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Pelegrini LNDC, da Silva VA, Grigoli MM, Vatanabe IP, Manzine PR, Cominetti MR. Plasma ADAM10 Levels and Their Association with Alzheimer's Disease Diagnosis in Older Adults with Fewer Years of Formal Education. Dement Geriatr Cogn Disord 2024; 53:153-161. [PMID: 38583419 DOI: 10.1159/000538630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/28/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION Low educational attainment is a potential risk factor for Alzheimer's disease (AD) development. Alpha-secretase ADAM10 plays a central role in AD pathology, attenuating the formation of beta-amyloid peptides and, therefore, their aggregation into senile plaques. This study seeks to investigate ADAM10 as a blood-based biomarker in mild cognitive impairment (MCI) and AD in a diverse group of community-dwelling older adults, focusing on those with limited educational attainment. METHODS Participants were recruited from public health services. Cognition was evaluated using Mini-Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination - Revised (ACE-R) batteries. Blood samples were collected to analyze plasma ADAM10 levels. A logistic regression was conducted to verify the influence of plasma ADAM10 on the AD diagnosis. RESULTS Significant differences in age, years of education, prescribed medications, and cognitive test scores were found between the MCI and AD groups. Regarding cognitive performance, both ACE-R and MMSE scores displayed significant differences between groups, with post hoc analyses highlighting these distinctions, particularly between AD and cognitively unimpaired individuals. Elevated plasma ADAM10 levels were associated with a 4.5-fold increase in the likelihood of a diagnosis of MCI and a 5.9-fold increase in the likelihood of a diagnosis of AD. These findings suggest ADAM10 levels in plasma as a valuable biomarker for assessing cognitive status in older individuals with low education attainment. CONCLUSION This study underscores the potential utility of plasma ADAM10 levels as a blood-based biomarker for cognitive status, especially in individuals with low educational backgrounds, shedding light on their relevance in AD development and diagnosis.
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Affiliation(s)
| | | | | | - Izabela Pereira Vatanabe
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
- Pharmaceutical Sciences Faculty, University of São Paulo, São Paulo, Brazil
| | | | - Marcia Regina Cominetti
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil,
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland,
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Brech GC, da Silva VC, Alonso AC, Machado-Lima A, da Silva DF, Micillo GP, Bastos MF, de Aquino RDC. Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods. Front Nutr 2024; 10:1183058. [PMID: 38235441 PMCID: PMC10792032 DOI: 10.3389/fnut.2023.1183058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/26/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction The aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over. Methods This cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD). Results The K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD. Conclusion Handgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.
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Affiliation(s)
- Guilherme Carlos Brech
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Vanderlei Carneiro da Silva
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Angelica Castilho Alonso
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Adriana Machado-Lima
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
| | - Daiane Fuga da Silva
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
| | | | - Marta Ferreira Bastos
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
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Shi Q, Yang S, Wang N, Zhang SE, Wang Y, Wu B, Lu X, She Y, Yue Z, Gao L, Zhang Z. An evolutionary game-based simulation study of a multi-agent governance system for smart senior care services in China. BMC Geriatr 2023; 23:871. [PMID: 38114919 PMCID: PMC10729546 DOI: 10.1186/s12877-023-04521-w] [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] [Received: 07/18/2023] [Accepted: 11/26/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The competing interests of the government, smart senior care technology service providers, and older adults have led to a serious fragmentation of governance in China. This study aims to identify the collaboration mechanisms and evolutionary stabilization strategies for these agents. METHODS An evolutionary game model is developed to analyze the strategic decisions made by the government, smart senior care technology service providers, and older adults. A sensitivity analysis is conducted using data from Anhui Province, China, to verify the effects of relevant parameters on the strategy decisions of each agent. RESULTS The results of the simulation and sensitivity analysis indicated that, first, despite changes in the initial willingness values of the tripartite agents, the system eventually converges on 1. Second, the collaboration mechanism of the tripartite agents in the smart senior care system is related to government incentives, penalties, and subsidies, smart senior care service costs, and the additional benefits provided to smart senior care technology service providers. CONCLUSION The strategy decisions of the government, providers, and older adults interact with each other. To promote collaboration among the tripartite agents and improve governance effectiveness, the government should strengthen the regulations for providers, increase penalties for providers that engage in a breach of trust, provide moderate incentives and subsidies, and control smart senior care service costs.
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Affiliation(s)
- Qiannan Shi
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Shumian Yang
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Na Wang
- Medical Department, Heilongjiang Provincial Hospital, Harbin, Heilongjiang, China
| | - Shu-E Zhang
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Yanping Wang
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Bing Wu
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Xinyuan Lu
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Yining She
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Zhihao Yue
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Lei Gao
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Zhong Zhang
- School of Health Management, Harbin Medical University, No. 157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China.
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Gomes DS, Silva Coelho PR, de Jesus Mendonça Severino A, Martins Cirilo T, Moreira Teodoro de Oliveira N, Soeiro Barbosa D, Michael Geiger S. Intestinal schistosomiasis-related mortality in Minas Gerais, Brazil, 2000-2019: Temporal trends and spatial patterns for determining priority areas. Trop Med Int Health 2023; 28:215-225. [PMID: 36591936 DOI: 10.1111/tmi.13850] [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: 01/03/2023]
Abstract
OBJECTIVE To identify priority areas for schistosomiasis control, we analysed the epidemiological characteristics, temporal trends and spatial patterns of schistosomiasis-related mortality in the state of Minas Gerais from 2000 to 2019. METHODS Ecological and time-series study with spatial analysis techniques on deaths from Schistosomiasis mansoni. A log-linear regression model was used to identify changes in mortality rates. Moran's global index, local indicators of spatial association and a retrospective spatio-temporal permutation model were applied to identify the spatial and temporal distribution of mortality rates and assist in identifying priority areas for interventions. RESULTS A total of 1290 deaths from schistosomiasis were recorded between 2000 and 2019, with an average mortality rate of 0.33 deaths/100,000. Although the overall mortality rate in the state of Minas Gerais decreased significantly over time (average annual percentage change = -9.6; 95% confidence interval = -14.4 to -4.6; p < 0.001), it increased in the mesoregions of Jequitinhonha, Mucuri Valley, and Rio Doce Valley. Spatial analysis identified the displacement and emergence of high-risk clusters from the central region of the state to the mesoregion of Rio Doce Valley. CONCLUSION Temporal changes and shifting of high-risk areas from the central region to the mesoregion of Rio Doce Valley may indicate possible failures in early diagnosis and treatment of the schistosomiasis control program in these areas. Our research contributes to a better understanding of the spatio-temporal dynamics of death rates due to schistosomiasis infections and might help health authorities to direct resources most efficiently to avoid serious clinical outcomes in Minas Gerais.
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Affiliation(s)
| | | | | | | | | | - David Soeiro Barbosa
- Department for Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Stefan Michael Geiger
- Department for Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Hossain B, James KS, Nagargoje VP, Barman P. Differentials in private and public healthcare service utilization in later life: do gender and marital status have any association? J Women Aging 2023; 35:183-193. [PMID: 34851802 DOI: 10.1080/08952841.2021.2011562] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present study investigates whether the differentials in private and public inpatient healthcare utilization are associated with marital status for men and women aged 60 years and above in India. Binary logistic regression was applied to examine the association of private and public inpatient healthcare utilization with the marital status of the elderly. The study found that widowed men and women generally used public healthcare for hospitalization, while married men and women preferred private healthcare. Our findings also indicated that private inpatient health services expenditure was higher for married elderly than widowed elderly. After controlling all covariates, widowhood was significantly associated with higher use of public healthcare services for women but not for men. India's current health care policy and program may be required to focus on improving the infrastructure quality of current public healthcare systems. It also needs to be favorable for vulnerable sections of society, especially widowed women, to avail better treatment at an affordable cost.
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Affiliation(s)
- Babul Hossain
- International Institute for Population Sciences (IIPS), Mumbai, India
| | - K S James
- International Institute for Population Sciences (IIPS), Mumbai, India
| | | | - Papai Barman
- International Institute for Population Sciences (IIPS), Mumbai, India
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Muhammad T, Maurya P. Gender differences in the association between perceived income sufficiency and self-rated health among older adults: A population-based study in India. J Women Aging 2023; 35:168-182. [PMID: 34821544 DOI: 10.1080/08952841.2021.2002663] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study explores whether gender differences in self-rated health can be attributed to socioeconomic status and self-perceived income sufficiency in particular. We used data from the Building a Knowledge Base on Population Ageing in India (BKPAI-2011) and carried out the descriptive and bivariate analysis along with a chi-square test to explore the significance of possible associations between explanatory and outcome variables in the study. Also, sex-stratified multiple logistic regression models were employed to fulfill the study objectives. The results show that a higher percentage of older women (58.4%) reported their health as fair/poor than older men (52%). Older women reported poor self-rated health than older men with similar self-perceived income sufficiency (OR: 2.04; p < .001 vs. OR: 1.56; p < .010). All the health indicators such as suffering from higher number of chronic conditions (AOR: 3.70; p < .001 vs. AOR: 2.73; p < .001) and disability (AOR: 3.79; p < .001 vs. AOR: 3.33; p < .001) increased odds of rating of poor health among older women than men, except having two plus difficulty in activities of daily living (ADL), which was positively associated with reporting poor health among men than women (OR: 4.03; p < .001 vs. OR: 2.36; p < .001). The study highlights the gender differences in self-rating of health associated with subjective income status and other socioeconomic and health-related variables that are important while framing social policies for the Indian graying population.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Priya Maurya
- International Institute for Population Sciences, Mumbai, Maharashtra, India
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Dotlic J, Markovic N, Gazibara T. Patterns of smoking and menopause-specific quality of life: smoking duration matters more. Behav Med 2023; 49:29-39. [PMID: 34818993 DOI: 10.1080/08964289.2021.1958739] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Evidence about the association of quantity of cigarettes smoked and duration of smoking with quality of life in menopause is sparse. The purpose of this study was to examine the association between smoking patterns and menopause-specific quality of life. This cross-sectional study included 513 consecutive midlife women at two primary health care centers in Belgrade, Serbia. Collection of data was carried out from February 2014 to January 2015, using three questionnaires: socio-epidemiologic questionnaire, Menopause-specific Quality of Life questionnaire (MENQOL) and Beck's Depression Inventory (BDI). Women reported their smoking status (smoker, former smoker, non-smoker), the length of time spent smoking and quantity of cigarettes smoked per day. There was no difference in proportions of ever smokers compared to never smokers. However, there were more women who were current nonsmokers than current smokers. A linear regression model, adjusted for residency district, relationship status, educational level, employment, drinking alcohol, having exercise, age and BDI, showed that longer duration of smoking, but not number of cigarettes smoked per day, was associated with worse Physical domain and total MENQOL score. Receiver Operating Characteristic analysis showed that menopausal symptoms as measured by total MENQOL score were significantly less bothersome for women who smoked less than 10 years and significantly more intense in women who smoked 21 to 30 years. Midlife women should be encouraged to quit smoking as soon as possible, preferably before menopause. Strategies to prevent and quit smoking should be prioritized at all levels of health care delivery for women.Supplemental data for this article is available online at.
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Affiliation(s)
- Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Tatjana Gazibara
- Institute for Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Invisible, unrecognised and undervalued: examining stories of unpaid work performed by older adults in their local neighbourhoods. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x2200126x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abstract
Over the past 40 years, positive ageing discourses that speak to an expectation of continued productivity have gained prominence within research and policy. Such discourses have been critiqued as placing disproportionate value on the extension of older adults' working lives, while obscuring other valuable forms of work performed by older adults. Despite the emergence of theoretical conversations about the expansion of conceptions of work, few studies have adopted an explicit focus on the work performed by older adults within their neighbourhoods. Informed by conceptions of work positioned at the intersection of critical gerontology and critical feminism, we drew upon qualitative data from a larger ethnographic study, generated from 17 participants aged 65 and older, to examine: (a) the various forms and contributions of unpaid work that older adults carry out at the neighbourhood level, and (b) the ways in which older adults' representations of this work relate to dominant notions of productivity. Specifically, each participant engaged in three types of qualitative interviews, including additional spatial and visual data generation: (a) completing a narrative interview; (b) carrying a small Global Positioning System (GPS) device to automatically log locations, completing an activity diary and a follow-up interview; and (c) participating in a go-along interview or a photo elicitation interview. Our findings highlight a range of unpaid work performed by participants in their neighbourhood, including formal volunteering, informal caring and informal civic participation. Although these forms of work were, at times, discussed by participants as enabling social inclusion, significant tensions arose from the general lack of discursive and social value assigned to them. In particular, participants described being subject to overwhelming expectations placed on older adults, and women in particular, to carry out this work, with little recognition or acknowledgement of their contributions to the neighbourhood. Taken together, our findings suggest the need not only to diversify understandings of the forms of work perceived as aligning with productive contributions to society in older age, but also to attend to the invisible work performed by older adults within their neighbourhoods. Additionally, we propose a variety of ways organisations and communities that benefit from older adults' unpaid labour may enhance accessibility, thereby reducing the work done by older adults to negotiate tensions between ableist expectations for productivity and their ageing bodies.
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Exploring the Effects of Gender Differences and Widowhood Status on the Days Spent in Poor Health: A Secondary Data Analysis from India. J Cross Cult Gerontol 2022; 37:221-235. [PMID: 35608788 DOI: 10.1007/s10823-022-09454-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 10/18/2022]
Abstract
The majority of research in India has focused on the impact of widowhood on health status and health care use, while little emphasis has been paid to the number of days spent in poor health among widowed population compare to other marital categories. Thus, the current study explores the relationship between widowhood and days spent with poor health outcomes among adults in India. Additionally, gender differences in the relationship between widowhood and days with poor health outcomes are further studied.The research employed nationally representative cross-sectional data from the 75th round (2017-2018) of the National Sample Survey (NSS). To investigate the associations of marital status (married vs widowed) and other factors with days spent in poor health, a negative binomial regression model was used. Additionally, the interaction model of age and widowhood was estimated separately for men and women.The findings suggest that widowed individuals had consistently prolonged days with an illness, limited activity, and confinement to bed. After adjusting for socioeconomic and demographic characteristics, the findings suggested that widowed women (IRR = 1.141, 95% Confidence interval = 1.01-1.29) were more likely to spend days with limited acitivities than married women. The marital status-age interaction indicated that older widowed women were more likely to have days of restricted activity and confinement to bed than married women, but such link is absent for men.In India, the elderly widow often spends her days confined to bed and prolonged days with limited activity. Policymakers and practitioners in public health should develop effective policies and programmes to enhance the health and well-being of widowed women, particularly those from socioeconomically disadvantaged backgrounds.
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Paranhos Amorim DN, Nascimento DDC, Stone W, Alves VP, Coelho Vilaça e Silva KH. Body composition and functional performance of older adults. Osteoporos Sarcopenia 2022; 8:86-91. [PMID: 35832415 PMCID: PMC9263164 DOI: 10.1016/j.afos.2022.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/16/2022] [Accepted: 04/30/2022] [Indexed: 12/16/2022] Open
Abstract
Objectives To determine if anthropometric variables, body composition, medication and gender are associated with functional performance and to compare these variables between octogenarians with high and low functional performance. Methods Observational, cross-sectional study. Weight, height, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were evaluated. Handgrip strength (HGS) was assessed. Participants’ body composition was assessed by dual-energy X-ray absorptiometry (DXA) and functional performance by Short Physical Performance Battery (SPPB). A binomial logistic regression was performed. Results One hundred and twenty-two octogenarians were included and separated into high and low function groups. The high function group showed lower values of WHtR (mean difference [MD] = 0.047, P = 0.025) and body fat (BF%) (MD = 3.54, P = 0.032) and higher values of apendicular skeletal muscle mass (ALM) (MD = 3.03, P = 0.001), HGS (MD = 6.11, P = 0.001) and SPPB score (MD = 4.20, P = 0.001). Women were more likely to be classified as low function (OR = 3.66, P = 0.002) and males showed 5.21 odds ratio (P = 0.021) of having high functional performance compared to females. Also, each decrease in age and medication use displayed 1.30 (P = 0.007) and 1.26 odds ratio increases (P = 0.008) in high functional performance. Conclusions Older males display better functional performance than women, and decrements in age and medications increase the high functional performance odds ratio. Octogenarians with high functional performance displayed lower BF measurements and higher values of muscle mass and strength.
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Affiliation(s)
- Diane Nogueira Paranhos Amorim
- Department of Gerontology, Catholic University of Brasilia, UCB, Brasília, DF, Brazil
- Corresponding author. Department of Gerontology, Catholic University of Brasilia, UCB, Brasília, DF, 71966-700, Brazil.
| | - Dahan da Cunha Nascimento
- Department of Gerontology, Catholic University of Brasilia, UCB, Brasília, DF, Brazil
- Department of Physical Education, Catholic University of Brasilia, UCB, Brasília, DF, Brazil
| | - Whitley Stone
- School of Kinesiology, Recreation & Sport, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Vicente Paulo Alves
- Department of Gerontology, Catholic University of Brasilia, UCB, Brasília, DF, Brazil
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Schmitt AK, Weiss C, Burkhardt H, Frohnhofen H, Wehling M, Pazan F. The Sex-Specific Impact of the FORTA (Fit-fOR-The-Aged) List on Medication Quality and Clinical Endpoints in Older Hospitalized Patients: Secondary Analysis of a Randomized Controlled Trial. Drugs Real World Outcomes 2022; 9:287-297. [PMID: 35297495 PMCID: PMC9114217 DOI: 10.1007/s40801-022-00292-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 11/27/2022] Open
Abstract
Background Little is known about the sex-specific impact of drug optimization tools such as the Fit fOR The Aged (FORTA) list on drug use and relevant clinical endpoints in older people. Objective We aimed to detect gender differences of interventional effects on medication quality and related clinical effects in the VALFORTA trial. Patients and methods A sex-specific analysis of data from 409 patients (147 men and 262 women, mean age 79.4 and 82.7 years, respectively) in acute geriatric care comparing the control and FORTA intervention groups was performed. Changes of the FORTA score (sum of over- and undertreatment errors per patient), the incidence of adverse drug events (ADEs) during hospitalization, and several clinically relevant endpoints [e.g., the Barthel index (BI)] were tested for equivalence at a 20% margin. “Success” or “failure” for the development of these clinical endpoints was defined and their frequencies compared by a risk reduction analysis. Results Sex differences were insignificant for the reduction of the FORTA score, the improvement of BI, or over- and undertreatment errors (p > 0.05). In women only, the FORTA intervention significantly increased the number of patients without an ADE (p = 0.010). Statistical sex equivalence was found for the improvement of the FORTA scores, BI, and the number of prevented events (e.g., falls, confusion, or renal failure) (p < 0.05), but not for the improvement of specific mistreatments or over- and undertreatment scores under altered inclusion criteria (p > 0.05). Conclusions Both sexes benefit equally from the FORTA intervention regarding the amelioration of the quality of drug treatment as well as several clinically relevant outcomes. In addition, the positive impact of the FORTA intervention on the number of adverse drug events appears to be greater in women. Trial Registration Number DRKS00000531. Supplementary Information The online version contains supplementary material available at 10.1007/s40801-022-00292-9.
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Affiliation(s)
- Ann-Kathrin Schmitt
- Clinical Pharmacology Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Christel Weiss
- Department of Medical Statistics, Biomathematics and Information Processing, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heinrich Burkhardt
- IV. Medical Department, Medical Faculty Mannheim, University Medical Center, Heidelberg University, Mannheim, Germany
| | - Helmut Frohnhofen
- Fakultät für Gesundheit, Universität Witten Herdecke, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany.,Heinrich Heine Universität Düsseldorf, UKD, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Martin Wehling
- Clinical Pharmacology Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Farhad Pazan
- Clinical Pharmacology Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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Abstract
Context: With the increasing number of the elderly suffering from chronic diseases and disabilities, elderly long-term care (LTC) has been the subject of attention by health and welfare policymakers. This study aimed to compare the components of LTC for the elderly in Iran and selected countries. Methods: This comparative study was conducted in 2020. The search was conducted in three databases (PubMed, Scopus, and Web of Science), two search engines (Google Scholar and Google), and the websites of WHO and the Ministry of Health and Welfare of the selected countries from 2000 to 2020 to find relevant documents on the subject. The selection of countries was based on three criteria: the type of health system, having the highest percentage of the elderly population, and the development status. Finally, Germany, France, Sweden, Japan, South Korea, Turkey, Thailand, and Iran were included in the study. The findings were organized using a common LTC framework. Results: In this study, the common framework of LTC systems, including beneficiaries, benefits packages, providers, and financing, was used. The study results showed that developed countries had formal LTC systems with specific mechanisms, but each country had differences in the implementation of different components of this system. On the other hand, in most developing countries, sporadic measures were taken in this field. Conclusions: In general, developed countries have adopted different LTC system approaches in the organization, financing, type of services, and generosity of benefits. In choosing the appropriate LTC model in developing countries, factors such as the health system, resource constraints, social, and cultural status should be considered.
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Social networks and their impact on access to health care: insights from older widows living alone in Kottayam, South India. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The feminisation of ageing observed across the world is a significant challenge in many societies. Women's greater longevity is associated with the increased likelihood of age-related disability and morbidity. Furthermore, gendered disadvantage and poverty can make access to health care increasingly problematic in later years. Among the Indian states, Kerala has the highest number of residents above the age of 60 and many are older widows. Given this context, this paper explores what promotes access to health care for older widows living alone in the south Indian state of Kerala. Thirty-two in-depth interviews, eight focus group discussions and eight units of participant observation were carried out among widows, health-care providers and key informants. Applying a reflexive inductive approach to our analysis, the main barriers to access that emerged were altered family structures and loneliness, whilst enablers included good social networks and access to neighbourhood clinics. Our participants’ social networks were drawn from three levels: family, neighbourhood and the wider community. The ability to form a personal community from their social networks and the quality of relationships within this community strongly predicted the capacity to access health care. Efforts to improve access to health care for older widows requires a response that is rooted in the socio-cultural context of the community. Comprehensive social protection policies that promote initiatives to engender social capital among the older population, decentralised primary health-care services, and the training and sensitisation of health service staff would be key to promote equitable access for older widows.
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Lopes MJ, de Pinho LG, Fonseca C, Goes M, Oliveira H, Garcia-Alonso J, Afonso A. Functioning and Cognition of Portuguese Older Adults Attending in Residential Homes and Day Centers: A Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137030. [PMID: 34209339 PMCID: PMC8297339 DOI: 10.3390/ijerph18137030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 12/14/2022]
Abstract
The functioning and cognition of older adults can be influenced by different care contexts. We aimed to compare the functioning profiles and cognition of institutionalized and noninstitutionalized older adults and to evaluate the effect of sociodemographic factors on the functioning and cognition. This is a cross-sectional study that included 593 older adults. The data were collected using the Elderly Nursing Core Set and Mini Mental State Examination. Women, older adults who did not attend school and those live in Residential Homes are more likely to have a higher degree of cognitive impairment than men, those who attended school and those frequent Day Centre. The chances of an older adult with moderate or severe cognitive impairment increases with age. Older women, older adults who did not attend school, and older adults who live in Residential Homes had a higher degree of functional problem than men, those who attended school and those who frequent a Day Centre, independently to age. It is necessary to promote the health literacy of older adults throughout life. The implementation of social and health responses should allow older adults to remain in their homes, given the influence of functioning and cognition on self-care and quality of life.
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Affiliation(s)
- Manuel José Lopes
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Correspondence: (M.J.L.); (L.G.d.P.); Tel.: +351-266-730-300
| | - Lara Guedes de Pinho
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Correspondence: (M.J.L.); (L.G.d.P.); Tel.: +351-266-730-300
| | - César Fonseca
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
| | - Margarida Goes
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Escola Superior de Saúde, Instituto Politécnico de Beja, 7800-111 Beja, Portugal
| | - Henrique Oliveira
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Escola Superior de Saúde, Instituto Politécnico de Beja, 7800-111 Beja, Portugal
- Instituto de Telecomunicações, 1049-001 Lisboa, Portugal
| | - José Garcia-Alonso
- Department of Computer Systems and Telematics Engineering, University of Extremadura, 10003 Cáceres, Spain;
| | - Anabela Afonso
- Departamento de Matemática, Escola de Ciências e Tecnologia, Universidade de Évora, 7000-671 Évora, Portugal;
- Centro de Investigação em Matemática e Aplicações, Universidade de Évora, 7000-671 Évora, Portugal
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Fonseca C, de Pinho LG, Lopes MJ, Marques MDC, Garcia-Alonso J. The Elderly Nursing Core Set and the cognition of Portuguese older adults: a cross-sectional study. BMC Nurs 2021; 20:108. [PMID: 34162387 PMCID: PMC8220736 DOI: 10.1186/s12912-021-00623-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The aging population and its associated health needs require specific nursing care. The aim of this study was to draw an epidemiological profile of Portuguese elderly adults attending in residential homes and day centers and to evaluate the association between the functioning and cognition of these older adults and their sociodemographic characteristics and presence of multimorbidity. METHODS This was a cross-sectional study of 613 older adults. Functioning was assessed using the Elderly Nursing Core Set, and cognition was assessed using the Mini Mental State Examination. Descriptive and inferential analyses were performed. RESULTS The mean age was 85.73 years; the majority of the participants were female (69.3 %), widowed (67.0 %) and over 85 years old (60.4 %). A total of 68.2 % of the sample presented multimorbidity. A total of 54.5 % had cognitive impairment, and the average functional profile was classified as "moderate difficulty". Institutionalized older adults had more diseases than those who attended the day center. Women, those who were illiterate, those who were institutionalized and older adults who had diseases of the nervous system had a worse functional profile and greater cognitive impairment. Those with multimorbidity had a worse functional profile, and those without a spouse had greater cognitive impairment. CONCLUSIONS Given the functional and cognitive profile of older adults, it is necessary to adopt care practices focused on the rehabilitation/maintenance of self-care and affective relationships. This care must be provided by highly qualified professionals. Therefore, it is necessary to increase the ratio of nurses per older adult in these institutions.
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Affiliation(s)
- César Fonseca
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Lara Guedes de Pinho
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal. .,Comprehensive Health Research Centre (CHRC), Évora, Portugal.
| | - Manuel José Lopes
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Maria do Céu Marques
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
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Santos FDS, de Lima Saintrain MV, de Souza Vieira LJE, Gomes Marques Sampaio E. Characterization and Prevalence of Elder Abuse in Brazil. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP3803-NP3819. [PMID: 29911483 DOI: 10.1177/0886260518781806] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We aimed to assess the prevalence and characterize the profile of elder abuse in Brazil in this quantitative descriptive and exploratory study using a document analysis of cases of elder abuse against people aged 60 and over reported to Brazil's Notifiable Disease Information System (Sistema de Informação de Agravos de Notificação-SINAN) from 2009 to 2013. Association between age groups (older adults and non-older adults) and (a) characteristics of the victims (gender, age, and race), (b) characteristics of the violence (type of violence, place of occurrence, and repeated violence) and, (c) characteristics of the perpetrator (gender, suspected alcohol consumption, and victim-perpetrator relationship) were assessed using the chi-square test and odds ratios (OR) with a 95% confidence interval. Statistical significance was set at p< .05. Elder abuse accounted for 5.7% of all cases of violence, with a higher prevalence among women (54.3%). Older men and older white people were more likely to suffer violence compared with their non-older peers (OR=1.75 and OR=1.47, respectively). Financial abuse (OR=5.95), violence resulting from legal intervention (OR=1.24), repeated violence (OR=1.22), and torture (OR=1.08) were at higher chances of occurring among older adults. In all, 30.3% of the cases of elder abuse were perpetrated by their children and 22% of the perpetrators were suspected to have consumed alcohol. Older adults were 30 times more likely to be abused by their children and eight times by caregivers and presented 2.37 more chances of evolving to death due to violence and 1.8 more chances to suffer violence in the household. The cases of elder abuse reported to SINAN highlight the greater fragility of this population group. In addition to reporting this public health problem, governmental and non-governmental actions are necessary to provide older adults with a healthy aging and ensure their rights, dignity, and autonomy.
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Staats K, Grov EK, Husebø BS, Tranvåg O. Dignity and loss of dignity: Experiences of older women living with incurable cancer at home. Health Care Women Int 2020; 41:1036-1058. [DOI: 10.1080/07399332.2020.1797035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Katrine Staats
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
| | - Ellen Karine Grov
- Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Bettina S. Husebø
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
| | - Oscar Tranvåg
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Oslo University Hospital, Norwegian National Advisory Unit on Women’s Health, Oslo, Norway
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Zasadzka E, Pieczyńska A, Trzmiel T, Pawlaczyk M. Polish Translation and Validation of the SARC-F Tool for the Assessment of Sarcopenia. Clin Interv Aging 2020; 15:567-574. [PMID: 32368023 PMCID: PMC7185989 DOI: 10.2147/cia.s245074] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/31/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Completion of the SARC-F questionnaire constitutes the obligatory first step in the diagnostic process of sarcopenia, according to the revised European consensus on the definition and diagnosis of sarcopenia published by the European Working Group on Sarcopenia in Older People2 (EWGSOP2). SARC-F has been recognized as the most up-to-date and coherent screening tool for sarcopenia. The aim of the study was to translate and to validate the Polish version of the SARC-F questionnaire. MATERIALS AND METHODS The validation process was performed in two stages: 1) translation and intercultural adaptation and 2) clinical validation. The inclusion criteria were as follows: age ≥65 years, unimpaired mobility, and no cognitive impairment. The EWGSOP2 criteria were used to diagnose sarcopenia. Hand grip strength measurement, physical fitness test, and body weight composition analysis were conducted. Sensitivity, specificity, accuracy-likelihood ratios, and SARC-F predictive values were calculated using the EWGSOP2 criteria. RESULTS Sixty-seven people participated in the study of whom 21% were diagnosed with sarcopenia (SARC-F score: ≥4). The reliability of the questionnaire based on the Cronbach's alpha coefficient was 0.784. Sensitivity, specificity, and negative predictive values were 92.9%, 98.1%, and 98.1%, respectively. CONCLUSION The process of validating the SARC-F questionnaire against Polish conditions demonstrated its applicability as a simple and reliable tool for diagnosing sarcopenia in daily clinical practice with older adults.
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Affiliation(s)
- Ewa Zasadzka
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland
| | - Anna Pieczyńska
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland
| | - Tomasz Trzmiel
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland
| | - Mariola Pawlaczyk
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland
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Goes M, Lopes MJ, Oliveira H, Fonseca C, Marôco J. A Nursing Care Intervention Model for Elderly People to Ascertain General Profiles of Functionality and Self Care Needs. Sci Rep 2020; 10:1770. [PMID: 32019984 PMCID: PMC7000781 DOI: 10.1038/s41598-020-58596-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/15/2020] [Indexed: 11/09/2022] Open
Abstract
A core set of International Classification of Functioning, Disability and Health codes was used to ascertain general profiles of functionality as a function of biological and sociodemographic characteristics and to develop structured nursing interventions in accordance with self care deficits identified by studying self care behavior for elderly people living in both extensively and sparsely populated rural areas. Data were collected by health professionals in the participants' houses. An exploratory factor analysis enabled reduced data dimensions, and factorial validity was assessed by a confirmatory factor analysis. An ordinal regression model was built to identify general profiles of functionality as a function of age. A bar graph was used as a measurement tool for nursing care needs as a function of self care behavior and functional profile level. No functional problems were expected among people under the age of 74 years, while mild functionality problems were expected among people older than 74 years. Regarding nursing care needs, the results of the constructed model suggested that the functional concept "Support and Relationships" is associated with higher levels of functional problems and thus a greater need for self care interventions and that people aged 85 years and older always show therapeutic self care deficits.
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Affiliation(s)
- Margarida Goes
- Escola Superior de Saúde, Instituto Politécnico de Beja, Beja, Portugal
| | - Manuel José Lopes
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, Évora, Portugal
| | | | - César Fonseca
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, Évora, Portugal
| | - João Marôco
- ISPA - Instituto Universitário de Ciências Psicológicas Sociais e da Vida, Lisbon, Portugal
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[Comprehensive geriatric assessment in a marginal community of Ecuador]. NUTR HOSP 2020; 37:926-932. [PMID: 32960638 DOI: 10.20960/nh.03040] [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: 11/02/2022] Open
Abstract
Introduction Background: older adults suffer from diseases that can affect their functional, psychological and social parameters. The Comprehensive Geriatric Assessment (CGA) is used as an evaluation tool for these parameters through the use of validated, simple and easy-to-apply instruments. Objective: to report the health status of older adults who attend a primary care center in an urban-marginal area of Guayaquil (Ecuador) through CGA, as a first step in order to establish a coordinated care plan in the areas studied. Material and Methods: a cross-sectional assessment of 196 aged subjects with a median age of 70.9 years (83 % females) who attended a Primary Care Community Health Center in Guayaquil. Nutritional, social, demographic, functional, and cognitive variables were assessed. Results: participants had a mean age of 70.9 ± 7.1 years. Demographic variables: 73 % were Afro-Ecuadorian, 69 % had basic education, and 57 % performed no physical activity. Clinical assessment: 47.4 % presented with vision impairment, and 37.8 % with hearing problems; 52 % had nutritional risk and 6 % malnutrition. Social valuation: 13 % had severe social deterioration; 40 % had some cognitive impairment, and 8.2 % had depression; 46.9 % were functionally dependent, and 16.8 % had dynapenia. Conclusions: CGA allows to identify major health problems in this population, which is why it is considered a practical and easy tool to apply in primary care centers in marginal urban populations as a first step to improve health status for this older population, which in recent years is growing significantly in developing countries such as Ecuador.
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Pieczyńska A, Zasadzka E, Trzmiel T, Pawlaczyk M. Physical Activity and Fitness in White- and Blue-Collar Retired Men. Am J Mens Health 2019; 13:1557988319891360. [PMID: 31849269 PMCID: PMC6920597 DOI: 10.1177/1557988319891360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The average life expectancy has increased and despite a distinct feminization of
aging, the number of older males continues to grow. Physical activity has a
positive effect on health and helps to slow down the negative consequences of
aging. The aim of the study was to evaluate possible relationships between
physical fitness, physical activity and type of work during occupational
activity among retired men (aged ≥65 years), no longer professionally active.
The study included 104 men (aged from 65 to 90 years), further stratified into
blue- and white-collar groups (66 and 38 subjects, respectively). The
International Physical Activity Questionnaire (IPAQ) was used to assess their
physical activity levels. Physical performance was assessed using the Short
Physical Performance Battery test (SPPB) and handgrip strength (HGS)
measurement. Geriatric Depression Scale (GDS) was used to identify the risk for
depression. Mean physical activity in the study population was moderate in
almost 70%, high in 19% and low in 11% of the subjects. Men with high physical
activity levels had better SPPB and GDS scores (p = .01 and
p = .001, respectively). In the blue-collar group, the IPAQ
scores were lower than in the white-collar group, although the differences were
statistically insignificant. The SPPB scores and mean HGS for the dominant hand
were similar in both groups. Occupational physical activity should not
substitute other forms of physical activity. Regardless of the type of work
performed before retirement, the men obtained similar results in terms of their
physical activity.
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Affiliation(s)
- Anna Pieczyńska
- Department of Geriatric Medicine and Gerontology, Poznań University of Medical Sciences, Poland
| | - Ewa Zasadzka
- Department of Geriatric Medicine and Gerontology, Poznań University of Medical Sciences, Poland
| | - Tomasz Trzmiel
- Department of Geriatric Medicine and Gerontology, Poznań University of Medical Sciences, Poland
| | - Mariola Pawlaczyk
- Department of Geriatric Medicine and Gerontology, Poznań University of Medical Sciences, Poland
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Zasadzka E, Trzmiel T, Roszak M, Pawlaczyk M. Is the outcome of frailty syndrome gender dependent? J Women Aging 2019; 32:349-360. [DOI: 10.1080/08952841.2019.1593797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Ewa Zasadzka
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznán, Poland
| | - Tomasz Trzmiel
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznán, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznań, Poland
| | - Mariola Pawlaczyk
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznán, Poland
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Tuohy D, Cooney A. Older Women's Experiences of Aging and Health: An Interpretive Phenomenological Study. Gerontol Geriatr Med 2019; 5:2333721419834308. [PMID: 30886880 PMCID: PMC6410378 DOI: 10.1177/2333721419834308] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/08/2019] [Accepted: 01/14/2019] [Indexed: 11/15/2022] Open
Abstract
Objective: This interpretive phenomenological study explored older Irish women’s experiences of aging and health related issues. Method: Data were collected using in-depth interviews with 23 older women (coresearchers). Data analysis followed the “Vancouver school of doing phenomenology” framework and included a meta-synthesis of individual case constructions. Results: “Retaining autonomy within a process of adaptation and continued engagement” describes the essential meaning of coresearchers’ experiences. Four themes were identified: “Being in control: Balancing needs and supports,” “Navigating a changing world,” “Being connected and involved,” “Trying to stay well.” Discussion: Gender shapes older women’s experience of aging, health, and ill health. Three major factors moderate their experience: autonomy and control, proactivity and adaptability, and staying engaged with life. The study concludes that aging, gender, and health are intrinsically linked and collectively shape older women’s experience. This is an important consideration when planning gender-appropriate health care services for older women.
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Chen C, Lim JT, Chia NC, Wang L, Tysinger B, Zissimopolous J, Chong MZ, Wang Z, Koh GC, Yuan JM, Tan KB, Chia KS, Cook AR, Malhotra R, Chan A, Ma S, Ng TP, Koh WP, Goldman DP, Yoong J. The Long-Term Impact of Functional Disability on Hospitalization Spending in Singapore. JOURNAL OF THE ECONOMICS OF AGEING 2019; 14:100193. [PMID: 31857943 PMCID: PMC6922027 DOI: 10.1016/j.jeoa.2019.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Singapore is one of the fastest-aging populations due to increased life expectancy and lowered fertility. Lifestyle changes increase the burden of chronic diseases and disability. These have important implications for social protection systems. The goal of this paper is to model future functional disability and healthcare expenditures based on current trends. To project the health, disability and hospitalization spending of future elders, we adapted the Future Elderly Model (FEM) to Singapore. The FEM is a dynamic Markov microsimulation model developed in the US. Our main source of population data was the Singapore Chinese Health Study (SCHS) consisting of 63,000 respondents followed up over three waves from 1993 to 2010. The FEM model enables us to investigate the effects of disability compounded over the lifecycle and hospitalization spending, while adjusting for competing risk of multi-comorbidities. Results indicate that by 2050, 1 in 6 elders in Singapore will have at least one ADL disability and 1 in 3 elders will have at least one IADL disability, an increase from 1 in 12 elders and 1 in 5 elders respectively in 2014. The highest prevalence of functional disability will be in those aged 85 years and above. Lifetime hospitalization spending of elders aged 55 and above is US$24,400 (30.2%) higher among people with functional disability compared to those without disability. Policies that successfully tackle diabetes and promote healthy living may reduce or delay the onset of disability, leading to potential saving. In addition, further technological improvements may reduce the financial burden of disability.
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Affiliation(s)
- C Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Schaeffer Center for Health Policy and Economics, University of Southern California, USA
| | - JT Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - NC Chia
- Department of Economics, National University of Singapore, Singapore
| | - L Wang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - B Tysinger
- Schaeffer Center for Health Policy and Economics, University of Southern California, USA
| | - J Zissimopolous
- Schaeffer Center for Health Policy and Economics, University of Southern California, USA
| | - MZ Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Z Wang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - GC Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - JM Yuan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - KB Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Policy Research and Economics Office, Ministry of Health, Singapore
| | - KS Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - AR Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - R Malhotra
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
| | - A Chan
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
| | - S Ma
- Epidemiology & Disease Control Division, Ministry of Health, Singapore
| | - TP Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - WP Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - DP Goldman
- Schaeffer Center for Health Policy and Economics, University of Southern California, USA
| | - J Yoong
- Center for Economic and Social Research, University of Southern California, USA
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Accepting, active and in control: older women's experiences of ageing with peripheral arterial disease. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x1800065x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe population of Australia is ageing, with women being the primary beneficiaries of this increase in longevity. Increasingly older individuals are being diagnosed with different chronic illnesses such as peripheral arterial disease (PAD) which causes blockages of the blood vessels in the legs resulting in pain, non-healing ulcers, immobility and the potential amputation of the threatened limb. PAD has been traditionally thought to affect men more than women. Resultingly, women have been under-represented in clinical trials of PAD and under-diagnosed in the health-care setting. However, it has recently been acknowledged that women are indeedmorelikely to suffer from PAD than men due to increased presence of disease and survival advantage. As such, very little is known about women's understanding of and the meaning they create of their experiences of PAD. Therefore, how older women with PAD experience the ageing process is the focus of this qualitative research project. Interviews were conducted with 11 women from Sydney, Australia aged over 65 years who had been diagnosed with PAD. The interviews were analysed using an inductive thematic analysis. Three manifest themes were constructed: independence and control, active and involved, and the acceptance of ageing. These findings emphasised the idea that despite the presence of a chronic illness and increased age, remaining independent and engaged with life was vital to these women's wellbeing. Their subjective experiences of ageing reflect the fact that by adapting to the physical, mental and social changes that come with growing older, the focus does not need to be on loss and decline but rather can be about the continuation of life that can be both positive and meaningful.
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Robinson JT, Murphy-Nugen AB. It makes you keep trying: Life review writing for older adults. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:171-192. [PMID: 29336698 DOI: 10.1080/01634372.2018.1427645] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Life review writing produces numerous psychosocial benefits for older adults, who are at risk for isolation and depression. This article shares findings from a study that examined the experiences of older adults participating in a life review writing group. The impact of gender composition on the group dynamic was also explored. Using interpretative phenomenological analysis, this study explored the experiences of six women and one man who participated in a life review writing group. Six unifying themes emerged from the research findings: (1) legacy, (2) connecting with others, (3) reflection, (4) vitality, (5) structure of the group, and (6) gender dynamics. Implications for theory, practice, and research are discussed.
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Affiliation(s)
| | - Amy B Murphy-Nugen
- b Department of Social Work , Western Carolina University , Cullowhee, North Carolina , USA
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Jentsch F, Allen J, Fuchs J, von der Lippe E. Typical patterns of modifiable health risk factors (MHRFs) in elderly women in Germany: results from the cross-sectional German Health Update (GEDA) study, 2009 and 2010. BMC Womens Health 2017; 17:23. [PMID: 28372561 PMCID: PMC5379506 DOI: 10.1186/s12905-017-0380-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 03/15/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Modifiable health risk factors (MHRFs) significantly affect morbidity and mortality rates and frequently occur in specific combinations or risk clusters. Using five MHRFs (smoking, high-risk alcohol consumption, physical inactivity, low intake of fruits and vegetables, and obesity) this study investigates the extent to which risk clusters are observed in a representative sample of women aged 65 and older in Germany. Additionally, the structural composition of the clusters is systematically compared with data and findings from other countries. METHODS A pooled data set of Germany's representative cross-sectional surveys GEDA09 and GEDA10 was used. The cohort comprised 4,617 women aged 65 and older. Specific risk clusters based on five MHRFs are identified, using hierarchical cluster analysis. The MHRFs were defined as current smoking (daily or occasionally), risk alcohol consumption (according to the Alcohol Use Disorders Identification Test, a sum score of 4 or more points), physical inactivity (less active than 5 days per week for at least 30 min and lack of sports-related activity in the last three months), low intake of fruits and vegetables (less than one serving of fruits and one of vegetables per day), and obesity (a body mass index equal to or greater than 30). A total of 4,292 cases with full information on these factors are included in the cluster analysis. Extended analyses were also performed to include the number of chronic diseases by age and socioeconomic status of group members. RESULTS A total of seven risk clusters were identified. In a comparison with data from international studies, the seven risk clusters were found to be stable with a high degree of structural equivalency. CONCLUSION Evidence of the stability of risk clusters across various study populations provides a useful starting point for long-term targeted health interventions. The structural clusters provide information through which various MHRFs can be evaluated simultaneously.
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Affiliation(s)
- Franziska Jentsch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, D-12101 Germany
| | - Jennifer Allen
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, D-12101 Germany
| | - Judith Fuchs
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, D-12101 Germany
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, D-12101 Germany
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Pou SA, Tumas N, Coquet JB, Niclis C, Román MD, Díaz MDP. Burden of cancer mortality and differences attributable to demographic aging and risk factors in Argentina, 1986-2011. CAD SAUDE PUBLICA 2017; 33:e00016616. [PMID: 28300967 DOI: 10.1590/0102-311x00016616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 05/02/2016] [Indexed: 01/01/2023] Open
Abstract
The world faces an aging population that implies a large number of people affected with chronic diseases. Argentina has reached an advanced stage of demographic transition and presents a comparatively high rate of cancer mortality within Latin America. The objectives of this study were to examine cancer mortality trends in the province of Córdoba, Argentina, between 1986 and 2011, and to analyze the differences attributable to risk variations and demographic changes. Longitudinal series of age-standardized mortality rates for overall, breast and prostate cancers were modeled by Joinpoint regression to estimate the annual percent change. The Bashir & Estève method was used to split crude mortality rate variation into three components: mortality risk, population age structure and population size. A decreasing cancer age-standardized mortality rates trend was observed (1986-2011 annual percent change: -1.4, 95%CI: -1.6, -1.2 in men; -0.8, 95%CI: -1.0, -0.6 in women), with a significant shift in 1996. There were positive crude mortality rate net changes for overall female cancer, breast and prostate cancers, which were primarily attributable to demographic changes. Inversely, overall male cancer crude mortality rate showed a 9.15% decrease, mostly due to mortality risk. Despite favorable age-standardized mortality rates trends, the influence of population aging reinforces the challenge to control cancer in populations with an increasingly aged demographic structure.
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Affiliation(s)
- Sonia Alejandra Pou
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Natalia Tumas
- Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Julia Becaria Coquet
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Camila Niclis
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María Dolores Román
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María Del Pilar Díaz
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Córdoba, Argentina
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Kuuire VZ, Tenkorang EY, Rishworth A, Luginaah I, Yawson AE. Is the Pro-Poor Premium Exemption Policy of Ghana’s NHIS Reducing Disparities Among the Elderly? POPULATION RESEARCH AND POLICY REVIEW 2016. [DOI: 10.1007/s11113-016-9420-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Goharinezhad S, Maleki M, Baradaran HR, Ravaghi H. A qualitative study of the current situation of elderly care in Iran: what can we do for the future? Glob Health Action 2016; 9:32156. [PMID: 27876456 PMCID: PMC5120385 DOI: 10.3402/gha.v9.32156] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 09/29/2016] [Accepted: 09/30/2016] [Indexed: 11/16/2022] Open
Abstract
Background With the successful improvement of global health systems and social security in societies, the world is now advancing toward aging. All countries have to face the phenomenon of population aging sooner or later depending on their degree of development; however, elderly care is predicted to soon become a major concern for developing countries such as Iran. Objectives This study was conducted to identify the challenges of elderly care in Iran and to help policymakers develop roadmaps for the future through providing a clearer image of the current state of affairs in this area of healthcare. Design This study has adopted a framework approach to qualitative data analysis. For this purpose, 37 semi-structured interviews were conducted in 2015 with a number of key informants in elderly care who were familiar with the process at macro-, meso-, and micro-levels. Maximum variation purposive sampling was performed to select the study samples. A conceptual framework was designed using a review of the literature, and key issues were then identified for data analysis. Results The elderly care process yielded five major challenges, including policymaking, access, technical infrastructure, integrity and coordination, and health-based care services. Discussion According to the stakeholders of elderly care in Iran, the current care system is not well-suited for meeting the needs of the elderly, as the elderly tend to receive the services they need sporadically and in a non-coherent manner. Given the rapid growth of the elderly population in the coming decades, it is the authorities’ job to concentrate on the challenges faced by the health system and to use foresight methods for the comprehensive and systematical management of the issue.
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Affiliation(s)
- Salime Goharinezhad
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.,Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadreza Maleki
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.,Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran;
| | - Hamid Reza Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism Iran University of Medical Sciences Tehran, Iran
| | - Hamid Ravaghi
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Gomes WF, Lacerda ACR, Brito-Melo GEA, Fonseca SF, Rocha-Vieira E, Leopoldino AAO, Amorim MR, Mendonça VA. Aerobic training modulates T cell activation in elderly women with knee osteoarthritis. ACTA ACUST UNITED AC 2016; 49:e5181. [PMID: 27828665 PMCID: PMC5112538 DOI: 10.1590/1414-431x20165181] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 09/05/2016] [Indexed: 01/12/2023]
Abstract
Osteoarthritis of the knee (kOA) is a disease that mainly affects the elderly and can
lead to major physical and functional limitations. However, the specific effects of
walking, particularly on the immune system, are unknown. Therefore, this study aimed
to analyze the effect of 12 weeks of walking (3×/week) on the leukocyte profile and
quality of life (QL) of elderly women with kOA. Sixteen women (age: 67±4 years, body
mass index: 28.07±4.16 kg/m2) participated in a walking program. The
variables were assessed before and after 12 weeks of training with a progressively
longer duration (30–55 min) and higher intensity (72–82% of HRmax determined using a
graded incremental treadmill test). The QL was assessed using the Medical Outcomes
Study 36-Item Short Form Health Survey (SF-36), and blood samples were collected for
analysis with a cell counter and the San Fac flow cytometer. Walking training
resulted in a 47% enhancement of the self-reported QL (P<0.05) and a 21% increase
in the VO2max (P<0.0001) in elderly women with kOA. Furthermore, there
was a reduction in CD4+ cells (pre=46.59±7%, post=44.58±9%, P=0.0189) and a higher
fluorescence intensity for CD18+CD4+ (pre=45.30±10, post=64.27±33, P=0.0256) and
CD18+CD8+ (pre=64.2±27, post=85.02±35, P=0.0130). In
conclusion, the walking program stimulated leukocyte production, which may be related
to the immunomodulatory effect of exercise. Walking also led to improvements in the
QL and physical performance in elderly women with kOA.
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Affiliation(s)
- W F Gomes
- Centro Integrado de Pós-Graduação e Pesquisa em Saúde (CIPq-Saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - A C R Lacerda
- Centro Integrado de Pós-Graduação e Pesquisa em Saúde (CIPq-Saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - G E A Brito-Melo
- Centro Integrado de Pós-Graduação e Pesquisa em Saúde (CIPq-Saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - S F Fonseca
- Centro Integrado de Pós-Graduação e Pesquisa em Saúde (CIPq-Saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - E Rocha-Vieira
- Centro Integrado de Pós-Graduação e Pesquisa em Saúde (CIPq-Saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - A A O Leopoldino
- Departamento de Fisioterapia e Terapia Ocupacional, Escola de Educação Física, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - M R Amorim
- Departamento de Fisiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V A Mendonça
- Centro Integrado de Pós-Graduação e Pesquisa em Saúde (CIPq-Saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
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Davidson PM, Glass NE, DiGiacomo M. Global women's health issues: sex and gender matter. Med J Aust 2016; 205:346-348. [PMID: 27736616 DOI: 10.5694/mja16.00904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/29/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Patricia M Davidson
- Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW
| | | | - Michelle DiGiacomo
- Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW
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Ko Y, Choi K. Prevalence of frailty and associated factors in Korean older women: The KLoSA study. J Women Aging 2016; 29:15-25. [PMID: 27400023 DOI: 10.1080/08952841.2015.1018069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to identify the prevalence of frailty in older women and its associated factors using data from the Korean Longitudinal Study of Aging (KLoSA). The level of frailty was moderate/severe in 20.2% of the women. Age, socioeconomic status, and depressive symptoms were significantly associated with all levels of frailty. Sensory function and grip strength were associated with both mild and moderate/severe frailty. The only factors associated with moderate/severe frailty were marriage status and regular exercise. Understanding the risk factors of frailty may help health care providers to deliver tailored interventions to prevent this condition and its adverse outcomes.
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Affiliation(s)
- Young Ko
- a College of Nursing , Gachon University , Incheon , South Korea
| | - Kyungwon Choi
- b Department of Nursing , Korea National University of Transportation , Chungbuk , South Korea
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Ribeiro O, Teixeira L, Araújo L, Paúl C. Health profile of centenarians in Portugal: a census-based approach. Popul Health Metr 2016; 14:13. [PMID: 27076791 PMCID: PMC4830015 DOI: 10.1186/s12963-016-0083-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 04/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The number of centenarians is rapidly increasing in Europe. In Portugal, it has almost tripled over the last 10 years and constitutes one of the fastest-growing segments of the population. This paper aims to describe the health and sociodemographic characteristics of Portuguese centenarians as given in the 2011 census and to identify sex differences. METHODS All persons living in Portugal mainland and Madeira and Azores islands aged 100 years old at the time of the 2011 census (N = 1,526) were considered. Measures include sociodemographic characteristics and perceived difficulties in six functional domains of basic actions (seeing, hearing, walking, cognition, self-care, and communication) as assessed by the Portuguese census official questionnaires. RESULTS Most centenarians are women (82.1 %), widowed (82 %), never attended school (51 %), and live in private households (71 %). The majority show major constraints in seeing (67.4 %), hearing (72.3 %), and particularly in their mobility (83.7 % cannot/have great difficulties in walking/climbing stairs and 80.7 % in bathing/dressing). In general, a better outcome was found for reported memory/concentration and understanding, with 39.1 % and 42.5 % presenting no or mild difficulty, respectively. Top-level functioning (no/mild difficulties in all dimensions concurrently) was observed in a minority of cases (5.96 %). Women outnumber men by a ratio of 4.6, and statistically significant differences were found between men and women for all health-related variables, with women presenting a higher percentage of difficulties. CONCLUSION Portuguese centenarians experience great difficulties in sensory domains and basic daily living activities, and to a lesser extent in cognition and communication. The obtained profile, though self-reported, is important in considering the potential of social and family participation of this population regardless of their functional and sensory limitations. Based on the observed differences between men and women, gender-specific and gender-sensitive interventions are recommended in order to acknowledge women's worse overall condition.
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Affiliation(s)
- Oscar Ribeiro
- Institute of Biomedical Sciences Abel Salazar (UNIFAI and CINTESIS), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Laetitia Teixeira
- Institute of Biomedical Sciences Abel Salazar (UNIFAI and CINTESIS), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Lia Araújo
- Institute of Biomedical Sciences Abel Salazar (UNIFAI and CINTESIS), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal ; Polytechnic Institute of Viseu (ESEV and CI&DETS) , Rua Maximiano Aragão, 3504 - 501 Viseu, Portugal
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar (UNIFAI and CINTESIS), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
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Davidson P, Cao Y. News From the International Council on Women's Health Issues. Health Care Women Int 2016; 37:391. [DOI: 10.1080/07399332.2016.1163973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schwind JK, Fredericks S, Metersky K, Porzuczek VG. What can be learned from patient stories about living with the chronicity of heart illness? A narrative inquiry. Contemp Nurse 2015; 52:216-29. [DOI: 10.1080/10376178.2015.1089179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nakua EK, Otupiri E, Dzomeku VM, Owusu-Dabo E, Agyei-Baffour P, Yawson AE, Folson G, Hewlett S. Gender disparities of chronic musculoskeletal disorder burden in the elderly Ghanaian population: study on global ageing and adult health (SAGE WAVE 1). BMC Musculoskelet Disord 2015; 16:204. [PMID: 26286129 PMCID: PMC4541744 DOI: 10.1186/s12891-015-0666-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 08/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traditionally, non-communicable diseases including musculoskeletal disorders have not been a priority in low-and-middle income countries. The main aim of this paper is to assess age and gender specific burden by estimating the current prevalence of musculoskeletal disorders and associated risk factors in the elderly Ghanaian population. METHODS Between May 2007 and June 2008, the World Health Organization conducted a nationwide study on AGEing (SAGE) and Adult Health in Ghana. The study employed a multistage cluster sampling strategy to identify participants by stratifying the population by age and setting. A structured questionnaire was used for data collection. A Poisson regression model was fitted with robust error variance. Prevalence estimates took into account the complex survey design and sampling weights. Statistical significance was considered at p ≤ 0.05 significance level. Statistical analysis was performed with STATA version 11.2. RESULTS The prevalence rates of chronic back pain and chronic arthritis/joints pain were higher in women than men. The overall crude prevalence's rates were 28.2 and 10.7% for chronic back pain and chronic arthritis/joints pain respectively. Substantial differences existed between men and women in terms of socio-economic status, education level and occupational status. Women with primary education had a chronic back pain prevalence of 36.2% (95% CI; 29.2, 43.3) and chronic arthritis/joints pain prevalence of 15.8% (95% CI; 11.1, 20.6) while their male counterparts had prevalence rates of 29.0% (95% CI; 23.4, 34.5) and 9.8% (95% CI; 6.4, 13.2) respectively. Residence (rural and urban) did not appear to influence the prevalence of chronic back pain and arthritis/joints pain. CONCLUSION Our findings suggest the existence of sex differences in chronic back pain and chronic arthritis/joint pain in the elderly population in Ghana after adjustment for demographic and socio-economic factors. It indicates the existence of inequalities in health between elderly men and women with women suffering more from chronic back pain and chronic arthritis/joints pain.
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Affiliation(s)
- Emmanuel Kweku Nakua
- Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University Science and Technology, Kumasi, Ghana.
| | - Easmon Otupiri
- Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University Science and Technology, Kumasi, Ghana.
| | - Veronica Millicent Dzomeku
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ellis Owusu-Dabo
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. .,Kumasi Collaborative Center for Tropical Research, Kumasi, Ghana.
| | - Peter Agyei-Baffour
- Department of Occupational and Environmental Health, School of Public Health, Kwame Nkrumah University Science and Technology, Kumasi, Ghana.
| | - Alfred Edwin Yawson
- Department of Community, College of Health Sciences, University of Ghana, School of Public Health, Korle-Bu, Accra, Ghana.
| | - Gloria Folson
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
| | - Sandra Hewlett
- College of Health Sciences, University of Ghana School of Medicine and Dentistry, Korle-Bu, Accra, Ghana.
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Rodolpho JRC, Hoga LAK, Reis-Queiroz J, Jamas MT. Experiences and daily life attitudes of women with severe mental disorders: integrative review of associated factors. Arch Psychiatr Nurs 2015; 29:223-35. [PMID: 26165977 DOI: 10.1016/j.apnu.2015.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/10/2015] [Accepted: 03/21/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective is to identify the factors that influence the experiences and daily life attitudes of women with severe mental disorders (SMD). METHOD A search for studies published from 2000 to 2014 was conducted in electronic databases. All relevant primary studies were screened using integrative methods. Findings were synthesized thereafter. RESULTS Fifteen articles were included. A total of 21 factors were identified as being associated with experiences and daily life attitudes of women with SMD. These factors consisted of the following five categories: strengths and limitations regarding self-care behavior and healthcare delivery, unmet healthcare needs, psychosocial vulnerabilities underlying SMD, gains and challenges of motherhood, and adoption of coping strategies. CONCLUSIONS Healthcare providers can greatly contribute to improving the quality of healthcare for women with SMD, but several barriers need to be overcome.
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Affiliation(s)
| | | | - Jéssica Reis-Queiroz
- University of São Paulo, School of Nursing, Cerqueira Cesar, São Paulo, SP, Brazil.
| | - Milena Temer Jamas
- São Paulo State University, Faculty of Medicine of Botucatu, Department of Nursing.
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Hoga L, Rodolpho J, Gonçalves B, Quirino B. Womenʼs experience of menopause: a systematic review of qualitative evidence. ACTA ACUST UNITED AC 2015. [DOI: 10.11124/01938924-201513080-00018] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Raggi A, Leonardi M. Burden and cost of neurological diseases: a European North-South comparison. Acta Neurol Scand 2015; 132:16-22. [PMID: 25345990 DOI: 10.1111/ane.12339] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To address the relationship between years lived with a disability (YLDs), prevalence and cost of neurological diseases, and to test whether there is a European North-South gradient for national health expenditure, disability, costs and prevalence of neurological diseases. MATERIALS AND METHODS Information on costs, prevalence and YLDs referred to 2010 were taken from the Study on the Cost of Disorders of the Brain and from the Global Burden of Disease study; data on health expenditure were taken from OECD reports. Selected conditions were as follows: brain tumours, stroke, dementia, Parkinson's disease, epilepsy, multiple sclerosis, migraine and tension-type headache; selected countries were from North (Denmark, Finland, Norway, Sweden) and South (Greece, Italy, Portugal, Spain) Europe. The association between the variables for each condition was tested using Spearman's correlation; Wilcoxon signed ranks test was used to test North-South Europe differences. RESULTS Correlations were largely non-significant (except for stroke). YLDs and cost were generally lower in South-European countries, and prevalence was lower in North-European countries, but no significant differences were found. CONCLUSIONS Health expenditure, YLDs, costs and prevalence of neurological conditions were generally not correlated across the eight countries. A clear North-South gradient was found for health expenditures, and partially for YLDs, costs and diseases' prevalence. We hypothesized that this is a consequence of the expansion of morbidity of neurological conditions connected to ageing, that health and welfare systems of selected countries were not prepared to face.
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Affiliation(s)
- A. Raggi
- Neurology; Public Health and Disability Unit; Neurological Institute C. Besta IRCCS Foundation; Milan Italy
| | - M. Leonardi
- Neurology; Public Health and Disability Unit; Neurological Institute C. Besta IRCCS Foundation; Milan Italy
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DiGiacomo M, Lewis J, Phillips J, Nolan M, Davidson PM. The business of death: a qualitative study of financial concerns of widowed older women. BMC WOMENS HEALTH 2015; 15:36. [PMID: 25906773 PMCID: PMC4407784 DOI: 10.1186/s12905-015-0194-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 04/13/2015] [Indexed: 11/29/2022]
Abstract
Background The feminisation of ageing and increasing number of widowed women in contemporary society has significant implications. Older women are at risk of poor health, social, and economic outcomes upon widowhood. The aim of the study was to describe women’s experiences in the period soon after their husbands’ death, including their financial issues and concerns, and the ways in which these experiences impacted on the transition to widowhood late in life. Methods This was a longitudinal study using serial in-depth semi-structured interviews with 21 community-dwelling women over the age of 65 in Australia. Verbatim transcripts underwent Interpretive Phenomenological Analysis. Results Thematic analysis revealed: 1) administrative burden increases vulnerability; 2) gender roles impact on transitions; and 3) financial adjustments render housing insecurity and health risk. High administrative burden within the context of significant grief and mourning was a defining feature of the early bereavement period. Complicated protracted administrative processes, insensitive interactions, and reminders of loss contributed to distress, anxiety and feelings of demoralisation. Several women identified assumption of household financial management as the most difficult aspect of coping with their husband’s death. Conclusions Older women may have unmet needs for assistance with administrative, financial, and legal issues immediately following spousal death and potentially for years afterward. Lack of familiarity and absence of instrumental support with financial and legal issues signal the need for policy reform, resources to improve financial literacy in women throughout the life course, increased advocacy, and consideration of different support and service models.
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Affiliation(s)
- Michelle DiGiacomo
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, New South Wales, 2008, Australia.
| | - Joanne Lewis
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, New South Wales, 2008, Australia.
| | - Jane Phillips
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, New South Wales, 2008, Australia.
| | - Marie Nolan
- Johns Hopkins University, School of Nursing, North Wolfe Street, Baltimore, MD, 21205, USA.
| | - Patricia M Davidson
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, New South Wales, 2008, Australia. .,Johns Hopkins University, School of Nursing, North Wolfe Street, Baltimore, MD, 21205, USA.
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Oh S, Ko Y. Activities of Daily Living, Depression, and Self-rated Health and Related Factors in Korean Elderly: Focused on Socioeconomic Status and Family Support. ACTA ACUST UNITED AC 2015. [DOI: 10.12799/jkachn.2015.26.2.140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Seieun Oh
- Department of Nursing, College of Health Sciences, Dankook University, Cheonan, Korea
| | - Young Ko
- School of Nursing, Gachon University, Incheon, Korea
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Westwood S. Dementia, women and sexuality: How the intersection of ageing, gender and sexuality magnify dementia concerns among lesbian and bisexual women. DEMENTIA 2014; 15:1494-1514. [PMID: 25527570 DOI: 10.1177/1471301214564446] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is a growing appreciation of the significance of socio-cultural context for the experiences of an individual living with dementia. There is, too, an emergent awareness that dementia is a gendered issue, disproportionately affecting women compared with men. However, little attention has been given as yet to the experiences of lesbian and bisexual women living with dementia. This article addresses this gap in knowledge, exploring the significance of the intersection of ageing, gender and sexuality for lesbian and bisexual women with dementia. It suggests that stigma and social marginalisation associated with dementia and with ageing, gender and sexuality intersect to compound the social exclusion of lesbians and bisexual women. This has implications for early diagnosis and treatment. Moreover, community care policy, which is predicated on heterosexist norms fails to take into account older lesbians and bisexual women's support networks and so is less likely to be attuned to their needs. Residential care provision is perceived by older lesbians and bisexual women as being heteronormative at best and homophobic at worst. Services which do not recognise, validate and support their identities will compound their anxiety, confusion and distress. This may be contrary to Equality and Human Rights legislation and UK social policies. This paper draws upon, and analyses, extracts from a range of authorship, synthesising the material to present novel insights into the significance of gender and sexuality for the experience of dementia and dementia care.
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Moreira BS, Sampaio RF, Kirkwood RN. Spatiotemporal gait parameters and recurrent falls in community-dwelling elderly women: a prospective study. Braz J Phys Ther 2014; 19:61-9. [PMID: 25714603 PMCID: PMC4351609 DOI: 10.1590/bjpt-rbf.2014.0067] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 08/01/2014] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND: Falling is a common but devastating and costly problem of aging. There is no
consensus in the literature on whether the spatial and temporal gait parameters
could identify elderly people at risk of recurrent falls. OBJECTIVE: To determine whether spatiotemporal gait parameters could predict recurrent falls
in elderly women. METHOD: One hundred and forty-eight elderly women (65-85 years) participated in this
study. Seven spatiotemporal gait parameters were collected with the GAITRite(r)
system. Falls were recorded prospectively during 12 months through biweekly phone
contacts. Elderly women who reported two or more falls throughout the follow-up
period were considered as recurrent fallers. Principal component analysis (PCA)
and discriminant analysis followed by biplot graph interpretation were applied to
the gait parameters. RESULTS: After 12 months, 23 elderly women fell twice or more and comprised the recurrent
fallers group and 110 with one or no falls comprised the non-recurrent fallers
group. PCA resulted in three components that explained 88.3% of data variance.
Discriminant analysis showed that none of the components could significantly
discriminate the groups. However, visual inspection of the biplot showed a trend
towards group separation in relation to gait velocity and stance time. PC1
represented gait rhythm and showed that recurrent fallers tend to walk with lower
velocity and cadence and increased stance time in relation to non-recurrent
fallers. CONCLUSIONS: The analyzed spatiotemporal gait parameters failed to predict recurrent falls in
this sample. The PCA-biplot technique highlighted important trends or red flags
that should be considered when evaluating recurrent falls in elderly females.
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Affiliation(s)
- Bruno S Moreira
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rosana F Sampaio
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renata N Kirkwood
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Chang YM, Tsao LI, Huang MH. Experiences of coexisting with chronic illnesses among elderly women in communities. Health Care Women Int 2014; 35:1337-51. [PMID: 25075737 DOI: 10.1080/07399332.2014.942905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Based on the increasing numbers of women in the aging population, the health of women will become critical in the future. Our purpose in this study was to analyze the experiences of elderly women with chronic illness. Twelve elderly Taiwanese women participated in in-depth interviews. "Using my own power out of the disease shackle" was the core category referring to elderly women who coexist with chronic illnesses. Elderly women should be provided with individually targeted plans for disease management and health maintenance to enable them to participate in health care decisions at the onset of chronic diseases.
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Affiliation(s)
- Yu-Mei Chang
- a Nursing Department , Oriental Institute of Technology , Taipei City , Taiwan
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Abstract
The present paper aims to shed light on the changing pattern of gender disparity in health and food expenditure over time among the elderly in India. National Sample Survey Organization (NSSO) data of the 55th (1999-2000) and the 64th (2007-2008) rounds on household consumer expenditure have been used for this study. Further, the paper examines whether change in the sex composition of the elderly in households contributes to a change in health and food expenditure. The findings indicate wide gender disparity in food and health care expenditure, with that of males being higher than that of their female counterparts; the gap, however, is narrowing with time. The compositional shift in sex among the elderly in households contributes significantly to the decline in household health and the increase in household food expenditure over time.
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Mhaka-Mutepfa M, Cumming R, Mpofu E. Grandparents fostering orphans: influences of protective factors on their health and well-being. Health Care Women Int 2014; 35:1022-39. [PMID: 24820960 DOI: 10.1080/07399332.2014.916294] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study the authors explore the impact of protective factors on the health and well-being of grandmothers who are primary caregivers. Although researchers in Africa have studied grandparents who assume primary caregiving responsibilities, it is rare that they do so from a strength perspective, hence the need to examine the utility of personal, social, and environmental assets on caregiving. Grandmothers are the primary caregivers of orphaned children due to HIV and AIDS deaths; thus it becomes pertinent to establish how they are coping without the provision of social security. The results of this study will be beneficial to all stakeholders interested in the welfare of elders with similar responsibilities. Knowledge about the health and well-being of grandmothers who are caregivers will assist public service and private sectors to formulate viable policies concerning elderly carers who foster orphans, particularly in countries with high HIV prevalence.
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Affiliation(s)
- Magen Mhaka-Mutepfa
- a School of Public Health , University of Sydney , Sydney , New South Wales , Australia
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Kowal P, Towers A, Byles J. Ageing across the Tasman Sea: the demographics and health of older adults in Australia and New Zealand. Aust N Z J Public Health 2014; 38:377-83. [PMID: 24750537 DOI: 10.1111/1753-6405.12194] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 02/01/2013] [Accepted: 11/01/2013] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The demographic and health aspects of ageing populations in Australia and New Zealand (NZ) are described. These data are relevant to compare impacts of policy and context in each country. METHODS Secondary analysis of international (Organization for Economic Co-operation and Development, United Nations and World Health Organization) and domestic population and health data. RESULTS Both countries will experience a greater than 80% increase in the population aged 60-plus years between 2013 and 2050. The increase in the 80-plus population will be 200% or higher, resulting in 2.8 million Australians and more than 510,000 New Zealanders in this age group by 2050. The speed of ageing in both countries is higher than the average rate of increase in developed countries. Average life expectancy at birth and age 60 is higher in Australia than NZ, with the differences increasing slightly by 2050, and gaps between men and women consistently smaller in NZ than in Australia. However, a higher proportion of older Australians report living with a disability (53%) than older New Zealanders (45%). CONCLUSIONS Australia and NZ are well aged in the context of a youthful Oceania region, with more similarities than differences between the countries. IMPLICATIONS Both countries need to continue to monitor health trends, unravel the major population attributable risks, and identify preventative and other interventions that can stimulate and support declines in disability in older populations in the future, particularly for non-indigenous older persons.
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Affiliation(s)
- Paul Kowal
- World Health Organization Study on global AGEing and adult health (SAGE), Switzerland; University of Newcastle Research Centre on Gender, Health and Ageing (Hunter Medical Research Institute), New South Wales
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