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Genaro LE, Marconato JV, Tagliaferro EPDS, Pinotti FE, Valsecki Júnior A, Adas Saliba T, Rosell FL. Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:539. [PMID: 38791748 PMCID: PMC11121688 DOI: 10.3390/ijerph21050539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 05/26/2024]
Abstract
This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.
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Affiliation(s)
- Luis Eduardo Genaro
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - José Victor Marconato
- School of Medicine, San Francisco University, Bragança Paulista 12.916-900, SP, Brazil;
| | - Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Felipe Eduardo Pinotti
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Aylton Valsecki Júnior
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Tânia Adas Saliba
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Fernanda Lopez Rosell
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
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Keeratisiroj O, Kitreerawutiwong N, Mekrungrongwong S. Development of Self-Active Aging Index (S-AAI) among rural elderly in lower northern Thailand classified by age and gender. Sci Rep 2023; 13:2676. [PMID: 36792795 PMCID: PMC9932059 DOI: 10.1038/s41598-023-29788-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
This study aimed to develop a Self-Active Aging Index (S-AAI) for the rural community of Thailand using the World Health Organization (WHO) framework, and score it according to age and gender. Overall, 1,098 elderly people were randomly selected. The self-reported questionnaires were categorized into three segments: health, participation, and security according to the WHO framework. An exploratory factor analysis was used to determine appropriate components. The S-AAI comprised 28 indicators and 9 factors: (1) mental/subjective health; (2) physical health; (3) health behavior and chronic disease; (4) vision and hearing; (5) oral health; (6) social participation; (7) stability in life; (8) financial stability; and (9) secure living. The overall S-AAI for all components was 0.65, with the index inversely proportional to age, but with no gender differences. The S-AAI is potentially Thailand's first multi-dimensional interactive aging assessment tool with a unique cultural context for rural areas. Although this tool is valid, it requires reliability testing.
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Affiliation(s)
- Orawan Keeratisiroj
- Faculty of Public Health, Naresuan University, Phitsanulok, 65000, Thailand.
| | - Nithra Kitreerawutiwong
- grid.412029.c0000 0000 9211 2704Faculty of Public Health, Naresuan University, Phitsanulok, 65000 Thailand
| | - Sunsanee Mekrungrongwong
- grid.412029.c0000 0000 9211 2704Faculty of Public Health, Naresuan University, Phitsanulok, 65000 Thailand
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Wongsala M, Anbäcken EM, Manasatchakun P, Rungkawatt V, Rosendahl S. Lifestyle Changes Using the Plan-Do-Study-Act Cycle among Older Thai Adults – A Focus Group Study. ACTIVITIES, ADAPTATION & AGING 2023. [DOI: 10.1080/01924788.2023.2172881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Manothai Wongsala
- School of Health, Care and Social Welfare, Mälardalen University, Hamngatan, Eskilstuna, Sweden/Lecturer in Nursing Boromarajonani College of Nursing Nakhonratchasima, Faculty of Nursing, Praboromarajchanok Institute, Nakhonratchasima, Thailand
| | - Els-Marie Anbäcken
- Social Work with Focus on Older Adults, Linköping University; Senior Lecturer in Social Work, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Pornpun Manasatchakun
- Caring Science, Nursing, Boromarajonani College of Nursing Chiang Mai, Faculty of Nursing, Praboromarajchanok Institute, Chiang Mai, Thailand
| | - Viliporn Rungkawatt
- Nursing, Boromarajonani College of Nursing Nakhonratchasima, Faculty of Nursing, Praboromarajchanok Institute, Nakhonratchasima, Thailand
| | - Sirpa Rosendahl
- Gerontology, Nursing, School of Health Sciences, University of Skövde, Skövde, Sweden
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DiGuiseppi CG, Hyde HA, Betz ME, Scott KA, Eby DW, Hill LL, Jones VC, Mielenz TJ, Molnar LJ, Strogatz D, Li G. Association of falls and fear of falling with objectively-measured driving habits among older drivers: LongROAD study. JOURNAL OF SAFETY RESEARCH 2022; 83:96-104. [PMID: 36481041 PMCID: PMC10115437 DOI: 10.1016/j.jsr.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 02/28/2022] [Accepted: 08/09/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Falls in older adults are associated with increased motor vehicle crash risk, possibly mediated by driving behavior. We examined the relationship of falls and fear of falling (FOF) with subsequent objectively measured driving habits. METHODS This multi-site, prospective cohort study enrolled 2990 active drivers aged 65-79 (53% female). At enrollment, we assessed falls in the past year and FOF (Short Falls Efficacy Scale-International). Driving outcomes included exposure, avoidance of difficult conditions, and unsafe driving during one-year follow-up, using in-vehicle Global Positioning System devices. RESULTS Past-year falls were associated with more hard braking events (HBE). High FOF was associated with driving fewer days, miles, and trips, driving nearer home and more HBE. Differences were attenuated and not significant after accounting for health, function, medications and sociodemographics. DISCUSSION Differences in objectively measured driving habits according to past-year fall history and FOF were largely accounted for by differences in health and medications. Rather than directly affecting driving, falls and FOF may serve as markers for crash risk and reduced community mobility due to age-related changes and poor health.
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Affiliation(s)
- Carolyn G DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Hailey A Hyde
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marian E Betz
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kenneth A Scott
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David W Eby
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA; Center for Advancing Transportation Leadership and Safety (ATLAS Center), University of Michigan, Ann Arbor, MI, USA
| | - Linda L Hill
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Vanya C Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thelma J Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia's Injury Control Research Center, Columbia University, New York, NY, USA
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA; Center for Advancing Transportation Leadership and Safety (ATLAS Center), University of Michigan, Ann Arbor, MI, USA
| | - David Strogatz
- Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY, USA
| | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia's Injury Control Research Center, Columbia University, New York, NY, USA; Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Pérez RA, Tejada CAO, Triaca LM, Bertoldi AD, dos Santos AMA. Socioeconomic inequality in health in older adults in Brazil. DIALOGUES IN HEALTH 2022; 1:100009. [PMID: 38515904 PMCID: PMC10953994 DOI: 10.1016/j.dialog.2022.100009] [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: 11/05/2021] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 03/23/2024]
Abstract
Objective This study analyzed socioeconomic inequality in self-rated health for older adults (aged fifty or over) in Brazil. Methods Data from the 2015-2016 Brazilian Longitudinal Study of Aging (ELSI-Brazil). Socioeconomic inequality in self-rated health was measured using the concentration index, which was decomposed to analyze the contribution of different factors. Results This study revealed that 11.5% of the older adults interviewed reported their health as poor and very poor. For the complete sample, the estimated concentration index, -0.2434, indicated that there is a concentration of poor and very poor self-rated health among older and poorer adults. Income, education and having a private health insurance plan are the factors that contributed most to the observed inequality. Discussion The decomposition showed that there are avoidable inequalities in relation to socioeconomic status for older adults in Brazil. These factors can guide the formulation of social and health policies aimed at reducing health inequalities.
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Affiliation(s)
- Raquel Alves Pérez
- Posgraduate Program in Economics, Federal University of Pelotas (Universidade Federal de Pelotas - UFPel), Rio Grande do Sul, Brazil
| | - Cesar Augusto Oviedo Tejada
- Posgraduate Program in Economics, Federal University of Pelotas (Universidade Federal de Pelotas - UFPel), Rio Grande do Sul, Brazil
| | - Lívia Madeira Triaca
- Posgraduate Program in Economics, Federal University of Pelotas (Universidade Federal de Pelotas - UFPel), Rio Grande do Sul, Brazil
- Department of Economics, Federal University of Rio Grande Foundation (Fundação Universidade Federal do Rio Grande – FURG), Rio Grande, Brazil
| | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas (Universidade Federal de Pelotas - UFPel), Rio Grande do Sul, Brazil
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Lima ALBD, Espelt A, Bosque-Prous M, Lima KC. Gender differences in disability among older adults in the context of social gender and income inequalities: 2013 Brazilian Health Survey. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200002. [DOI: 10.1590/1980-549720200002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 01/10/2019] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT: Objectives: To estimate the magnitude of gender differences in disability among adults aged 60 and older and to evaluate whether they can be associated with social gender inequality and socioeconomic contextual factors at the level of Brazilian federative units. Methods: This is a multilevel study that used data from 23,575 older adults of 27 federative units who participated in the 2013 Brazilian Health Survey. The activity limitation index was developed from the item response theory, using activities of daily living and instrumental activities of daily living variables. The association of individual and contextual variables with disability was estimated by assessing the magnitude of differences between genders, using cross-level interaction effects in multilevel generalized linear models, including only the variables that were statistically significant in the final model. Results: The prevalence of disability was higher among women (37.6%) than among men (26.5%), totaling 32.7% of the older adults. In the adjusted multilevel analysis, disability was influenced by income inequality (γgini = 0.022, p < 0.001) among federative units. In addition, gender differences in disability were associated with social gender inequalities (γmgiiXsex = 0.020, p = 0.004). Conclusion: Women had higher disability disadvantages compared to men, and those differences were associated with social gender inequalities among the Brazilian federative units influenced by income inequality.
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Affiliation(s)
| | - Albert Espelt
- Universitat de Vic Universitat Central de Catalunya, Spain; Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Spain
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Melo RC, Cipolli GC, Buarque GLA, Yassuda MS, Cesari M, Oude Voshaar RC, Aprahamian I. Prevalence of Frailty in Brazilian Older Adults: A Systematic Review and Meta-analysis. J Nutr Health Aging 2020; 24:708-716. [PMID: 32744566 DOI: 10.1007/s12603-020-1398-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Frailty is characterized by a functioning decline in multiple systems accompanied by an increase in individual's vulnerability to stressors. It appears to be higher in low and middle-income countries compared with high-income ones. This study aimed to evaluate the prevalence of frailty in non-institutionalized Brazilian older adults. DESIGN a systematic review and meta-analysis study. SETTING Cross-sectional and prospective data from Brazil. PARTICIPANTS non-institutionalized adults aged 60 and older. METHODS Electronic searches were performed in PubMed/MEDLINE, LILACS, SCOPUS and Web of Science, considering the studies published between March 2001 and July 2018, using a combination of the following terms and correlates: "elder" AND "frail" AND "prevalence" AND "Brazil". Two independent reviewers selected studies according to the inclusion criteria. Disagreements were resolved by a third reviewer (title/abstract) and by consensus. Studies with samples ≥221 subjects were considered for meta-analysis. RESULTS 28 studies were included, while 18 had the data meta-analyzed. The majority of studies (61%) included older adults only from the Southeastern region. The number of subjects ranged from 53 to 5,532 individuals (N = 17,604) and the average age ranged from 65.6 to 85.5 years. The overall prevalence of frailty was 24%. When considering the different assessment methods, the prevalence was lower for frailty phenotype (16%) compared with other criteria (40%). Regarding sex, the prevalence of frailty was similar for women (28%) and men (25%). The prevalence of frailty was higher in older adults recruited from health care services (30%) compared to community ones (22%). CONCLUSION In Brazil, the overall prevalence of frailty in non-institutionalized older adults is higher than observed from more developed countries. However, it may vary according to the assessment methods and settings.
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Affiliation(s)
- R C Melo
- R.C. Melo, Universidade de Sao Paulo, Brazil,
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Social Determinants and Disparities in Active Aging Among Older Taiwanese. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16163005. [PMID: 31434349 PMCID: PMC6721230 DOI: 10.3390/ijerph16163005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/17/2019] [Accepted: 08/17/2019] [Indexed: 12/31/2022]
Abstract
This study assesses equity in active aging across social determinants among older Taiwanese. The data were collected from face-to-face interviews with adults aged 55 years or more in Taiwan in 2017 (n = 738). A total of 30 individual-level Taiwan active aging indicators were chosen, and the relationship between social determinants and active aging indicators were analyzed by logistic regression models. Women were more likely to participate in volunteering and other social groups and in lifelong learning activities, whereas men were more likely to be employed, to engage in physical activity, to feel safe from violence, and to use preventive care. Higher education was related to higher employment, social participation, independent living, lifelong learning, and a lower likelihood of poverty and severe cognitive impairment. Those living in rural areas were more likely to be employed, perform physical activity, feel physically safe, have better mental well-being, and have higher social respect and social integration ratings, whereas living in urban areas was related to greater access to medical care, owning assets, less severe cognitive impairment, greater likelihood of using information and communications technology, higher level of education, and higher access to convenient transportation. The significant disparities that exist in active aging may suggest inequality.
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Lima ALBD, Espelt A, Lima KCD, Bosque-Prous M. Activity limitation in elderly people in the European context of gender inequality: a multilevel approach. CIENCIA & SAUDE COLETIVA 2019; 23:2991-3000. [PMID: 30281736 DOI: 10.1590/1413-81232018239.20662016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/21/2016] [Indexed: 02/04/2023] Open
Abstract
The objective of the present study was to examine the magnitude of gender differences in activity limitations among the elderly, and the effect of the health and social individual factors and the context of social gender inequality in Europe. Cross-sectional design was performed. The study population included residents aged 60 years or over from 17 countries that participated in the Survey of Health, Ageing and Retirement in Europe conducted in 2010-13 (n = 49,685). Gender differences in activity limitation in each country was estimated. For multilevel analysis adjusted linear mixed effect models were used, where the intercept and 'sex' were considered random effects, with the 95% confidence intervals. The activity limitation index was created from a two parameter logistic combined models of item response theory. The average activity limitation index was significantly higher in women, (g10 = b1j = 0.36, p < 0.001), and was then controlled by individual and contextual factors, while the extent of these differences varied among countries. The European countries with the greatest gender differences in activity limitations were those with the greatest social gender inequalities, with women presenting a significant disadvantage.
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Affiliation(s)
- André Luiz Barbosa de Lima
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte. Av. Hermes da Fonseca s/n, Lagoa Nova. 59084-100 Natal RN Brasil.
| | - Albert Espelt
- Faculty of Health Sciences, Open University of Catalonia. Barcelona Spain
| | - Kenio Costa de Lima
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte. Av. Hermes da Fonseca s/n, Lagoa Nova. 59084-100 Natal RN Brasil.
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Affiliation(s)
| | - Steven M Albert
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pennsylvania
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