Assessment of physical health status and quality of life among Saudi older adults

A Cross-Sectional Study on Social Isolation and Loneliness Related to COVID-19 Among Middle and Late-Stage Elderly in Jazan, Saudi Arabia

BACKGROUND

Precautionary measures implemented to reduce the spread of COVID-19, such as social distancing and stay-at-home orders, have inevitably affected the mental health of older adults. This study aimed to measure loneliness among the elderly living in the Jazan region, Saudi Arabia, during the COVID-19 pandemic.

METHODS

This cross-sectional study was conducted between February and April 2022 in the Jazan area, Saudi Arabia. A convenience sampling method was employed to recruit 100 elderly participants (≥ 60 years) from various public locations, including malls, social gatherings, parks, and beaches, across different neighborhoods in Jazan. Qualitative survey data was collected by interviewing each participant. Loneliness level was measured using the De Jong Gierveld Scale, complemented by self-made questions addressing sociodemographic information, communication means, frequency of contact with family and friends, and ability to perform daily activities. The chi-square test was utilized to identify factors associated with loneliness.

RESULTS

The De Jong Gierveld scale revealed that most study participants (80%) experienced moderate loneliness despite living arrangements, as 87% were living with their family members. In contrast, only 12% of participants reported severe loneliness. Of all sociodemographic variables, only age and housing companion showed statistically significant relations with loneliness levels (p = 0.005 and < 0.001, respectively). Additionally, loneliness levels were found to be significantly associated with the frequency of communication with family and/or friends (p = 0.002) and knowledge of modern communication means (p = 0.048).

CONCLUSION

This study highlights a high prevalence of social and emotional loneliness among elderly individuals in Jazan, Saudi Arabia, during the COVID-19 pandemic. It indicates that robust family living arrangements alone did not mitigate loneliness in this population. The findings suggest that limited adoption of digital communication and cultural factors contributed to loneliness. While these insights provide a foundation for understanding elderly loneliness in Saudi Arabia, further research is needed to explore these factors in greater depth and assess the effectiveness of potential interventions like mental health counseling and social support programs.

The effects of walking on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia: a study protocol of randomized control trial by comparing supervised group-based intervention and non-supervised individual-based intervention

BACKGROUND

Kingdom of Saudi Arabia (KSA) demographics are also changing with the increase in life expectancy in the country and the rise in the number of older Saudi Arabians. Saudi Arabia has a higher rate of physically inactive people, and most of them are between the ages of 55-64. Walking is one of the most prevalent forms of physical activity in Saudi Arabia and the study showed that most people prefer walking for recreational and health benefits. Therefore, the purpose of the proposed study is to compare the effects of supervised group-based walking and non-supervised individual-based walking interventions on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia.

METHOD

This study will apply a three-group (2 intervention groups and 1 control group), double-blinded, randomized controlled trial (RCT) to examine the effect of different forms of walking interventions on Saudi Arabia older adults' frailty, cognitive function and quality of life immediately after a 16-week intervention, as well as the residual effects 12 weeks after completion of the interventions.

DISCUSSION

This study aims to determine whether supervised group walking and non-supervised individual walking lead to different effects. Given the limited evidence in the literature regarding Saudi Arabia older adults' physical fitness and health, it is worthwhile to explore the effect of walking, as well as the forms of walking on improving the overall physical fitness and psychological status of older adults in Saudi Arabia. The findings of the current study could also create awareness of the government and the general public in Saudi Arabia of the ageing problems and the effective ways of achieving better intervention results.

TRIAL REGISTRATION

The trial is registered at the ClinicalTrials.gov PRS (Trial ID: NCT05151575; Date of first posted: 12/07/2021).

Depression and Quality of Life Among Caregivers of Pediatric Cancer Patients

Background

This study aimed to assess the prevalence of depression, depressive symptoms, and quality of life among caregivers of pediatric cancer patients and the associated risk factors.

Methodology

In total, 73 participants were recruited for this cross-sectional study in King Abdullah Specialist Children Hospital. Two self-administered questionnaires were used, the Patient Health Questionnaire 9 (PHQ9) and World Health Organization Quality of Life (WHOQOL), to assess the depressive symptoms as well as the prevalence of clinical depression and quality of life, respectively. Data were analyzed using SPSS (IBM Corp., Armonk, NY, USA) to assess the level of depression and quality of life and the associated factors using Fisher’s exact and Mann-Whitney tests.

Results

It was found that 90.4% were females and 9.6% were males, with 49.3% being between the ages of 31 and 40. Regarding the level of depression, 47.80% had mild depression. There were no significant associations between the baseline characteristics and the level of depression. Gender was significantly associated with all four domains of quality of life, age was significant in physical health and environmental domains, duration of illness was significant only in the physical health domain, while education level was found to be not significantly associated with any of the domains.

Conclusions

This study found that nearly half of the participants had mild levels of depression, and the four domains of the WHOQOL were significantly affected by several risk factors. We recommend further research into this topic with larger sample sizes, as well as a follow-up assessment of caregivers for a more accurate representation of caregivers’ depression and quality of life. We recommend that in addition to the assessment of pediatric cancer patients, caregivers must also be assessed due to the burden associated with the task of being a caregiver.

Decision-making framework for using ambient assisted living

Purpose

Technology plays an important role in assisting elderly people to live independently, longer and improve their quality of life and health, in supporting their daily activities, etc. The ageing population becomes a global phenomenon. The population of Saudi Arabia continues to age (>60 years of age) currently (5%) compared to other group ages. In 2050, it will increase rapidly to 20.9% of the Saudi population. The current research aims at examining the barriers that health-care providers in the Kingdom of Saudi Arabia are experiencing in the adoption of ambient assisted living (AAL) technologies among the elderly. The study aims to identify a challenging issue with the increasing the number of elderly among the population in the country, which has highlighted the need to use AAL technology to improve the quality of life among the elderly.

Design/methodology/approach

This study involved a community of practice (CoP) study as a method of data collection where data collected were presented and discussed in line with the existing literature review findings.

Findings

In total, 14 factors were identified in this study and discussed in the context of Saudi Arabia, which resulted in developing a decision-making framework for using AAL by health-care providers. Those factors are essential in boosting the usage of technology in improving elderly health in Saudi Arabia.

Research limitations/implications

This study includes implications for developing a decision-making framework for using AAL.

Social implications

This study clarifies that technology can connect elderly people with society.

Originality/value

In total, 14 factors were identified in this study and discussed in the context of Saudi Arabia.

The Prevalence of Functional Disability and Associated Factors among Older People Attending Primary Health-care Centers in Riyadh City

BACKGROUND: The burden of disability among the older population is increasing as older people grow with significant social and economic negative impacts. AIM: This study examines functional disability and its associated risk factors among older Saudi citizens attending primary health-care centers (PHCCs) in Riyadh city. METHODS: This descriptive cross-sectional study was carried out on 504 older Saudi citizens aged ≥60 years who attended a PHCC in Riyadh city between December 2019 and May 2020. Interviewer-administered questionnaire was used to assessing the disability in activities of daily living (ADL) and instrumental activities of daily living (IADL) using the Katz Index and Lawton scale. RESULTS: The prevalence of ADL and IADL disability among participants was 24.6% and 58.5%, respectively. Smoking (p = 0.019), dyslipidemia (p = 0.018), rheumatoid arthritis (p = 0.028), history of falls (p = 0.014), and an emergency visit (p = 0.049) were risk factors associated with ADL disability. Predictors of IADL disability were advanced age (p = 0.004), being female (p = 0.029), and the need for a caregiver (p = 0.000). The need for homecare was positively associated with ADL dependency (p = 0.008) and IADL dependency (p = 0.003). Furthermore, regular physical activity was a protective factor against ADL functional disabilities (p = 0.002) and IADL functional disabilities (p = 0.000). CONCLUSION: This study found a high prevalence of ADL and IADL disability among elderly Saudis. Disability was associated with several sociodemographic and health status factors. The findings of this study highlight the priority of effective and targeted preventive interventions for disability.

Association between Levels of Physical Activity, Sarcopenia, Type 2 Diabetes and the Quality of Life of Elderly People in Community Dwellings in Lebanon

There is a lack of data from developing countries on the link between physical activity (PA) on health outcomes. This study examines the association between the level of PA and sarcopenia, cardiovascular risk factors (i.e., dyslipidemia, type 2 diabetes (T2D), and cardiovascular diseases), and the health-related quality of life (HRQoL) among elderly people, in community dwellings in Lebanon. In this cross-sectional, observational study, body composition, levels of PA, and the HRQoL of 243 elderly people living in community dwellings, are obtained. The participants are then categorized based on a PA cut-off point of 600 metabolic equivalent task minutes per week (MET-min/week). In our sample, the prevalence of physical inactivity, defined as performing less than 600 MET-min/week, is 51.44% (125/243 participants).They displayed a higher prevalence of sarcopenia (36.0% vs. 18.6%), T2D (39.6% vs. 21.1%), as well as a lower physical (65.67 ± 20.72 vs. 75.08 ± 17.29) and mental (67.58 ± 21.51 vs. 76.95 ± 17.16) HRQoL. On the other hand, regression analysis shows that an increased rate of PA to ≥600 MET-min/week is associated with a lower risk of T2D (OR = 0.43, 95% CI: 0.22–0.84, p = 0.013) and sarcopenia (OR= 0.40, 95% CI: 0.22–0.73, p = 0.003) by 60%, and higher scores of the physical (β = −7.65; −11.87, −3.43, p = 0.0004) and mental (β = −8.47; −13.08, −3.85, p = 0.0004) HRQoL by nearly eight points. Our results show a high prevalence of physical inactivity in Lebanese adults over the age of 60; however, an adequate level of PA among this population seemed to be associated with a lower risk of sarcopenia and T2D, as well as a better HRQoL. However, future longitudinal studies are still needed to clarify if intervention based on increasing levels of PA can determine improvement in these clinical outcomes. If this is shown to be the case, it emphasizes the importance of implementing strategies to increase physical activity within this population.

Health Status and Functional Abilities of Elderly Males Visiting Primary Health-care Centers in Khamis Mushait, Saudi Arabia

Background

There is an aging population all over the world, and Saudi Arabia is no exception to it. An aging population poses several challenges to the health-care sector.

Aim

The aim of this study was to examine the health status and functional abilities of elderly people visiting primary health-care centers in Khamis Mushait, Saudi Arabia.

Methods

This cross-sectional study involved elderly male Saudi nationals aged 60 years and above. Self-rated health status and body pain, functional status, geriatric review of systems and other relevant data were collected using the Geriatric Health Questionnaire of University of Iowa Health Care. All statistical analyses were performed using SPSS version 21.

Results

The study results showed that the overall health of the elderly was either good (32.9%) or very good (32.3%), while 14.2% rated their health as excellent. Only two participants rated their health as poor. The majority of the participants (71.9%) had no functional impairment in basic activities of daily living (BADL), while 35.7% had mild impairment in instrumental activities of daily living (IADL). Only two participants were found to have total impairment in IADL. The most common limitation among BADL was walking (21.1%) and among IADL was doing the housework. The notable factors associated with functional impairment in BADL and IADL were old age (≥80 years), poor eyesight, memory impairment, having trouble with control of bladder, falls twice or more, taking more than two medications, being sexually inactive, poor self-rated general health and severe self-rated body pain (all P<0.05) among others.

Conclusion

The majority of the elderly were able to perform BADL independently and to a lesser extent IADL; the overall self-rated general health was found to be good. Further research in the field of geriatrics is warranted to plan better, and design public health policies and provide efficient care to elderly patients.

Health-related quality of life among patients with type 2 diabetes mellitus in Eastern Province, Saudi Arabia: A cross-sectional study

Diabetes mellitus has reached epidemic levels, and it threatens the economy and health globally and Saudi Arabia in particular. The study assessed health-related quality of life using EuroQol instrument and its predictors among patients with Type 2 diabetes mellitus in Eastern Province, Saudi Arabia. A cross-sectional study was conducted among 378 patients with Type 2 diabetes mellitus from two major health centers in Eastern Province. The study showed moderate health-related quality of life, as reported by the median index score of 0.808 with more than a quarter of patients with severe-extreme health state in some or all domains. Multiple-regression models showed that male gender, high monthly income, having no diabetes-related complications and having random blood glucose level less than 200 mg/dl were prone to have a higher index score compared to the corresponding contrary groups. The study will help in guiding the development of effective intervention programs to improve diabetes-related health-related quality of life among the Saudi population.

Limitations in Activities of Daily Living in People With Chronic Pain: Identification of Groups Using Clusters Analysis

BACKGROUND

Chronic pain (CP) is a major public health problem affecting patients' lives and reducing physical activity. The aim is to establish subgroups of people with chronic pain (PCP) according to limitations in activities of daily living (ADLs), and to identify sociodemographic, pain-related, and psychosocial variables associated with each subgroup.

METHODS

Nationwide cross-sectional study on a representative sample of the Spanish adult population. Information on pain characteristics and ADL limitations was collected via telephone survey. A cluster analysis was used to identify subgroups of subjects according to the limitations on ADLs. Multivariate analysis was performed to analyze the variables related to each subgroup.

RESULTS

Out of the 1,957 surveys included in the original study, 325 PCP were identified according to the definition of the International Association for the Study of Pain. More than 50% reported some limitation in ADLs. Three groups of PCP were identified, with low, medium, and high ADL limitation. Older age, widespread and more intense pain, decrease in work activity, and belief that their pain affected the relationship with their friends were associated with higher limitations.

CONCLUSIONS

The identification of the characteristics of people with higher limitations could help guide future prevention and treatment initiatives to minimize the disabling impact of chronic pain on patients' family, work, and social life.

Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature

Background

Physical inactivity is associated with excess weight and adverse health outcomes. We synthesize the evidence on physical inactivity and its social determinants in Arab countries, with special attention to gender and cultural context.

Methods

We searched MEDLINE, Popline, and SSCI for articles published between 2000 and 2016, assessing the prevalence of physical inactivity and its social determinants. We also included national survey reports on physical activity, and searched for analyses of the social context of physical activity.

Results

We found 172 articles meeting inclusion criteria. Standardized data are available from surveys by the World Health Organization for almost all countries, but journal articles show great variability in definitions, measurements and methodology. Prevalence of inactivity among adults and children/adolescents is high across countries, and is higher among women. Some determinants of physical inactivity in the region (age, gender, low education) are shared with other regions, but specific aspects of the cultural context of the region seem particularly discouraging of physical activity. We draw on social science studies to gain insights into why this is so.

Conclusions

Physical inactivity among Arab adults and children/adolescents is high. Studies using harmonized approaches, rigorous analytic techniques and a deeper examination of context are needed to design appropriate interventions.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5472-z) contains supplementary material, which is available to authorized users.

Period prevalence, risk factors and consequent injuries of falling among the Saudi elderly living in Riyadh, Saudi Arabia: a cross-sectional study

OBJECTIVES

Approximately 28% to 35% of people aged 65 and over fall each year. The consequent injuries of falls are considered a major public health problem. Falls account for more than half of injury-related hospitalisations among old people. The aim of this study was to measure a 1-year period prevalence of falling among old people in Riyadh, Saudi Arabia. In addition, this study described the most common risk factors and consequent injuries of falls.

SETTING AND PARTICIPANTS

A cross-sectional survey was carried out in Riyadh, using a convenient sampling. The targeted population were Saudi citizens who were 60 years or above. Over a 6-month period, 1182 individuals were sampled (545 men and 637 women).

RESULTS

The 1-year prevalence of falling among old Saudis (>=60 years) was 49.9%. Our results show that 74% of the participants who experienced falls had postfall injuries. Old participants who were uneducated and those with middle school certification were associated with falls (adjusted OR (aOR) 1.72; 95% CI 1.15 to 2.56, aOR 1.81; 95% CI 1.15 to 2.85, respectively). Those who live in rented houses had a higher risk of falls. Interestingly, having a caregiver was significantly associated with more falls (aOR 1.39; 95% CI 1.08 to 1.79). However, not using any medications was significantly related to fewer falls. In addition, old individuals using walking aids were more likely to fall than those who did not. Participants who mentioned 'not having stressors were associated with less frequent falls (aOR 0.62; 95% CI 0.39 to 0.97). Cerebrovascular accidents were strongly associated with falls with an estimated OR of 2.75 (95% CI 1.18 to 6.43). Moreover, osteoporosis, poor vision and back pain were found to be predictors for falls among the elderly.

CONCLUSION

49.9% of elderly Saudis had experienced one or more falls during a 12-month period. Several preventable risk factors could be addressed by routine geriatric assessment. Research on the impact of these risk factors is needed.

Joint Association of Obesity and Hypertension with Disability in the Elderly-- A Community-Based Study of Residents in Shanghai, China

BACKGROUND

Although both obesity and hypertension are known risk factors for disability, the joint association of obesity and hypertension with risk of disability is unknown. This paper is aim to examine the joint association of obesity and hypertension with risk of disability.

METHODS

Cross-sectional study with 8060 elderly community-dwelling individuals participating in the survey initiated by Shanghai Health and Family Planning Commission from March to September 2013. Obesity was measured using the body mass index (BMI) in World Health Organization (WHO) Asia criteria. Hypertension, based on the doctor's diagnosis, was obtained through face-to-face interview. Disability was measured using the self-reported physical self-maintenance scale (PSMS) and the instrumental activities of daily living (IADL) scale developed by Lawton and Brody.

RESULTS

A total of 8.97% of participants reported ADL disability, and 15.18% for IADL disability. After adjusting social demographics and chronic conditions, the risk of ADL disability was progressively greater in obese persons with hypertension (OR=1.40, 95% CI=1.05-1.89), underweight persons without hypertension (OR=2.05, 95% CI=1.29-3.25), and underweight persons with hypertension (OR=2.14, 95% CI=1.36-3.36). For IADL disability, only underweight persons with hypertension were significantly associated (OR=1.65, 95% CI=1.23-2.21).

CONCLUSIONS

Low or extremely high BMI, independent of its metabolic consequences, is a risk factor for disability among the elderly. Simple hypertension wasn't significantly associated with disability. In addition, having hypertension significantly increased the risk of ADL disability in obese individuals and IADL disability in underweight individuals.