DETERMINATION OF THE EFFECTS OF DAILY LIFE ACTIVITIES AND SELF-CARE CAPACITY ON DEPRESSION OF THE ELDERLY IN NORTHERN TURKEY

Association between dysphagia and activities of daily living in older adults: a systematic review and meta-analysis

PURPOSE

Numerous epidemiological studies have suggested a possible association between dysphagia and the risk of decline in Activities of daily living (ADL) among older adults. This systematic review and meta-analysis aimed to elucidate the relationship between dysphagia and ADL in older adults.

METHODS

PubMed, Web of Science, Cochrane Library, Embase, Ebsco, MEDLINE, Wiley, CINAHL, and Ovid databases were comprehensively examined for relevant studies published up to October 31, 2022. Quantitative studies published in English were included to explore the relationship between dysphagia and ADL in people aged 65 years and older. The NIH Quality Assessment Tool was used to assess the study quality. R software was used to draw forest plots and I2 was employed to indicate study heterogeneity. Sensitivity analysis was performed using the one-by-one exclusion method. Publication bias was measured using funnel plots and Egger's test.

RESULTS

A total of 3,498 studies were retrieved from the database, 22 of which were eventually included in the systematic evaluation, and 14 of which were subjected to meta-analysis. Data from nine studies were categorical variables, and meta-analysis results showed that swallowing disorders in older adults were associated with a lower ability to perform ADL (OR = 3.39, 95% CI: 2.55-4.50, p < 0.001), with moderate heterogeneity (I2 = 62%, p = 0.006). Data from seven studies were continuous variables, resulting in a negative association between the prevalence of dysphagia and ADLs in older adults (SMD = -0.80, 95% CI: -1.08 to -0.51, p < 0.001), with high heterogeneity (I2 = 94%, p < 0.001). Sensitivity analysis showed robust results, funnel plots and Egger's test indicated no publication bias.

CONCLUSION

Dysphagia is significantly associated with the capacity to perform ADL. Prevention and screening of dysphagia in older patients dependent on others for daily care are needed. Further long-term studies are needed in the future to prove causality.

Factors Related to the Depression Score in the Elderly at the Social Service of the Dharma Asri Binjai Nursing Home

BACKGROUND: Depression is the most common psychiatric problem in the elderly. Suicidal thoughts or recurring thoughts of death are common in people suffering from depression. Depression in the elderly has a very poor prognosis compared to people in other age groups because they have a relatively higher risk of suicide and death. Elderly people in nursing homes is a condition that significantly affects the quality of life and survival and harms the psychology of the elderly, cause stress is due to elderly people in nursing homes associated with medical and psychosocial problems such as divorce/widows, poverty, and social isolation. AIM: We aimed to find out the factors that affect the Geriatric Depression Scale (GDS 15) score in elderly people at the Social Service of the Dharma Asri Binjai Nursing Home. METHODS: This study used a cross-sectional approach to 91 subjects at the Dharma Asri Binjai Nursing Home Social Service starting from June to July 2020 utilizing sampling, namely, simple random sampling. The tests conducted in this study consisted of a bivariate test and a multivariate linear regression test to determine which factors are associated with depression. The measuring instrument used was the GDS 15. RESULTS: After the multivariate test was carried out, the variables that were statistically significant to the total score of depression in the elderly at the Binjai Dharma Asri nursing home were Gender (p < 0.001) and activity of daily living (ADL) Score (p < 0.001). CONCLUSION: The factors associated with the GDS score of 15 and the occurrence of depression in the elderly were found in the gender variable and the ADL score variable.

Association between self-care agency and depression and anxiety in patients with diabetic retinopathy

BACKGROUND

This study aimed at investigating: 1) the relationship between self-care agency and depression and anxiety; 2) the sociodemographic and clinical factors associated with depression and anxiety in patients with diabetic retinopathy (DR) in China.

METHODS

A cross-sectional study was conducted. One-hundred and five patients with DR were recruited. Self-care agency was assessed by the exercise of self-care agency (ESCA) scale. Depression and anxiety were assessed by the hospital anxiety and depression scale (HADS-D and HADS-A). Pearson or Spearman correlations were performed to assess the association between self-care agency and depression and anxiety. Stepwise multivariate linear regression analyses were conducted to assess the contribution of the sociodemographic and clinical factors to depression and anxiety.

RESULTS

Thirty-six (34.3%) and 43 (41.1%) patients exhibited depressive and anxiety symptoms, respectively. Only 24 (22.9%) patients showed a high self-care agency. The ESCA total and subscale scores were negatively correlated depressive symptoms (P < 0.05). Self-care skills were negatively correlated with anxiety symptoms (P < 0.05). ESCA total score, rural residence, history of hypertension and visual acuity were associated with depression; self-care skills and diastolic blood pressure were associated with anxiety.

CONCLUSIONS

Self-care agency negatively correlates with depression and anxiety in patients with DR. Special attention should be paid to patients living in rural areas and/or those having a history of hypertension when assessing depression and anxiety in patients with DR. Future studies are needed to clarify the causal relationship between self-care agency and depression and anxiety.