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Pan Z, Dong W, Yang F, Huang Z. Health disparity among older adults in urban China: The role of local fiscal conditions. Health Place 2024; 88:103281. [PMID: 38833847 DOI: 10.1016/j.healthplace.2024.103281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/13/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
This study explores the disparities in older adults' self-rated health within the urban landscape of China. Drawing on the 1% national population survey of China in 2015, it highlights how variations in city development contribute to geographical health disparities among older residents. In the era of the decentralized fiscal system, a crucial mechanism identified is the role of cities' local fiscal revenue in connecting their socioeconomic development and the health status among older adults. Despite efforts by cities in lower socioeconomic positions to increase fiscal expenditure and address deficits through central transfer payments, they prove inadequate in effectively mitigating population health disparities. The prioritization of economic growth and neglect of public service provision responsibilities are fundamental causes within this fiscal framework. The findings underscore the urgent need for increased central transfer payments in public services to address the growing disparities in older adults' health.
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Affiliation(s)
- Zehan Pan
- School of Social Development and Public Policy, Fudan University, 220 Handan Road, Yangpu District, Shanghai, 200437, China
| | - Weizhen Dong
- Department of Sociology and Legal Studies, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Feiyang Yang
- School of Social Development and Public Policy, Fudan University, 220 Handan Road, Yangpu District, Shanghai, 200437, China
| | - Zuyu Huang
- School of Public Administration, Hunan University, 2 South Lushan Road, Yuelu District, Changsha, Hunan, 410000, China.
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Gross AL, Nichols E, Angrisani M, Ganguli M, Jin H, Khobragade P, Langa KM, Meijer E, Varghese M, Dey AB, Lee J. Prevalence of DSM-5 mild and major neurocognitive disorder in India: Results from the LASI-DAD. PLoS One 2024; 19:e0297220. [PMID: 38324518 PMCID: PMC10849236 DOI: 10.1371/journal.pone.0297220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/30/2023] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION India, with its rapidly aging population, faces an alarming burden of dementia. We implemented DSM-5 criteria in large-scale, nationally representative survey data in India to characterize the prevalence of mild and major Neurocognitive disorder. METHODS The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) (N = 4,096) is a nationally representative cohort study in India using multistage area probability sampling methods. Using neuropsychological testing and informant reports, we defined DSM-5 mild and major neurocognitive disorder, reported its prevalence, and evaluated criterion and construct validity of the algorithm using clinician-adjudicated Clinical Dementia Ratings (CDR)®. RESULTS The prevalence of mild and major neurocognitive disorder, weighted to the population, is 17.6% and 7.2%. Demographic gradients with respect to age and education conform to hypothesized patterns. Among N = 2,390 participants with a clinician-adjudicated CDR, CDR ratings and DSM-5 classification agreed for N = 2,139 (89.5%) participants. DISCUSSION The prevalence of dementia in India is higher than previously recognized. These findings, coupled with a growing number of older adults in the coming decades in India, have important implications for society, public health, and families. We are aware of no previous Indian population-representative estimates of mild cognitive impairment, a group which will be increasingly important in coming years to identify for potential therapeutic treatment.
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Affiliation(s)
- Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, Los Angeles, California, United States of America
| | - Marco Angrisani
- Center for Economic and Social Research, University of Southern California, Los Angeles, Los Angeles, California, United States of America
- Department of Economics, University of Southern California, Los Angeles, Los Angeles, California, United States of America
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Haomiao Jin
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Pranali Khobragade
- Department of Economics, University of Southern California, Los Angeles, Los Angeles, California, United States of America
| | - Kenneth M. Langa
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Institute for Social Research, Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, United States of America
| | - Erik Meijer
- Center for Economic and Social Research, University of Southern California, Los Angeles, Los Angeles, California, United States of America
- Department of Economics, University of Southern California, Los Angeles, Los Angeles, California, United States of America
| | - Mathew Varghese
- Department of Psychiatry, St. John’s Medical College, Bengaluru, Karnataka, India
| | - A. B. Dey
- Venu Geriatric Institute, New Delhi, India
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, Los Angeles, California, United States of America
- Department of Economics, University of Southern California, Los Angeles, Los Angeles, California, United States of America
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Shi L, Pang T, Zheng Q, Liu G, Zhang W, Leung W. Utilisation of community healthcare services among older adults with disabilities in Luohu district, Shenzhen: a community-based survey. BMJ Open 2024; 14:e076249. [PMID: 38286707 PMCID: PMC10826561 DOI: 10.1136/bmjopen-2023-076249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE China faces the challenge of an ageing population with disabilities. Community healthcare centres (CHCs) serve as frontline community healthcare providers for older adults with and without disabilities. Despite their significance, there is a lack of literature examining the utilisation of CHC services among older adults. This study aims to examine and compare the utilisation and satisfaction of CHC healthcare services among older adults with and without disabilities. SETTING Data from the 2019 Community Health Diagnosis Questionnaire, which interviewed 259 older adults residing in the Luohu district of Shenzhen, were used in the current study. PRIMARY OUTCOME MEASURES Participants self-reported outcomes including use of CHCs, use of home health services from CHCs and satisfaction with CHCs. Five different disability types and an integrated disability variable were assessed as independent variables. Linear probability models were used to determine the relationship between disability types and outcome variables. RESULTS Among 259 older adults aged 60 years and older, 70.66% self-identified as having a disability. No statistically significant associations were found between the use of CHCs, the use of home health services from CHCs and satisfaction with CHCs, and disability status. However, older adults with mobility and cognitive disabilities were more likely to receive home health services from CHCs. CONCLUSION Community health promotion policies should be implemented to improve access to health services for older adults with and without disabilities. In addition, CHCs should implement effective health management plans to ensure the health needs of older adults with disabilities.
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Affiliation(s)
- Lu Shi
- College of Health, Oregon State University, Corvallis, Oregon, USA
| | | | - Qingming Zheng
- Shenzhen Luohu Disease Prevention and Control Center, Shenzhen, China
| | - Gang Liu
- Shenzhen Luohu Disease Prevention and Control Center, Shenzhen, China
| | - Wei Zhang
- College of Health, Oregon State University, Corvallis, Oregon, USA
| | - Willie Leung
- Health Sciences & Human Performance, The University of Tampa, Tampa, Florida, USA
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Saravanakumar P, Muhammad T, Paul R, Srivastava S. Explaining the Urban-Rural Difference in Late-Life Depression in India: Evidence from a Multivariate Decomposition Analysis Based on Longitudinal Aging Study in India, Wave 2017-18. Clin Gerontol 2024; 47:270-287. [PMID: 37700396 DOI: 10.1080/07317115.2023.2257179] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
OBJECTIVES The study explored the associated factors of depression among older Indian adults and the influences of individual and socio-environmental factors in explaining the rural-urban difference in the prevalence of late-life depression. METHODS Data come from the Longitudinal Aging Study in India, with a sample of 30,637 older adults aged 60 and above. Multivariable logistic regression and nonlinear multivariate decomposition analyses were conducted to fulfill the objectives. RESULTS About 6.2% older adults in urban areas and 9.5% in rural areas were depressed. Older adults in rural areas had significantly higher likelihood to be depressed than those in urban areas. Poor self-rated health, multiple chronic conditions, functional difficulty, low life satisfaction, social inactivity, low satisfaction with living arrangement, ill-treatment and being widowed increased the risk of depression. Additionally, work status similar to urban older adults, physical activity, living arrangement satisfaction, self-rated health and ill-treatment would decrease the urban-rural difference in depression. CONCLUSIONS The study showed significant rural-urban difference in late-life depression, with a rural disadvantage. CLINICAL IMPLICATIONS The findings suggest the need for identifying at-risk populations and developing a framework of targeted policy interventions for mitigating the increased risk of late-life depression among older Indians and in rural areas in particular.
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Affiliation(s)
- Priya Saravanakumar
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - Ronak Paul
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
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Xu X, Zhao Y, Wu B, Pei Y, Gu D. Association between tooth loss and frailty among Chinese older adults: the mediating role of dietary diversity. BMC Geriatr 2023; 23:668. [PMID: 37848821 PMCID: PMC10583397 DOI: 10.1186/s12877-023-04355-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND This study aimed to examine the association between tooth loss and frailty among Chinese older adults and the mediating role of dietary diversity in this association. METHODS Data from five waves of the Chinese Longitudinal Healthy Longevity Survey conducted between 2005 and 2018 were used. Path analyses were employed to assess both concurrent and cross-lagged relationships between tooth loss and frailty index while accounting for intrapersonal correlation. Furthermore, the mediation effect of dietary diversity was also examined. RESULTS In concurrent models, severe tooth loss was associated with frailty after adjusting for demographic characteristics (odds ratio [OR] = 1.82, p < 0.001). The OR of frailty for severe tooth loss was only slightly decreased to 1.74 (p < 0.001) when dietary diversity was added to the model and to 1.64 (p < 0.001) when socioeconomic status, family support, and healthy lifestyles were further adjusted. In the cross-lag or longitudinal models, the ORs were mildly or moderately reduced to 1.29, 1.27, and 1.23, respectively, yet remained statistically significant (p < 0.001 or p < 0.01). The mediation analyses showed that dietary diversity had some small yet significant effects on the relationship between tooth loss and frailty in both concurrent and longitudinal settings. CONCLUSIONS This study improves current knowledge regarding the impact of tooth loss on frailty among Chinese older adults. Future intervention strategies designed to improve healthy diets may have preventive effects against the risk of frailty among Chinese older adults with severe tooth loss.
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Affiliation(s)
- Xin Xu
- Population Research Institute, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Yuan Zhao
- School of Geography, Nanjing Normal University, Nanjing, China.
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, China.
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, 433 First Avenue, 10010, New York, NY, USA.
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, 433 First Avenue, 10010, New York, NY, USA
| | - Danan Gu
- Independent Researcher, New York, USA
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Wang D, Tankumpuan T, Utriyaprasit K, Davidson PM. Reliability and Validity of the Chinese Version of the Perceived Access to Health Care Questionnaire. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2023; 10. [DOI: 10.5812/jnms-139931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2024] Open
Abstract
Background: The Perceived Access to Health Care Questionnaire (PAHCQ) is the latest specific tool used to evaluate patients' accessibility to the health system. Objectives: This study aimed to translate and verify the item analysis, test-retest reliability, content validity, construct validity, and known-group analysis of the PAHCQ in a Chinese population. Methods: This study developed and validated the Chinese version of the PAHCQ. The translation of the PAHCQ was based on the back translation of Brislin. This study used simple random sampling to include a sample of 591 subjects in Jiangsu, China. Item analysis was used to verify the questionnaire's expert consistency and cultural adaptation. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the effectiveness of the structure. Internal consistency was determined using Cronbach's α, and item validity and test-retest reliability were analyzed. Results: The CFA results indicated that the modified PAHCQ is reasonable. The Cronbach alpha value of the PAHCQ was 0.96. The correlation coefficients for the six domains in test-retest reliability were between 0.67 and 0.91. Comparison of the total PAHCQ scores among participants in different groups of age, gender, maternal status, education level, per capita monthly income, and CCI levels showed statistically significant differences (P < 0.05). Conclusions: The Chinese version of the PAHCQ is a feasible, effective, and reliable tool that can be used to evaluate Chinese patients' perception of health system accessibility.
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Bayati M, Kiadaliri A. Contributions of avoidable mortality to the sex gap in life expectancy and life disparity in Iran. Arch Public Health 2023; 81:126. [PMID: 37420294 DOI: 10.1186/s13690-023-01141-z] [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: 04/07/2023] [Accepted: 06/23/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Public health policies and healthcare quality play a pivotal role on the health outcome level and disparities across sociodemographic groups. However, there is little evidence on their role on disparities in life expectancy (LE) and life disparity (LD) in low and middle income countries. The present study aimed to assess the contributions of avoidable mortality, as a measure of inter-sectoral public health policies and healthcare quality, into the sex gap in LE (SGLE) and LD (SGLD) in Iran. METHODS Latest available data of death causes, according to the ICD codes, for Iran was obtained from the WHO mortality database for the period 2015-2016. An upper age limit of 75 years was applied to define avoidable causes of death. LD was measured as the average years of life lost at birth. The SGLE and SGLD (both females minus males) were decomposed by age and cause of death using a continuous-change model. RESULTS Females, on average, outlived males for 3.8 years (80.0 vs. 76.2 years) with 1.9 lower life years lost (12.6 vs. 14.4 years). Avoidable causes accounted for 2.5 (67%) and 1.5 (79%) years of the SGLE and SGLD, respectively. Among avoidable causes, injury-related deaths followed by ischaemic heart disease had the greatest contributions to both SGLE and SGLD. Across age groups, the age groups 55-59 and 60-64 accounted for the greatest contributions of avoidable causes to SGLE (0.3 years each), while age groups 20-24 and 55-59 had the greatest contributions to SGLD (0.15 years each). Lower mortality rates for females than males in age groups 50-74 years accounted for about half of the SGLE, while age groups 20-29 and 50-64 years accounted for around half of SGLD. CONCLUSION More than two third of the SGLE and SGLD in Iran were attributed to the avoidable mortality, particularly preventable causes. Our results suggest the need for public health policies targeting injuries in young males as well as lifestyle risk factors including smoking in middle aged males in Iran.
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Affiliation(s)
- Mohsen Bayati
- Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Kiadaliri
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopaedics, Skåne University Hospital, Lund University, Remissgatan 4, Lund, SE-221 85, Sweden.
- Centre for Economic Demography, Lund University, Lund, Sweden.
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Li Z, Xuan M, Gao Y, He R, Qian D, Hung P. Trends in the availability of community-based home visiting services for oldest-old in China, 2005-2018. BMJ Open 2023; 13:e070121. [PMID: 37019484 PMCID: PMC10083737 DOI: 10.1136/bmjopen-2022-070121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVES This study aims to examine trends in neighbourhood availability of community-based home visiting services (CHVS) (ie, coverage by local primary healthcare providers) over time and disparities in service availability according to individual characteristics using nationwide data of oldest-old individuals (age >80) in China. DESIGN Repeated, cross-sectional study. SETTING This study derived nationally representative data from the 2005-2018 Chinese Longitudinal Health Longevity Survey. PARTICIPANTS A final analytical sample of 38 032 oldest-old individuals. PRIMARY OUTCOME MEASURES Availability of CHVS was defined as having home visiting services in one's neighbourhood. Cochran-Armitage tests were used to test linear trends in the proportions of oldest-old with service availability. Weighted logistic regression models were used to examine variations in service availability across individual characteristics. RESULTS Of 38 032 oldest-old individuals, availability of CHVS decreased from 9.7% in 2005 to 7.8% in 2008/2009, followed by continual increases to 33.7% in 2017/2018. These changes were similar between rural and urban oldest-old. After accounting for individual characteristics, in 2017/2018, compared with their counterparts, urban residents who had white-collar jobs before retirement and those residing in Western and Northeast China were less likely to have service availability. Oldest-old with disabilities, those living alone and those with low incomes did not report having greater availability of CHVS in either 2005 or 2017/2018. CONCLUSIONS Despite the increasing service availability over the past 13 years, persistent geographical disparities in the availability of CHVS remain. As of 2017/2018, only one in three oldest-old in China reported having service availability, which raises concerns regarding continuity of care across different settings of services for those most in need, especially those living alone or with disabilities. National policies and targeting efforts are necessary to improve the availability of CHVS and reduce inequity in service availability for optimal long-term care to the oldest-old population in China.
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Affiliation(s)
- Zhong Li
- School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mingsong Xuan
- School of Pharmacy, University of Southern California, Los Angeles, California, USA
| | - Yukuan Gao
- School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ruibo He
- School of Finance and Public Administration, Hubei University of Economics, Wuhan, Hubei, China
| | - Dongfu Qian
- School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Peiyin Hung
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Abjani F, Madhavan P, Chong PP, Chinna K, Rhodes CA, Lim YAL. Urbanisation and its Associated Factors Affecting Human Gut Microbiota: Where are we Heading to? Ann Hum Biol 2023; 50:137-147. [PMID: 36650931 DOI: 10.1080/03014460.2023.2170464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
ContextThe continuous rise in urbanisation and its associated factors have been reflected in the structure of the human gut ecosystem.ObjectiveThe main focus of the review is to discuss and summarise the major risk factors associated with urbanisation that affects human gut microbiota thus affecting human health.MethodsMultiple medical literature databases, namely PubMed, Google, Google Scholar, and Web of Science were used to find relevant materials for urbanization and its major factors affecting human gut microbiota/microbiome. Both layman and Medical Subject Headings (MeSH) terms were used in the search. Due to the scarcity of the data, no limitation was set on the publication date. Relevant material in the English language which includes case reports, chapters of books, journal articles, online news reports and medical records was included in this review.ResultsBased on the data discussed in the review, it is quite clear that urbanisation and its associated factors have long-standing effects on the human gut microbiota that result in alterations of gut microbial diversity and composition. This is a matter of serious concern as chronic inflammatory diseases are on the rise in urbanised societies.ConclusionA better understanding of the factors associated with urbanisation will help us to identify and implement new biological and social approaches to prevent and treat diseases and improve health globally by deepening our understanding of these relationships and increasing studies across urbanisation gradients.HIGHLIGHTSHuman gut microbiota has been linked to almost every important function, including metabolism, intestinal homeostasis, immune system, biosynthesis of vitamins, brain processes, and its behaviour.However, dysbiosis i.e., alteration in the composition and diversity of gut microbiota is associated with the pathogenesis of many chronic conditions.In the 21st century, urbanisation represents a major demographic shift in developed and developing countries.During this period of urbanisation, humans have been exposed to many environmental exposures, all of which have led to the dysbiosis of human gut microbiota.The main focus of the review is to discuss and summarize the major risk factors associated with urbanisation and how it affects the diversity and composition of gut microbiota which ultimately affects human health.
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Affiliation(s)
- Farhat Abjani
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Pei Pei Chong
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University 56100 Cheras, Kuala Lumpur, Malaysia
| | - Charles Anthony Rhodes
- Department of Parasitology, University Malaya Medical Centre, 50603 Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
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Shi S, Chen YC, Yip PSF. Relative deprivation patterns in social and geographical references for health trajectories in China: Investigations of gender and urban-rural disparities. Soc Sci Med 2023; 317:115589. [PMID: 36470055 DOI: 10.1016/j.socscimed.2022.115589] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/20/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVE A pervasive link between relative deprivation and health has been well-documented. However, prior studies suffered from inadequate relative deprivation measures that fail to define appropriate reference groups to which individuals compare themselves, and few provided longitudinal evidence. This study explores latent relative deprivation patterns based on multiple social and geographic reference groups, examining their impacts on health trajectories and variations by gender and urban-rural areas. METHODS Using three waves (2013, 2015, & 2018) of the China Health and Retirement Longitudinal Study (n = 6035), we conducted latent class analysis (LCA) to identify the baseline latent relative deprivation patterns among five social and geographic reference groups (relatives, schoolmates, colleagues, neighbors, and other people in the city or county). The LCA results were linked to the latent growth curve parallel process modeling (PPM) to investigate the impacts of deprivation patterns on dual health trajectories (depressive symptoms and self-rated health), and the results were stratified to explore gender and urban-rural differences. RESULTS The LCA revealed a relatively deprived group (36.39%) and a non-deprived group (63.61%). The PPM results indicated that the relatively deprived group showed a higher initial level of depressive symptoms and a lower initial level of self-rated health than the non-deprived group. However, the relatively deprived group showed a slower growth rate in depressive symptoms than the non-deprived group. These findings were particularly evident among women and rural residents. CONCLUSIONS Findings emphasize the negative impact of relative deprivation on health. Furthermore, there is a complex interplay in these effects intertwined with gender and locality. Policies aimed at promoting mental health should not only consider relatively deprived groups, but also non-deprived women and rural residents who are at higher risk for later-life depression.
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Affiliation(s)
- Songyun Shi
- Department of Social Work and Social Administration, The University of Hong Kong, China
| | - Yu-Chih Chen
- Department of Social Work and Social Administration, The University of Hong Kong, China; Social Policy Institute, Washington University in St. Louis, St. Louis, Missouri, USA.
| | - Paul S F Yip
- Department of Social Work and Social Administration, The University of Hong Kong, China; Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, China
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Galvani-Townsend S, Martinez I, Pandey A. Is life expectancy higher in countries and territories with publicly funded health care? Global analysis of health care access and the social determinants of health. J Glob Health 2022; 12:04091. [PMID: 36370409 PMCID: PMC9653205 DOI: 10.7189/jogh.12.04091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background To better understand factors influencing life expectancy, this paper examines how the availability of publicly funded health care in a country and multiple social determinants of health impact longevity of life. Methods In this descriptive statistical analysis, data regarding publicly funded health care, life expectancy, and social determinants of health were obtained for 196 countries and 4 territories. Social determinants included 10 indicators detailing country-level information to represent 5 key categories: economic stability, education, health & health care, neighbourhood & built environment, and social & community context. Analyses consisted of: 1) comparison of mean life expectancy among countries and territories with- and without- publicly funded health care; 2) correlations in life expectancy across social determinants by health care access and level of burden; and 3) correlations in life expectancy within social determinants for health care access by level of burden. Results Overall, life expectancy in countries and territories with- publicly funded health care (Mean (m) = 76.7 years) was significantly longer compared to countries and territories without- publicly funded health care (m = 66.8 years, P < 0.0001). For each social determinant, we observed longer life expectancy continued to be associated with publicly funded health care access across stratum (P < 0.0001), but difference in years of life expectancy existed both by burden of social determinant, as well as access to health care within quartiles of burden (Publicly funded care (yes): 68.12-80.88 years, (no): 62.39-77.33 years, all P < 0.05). Both social determinants as well as the availability of publicly funded health care were individually and simultaneously associated with mean longevity of life between countries and territories worldwide. Conclusions These findings demonstrate how, if made widely available, publicly funded health care could extend longevity of life. If combined with programs to reduce the burden of social determinants, a substantial impact can be made to promote more equitable distribution of life expectancies across the world. Ultimately, both access to publicly funded care and reducing inequalities in social determinants are needed in order to promote longer and healthier aging in populations worldwide.
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Affiliation(s)
- Sarah Galvani-Townsend
- Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, Connecticut, USA
| | - Isabel Martinez
- Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, Connecticut, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Abhishek Pandey
- Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, Connecticut, USA
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Li Y, Ning Y, Shen B, Shi Y, Song N, Fang Y, Ding X. Temporal trends in prevalence and mortality for chronic kidney disease in China from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019. Clin Kidney J 2022; 16:312-321. [PMID: 36755850 PMCID: PMC9900593 DOI: 10.1093/ckj/sfac218] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Indexed: 11/12/2022] Open
Abstract
Background This study aimed to characterize the temporal trends of chronic kidney disease (CKD) burden in China during 1990-2019, evaluate their age, period and cohort effects, and predict the disease burden for the next 10 years. Methods Data were obtained from the Global Burden of Disease (GBD) 2019 study. Join-point regression model was used to estimate the average annual percentage change (AAPC) of CKD prevalence and mortality, and the age-period-cohort analysis was used to estimate the age, period and cohort effects. We extended the autoregressive integrated moving average (ARIMA) model to predict the disease burden of CKD in 2020-2029. Results In 2019, there were 150.5 million cases of (10.6%) and 196 726 deaths from (13.8 per 100 000 general population) CKD in China. Between 1990 and 2019, the prevalence and mortality rate of CKD increased significantly from 6.7% to 10.6%, and from 8.3/100 000 to 13.8/100 000. The AAPC was estimated as 1.6% and 1.8%, respectively. Females had a higher CKD prevalence of CKD but a lower mortality rate. Setting the mean level of age, period and cohort as reference groups, the risk of developing CKD increased with age [RRage(15-19) = 0.18 to RRage(85-89) = 2.45]. The cohort risk was significantly higher in the early birth cohort [RRcohort(1905-1909) = 1.56]. In contrast, the increase in age-specific CKD mortality rate after 60-64 years was exponential [RRage(60-64) = 1.24]. The cohort-based mortality risk remained high prior to the 1945-1949 birth cohorts (RRcohort ranging from 1.69 to 1.89) and then declined in the 2000-2004 birth cohort [RRcohort(2000-2004) = 0.22]. The CKD prevalence and mortality are projected to rise to 11.7% and 17.1 per 100 000, respectively, by 2029. Conclusions To reduce the disease burden of CKD, a comprehensive strategy that includes risk factors prevention at the primary care level, CKD screening among the elderly and high-risk population, and access to high-quality medical services is required.
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Affiliation(s)
| | | | - Bo Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yiqin Shi
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Nana Song
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,Shanghai Medical Center of Kidney, Shanghai, China,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yi Fang
- Correspondence to: Yi Fang; E-mail:
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Atakro CA. Gerontological nursing in Ghana: Preferences and perceptions of nursing students. GERONTOLOGY & GERIATRICS EDUCATION 2022; 43:482-498. [PMID: 35380940 DOI: 10.1080/02701960.2022.2060419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Undergraduate nursing students in developed countries are reported to have poor perceptions and low preference for gerontological nursing. However, perceptions and preferences of undergraduate nursing students toward gerontological nursing in low-income countries have not been well explored. This study explored the perceptions and preferences of undergraduate nurses in Ghana toward gerontological nursing. A mixed method study design was used to explore Ghanaian undergraduate nursing students' perceptions and preferences for caring for older people. One hundred and seventy-four nursing students were surveyed and 30 of them were interviewed. Quantitative data were analyzed descriptively using SPSS version 27. Content analysis was used to analyze qualitative data to generate themes. Response rate in the study was 73%. The majority of participants (95.4%) were below the age of 29. Gerontological nursing was ranked as the least preferred nursing specialty among graduating undergraduate nurses. Poor perceptions and inadequate knowledge about the care of older people were largely responsible for the lack of preference for gerontological nursing. Improving undergraduate nursing students' knowledge about gerontological nursing is critical in correcting poor perceptions about gerontological nursing.
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14
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You W, Donnelly F. Physician care access plays a significant role in extending global and regional life expectancy. Eur J Intern Med 2022; 103:62-68. [PMID: 35715281 DOI: 10.1016/j.ejim.2022.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous cross-sectional studies generally did not fully consider the potential confounding factors associated with physician impact on overall population health. This ecological study controlled for health, demographic and socioeconomic confounders while using total physician density for predicting overall population health globally and regionally. METHODS Ecological data were extracted from the United Nations agencies for 215 populations. Considering the competing effects of economic affluence, urban advantages and obesity, correlations between physician density and life expectancy at birth (LEB) were analysed with scatter plots, bivariate correlation, partial correlation and multiple linear regression analyses. Countries are also grouped for exploring the regional correlations between physician density and LEB. RESULTS Physician density correlates to LEB and this relationship remains regardless of the competition of the individual confounders, economic affluence, urbanization and obesity, or their combination. Physician density has the greatest influence on LEB, while economic affluence is second. Physician density explains 64.89% of LEB in this study. Together with constant bivariate correlations in country groupings, power correlation without a plateau or U shape in the trendline of the scatterplots, suggests that a shortage of physicians is a worldwide issue. CONCLUSIONS Physician density is a major independent contributor for LEB both globally and with special regard to the developing world. Telehealth may be an alternative to increase physicians' capacity while funding for increasing physician employment is desirable.
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Affiliation(s)
- Wenpeng You
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; Acute and Urgent Care, Royal Adelaide Hospital, Adelaide, Australia.
| | - Frank Donnelly
- Adelaide Nursing School, The University of Adelaide, Australia
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Castruita PA, Piña-Escudero SD, Rentería ME, Yokoyama JS. Genetic, Social, and Lifestyle Drivers of Healthy Aging and Longevity. CURRENT GENETIC MEDICINE REPORTS 2022; 10:25-34. [PMID: 38031561 PMCID: PMC10686287 DOI: 10.1007/s40142-022-00205-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 10/14/2022]
Abstract
Purpose of Review "Healthy aging" is the state of the aging process in which a person can maintain physical, social, mental, and spiritual wellness. This literature review presents an overview of recent studies that explore how biological, social, and environmental factors contribute to healthy aging. Recent Findings A number of genome-wide association studies have been conducted recently for traits related to healthy aging, such as frailty index, healthspan, muscle strength, and parental longevity, leading to the discovery of dozens of genetic variants associated with these traits. In parallel, associations between healthy aging measures and multiple non-biological environmental elements have been identified as key moderators of the aging process, indirectly influencing day-to-day homeostatic processes. Summary Individual variations in lifespan and healthspan are influenced by genetic factors, with a heritability of ~ 25% in developed countries. Non-genetic risk variance is explained in part by social, cultural, and lifestyle conditions. Altogether, these factors contribute to a multifaceted state of wellness over time, shaping individual risk to frailty and resilience during the aging process. Notably, "Blue Zone" populations, which are characterized by an abundance in healthy lifestyles across generations, share some commonalities regarding determinants of health.
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Affiliation(s)
- Patricia Alejandra Castruita
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
- Health Equity Research Lab, San Francisco State University, San Francisco, CA, USA
| | - Stefanie Danielle Piña-Escudero
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Miguel E. Rentería
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
- Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Insitute, Brisbane, QLD, Australia
| | - Jennifer S. Yokoyama
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, Weill Institute of Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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Luo W, Wu M, Chen Y. Laparoscopic versus open surgery for elderly patients with colorectal cancer: a systematic review and meta-analysis of matched studies. ANZ J Surg 2022; 92:2003-2017. [PMID: 35969025 DOI: 10.1111/ans.17972] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND To compare clinical and survival outcomes between laparoscopic versus open surgery in elderly colorectal cancer patients. METHODS PubMed, Embase and Scopus databases were systematically searched. The review included studies that were either randomized controlled trials (RCTs) or observational in design. STATA was used for statistical analysis. RESULTS The meta-analysis was conducted with 24 studies. Compared with elderly subjects with open surgery, those undergoing laparoscopic surgery had a lower risk of mortality (within 3 months postoperatively) (RR 0.70, 95% CI: 0.53, 0.94). The long-term overall survival (HR 0.96, 95% CI: 0.89, 1.04), disease-free survival (HR 1.02, 95% CI: 0.93, 1.13), risk of recurrence (RR 1.44, 95% CI: 0.90, 2.30) and readmission (RR 1.11, 95% CI: 0.88, 1.40) rates were statistically similar in both the groups. The operative time (in minutes) was higher (WMD 30.37, 95% CI: 17.75, 43.0) and the blood loss (in ml) was lower (WMD -78.85, 95% CI: -101.96, -55.75) in those undergoing laparoscopic surgery. The length of hospital stay (in days) (WMD -2.53, 95% CI: -3.11, -1.95) and the time of return of bowel movements (in days) (WMD -1.06, 95% CI: -1.20, -0.93) was lower in those with laparoscopic surgery. The pooled risk of complications was lower in those with laparoscopic surgery (RR 0.66, 95% CI: 0.60, 0.74), compared with open surgery. CONCLUSIONS Findings suggest that in elderly subjects with colorectal cancer, laparoscopic surgery appears to be more beneficial than open surgery and should be prioritized, subject to the availability of required technical skills and facilities.
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Affiliation(s)
- Weimin Luo
- Department of Proctology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mengyuan Wu
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanling Chen
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
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Makmee P, Wongupparaj P. Virtual Reality-based Cognitive Intervention for Enhancing Executive Functions in Community-dwelling Older Adults. INTERVENCION PSICOSOCIAL 2022; 31:133-144. [PMID: 37361011 PMCID: PMC10268555 DOI: 10.5093/pi2022a10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/22/2022] [Indexed: 06/28/2023]
Abstract
With the rapid growth of the older population globally, it is anticipated that age-related cognitive decline in the prodromal phase and more severe pathological decline will increase. Moreover, currently, no effective treatment options for the disease exist. Thus, early and timely prevention actions are promising and prior strategies to preserve cognitive functions by preventing symptomatology from increasing the age-related deterioration of the functions in healthy older adults. This study aims to develop the virtual reality-based cognitive intervention for enhancing executive functions (EFs) and examine the EFs after training with the virtual reality-based cognitive intervention in community-dwelling older adults. Following inclusion/exclusion criteria, 60 community-dwelling older adults aged 60-69 years were involved in the study and randomly divided into passive control and experimental groups. Eight 60 min virtual reality-based cognitive intervention sessions were held twice a week and lasted for 1 month. The EFs (i.e., inhibition, updating, and shifting) of the participants were assessed by using standardized computerized tasks, i.e., Go/NoGo, forward and backward digit span, and Berg's card sorting tasks. Additionally, a repeated-measure ANCOVA and effect sizes were applied to investigate the effects of the developed intervention. The virtual reality-based intervention significantly improved the EFs of older adults in the experimental group. Specifically, the magnitudes of enhancement were observed for inhibitory as indexed by the response time, F(1) = 6.95, p < .05, ηp2 = .11, updating as represented by the memory span, F(1) = 12.09, p < .01, ηp2 = .18, and the response time, F(1) = 4.46, p = .04, ηp2 = .07, and shifting abilities as indexed by the percentage of correct responses, F(1) = 5.30, p = .03, ηp2 = .09, respectively. The results indicated that the simultaneous combined cognitive-motor control as embedded in the virtual-based intervention is safe and effective in enhancing EFs in older adults without cognitive impairment. Nevertheless, further studies are required to investigate the benefits of these enhancements to motor functions and emotional aspects relating to daily living and the well-being of older populations in communities.
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Affiliation(s)
- Pattrawadee Makmee
- Burapha UniversityCollege of Research Methodology and Cognitive ScienceCognitive Science and Innovation Research UnitThailandCognitive Science and Innovation Research Unit, College of Research Methodology and Cognitive Science, Burapha University, Thailand
| | - Peera Wongupparaj
- Burapha UniversityCollege of Research Methodology and Cognitive ScienceCognitive Science and Innovation Research UnitThailandCognitive Science and Innovation Research Unit, College of Research Methodology and Cognitive Science, Burapha University, Thailand
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Mlambo C, Sibanda K, Ntshangase B, Mvuyana B. ICT and Women's Health: An Examination of the Impact of ICT on Maternal Health in SADC States. Healthcare (Basel) 2022; 10:802. [PMID: 35627939 PMCID: PMC9141576 DOI: 10.3390/healthcare10050802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 11/25/2022] Open
Abstract
Attainment of sexual and reproductive health is regarded as a human rights matter. Notwithstanding this, maternal mortality continues to be a major public health concern in low-income countries, especially those in sub-Saharan Africa. Maternal mortality remains high in Africa, yet there are information communication technologies (ICTs) (such as the internet, mobile communication, social media, and community radios) that have the potential to make a difference. Making effective use of all of these ICTs can considerably decrease preventable maternal deaths. ICTs, particularly mobile devices, offer a platform for access to health information and services that can bring change in areas where health infrastructure and resources are often limited. However, for Southern Africa, maternal mortality remains high despite the presence of ICT tools that have transformative potential to improve maternal health. In light of this, this study sought to examine the impact of ICT on maternal health. The study was quantitative in nature, and it used panel data that covered the period from 2000-2018. The Mean Group and Pooled Mean Group cointegration techniques and a generalised method of moments panel technique were used for estimation purposes. Results showed that ICT has a negative effect on maternal health. This shows that ICT tools contribute positively to maternal health. The study gave a number of recommendations. The mobile gender gap should be closed (digital inclusion), mobile network connectivity boosted, and digital platforms must be created in order to enhance the transformative potential of ICT in improving health outcomes.
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Affiliation(s)
- Courage Mlambo
- Public Administration and Economics, Faculty of Management Sciences, Mangosuthu University, Umlazi 4031, South Africa; (B.N.); (B.M.)
| | - Kin Sibanda
- Department of Economics, Faculty of Management Sciences, Walter Sisulu University, Mthatha 5099, South Africa;
| | - Bhekabantu Ntshangase
- Public Administration and Economics, Faculty of Management Sciences, Mangosuthu University, Umlazi 4031, South Africa; (B.N.); (B.M.)
| | - Bongekile Mvuyana
- Public Administration and Economics, Faculty of Management Sciences, Mangosuthu University, Umlazi 4031, South Africa; (B.N.); (B.M.)
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Liu Y, Zhao J, Zhong H. Grandparental care and childhood obesity in China. SSM Popul Health 2022; 17:101003. [PMID: 35005186 PMCID: PMC8715210 DOI: 10.1016/j.ssmph.2021.101003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/06/2021] [Accepted: 12/12/2021] [Indexed: 11/27/2022] Open
Abstract
Ongoing increases in childhood obesity have become a serious public health concern. Meanwhile, caregiving by grandparents becomes a worldwide social phenomenon. This study estimates the effect of grandparental care on childhood obesity and explores its pathways. Utilizing five waves of panel data from the China Family Panel Studies, we found that grandparental care significantly increases the probability of childhood obesity, adding 3.6 percentage points. The effect is heterogeneous between boys and girls and between grandparents with different education attainments. The channels through which grandparents contribute to childhood obesity include inappropriate dietary patterns and insufficient physical activities. Additionally, we found that grandparents' famine experience generates a long-term fear of hunger, which translates into overfeeding their grandchildren, thus aggravating childhood obesity in China. We estimate the longitudinal causal relationship of grandparental care on childhood obesity. Our multiple robustness checks support the positive effect of grandparental care on childhood obesity. Grandparents' famine experience generates a long-term fear of hunger, which aggravates childhood obesity in China.
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Affiliation(s)
- Yue Liu
- China Academy of Public Finance and Public Policy, Central University of Finance and Economics, 39 South College Road, Beijing, 100081, China
| | - Jianmei Zhao
- China Academy of Public Finance and Public Policy, Central University of Finance and Economics, 39 South College Road, Beijing, 100081, China
| | - Hai Zhong
- China Academy of Public Finance and Public Policy, Central University of Finance and Economics, 39 South College Road, Beijing, 100081, China
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Abd-Alrazaq A, Alhuwail D, Al-Jafar E, Ahmed A, Shuweihdi F, Reagu SM, Househ M. The effectiveness of serious games in improving memory among the elderly with cognitive impairment: A systematic review and meta-analysis (Preprint). JMIR Serious Games 2021; 10:e35202. [PMID: 35943792 PMCID: PMC9399845 DOI: 10.2196/35202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/10/2022] [Accepted: 05/13/2022] [Indexed: 12/17/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Dari Alhuwail
- Information Science Department, Kuwait University, Kuwait, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Kuwait, Kuwait
| | | | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Farag Shuweihdi
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
| | | | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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21
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Abd-alrazaq A, Alhuwail D, Al-jafar E, Ahmed A, Reagu SM, Househ M. The effectiveness of serious games in improving memory among elderly people with cognitive impairment: A systematic review and meta-analysis (Preprint).. [DOI: 10.2196/preprints.35202] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Memory, one of the main cognitive functions, is known to decline by age. Serious games have been used for improving memory among the elderly. The effectiveness of serious games in improving memory has been investigated by several systematic reviews; however, they are limited by design and methodological weaknesses.
OBJECTIVE
This study aims to assess the effectiveness of serious games in improving memory among the elderly with cognitive impairment.
METHODS
A systematic review of randomized controlled trials (RCTs) was carried out. The search sources included searching 8 databases, screening reference lists of the included studies and relevant reviews, and checking studies that cited the included studies. Two reviewers independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence appraisal. Extracted data were synthesized using a narrative approach and a statistical approach (i.e., meta-analysis), as appropriate.
RESULTS
Out of 466 citations retrieved, 18 studies met the eligibility criteria of this review. Of those, 15 RCTs were eventually included in 10 meta-analyses. We found that serious games are more effective than no or passive interventions in improving non-verbal memory (P=0.002) and working memory (P=0.02), but not verbal memory (P=0.13). The review also showed that serious games are more effective than conventional exercises in improving verbal memory (P=0.004), but not for non-verbal memory (P=0.12) and working memory (P=0.49). Serious games were as effective as conventional cognitive activities in improving verbal memory (P=0.07), non-verbal memory (P=0.94), and working memory (P=0.08) among the elderly with cognitive impairment. Lastly, the effect of adaptive serious games on working memory was comparable to non-adaptive serious games (P=0.08).
CONCLUSIONS
Serious games have the potential to improve verbal, non-verbal, and working memory among elderly people with cognitive impairment. However, our findings should be interpreted cautiously given that most meta-analyses were based on a few studies (≤3) and judged to have a low quality of evidence. Therefore, serious games should be offered as supplemental to existing proven and safe interventions, rather than a complete substitute until further, more robust evidence is available. Future studies should investigate the short and long-term effects of serious games on memory and other cognitive abilities among people from different age groups with or without cognitive impairment.
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Shively CA, Lacreuse A, Frye BM, Rothwell ES, Moro M. Nonhuman primates at the intersection of aging biology, chronic disease, and health: An introduction to the American Journal of Primatology Special Issue on aging, cognitive decline, and neuropathology in nonhuman primates. Am J Primatol 2021; 83:e23309. [PMID: 34403529 PMCID: PMC8935964 DOI: 10.1002/ajp.23309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/05/2021] [Indexed: 11/06/2022]
Abstract
Aging across the Primate Order is poorly understood because ages of individuals are often unknown, there is a dearth of aged animals available for study, and because aging is best characterized by longitudinal studies which are difficult to carry out in long-lived species. The human population is aging rapidly, and advanced age is a primary risk factor for several chronic diseases and conditions that impact healthspan. As lifespan has increased, diseases and disorders of the central nervous system (CNS) have become more prevalent, and Alzheimer's disease and related dementias have become epidemic. Nonhuman primate (NHP) models are key to understanding the aging primate CNS. This Special Issue presents a review of current knowledge about NHP CNS aging across the Primate Order. Similarities and differences to human aging, and their implications for the validity of NHP models of aging are considered. Topics include aging-related brain structure and function, neuropathologies, cognitive performance, social behavior and social network characteristics, and physical, sensory, and motor function. Challenges to primate CNS aging research are discussed. Together, this collection of articles demonstrates the value of studying aging in a breadth of NHP models to advance our understanding of human and nonhuman primate aging and healthspan.
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Affiliation(s)
- Carol A. Shively
- Department of Pathology/Comparative Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
- Alzheimer’s Disease Research Center, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Agnès Lacreuse
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Brett M. Frye
- Department of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Emily S. Rothwell
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Manuel Moro
- Division of Aging Biology, National Institute on Aging, National Institutes of Health, Maryland, USA
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Shariff Ghazali S, Seman Z, Zainuddin NH, Omar MA, Sooryanarayana R, Ariaratnam S, Mohd Tohit N, Ho BK, Krishnapillai AD, Zainal Abidin SI. Prevalence and factors associated with multimorbidity among older adults in Malaysia: a population-based cross-sectional study. BMJ Open 2021; 11:e052126. [PMID: 34670764 PMCID: PMC8529977 DOI: 10.1136/bmjopen-2021-052126] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To determine the prevalence and factors associated with multimorbidity among community-dwelling older adults in Malaysia. DESIGN A population-based cross-sectional study. SETTING 13 states and 3 Federal Territories in Malaysia. PARTICIPANTS A total of 3966 adults aged 60 years and above were extracted from the nationwide National Health and Morbidity Survey (NHMS) 2018 data set. PRIMARY OUTCOME MEASURES Multimorbidity was defined as co-occurrence of at least two known chronic non-communicable diseases in the same individual. The chronic diseases included hypertension, type 2 diabetes mellitus, dyslipidaemia and cancer. RESULTS The prevalence of multimorbidity among Malaysian older adults was 40.6% (95% CI: 37.9 to 43.3). The factors associated with multimorbidity were those aged 70-79 years (adjusted OR (AOR)=1.30; 95% CI=1.04 to 1.63; p=0.019), of Indian (AOR=1.69; 95% CI=1.14 to 2.52; p=0.010) and Bumiputera Sarawak ethnicities (AOR=1.81; 95% CI=1.14 to 2.89; p=0.013), unemployed (AOR=1.53; 95% CI=1.20 to 1.95; p=0.001), with functional limitation from activities of daily livings (AOR=1.66; 95% CI=1.17 to 2.37; p=0.005), physically inactive (AOR=1.28; 95% CI=1.03 to 1.60; p=0.026), being overweight (AOR=1.62; 95% CI=1.11 to 2.36; p=0.014), obese (AOR=1.88; 95% CI=1.27 to 2.77; p=0.002) and with abdominal obesity (AOR=1.52; 95% CI=1.11 to 2.07; p=0.009). CONCLUSION This study highlighted that multimorbidity was prevalent among older adults in the community. Thus, there is a need for future studies to evaluate preventive strategies to prevent or delay multimorbidity among older adults in order to promote healthy and productive ageing.
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Affiliation(s)
- Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Laboratory of Medical Gerontology, Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nabilah Hanis Zainuddin
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Rajini Sooryanarayana
- Elderly Health Sector, Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Cawangan Selangor, Kampus Selayang, Batu Caves, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Malaysia
| | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Ministry of Health Malaysia, Bandar Botanic, Klang, Malaysia
| | - Ambigga Devi Krishnapillai
- Department of Family Medicine, Faculty of Medicine and Health, National Defense University of Malaysia, Kem Sg. Besi, Malaysia
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Zhao Y, Xu X, Dupre ME, Xie Q, Qiu L, Gu D. Individual-level factors attributable to urban-rural disparity in mortality among older adults in China. BMC Public Health 2020; 20:1472. [PMID: 32993592 PMCID: PMC7526413 DOI: 10.1186/s12889-020-09574-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urban-rural disparity in mortality at older ages is well documented in China. However, surprisingly few studies have systemically investigated factors that contribute to such disparity. This study examined the extent to which individual-level socioeconomic conditions, family/social support, health behaviors, and baseline health status contributed to the urban-rural difference in mortality among older adults in China. METHODS This research used the five waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014, a nationally representative sample of older adults aged 65 years or older in China (n = 28,235). A series of hazard regression models by gender and age group examined the association between urban-rural residence and mortality and how this association was modified by a wide range of individual-level factors. RESULTS Older adults in urban areas had 11% (relative hazard ratio (HR) = 0.89, p < 0.01) lower risks of mortality than their rural counterparts when only demographic factors were taken into account. Further adjustments for family/social support, health behaviors, and health-related factors individually or jointly had a limited influence on the mortality differential between urban and rural older adults (HRs = 0.89-0.92, p < 0.05 to p < 0.01). However, we found no urban-rural difference in mortality (HR = 0.97, p > 0.10) after adjusting for individual socioeconomic factors. Similar results were found in women and men, and among the young-old and the oldest-old populations. CONCLUSIONS The urban-rural disparity in mortality among older adults in China was largely attributable to differences in individual socioeconomic resources (i.e., education, income, and access to healthcare) regardless of gender and age group.
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Affiliation(s)
- Yuan Zhao
- Ginling College & School of Geographic Sciences, Nanjing Normal University, Nanjing, China
| | - Xin Xu
- International Center on Aging and Health & School of Geographic Sciences, Nanjing Normal University, Nanjing, China
| | - Matthew E Dupre
- Department of Population Health Sciences & Department of Sociology, Duke University, Durham, NC, USA
| | - Qianqian Xie
- School of Geographic Sciences, Nanjing Normal University, Nanjing, China
| | - Li Qiu
- Independent Researcher, New York, NY, USA
| | - Danan Gu
- Independent Researcher, New York, NY, USA.
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Have the Chinese Older Adults Received Adequate Healthcare Services since the 2009 Health Reform? Examining the Socioeconomic Disparity in Receiving Adequate Healthcare. Healthcare (Basel) 2020; 8:healthcare8030208. [PMID: 32664263 PMCID: PMC7551592 DOI: 10.3390/healthcare8030208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/25/2020] [Accepted: 07/07/2020] [Indexed: 01/09/2023] Open
Abstract
China launched a comprehensive health reform in 2009, as part of the central government's plan to improve its healthcare system. This study investigates the associations of socioeconomic status with receiving adequate healthcare services among Chinese older adults following the 2009 health reform. Using the 6th and the 7th waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a repeated cross-sectional study design was adopted (n = 9305). Firth's logistic regression models were used for statistical analysis. In the fully adjusted model, being non-married was negatively associated with adequate healthcare services (adjusted odds ratio (AOR) = 0.68, 95% confidence interval (CI): 0.54, 0.86). Higher levels of income were positively associated with adequate healthcare services (all ps < 0.05). Participants who relied on non-urban social insurance plans all had lower odds of receiving adequate healthcare services (all ps < 0.01), compared with older adults who used the urban employment basic medical insurance (UEBMI). However, disparities regarding education and urban-rural differences were not observed in the full model. As China is pushing for further reforms, vulnerable population groups, such as non-married or more impoverished older adults, should be assisted in receiving adequate healthcare services.
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