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Abufaraj M, Alhalaseh L, Al-Sabbagh MQ, Eyadat Z, Khatib WA, Samara OA, Moonesar IA, Smith L, Al Qutob R. The current status of health care indices and functional independence among older adults: data from HelpAge international-jordan study. Aging Clin Exp Res 2024; 36:124. [PMID: 38811496 PMCID: PMC11136843 DOI: 10.1007/s40520-024-02738-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/17/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Health services should anticipate the changing pattern of illnesses associated with population aging to promote healthy aging. AIM We aimed to evaluate health indices and chronic illnesses and their relationship with functional independence in community Syrian refugees & Jordanian elderly. METHODS A stratified sample of 1,718 community older adults aged ≥ 60-year-old from four major Jordanian governorates was interviewed in this cross-sectional study. Katz Index of Independence in Activities of Daily Living was utilized to assess functional status. Data were analyzed using STATA 15. RESULTS Despite the similarities in baseline function, Syrian refugees had more multimorbidities but less active health insurance, accessibility to healthcare services and availability of medications and medical devices than Jordanians. Two-thirds had multimorbidities; with heart diseases, musculoskeletal conditions, hypertension, and diabetes being the most commonly reported chronic illnesses. Females had significantly more multimorbidities, and functional dependence, yet less education, income and accessibility to healthcare services. The mean Katz Index score was 4.99 ± 1.61. Significant predictors of functional dependence included increasing age, lower level of education, and some chronic illnesses. CONCLUSION National inclusive plans to support vulnerable older adults especially refugees and older women, provide health insurance, enhance access to health care facilities, and manage chronic medical illnesses comprehensively are urgently needed to improve independence of community-living older adults and to promote healthy aging.
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Affiliation(s)
- Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, 11942, Jordan.
- Center of strategic studies, The University of Jordan, Amman, Jordan.
| | - Lana Alhalaseh
- Division of Geriatrics, Department of Family and Community Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Zaid Eyadat
- Center of strategic studies, The University of Jordan, Amman, Jordan
| | - Walid Al Khatib
- Center of strategic studies, The University of Jordan, Amman, Jordan
| | - Osama A Samara
- Department of Radiology and nuclear medicine, University Hospital, The University of Jordan, Amman, Jordan
| | - Immanuel Azaad Moonesar
- Health Administration & Policy, Mohammed Bin Rashid School of Government, Dubai, United Arab Emirates
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Raeda Al Qutob
- Department of Family and Community Medicine, School of medicine, The University of Jordan, Amman, Jordan
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Agyekum MW, Afrifa-Anane GF, Kyei-Arthur F. Prevalence and correlates of disability in older adults, Ghana: evidence from the Ghana 2021 Population and Housing Census. BMC Geriatr 2024; 24:52. [PMID: 38212686 PMCID: PMC10785330 DOI: 10.1186/s12877-023-04587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Although there are studies on disabilities in older persons, most of these studies have been carried out in developed countries. Hence, there are limited studies on disability in older adults in sub-Saharan Africa, including Ghana. The few studies that have examined the prevalence and correlates of disability in older adults used survey data for their analyses. To contribute to addressing this knowledge gap that has arisen, this study used a national census, the 2021 Ghana Population and Housing Census, to examine the prevalence and correlates of disability in older adults in Ghana. METHODS The 2021 Ghana Population and Housing Census data was used for this study. A sample size of 197,057 Ghanaians aged 60 years and above was used for this study. The Washington Group questions on disability were used to measure disability by asking older adults about their difficulties in performing the six domains of disability (physical, sight, intellectual, hearing, self-care, and speech). A multinomial logistic regression housed in STATA was used to analyse the correlates of disability in older adults in Ghana. A p-value less than 0.05 was used for statistical significance. RESULTS The results show that slightly more than one-third (38.4%) of the older adults were disabled. In terms of the number of disabilities in older adults, 16.9% had one disability condition, while 2.4% had six disability conditions. Also, 9.4% had two disability conditions. Older adults who were females, aged 70-79 years and 80 years and above, resided in rural areas, with primary, JHS/Middle, SHS, unaffiliated with religion, ever married and never married, unemployed, and belonged to the middle and rich households were more likely to have a disability condition. Also, older adults residing in the Middle and Northern zones, having no health insurance, and using clean cooking fuel were less likely to have a disability condition. CONCLUSIONS The results show that socio-demographic and household factors were associated with disability in older adults in Ghana. Hence, policymakers and researchers should target these factors when designing appropriate policies, programmes, and interventions to improve the wellbeing of older adults.
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Affiliation(s)
- Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education Winneba, Winneba, Ghana.
| | - Grace Frempong Afrifa-Anane
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | - Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
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Barteit S, Colmar D, Nellis S, Thu M, Watterson J, Gouwanda D, Bärnighausen T, Su TT. Developing Climate Change and Health Impact Monitoring with eHealth at the South East Asia Community Observatory and Health and Demographic Surveillance Site, Malaysia (CHIMES). Front Public Health 2023; 11:1153149. [PMID: 38125843 PMCID: PMC10732307 DOI: 10.3389/fpubh.2023.1153149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/31/2023] [Indexed: 12/23/2023] Open
Abstract
Background Malaysia is projected to experience an increase in heat, rainfall, rainfall variability, dry spells, thunderstorms, and high winds due to climate change. This may lead to a rise in heat-related mortality, reduced nutritional security, and potential migration due to uninhabitable land. Currently, there is limited data regarding the health implications of climate change on the Malaysian populace, which hinders informed decision-making and interventions. Objective This study aims to assess the feasibility and reliability of using sensor-based devices to enhance climate change and health research within the SEACO health and demographic surveillance site (HDSS) in Malaysia. We will particularly focus on the effects of climate-sensitive diseases, emphasizing lung conditions like chronic obstructive pulmonary disease (COPD) and asthma. Methods In our mixed-methods approach, 120 participants (>18 years) from the SEACO HDSS in Segamat, Malaysia, will be engaged over three cycles, each lasting 3 weeks. Participants will use wearables to monitor heart rate, activity, and sleep. Indoor sensors will measure temperature in indoor living spaces, while 3D-printed weather stations will track indoor temperature and humidity. In each cycle, a minimum of 10 participants at high risk for COPD or asthma will be identified. Through interviews and questionnaires, we will evaluate the devices' reliability, the prevalence of climate-sensitive lung diseases, and their correlation with environmental factors, like heat and humidity. Results We anticipate that the sensor-based measurements will offer a comprehensive understanding of the interplay between climate-sensitive diseases and weather variables. The data is expected to reveal correlations between health impacts and weather exposures like heat. Participant feedback will offer perspectives on the usability and feasibility of these digital tools. Conclusion Our study within the SEACO HDSS in Malaysia will evaluate the potential of sensor-based digital technologies in monitoring the interplay between climate change and health, particularly for climate-sensitive diseases like COPD and asthma. The data generated will likely provide details on health profiles in relation to weather exposures. Feedback will indicate the acceptability of these tools for broader health surveillance. As climate change continues to impact global health, evaluating the potential of such digital technologies is crucial to understand its potential to inform policy and intervention strategies in vulnerable regions.
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Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - David Colmar
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Syahrul Nellis
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Min Thu
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Jessica Watterson
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Darwin Gouwanda
- School of Engineering (Mechanical), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, United States
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, United States
| | - Tin Tin Su
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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Huang D, Wang J, Fang H, Fu Y, Lou J. Longitudinal association of chronic diseases with depressive symptoms in middle-aged and older adults in China: Mediation by functional limitations, social interaction, and life satisfaction. J Glob Health 2023; 13:04119. [PMID: 37766663 PMCID: PMC10534192 DOI: 10.7189/jogh.13.04119] [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: 09/29/2023] Open
Abstract
Background Several previous studies have shown that the development of depression is often accompanied by chronic diseases; although closely related, the mechanism between them is not clear. Here we investigate the potential role of functional limitations, social interaction, and life satisfaction in the relationship between chronic diseases and depressive symptoms in middle-aged and older adults in China. Methods We selected 2407 respondents aged ≥45 from the China Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. We established panel data to estimate the longitudinal impact of chronic diseases on depressive symptoms and the mediating role of functional limitations, social interaction, and life satisfaction. Results Chronic diseases were associated with more depressive symptoms. All of the mediating pathways examined passed functional limitations, and approximately 43.4% of the association between chronic diseases and depressive symptoms was explained by these three mediating variables. Conclusions The impact of chronic diseases on depressive symptoms was primarily mediated by functional limitations, and the mediating role of social interaction and life satisfaction was also confirmed. Therefore, attention should be paid to reducing the level of functional limitation in middle-aged and older adults with chronic diseases and improving life satisfaction by increasing social opportunities to alleviate depressive symptoms in middle-aged and older adults.
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Affiliation(s)
- Derong Huang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Huiling Fang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yingjie Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jiaxu Lou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
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Anwar A, Yadav UN, Huda MN, Rifat MA, Ali AM, Mondal PK, Rizwan AAM, Shuvo SD, Mistry SK. Prevalence and determinants of self-reported functional status among older adults residing in the largest refugee camp of the world. BMC Geriatr 2023; 23:345. [PMID: 37264327 DOI: 10.1186/s12877-023-04067-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The older adults of refugee camps might be vulnerable to exhibiting limited functional abilities because of the limited resources available to create a supportive environment for older population in the camps. This study aims to explore the prevalence and determinants of self-reported functional status among the older adults residing in the Rohingya refugee camp in Bangladesh. METHODS This cross-sectional study was conducted on 864 older adults aged 60 years and above living in five selected sub-camps of Rohingya refugee camp in Cox's Bazar, Bangladesh. Data were collected through face-to-face interviews of the participants between November-December 2021. Functional status was measured using the Barthel Index. Information on participants' sociodemographic characteristics, self-reported chronic diseases and lifestyle characteristics were also collected. A multiple logistic regression model was used to assess the factors associated with self-reported functional abilities among the participants. RESULTS The overall percentage of people having limited self-reported functional ability was 26.5% (male: 22.6% and female: 31.5%) with inability most found in grooming (33.2%), bathing (31.8%), stair using (13.2%) and mobility (10.7%). In the final adjusted model, having age of 80 years or more (aOR = 2.01,95% CI: 1.08,3.75), being female (aOR = 1.44, 95% CI: 1.04,2.0), having low memory or concentration (aOR = 1.83, 95% CI: 1.30,2.56), loneliness (aOR = 2.89, 95% CI:1.74,4.80) and living with aid alone (aOR = 2.89, 95% CI: 1.74,4.80) were found to be associated with self-reported limited functional ability. CONCLUSION The findings of this study highlight the need for attention from policymakers and public health practitioners on addressing functional limitations among older adults residing in the Rohingya refugee camp. Our findings emphasize the need for the development of comprehensive interventions that can address the wider unmet needs (e.g., ensuring family/caregiver support, engaging in social and physical activities, providing nutritional support packages, etc.) to improve the health and well-being of older Rohingya adults.
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Affiliation(s)
- Afsana Anwar
- Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, 2601, Australia
- Centre for Primary Health Care and Equity, University of New Sotuh Wales, Kensington, New South Wales, 2052, Australia
| | - Md Nazmul Huda
- Translational Health Research Institute, School of Health Science, Western Sydney University, Campbelltown, New South Wales, 2560, Australia
| | - M A Rifat
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Arm Mehrab Ali
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, 1216, Bangladesh
| | - Probal Kumar Mondal
- Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Abu Ansar Md Rizwan
- Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, 7408, Bangladesh
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New Sotuh Wales, Kensington, New South Wales, 2052, Australia.
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, 1216, Bangladesh.
- Department of Public Health, Daffodil International University, Dhaka, 1207, Bangladesh.
- Brain and Mind Centre, The University of Sydney, 94 Mallet St, Camperdown, New South Wales, 2050, Australia.
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Pattnaik S, Murmu J, Agrawal R, Rehman T, Kanungo S, Pati S. Prevalence, pattern and determinants of disabilities in India: Insights from NFHS-5 (2019-21). Front Public Health 2023; 11:1036499. [PMID: 36923034 PMCID: PMC10009251 DOI: 10.3389/fpubh.2023.1036499] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 02/08/2023] [Indexed: 03/02/2023] Open
Abstract
There is a need to provide an overview of the disability burden in India as there are limited studies. The present study aimed to estimate the prevalence and assess the pattern and determinants of disability in India. We analyzed National Family Health Survey-5 data using the "svyset" command in STATA software. We assessed the correlates by multivariable regression and reported an adjusted prevalence ratio (aPR) with a 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of distributions of different disabilities. The mean (SD) age of 28,43,917 respondents was 30.82 (20.62) years, with 75.83% (n = 21,56,633) and 44.44% (n = 12,63,086) of them being from a rural area and were not educated, respectively. The overall prevalence of disability was 4.52% [(95% CI: 4.48-4.55), n = 1,28,528]. Locomotor disabilities accounted for 44.70% of all disabilities (n = 51,659), followed by mental disabilities (20.28%, n = 23,436). Age 75 years and above (vs. 0-14 years) [aPR: 2.65 (2.50-2.81)], male (vs. female) [aPR: 1.02 (1.0-1.04)], no education (vs. higher education) [aPR 1.62 (1.56-1.68)], unmarried (vs married) [aPR: 1.76 (1.70-1.82)], seeking the care of non-governmental organization (NGO) (vs. other) [aPR: 1.32 (1.13-1.55)] were significant independent determinants. The highest overall prevalence of locomotor was in Lakshadweep/UTs (8.88%) and Delhi (57.03%), respectively. Out of every hundred individuals in India, four have a disability. More intervention strategies should be planned, considering factors like education, residence, health promotion and caste so that the services provided by the government can be available and accessible to everyone in need.
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Yau PN, Foo CJE, Cheah NLJ, Tang KF, Lee SWH. The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis. Epidemiol Health 2022; 44:e2022058. [PMID: 35843601 PMCID: PMC9754909 DOI: 10.4178/epih.e2022058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/12/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region. METHODS A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis. RESULTS Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life. CONCLUSIONS Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.
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Affiliation(s)
- Phei Nie Yau
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | | | | | - Kar Foong Tang
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia,School of Pharmacy, Taylor’s University, Subang Jaya, Malaysia,Correspondence: Shaun Wen Huey Lee School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Malaysia E-mail:
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Peter RM, Logaraj M, Ramraj B. Association of comorbidities with activity of daily living (ADL) in a community-based sample of older adults in Tamil Nadu, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Tan MP. Healthcare for older people in lower and middle income countries. Age Ageing 2022; 51:6563041. [PMID: 35373815 DOI: 10.1093/ageing/afac016] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/05/2021] [Indexed: 11/13/2022] Open
Abstract
Two-thirds of the world's population aged 60 years and over will reside in lower and middle income countries (LMIC) by 2050. Many LMICs are experiencing rapid population ageing at a faster rate than in Western Europe and North America, but may not have the resources to respond to the World Health Organization's call to action. As population ageing is a global issue, effective and sustainable global solutions are much needed. Proposed strategies include stemming the outflow of trained healthcare workers to high-income nations where migrants from LMICs often contribute to the work force caring for older people. Public education, preventive measures and innovative approaches to training are additional proposed solutions. Higher income countries have a responsibility to contribute towards the development of healthcare services for older people in LMICs.
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Affiliation(s)
- Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Ageing and Age-Associated Disorders Research Group, Health and Wellbeing Research Cluster, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Department of Healthcare and Medical Sciences, Faculty of Health Sciences, Sunway University, Bandar Sunway, Malaysia
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Nesemann JM, Kandel RP, Byanju R, Poudyal B, Bhandari G, Bhandari S, O’Brien KS, Stevens VM, Melo JS, Keenan JD. Association of visual impairment with disability: a population-based study. Eye (Lond) 2022; 36:540-546. [PMID: 33731892 PMCID: PMC8873270 DOI: 10.1038/s41433-021-01498-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To determine the relationship between visual impairment and other disabilities in a developing country. METHODS In this cross-sectional ancillary study, all individuals 50 years and older in 18 communities in the Chitwan region of Nepal were administered visual acuity screening and the Washington Group Short Set (WGSS) of questions on disability. The WGSS elicits a 4-level response for six disability domains: vision, hearing, walking/climbing, memory/concentration, washing/dressing, and communication. The association between visual impairment and disability was assessed with age- and sex-adjusted logistic regression models. RESULTS Overall, 4719 of 4726 individuals successfully completed visual acuity and disability screening. Median age of participants was 61 years (interquartile range: 55-69 years), and 2449 (51.9%) were female. Participants with vision worse than 6/60 in the better-seeing eye were significantly more likely to be classified as having a disability in vision (OR 18.4, 95% CI 9.9-33.5), walking (OR 5.3, 95% CI 2.9-9.1), washing (OR 9.4, 95% CI 4.0-21.1), and communication (OR 5.0, 95% CI 1.7-13.0), but not in hearing (OR 0.6, 95% CI 0.006-2.2) or memory (OR 2.2, 95% CI 0.7-5.1). CONCLUSIONS Visually impaired participants were more likely to self-report disabilities, though causality could not be ascertained. Public health programs designed to reduce visual impairment could use the WGSS to determine unintended benefits of their interventions.
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Affiliation(s)
- John M. Nesemann
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA
| | | | | | | | | | | | - Kieran S. O’Brien
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA ,grid.47840.3f0000 0001 2181 7878Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA USA
| | - Valerie M. Stevens
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA
| | - Jason S. Melo
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA
| | - Jeremy D. Keenan
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Ophthalmology, University of California San Francisco, San Francisco, CA USA
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Aravindhan K, Mat S, Hamid TA, Shahar S, Abdul Majeed AB, Teh PL, Ramasamy K, Singh DKA, Tan MP. Development of Virtual Surveys for the COVID-19 Wave of the AGELESS Longitudinal Study in Malaysia. Gerontology 2021; 68:551-555. [PMID: 34515120 PMCID: PMC8450846 DOI: 10.1159/000517946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background Rapid population aging occurring in developing nations necessitates innovation to ensure we continue to gain ground on aging research despite pandemic threats. While developed nations have resorted to virtual communications, this is challenging in developing nations due to poor internet connectivity and digital literacy. Objectives The aim of this study was to determine the feasibility of virtual data collection for a longitudinal study of aging assessing cognitive frailty in a middle-income Southeast Asian country. Methods The Transforming Cognitive Frailty into Later-Life Self-Sufficiency (AGELESS) longitudinal study of aging involved community-dwelling participants aged 60 years and above. A semi-structured focus group discussion was conducted via videoconferencing with selected representatives from existing participants. The survey instrument was compiled during a hybrid meeting and refined using a virtual Delphi process involving 51 AGELESS investigators. The final draft survey and recruitment strategy were then piloted among selected participants. Results Twelve individuals participated in the virtual focus group interview. Smartphone, tablet computer, laptops, and desktop personal computers were used for information gathering, communication, banking, shopping, leisure, religion, and education, within this group. The survey instrument was redacted from 362 items in 18 sections to 141 items in 12 sections through 3 virtual Delphi rounds facilitated by email, social media messaging, and videoconferencing which attracted 213 comments. Of 45 participants selected for the pilot survey, 30 were successfully contacted after one attempt and 18 completed the survey. Cognitive frailty was present in 13%, cognitive impairment in 20%, frailty in 20%, and 47% were robust. Conclusion A virtual survey instrument was developed for the AGELESS longitudinal survey of aging which was vital for determining the effects of the COVID-19 pandemic on our older population as well as sustaining research into aging despite barriers posed by the pandemic.
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Affiliation(s)
- Kiirtaara Aravindhan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Tengku Aizan Hamid
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Abu Bakar Abdul Majeed
- Brain Degeneration and Therapeutics Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Malaysia
| | - Pei-Lee Teh
- Gerontechnology Laboratory, Monash University Malaysia, Bandar Sunway, Malaysia.,School of Business, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Kalavathy Ramasamy
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Puncak Alam, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia
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12
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A User-Driven Approach to Prosthetic Upper Limb Development in Korea. Healthcare (Basel) 2021; 9:healthcare9070839. [PMID: 34356217 PMCID: PMC8303819 DOI: 10.3390/healthcare9070839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/21/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022] Open
Abstract
Despite recent significant advances in technology and medicine, the number of patients who undergo amputation of body parts for various reasons continues to increase. Assistive devices such as prosthetic arms can enable limited activities in upper limb amputees and improve their quality of life. This study aims to help in the development of user-centered prosthetics by identifying user requirements and key considerations during selection of prosthetics. This study conducted a questionnaire survey after obtaining prior consent for persons with disabilities with upper limb amputation who visited orthosis companies, rehabilitation centers for the disabled, veteran’s hospitals, and labor welfare corporations. A modified questionnaire was conducted to upper limb prosthetic users and results were analysed using descriptive statistics and t-test. Results of the study showed that the main reasons for discontinuing the use of prosthetics were discomfort (discomfort in wear, weight, and difficulty of detachment) and complaints regarding design and function. Regardless of the prosthesis type, the color and design of the prosthesis were key considerations in prosthesis choices. Respondents indicated that they needed various prostheses designed according to the purpose and situation, such as for sports like golf and cycling as well as everyday use. Most of the respondents answered that buttoning shirts, tying knots, and using chopsticks were challenging or impossible to do on their own. Based on the results of this study, the quality of life of upper limb amputees can be improved if a prosthetic arm with various functions that can satisfy both the user’s needs and wants is developed.
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Asim M, Aftab M, Bhatti SH, Ahmad T, Ali Shah SM, Akram M. Identifying factors causing decline in physical functionality of geriatric population. EUR J INFLAMM 2021. [DOI: 10.1177/20587392211026109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The objective of the study was to find major correlates of decline in the physical functionality of the geriatric population. The main focus was the evaluation of demographic, social, economic, and health-related factors that have a potential impact on physical functionality. A sample of 423 elderly people were selected from district Faisalabad, Pakistan by using a snowball sampling approach. Statistical analysis was performed using frequency analysis and some tests for association like chi-square, Cramer’s V, and gamma coefficient. It was observed that 42.8% of the respondents were independent in doing their all-routine work and the physical functional status decline was observed partially in 35.2% and completely in 22.0% of the respondents. Using frequency analysis and association measures, age, education, marital status, living with family, having an independent source of income, level of social network and support, having exercise routine were found to be significantly associated with functional status of elders. The study concluded that besides age and other demographic factors that cannot be controlled, the socio-economic factors can be improved to substantially reduce the decline in the physical functionality of the geriatric population.
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Affiliation(s)
- Muhammad Asim
- Department of Statistics, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Muhammad Aftab
- Department of Statistics, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Sajjad Haider Bhatti
- Department of Statistics, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Tanvir Ahmad
- Department of Statistics, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Syed Muhammad Ali Shah
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
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14
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Tetteh J, Asare IO, Adomako I, Udofia EA, Seneadza NAH, Adjei-Mensah E, Calys-Tagoe BNL, Swaray SM, Ekem-Ferguson G, Yawson A. Sex differences and factors associated with disability among Ghana's workforce: a nationally stratified cross-sectional study. BMJ Open 2021; 11:e044246. [PMID: 33687955 PMCID: PMC7944976 DOI: 10.1136/bmjopen-2020-044246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE This study was conducted to estimate the prevalence of disability and associated factors and further quantify the associated sex differential among Ghana's workforce aged 15+ years. DESIGN A nationally stratified cross-sectional study. SETTING Ghana. PARTICIPANTS Individuals aged 15 years and above. OUTCOME MEASURE Disability that limits full participation in life activities. METHODS Three predictive models involving Poisson, logistic and probit regression were performed to assess the association between disability and covariates. Modified Poisson multivariate decomposition analysis method was employed to assess sex differential and associated factors using Stata V.16. RESULTS The prevalence of disability was 2.1% (95% CI 1.2 to 2.4), and the risk of disability among males was approximately twice compared with females (Poisson estimate: adjusted prevalence ratio (95% CI)=1.94 (1.46 to 2.57); logistic estimate: aOR (95% CI)=2.32 (1.73 to 3.12)). Male sex increased the log odds of disability by 0.37 (probit estimate, aβ (95% CI)=0.37 (0.23 to 0.50)). The variability in age group, marital status, household (HH) size, region, place of residence, relationship to HH head, hours of work per week and asset-based wealth were significantly associated with disability-based sex differential. (Significant increased endowment: β×10-3 (95% CI×10-3)=-37.48 (-56.81 to -18.16) and significant decreased coefficient: β×10-3 (95% CI×10-3)=42.31 (21.11 to 63.49).) All disability participants were challenged with activities of daily living, limiting them in full participation in life activities such as mobility, work and social life. CONCLUSION The magnitude of experiencing disability among working males was nearly twice that of females. Sex differentials were significantly associated with age groups, marital status, HH size, region of residence, relationship to HH head, hours of work per week and wealth. Our findings amass the provisional needs of persons living with a disability that are indicators to consider to achieve the United Nations Convention on the Rights of Persons with Disabilities Article 10. In addition, formulation of workplace policies should adopt a gender-sensitive approach to reduce disparities and eliminate disability in the target population.
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Affiliation(s)
- John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Isaac Ofori Asare
- Department of Mathematics and Statistics, Accra Technical University, Accra, Ghana
- Vita Verde consult, Accra, Ghana
| | - Isaac Adomako
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emilia Asuquo Udofia
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Nana Ayegua Hagan Seneadza
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Evelyn Adjei-Mensah
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Benedict N L Calys-Tagoe
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | | | - Alfred Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
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15
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Socio-economic and Demographic Correlates of the Health Status of Older Adults in India: An Analysis of NSS 71st Round Data. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-020-09407-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Parajuli J, Berish D, Jao YL. Chronic conditions and depressive symptoms in older adults: the mediating role of functional limitations. Aging Ment Health 2021; 25:243-249. [PMID: 31762296 DOI: 10.1080/13607863.2019.1693971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Depressive symptoms, chronic conditions, and functional limitations are common in older adults. Several studies have examined the relationship between chronic conditions or functional limitations and depressive symptoms separately. However, little is known about how much of the effect of chronic conditions on depressive symptoms is due to the functional limitations resulting from such conditions. METHODS This paper examined the longitudinal association of chronic conditions and functional limitations with depressive symptoms in older adults aged 65 and over in the USA using the data from the 2012 wave and 2014 wave of the Health and Retirement Study (HRS). Mediation analysis was used to examine the mediation effects of 2012 functional limitations on the relationship between 2012 chronic conditions and 2014 depressive symptoms controlling for other measures including gender, age, race, education, marital status, and BMI. RESULTS Results revealed that chronic conditions and functional limitations were significantly associated with depressive symptoms. There was a 13.7% mediation effect when 2012 functional limitations were added as a mediator on the relationship between 2012 chronic conditions and 2014 depressive symptoms. CONCLUSION Functional limitations mediate the relationship between chronic conditions and depressive symptoms. Preventing or managing functional limitations may help reduce depressive symptoms in older adults with chronic conditions.
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Affiliation(s)
- Jyotsana Parajuli
- College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Diane Berish
- College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Ying-Ling Jao
- College of Nursing, Pennsylvania State University, University Park, PA, USA
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17
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Delaney M, Warren M, Kinslow B, de Heer H, Ganley K. Association and Dose-Response Relationship of Self-Reported Physical Activity and Disability Among Adults ≥50 Years: National Health and Nutrition Examination Survey, 2011-2016. J Aging Phys Act 2020; 28:434-441. [PMID: 31756719 DOI: 10.1123/japa.2019-0163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 11/18/2022]
Abstract
Disability is a tremendous public health challenge. No study has assessed whether meeting U.S. Physical Activity guidelines is associated with disability in mobility tasks, activities of daily living, and social participation among U.S. older adults. Using 2011-2016 National Health and Nutrition Examination Survey data, this study examined this relationship among 8,309 individuals aged ≥50 years. Most participants (n = 4,272) did not achieve guidelines, and 2,912 participants were completely inactive. People who did not meet guidelines had higher odds of disability compared with those who did (adjusted odds ratio [AOR] = 1.80) in addition to difficulty with mobility tasks (AOR = 1.85), activities of daily living (AOR = 1.66), and social participation (AOR = 2.09). There was a dose-response effect for each level of activity (inactive, insufficient, and meeting and exceeding recommendations). Among adults aged ≥50 years, meeting the U.S. guidelines was associated with better social and physical functioning.
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18
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Harithasan D, Mukari SZMS, Ishak WS, Shahar S, Yeong WL. The impact of sensory impairment on cognitive performance, quality of life, depression, and loneliness in older adults. Int J Geriatr Psychiatry 2020; 35:358-364. [PMID: 31736109 DOI: 10.1002/gps.5237] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the relationship between sensory impairment (hearing loss only, vision loss only, and dual sensory impairment [DSI]) and depression, loneliness, quality of life, and cognitive performance in older adults. METHODS A total of 229 community-dwelling older adults aged 60 years or older participated in this study. Variables were measured using the Geriatric Depression Scale (GDS-15), Revised University of California at Los Angeles Loneliness Scale (R-UCLA), Satisfaction with Life Scale (SWLS), and Mini-Mental State Examination (MMSE). RESULTS There was an independent association between DSI and quality of life (P < .05) and between DSI and hearing loss alone and cognitive function (P < .05) in older adults. In addition, higher education was associated with better quality of life and cognitive function. CONCLUSIONS DSI is a significant factor affecting the quality of life and cognitive function in older adults. Sociodemographic factors such as education play an important role in improving quality of life and cognitive function. Thus, increasing the awareness of this disability is important to ensure that older adults receive the necessary support services and rehabilitation to improve their level of independence.
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Affiliation(s)
- Deepashini Harithasan
- Physiotherapy Programme and Centre for Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Wan Syafira Ishak
- Institute of Ear, Hearing and Speech, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Center of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Center of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Wong Lai Yeong
- School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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19
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Wong PL, Sii HL, P'ng CK, Ee SS, Yong Oong X, Ng KT, Hanafi NS, Tee KK, Tan MP. The effects of age on clinical characteristics, hospitalization and mortality of patients with influenza-related illness at a tertiary care centre in Malaysia. Influenza Other Respir Viruses 2020; 14:286-293. [PMID: 32022411 PMCID: PMC7182601 DOI: 10.1111/irv.12691] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 09/19/2019] [Accepted: 09/22/2019] [Indexed: 12/14/2022] Open
Abstract
Background Age is an established risk factor for poor outcomes in individuals with influenza‐related illness, and data on its influence on clinical presentations and outcomes in the South‐East Asian settings are scarce. The aim of this study was to determine the above among adults with influenza‐related upper respiratory tract infection at a teaching hospital in Malaysia. Methods A retrospective case‐note analysis was conducted on a cohort of 3935 patients attending primary care at the University Malaya Medical Centre, Malaysia from February 2012 till May 2014 with URTI symptoms. Demographics, clinical characteristics, medical and vaccination history were obtained from electronic medical records, and mortality data from the National Registration Department. Comparisons were made between those aged <25, ≥25 to <65 and ≥65 years. Results 470 (11.9%) had PCR‐confirmed influenza virus infection. Six (1.3%) received prior influenza vaccination. Those aged ≥65 years were more likely to have ≥2 comorbidities (P < .001) and were less likely to present with fever (P = .004). One‐third of those aged ≥65 years experienced hospitalization, intensive care admission or death within a year compared to 10% in the ≥25 to <65 years. Age ≥65 years was an independent predictor of hospitalization and death (OR = 9.97; 95% CI = 3.11‐31.93) compared to those aged <25 years. Conclusion Older patients in our cohort were more likely to have comorbidities and present with atypical features, with older age being an independent predictor of poor health outcomes. Our findings will now inform future health policies on older persons and economic modelling of adult vaccination programmes.
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Affiliation(s)
- Pui Li Wong
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hoe Leong Sii
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chun Keat P'ng
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soon Sean Ee
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Xiang Yong Oong
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kim Tien Ng
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kok Keng Tee
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Malaysia
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20
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Burman J, Sembiah S, Dasgupta A, Paul B, Pawar N, Roy A. Assessment of Poor Functional Status and its Predictors among the Elderly in a Rural Area of West Bengal. J Midlife Health 2019; 10:123-130. [PMID: 31579173 PMCID: PMC6767957 DOI: 10.4103/jmh.jmh_154_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
CONTEXT Functional ability considered a proxy for healthy aging, not only related to mental and physical health but it also determines social well-being. Eliciting the determinants of functionality components among the elderly will assist in evolving with appropriate plans at both domiciliary and facility level to eliminate their sufferings and disabilities. AIM The aim of this study is to find out the magnitude of poor functional status among the elderly and its predictors. MATERIALS AND METHODS This is a community-based cross-sectional study conducted among 246 geriatric people in a rural area of West Bengal from August 2017 to December 2017; data were analyzed using the SPSS software (version 16.0. Chicago, SPSS Inc.). Logistic regression analysis was performed to find out the factors associated with poor functional status (activities of daily living [ADL] and instrumental ADL [IADL]). RESULTS The study concluded that 32.4% and 59.3% were dependent for basic ADL and IADL, respectively. Binary logistics showed people aged >70 years, female gender, less than primary level education, widowed/separated, who lived in the joint family, poorest percentile of economic status, who were depressed and who suffered from multimorbidity had increased odds of dependency for ADL and IADL. In multivariate logit regression, age >70 years and depression remained significant for ADL; in addition, marital status, education, and family type remained significant for IADL. CONCLUSION There should be a provision for community-based comprehensive geriatric health and disability assessment, as it enables older people to avert the illness at the early stage, to delay the onset of disabling diseases. This will ensure their participation in the upliftment of the society, and they thus will be less dependent on their progeny.
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Affiliation(s)
- Jayeeta Burman
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Sembagamuthu Sembiah
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Aparajita Dasgupta
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Bobby Paul
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Neeraj Pawar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Adrija Roy
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Harsha N, Ziq L, Giacaman R. Disability among Palestinian elderly in the occupied Palestinian territory (oPt): prevalence and associated factors. BMC Public Health 2019; 19:432. [PMID: 31023288 PMCID: PMC6482486 DOI: 10.1186/s12889-019-6758-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disability poses an important challenge to countries all over the world since it affects more than 15% of the global population. The disability prevalence is higher in developing countries compared to developed ones. Disability has negative consequences on health, wellbeing, and quality of life. The goal of this study is to assess the prevalence of disability and to determine some of its associated factors among Palestinian elderly in the occupied Palestinian territory (oPt), a country marked by a chronic lack of political, economic, and social stability which affect various aspects of the population's life. METHODS We used data from the Palestinian Central Bureau of Statistics (PCBS) disability survey conducted in 2011 using a nationally representative sample of the Palestinians living in the West Bank (WB) and Gaza Strip (GS). Data were collected using a standardized questionnaire developed and adopted by the World Health Organization (WHO) and the Washington Group (WG) for Disability Statistics, adapted to satisfy the Palestinian context. RESULTS Overall, 31.2% of the Palestinian elderly 60 years and above reported one or more type of disability. Binary logistic regression with disability as the dependent variable showed that older people [OR = 2.88, 95% CI: 2.31-3.60], women [OR = 1.65, 95% CI: 1.33-2.04], illiterate people [OR = 2.37, 95% CI: 1.83-3.06], people reporting small family sizes with 1 to 2 members [OR = 1.69, 95% CI: 1.34-2.14], people who reported that they were not working at the time of the survey [OR = 4.59, 95% CI: 3.13-6.73], and Palestinian refugees [OR = 1.22, 95% CI: 1.04-1.42] were more likely to have a disability. However, residents of the Centre of WB were less likely to have disability compared to residents of the GS [OR = 0.46, 95% CI: 0.37-0.58]. CONCLUSIONS The study found a high prevalence of disability among Palestinian elderly, as has been reported by the majority of studies performed in developing countries. However, results indicate that demographic and socioeconomic differences among the disabled should be taken into special consideration in setting policies and practices to improve the health and wellbeing of the disabled.
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Affiliation(s)
- Nouh Harsha
- Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- Institute of Community and Public Health, Birzeit University- ICPH/BZU, Birzeit, Occupied Palestinian Territory
| | - Luay Ziq
- MPH, ICPH/BZU, UNRWA, Ramallah, West Bank, Occupied Palestinian Territory
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Tan PJ, Khoo EM, Chinna K, Saedon NI, Zakaria MI, Ahmad Zahedi AZ, Ramli N, Khalidin N, Mazlan M, Chee KH, Zainal Abidin I, Nalathamby N, Mat S, Jaafar MH, Khor HM, Khannas NM, Majid LA, Tan KM, Chin AV, Kamaruzzaman SB, Poi P, Morgan K, Hill KD, MacKenzie L, Tan MP. Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial. PLoS One 2018; 13:e0199219. [PMID: 30074996 PMCID: PMC6075745 DOI: 10.1371/journal.pone.0199219] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 06/02/2018] [Indexed: 11/25/2022] Open
Abstract
Objective To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia. Design Pragmatic, randomized-controlled trial. Setting Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia. Participants Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months. Intervention Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment. Primary and secondary outcome measures The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall. Results Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613–1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846–1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782–1.522)] and mortality rate [RR = 0.896 (95% CI 0.335–2.400)] did not differ between groups. Conclusion Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations. Trial registration ISRCTN Registry no. ISRCTN11674947
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Affiliation(s)
- Pey June Tan
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
- Geriatric Education and Research Institute, Singapore
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor I’zzati Saedon
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Idzwan Zakaria
- Department of Trauma and Emergency Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Norlina Ramli
- Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nurliza Khalidin
- Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mazlina Mazlan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Limpur, Malaysia
| | - Kok Han Chee
- Division of Cardiology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Imran Zainal Abidin
- Division of Cardiology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nemala Nalathamby
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohamad Hasif Jaafar
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Hui Min Khor
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norfazilah Mohamad Khannas
- Department of Rehabilitation Medicine, Kuala Lumpur, University of Malaya Medical Centre, Kuala Limpur, Malaysia
| | - Lokman Abdul Majid
- Department of Rehabilitation Medicine, Kuala Lumpur, University of Malaya Medical Centre, Kuala Limpur, Malaysia
| | - Kit Mun Tan
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ai-Vyrn Chin
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Philip Poi
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karen Morgan
- Department Psychology and Behavioural Science, Perdana University-RCSI School of Medicine, Serdang, Selangor, Malaysia
| | - Keith D. Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Lynette MacKenzie
- Department of Occupational Therapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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Abstract
Top themes of international research on disability in the past three decades are discussed: disability dynamics, buffers and barriers for disability, disability trends, and disability among very old persons. Each theme is highlighted by research examples. Turning to measurement, I discuss traditional measures of disability, new longer and shorter ones, and composites like disability-free life expectancy, noting their merits. Contemporary models of disability are presented, ranging from visual images to formal theories. The article ends on how scientists can facilitate movement of disability science into health care practice and policy.
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Ahmad NA, Mohamad Kasim N, Mahmud NA, Mohd Yusof Y, Othman S, Chan YY, Abd Razak MA, Yusof M, Omar M, Abdul Aziz FA, Jamaluddin R, Ibrahim Wong N, Aris T. Prevalence and determinants of disability among adults in Malaysia: results from the National Health and Morbidity Survey (NHMS) 2015. BMC Public Health 2017; 17:756. [PMID: 28962562 PMCID: PMC5622591 DOI: 10.1186/s12889-017-4793-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 09/21/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Reliable national data on disability which is internationally comparable is needed in Malaysia. This study aims to examine the prevalence of disability among adults in Malaysia and its determinants, particularly the socioeconomic factors and comorbidities. METHODS This study was based on the disability module, which is part of the National Health and Morbidity Survey 2015. This survey was implemented using a multi-stage stratified sampling design. A locally validated Washington Group questionnaire was used to collect data on disability. RESULTS Based on the definition of having at least one domain scored "a lot of difficulty or unable to do at all" or at least "some difficulty" scored in two domains, the prevalence of disability among adults in Malaysia was 11.8% (95% CI: 11.15, 12.53). Logistic regression analysis performed showed that population at risk of having disability in Malaysia were those of older people, ethnic minority, low level of education, single, obese, physically inactive and having mental health problems. Among older people, disability was significantly higher among those with no formal education, having mental health problems and physically inactive. CONCLUSIONS The prevalence of disability among adults in Malaysia is comparable to WHO estimates and most developing countries. Planning for healthcare services should consider at-risk population, particularly older people and those from disadvantaged background to ensure equity healthcare.
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Affiliation(s)
- Noor Ani Ahmad
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Noraida Mohamad Kasim
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Nur Azna Mahmud
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Yusniza Mohd Yusof
- Cheras Rehabilitation Hospital, Ministry of Health, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia
| | - Salimah Othman
- Family Health and Development Division, Ministry of Health Malaysia, Kompleks E, Pusat Pentadbiran Kerajaan Persekutuan, 62590 Putrajaya, Malaysia
| | - Ying Ying Chan
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Mohamad Aznuddin Abd Razak
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Muslimah Yusof
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Maisarah Omar
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Fazly Azry Abdul Aziz
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Rasidah Jamaluddin
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Norazizah Ibrahim Wong
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Tahir Aris
- Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590 Kuala Lumpur, Malaysia
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Health Status and the Demand for Healthcare among the Elderly in the Rural Quoc-Oai District of Hanoi in Vietnam. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4830968. [PMID: 29147653 PMCID: PMC5632875 DOI: 10.1155/2017/4830968] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 08/03/2017] [Indexed: 11/17/2022]
Abstract
Background Vietnam is experiencing an unprecedented demographic transition. Its proportion of elderly people is growing rapidly. Objective This study explored the health status and health-related quality of life (HRQoL) of rural elderly Vietnamese and assessed their needs for healthcare services. Design This study used a survey with stratified proportion sampling and quota assignment. In 2016, data was collected from 713 people in the rural Quoc-Oai district of Hanoi aged 60 or older. Results The mean age of the respondents was 70.9. Both self-rated health status and functional status decreased with age. Women reported more functional limitations than men. Musculoskeletal disorders were the most frequently reported chronic diseases, followed by hypertension, gastrointestinal diseases, and cardiovascular diseases. Age, self-rated health status, BMIs, and the number of noncommunicable diseases (NCDs) were found to be significant determinants of HRQoL, after controlling for socioeconomic effects. More than half the respondents requested more healthcare information, particularly on disease management. Conclusions Vietnam's healthcare system is being challenged to make health services easily accessible and meet the growing needs for chronic illness management, risk reduction, promoting healthy lifestyles, and improving the aging population's quality of life.
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Sooryanarayana R, Choo WY, Hairi NN, Chinna K, Hairi F, Ali ZM, Ahmad SN, Razak IA, Aziz SA, Ramli R, Mohamad R, Mohammad ZL, Peramalah D, Ahmad NA, Aris T, Bulgiba A. The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey. BMJ Open 2017; 7:e017025. [PMID: 28864485 PMCID: PMC5588933 DOI: 10.1136/bmjopen-2017-017025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia. DESIGN Cross-sectional study, analysing baseline findings of a cohort of older adults. SETTING Kuala Pilah district, Negeri Sembilan state, Malaysia. OBJECTIVES To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. PARTICIPANTS A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census. PRIMARY AND SECONDARY OUTCOME MEASURES Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined. RESULTS The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse. CONCLUSION Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse.
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Affiliation(s)
- Rajini Sooryanarayana
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
- Institute for Public Health, National Institutes of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran N Hairi
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Hairi
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Sharifah Nor Ahmad
- Kuala Pilah District Health Office, Negeri Sembilan State Health Department, Ministry of Health, Seremban, Malaysia
| | - Inayah Abdul Razak
- Kuala Pilah District Health Office, Negeri Sembilan State Health Department, Ministry of Health, Seremban, Malaysia
| | - Suriyati Abdul Aziz
- Negeri Sembilan State Health Department, Ministry of Health, Seremban, Malaysia
| | - Rohaya Ramli
- Negeri Sembilan State Health Department, Ministry of Health, Seremban, Malaysia
| | - Rosmala Mohamad
- Negeri Sembilan State Health Department, Ministry of Health, Seremban, Malaysia
| | - Zaiton Lal Mohammad
- Negeri Sembilan State Health Department, Ministry of Health, Seremban, Malaysia
| | - Devi Peramalah
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institutes of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Awang Bulgiba
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
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Tareque MI, Tiedt AD, Islam TM, Begum S, Saito Y. Gender differences in functional disability and self-care among seniors in Bangladesh. BMC Geriatr 2017; 17:177. [PMID: 28789638 PMCID: PMC5549315 DOI: 10.1186/s12877-017-0577-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 08/02/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Disability among older adults is a public health concern. To date there are no in-depth and comprehensive analyses on older adults' disabilities in Bangladesh. This study investigated gender differences in the prevalence of disability and the socio-demographic factors associated with disability among older adults in Bangladesh. METHODS This research used a sample of 4176 elderly males and females aged 60 years and over from a nationally representative data set- Bangladesh's 2010 Household Income and Expenditure Survey. The study used both household level and individual level data and applied a wealth index, which was constructed based on household assets using principal component analysis. The Washington Group's short set of questions on disability were used to measure disability. Chi-square tests and ordinal logistic regression models were fit. RESULTS Forty-two percent of older had some form of functional disability, including 5% of elderly with severe/extreme functional disability. Seven percent of older adults had a self-care disability, including 3% of elderly with a severe/extreme form of self-care disability. Elderly females suffered from all the studied disabilities, including functional and self-care disabilities in higher percentages, and had higher odds ratios of having both functional disability and self-care disability compared to elderly males. The study also identified some significant factors affecting functional disability and self-care disability, namely age, having a chronic condition, wealth status and place of residence, including divisional differences. CONCLUSIONS Programs aimed at reducing functional disability among seniors, particularly elderly females, should be granted the highest priority in Bangladesh.
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Affiliation(s)
- Md Ismail Tareque
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh.
| | | | | | - Sharifa Begum
- Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Yasuhiko Saito
- University Research Center and School of Medicine, Nihon University, Tokyo, Japan.,Duke-NUS Graduate Medical School, Singapore, Singapore
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Kurichi JE, Kwong PL, Xie D, Bogner HR. Predictive Indices for Functional Improvement and Deterioration, Institutionalization, and Death Among Elderly Medicare Beneficiaries. PM R 2017; 9:1065-1076. [PMID: 28456694 DOI: 10.1016/j.pmrj.2017.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/06/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prediction models can help clinicians provide the best and most appropriate care to their patients and can help policy makers design services for groups at highest risk for poor outcomes. OBJECTIVE To develop prediction models identifying both risk factors and protective factors for functional deterioration, institutionalization, and death. DESIGN Cohort study using data from the Medicare Current Beneficiary Survey (MCBS). SETTING Community survey. PARTICIPANTS This study included 21,264 Medicare beneficiaries 65 years of age and older who participated in the MCBS from the 2001-2008 entry panels and were followed up for 2 years. METHODS The index was derived in 60% and validated in the remaining 40%. β Coefficients from a multinomial logistic regression model were used to derive points, which were added together to create scores associated with the outcome. MAIN OUTCOME MEASURE The outcome was activity of daily living (ADL) stage transitions over 2 years following entry into the MCBS. Beneficiaries were categorized into 1 of 4 outcome categories: stable or improved function, functional deterioration, institutionalization, or death. RESULTS Our model identified 16 factors for functional deterioration (age, gender, education, living arrangement, dual eligibility, proxy use, Alzheimer disease/dementia, angina pectoris/coronary heart disease, diabetes, emphysema/asthma/chronic obstructive pulmonary disease, mental/psychiatric disorder, Parkinson disease, stroke/brain hemorrhage, hearing impairment, vision impairment, and baseline ADL stage) after backward selection (P < .05). Compared to stable or improved function, the risk of functional deterioration ranged from ≤1 to ≥6, ≤4 to ≥22 for the risk of institutionalization, and ≤3 to ≥16 for the risk of death. CONCLUSION Predictive indices, or point and scoring systems used to predict outcomes, can identify elderly Medicare beneficiaries at risk for functional deterioration, institutionalization, and death and can aid policy makers, clinicians, and family members in improving care for older adults and supporting successful aging in the community. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Jibby E Kurichi
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, 423 Guardian Dr, 907 Blockley Hall, Philadelphia, PA 19104-6021(∗).
| | - Pui L Kwong
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA(†)
| | - Dawei Xie
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA(‡)
| | - Hillary R Bogner
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA(§)
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Islam FMA, Bhowmik JL, Islam SZ, Renzaho AMN, Hiller JE. Factors Associated with Disability in Rural Bangladesh: Bangladesh Population-Based Diabetes and Eye Study (BPDES). PLoS One 2016; 11:e0165625. [PMID: 27936096 PMCID: PMC5147781 DOI: 10.1371/journal.pone.0165625] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 10/15/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To assess factors associated with disability in a rural district of Bangladesh. METHODS Using a population-based systematic sampling technique, data were collected from 3104 adults aged ≥ 30 years from the Banshgram union of Narail district. Data collected included an interviewer administered questionnaire to report physical disabilities including impairment that prevents engagement with paid work, visual, hearing, and mobility as well as mental disabilities. Socio-demographic and anthropometric factors including educational attainment and body mass index, as well as clinical factors such as blood pressure, and fasting blood glucose were also collected. Binary and multinomial logistic regression techniques were used to explore the association of various socio-demographic and clinical factors with disability. RESULTS The mean (SD), minimum and maximum ages of the participants were 51 (12), 30 and 89 years. Of total participants, 65% were female. The prevalence of disability varied from 29.1% for visual impairment (highest) to 16.5% for hearing, 14.7% for movement difficulties and 1.6% (lowest) for any other disability that prevented engagement with paid work. Overall, the prevalence of a single disability was 28.6% and that of two or more disabilities was 14.7%. Older age, gender (female), lower socio-economic status (SES), and hypertension were associated with a higher prevalence of most of the disability components. The prevalence of hearing problems (24.5% vs. 13.3%, p<0.001) and movement difficulties (24.9% vs. 13.0%, p<0.001) was significantly higher among lower-income participants than their higher-income counterparts after controlling for age. Prevalence of visual impairment (54.6% vs. 9.2%, p<0.001), hearing (32.2% vs. 6.7%, p<0.001) and movement difficulties (29.2% vs. 5.5%, p<0.001) were significantly higher in people of aged 60 years or older than those aged 30-34 years. After multivariate adjustment, the prevalence of single disability (prevalence risk ratio [PRR] 1.25, 95% CI: 1.09-1.42, p<0.001), and multiple disabilities (PRR 1.41, 95% CI 1.14-1.73, p<0.001) was higher among females than males. The prevalence of single disability and multiple disabilities was respectively 21% (PRR 1.21, 95% CI: 1.02-1.42, p<0.001) and 88% (PRR 1.88, 95% CI: 1.38-2.54, p<0.001) higher among participants with low educational attainment (primary level or less) than those with at least a secondary level of education. CONCLUSIONS In rural Bangladesh, the prevalence of disability is high. Public health programs should target those of low SES, older age, and female participants and aim to provide necessary supports in order to bridge disability-related inequities.
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Affiliation(s)
- Fakir M. Amirul Islam
- Department of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn campus, Hawthorn, Victoria, Australia
- Organization for Rural Community Development, Dariapur, Narail, Bangladesh
- * E-mail:
| | - Jahar L. Bhowmik
- Department of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn campus, Hawthorn, Victoria, Australia
| | - Silvia Z. Islam
- Organization for Rural Community Development, Dariapur, Narail, Bangladesh
- School of Economics, Finance and Marketing, RMIT University, Melbourne, Victoria, Australia
| | - Andre M. N. Renzaho
- Humanitarian and Development Studies, School of Social Science and Psychology, Western Sydney University, Penrith, New South Wales, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Janet E. Hiller
- School of Health Science, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn campus, Hawthorn, Victoria, Australia
- School of Population Health, University of Adelaide, Adelaide, Australia
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Nagarkar A, Kashikar Y. Predictors of functional disability with focus on activities of daily living: A community based follow-up study in older adults in India. Arch Gerontol Geriatr 2016; 69:151-155. [PMID: 27936458 DOI: 10.1016/j.archger.2016.11.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 11/25/2016] [Accepted: 11/26/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Disability in activities of daily living is a growing concern among older populations all over the world. India has one of the rapidly ageing populations and predicted burden of functional disability is higher for Indian older adults as compared to other ageing Asian countries. METHODS Total 1140 aged 60 years and over participated in a baseline study. 560 of them participated in the prospective cohort study conducted in the city of Pune, India. An interview and functional assessment using a questionnaire and Pune-FAAT tool was carried out in 2013-14. Binary logistic regression was used to obtain the factors that increased the odds of having ADL disability at follow-up. RESULTS The mean age of the study population was 69.73±5.48years. Squatting, walking and climbing functions were affected significantly. Total 376 participants (67.1%) reported difficulties and/or disability in performing activities of daily living (ADL) at follow-up. Hospitalization (OR=3.6; 95% CI: 1.9-6.7), being female (OR=2.3; 95% CI: 1.5-3.5), presence of two or more chronic diseases (OR=1.7; 95% CI: 1.1-2.7), experience of memory loss (OR=1.9; 95% CI: 1.2-3.0) and feeling of loneliness (OR=2.3; 95% CI: 1.0-5.3) increased the odds of being in the "With disability" group at follow-up. Apart from this, self-rated health and self-reported depression were associated with limitations in ADL. CONCLUSION Hospitalization and being female appeared to be the most significant risk factors for disability in urban older adults in India. Rehabilitation services after hospitalization, physical exercise, effective control on chronic illness, and social participation to reduce loneliness is recommended.
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Affiliation(s)
- Aarti Nagarkar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Ganeshkhind, Pune, 411007 Maharashtra, India.
| | - Yashoda Kashikar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Ganeshkhind, Pune, 411007 Maharashtra, India
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Abstract
This study proposes a well-being index of older adults which integrates five domains, namely, activities of daily living, health status, psychological strength, life accomplishment and social ties, and examines potential socio-demographic, living arrangement, lifestyle and religiosity determinants of well-being. The present study uses micro data of 1255 older adults from the recent pilot survey for the Longitudinal Aging Study in India (LASI) conducted in 2010. The results suggest that normal activities of daily life, health, and social ties decline with advancing age, while life accomplishment remains stable over age. However, when all domains are integrated, well-being tends to fade out with advancing age. While smoking has a deterrent effect on well-being, better economic status, literacy, living in a joint family with spouse, religiosity, and regular physical exercise have a statistically significant positive effect on the well-being of older adults in India.
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Affiliation(s)
- Laishram Ladusingh
- International Institute for Population Sciences, Deonar, Mumbai, 400088, India.
| | - Sapana Ngangbam
- International Institute for Population Sciences, Deonar, Mumbai, 400088, India
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Johari N, Manaf ZA, Ibrahim N, Shahar S, Mustafa N. Predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge. Clin Interv Aging 2016; 11:1455-1461. [PMID: 27799751 PMCID: PMC5074738 DOI: 10.2147/cia.s105652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Purpose Diabetes mellitus is prevalent among older adults, and affects their quality of life. Furthermore, the number is growing as the elderly population increases. Thus, this study aims to explore the predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge in Malaysia. Methods A total of 110 hospitalized geriatric patients aged 60 years and older were selected using convenience sampling method in a cross-sectional study. Sociodemographic data and medical history were obtained from the medical records. Questionnaires were used during the in-person semistructured interviews, which were conducted in the wards. Linear regression analyses were used to determine the predictors of each domain of quality of life. Results Multiple regression analysis showed that activities of daily living, depression, and appetite were the determinants of physical health domain of quality of life (R2=0.633, F(3, 67)=38.462; P<0.001), whereas depression and instrumental activities of daily living contributed to 55.8% of the variability in psychological domain (R2=0.558, F(2, 68)=42.953; P<0.001). Social support and cognitive status were the determinants of social relationship (R2=0.539, F(2, 68)=39.763; P<0.001) and also for the environmental domain of the quality of life (R2=0.496, F(2, 68)=33.403; P<0.001). Conclusion The findings indicated different predictors for each domain in the quality of life among hospitalized geriatric patients with diabetes mellitus. Nutritional, functional, and psychological aspects should be incorporated into rehabilitation support programs prior to discharge in order to improve patients’ quality of life.
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Affiliation(s)
| | | | | | | | - Norlaila Mustafa
- Medical Department, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Risk Factors for Six Types of Disability among the Older People in Thailand in 2002, 2007, and 2011. J Aging Res 2016; 2016:6475029. [PMID: 27642523 PMCID: PMC5013201 DOI: 10.1155/2016/6475029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/12/2016] [Accepted: 07/26/2016] [Indexed: 11/17/2022] Open
Abstract
Background. There is an important need to characterize risk factors for disability in Thailand, in order to inform effective prevention and control strategies. This study investigated factors associated with risk of 6 types of disability in Thailand's ageing population in 2002, 2007, and 2011. Methods. Data came from the Cross-Sectional National Surveys of Older Persons in Thailand conducted by the National Statistical Office (NSO) in 2002, 2007, and 2011. Stratified two-stage sampling was employed. Interviews of 24,835, 30,427, and 34,173 elderly people aged 60 and above were conducted in the respective study years. Prevalence of disabilities was measured, and factors associated with disability risk were assessed with probability-weighted multiple logistic regression. Results. Disability prevalence decreased slightly over the study period. The characteristics with greatest positive impact on disability prevalence were not working over the past week (average impact: 61.2%), age (53.7% per decade), and suffering from one or more chronic illnesses (46.3%). Conclusions. The strong observed positive impact of not working on disability prevalence suggests that raising the mandatory retirement age might result in some reduction of disability risk. Also, the observed positive impact of living with others (versus alone) on disability risk was somewhat unexpected.
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Fávaro-Moreira NC, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, Bekkering GE, Duyck J. Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data. Adv Nutr 2016; 7:507-22. [PMID: 27184278 PMCID: PMC4863272 DOI: 10.3945/an.115.011254] [Citation(s) in RCA: 332] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The present systematic review critically examines the available scientific literature on risk factors for malnutrition in the older population (aged ≥65 y). A systematic search was conducted in MEDLINE, reviewing reference lists from 2000 until March 2015. The 2499 papers identified were subjected to inclusion criteria that evaluated the study quality according to items from validated guidelines. Only papers that provided information on a variable's effect on the development of malnutrition, which requires longitudinal data, were included. A total of 6 longitudinal studies met the inclusion criteria and were included in the systematic review. These studies reported the following significant risk factors for malnutrition: age (OR: 1.038; P = 0.045), frailty in institutionalized persons (β: 0.22; P = 0.036), excessive polypharmacy (β: -0.62; P = 0.001), general health decline including physical function (OR: 1.793; P = 0.008), Parkinson disease (OR: 2.450; P = 0.047), constipation (OR: 2.490; P = 0.015), poor (OR: 3.30; P value not given) or moderate (β: -0.27; P = 0.016) self-reported health status, cognitive decline (OR: 1.844; P = 0.001), dementia (OR: 2.139; P = 0.001), eating dependencies (OR: 2.257; P = 0.001), loss of interest in life (β: -0.58; P = 0.017), poor appetite (β: -1.52; P = 0.000), basal oral dysphagia (OR: 2.72; P = 0.010), signs of impaired efficacy of swallowing (OR: 2.73; P = 0.015), and institutionalization (β: -1.89; P < 0.001). These risk factors for malnutrition in older adults may be considered by health care professionals when developing new integrated assessment instruments to identify older adults' risk of malnutrition and to support the development of preventive and treatment strategies.
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Affiliation(s)
| | | | - Christophe Matthys
- Department of Clinical and Experimental Medicine,,Clinical Nutrition Unit, Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Carine Vereecken
- University College Leuven-Limburg, Knowledge and Information Center FOOD, Leuven, Belgium; and
| | - Erika Vanhauwaert
- Department of Clinical and Experimental Medicine,,University College Leuven-Limburg, Knowledge and Information Center FOOD, Leuven, Belgium; and
| | | | | | - Joke Duyck
- Population Studies in Oral Health, Department of Oral Health Sciences, BIOMAT Research Cluster, Department of Oral Health Sciences, Katholieke Universiteit Leuven, Leuven, Belgium;
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Hosseinpoor AR, Bergen N, Kostanjsek N, Kowal P, Officer A, Chatterji S. Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: results from World Health Survey. Int J Public Health 2016; 61:337-45. [PMID: 26537634 PMCID: PMC4879166 DOI: 10.1007/s00038-015-0742-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Our objective was to quantify disability prevalence among older adults of low- and middle-income countries, and measure socio-demographic distribution of disability. METHODS World Health Survey data included 53,447 adults aged 50 or older from 43 low- and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. RESULTS Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. CONCLUSIONS Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.
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Affiliation(s)
- Ahmad Reza Hosseinpoor
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland.
| | - Nicole Bergen
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland
| | - Nenad Kostanjsek
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland
| | - Paul Kowal
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland
| | - Alana Officer
- Department of Ageing and Life Course, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland
| | - Somnath Chatterji
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland
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Gupta S, Yadav R, Malhotra AK. Assessment of physical disability using Barthel index among elderly of rural areas of district Jhansi (U.P), India. J Family Med Prim Care 2016; 5:853-857. [PMID: 28349004 PMCID: PMC5353827 DOI: 10.4103/2249-4863.201178] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The health of the elderly will be an important issue defining the health status of a population. With the rise in aged population, there is a greater need to look into their physical disability aspects, which is otherwise neglected. The rationale behind the study is to assess the physical disability of the elderly living in rural area of Jhansi. The aims of the study were to study the prevalence of physical disability among the elderly of rural area, and to find out the factors and association affecting the physical disability. METHODS A community-based cross-sectional study was carried out in a Baragaon block of rural area of Jhansi, Uttar Pradesh, India, from July 2015 to October 2015. Multistage random sampling was performed. A total of 265 participants of age 60 years and above were selected. Physical disability was assessed using Barthel index. Appropriate data entry and statistical analysis were done in EpiInfo. Frequency tables were used to calculate the prevalence, and Chi-square test was used to find out the association. RESULTS The overall prevalence of physical disability was 23.4%. 70% belongs to the age group from 60 to 69 years. Physical disability was significantly higher among age group >80 years. Similarly, women were more affected with physical disability than men. CONCLUSIONS High prevalence of physical disability is the major area of concern. More extensive postdischarge health facilities to be provided to elderly.
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Affiliation(s)
- Shubhanshu Gupta
- Department of Community Medicine, MLBMC, Jhansi, Uttar Pradesh, India
| | - Rashmi Yadav
- Department of Community Medicine, MLBMC, Jhansi, Uttar Pradesh, India
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Karvonen-Gutierrez CA. The importance of disability as a health issue for mid-life women. Womens Midlife Health 2015; 1:10. [PMID: 30766697 PMCID: PMC6297968 DOI: 10.1186/s40695-015-0011-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 09/25/2015] [Indexed: 12/17/2022] Open
Abstract
Data suggest that disability prevalence among mid-aged populations is increasing in recent years; current prevalence estimates for mid-aged adults range from 20 to 40 %. The World Health Organization’s International Classification of Functioning (ICF) has provided a multi-dimensional biopsychosocial model to understand disability that is highly relevant to mid-aged populations. Under the ICF framework, mid-aged women experience high levels of work, non-work, and mobility-associated disability but very little difficulty with self care. Despite the high prevalence, evidence suggests that there is a large proportion of non-chronic disability and that mid-aged women can both worsen and improve their functioning. Thus, the mid-life period may represent a critical window during which interventions to improve disability may be most efficacious for the improvement of current and future functioning. Interventions that are initiated during the mid-life are highly relevant as a strategy to reduce disability during this life stage and prevent or forestall the onset of late life disability. Targets for intervention include improvement of depressive symptoms and increasing physical activity levels, both of which have shown to be efficacious in older populations and are correlates of mid-life functioning and disability.
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Affiliation(s)
- Carrie A Karvonen-Gutierrez
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Room 6618, Ann Arbor, MI 48109 USA
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Assessment of Disability among the Elderly in Xiamen of China: A Representative Sample Survey of 14,292 Older Adults. PLoS One 2015; 10:e0131014. [PMID: 26126109 PMCID: PMC4488423 DOI: 10.1371/journal.pone.0131014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 05/26/2015] [Indexed: 11/19/2022] Open
Abstract
Background The unprecedented number of elderly individuals in China presents a serious public health challenge. Limited data are available on the prevalence of disability or factors resulting in disability among the elderly in China. Objective We aimed to assess the prevalence of disability and related risk factors among the elderly of Xiamen, China. Methods A cross-sectional study was performed on individuals who were ≥60 years of age. The subjects were recruited by multi-stage sampling; a total of 14,292 valid questionnaires were received. Study measurements included activities of daily living (ADL), demographics, and health status. The ADL was assessed by the Katz Index Scale to evaluate disability. Chi-square tests and binary logistic regression were used to identify factors associated with disabilities. Results Among the valid participants, 4.27% had at least one disability. Bathing was the most frequently reported disability and feeding was the least frequently reported disability. Disabilities were significantly associated with female gender, older age, unmarried status, living with family, urban residence, illiteracy, poor economic status, self-rated bad health, chronic illnesses, lower life satisfaction, bad mood, and feelings of loneliness. Conclusion Functional disability among the elderly requires more public attention. Culturally appropriate policies and programs are also needed to address the care for the disabled elderly.
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Talarska D, Pacholska R, Strugała M, Wieczorowska-Tobis K. Functional assessment of the elderly with the use of EASY-Care Standard 2010 and Comprehensive Geriatric Assessment. Scand J Caring Sci 2015; 30:419-26. [PMID: 26058414 DOI: 10.1111/scs.12241] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 03/26/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The wide variation in performance among the elderly leads to the search for a suitable instrument to identify the necessary support. The aim of this study was to examine the scope of independent functioning of the elderly and to indicate the necessary support using basic instruments, Comprehensive Geriatric Assessment (CGA) and EASY-Care Standard 2010. METHODS For statistical analysis were qualified 101 questionnaires of patients from oncological surgery clinic. RESULTS The study group was dominated by women (79.2%). The average age for the entire group was 74.7 ± 7.5 years. In terms of basic life activities (Barthel Index), 75.2% of the elderly performed most of their activities independently. The Lawton IADL (Instrumental Activity of Daily Living Scale) median was 25 points. Moderate depression (Geriatric Depression Scale) reported 37.6% of the group. The influence of age, education, mode of movement and efficiency in basic and instrumental life activities and depression (Geriatric Depression Scale) was demonstrated in the results in three scales of the EASY-Care Standard 2010 questionnaire: Independence score, Risk of break down in care and Risk of falls. There was no difference in terms of gender and the nature of the residence. CONCLUSION The study group of the elderly was characterised by a good level of efficiency in basic and instrumental activities of daily living. Questionnaire EASY-Care Standard 2010 enables to identify functional limitations of the elderly that may form the basis for planning individual support.
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Affiliation(s)
- Dorota Talarska
- Department of Preventive Medicine, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | | | - Magdalena Strugała
- Department of Preventive Medicine, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
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Kuvalekar K, Kamath R, Ashok L, Shetty B, Mayya S, Chandrasekaran V. Quality of Life among Persons with Physical Disability in Udupi Taluk: A Cross Sectional Study. J Family Med Prim Care 2015; 4:69-73. [PMID: 25810992 PMCID: PMC4367009 DOI: 10.4103/2249-4863.152258] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Disability is not just a health problem or attribute of individuals, but it reflects the problems individuals experience in their interaction with society and physical movements. Disabled persons remain neglected part of society and they also experience various barriers due to restriction of participation. OBJECTIVES The aim was to assess the quality of life (QOL) of physically disabled persons, the impact of physical disability on activities of daily living (ADL) and to study the awareness about laws and facilities available for disabled persons. MATERIALS AND METHODS A cross-sectional community based study was conducted among 130 physical disabled persons who were selected using convenience sampling technique. The WHO BREF scale was used to assess QOL, while assessment of ADL was done using Barthel Index. Socio-demographic assessment was done using Udai Pareek scale. SPSS version 15.0 was used to analyze data. Categorical variables were expressed as frequencies and percentages. As per guidelines physical, psychological, social, and environmental domain scores for WHO BREF scale were calculated. RESULTS Among the study participants, 36.2% had a disability from birth that is, congenital. The second common cause of disability was found to be postpolio residual paralysis as it was found among 26.2% respondents. Other causes found were stroke/paralysis and accidents, in 19.2% and 18.5% respondents, respectively. Activities such as transfer, mobility, and stair climbing showed greater impact of physical disability. It was found that 11.5% respondents required help in one of the ADL. QOL score was found to be low under the psychological domain reflecting on negative feelings, bodily image, appearance, spirituality, and self-esteem of respondents. CONCLUSION Physical disability had affected social participation as well as marriage of the respondents. However, it was found that very few of them are aware about facilities provided under persons with disability act.
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Affiliation(s)
- Kunal Kuvalekar
- Department of Public Health, Manipal University, Manipal, Karnataka, India
| | - Ramachandra Kamath
- Department of Public Health, Manipal University, Manipal, Karnataka, India
| | - Lena Ashok
- Department of Public Health, Manipal University, Manipal, Karnataka, India
| | - Bhartesh Shetty
- Department of Public Health, Manipal University, Manipal, Karnataka, India
| | - Shreemathi Mayya
- Department of Biostatistics, Manipal University, Manipal, Karnataka, India
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Abbastabar H, Alizadeh A, Darparesh M, Mohseni S, Roozbeh N. Spatial distribution and prevalence of physical disabilities in the provinces of Iran. J Med Life 2015; 8:105-110. [PMID: 28255407 PMCID: PMC5327706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: To identify the influential social factors and spatial distribution of physical disabilities in Iran between 2006 and 2011. Materials and Methods: First, the prevalence of physical disability in each province between 2006 and 2011 was mapped via GIS. Moreover, the percentage of physical disability was estimated with regard to age, sex, and residential area. Finally, the prevalence of physical disability was estimated with regard to the afore-mentioned variables. Findings: The findings revealed that in the majority of the provinces of Iran, there was a decreasing trend in the prevalence of physical disability from 2006 to 2011. The prevalence of physical disability in the total population of the country was also decreased during these years. The results were also indicative of a higher prevalence among men than among women and also in rural residential areas than in urban areas. Conclusion: The results of this research can be used to identify the high- and low-risk areas. In addition, this information can be used for the etiology and the specification of the factors that cause the residents of some regions to get afflicted more than the others.
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Affiliation(s)
- H Abbastabar
- Islamshahr Health and Treatment Network, Department of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - A Alizadeh
- Department of Public Health, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - M Darparesh
- Research Center for Social Determinants in Health Promotion, Department of Research and Technology, Hormozgan University of Medical Sciences, Bandar-e-Abbas, Iran
| | - S Mohseni
- Department of Public Health, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - N Roozbeh
- Reproductive Health, Shahid Beheshti University of Medical Science, Tehran, Iran
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Wandera SO, Ntozi J, Kwagala B. Prevalence and correlates of disability among older Ugandans: evidence from the Uganda National Household Survey. Glob Health Action 2014; 7:25686. [PMID: 25413721 PMCID: PMC4238972 DOI: 10.3402/gha.v7.25686] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/27/2014] [Accepted: 10/27/2014] [Indexed: 12/20/2022] Open
Abstract
Background Nationally representative evidence on the burden and determinants of disability among older people in sub-Saharan Africa in general, and Uganda in particular, is limited. Objective The aim of this study was to estimate the prevalence and investigate the correlates of disability among older people in Uganda. Design We conducted secondary analysis of data from a sample of 2,382 older persons from the Uganda National Household Survey. Disability was operationalized as either: 1) having a lot of difficulty on any one question; 2) being unable to perform on any one question; or, 3) having some difficulty with two of the six domains. We used frequency distributions for description, chi-square tests for initial associations, and multivariable logistic regressions to assess the associations. Results A third of the older population was disabled. Among all older persons, disability was associated with advancement in age (OR=4.91, 95% CI: 3.38–7.13), rural residence (0.56, 0.37–0.85), living alone (1.56, 1.07–2.27), separated or divorced (1.96, 1.31–2.94) or widowed (1.86, 1.32–2.61) marital status, households’ dependence on remittances (1.48, 1.10–1.98), ill health (2.48, 1.95–3.15), and non-communicable diseases (NCDs) (1.81, 0.80–2.33). Gender was not associated with disability among older persons. Conclusions Disability was associated with advancement in age, rural residence, living alone, divorced/separated/widowed marital status, dependence on remittances, ill health, and NCDs. Interventions to improve health and functioning of older people need to focus on addressing social inequalities and on the early preventive interventions and management of NCDs in old age in Uganda.
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Affiliation(s)
- Stephen O Wandera
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda;
| | - James Ntozi
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - Betty Kwagala
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
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Goh CH, Muslimah Y, Ng SC, Subramanian P, Tan MP. The Use of the Self-Standing Turning Transfer Device to Perform Bed-To-Chair Transfers Reduces Physical Stress among Caregivers of Older Patients in a Middle-Income Developing Country. Front Med (Lausanne) 2014; 1:32. [PMID: 25593906 PMCID: PMC4292054 DOI: 10.3389/fmed.2014.00032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 09/11/2014] [Indexed: 11/13/2022] Open
Abstract
Manual transfer of elderly patients remains commonplace in many developing countries because the use of lifting equipment, such as hoists, is often considered unaffordable luxuries. The aim of this study was, therefore, to evaluate the usage and potential benefits of a low-cost, mechanical turning transfer device among elderly patients and their caregivers on a geriatric ward in a developing country in South East Asia. Fifty-six inpatients, aged 66–92 years, on a geriatric ward, and their caregivers were recruited. Participants were asked to transfer from bed-to-chair transfer with manual assistance, and the task was repeated using the Self-standing Turning Transfer Device (STurDi). The time taken to perform manual transfers and STurDi-assisted transfers was recorded. Physical strain was assessed using the perceived physical stress-rating tool for caregivers with and without the use of the device. User satisfaction was evaluated using the usefulness, satisfaction, and ease of use questionnaire. There was a significant reduction in transfer-time with manual transfers compared to STurDi-assisted transfers [mean (SD) = 48.39 (13.98) vs. 36.23 (10.96); p ≤ 0.001]. The physical stress rating was significantly lower in STurDi-aided transfers compared to manual transfers, shoulder [median (interquartile range) = 0 (1) vs. 4 (3); p = 0.001], upper back [0 (0) vs. 5 (4); p = 0.001], lower back [0 (1) vs. 5 (3), p = 0.001], whole body [1 (2) vs. 4 (3), p = 0.001], and knee [0 (1) vs. 1 (4), p = 0.001]. In addition, majority of patients and caregivers definitely or strongly agreed that the device was useful, saved time, and was easy to use. We have therefore demonstrated in a setting where manual handling was commonly performed that a low-cost mechanical transfer device reduced caregiver strain and was well received by older patients and caregivers.
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Affiliation(s)
- Choon Hian Goh
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya , Kuala Lumpur , Malaysia
| | - Muslimah Y
- Institute for Public Health , Kuala Lumpur , Malaysia ; Department of Nursing Studies, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Siew-Cheok Ng
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya , Kuala Lumpur , Malaysia
| | - Pathmawathi Subramanian
- Department of Nursing Studies, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia ; Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia ; Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
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Tomita A, Burns JK. Depression, disability and functional status among community-dwelling older adults in South Africa: evidence from the first South African National Income Dynamics Study. Int J Geriatr Psychiatry 2013; 28:1270-9. [PMID: 23512338 PMCID: PMC3751982 DOI: 10.1002/gps.3954] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 02/15/2013] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study examined the relationship between depression and functional status among a community-dwelling older population of 65 years and older in South Africa. METHOD Data from the first wave of the South African National Income Dynamics Study were used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n = 1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale. Functional status, pertaining to both difficulty and dependence in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. RESULTS Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependence in ADL (adjusted OR = 2.57 [CI: 1.03-6.41]), IADL (adjusted OR = 2.76 [CI: 1.89-4.04]), and PFM (adjusted OR = 1.66 [CI: 1.18-2.33]), but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. CONCLUSION The relationship between depression symptoms and function is complex. Functional characteristics between older and younger old populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population.
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Affiliation(s)
- Andrew Tomita
- Department of Epidemiology, Mailman School of Public Health, Columbia
University, New York, U.S.A
| | - Jonathan K Burns
- Department of Psychiatry, Nelson R. Mandela School of Medicine,
University of KwaZulu-Natal, Durban, South Africa
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Lawang W, Horey DE, Blackford J. Family caregivers of adults with acquired physical disability: Thai case-control study. Int J Nurs Pract 2013; 21:70-7. [DOI: 10.1111/ijn.12215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Wannarat Lawang
- School of Nursing and Midwifery; Faculty of Health Sciences; La Trobe University; Melbourne Victoria Australia
- Department of Community Nursing; Faculty of Nursing; Burapha University; Muang Chonburi Thailand
| | - Dell Elizabeth Horey
- School of Public Health; Faculty of Health Sciences; La Trobe University; Melbourne Victoria Australia
| | - Jeanine Blackford
- School of Nursing and Midwifery; Faculty of Health Sciences; La Trobe University; Melbourne Victoria Australia
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Nutritional and functional assessment of hospitalized elderly: impact of sociodemographic variables. J Aging Res 2013; 2013:101725. [PMID: 24222851 PMCID: PMC3810317 DOI: 10.1155/2013/101725] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 07/20/2013] [Accepted: 07/21/2013] [Indexed: 11/26/2022] Open
Abstract
Background. This work was constructed in order to assess the nutritional and functional status in hospitalized elderly and to study the associations between them and sociodemographic variables. Methods. 200 elderly patients (>65 years old) admitted to Internal Medicine and Neurology Departments in nonemergency conditions were included. Comprehensive geriatric assessments, including nutritional and functional assessments, were done according to nutritional checklist and Barthel index, respectively. Information was gathered from the patients, from the ward nurse responsible for the patient, and from family members who were reviewed. Results. According to the nutritional checklist, 56% of participants were at high risk, 18% were at moderate risk of malnutrition, and 26% had good nutrition. There was a high nutritional risk in patients with low income and good nutrition in patients with moderate income. Also, there was a high nutritional risk in rural residents (61.9%) in comparison with urban residents (25%). Barthel index score was significantly lower in those at high risk of malnutrition compared to those at moderate risk and those with good nutrition. Conclusions. Hospitalized elderly are exposed to malnutrition, and malnourished hospitalized patients are candidates for functional impairment. Significant associations are noticed between both nutritional and functional status and specific sociodemographic variables.
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Fauth EB, Schwartz S, Tschanz JT, Østbye T, Corcoran C, Norton MC. Baseline disability in activities of daily living predicts dementia risk even after controlling for baseline global cognitive ability and depressive symptoms. Int J Geriatr Psychiatry 2013; 28:597-606. [PMID: 22968965 PMCID: PMC3565032 DOI: 10.1002/gps.3865] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 06/25/2012] [Accepted: 07/11/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Late-life disability in activities of daily living (ADL) is theorized to be driven by underlying cognitive and/or physical impairment, interacting with psychological and environmental factors. Although we expect that cognitive deficits would explain associations between ADL disability and dementia risk, the current study examined ADL as a predictor of future dementia after controlling for global cognitive status. METHODS The population-based Cache County Memory Study (N = 3547) assessed individuals in four triennial waves (average age 74.9 years, years of education 13.36 years; 57.9% were women). Cox proportional hazards regression models assessed whether baseline ADL disability (presence of 2+ Instrumental ADL and/or 1+ Personal ADL) predicted incident dementia after controlling for APOE status, gender, age, baseline cognitive ability (Modified Mini-mental State Exam, 3MS-R; adjusted for education level), and baseline depressive symptoms (Diagnostic Interview Schedule). RESULTS Over the course of study, 571 cases of incident dementia were identified through in-depth cognitive assessment, ending in expert consensus diagnosis. Results from Cox models suggest that ADL disability is a statistically significant predictor of incident dementia (adjusted hazard ratio = 1.83, p < 0.001), even after controlling for covariates. CONCLUSIONS Findings suggest that ADL disability offers unique contributions in risk for incident dementia, even after controlling for global cognitive status. We discuss how physical impairment and executive function may play important roles in this relationship, and how ADL is useful, not just a diagnostic tool at, or after dementia onset, but also as a risk factor for future dementia, even in individuals not impaired on global cognitive tests.
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Affiliation(s)
- Elizabeth B. Fauth
- Department of Family, Consumer, and Human Development, Utah State University
- Center for Epidemiological Studies, Utah State University
| | - Sarah Schwartz
- Center for Epidemiological Studies, Utah State University
| | - JoAnn T. Tschanz
- Center for Epidemiological Studies, Utah State University
- Department of Psychology, Utah State University
| | - Truls Østbye
- Department of Community and Family Medicine, Duke University School of Medicine
| | - Christopher Corcoran
- Center for Epidemiological Studies, Utah State University
- Department of Mathematics and Statistics, Utah State University
| | - Maria C. Norton
- Department of Family, Consumer, and Human Development, Utah State University
- Center for Epidemiological Studies, Utah State University
- Department of Psychology, Utah State University
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Stineman MG, Zhang G, Kurichi JE, Zhang Z, Streim JE, Pan Q, Xie D. Prognosis for functional deterioration and functional improvement in late life among community-dwelling persons. PM R 2013; 5:360-71. [PMID: 23454447 DOI: 10.1016/j.pmrj.2013.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 01/30/2013] [Accepted: 02/21/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine how health-related, socioeconomic, and environmental factors combine to influence the onset of activity of daily living (ADL) limitations or prognosis for death or further functional deterioration or improvement among elderly people. DESIGN A national representative sample with 2-year follow-up. SETTING Community-dwelling people. PARTICIPANTS Included were 9447 persons (≥70 years of age) in the United States from the Second Longitudinal Study of Aging who were interviewed in 1994, 1995, or 1996. METHODS Self- or proxy-reported health conditions, ADLs expressed as 5 stages describing severity and pattern of limitations, and other baseline characteristics were obtained. A multinomial logistic regression model was used to predict stage transitions. Because of incomplete follow-up (17.7% of baseline sample), primary analyses were determined by multiple imputation to address potential bias associated with loss to follow-up. MAIN OUTCOME MEASUREMENT ADL stage transitions in 2 years (death, deteriorated, stable, and improved ADL function). RESULTS In the imputed-case analysis, the percentages for those who died, deteriorated, were stable, and improved were 12.6%, 32.7%, 48.4%, and 6.2%, respectively. Persons at a mild stage of ADL limitation were most likely to deteriorate further. Persons at advanced stages were most likely to die. Married people and high school graduates had a lower likelihood of deterioration. The risk of mortality and functional deterioration increased with age. Certain conditions, such as diabetes, were associated both with mortality and functional deterioration; other conditions, such as cancer, were associated with mortality only, and arthritis was associated only with functional deterioration. CONCLUSIONS Although overlap occurs, different clinical traits are associated with mortality, functional deterioration, and functional improvement. ADL stages might aid physical medicine and rehabilitation clinicians and researchers in developing and monitoring disability management strategies targeted to maintaining and enhancing self-care among community-dwelling older people.
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Affiliation(s)
- Margaret G Stineman
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, and Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Hairi NN, Bulgiba A, Peramalah D, Mudla I. Do older people with visual impairment and living alone in a rural developing country report greater difficulty in managing stairs? Prev Med 2013; 56:8-11. [PMID: 23103916 DOI: 10.1016/j.ypmed.2012.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 10/16/2012] [Accepted: 10/18/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others. METHODS A population-based cross sectional study was conducted in rural Malaysia from 2007 till 2008. Seven hundred and sixty five older people aged 60 years and over underwent eye examination for visual impairment. Visual acuity criteria were used to define visual impairment. Presenting visual acuity was assessed using a standard metric Snellen Chart of E type. Difficulty in managing stairs was measured according to a question drawn from the Barthel Index which asks "do you need help in climbing stairs". RESULTS Overall, the prevalence of difficulty in managing stairs among older people in our population was 135 (18.3%, 95% CI 15.7-21.2). After adjusting for important confounders the odds ratio (OR) for visual impairment and difficulty in managing stairs among older people living alone was 5.04 (95% CI 2.27, 10.62). Among older people living with others, the adjusted OR for visual impairment and difficulty in managing stairs was 3.10 (95% CI 1.52, 6.80). CONCLUSION In a sample of older people aged 60 years and over, those living alone with visual impairment had greater difficulty in managing stairs than those living with others. Identification of these groups of older people is useful for targeting interventions.
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Affiliation(s)
- Noran N Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia.
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Momtaz YA, Hamid TA, Ibrahim R. Unmet needs among disabled elderly Malaysians. Soc Sci Med 2012; 75:859-63. [DOI: 10.1016/j.socscimed.2012.03.047] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 01/13/2012] [Accepted: 03/21/2012] [Indexed: 11/16/2022]
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