1
|
Xie Y, Sinclair C, Hamilton M, Peisah C, Temple J, Anstey KJ. Barriers Experienced by Community-Dwelling Older Adults Navigating Formal Care: Evidence From an Australian Population-Based National Survey. J Aging Health 2024:8982643241263132. [PMID: 38914050 DOI: 10.1177/08982643241263132] [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: 06/26/2024]
Abstract
OBJECTIVES This study aims to identify the relationship between psychosocial factors and unmet needs among community-dwelling older adults who have received or who expect to receive formal home-based aged care services. METHODS A subsample of the national Survey of Disability, Ageing and Carers was used to examine the prevalence of having any unmet needs among older adults navigating care. We also examined associations between older adults' psychosocial factors and their unmet needs using logistic regression. RESULTS Regression analyses highlighted that perceived social isolation (OR = 1.62, 95% CI: 1.30-2.01), high/very high psychological distress (OR = 2.11, 95% CI: 1.52-2.93), and occasional assistance from informal support (OR = 1.92, 95% CI: 1.22-3.05) were associated with increased odds of having unmet needs, after adjusting for other covariates. DISCUSSION Our study suggests that older adults facing psychosocial difficulties or lacking informal support are more likely to encounter barriers in accessing formal care. Future policy should address the psychosocial needs and support networks of older adults.
Collapse
Affiliation(s)
- Yuchen Xie
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Craig Sinclair
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Myra Hamilton
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Carmelle Peisah
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- Discipline of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jeromey Temple
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Kaarin J Anstey
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| |
Collapse
|
2
|
Berryman K, Wirth M, Bombardier CH, Motl RW, Bartle B, Jacob RL, Aguina K, LaVela SL. Variables Associated With Moderate to High Loneliness Among Individuals Living With Spinal Cord Injuries and Disorders. Arch Phys Med Rehabil 2024; 105:1076-1082. [PMID: 38281576 DOI: 10.1016/j.apmr.2024.01.010] [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: 08/03/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE To identify variables independently associated with moderate to high loneliness in individuals living with Spinal Cord Injuries or Disorders (SCI/D). DESIGN A cross-sectional, national survey of a random sample of community-dwelling Veterans with SCI/D in the United States. Survey methodology was used to collect data on demographic and injury characteristics, general health, chronic and SCI-secondary conditions, and loneliness. SETTING The VHA SCI/D System of Care including 25 regional SCI/D Centers (or Hubs). PARTICIPANTS Among 2466 Veterans with SCI/D, 592 completed surveys (24%). Most participants were men (91%), white (81%), not currently married (42%), had tetraplegia (33%), and on average injured for 18 years at the time of data collection (N=562). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The dependent variable, loneliness, was collected using the UCLA-3 instrument. Loneliness was dichotomized into never/low loneliness and moderate/high loneliness (UCLA score ≥ 4). RESULTS Bivariate analyses assessed unadjusted associations in demographics, injury characteristics, chronic disease, and SCI-secondary conditions. Multivariable logistic regression was used to identify factors independently associated with moderate/high loneliness. Participants had a mean loneliness score of 5.04, SD=1.99. The point prevalence of moderate to high loneliness was 66%. Lower duration of injury, paraplegia, being unmarried, being in fair/poor general health, having dysfunctional sleep, and having a diagnosis of bowel dysfunction were each independently associated with greater odds of moderate/high loneliness. CONCLUSIONS Findings suggest that interventions to reduce/manage loneliness in the Veteran SCI/D population should focus on those who are more newly injured, have paraplegia, currently unmarried, have bowel problems, and experience dysfunctional sleep.
Collapse
Affiliation(s)
- Kelsey Berryman
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL.
| | - Marissa Wirth
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | | | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL
| | - Brian Bartle
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - R Lorie Jacob
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - Keith Aguina
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - Sherri L LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| |
Collapse
|
3
|
Kraake S, Pabst A, Wiese B, Moor L, König HH, Hajek A, Kaduszkiewicz H, Scherer M, Stark A, Wagner M, Maier W, Werle J, Weyerer S, Riedel-Heller SG, Stein J. Profiles of met and unmet care needs in the oldest-old primary care patients with depression - results of the AgeMooDe study. J Affect Disord 2024; 350:618-626. [PMID: 38244789 DOI: 10.1016/j.jad.2024.01.138] [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: 06/07/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Unmet care needs have been associated with an increased risk of depression in old age. Currently, the identification of profiles of met and unmet care needs associated with depressive symptoms is pending. Therefore, this exploratory study aimed to identify profiles of care needs and analyze associated factors in oldest-old patients with and without depression. METHODS The sample of 1092 GP patients aged 75+ years is based on the multicenter study "Late-life depression in primary care: needs, health care utilization and costs (AgeMooDe)". Depression (i.e. clinically meaningful depressive symptoms) was determined using the Geriatric Depression Scale (GDS) (cutoff score ≥ 4). Needs of patients were assessed using the Camberwell Assessment of Need for the Elderly (CANE). Associated sociodemographic and clinical factors were examined, and latent class analysis identified the need profiles. RESULTS The main result of the study indicates three need profiles: 'no needs', 'met physical needs', and 'unmet social needs'. Members of the 'met physical needs' (OR = 3.5, 95 %-CI: 2.5-4.9) and 'unmet social needs' (OR = 17.4, 95 %-CI: 7.7-39.7) profiles were significantly more likely to have depression compared to members of the 'no needs' profile. LIMITATIONS Based on the cross-sectional design, no conclusions can be drawn about the causality or direction of the relationships between the variables. CONCLUSIONS The study results provide important insights for the establishment of needs-based interventions for GPs. Particular attention should be paid to the presence of unmet social needs in the oldest-old GP patients with underlying depressive symptoms.
Collapse
Affiliation(s)
- Sophia Kraake
- Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Birgitt Wiese
- Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - Lilia Moor
- Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Medical Faculty, Kiel University, Kiel, Germany
| | - Martin Scherer
- Institute of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Stark
- Institute of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Wagner
- Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| |
Collapse
|
4
|
Wang S, Zhang H, Lou Y, You Q, Jiang Q, Cao S. Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey. J Affect Disord 2024; 349:577-582. [PMID: 38199413 DOI: 10.1016/j.jad.2024.01.008] [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: 04/25/2023] [Revised: 11/24/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Social isolation and loneliness have been proved to be associated with many adverse health outcomes, but their influence on hypertension remains unclear. This study aimed to assess the relationship of social isolation and loneliness with hypertension risk among middle-aged and older adults in China. METHODS We used data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were assessed for social isolation and loneliness at baseline, and hypertension was identified by self-report and blood pressure measurement at follow-up in 2015. Binary logistic regression analyses were conducted to assess the association of social isolation and loneliness with the risk of hypertension. RESULTS A total of 3711 residents were included. 13.7 % of the participants had high level of social isolation and 18.1 % felt lonely. During the four-year follow up period, 651 participants developed hypertension. People with high level of social isolation had an increased risk of hypertension (odds ratio [OR]: 1.40, 95 % confidence interval [CI]: 1.09-1.79). Similar results were found between social isolation score and hypertension risk (OR: 1.14, 95 % CI: 1.04-1.26). No significant association between loneliness and hypertension or any interaction effect of social isolation and loneliness on hypertension were observed. LIMITATIONS Limited by the structure of questionnaire, some of the information was derived by self-report, which may lead to recalling bias. CONCLUSION Social isolation, rather than loneliness was associated with hypertension for middle aged and older adults. Social support needs to be strengthened for hypertension prevention in community.
Collapse
Affiliation(s)
- Shiqi Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Hao Zhang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yiling Lou
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Qiqi You
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Qingqing Jiang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Shiyi Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| |
Collapse
|