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Wu Y, Ye Z, Wang Z, Duan S, Zhu J, Fang Y. Examining individual and contextual predictors of disability in Chinese older adults: A machine learning approach. Int J Med Inform 2024; 191:105552. [PMID: 39068893 DOI: 10.1016/j.ijmedinf.2024.105552] [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: 03/18/2024] [Revised: 06/12/2024] [Accepted: 07/14/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND There is a large gap of understanding the determinants of disability, especially the contextual characteristics. Therefore, this study aimed to examine the important predictors of disability in Chinese older adults based on the social ecological framework. METHODS We used the China Health and Retirement Longitudinal Study to examine predictors of disability, defined as self-report of any difficulty for six activity of daily living items. We restricted analytical sample to older adults aged 65 or above (N=1816). We considered 44 predictors, including personal-, behavioral-, interpersonal-, community-, and policy-level characteristics. The built-in variable importance measure (VIM) of random forest and SHapley Additive exPlanations (SHAP) were applied to assess key predictors of disability. A multilevel logit regression was further used to examine the associations of individual and contextual characteristics with disability. RESULTS The mean age of study sample was 72.62 years old (standard deviation: 5.77). During a 2-year of follow-up, 518 (28.52 %) of them developed into disability. Walking speed, age, and peak expiratory flow were the top important predictors in both VIM and SHAP. Contextual characteristics such as humidity, PM2.5, temperature, normalized difference vegetation index, and landscape also showed promise in predicting disability. Multilevel logit regression showed that people with male gender, arthritis, vision impairment, unable to finish semi tandem, no social activity, lower grip strength, and higher waist circumference, had much higher risk of disability. CONCLUSION Disability prevention strategies should specifically focus on multilevel factors such as individual and contextual characteristics, although the latter is warranted to be verified in future studies.
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Affiliation(s)
- Yafei Wu
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China; School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Zirong Ye
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
| | - Zongjie Wang
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
| | - Siyu Duan
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
| | - Junmin Zhu
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
| | - Ya Fang
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China; National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian, China.
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Esterhuizen M, Park CB, Kim YJ, Kim TY, Yoon H, Andres F, Rodriguez-Rodriguez R, Tanabe S. A perspective on the role of physiological stresses in cancer, diabetes and cognitive disease as environmental diseases. Front Mol Biosci 2023; 10:1274221. [PMID: 38053578 PMCID: PMC10694350 DOI: 10.3389/fmolb.2023.1274221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
With rapid industrialization, urbanization, and climate change, the impact of environmental factors on human health is becoming increasingly evident and understanding the complex mechanisms involved is vital from a healthcare perspective. Nevertheless, the relationship between physiological stress resulting from environmental stressors and environmental disease is complex and not well understood. Chronic exposure to environmental stressors, such as air and water contaminants, pesticides, and toxic metals, has been recognized as a potent elicitor of physiological responses ranging from systemic inflammation to immune system dysregulation causing or progressing environmental diseases. Conversely, physiological stress can exacerbate susceptibility to environmental diseases. Stress-induced alterations in immune function and hormonal balance may impair the ability to detoxify harmful substances and combat pathogens. Additionally, prolonged stress can impact lifestyle choices, leading to harmful behaviors. Understanding the link between physiological stress and environmental disease requires a systematic, multidisciplinary approach. Addressing this complex relationship necessitates the establishment of a global research network. This perspective discusses the intricate interplay between physiological stress and environmental disease, focusing on common environmental diseases, cancer, diabetes, and cognitive degeneration. Furthermore, we highlight the intricate and reciprocal nature of the connection between physiological stress and these environmental diseases giving a perspective on the current state of knowledge as well as identifying where further information is necessary. Recognizing the role of physiological stress in environmental health outcomes will aid in the development of comprehensive strategies to safeguard public health and promote ecological balance.
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Affiliation(s)
- Maranda Esterhuizen
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | - Chang-Beom Park
- Environmental Exposure and Toxicology Research Center, Korea Institute Toxicology (KIT), Jinju, Republic of Korea
| | - Young Jun Kim
- Korean Institute of Science and Technology Europe (KIST Europe), Saarbrücken, Germany
| | - Tae-Young Kim
- School of Earth Sciences and Environmental Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Hakwon Yoon
- Environmental Exposure and Toxicology Research Center, Korea Institute Toxicology (KIT), Jinju, Republic of Korea
| | - Frederic Andres
- Digital Content and Media Sciences Research Division, National Institute of Informatics, Tokyo, Japan
| | - Rosalia Rodriguez-Rodriguez
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC Barcelona), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Shihori Tanabe
- Division of Risk Assessment, Center for Biological Safety and Research, National Institute of Health Sciences, Kawasaki, Japan
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Bernetti A, Ruggiero M, Ruiu P, Napoli M, D’Urzo R, Mancuso A, Mariani F, Tota L, Agostini F, Mangone M, Paoloni M. Analysis and Report of the Physical and Rehabilitation Medicine Evaluation Activity in Patients Admitted to Acute Care Setting: An Observational Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6039. [PMID: 37297646 PMCID: PMC10252334 DOI: 10.3390/ijerph20116039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/01/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Disability (both temporary and transitory, or definitive) might occur for the first time in a given patient after an acute clinical event. It is essential, whenever indicated, to undergo a Physical Medicine and Rehabilitation assessment to detect disability and any need for rehabilitation early. Although access to rehabilitation services varies from country to country, it should always be governed by a PRM prescription. OBJECTIVE The aim of the present observational retrospective study is to describe consultancy activity performed by PRM specialists in a university hospital in terms of requests' typology, clinical questions, and rehabilitation setting assignment. METHODS Multiple parameters were analyzed (clinical condition, patient's socio-family background, and rehabilitation assessment scale scores) and a correlation analysis was performed between the analyzed characteristics and both the different clinical conditions and the assigned rehabilitation setting. RESULTS PRM evaluations of 583 patients from 1 May 2021 to 30 June 2022 were examined. Almost half of the total sample (47%) presented disability due to musculoskeletal conditions with a mean age of 76 years. The most frequently prescribed settings were home rehabilitation care, followed by intensive rehabilitation and long-term care rehabilitation. CONCLUSIONS Our results suggest the high public health impact of musculoskeletal disorders, followed by neurological disorders. This is, however, without forgetting the importance of early rehabilitation to prevent other types of clinical conditions such as cardiovascular, respiratory, or internal diseases from leading to motor disability and increasing costs.
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Affiliation(s)
- Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Marco Ruggiero
- Physical and Rehabilitation Medicine, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Pierangela Ruiu
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Martina Napoli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Rossella D’Urzo
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Annalisa Mancuso
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Flavio Mariani
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Luigi Tota
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
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Fu JCM, Fu PK, Cheng YY. Benefits of Cycling Wheelchair Training for Elderly with Physical Disability: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16773. [PMID: 36554652 PMCID: PMC9779290 DOI: 10.3390/ijerph192416773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
AIM In order to investigate the effect of cycling wheelchair training as an exercise for aged 65+ disabled patients on cognitive function, quality of life, aerobic capacity and physiological parameters. METHODS Participants in nursing home performed cycling wheelchair training for 30 min a day, 5 days a week, for a total of 4 weeks. The main outcome measure was the short form 12 survey (SF-12). Other outcome measures included the Mini-Mental State Examination (MMSE), aero bike work rate test, resting blood pressure, and heart rate. RESULTS In this study, 41 volunteers were recruited and no participants dropped out of the study voluntarily during training, and no serious adverse effect was identified. Physical and mental component summary total scores of SF-12 were significantly higher after training with statistical significance (p = 0.001). 8 subscales also showed significant improvements after training (p = 0.025 ~ <0.001). Total MMSE score has no difference before and after training. Attention/calculation (p = 0.018), short term memory (p = 0.041), and aerobic capacity (p < 0.001) as measured by subscales of MMSE and aero bike test showed marked improvements, while resting systolic blood pressure (p = 0.931) and heart rate (p = 0.793) did not change. CONCLUSIONS Cycling wheelchair is practical for the disabled elderly to exercise, and a 4-week exercise program enhanced their quality of life and aerobic capacity.
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Affiliation(s)
- Jimmy Chun-Ming Fu
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Pin-Kuei Fu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- College of Human Science and Social Innovation, Hungkuang University, Taichung 433304, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Yuan-Yang Cheng
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
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