Assessing Quality of Life with Community Dwelling Elderly Adults: A Mass Survey in Taiwan

Investigating medication adherence among Taiwanese patient with hypertension, hyperlipidemia, and diabetes: A pilot study using the Chinese version of a Two-Part Medication Nonadherence Scale and the NHI MediCloud system

BACKGROUND

This pilot study aimed to investigate medication nonadherence among Taiwanese patients with diabetes, hypertension, and hyperlipidemia using the Chinese version of the Two-Part Medication Nonadherence Scale (C-TPMNS) and the National Health Insurance (NHI) Medicloud system. The study revealed insights into the factors contributing to nonadherence and the implications for improving patient adherence to medications for chronic conditions. However, the small sample size limits the generalizability of the findings. Additionally, the study identified the need for further research with larger and more diverse samples to validate the preliminary findings.

METHODS

The study conducted surveys individuals in central Taiwan who received three-high medications and those who returned expired medications from chain pharmacies. A structured questionnaire including the C-TPMNS was administered, and additional data on medical history and HbA1c, LDL, and blood pressure levels were collected from the NHI Medicloud system. Data analysis was performed using multiple ordered logistic regression and Wald test methods. Setting interpretation cutoff point to determine medication nonadherence.

RESULTS

The study found that 25.8% of participants were non-adherent to prescribed medications. Non-adherent individuals had significantly higher systolic blood pressure (SBP ≥ 140 mmHg) than adherent participants. Non-adherence was also associated with factors such as lower education, single status, living alone, abnormal glucose postprandial concentration, and triglyceride levels. The C-TPMNS demonstrated good reliability (Cronbach's alpha = 0.816) and validity (area under the ROC curve = 0.72).

CONCLUSION

The study highlighted the complexity of medication nonadherence with diverse determinants and emphasized the importance of tailored interventions. The findings underscored the need for region-specific research to comprehensively address medication nonadherence, especially focusing on adherence to medications for hypertension, hyperlipidemia, and diabetes. The study also identified the need for larger, more diverse studies to validate and expand upon the initial findings and emphasized the importance of pharmacist interventions and patient empowerment in managing chronic conditions and improving overall health outcomes.

Role of handgrip strength in predicting the quality of life in older adults: A cross-sectional study

BACKGROUND

Quality of life (QOL) is a vital component in assessing the standard of living for seniors. Hand grip strength (HGS) is a widely used measure to diagnose muscle strength decline that often occurs due to age-related loss of skeletal muscle mass and function. This study focuses on the HGS in predicting the QOL of older adults who are referred to retirement centers in Guilan Province.

MATERIALS AND METHODS

In 2021, a cross-sectional analytical study was conducted among 115 older adults who were residing in retirement centers located in Guilan Province, Northern Iran. The participants were selected using a two-stage sampling method, where three retirement centers were randomly chosen followed by convenience sampling from each center. The selected retirement centers were situated in Langrod, Sowme'eh Sara, and Rasht cities in the east, west, and center of the province, respectively. The data were collected through a demographic information questionnaire, QOL scale (CASP-19), and HGS measurement using a dynamometer.

RESULTS

Of the participants, 57.4% were male, 51.3% had middle income, and 96.5% were categorized as young elderly. The mean overall QOL score was found to be 37.026 ± 6.123, while the mean HGS level was 31.74 ± 7.45 and 18.48 ± 5.13 among males and females, respectively. There was a significant association between the level of education and QOL (P = 0.002). Moreover, there was a positive and significant correlation between HGS and QOL (r = 0.54, P = 0.001). The results of the multiple linear regression identified HGS as a predictor of QOL (Adj R2 = 0.44, βHGS = 0.79).

CONCLUSION

Given that HGS has been identified as a predictor of QOL in older adults, improving this factor through exercise can lead to enhancement in their QOL. Therefore, regular sports exercises can be recommended as a means of improving HGS and subsequently enhancing the QOL of older adults.

Quality of life profiles and their associations with depressive symptoms and cognitive impairment of community-dwelling older adults in Hong Kong

Background

This study aimed to (1) explore the quality of life (QoL) profiles of older adults in Hong Kong and (2) examine their association with predictors (age, sex, body mass index, and depressive symptoms) and distal outcome (cognitive impairment) using a person-centered approach.

Methods

A total number of 328 community-dwelling older adults in Hong Kong were invited to participate in this study. Data from 259 older adults were identified as valid for the primary analysis. Latent profile analysis was used to explore QoL profiles. Multinomial logistic regression using the R3STEP function in Mplus was used to explore the predictive role of age, sex, body mass index, and depressive symptoms in profile membership. The Bolck-Croon-Hagenaars approach was used to examine how the distal outcome of cognitive impairment differs as a function of QoL profiles.

Results

Three QoL profiles emerged from the latent profile analysis (Low, Moderate and High QoL). It was found that depression, but not age, sex, or body mass index, significantly predicted QoL profile membership. The results of the Bolck-Croon-Hagenaars analysis revealed no significant differences in cognitive impairment across the three QoL profiles.

Conclusion

This is the first study that examined the relationship between QoL, depressive symptoms and cognitive impairment of older adults using a person-centered approach. The findings provide additional information for the evidence obtained from variable-centered approach on the associations among variables abovementioned. Our additional focus on the antecedents of emergent QoL profiles also provide practical knowledge regarding timely treatment for or prevention of depressive symptoms, which we submit will be crucial for enhancing the QoL of older adults.

Evaluation of the quality of life in the university of third age students: a cross-sectional study

PURPOSE

The purpose of this paper was to determine the quality of life (QoL) and related factors in university of third age (U3A) students, as well as to compare the QoL between those who participated in education and those who did not.

METHODS

Two hundred seventy-one people aged 60 and over who are students at Ege U3A, were included in this cross-sectional study. Demographic data of participants were collected through a pre-prepared form. Data on the QoL of individuals were collected through the short form of the WHO QoL Scale (WHOQOL-BREF).

RESULTS

A total of 271 participants were included in this study. 82.2% (n = 221) of the research group were women. In U3A, 65.3% (n = 177) of the individuals were former students. The highest value was found in the psychological and general health sub-parameter with 75.0%, and the lowest value in the social relations sub-parameters with 66.7%. The scores of sub-parameters of social environment were significantly higher in men than in women (p < 0.001, respectively). The physical health scores of the former students were higher than those of the new students (p < 0.001).

CONCLUSIONS

It was determined that the QoL of U3A students was higher among males, those with higher education levels, and those who were married, as well as that the QoL of the individuals participating in the U3A training was positive in the physical health sub-dimension. There is a need for future studies in which pre- and post-training evaluations will be conducted to determine the impact of the U3A training program.

Characteristics and Spatial-Temporal Differences of Urban "Production, Living and Ecological" Environmental Quality in China

The article analyses the spatial and temporal differences in the environmental quality of production, living and ecology of 285 cities in China from 2010 to 2020 by using the entropy method, the Theil index and correlation analysis. The study concludes the following: (1) in terms of overall differences, the overall differences in the "production, living and ecological" environmental quality indices of 285 cities during the study period undergo a process of "narrowing-widening-narrowing". The differences within the four major zones of the country are higher than those between the four major zones, and the differences within the zones show an increasing trend year by year. (2) In terms of temporal differences, the combined scores of "production, living and ecological" environmental quality of the 285 cities in the study period show a decreasing trend, and the contribution of the PLE subsystem scores are, in descending order, production environmental quality > living environmental quality > ecological environmental quality. (3) In terms of overall ranking, the head effect of the combined production, living and ecological environmental quality (PLE) scores of cities in the study period is significant, and the top 10 cities in terms of combined scores are all small and medium-sized cities with significant regionalization characteristics. (4) In terms of spatial pattern, there is a significant spatial gradient in the east, central and western regions, with the overall PLE scores of the four major regions in descending order: eastern region > central region > western region > northeastern region. The regions with high scores in the "production, living and ecological" environmental quality of cities can be divided into three types: multi-core, dual-core and single-core. (5) In terms of influencing factors, there is a logarithmic curve relationship between the combined production, living and ecological environmental quality (PLE) score and the built-up area (BUA) of cities. The study proposes to optimize the layout of urban production, strengthen the industrial links of urban clusters, improve the level of public services, ensure the equalization of urban public services, strengthen the management of ecological environment and improve the quality of ecological environment in order to optimize the quality of urban "production, living and ecological" environment.