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Reyes-Ortiz CA, Robinson CC, Williams DR, Moncayo-Hernández BA, Ocampo-Chaparro JM, Cheung N, Campo-Arias A. Perceived Ageism is Associated With Recurrent Falling Among Older Colombian Adults. J Appl Gerontol 2024:7334648241242334. [PMID: 38557169 DOI: 10.1177/07334648241242334] [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: 04/04/2024] Open
Abstract
Literature on the association between ageism and falling among older adults is limited. Using data from the nationwide cross-sectional SABE (Salud, Bienestar y Envejecimiento) Colombia Survey in 2015 with 18,875 participants aged ≥60 years living in the communities, the study aims to evaluate the association between perceived ageism within the family, neighborhood, health services, and public services, and recurrent falling. Participants had a mean age of 69.2 ± 7.1; 56.1% were female. Recurrent falling prevalence was 15%, and experiencing any ageism was 10%. Multivariable logistic regression analyses showed higher odds of recurrent falling for any ageism (OR = 1.81, 95% CI 1.61-2.02, p < .0001). High depressive symptoms mediated 10.1% of the association between any ageism and recurrent falling, followed by low instrumental activities of daily living (9.7%) and multimorbidity (9.3%). Current findings open new areas of gerontological research by expanding the risk factors for falling among older adults to include ageism perceptions.
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Affiliation(s)
- Carlos A Reyes-Ortiz
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A & M University, Tallahassee, Florida, USA
| | - Crystall C Robinson
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A & M University, Tallahassee, Florida, USA
| | - Donna R Williams
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A & M University, Tallahassee, Florida, USA
| | | | - Jose M Ocampo-Chaparro
- Geriatrics Program, Department of Family Medicine, Universidad del Valle, Cali, Colombia
| | - Nicole Cheung
- Northwell, New Hyde Park, NY, USA
- Department of Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, NY, USA
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Sandoval Garrido FA, Bolt T, Taniguchi Y, Lloyd-Sherlock P. The relationship of perceived discrimination in healthcare and future falls among community-dwelling older persons from an English longitudinal cohort. F1000Res 2023; 12:1134. [PMID: 38585229 PMCID: PMC10997987 DOI: 10.12688/f1000research.140302.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The objective of this study is to examine the relation between the perceived discrimination suffered by older adults aged 60 and over during a healthcare encounter and its effects on the likelihood of falling 4 and 8 years later. METHODS To identify discrimination, we used the English Longitudinal Study of Ageing (ELSA) data collected in 2010-2011 (wave 5) that asked respondents about feeling discriminated against by doctors or at hospitals in the past year. Falls were assessed by the question: "Have you fallen down in the last two years?" in subsequent waves. We performed longitudinal analyses using the 2014-2015 (wave 7) and 2018-2019 (wave 9) follow-ups. Multivariable logistic regression was used to estimate the odds ratios of falling. RESULTS At baseline, 707 (15.1%) of all respondents experienced healthcare discrimination. Those suffering from discrimination in health care had 64% higher chances of falling 4 years later (odds ratio: 1.637, 95% confidence interval: 1.131-2.368) compared to those who did not, adjusting for age, sex, marital status, wealth, ethnicity, education levels, self-perceived health, depressive symptoms, and difficulties with basic and/or instrumental activities of daily living (ADL/IADL) and difficulties with walking. After 8 years, the effect was not statistically significant. Older age was the only significant detrimental factor at both 4 and 8 years. CONCLUSIONS Understanding discrimination in health care is important to enable safe and welcoming environments for the timely future use of services. These results remind us of the physical risk and the complex panorama of bio-psychosocial determinants involved in tackling discrimination over time.
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Affiliation(s)
- Felipe Alfonso Sandoval Garrido
- Health Services Research Department, University of Tsukuba, Tsukuba, Ibaraki Prefecture, 3057583, Japan
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki Prefecture, 3058573, Japan
| | - Timothy Bolt
- Faculty of Economics, Saitama University, Saitama, Saitama Prefecture, 3388570, Japan
| | - Yuta Taniguchi
- Health Services Research Department, University of Tsukuba, Tsukuba, Ibaraki Prefecture, 3057583, Japan
| | - Peter Lloyd-Sherlock
- School of International Development, University of East Anglia, Norwich, England, NR4 7TJ, UK
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Reyes-Ortiz CA, Campo-Arias A, Ocampo-Chaparro JM, Moncayo-Hernández BA, Lee T, Luque JS. The Association Between Discrimination and Falling. A National Sample of Older Adults. J Aging Health 2022; 34:614-625. [PMID: 35341379 DOI: 10.1177/08982643211052364] [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]
Abstract
OBJECTIVE To assess the relationship between discrimination and falling among older people. METHODS A cross-sectional nationwide population-based face-to-face survey, 2015. The SABE (Salud, Bienestar y Envejecimiento) Colombia Study, 19,004 community-dwelling adults aged ≥60 years. Recurrent falling was defined as ≥2 falls during the prior year. Main independent variable was discrimination. RESULTS Multivariate logistic regression models showed that recurrent falling was significantly associated with a number of reasons for experiences of everyday discrimination (due to racial, socioeconomic status, gender, age, religion, sexual orientation, or disability) (OR = 1.27, 95% CI 1.21-1.33), childhood discrimination score (never = 0 to many times = 3) (OR = 1.23, 95% CI 1.13-1.33), and number of situations for discrimination during the last 5 years due to skin color (group activities, public places, inside the family, or health centers) (OR = 1.12, 95% CI 1.08-1.17). DISCUSSION Discrimination experiences were associated with higher odds of recurrent falling.
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Affiliation(s)
| | | | | | | | - Torhonda Lee
- 15467Florida A and M University, Tallahassee, FL, USA
| | - John S Luque
- 15467Florida A and M University, Tallahassee, FL, USA
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Assessment of abuse and related factors in older patients with cancer. Support Care Cancer 2021; 29:7957-7964. [PMID: 34213643 DOI: 10.1007/s00520-021-06391-7] [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: 04/06/2021] [Accepted: 06/23/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Older cancer patients are more likely to present with functional dependency, multiple comorbidities, polypharmacy, malnutrition, and cognitive dysfunction than their younger counterparts which increases the risk of elder abuse. Herein, in this single-institution observational study, we aimed to determine the frequency and risk factors of abuse in cancer patients aged 70 and above. METHODS A total of 217 cancer patients aged ≥ 70 years who applied to the medical oncology outpatient clinic between June 2020 and January 2021 were included in this study. Informed consent was obtained before data collection. The Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) was used to evaluate elder abuse. Sociodemographic characteristics and clinical measurements were collected. RESULTS The mean age was 75.5, and 59.4% were male. The prevalence of abuse risk in older patients with cancer was 39.2%. In the multivariate logistic regression model, applying to the outpatient clinic for treatment (OR: 3.369, 95% CI: 1.455-7.802, p = 0.005), living in urban (OR: 5.787, 95% CI: 2.377-14.090, p < 0.001), history of falls (OR: 4.587, 95% CI: 1.789-11.762, p = 0.002), and being depressed according to the Geriatric Depression Scale-15 (GDS-15) score (OR: 10.788, 95% CI: 4.491-25.914, p < 0.001) were associated with an increased risk of elder abuse. Primary/junior education level and high school/university education level were protective against elder abuse risk compared to being illiterate (OR: 0.073, 95% CI: 0.025-0.210 and OR: 0.213, 95% CI: 0.056-0.806, respectively). CONCLUSION Cancer patients aged ≥ 70 years had a high risk of elder abuse. Elder abuse should be screened in patients with cancer, and the effects of this phenomenon on cancer care should be investigated in larger studies.
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Liu PJ, Hernandez Chilatra JA, Phelan A. Examining nurses' role in Adult Protective Services related to safeguarding older people. J Adv Nurs 2021; 77:2481-2497. [PMID: 33606282 PMCID: PMC8048587 DOI: 10.1111/jan.14792] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/08/2020] [Accepted: 01/23/2021] [Indexed: 12/22/2022]
Abstract
Aim To examine the role of Adult Protective Services' (APS's) nurses in helping abused, neglected and exploited older people, this study investigated how nurses' contribution differs from social workers. Though the majority of APS' workforce is staffed by social workers, some programmes also employ nurses. Design Secondary data analysis using convergent parallel mixed‐method design was conducted. Methods Using survey data from the National Adult Protective Services Association, 99 nurses' responses between October 2014 and August 2015 were analysed to examine their agency characteristics, training and qualities, job responsibilities and interprofessional collaboration. Results The majority of nurses work with social workers or other professionals using a multidisciplinary team (MDT) approach. Among those carrying a caseload, 69% (49 out of 71) of nurses work in conjunction with social workers. Out of all nurses, 64% (63 out of 99) indicated participation in at least one MDT. While the responsibilities nurses provided were similar to social workers, nurses were also able to provide healthcare related services, in their professional competencies, without referral. Conclusion Nurses in APS are in a privileged position to investigate mistreatment and provide/coordinate direct care for victims. Impact Not much was known about nurses who directly investigate elder mistreatment and provide services to victims. This study was the first to highlight the nursing workforce in APS, and described the nurses' unique contribution to the field. Nurses functioned as both social workers and healthcare professionals in APS. Since victims of elder mistreatment often suffer from negative physical, psychological and social consequences, having nurses in APS benefits victims to receive and the programmes in providing better care and services.
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Affiliation(s)
- Pi-Ju Liu
- School of Nursing and Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA
| | | | - Amanda Phelan
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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Reyes-Ortiz CA, Perez-Zepeda MU, Ocampo-Chaparro JM, Campo-Arias A, Borda MG, Holmes HM, Luque JS. Polyvictimization and Recurrent Falling in Older Ecuadorian Adults: The Mediation Role of Depressive Symptoms. J Aging Health 2020; 33:27-38. [PMID: 32877294 DOI: 10.1177/0898264320952916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To assess depressive symptoms as a mediator in the association between polyvictimization and recurrent falling. Methods: Using data from the Salud, Bienestar y Envejecimiento (Health, Well-being, and Aging) Ecuador Study, we analyzed community-dwelling adults 60 years and older (n = 5227). Recurrent falling was determined as ≥2 falls during the prior 12 months. Polyvictimization was determined as a history of ≥2 types of abuse. The mediator was depressive symptoms. Mediation analyses were based on the VanderWeele method. Results: Polyvictimization was significantly associated with higher odds of recurrent falling, and odds ratio (OR) = 1.45 (95% confidence intervals [CI] 1.20-1.76). Higher depressive symptoms increase the odds for recurrent falling (OR = 1.09 and 95% CI 1.07-1.11). Moreover, depressive symptoms were a significant mediator between polyvictimization and recurrent falling. The mediating effect was 28.4%. Discussion: Polyvictimization was associated with higher odds of recurrent falling, and this association was mediated by depressive symptoms.
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Affiliation(s)
- Carlos A Reyes-Ortiz
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, 15467Florida A&M University, FL, USA
| | - Mario U Perez-Zepeda
- Geriatric Medicine Research, Nova Scotia Health Authority, 12361Dalhousie University, Canada.,Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, 27964Pontificia Universidad Javeriana, Colombia.,233936Instituto Nacional de Geriatría, Mexico.,Centro de Investigación en Ciencias de la Salud (CICSA), FCS, 27753Universidad Anáhuac México Campus Norte, México
| | - José M Ocampo-Chaparro
- 28006Universidad del Valle, Colombia.,Grupo Interinstitucional de Medicina Interna (GIMI 1), 67637Universidad Libre, Colombia
| | - Adalberto Campo-Arias
- Programa de Medicina, Facultad de Ciencias de la Salud, 469579Universidad del Magdalena, Colombia
| | - Miguel G Borda
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, 27964Pontificia Universidad Javeriana, Colombia.,Centre for Age-Related Medicine (SESAM), 60496Stavanger University Hospital, Norway.,Faculty of Health Sciences, 56627University of Stavanger, Norway
| | - Holly M Holmes
- McGovern Medical School, Geriatric and Palliative Medicine Division, 12339University of Texas Health Science Center at Houston, TX, USA
| | - John S Luque
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, 15467Florida A&M University, FL, USA
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Reyes-Ortiz CA, Ocampo-Chaparro JM, Campo-Arias A, Holmes H, Halphen J. Reply to: The Interplay between Experiences of Abuse, Physical Activity, and Falls in Older Adults. J Am Geriatr Soc 2019; 67:1097-1098. [PMID: 30629743 DOI: 10.1111/jgs.15742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 12/16/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Carlos A Reyes-Ortiz
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Texas Health Science Center at Houston, Houston, Texas
| | | | - Adalberto Campo-Arias
- Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia
| | - Holly Holmes
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Texas Health Science Center at Houston, Houston, Texas
| | - John Halphen
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Texas Health Science Center at Houston, Houston, Texas
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Subedi P. The Interplay between Experiences of Abuse, Physical Activity, and Falls in Older Adults. J Am Geriatr Soc 2019; 67:1097. [PMID: 30629735 DOI: 10.1111/jgs.15744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Pooja Subedi
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
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