population assisted by telemonitoring during the pandemic lockdown. METHODS: This analytical, cross-sectional study included 104 older adults who were telemonitored during the COVID-19 lockdown by a team from a Brazilian Unified Health System outpatient clinic specializing in geriatrics and gerontology. A structured interview was used to collect data. Following normality testing with the Shapiro-Wilk test, Student’s t-test was used for group comparisons. Associations were analyzed using the χ2 test, and the odds ratio was calculated in a 2x2 table of sedentarism and falls in the last six months. The data were analyzed using SPSS version 26.0, with p ≤ 0.05 considered significant. RESULTS: The 57 active older adults had a lower rate of continuous medication use (24.84 vs 27.62%), fewer falls (50 vs 32.11%), less pain (12.31 vs 3.83%), and greater independence in basic activities of daily living (44.39 vs 26.46%). CONCLUSIONS: Older adults who were physically active in the midst of social distancing had better functional capacity in basic activities of daily living, fewer falls, and less pain than their sedentary peers. Independence in instrumental activities of daily living did not differ significantly between the groups.
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Affiliation(s)
- Rute Araújo
- Health Sciences Education and Research Foundation, Brazil
| | - Neuza Matos
- Health Sciences Education and Research Foundation, Brazil
| | | | - Isabely Medved
- Health Sciences Education and Research Foundation, Brazil
| | - Silvana Santos
- Health Sciences Education and Research Foundation, Brazil
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