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Ahmed KT, Afrin A, Hasan M, Sogir SB, Rahman L, Karimuzzaman M, Rahman KA, Hossain MM, Khan HTA. Age and sex-specific disability-free life expectancy in urban and rural settings of Bangladesh. Popul Health Metr 2024; 22:7. [PMID: 38643138 DOI: 10.1186/s12963-024-00327-z] [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: 05/22/2023] [Accepted: 04/15/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Disability-free life expectancy (DFLE) has been used to gain a better understanding of the population's quality of life. OBJECTIVES The authors aimed to estimate age and sex-specific disability-free life expectancy (DFLE) for urban and rural areas of Bangladesh, as well as to investigate the differences in DFLE between males and females of urban and rural areas. METHODS Data from the Bangladesh Sample Vital Statistics-2016 and the Bangladesh Household Income and Expenditure Survey (HIES)-2016 were used to calculate the disability-free life expectancy (DFLE) of urban and rural males and females in Bangladesh in 2016. The DFLE was calculated using the Sullivan method. RESULTS With only a few exceptions, rural areas have higher mortality and disability rates than urban areas. For both males and females, statistically significant differences in DFLE were reported between urban and rural areas between the ages of birth and 39 years. In comparison to rural males and females, urban males and females had a longer life expectancy (LE), a longer disability-free life expectancy, and a higher share of life without disability. CONCLUSION This study illuminates stark urban-rural disparities in LE and DFLE, especially among individuals aged < 1-39 years. Gender dynamics reveal longer life expectancy but shorter disability-free life expectancy for Bangladeshi women compared to men, emphasizing the need for targeted interventions to address these pronounced health inequalities.
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Affiliation(s)
- Khandaker Tanveer Ahmed
- Department of Statistics and Data Science, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
| | - Aziza Afrin
- Department of Statistics and Data Science, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Mehedi Hasan
- Department of Statistics and Data Science, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Sajjad Bin Sogir
- Department of Statistics and Data Science, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Labiba Rahman
- Department of Statistics and Data Science, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Md Karimuzzaman
- DREXEL Dornsife School of Public Health, DREXEL University, Philadelphia, PA, USA
| | - Kazi Arifur Rahman
- Office of the Deputy Commissioner, People's Republic of Bangladesh, Satkhira, Bangladesh
| | - Md Moyazzem Hossain
- Department of Statistics and Data Science, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
- School of Mathematics, Statistics and Physics, Newcastle University, Newcastle Upon Tyne, Tyne and Wear, NE1 7RU, UK
| | - Hafiz T A Khan
- Public Health & Statistics, College of Nursing, Midwifery and Healthcare, University of West London, Brentford, UK
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Kalu ME, Dal Bello-Haas V, Griffin M, Ploeg J, Richardson J. A comprehensive mobility discharge assessment framework for older adults transitioning from hospital-to-home in the community—What mobility factors are critical to include? Protocol for an international e-Delphi study. PLoS One 2022; 17:e0267470. [PMID: 36137073 PMCID: PMC9499191 DOI: 10.1371/journal.pone.0267470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 04/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Mobility deficits have been identified as an independent risk factor for hospital readmission for adults ≥65 years. Despite evidence indicating how determinants additively influence and predict mobility, no hospital-to-home care transition models comprehensively assess all seven mobility determinants, cognitive, financial, environmental, personal, physical, psychological, and social. There is currently a lack of clarity regarding what factors clinicians and researchers should evaluate for each mobility determinant. The purpose of this e-Delphi study is to prioritize and reach consensus on the factors for each mobility determinant that are critical to assess as part of the Comprehensive Mobility Discharge Assessment Framework (CMDAF) when older adults are discharged from hospital-to-home.
Methods
This protocol paper is an international modified e-Delphi study following the Recommendations for the Conducting and Reporting of Delphi Studies. International researchers, clinicians, older adults and family caregivers residing in a country with universal or near-universal health coverage will be invited to participate as ‘experts’ in three e-Delphi rounds administered through DelphiManager©. The e-Delphi Round 1 questionnaire will be developed based on scoping review findings and will be pilot tested. For each round, experts will be asked to rate factors for each determinant that are critical to assess as part of the CMDAF using a 9-point scale: Not Important (1–3), Important but Not Critical (4–6), and Critical (7–9). The scale will include a selection option of "unable to score" and experts will also be asked to provide a rationale for their scoring and suggest missing factors. Experts will receive feedback summaries in Rounds 2 and 3 to guide them in reflecting on their initial responses and re-rating of factors that have not reached consensus. The criteria for reaching consensus will be if ≥70% of experts rate a factor as "critical" (scores ≥7) and ≤ 15% of experts rate a factor as "not important" (scores≤ 3). Quantitative data will be analyzed using median values, frequencies, percentages, interquartile range, and bar graphs; Wilcoxon matched-pairs signed-rank test will be used to assess the stability of participants’ responses. Rationale (qualitative data) provided in the open-ended comments section will be analyzed using content analysis.
Conclusion
This study is a first step in developing the CMDAF and will be used to guide a subsequent e-Delphi survey to decide on the tools that should be used to measure the examples of each factor included in our framework.
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Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, Faculty of Health Sciences, McMaster University Hamilton, Ontario, Canada
| | - Julie Richardson
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Evaluation and Impact, Faculty of Health Sciences, McMaster University, Ontario, Canada
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Nascimento CFD, Duarte YADO, Porto Chiavegatto Filho AD. Fatores associados à limitação da mobilidade funcional em idosos do Município de São Paulo, Brasil: análise comparativa ao longo de 15 anos. CAD SAUDE PUBLICA 2022; 38:e00196821. [DOI: 10.1590/0102-311x00196821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/03/2021] [Indexed: 11/21/2022] Open
Abstract
Este estudo teve como objetivo analisar a prevalência de limitação na mobilidade funcional autorreferida e os fatores associados no período entre os anos 2000 e 2015, em idosos residentes no Município de São Paulo, Brasil. Para as presentes análises foram utilizados os dados das quatro ondas (2000, 2006, 2010 e 2015) do Estudo Saúde, Bem Estar e Envelhecimento (SABE). Foram conduzidos modelos de regressão para analisar as características demográficas, socioeconômicas, comportamentais e relativas à saúde dos indivíduos associadas à limitação da mobilidade em cada onda do estudo, e análise multinível para a comparação entre as quatro ondas. Os resultados indicaram aumento nas prevalências de limitações na mobilidade autorreferida, mais evidente no ano de 2006. Foi observado, ainda, associação com condições crônicas de saúde, como a história de AVC (RP = 1,43; IC95%: 1,29; 1,58, em 2000), a presença de doenças osteoarticulares (RP = 1,35; IC95%: 1,23; 1,49, em 2015), e a queixa de “dor nas costas” (RP = 1,33; IC95%: 1,22; 1,45, em 2006), bem como com aspectos socioeconômicos, como a renda insuficiente (RP = 1,17; IC95%: 1,07; 1,28, em 2010). Em um contexto de envelhecimento populacional acelerado, esses resultados trazem informações relevantes para a promoção de políticas públicas voltadas à prevenção de declínio da mobilidade em pessoas idosas.
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Soh BFJR, Ang WHD, De Roza JG, Quek IP, Lim PS, Lau Y. They Are Partners in Care: A Qualitative Exploration of Physicians' Perceptions of Primary Care Advanced Practice Nurses. J Nurs Scholarsh 2021; 53:542-551. [PMID: 33870641 DOI: 10.1111/jnu.12665] [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] [Accepted: 02/23/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE This study explores physicians' perceptions of the advanced practice nurse (APN) role in the primary care setting in Singapore. METHODS AND DESIGN A descriptive qualitative design utilizing face-to-face semistructured interviews was conducted on a purposive sample of 16 primary care physicians from six primary care clinics. Thematic analysis and constant comparative analysis were used. FINDINGS Three themes were identified: a collaborative partner in primary care, a conduit for specialist care and information, and a leader in community care. Physicians generally reported positivity about the clinical role of APNs and their potential in leading community care. However, they verbalized role ambiguity beyond clinical practice. CONCLUSIONS Physicians viewed primary care APNs as competent healthcare professionals. They viewed APNs as specialists in their fields, with the potential for expanding their services into the community. However, there remains gaps in physicians' understanding of the primary care APNs' nonclinical roles. The findings from this study indicate a need for nursing schools and nurse leaders to increase awareness of the complete APN role among physicians. APNs' roles in educating healthcare professionals and delivering care to the community can be further developed. CLINICAL RELEVANCE APNs are at the forefront in leading nursing care. There is a need to develop greater collaborative partnerships while delineating their respective roles in patient care.
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Affiliation(s)
| | - Wei How Darryl Ang
- PhD Student, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Imm Pin Quek
- Advanced Practice Nurse, National Healthcare Group Polyclinic, Singapore
| | - Pui San Lim
- Family Physician Principal Staff, National Healthcare Group Polyclinic, Singapore
| | - Ying Lau
- Associate Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Abstract
Objective: To examine whether we live healthier as we live longer in Hong Kong, which has one of the highest life expectancies in the world. Methods: Sullivan's method was used to evaluate the chronic disease-free life expectancy (CDFLE), life expectancy in good self-perceived health (GPHLE), and impairment-free life expectancy (IFLE) among population aged 50 years and older in Hong Kong in 2007-2016. Results: In spite of the marked improvement in life expectancy in Hong Kong, the increase in GPHLE was much smaller, while CDFLE and IFLE even declined for both genders. The situation was more severe among older population. Discussion: People in Hong Kong live longer but with worsening health. The expansion of chronic diseases, self-perceived poor health, and impairments among older adults calls for more fiscal investments, government attention, and public health policies.
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Affiliation(s)
- Yan Zheng
- Department of Social Work and Social Administration, Faculty of Social Sciences, 25809The University of Hong Kong, Hong Kong
| | - Karen Siu Lan Cheung
- Mindlink Research Centre, Hong Kong.,Sau Po Centre on Ageing, 25809The University of Hong Kong, Hong Kong
| | - Paul S F Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, 25809The University of Hong Kong, Hong Kong.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, 25809The University of Hong Kong, Hong Kong
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Enroth L, Raitanen J, Halonen P, Tiainen K, Jylhä M. Trends of Physical Functioning, Morbidity, and Disability-Free Life Expectancy Among the Oldest Old: Six Repeated Cross-Sectional Surveys Between 2001 and 2018 in the Vitality 90+ Study. J Gerontol A Biol Sci Med Sci 2020; 76:1227-1233. [PMID: 32506117 DOI: 10.1093/gerona/glaa144] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It remains unclear whether increasing longevity is accompanied by a compression or expansion of poor health and disability. We examined trends of physical functioning and morbidity in a population aged 90 and older, and disease- and disability-free life expectancy (LE) at age 90 between 2001 and 2018 in Finland's third most populated city. METHODS We used survey data from the Vitality 90+ Study, which comprises a series of six repeated mailed surveys (7,590 observations). Information on mortality came from Statistics Finland. We examined trends of functioning (activities of daily living [ADL] and mobility) and cardiovascular and dementia morbidity using age-adjusted generalized estimating equation models stratified by sex. In addition, age-, sex-, and period-specific health expectancies were calculated using Sullivan's method. RESULTS Over time, functioning improved, especially, in women, and morbidity increased in men. From 2001 to 2018, LE at age 90 increased by 5.3 months for men and 6.4 months for women. LE without ADL disability increased by 5.0 months for men and 8.4 months for women, and LE without mobility disability by 6.0 months for men and 4.4 months for women. LE without cardiovascular and dementia morbidity decreased for men (2.6 months) and increased for women (1.9 months). CONCLUSIONS In relative terms, we found a compression of disability for both sexes and an expansion of morbidity for men. Although the trends overall are rather positive, the increase in absolute morbidity and, to some extent, in disability will inevitably mean increasing care needs with population aging.
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Affiliation(s)
- Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Kristina Tiainen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
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8
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Sheehan C, Domingue BW, Crimmins E. Cohort Trends in the Gender Distribution of Household Tasks in the United States and the Implications for Understanding Disability. J Aging Health 2019; 31:1748-1769. [PMID: 30141717 PMCID: PMC6774921 DOI: 10.1177/0898264318793469] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: Measures of disability depend on health and social roles in a given environment. Yet, social roles can change over time as they have by gender. We document how engagement in Instrumental Activities of Daily Living (IADLs) is shifting by gender and birth cohort among older adults, and the challenges these shifts can create for population-level estimates of disability. Method: We used the Health and Retirement Study (N = 25,047) and multinomial logistic regression models with an interaction term between gender and birth cohort to predict limitation and nonperformance relative to no difficulty conducting IADLs. Results: Nonperformance of IADLs have significantly decreased among younger cohorts. Women in younger cohorts were more likely to use a map, whereas men in younger cohorts were more likely to prepare meals and shop. Discussion: Failing to account for gender and cohort changes in IADL, performance may lead to systematic bias in estimates of population-level disability.
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9
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Tareque MI, Chan A, Saito Y, Ma S, Malhotra R. The Impact of Self-Reported Vision and Hearing Impairment on Health Expectancy. J Am Geriatr Soc 2019; 67:2528-2536. [PMID: 31411348 DOI: 10.1111/jgs.16086] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/04/2019] [Accepted: 06/26/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Vision and hearing impairment may impact both life expectancy (LE) and health expectancy, that is, duration of life with and without health problems, among older adults. We examined the impact of self-reported vision and hearing impairment on years of life with and without limitation in physical function and in activities of daily living (ADLs). DESIGN Life table analysis, using a nationally representative longitudinal survey of community-dwelling older adults aged 60 years or older, Panel on Health and Ageing of Singaporean Elderly. SETTING Singapore. PARTICIPANTS Survey participants (n = 3452) who were interviewed in 2009 and followed up in 2011-2012 and 2015. MEASUREMENTS Participants reporting difficulty with any of nine tasks involving upper or lower extremities were considered to have a limitation in physical function. Those reporting health-related difficulty with any of six basic ADLs or seven instrumental ADLs were considered to have a limitation in ADLs. We used the multistate life table method with a microsimulation approach to estimate health expectancy, considering self-reported sensory impairment status as time varying. RESULTS Either or both impairments, vs neither, were associated with less years without limitation in physical function and in ADLs and more years with limitation in physical function and in ADLs, with the greatest impact on health expectancy among those with both impairments, who also had the lowest LE. For example, at age 60, those with both impairments, vs neither, could expect not only shorter LE (4.2 [95% confidence interval [CI] = 1.9-5.7] less years; 20.7 [95% CI = 18.9-22.5] vs 24.9 [95% CI = 23.8-26.0]) but also more years of life with limitations in physical function (3.3 [95% CI = .9-5.8] more years; 12.8 [95% CI = 10.7-14.8] [about 61.7% of LE] vs 9.5 [95% CI = 8.4-10.5] [about 38.0% of LE]). CONCLUSION Timely and appropriate management of vision and hearing impairment, especially when coexisting, among older adults has the potential to reduce the years of life they live with limitation in physical function and in ADLs. J Am Geriatr Soc 67:2528-2536, 2019.
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Affiliation(s)
- Md Ismail Tareque
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Angelique Chan
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
| | - Yasuhiko Saito
- College of Economics and Population Research Institute, Nihon University, Tokyo, Japan
| | - Stefan Ma
- Ministry of Health, Singapore, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
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Lane AP, Wong CH, Močnik Š, Song S, Yuen B. Association of Neighborhood Social Capital With Quality of Life Among Older People in Singapore. J Aging Health 2019; 32:841-850. [PMID: 31216922 DOI: 10.1177/0898264319857990] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To examine how neighborhood-based cognitive and structural social capital are associated with individual quality of life among a sample of community-dwelling older adults in Singapore. Method: Using survey data from 981 older adults (aged 55 years and above) in nine residential neighborhoods, multilevel models simultaneously estimated the effects of independent variables at the individual and neighborhood levels on quality of life (CASP-12). Results: Social cohesion (β = 1.39, p < .01) and associational membership (β = 19.16, p < .01) were associated with higher quality of life in models adjusted for neighborhood facilities and individual sociodemographics, social networks, functional limitations, global cognitive status, and medical conditions. Discussion: The results suggest that place-based or neighborhood social capital may be important for older person's well-being. It identifies the contribution of structural (associational membership) and cognitive (social cohesion) social capital to the well-being of community-dwelling older adults in Singapore.
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Affiliation(s)
- Anna P Lane
- Singapore University of Technology and Design, Singapore
| | | | - Špela Močnik
- Singapore University of Technology and Design, Singapore
| | - Siqi Song
- Singapore University of Technology and Design, Singapore
| | - Belinda Yuen
- Singapore University of Technology and Design, Singapore
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11
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Years of life with and without limitation in physical function and in activities of daily living by body mass index among older adults. Int J Obes (Lond) 2019; 43:2244-2253. [PMID: 31068661 DOI: 10.1038/s41366-019-0370-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/19/2019] [Accepted: 03/25/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND While older adults with pre-obesity and Class I obesity have similar or lower mortality risk versus those with normal weight, a heavier body mass index (BMI) may not translate into more healthy life years. Utilizing longitudinal data on 3452 older (≥60 years) Singaporeans, we assessed the association between BMI and years of remaining life overall with and without limitation in physical function and in activities of daily living (ADLs). METHODS Difficulty in any of nine tasks involving upper or lower extremities was considered as limitation in physical function, and health-related difficulty in any basic ADL or instrumental ADL as limitation in ADLs. We utilized multistate life tables, including BMI as a time-varying covariate. RESULTS At age 60, life expectancy (LE) was similar for those with normal weight, pre-obesity and obesity. However, those with obesity, versus normal weight, had 6.3 [95% confidence interval: 3.4-9.2] more years with limitation in physical function and 4.9 [3.4-6.5] less years without limitation in physical function. Those with pre-obesity, versus normal weight, also had 3.7 [1.9-5.3] more years with limitation in physical function. The same pattern across BMI categories was observed for years of life with and without limitation in ADLs. In stratified analyses, similar associations of BMI with years of life with and without limitation in physical function and in ADLs were observed across gender, ethnicity, and educational status. CONCLUSIONS The increasing global prevalence of obesity may result in an increase in years of life with limitation in physical function and in ADLs at older ages. Older adults, their families and healthcare systems should be cognizant of this issue.
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Härkänen T, Sainio P, Stenholm S, Lundqvist A, Valkeinen H, Aromaa A, Koskinen S. Projecting long-term trends in mobility limitations: impact of excess weight, smoking and physical inactivity. J Epidemiol Community Health 2019; 73:443-450. [PMID: 30777889 DOI: 10.1136/jech-2017-210413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 12/20/2018] [Accepted: 01/10/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Policy makers need disability projections for planning adequate services and measures for health promotion. The aim of this study is to provide projections on severe mobility limitations up to year 2044 and illustrate how the projected prevalence and the number of persons with severe mobility limitations are affected by potential changes in the modifiable risk factors, namely excess weight, physical inactivity and smoking. METHODS We analysed the nationally representative, repeated measures Health 2000 and 2011 Surveys (BRIF8901) with 8615 and 6740 participants, respectively, aged 18 years and older. Severe mobility limitations were defined as major difficulties or unable to walk about half a kilometre. We applied a multistate model on repeated measures to account for both individual risk factors and their changes over time. RESULTS The number of people with severe mobility limitations was projected to double by the year 2044 in Finland, due to the rapid ageing of the population. Eliminating half of the excess weight would reduce their number by one-fifth, while reductions in the prevalence of smoking and physical inactivity would have a minor impact. Even if excess weight, smoking and physical inactivity were completely eliminated, the number of persons with severe mobility limitations is projected to increase. CONCLUSIONS Designing and implementing strategies to promote healthy weight are important to slow down the rapid increase in mobility limitations due to population ageing. Providing adequate health and social services for the increasing population with disabilities will nevertheless be an increasing national challenge.
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Affiliation(s)
- Tommi Härkänen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Päivi Sainio
- National Institute for Health and Welfare, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland
| | | | - Heli Valkeinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Seppo Koskinen
- National Institute for Health and Welfare, Helsinki, Finland
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13
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Liu Z, Han L, Feng Q, Dupre ME, Gu D, Allore HG, Gill TM, Payne CF. Are China's oldest-old living longer with less disability? A longitudinal modeling analysis of birth cohorts born 10 years apart. BMC Med 2019; 17:23. [PMID: 30704529 PMCID: PMC6357399 DOI: 10.1186/s12916-019-1259-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/14/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND China has transitioned from being one of the fastest-growing populations to among the most rapidly aging countries worldwide. In particular, the population of oldest-old individuals, those aged 80+, is projected to quadruple by 2050. The oldest-old represent a uniquely important group-they have high demand for personal assistance and the highest healthcare costs of any age group. Understanding trends in disability and longevity among the oldest-old-that is, whether successive generations are living longer and with less disability-is of great importance for policy and planning purposes. METHODS We utilized data from successive birth cohorts (n = 20,520) of the Chinese oldest-old born 10 years apart (the earlier cohort was interviewed in 1998 and the later cohort in 2008). Disability was defined as needing personal assistance in performing one or more of five essential activities (bathing, transferring, dressing, eating, and toileting) or being incontinent. Participants were followed for age-specific disability transitions and mortality (in 2000 and 2002 for the earlier cohort and 2011 and 2014 for the later cohort), which were then used to generate microsimulation-based multistate life tables to estimate partial life expectancy (LE) and disability-free LE (DFLE), stratified by sex and age groups (octogenarians, nonagenarians, and centenarians). We additionally explored sociodemographic heterogeneity in LE and DFLE by urban/rural residence and educational attainment. RESULTS More recently born Chinese octogenarians (born 1919-1928) had a longer partial LE between ages 80 and 89 than octogenarians born 1909-1918, and octogenarian women experienced an increase in partial DFLE of 0.32 years (P = 0.004) across the two birth cohorts. Although no increases in partial LE were observed among nonagenarians or centenarians, partial DFLE increased across birth cohorts, with a gain of 0.41 years (P < 0.001) among nonagenarians and 0.07 years (P = 0.050) among centenarians. Subgroup analyses revealed that gains in partial LE and DFLE primarily occurred among the urban resident population. CONCLUSIONS Successive generations of China's oldest-old are living with less disability as a whole, and LE is expanding among octogenarians. However, we found a widening urban-rural disparity in longevity and disability, highlighting the need to improve policies to alleviate health inequality throughout the population.
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Affiliation(s)
- Zuyun Liu
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Ling Han
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Qiushi Feng
- Department of Sociology, National University of Singapore, Singapore, Singapore
| | - Matthew E Dupre
- Department of Population Health Sciences, Duke University, Durham, NC, USA.,Department of Sociology, Duke University, Durham, NC, USA
| | - Danan Gu
- Independent Researcher, New York, NY, USA
| | - Heather G Allore
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Collin F Payne
- School of Demography, Research School of Social Sciences, Australian National University, 9 Fellows Road, Acton, ACT, Canberra, 2601, Australia.
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Boissy P, Blamoutier M, Brière S, Duval C. Quantification of Free-Living Community Mobility in Healthy Older Adults Using Wearable Sensors. Front Public Health 2018; 6:216. [PMID: 30151357 PMCID: PMC6099098 DOI: 10.3389/fpubh.2018.00216] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 07/10/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: Understanding determinants of community mobility disability is critical for developing interventions aimed at preventing or delaying disability in older adults. In an effort to understand these determinants, capturing and measuring community mobility has become a key factor. The objectives of this paper are to present and illustrate the signal processing workflow and outcomes that can be extracted from an activity and community mobility measurement approach based on GPS and accelerometer sensor data and 2) to explore the construct validity of the proposed measurement approach using data collected from healthy older adults in free-living conditions. Methods: Personal, functional impairment and environmental variables were obtained by self-report questionnaires in 75 healthy community-living older adults (mean age = 66 ± 7 years old) living on the island of Montreal, QC, Canada. Participants wore, for 14 days during waking hours on the hip, a data logger incorporating a GPS receiver with a 3-axis accelerometer. Time at home ratio (THR), Trips out (TO), Destinations (D), Maximal distance of destinations (MDD), Active time ratio (ATR), Steps (S), Distance in a vehicle (DV), Time in a vehicle (TV), Distance on foot (DF), Time on foot (TF), Ellipse area (EA), and Ellipse maximum distance (EMD) were extracted from the recordings. Results: After applying quality control criteria, the original data set was reduced from 75 to 54 participants (28% attrition). Results from the remaining sample show that under free-living conditions in healthy older adults, location, activity and community mobility outcomes vary across individuals and certain personal variables (age, income, living situation, professional status, vehicle access) have potential mitigating effects on these outcomes. There was a significant (yet small) relationship (rho < 0.40) between self-reported life space and MDD, DV, EA, and EMD. Conclusion: Wearability and usability of the devices used to capture free-living community mobility impact participant compliance and the quality of the data. The construct validity of the proposed approach appears promising but requires further studies directed at populations with mobility impairments.
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Affiliation(s)
- Patrick Boissy
- Orthopedic Service, Department of Surgery, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, CIUSSS Estrie CHUS, Sherbrooke, QC, Canada
| | - Margaux Blamoutier
- Department des Sciences de l'activité Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Simon Brière
- Research Centre on Aging, CIUSSS Estrie CHUS, Sherbrooke, QC, Canada
| | - Christian Duval
- Department des Sciences de l'activité Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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15
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Li C, Jiang S, Li N, Zhang Q. Influence of social participation on life satisfaction and depression among Chinese elderly: Social support as a mediator. JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 46:345-355. [DOI: https:/doi.org/10.1002/jcop.21944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Chunkai Li
- School of Social and Behavioral Sciences; Nanjing University; Nanjing China
| | - Shan Jiang
- School of Social and Behavioral Sciences; Nanjing University; Nanjing China
| | - Na Li
- School of Social and Behavioral Sciences; Nanjing University; Nanjing China
| | - Qiunv Zhang
- School of Social and Behavioral Sciences; Nanjing University; Nanjing China
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16
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Islam MS, Tareque MI, Mondal MNI, Fazle Rabbi AM, Khan HTA, Begum S. Urban-rural differences in disability-free life expectancy in Bangladesh using the 2010 HIES data. PLoS One 2017; 12:e0179987. [PMID: 28742101 PMCID: PMC5524410 DOI: 10.1371/journal.pone.0179987] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 06/07/2017] [Indexed: 01/15/2023] Open
Abstract
Background Research on health expectancy has been carried out in Bangladesh but none of it has examined the differences in Disability-Free Life Expectancy (DFLE) between urban and rural setting in context of rapid urbanization of Bangladesh in past decades. Objectives The present study aims to estimate DFLE for people of all ages living in urban and rural areas in Bangladesh, and to examine the differences in DFLE between these two areas. Methods Data from the Sample Vital Registration System 2010 and the Bangladesh Household Income and Expenditure Survey (HIES) 2010 were used in this study. The Sullivan method was applied to estimate DFLE in Bangladesh. Results Higher rates of mortality and disability were observed in rural areas compared to urban areas with few exceptions. Statistically significant differences in DFLE were revealed from birth to age 15 years for both sexes between urban and rural areas. Urban males had a longer life expectancy (LE), longer DFLE and shorter LE with disability both in number and proportion when compared to rural males. Rural females at age 20+ years had a longer LE than urban females but urban females had a longer DFLE and a shorter LE with disability in both number and proportion at all ages than did rural females. Conclusion This study demonstrates that there were clear inequalities in LE, DFLE and LE with disability between rural and urban areas of Bangladesh along with age-specific differences as well. These findings may serve as useful and benchmark for intervention and policy implications for reducing the gap in health outcomes.
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Affiliation(s)
- Md. Shariful Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Ismail Tareque
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
- * E-mail:
| | - Md. Nazrul Islam Mondal
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | | | - Hafiz T. A. Khan
- Graduate School, The University of West London, St Mary’s Road, Ealing, London, United Kingdom
| | - Sharifa Begum
- Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
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17
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Kang SH, Yong V, Chan A, Saito Y. Revisiting Mobility Limitations of Seniors in Singapore, 1995 to 2011. Gerontol Geriatr Med 2017; 2:2333721416645034. [PMID: 28138497 PMCID: PMC5119869 DOI: 10.1177/2333721416645034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 01/25/2016] [Accepted: 03/14/2016] [Indexed: 11/26/2022] Open
Abstract
Singapore’s life expectancy at birth and at age 65 continues to improve. Although this is a positive development, it is necessary to understand how much of this increased life expectancy is spent with and without mobility limitations. This research uses the latest round of the National Survey of Senior Citizens to examine the situation in 2011 and the possible changes that may have occurred since the last survey in 2005. It seeks to add to earlier research in this area in Singapore and uses the prevalence-based Sullivan method to calculate lifetime free of mobility limitations for this population. Pertinent conclusions drawn from this research include evidence pointing to changing prevalence rates among the older adult population and observations that suggest the possibility of a compression of morbidity for this population in 2011 compared with an expansion of morbidity observed in the previous survey conducted in 2005. The research also shows that women continue to be disadvantaged as they age compared with men.
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Affiliation(s)
- Soon-Hock Kang
- School of Arts and Social Sciences, SIM University, Singapore
| | - Vanessa Yong
- Population Research Institute, Nihon University, Japan
| | - Angelique Chan
- Centre of Ageing Research and Education, DukeNUS Medical School, Singapore; Health Services and Systems Research, DukeNUS Medical School, Singapore; Department of Sociology, National University of Singapore, Singapore
| | - Yasuhiko Saito
- University Research Center, Nihon University, Japan; Population Research Institute, Nihon University, Japan; Health Services and Systems Research, DukeNUS Medical School, Singapore
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18
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Li L, Loo BPY. Mobility impairment, social engagement, and life satisfaction among the older population in China: a structural equation modeling analysis. Qual Life Res 2016; 26:1273-1282. [PMID: 27796773 DOI: 10.1007/s11136-016-1444-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Revealing the relationship between mobility impairment and life satisfaction can help to propose effective interventions to secure mobility and life satisfaction. However, the relationship remains unclear and lacks quantitative evidence in China. This study therefore assesses the association of mobility impairment, social engagement, and life satisfaction among the older population in China. METHODS Based on the sample of China Health and Retirement Longitudinal Survey database in 2013, a structural equation modeling is established. The sample size is 4245 with 55.9% with mobility impairment. RESULTS The model shows that the length of suffering from disability is significantly related to mobility impairment (β = 0.058, p < 0.001). Mobility impairment is inversely related to social engagement (β = -0.300, p < 0.001) and life satisfaction (β = -0.311, p < 0.001). Social engagement is positively related to life satisfaction (β = 0.211, p < 0.001). Moreover, the relationships have some differences for the seniors with different sociodemographic characteristics and living in different residential areas. CONCLUSIONS As seniors get older, they tend to have more severe mobility impairment and participate less in social activities. Those with higher mobility impairment are more likely to report lower life satisfaction partly because they usually participate less in social activities. Different strategies are suggested to be adopted to improve the life satisfaction of the older population from the aspects of promoting mobility and social engagement, including improving the design of transport facilitates, providing assistive facilities for the seniors with severe mobility impairment, promoting the accessibility of community leisure and healthcare services, and constructing more community senior activity centers.
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Affiliation(s)
- Linna Li
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong, China.
| | - Becky P Y Loo
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong, China
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19
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Thong ISK, Tan G, Lee TYC, Jensen MP. A Comparison of Pain Beliefs and Coping Strategies and Their Association with Chronic Pain Adjustment Between Singapore and United States. PAIN MEDICINE 2016; 18:1668-1678. [PMID: 27694147 DOI: 10.1093/pm/pnw237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | | | | | - Mark P Jensen
- Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
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20
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Apinonkul B, Soonthorndhada K, Vapattanawong P, Jagger C, Aekplakorn W. Regional and Gender Differences in Years with and without Mobility Limitation in the Older Population of Thailand. PLoS One 2016; 11:e0153763. [PMID: 27138811 PMCID: PMC4854393 DOI: 10.1371/journal.pone.0153763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/04/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To examine gender and regional differences in health expectancies based on the measure of mobility. METHODS Health expectancies by gender and region were computed by Sullivan's method from the fourth Thai National Health Examination Survey (2009). A total of 9,210 older persons aged 60 years and older were included. Mobility limitation was defined as self-reporting of ability to perform only with assistances/aids at least one of: walking at least 400 metres; or going up or down a flight of 10 stairs. Severe limitation was defined as complete inability to do at least one of these two functions, even with assistances or aids. RESULTS At age 60, females compared to males, spent significantly fewer years without mobility limitation (male-female = 3.2 years) and more years with any limitation (female-male = 6.7 years) and with severe limitation (female-male = 3.2 years). For both genders, years lived with severe limitation were remarkably constant across age. Significant regional inequalities in years lived without and with limitation were evident, with a consistent pattern by gender in years free of mobility limitation (Central ranked the best and the North East ranked the worst). Finally, both males and females in the South had the longest life expectancy and the most years of life with severe mobility limitation. CONCLUSION This study identifies inequalities in years without and with mobility limitations with important policy implication.
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Affiliation(s)
- Benjawan Apinonkul
- Faculty of Physical Therapy, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Kusol Soonthorndhada
- Institute for Population and Social Research, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Patama Vapattanawong
- Institute for Population and Social Research, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Carol Jagger
- Newcastle University Institute for Ageing and Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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21
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Penkunas MJ, Chan AWM, Wong CH, de Korne DF, Tan SM, Wong SF. The Role of a Multicomponent Home-Health Intervention in Reducing Caregiver Stress in Singapore: A Qualitative Study. J Gerontol B Psychol Sci Soc Sci 2016; 73:314-325. [DOI: 10.1093/geronb/gbw008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 01/16/2016] [Indexed: 11/14/2022] Open
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22
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Nascimento CDM, Mambrini JVDM, de Oliveira CM, Giacomin KC, Peixoto SV. Diabetes, hypertension and mobility among Brazilian older adults: findings from the Brazilian National Household Sample Survey (1998, 2003 and 2008). BMC Public Health 2015; 15:591. [PMID: 26116434 PMCID: PMC4483209 DOI: 10.1186/s12889-015-1956-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/19/2015] [Indexed: 12/02/2022] Open
Abstract
Background The rapid population ageing has been accompanied by a growing number of older adults experiencing chronic conditions, especially diabetes and hypertension, which are conditions associated to the decline in physical functioning. The aim of this study was to investigate changes in the strength of the association between mobility and two chronic conditions (hypertension and diabetes) in a large representative sample of Brazilian older adults over a ten year period. Methods The data came from the Brazilian National Household Sample Survey (PNAD) of 1998, 2003 and 2008. The sample comprised 28,943 participants aged 60 years and older investigated in 1998, 35,042 in 2003 and 41,269 in 2008, totalling 105,254 older adults. The dependent variable was the physical mobility index (PMI) constructed based on the Item Response Theory (IRT) using five physical mobility indicators. The chronic conditions were self-reported and the confounders included: age, sex, schooling, ethnicity, family income, household composition, other co-morbidities and use of health services. The association between physical mobility (three different groups) and chronic conditions (hypertension and diabetes) was performed using multinomial logistic regression. Results Over the ten year period the prevalence of hypertension increased from 44 % (1998), 49 % (2003) to 53 % (2008) (p < 0.001). Similar pattern was observed for the prevalence of diabetes: 10 % in 1998, 13 % in 2003 and 16 % in 2008 (p < 0.001). Overall, physical mobility showed a statistical significant association with both chronic diseases studied even after adjusting for potential confounders. The time-disease interaction term was significant (p < 0.05) for the two chronic conditions studied, and the strength of the associations decreased over the first five years, but it was not sustained between 2003 and 2008. Conclusions Despite the increases observed in the prevalence of the hypertension and diabetes over the ten year period, the decrease in strength of the association with physical mobility during the first period could be explained by improvements in health services and treatment of older adults. Special attention should be given to the treatment and management of diabetes in order to avoid declines in physical mobility levels.
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Affiliation(s)
| | | | | | - Karla Cristina Giacomin
- Rene Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil. .,Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
| | - Sérgio Viana Peixoto
- Rene Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil. .,Nursing School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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23
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Chan A, Malhotra R, Matchar DB, Ma S, Saito Y. Gender, educational and ethnic differences in active life expectancy among older Singaporeans. Geriatr Gerontol Int 2015; 16:466-73. [PMID: 25868426 DOI: 10.1111/ggi.12493] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2015] [Indexed: 11/28/2022]
Abstract
AIM The aim of the present study was to compute total life expectancy (TLE), active life expectancy (ALE) and inactive life expectancy among older Singaporeans by gender, education and ethnicity. METHODS Data from a longitudinal survey of older Singaporeans were used. No difficulty in carrying out activities of daily living or instrumental activities of daily living was considered as "active." Transition probabilities across health states (active/inactive/dead) were assessed to develop multistate life tables, which estimated TLE, ALE and inactive life expectancy. RESULTS At age 60 years, women, versus men, had significantly higher TLE (25.9, 95% confidence interval [CI] 24.0-27.8 vs 21.6, 95% CI 20.1-23.1), but similar ALE (18.1, 95% CI 17.0-19.2 vs 18.9, 95% CI 17.7-20.2). Those with high (secondary or higher), versus low (primary or less), education had significantly higher TLE (28.5, 95% CI 25.0-32.0 vs 22.5, 95% CI 21.1-23.9) and ALE (23.5, 95% CI 21.2-25.7 vs 17.1, 95% CI 16.1-18.0) at age 60 years. Those of Chinese, versus non-Chinese, ethnicity had significantly higher ALE at age 60 years (19.4, 95% CI 18.4-20.3 vs 15.0, 95% CI 13.4-16.7). CONCLUSION Unlike Western nations, there was no gender difference in ALE among older adults in Singapore. However, difference in ALE by education among older Singaporeans was similar to that observed in Western societies. Policies focusing specifically on improving women's health at all ages, in addition to policies that increase population education levels, are promising approaches to improving ALE. Recognizing ethnic differences in ALE will help target policies that increase ALE in multicultural societies.
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Affiliation(s)
- Angelique Chan
- Health Services and Systems Research (HSSR), Duke-NUS Graduate Medical School, Singapore.,Department of Sociology, National University of Singapore, Singapore
| | - Rahul Malhotra
- Health Services and Systems Research (HSSR), Duke-NUS Graduate Medical School, Singapore.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - David B Matchar
- Health Services and Systems Research (HSSR), Duke-NUS Graduate Medical School, Singapore.,Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Stefan Ma
- Epidemiology & Disease Control Division, Singapore Ministry of Health, Singapore
| | - Yasuhiko Saito
- Health Services and Systems Research (HSSR), Duke-NUS Graduate Medical School, Singapore.,Advanced Research Institute for the Sciences and Humanities, Nihon University, Tokyo, Japan
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Apinonkul B, Soonthorndhada K, Vapattanawong P, Aekplakorn W, Jagger C. Gender differences in health expectancies across the disablement process among older Thais. PLoS One 2015; 10:e0121310. [PMID: 25799568 PMCID: PMC4370608 DOI: 10.1371/journal.pone.0121310] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/30/2015] [Indexed: 12/02/2022] Open
Abstract
Objectives To estimate health expectancies based on measures that more fully cover the stages in the disablement process for the older Thais and examine gender differences in these health expectancies. Methods Health expectancies by genders using Sullivan’s method were computed from the fourth Thai National Health Examination Survey conducted in 2009. A total of 9,210 participants aged 60 years and older were included in the analysis. Health measures included chronic diseases; cognitive impairment; depression; disability in instrumental activities of daily living (IADL); and disability in activities of daily living (ADL). Results The average number of years lived with and without morbidity and disability as measured by multiple dimensions of health varied and gender differences were not consistent across measures. At age 60, males could expect to live the most years on average free of depression (18.6 years) and ADL disability (18.6 years) and the least years free of chronic diseases (9.1 years). Females, on the contrary, could expect to live the most years free of ADL disability (21.7 years) and the least years free of IADL disability (8.1 years), and they consistently spent more years with all forms of morbidity and disability. Finally, and for both genders, years lived with cognitive impairment, depression and ADL disability were almost constant with increasing age. Conclusion This study adds knowledge of gender differences in healthy life expectancy in the older Thai population using a wider spectrum of health which provides useful information to diverse policy audiences.
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Affiliation(s)
- Benjawan Apinonkul
- Institute for Population and Social Research, Mahidol University, Salaya, Phutthamonthon, NakhonPathom, Thailand
- * E-mail:
| | - Kusol Soonthorndhada
- Institute for Population and Social Research, Mahidol University, Salaya, Phutthamonthon, NakhonPathom, Thailand
| | - Patama Vapattanawong
- Institute for Population and Social Research, Mahidol University, Salaya, Phutthamonthon, NakhonPathom, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Carol Jagger
- Newcastle University Institute for Ageing and Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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Tareque MI, Saito Y, Kawahara K. Application of Health Expectancy Research on Working Male Population in Bangladesh. ASIAN POPULATION STUDIES 2015. [DOI: 10.1080/17441730.2015.1007558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Marshall A, Nazroo J, Tampubolon G, Vanhoutte B. Cohort differences in the levels and trajectories of frailty among older people in England. J Epidemiol Community Health 2015; 69:316-21. [PMID: 25646207 PMCID: PMC4392235 DOI: 10.1136/jech-2014-204655] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background The level of frailty in the older population across age cohorts and how this changes is a factor in determining future care costs and may also influence the extent of socioeconomic and gender inequalities in frailty. Methods We model cohort-specific trajectories in frailty among the community dwelling population older than 50 years, using five waves (2002–2010) of the English Longitudinal Study of Ageing. We stratify our analysis by wealth and gender and use a frailty index, based on accumulation of ‘deficits’. Results For males and females between the ages of 50 and 70 in 2002, frailty trajectories for adjacent age cohorts converge. However, levels of frailty are higher in recent compared with earlier cohorts at the older ages (for cohorts aged over 70 in 2002). These cohort differences are largest in the poorest wealth group, while for the most affluent, frailty trajectories overlap across all adjacent cohorts suggesting no change across cohorts. Conclusions A key driver of the cohort differences in frailty that we observe is likely to be increased survival of frail individuals. Importantly, this paper illustrates that the social conditions experienced across the wealth distribution impacts on the rate of deficit accumulation in older populations. Our results on trajectories of frailty between 2002 and 2010 are pessimistic and, in the context of rising life expectancies, suggest that poorer older people in particular spend additional years of life in a frail state.
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Affiliation(s)
- Alan Marshall
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
| | - James Nazroo
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
| | - Gindo Tampubolon
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
| | - Bram Vanhoutte
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
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27
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Chan A, Malhotra C, Malhotra R, Rush AJ, Østbye T. Health Impacts of Caregiving for Older Adults With Functional Limitations. J Aging Health 2013; 25:998-1012. [DOI: 10.1177/0898264313494801] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To estimate the health impact, in terms of depression, self-rated health, and health services utilization, of providing care to older adults (75+) requiring human assistance in at least one activity of daily living (ADL) limitation. Method: Data from 1,077 caregivers and 318 noncaregivers, interviewed in the Singapore Survey on Informal Caregiving, was used to examine differences in depressive symptoms, self-rated health, and number of outpatient visits in the last 1 month between caregivers and noncaregivers. Multivariate models for the outcomes, adjusting for characteristics of the caregiver/noncaregiver and care-recipient/potential care recipient, were run. Results: Caregivers were more depressed, had poorer self-rated health, and had a higher rate of outpatient visits in the past month compared to noncaregivers. Discussion: The study indicates the need for support services to family caregivers of older adults with ADL limitations.
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Affiliation(s)
- Angelique Chan
- Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
- Department of Sociology, National University of Singapore, Singapore
| | - Chetna Malhotra
- Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Rahul Malhotra
- Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Augustus John Rush
- Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
| | - Truls Østbye
- Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
- Department of Community and Family Medicine, Duke University, USA
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Malhotra C, Chan A, Malhotra R, Østbye T. Prevalence, correlates and perceived causes of limitations in activities of daily living among older Singaporeans. Aging Clin Exp Res 2012; 24:56-61. [PMID: 22643305 DOI: 10.1007/bf03325354] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIMS To describe the prevalence of limitations in Activities of Daily Living (ADL) among older Singaporeans, examine the association of ADL limitations with various self-reported health conditions, assess perceived causes of ADL limitations, and compare prevalence of health conditions among those who perceive only 'old age' vs those who perceive at least one specific health condition as the cause of their limitations. METHODS Data from a national survey of Singaporeans 60 years and over was used. The association between ADL limitations and health conditions was assessed through logistic regression. Those with ADL limitations were asked about the perceived cause/s of their limitation/ s. Any significant difference in the prevalence of health conditions between those attributing their ADL limitations only to old age and those attributing to at least one specific health condition was ascertained. RESULTS Overall prevalence of ADL limitations was 9.7%. Joint/nerve pain, stroke, pelvic/femoral fractures, heart diseases, diabetes, osteoporosis, chronic respiratory illness and renal/urinary tract illness were significantly associated with ADL limitations, and the most common perceived cause was 'old age' (33%). The prevalence of most health conditions was similar in older adults attributing their limitations to only 'old age' and to at least one specific health condition. CONCLUSION Clinical suspicion is called for if individuals with ADL limitations attribute them solely to 'old age'.
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Chan A, Malhotra C, Do YK, Malhotra R, Ostbye T. Self reported pain severity among multiethnic older Singaporeans: does adjusting for reporting heterogeneity matter? Eur J Pain 2011; 15:1094-9. [PMID: 21646030 DOI: 10.1016/j.ejpain.2011.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 04/18/2011] [Accepted: 05/14/2011] [Indexed: 01/21/2023]
Abstract
The objective of this paper is to test and correct for systematic differences in reporting of pain severity among older adults by age, gender, ethnic group and socio-economic status using anchoring vignettes. Data from a national survey of community-dwelling older Singaporeans (aged 60 years and over) conducted in 2009 was used. Respondents were asked to rate the severity of their own pain as well as that of others described in the vignettes on a five-point scale ranging from none to extreme. An ordered probit model was used to estimate the coefficients of the independent variables (age, gender, ethnic group, education, housing type) on self-reported pain. Reporting heterogeneity in pain severity was then corrected using a Hierarchical Ordered Probit model. The results showed that before correcting for reporting heterogeneity, women, those older, and those of Malay ethnicity reported greater severity of pain, while there was no association of reported pain severity with housing type and education. However, after correcting for reporting heterogeneity, while women and those older were found to have an even greater severity of pain than what they had reported, Malays were found to have a lower severity of pain than what they had reported. We conclude that there are systematic differences in reporting pain severity by age, gender and ethnic group. We propose that pain management may be improved if medical professionals take into account reporting heterogeneity for pain severity among various population sub-groups in Singapore.
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Affiliation(s)
- Angelique Chan
- Department of Health Services and Systems Research, Duke-NUS Graduate Medical School, 8 College Road, 169857 Singapore
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