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Sert EN, Ilgaz A. Successful Aging and Self-Neglect Among Community-Dwelling Older People. Public Health Nurs 2024. [PMID: 39375188 DOI: 10.1111/phn.13439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 08/18/2024] [Accepted: 09/20/2024] [Indexed: 10/09/2024]
Abstract
OBJECTIVE It was aimed to explore the relationship between successful aging and self-neglect and factors affecting successful aging among community-dwelling older people. METHODS This cross-sectional study was conducted with 316 participants aged 60 years and older in a Family Health Center (FHC). The data were collected by using the questionnaire form, Successful Aging Scale and Self-Neglect Scale. The questionnaire form includes sociodemographic characteristics, independence (Katz Daily Life Activities Scale) and well-being status (WHO-5 Well-Being Index), psychosocial support (Multidimensional Perceived Social Support Scale), and depressive symptoms (two questions-complaints such as feeling depressed or hopeless and loss of interest and inability to enjoy life). RESULTS Participants had a mean age of 67.5 (SD: 6.5) years, 55.4% were female. A strong positive correlation was determined between successful aging score and self-neglect score (r = 0.741, p < 0.001). Factors affecting successful aging were age, working status, education level, body mass index, physical activity, subjective health perception, health screening status, self-neglect level, depressive symptoms, independence in activities, well-being status, and psychosocial support. Gender, income status, chronic disease presence, cigarette and alcohol use, living alone, and family type did not affect it. According to multivariate linear regression, the factors affecting successful aging were age, psychosocial support presence, and self-neglect level (p < 0.05). CONCLUSION Older people have low successful aging and self-neglect scores. Successful aging is better at a young age, in the presence of psychosocial support and a low level of self-neglect. It is recommended to increase the existence of psychosocial support for them and to plan interventions to reduce self-neglect.
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Affiliation(s)
- Esma Nur Sert
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Aysegul Ilgaz
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Almeida Barros AA, Lucchetti G, Guilhermino Alves EB, de Carvalho Souza SQ, Rocha RPR, Almeida SM, Silva Ezequiel OD, Granero Lucchetti AL. Factors associated with frailty, pre-frailty, and each of Fried's criteria of frailty among older adult outpatients. Geriatr Nurs 2024; 60:85-91. [PMID: 39236370 DOI: 10.1016/j.gerinurse.2024.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/13/2024] [Accepted: 08/19/2024] [Indexed: 09/07/2024]
Abstract
This study aims to investigate both the prevalence and associated factors of frailty, pre-frailty, and each criterion of frailty according to the Fried phenotype criteria among older adult outpatients receiving care from geriatric services. A cross-sectional study was conducted between 2020 and 2022 and included 335 older adults. Fried's criteria and a comprehensive geriatric assessment, including physical, clinical and mental health variables were investigated. More than half of participants presented frailty (11.6 %) and/or pre-frailty (43.3 %) according to Fried's criteria, with physical inactivity and low gait speed as the most prevalent criteria. Several factors demonstrated associations with the diagnosis of frailty/pre-frailty, including retirement status, marital status (unmarried), the use of walking aids, lower educational attainment, decreased functional status, and poor mental health. Furthermore, various factors were associated with each of Fried's criteria, highlighting that certain factors might align with a specific criterion without necessarily correlating with the diagnosis of frailty and pre-frailty.
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Ghahremani L, Zare E, Karimi M, Nazari M, Khoramaki Z, Dias EN. Psychometric properties of Persian version of the advanced activities of daily living scale: A psychometric study on Iranian older adults. Geriatr Nurs 2024; 60:14-20. [PMID: 39216212 DOI: 10.1016/j.gerinurse.2024.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 08/03/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
This study was conducted to determine the psychometric properties of the Persian version of an AADL scale in Iranian older adults. A total of 237 males and females aged over 60 years old were recruited. Personal information questionnaires, the CASP-19 Quality of Life, and AADL questionnaires were used for data collection. SPSS 24 and IBM AMOS 24 were used for data processing and analysis. Three factors that had eigenvalues higher than one were extracted, which explained 51.2 % of the total variances. The Cronbach α of the total score was 0.76, and it was >0.64 for each extracted factor. The goodness of fit indices indicated an acceptable fit to the data in confirmatory factor analysis. The culturally modified Persian version of the AADL scale has acceptable psychometric properties and is proper for evaluating the advanced activities of daily living in the Iranian population.
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Affiliation(s)
- Leila Ghahremani
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran
| | - Elahe Zare
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran
| | - Masoud Karimi
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran.
| | - Mahin Nazari
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran
| | - Zakieh Khoramaki
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran
| | - Ewerton Naves Dias
- University of Porto, Portugal; Department of Biological and Health Sciences, Universities of Guarulhos and Mogi das Cruzes, Brazil
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Zhou Y, Sun Y, Pan Y, Dai Y, Xiao Y, Yu Y. Prevalence of successful aging in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 128:105604. [PMID: 39182347 DOI: 10.1016/j.archger.2024.105604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/27/2024] [Accepted: 08/19/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Successful aging (SA) describes the multidimensional aspects of achieving optimal physical and mental health and social well-being combinations in old age. Recent years have seen increasing interest in understanding SA prevalence. This study systematically evaluates the current state of SA globally, defined as multidimensional outcomes. OBJECTIVE To systematically evaluate the global prevalence of SA in older adults. METHODS We searched PubMed, Embase, Web of Science, Cochrane Library, China Biomedical Database, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and Weipu Database from inception to February 14, 2024. Two researchers independently conducted literature screening, data extraction, and quality evaluation. Meta-analysis was performed using Stata 16.0. RESULTS Thirty studies comprising 250,460 older adults were included. Meta-analysis showed the overall global prevalence of SA was 24.0 % [95 % CI (20.7 %, 27.3 %)]. Prevalence rates were 25.1 % in Asia, 21.5 % in Europe, 20.6 % in the Americas; 16.8 % in developed and 27.1 % in developing countries. Subgroup analyses indicated higher SA rates among male older adults, married/cohabiting, living in urban areas, and having higher education levels. CONCLUSIONS The global prevalence of SA among older adults is low, with variations across age groups, regions, and education levels. Due to the limitations of the included studies, further high-quality research is needed to validate these findings.
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Affiliation(s)
- Yue Zhou
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yujian Sun
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yufan Pan
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu Dai
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yi Xiao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yufeng Yu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Hawley AL, Baum JI. Nutrition as the foundation for successful aging: a focus on dietary protein and omega-3 polyunsaturated fatty acids. Nutr Rev 2024; 82:389-406. [PMID: 37319363 DOI: 10.1093/nutrit/nuad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Skeletal muscle plays a critical role throughout the aging process. People living with sarcopenia, a progressive and generalized loss of skeletal muscle mass and function, often experience diminished quality of life, which can be attributed to a long period of decline and disability. Therefore, it is important to identify modifiable factors that preserve skeletal muscle and promote successful aging (SA). In this review, SA was defined as (1) low cardiometabolic risk, (2) preservation of physical function, and (3) positive state of wellbeing, with nutrition as an integral component. Several studies identify nutrition, specifically high-quality protein (eg, containing all essential amino acids), and long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), as positive regulators of SA. Recently, an additive anabolic effect of protein and n-3 PUFAs has been identified in skeletal muscle of older adults. Evidence further suggests that the additive effect of protein and n-3 PUFAs may project beyond skeletal muscle anabolism and promote SA. The key mechanism(s) behind the enhanced effects of intake of protein and n-3 PUFAs needs to be defined. The first objective of this review is to evaluate skeletal muscle as a driver of cardiometabolic health, physical function, and wellbeing to promote SA. The second objective is to examine observational and interventional evidence of protein and n-3 PUFAs on skeletal muscle to promote SA. The final objective is to propose mechanisms by which combined optimal intake of high-quality protein and n-3 PUFAs likely play a key role in SA. Current evidence suggests that increased intake of protein above the Recommended Dietary Allowance and n-3 PUFAs above the Dietary Guidelines for Americans recommendations for late middle-aged and older adults is required to maintain skeletal muscle mass and to promote SA, potentially through the mechanistical target of rapamycin complex 1 (mTORC1).
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Affiliation(s)
- Aubree L Hawley
- School of Human and Environmental Sciences, University of Arkansas, Fayetteville, AR, USA
| | - Jamie I Baum
- Center for Human Nutrition, Department of Food Science, University of Arkansas System Division of Agriculture, Fayetteville, AR, USA
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Soylu C, Cengelci Ozekes B. Pathways from education and childhood parental death to successful aging: the role of social conditions and perceived income level. Aging Ment Health 2023; 27:2499-2507. [PMID: 37129857 DOI: 10.1080/13607863.2023.2206365] [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: 06/16/2022] [Accepted: 03/21/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Although the association between adverse childhood conditions and health in later life has been relatively well established, little is known about how and through which mechanism this association develops. Building on the developmental adaptation model (Martin & Martin, 2002), the present study investigates the effects of distal and proximal influences on successful aging (SA). METHODS A cross-sectional survey was conducted of 475 adults aged 50 and above (Mean age = 72.13, SD = 10.46). SA was measured based on Rowe and Kahn's successful aging criteria model (1997) and an SA operationalization based on a number of multidimensional biopsychosocial indicators, including no disease and disability, active engagement with life, high physical and cognitive functioning, psychological well-being, life satisfaction and a one-item subjective SA question. RESULTS Parental death had no direct effect on SA (β = .03, p = .629), whereas education had (β = .39, p < .001). Furthermore, perceived income level and social conditions were identified as two sequential mediators between both education and SA; and parental death and SA. CONCLUSIONS The findings suggest that both early life and current factors contribute to explaining SA in a variety of ways.
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Affiliation(s)
- Cem Soylu
- Department of Psychology, Adana Alparslan Türkeş Science and Technology University, Sarıçam, Adana, Turkey
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Yeverino-Castro SG, Garza-Guerra JD, Aguilar-Díaz GE, González-Galván CR, Salinas-Martínez R, Morales-Delgado R. Cognition in older adults with healthy aging: analysis of the Mexican Health and Aging Study 2012-2015. Front Med (Lausanne) 2023; 10:1207063. [PMID: 37484850 PMCID: PMC10361761 DOI: 10.3389/fmed.2023.1207063] [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: 04/17/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Maintaining older adults' health and well-being can be achieved through the optimization of physical and mental health, while preserving independence, social participation, and quality of life. Cognitive change has been described as a normal process of aging and it involves domains such as processing speed, attention, memory, language, visuospatial abilities, and executive functioning, among others. Objective To describe cognitive changes in older adults with healthy aging. Methods This is a study that involved data from 14,893 and 14,154 individuals aged >60 years or older from the 2012 and 2015 waves, respectively, who participated in the Mexican Health and Aging Study (MHAS). Participants with healthy aging were identified and described in the MHAS-2012 wave and followed to 2015. Eight cognitive domains evaluated in the Cross-Cultural Cognitive Evaluation (CCCE,) as well as sociodemographic and health characteristics, were described. Criteria for healthy aging involved the following: CCCE ≥ -1.5 standard deviations above the mean on reference norms, independence on basic and instrumental activities of daily living, self-reported "life close to ideal," and preserved functional and social performance. Results From a total of n = 9,160 older adults from the MHAS-2012 wave, n = 1,080 (11.8%) had healthy aging. In the healthy aging group, the median age was 67 years (IQR: 63-73), 58.1% were female and the median for education was 6 (IQR: 3-8) years. The mean CCCE score was 57 (SD: 16.9) points. In the MHAS-2012 cross-sectional analysis, except for orientation, visuospatial abilities, and verbal fluency, all cognitive domain scores were lower with passing age. When comparing cognitive domain scores in the 225 older adults identified with healthy aging between the 2012 and 2015 MHAS waves, there were almost no observable differences. Conclusion In the cross-sectional analysis, Mexican adults with healthy aging had lower scores in the verbal learning memory, visual scanning, numeracy, visual memory, and verbal recall domains', as well as lower global cognitive scores in the higher age groups. There were no cognitive changes in the 3 year follow-up, except for a lower gradient of scores in the verbal recall memory domain. Longer prospective studies are needed to characterize greater cognitive changes.
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Affiliation(s)
- Sara G. Yeverino-Castro
- Universitary Hospital “Dr. José E. González”, Geriatric Service, Universidad Autónoma de Nuevo León, Monterrey, Mexico
- CHRISTUS Center of Excellence and Innovation, San Pedro Garza García, Mexico
| | - José D. Garza-Guerra
- Universitary Hospital “Dr. José E. González”, Geriatric Service, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Gabriela E. Aguilar-Díaz
- Universitary Hospital “Dr. José E. González”, Geriatric Service, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Célica R. González-Galván
- Universitary Hospital “Dr. José E. González”, Geriatric Service, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Ricardo Salinas-Martínez
- Universitary Hospital “Dr. José E. González”, Geriatric Service, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Rocío Morales-Delgado
- Universitary Hospital “Dr. José E. González”, Geriatric Service, Universidad Autónoma de Nuevo León, Monterrey, Mexico
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Zhao X, Chen S, Liu N, Hu F, Yu J. Handgrip strength is positively associated with successful aging in older adults: A national cross-sectional study in China. J Affect Disord 2023; 333:30-37. [PMID: 37084959 DOI: 10.1016/j.jad.2023.04.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/26/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES Muscle strength gradually decreases with advancing age. This study aimed to explore the relationship between handgrip strength and successful aging and its specific dimensions in older adults using a nationally representative sample. METHODS A total of 5269 adults aged 60 and older were included in this study. Handgrip strength was measured using a dynamometer and was organized into quartiles by sex. Successful aging was defined by Rowe and Kahn's conceptual model including the following five dimensions: (a) no major diseases; (b) freedom from disability; (c) high cognitive function; (d) good psychological status; and (e) active social engagement in life. Logistic regression models were used to examine the association between handgrip strength and successful aging and its specific dimensions. RESULTS The prevalence of successful aging was found to be 35.1 % in Chinese older adults. Compared to older adults with handgrip strength in the first quartile, those with handgrip strength in the second quartile, third quartile, and fourth quartile had a higher probability of successful aging (adjusted odds ratio (OR): 1.40 (95 % CI: 1.16, 1.69) to 2.06 (95 % CI: 1.70, 2.50)). We further found that the association between handgrip strength and successful aging was related to different ages. CONCLUSION This study suggested that there is a close association between handgrip strength and successful aging. Older adults who have greater handgrip strength can successfully deal with the challenges of aging. For older people, keeping a high level of muscle strength in late life may be helpful to the constant successful aging.
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Affiliation(s)
- Xiaoguang Zhao
- Department of Research Academy of Grand Health, Ningbo University, No. 818 Fenghua Road, Ningbo 315211, Zhejiang, China; Faculty of Sport Science, Ningbo University, No. 818 Fenghua Road, Ningbo 315211, Zhejiang, China.
| | - Siyuan Chen
- Faculty of Sport Science, Ningbo University, No. 818 Fenghua Road, Ningbo 315211, Zhejiang, China
| | - Nan Liu
- Faculty of Sport Science, Ningbo University, No. 818 Fenghua Road, Ningbo 315211, Zhejiang, China
| | - Fei Hu
- Faculty of Sport Science, Ningbo University, No. 818 Fenghua Road, Ningbo 315211, Zhejiang, China
| | - Jiabin Yu
- Department of Research Academy of Grand Health, Ningbo University, No. 818 Fenghua Road, Ningbo 315211, Zhejiang, China; Faculty of Sport Science, Ningbo University, No. 818 Fenghua Road, Ningbo 315211, Zhejiang, China
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Zhao X, Chen S, Yu J. Evaluating the association between anthropometric parameters and successful aging in older adults. Geriatr Nurs 2023; 50:240-246. [PMID: 36812848 DOI: 10.1016/j.gerinurse.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/22/2023]
Abstract
This study aimed to determine the relationship between successful aging (SA) and anthropometric parameters in older adults. We used body mass index (BMI), waist circumference, hip circumference, and calf circumference to reflect anthropometric parameters. SA was assessed by the following five aspects: self-rated health, self-rated psychological status or mood, cognitive function, activities of daily life, and physical activity. Logistic regression analyses were employed to examine the relationship between anthropometric parameters and SA. Results showed that larger BMI, waist circumference, and calf circumference are related to a higher prevalence of SA in older women; greater waist circumference and calf circumference are associated with a higher rate of SA in old-old adults. These findings suggest that the greater BMI, waist circumference, hip circumference, and calf circumference are associated with a higher rate of SA in older adults, and the associations are influenced to some extent by the sex and age.
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Affiliation(s)
- Xiaoguang Zhao
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China; Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China.
| | - Siyuan Chen
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Jiabin Yu
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China; Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
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Ho M, Pullenayegum E, Burnes D, Fuller-Thomson E. Successful Aging among Immigrant and Canadian-Born Older Adults: Findings from the Canadian Longitudinal Study on Aging (CLSA). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13199. [PMID: 36293780 PMCID: PMC9603725 DOI: 10.3390/ijerph192013199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Few studies in Canada have focused on the relationship between immigrant status and successful aging. The concept of successful aging used in this study includes the ability to accomplish both activities of daily living (ADLs) and instrumental activities of daily living (IADLs), freedom from mental illness, memory problems and disabling chronic pain, adequate social support and older adults' self-reported happiness and subjective perception of their physical health, mental health and aging process as good. METHODS The present study analyzed the first two waves of data from the comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA). The sample includes 7651 respondents aged 60+ at time 2, of whom 1446 respondents were immigrants. Bivariate and multivariable binary logistic regression analyses were conducted. RESULTS Canadian-born older adults had a slightly higher prevalence and age-sex adjusted odds of achieving successful aging than their immigrant counterparts (aOR = 1.18, 95% CI: 1.04, 1.34, p < 0.001). After adjusting for 18 additional factors, immigrant status remained statistically significant (aOR = 1.24, 95% CI: 1.09, 1.41, p < 0.001). Significant baseline factors associated with successful aging among immigrants included being younger, having higher income, being married, not being obese, never smoking, engaging in moderate or strenuous physical activities, not having sleeping problems and being free of heart disease or arthritis. CONCLUSIONS Immigrant older adults had a lower prevalence of successful aging than their Canadian-born peers. Further research could investigate whether policies and interventions supporting older immigrants and promoting a healthy lifestyle enhance older adults achieve successful aging in later life.
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Affiliation(s)
- Mabel Ho
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - David Burnes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
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Asghari Varzaneh Z, Shanbehzadeh M, Kazemi-Arpanahi H. Prediction of successful aging using ensemble machine learning algorithms. BMC Med Inform Decis Mak 2022; 22:258. [PMID: 36192713 PMCID: PMC9527392 DOI: 10.1186/s12911-022-02001-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Aging is a chief risk factor for most chronic illnesses and infirmities. The growth in the aged population increases medical costs, thus imposing a heavy financial burden on families and communities. Successful aging (SA) is a positive and qualitative view of aging. From a biomedical perspective, SA is defined as the absence of diseases or disability disorders. This is distinct from normal aging, which is associated with age-related deterioration in physical and cognitive functions. From a social perspective, SA highlights life satisfaction and individual well-being, usually attained through socialization. It is an abstract and multidimensional concept surrounded by imprecision about its definition and measurement. Our study attempted to find the most effective features of SA as defined by Rowe and Kahn's theory. The determined features were used as input parameters of six machine learning (ML) algorithms to create and validate predictive models for SA. METHODS In this retrospective study, the raw data set was first pre-processed; then, based on the data of a sample of 983, five basic ML techniques including artificial neural network, decision tree, support vector machine, Naïve Bayes, and k-nearest neighbors (K-NN) with one ensemble method (that gathers 30 K-NN algorithms as weak learners) were trained. Finally, the prediction result was yielded using the majority vote method based on the output of the generated base models. RESULTS The experimental results revealed that the predictive system has been more successful in predicting SA with a 93% precision, 92.40% specificity, 87.80% sensitivity, 90.31% F-measure, 89.62% accuracy, and a ROC of 96.10%, using a five-fold cross-validation procedure. CONCLUSIONS Our results showed that ML techniques potentially have satisfactory performance in supporting the SA-related decisions of social and health policymakers. The KNN-based ensemble algorithm is superior to the other ML models in classifying people into SA and non-SA classes.
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Affiliation(s)
- Zahra Asghari Varzaneh
- Department of Computer Science, Faculty of Mathematics and Computer, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Hadi Kazemi-Arpanahi
- Department of Health Information Technology, Abadan University of Medical Sciences, Abadan, Iran.
- Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran.
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Barbosa GC, Caparrol AJDS, Melo BRDS, Medeiros TJ, Ottaviani AC, Gratão ACM. Factors correlated with the frailty of elderly in outpatient care: difference between age groups. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0408en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Abstract Objective to correlate socio-demographic and health variables of elderly people of different age groups with frailty. Method this is a quantitative, cross-sectional study conducted with 50 elderly individuals seen at a Gerontology Outpatient Clinic in the interior of São Paulo. Socio-demographic and health data were collected, including: frailty, cognitive performance, dependence on Basic and Instrumental Activities of Daily Living, and depressive symptoms. For data analysis, the Spearman correlation test was used. Results there was a predominance of women, with a mean age of 79.4 (±9.4) years and low education. A total of 58.3% of the elderly aged between 60 and 79 years and 84.6% of those above 80 years were considered frail. In the first group, there was a correlation between frailty and a higher number of medications, worse cognitive performance, and dependence on Basic and Instrumental Activities of Daily Living. In the oldest old, frailty correlated with a greater number of morbidities, worse cognitive performance, and dependence on Basic and Instrumental Activities of Daily Living. Conclusion and implications for practice the correlations found allow the establishment of measures to improve the planning of actions aimed at outpatient care, enabling the organization of prevention and intervention priorities.
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Barbosa GC, Caparrol AJDS, Melo BRDS, Medeiros TJ, Ottaviani AC, Gratão ACM. Fatores correlacionados à fragilidade de idosos em atenção ambulatorial: diferença entre grupos etários. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0408pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo correlacionar variáveis sociodemográficas e de saúde de idosos de diferentes grupos etários com a fragilidade. Método estudo quantitativo, transversal, realizado com 50 idosos atendidos em um Ambulatório de Gerontologia no interior de São Paulo. Foram coletados dados sociodemográficos e de saúde, sendo: fragilidade; desempenho cognitivo; dependência em Atividades Básicas e Instrumentais de Vida Diária e sintomas depressivos. Para a análise dos dados, foi utilizado o teste de correlação de Spearman. Resultados houve o predomínio de mulheres, com média de 79,4 (±9,4) anos de idade e baixa escolaridade. Foram considerados frágeis 58,3% dos idosos entre 60 e 79 anos e 84,6% daqueles acima de 80 anos. No primeiro grupo, houve correlação entre a fragilidade e o maior número de medicamentos, pior desempenho cognitivo, dependência em Atividades Básicas e Instrumentais de Vida Diária. Nos mais longevos, a fragilidade correlacionou-se ao maior número de morbidades, pior desempenho cognitivo e dependência em Atividades Básicas e Instrumentais de Vida Diária. Conclusão e implicações para a prática: as correlações encontradas permitem o estabelecimento de medidas para aperfeiçoar o planejamento de ações voltadas à assistência ambulatorial, possibilitando organizar prioridades de prevenção e intervenção.
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Chen X, Su D, Chen X, Chen Y. What intensity of exercise is most suitable for the elderly in China? A propensity score matching analysis. BMC Public Health 2021; 21:1396. [PMID: 34261461 PMCID: PMC8281566 DOI: 10.1186/s12889-021-11407-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The strategy of successful ageing is an important means to deal with the challenges of the current ageing society. This paper aims to explore the effects of different intensities of physical activity on the successful ageing of the elderly. METHODS Our data were from wave 4 of the China Health and Retirement Longitudinal Survey (CHARLS), involving 9026 residents aged 60 years and older. The intensity of physical activity was divided into three levels: vigorous, moderate and mild. The concept of successful ageing adopted a four-dimensional model of life satisfaction added to the theoretical model of Rowe and Kahn's. Propensity score matching (PSM) with controlling nine confounding factors were used to analyse the effects of different intensities of physical activity. RESULTS The percentage of successful ageing was 1.88% among all subjects. Among them, 30.26, 29.57 and 29.40% of the elderly often participated in vigorous, moderate and mild physical activity, respectively. The results of PSM showed that participation in moderate activity increased the probability of successful ageing of the elderly by 0.76-0.78% (P < 0.001), while participation in vigorous and mild physical activity had no significant effect on successful ageing (P > 0.05). Moderate physical activity had statistically significant effects on four components of successful aging, including major disease, physical function, life satisfaction, and social participation (P < 0.05). CONCLUSION Moderate-intensity physical activity was most beneficial to the successful ageing of the elderly and should be promoted in the elderly population.
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Affiliation(s)
- Xinlin Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030 China
| | - Dai Su
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030 China
| | - Xinlan Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030 China
| | - Yingchun Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030 China
- Present address: Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
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Normative reference values of handgrip strength for Brazilian older people aged 65 to 90 years: Evidence from the multicenter Fibra‑BR study. PLoS One 2021; 16:e0250925. [PMID: 33945557 PMCID: PMC8096087 DOI: 10.1371/journal.pone.0250925] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Handgrip strength (HGS) is an indicator of muscle strength, suited for evaluating the aging process. Its use depends on the availability of reliable normative reference values (NRV). The main objective of this study is to provide NRV of HGS for Brazilians aged 65 to 90 years. METHODS Participants were from the Frailty in Brazilian Older People research. 2,999 successful aging (SA) subjects comprised the development sample. HGS was measured using a hydraulic dynamometer. Obtaining NRV involved regressing HGS on age per sex-height strata, fitting separate fractional polynomial (FP) models for the mean and coefficient of variation. Model fit was assessed via standardized residuals, probability/quantile plots, and comparing observed to normal expected percentages of subjects falling within specified centile intervals. For validation, the latter procedure was applied to 2,369 unsuccessfully aging (UA) subjects. RESULTS Across strata, the best-fitting models for the means were FP of power 1. FP models for the CV indicated age invariance, entailing steady heteroscedastic age decline in SD since coefficients for the means were negative and SD = CV×mean. All models adjusted well. Centiles distributions for the SA and UA populations showed anticipated patterns, respectively falling on and below the normative expected centile references. Results (NRV) are presented in tables and centile charts. Equations are also provided. CONCLUSION NRV/charts may be endorsed for routine use, while still tested further. They would aid professionals caring for older people, not only to identify those at risk and eligible for immediate provisions, but also in planning prevention and rehabilitation measures.
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Lucchese SP, Bishop S, Guruge S, Zanchetta MS, Pirner D. Finding the Silver Lining: Aging Well Amongst Older Brazilian Women in the Post-Migration Context. Can J Nurs Res 2021; 54:156-167. [PMID: 33752458 DOI: 10.1177/08445621211004332] [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: 11/15/2022] Open
Abstract
STUDY BACKGROUND The aging population in Canada has been increasing steadily over the past 40 years, however, there is limited information about the meaning of aging well amongst older Brazilian women in Canada. METHODS A Heideggerian interpretive phenomenology study was conducted to understand the meaning of aging well amongst older Brazilian women in the post-migration context living in the Greater Toronto Area (GTA) in Ontario, Canada. RESULTS Eight older Brazilian women residing in the GTA were recruited through purposive and snowball sampling and participated in individual face-to-face interviews. Through data analysis and the incorporation of Heidegger's four existentials of human existence, the themes that emerged were (a) Embracing being part of a mosaic, (b) Aging with grace, (c) Chasing your dreams and (d) Being a bridge and not a fence. The overarching theme was: Finding the silver lining: Aging well. CONCLUSION This study informs nursing practice, research and policy development to advance the health of older immigrant adults in Canada.
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Affiliation(s)
| | - Susan Bishop
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Sepali Guruge
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | | | - Diane Pirner
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
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Salamene LC, Martins ELM, Lucchetti G, Lucchetti ALG. Factors associated with successful aging in Brazilian community-dwelling older adults: When physical health is not enough. Geriatr Nurs 2021; 42:372-378. [PMID: 33571931 DOI: 10.1016/j.gerinurse.2021.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To determine the main factors (physical, psychological, social and spiritual) associated with successful aging in community-dwelling older adults. METHODS A cross-sectional study of older adults was conducted evaluating successful aging (Successful Aging Scale-SAS) and its associated factors (sociodemographics, resilience, religiosity/spirituality, meaning in life, quality of life, social support, self-reported diseases, mental health, medications used, among others) using regression models. RESULTS A total of 534 older adults were assessed. Linear regression models showed an association of higher SAS score with greater resilience (Beta = 0.371, p < 0.001), spiritual well-being - meaning (Beta = 0.174, p < 0.001) and quality of life - physical (Beta=0.203, p < 0.001), fewer diseases (Beta=-0.128, p < 0.001), greater meaning in life (Beta=0.116, p = 0.001), less loneliness (Beta=-0.133, p = 0.001), lower tobacco use (Beta=0.080, p = 0.013), greater quality of life - environment (Beta=-0.092, p = 0.013) and more frequent religious attendance (Beta=0.068, p = 0.035). CONCLUSION The study results suggested that physical factors, although relevant, were not the main factors associated with successful aging.
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Affiliation(s)
- Laís Cunha Salamene
- Division of Geriatrics, School of Medicine, Federal University of Juiz de Fora, Brazil
| | | | - Giancarlo Lucchetti
- Division of Geriatrics, School of Medicine, Federal University of Juiz de Fora, Brazil.
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Cai T, Long J, Kuang J, You F, Zou T, Wu L. Applying machine learning methods to develop a successful aging maintenance prediction model based on physical fitness tests. Geriatr Gerontol Int 2020; 20:637-642. [PMID: 32358851 DOI: 10.1111/ggi.13926] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/10/2020] [Accepted: 03/28/2020] [Indexed: 01/08/2023]
Abstract
AIM The purpose of this study was to develop a machine learning prediction model for successful aging (SA) based on physical fitness tests. METHODS A total of 3657 community-dwelling adults aged ≥60 years from Nanchang city were recruited in this study. A 3-year follow-up test was carried out for all the participants to determine whether they turn to non-SA. Developed questionnaires and physical fitness tests were used to obtain overall health condition, balance, agility, speed, reactions and gait. Four machine learning models (logistic regression, deep learning, random forest and gradient boosting decision tree) were applied to develop the prediction models, the analyzed sample was 890. RESULTS The baseline prevalence of successful aging was 26.99%, The average annual incidence rate of SA to non-SA was 11.04%. There were significant differences between the SA and non-SA groups for all physical fitness tests at baseline. The accuracy and area under the curve of all four machine learning models was >85%, the positive predictive value and sensitivity was >75%, and the specificity was >86% on the average. The deep learning model outperformed the other model, with area under the curve 90.00%, accuracy 89.3%, positive predictive value 85.8% and specificity 93.1%, respectively. Compared with other models, the logistic regression model performed best in sensitivity. Age, arm curl, 30-s sit-to-stand and reaction time were important predictors in all models. CONCLUSION The deep learning model is ideal in the prediction of SA maintenance, and the corresponding physical fitness interventions are essential to ensuring SA. Geriatr Gerontol Int 2020; ••: ••-••.
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Affiliation(s)
- TianPan Cai
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - JingWen Long
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Jie Kuang
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Fu You
- School of Community Health Sciences, University of Nevada Reno, Reno, Nevada, USA
| | - TingTing Zou
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Lei Wu
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
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Maia LC, Colares TDFB, de Moraes EN, Costa SDM, Caldeira AP. Robust older adults in primary care: factors associated with successful aging. Rev Saude Publica 2020; 54:35. [PMID: 32267369 PMCID: PMC7112742 DOI: 10.11606/s1518-8787.2020054001735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/07/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of robustness among older adults assisted in primary health care and identify factors in successful aging. METHODS This is a cross-sectional study conducted with older adults in Northern Minas Gerais, Brazil. Two questionnaires were used for data collection: the Brazilian Older Americans Resources and Services Multidimensional Function Assessment Questionnaire (BOMFAQ) and the Clinical-Functional Vulnerability Index IVCF-20). The adjusted prevalence ratios were obtained by robust Poisson regression. Statistical analysis was performed for older adults in general (60 to 107 years) and stratified by age: from 60 to 79 years and 80 years or more. RESULTS A total of 1,750 older adults aged 60 to 107 years participated; between them, 48.7% were robust. Older adults aged 60 to 79 years (n = 1,421) and 80 years or more (n = 329) had a prevalence of robustness of 55.4% and 19.3%, respectively. Some factors associated with successful aging were: positive self-perception of health, dancing habits, walking habits, absence of cognitive impairment, absence of depressive symptoms and polypathology, as well as daily life independence. After adjustment by age, the absence of polypathology and independence for activities of daily living stand out for robustness between 60 and 79 years; in those aged 80 years and over, independence for activities of daily living and dance practice presented greater strength of association. CONCLUSION The prevalence of robust older adults in primary care is considered satisfactory for the older population in general but decreases with age and is associated with the absence of diseases and disabilities. These results denote the need to redesign the health care system, focusing on promoting and preventing clinical-functional vulnerability.
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Affiliation(s)
- Luciana Colares Maia
- Universidade Estadual de Montes ClarosCentro de Ciências Biológicas e da SaúdeDepartamento de Clínica MédicaMontes ClarosMGBrasilUniversidade Estadual de Montes Claros - Unimontes. Centro de Ciências Biológicas e da Saúde (CCBS). Departamento de Clínica Médica. Montes Claros, MG, Brasil
| | - Thomaz de Figueiredo Braga Colares
- Universidade Estadual de Montes ClarosCentro Mais Vida Eny Faria de OliveiraMontes ClarosMGBrasilUniversidade Estadual de Montes Claros - Unimontes. Centro Mais Vida Eny Faria de Oliveira (CRASI-EFO). Montes Claros, MG, Brasil
| | - Edgar Nunes de Moraes
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de Clínica MédicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Clínica Médica. Belo Horizonte, MG, Brasil
| | - Simone de Melo Costa
- Universidade Estadual de Montes ClarosCentro de Ciências Biológicas e da SaúdeDepartamento de OdontologiaMontes ClarosMGBrasilUniversidade Estadual de Montes Claros - Unimontes. Centro de Ciências Biológicas e da Saúde (CCBS). Departamento de Odontologia. Montes Claros, MG, Brasil
| | - Antônio Prates Caldeira
- Universidade Estadual de Montes ClarosCentro de Ciências Biológicas e da SaúdeDepartamento de Saúde da Mulher e da CriançaMontes ClarosMGBrasilUniversidade Estadual de Montes Claros - Unimontes. Centro de Ciências Biológicas e da Saúde (CCBS). Departamento de Saúde da Mulher e da Criança. Montes Claros, MG, Brasil
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BANDEIRA GFDS, MOREIRA RDS, SILVA VDL. Nutritional status of elderly assisted in primary care and their relationship with social determinants of health. REV NUTR 2019. [DOI: 10.1590/1678-9865201932e190042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To review the influence of social determinants of health in the nutritional status of the elderly assisted in a primary care Unit in a Recife, Pernambuco, Brazil, community. Methods This was a cross-sectional study with an analytical approach. The universe was composed of 129 elderly attending a family health unit in Recife, Pernambuco, Brazil. The data were collected according to a protocol. The effect of the association of independent variables with the body mass index was estimated using hierarchical logistic regression models, simple and multiple multinomial. The significance level was set at 5%. Results There was a higher percentage of elderly people with excess weight (52.34%) in the assessment of body mass index. On analysis of the Mini nutritional assessment, the risk of malnutrition was 38.76%. On analysis of the calf circumference 13.39% of the elderly were malnourished. In the final model, the criteria for maintaining the elderly patients were the following: excess weight, marital status, hypertension, osteoarthritis and sewer destination. Elderly widowers had a higher chance (OR=5.17) of having excess weight and not to have sewage network serving their home and be hypertense (OR=2.71 e 2.83). The fact that the elderly have osteoarthritis also indicated a greater chance (OR=3.76) that they present excess weight. Conclusion Among the social determinants of health, the nutritional status of the elderly was associated with marital status, high blood pressure, osteoarthritis and basic sanitation. The social setting of the elderly is associated with their nutritional status.
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