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Pengpid S, Peltzer K. Lifestyle factors and incident functional disability among a rural ageing population in South Africa. Australas J Ageing 2024; 43:215-221. [PMID: 37309611 DOI: 10.1111/ajag.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/09/2023] [Accepted: 05/23/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The study aimed to assess the relationship between lifestyle factors and incident functional disability in South Africa. METHODS Longitudinal data (N = 4113) from two consecutive waves in 2014/2015 and 2018/2019 in Agincourt, South Africa, were analysed. RESULTS Moderate sedentary behaviour (AOR: 1.84, 95% CI: 1.31-2.58) and being overweight (AOR: 1.61, 95% CI: 1.10-2.36) increased the odds of incident functional disability among men. Moderate and high sedentary behaviour (AOR: 1.83, 95% CI: 1.31, 2.57, and AOR: 1.83, 95% CI: 1.08-3.10) increased the odds, and frequent fruit intake (AOR: 0.41, 95% CI: 0.19-0.91) and moderate physical activity (AOR: 0.47, 95% CI: 0.30-0.75) decreased the odds of incident functional disability among women. CONCLUSIONS Sedentary behaviour and being overweight increased odds, and physical activity and frequent fruit intake decreased odds of incident functional disability among ageing men and/or women in South Africa.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Impact of exercising alone and exercising with others on the risk of cognitive impairment among older Japanese adults. Arch Gerontol Geriatr 2023; 107:104908. [PMID: 36565607 DOI: 10.1016/j.archger.2022.104908] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This longitudinal study investigates the influence of the stratified frequency of exercising alone and exercising with others on the prevention of cognitive impairment among older Japanese adults. METHODS This four-year follow-up study targeted 4,358 individuals (mean age: 76.9 ± 5.6 years, female: 51.8%) who participated in an inventory mail survey in one region of Japan. The exercise forms surveyed involved the frequency of exercising alone and with others. Cognitive impairment was assessed using the nationally standardized dementia scale proposed by the Ministry of Health, Labour and Welfare of Japan. Adjusted Cox proportional-hazard models were used to examine the association between the exercise forms and the development of cognitive impairment, and calculate population-attributable fractions (PAFs). RESULTS The cumulative incidence of cognitive impairment throughout the study was 7.7%. Participants who exercised ≥ 2 times/week alone (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.61-0.998) had a lower risk of developing cognitive impairment than those who did not exercise alone. Similarly, participants who exercised ≥ 2 times/week with others (HR = 0.66; 95% CI = 0.47-0.94) showed a lower risk of developing cognitive impairment than those who did not exercise with others. The scenarios involving PAFs demonstrated that, if all participants exercised alone or with others ≥ 2 times/week, the risk of cognitive impairment decreased by 15.1% and 29.2%, respectively. CONCLUSION Both forms of exercise reduced the development of cognitive impairment, with exercising with others potentially being highly effective in preventing cognitive impairment.
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Modifiable healthy behaviours and incident disability in older adults: Analysis of combined data from two cohort studies in Japan. Exp Gerontol 2023; 173:112094. [PMID: 36681130 DOI: 10.1016/j.exger.2023.112094] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/03/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Healthy behaviours reduce the risk of incident disability; however, their components require further consideration. Specifically, little evidence exists on healthy behaviours that comprise modifiable factors, including social aspects, and their effects on those who do not engage in them. This study aimed to examine the association between engaging in healthy behaviours with modifiable factors and incident disability among community-dwelling older adults; as well as identify factors associated with nonengagement in healthy behaviours. We analysed data obtained from 1357 older adults aged 65 years and more without disabilities at baseline. The outcome was incident disability, which was defined based on the long-term care insurance certification in Japan. This study included regular exercise (≥1 day/week), favourable eating habits (≥4 dietary variety score), and social participation (engaging in two or more social activities) as components of healthy behaviours. We used the Cox proportional hazards model to calculate hazard ratios (HR) for incident disabilities. The proportion of those who satisfied all healthy behaviours was 21 %. During the follow-up period (median: 6.3 years), 282 incident disabilities were confirmed. Compared to those who engaged in one healthy behaviour, those who satisfied all healthy behaviours showed a 31 % (95 % confidence interval: 0.48, 0.98) lower HR of incident disability after adjusting for covariates. Current smoking and depressive mood were associated with non-engagement in healthy behaviours. This study found that having physically and socially active lifestyles and favourable eating habits are effective in reducing the risk of incident disability. Meanwhile, several older adults lack the components of a healthy lifestyle. Approaches that focus on multiple healthy behaviours are necessary to enhance the benefits of healthy lifestyles.
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Chen B, Wang M, He Q, Wang Y, Lai X, Chen H, Li M. Impact of frailty, mild cognitive impairment and cognitive frailty on adverse health outcomes among community-dwelling older adults: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:1009794. [PMID: 36388900 PMCID: PMC9659908 DOI: 10.3389/fmed.2022.1009794] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022] Open
Abstract
Aims This study analyzes the impact of frailty, mild cognitive impairment, and cognitive frailty on adverse outcomes in community-dwelling older adults. Methods This systematic review and meta-analysis were conducted using the PRISMA guidelines and MOOSE statement. We developed a specific search strategy for each electronic database and searched PubMed, Web of Science, MEDLINE, and Embase from initial records to July 2021. The studies on adverse outcomes of frailty, pre-frailty, mild cognitive impairment, and mild cognitive impairment with pre-frailty and cognitive frailty were included. Two researchers independently extracted data based on a spreadsheet and assessed the risk of bias. The primary outcomes were mortality, dementia, disability, and hospitalization. The second outcome included quality of life and falls. All analysis was conducted by using Review Manager (RevMan) 5.3 software. Results A total of 22 cohort studies (71,544 older adults with mean age ranging from 65.1 to 93.6 years) were included with a low risk of bias and high methodological quality with a NOS score ≥7. Compared to robust elders, individuals identified as frailty were associated with a higher risk of mortality (RR = 2.11, 95% CI: 1.57–2.83) and disability (RR = 5.91, 95% CI: 2.37–14.74). Mild cognitive impairment with pre-frailty was associated with mortality (RR = 1.74, 95% CI: 1.48–2.05) and dementia (RR = 4.15, 95% CI: 1.87–9.20). Pre-frailty was associated with a higher risk of mortality (RR = 1.29, 95% CI: 1.11–1.50). Cognitive frailty was associated with higher risk of incident mortality (RR = 2.41, 95% CI: 1.97–2.94), dementia (RR = 3.67, 95% CI: 2.81–4.78), disability (RR = 11.32, 95% CI: 4.14–30.97), and hospitalization (RR = 2.30, 95% CI: 1.60–3.32), as well as poor quality of life. Conclusion Cognitive frailty could be a comprehensive psychosomatic predictor for adverse outcomes among older people. Interactions between frailty, mild cognitive impairment, and cognitive frailty on adverse outcomes must be further explored. Systematic review registration [https://inplasy.com/inplasy-2022-5-0064/], identifier [INPLASY202250064].
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Affiliation(s)
- Baoyu Chen
- Key Laboratory of Mental Health, Institute of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
| | - Mingting Wang
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qin He
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yong Wang
- Key Laboratory of Mental Health, Institute of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
| | - Xiaoxing Lai
- Peking Union Medical College Hospital, Beijing, China
| | - Hongguang Chen
- Key Laboratory of Mental Health, Institute of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
- *Correspondence: Hongguang Chen,
| | - Mengqian Li
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Mengqian Li,
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Lu Y, Matsuyama S, Sugawara Y, Sone T, Tsuji I. Dairy intake and incident functional disability among older Japanese adults: the Ohsaki Cohort 2006 Study. Eur J Nutr 2022; 61:2627-2637. [PMID: 35246747 DOI: 10.1007/s00394-022-02843-w] [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: 08/25/2021] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Previous studies have investigated the association between dairy intake and functional disability, but their results were inconsistent. Our study aimed to investigate whether dairy intake may protect against incident functional disability among Japanese older adults. METHODS We conducted a longitudinal analysis of dairy intake with incident functional disability in a prospective cohort study of 11,911 Japanese individuals aged ≥ 65 years who were followed up for 8.2 years on average. Data on milk, yogurt, and cheese intake were collected using a validated food frequency questionnaire. Total dairy intake was the sum of the daily intake of milk, yogurt, and cheese, which was sex-specifically categorized in quintiles. Data on functional disability were retrieved from the public Long-term Care Insurance database. The Cox proportional hazards model was used to estimate the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95%CIs) for incident functional disability. RESULTS During 97,234 person-years of follow-up, 4874 persons (40.9%) were ascertained as having functional disability. Our study suggested a null association between total dairy intake and incident risk of functional disability; compared to Q1 (the lowest quintile) group, the multivariable-adjusted HRs (95%CIs) were 0.96 (0.88-1.05) for Q2, 0.93 (0.85-1.02) for Q3, 0.93 (0.85-1.02) for Q4, and 1.01 (0.92-1.10) for Q5 (p-trend = 0.840). We did not find any associations between milk, yogurt, or cheese intake and incident risk of functional disability. CONCLUSION We found no evidence showing that dairy intake was associated with functional disability among Japanese older adults.
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Affiliation(s)
- Yukai Lu
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Sanae Matsuyama
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Toshimasa Sone
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Risk Factors of Long-Term Care Insurance Certification in Japan: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042162. [PMID: 35206350 PMCID: PMC8872097 DOI: 10.3390/ijerph19042162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 02/06/2023]
Abstract
This study aimed to review evidence on future long-term care associated with pre-existing factors among community-dwelling Japanese older adults. We systematically searched cohort and nested case–control studies published between 2000 and 2019 that assessed long-term care certification using the PubMed, CINAHL, and EMBASE databases. The relationship between long-term care insurance information and risk factors was investigated. The protocol was registered with the Open Science Framework. We extracted 91 studies for synthesis, including 84 prospective cohort studies, 1 retrospective cohort study, and 6 nested case–control studies. Certification for long-term care was classified into two endpoints: onset of functional disability and dementia. There were 72 studies that used long-term care certification as a proxy for functional disability, and 22 used long-term care information to indicate the onset of dementia. Common risk factors related to functional disability were physical function, frailty, and oral condition. Motor function and nutritional status were common risk factors for dementia. We found consistent associations between premorbid risk factors and functional disability and dementia. The accumulation of evidence on the incidence of long-term care and associated factors can aid the development of preventive measures. Future studies should aim to integrate this evidence.
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Seino S, Nofuji Y, Yokoyama Y, Abe T, Nishi M, Yamashita M, Narita M, Hata T, Shinkai S, Kitamura A, Fujiwara Y. Combined impacts of physical activity, dietary variety, and social interaction on incident functional disability in older Japanese adults. J Epidemiol 2021. [PMID: 34924454 DOI: 10.2188/jea.je20210392] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This 3.6-year prospective study examined combined impacts of physical activity, dietary variety, and social interaction on incident disability and estimated population-attributable fraction for disability reduction in older adults. METHODS Participants were 7,822 initially non-disabled residents (3,966 men; 3,856 women) aged 65-84 years of Ota City, Tokyo, Japan. Sufficiency of moderate-to-vigorous-intensity physical activity (MVPA) ≥150 min/week, dietary variety score (DVS) ≥3 (median), and social interaction (face-to-face and/or non-face-to-face) ≥1 time/week was assessed using self-administered questionnaires. Disability incidence was prospectively identified using the long-term care insurance system's nationally unified database. RESULTS During a follow-up of 3.6 years, 1,046 (13.4%) individuals had disabilities. Independent multivariate-hazard ratios (HRs) and 95% confidence intervals of MVPA, DVS, and social interaction sufficiency for incident disability were 0.68 (0.59-0.78), 0.87 (0.77-0.99), and 0.91 (0.79-1.03), respectively. Incident disability HRs (95% CIs) gradually reduced with increased frequency of satisfying these behaviors (any one: 0.82, 0.65-1.03; any two: 0.65, 0.52-0.82; and all three behaviors: 0.54, 0.43-0.69), in an inverse dose-response manner (P < 0.001 for trend). Population-attributable fraction for disability reduction in satisfying any one, any two, and all three behaviors were 4.0% (-0.2, 7.9), 9.6% (4.8-14.1), and 16.0% (8.7-22.8), respectively. CONCLUSION Combining active physical activity, dietary variety, and social interaction substantially enhances the impacts on preventing disability among older adults, with evidence of an inverse dose-response manner. Adding the insufficient behavior element to individual habits and preexisting social group activities may be effective in preventing disability in the community.
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Affiliation(s)
- Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Yuri Yokoyama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology
| | - Mariko Nishi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Mari Yamashita
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology
| | - Miki Narita
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Toshiki Hata
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Department of Nutrition Sciences, Kagawa Nutrition University
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Health Town Development Science Center, Yao City Health Center
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.,Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology
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Takashima N, Nakamura Y, Miyagawa N, Kadota A, Tanaka-Mizuno S, Matsui K, Miura K, Ueshima H, Kita Y. Association between Stress-Coping Strategy and Functional Disability in the General Older Adult Population: The Takashima Study. Gerontology 2021; 68:699-706. [PMID: 34592746 DOI: 10.1159/000519194] [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] [Received: 03/01/2021] [Accepted: 08/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Both physical and psychological factors have been associated with functional disability. However, the associations between stress-coping strategies and future functional disability remain unclear. METHODS We analyzed 2,924 participants who did not have incidence of functional disability or death within the first 3 years of the baseline survey and were aged 65 years or more at the end of follow-up. Stress-coping strategies were assessed via a self-administered questionnaire (emotional expression, emotional support seeking, positive thought, problem-solving, and disengagement) in a baseline survey from 2006 to 2014. Levels of coping strategies were classified as low, middle, and high based of frequency. Functional disability decline was followed up using the long-term-care insurance program until November 1, 2019. Functional disability decline was defined as a new long-term-care insurance program certification. Cox proportional hazards model with competing risk analysis for death was used to evaluate associations between coping strategy levels and functional disability. RESULTS During the follow-up period, we observed 341 cases of functional disability and 73 deaths without previous incidence of functional disability. A significant inverse association between "positive thought" and "problem-solving" and future functional disability was observed. Multivariable adjusted hazard ratios (95% confidence interval) for functional disability were 0.68 (0.51-0.92) for high levels of "positive thought" and 0.73 (0.55-0.95) for high levels of "problem-solving," compared with low levels of the coping strategies. The inverse association was stronger in men. CONCLUSIONS Some subcomponents of stress-coping strategies might be associated with future incidence of functional disability among older adults.
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Affiliation(s)
- Naoyuki Takashima
- Department of Public Health, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.,Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Yasuyuki Nakamura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Yamashina Racto Clinic and Medical Examination Center, Kyoto, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Sachiko Tanaka-Mizuno
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenji Matsui
- Center for Public Health Sciences, National Cancer Center Japan, Chuo-ku, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Yoshikuni Kita
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga, Japan
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Loke YJ, Lim ES, Senadjki A. Health promotion and active aging among seniors in Malaysia. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-07-2019-0148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PurposeThis paper explores the relationship between health promotion and active aging among seniors in Malaysia. The specific objectives were to (1) identify the contributing factors for seniors undergoing full medical check-up and (2) to explore the association between selected active aging factors and health promotion behavior and beliefs.Design/methodology/approachThe study used data from 662 seniors from three different states in Peninsular Malaysia. Logistic regression was used to identify significant determinants of full medical check-up, and chi-square statistics were used to explore the association of active aging and selected health promotion behavior and beliefs. Healthy aging was characterized by being employed or traveling outdoors for leisure.FindingsHousehold income was found to be a significant barrier to seniors undergoing a full medical check-up. Overall, active seniors were more likely to have positive self-rated health, positive health responsibility and health promotion beliefs but were less likely to undergo a full medical check-up.Practical implicationsGiven that cost of a medical check-up could be a barrier for seniors, authorities could consider subsidizing medical check-ups to promote early detection of disease. There is also a need for continuous effort to educate seniors on health risk factors and the importance of taking fuller responsibility for their own health.Originality/valueThis study examined the relationship between active aging and health promotion together, as both components are essential in enhancing the mental and physical well-being of seniors.
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Combined Healthy Lifestyle Behaviors and Disability-Free Survival: the Ohsaki Cohort 2006 Study. J Gen Intern Med 2019; 34:1724-1729. [PMID: 31144283 PMCID: PMC6712118 DOI: 10.1007/s11606-019-05061-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 02/27/2019] [Accepted: 04/15/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Previous studies have suggested that a healthy lifestyle (HL) may prolong the years of life spent in good health. However, the impact of HL on disability-free survival (DFS) among the elderly is still uncertain. OBJECTIVE To investigate the relationship between HL and DFS in the general elderly population. DESIGN Prospective cohort study with a 10-year follow-up (2006-2016). PARTICIPANTS 9910 community-dwelling elderly people (≥ 65 years). MAIN MEASURES A HL index derived by summing the number of HL behaviors. Data on incident disability were retrieved from the public Long-term Care Insurance database. Multivariate-adjusted 50th percentile differences (PDs) in age at disability or death (months) and their 95% CIs were estimated with the Laplace regression model. KEY RESULTS During the 10 years, 4562 disability or death events occurred. Participants who adhered to all three HL behaviors lived 17.1 (95% CI 12.7, 21.5) months longer without disability than those who adhered to zero or one. Each 1-point increase of the index score conferred 8.8 months additional life without disability. The tendency for the 50th PDs to increase with a higher HL index score did not differ according to age (< 75 or ≥ 75 years), sex, or the presence of chronic conditions (none, or ≥ 1 chronic condition). CONCLUSIONS A combination of HL behaviors may substantially increase DFS, even for late-elderly (≥ 75 years), or elderly people with chronic conditions.
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Association between frailty and incident risk of disability in community-dwelling elder people: evidence from a meta-analysis. Public Health 2019; 175:90-100. [PMID: 31454631 DOI: 10.1016/j.puhe.2019.06.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/11/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Frailty is considered to be one of the risk factors of disability. However, the results of original reported studies are not consistent with respect to the frailty and incidence of disability, and previously published meta-analyses have also shown inconsistent results. This meta-analysis was conducted to investigate the relationship between the different stages of frailty and the incidence of disability by examining updated overall trends in community-dwelling elders. STUDY DESIGN Cohort studies in English or Chinese based on associations between frailty and incident disability risks that were published from 2000 until the current date were researched using PubMed, Embase, Web of Science, and CENTRAL databases. METHODS The Q test and I2 statistic were used to examine between-study heterogeneity. Random-effect models were adopted to synthesize the results based on the study heterogeneity. Subgroup analyses were also conducted to explore the possible sources of between-study heterogeneity based on the characteristics of participants. RESULTS Eighteen cohort studies with 88,906 participants were included in our meta-analyses. Compared with the non-frailty category, the combined relative risks (RRs) (95% confidence interval [CI]) of the disability were 1.66 (1.49-1.85) and 2.53 (2.01-3.14) for the category of prefrailty and frailty, respectively. Results suggested that the incident risk of disability at follow-up times <5 (RR = 3.19, 95% CI = 2.25-4.53) was significantly higher than for follow-up times ≥5 in the frailty category (RR = 2.00, 95% CI = 1.55-2.56). The risk in a sample size of ≥1000 (RR = 2.78, 95% CI = 2.04-3.14) was significantly higher than that when the sample size was <1000 (RR = 1.91, 95% CI = 1.53-2.37) in the frailty group. Compared with a value adjusted for comorbidity, the unadjusted comorbidity was significantly higher in the prefrailty category (1.90 vs. 1.52). Compared with a value adjusted for education, the unadjusted education was significantly higher in the prefrailty category (1.81 vs. 1.46). No publication bias was observed. CONCLUSION The overall meta-analysis confirms that frailty has significantly increased the incident risk of disability. Frail, elderly people are at the highest risk of future disability and may be adequate candidates for taking part in prevention and intervention programs.
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The Impact of Psychological Distress on Incident Functional Disability in Elderly Japanese: The Ohsaki Cohort 2006 Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112502. [PMID: 30413102 PMCID: PMC6265961 DOI: 10.3390/ijerph15112502] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 12/22/2022]
Abstract
Background: Although psychological distress is known to be a risk factor for death, there are relatively few data on the impact of psychological distress on incident functional disability in older adults. The aim of this study was to examine the impact of psychological distress on incident functional disability in older adults. Methods: We conducted a cohort study of 12,365 disability-free individuals aged ≥65 years who live in Ohsaki City, Japan. In 2006, the level of psychological distress was assessed using the K6 (range: 0⁻24 points). Data on 10-year functional disability were retrieved from the public Long-term Care Insurance database. The multivariate-adjusted hazard ratios (HRs) and population attributable fractions (PAFs) according to the K6 groups (<5, 5⁻9, 10⁻12, and ≥13 points) were estimated. Results: Among 94,636 person-years, incident functional disability occurred in 4533 persons (36.7%). Significantly higher risk was observed in higher K6 score groups. The multiple-adjusted HRs (95% CIs) of incident functional disability were 1.14 (1.06⁻1.22) for 5⁻9 points, 1.28 (1.15⁻1.43) for 10⁻12 points, and 1.62 (1.44⁻1.84) for ≥13 points, in comparison with <5 points (p-trend < 0.001). The PAFs in each of the K6 score groups were 3.0% for 5⁻9 points, 1.7% for 10⁻12 points, and 2.6% for ≥13 points. Conclusions: Even when mild to moderate, psychological distress had a considerable impact on incident functional disability in this cohort.
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