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Brückner RM, Schönenberg A, Wientzek R, Schreiber M, Prell T. Exploring factors associated with self-rated health in individuals with diabetes and its impact on quality of life: Evidence from the Survey of Health, Ageing, and Retirement in Europe. J Diabetes 2024; 16:e13522. [PMID: 38168898 PMCID: PMC11333853 DOI: 10.1111/1753-0407.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/13/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Self-rated health (SRH), a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. METHODS We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. RESULTS We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = -1.261 (Wald chi-square test, χ2 = 22.097, df = 1, p < .05). CONCLUSIONS As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL.
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Affiliation(s)
| | | | | | - Mandy Schreiber
- Department of Internal Medicine IIHalle University HospitalHalleGermany
| | - Tino Prell
- Department of GeriatricsHalle University HospitalHalleGermany
- Department of NeurologyJena University HospitalJenaGermany
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Su L, Yang W, Han J, Wu Y, Xie Q, Pan G, Sun W, Hong T. Risk factors associated with self-rated health among elderly females with different visual abilities in Chinese urban areas: a population-based study. BMC Public Health 2024; 24:1974. [PMID: 39044199 PMCID: PMC11267913 DOI: 10.1186/s12889-024-19514-6] [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: 06/14/2023] [Accepted: 07/17/2024] [Indexed: 07/25/2024] Open
Abstract
OBJECTIVE Self-rated health (SRH) has been documented as an important predictor of quality of life among the elderly and its risk factors are vision-specific among elderly males. The aim of this study was to clarify vision-specific risk factors to SRH among elderly females without dementia in Chinese urban areas. METHODS From March to November 2012, 2147 elderly women in Liaoning Province of China were selected using a stratified sampling method. After cognitive screening, 1956 participants without dementia were finally enrolled. A questionnaire including SRH, visual ability and factors including demographic characteristics, physical conditions, lifestyle factors, social psychological status and social activities were analyzed. Multivariate logistic regression was used to clarify the association of SRH with risk factors, while stepwise multivariate logistic regression was used to examine the vision-specific associations with SRH. RESULTS The mean age was 73.6 ± 5.82 (mean ± SD). The percentages of good SRH in good and impaired visual ability groups were 36.2% and 24.4%, respectively. Most characteristics between elderly females with different visual abilities were significantly different. Visual ability had interactions with physical conditions, lifestyle factors and social activities to affect SRH. Among elderly females with good visual ability, depressive symptoms, rather than chronic disease had the strongest association with good SRH followed by marital status, regular diet, going out alone to distant places, taking a walk, smoking and alcohol consumption. In the impaired visual ability group, going out alone to distant places had the strongest association with good SRH followed by chronic disease, filial piety, taking a walk, participating in entertainment, ethnicity, quality of sleep, worrying about falling and alcohol consumption. CONCLUSIONS Good SRH status was at a low level especially among elderly females with impaired visual ability and the risk factors differed between elderly females with different visual abilities. Social psychological status was crucial for SRH among elderly females with good visual ability whereas physical conditions were prominent for impaired visual ability group.
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Affiliation(s)
- Lin Su
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China
- Research Center for Universal Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, PR China
| | - Wei Yang
- Department of Thoracic Surgery Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China
| | - Jinsong Han
- Research Center for Universal Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, PR China
| | - Yijiao Wu
- Research Center for Universal Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, PR China
| | - Qiong Xie
- Research Center for Universal Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, PR China
| | - Guowei Pan
- Research Center for Universal Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, PR China
| | - Wei Sun
- Research Center for Universal Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, PR China.
| | - Tao Hong
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China.
- Research Center for Universal Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, PR China.
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Cholli PA, Buchacz KM, Harris NS, Crim SM, Yuan X, Tie Y, Koenig LJ, Beer L. Self-rated health and HIV outcomes among adults with diagnosed HIV - Medical Monitoring Project, United States. AIDS 2024; 38:1237-1247. [PMID: 38507582 DOI: 10.1097/qad.0000000000003890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVES To evaluate associations between self-rated health (SRH) and care outcomes among United States adults with diagnosed HIV infection. DESIGN We analyzed interview and medical record data collected during June 2020-May 2021 from the Medical Monitoring Project, a complex, nationally representative sample of 3692 people with HIV (PWH). Respondents reported SRH on a 5-point Likert type scale (poor to excellent), which we dichotomized into "good or better" and "poor or fair". We computed weighted percentages with 95% confidence intervals (CIs) and age-adjusted prevalence ratios (aPRs) to investigate associations between SRH and HIV outcomes and demographic, psychosocial, and behavioral characteristics. RESULTS Nationally, 72% of PWH reported "good or better" SRH. PWH with the following characteristics had a lower prevalence of "good or better" SRH, compared with those without: any missed HIV care appointment in the last 12 months (aPR 0.86, 95% CI: 0.81-0.91), symptoms of moderate or severe depression (aPR 0.51, 95% CI: 0.43-0.59) and anxiety (aPR 0.60, 95% CI: 0.54-0.68), unstable housing or homelessness (aPR 0.77, 95% CI: 0.71-0.82), and hunger or food insecurity (aPR 0.74, 95% CI: 0.69-0.80), as well as having a mean CD4 count <200 cells/mm 3 vs. CD4 + >500 cells/mm 3 (aPR 0.70, 95% CI: 0.57-0.86). CONCLUSIONS Though SRH is a holistic measure reflective of HIV outcomes, integrated approaches addressing needs beyond physical health are necessary to improve SRH among PWH in the United States. Modifiable factors like mental health, unstable housing or homelessness, and food insecurity warrant further study as potential high-yield targets for clinical and policy interventions to improve SRH among PWH.
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Affiliation(s)
- Preetam A Cholli
- Division of HIV Prevention, Centers for Disease Control and Prevention
- Epidemic Intelligence Service, Centers for Disease Control and Prevention
| | - Kate M Buchacz
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Norma S Harris
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Stacy M Crim
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Xin Yuan
- DLH Corporation, Atlanta, GA, USA
| | - Yunfeng Tie
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Linda J Koenig
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Linda Beer
- Division of HIV Prevention, Centers for Disease Control and Prevention
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Lem K, McGilton KS, Aelick K, Iaboni A, Babineau J, Hewitt Colborne D, Edwards C, Bretzlaff M, Lender D, Gibson JL, Bethell J. Social connection and physical health outcomes among long-term care home residents: a scoping review. BMC Geriatr 2021; 21:722. [PMID: 34922469 PMCID: PMC8683818 DOI: 10.1186/s12877-021-02638-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social connection is recognized as an important determinant of health and well-being. The negative health impacts of poor social connection have been reported in research in older adults, however, less is known about the health impacts for those living in long-term care (LTC) homes. This review seeks to identify and summarize existing research to address the question: what is known from the literature about the association between social connection and physical health outcomes for people living in LTC homes? METHODS A scoping review guided by the Arksey & O'Malley framework was conducted. Articles were included if they examined the association between social connection and a physical health outcome in a population of LTC residents. RESULTS Thirty-four studies were included in this review. The most commonly studied aspects of social connection were social engagement (n = 14; 41%) and social support (n = 10; 29%). A range of physical health outcomes were assessed, including mortality, self-rated health, sleep, fatigue, nutrition, hydration, stress, frailty and others. Findings generally support the positive impact of social connection for physical health among LTC residents. However, most of the studies were cross-sectional (n = 21; 62%) and, of the eleven cohort studies, most (n = 8; 73%) assessed mortality as the outcome. 47% (n = 16) were published from 2015 onwards. CONCLUSIONS Research has reported positive associations between social connection and a range of physical health outcomes among LTC residents. These findings suggest an important role for social connection in promoting physical health. However, further research is needed to consider the influence of different aspects of social connection over time and in different populations within LTC homes as well as the mechanisms underlying the relationship with health.
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Affiliation(s)
- Kaitlyn Lem
- Faculty of Arts & Sciences, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
| | - Katherine S McGilton
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Katelynn Aelick
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, ON, Canada
| | - Andrea Iaboni
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jessica Babineau
- Library and Information Services, University Health Network, Toronto, ON, Canada
| | - Debbie Hewitt Colborne
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, ON, Canada
| | | | - Monica Bretzlaff
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, ON, Canada
| | - Dee Lender
- Ontario Association of Residents' Councils, Newmarket, ON, Canada
| | - Josie-Lee Gibson
- Ontario Association of Residents' Councils, Newmarket, ON, Canada
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
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Hierarchical Regression of Wellbeing and Self-Rated Health among Older Adults in Abu Dhabi. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158006. [PMID: 34360297 PMCID: PMC8345788 DOI: 10.3390/ijerph18158006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022]
Abstract
This study investigates the wellbeing factors related to self-rated health for older adults in Abu Dhabi (≥55 years). The purpose is to provide a comprehensive analysis of the determinants of self-rated health, considering various wellbeing factors, controlling for factors such as gender, nationality and long-standing illness if present. This research drew from a sample of 2375 older adults who participated in the Abu Dhabi Quality-of-Life Survey (QoL) conducted in 2018. Hierarchical multiple regression analysis was employed where the first two models corresponded to gender, nationality and having a long-standing illness or not. The third model focused on the wellbeing factors of Abu Dhabi citizens (i.e., social networks and connection, income and housing, sports and activities, mental feelings). The analysis revealed the insignificance of gender and nationality as controlled variables while having a long-standing illness showed significant adverse effects. The most significant variables were social support networks, family and social arrangements and connections. Other variables of significance included housing satisfaction, household income satisfaction, frequency of practicing sports, current mental status and life satisfaction. Policymakers could use the outcomes as insider intelligence for policymakers and social work professionals to create policies, programs and services to enhance the lives of older people in Abu Dhabi.
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Peleg S, Nudelman G. Associations between self-rated health and depressive symptoms among older adults: Does age matter? Soc Sci Med 2021; 280:114024. [PMID: 34049050 DOI: 10.1016/j.socscimed.2021.114024] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/03/2021] [Accepted: 05/07/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE It has been suggested that self-rated health (SRH), a construct of overall subjective health, is predicted by depressive symptoms. However, depressive symptoms were also found to predict SRH. The present study aimed to simultaneously examine these alternatives as well as test the potential moderating role of age. METHODS Data concerning self-reported measures from two consecutive waves of the Survey of Health, Aging and Retirement in Europe (SHARE) were examined by using a longitudinal cross-lagged panel analysis. RESULTS The model that included the effects of both paths, i.e. from SRH to depressive symptoms and from depressive symptoms to SRH, demonstrated better fit than models including one or no cross-lagged paths. However, the longitudinal effect of SRH on depressive symptoms was stronger than the longitudinal effect of depressive symptoms on SRH, particularly among adults aged 65-79. The longitudinal effect of depressive symptoms on SRH was stronger among individuals aged 80 and older, compared with younger ages. CONCLUSIONS Bidirectional effects may exist between SRH and depressive symptoms among adults aged 50 and older. Special attention should be paid to the unique effects of SRH on depressive symptoms in the years following retirement and also to depressive symptoms on SRH among the old-old.
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Affiliation(s)
- Shira Peleg
- The Israel Gerontological Data Center, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Gabriel Nudelman
- Department of Psychology, The Academic College of Tel Aviv-Yaffo, Rabenu Yeruham St., P.O.B 8401 Yaffo, 6818211, Israel.
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Srivastava S, Purkayastha N, Chaurasia H, Muhammad T. Socioeconomic inequality in psychological distress among older adults in India: a decomposition analysis. BMC Psychiatry 2021; 21:179. [PMID: 33823847 PMCID: PMC8025542 DOI: 10.1186/s12888-021-03192-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/31/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Older people coming from a lower wealth gradient are more vulnerable to have stressful life events further adding more risk for common mental health disorders and psychological distress situations. The present study explores the associations between socioeconomic and health-related variables and psychological distress among older adults in India and the contribution of such factors to the inequalities in psychological distress. METHODS A cross-sectional survey of 9181 older adults conducted as 'Building a Knowledge Base on Population Ageing in India' was assessed. Logistic regression and decomposition models were used to analyze the data. Psychological distress was measured from General Health Questionnaire (GHQ-12). The value of Cronbach's alpha was 0.90. It was having a scale of 0 to 12 on the basis of experiencing stressful symptoms and was re-coded as 0 (representing 6+ stressful symptoms) and 1 (representing 5 and fewer symptoms). RESULTS Older adults from the poored, suffering from multi-morbidity, disabled, with low activities of daily living and low instrumental activities of daily living and poor cognitive ability were suffering from high psychological distress in India. Further, factors such as religion, caste, education, living arrangements, and self-worth in the family were major contributors to the concentration of psychological distress in older adults from poor households (concentration index: - 0.23). CONCLUSION The study suggests that among older people, there is a wide disparity of experiencing psychological distress across different socio-economic groups with significant factors being responsible for inequality in psychological distress. There is a need to build a "win-win" circumstance across sectors, including a broad spectrum of health, social and economic benefits to the vulnerable older population.
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Affiliation(s)
- Shobhit Srivastava
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Naina Purkayastha
- grid.412023.60000 0001 0674 667XDepartment of Statistics, Dibrugarh University, Dibrugarh, Assam India
| | - Himanshu Chaurasia
- grid.416737.00000 0004 1766 871XNational Institute for Research in Reproductive Health, ICMR, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Elliott AF, Heskett M, Spiker C, McGwin G, Owsley C. Low rates of eye care utilization among visually impaired subsidized senior housing residents. Aging Ment Health 2021; 25:360-366. [PMID: 31694391 PMCID: PMC7202945 DOI: 10.1080/13607863.2019.1683813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine the rate of self-reported vision impairment, eye disease, and eye care utilization among residents of subsidized senior housing (SSH) communities. METHODS In this cross-sectional, observational study, residents of 14 SSH communities in Jefferson County, AL, USA self-reported their vision status and eye care utilization as part of vision screening events held in their community. RESULTS Two hundred and thirty-seven residents self-reported their vision status, presence of eye disease, and eye care utilization. A third of participants (33.3%) reported difficulty with distance vision while 38% reported difficulty with near vision. Rates of eye disease among this sample were as follows: 40.3% reported having cataracts, 13.6% reported having glaucoma, 4.2% reported having age-related macular degeneration, and 5.5% reported having diabetic retinopathy. The majority of participants (52.8%) had not been to see an eye care provider within the last year. Persons with vision impairment were less likely to report having seen an eye care provider within the last year than those without impairment (p = .03). CONCLUSION This study illuminates the low utilization of eye care among socioeconomically disadvantaged older adults residing in SSH, especially among those with vision impairment and eye disease. Vision-related health care is important in maintaining both physical and mental health in older adults.
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Affiliation(s)
| | | | - Christopher Spiker
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham
| | - Gerald McGwin
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham,Department of Epidemiology, School of Public Health, University of Alabama at Birmingham,Department of Surgery, School of Medicine, University of Alabama at Birmingham
| | - Cynthia Owsley
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham
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Höbler F, McGilton KS, Wittich W, Dupuis K, Reed M, Dumassais S, Mick P, Pichora-Fuller MK. Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review. J Alzheimers Dis 2021; 84:1115-1138. [PMID: 34633326 PMCID: PMC8673512 DOI: 10.3233/jad-215087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. OBJECTIVE To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. METHODS Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O'Malley's scoping review and appraisal process was followed. RESULTS There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. CONCLUSION Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.
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Affiliation(s)
- Fiona Höbler
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katherine S. McGilton
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Walter Wittich
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Kate Dupuis
- Sheridan Centre for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Marilyn Reed
- Audiology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Shirley Dumassais
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
| | - Paul Mick
- Department of Surgery, Faculty of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Mannion C, Hughes J, Moriarty F, Bennett K, Cahir C. Agreement between self-reported morbidity and pharmacy claims data for prescribed medications in an older community based population. BMC Geriatr 2020; 20:283. [PMID: 32778067 PMCID: PMC7419222 DOI: 10.1186/s12877-020-01684-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/29/2020] [Indexed: 11/21/2022] Open
Abstract
Background Studies have indicated variability around prevalence estimates of multimorbidity due to poor consensus regarding its definition and measurement. Medication-based measures of morbidity may be valuable resources in the primary-care setting where access to medical data can be limited. We compare the agreement between patient self-reported and medication-based morbidity; and examine potential patient-level predictors of discordance between these two measures of morbidity in an older (≥ 50 years) community-based population. Methods A retrospective cohort study was performed using national pharmacy claims data linked to The Irish LongituDinal study on Ageing (TILDA). Morbidity was measured by patient self-report (TILDA) and two medication-based measures, the Rx-Risk (< 65 years) and Rx-Risk-V (≥65 years), which classify drug claims into chronic disease classes. The kappa statistic measured agreement between self-reported and medication-based morbidity at the individual patient-level. Multivariate logistic regression was used to examine patient-level characteristics associated with discordance between measures of morbidity. Results Two thousand nine hundred twenty-five patients were included (< 65 years: N = 1095, 37.44%; and ≥ 65 years: N = 1830 62.56%). Hypertension and high cholesterol were the most prevalent self-reported morbidities in both age cohorts. Agreement was good or very good (κ = 0.61–0.81) for diabetes, osteoporosis and glaucoma; and moderate for high cholesterol, asthma, Parkinson’s and angina (κ = 0.44–0.56). All other conditions had fair or poor agreement. Age, gender, marital status, education, poor-delayed recall, depression and polypharmacy were significantly associated with discordance between morbidity measures. Conclusions Most conditions achieved only moderate or fair agreement between self-reported and medication-based morbidity. In order to improve the accuracy in prevalence estimates of multimorbidity, multiple measures of multimorbidity may be necessary. Future research should update the current Rx-Risk algorithms in-line with current treatment guidelines, and re-assess the feasibility of using these indices alone, or in combination with other methods, to yield more accurate estimates of multimorbidity.
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Affiliation(s)
- Clionadh Mannion
- Department of Pharmacology and Therapeutics, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - John Hughes
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Frank Moriarty
- Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland.,The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Bennett
- Department of Pharmacology and Therapeutics, University of Dublin, Trinity College Dublin, Dublin, Ireland.,Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Caitriona Cahir
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
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Cai J, Laporte A, Zhang L, Zhao Y, Tang D, Fan H, Deng L, Coyte PC. Impacts of Absolute and Relative Income on Self-Rated Health in Urban and Rural China. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2020; 52:129-140. [PMID: 32363997 DOI: 10.1177/0020731420922689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to assess the impacts of absolute and relative income on self-rated health (SRH) of residents in rural and urban China. Data were derived from the China Health and Nutrition Survey. Three distinct measures of relative income were considered (Gini coefficient, Yitzhaki index, and Deaton index) and computed for 3 geographic units (nation, province, and community). Nonlinear dynamic models for panel data were employed to test the absolute and relative income hypotheses. Absolute income was significantly associated with SRH among urban and rural populations. Relative income, as measured by the Gini coefficient, the Yitzhaki index, and the Deaton index, had statistically significant and negative impacts on SRH among the rural population, regardless of the reference group. For the urban population, the Gini coefficient was associated with SRH regardless of the reference group. In contrast, only the Yitzhaki index and the Deaton index at the provincial level were associated with SRH among the urban population. Our findings may provide a reference for policymakers to implement health policies designed to improve population health.
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Affiliation(s)
- Jiaoli Cai
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Audrey Laporte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Canadian Centre for Health Economics, Toronto, Ontario, Canada
| | - Li Zhang
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Yulin Zhao
- School of Economics, Wuhan University of Technology, Wuhan, China
| | - Di Tang
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.,School of Public Administration, East China Normal University, Shanghai, China
| | - Hongli Fan
- School of Insurance, Shandong University of Finance and Economics, Jinan, China
| | - Liqian Deng
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Canadian Centre for Health Economics, Toronto, Ontario, Canada
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12
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Machón M, Mosquera I, Larrañaga I, Martín U, Vergara I. [Socioeconomic inequalities in health among the elderly population in Spain]. GACETA SANITARIA 2020; 34:276-288. [PMID: 31563284 DOI: 10.1016/j.gaceta.2019.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/29/2019] [Accepted: 06/19/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine socioeconomic inequalities in health in the older population in Spain. METHOD A systematic search and review of the literature published between 2000 and 2017 in English and Spanish was conducted in Social Science Citation Index, Sociology Database, Scopus, PubMed and Embase. Primary and secondary studies analysing these inequalities in Spain were included. Two researchers were responsible for the selection of the studies and the extraction of the information (first author, year of publication, region, design, population/sample, socioeconomic and health indicators used, and main results). RESULTS A total of 89 articles were included, corresponding to 87 studies. Of the studies, 81.6% were cross-sectional, 88.5% included only non-institutionalised population and 35.6% were carried out at a national level. The studies analysed social inequalities in the following health indicators: functional status (n=29), morbidity (n=19), self-perceived health (n=18), mental and emotional health (n=10), cognitive status (n=7), quality of life (n=9), mortality (n=15) and life expectancy (n=2). Socioeconomic inequalities were detected in all of them, although the magnitude varied depending on the socioeconomic and health indicator used. The educational level and the ecological indexes were the indicators that detected more inequalities in health. The impact of inequalities by sex was different in functional status, morbidity, self-perceived health, mental and emotional health and mortality. CONCLUSION There are socioeconomic inequalities in health among the elderly population and their magnitude varies by sex in some of the health indicators. The increase in educational level and the maintenance of sufficient pensions can be key policies that contribute to the reduction of inequalities in this population group.
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Affiliation(s)
- Mónica Machón
- Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, San Sebastián (Guipúzcoa), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
| | - Isabel Mosquera
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; OPIK - Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España.
| | - Isabel Larrañaga
- Departamento de Salud, Delegación Territorial de Gipuzkoa, Gobierno Vasco, San Sebastián (Guipúzcoa), España
| | - Unai Martín
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; OPIK - Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España
| | - Itziar Vergara
- Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, San Sebastián (Guipúzcoa), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
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13
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Lisko I, Törmäkangas T, Jylhä M. Structure of self-rated health among the oldest old: Analyses in the total population and those living with dementia. SSM Popul Health 2020; 11:100567. [PMID: 32258355 PMCID: PMC7110410 DOI: 10.1016/j.ssmph.2020.100567] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/08/2020] [Accepted: 03/12/2020] [Indexed: 01/04/2023] Open
Abstract
No previous study has explored the structure of self-rated health (SRH), a measure holding strong predictive value for future health events, in the oldest old or in individuals with dementia. The aim was to construct a structural equation model of SRH for oldest old in general and for oldest old with dementia, and to explore direct and indirect associations between health-related factors and SRH. Cross-sectional data from the Vitality 90+, a population-based study in the city of Tampere, Finland, was used. Data were gathered by a mailed questionnaire in 2014. Altogether 1299 nonagenarians, of which 408 had self-reported dementia or cognitive decline, were included. Structural equation models were constructed for all participants and separately for participants with dementia. Diseases (heart disease, stroke, diabetes, arthritis, hip fracture, cancer and dementia for the model for all), dizziness, hearing, vision, mobility, activities of daily living, fatigue, depression and SRH were included in the models. Among all participants, fatigue, depression, problems in mobility, dizziness, deficits in vision and heart disease were directly associated with poor SRH. Among participants with dementia, only fatigue, dizziness and deficits in vision were directly associated with poor SRH. Among all participants, dementia and arthritis were indirectly associated with poor SRH through problems in mobility, depression and fatigue. Among the oldest old, the effects of diseases on SRH were mainly manifested through the consequences of diseases, namely fatigue, dizziness, deficits in vision and problems in mobility. Depression has an important direct and indirect role, and dementia and arthritis an important indirect role in the structure of SRH. Dementia weakens many of the direct and indirect associations for SRH. First study to explore structure of self-rated health in oldest old and persons with dementia. Fatigue, depression, mobility, dizziness, vision and heart disease directly affect health-rating in oldest old. Dementia, depression and arthritis affect health rating indirectly through various routes in oldest old. Dementia weakens many of the associations between objective indicators of health with self-rated health.
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Affiliation(s)
- Inna Lisko
- Tampere University, Faculty of Social Sciences (Health Sciences), P.O. Box 100, FI-33014, Finland.,Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,University of Jyväskylä, Faculty of Sport and Health Sciences, P.O. Box 35, FI-40014, Finland.,Karolinska Institutet, Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Stockholm, Karolinska Vägen 37 A, QA32, SE-171 64, Solna, Sweden
| | - Timo Törmäkangas
- Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,University of Jyväskylä, Faculty of Sport and Health Sciences, P.O. Box 35, FI-40014, Finland
| | - Marja Jylhä
- Tampere University, Faculty of Social Sciences (Health Sciences), P.O. Box 100, FI-33014, Finland.,Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,Science Center, Tampere University Hospital, Finland
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14
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Determinants of self-rated health in older adults before and 3 months after an emergency department visit: a prospective study. Eur J Emerg Med 2020; 26:255-260. [PMID: 29384753 DOI: 10.1097/mej.0000000000000538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Self-rated health (SRH) is an important patient-reported outcome, but little is known about SRH after a visit to the emergency department (ED). We investigated the determinants of decline in SRH during 3 months after an ED visit in older patients. DESIGN This was a multicenter prospective cohort study including acutely presenting older ( ≥ 70 years) patients in the ED (the Netherlands). Patients were asked to self-rate their health between 0 and 10. The main outcome was a decline in SRH defined as a transition of a SRH of at least 6 to a SRH of less than 6, 3 months after the patient's visit to the ED. RESULTS Three months after the ED visit, 870 (71.4%) patients had a stable SRH and 209 (11.5%) patients declined in SRH. Independent predictors with a decline in SRH were: male gender (OR 1.83) living alone (OR 1.56), living in residential care or nursing home (OR 2.75), number of different medications (OR 1.08), using a walking device (OR 1.70), and the Katz-ADL score (OR 1.22). Patients with functional decline 3 months after an ED visit show a steeper decline in the mean SRH (0.68 points) than patients with no functional decline (0.12 points, P < 0.001). CONCLUSION Decline in SRH after an ED visit in older patients is at least partly dependent on factors of functional capacity and functional decline. Preventive interventions to maintain functional status may be the solution to maintain SRH, but more research is needed to further improve and firmly establish the clinical usability of these findings.
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15
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Rodríguez-García MDP, Ayala A, Rodríguez-Blázquez C, Martínez-Martín P, Forjaz MJ, Damián J. Features and impact of missing values in the association of self-rated health with mortality in care homes: a longitudinal study. Health Qual Life Outcomes 2019; 17:111. [PMID: 31255183 PMCID: PMC6599327 DOI: 10.1186/s12955-019-1184-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 06/19/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Self-rated health (SRH) is a health measure used in studies of older adults. The objective of this study is to analyze SRH as a predictor of mortality in the institutionalized older population and the characteristics of those who do not provide information about their SRH on health questionnaires. METHODS This is a 15-year follow-up study of older adult residents in nursing or care homes in of Madrid, Spain. SRH was measured on a 5-point Likert type scale. The association between answering the SRH question and socio-demographic and health characteristics was evaluated through prevalence ratio (PR), estimated by Poisson regression models. Survival rates associated with SRH were studied through a multivariate Cox regression. RESULTS The sample has a mean age of 83.4 (standard deviation, SD = 7.3), with 75.7% women. Twelve percent did not answer the SRH item. Those who did not answer showed a higher probability of disability (Barthel index, PR = 0.76, 95% confidence interval = 0.67-0.86) and/or dementia (PR = 8.03, 3.38-19.03). A trend for higher mortality was observed in those persons who did not respond (adjusted hazard ratio HR = 1.26, 0.75-2.11). The mortality rate was 32% higher for those who declared poor SRH in comparison with those who reported good SRH (adjusted HR = 1.32, 1.08-1.6). CONCLUSIONS There is an elevated number of people who do not respond to the SRH item, mainly those with disabilities and cognitive deterioration. Lack of response to SRH is a good indicator of 15-year mortality for persons institutionalized in care or nursing homes.
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Affiliation(s)
| | - Alba Ayala
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Avda Monforte de Lemos 5, 28029 Madrid, Spain
| | | | - Pablo Martínez-Martín
- National Center of Epidemiology, Institute of Health Carlos III and CIBERNED, Madrid, Spain
| | - Maria João Forjaz
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Avda Monforte de Lemos 5, 28029 Madrid, Spain
| | - Javier Damián
- National Center of Epidemiology, Institute of Health Carlos III and CIBERNED, Madrid, Spain
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16
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Mosquera I, Machón M, Vergara I, Larrañaga I, Martín U. [Social inequalities in health among the elderly population: review of indicators used in Spain]. GACETA SANITARIA 2019; 34:297-304. [PMID: 30665691 DOI: 10.1016/j.gaceta.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To identify the indicators of social position used to evaluate inequalities in health among the population aged 65 and over in Spain. METHOD A systematic search of the literature published in English and Spanish since 2000 in health and social databases was carried out. Primary and secondary studies analyzing these inequalities in Spain were included. The indicators used were identified, as well as the advantages and limitations pointed out by the authors. The main findings were synthesized in a review of the literature. RESULTS We included 87 studies, described in 89 articles. The socioeconomic indicators employed were both individual and ecological. Among the former, educational level was the most analyzed socioeconomic variable (n=73). Other individual variables used were occupation (n=17), objective economic level (n=16), subjective economic level (n=4), housing and household material wealth (n=6), relationship with work activity (n=5), and mixed measures (n=5). Among the ecological indicators, simple (n=3) and complex indices (n=7) were identified. The latter had been constructed based on several indicators, such as educational level and unemployment. Inequalities in multiple health indicators were analyzed, self-perceived health being the only indicator assessed according to all the socioeconomic indicators described. CONCLUSIONS A wide variety of indicators is identified for the evaluation of social inequalities in health among the elderly population. There have not been sufficiently assessed from a gender perspective; this is a line of interest for future research.
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Affiliation(s)
- Isabel Mosquera
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; Opik-Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV-EHU, Leioa (Vizcaya), España
| | - Mónica Machón
- Unidad de Investigación de Atención Primaria - OSIs Gipuzkoa, Osakidetza, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España.
| | - Itziar Vergara
- Unidad de Investigación de Atención Primaria - OSIs Gipuzkoa, Osakidetza, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
| | - Isabel Larrañaga
- Departamento de Salud, Gobierno Vasco, San Sebastián (Guipúzcoa), España
| | - Unai Martín
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; Opik-Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV-EHU, Leioa (Vizcaya), España
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17
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Su SW, Wang D. Health-related quality of life and related factors among elderly persons under different aged care models in Guangzhou, China: a cross-sectional study. Qual Life Res 2019; 28:1293-1303. [PMID: 30649697 PMCID: PMC6470275 DOI: 10.1007/s11136-019-02107-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE To analyze health-related quality of life (HRQoL) and related factors among elderly persons receiving community-based home care and institutional care in Guangzhou, a large city of mainland China. METHODS A representative sample of 1600 subjects aged 60 years and over residing in communities and nursing homes was randomly selected through stratified sampling. The 12-item Short Form Health Survey version 2 (SF-12v2) was used to assess HRQoL. RESULTS In total, 1014 elderly persons under different aged care models responded to the survey (response rate 63.4%) and 1000 were eligible for data analyses. Compared with the elderly receiving community-based home care or private institutional care, those in public institutional care had the lowest scores on the physical component summary (PCS, 36.89 ± 10.44) and the mental component summary (MCS, 47.16 ± 11.14). Number of chronic diseases, loneliness, and age were the most common significant factors (P < 0.05) affecting PCS and MCS. The interaction term between aged care model and number of chronic diseases significantly affected PCS (β = - 0.165, P < 0.05), indicating a stronger association between these factors for participants receiving community-based home care than institutional care. The interaction term between aged care model and loneliness had a significant effect on MCS (β = 0.189, P < 0.05), indicating a weaker association between loneliness and MCS for participants receiving community-based home care. CONCLUSIONS This study found poor HRQoL among the elderly in Guangzhou. The main factors associated with the physical and mental HRQoL of elderly persons included number of chronic diseases, loneliness, age, and education level. It also revealed the moderating effects of aged care model on HRQoL, suggesting specific health management strategies for elderly in community-based home care and institutional care, respectively.
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Affiliation(s)
- Shu-Wen Su
- School of Health Services Management, Southern Medical University, 1023 Shatai Road, Guangzhou, 510515, China
| | - Dong Wang
- School of Health Services Management, Southern Medical University, 1023 Shatai Road, Guangzhou, 510515, China.
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Maharlouei N, Kazemeini F, Shahraki HR, Lankarani KB. Associated Factors of Self-Rated Mental Health Status in Southwestern Iran: Using SCAD Regression Model in a Population-Based Study. Community Ment Health J 2018; 54:616-624. [PMID: 29119361 DOI: 10.1007/s10597-017-0176-x] [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] [Received: 01/08/2017] [Accepted: 10/24/2017] [Indexed: 02/08/2023]
Abstract
This study aimed to investigate the association between self-rated mental health (SRMH) and current health status of an Iranian population. A cross-sectional study was conducted on 3400 individuals selected through random sampling in Shiraz, Iran between January 2014 and March 2015. Data were gathered through face-to-face interviews. Statistical analyses were performed using the SPSS 19.0, and R.3.1.2 software was used for SCAD penalized logistic regression. The mean age of the participants was 38.5 (± 14.1 years). There were significant relationships between better SRMH and younger ages (p < 0.001), and between better SRMH and better self-rated physical health (p < 0.001). Individuals with poor SRMH were more likely to have signs and symptoms of medical diseases. SRMH, a component of self-rated health, was related to a variety of health problems in our study population. Therefore, paying attention to SRMH and mental well-being could be useful in making decision about implementation of preventive measures.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fereshteh Kazemeini
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Motahhari Hospital, Marvdasht, Iran
| | - Hadi Raeisi Shahraki
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Kamran B Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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19
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Araújo L, Teixeira L, Ribeiro O, Paúl C. Objective vs. Subjective Health in Very Advanced Ages: Looking for Discordance in Centenarians. Front Med (Lausanne) 2018; 5:189. [PMID: 29998108 PMCID: PMC6028557 DOI: 10.3389/fmed.2018.00189] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/08/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Living beyond 100 years of age is associated with several functional and health constraints but their impact depends on one's perception of the situation. Associations between self-rated health (SRH) with sociodemographic and psychosocial variables have been explored in several studies, revealing that one's health appraisal depends of factors beyond the objective health condition. There is a large body of literature concerning SRH in later life but lack of evidence about centenarians' perception of health and its associated factors, which could increase the available knowledge on the strengths and resources individuals in very advanced ages have for facing daily life limitations. Objective and Methods: This study aims to analyse the relationship between subjective and objective health status in a sample of centenarians (n = 127). Subjective health was assessed by a single-item health measure, and objective health by considering the number of reported diseases and a functional capacity scale (BADL and IADL). Main health characteristics are described as well as examined the association between objective and subjective health. Results: 46.5% of the sample has a good, very good, or excellent appraisal of their own health. SRH was associated (p < 0.05) with BADL and IADL scores and with the total number of diagnosis; when analyzing SRH according to the level of functional capacity, results revealed that most individuals with severe and moderate dependence have a reasonable to excellent SRH (p > 0.05). Conclusion: Having diseases and functional dependence at 100 years old may not mean to have a bad SRH. The high variability in SRH and the discordance between objective and subjective measures are a proof of centenarian's capacity of adaptation and the existence of individual resources, which may be decisive for one' perception and handling of health situation at such an advanced age.
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Affiliation(s)
- Lia Araújo
- Center for Health Technology and Services Research, Institute of Biomedical Sciences Abel Salazar (CINTESIS-ICBAS), University of Porto, Porto, Portugal
- School of Education, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Laetitia Teixeira
- Center for Health Technology and Services Research, Institute of Biomedical Sciences Abel Salazar (CINTESIS-ICBAS), University of Porto, Porto, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research, Institute of Biomedical Sciences Abel Salazar (CINTESIS-ICBAS), University of Porto, Porto, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Constança Paúl
- Center for Health Technology and Services Research, Institute of Biomedical Sciences Abel Salazar (CINTESIS-ICBAS), University of Porto, Porto, Portugal
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20
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Patrão AL, Alves VP, Neiva TS. Gender differences in psychosocial predictors of self-perceived health status in the elderly: Evidence from a Brazilian community study. J Women Aging 2017; 30:553-570. [PMID: 29200379 DOI: 10.1080/08952841.2017.1409269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article aims to identify the psychosocial factors associated with self-perceived health status in the Brazilian elderly population and to present differences related to gender. The data were collected by questionnaire, including sociodemographic and behavioral questions, and scales for psychological dimensions. Self-perceived health status is related to level of education, physical activity, and self-efficacy in the total population. Regarding gender differences, self-rated health status among men is related to education level and self-efficacy and in women to level of education, physical activity, social support, and self-efficacy. These results can inform future health promotion interventions.
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Affiliation(s)
- Ana Luísa Patrão
- a Institute of Collective Health , Federal University of Bahia , Salvador , BA , Brazil
| | - Vicente Paulo Alves
- b Graduate Program in Gerontology , Catholic University of Brasília , Brasília , DF , Brazil
| | - Tiago Sousa Neiva
- b Graduate Program in Gerontology , Catholic University of Brasília , Brasília , DF , Brazil
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21
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Liu F, Zhang C, Liang Y, Deng Q, Hang D, Pan Y, Li X, He Z, Liu M, Liu Y, Li J, Ning T, Guo C, Xu R, Zhang L, Cai H, Ke Y. Epidemiology of self-rated health in rural China: a population-based cross-sectional study. Sci Rep 2017; 7:4459. [PMID: 28667261 PMCID: PMC5493681 DOI: 10.1038/s41598-017-04381-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 05/16/2017] [Indexed: 11/09/2022] Open
Abstract
Self-rated health (SRH) has been shown to be a good predictor of mortality. Data on SRH and its associated factors in the Chinese general population are limited. This study aims to assess the epidemiology of SRH in rural Anyang, China. SRH (categorized as "healthy", "fair" or "unhealthy") was measured in a population-based study of 2,814 adults (including 697 couples) aged 25 to 69 who were recruited from rural Anyang in 2014. Of 2,814 subjects, 63.1% rated their health as "healthy", whereas 28.1% and 8.8% rated their health as "fair" and "unhealthy". Compared to males, females had a higher likelihood of reporting a better SRH. Health ratings declined with increasing age, unmarried status, lower education levels. Poor SRH was positively correlated with medical history as well as high levels of fasting plasma glucose and total cholesterol, but not with unhealthy lifestyle indicators including smoking, drinking, and obesity. High household income was predictive of better SRH in men but not in women. Among couples, a positive spousal SRH concordance was observed, although the strength of this concordance was low. These findings will be useful for formulation of appropriate strategies for improving risk perception and promoting general health in economically developing regions.
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Affiliation(s)
- Fangfang Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Chaoting Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Yongmei Liang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Qiuju Deng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Dong Hang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Yaqi Pan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Xiang Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Zhonghu He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Mengfei Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Ying Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Jingjing Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Tao Ning
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Chuanhai Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Ruiping Xu
- Anyang Cancer Hospital, No. 1 Binhebei Rd, Anyang, Henan Province, 455000, China
| | - Lixin Zhang
- Anyang Cancer Hospital, No. 1 Binhebei Rd, Anyang, Henan Province, 455000, China
| | - Hong Cai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China.
| | - Yang Ke
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China.
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Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model. BIOMEDICA 2017; 37:92-103. [PMID: 28527271 DOI: 10.7705/biomedica.v37i3.3070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 08/09/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status. OBJECTIVE To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults. MATERIALS AND METHODS We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health. RESULTS A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20). CONCLUSIONS A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.
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Cai J, Coyte PC, Zhao H. Determinants of and socio-economic disparities in self-rated health in China. Int J Equity Health 2017; 16:7. [PMID: 28077141 PMCID: PMC5225569 DOI: 10.1186/s12939-016-0496-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 12/08/2016] [Indexed: 11/23/2022] Open
Abstract
Background Self-rated health (SRH) is not only used to measure health status and health inequalities, but also as a strong predictor of morbidity and mortality. The purpose of this study was to: 1) evaluate the factors that account for variations in self-rated health among Chinese citizens; and to 2) explore the process through which socio-economic status may impact self-rated health. Methods Data were derived from the Chinese General Social Survey (CGSS) (2013). Determinants of self-rated health were analyzed along four main dimensions: demographic characteristics, socio-economic status, lifestyle, and psychosocial factors. Multivariate odds ratios for good self-rated health were calculated for different variables in order to analyze the determinants. Binary logistic regression analysis was performed to assess the extent to which lifestyle and psychosocial factors explained the association between socio-economic status and self-rated health. Results About 65% of the survey respondents reported good self-rated health. Women, the elderly, married or single respondents and residents of Western China were less likely to report good self-rated health. Respondents who were engaged in work, had higher household income, reported high social class and higher socio-economic status compared with peers were more likely to report good self-rated health. Normal weight and physically active respondents along with those reporting a happy life, no depression, and good relationships with families and friends were related to good self-rated health. We also found the effect of socio-economic status on self-rated health was partly explained by lifestyle and psychosocial factors. Conclusion The present findings support the notion that both socio-economic status and lifestyle as well as psychosocial factors were related with good self-rated health. The interventions targeting these factors could improve the health status of the population. The depression was the most influential predictor of self-rated health, especially for the women and the elderly. Although lifestyle and psychosocial factors explained partly the the association between socio-economic status and health, the reason why socio-economic difference exists in health must be further explored. What’s more, it needs to be further studied why the same determinant has different influence strengths on the health of different groups of people.
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Affiliation(s)
- Jiaoli Cai
- School of Economics, Wuhan University of Technology, 122 Luoshi Road, Wuhan, Hubei Province, 430070, People's Republic of China. .,Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building,155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada.
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building,155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada
| | - Hongzhong Zhao
- School of Economics, Wuhan University of Technology, 122 Luoshi Road, Wuhan, Hubei Province, 430070, People's Republic of China
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Pan CW, Wang X, Ma Q, Sun HP, Xu Y, Wang P. Cognitive dysfunction and health-related quality of life among older Chinese. Sci Rep 2015; 5:17301. [PMID: 26601612 PMCID: PMC4658548 DOI: 10.1038/srep17301] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/28/2015] [Indexed: 11/09/2022] Open
Abstract
We aimed to assess the association of cognitive dysfunction with health-related quality of life (HRQOL) among older adults in China. We analyzed community-based cross-sectional data of 5,557 Chinese individuals aged 60 years and above in the Weitang Geriatric Diseases Study. Cognitive dysfunction and HRQOL were assessed using the Abbreviated Mental Test (AMT) and the European Quality of Life-5 dimensions (EQ-5D), respectively. We estimated the impacts of cognitive dysfunction on the EQ-5D index and visual analogue scale (VAS) scores using linear regression models, and the association between cognitive dysfunction and self-reported EQ-5D health problems using logistic regression models. The EQ-5D index and VAS scores were significantly lower for individuals with cognitive dysfunction than their counterparts. After controlling for covariates, the differences in EQ-5D index and VAS scores between individuals with and without cognitive dysfunction were −0.016 (95% confidence interval [CI]: −0.024, −0.008), and −3.4 (95% CI: −4.5, −2.4), respectively. Cognitive dysfunction was associated with reporting of problems in pain/discomfort (odds ration [OR]: 1.37; 95% CI: 1.12, 1.69), and anxiety/depression (OR: 2.13; 95% CI: 1.41, 3.23). The negative impact on HRQOL increased with the severity of cognitive dysfunction. The results indicate cognitive dysfunction was associated with worse HRQOL in older adults.
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Affiliation(s)
- Chen-Wei Pan
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xingzhi Wang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Qinghua Ma
- The 3rd People's Hospital of Xiangcheng District, Suzhou, China
| | - Hong-Peng Sun
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yong Xu
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Pei Wang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Damián J, Pastor-Barriuso R, Valderrama-Gama E, de Pedro-Cuesta J. Discordance between physician-rated health and an objective health measure among institutionalized older people. BMC Geriatr 2015; 15:78. [PMID: 26155790 PMCID: PMC4497415 DOI: 10.1186/s12877-015-0074-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/15/2015] [Indexed: 11/26/2022] Open
Abstract
Background Although physician-rated health is emerging as a potentially useful variable in research, with implications in practice, it has not been analyzed. Moreover, one of its most important aspects, namely, concordance with patients’ objective health state, has not been investigated. This study sought to measure concordance between physician-rated health and an objective health measure, and assess both measures’ validity in predicting death. Methods The data for the study were drawn from a 1998–1999 survey and subsequent mortality follow-up of residential and nursing homes in Madrid (Spain). Study subjects were 630 residents aged ≥65 years, and their respective facility physicians. Measures included agreement between physicians’ rating of residents’ overall health (good, intermediate or poor) and an objective measure of residents’ health (good, intermediate or poor), based on functional capacity, cognitive status, and number of chronic conditions. Overrating was defined as any case where health, rated as good by a physician, was objectively rated as poor. Results Whereas 45 % of physicians and 55 % of residents rated their health as good, only 4 % of such residents had good objective health. Of those who received a physician rating of good/very good health, 39.0 % had poor objective health. There was evidence of clear overrating in 18 % of the population, and clear to moderate overrating in 73 % of the population. In terms of power to predict mortality, the pattern of behavior shown by the objective health measure was good, graded and congruent, and better than that shown by physician-rated health. Conclusion Physician overrating of the overall health of older persons in residential and nursing homes, would appear to be very high. Although some degree of contextualization by physicians in this setting might be considered reasonable, the degree of overrating in our population seems nevertheless excessive.
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Affiliation(s)
- Javier Damián
- National Center for Epidemiology, Carlos III Institute of Health, Av/ Monforte de Lemos 5, 28029, Madrid, Spain. .,Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Madrid, Spain.
| | - Roberto Pastor-Barriuso
- National Center for Epidemiology, Carlos III Institute of Health, Av/ Monforte de Lemos 5, 28029, Madrid, Spain. .,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
| | - Emiliana Valderrama-Gama
- "Arroyo de la Media Legua" Primary Care Center, Madrid Health Service (Servicio Madrileño de Salud), Madrid, Spain.
| | - Jesús de Pedro-Cuesta
- National Center for Epidemiology, Carlos III Institute of Health, Av/ Monforte de Lemos 5, 28029, Madrid, Spain. .,Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Madrid, Spain.
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Kim JI, Choe MA, Chae YR. Prevalence and predictors of geriatric depression in community-dwelling elderly. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 3:121-9. [PMID: 25030470 DOI: 10.1016/s1976-1317(09)60023-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Revised: 07/03/2009] [Accepted: 09/04/2009] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This study aimed to examine the relationship between depressive mood and physical and socio-environmental variables of community-dwelling elderly. METHODS This study was designed as a cross-sectional descriptive survey. The setting was two elderly welfare centers and two public health centers in Korea. The subjects were recruited by public announcement and participated after giving their written informed consent. A total of 295 participants were included in the final analysis. The Korean version of the short form of Geriatric Depression Scale (SGDS-K), Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) of activities of daily living (ADL) and a socio-demographic questionnaire were administered to participants. Hand-grip strength was measured with a hand dynamometer. RESULTS The prevalence of depression among the subjects was 63%. Of the elderly, 21% had severe depressive symptoms. The mean depression score was 6.21 (SD = 3.83) and it was higher in women than in men. In the regression analysis, perceived health status alone had an accountability of 17.3% to depression. When TMIG-IC was added, this increased to 22.6%. Additionally, when hand-grip strength and social activities were input, it increased to 25.2%. Therefore, perceived health status was a significant and powerful factor explaining depression among the Korean elderly. CONCLUSION In this research, perceived health status was the most powerful predictor of elderly depression. TMIG-IC, hand-grip strength and social activities also predicted Korean elderly depression. These factors should be considered when the program is developed for elderly people with depression. [Asian Nursing Research 2009;3(3):121-129].
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Affiliation(s)
- Jeung-Im Kim
- School of Nursing, Soon Chun Hyang University, Asan, Korea
| | - Myoung-Ae Choe
- College of Nursing, Seoul National University, Seoul, Korea
| | - Young Ran Chae
- Department of Nursing, Kangwon National University, Chunchon, Korea
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Chen Y, While AE, Hicks A. Self-rated health and associated factors among older people living alone in Shanghai. Geriatr Gerontol Int 2014; 15:457-64. [PMID: 24750391 DOI: 10.1111/ggi.12298] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2014] [Indexed: 11/27/2022]
Abstract
AIM Self-rated health is a reliable and important health measure related to older people's mortality and quality of life. Few studies regarding the self-rated health of older people living alone have been carried out in Mainland China. The present study aimed to investigate the self-rated health of older people living alone in Shanghai and its associated factors. METHODS A stratified random cluster sample of 521 community-dwelling older people living alone in Shanghai completed structured questionnaires through face-to-face interviews. The data collected included self-rated health, physical health, depression, functional ability, physical activity, health services satisfaction, loneliness, social support and sociodemographic variables. RESULTS More than two-fifths of the participants (43.2%) reported good self-rated health. Multinomial logistic regression analyses found that chronic disease, acute disease, functional ability, satisfaction with health services, depression and age were predictors of self-rated health. CONCLUSIONS Identifying factors associated with the self-rated health of older people living alone could inform the delivery of appropriate health and social care interventions to promote older people's health.
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Affiliation(s)
- Yu Chen
- School of Nursing, Fudan University, Shanghai, China
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Toci E, Burazeri G, Jerliu N, Sørensen K, Ramadani N, Hysa B, Brand H. Health literacy, self-perceived health and self-reported chronic morbidity among older people in Kosovo. Health Promot Int 2014; 30:667-74. [DOI: 10.1093/heapro/dau009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tamayo-Fonseca N, Quesada JA, Nolasco A, Melchor I, Moncho J, Pereyra-Zamora P, López R, Calabuig J, Barber X. Self-rated health and mortality: a follow-up study of a Spanish population. Public Health 2013; 127:1097-104. [PMID: 24144258 DOI: 10.1016/j.puhe.2013.09.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 04/28/2013] [Accepted: 09/09/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Self-rated health (SRH) is known to be a valid indicator for the prediction of health outcomes. The aims of this study were to describe and analyse the associations between SRH and health status, socio-economic and demographic characteristics; and between SRH and mortality in a Spanish population. STUDY DESIGN Longitudinal study. METHODS A sample of 5275 adults (age ≥21 years) residing in the Valencian Community (Spanish Mediterranean region) was surveyed in 2005 and followed for four years. SRH was categorized into good and poor health. The response variable was mortality (dead/alive), obtained from the local mortality register. Logistic regression models were adjusted in order to analyse the associations between SRH and health status, socio-economic and demographic characteristics; odds ratios were calculated to measure the associations. Poisson regression models were adjusted in order to analyse the associations between mortality and explanatory variables; the relative risk of death was calculated to measure the associations. RESULTS Poor SRH was reported by 25.9% of respondents, and the mortality rate after four years of follow-up was 3.6%. An association was found between SRH and the presence of chronic disease and disability in men and women. A perception of poor health vs good health led to a mortality risk of 3.0 in men and 2.7 in women. SRH was predictive of mortality, even after adjusting for all other variables. In men and women, the presence of disability provided additional predictive ability. CONCLUSIONS SRH was predictive of mortality in both men and women, and acted as a mediator between socio-economic, demographic and health conditions and mortality.
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Affiliation(s)
- N Tamayo-Fonseca
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, Alicante, Spain
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Simsek H, Doganay S, Budak R, Ucku R. Relationship of socioeconomic status with health behaviors and self-perceived health in the elderly: A community-based study, Turkey. Geriatr Gerontol Int 2013; 14:960-8. [DOI: 10.1111/ggi.12166] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2013] [Indexed: 12/26/2022]
Affiliation(s)
- Hatice Simsek
- Department of Public Health; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - Sinem Doganay
- Department of Public Health; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - Refik Budak
- Department of Public Health; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - Reyhan Ucku
- Department of Public Health; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
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Personality, self-rated health, and cognition in centenarians: do personality and self-rated health relate to cognitive function in advanced age? Aging (Albany NY) 2013; 5:183-91. [PMID: 23524310 PMCID: PMC3629290 DOI: 10.18632/aging.100545] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Personality and self-rated health have been linked previously to cognitive outcome in late life. However, these associations have not been shown among the oldest old. This study examined relationships between personality, self-rated health, and cognitive function in a selected sample of Ashkenazi Jewish centenarians (n = 68, 59% female) aged 95 to 106 who lived independently in the community. Personality was measured using the Personality Outlook Profile Scale (POPS), a brief measure that was validated in this population. Self-rated health was assessed by participants’ subjective rating of their present health, and Mini-Mental Status Examination was used to determine cognitive function. Results showed positive associations of the Positive Attitude Towards Life domain of the POPS and self-rated health with participants’ current cognitive function. These associations remained significant even after adjusting for the effects of participants'age, gender, marital status, education, and history of medical illnesses. Further exploratory analysis using structural equations modeling showed significant associations among the three variables, but demonstrated a borderline significant level of mediating effect of personality on the relationship between self-rated health and cognition. These results reemphasized the independent roles of personality and self-rated health on centenarians’ cognitive outcomes. Future studies will further elucidate the impact of personality and self-rated health on cognitive outcomes in the oldest old.
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Mavaddat N, Van der Linde R, Savva GM, Brayne C, Mant J. What determines the self-rated health of older individuals with stroke compared to other older individuals? A cross-sectional analysis of the Medical Research Council Cognitive Function and Aging Study. BMC Geriatr 2013; 13:85. [PMID: 23968389 PMCID: PMC3847649 DOI: 10.1186/1471-2318-13-85] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 08/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor self-rated health has been associated with poorer objective health outcomes across a range of conditions including stroke. Identification of factors associated with poor self-rated health in stroke survivors has received little attention compared to that in other older individuals. This study identifies determinants of self-rated health in older individuals with or without a history of stroke participating in the population-representative MRC Cognitive Function and Aging Study (MRC CFAS). METHODS The MRC CFAS is a multicentred longitudinal survey of a population representative sample of people in their 65th year and older at baseline. Baseline interview included questions about functional disability, psychiatric history, independent living status, social interactions, and cognitive function. Multiple logistic regression was used to determine associations between demographic, physical, cognitive, psychological and social factors with poor self-rated health among those with and without stroke. RESULTS After excluding those with impaired cognitive function, 776 individuals out of 11,957 reported a stroke. Factors associated with self-rated health were similar between those with or without a stroke in older individuals. Poorer self-rated health in those who had suffered a stroke was associated predominantly with the presence of comorbidity with diabetes (OR 3.5; 95% CI 1.5-8.1) and not "getting out and about" (OR 2.6; 95% CI 1.7-4.1) even after adjustment for disability levels and for depression. In those without a stroke the most important determinants were disability (OR 3.9; 95% CI 3.2-4.8) and not "getting out and about" (OR 2.9; 95% CI 2.5-3.3). The presence of disability was less strongly associated with poor self-rated health in those with a history of stroke than those without due to a substantially higher reporting of poor self-rated health in the non-disabled stroke group than the non-disabled stroke-free group, while those with disabilities reported poor self-rated health irrespective of stroke status. CONCLUSIONS Self-rated health is determined by a range of psychological and social factors in addition to disability in older patients with stroke. Addressing social integration and mobility out of the home is an important element of rehabilitation for older people with stroke as well as those without.
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Affiliation(s)
- Nahal Mavaddat
- Department of Public Health and Primary Care, University of Cambridge Strangeways Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
| | - Rianne Van der Linde
- Department of Public Health and Primary Care, University of Cambridge Forvie Site, Robinson Way, Cambridge CB2 0SR, UK
| | - George M Savva
- School of Nursing Sciences, University of East Anglia Norwich Research Park, Norwich NR4 7TJ, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge Forvie Site, Robinson Way, Cambridge CB2 0SR, UK
| | - Jonathan Mant
- Department of Public Health and Primary Care, University of Cambridge Strangeways Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
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Galenkamp H, Deeg DJH, Huisman M, Hervonen A, Braam AW, Jylhä M. Is self-rated health still sensitive for changes in disease and functioning among nonagenarians? J Gerontol B Psychol Sci Soc Sci 2013; 68:848-58. [PMID: 23921719 DOI: 10.1093/geronb/gbt066] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES With age, there is an increasing gap between relatively stable levels of self-rated health (SRH) and actual health status. This study investigates longitudinal changes in SRH and examines its sensitivity to changes in chronic conditions and functioning among people aged 90 and older. METHODS In the Vitality 90+ Study, questionnaires were sent to all people aged 90 years and older living in Tampere, Finland. Included were respondents who provided data on the 2001 measurement and at least one follow-up measurement in 2003, 2007, or 2010 (N = 334). Generalized Estimating Equations analyses examined longitudinal change in SRH and the predictive value of number of chronic conditions and a functioning score based on 5 activities. RESULTS Within 2 years, most people (56.3%) had unchanged SRH, but declined SRH (22.3%) was associated with worse baseline functioning and declined functioning. Clear declines in SRH after 6 and 9 years were associated with increased chronic conditions (odds ratio [OR] = 1.23) and decreased functioning (OR = 1.28). The impact of chronic conditions and functioning was smaller among institutionalized people (chronic conditions OR = 0.90; functioning OR = 1.18) than among people living independently (chronic conditions OR = 1.30; functioning OR = 1.44). DISCUSSION SRH among nonagenarians was sensitive to changes in the number of chronic conditions and functioning although more pronounced on the longer than on the shorter term.
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Affiliation(s)
- Henrike Galenkamp
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
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Almomani FM, McDowd JM, Bani-Issa W, Almomani M. Health-related quality of life and physical, mental, and cognitive disabilities among nursing home residents in Jordan. Qual Life Res 2013; 23:155-65. [DOI: 10.1007/s11136-013-0461-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2013] [Indexed: 10/26/2022]
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Alonso J, Vilagut G, Adroher ND, Chatterji S, He Y, Andrade LH, Bromet E, Bruffaerts R, Fayyad J, Florescu S, de Girolamo G, Gureje O, Haro JM, Hinkov H, Hu C, Iwata N, Lee S, Levinson D, Lépine JP, Matschinger H, Medina-Mora ME, O'Neill S, Ormel JH, Posada-Villa JA, Ismet Taib N, Xavier M, Kessler RC. Disability mediates the impact of common conditions on perceived health. PLoS One 2013; 8:e65858. [PMID: 23762442 PMCID: PMC3675077 DOI: 10.1371/journal.pone.0065858] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 05/02/2013] [Indexed: 02/05/2023] Open
Abstract
Background We examined the extent to which disability mediates the observed associations of common mental and physical conditions with perceived health. Methods and Findings WHO World Mental Health (WMH) Surveys carried out in 22 countries worldwide (n = 51,344 respondents, 72.0% response rate). We assessed nine common mental conditions with the WHO Composite International Diagnostic Interview (CIDI), and ten chronic physical with a checklist. A visual analog scale (VAS) score (0, worst to 100, best) measured perceived health in the previous 30 days. Disability was assessed using a modified WHO Disability Assessment Schedule (WHODAS), including: cognition, mobility, self-care, getting along, role functioning (life activities), family burden, stigma, and discrimination. Path analysis was used to estimate total effects of conditions on perceived health VAS and their separate direct and indirect (through the WHODAS dimensions) effects. Twelve-month prevalence was 14.4% for any mental and 51.4% for any physical condition. 31.7% of respondents reported difficulties in role functioning, 11.4% in mobility, 8.3% in stigma, 8.1% in family burden and 6.9% in cognition. Other difficulties were much less common. Mean VAS score was 81.0 (SD = 0.1). Decrements in VAS scores were highest for neurological conditions (9.8), depression (8.2) and bipolar disorder (8.1). Across conditions, 36.8% (IQR: 31.2–51.5%) of the total decrement in perceived health associated with the condition were mediated by WHODAS disabilities (significant for 17 of 19 conditions). Role functioning was the dominant mediator for both mental and physical conditions. Stigma and family burden were also important mediators for mental conditions, and mobility for physical conditions. Conclusions More than a third of the decrement in perceived health associated with common conditions is mediated by disability. Although the decrement is similar for physical and mental conditions, the pattern of mediation is different. Research is needed on the benefits for perceived health of targeted interventions aimed at particular disability dimensions.
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Affiliation(s)
- Jordi Alonso
- IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain ; Pompeu Fabra University, Barcelona, Spain.
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Palacios-Ceña D, Gómez-Calero C, Cachón-Pérez JM, Brea-Rivero M, Gómez-Pérez D, Fernández-de-las-Peñas C. Non-capable residents: is the experience of dependence understood in nursing homes? A qualitative study. Geriatr Gerontol Int 2013; 14:212-9. [PMID: 23581535 DOI: 10.1111/ggi.12066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the present study was to describe how dependence was experienced by Spanish nursing home residents with functional limitations. METHODS A qualitative phenomenological approach was followed. An initial purposeful sampling of Spanish residents in for-profit nursing homes in the southern area of Madrid was carried out. Theoretical sampling was also implemented in order to gain a more in-depth understanding of dependence. The inclusion criteria for nursing home residents were: aged 60 years old or older, having a functional impairment (Barthel Index <90), and lack of any cognitive impairment (Mini-Mental State Examination-Folstein >19) and able to communicate verbally in Spanish. Data were collected using unstructured and semi-structured interviews. The interviews were tape recorded and fully transcribed. Data collection was concluded once theoretical saturation was reached, and the data were analyzed using the Giorgi proposal. RESULTS A total of 30 residents (15 female and 15 male) with a mean age of 83 years were included. Two main themes that describe the significance of dependence in nursing homes emerged from the data: (i) remaining "capable", with one subtheme named "building the difference", where residents described their own dependence classification of "non-capable" residents; and (ii) "sharing life", with two subthemes named "living together with non-capable residents" and "sharing the environment". Being considered as "non-capable" is labelling the resident forever. CONCLUSIONS The dependence experience of Spanish nursing home residents might help us gain a deeper insight into their expectations about functional limitations, as well as to understand the change in the relationship between residents considered "non-capable", caregivers and the other residents.
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Affiliation(s)
- Domingo Palacios-Ceña
- Department of Nursing, Obstetrics, Gynecology, Pediatrics, and Psychiatry, Rey Juan Carlos University, Madrid, Spain
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French DJ, Sargent-Cox K, Luszcz MA. Correlates of subjective health across the aging lifespan: understanding self-rated health in the oldest old. J Aging Health 2012; 24:1449-69. [PMID: 23103451 DOI: 10.1177/0898264312461151] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the determinants of self-rated health (SRH) in different age groups of older adults, including the oldest old. METHODS Variables assessing physical health, difficulty with self-care, depressive symptoms, and cognitive impairment were pooled and harmonized from three Australian longitudinal studies of ageing (N = 5,222). The association of these with SRH was examined in older adults aged 60 to 64 years, 65 to 74 years, 75 to 84 years, and 85 years and older. RESULTS SRH was not associated with cognitive impairment or difficulty with self-care in the oldest old, and its association with physical health was diminished compared with younger groups. Depression showed a significant relationship in all age groups, conferring an approximately fourfold increase in the likelihood of poorer SRH. DISCUSSION As old age progresses, self-reports of poor health become most closely related to psychological symptoms. This explains some of the paradoxes of past literature and offers important insights for health professionals working with the oldest old.
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Whitson HE, Malhotra R, Chan A, Matchar DB, Østbye T. Comorbid visual and cognitive impairment: relationship with disability status and self-rated health among older Singaporeans. Asia Pac J Public Health 2012; 26:310-9. [PMID: 22535554 DOI: 10.1177/1010539512443698] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study was to examine the prevalence and consequences of coexisting vision and cognitive impairments in an Asian population. Data were collected from 4508 community-dwelling Singaporeans aged 60 years and older. Cognition was assessed by the Short Portable Mental Status Questionnaire whereas vision, disability, and self-rated health (SRH) were determined by self-report. Vision impairment was present in 902 (18.5%) participants and cognitive impairment in 835 (13.6%), with 232 (3.5%) participants experiencing both impairments. Persons with the comorbidity experienced higher odds of disability than persons with either single impairment. The association of vision impairment with SRH was stronger among women (odds ratio [OR] = 6.79, 95% confidence interval [CI] = 4.64-9.92) than among men (OR = 1.71, 95% CI = 1.21-2.41). Concurrent cognitive and vision impairment is prevalent in older Singaporeans and is associated with high rates of disability. Gender differences in vision-dependent roles may affect the patient-perceived impact of this comorbidity.
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Affiliation(s)
- Heather E Whitson
- Duke University Medical Center, Durham, NC, USA Durham VA Geriatrics Research Education and Clinical (GRECC), Durham, NC, USA
| | - Rahul Malhotra
- Duke-National University of Singapore Graduate Medical School, Singapore
| | - Angelique Chan
- Duke-National University of Singapore Graduate Medical School, Singapore National University of Singapore, Singapore
| | - David B Matchar
- Duke University Medical Center, Durham, NC, USA Duke-National University of Singapore Graduate Medical School, Singapore
| | - Truls Østbye
- Duke University Medical Center, Durham, NC, USA Duke-National University of Singapore Graduate Medical School, Singapore
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Yang TC, Matthews SA. Understanding the non-stationary associations between distrust of the health care system, health conditions, and self-rated health in the elderly: a geographically weighted regression approach. Health Place 2012; 18:576-85. [PMID: 22321903 DOI: 10.1016/j.healthplace.2012.01.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 01/16/2012] [Accepted: 01/17/2012] [Indexed: 10/14/2022]
Abstract
The goals of this study are to explore whether health condition is an antecedent extraneous factor for the relationship between health care system distrust and self-rated health among the elderly, and to investigate if the associations among these variables are place-specific. We used logistic geographically weighted regression to analyze data on an elderly sample residents in the Philadelphia metropolitan area. We found that the health conditions of the elderly account for the association between high distrust and poor/fair self-rated health and that the distrust/self-rated health relationship varied spatially. This finding suggests that a place-centered perspective can inform distrust/self-rated health research.
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Affiliation(s)
- Tse-Chuan Yang
- The Social Science Research Institute, The Population Research Institute, The Pennsylvania State University, 803 Oswald Tower, University Park, PA 16802, USA.
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Factores asociados con calidad de vida relacionada con la salud en mayores institucionalizados: diferencias entre hombres y mujeres. ENFERMERIA CLINICA 2012; 22:27-34. [DOI: 10.1016/j.enfcli.2011.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 08/26/2011] [Accepted: 09/25/2011] [Indexed: 11/19/2022]
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Unmet needs of outpatients with late-life depression; a comparison of patient, staff and carer perceptions. J Affect Disord 2011; 134:242-8. [PMID: 21684611 DOI: 10.1016/j.jad.2011.05.052] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 05/26/2011] [Accepted: 05/27/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is evidence that late life depression is associated with high levels of unmet needs. Only a minority of the depressed patients appears to be adequately treated. METHODS Ninety-nine older patients (58-92 years), 96 informal carers and 85 health-care professionals were recruited from six outpatient facilities for old age psychiatry in the Netherlands and interviewed to identify met and unmet needs, using the Camberwell Assessment of Needs for the Elderly (CANE). The severity of depression was measured with the Montgomery Åsberg Depression Rating Scale (MADRS). RESULTS On average patients scored more unmet needs than staff and carers. On item level, patients and staff showed the highest agreement in the psychological needs category. Patient and carers showed the highest agreement on physical health needs. Logistic regression showed that severe depression is a significant predictor of low concordance between stakeholders on a substantial number of CANE items. LIMITATIONS Kappa coefficients were computed to determine agreement between parties involved. However, Kappa coefficients should be interpreted with caution, especially when obvious disparity in unmet needs scores between groups of interest can be observed. CONCLUSION Home dwelling older patients with major depressive disorder, their practitioners and their informal carers have different perceptions of the older patients unmet needs.Practitioners should be aware of the negative impact of depression severity on reaching agreement regarding unmet needs and its possible consequences for mutual goal setting and compliance.
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Fifteen Dimensions of Health among Community-Dwelling Older Singaporeans. Curr Gerontol Geriatr Res 2011; 2011:128581. [PMID: 22110500 PMCID: PMC3205690 DOI: 10.1155/2011/128581] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 08/24/2011] [Accepted: 08/26/2011] [Indexed: 11/17/2022] Open
Abstract
This paper aims to present a broad perspective of health of older Singaporeans spanning 15 health dimensions and study the association between self-rated health (SRH) and other health dimensions. Using data from a survey of 5000 Singaporeans (≥60 years), SRH and health in 14 other dimensions were assessed. Generalized logit model was used to assess contribution of these 14 dimensions to positive and negative SRH, compared to average SRH. About 86% reported their health to be average or higher. Prevalence of positive SRH and "health" in most other dimensions was lower in older age groups. Positive and negative SRH were associated with mobility, hearing, vision, major physical illness, pain, personal mastery, depressive symptoms, and perceived financial adequacy. The findings show that a majority of older Singaporeans report themselves as healthy overall and in a wide range of health dimensions.
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Leskinen R, Antikainen R, Peltonen M, Sippola R, Jousilahti P, Laatikainen T. Determinants of changes in self-rated health among Finnish war veterans: results from the Veteran Project 1992 and 2004 surveys. Arch Gerontol Geriatr 2011; 55:343-8. [PMID: 22023880 DOI: 10.1016/j.archger.2011.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 09/20/2011] [Accepted: 09/21/2011] [Indexed: 10/16/2022]
Abstract
Self-rated health is a strong predictor of mortality, morbidity, future functional capacity and the quality of life. Measures of self-rated health have been collected fairly regularly since the 1980s, but few of them focus on self-rated health among the elderly war veterans. The aim of this study was to examine changes in self-rated health among Finnish war veterans from 1992 to 2004 and to analyze the independent determinants associated with changes in veterans' self-rated health. The study population was 4999 veterans living in Finland, who participated in data collection of both the Veteran Project 1992 and 2004. Logistic regression models were used to identify independent predictors for changes in self-rated health. Analyses were conducted separately for men with and without disability and for women. During the follow-up, self-rated health improved or remained unchanged among 88.8% of the men without disability, 90.5% of the men with disability and 87.9% of the women. Determinants for declined self-rated health were a new cardiovascular disease (CVD) among all veteran groups, increased walking difficulties among men without disability and women, a new neurological disease and institutionalization among men without disability, and a new musculoskeletal disease among men with disability. In conclusion, the majority of veterans rated their health improved or unchanged during the follow-up. The importance of mobility impairments and cardiovascular, musculoskeletal and neurological diseases as the predictors of declined self-rated health were confirmed.
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Affiliation(s)
- Riitta Leskinen
- Oulu Deaconess Institute, PO Box 365, FI-90101 Oulu, Finland.
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Millán-Calenti JC, Sánchez A, Lorenzo T, Maseda A. Depressive symptoms and other factors associated with poor self-rated health in the elderly: Gender differences. Geriatr Gerontol Int 2011; 12:198-206. [DOI: 10.1111/j.1447-0594.2011.00745.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Xu Z, Su H, Zou Y, Chen J, Wu J, Chang W. Self-rated health of Chinese adolescents: distribution and its associated factors. Scand J Caring Sci 2011; 25:780-6. [DOI: 10.1111/j.1471-6712.2011.00893.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Söderhamn U, Flateland S, Jessen L, Söderhamn O. Perceived health and risk of undernutrition: a comparison of different nutritional screening results in older patients. J Clin Nurs 2011; 20:2162-71. [DOI: 10.1111/j.1365-2702.2010.03677.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Xu J, Zhang J, Feng L, Qiu J. Self-rated health of population in Southern China: association with socio-demographic characteristics measured with multiple-item self-rated health measurement scale. BMC Public Health 2010; 10:393. [PMID: 20598154 PMCID: PMC2910680 DOI: 10.1186/1471-2458-10-393] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 07/03/2010] [Indexed: 12/21/2022] Open
Abstract
Background Self-rated health (SRH) status has been increasingly acknowledged as a valid and appropriate indicator of public health and chronic morbidity. However, limited research was conducted in China due to the different culture and socioeconomic situations. The aim of this study is to assess the SRH status of the population in Southern China using multiple-item SRH measurement scale (SRHMS). Socio-demographic characteristics including sex, age, marital status, education, and income are considered variable in this survey. Methods A cross-sectional survey was conducted in a total of 8400 community residents of 14 years old and over in Southern China. SRH status was measured using SRHMS with a stratified sampling approach, and compared between different subgroups with t-test and one-way analysis of variance (ANOVA). Results Totally 8400 subjects were recruited in this study and 80.96% (6801) responded to the survey. The mean score for SRHMS dimensions ranged from 66.16 ± 20.65 (mean ± sd) for positive emotion (M2) to 92.14 ± 14.06 for daily physical activities (B2). Results showed that SRHMS scores for women, elderly men, low education level, low income, divorced, separated or widowed and suburban residents in Southern China were significantly lower than other subgroups (P < 0.05). Conclusions In this study, using SRHMS we assessed the association of SRH with socio-demographic characteristics including sex, age, marital status, education, and income in Southern China. The performance of the questionnaire in the large scale survey is satisfactory and provides a large picture of SRH status in Southern China. Our results indicate that women, elderly men, low education level, low income, divorced, separated or widowed and suburban residents in Southern China suffer from relatively poor SRH status.
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Affiliation(s)
- Jun Xu
- Department of Pharmacology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, PR China.
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Damián J, Pastor-Barriuso R, Valderrama-Gama E. Descriptive epidemiology of undetected depression in institutionalized older people. J Am Med Dir Assoc 2010; 11:312-9. [PMID: 20511097 DOI: 10.1016/j.jamda.2010.01.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 01/26/2010] [Accepted: 01/26/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To measure the prevalence and associated factors of undetected depression in institutionalized older people. DESIGN AND SETTING Epidemiologic cross-sectional study in nursing homes and residential facilities. PARTICIPANTS A stratified cluster sample of residents 65 years of age and older living in institutions of Madrid (Spain). MEASUREMENTS Residents were considered to be depressed if they met at least 1 of the following 3 criteria: 10-item Geriatric Depression Scale score of 4 or higher, physician's diagnosis, or antidepressant use. Prevalence of undetected depression was defined as the proportion of depressed residents without documented diagnosis or treatment. RESULTS A total of 255 of 579 residents had depression (weighted prevalence 46.1%, 95% confidence interval [CI] 41.0%-51.3%) and 108 depressed residents were undetected (undetection prevalence 41.5%, 95% CI 33.2%-50.2%). Undetection was lower in younger residents, private versus public facilities (sex-, age-, and size-adjusted prevalence ratio [PR] 0.59, 95% CI 0.37-0.94), and larger facilities (sex-, age-, and ownership-adjusted PR 0.94 per 50-bed increase, 95% CI 0.88-1.00). Undetected depression was higher in residents with poor self-rated health (sex- and age-adjusted PR 1.83, 95% CI 1.24-2.73), whereas the opposite came about for physician-rated health (PR 0.65, 95% CI 0.44-0.95). Undetection decreased 11% (95% CI 4%-17%) per 1-medication increase, and it was lower in patients with Alzheimer disease, anxiety, and arrhythmia. CONCLUSIONS Number of medications and self-rated health were the main determinants of undetected depression. Physician-rated health, facility characteristics (size and ownership), and some diseases could also be considered.
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Affiliation(s)
- Javier Damián
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
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Surkan PJ, O'Donnell EM, Berkman LF, Peterson KE. Social ties in relation to health status of low-income Brazilian women. J Womens Health (Larchmt) 2010; 18:2049-56. [PMID: 20044869 DOI: 10.1089/jwh.2008.1340] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Social support resources are thought to buffer stressful life events and have been associated with numerous health outcomes in industrialized countries. Because the nature of supportive relationships varies by culture and social class, we studied the relationship of informal social support and networks to self-rated health among low-income women in northeastern Brazil. METHODS Participants included 595 randomly sampled mothers from nine low-income communities in Teresina, Piauí, Brazil. Data on sociodemographic variables, social support, quality of the partner relationship, and self-rated health were collected cross-sectionally in 2002. Using multivariable logistic regression, we modeled the association between different aspects of social support and self-rated health. RESULTS Poor or fair health was reported by 47% of participants. Women with poor partner relationships had an increased likelihood of poor or fair health (OR 1.7, 95% CI 1.1-2.7), as did those with no material support for food or money (OR 1.6, 95% CI 1.2, 2.0) and no support to resolve a conflict (OR 1.5, 95% CI 1.1, 2.1). Likewise, women with the lowest scores of the Medical Outcomes Study (MOS) social support survey were more likely than other women to report poor or fair health (OR 1.5, 95% CI 1.0, 2.1). CONCLUSIONS Poor quality of a partner relationship, lack of support to resolve a conflict, and lack of material support as well as such sociodemographic variables as low education, poor sanitation, and depressive symptomatology are associated with lower health status in a population of low-income women from northeastern Brazil.
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Affiliation(s)
- Pamela J Surkan
- Department of International Health, Bloomberg School of Public Health, Baltimore, Maryland 21205-2103, USA.
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Zikic L, Jankelic S, Milosevic DP, Despotovic N, Erceg P, Davidovic M. Self-perception of health (SPH) in the oldest-old subjects. Arch Gerontol Geriatr 2009; 49 Suppl 1:245-9. [PMID: 19836640 DOI: 10.1016/j.archger.2009.09.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
SPH is a subjective and objective assessment of personal health. It is important in evaluation of health status in the elderly as it has capacity to predict mortality, functional declining, and health-care demands. A lot of research has been published about SPH in the elderly, but little is known about SPH in the very old, especially in comparison with the "younger-old" (YO) population. The study has aimed to investigate SPH in 240 elderly patients and compare the data between the "oldest-old" (OO) (aged >or= 90 years; n=52) and the YO (aged 60-74 years; n=188) subjects. Results have shown that the OO group of patients had better SPH than their YO counterparts. Our findings implicate that very old persons belong to a special sub-group of elderly, the "successfully aged", probably due to their genetic stability, distinctive lifestyle, or both.
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Affiliation(s)
- L Zikic
- Institute of Gerontology, Home Treatment and Care, Belgrade, Serbia
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