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Hwang Y, Massimo L, Aryal S, Hirschman KB, Cacchione PZ, Hodgson NA. Does cognitive impairment moderate the relationship between social isolation and anxiety? A 5-year longitudinal study of a nationally representative sample of community residing older adults. BMC Geriatr 2024; 24:63. [PMID: 38225544 PMCID: PMC10790424 DOI: 10.1186/s12877-024-04685-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Anxiety is common in older adults and social isolation is one of the leading factors associated with their anxiety. However, what is unknown is how the relationship between social isolation and anxiety differs by cognitive status. Therefore, this study was conducted to (1) compare the level of social isolation and anxiety in older adults who developed probable dementia and mild cognitive impairment (MCI) to those who maintained normal cognitive function over 5 years; and (2) determine if cognitive impairment moderates the relationship between changes in social isolation and changes in anxiety over 5 years. METHODS A secondary data analysis was conducted using the National Social Life, Health, and Aging Project (NSHAP): Wave 2 (2010-2011) and Wave 3 (2015-2016). The participants were categorized into three groups: Participants who developed probable dementia over 5 years (4.3%), developed probable MCI (19.1%), or maintained normal cognitive function (76.6%). Weighted linear regression analyses with a group interaction were used to examine the moderating effect of cognitive impairment on the relationship between changes in social isolation and anxiety. RESULTS At the 5-year follow up, there were statistically significant differences in social isolation between the three groups (p = 0.043). Regression analyses showed that increased social isolation over time was related to increased anxiety over 5 years regardless of cognitive status after controlling for covariates (p = 0.017). CONCLUSIONS The relationship between social isolation and anxiety was a universal phenomenon regardless of cognitive status. Tailored interventions targeting both people with or without cognitive impairment are needed to lessen social isolation and anxiety.
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Affiliation(s)
- Yeji Hwang
- College of Nursing and Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, 03080, Seoul, Korea.
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
| | - Lauren Massimo
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Subhash Aryal
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Karen B Hirschman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Nancy A Hodgson
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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2
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Lim E, Nielsen N, Lapane L, Barooah A, Xu S, Qu S, McPhillips E, Dube CE, Lapane K. Health effects of social connectedness in older adults living in congregate long-term care settings: A systematic review of quantitative and qualitative evidence. Int J Older People Nurs 2023; 18:e12577. [PMID: 37803996 PMCID: PMC10843483 DOI: 10.1111/opn.12577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/21/2023] [Accepted: 09/17/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND The overall impact of social connectedness on health outcomes in older adults living in nursing homes and assisted living settings is unknown. Given the unclear health impact of social connectedness for older adults in congregate long-term care settings worldwide, a comprehensive systematic review is required to evaluate the overall relationship between social connectedness and health outcomes for them. OBJECTIVES The purpose of this article was to synthesize the literature regarding the health impact of social connectedness among older adults living in nursing homes or assisted living settings. METHODS Using PRISMA guidelines, we identified eligible studies from Scopus, MEDLINE, PsycINFO, CINAHL and Cochrane databases (1990-2021). Bias and quality reporting assessment was performed using standardized criteria for cohort, cross sectional and qualitative studies. At each stage, ≥ 2 researchers conducted independent evaluations. RESULTS Of the 7350 articles identified, 25 cohort (follow-up range: 1 month-11 years; with two also contributing to cross sectional), 86 cross sectional, eight qualitative and two mixed methods were eligible. Despite different instruments used, many residents living in nursing homes and assisted living settings had reduced social engagement. Quantitative evidence supports a link between higher social engagement and health outcomes most studied (e.g. depression, quality of life). Few studies evaluated important health outcomes (e.g. cognitive and functional decline). Most cohort studies showed that lack of social connectedness accelerated time to death. CONCLUSIONS Social connectedness may be an important modifiable risk factor for adverse health outcomes for older adults living in nursing homes and assisted living facilities. Most studies were cross sectional and focused on quality of life and mental health outcomes. Longitudinal studies suggest that higher social engagement delays time to death. Evidence regarding other health outcomes important to older adults was scant and requires further longitudinal studies.
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Affiliation(s)
- Emily Lim
- Department of Gerontology, University of Massachusetts Boston, Wheatley Hall, 100 William T. Morrissey Boulevard, Boston, MA, 02125, USA
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
| | - Natalia Nielsen
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
| | - Lucienne Lapane
- Boston University, School of Social Work, 264 Bay State Road, Boston, MA, 02215, USA
| | - Adrita Barooah
- Department of Gerontology, University of Massachusetts Boston, Wheatley Hall, 100 William T. Morrissey Boulevard, Boston, MA, 02125, USA
| | - Shu Xu
- Department of Gerontology, University of Massachusetts Boston, Wheatley Hall, 100 William T. Morrissey Boulevard, Boston, MA, 02125, USA
| | - Shan Qu
- Department of Gerontology, University of Massachusetts Boston, Wheatley Hall, 100 William T. Morrissey Boulevard, Boston, MA, 02125, USA
| | - Emily McPhillips
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
| | - Catherine E. Dube
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
| | - Kate Lapane
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
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Chen P, Cai H, Bai W, Zhang Q, Su Z, Tang YL, Ungvari GS, Ng CH, Xiang YT. Global prevalence of mild cognitive impairment among older adults living in nursing homes: a meta-analysis and systematic review of epidemiological surveys. Transl Psychiatry 2023; 13:88. [PMID: 36906613 PMCID: PMC10008549 DOI: 10.1038/s41398-023-02361-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 03/13/2023] Open
Abstract
Mild cognitive impairment (MCI) is the early stage of cognitive impairment between the expected cognitive decline of normal aging and the more serious decline of dementia. This meta-analysis and systematic review explored the pooled global prevalence of MCI among older adults living in nursing homes and its relevant factors. The review protocol was registered in INPLASY (INPLASY202250098). PubMed, Web of Science, Embase, PsycINFO, and CINAHL databases were systematically searched from their respective inception dates to 8 January 2022. The inclusion criteria were made based on the PICOS acronym, as follows: Participants (P): Older adults living in nursing homes; Intervention (I): not applicable; Comparison (C): not applicable; Outcome (O): prevalence of MCI or the data can generate the prevalence of MCI according to study-defined criteria; Study design (S): cohort studies (only baseline data were extracted) and cross-sectional studies with accessible data published in a peer-reviewed journal. Studies involving mixed resources, reviews, systematic reviews, meta-analyses, case studies, and commentaries were excluded. Data analyses were performed using Stata Version 15.0. Random effects model was used to synthesize the overall prevalence of MCI. An 8-item instrument for epidemiological studies was used to assess the quality of included studies. A total of 53 articles were included involving 376,039 participants with a mean age ranging from 64.42 to 86.90 years from 17 countries. The pooled prevalence of MCI in older adults in nursing homes was 21.2% (95% CI: 18.7-23.6%). Subgroup and meta-regression analyses revealed that the screening tools used were significantly associated with MCI prevalence. Studies using the Montreal Cognitive Assessment (49.8%) had a higher prevalence of MCI than those using other instruments. No significant publication bias was found. Several limitations warrant attention in this study; for example, significant heterogeneity between studies remained and some factors associated with the prevalence of MCI were not examined due to insufficient data. Adequate screening measures and allocation of resources are needed to address the high global prevalence of MCI among older adults living in nursing homes.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, SAR, China
| | - Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.,Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia.,Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China. .,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China.
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4
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Tang L, Wang D, Bai Z, Zhu Y, Chen R. [Relationship between social support and depression among older people from elderly care social organizations in Anhui Province, China]. Rev Epidemiol Sante Publique 2022; 70:222-229. [PMID: 35933267 DOI: 10.1016/j.respe.2022.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To examine the relationship between absent social support and depression among older adults from elderly care social organizations in Anhui Province, China. METHODS A cross-sectional study using a multi-stage stratified random sampling method was conducted in six selected cities of Anhui Province, China. A linear regression model was employed to estimate the association between absent social support and depression. RESULTS All in all, 1167 older people were included. Social support and the three dimensions studied were all negatively correlated with depression. These findings suggest that older people from elderly care organizations, who reported higher social support, were less likely to develop depression. This association also existed after stratified analysis in different areas: household (urban/rural), age and gender. DISCUSSION A higher level of social support was correlated with lower chances of experiencing depression. These findings are consistent with the majority of previous literature having reported on social support among elderly populations. However, some of our findings differ from those of other studies. CONCLUSIONS Our study suggests that improved social support could help to prevent depression among older adults.
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Affiliation(s)
- Ling Tang
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China; Pediatric Hospital Affiliated to Fudan University, Shanghai, 201102, China
| | - Danni Wang
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Zhongliang Bai
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Ying Zhu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China; Affiliated Suzhou Hospital of Anhui Medical University, Suzhou, 234000, China.
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A Qualitative Study Exploring Negative Affect in Older Adults Residing in Long-Term Care Facilities. Res Theory Nurs Pract 2022. [DOI: 10.1891/rtnp-2021-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose: To explore the experience of negative affect amongst older adults residing in long-term care facilities (LTCFs).Methods: A total of 38 participants aged 65 years or above from seven LTCFs in the Henan Province were interviewed in an unstructured manner by using the phenomenological research method. Data were analyzed by the Colaizzi method with NVivo11.0 software.Results: Three main themes emerged: (a) loneliness (lack of family affection, no common topic, and few entertainment activities), (b) chronic anxiety (suffering from disease, fear of death, and interpersonal tension), (c) subthreshold depression (diminished self-care ability, high economic pressure, and spousal bereavement).Conclusions: Older adults residing in LTCFs experienced the negative affect of loneliness, chronic anxiety, and subthreshold depression. By identifying the specific psychological issues of older adults, tailored practical initiatives need to be developed in order to reduce negative affect, improve psychological resilience, and enhance subjective well-being of older adults.
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Cameron N, Fetherstonhaugh D, Rayner JA, McAuliffe L. Loss, Unresolved Trauma and Gaps in Staff Knowledge: A Qualitative Study on Older Adults Living in Residential Aged Care. Issues Ment Health Nurs 2022; 43:748-754. [PMID: 35235481 DOI: 10.1080/01612840.2022.2043496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Despite the prevalence of mental health concerns among those who live in residential aged care, many residential aged care facilities (RACFs) provide little by way of psychological support. Drawing on qualitative data obtained from interviews with residents from across 15 RACFs in Victoria, Australia, this article adds to understandings about the diversity and impact of mental health challenges experienced by residents, and gaps in the knowledge of staff about how to address such. Thus, it also offers evidence of the urgent need for RACFs to provide residents both better access to specialist mental health practitioners and training to care staff on mental health issues.
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Affiliation(s)
- Nadine Cameron
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Australia
| | | | - Jo-Anne Rayner
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Australia
| | - Linda McAuliffe
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Australia
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- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Australia
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7
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Strong JV, Plys E, Hinrichs KLM, Hartmann CW, McCullough M. Music for your mental health? The development and evaluation of a group mental health intervention in subacute rehabilitation. Aging Ment Health 2022; 26:950-957. [PMID: 34121525 DOI: 10.1080/13607863.2021.1935463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Short-stay residents of nursing homes experience high rates of mental health (MH) distress compared to community dwelling counterparts, yet MH interventions are difficult to implement and sustain. We modified a music therapy framework to Effective Music in Psychotherapy. Using the modified model, we integrated music listening into MH group intervention and evaluated MH outcomes. This pilot study reports the development and evaluation of the Mental Health and Music Group for short-stay nursing homes residents.Method: The group was developed and refined to be non-sequential and non-cumulative, specific to the needs of short-stay nursing home residents. Pre-/post-session ratings examined affect, quality of life, and pain. Leaders monitored engagement across and between sessions. Qualitative interviews were conducted with a selection of attendees.Results: Findings indicated decreases in irritation and worry, and increases in mood, energy, and self-as-a-whole from pre- to post-session. There were no changes in pain, perception of physical health or life-as-a-whole, energetic, sad, or happy affect, or differences in engagement. Qualitative interviews demonstrated benefits of group modality and music to group cohesion and highlighted the relevance of music for mental health outcomes.Conclusion: The Mental Health and Music group was designed around a framework of Effective Music in Psychotherapy, for short-stay nursing home settings, and demonstrated promising results. Future research can solidify the interventions generalizeability to medical and rehabilitation settings addressing the specific population needs and preferences.Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2021.1935463 .
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Affiliation(s)
- Jessica V Strong
- VA Boston Healthcare System, Boston, MA, USA.,New England Geriatric Research Education and Clinical Center, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Department of Psychology, Faculty of Arts, University of Prince Edward Island, Charlottetown, Canada
| | - Evan Plys
- VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kate L M Hinrichs
- VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Christine W Hartmann
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System.,Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Megan McCullough
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System.,Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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8
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Hwang Y, Massimo L, Aryal S, Hodgson NA. The relationship between social isolation and anxiety in people with cognitive impairment in the United States. Int J Geriatr Psychiatry 2022; 37. [PMID: 34997619 DOI: 10.1002/gps.5679] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/02/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Social isolation among older adults with cognitive impairment is understudied. The purpose of this study is to examine the relationship between social isolation and anxiety in people with cognitive impairment in the United States. METHODS/DESIGN Secondary data analyses were conducted using the National Social Life, Health, and Aging Project (NSHAP) Wave 2 (2010-2011) dataset which includes a nationally representative sample of American older adults living at home. A total of 1343 people who had probable cognitive impairment measured by a Montreal Cognitive Assessment (MoCA) score of 22 or less were selected. Anxiety was measured using the anxiety measure of Hospital Anxiety and Depression Scale (HADS-A) and social isolation was measured using Perceived Social Isolation Scale. A weighted multivariable linear regression analysis and weighted F tests were used to examine the relationship between social isolation and anxiety. RESULTS We observed that greater social isolation was related to increased anxiety in people with cognitive impairment (coefficients = 0.7242, t = 2.51, p = 0.015), adjusting for severity of cognitive impairment, race, pain, depression, activities of daily living, and instrumental activities of daily living. Weighted F tests showed that persons with clinically significant anxiety (HADS-A ≥ 8) had higher levels of loneliness, including feeling a lack of companionship, feeling left out, and greater social isolation. CONCLUSIONS The results of our study suggest that people with cognitive impairment can feel social isolation and it may contribute to their anxiety. Health care professionals, family, and friends of people with cognitive impairment should pay greater attention to social isolation of their loved ones.
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Affiliation(s)
- Yeji Hwang
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Lauren Massimo
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Subhash Aryal
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Nancy A Hodgson
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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9
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Self-Esteem, Anxiety, and Depression in Older People in Nursing Homes. Healthcare (Basel) 2021; 9:healthcare9081035. [PMID: 34442172 PMCID: PMC8392518 DOI: 10.3390/healthcare9081035] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Social environment and type of care may influence mental health in late life. The aim of this study was to assess the associations between depression, anxiety, and self-esteem in older people. Methods: The study evaluated mental health in people older than 65 years of age in Zadar County, Croatia. The participants were interviewed using the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Rosenberg Self-Esteem Scale. Multiple linear regressions were used to assess the correlations between depression, anxiety, and self-esteem. Results: Compared with elderly people living in their own homes, elderly people in nursing homes reported lower self-esteem, higher depression, and higher anxiety. The level of self-esteem decreased with increased levels of depression. Anxiety was significantly associated with depression, while depression strongly increased with an increase in anxiety. Older age was associated with depression, while widowhood was a negative predictor of self-esteem. Institutionalization was borderline significantly associated with anxiety, while gender was associated with anxiety. Conclusions: The study found associations between self-esteem, anxiety, and depression in the elderly. The strategy of humanization in nursing care for older people should be applied equally in nursing homes and in community-dwelling states. Public health programs aimed at maintaining the mental health of older people are needed.
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Nair P, Gill JS, Sulaiman AH, Koh OH, Francis B. Mental Health Correlates Among Older Persons Residing in Malaysian Nursing Homes During the COVID-19 Pandemic. Asia Pac J Public Health 2021; 33:940-944. [PMID: 34243684 DOI: 10.1177/10105395211032094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Pritiss Nair
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Jesjeet Singh Gill
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ong Hui Koh
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Benedict Francis
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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11
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Baldelli G, De Santi M, De Felice F, Brandi G. Physical activity interventions to improve the quality of life of older adults living in residential care facilities: a systematic review. Geriatr Nurs 2021; 42:806-815. [PMID: 34090224 DOI: 10.1016/j.gerinurse.2021.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Pursuing active aging and maintaining the quality of life (QoL) is essential, particularly in older people living in residential care facilities (RCFs). We evaluated physical activity (PA) as an intervention to improve the QoL in this population, trying to hypothesize future perspectives in this field. METHODS A systematic search was performed on Pubmed. Only randomized control trials or quasi-experimental control group trials were considered. RESULTS Results showed that a high-frequency PA can be effective in older people, allowing them to improve their functional mobility, autonomy, anxiety level, balance, and social interactions. Moreover, a moderate-intensity PA showed the most interesting results, improving all the QoL-related aspects considered. CONCLUSION Results highlight the beneficial effects of multidisciplinary intervention strategies in increasing QoL and QoL-related aspects of RCFs older residents, contemplating PA as the main instrument. However, structured PA is necessary to fully understand which protocol could be the most effective.
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Affiliation(s)
- Giulia Baldelli
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy.
| | - Mauro De Santi
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy
| | | | - Giorgio Brandi
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy
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12
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Ulbricht CM, Hunnicutt JN, Gambassi G, Hume AL, Lapane KL. Nonmalignant Pain Symptom Subgroups in Nursing Home Residents. J Pain Symptom Manage 2019; 57:535-544.e1. [PMID: 30508639 PMCID: PMC6690183 DOI: 10.1016/j.jpainsymman.2018.11.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 11/19/2018] [Accepted: 11/22/2018] [Indexed: 11/20/2022]
Abstract
CONTEXT Despite many nursing home residents experiencing pain, research about the multidimensional nature of nonmalignant pain in these residents is scant. OBJECTIVES To identify and describe pain symptom subgroups and to evaluate whether subgroups differed by sex. METHODS Using Minimum Data Set 3.0 data (2011-2012), we identified newly admitted nursing home residents reporting pain (n = 119,379). A latent class analysis included 13 indicators: markers for pain (i.e., severity, frequency, impacts sleep, and function) and depressive symptoms. Sex was evaluated as a grouping variable. Multinomial logistic models identified the association between latent class membership and covariates, including age and cognitive impairment. RESULTS Four latent subgroups were identified: severe (15.2%), moderate frequent (26.4%), moderate occasional with depressive symptoms (26.4%), and moderate occasional without depressive symptoms (32.0%). Measurement invariance by sex was ruled out. Depressed mood, sleep disturbances, and fatigue distinguished subgroups. Age ≥75 years was inversely associated with belonging to the severe, moderate frequent, or moderate occasional with depressive symptoms subgroups. Residents with severe cognitive impairment had reduced odds of membership in the severe pain subgroup (adjusted odds ratio [aOR]: 0.84; 95% confidence interval [CI]: 0.78-0.90) and moderate frequent pain subgroup (aOR: 0.60; 95% CI: 0.56-0.64) but increased odds in the moderate occasional pain with depressive symptoms subgroup (aOR: 1.12; 95% CI: 1.06-1.18). CONCLUSION Identifying subgroups of residents with different patterns of pain and depressive symptoms highlights the need to consider physical and psychological components of pain. Expanding knowledge about pain symptom subgroups may provide a promising avenue to improve pain management in nursing home residents.
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Affiliation(s)
- Christine M Ulbricht
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Jacob N Hunnicutt
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts, Worcester, Massachusetts, USA
| | - Giovanni Gambassi
- Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy
| | - Anne L Hume
- University of Rhode Island College of Pharmacy, Kingston, Rhode Island, USA
| | - Kate L Lapane
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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