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Ni Z, Zhu X, Tian K, Chen Q, Yang Y, Xie S. Depressive symptoms of older adults with chronic diseases: the mediating roles of activities of daily living and economic burden of diseases. Front Psychol 2024; 15:1387677. [PMID: 39015326 PMCID: PMC11249773 DOI: 10.3389/fpsyg.2024.1387677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 06/18/2024] [Indexed: 07/18/2024] Open
Abstract
Objective To explore the mediating roles of activities of daily living (ADL) and economic burden of diseases in the relationship between chronic diseases and depressive symptoms of older adults. Methods The data were sourced from China Health and Retirement Longitudinal Study (CHARLS). The number of chronic diseases, ADL, out-of-pocket medical expenses and the Center for Epidemiological Studies Depression Scale (CES-D) were selected as measuring indexes. Mediation analysis was conducted to explore the potential mediating roles of ADL and economic burden of diseases in the association between chronic diseases and depressive symptoms. Results The number of chronic diseases, ADL, economic burden of diseases and depressive symptoms of older adults were significantly correlated with each other. ADL and economic burden of diseases individually mediated the relationship between the number of chronic diseases and depressive symptoms, accounting for 31.460% and 5.471% of the total effect, respectively. Additionally, ADL and economic burden of diseases demonstrated a chain mediating effect in this relationship, contributing to 0.759% of the total effect. Conclusion The chain-mediated model effectively elucidated the mediating roles of ADL and economic burden of diseases in the association between chronic diseases and depressive symptoms among older adults. The study underscores the need for policymakers to focus attentively on the mental health of older adults with chronic diseases. Enhancing the capacity for ADL and strengthening social security to mitigate the economic burden of diseases are recommended strategies to alleviate depressive symptoms in older adults.
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Affiliation(s)
- Zihan Ni
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiuyuan Zhu
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Kan Tian
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Chen
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yi Yang
- School of Public Health, Fudan University, Shanghai, China
- National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shiyu Xie
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
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Ahmed W, Muhammad T, Muneera K. Prevalence of early and late onset of chronic diseases and multimorbidity and its association with physical, mental and functional health among older Indian adults. BMC Geriatr 2023; 23:563. [PMID: 37710170 PMCID: PMC10502995 DOI: 10.1186/s12877-023-04264-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Identifying people with early and late onset of chronic conditions might help target the subpopulations that are more vulnerable to negative mental, physical and functional health outcomes. The current study aimed to examine the association of early and late onset of chronic single and multiple morbidities with self-perceived physical and mental health, functional limitations and physical inactivity among older Indian adults. METHODS Cross-sectional study was conducted using data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-2018). The total sample size for the present study was 31,386 older adults age 60 years or older. Multivariable binary logistic regression analysis was used to establish the association between the outcomes (poor perceived physical/mental health, functional difficulty and physical inactivity) and explanatory variables (early [ = < 50 years of age] and late [> 50 years]) onset of chronic illnesses such as hypertension, diabetes, heart attack, heart disease, stroke, cancer, lung disease, arthritis, osteoporosis and psychiatric disease). RESULTS Overall, 24.21% of the sample population had poor self-perceived physical health, whereas 8.67% of participants had poor self-perceived mental health. The prevalence of difficulty in ADL, difficulty in IADL, and physical inactivity was 23.77%, 48.36%, and 68.9%, respectively. Odds of poor perceived mental health were higher for the respondents with early as well as late onset of hypertension, stroke, and arthritis; while individuals with late onset of diabetes, and heart disease had higher odds of poor perceived mental health than those without chronic disease. Individuals with early onset of single morbidity were more likely to report ADL difficulty (adjusted odds ratio [AOR]: 1.33, confidence interval [CI]: 1.06-1.67); while those with late onset of single (AOR: 1.34, CI: 1.17-1.53) and multimorbidity (AOR: 1.91, CI: 1.63-2.24) were more likely to report ADL difficulty compared with individuals without morbidity. Individuals with early as well as late-onset of multimorbidity had more than two times higher odds of reporting poor physical health, poor mental health and IADL difficulty compared with individuals without chronic disease. CONCLUSIONS The present study revealed that early and/or late onset of chronic single and/or multiple morbidities significantly predicted poor self-perceived physical and mental health, functional limitations and physical inactivity among older Indian adults. The findings further suggest that late onset of chronic diseases such as cancer and stroke and multi-morbidity had stronger associations with physical inactivity that may help identify high risk groups for screening and support.
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Affiliation(s)
- Waquar Ahmed
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| | - T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India.
| | - K Muneera
- National Institute of Technology, Calicut, Kerala, 673601, India
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Blanco-Reina E, Ocaña-Riola R, Ariza-Zafra G, García-Merino MR, Aguilar-Cano L, Valdellós J, Torres-Blanco C, Bellido-Estévez I. Prevalence and Clinical Conditions Related to Sarcopaenia among Older Persons Living in the Community. J Clin Med 2022; 11:jcm11133814. [PMID: 35807099 PMCID: PMC9267841 DOI: 10.3390/jcm11133814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 01/27/2023] Open
Abstract
(1) Background: In health care and in society at large, sarcopaenia is a disorder of major importance that can lead to disability and other negative health-related events. Our study aim is to determine the prevalence of sarcopaenia among older people attended in primary care and to analyse the factors associated with this age-related clinical condition; (2) Methods: A multicentre cross-sectional study was conducted of 333 community-dwelling Spanish adults aged 65 years or more. Sociodemographic, clinical, functional, anthropometric, and pharmacological data were collected. Sarcopaenia was defined following European Working Group on Sarcopaenia in Older People (EWGSOP) criteria; (3) Results: Sarcopaenia was present in 20.4% of the study sample, and to a severe degree in 6%. The intensity of the association between sarcopaenia and frailty was weak-moderate (Cramer V = 0.45). According to the multinomial logistic regression model performed, sarcopaenia was positively associated with age and with the presence of psychopathology (OR = 2.72; 95% CI = 1.30–5.70) and was inversely correlated with body mass index (OR = 0.73, 95% CI = 0.67–0.80; (4) Conclusions: Sarcopaenia commonly affects community-dwelling older persons and may be associated with age, body mass index, and psychopathology. The latter factor may be modifiable or treatable and is therefore a possible target for intervention.
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Affiliation(s)
- Encarnación Blanco-Reina
- Pharmacology and Therapeutics Department, Instituto de Investigación Biomédica de Málaga-IBIMA, School of Medicine, University of Málaga, 29016 Málaga, Spain;
- Correspondence: ; Tel.: +34-952-136-648
| | | | - Gabriel Ariza-Zafra
- Geriatrics Department, Complejo Hospitalario Universitario, 02006 Albacete, Spain;
| | | | - Lorena Aguilar-Cano
- Physical Medicine and Rehabilitation Department, Hospital Regional Universitario, 29010 Málaga, Spain;
| | - Jenifer Valdellós
- Health District of Málaga-Guadalhorce, 29009 Málaga, Spain; (M.R.G.-M.); (J.V.)
| | - Claudia Torres-Blanco
- Pharmacology and Therapeutics Department, School of Medicine, University of Málaga, 29016 Málaga, Spain;
| | - Inmaculada Bellido-Estévez
- Pharmacology and Therapeutics Department, Instituto de Investigación Biomédica de Málaga-IBIMA, School of Medicine, University of Málaga, 29016 Málaga, Spain;
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Srivastava S, Muhammad T, Paul R, Thomas AR. Multivariate decomposition analysis of sex differences in functional difficulty among older adults based on Longitudinal Ageing Study in India, 2017-2018. BMJ Open 2022; 12:e054661. [PMID: 35487710 PMCID: PMC9058763 DOI: 10.1136/bmjopen-2021-054661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study investigates the gender disparities in difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) and explores its contributing factors among older adults in India. DESIGN A cross-sectional study was conducted using country representative survey data. SETTING AND PARTICIPANTS The present study uses the data from the Longitudinal Ageing Study in India, 2017-2018. Participants included 15 098 male and 16 366 female older adults aged 60 years and above in India. PRIMARY AND SECONDARY OUTCOME MEASURES Difficulty in ADL and IADL were the outcome variables. Descriptive statistics and bivariate analysis were carried out to present the preliminary results. Multivariate decomposition analysis was used to identify the contributions of covariates that explain the group differences to average predictions. RESULTS There was a significant gender differential in difficulty in ADL (difference: 4.6%; p value<0.001) and IADL (difference: 17.3%; p value<0.001). The multivariate analysis also shows significant gender inequality in difficulty in ADL (coefficient: 0.046; p value<0.001) and IADL (coefficient: 0.051; p value<0.001). The majority of the gender gap in difficulty in ADL was accounted by the male-female difference in levels of work status (18%), formal education (15% contribution), marital status (13%), physical activity (9%), health status (8%) and chronic morbidity prevalence (5%), respectively. Equivalently, the major contributors to the gender gap in difficulty in IADL were the level of formal education (28% contribution), marital status (10%), alcohol consumption (9%), health status (4% contribution) and chronic morbidity prevalence (2% contribution). CONCLUSION Due to the rapidly increasing ageing population, early detection and prevention of disability or preservation of daily functioning for older adults and women in particular should be the highest priority for physicians and health decision-makers.
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Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Ronak Paul
- International Institute for Population Sciences, Mumbai, Maharashtra, India
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Impact of the COVID-19 Pandemic on Elderly Patients with Spinal Disorders. J Clin Med 2022; 11:jcm11030602. [PMID: 35160053 PMCID: PMC8836518 DOI: 10.3390/jcm11030602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
During the ongoing coronavirus disease 2019 (COVID-19) pandemic, home-quarantine has been necessary, resulting in lifestyle changes that might negatively affect patients with spinal disorders, including a reduction in their quality of life (QoL) and activities of daily living (ADLs). However, studies on this impact are lacking. This study aimed to investigate the age-related changes in QoL and ADLs in patients with spinal disorders, and also identify factors associated with decline in ADLs. This multicenter cross-sectional study included patients who visited four private spine clinics for any symptoms. The study participants either had a clinic reservation, were first-time clinic visitors, or had a return visit to the clinic. The participants completed several questionnaires at two points: pre-pandemic and post-second wave. Changes in patient symptoms, exercise habits, ADLs, and health-related QoL were assessed. A logistic regression model was used to calculate the odds ratio (OR) of each variable for decline in ADLs. We included 606 patients; among them, 281 and 325 patients were aged <65 and ≥65 years, respectively. Regarding exercise habits, 46% and 48% of the patients in the <65 and ≥65-year age groups, respectively, did not change their exercise habits. In contrast, 40% and 32% of the patients in the <65 and ≥65-year age groups, respectively, decreased their exercise habits. In the multivariate analysis, the adjusted ORs for sex (female), decreased exercise habit, and age >65 years were 1.7 (1.1–2.9), 2.4 (1.4–3.9), and 2.7 (1.6–4.4), respectively. In conclusion, there was a decline in the ADLs and QoL after the COVID-19 outbreak in patients with spinal disorders. Aging, reduction of exercise habits, and female sex were independent factors related to decline in ADLs.
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Sharma P, Maurya P, Muhammad T. Number of chronic conditions and associated functional limitations among older adults: cross-sectional findings from the longitudinal aging study in India. BMC Geriatr 2021; 21:664. [PMID: 34814856 PMCID: PMC8609791 DOI: 10.1186/s12877-021-02620-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/11/2021] [Indexed: 02/01/2023] Open
Abstract
Background Chronic conditions reduce the likelihood of physical functioning among older adults. However, the contribution of most prevalent diseases and multimorbidity to different measures of functional limitations is relatively underexplored among Indian older adults. The present study explores the prospective association between number of chronic conditions and limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) among older adults in India. Methods This study utilized data from the nationally representative Longitudinal Ageing Study in India (LASI-2017-18). The effective sample size was 31,464 older adults aged 60 years and above. Descriptive statistics along with cross-tabulation were presented in the study. Additionally, binary logistic regression analysis was used to fulfil the objectives. The outcome variables were dichotomized; high representing no difficulty in ADL/IADL and low representing a difficulty in at least one ADL/IADL. The chronic conditions included hypertension, diabetes, neurological/psychiatric disease, lung disease, heart diseases, stroke, and bone-related disease. The number of chronic diseases was categorized into no disease, single, two and three plus based on number of reported disease. Results 26.36% of older women and 20.87% of older men had low ADL and the figures for low IADL were 56.86 and 38.84% for older men and women respectively. The likelihood of low ADL (AOR: 1.698, CI:1.544, 1.868) and low IADL (AOR: 1.197; CI: 1.064, 1.346) was higher among womenthan men. With increasing age, the prevalence of low ADL increased among older adults. Respondents with pre-existing chronic conditions had higher likelihood of low ADL and IADL. Older adults with hypertension, psychiatric disease, heart disease, stroke and bone-related disease had significantly higher odds of reporting low IADL. The chances of low ADL and IADL were 2.156 (CI: 1.709, 2.719) and 2.892 (CI: 2.067, 4.047) times respectively higher among older adults with more than three chronic conditions. After controlling for socio-economic and health-related covariates, it was found that men with more than three pre-existing chronic conditions had higher odds of low ADL than women. On the other hand, low IADL were found higher among women with more than three pre-existing chronic conditions. Conclusions The present study demonstrates a significant burden of functional limitations among older individuals and that there is a strong association between pre-existing chronic conditions and functional disability. Those with hypertension, diabetes, psychiatric disorders, heart disease, stroke, lung disease or bone-related diseases should be effectively monitored to predict future functional limitations, which may lead to worsening health. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02620-0.
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Affiliation(s)
- Palak Sharma
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Priya Maurya
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - T Muhammad
- Department of Population Policies and Programmes, International Institute for Population Sciences, Deonar, Mumbai, Maharashtra, 400088, India.
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Feng Z, Li Q, Zhou L, Chen Z, Yin W. The relationship between depressive symptoms and activity of daily living disability among the elderly: results from the China Health and Retirement Longitudinal Study (CHARLS). Public Health 2021; 198:75-81. [PMID: 34365109 DOI: 10.1016/j.puhe.2021.06.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/25/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The acceleration of population aging has brought an unprecedented impact on China's health system. This study is designed to examine the association between depressive symptoms and activity of daily living disability among the elderly in China. STUDY DESIGN This is a cross-sectional study. METHODS Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). The 10-item Center for Epidemiologic Studies-Depression (CES-D) scale was used to access depressive symptoms, and physical function was assessed by the Activity of Daily Living (ADL) scale. Multivariate logistic regression was used to assess the association between depressive symptoms and ADL among the elderly. RESULTS Based on a sample of 5863 elderly people over 60 years old, our results showed that 1999 elderly people are with depressive symptoms, accounting for 34.1%. The mean score of ADL among the elderly with depressive symptoms (20.65 ± 7.14) was much higher than that in those without depressive symptoms (17.40 ± 4.87). After controlling potential confounders, multivariate logistic regression showed that ADL and its specific domains including personal care, transfer, medical care, household, and managing money were associated with depressive symptoms. CONCLUSION This cross-sectional study provides evidence of the association between depressive symptoms and ADL disability among the Chinese elderly. As a result, prevention or reduction of ADL disability may have a positive effect on the medical care of the elderly with depressive symptoms.
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Affiliation(s)
- Z Feng
- School of Public Health, Weifang Medical University, Shandong, China; "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China
| | - Q Li
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - L Zhou
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - Z Chen
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - W Yin
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China.
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Multiple factors associated with life satisfaction in older adults. MENOPAUSE REVIEW 2021; 20:65-71. [PMID: 34321983 PMCID: PMC8297631 DOI: 10.5114/pm.2021.107025] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/20/2021] [Indexed: 11/18/2022]
Abstract
Introduction The population of older adults is increasing as science progresses and health conditions improve. Social, psychological and behavioral factors will influence life satisfaction in older adults. We aimed to assess multiple factors associated with life satisfaction in older adults in Qom city, Iran. Material and methods It was a descriptive-analytical study which has conducted on 679 older adults through convenience sampling from Qom city, Iran during 2018. The data were collected using demographic characteristics, life satisfaction, well-being, cognitive status, social support, and daily activities of life questionnaire. Data were analyzed by SPSS version 22 software and independent t-test, ANOVA, Pearson’s correlation coefficient and multiple regression analysis. Results The mean older adult’s age was 70.43 ± 7.62 years. The mean life satisfaction score was 13.77 ± 3.73. The results showed a significant relationship of job and education with life satisfaction (p < 0.001). The results also showed that social support (p = 0.001) and daily activities (p = 0.017) significantly predict the level of life satisfaction, and the dimensions of health (p = 0.001) and cognitive status (p = 0.007) have a larger share in predicting the satisfaction of older adults’ life. Conclusions We found that some parts of life changes in older adults can be predicted with the help of social support, health status, cognitive status, and everyday life activities. Therefore, in order to increase the level of life satisfaction of older adults, it is suggested that promotion of social support, health status, and cognitive status be provided.
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Kwak M, Kim B, Lee H, Zhang J. Does Gender Matter in the Receipt of Informal Care Among Community-Dwelling Older Adults? Evidence from a Cross-National Comparative Study Across the United States, South Korea, and China. J Gerontol B Psychol Sci Soc Sci 2021; 76:S64-S75. [PMID: 32112112 DOI: 10.1093/geronb/gbaa018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study compares patterns of gender difference in the receipt of informal care among community-dwelling older adults across the United States, Korea, and China where family-oriented systems for providing care to older adults are emphasized. METHOD Data came from the 2014 Health and Retirement Study, the 2014 Korea Longitudinal Study of Aging, and the 2015 China Health and Retirement Longitudinal Study. Logistic regression models were used to predict the receipt of informal care by gender. We also examined how the effects of health and living arrangement on the receipt of informal care differ depending on gender. RESULTS In the United States and China, older women were more likely to receive informal care than men. However, older Korean women were less likely to receive informal care than men. The effects of health and living arrangement on the use of informal care were moderated by gender in different ways across countries. DISCUSSION This study provides evidence that patterns of gender differences in the receipt of informal care vary across the three countries. More attention needs to be paid to the design and implementation of long-term supports and services to address the unique patterns of gender difference in care arrangement in each country.
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Artificial Intelligence Approaches to Social Determinants of Cognitive Impairment and Its Associated Conditions. Dement Neurocogn Disord 2020; 19:114-123. [PMID: 32985151 PMCID: PMC7521952 DOI: 10.12779/dnd.2020.19.3.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/25/2020] [Accepted: 09/06/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE This study uses an artificial-intelligence model (recurrent neural network) for evaluating the following hypothesis: social determinants of disease association in a middle-aged or old population are different across gender and age groups. Here, the disease association indicates an association among cerebrovascular disease, hearing loss and cognitive impairment. METHODS Data came from the Korean Longitudinal Study of Ageing (2014-2016), with 6,060 participants aged 53 years or more, that is, 2,556 men, 3,504 women, 3,640 aged 70 years or less (70-), 2,420 aged 71 years or more (71+). The disease association was divided into 8 categories: 1 category for having no disease, 3 categories for having 1, 3 categories for having 2, and 1 category for having 3. Variable importance, the effect of a variable on model performance, was used for finding important social determinants of the disease association in a particular gender/age group, and evaluating the hypothesis above. RESULTS Based on variable importance from the recurrent neural network, important social determinants of the disease association were different across gender and age groups: 1) leisure activity for men; 2) parents alive, income and economic activity for women; 3) children alive, education and family activity for 70-; and 4) brothers/sisters cohabiting, religious activity and leisure activity for 70+. CONCLUSIONS The findings of this study support the hypothesis, suggesting the development of new guidelines reflecting different social determinants of the disease association across gender and age groups.
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Molina-Mula J, Miguélez-Chamorro A, Taltavull-Aparicio JM, Miralles-Xamena J, Ortego-Mate MDC. Quality of Life and Dependence Degree of Chronic Patients in a Chronicity Care Model. Healthcare (Basel) 2020. [DOI: https://doi.org/10.3390/healthcare8030293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: The complex chronic patient is a person with one or several long-term diseases, the clinical management of which are considered difficult and related to cognitive or functional impairment. The chronicity care model deeply affects the quality of life and degree of dependence. Objectives: The objective of this study was to analyse the perceived quality of life and dependence degree in complex chronic patients within a chronicity care model in the Autonomous Communities of Cantabria and the Balearic Islands (Spain). Design: This was a multicentred, transversal, descriptive, and observational study on a cohort of 206 chronic patients included in a chronicity care program. Methods: Patients’ sociodemographic variables, integral valuation, nurse follow-up records, nursing outcomes classification (NOC)/nursing interventions classification (NIC), nurse diagnoses, and hospitalization data were analysed. A descriptive analysis of all data was carried out. The bivariate analysis assessed the relation between covariables and the overall scoring in European Quality of Life Scale (EuroQuol-5D), Barthel, Braden, and Chronic Patient eXperience Assessment Instrument (IEXPAC in the Spanish abbreviation). A multivariate linear regression analysis was conducted. Results: The mean age was 79.4 years (standard deviation (SD) = 9.12; range: 39–94). A percentage of 79.3% of the study population shows functional impairment in one or more activities of daily life. A percentage of 83.3% of patients showed a physical dependence. There is a significant relationship between the gender and kinship degree of the caregiver (χ2 = 18.2; p = 0.001). An overall mean score of 55.38 points in EuroQuol-5D was obtained, along with a 36.87-point satisfaction with the care given in IEXPAC. The overall score correlated positively and significantly with Barthel, Braden, and IEXPAC. The dependence levels improved slightly in the observed patients, which was a very significant outcome in statistical terms (t = 2.08; p = 0.039). A percentage of 66% (R2 = 0.66) of the score variability at the Barthel index could be predicted from Braden scale scoring. Conclusions: Dependence is not only affected by the related pathology, but also by the effect on mobility and daily-life activities, which cause a worse perception of the quality of life. The health-care model based on the case management nurse is having positive effects, especially on dependence and patients with ulcer issues.
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Molina-Mula J, Miguélez-Chamorro A, Taltavull-Aparicio JM, Miralles-Xamena J, Ortego-Mate MDC. Quality of Life and Dependence Degree of Chronic Patients in a Chronicity Care Model. Healthcare (Basel) 2020; 8:E293. [PMID: 32846995 PMCID: PMC7551615 DOI: 10.3390/healthcare8030293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The complex chronic patient is a person with one or several long-term diseases, the clinical management of which are considered difficult and related to cognitive or functional impairment. The chronicity care model deeply affects the quality of life and degree of dependence. OBJECTIVES The objective of this study was to analyse the perceived quality of life and dependence degree in complex chronic patients within a chronicity care model in the Autonomous Communities of Cantabria and the Balearic Islands (Spain). DESIGN This was a multicentred, transversal, descriptive, and observational study on a cohort of 206 chronic patients included in a chronicity care program. METHODS Patients' sociodemographic variables, integral valuation, nurse follow-up records, nursing outcomes classification (NOC)/nursing interventions classification (NIC), nurse diagnoses, and hospitalization data were analysed. A descriptive analysis of all data was carried out. The bivariate analysis assessed the relation between covariables and the overall scoring in European Quality of Life Scale (EuroQuol-5D), Barthel, Braden, and Chronic Patient eXperience Assessment Instrument (IEXPAC in the Spanish abbreviation). A multivariate linear regression analysis was conducted. RESULTS The mean age was 79.4 years (standard deviation (SD) = 9.12; range: 39-94). A percentage of 79.3% of the study population shows functional impairment in one or more activities of daily life. A percentage of 83.3% of patients showed a physical dependence. There is a significant relationship between the gender and kinship degree of the caregiver (χ2 = 18.2; p = 0.001). An overall mean score of 55.38 points in EuroQuol-5D was obtained, along with a 36.87-point satisfaction with the care given in IEXPAC. The overall score correlated positively and significantly with Barthel, Braden, and IEXPAC. The dependence levels improved slightly in the observed patients, which was a very significant outcome in statistical terms (t = 2.08; p = 0.039). A percentage of 66% (R2 = 0.66) of the score variability at the Barthel index could be predicted from Braden scale scoring. CONCLUSIONS Dependence is not only affected by the related pathology, but also by the effect on mobility and daily-life activities, which cause a worse perception of the quality of life. The health-care model based on the case management nurse is having positive effects, especially on dependence and patients with ulcer issues.
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Affiliation(s)
- Jesús Molina-Mula
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain
| | - Angélica Miguélez-Chamorro
- Chronicity Care, Sociosanitary Coordination and Rare Diseases in the Regional Health Service of the Balearic Islands, 07003 Palma, Spain;
| | | | - Jerónima Miralles-Xamena
- Technical Office, Primary Care Service, Scientific Committee, J. Briggs Institute, 07003 Palma, Spain;
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Abstract
The Healthy City program is a comprehensive health promotion program implemented by local governments to improve citizens’ health. The Healthy City program aims to improve citizens’ quality of life through health promotion activities in daily life. It also improves health by eliminating health risk factors and increasing citizens’ happiness. Therefore, this study investigated the effects of the Healthy City program on the happiness index of local residents and the correlation between the Healthy City program and the happiness index using quality of life as a parameter. We conducted a questionnaire survey of residents of Seoul, where Healthy City networks are actively promoted. A total of 392 responses were obtained. Structural equations were used to analyze the collected data. The Healthy City program had positive effects on the happiness index. In other words, it increased the happiness index by improving the health of the local residents. Relevant policy efforts are also being made to advance health services through Healthy City programs. For an effective Healthy City program, it is necessary to implement policies regarding health equity, to expand Healthy City programs based on a settings approach, and to implement a sustainable Healthy City program through the establishment of Healthy City governance.
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Tavares DMDS, Pelizaro PB, Pegorari MS, Paiva MMD, Marchiori GF. Prevalence of self-reported morbidities and associated factors among community-dwelling elderly in Uberaba, Minas Gerais, Brazil. CIENCIA & SAUDE COLETIVA 2019; 24:3305-3313. [PMID: 31508751 DOI: 10.1590/1413-81232018249.31912017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/11/2018] [Indexed: 11/21/2022] Open
Abstract
This study aimed to verify the prevalence and socioeconomic and health factors associated with morbidity among community-dwelling elderly. This is an analytical and cross-sectional survey conducted in 2012 with 1,691 elderly from Uberaba-MG. A tool structured for socioeconomic data and self-reported morbidities was used along with the Abbreviated Geriatric Depression, Katz and Lawton-Brody scales. We proceeded to a descriptive analysis and linear regression (p < 0.05). A high percentage (88.3%) of elderly reported two or more morbidities, with higher prevalence for systemic arterial hypertension (61.9%) and back problems (48.6%). Female gender (β = 0.216; p< 0.001), functional disability in basic (β = 0.240; p < 0.001) and instrumental activities of daily living (β = 0.120; p < 0.001) and indicative of depression (β = 0.209; p < 0.001) were associated with the highest number of morbidities. The presence of two or more comorbidities and the association with socioeconomic and health variables show the need for monitoring and control actions of the factors that interfere in the elderly in this condition.
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Affiliation(s)
- Darlene Mara Dos Santos Tavares
- Curso de Graduação em Enfermagem, Universidade Federal do Triângulo Mineiro (UFTM). Pç. Manoel Terra 330, Centro. 38015-050 Uberaba MGBrasil.
| | | | | | | | - Gianna Fiori Marchiori
- Curso de Graduação em Enfermagem, Universidade Federal do Triângulo Mineiro (UFTM). Pç. Manoel Terra 330, Centro. 38015-050 Uberaba MGBrasil.
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Belo LF, Rodrigues A, Paes T, Machado FVC, Schneider LP, Vicentin AP, Probst VS, Pitta F, Hernandes NA. Functional Status of Patients with COPD Assessed by London Chest Activity of Daily Living Scale: Gender Association and Validity of a Cutoff Point. Lung 2019; 197:509-516. [PMID: 31079224 DOI: 10.1007/s00408-019-00235-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Whether the difference in the impact of chronic obstructive pulmonary disease (COPD) on the functional status of men and women stems from clinical distinctions or to the measuring instrument used is unclear. Like most instruments for assessing functional limitation in COPD, the interpretation of the results of the London Chest Activity of Daily Living (LCADL) scale is limited because a lack of a valid cutoff point to this scale. For that, this study sought to compare the functional status between men and women with COPD; and propose a cutoff point for LCADL capable of discriminating the prognosis of these individuals. METHODS A sample of 138 subjects with moderate-severe COPD was evaluated by the LCADL. The percentage of the individual maximum score was used to obtain a cutoff point capable of discriminating patients with the worse prognosis according to the BODE Index. The cutoff point was also tested in an independent sample (n = 70). RESULTS Regarding the total score, domestic and leisure domains of the LCADL, men had better scores than women (P ≤ 0.01). The cutoff point found was 37% (area under the curve = 0.70, 95% confidence interval = 0.60-0.80, sensitivity = 0.55 and specificity = 0.74). Individuals who scored ≥ 37% had a worse prognosis and level of physical activities of daily living than those who scored below (P ≤ 0.02). CONCLUSION When evaluated by the LCADL, men and women with COPD present difference in the functional status. The established cutoff point (37%) adequately discriminates individuals regarding the prognosis, contributing to improve the interpretation capacity of the LCADL.
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Affiliation(s)
- Letícia Fernandes Belo
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Antenor Rodrigues
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil.,Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium
| | - Thaís Paes
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Felipe Vilaça Cavallari Machado
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Lorena Paltanin Schneider
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Ana Paula Vicentin
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | | | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Nidia Aparecida Hernandes
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil.
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Botes R, Vermeulen KM, Correia J, Buskens E, Janssen F. Relative contribution of various chronic diseases and multi-morbidity to potential disability among Dutch elderly. BMC Health Serv Res 2018; 18:24. [PMID: 29334922 PMCID: PMC5769323 DOI: 10.1186/s12913-017-2820-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 12/28/2017] [Indexed: 11/16/2022] Open
Abstract
Background The amount of time spent living with disease greatly influences elderly people’s wellbeing, disability and healthcare costs, but differs by disease, age and sex. Methods We assessed how various single and combined diseases differentially affect life years spent living with disease in Dutch elderly men and women (65+) over their remaining life course. Multistate life table calculations were applied to age and sex-specific disease prevalence, incidence and death rates for the Netherlands in 2007. We distinguished congestive heart failure, coronary heart disease (CHD), breast and prostate cancer, colon cancer, lung cancer, diabetes, COPD, stroke, dementia and osteoarthritis. Results Across ages 65, 70, 75, 80 and 85, CHD caused the most time spent living with disease for Dutch men (from 7.6 years at age 65 to 3.7 years at age 85) and osteoarthritis for Dutch women (from 11.7 years at age 65 to 4.8 years at age 85). Of the various co-occurrences of disease, the combination of diabetes and osteoarthritis led to the most time spent living with disease, for both men (from 11.2 years at age 65 to 4.9 -years at age 85) and women (from 14.2 years at age 65 to 6.0 years at age 85). Conclusions Specific single and multi-morbid diseases affect men and women differently at different phases in the life course in terms of the time spent living with disease, and consequently, their potential disability. Timely sex and age-specific interventions targeting prevention of the single and combined diseases identified could reduce healthcare costs and increase wellbeing in elderly people.
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Affiliation(s)
- Riaan Botes
- Clinical Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
| | - Karin M Vermeulen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Janine Correia
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
| | - Erik Buskens
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Fanny Janssen
- Population Research Centre, University of Groningen, Groningen, the Netherlands.,The Netherlands Interdisciplinary Demographic Institute, The Hague, the Netherlands
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Park S, Kang JY, Chadiha LA. Social Network Types, Health, and Health-Care Use Among South Korean Older Adults. Res Aging 2016; 40:131-154. [PMID: 29291689 DOI: 10.1177/0164027516682814] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines the associations among social network types, multiple health conditions, and various health-care use. Data came from the 2006 and 2008 wave of the Korean Longitudinal Study of Aging. A two-step cluster analytical approach was used to identify social network types. Regression models determined associations between social network types, health changes, and health-care use, including checkups, outpatient service, traditional medicine use, and hospitalization. Four social network types (restricted, couple focused, friend, and diverse) were found. Compared with the restricted type, individuals in the couple-focused type were more likely to use traditional medicine and outpatient care; members in the diverse type were more likely to use traditional medicine. The interaction model revealed varying associations between health change and social network on health-care use. Findings reveal the culturally contextualized association among multiple health conditions and how social network type moderates the relationship with health-care use.
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Affiliation(s)
- Sojung Park
- 1 George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Ji Young Kang
- 2 School of Social Work, University of Washington, Seattle, WA, USA
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Nagarkar A, Kashikar Y. Predictors of functional disability with focus on activities of daily living: A community based follow-up study in older adults in India. Arch Gerontol Geriatr 2016; 69:151-155. [PMID: 27936458 DOI: 10.1016/j.archger.2016.11.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 11/25/2016] [Accepted: 11/26/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Disability in activities of daily living is a growing concern among older populations all over the world. India has one of the rapidly ageing populations and predicted burden of functional disability is higher for Indian older adults as compared to other ageing Asian countries. METHODS Total 1140 aged 60 years and over participated in a baseline study. 560 of them participated in the prospective cohort study conducted in the city of Pune, India. An interview and functional assessment using a questionnaire and Pune-FAAT tool was carried out in 2013-14. Binary logistic regression was used to obtain the factors that increased the odds of having ADL disability at follow-up. RESULTS The mean age of the study population was 69.73±5.48years. Squatting, walking and climbing functions were affected significantly. Total 376 participants (67.1%) reported difficulties and/or disability in performing activities of daily living (ADL) at follow-up. Hospitalization (OR=3.6; 95% CI: 1.9-6.7), being female (OR=2.3; 95% CI: 1.5-3.5), presence of two or more chronic diseases (OR=1.7; 95% CI: 1.1-2.7), experience of memory loss (OR=1.9; 95% CI: 1.2-3.0) and feeling of loneliness (OR=2.3; 95% CI: 1.0-5.3) increased the odds of being in the "With disability" group at follow-up. Apart from this, self-rated health and self-reported depression were associated with limitations in ADL. CONCLUSION Hospitalization and being female appeared to be the most significant risk factors for disability in urban older adults in India. Rehabilitation services after hospitalization, physical exercise, effective control on chronic illness, and social participation to reduce loneliness is recommended.
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Affiliation(s)
- Aarti Nagarkar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Ganeshkhind, Pune, 411007 Maharashtra, India.
| | - Yashoda Kashikar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Ganeshkhind, Pune, 411007 Maharashtra, India
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Preventing Loss of Basic Activities of Daily Living and Instrumental Activities of Daily Living in Elderly: Identification of Individual Risk Factors in a Holistic Perspective. Holist Nurs Pract 2016; 29:313-22. [PMID: 26263291 DOI: 10.1097/hnp.0000000000000106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study investigated the association between physical functioning and activities of daily living (ADL) of elderly people, taking into account the role of cognitive, psychological, and social factors. We administered physical, cognitive, psychological, and social instruments to investigate the level of basic and instrumental activities of daily living (BADL and IADL). The analysis showed that physical functioning was the only individual factor that was significantly linked with the level of BADL and IADL. This study underlines that physical functioning is the main individual characteristic directly associated with the level of BADL and IADL in old age.
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Heo WS, Baik HW, Kang JH, Park JS, Park SJ, Jang EJ, Park SW, Kim SJ, Koh BS, Noh GT, Lee KH, Choi JA. The Prevalence of Sarcopenia in Korean Hospitalized Elderly. ACTA ACUST UNITED AC 2015. [DOI: 10.4235/jkgs.2015.19.4.235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Garin N, Olaya B, Moneta MV, Miret M, Lobo A, Ayuso-Mateos JL, Haro JM. Impact of multimorbidity on disability and quality of life in the Spanish older population. PLoS One 2014; 9:e111498. [PMID: 25375890 PMCID: PMC4222819 DOI: 10.1371/journal.pone.0111498] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 09/30/2014] [Indexed: 12/23/2022] Open
Abstract
Background Population aging is closely related to high prevalence of chronic conditions in developed countries. In this context, health care policies aim to increase life span cost-effectively while maintaining quality of life and functional ability. There is still, however, a need for further understanding of how chronic conditions affect these health aspects. The aim of this paper is to assess the individual and combined impact of chronic physical and mental conditions on quality of life and disability in Spain, and secondly to show gender trends. Methods Cross-sectional data were collected from the COURAGE study. A total of 3,625 participants over 50 years old from Spain were included. Crude and adjusted multiple linear regressions were conducted to detect associations between individual chronic conditions and disability, and between chronic conditions and quality of life. Separate models were used to assess the influence of the number of diseases on the same variables. Additional analogous regressions were performed for males and females. Results All chronic conditions except hypertension were statistically associated with poor results in quality of life and disability. Depression, anxiety and stroke were found to have the greatest impact on outcomes. The number of chronic conditions was associated with substantially lower quality of life [β for 4+ diseases: −18.10 (−20.95,−15.25)] and greater disability [β for 4+ diseases: 27.64 (24.99,30.29]. In general, women suffered from higher rates of multimorbidity and poorer results in quality of life and disability. Conclusions Chronic conditions impact greatly on quality of life and disability in the older Spanish population, especially when co-occurring diseases are added. Multimorbidity considerations should be a priority in the development of future health policies focused on quality of life and disability. Further studies would benefit from an expanded selection of diseases. Policies should also deal with gender idiosyncrasy in certain cases.
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Affiliation(s)
- Noe Garin
- Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Beatriz Olaya
- Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Maria Victoria Moneta
- Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Marta Miret
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
| | - Antonio Lobo
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad de Zaragoza and Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Jose Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Josep Maria Haro
- Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- * E-mail:
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Chin HJ, Ahn SY, Ryu J, Kim S, Na KY, Kim KW, Chae DW, Kim CH, Kim KI. Renal function and decline in functional capacity in older adults. Age Ageing 2014; 43:833-8. [PMID: 24908107 DOI: 10.1093/ageing/afu071] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND longitudinal relationship between renal function, disability and mortality has not been evaluated. OBJECTIVE we investigated the temporal association between renal function and disability, and aimed to identify the influence of disability on mortality according to renal function in a cohort of older Koreans. DESIGN/SETTING Korean Longitudinal Study on Health and Aging is a prospective, population-based cohort. SUBJECTS community-dwelling Koreans ≥65 years of age. MAIN OUTCOME MEASURES Korean version of activities of daily living (ADL), Instrumental activities of daily living (IADL) and all-cause mortality. RESULTS a total of 984 participants were followed for 5 years with a 70.9% participation rate. The participants were categorized into three groups according to their baseline estimated glomerular filtration rates (eGFRs) (Group I, ≥60; Group II, 45-59; and Group III, <45 ml/min/1.73 m(2)). Baseline eGFR was higher in participants who maintained functional status compared with participants who died or had disability at follow-up examination. The incidence of ADL/IADL decline was 13, 12.5 and 29.5% in participants who showed improvement, no change, and decline in renal function, respectively (P = 0.01). The hazard ratio for mortality in the subgroup with IADL disability was 1.87 (95% CI: 1.10-3.20, P = 0.022) in Group I, and 2.53 (95% CI: 1.57-4.09, P<0.001) in Groups II and III after adjustment. CONCLUSIONS impaired renal function was related to disability and ADL/IADL decline. The effect of ADL/IADL disability on mortality was more prominent in participants with impaired eGFR.
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Affiliation(s)
- Ho Jun Chin
- Department of Internal Medicine, Seoul National University Bundang Hopsital, Seongnam, Korea Department of Internal Mecidine, Seoul National University College of Medicine, Seoul, Korea Renal Institute, Clinical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Shin Young Ahn
- Department of Internal Medicine, Seoul National University Bundang Hopsital, Seongnam, Korea
| | - Jiwon Ryu
- Department of Internal Medicine, Seoul National University Bundang Hopsital, Seongnam, Korea
| | - Sejoong Kim
- Department of Internal Medicine, Seoul National University Bundang Hopsital, Seongnam, Korea
| | - Ki Young Na
- Department of Internal Medicine, Seoul National University Bundang Hopsital, Seongnam, Korea Department of Internal Mecidine, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Dong-Wan Chae
- Department of Internal Medicine, Seoul National University Bundang Hopsital, Seongnam, Korea Department of Internal Mecidine, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol-Ho Kim
- Department of Internal Medicine, Seoul National University Bundang Hopsital, Seongnam, Korea Department of Internal Mecidine, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Il Kim
- Department of Internal Medicine, Seoul National University Bundang Hopsital, Seongnam, Korea Department of Internal Mecidine, Seoul National University College of Medicine, Seoul, Korea
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Sex differences in health-related quality of life among adult stroke patients in Northeastern China. J Clin Neurosci 2014; 21:957-61. [DOI: 10.1016/j.jocn.2013.08.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 08/18/2013] [Indexed: 01/08/2023]
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Smoliner C, Sieber CC, Wirth R. Prevalence of Sarcopenia in Geriatric Hospitalized Patients. J Am Med Dir Assoc 2014; 15:267-72. [DOI: 10.1016/j.jamda.2013.11.027] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/26/2013] [Accepted: 11/26/2013] [Indexed: 12/31/2022]
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Tomomitsu MR, Perracini MR, Neri AL. Influência de gênero, idade e renda sobre o bem-estar de idosos cuidadores e não cuidadores. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2013. [DOI: 10.1590/s1809-98232013000400002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVOS: Comparar idosos cuidadores e não cuidadores quanto às condições de saúde, psicossociais e de desempenho funcional e conhecer a influência das variáveis socioeconômicas sobre estes grupos. MÉTODO: Estudo envolvendo idosos residentes de três cidades brasileiras - Parnaíba-PI, Campinas-SP e Ivoti-RS - com base nos dados do estudo FIBRA. A amostra foi composta de 676 idosos, 338 cuidadores e 338 não cuidadores. Os cuidadores responderam afirmativamente a duas questões sobre a prestação de cuidado no Elders Life Stress Inventory. Os instrumentos utilizados foram: versões brasileiras da Geriatric Depression Scale, da Interpersonal Support Evaluation List, da escala de atividades instrumentais de vida diária (AIVD), de 13 itens de atividades avançadas de vida diária e escala de satisfação com a vida. Foram aplicadas questões de autorrelato sobre idade, gênero, renda familiar, número de doenças e fadiga. RESULTADOS: Os cuidadores compuseram 29,7% da amostra. A tarefa de cuidar era mais frequente entre as mulheres (65,7%), os idosos de 65 a 74 anos e os de menor renda familiar. Houve frequência maior de queixa de insônia entre os cuidadores comparados com os não cuidadores (p=0,013). Para os grupos, ser mais pobre significou maior frequência de insônia e de dependência em AIVD, além de mais sintomas depressivos entre os cuidadores (p=0,24). As mulheres eram as mais doentes e os homens os mais isolados socialmente. Os cuidadores mais velhos reportaram maior grau de dependência em AIVD (p=0,015). CONCLUSÃO: Circunstâncias socioeconômicas podem contribuir para desfechos negativos sobre as condições de saúde física e bem-estar psicológico, especialmente entre os cuidadores.
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Abstract
PURPOSE OF REVIEW The primary focus of this review is to characterize the physiological elements of sarcopenia. In addition, we will also describe the impact of bedrest on sarcopenia and how various countermeasures may be able to offset the deleterious clinical consequences of unanticipated bedrest or hospitalization. It is well known that the aging process presents many challenges to the maintenance of overall health. With the increasing rate of obesity and the potentially simultaneous development of sarcopenia, bedrest presents a difficult clinical challenge to the elderly individual. RECENT FINDINGS The etiology of accelerated sarcopenia has been described as a syndrome. The characteristics of this syndrome include combined alterations in neuromuscular control and muscle protein synthesis that increase the risk of morbidity and mortality in the elderly population. Moreover, the acute onset of bedrest-induced insulin resistance may further complicate the nutritionally derived maintenance of muscle mass and physical function. SUMMARY Even though many questions remain unresolved concerning the optimal clinical management of elderly individuals who undergo unanticipated bedrest, the supplementation of essential amino acids has shown promise as a therapeutic strategy to minimize the detrimental influence of hospitalization in the elderly. In turn, this nutritional adjunctive therapy may reduce the length of stay and the likelihood of repeated hospitalization.
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Affiliation(s)
- Robert H Coker
- Department of Geriatrics and the Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
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Affiliation(s)
- Seong Jae Lee
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Korea
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