Older Community Residents Who Participate in Group Activities Have Higher Daily Physical Activity Levels and Lower Medical Costs

Association between dysphagia and activities of daily living in older adults: a systematic review and meta-analysis

PURPOSE

Numerous epidemiological studies have suggested a possible association between dysphagia and the risk of decline in Activities of daily living (ADL) among older adults. This systematic review and meta-analysis aimed to elucidate the relationship between dysphagia and ADL in older adults.

METHODS

PubMed, Web of Science, Cochrane Library, Embase, Ebsco, MEDLINE, Wiley, CINAHL, and Ovid databases were comprehensively examined for relevant studies published up to October 31, 2022. Quantitative studies published in English were included to explore the relationship between dysphagia and ADL in people aged 65 years and older. The NIH Quality Assessment Tool was used to assess the study quality. R software was used to draw forest plots and I2 was employed to indicate study heterogeneity. Sensitivity analysis was performed using the one-by-one exclusion method. Publication bias was measured using funnel plots and Egger's test.

RESULTS

A total of 3,498 studies were retrieved from the database, 22 of which were eventually included in the systematic evaluation, and 14 of which were subjected to meta-analysis. Data from nine studies were categorical variables, and meta-analysis results showed that swallowing disorders in older adults were associated with a lower ability to perform ADL (OR = 3.39, 95% CI: 2.55-4.50, p < 0.001), with moderate heterogeneity (I2 = 62%, p = 0.006). Data from seven studies were continuous variables, resulting in a negative association between the prevalence of dysphagia and ADLs in older adults (SMD = -0.80, 95% CI: -1.08 to -0.51, p < 0.001), with high heterogeneity (I2 = 94%, p < 0.001). Sensitivity analysis showed robust results, funnel plots and Egger's test indicated no publication bias.

CONCLUSION

Dysphagia is significantly associated with the capacity to perform ADL. Prevention and screening of dysphagia in older patients dependent on others for daily care are needed. Further long-term studies are needed in the future to prove causality.

An Overview of Social Participation in Older Adults: Concepts and Assessments

In older adults, social participation is an important component of rehabilitation and health promotion. Several studies have attempted to describe the definition and concepts of social participation, and there were many outcomes to measure social participation. This overview provides information about representative social participation and related concepts that have been defined in the literature. A standardized definition of social participation has not been developed; commonly, recognition for social participation was proposed as focused on involvement in social activities that provide interaction with others in a society or community. Many instruments assess the various aspects of social participation. Because of operational definition and diversity in social participation, performance in social participation was adopted as an aspect of assessment. Further discussions are needed to clarify the definition of social participation and evaluate the instruments used to assess social participation for it to be useful for rehabilitation and health promotion. In doing so, determining and developing assessment and intervention based on the purpose or perspective of social participation in older adults with and without disabilities is important.

Promoting social engagement of the elderly to cope with aging of the Chinese population

China is in a stage of rapid aging of its population, and its old-age dependency ratio has been increasing for decades. The acceleration of aging of the population and the increasing old-age dependency ratio will significantly increase the pressure on social security and public services, highlight the need for the effective supply of labor, and weaken the demographic dividend, which will continue to affect social vitality, the power to innovate, and potential economic growth rates. Promoting social engagement has been widely recognized as an effective strategy to address these challenges. Such an approach not only promotes the development of social productivity, but it also alleviates the social burden. Actively promoting the social engagement of the elderly is an important task in gerontology in China. Although the development of social engagement of the elderly is on the rise, the infrastructure and institutions to provide social engagement need to be enhanced. Improving social engagement in China is not just the responsibility of older adults themselves but also of the country and society as a whole. In the future, the entire society will fully understand the special role of older adults and increase their value through social engagement to achieve active and healthy aging in China.