Regional and Gender Differences in Years with and without Mobility Limitation in the Older Population of Thailand

The Association of Sociodemographic Variables and Unhealthy Behaviors With Limitations in Activities of Daily Living Among Thai Older Adults: Cross-sectional Study and Projected Trends Over the Next 20 Years

BACKGROUND

Extended life spans have led to an increase in the number of older people and an increase in the prevalence of disability among people older than 60 years of age.

OBJECTIVE

This study aims to investigate the association of sociodemographic variables and unhealthy behaviors with limitations in activities of daily living (ADL) among Thai older adults. The study also projects the number of older individuals likely to experience ADL limitations in the next 20 years.

METHODS

We performed sex-specific multinomial logistic regression analysis based on the 5th Thai National Health Examination Survey in 2014 to investigate the association between sociodemographic variables and health behaviors with ADL limitations among Thai older adults. Age- and sex-specific prevalence estimates of ADL limitations were obtained by applying the same models. These estimates were combined with population projections up to 2040 from the Office of the National Economic and Social Development Board, Thailand, to generate projections of older individuals with ADL limitations.

RESULTS

Age and physical activity were significant factors for both sexes, with age positively associated with the level of ADL limitations and low physical activity associated with an increased relative probability of mild or moderate to severe ADL limitations compared to individuals with no ADL limitation (1.2-2.2 times). Other variables such as education, marital status, diabetes, hypertension, smoking, alcohol consumption, and having a fruit- and vegetable-based diet showed significant associations, but the results varied regarding sex and levels of ADL limitations. This study also projected the number of older adults with mild and moderate to severe ADL limitations over the next 20 years from 2020 to 2040, revealing an increase of 3.2 and 3.1 times, respectively, along with a significant increase in men compared to that in women.

CONCLUSIONS

This study identified age and physical activity as significant factors associated with ADL limitations in older adults, while other factors showed varying associations. Over the next 2 decades, projections suggest a significant increase in the number of older adults with ADL limitations, particularly men. Our findings emphasize the importance of interventions to reduce ADL limitations, and health care providers should consider various factors impacting them.

Disparity between knowledge and practice regarding COVID-19 in Thailand: A cross-sectional study of older adults

The efficacy of the public health measures to mitigate COVID-19 is influenced by health literacy which includes the level of knowledge about the disease and the preventive behaviours adopted by individuals. Thailand, being a low- and middle-income country with an ageing society, has to consider both the challenges that its health system has in disseminating information and the disparities in health literacy among its older population. This study investigated the knowledge and behaviour of older adults in Thailand regarding COVID-19 using the Impact of COVID-19 on Older Persons in Thailand, a cross-sectional survey. The data was primarily collected online and included 1,230 adults aged at least 60 years from nine provinces of the five regions of the country. The associated factors with the health literacy outcomes were tested using bivariate logistic regression analyses. It was observed that 43% of the older adults in the sample had proper knowledge of the disease and 33% adopted preventive behaviours. Knowledge about the disease was not associated with preventive behaviour. The associated factors common between the increased levels of knowledge and adoption of behaviours were rural area residence and higher educational attainment levels. Obtaining information from the internet was observed to increase knowledge while having the television and radio as sources of information had negative relationship. Many older adults continued to be employed during the lockdown period and this was associated with decreased adoption of preventive behaviour. The context of vulnerable populations, particularly older adults, is different with regard to their access to information and concern about income. Health information has to be tailored for targeted populations. Their needs also have to be addressed as they have increased risks because of financial and health susceptibilities.

Self-determination and Physical Functioning as Mediators of the Association between Self-reported Sensory Impairments and Happiness among Older Adults

Introduction: The prevalence of vision and hearing impairments increases through age. This development is individually associated with physical functioning difficulties, self-determination issues, and lower levels of happiness. Method: This study examined how self-reported sensory impairments relate to happiness with physical autonomy and social engagement as mediators using structural equation modelling. Using the nationally representative 2017 Survey of Older Persons in Thailand, the analytic sample size was 34,195 with an age range of 60-103 years and a mean age of 69.6 years. Results: A negative association between subjective vision impairment and happiness was observed through the mediation of limitations in physical functioning and community activity. Subjective hearing impairment was observed to lack association with happiness taking into account all the mediating factors. Conclusion: The care needs of older adults in Thailand where the ageing of the population progresses could then differ depending on their health and well-being status.

Extent of aging across education and income subgroups in Thailand: Application of a characteristic-based age approach

Aim

This study aimed to identify differences in physical performance across various socioeconomic groups within an older population and to convert those differences into a common metric to facilitate comparisons of aging speed across socioeconomic subgroups.

Methods

We employed data from the 2009 National Health Examination Survey of Thailand. Physical performance was assessed using three health characteristics: grip strength, as a measure of upper body strength; walking speed, as a measure of lower body strength; and a combined measure of grip strength and walking speed, to capture the strength of the whole body. Education level and income were used to distinguish socioeconomic subpopulations. We followed a characteristic-based age approach to transform these population characteristics, which were measured in different units, into a common and comparable aging metric, referred to as α − age.

Results

Physical aging trajectories varied by sex and socioeconomic status. Some education, particularly secondary or higher education levels, was significantly associated with greater physical strength in older age for both men and women, whereas higher income was significantly associated with physical strength only for men. Across the three health characteristics, having a primary education slowed age-related declines by up to 6.3 years among men and 2.8 years among women, whereas being in a higher income group slowed age-related declines by 8.2 years among men and up to 4.9 years among women.

Conclusions

This study adds new evidence from a developing Asian country regarding the difference in aging speeds across subpopulations associated with different levels of education and income.

Current and Future Burden of Prostate Cancer in Songkhla, Thailand: Analysis of Incidence and Mortality Trends From 1990 to 2030

PURPOSE

Prostate cancer is the second most common malignancy among men worldwide, and it poses a significant public health burden that has traditionally been limited mostly to developed countries. However, the burden of the disease is expected to increase, affecting developing countries, including Thailand. We undertook an analysis to investigate current and future trends of prostate cancer in the province of Songkhla, Thailand, using data from the Songkhla Cancer Registry from 1990 to 2013.

METHODS

Joinpoint regression analysis was used to examine trends in age-adjusted incidence and mortality rates of prostate cancer and provide estimated annual percent change (EAPC) with 95% CIs. Age-period-cohort (APC) models were used to assess the effect of age, calendar year, and birth cohort on incidence and mortality rates. Three different methods (Joinpoint, Nordpred, and APC) were used to project trends from 2013 to 2030.

RESULTS

Eight hundred fifty-five cases of prostate cancer were diagnosed from 1990 to 2013 in Songkhla, Thailand. The incidence rates of prostate cancer significantly increased since 1990 at an EAPC of 4.8% (95% CI, 3.6% to 5.9%). Similarly, mortality rates increased at an EAPC of 5.3% (95% CI, 3.4% to 7.2%). The APC models suggest that birth cohort is the most important factor driving the increased incidence and mortality rates of prostate cancer. Future incidence and mortality of prostate cancer are projected to continue to increase, doubling the rates observed in 2013 by 2030.

CONCLUSION

It is critical to allocate resources to provide care for the men who will be affected by this increase in prostate cancer incidence in Songkhla, Thailand, and to design context-appropriate interventions to prevent its increasing burden.

Gender, nutritional status and disability-free life expectancy among older people in Santiago, Chile

Background

This study was aimed to estimate life expectancy (LE), disability-free life expectancy (DFLE) and disabled life expectancy (DLE) among older adults from Santiago, Chile, and to determine the existence of differences by gender and by body mass index (BMI) categories in these indicators.

Methods

A sample of 1216 people aged 60 or more, from the Chilean cohort of the Study of Health, Ageing and Well-Being was recruited in 2000; two follow-up assessments were carried out in a 10-year period. Functional limitation was assessed through self-report of difficulties in activities of daily living, instrumental activities of daily living and mobility. BMI was determined with measured weight and height. Multistate life tables were employed to estimate LE and healthy life expectancy (HLE).

Results

At 60 years, women could expect to live on average an additional 20.4 years (95% CI 19.0–21.6), and men an additional 16.4 years (95% CI 14.9–17.7). Total LE was longer among women at all ages, but they had a higher proportion of disabled years to be lived compared to men, with a difference of 14% at 60 years, and 10% at 90 years. There were no significant differences in LE, DFLE and DLE between BMI categories.

Discussion

Despite a longer LE, Chilean older women expect to live a higher proportion of years with disabilities, compared to men. Public health programs should address factors affecting LE of older men, and those associated with disability among older women.