Social relationships and HRQL: a cross-sectional survey among older Italian adults

Psychosocial factors as main predictors of quality of life 5 years after stroke: a cross-sectional study from a third-level Italian center

Stroke causes a significant reduction in health-related quality of life (HRQoL), and studies addressing its predictors often rely on models with few variables. This study aimed to assess the degree to which health status, health habits, and features of the environment predict HRQoL in stroke survivors with stable clinical condition. WHO Quality of Life questionnaire for old-Age subjects (WHOQOL-AGE) was used to assess HRQoL. We ran a multivariable linear regression to predict WHOQOL-AGE variation, entering measures of health state, bad habits, healthy behaviors, physical environment features, and social support. Patients were stroke survivors with a stable clinical condition, distance from acute event of more than 6 months, and National Institutes of Health Stroke Scale (NIHSS) of 10 or less. A total of 122 participants (47 females, 97 with ischemic stroke) were enrolled, the mean age was 64.1, mean NIHSS 2.9, and mean distance from the acute event was 5.1 years. State anxiety (β = -0.202), trait anxiety (β = -0.232), depression (β = -0.255), social support (β = 0.247), and functional independence (β = -0.210) predicted WHOQOL-AGE variation (Adj. R2 = 0.549). Our results show that psychological symptoms, reduced social network, and functional dependence together have a negative impact on HRQoL. These elements, which are partly stroke-specific, should be taken into account in the recovery process to enhance patients' health outcomes.

The Effect of Social Isolation Types on Quality of Life during the Coronavirus Disease 2019 Pandemic in Saudi Arabia: A Cross-Sectional Study

COVID-19 has caused a global pandemic that has spread rapidly to six continents, with over 2.5 million deaths from December 2019 to March 2021. The number of confirmed COVID-19 cases is still growing worldwide, and quarantines have been recommended to prevent the disease's spread. However, quarantines affect people's quality of life (QOL). The aim of this study is to assess the effect of social isolation-quarantine-on QOL during the first wave of the COVID-19 pandemic in Saudi Arabia. A cross-sectional, descriptive design was used in the present study. We obtained data from an online survey conducted in Saudi Arabia. We included a convenience sample of 775 participants in the study. Most of the participants were female (67%), with a mean age of 46 years ranging from 18 to 75 years. Many participants were government employees (n = 308, 39.7%) and had a bachelor's degree or greater (n = 513, 66.2%). Most of the participants (n = 629, 81%) were free from any chronic disease. Nearly 88% of participants were partially isolated socially owing to COVID-19. Concerning QOL, the means of both the Physical Health Composite Scale and the Mental Health Composite Scale SF-12 scores were 44.7 and 34.6, respectively. Furthermore, the results demonstrate that partially socially isolated participants appeared to have significantly better physical health statuses (M = 44.96, SD = 5.90) than completely socially isolated participants (M = 42.87 ± 7.26). There was no significant social isolation effect on mental health status (t (773) = 2.5, p = 0.115). Social isolation during the COVID-19 pandemic considerably influenced various aspects of QOL including physical and mental health. Community-based interventions such as online counseling services and wellness programs are required to reduce the pandemic's negative impact and enhance overall health status and QOL.

Utilization of ADCCs and quality of life among older adults: ethno-regional disparities in Israel

Background

Adult day care centers (ADCCs) are a common service provided for frail older adults in the community. We examined the influence of older adults’ utilization of ADCC’s on their quality of life (QoL), and whether ethno-regional disparities are factors in the gaps found concerning QoL in different regions and between different ethnic groups.

Methods

Cross sectional data were collected through structured interviews with 360 older adults attending ADCCs. Participants represented three ethnic groups and three regions in Israel. QoL was assessed by SF-36 questionnaire.

Results

The results revealed a positive correlation between weekly hours at the ADCC, satisfaction with attending ADCC, and QoL. Older adults living in the central region had higher QoL than those living in the southern and northern regions. Veteran Israeli Jews reported higher QoL than FSU immigrants Israeli Arabs in all regions. Connection to one’s residential area was also correlated with QoL. A significant moderating effect of the interaction (ethnicity*area of residence) on QoL was also revealed.

Conclusions

Attending ADCC is a vital community services to promote QoL in later life. Gaps in ADCC utilization between ethnic groups and residential region may cause disparities in QoL, specifically, in minority groups and those living in peripheral regions. Service providers should minimize the disparities by improving accessibility and availability for each person regardless of ethnicity and region of residence.

Associations between Disability in Activities of Daily Living and Social Capital aspects among older adults: a scoping review

Social capital aspects are playing an important role in activities of daily living (ADL) performance, thus on independent living. This paper was aimed to present an overview of the associations and adverse effects between social capital aspects and disability in ADL and health-related quality of life (HRQoL) in an older population aged 65 years old and over. Α scoping review was designed following the guidelines of PRISMA Extension for Scoping Reviews (PRISMA-ScR) and the review was conducted by 3 authors. A total of 185 primary studies were extracted and, finally, 40 studies did meet the inclusion criteria and critically appraised in two main categories; Category 1(29 studies) ‘social capital and disability in ADL’ deducing that as greater a social capital as better ADL performance and Category 2 (11 studies) ‘Social capital and HRQoL’ concluding that people 65 years old and over with lower social capital were presented with a poor HRQoL. Study synthesis highlights the impact of social capital suggesting that nurses caring for older people must focus on their engagement in terms of social diversity and trust in the community.

The Effects of Social Media Use on the Health of Older Adults: An Empirical Analysis Based on 2017 Chinese General Social Survey

An aging population and social informatization are currently the two main social phenomena affecting China. Under their influences, the real-life experiences of older adults are becoming more and more closely connected to the online world, and the influences of the Internet on healthy aging cannot be ignored. This work aimed to study whether Internet use had an effect on the physical and mental health of older adults, whether the effect was positive or negative, and whether its influence on physical and mental health was heterogeneous. In this study, data from the 2017 Chinese General Social Survey (CGSS) was used to analyze the effects of social media use on the physical and mental health of older adults. The results indicated that there was a significant positive relationship between social media use and the health of older adults. The correlation between social media use and mental health of older adults was more significant than physical health. These results could help us further study the effects of Internet use on the health of older adults.

Piloting a web-based systematic collection and reporting of patient-reported outcome measures and patient-reported experience measures in chronic heart failure

OBJECTIVES

To evaluate the feasibility of a digital and continuous collection and reporting of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) for chronic heart failure (CHF).

DESIGN

A single-site pilot study was settled for evaluating the feasibility of the intervention, both using qualitative and quantitative data (ie, workshop, surveys).

SETTING

The pilot has been implemented in a Tuscan specialised hospital (Italy).

PARTICIPANTS

162 patients were involved. Inclusion criteria were: a previous diagnosis of HF, age ≥18 years, absence of cognitive impairment or active tumours, ability to provide informed consent to study participation.

INTERVENTION

The continuous collection and reporting of PROMs and PREMs has been designed and implemented in 2018. PREMs questionnaires for patients were developed, while Kansas City Cardiomyopathy Questionnaire-12 was used for assessing PROMs. Questionnaires are administered at specific time points: discharge; 30 days, 7 and 12 months after the discharge. Enrolment of patients, administration and real-time reporting of questionnaires are carried on through a digital platform.

OUTCOME MEASURES

Enrolment, response and drop-out rates were considered to assess the feasibility of the intervention. Qualitative data were collected during meetings and workshops with health workers. The representativeness of the recruited sample with respect to the population characteristics was also evaluated.

RESULTS

The system has been successfully implemented during 2018. Response rates have been consistently above 50%, demonstrating patients' transversal willingness to participate. All the involved stakeholders acknowledged the feasibility of the design. The recruited sample is significantly different in terms of age and educational level compared with the overall population characteristics.

CONCLUSION

It is possible to run a web-based systematic collection and reporting system for CHF patient-reported data. Systematic collection and reporting of PROMs and PREMs data allows professionals to increasingly assume CHF patient perspective in their daily work. Limitations will be used to improve the system.

[Health-related QOL and Life Background of Outpatients Using Free/Low-Cost Medical Care Program]

OBJECTIVES

We investigated the quality of life (QOL) of patients using the Free/Low-Cost Medical Care Program, which is a system that enables people in financial difficulities to receive treatment free of charge or at a low cost. We also investigated the background charateristics and lifestyle of the patients.

METHODS

The subjects were 226 outpatients who used the Free/Low-Cost Medical Care Program (use group) and 226 outpatients who did not use the program (non-use group). The method was an anonymous cross-sectional servey by mail. The survey items included basic attributes, health-related QOL (HRQOL), feeling of being poor, lifestyle diseases, lifestyle, and connection with the community.

RESULTS

The number of respondants with valid responses was 97 in the use group and 85 in the non-use group. Among the basic attributes, there were a significant differense between the use group and the non-use group in the family structure, type of work, household income, and educational background. The HRQOL scores of the physical and social summary components were significantly lower in the use group than in the non-use group. The HRQOL scores of mental summary component were higher than the national standard HRQOL score in both the use and non-use groups.

CONCLUSIONS

In this study, it was considered that old age affected the HRQOL scores of the physical and social components. It was considered from the HRQOL scores of the mental aspect that the use of the Free/Low-Cost Medical Care Program might have contributed to mental stability a certain to extent.

Influence of Sociodemographic Factors on Disease Characteristics and Vision-related Quality of Life in Primary Open-angle Glaucoma Patients: The Italian Primary Open Angle Glaucoma Study (IPOAGS)

PURPOSE

The purpose of this article was to evaluate the potential association between sociodemographic factors with clinical characteristics, vision-related quality of life (QoL), and glaucoma-related symptoms scores in a large cohort of primary open-angle glaucoma patients.

MATERIALS AND METHODS

Multicenter, cross-sectional study involving academic and nonacademic centers. Previously diagnosed primary open-angle glaucoma patients aged >18 years were enrolled. At baseline, information on demographic characteristics, social, medical and ocular history, clinical presentation and treatments was collected. Vision-related QoL was evaluated by means of the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), while glaucoma-related symptoms were evaluated using the Glaucoma Symptom Scale (GSS) questionnaire. The associations between sociodemographic factors with clinical characteristics (mean deviation, pattern standard deviation, best-corrected visual acuity), NEI-VFQ-25, and GSS scores were evaluated by means of univariate and multivariate general linear models.

RESULTS

A total of 3227 patients were enrolled. Older age and male sex were significantly associated with lower mean deviation (P<0.01) and higher pattern standard deviation (P<0.01), whereas older age was associated with lower best-corrected visual acuity (P<0.01). The composite GSS score was related to age (P=0.02), sex (P<0.01), employment (P=0.01), and profession (P=0.04), while the total NEI-VFQ-25 score was associated with sex (P<0.01), marital status (P=0.02), and employment (P=0.02).

CONCLUSIONS

Age and sex were significantly associated with almost all indicators of glaucoma severity at baseline. Other variables, such as employment, profession, and marital status were significantly associated with vision-related QoL scores.

The Role of Cultural and Family Values on Social Connectedness and Loneliness among Ethnic Minority Elders

OBJECTIVES

Ethnic minority elders have high levels of social isolation and loneliness. Assumptions about the family providing enough social support exist in the literature, contradicting ethnic minority elders' reported levels of isolation and loneliness. While structural barriers influence feelings of isolation and loneliness, limited information exists about the role of cultural factors such as acculturation and family values. Accordingly, this study investigated the roles of acculturation and family values on loneliness and social isolation among ethnic minority elders.

METHODS

Ethnic minority elders (N = 123) completed a questionnaire that assessed their social connectedness, measured by social network and levels of loneliness, and structural factors such as income. Additionally, cultural and family values were assessed by acculturation and the 'family as referents' dimension of familism, which refers to the belief that family members' behaviour should meet with familial expectations.

RESULTS

Statistical analysis using hierarchical regression indicated that 'family as referents' and acculturation predicted loneliness, but not social network.

CONCLUSIONS

This study raises the importance of considering cultural values when investigating predictors of loneliness among ethnic minority elders.

CLINICAL IMPLICATIONS

Findings highlight the importance of addressing familial expectations in programs aimed at alleviating loneliness among ethnic minority elders.

Life Quality Protection Rights for Elderly People. Communities of Posorja and Puna

Antecedentes: este artículo tiene como propósito medir el grado en que se satisfacen las necesidades físicas y recreativas de los adultos mayores en las comunidades de Posorja y Puna. Hoy en día, se sabe que la actividad física es beneficiosa para los ancianos, ya que ayuda para disminuir dolencias y todo tipo de enfermedades. Método: La población en este estudio está compuesta por 378 personas mayores entre 65 y 90 años de edad: 200 pertenecen a la comunidad de Posorja y 178 a la comunidad de Puna en la provincia de Guayas. Las herramientas utilizadas para esta investigación se incluyen, entre otros, la Prueba ADL (Actividades de la vida diaria), que evalúa el grado de autocuidado y movilidad; la Escala de Lawton y Brody, que es un instrumento apropiado para evaluar el nivel de independencia y habilidades; y la MMT (Mini prueba mental), que evalúa las funciones cognitivas, como la memoria, el lenguaje, la praxis y la atención. Todos son esenciales para detectar y diagnosticar la enfermedad de Alzheimer. Resultados: Se utilizaron diversas técnicas estadísticas para obtener los resultados, como el análisis descriptivo, tablas de contingencia y componentes principales. Conclusiones: Se analizó la población entre 65 y 90 años de edad que representó el 35.9% de la población total en 2010, lo que significa que hubo una variación. Hoy en día, representa el 56.6% de la muestra obtenida. Este grupo generacional se refiere a las personas mayores, que deberían ser favorecidos por las políticas públicas que se pretenden para mejorar los programas de salud, generar áreas recreativas y crear centros de cuidado para adultos mayores. En general, la dinámica demográfica de Posorja muestra una pirámide estructurada, con una población en expansión, una gran cantidad de jóvenes y adultos que contribuyen a la dinámica económica y productividad del área. El cuestionario podría modificarse y contener las especificaciones requeridas para adaptarse a las verdaderas dimensiones de esta población.

The mediation effect of political interest on the connection between social trust and wellbeing among older adults

Previous research has established significant positive associations between social trust and wellbeing among older adults. This study aimed to obtain a deeper understanding of the relationship between different sources of social trust and wellbeing by examining the mediational role of political interest. A sample of 4,406 Italian residents aged 65 years and over was extracted from a national cross-sectional survey during 2013 in Italy, representative of the non-institutionalised population. Measures included trust in people, trust in institutions, political interest, life satisfaction and self-perceived health. Mediation path analysis and structural equation modelling were used to test the mediation effects of political interest on the relationship between trust in people and trust in institutions with life satisfaction and self-perceived health. Associations between trust in people, life satisfaction and self-perceived health, and between trust in institutions and life satisfaction were partially mediated by political interest, while the association between trust in institutions and self-perceived health was fully mediated by political interest. Having high levels of political interest may thus enhance the relationship between social trust and wellbeing among older adults. These results suggest that interventions to enhance wellbeing in older adults may benefit from examining individuals’ levels of political interest.

Quality of life and its association with work, the Internet, participation in groups and physical activity among the elderly from the EpiFloripa survey, Florianópolis, Santa Catarina State, Brazil

The study aimed to investigate the association between changes in social relations and physical activity on the quality of life of the elderly in the city of Florianópolis, Santa Catarina state, Brazil. Data on 1,197 elderly from two waves of the population and household survey, EpiFloripa Idoso, were analyzed. Multiple linear regression was performed to estimate association of social change variables and lifestyle on quality of life score (QoL; measured by CASP-16 Brazil, score can range from 0, which represents no QoL to 48, total satisfaction in all domains of CASP). The average QoL score in the sample was 37.6 (95%CI: 37.2; 38.1). The social relations that were associated with positive QoL score were to start to work, to continue to use the Internet, to start participating in religious or lifestyle groups, to remain and to become physically active, and for those who were physically active, but became inactive in the second wave. To remain living with family had a negative effect on QoL score for the elderly. Some changes in social relations had a positive effect on QoL, and results reaffirmed the importance of physical activity to healthy aging, since to pursue it in some of the waves was better than to remain inactive.

Qualidade de vida relacionada à saúde em idosos residentes em região de alta vulnerabilidade para saúde de Belo Horizonte, Minas Gerais

RESUMO: Objetivo: Investigar se as relações sociais, juntamente com características sociodemográficas, hábitos de vida e condições de saúde estão associados à qualidade de vida relacionada à saúde (QVRS) em idosos residentes em região considerada de alta vulnerabilidade para a saúde. Métodos: Estudo transversal realizado com amostra aleatória de 366 idosos (≥ 60 anos) adscritos a um centro de saúde de Belo Horizonte, Minas Gerais. A QVRS foi aferida pelo Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) e os escores obtidos nos componentes físico (PCS) e mental (MCS) foram utilizados como variáveis resposta. As variáveis explicativas foram divididas em quatro blocos: sociodemográfico, relações sociais, hábitos de vida e condições de saúde. Modelos de regressão linear múltipla foram utilizados. Resultados: Nos modelos multivariados finais, encontramos que elevado número de diagnósticos de doenças crônicas e ter estado acamado nos últimos 15 dias foram variáveis associadas à pior QVRS no domínio físico e mental. Entretanto, ausência de escolaridade, insatisfação com relacionamentos pessoais e não ter sempre que necessário o apoio de alguém para ajudar a ficar de cama, ir ao médico e preparar refeições foi associado à pior QVRS apenas no MCS. Ter declarado cor da pele preta, ausência de atividade de trabalho, não praticar atividade física, não consumir álcool e internação nos últimos 12 meses estiveram associados à pior QVRS apenas no PCS. Conclusão: Além da adversidade social, hábitos de vida e condições de saúde, alguns aspectos funcionais das relações sociais foram importantes para compreensão da QVRS em idosos em vulnerabilidade social.

Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review

OBJECTIVES

Previous studies of older European populations have established that disability and morbidity vary with indicators of socio-economic position (SEP). We undertook a systematic narrative review of the literature to ascertain to what extent there is evidence of similar inequalities in the subjective health and well-being of older people in Europe.

METHOD

Relevant original research articles were searched for using Medline, Global Health, Embase, Social Policy and Practice, Cinahl, Web of Science and International Bibliography of the Social Sciences (IBSS). We included studies of SEP and indicators of subjective health and well-being (self-rated health; life satisfaction; quality of life) conducted since 1991 using population-based samples of older people in Europe and published 1995-2013.

RESULTS

A total of 71 studies were identified. Poorer SEP was associated with poorer subjective health and well-being. Associations varied somewhat depending on the SEP measure and subjective health and well-being outcome used. Associations were weaker when social support and health-related behaviours were adjusted for suggesting that these factors mediate the relationship between SEP and subjective health and well-being. Associations tended to be weaker in the oldest age groups. The patterns of associations by gender were not consistent and tended to diminish after adjusting for indicators of health and life circumstances.

CONCLUSION

The results of this systematic narrative review of the literature demonstrate the importance of social influences on later life subjective health and well-being and indicate areas which need further investigation, such as more studies from Eastern Europe, more longitudinal studies and more research on the role of mediating factors.

Do self-referent metacognition and residential context predict depressive symptoms across late-life span? A developmental study in an Italian sample

OBJECTIVES

There is controversial evidence concerning the variables favoring depression in community-dwelling elderly individuals. This study mainly investigates the impact of lifestyle, residential environment, cognitive efficiency and social desirability in predicting self-assessed depressive signs in late adult span.

METHOD

One hundred forty-nine elders were recruited in Northern Italy and Sardinia - an Italian island characterized by the longevity of people living in the inner areas. Participants were presented a battery of questionnaires assessing cognitive efficiency and self-referent measures of depression, metacognition and social desirability.

RESULTS

A hierarchical regression analysis showed that residential environment was the most effective predictor of depressive symptoms, along with gardening and spending time for hobbies. In contrast, social desirability and metacognitive scores played a minor role in predicting mental health. An analysis of variance showed that Sardinian elders showed fewer signs of depression than age-matched elders residing in Northern Italy.

CONCLUSION

The Sardinian residential environment is a strong predictor of preserved mental health in late adulthood. In contrast, self-rated metacognitive efficiency and social desirability play a very marginal role in predicting depression among the elderly.

Quality of life and associated morbidities among elderly persons registered with the Family Health Strategy of Senador Guiomard in the state of Acre

Objectives: To verify the prevalence of a low quality of life and analyze the morbidities associated with such a condition among elderly persons registered with the Family Health Strategy of the municipality of Senador Guiomard. Method : A cross-sectional study was performed of elderly persons registered with the Family Health Strategy in the urban area of the municipality of Senador Guiomard in the state of Acre. A comparison between men and women regarding morbidities and quality of life was performed using Pearson's chi-squared test. The associations between the tertiles of quality of life and morbidities were estimated by odds ratio through multivariate logistic regression analysis. Results : There were differences between men and women in the reporting of hypertension (p=0.015), diabetes (p=0.033), in the psychological domain (p=0.009) and in total quality of life (<0.001). Elderly people classified in the lower tertile of the physical and social domains of quality of life were more likely to suffer from hypertension, cardiovascular disorders and anemia. Those in the lower tertile of the psychological domain were also more likely to suffer from hypertension, cardiovascular disorders and insomnia, as well as anemia. Elderly individuals in the lower overall tertile were more likely to suffer from hypertension, cardiovascular disorders, insomnia and anemia. No statistically significant associations were found for the environmental domain. Conclusion : The total quality of life and the physical, psychological and social domains of quality of life can be considered good indicators of the described morbidities among the elderly. The environmental domain, however, was not a useful indicator.

Assessing the health of the general population in England: how do the three- and five-level versions of EQ-5D compare?

Background

The EQ-5D is a brief, generic measure of health status that can be easily incorporated into population health surveys. There are two versions of the EQ-5D for use in adult populations, one with 3 response levels in each of the instrument’s 5 dimensions (EQ-5D-3L) and one with 5 levels in each dimension (EQ-5D-5L). We compared the two versions as measures of self-reported health status in representative samples of the English general population.

Methods

EQ-5D-5L data were available from 996 respondents selected at random from residential postcodes who took part in the EQ-5D-5L value set for England study. EQ-5D-3L data were available from 7294 participants included in the 2012 Health Survey for England. Responses on the 3L and 5L versions of EQ-5D were compared by examining score distributions on the two versions, both in terms of the profile (dimensions) and the EQ-VAS. To determine the extent of variations in score according to respondent characteristics, we analysed health status reporting on the descriptive profile, EQ-5D Index, and EQ-VAS of both versions of EQ-5D by age, sex, and educational background. We used X² to test for differences between respondent categories when analyzing EQ-5D profile data and the t test when analyzing EQ-5D Index and VAS scores.

Results

The 5L version of EQ-5D led to a considerably reduced ceiling effect and a larger proportion of respondents reporting severe health problems compared to the 3L. The 5L version also led to the use of a wider spread of health states; just 3 health states on the 3L covered 75 % of the sample, compared to 12 states on the 5L. Both versions showed poorer health status in older respondents, females, and those in a lower educational category and the EQ-5D-5L descriptive system, though not the Index or VAS, discriminated better between age groups than the 3L. There were no appreciable differences between the two versions in their ability to discriminate between groups defined by gender or educational level.

Conclusions

The new, expanded 5L version of EQ-5D may be a more useful instrument for the measurement of health status in population health surveys than the original 3L version.

Qualidade de Vida, Morbilidade Psicológica e StressFamiliar em Idosos Residentes na Comunidade

Este estudo procurou investigar as relações existentes entre morbilidade psicológica, stress familiar e qualidade de vida (QV) da pessoa idosa. A amostra foi constituída por 126 idosos. Os instrumentos utilizados foram: The Lawton Instrumental Activities of Daily Living (IADL), Quality of Life (WHOQOL-Bref), Geriatric Anxiety Inventory (GSI), Geriatric Depression Scale (GDS); e Index of Family Relations (IFR). Os resultados revelaram a importância da idade, estado civil, escolaridade e número de patologias assim como o género na capacidade funcional, morbilidade, stress familiar e QV. Ao nível dos preditores, a depressão foi a variável que mais contribuiu para a QV. Não foram encontradas variáveis moderadoras no modelo. A discussão e implicações dos resultados são abordadas bem como a intervenção psicológica nesta população.

Immersive technology and the elderly: a mini-review

Technologies that provide immersive experiences continue to become more ubiquitous across all age groups. This paper presents a review of the literature to provide a snapshot of the current state of research involving the use of immersive technologies and the elderly. A narrative literature review was conducted using the ScienceDirect, EBSCOhost, Springerlink and ERIC databases to summarize primary studies from which conclusions were drawn into a holistic interpretation. The majority of the studies examined the effect of immersive technologies on elder peoples' age-related declines, including sensory and motor changes (vision, hearing, motor skills), cognitive changes and social changes. Various immersive technologies have been described and tested to address these age-related changes, and have been categorized as 'games and simulations', 'robotics' and 'social technologies'. In most cases, promising results were found for immersive technologies to challenge age-related declines, especially through the increase of morale.

[Factors associated with the quality of life of elderly men]

This was an analytical, cross-sectional household survey study aimed at describing the sociodemographic characteristics, health and quality of life of elderly men, and to verify the socioeconomic and health factors related to quality of life. Participants in this study included 804 elderly men. Data were collected using the following instruments: Older Americans Resources and Services scale (OARS), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). Descriptive analysis, student's t-test, Pearson correlation and multiple linear regression (p<0.05) were used. The prevalent characteristics were: individuals 60-70 years old, married, 4-8 years of education, and a minimum wage income. The lowest quality of life scores were in the physical domain and autonomy facet, and were associated with: the absence of a companion, education, low income, higher number of comorbidities, and functional disability. Functional disability had the strongest influence on the quality of life, except for the physical domain and intimacy facet.

Factors influencing quality of life for disabled and nondisabled elderly population: the results of a multiple correspondence analysis

Objectives. The aim of our study is to examine the role of some factors (sociodemographic patterns, social relationship support, and trust in healthcare actors) on structure of quality of life among the Italian elderly population, by stratifying according to presence or absence of disability. Methods. Using data of the Italian National Institute of Statistics (ISTAT) survey, we obtained a sample of 25,183 Italian people aged 65+ years. Multiple Correspondence Analysis (MCA) was used to test such a relationship. Results. By applying the MCA between disabled and nondisabled elderly population, we identified three dimensions: "demographic structure and social contacts," "social relationships," "trust in the Italian National Health Services (INHS)." Furthermore, the difference in trust on the INHS and its actors was seen among disabled and non-disabled elderly population. Conclusions. Knowledge on the concept of quality of life and its application to the elderly population either with or without disability should make a difference in both people's life and policies and practices affecting life. New domains, such as information and trusting relationships both within and towards the care network's nodes, are likely to play an important role in this relationship.

Assessment of perceived health status among primary care patients in Southern Italy: findings from a cross-sectional survey

Background

The primary aim of this study was to measure HRQOL of primary care patients in one of the poorest areas of Italy, using SF-12, whereas the secondary aim was to identify subgroups of this population, according to socio-demographics, clinical characteristics, behavioural risk factors, and health services utilization, that manifest poorer HRQOL. These data may be helpful to policy makers to implement health care policies and social interventions for improving HRQOL.

Methods

A cross-sectional survey was conducted in Southern Italy on primary care patients aged 18 and over. SF-12 was used to measure perceived health status. Physical component and mental summary scores were obtained. We performed univariate and multivariate analysis to evaluate eventual significant differences of mean PCS-12 and MCS-12 according to various characteristics (demographics, presence of chronic diseases, behavioral risk factors, and utilization of health services).

Results

Of the 1467 participating in our survey, more than one third evaluated their health as unsatisfactory, noted significant limitations and reported problems on all SF-12-scales. Physical and mental summary scores showed an overall mean of 45.9 (SD ± 10.8) and 44.9 (SD ± 11.6), respectively. Statistical analysis showed significant differences in perceived health status by socio-demographic characteristics, such as gender, age, education level and employment status, by behavioral risk factors, chronic diseases and health services utilization.

Conclusions

Our findings seem to indicate that primary care patients in Southern Italy have a poor HRQOL and this perception is even poorer in subgroups of the population, according to several sociodemographic, clinical characteristics, and behavioural risk factors. These results may have significant implications for health care policymakers, since they emphasize the need of developing effective and targeted strategies to improve HRQOL in Southern Italy.

Capacidade funcional, morbidades e qualidade de vida de idosos

Pesquisa que objetivou descrever o perfil sociodemográfico, capacidade funcional e morbidades de idosos, e verificar a associação da qualidade de vida com o número de incapacidade funcional e de morbidades. Estudo analítico e transversal realizado com 2.142 idosos. Os dados foram coletados no domicílio com instrumento estruturado. A análise foi por meio da distribuição de frequência, teste ANOVA-F e Bonferroni (p<0,05). A maioria era do sexo feminino, com 60├70 anos, casados, 4├8 anos de estudo e renda de um salário mínimo. Houve predomínio entre os idosos de 1├3 incapacidades funcionais, relacionadas à mobilidades e 4├7 morbidades associadas, sendo as mais prevalentes problemas de visão e de coluna e hipertensão arterial. Os maiores escores de qualidade de vida foram para relações sociais e funcionamento dos sentidos e os menores para o físico e a autonomia. O maior número de incapacidade funcional e de morbidades associou-se aos menores escores de qualidade de vida.

The impact of social isolation on the health status and health-related quality of life of older people

PURPOSE

To investigate for socially isolated older people, and older people at risk of social isolation: (1) health status and health-related quality of life (HRQL); (2) the relationship between social isolation and health status/HRQL; (3) the relationship between two alternative measures of health status/HRQL.

METHODS

Older people at risk of social isolation (n = 393) completed the EQ-5D and the SF-12. Multiple regression analyses were performed to examine the relationship between levels of social isolation and health status/HRQL, controlling for demographic/clinical characteristics. The agreement between EQ-5D and SF-6D (SF-12) scores was explored using descriptive psychometric techniques.

RESULTS

Health status and health state values were much lower than UK general population age-matched norms. After controlling for depression, physical co-morbidities, age, gender, living alone status, employment and accommodation, social isolation was significantly associated, to a degree that was clinically relevant, with EQ-5D DSI, SF-6D (SF-12) and SF-12 MCS scores. The potential for ceiling effects on the EQ-5D with this population was identified.

CONCLUSION

This work highlights the burden that social isolation may have on the health and well-being of older people. The potential HRQL gains from addressing social isolation may be considerable, with those at risk of social isolation also a key target group.

Day care centre attendance and quality of life in depressed older adults living in the community

Late-life depression is associated with disabled functioning and a poor quality of life (QOL). The aim of this cross-sectional study was to find out whether the attendance of a day care centre (DC) was associated with QOL in community-dwelling older adults suffering from a depressive disorder without dementia. The study enrolled 149 depressed older adults aged 70 or older, who consecutively underwent a comprehensive geriatric assessment from April to July 2008 at the Geriatric Medicine Unit of the Fondazione Ospedale Maggiore Policlinico in Milan, Italy. QOL was evaluated by means of the European Quality of Life Visual Analogue Scale (EuroQol VAS). DC attendance was quantified as number of days of attendance per week in the past month. Participants attending a DC at least once a week (n = 17) had a higher mean EuroQol VAS score than non-attendants (n = 132) (mean ± SD 58.8 ± 19 vs. 45.3 ± 22.5; P = 0.019). In multiple linear regression analysis a higher weekly attendance of DCs was related to a better quality of life according to the EuroQol VAS score (unstandardized coefficient 3.048, 95% CI 0.063-6.033, P = 0.045) after correction for age, sex, balance and gait abilities, comorbidity, pharmacotherapy, living alone, and severity of depression. Therefore, in older outpatients suffering from a depressive disorder without dementia the attendance of a DC was an independent correlate of the QOL. A randomized controlled longitudinal study will be necessary to determine whether attending a DC is really effective on the QOL in the management of late-life depression.

Quality of life in parents of children with attention-deficit-hyperactivity disorder in Hong Kong

OBJECTIVE

There is no study on the quality of life (QOL) of parents of children with attention-deficit-hyperactivity disorder (ADHD), although QOL is increasingly gaining more attention and the interactions between children and their parents are bi-directional. The aim of the present study was therefore to survey the QOL of parents of children with ADHD in Hong Kong, and explore the relationships of sociodemographic and clinical variables with QOL.

METHOD

Seventy-seven parents of children with ADHD were consecutively selected and the sociodemographic and clinical characteristics of the parents and their children were assessed.

RESULTS

Compared with the general population in Hong Kong, significantly lower scores in physical, psychological, social and environmental QOL domains were found in the parents of children with ADHD. On multivariate analysis, for the children with ADHD, the severity of emotional and hyperactivity/inattention symptoms, and having a comorbid pervasive developmental disorder were significantly correlated with one or more domains of QOL; while for the parents, educational level, household monthly income and having major medical conditions were significantly correlated with one or more domains of QOL.

CONCLUSIONS

Parents of children with ADHD have low QOL and research is needed to understand the underlying problems.