Identifying demographic and home features influencing older adults' home functioning by using machine learning models

OBJECTIVES

This study aimed to identify demographic and housing features associated with functional difficulties experienced by older adults in their homes.

PARTICIPANTS

Individuals aged ≥ 65 years who completed American Housing Survey (AHS) questionnaires. We selected one random person per household and excluded participants with missing data for the 12 AHS functional challenge items.

METHODS

Multiple machine learning models were compared to identify the best-performing model, which was then used to analyze the impact of demographic and housing features on older adults' functional difficulties at home.

RESULTS

The random forest model was selected for its preferred predictive performance (accuracy: 85.8%, sensitivity: 94.4%, specificity: 60.2%, precision: 87.6%, and negative predictive value: 78.2%). The top five variables that significantly influenced the model were: 1) walking disability, 2) presence or use of a cane or walker, 3) presence or use of handrails or grab bars in the bathroom, 4) go-outside-home disability, and 5) self-care disability. These variables had a stronger impact on the model than the householder's health and age.

CONCLUSION

Home modifications and environmental adaptations may be critical in enhancing functional abilities and independence among older adults. These findings could inform the development of interventions that promote safe and accessible living environments for older adults, thereby improving their quality of life.

The level of actual functional fitness of men from different living environments in Poland and associations with health - a cross-sectional study

BACKGROUND

The study aimed to assess the differences in functional fitness between older men living in social welfare homes (SWH) and men living in society.

METHODS

The study involved 474 men aged 60-84, including 134 men living in social welfare homes and 340 men living in community. The Senior Fitness Test was used to assess functional fitness. Body weight and height were measured. Moreover, data on age, education, taking up physical activity and place of residence were collected.

RESULTS

A significantly lower level of functional fitness of SWH residents was demonstrated compared to men living in the society (p < 0.001). A significant percentage of seniors living in SWH did not reach the normal range for the Polish population. Also, the level of education, physical activity and health self-assessment differentiated the institutionalized men from those living in the community.

CONCLUSIONS

The place of residence is a factor that differentiates seniors' functional fitness levels. The reduced fitness of social welfare home residents may also result from the low level of their daily physical activity, education and health. Introducing physical activity programs for elderly residents in social welfare homes seems reasonable.

TRIAL REGISTRATION

ISRCTN platform as 18,225,729; December 2020.

[The general practitioner in old age homes : an incongruous actor ? Study in old-age homes in a deprived area]

CONTEXT

Residential facilities for dependent elderly people have difficulties ensuring medical follow-up of their residents by general practitioners. The barriers to medical visits are well-known. Seine-Saint-Denis is particularly affected by the medical demography crisis.

OBJECTIVES

To describe the organization of visits by general practitioners in residential facilities for dependent elderly people in Seine-Saint-Denis. To assess the influence of the institutions' status on this organization.

METHOD

Quantitative descriptive cross-sectional study of 65 facilities in Seine Saint-Denis. A questionnaire drawn from the literature on known barriers to medical visits was used.

RESULTS

Fifty institutions (76.9%) contributed. Most visits (88.0%) took place in patients' rooms. When the practitioner arrived, the patient was present at the site in 80.0% of the facilities, especially when they were private and associative (p = 0.01). The doctor was accompanied by a staff member in 30.0% of the facilities, especially when they were for-profit (p = 0.02). Exchanges between general practitioners and the staff were sporadic and unorganized. All in all, the public facilities seemed to be less well-organized to receive general practitioners.

DISCUSSION

Residential facilities for the elderly do not seem to have implemented specific organization for visits by general practitioners, who are not integrated in the staff.

CONCLUSION

Experiments with doctors gainfully employed in institutions could be carried out, following the example of several foreign countries.

Sex differences for predicting metabolic syndrome by adipose dysfunction markers in institutionalized elderly

AIMS

Recent studies have emphasized that metabolic syndrome (MetS) was the most important modifiable risk factor for cardiovascular and cerebrovascular diseases in the institutionalized elderly. In addition, the occurrence of MetS was higher in those with longer age-adjusted institutionalization time. The present study was conducted to assess predictive value of markers of adipose tissue dysfunction for the early screening of MetS in this population.

METHODS AND RESULTS

Two hundred and eleven institutionalized older adults (132 women, aged 74.3 ± 7.3 years; 79 men, aged 71.5 ± 7.3 years) were enrolled in the current cross-sectional study. Lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index (BAI), and triglycerides (TG)/high-density lipoprotein (HDL)-cholesterol ratio were determined. The receiver operating characteristic curve was calculated to compare the area under the curve of each index. The total prevalence of MetS was 23.8%. In female group, VAI and TG/HDL ratio presented moderate-high sensitivity (77.78% and 78.38%, respectively) and specificity (77.62% and 73.49%, respectively). In males group, LAP presented moderate-high sensitivity (75%) and specificity (76.9%).

CONCLUSION

Gender played a key role on the prediction of MetS by adipose dysfunction markers in institutionalized elderly. Accordingly, VAI and TG/HDL-cholesterol ratio showed the highest predictive value for MetS in female elderly. LAP was the strongest predictor of MetS in male elderly.

Smoke-Free Multi-unit Housing Policies Show Promise in Reducing Secondhand Smoke Exposure Among Racially and Ethnically Diverse, Low-Income Seniors

Secondhand smoke (SHS) exposure is a public health issue for residents of multi-unit housing (MUH) properties. We evaluated the impact of smoke-free policy implementation on reported SHS exposure among racially, ethnically diverse seniors living in low-income MUH properties. In Spring 2013 and Summer 2014, we surveyed residents (n = 960) at 15 MUH properties in Broward and Miami-Dade Counties, Florida. The percentage of residents reporting SHS exposure within their apartments from elsewhere in or around their building decreased from 31.1 %, before policy implementation, to 23.6 % at follow-up (p = 0.02). In multivariate analysis of non-smoking residents after policy implementation, residents who reported having one or more comorbidities were two times more likely to report SHS exposure (aOR 2.23, 95 % CI 1.12-4.40). Considering the vulnerability of low-income seniors to SHS exposure, our findings are relevant to residents, property owners/managers, and public health professionals making decisions about smoke-free policies for MUH properties in which seniors reside.

Assessing health literacy among older adults living in subsidized housing: a cross-sectional study

OBJECTIVES

This study aimed to assess functional health literacy levels among older adults living in subsidized housing in Hamilton, Ontario, and to assess the relationships between health literacy and other important health indicators, such as education level, age, ethnicity, body mass index (BMI), and self-reported health status.

METHODS

Older adults (n = 237) living in subsidized housing buildings in Hamilton, ON, were assessed using the NVS-UK as a measure of functional health literacy in addition to a health indicator questionnaire through structured interview. Health literacy levels were analyzed using descriptive statistics and logistic regression to determine relationships between health literacy levels and other health indicators.

RESULTS

Participants' mean age was 73 years, 67% were female, 70% were not educated beyond high school, and 91% were white. Over 82% of participants had below adequate health literacy levels using the NVS-UK. Multivariable logistic regression revealed significant relationships between functional health literacy and BMI, education level, and pain and discomfort levels. No significant relationships were found between health literacy level and age group, anxiety and depression levels, CANRISK (Diabetes risk) score, gender, marital status, mobility issues, self-care issues, self-reported health status, or performance of usual activities.

CONCLUSIONS

As the population of older adults continues to grow, the appropriate resources must be available to both improve and support the health literacy level of the population. Future health research should gather information on the health literacy levels of target populations to ensure more equitable health service. This research provides a significant opportunity to better understand populations with health literacy barriers.

[Perception of knowledge in palliative care housing for the elderly workers in a basic health zone]

OBJECTIVE

To analyze the level of knowledge in palliative care that health and non health housing for the elderly workers refer, to study the differences between professional categories and to detect their interest in receiving palliative care training.

PATIENTS AND METHODS

Cross-sectional study conducted among physicians, nurses, physiotherapists, nursing assistant and occupational therapists applying a questionnaire assisting terminal patients with 22 items grouped into four sections: generalities palliative care, physical care, psycho-emotional and spiritual. Each question is answered using a four point scale in much-regulate-little-nothing.

RESULTS

86.8% of respondents know quite what they mean or regular palliative care. 3.8% consider themselves sufficiently trained in palliative care. We found significant differences in non-pharmacological management of dyspnea and insomnia where concerns have less knowledge worker. Medicine and nursing reported having more knowledge in the recognition of a tumor ulcer.

CONCLUSIONS

There is a very high interest in receiving palliative care training and these are considered very useful. Required impact on the acquisition of knowledge in the medical staff not optional as to non-pharmacological management of major symptoms It also emphasizes the need to approach not to question the patient's pain by physicians. The test to detect cognitive impairment are not well known for nursing assistants. The spiritual realm is the acceptable level of knowledge on the part of all professional categories surveyed.

[Recommendations on the safety of patients for socio-health centers: systematic review]

We did a systematic review to find recommendations on patient safety oriented toward improving the quality of care in nursing homes, residential facilities, housing for the elderly and long-term care facilities, among others. One hundred and thirty-four articles were selected in MEDLINE, EMBASE and CINAHL up to October 2012. Of these, 17 met inclusion criteria and 5 studies were added in the secondary search for further detailed analysis. Few studies with high or very high level of scientific evidence on the scale SIGN were identified. Analyzed studies focused primarily on nursing staff. Most of the recommendations are oriented toward medication-related issues, staff training, pressure ulcers or falls, adherence to guidelines and protocols and topics referred to organizational culture.