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Liu X, Li C, Jin S, Cao X, Hoogendijk EO, Han L, Xu X, Allore H, Feng Q, Zhang Q, Liu Z. Functional disability and receipt of informal care among Chinese adults living alone with cognitive impairment. Exp Gerontol 2024; 194:112490. [PMID: 38876449 DOI: 10.1016/j.exger.2024.112490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Adults with cognitive impairment are prone to living alone in large numbers but receive relatively little attention. This study aimed to evaluate whether living alone with cognitive impairment was associated with a higher burden of functional disability but lack of informal care. METHODS 982 observations of adults living alone with cognitive impairment and 50,695 observations of adults living with others and with normal cognition were identified from 4 waves (2011/2012, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (CHARLS). A matched comparator was selected using propensity score matching (1:2). Functional disability included disability in Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), and mobility. The time of receiving informal care was measured in monthly hours. RESULTS Adults living alone with cognitive impairment demonstrated significantly higher odds ratio of ADL disability (OR = 1.59, 95 % CI: 1.30, 1.95), IADL disability (OR = 1.19, 95 % CI: 1.00, 1.44), mobility disability (OR = 1.38, 95 % CI: 1.12, 1.70), but received fewer hours of informal care (β = -127.7 h per month, standard error = 25.83, P < 0.001), compared to the adults living with others and with normal cognition. CONCLUSIONS This study highlights the high burden of functional disability but low coverage of informal care among Chinese adults living alone with cognitive impairment and calls for more resources to be allocated to this vulnerable subpopulation to improve the functional health and to increase the provision of long-term care services.
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Affiliation(s)
- Xiaoting Liu
- Institute of Wenzhou, Zhejiang University, Wenzhou, Zhejiang, China; School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chenxi Li
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shuyi Jin
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xingqi Cao
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, the Netherlands
| | - Ling Han
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Xin Xu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Heather Allore
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Qiushi Feng
- Department of Sociology, National University of Singapore, Singapore
| | - Qiqi Zhang
- The Center for Ageing and Health Study, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Can B, Tufan A, Karadağ Ş, DurmuŞ NŞ, Topçu M, Aysevinç B, Düzel SÇ, Dağcıoğlu S, AfŞar Fak N, Tazegül G, Fak AS. The effectiveness of a fall detection device in older nursing home residents: a pilot study. Psychogeriatrics 2024; 24:822-829. [PMID: 38634167 DOI: 10.1111/psyg.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/18/2024] [Accepted: 04/01/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Real-world research to evaluate the effect of device technology in preventing fall-related morbidity is limited. This pilot study aims to investigate the effectiveness of a non-wearable fall detection device in older nursing home residents. METHODS The study was conducted in a nursing home with single-resident rooms. Fall detection devices were randomly set up in half of the rooms. Demographic data, comorbidities, lists of medications, and functional, nutritional, and frailty status were recorded. The residents were followed up for 3 months. The primary outcome was falls and the secondary outcome was all-cause mortality. RESULTS A total of 26 participants were enrolled in the study. The study group consisted of 13 residents who had a fall detection device in their rooms. The remaining 13 residents on the same floor formed the control group. Participants had a mean age of 82 ± 10 years and 89% of the residents were female. The most prevalent comorbidity was dementia. Two residents from the control group and one resident from the study group experienced a fall event during follow-up. The fall events in the control group were identified retrospectively by the nursing home staff, whereas the fall in the study group received a prompt response from the staff who were notified by the alarm. One resident was transferred to the hospital and died due to a non-fall related reason. CONCLUSION Device technology may provide an opportunity for timely intervention to prevent fall-related morbidity in institutionalized older adults.
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Affiliation(s)
- Büşra Can
- Marmara University Medical School, Department of Internal Medicine, Divisions of Geriatrics, Istanbul, Turkey
| | - Aslı Tufan
- Marmara University Medical School, Department of Internal Medicine, Divisions of Geriatrics, Istanbul, Turkey
| | - Şevval Karadağ
- VivaSmartTech, Marmara Üniversitesi Teknopark Ar-Ge Şirketi, Istanbul, Turkey
| | - Nurdan Şentürk DurmuŞ
- Marmara University Medical School, Department of Internal Medicine, Divisions of Geriatrics, Istanbul, Turkey
| | - Mümüne Topçu
- Marmara University Medical School, Hypertension and Atherosclerosis Education, Application and Research Center, Istanbul, Turkey
| | - Berrin Aysevinç
- Marmara University Medical School, Hypertension and Atherosclerosis Education, Application and Research Center, Istanbul, Turkey
| | - Songül Çeçen Düzel
- Marmara University Medical School, Hypertension and Atherosclerosis Education, Application and Research Center, Istanbul, Turkey
| | | | - Nazire AfŞar Fak
- Marmara University Medical School, Department of Neurology, Istanbul, Turkey
| | - Gökhan Tazegül
- Marmara University Medical School, Department of Internal Medicine, Istanbul, Turkey
| | - Ali Serdar Fak
- Marmara University Medical School, Hypertension and Atherosclerosis Education, Application and Research Center, Istanbul, Turkey
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Nguyen T, Thiamwong L, Lou Q, Xie R. Unveiling Fall Triggers in Older Adults: A Machine Learning Graphical Model Analysis. MATHEMATICS (BASEL, SWITZERLAND) 2024; 12:1271. [PMID: 38784721 PMCID: PMC11113328 DOI: 10.3390/math12091271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
While existing research has identified diverse fall risk factors in adults aged 60 and older across various areas, comprehensively examining the interrelationships between all factors can enhance our knowledge of complex mechanisms and ultimately prevent falls. This study employs a novel approach-a mixed undirected graphical model (MUGM)-to unravel the interplay between sociodemographics, mental well-being, body composition, self-assessed and performance-based fall risk assessments, and physical activity patterns. Using a parameterized joint probability density, MUGMs specify the higher-order dependence structure and reveals the underlying graphical structure of heterogeneous variables. The MUGM consisting of mixed types of variables (continuous and categorical) has versatile applications that provide innovative and practical insights, as it is equipped to transcend the limitations of traditional correlation analysis and uncover sophisticated interactions within a high-dimensional data set. Our study included 120 elders from central Florida whose 37 fall risk factors were analyzed using an MUGM. Among the identified features, 34 exhibited pairwise relationships, while COVID-19-related factors and housing composition remained conditionally independent from all others. The results from our study serve as a foundational exploration, and future research investigating the longitudinal aspects of these features plays a pivotal role in enhancing our knowledge of the dynamics contributing to fall prevention in this population.
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Affiliation(s)
- Tho Nguyen
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL 32816, USA
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA
| | - Qian Lou
- Department of Computer Science, University of Central Florida, Orlando, FL 32816, USA
| | - Rui Xie
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL 32816, USA
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA
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Boonkhao L, Puangjan K, Ouengprasert I, Laosupap K, Bootsorn A, Junsiri S, Thongdamrongtham S, Chaikhan S, Pramaya P, Rattanachaikunsopon P. Home Environmental Factors Associated with Falls Among Elderly in Ubon Ratchathani, Thailand. J Multidiscip Healthc 2024; 17:1363-1373. [PMID: 38560486 PMCID: PMC10981419 DOI: 10.2147/jmdh.s456128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose The demographics of the world's population have changed over time. Previous research demonstrated the high rate of falls among elderly people living in rural areas in their own houses. This study aimed to use the Thai-Home Fall Hazard Assessment Tool (Thai-HFHAT) to look into the environmental factors inside and outside of residential homes connected to falls among elderly living in rural Thailand. Methods Data was gathered between August and October 2023 using a questionnaire to obtain demographic data and the 44-question Thai-HFHAT survey. The survey was divided into seven sections covering the areas inside and outside the elderly home facility. Descriptive statistics were used in the data analysis, and statistical tests, including Fisher's exact test and the Chi-square test, were used to examine the relationship between environmental factors and falls in elderly people. Results The study found that issues with an elderly rural home included split-level flooring in the living room, bathroom, and bedroom, an insecurely attached carpet in the kitchen and bedroom, and a shower area not separated from the toilet. The environmental factors linked to falls among the elderly encompass insufficient lighting in the living room, bathroom, bedroom, and parking garage, debris and obstacles such as wires along the path in the living room and parking garage, and the poor condition of the staircase, characterized by inconsistent step heights or a slippery surface. Conclusion Community agencies should consider the living conditions of elderly people in rural areas to effectively reduce the occurrence of falls among this population.
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Affiliation(s)
- Laksanee Boonkhao
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani Province, Thailand
| | - Kanyarat Puangjan
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani Province, Thailand
| | - Itsaraporn Ouengprasert
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani Province, Thailand
| | - Kitti Laosupap
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani Province, Thailand
| | - Aree Bootsorn
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani Province, Thailand
| | - Supanee Junsiri
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani Province, Thailand
| | - Somjate Thongdamrongtham
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani Province, Thailand
| | - Sitthichai Chaikhan
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani Province, Thailand
| | - Panjaporn Pramaya
- Office of the That Subdistrict Municipality, Ubon Ratchathani Province, Thailand
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Chen K, Qiu J, Wang W, Hu Q, Qiao H. Analysis of health risk factors for older adults living alone in China and establishment and evaluation of a nomogram prediction model. Front Public Health 2024; 12:1309561. [PMID: 38566800 PMCID: PMC10986849 DOI: 10.3389/fpubh.2024.1309561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Objective To understand the health status of older adults living alone in China and analyze the influencing factors, so as to provide reference for improving the health status of older adults living alone. Methods Based on CGSS data from China General Social Survey (2017), the influencing factors of health status of older adults living alone were analyzed by unconditional Logistic regression, and the R software was used to develop a nomogram for predicting the risk of self-assessed unhealthy adverse outcomes. Results Gender, annual income, mandarin listening level and participation in medical insurance were the influencing factors of self-rated health of older adults living alone. Age and annual income are the influencing factors of physiological health. Annual income and Internet use were influential factors for mental health. C-Statistic of nomogram prediction model was 0.645. The calibration curve showed that goodness of fit test (χ2 = 58.09, p < 0.001), and the overall prediction ability of the model was good. Conclusion The health status of older adults living alone in the home-based older adults care is worrying, and it is affected by various factors. We should pay more attention to older adults living alone, improve the ability of listening and distinguishing mandarin and the use of health information platforms for older adults living alone, and further implement medical insurance policies and health services. Announcing the solution to promote healthy home-based care for older adults living alone.
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Affiliation(s)
- Kexin Chen
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Jiangwei Qiu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Wenlong Wang
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Qi Hu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Hui Qiao
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
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Chepyala P, Stead TS, Mangal RK, Ganti L. Prevalence of Craniofacial Injuries in the Elderly Population. J Craniofac Surg 2024:00001665-990000000-01309. [PMID: 38299824 DOI: 10.1097/scs.0000000000009974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
INTRODUCTION Recognizing and understanding risk factors for craniofacial injury in the elderly is of paramount importance in prevention. This research aims to investigate the prevalence of craniofacial injuries in connection with extrinsic preventable factors, particularly identifying common household products that pose the greatest risk for such injuries. MATERIALS AND METHODS This study was done with the utilization of the 2013 to 2022 National Electronic Injury Surveillance System (NEISS). Data gathered included patient age, injury type, cause of injury, and year of incidence. "Elderly" was defined as an individual of 65 years of age or older. RESULTS There was a total of 9,703,688 estimated national cases of elderly craniofacial injury from 2013 to 2022. In all, 5,888,112 (60.68%) of these occurred in females. In descending order, the 5 most common items responsible for craniofacial injury in the elderly are floors/flooring Materials (3,741,706, 30.92%), beds/bed frames (1,250,396, 10.33%), stairs/steps (907,92, 7.50%), chairs (546,697, 4.52%), and tables (453,989, 3.75%). These top 5 account for roughly 57% of all cases. The 5 most common presenting diagnoses were internal injury (2,957,095, 40.21%), lacerations (1,435,926, 19.53%), ABR (1,191,008, 16.20%), fracture (568,842, 7.74%), and hematoma (355,871, 4.84%). CONCLUSIONS Out of the roughly 10 million cases of craniofacial injury in the last decade, ~three-fifths have happened to women. The majority of injuries occur in a home setting. The overwhelming majority of cases were related to the product code 1807-floors or flooring materials, and the largest diagnosis was internal injury by a wide margin. Evidently, there is a large population of elderly patients who suffer from craniofacial injuries related to objects and items that permeate within their living residences. The elimination of excess elderly craniofacial injury can be achieved by reducing fall risk factors in the immediate vicinity of the elderly.
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Affiliation(s)
- Pranav Chepyala
- Department of Emergency Medicine, University of Central Florida, Orlando, FL
| | - Thor S Stead
- Division of Plastic Surgery, Department of Surgery, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Rohan K Mangal
- Department of Orthopaedics, University of Miami Miller School of Medicine, Miami, FL
| | - Latha Ganti
- Department of Emergency Medicine, University of Central Florida, Orlando, FL
- Division of Plastic Surgery, Department of Surgery, The Warren Alpert Medical School of Brown University, Providence, RI
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Li S, Cui G, Er Y, Ye P, Xue T, Zhang J(J, Liu X, Duan L, Lv F, Yao Y. Housing Environmental Factors Driving Falls Among Middle-Aged and Older Adults: A National Cohort Study. Innov Aging 2023; 7:igad121. [PMID: 38106373 PMCID: PMC10724174 DOI: 10.1093/geroni/igad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Indexed: 12/19/2023] Open
Abstract
Background and Objectives Housing is one of the main places where falls occur; however, few studies have examined housing environmental factors driving fall risk. This study aimed to explore the associations between housing environmental factors and falls in China. Research Design and Methods The study included data of middle-aged and older adults aged ≥45 years from 4 waves of the China Health and Retirement Longitudinal Study. We assessed 7 housing environmental factors: building materials, toilet types, household tidiness, household cooking fuels, and access to electricity, running water, and bathing facilities. Based on these, we divided housing environments into 3 types: good (0-2 poor factors), moderate (3-5 poor factors), and poor (6-7 poor factors). Falls incidence (yes or no) was self-reported during the survey period. We applied the Cox proportional hazard model to estimate the associations, adjusting for a set of covariates such as sociodemographic characteristics, lifestyles, and disease status. Results A total of 12,382 participants were analyzed, and the incidence of falls was 31.7%. According to the fully adjusted model, having a squatting toilet (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.03-1.26), household untidiness (HR = 1.09, 95% CI = 1.01-1.18), and solid fuel use for cooking (HR = 1.10, 95% CI = 1.02-1.18) were associated with a higher risk of falls (ps < .05), compared to their counterparts. We found a linear relationship between housing environments and falls (p for trend = .001). Specifically, moderate (HR = 1.16, 95% CI = 1.06-1.27) and poor housing environments (HR = 1.21, 95% CI = 1.08-1.34) were associated with a higher risk of falls compared to a good housing environment. Discussion and Implications Among middle-aged and older Chinese adults, a better household environment, including sitting toilets, tidy living conditions, and clean fuel use for cooking, may reduce the risk of falls. The evidence from our study suggests the need to implement age-friendly housing environments to prevent falls and disability in an aging society.
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Affiliation(s)
- Shaojie Li
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Guanghui Cui
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
| | - Yuliang Er
- Division of Injury Prevention and Mental Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Xue
- School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Junfeng (Jim) Zhang
- Global Health Institute and the Nicholas School of Environment, Duke University, Durham, North Carolina, USA
| | - Xiaoyun Liu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Leilei Duan
- Division of Injury Prevention and Mental Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Faqin Lv
- Ultrasonic Department, The Third Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
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