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Orellano-Colón EM, Fernández-Torres A, Figueroa-Alvira N, Ortiz-Vélez B, Rivera-Rivera NL, Torres-Ferrer GA, Martín-Payo R. Empowering Potential of the My Assistive Technology Guide: Exploring Experiences and User Perspectives. DISABILITIES (BASEL, SWITZERLAND) 2024; 4:303-320. [PMID: 38962656 PMCID: PMC11221796 DOI: 10.3390/disabilities4020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
The use of assistive technology (AT) devices enhances older adults' function in daily activities. However, the lack of awareness of AT among potential AT users has been identified as a major barrier to its adoption. This study aimed to assess the quality of the Mi Guía de Asistencia Tecnológica (MGAT) web app, which provides information on AT, from the perspective of older Latinos with physical disabilities, and to explore their experience using the MGAT. We employed a convergent parallel mixed-method design involving 12 older Latinos living in Puerto Rico. In Phase I, the researchers trained the participants in the use of the MGAT. In Phase II, participants were encouraged to use it for 30 days. In Phase III, the participants completed the User Mobile Application Rating Scale and individual interviews, analyzed with descriptive statistics and a directed thematic content analysis. The quality of the MGAT was rated high in both the objective (mean = 3.99; SD = 0.7) and subjective (mean = 4.13; SD = 1.1) domains. Qualitative data revealed the MGAT was accessible, usable, desirable, credible, useful, and valuable to increasing older Latinos' AT knowledge, function, and autonomy. The MGAT has the potential to increase AT awareness and adoption among older adults.
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Affiliation(s)
- Elsa M. Orellano-Colón
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan 00936-5067, Puerto Rico
| | - Angelis Fernández-Torres
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan 00936-5067, Puerto Rico
| | - Nixmarie Figueroa-Alvira
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan 00936-5067, Puerto Rico
| | - Bernice Ortiz-Vélez
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan 00936-5067, Puerto Rico
| | - Nina L. Rivera-Rivera
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan 00936-5067, Puerto Rico
| | - Gabriela A. Torres-Ferrer
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan 00936-5067, Puerto Rico
| | - Rubén Martín-Payo
- Faculty of Medicine and Health Sciences, University of Oviedo, Calle de Valentín Andrés Alvarez, 33006 Oviedo, Spain
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Irshad C, Govil D, Sahoo H. Social frailty among older adults in India: Findings from the Longitudinal Ageing Study in India (LASI) - Wave 1. Exp Aging Res 2024; 50:331-347. [PMID: 36974668 DOI: 10.1080/0361073x.2023.2195291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 02/23/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND From an individual's perspective, social frailty may act as a key determinant of social capital, which is essential for meeting social needs and improvement of overall wellbeing. The present study aimed to understand the social frailty and its determining factors among Indian older adults. METHODS Data from the Longitudinal Ageing Study in India (LASI)-wave 1 was used. For the assessment of social frailty the study proposed a multidimensional Social Frailty Index (SFI) score ranging between 0 and 100 using 17 indicators. Bivariate analysis and quantile regression models were applied. RESULTS The study results indicated that on average female older adults (mean SFI = 63.7) are relatively more socially frail than male older adults (mean SFI = 59.0). Further, the quantile regression analysis revealed that at the 10th, 25th, 50th, and 75th percentiles, female older adults were significantly more likely to be socially frail than male older adults (β = 3.80, p < .01; β = 2.82, p < .01; β = 1.72, p < .01; and β = 2.62, p < .01, respectively). Educational attainment and better economic condition showed a protective effect against social frailty. CONCLUSIONS Investment to improve geriatric health status and socioeconomic conditions shall be a key focus to reduce social frailty prevalence among the older adults. A specific consideration is needed for addressing social frailty among female older adults.
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Affiliation(s)
- Cv Irshad
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
| | - Dipti Govil
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Harihar Sahoo
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Mobasseri K, Matlabi H, Allahverdipour H, Kousha A. Home-based supportive and health care services based on functional ability in older adults in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:124. [PMID: 38784273 PMCID: PMC11114482 DOI: 10.4103/jehp.jehp_422_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/22/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Home-based care is affordable due to population aging, increased chronic disease, and higher hospitalization costs. The objective was to evaluate home-based supportive and health care services provided to older adults and identify possible associations between activities of daily living (ADLs), instrumental ADL (IADLs) classifications, sociodemographic variables, clinical characteristics, and perceived social support among older adults. MATERIALS AND METHODS In this cross-sectional study, 700 people aged 60 years and older were selected by stratified cluster sampling. Areas of Tabriz City were selected as clusters, and 55 comprehensive urban health centers were selected as stratifies. Chi-square, Pearson's and Spearman's tests, and multiple linear regression were used for statistical analyses. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS 24.0, SPSS Inc., Chicago, USA). The study instrument included demographic characteristics of older adults and caregivers, health services provided at home, and two valid questionnaires, including the KATZ index of independence in (instrumental) activities of daily living and a multidimensional scale of perceived social support. Scores on scales and demographic variables were collected during telephone interviews. The study lasted from April 25, 2022, to October 30, 2022. RESULTS A high level of perceived social support was 56.6%. The study found that 51.3% of participants had family caregivers. Most participants had ADL independence (85.4%), while 22.9% and 24.3% were dependent and needed assistance with IADL, respectively. Women had a lower ADL score and a higher IADL score than men (P < 0.05). The obtained results of multiple regression analysis revealed a negative and significant association between unemployment, illiteracy, increasing age, five and more medications, and ADL and IADL dependency (P < 0.05). CONCLUSION Empowering older adults to reduce dependency, and designing a formal home-based care system is recommended.
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Affiliation(s)
- Khorshid Mobasseri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Matlabi
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Kousha
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Ai F, Li E, Dong A, Zhang H. Association between disability and cognitive function in older Chinese people: a moderated mediation of social relationships and depressive symptoms. Front Public Health 2024; 12:1354877. [PMID: 38689766 PMCID: PMC11058663 DOI: 10.3389/fpubh.2024.1354877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
Objective Many previous studies have found that disability leads to cognitive impairment, and in order to better understand the underlying mechanisms between disability and cognitive impairment, the present study aimed to investigate the moderating role of social relationships, including their role as mediators between disability and cognitive impairment in depressive symptoms. Study design This is a cross-sectional study. Methods A total of 5,699 Chinese older adults from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS) were included in this study, and PROCESS macro was used to perform simple mediator and moderator mediator analyses, which were used to analyze the relationship between depressive symptoms and social relationships between disability and cognitive impairment. Results The results of this study showed significant correlations between disability, cognitive impairment, depressive symptoms, and social relationships, and that depressive symptoms mediated the relationship between disability and cognitive functioning [B = -0.232; 95% CI: (-0.304, -0.164)], and that social relationships mediated disability and cognitive functioning through pathway a (Disability-Depressive Symptoms) [B = 0.190; 95% CI: (0.020, 0.036)], path b (depressive symptoms-cognitive impairment) [B = 0.029; 95% CI: (0.015, 0.042)], and path c' (incapacitation-cognitive impairment) [B = 0.492; 95% CI: (0.298, 0.685)] to modulate the effect of incapacitation on cognitive impairment. In addition, social activities and social networks moderated the mediation model directly or indirectly, whereas social support moderated only the direct effect. Conclusion This study explains the intrinsic link between incapacitation and cognitive impairment in Chinese older adults, and that social relationships and depressive symptoms can directly or indirectly modulate the effects between them. This provides a basis for healthcare professionals to be able to better develop interventions that can be used to improve the level of cognitive functioning and mental health of older adults.
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Affiliation(s)
| | | | | | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
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Xu Q, Lin Y, He Y, Zhou X, Liu J, Shen D, Wu F, Lin X, Zhang Y, Li T, Yan T. Predictive models for perceived convenience of accessing outdoor activities among elderly with physical disabilities in rural China. BMC Public Health 2024; 24:776. [PMID: 38475781 DOI: 10.1186/s12889-024-18311-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 03/08/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The elderly, especially those with physical disabilities, often encounter barriers that prevent them from accessing outdoor activities. Their perceptions of the convenience of accessing outdoor activities may be influenced by various factors including their health, the social context, and/or planned behavior. This study aimed to develop predictive models that identify the principal determinants of perceived convenience among this demographic, and it also examined the disparities observed between genders. METHODS This was a cross-sectional survey of 1216 community-dwelling older people with physical disabilities in rural China. Grounded on the rehabilitation concepts and the theory of planned behavior, structural equation models integrated health and social behavior factors were constructed to predict perceived convenience of accessing outdoor activities. The standardized coefficients explained the contributions of various factors to the variance. RESULTS The final structural models demonstrated good fit for both female and male participants. Perceptions of the convenience of accessing outdoor activities among both women and men were directly impacted by their physical functioning and their intention to participate, and indirectly by medical expenditure, subjective norms, pain, and role limitation in emotional interactions. Positive mental health was more influential for women, while men were more influenced by subjective norms. CONCLUSIONS Structural equation models have effectively predicted the self-reported convenience of accessing outdoor activities, underscoring the importance of functional and behavioral rehabilitation. Furthermore, gender-sensitive rehabilitation programs are advised to promote engagement in outdoor activities among elderly individuals with physical disabilities.
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Affiliation(s)
- Qi Xu
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Youyi Lin
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Yiqi He
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | | | - Jinhai Liu
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Dewang Shen
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Fan Wu
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Xin Lin
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
- Macau University of Science and Technology, Macao, China
| | - Yun Zhang
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Taibiao Li
- The Fifth Hospital of Xiamen, 361101, Xiamen, China.
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120, Guangzhou, China.
- The Engineering Technology Research Center of Rehabilitation and Elderly Care of Guangdong Province, 510120, Guangzhou, China.
- Renowned Physician Tiebin Yan Office, XiaMen, China.
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de Oliveira Grigorini AE, Pereira LSM, Koes B, da Silva SLA, Chiarotto A, Felício DC, Leopoldino AAO. Does the intensity of pain and disability affect health-related quality of life of older adults with back pain? Multilevel analysis between Brazil and Netherlands: a cross-sectional study of the BACE consortium. BMC Geriatr 2024; 24:230. [PMID: 38443807 PMCID: PMC10916242 DOI: 10.1186/s12877-024-04803-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/12/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The prognosis of back pain (BP) in the older adults is less favorable than in younger adults and progress to adverse outcomes and consequent worsening of health-related quality of life (HRQoL). The present study aimed to verify the association between BP intensity, disability and HRQoL in older adults residents in Brazil and Netherlands, and to evaluate whether the country of residence influences the associations. METHODS Data were collected from 602 Brazilian and 675 Dutch participants with a new episode of BP from the Back Complaints in Elders (BACE) consortium. For the present study, a cross section was used. Pain intensity and disability were assessed using the Numerical Rating Scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ), respectively. HRQoL was assessed using the Short Form Health Survey (SF-36) quality of life questionnaire. Age, sex, and education were descriptive variables. Pain intensity (NPS score) and country were the independent variables and quality of life assessed by each SF domain - 36 was the dependent variable. Analysis of models at the individual level was performed to verify the association between pain and disability, also HRQoL in Netherlands and Brazil in the total sample. The multilevel model was used to verify whether the older adults person's country of residence influenced this relationship. RESULTS The average age of the participants was 67.00 (7.33) years. In the total sample, linear regression analysis adjusted for sex and age showed a significant association between BP intensity scores and HRQoL, for all domains. There was no association between disability and HRQoL. In the multilevel analysis, there was an association between BP intensity and HRQoL in all domains and an association between the country of residence and HRQoL, influencing the effect of pain, in all domains, except for the physical functioning. CONCLUSION Socioeconomic and cultural aspects of different countries can affect the perception of the elderly about their HRQoL in the presence of BP. Pain and disability in Brazilian and Dutch older adults ones are experienced differently in relation to their HRQoL.
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Affiliation(s)
- Adriana Estela de Oliveira Grigorini
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, 275 Alameda Ezequiel Dias, 30130-110, Belo Horizonte, Minas Gerais, Brazil
| | - Leani Souza Máximo Pereira
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, 275 Alameda Ezequiel Dias, 30130-110, Belo Horizonte, Minas Gerais, Brazil
- Department of Physical Therapy, Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bart Koes
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Diogo Carvalho Felício
- Department of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Amanda Aparecida Oliveira Leopoldino
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, 275 Alameda Ezequiel Dias, 30130-110, Belo Horizonte, Minas Gerais, Brazil.
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Kumari R, Gupta RK, Shalli, Bahl R, Langer B. Assessment of Dependency in Activities of Daily Living (ADL) and its Predictors: A Cross-Sectional Study among the Elderly Rural Population in a Sub-Himalayan UT of India. Indian J Community Med 2024; 49:398-403. [PMID: 38665471 PMCID: PMC11042144 DOI: 10.4103/ijcm.ijcm_1001_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 11/09/2023] [Indexed: 04/28/2024] Open
Abstract
Background With an increase in life expectancy over the last few decades, there has been a parallel increase in the prevalence of disabilities among the elderly population. To estimate the prevalence of dependency in activities of daily living (ADL) and its predictors among the rural elderly population. Material and Methods This was a cross-sectional study carried out in the community among the rural geriatric population in the field practice area of PG Department of Community Medicine, Government Medical College Jammu. The Barthel Scale Index was used to measure ADL dependency. PSPP software was used to analyze the data. Results The mean age of study participants was 68.31 ± 7.9 years. ADL dependency was observed in 46.3% of the subjects, with the majority demonstrating mild to moderate dependence. Only 2.5% of the respondents reported a severe degree of ADL dependence. The mean ADL score was 94.47 ± 8.98. On multivariate logistic regression analysis, age, educational status, the presence of stress in the family, personal history, and the presence of co-morbidities emerged to be independent predictors of ADL dependence. Conclusion High prevalence of physical disability in the geriatric population is now an area of major concern. This emphasizes the significance of setting up geriatric care centers especially in rural areas preferably integrating with health and wellness centers.
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Affiliation(s)
| | | | - Shalli
- Department of Community Medicine, AIIMS Jammu, Jammu and Kashmir, India
| | - Rakesh Bahl
- Department of Community Medicine, GMC Jammu, India
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Arioz U, Smrke U, Plohl N, Špes T, Musil B, Mlakar I. Scoping Review of Technological Solutions for Community Dwelling Older Adults and Implications for Instrumental Activities of Daily Living. Aging Dis 2024:AD.2024.0215. [PMID: 38421834 DOI: 10.14336/ad.2024.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
Aging in place is not without its challenges, with physical, psychological, social, and economic burdens on caregivers and seniors. To address these challenges and promote active aging, technological advancements offer a range of digital tools, applications, and devices, enabling community dwelling older adults to live independently and safely. Despite these opportunities, the acceptance of technology among the older adults remains low, often due to a mismatch between technology development and the actual needs and goals of seniors. The aim of this review is to identify recent technological solutions that monitor the health and well-being of aging adults, particularly within the context of instrumental activities of daily living (IADL). A scoping review identified 52 studies that meet specific inclusion criteria. The outcomes were classified based on social connectedness, autonomy, mental health, physical health, and safety. Our review revealed that a predominant majority (82%) of the studies were observational in design and primarily focused on health-related IADLs (59%) and communication-related IADLs (31%). Additionally, the study highlighted the crucial role of involving older adults in study design processes, with only 8 out of the 52 studies incorporating this approach. Our review also established the interview method as the most favoured technology evaluation tool for older adults' studies. The metrics of 'usability' and 'acceptance' emerged as the most frequently employed measures for technology assessment. This study contributes to the existing literature by shedding light on the implications of technological solutions for community dwelling older adults, emphasizing the types of technologies employed and their evaluation results.
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Affiliation(s)
- Umut Arioz
- The University of Maribor, Faculty of Electrical Engineering and Computer Science, Maribor, Slovenia
| | - Urška Smrke
- The University of Maribor, Faculty of Electrical Engineering and Computer Science, Maribor, Slovenia
| | - Nejc Plohl
- The University of Maribor, Faculty of Arts, Department of Psychology, Maribor, Slovenia
| | - Tanja Špes
- The University of Maribor, Faculty of Arts, Department of Psychology, Maribor, Slovenia
| | - Bojan Musil
- The University of Maribor, Faculty of Arts, Department of Psychology, Maribor, Slovenia
| | - Izidor Mlakar
- The University of Maribor, Faculty of Electrical Engineering and Computer Science, Maribor, Slovenia
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Giannios G, Mpaltadoros L, Alepopoulos V, Grammatikopoulou M, Stavropoulos TG, Nikolopoulos S, Lazarou I, Tsolaki M, Kompatsiaris I. A Semantic Framework to Detect Problems in Activities of Daily Living Monitored through Smart Home Sensors. SENSORS (BASEL, SWITZERLAND) 2024; 24:1107. [PMID: 38400265 PMCID: PMC10892043 DOI: 10.3390/s24041107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Activities of daily living (ADLs) are fundamental routine tasks that the majority of physically and mentally healthy people can independently execute. In this paper, we present a semantic framework for detecting problems in ADLs execution, monitored through smart home sensors. In the context of this work, we conducted a pilot study, gathering raw data from various sensors and devices installed in a smart home environment. The proposed framework combines multiple Semantic Web technologies (i.e., ontology, RDF, triplestore) to handle and transform these raw data into meaningful representations, forming a knowledge graph. Subsequently, SPARQL queries are used to define and construct explicit rules to detect problematic behaviors in ADL execution, a procedure that leads to generating new implicit knowledge. Finally, all available results are visualized in a clinician dashboard. The proposed framework can monitor the deterioration of ADLs performance for people across the dementia spectrum by offering a comprehensive way for clinicians to describe problematic behaviors in the everyday life of an individual.
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Affiliation(s)
- Giorgos Giannios
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Lampros Mpaltadoros
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Vasilis Alepopoulos
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Margarita Grammatikopoulou
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Thanos G. Stavropoulos
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Spiros Nikolopoulos
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Ioulietta Lazarou
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Magda Tsolaki
- Department of Neurology I, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Buildings A & B, 57001 Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
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Lim ST, Kwak HB, Kang JH, Chang E, Joa KL, Park HJ, Park DH. Effects of physical activity participation on cognitive impairment in older adults population with disabilities. Front Public Health 2024; 12:1293023. [PMID: 38327569 PMCID: PMC10847270 DOI: 10.3389/fpubh.2024.1293023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Background Existing research on the association between cognitive function and physical activity in the older adults population with disabilities is limited. Additionally, there is a need to explore avenues for enhancing the longevity and quality of life among these individuals. Objective This study aimed to investigate the independent and joint associations between cognitive function and levels of physical activity in the older adults population with disabilities. Methods A total of 315 older adults adults (men = 182, women = 133), identified with disabilities based on medical evaluation, were recruited from the first survey of the Korean Longitudinal Study of Aging (KLoSA). Participants underwent assessments for cognitive function, physical activity (PA), activities of daily living (ADLs), instrumental activities of daily living (IADLs), and grip strength. Results ADLs (p < 0.001) and IADLs (p < 0.001) scores were significantly higher in the male normal cognitive group compared to both the male and female cognitive impairment groups. In an unadjusted model, disabled older adults individuals who did not meet the recommended PA guidelines showed an increased odds ratio for cognitive dysfunction (OR = 2.29, 95% CI = 1.32-3.97). Those participating in PA at least 1 day per week also demonstrated an elevated odds ratio (OR = 1.22, 95% CI = 1.08-1.38) for cognitive dysfunction compared to those who engaged in regular PA. A negative correlation was observed between K-MMSE scores and grip strength (r = 0.448, p < 0.001). Conclusion This study provides robust evidence that disabled older adults individuals who do not meet the recommended guidelines for PA or who do not participate in PA at least once a week have an increased likelihood of cognitive impairment compared to those who are regularly active.
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Affiliation(s)
- Seung-Taek Lim
- College of General Education, Kookmin University, Seoul, Republic of Korea
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
| | - Hyo-Bum Kwak
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, Republic of Korea
| | - Ju-Hee Kang
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, Republic of Korea
- Department of Pharmacology and Research Center for Controlling Intercellular Communication, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Eunwook Chang
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
| | - Kyung-Lim Joa
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Physical and Rehabilitation Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Hee-Jung Park
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, Republic of Korea
| | - Dong-Ho Park
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, Republic of Korea
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Liu L, Zheng Y, Tian J, Li L, Ruan H, Jia S, Zhang X, Ye R, Zuo X, Chen X, He S. Disparities in overall survival by varying duration of disability in activities of daily living in older people: A population-based cohort from Chinese Longitudinal Healthy Longevity Survey (CLHLS). J Nutr Health Aging 2024; 28:100022. [PMID: 38267151 DOI: 10.1016/j.jnha.2023.100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/12/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To investigate the association between duration of disability in activity of daily living (ADL) and overall survival in older individuals. DESIGN A prospective cohort study. SETTING Community-based data from Chinese Longitudinal Healthy Longevity Survey. PARTICIPANTS In total, 13,560 participants without ADL disability and 2772 participants with ADL disability at baseline were included. MEASUREMENTS ADL disability was assessed using Katz index scale, which included six essential ADLs: dressing, bathing, transferring, toileting, continence, and eating. Dependence of each item was scored on a scale of 1, the maximum total score was 6. At baseline, duration of ADL disability was defined as the maximum duration among the six items. The study outcome was overall survival. Accelerated failure time models were constructed to investigate the association between duration of ADL disability and overall survival. Subgroup analyses by sex, age, and multimorbidites, as well as sensitive analyses were conducted. RESULTS During 81,868.7 person-years follow-up, 11,092 deaths were recorded. Overall, ADL disability was associated with lower overall survival compared to non-ADL disability. With duration of ADL disability extending, the overall survival strikingly dropped in the first 12 months, reaching its lowest point with adjusted time ratio (TR) at 0.66 (95%CI: 0.61-0.72, p < 0.001), then moderately grew until the 60th month, finally stayed constant thereafter. Participants with ADL scores of 1-3 had higher survival compared to those with scores of 4-6, and both groups followed a similar trend of varied survival to the whole cohort. Moreover, subgroup analyses and sensitivity analyses showed the robustness of these findings. CONCLUSIONS Our findings first address a golden time window for the older individuals with ADL disability. More attention should be given to them, especially in the first 12 months since diagnosis, to reduce mortality and extend the lifespan.
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Affiliation(s)
- Lu Liu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Zheng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiawei Tian
- School of Public Health, Wuhan University, Wuhan, China
| | - Liying Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Haiyan Ruan
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China; Department of Cardiology, Hospital of Traditional Chinese Medicine, Shuangliu District, Chengdu, China
| | - Shanshan Jia
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Runyu Ye
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xianghao Zuo
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
| | - Sen He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
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Li M, Yao L, Lu Z, Yang L, Fan H. Preliminary MRS study of critical values of relevant brain metabolites in elderly Chinese patients with post-stroke cognitive impairment. IBRO Neurosci Rep 2023; 15:287-292. [PMID: 37885832 PMCID: PMC10598682 DOI: 10.1016/j.ibneur.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/18/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023] Open
Abstract
Objective Proton magnetic resonance spectroscopy (1H-MRS) was applied in this study to detect metabolite changes in the brain of post-stroke cognitive impairment (PSCI) and normal volunteers. The levels of N-acetylaspartate (NAA) and creatinine (Cr) and in the frontal lobe, hippocampus and cingulate gyrus were measured to distinguish patients with post-stroke cognitive impairment (PSCI) and normal control group (NC). The relationship between them and cognitive function was explored and a critical value of the metabolite ratio was predicted. This study may serve as a reference for the diagnosis of cognitive dysfunction after stroke. Methods A total of 46 patients with PSCI (PSCI group, all patients are unilateral cerebral infarction or intracerebral haemorrhage) were screened by the Mini-Mental Status Examination (MMSE), and 35 healthy volunteers were selected as normal control group (NC group). The general information of gender, age, and education level was matched between the two groups. Two groups of subjects were examined using MRS and evaluated for cognitive function using the MMSE test and the Montreal Cognitive Assessment Scale (MoCA). The correlation between MRS and neurobehavioral scale (MMSE test and MoCA scale) was analysed, and the possible demarcation points of the brain metabolism of PSCI were evaluated. Result The MMSE and MoCA scores of patients with PSCI were lower significantly when compared with those of the NC group (P < 0.05). The NAA/Cr values of the bilateral hippocampus, bilateral frontal lobe and bilateral anterior and posterior cingulate gyrus in the PSCI group were lower than those in the NC group (P < 0.05). The NAA/Cr cut-off value for the right frontal lobe was 1.533, and the NAA/Cr sensitivity, specificity and Youden index for the right frontal lobe were 0.943, 0.935, and 0.878. Conclusion NAA/Cr values in the MRS bilateral frontal, bilateral hippocampus and bilateral anterior and posterior cingulate gyrus were reduced in the cognitively impaired post-stroke patients compared to the normal control group. MRS was also found to be correlated with the score of neurobehavioral scale (MMSE test and MoCA scale) and the combination of the two could evaluate cognitive dysfunction more comprehensively and objectively. NAA/Cr value of the right frontal lobe < 1.533 indicated that PSCI may occur. In accordance with this cut-off point, PSCI could be detected as early as possible and timely intervention could be carried out.
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Affiliation(s)
- MengQi Li
- School of Medicine, Shaoxing University, Shaoxing, Zhejiang, PR China
| | - LingLing Yao
- Department of Rehabilitation, Shaoxing People’s Hospital (The First Affiliated Hospital of Shaoxing University), Shaoxing, Zhejiang, PR China
| | - ZengXin Lu
- Department of Radiology, Shaoxing People’s Hospital (The First Affiliated Hospital of Shaoxing University), Shaoxing, Zhejiang, PR China
| | - LiMing Yang
- Department of Radiology, Shaoxing People’s Hospital (The First Affiliated Hospital of Shaoxing University), Shaoxing, Zhejiang, PR China
| | - Hong Fan
- Department of Geriatrics, Shaoxing People’s Hospital (The First Affiliated Hospital of Shaoxing University), Shaoxing, Zhejiang, PR China
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13
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Han Y, Wang S. Disability risk prediction model based on machine learning among Chinese healthy older adults: results from the China Health and Retirement Longitudinal Study. Front Public Health 2023; 11:1271595. [PMID: 38026309 PMCID: PMC10665855 DOI: 10.3389/fpubh.2023.1271595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background Predicting disability risk in healthy older adults in China is essential for timely preventive interventions, improving their quality of life, and providing scientific evidence for disability prevention. Therefore, developing a machine learning model capable of evaluating disability risk based on longitudinal research data is crucial. Methods We conducted a prospective cohort study of 2,175 older adults enrolled in the China Health and Retirement Longitudinal Study (CHARLS) between 2015 and 2018 to develop and validate this prediction model. Several machine learning algorithms (logistic regression, k-nearest neighbors, naive Bayes, multilayer perceptron, random forest, and XGBoost) were used to assess the 3-year risk of developing disability. The optimal cutoff points and adjustment parameters are explored in the training set, the prediction accuracy of the models is compared in the testing set, and the best-performing models are further interpreted. Results During a 3-year follow-up period, a total of 505 (23.22%) healthy older adult individuals developed disabilities. Among the 43 features examined, the LASSO regression identified 11 features as significant for model establishment. When comparing six different machine learning models on the testing set, the XGBoost model demonstrated the best performance across various evaluation metrics, including the highest area under the ROC curve (0.803), accuracy (0.757), sensitivity (0.790), and F1 score (0.789), while its specificity was 0.712. The decision curve analysis (DCA) indicated showed that XGBoost had the highest net benefit in most of the threshold ranges. Based on the importance of features determined by SHAP (model interpretation method), the top five important features were identified as right-hand grip strength, depressive symptoms, marital status, respiratory function, and age. Moreover, the SHAP summary plot was used to illustrate the positive or negative effects attributed to the features influenced by XGBoost. The SHAP dependence plot explained how individual features affected the output of the predictive model. Conclusion Machine learning-based prediction models can accurately evaluate the likelihood of disability in healthy older adults over a period of 3 years. A combination of XGBoost and SHAP can provide clear explanations for personalized risk prediction and offer a more intuitive understanding of the effect of key features in the model.
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Affiliation(s)
| | - Shaobing Wang
- School of Public Health, Hubei University of Medicine, Shiyan, Hubei, China
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14
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Wang LY, Feng M, Hu XY, Tang ML. Association of daily health behavior and activity of daily living in older adults in China. Sci Rep 2023; 13:19484. [PMID: 37945611 PMCID: PMC10636023 DOI: 10.1038/s41598-023-44898-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/13/2023] [Indexed: 11/12/2023] Open
Abstract
This study aims to describe the activity of daily living (ADL) situation and determine the relationship between health behavior and ADL among older adults in China. A cross-sectional, observational study was conducted in one urban community and one rural community in Chengdu (a city located in Southwest China), China, from October 2022 to March 2023. A total of 706 older adults were included in this study. The associations between health behaviour and ADL were assessed by logistic regression model. Of the 706 older adults, 169 (23.9%) were disabled in ADL. According to the logistic regression analysis, age (60-69 years old: OR = 0.015, 95% CI 0.007 to 0.035, P < 0.001; 70-79 years old: OR = 0.116, 95% CI 0.060 to 0.227, P < 0.001), resident(OR = 0.568, 95% CI 0.330 to 0.976, P = 0.041), chronic disease (0 type: OR = 0.023, 95% CI 0.001 to 0.379, P = 0.008; 1-4 types: OR = 0.357, 95% CI 0.219 to 0.582, P < 0.001), no exercise (OR = 4.562, 95% CI 2.263 to 8.026, P < 0.001), and physical examination (OR = 2.217, 95% CI 1.294 to 3.496, P = 0.003) were significantly associated with ADL among older adults in Southwest China. This study showed that older adults had a higher ADL disability ratio. Age, resident, chronic disease, exercise and physical examination were associated with ADL among older adults. The study indicates that medium/high exercise maybe a protective factor for older adults, and nursing staff can encourage older adults to exercise when carrying out primary prevention measures. The government and public health institutions should give special attention to older adults and help them to acquire the habit of having an annual physical examination.
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Affiliation(s)
- Ling-Ying Wang
- West China Hospital Critical Care Medicine Department, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Mei Feng
- West China Hospital Critical Care Medicine Department, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Xiu-Ying Hu
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
| | - Meng-Lin Tang
- West China Hospital Critical Care Medicine Department, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
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15
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Irshad CV, Lekha PPS, Azeez EPA, Rajan SI. Active and productive ageing in India: evidence from the time use pattern of ageing adults. BMC Geriatr 2023; 23:718. [PMID: 37932680 PMCID: PMC10626682 DOI: 10.1186/s12877-023-04428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/25/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND With the increasing proportion of older adults in India, it becomes essential to get an insight into the various influencing factors of successful ageing. However, the literature on successful ageing is minuscule in the Indian context. The present study attempted to understand successful ageing in terms of active and productive ageing by exploring their determining factors. METHODS The data were extracted from the Longitudinal Ageing Study in India (LASI) Wave-1 (2017-2018). We utilized self-reported time use information from the experimental module of the LASI. A total of 7837 ageing adults were included in the study. We employed descriptive statistics, bivariate analysis and a multinominal logistic regression model to examine the prevalence and the determinants of active and productive ageing. RESULTS The prevalence of inactive ageing was higher among the Indian ageing population (57.47%), followed by active ageing (29.59%) and productive ageing (12.94%). Poor sleep quality and the prevalence of morbidity and disability limited the ageing population from attaining active and productive ageing. Engagement in physical activity was significantly associated with active and productive ageing (β = 0.83, 99% CI: -0.72-0.94 and β = 0.82, 99% CI: 0.66-0.98), respectively. Rural ageing adults were more likely to attain active ageing and less likely to attain productive ageing. CONCLUSION Engagement in physical activities among the ageing population shall be promoted to attain active and productive ageing. Since the rural ageing population were less likely to attain productive ageing than their urban counterparts, opportunities to participate in more formal economic activities in rural areas could be promoted for the wellbeing of the second demographic dividend.
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Affiliation(s)
- C V Irshad
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
- The International Institute of Migration and Development, Thiruvananthapuram, Kerala, 695011, India
| | - P Padma Sri Lekha
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - E P Abdul Azeez
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
| | - S Irudaya Rajan
- The International Institute of Migration and Development, Thiruvananthapuram, Kerala, 695011, India
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Chen X, Xiao X, Huang X, Wang R, Yang J, Yang L, Wang Y, Zhou C. Empowerment and quality of life: the mediating role of self-efficacy and health literacy among spousal caregivers in China. Health Promot Int 2023; 38:daad133. [PMID: 37874985 DOI: 10.1093/heapro/daad133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
The aim of this study was to explore the chain mediation model of self-efficacy and health literacy between empowerment and quality of life among spousal caregivers of disabled elderly based on 'Marriage Binding'. From December 2020 to June 2022, the cross-sectional study was conducted in hospitals and communities, in Guangdong, Fujian, Sichuan, Hunan, Jiangxi, Guangxi and Yunnan provinces, China. Descriptive statistics were used to describe the demographic data and four main variables, including empowerment, self-efficacy, health literacy and quality of life. Spearman correlation analysis was used to analyze the correlation between the four main research variables. Multiple Linear Regression and bootstrap analysis were used to analyze the direct and indirect effects among them. Any two variables of spousal caregivers were correlated among empowerment, self-efficacy, health literacy and quality of life. Self-efficacy and health literacy can separately and sequentially mediate the relationship between empowerment and quality of life. To improve the quality of life of spousal caregivers of disabled elderly, the mediating role of self-efficacy, the mediating role of health literacy and the chain mediating role of self-efficacy and health literacy should take effect. In the future, some intervention studies should be taken to enhance the effects of those variables that may be beneficial for improving quality of life of spousal caregivers of disabled elderly.
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Affiliation(s)
- Xuan Chen
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Xiuying Xiao
- Department of Nursing, Zhuhai Fifth People's Hospital, Zhuhai, Guangdong, 519090, PR China
| | - Xiu'e Huang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Run Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Jing Yang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Lingli Yang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Yiling Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Chunlan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
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Sharma S, Hale JM, Myrskylä M, Kulu H. Racial, Ethnic, Nativity, and Educational Disparities in Cognitive Impairment and Activity Limitations in the United States, 1998-2016. Demography 2023; 60:1441-1468. [PMID: 37638648 DOI: 10.1215/00703370-10941414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Despite extensive research on cognitive impairment and limitations in basic activities of daily living, no study has investigated the burden of their co-occurrence (co-impairment). Using the Health and Retirement Study data and incidence-based multistate models, we study the population burden of co-impairment using three key indicators: mean age at onset, lifetime risk, and health expectancy. We examine patterns by gender, race, ethnicity, nativity, education, and their interactions for U.S. residents aged 50-100. Furthermore, we analyze what fractions of racial, ethnic, and nativity disparities in co-impairment are attributable to inequalities in educational attainment. Results reveal that an estimated 56% of women and 41% of men aged 50 will experience co-impairment in their remaining life expectancy. Men experience an earlier onset of co-impairment than women (74 vs. 77 years), and women live longer in co-impairment than men (3.4 vs. 1.9 years). Individuals who are Black, Latinx, and lower educated, especially those experiencing intersecting disadvantages, have substantially higher lifetime risk of co-impairment, earlier co-impairment onset, and longer life in co-impairment than their counterparts. Up to 75% of racial, ethnic, and nativity disparity is attributable to inequality in educational attainment. This study provides novel insights into the burden of co-impairment and offers evidence of dramatic disparities in the older U.S. population.
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Affiliation(s)
- Shubhankar Sharma
- Max Planck Institute for Demographic Research, Rostock, Germany
- University of St Andrews, St Andrews, Scotland
- University of Helsinki, Helsinki, Finland
- Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland, and Rostock, Germany
| | - Jo Mhairi Hale
- University of St Andrews, St Andrews, Scotland
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany
- University of Helsinki, Helsinki, Finland
- Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland, and Rostock, Germany
| | - Hill Kulu
- University of St Andrews, St Andrews, Scotland
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da Costa Pereira JP, Diniz ADS, de Lemos MCC, Pinho Ramiro CPS, Cabral PC. Frailty but not low muscle quality nor sarcopenia is independently associated with mortality among previously hospitalized older adults: A prospective study. Geriatr Gerontol Int 2023; 23:736-743. [PMID: 37691481 DOI: 10.1111/ggi.14660] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023]
Abstract
AIM There are few studies comparing the effects of geriatric syndromes and abnormalities in nutritional status and body composition on outcomes among older individuals who have been previously hospitalized. Our study aimed to evaluate the frequency and diagnosis of geriatric syndromes, low muscle quality, and nutritional status in hospitalized older individuals, and to examine their impact on both short- and long-term outcomes. METHODS This was a prospective study involving older adults (≥60 years). We assessed nutritional status, muscle quality, sarcopenia, and frailty. The outcomes were functional dependence, length of hospital stay, transfer to the Intensive Care Unit, number of readmissions, and mortality. Multivariate analysis was conducted to identify independent risk factors. RESULTS Even after adjustment for age and sex, increased risk of death was associated with possible undernourishment, sarcopenia, low muscle quality, and frailty (P < 0.05), but not the length of hospital stay (P > 0.05). Our multivariate analysis showed that frailty was independently associated with mortality and functional dependence. Low muscle quality was independently associated with functional dependence. CONCLUSIONS Geriatric syndromes, abnormalities in body composition, and the overall nutritional status of older patients are important risk factors for adverse outcomes, including functional dependence and mortality. These findings emphasize the need for interventions to improve muscle quality, prevent and treat malnutrition and sarcopenia, and address frailty in hospitalized patients. Geriatr Gerontol Int 2023; 23: 736-743.
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Huang D, Wang J, Fang H, Fu Y, Lou J. Longitudinal association of chronic diseases with depressive symptoms in middle-aged and older adults in China: Mediation by functional limitations, social interaction, and life satisfaction. J Glob Health 2023; 13:04119. [PMID: 37766663 PMCID: PMC10534192 DOI: 10.7189/jogh.13.04119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
Background Several previous studies have shown that the development of depression is often accompanied by chronic diseases; although closely related, the mechanism between them is not clear. Here we investigate the potential role of functional limitations, social interaction, and life satisfaction in the relationship between chronic diseases and depressive symptoms in middle-aged and older adults in China. Methods We selected 2407 respondents aged ≥45 from the China Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. We established panel data to estimate the longitudinal impact of chronic diseases on depressive symptoms and the mediating role of functional limitations, social interaction, and life satisfaction. Results Chronic diseases were associated with more depressive symptoms. All of the mediating pathways examined passed functional limitations, and approximately 43.4% of the association between chronic diseases and depressive symptoms was explained by these three mediating variables. Conclusions The impact of chronic diseases on depressive symptoms was primarily mediated by functional limitations, and the mediating role of social interaction and life satisfaction was also confirmed. Therefore, attention should be paid to reducing the level of functional limitation in middle-aged and older adults with chronic diseases and improving life satisfaction by increasing social opportunities to alleviate depressive symptoms in middle-aged and older adults.
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Affiliation(s)
- Derong Huang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Huiling Fang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yingjie Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jiaxu Lou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
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Confer C, Castellanos DC, Beerse M, Gonter-Dray R. Parental perceptions of nutritional intake, cooking skills, and food skills among preschoolers. Nutr Health 2023:2601060231200517. [PMID: 37715658 DOI: 10.1177/02601060231200517] [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: 09/18/2023]
Abstract
Objective: To determine parents' perceptions of cooking skills, food skills, and nutritional status of children ages 3 to 5 years. Methods: Parents of preschoolers aged 3 to 5 years completed two questionnaires, a Nutri-STEP questionnaire, assessing nutritional status, and a cooking exposure questionnaire. This parent recall questionnaire assessed cooking skills and food skills children possessed. Results: Willingness to try a new vegetable, parental confidence of child's cooking skills, total food skills possessed, and the covariates of gender, age, and ethnicity significantly predicted child dietary quality grouping p = 0.04. Conclusions and Implications: Trying new vegetables was a significant predictor of dietary behavior, with children more likely to try new vegetables demonstrating better dietary behavior (odds ratio= .43, p = 0.03). Trends showed that children with more cooking skills had better diets. Empirical data are needed through experimental designs to examine the integration of cooking skills in the home on child dietary behaviors and long-term cooking development.
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Affiliation(s)
- Cara Confer
- Department of Health and Sport Science, University of Dayton, Dayton, OH, USA
| | | | - Matthew Beerse
- Department of Health and Sport Science, University of Dayton, Dayton, OH, USA
| | - Rebecca Gonter-Dray
- Department of Health and Sport Science, University of Dayton, Dayton, OH, USA
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Chen J, Gan L, Tuersun Y, Xiong M, Sun J, Zhang C, Li H. Social Participation: A Strategy to Manage Depression in Disabled Populations. J Aging Soc Policy 2023:1-17. [PMID: 37699113 DOI: 10.1080/08959420.2023.2255492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/05/2022] [Indexed: 09/14/2023]
Abstract
This study aimed to investigate whether social participation (SP) can decrease depressive symptom severity in disabled older adults. A total of 5,937 disabled participants (4877, 1970, 219, and 8 participants responding 1, 2, 3, 4 times, respectively), obtained from the China Health and Retirement Longitudinal Study, were enrolled in our analysis. Based on pooled Ordinary Least Square regressions, SP was associated with decreased depressive symptom severity, and this association was significant in recreational activities and interacting with friends. For brain-disabled respondents, the association was not significant. SP is effective in decreasing depressive symptom severity in disabled older populations. Diversified activities and targeted interventions should be applied to specified older disabled populations to prevent depression.
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Affiliation(s)
- Jiangyun Chen
- School of Health Management of Southern Medical University, Guangzhou, Guangdong, China
- ACACIA Labs of SMU Institute for Global Health (SIGH) and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, Guangdong, China
- Institute for Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Li Gan
- School of Health Management of Southern Medical University, Guangzhou, Guangdong, China
- Institute for Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yusupujiang Tuersun
- School of Health Management of Southern Medical University, Guangzhou, Guangdong, China
- Institute for Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Man Xiong
- School of Health Management of Southern Medical University, Guangzhou, Guangdong, China
- Institute for Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Ju Sun
- School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China
| | - Chichen Zhang
- School of Health Management of Southern Medical University, Guangzhou, Guangdong, China
- Institute for Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Haomiao Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China
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22
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Mobasseri K, Kousha A, Allahverdipour H, Matlabi H. Developing a comprehensive model of home-based formal care for elderly adults in Iran: A study protocol. PLoS One 2023; 18:e0284462. [PMID: 37552674 PMCID: PMC10409284 DOI: 10.1371/journal.pone.0284462] [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: 12/07/2022] [Accepted: 04/01/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Due to the increasing Iran's aging population, designing a home care model is necessary. However, the data on designing the home care model for elderly adults among developing countries are limited. This study will be carried out to develop a formal home-based care model for elderly adults in Iran. METHODS This multi-method study will include three phases: First, Mixed-methods sequential explanatory study including two steps: One, survey to determine the prevalence of dependence on formal and informal caregivers among people aged ≥ 60 years living in Tabriz metropolis; and two, content analysis approach includes face-to-face, semi-structured interviews with the older adults receiving formal care at home, their caregivers and relevant key informants on the characteristics of care and caregiver, challenges and expectations of standard care. In phase 2, a scoping review will be used to find out the components of home care in other countries, such as care provider organization, caregivers training, and financing. PubMed, Scopus, Web of Science, EMBASE, Google scholar databases and grey literature will be run to retrieve relevant evidence using proper MeSH terms. In phase3, the triangulation method (using the results of the previous phases, reviewing national upstream documents and the focus group discussion) will be done to reach consensus and design the initial model for the Iranian context. In the following, a Delphi study will be conducted on the validation and feasibility of the developed model. DISCUSSION The current health infrastructure in Iran is focused on caring for younger people, despite the near future population aging. Most studies have addressed the challenges of geriatric care, but no study has addressed the various dimensions of home care in Iran and how to provide this service to elderly adults. Providing a comprehensive model of home care for the elderly can improve the quality of life and satisfaction of the elderly and their caregivers.
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Affiliation(s)
- Khorshid Mobasseri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Kousha
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Matlabi
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Integrative Medicine in Aging, Tabriz University of Medical Sciences, Tabriz, Iran
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Marroig A. Transitions across states with and without difficulties in performing activities of daily living and death: a longitudinal comparison of ten European countries. Eur J Ageing 2023; 20:18. [PMID: 37202643 DOI: 10.1007/s10433-023-00763-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
Ageing has been related to the onset of disability and dependency in older adults. There is a need to better understand the disability and dependency trajectories of older adults and their relationship with socio-demographic characteristics and institutional or cultural context. This study analyses the role of age, sex, education and self-perceived health in disability, dependency and death transitions, addressing the heterogeneity across European countries and inconsistencies when using different measures of disability. Multi-state models were adjusted to evaluate the role of risk and protective factors in the transitions to disability, dependency and death. Difficulties in performing activities of daily living (ADLs) assess disability and dependency states. Data were from the Survey of Health, Ageing and Retirement in Europe conducted in 2004-2013, considering individuals aged 65 and older at baseline from Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden and Switzerland. The results showed that transitions to disability and dependency varied with age, sex, education and self-perceived health. The probability of transition to disability and dependency states increases until the age of 70 for all countries. However, there was heterogeneity in the disability and dependency trajectories with ageing between men and women. In most countries, women live with difficulties and may need help for longer than men. Care policies should consider sex differences to decrease the burden of care of informal caregivers, particularly in countries where care systems are absent or partially developed and a high level of family obligations to care needs exist.
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Affiliation(s)
- Alejandra Marroig
- Instituto de Estadística, Universidad de la República, Montevideo, Uruguay.
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24
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Echagüe de Mendez G, Sosa de Sforza L, Funes P, Díaz RV, Ferrero M, Cardozo O, Florentín M, Orué E, Franco R. Estado de salud y nutrición del adulto mayor que concurre al Hospital Geriátrico del Seguro Social en la Asunción. Paraguay. INVESTIGACIÓN CLÍNICA 2023. [DOI: 10.54817/ic.v64n1a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
The increase in the population of older adults and their more significant demand for health care in Paraguay requires a multidimensional evaluation to identify risks or deteriorating conditions. The objective of this research was to evaluate the health and nutrition status of a sample of older adults who attended the Geriatric Hospital of the Social Security for outpa-tient consultation. The research had a cross-sectional descriptive observational design, which included 108 older adults who underwent the Comprehensive Geriatric Assessment (CGA) and whose nutritional parameters were evaluated. Their average age was 71 years, with a predominance of females. According to their BMI, 64% were overweight or obese. As for the CGA, 18% presented a nutritional risk, 43% had mild dependence on activities of daily living and 12% on instrumental activities, 18% had a cognitive deficit, 6% had depression, and 30% had social risk. The population was characterized by a high prevalence of overweight and hypertension and a low frequency of risk of malnutrition. The most significant limitations were in the basic activities of daily life and social risk. Being female and being overweight were significantly associated with ba-sic functional limitations. This work was one of the first in the country on am-bulatory older adults, allowing the establishment of a baseline for areas where health is compromised or at risk of decline and the development of preventive strategies and actions to promote healthy aging.
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Affiliation(s)
- Gloria Echagüe de Mendez
- Universidad Nacional de Asunción- Instituto de Investigaciones en Ciencias de la Salud (UNA-IICS). San Lorenzo, Paraguay
| | - Liliana Sosa de Sforza
- Universidad Nacional de Asunción- Instituto de Investigaciones en Ciencias de la Salud (UNA-IICS). San Lorenzo, Paraguay
| | - Patricia Funes
- Universidad Nacional de Asunción- Instituto de Investigaciones en Ciencias de la Salud (UNA-IICS). San Lorenzo, Paraguay
| | - Ramona Valentina Díaz
- Universidad Nacional de Asunción- Instituto de Investigaciones en Ciencias de la Salud (UNA-IICS). San Lorenzo, Paraguay
| | - Margarita Ferrero
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| | - Osvaldo Cardozo
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| | - Marilina Florentín
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| | - Estela Orué
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| | - Rosa Franco
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
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25
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Muñoz-López S, Molina-Garcia P, Gutiérrez-Cruz C, Ubago-Díaz R, Romero-Ayuso D, Ariza-Vega P. The influence of meaningful activities in the quality of life and functional autonomy of adults with intellectual disability: A prospective study during the COVID-19 pandemic. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:538-546. [PMID: 36754365 DOI: 10.1111/jar.13077] [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: 02/18/2022] [Revised: 10/03/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic might negatively impact the quality of life and functional autonomy of Spanish adults with intellectual disability, and meaningful activities could prevent this negative progression. METHODS This is a prospective cohort study in Spanish adults with intellectual disability during the COVID-19 pandemic. Quality of life, functional autonomy and functional independence were measured. The meaningful activities studied were structured-leisure, community self-management, and occupational and physical activities. RESULTS Seventy-three participants were included in the study. Quality of life and functional autonomy significantly deteriorated during the COVID-19 pandemic (all p > .001). Greater participation in community self-management activities before COVID-19 was associated with less detriment to quality of life (ß = -.312; p = .008), while greater participation in occupational and physical activities was associated with less detriment to the performance of instrumental activities (ß = -.317; p = .016; and ß = -.285; p = .030, respectively). CONCLUSION People with intellectual disability living in residential homes experienced a decrease in their quality of life and functional autonomy during the COVID-19 pandemic. Their involvement in community self-management activities and physical and occupational activities before the pandemic had preventive effects on the detriment to the quality of life and functional autonomy.
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Affiliation(s)
| | - Pablo Molina-Garcia
- Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | | | | | - Dulce Romero-Ayuso
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain.,Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain.,PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
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26
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Corrêa LCDAC, Gomes CDS, da Camara SMA, Barbosa JFDS, Azevedo IG, Vafaei A, Guerra RO. Gender-Specific Associations between Late-Life Disability and Socioeconomic Status: Findings from the International Mobility and Aging Study (IMIAS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2789. [PMID: 36833484 PMCID: PMC9956095 DOI: 10.3390/ijerph20042789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Disability is a dynamic process and can be influenced by a sociocultural environment. This study aimed to determine whether the associations between socioeconomic status and late-life disability differ by gender in a multi-sociocultural sample from different countries. A cross-sectional study was developed with 1362 older adults from The International Mobility in Aging Study. Late-life disability was measured through the disability component of the Late-Life Function Disability Instrument. Level of education, income sufficiency and lifelong occupation were used as indicators of SES. The results indicated that a low education level β = -3.11 [95% CI -4.70; -1.53] and manual occupation β = -1.79 [95% -3.40; -0.18] were associated with frequency decrease for men, while insufficient income β = -3.55 [95% CI -5.57; -1.52] and manual occupation β = -2.25 [95% CI -3.89; -0.61] played a negative role in frequency for women. For both men β = -2.39 [95% -4.68; -0.10] and women β = -3.39 [95% -5.77; -1.02], insufficient income was the only factor associated with greater perceived limitation during life tasks. This study suggested that men and women had different late-life disability experiences. For men, occupation and education were associated with a decrease in the frequency of participation, while for women this was associated with income and occupation. Income was associated with perceived limitation during daily life tasks for both genders.
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Affiliation(s)
| | | | | | | | - Ingrid Guerra Azevedo
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Catolica de Temuco, Temuco 4813302, Chile
| | - Afshin Vafaei
- School of Health Studies, Western University, London, ON N6A 3K7, Canada
| | - Ricardo Oliveira Guerra
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal 59078-140, Brazil
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Luo J, Liu Q, Gama Z, Gesang D, Zhu Y, Yang L, Bai D, Zhao Q, Xiao M. Factors Influencing Utilization of Assistive Devices by Tibetan Seniors on the Qinghai-Tibet Plateau: Based on Research Strategy of Triangulation. Patient Prefer Adherence 2023; 17:401-411. [PMID: 36815130 PMCID: PMC9939664 DOI: 10.2147/ppa.s400346] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE To investigate the current situation of assistive device (AD) usage among seniors in Tibet, China, and explore its influencing factors. METHODS A mixed-methods design was used. Cognition, attitude, behavior, and preference toward ADs were assessed by a self-designed questionnaire. Additionally, participants responded to the open-ended questions. Anderson's behavior model analyzed the impacts of the prerequisite factors, enabling factors, and demand factors influencing the utilization of ADs by Tibetan seniors. RESULTS Of the 211 Tibetan seniors, 149 (70.6%) Tibetan seniors expressed the willingness to utilize ADs. Binary Logistic regression analysis showed that one prerequisite factor: age; one enabling factor: care situation, and one demand factor: dysfunctional condition were factors influencing the utilization of ADs. Qualitative comments described: psychological, physical environment, and social support factors were the main influencing factors. CONCLUSION This study presents the current situation to utilize ADs by Tibetan seniors on the Qinghai-Tibet Plateau, incorporates Anderson's behavioral model for quantitative analysis, and combines qualitative research to explore the facilitating and hindering factors, to provide reference and basis for the development of ADs for seniors and policy formulation. The sample size of this study is relatively small and limited to ethnic groups, and we plan to increase the sample size and include more ethnic groups in the future study.
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Affiliation(s)
- Jun Luo
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qing Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhujizhaba Gama
- Department of Rehabilitation Medicine, Tibet Autonomous Region People’s Hospital, Tibet, People’s Republic of China
| | - Deji Gesang
- Department of Rehabilitation Medicine, Tibet Autonomous Region People’s Hospital, Tibet, People’s Republic of China
| | - Ying Zhu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lining Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dingqun Bai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Mingzhao Xiao, 1st Youyi Road, Chongqing, 400016, People’s Republic of China, Tel +86 13608399433, Email
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Miranda FB, de Castro JBP, dos Santos AOB, da Silva GCPSM, Nogueira CJ, Guimarães AC, Lima VP, Vale RGDS, Dantas EHM. Effects of resistance training on the functional autonomy of middle-aged and older women: a systematic review and meta-analysis of randomized controlled trials. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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29
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Papanova EK, Vorobyeva NM, Kotovskaya YV, Tkacheva ON, Ovcharova LN, Selezneva EV. Healthy Life Expectancy of People Over Age 65: Results of the Russian Epidemiological Study EVCALIPT. ADVANCES IN GERONTOLOGY 2022. [DOI: 10.1134/s2079057022040130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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30
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He X, Wang X, Zhang M, Zhu W, Liu Y, Sun Q, Chen G, Li M, Ding H. Gender specific cut-off points of age for disability among rural elderly in Anhui Province, China. Front Public Health 2022; 10:945849. [PMID: 36268001 PMCID: PMC9577323 DOI: 10.3389/fpubh.2022.945849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/07/2022] [Indexed: 01/21/2023] Open
Abstract
Objective The purpose of this study was to determine the optimal cut-off values of age for disability in order to predict the risk of disability for older adults in rural areas. Methods WHO Disability Assessment Schedule 2.0 was used to assess disability. The cut-off values of age for disability were obtained by ROC curve analysis. Results The cut-off points of age for cognition restriction, mobility restriction, self-care restriction, getting along with people restriction, life activities restriction, and social participation restriction for men were 70.5, 68.5, 72.5, 70.5, 71.5, and 68.5 years old, respectively. The cut-off points of age for cognition disability, mobility restriction, self-care disability, getting along with people disability, life activities disability, and social participation disability for women were 72.5, 71.5, 70.5, 70.5, 71.5, and 71.5 years old, respectively. Over the cut-off values of age was an independent risk factor for disability (P < 0.05). Conclusion Presenting first disability symptoms were different between men and women. Preventive efforts to prevent future disability should be different for men and women.
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Affiliation(s)
- Xinran He
- School of Health Management, Anhui Medical University, Hefei, China
| | - Xianwen Wang
- School of Public Health and Health Management, Anhui Medical College, Hefei, China
| | - Min Zhang
- School of Health Management, Anhui Medical University, Hefei, China
| | - Weizheng Zhu
- School of Health Management, Anhui Medical University, Hefei, China
| | - Yuyang Liu
- School of Health Management, Anhui Medical University, Hefei, China
| | - Qian Sun
- School of Health Management, Anhui Medical University, Hefei, China
| | - Guimei Chen
- School of Health Management, Anhui Medical University, Hefei, China
| | - Min Li
- School of Health Management, Anhui Medical University, Hefei, China
| | - Hong Ding
- School of Health Management, Anhui Medical University, Hefei, China,*Correspondence: Hong Ding
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Handajani YS, Schröder-Butterfill E, Hogervorst E, Turana Y, Hengky A. Depression among Older Adults in Indonesia: Prevalence, Role of Chronic Conditions and Other Associated Factors. Clin Pract Epidemiol Ment Health 2022; 18:e174501792207010. [PMID: 37274861 PMCID: PMC10156049 DOI: 10.2174/17450179-v18-e2207010] [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: 12/15/2021] [Revised: 03/16/2022] [Accepted: 04/01/2022] [Indexed: 06/07/2023]
Abstract
Background Depression is one of the most common illnesses worldwide, with a prevalence of 5.7% among older adults aged over 60. Depression is a severe health condition that can significantly affect the quality of life. Objective The objective of this study is to investigate the determinant factors of depression among older adults in Indonesia. Methods Data of 4236 adults of 60 years old and over were taken from the fifth wave of the Indonesian Family Life Survey (IFLS-5). Sociodemographic and multiple health-related variables collected through interviews and measurements were analyzed. Multivariate logistic regression was used to evaluate depression and its associated factors. Results The prevalence of depression assessed using ten questions from the Center for Epidemiologic Studies Depression Scale (CES-D 10) was 16.3%. Significant associated factors for depression were moderate and low subjective economic status, living in Java or other regions outside Sumatra and Java, no life satisfaction, self-perceived as having poor health, having dependency (IADL scores), and experienced falls and insomnia. Among chronic conditions, stroke, arthritis, and hearing impairment were also more common in depressed older adults. Conclusion Predictors of depression identified in this study may be used to help prevent and improve depression in Indonesian older adults, especially those who live on Java. Improvement in healthcare, especially in the prevention and rehabilitation of stroke, arthritis, possible frailty (falls and dependency), hearing impairment, and insomnia, concurrent with early detection of depression in these chronic conditions, may help create a better quality of life among Indonesian older adults.
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Affiliation(s)
- Yvonne Suzy Handajani
- School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Eef Hogervorst
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Yuda Turana
- School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Antoninus Hengky
- Center of Health Research, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
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Son YH, Cho MS. Abuse and risk factors among community-dwelling elderly in South Korea during COVID-19. J Elder Abuse Negl 2022; 34:259-279. [PMID: 36000157 DOI: 10.1080/08946566.2022.2114971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Elder abuse is a serious social problem in South Korea. This study aimed to estimate the prevalence and identify risk factors of elder abuse during the coronavirus disease 2019 (COVID-19) pandemic. By using the 2020 Living Profiles of Older People Survey in Seoul Metropolitan City and considering sociodemographic, health-related, social support, and isolation factors as independent variables, a logistic regression model was established. Among 3,106 samples, the overall rate of elder abuse was 8.5%, with emotional abuse being the most frequent. Social isolation (OR = 1.47, p = .018) and recognition of abuse (OR = 0.90, p = .003) were associated with having experienced abuse. Seniors with a greater number of diseases, higher levels of dependency, depressive symptoms, and/or cognitive impairments were more likely to suffer abuse, as were those who smoked or drank alcohol. To prevent elder abuse by social isolation during and after COVID-19, more active health promotion programs and healthy aging policies should be implemented.
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Affiliation(s)
- Yoon Hee Son
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Myong Sun Cho
- Department of Nursing, Gangneung-Wonju National University, Wonju, South Korea
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Ghiotto L, Muollo V, Tatangelo T, Schena F, Rossi AP. Exercise and physical performance in older adults with sarcopenic obesity: A systematic review. Front Endocrinol (Lausanne) 2022; 13:913953. [PMID: 35966077 PMCID: PMC9366852 DOI: 10.3389/fendo.2022.913953] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022] Open
Abstract
Background Sarcopenic obesity is characterized by low muscle mass and high body fat; prevalence increases with age, particularly after age 65 years. For this systematic literature review we searched scientific databases for studies on exercise interventions for improving physical performance in adults with sarcopenic obesity; also, we identified potential gaps in clinical practice guidelines that need to be addressed. Methods We followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases were searched for studies published through November 2021 that measured physical performance in adults with sarcopenic obesity. Results Most of the studies applied a strength training protocol in which improvement was noted post-treatment on the Time Chair Rise (TCR), 30-s Chair Stand, and Single Leg Stance (SLS) tests. Discrepancies between the studies were observed when resistance training was combined with or without elastic bands or electromyostimulation, as measured with the Short Physical Performance Battery (SPPB), Physical Performance Test (PPT), Gait Speed, and Timed Up & Go (TUG) test. Post-intervention SPPB, PPT, and gait speed scores showed an increase or maintenance of performance, while TUG test scores were higher according to one study but lower according to another. Conclusions Engagement in physical exercise, and resistance training in particular, can improve or maintain physical performance in adults with sarcopenic obesity. Study samples should include more men. A future area of focus should be the impact of different types of training (aerobic, power training, combined modalities). Finally, studies with longer intervention periods and follow-up periods are needed to gain a better understanding of the effectiveness of exercise on physical function in adults with sarcopenic obesity.
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Affiliation(s)
- Laura Ghiotto
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | - Toni Tatangelo
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Andrea P. Rossi
- Geriatrics Division, Department of Medicine, Ospedale Cà Foncello ULSS2, Treviso, Italy
- Healthy Aging Center, Department of Medicine, Division of Geriatrics, University of Verona, Verona, Italy
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Zhu Q, Ping P, Zhang P, Ning C, Zhao Y, Yao Y, Li X, Fu S. Sex hormones and physical function among the Chinese oldest-old and centenarian women. J Transl Med 2022; 20:340. [PMID: 35902963 PMCID: PMC9331572 DOI: 10.1186/s12967-022-03539-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/15/2022] [Indexed: 11/29/2022] Open
Abstract
Background Physical independence is crucial for overall health in the elderly individuals. The life expectancy of women has been shown to be higher than that of men, which is also known as the “male–female health-survival paradox”. Sex hormones may be one of the explanations. However, the relationships between sex hormones and physical function remain unclear in the elderly females. This study was designed to explore these relationships among the Chinese oldest-old and centenarian women. Methods Data from 1226 women were obtained from the China Hainan Centenarian Cohort Study. Home interviews, physical examinations and blood analyses were conducted using standardized procedures. Variables including age, Han ethnicity, illiteracy, smoker, drinker, estradiol (E2), testosterone (T), follicle-stimulating hormone, and luteinizing hormone were used in the multivariate logistic and linear regression analyses. Results In all the participants, age [beta (95% confidence interval): − 0.84 (− 0.98, − 0.71)] and E2 levels [beta (95% confidence interval): − 0.22 (− 0.28, − 0.17)] were negatively associated with activities of daily living (ADLs) in the multivariate linear regression analyses (P < 0.05 for all). We also observed significantly negative associations of age [odds ratio (95% confidence interval): 0.90 (0.88, 0.91)] and E2 levels [odds ratio (95% confidence interval): 0.98 (0.98, 0.99)] with physical normality in the multivariate logistic regression analyses (P < 0.05 for all). Age and E2 levels gradually decreased with increases in the ADL quartiles across all the participants (P < 0.05 for all). Conclusions This study demonstrated that E2 levels were negatively associated with physical function among the Chinese oldest-old and centenarian women.
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Affiliation(s)
- Qiao Zhu
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Ping Ping
- Main Station of Drug Instrument Supervision and Inspection, Joint Logistic Support Force of Chinese People's Liberation Army, Beijing, China
| | - Pei Zhang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Chaoxue Ning
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Yao Yao
- Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, USA. .,Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.
| | - Xiubing Li
- Department of Urology Medicine, The Third Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China. .,Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
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Chereches FS, Brehmer Y, Olaru G. Personality and limitations in instrumental activities of daily living in old age: Reciprocal associations across 12 years. EUROPEAN JOURNAL OF PERSONALITY 2022. [DOI: 10.1177/08902070221111856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Personality traits have been reported to predict difficulties in performing instrumental activities of daily living (IADL) in old age, such as preparing meals or shopping. However, little is known about the reciprocal effects on personality. In this study, we examined bidirectional relationships between personality traits and the capacity to perform IADL using four waves of longitudinal data from 3540 older adults (aged 65 years and older) from the Health and Retirement Study. We applied a random-intercept cross-lagged panel model to separate between- and within-person effects across time and compared it to a traditional cross-lagged panel model. At the between-person level, higher neuroticism and lower conscientiousness were associated with more IADL limitations. Within individuals across time, increases in neuroticism and decreases in conscientiousness and extraversion were associated with increases in IADL limitations 4 years later. In contrast, increases in IADL limitations only predicted increases in neuroticism and decreases in extraversion. These results indicate that some personality traits affect and are affected by limitations in functional capacities in old age. Results of the within-person model build a strong foundation for future personality interventions as a pathway to maintain high functioning in old age.
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Affiliation(s)
| | - Yvonne Brehmer
- Developmental Psychology, Tilburg University, Tilburg, Netherlands
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Gabriel Olaru
- Developmental Psychology, Tilburg University, Tilburg, Netherlands
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An Observational Cross-Sectional Study of Gender and Disability as Determinants of Person-Centered Medicine in Botulinum Neurotoxin Treatment of Upper Motoneuron Syndrome. Toxins (Basel) 2022; 14:toxins14040246. [PMID: 35448855 PMCID: PMC9024520 DOI: 10.3390/toxins14040246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
The motor behaviour of patients with Upper Motor Neuron Syndrome (UMNS) is characterised by spasticity. The first-line treatment for this clinical condition is Botulinum neurotoxin A (BoNTA), but the number and key locations of muscles which need to be treated is not much discussed in the literature. Cross-sectional analysis of outpatient cohort with UMNS spasticity, who were potential candidates for BoNTA treatment, was performed. Between November 2020 and November 2021, all consecutive adult patients eligible for BoNTA treatment were enrolled. The inclusion criteria encompass UMNS spasticity (onset being ≥6 months), with disabling muscles hypertonia. Patients underwent a clinical evaluation, a comprehensive assessment with the Modified Ashworth Scale, with the Modified Rankin Scale, and a patients’ perception-centred questionnaire. In total, 68 participants were enrolled in the study, among them 40 (58.8%) were male; mean age 57.9 ± 15.1. In women, BoNTA was more frequently required for adductor group muscles, independently from potential confounders (OR = 7.03, 95%CI: 1.90–25.97). According to the pattern of disability, patients with hemiparesis more frequently need to be treated in the upper limb, whereas the diplegia/double-hemiparesis group needed to be treated more frequently at the adductor and crux muscles compared to their counterparts. UMNS spasticity in women could require more attention to be paid to the treatment of adductor muscle spasticity, potentially because the dysfunction of those muscles could influence sphincteric management, required for perineal hygiene and/or sexual life.
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Fuchs J, Gaertner B, Prütz F. Limitations in activities of daily living and support needs - Analysis of GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2022; 7:6-25. [PMID: 35434501 PMCID: PMC9009067 DOI: 10.25646/9570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022]
Abstract
Being able to perform activities of daily living is an important component of a person's ability to function. If these activities are impaired, support is needed. Using data from GEDA 2019/2020-EHIS, we present how many people aged 55 and older living in private households in Germany experience limitations in activities of daily living. Severe limitations in basic (fundamental) activities (e.g. food intake) are reported by 5.8% of women and 3.7% of men. The proportion increases with age as 13.4% of women and 9.0% of men aged 80 and older experience limitations. Severe limitations of instrumental activities of daily living (e.g. grocery shopping) are rather rare in participants less than 80 years of age. But at age 80 and older the proportion rises to 35.9% of women and 21.0% of men. A total of 68.1% of afflicted women and 57.5% of men receive help and support related to limitations of basic activities. Women are also more likely to report a lack of support (48.8% vs. 43.2%). The situation is slightly better with regard to instrumental activities. The results of GEDA 2019/2020-EHIS show in which areas of daily life older and very old people are impaired, give an impression of who is affected particularly strongly and indicate where support services are insufficient. As such, these results provide clues as to where support can be provided to enable older people to keep living in their own homes for a long time.
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Affiliation(s)
- Judith Fuchs
- Corresponding author Dr Judith Fuchs, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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Nomogram for predicting the 12-year risk of ADL disability among older adults. Aging Clin Exp Res 2022; 34:1583-1591. [PMID: 35301701 DOI: 10.1007/s40520-022-02105-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: 10/13/2021] [Accepted: 02/24/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Previous studies have identified plenty of risk factors for activities of daily living (ADL). However, there are no reliable and widely available prediction models for ADL disability up to now. This study aimed to develop and validate a nomogram for predicting the 12-year risk of ADL disability in older adults. METHODS Data from 4,809 participants in the English Longitudinal Study of Ageing (ELSA) and 18,620 participants in the Survey of Health, Ageing and Retirement in Europe (SHARE) were used as training set and validation set, respectively. We used the least absolute shrinkage and selection operator (LASSO) and Cox regression to screen the predictors and develop the nomogram. The P value, concordance index (C-index), integrated area under the ROC (receiver operating characteristic) curve (AUC) and calibration curves were used to validate the nomogram. RESULTS During 12 years, 30.0% (n = 1,441) participants developed ADL disability in the training set, while the corresponding percentages were 18.5% in the validation set (n = 3,445). After screening, 13 variables were contained in the final prediction model. In ADL nomogram, the C-index and AUC were 0.744 ± 0.013 and 0.793 in internal valid ation, respectively, while in external validation, the C-index and AUC were 0.755 ± 0.009 and 0.796. CONCLUSIONS This study developed and validated a nomogram that predicts functional disability. The application of the predictive model could have important implications for patient prognosis and health care.
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Smrke U, Plohl N, Mlakar I. Aging Adults' Motivation to Use Embodied Conversational Agents in Instrumental Activities of Daily Living: Results of Latent Profile Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042373. [PMID: 35206564 PMCID: PMC8872482 DOI: 10.3390/ijerph19042373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023]
Abstract
The rapidly increasing share of ageing adults in the population drives the need and interest in assistive technology, as it has the potential to support ageing individuals in living independently and safely. However, technological development rarely reflects how needs, preferences, and interests develop in different ways while ageing. It often follows the strategy of “what is possible” rather than “what is needed” and “what preferred”. As part of personalized assistive technology, embodied conversational agents (ECAs) can offer mechanisms to adapt the technological advances with the stakeholders’ expectations. The present study explored the motivation among ageing adults regarding technology use in multiple domains of activities of daily living. Participants responded to the questionnaire on the perceived importance of instrumental activities of daily living and acceptance of the idea of using ECAs to support them. Latent profile analysis revealed four profiles regarding the motivation to use ECAs (i.e., a low motivation profile, two selective motivation profiles with an emphasis on physical and psychological well-being, and a high motivation profile). Profiles were compared in terms of their acceptance of ECA usage in various life domains. The results increase the knowledge needed in the development of assistive technology adapted to the expectations of ageing adults.
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Affiliation(s)
- Urška Smrke
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Koroška Cesta 46, 2000 Maribor, Slovenia;
| | - Nejc Plohl
- Department of Psychology, Faculty of Arts, University of Maribor, Koroška Cesta 160, 2000 Maribor, Slovenia;
| | - Izidor Mlakar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Koroška Cesta 46, 2000 Maribor, Slovenia;
- Correspondence:
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Naughton C, Cummins H, de Foubert M, Barry F, McCullagh R, Wills T, Skelton DA, Dahly D, Palmer B, Murphy A, McHugh S, O'Mahony D, Tedesco S, O Sullivan B. Implementation of the Frailty Care Bundle (FCB) to promote mobilisation, nutrition and cognitive engagement in older people in acute care settings: protocol for an implementation science study. HRB Open Res 2022. [DOI: 10.12688/hrbopenres.13473.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Older people are among the most vulnerable patients in acute care hospitals. The hospitalisation process can result in newly acquired functional or cognitive deficits termed hospital associated decline (HAD). Prioritising fundamental care including mobilisation, nutrition, and cognitive engagement can reduce HAD risk. Aim: The Frailty Care Bundle (FCB) intervention aims to implement and evaluate evidence-based principles on early mobilisation, enhanced nutrition and increased cognitive engagement to prevent functional decline and HAD in older patients. Methods: A hybrid implementation science study will use a pragmatic prospective cohort design with a pre-post mixed methods evaluation to test the effect of the FCB on patient, staff, and health service outcomes. The evaluation will include a description of the implementation process, intervention adaptations, and economic costs analysis. The protocol follows the Standards for Reporting Implementation Studies (StaRI). The intervention design and implementation strategy will utilise the behaviour change theory COM-B (capability, motivation, opportunity) and the Promoting Action on Research Implementation in Health Services (i-PARIHS). A clinical facilitator will use a co-production approach with staff. All patients will receive care as normal, the intervention is delivered at ward level and focuses on nurses and health care assistants (HCA) normative clinical practices. The intervention will be delivered in three hospitals on six wards including rehabilitation, acute trauma, medical and older adult wards. Evaluation: The evaluation will recruit a volunteer sample of 180 patients aged 65 years or older (pre 90; post 90 patients). The primary outcomes are measures of functional status (modified Barthel Index (MBI)) and mobilisation measured as average daily step count using accelerometers. Process data will include ward activity mapping, staff surveys and interviews and an economic cost-impact analysis. Conclusions: This is a complex intervention that involves ward and system level changes and has the potential to improve outcomes for older patients.
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Iwasawa T, Fukui S, Kawakami M, Kawakami T, Kataoka M, Yuasa S, Fukuda K, Fujiwara T, Tsuji T. Factors related to instrumental activities of daily living in persons with chronic thromboembolic pulmonary hypertension. Chron Respir Dis 2021; 18:14799731211046634. [PMID: 34592826 PMCID: PMC8489748 DOI: 10.1177/14799731211046634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Instrumental activities of daily living (IADL) are significantly related to quality of life and mortality among individuals with heart disease. However, few reports have examined IADL in persons with chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to clarify factors related to IADL in persons with CTEPH. This retrospective, observational study enrolled 163 persons with CTEPH (mean ± standard deviation age = 65 ± 13 years; 68% female) admitted to the Department of Cardiology at Keio University Hospital between January 2015 and July 2019. The Frenchay Activities Index (FAI) was used to assess IADL. Age, sex, body mass index, World Health Organization functional class (WHO-FC), cardiac function (mean pulmonary arterial pressure, mean right atrial pressure, pulmonary capillary wedge pressure, and cardiac index), pulmonary function (percentage vital capacity, percentage forced expiratory volume in 1 s, diffusion capacity of carbon monoxide (DLCO)/alveolar volume (VA)), physical function (knee extension strength and walking speed), and 6-min walking distance (6MWD) were assessed. Multiple regression analysis was performed to identify factors significantly associated with FAI. Mean FAI was 25 ± 8. Univariate analysis showed that sex, WHO-FC, DLCO/VA, walking speed, and 6MWD were correlated with FAI. Multiple regression analysis showed that 6MWD (sβ = 0.338, 95% CI 0.014–0.034, p < .001), sex (sβ = 0.268, 95% CI 2.238–7.165, p < .001), and DLCO/VA (sβ = 0.257, 95% CI 1.011–3.528, p < .001) were significantly correlated with FAI (R2 = 0.261). IADL were associated with exercise tolerance, sex, and DLCO/VA in persons with CTEPH. In the future, more details of IADL are expected to be clarified by analyzing individual components of IADL and investigating social background characteristics, including living environment.
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Affiliation(s)
- Tatsuya Iwasawa
- Department of Rehabilitation Medicine, 34787Keio University Hospital, Tokyo, Japan.,Department of Rehabilitation Medicine, 34787Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shogo Fukui
- Department of Rehabilitation Medicine, 34787Keio University Hospital, Tokyo, Japan.,Graduate School of Health Management, Keio University, Tokyo, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kawakami
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Masaharu Kataoka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Shinsuke Yuasa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Toshiyuki Fujiwara
- Department of Rehabilitation Medicine, 34787Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
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Dios-Guerra C, Carmona-Torres JM, Morales-Cané I, Rodríguez-Borrego MA, López-Soto PJ. Evolution in the use of health services by older people in Spain (2009-2017). HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e11-e20. [PMID: 33211360 DOI: 10.1111/hsc.13229] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/26/2020] [Accepted: 10/24/2020] [Indexed: 06/11/2023]
Abstract
As people age, they tend to increase their use of health services. For this, the aims of this study were to analyse the frequency and variability in the use of different health services by people over 65 years, their evolution from 2009 to 2017 and the factors associated it. We carried out a cross-sectional study with 25,465 people over 65 years who participated in the National Health Survey in Spain in 2011/2012 and 2017 and the European Health Survey in Spain in 2009 and 2014. A descriptive analysis was performed using the attendance records of family/general physicians, nurse consultations, or both over the last 12 months as well as these data over the following years of study. Our findings show that approximately 93.2% of the participants had consulted with a family/general physician over the last year, and women were almost twice as likely to do so compared with men (61.2% vs. 38.8%). The use of health services gradually increased from 2009 to 2017, being the visits to nursing that more increased their frequency. Being a woman and a widower as well as having no higher education, a low social class, a serious or long-term illness, obesity and bed restraint were associated with a greater use of health services. Findings suggested that the increased health services due to ageing and comorbidities associated with it present new challenges. It is necessary to determine realistic plans that can meet future healthcare demands and not lead to a collapse of the health system. For this it is very important the primary prevention of chronic diseases, functional limitations, obesity and disability.
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Affiliation(s)
- Caridad Dios-Guerra
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Área de Enfermería, Universidad de Córdoba, Córdoba, Spain
- UGC Occidente. Distrito Sanitario Córdoba y Guadalquivir, Córdoba, Spain
| | - Juan Manuel Carmona-Torres
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha (UCLM), Toledo, Spain
| | - Ignacio Morales-Cané
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Área de Enfermería, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | - María Aurora Rodríguez-Borrego
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Área de Enfermería, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | - Pablo Jesús López-Soto
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Área de Enfermería, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
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Kim J, Angel JL, Rote SM. A Longitudinal Study of Cognitive and Instrumental Activities of Daily Living Disablement Among the Oldest Mexican Americans. J Aging Health 2021; 34:196-205. [PMID: 34388944 DOI: 10.1177/08982643211037512] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
ObjectivesMexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in instrumental activities of daily living (IADL) disability and tertiary outcomes of the IADL disablement for the oldest old (after 80 years old). Methods We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010-2011, 2012-2013, and 2016, N = 1,078) to investigate the longitudinal patterns of IADL decline using latent transition analysis. Results Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. Discussion These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.
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Affiliation(s)
- Jiwon Kim
- The University of Texas at Austin, Austin, TX, USA
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Ansari S, Muhammad T, Dhar M. How Does Multi-Morbidity Relate to Feeling of Loneliness among Older Adults? Evidence from a Population-Based Survey in India. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09343-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Asim M, Aftab M, Bhatti SH, Ahmad T, Ali Shah SM, Akram M. Identifying factors causing decline in physical functionality of geriatric population. EUR J INFLAMM 2021. [DOI: 10.1177/20587392211026109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The objective of the study was to find major correlates of decline in the physical functionality of the geriatric population. The main focus was the evaluation of demographic, social, economic, and health-related factors that have a potential impact on physical functionality. A sample of 423 elderly people were selected from district Faisalabad, Pakistan by using a snowball sampling approach. Statistical analysis was performed using frequency analysis and some tests for association like chi-square, Cramer’s V, and gamma coefficient. It was observed that 42.8% of the respondents were independent in doing their all-routine work and the physical functional status decline was observed partially in 35.2% and completely in 22.0% of the respondents. Using frequency analysis and association measures, age, education, marital status, living with family, having an independent source of income, level of social network and support, having exercise routine were found to be significantly associated with functional status of elders. The study concluded that besides age and other demographic factors that cannot be controlled, the socio-economic factors can be improved to substantially reduce the decline in the physical functionality of the geriatric population.
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Affiliation(s)
- Muhammad Asim
- Department of Statistics, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Muhammad Aftab
- Department of Statistics, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Sajjad Haider Bhatti
- Department of Statistics, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Tanvir Ahmad
- Department of Statistics, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Syed Muhammad Ali Shah
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
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Chan YM, Sahril N, Chan YY, Ab Wahab NA, Shamsuddin N, Ismail MZH. Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126271. [PMID: 34200564 PMCID: PMC8296057 DOI: 10.3390/ijerph18126271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/04/2021] [Accepted: 06/05/2021] [Indexed: 11/16/2022]
Abstract
Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults' level of independence.
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Affiliation(s)
- Yee Mang Chan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
- Correspondence:
| | - Norhafizah Sahril
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
| | - Ying Ying Chan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
| | - Nor’ Ain Ab Wahab
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
| | - Norliza Shamsuddin
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
| | - Muhd Zulfadli Hafiz Ismail
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia;
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Ghimire S, Paudel G, Mistry SK, Parvez M, Rayamajhee B, Paudel P, Tamang MK, Yadav UN. Functional status and its associated factors among community-dwelling older adults in rural Nepal: findings from a cross-sectional study. BMC Geriatr 2021; 21:335. [PMID: 34034657 PMCID: PMC8152303 DOI: 10.1186/s12877-021-02286-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The high burden of chronic conditions, coupled with various physical, mental, and psychosocial changes that accompany the phenomenon of aging, may limit the functional ability of older adults. This study aims to assess the prevalence of poor functional status and investigate factors associated with poor functional status among community-dwelling older adults in rural communities of eastern Nepal. METHODS Data on 794 older adults aged ≥ 60 years from a previous community-based cross-sectional study was used. Participants were recruited from rural municipalities of Morang and Sunsari districts of eastern Nepal using multi-stage cluster sampling. Functional status was assessed in terms of participants' ability to perform activities of daily living using the Barthel Index. Covariates included sociodemographic characteristics, lifestyle factors, and self-reported chronic conditions. A binary logistic regression model was used to investigate factors associated with poor functional status. RESULTS The overall prevalence of poor functional status was 8.3 % (male: 7.0 % and female: 9.6 %), with most dependence noted for using stairs (17.3 %), followed by dressing (21.9 %) on Barthel Index. In the adjusted model, oldest age group (odds ratio [OR] = 2.83, 95 %CI: 1.46, 5.50), those unemployed (OR = 2.41, 95 %CI: 1.26, 4.65), having memory/concentration problems (OR = 2.32, 95 %CI: 1.30, 4.13), depressive symptoms (OR = 2.52, 95 %CI: 1.28, 4.95), and hypertension (OR = 1.78, 95 %CI: 1.03, 3.06) had almost or more than two times poor functioning. CONCLUSIONS One in 12 older adults had poor functional status as indicated by their dependency on the items of the Barthel Index; those in the oldest age bracket were more likely to exhibit poor functional status. We suggest future studies from other geographies of the country to supplement our study from the rural setting for comprehensive identification of the problem, which could guide the development of prevention strategies and comprehensive interventions for addressing the unmet needs of the older adults for improving functional status.
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Affiliation(s)
- Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, 45056, Oxford, OH, USA
| | - Grish Paudel
- Centre for Research Policy and Implementation, Biratnagar, Nepal
| | - Sabuj Kanti Mistry
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Mahmood Parvez
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Binod Rayamajhee
- School of Optometry, University of New South Wales, Sydney, Australia
| | - Pravash Paudel
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Man Kumar Tamang
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Uday Narayan Yadav
- Centre for Research Policy and Implementation, Biratnagar, Nepal. .,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia. .,School of Population Health, University of New South Wales, Sydney, Australia. .,Torrens University, Sydney, Australia.
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Marroig A, Machado M, Muniz-Terrera G. Dependency Change with Aging and Associated Factors in Uruguay: A Cohort Study. J Aging Health 2021; 33:886-895. [PMID: 33966467 DOI: 10.1177/08982643211017726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess the heterogeneity of transitions toward dependency in older adults and to explore the robustness of results to different operationalizations of dependency. METHOD Using data from people aged 60 years and older from a national representative study in Uruguay (Encuesta Longitudinal de Protección Social, N = 5071), we fitted multinomial regressions adjusted by sociodemographic and health characteristics to model transitions into dependency and death. We used a harder operationalization with basic activities of daily living (Katz-dependency) and Comprehensive-dependency with basic, instrumental, and advanced activities. RESULTS Increasing age (RRR = 1.08, CI = [1.05; 1.12], p < .001) and having comorbidities (RRR = 2.16, CI = [1.31; 3.57], p = .003) increased the risk of transition from nondependent to dependent using Katz-dependency. Women with at least two chronic conditions have increased risk of Comprehensive-dependency (RRR = 1.79, CI = [1.15; 2.80], p = .010). DISCUSSION Inconsistencies in findings emerged when evaluating transitions into dependency with the different measures, which may have social care implications.
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Xu X, Zhao C, Wang M, Chen X, Shao S, Du J. Comparison of the caregivers' and community health professionals' views on home health care services for disabled older adults: a cross-sectional study in Beijing, China. BMC Health Serv Res 2021; 21:389. [PMID: 33902564 PMCID: PMC8077684 DOI: 10.1186/s12913-021-06400-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/15/2021] [Indexed: 11/29/2022] Open
Abstract
Background In an era of an increasingly ageing society, part of healthcare for older adults can be provided in patients’ homes, and the need for home health care services (HHCSs) is increasing. This study sought to determine whether a gap exists between the views of community health professionals and the caregivers of disabled older adults towards HHCSs in Beijing, China. Methods A cross-sectional study with two comparative questionnaire surveys was conducted in Beijing, China. One survey was administered to the caregivers of disabled older adults, and the other was administered to health professionals in community health service institutions (CHSIs). T-tests and Wilcoxon signed-rank tests were used to explore potential differences between the views of caregivers and community health professionals towards HHCSs. Results We received 370 valid questionnaires from caregivers and 224 questionnaires from health professionals. Of the 370 caregivers, 314 (84.9%) were willing to apply for HHCSs for the older adults, but only 20.5% (N = 76) received HHCSs. Over 80% of the caregivers accepted out-of-pocket costs less than 100 yuan per visit. Caregivers’ demands on home nursing services were significantly higher than those of health guidance services (Z = − 7.725, P < 0.001). Most of the 224 health professionals chose “health professionals’ personal safety cannot be guaranteed” as a problem limiting the provision of HHCSs (N = 151, 40.8%). The health professionals’ attitudes towards home nursing services were significantly less positive than those towards health guidance services (Z = − 10.081, P < 0.001). For home nursing services, health professionals’ attitude scores were lower than the caregivers’ demand scores (Z = − 4.960, P < 0.001), while for health guidance services, health professionals’ attitude scores were higher than the caregivers’ demand scores (Z = − 8.373, P < 0.001). Conclusions Gaps exist between the views of caregivers and health professionals on HHCSs. Compared to health professionals with a higher willingness to provide health guidance services, caregivers need home nursing services. Feasible policies should be implemented to safeguard the rights and interests of health professionals, and qualified health professionals should be trained for HHCSs. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06400-9.
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Affiliation(s)
- Xiaojingyuan Xu
- School of General Practice and Continuing Education, Capital Medical University, Beijing, 100069, China
| | - Chunyan Zhao
- Community Health Service Center, Beijing University of Posts and Telecommunications, Beijing, 100876, China
| | - Meirong Wang
- School of General Practice and Continuing Education, Capital Medical University, Beijing, 100069, China
| | - Xiaolei Chen
- School of General Practice and Continuing Education, Capital Medical University, Beijing, 100069, China
| | - Shuang Shao
- School of General Practice and Continuing Education, Capital Medical University, Beijing, 100069, China.
| | - Juan Du
- School of General Practice and Continuing Education, Capital Medical University, Beijing, 100069, China.
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Functional difficulties and toileting among older adults in Ghana: evidence from the World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 1. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000453] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.
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