Community-living Elderly People Research Articles

Relationship between physical performance and mental health in community-living elderly people

BACKGROUND: Aging is a sensitive period in human life, in which people are at increased risk of developing chronic illness, isolation, and lack of social protection and their autonomy is threatened due to their physical and mental disabilities. Widespread lockdown and preventative measures have made elderly individuals homebound and experienced limited access to physical performance and mental health care. Mental health problems in the elderly are the result of a complex interaction of social, psychological, and biological factors. OBJECTIVE OF THE STUDY: The objective of the study was to determine the relationship between physical performance and mental health (stress, anxiety, and depression) in community-living elderly people during the COVID-19 pandemic. MATERIALS AND METHODS: Physical performance was assessed by physical performance test (PPT) and mental health was assessed by the Depression, Anxiety, and Stress Scale-21. Spearman’s rank correlation test was used to find the relationship between variables. RESULTS: Twenty-eight urban and semi-urban community-living elderly people participated in this study. A statistically significant negative correlation was found (1) between PPT and anxiety (r = −0.386, P = 0.042) and (2) between PPT and depression (r = −0.376 and P = 0.045). There was also a weak negative correlation between PPT and stress level (r = −0.243 and P = 0.212), but the same was not statistically significant. CONCLUSION: The study concluded that individuals with higher physical performance have less anxiety and depression symptoms among community-living elderly people.

Content and face validity of an occupational identity questionnaire based on MOHO concept for community-living elderly people requiring support

Content and face validity of an occupational identity questionnaire based on MOHO concept for community-living elderly people requiring support

Short test of mental status in the detection of mild cognitive impairment in India.

Context:Mild cognitive impairment (MCI) is an under-diagnosed health problem in the community. Cognitive screening tools are widely used for MCI detection, but many of them lack sensitivity and specificity in MCI detection. On the basis of literature review, Short test of mental status (STMS) was selected for the present purpose.Aims:The present study purports to standardize STMS for using as a cognitive screening tool in MCI detection in the community-living elderly people in Kolkata.Materials and Methods:Data were collected from 102 community-living elderly people from the city of Kolkata using the purposive method of sampling. MCI was diagnosed using the Peterson's criteria of MCI as the gold standard. A semi-structured demographic proforma, clock-drawing test (CDT), and the Groningen Activity Restriction Scale (GARS) were used for the purpose. Finally, STMS was administered.Statistical Analysis:Statistical computation was done using the SPSS 21. Descriptive statistics, receiver operating curve analysis, and binary logistic regression were used for statistical analysis of the data.Results and Conclusion:STMS emerged as a sensitive and specific cognitive screening tool in the detection of MCI in the current cultural setting. It was also found to be more suited for the purpose than CDT. A score of 34.5 with a sensitivity of 97.5 and a specificity of 90.3% were selected for the optimum cutoff score for the detection of MCI in the present population. With a unit increase in STMS score, the odds of getting diagnosed with MCI were found to be reduced by 48.5%.

Construct of resilience in community-living elderly people facing health-related adversities

Construct of resilience in community-living elderly people facing health-related adversities

The association between anemia and falls in community-living women and men aged 65 years and older from the fifth Troms\xf8 Study 2001-02: a replication study

BackgroundFalls are common among elderly people, and the risk increase with age. Falls are associated with both health and social consequences for the patient, and major societal costs. Identification of risk factors should be investigated to prevent falls. Previous studies have shown anemia to be associated with increased risk of falling, but the results are inconsistent. The aim of this study was to investigate the association between anemia and self-reported falls among community-living elderly people. The study is a replication of the study by Thaler-Kall and colleagues from 2014, who studied the association between anemia and self-reported falls among 967 women and men 65 years and older in the KORA-Age study from 2009.MethodsWe included 2441 participants (54% women) 65 years and older from the population-based Tromsø 5 Study 2001-2002. Logistic regression models were used to investigate the association between anemia (hemoglobin <12 g/dL in women and <13 g/dL in men) or hemoglobin level and self-reported falls last year, adjusted for sex, age, medication use and disability. Further, associations between combinations of anemia and frailty or disability, and falls, were investigated.ResultsNo statistical significant associations were found between anemia and falls (OR 95% CI: 0.83, 0.50-1.37) or hemoglobin level and falls (OR, 95% CI: 0.94, 0.81-1.09), or with combinations of anemia and frailty or disability, and falls (OR, 95%: CI: 0.94, 0.40-2.22 and 0.78, 0.34-1.81, respectively).ConclusionsIn this replication analysis, in accordance with the results from the original study, no statistically significant association between anemia or hemoglobin and falls was found among community-living women and men aged 65 years or older.

Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial.

Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65years or older having experienced at least one fall during the last 12months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p=0.77, significant changes in favour of the intervention group were noted for balance (p=0.03), ADL (p=0.035), bodily pain (p=0.003) and reported health transition over time (p=0.008) as well as less hospital care due to fractures (p=0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention.

THE CONSTRUCT OF RESILIENCE IN THE FACE OF HEALTH-RELATED ADVERSITY AMONG COMMUNITY-LIVING ELDERLY

AbstractDecline of physical, psychological, and life functions is an inevitable consequence of aging. Interestingly, it has been reported that psychological factors, such as the purpose in life, has an effect on physiolosical aspects of aging, such as cognitive decline. This study, based on previous research, the purpose in life was considered as one construct of resilience. Resilience, defined as a psychological treat that promotes recovery and maintains life functions in the face of health-related adversities including illnesses, was investigated among community-living elderly people in Japan. Participants (N=20, mean age 81.45 years, Age range 72–92 years, 80% women) were recruited for the study by community care managers and volunteer workers. Episodic interviews were conducted with the participants about their thoughts, efforts and ideas for promoting recovery and maintaining life functions in the face of health-related adversity that they had experienced after approximately 60 years of age, following even a slight recovery. Responses from transcripts revealed four themes: Activation (acceptance of novelty, resolute will, natural pose, and trust of intuitions), Purpose in life (affirmative acceptance, meaning, past feelings in overcoming difficulties, and goals in life), Relationship preferences (enjoyment of contact with others, support seeking, and willingness to serve), and Health consciousness (health for life, industrious attitude, assessment, and sensitivity to information). It is suggested that these four constructs are linked in a chain reaction. The results of this study will contribute to the development of preventive psychological interventions for dementia among the aging population in Japan.

Risk Factors Associated with the Fear of Falling in Community-Living Elderly People in Korea: Role of Psychological Factors.

Little is known about the risk factors for the fear of falling in elderly Korean individuals. Thus, the present study aimed to investigate the risk factors for fear of falling in a representative elderly population of over 10,000 individuals aged 65 years and older. A multivariate multinomial analysis revealed that the risk factors associated with a severe fear of falling were being female [odds ratio (OR)=4.396], older age (OR=5.550 for those aged ≥85 years), lower level of education (OR=0.719 for those with ≥13 years of schooling), chronic illness (OR=2.788 for those with more than three chronic illnesses), poor subjective health (OR=6.268), functional impairments (OR=2.340), a history of falling (OR=7.062), and depression (OR=1.774). The ORs for each of these risk factors were particularly high in participants with a severe fear of falling. Particularly, a history of falling and/or poor subjective health status had strong independent associations with the fear of falling. The present findings may help health care professionals identify individuals that would benefit from interventions aimed at reducing the fear of falling.

Loneliness and its associated Factors in Community-living Elderly People who Use Day Care Services

Loneliness and its associated Factors in Community-living Elderly People who Use Day Care Services

Food security for community-living elderly people in Beijing, China.

Food security has been identified as an important issue for elderly people's quality of life and ageing in place. A food security index composed of three indicators (food intake, food quality and food affordability) was developed to measure the food security status of community-living elderly people. Food security was then examined among community-living elderly in the central urban districts of Beijing, China. Data were collected by a questionnaire survey in the summer of 2013 and the response rate was 78.5%. Descriptive statistics and binary logistic regression were applied to analyse food security and the associations between food security and demographic and socioeconomic factors. The results showed that 54.2% of the surveyed elderly experienced food security. Participants with better education (OR=1.68) and better health (OR=1.47) were more likely to experience food security. The young-old were less likely to experience food security than the older old (OR=0.94). Elderly people who lived with their children were less likely to experience food security than those who lived alone (OR=0.43). The results of impact factors on food security highlight both similarities with studies from more developed countries and the unique challenges faced in a rapidly changing China with its unique social, cultural and political systems. The food security index we developed in this study is a simple and effective measure of food security status, which can be used in surveys for evaluating the food security status of elderly people in the future.

Factors Influencing the Preferred Place of Death in Community-dwelling Elderly People in Japan

To investigate factors influencing the preferred place of death among community-living elderly people in Japan in relation to personal attributes, health status, self-rated health, and social capital indicators. A self-report questionnaire survey was conducted between July 2009 and September 2009 on a total of 238 elderly people aged ≥65 years living in Nagasaki Prefecture, Japan. Patients were either members of a social club for the elderly, individuals undergoing special health check-ups, or participants of health workshops held by cities. A total of 178 patients who provided complete responses (79 men, 99 women) were analyzed. Half or more of the patients (men: 68.4%, women: 52.5%) indicated home as their preferred place of death. Multiple logistic regression analysis showed that good self-rated health [odds ratio (OR): 2.6, 95% confidence interval (95% CI): 1.2–5.7, p = 0.013], participation in volunteer activities (OR: 2.0, 95% CI: 1.0–3.8, p = 0.038) and the spouse as the preferred caregiver (OR: 2.5, 95% CI: 1.3–4.8, p = 0.007) were associated with home as the preferred place of death. It is necessary to consider individual preferences and public health strategies in order to enable elderly people to receive suitable and comfortable end-of-life care in their preferred location.

Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea

The objective of this study is to investigate the cross-cultural relationship between depressive state and subjective economic status, as well as subjective quality of life (QOL) and activities of daily living (ADL) among elderly people in communities in Japan, Taiwan, and Korea. We studied 595 subjects aged 65 years or older in three Asian communities (261 subjects in T town in Japan, 164 in D town in Taiwan, and 170 in H town in Korea). The Geriatric Depression Scale-15, a self-rating questionnaire assessing ADL, subjective QOL, social situations, and past and current medical status, was used. Depression of the elderly was associated with dependence in basic ADL, subjective QOL, and subjective sense of low economic status. After adjusting for the effects of age, sex, and basic ADL, subjective sense of low economic status was closely associated with depression in community-living elderly people in all three communities in Asia. In conclusion, absolute and objective economic status is an important contributing factor to depressive state or psychosocial deterioration, however, we should pay more attention to the roles of perception of low economic status in determining depressive state in community-dwelling elderly people.

Risk of malnutrition and zinc deficiency in community-living elderly men and women: the Tromsø Study.

Elderly people may be at particular risk of Zn deficiency due to an increased prevalence of malnutrition. The aim of the present study was to evaluate the Zn status in community-living elderly people at risk of malnutrition. Cross-sectional population-based survey. Individuals at risk of malnutrition were identified by the Malnutrition Universal Screening Tool. Zn status was assessed by measuring serum Zn. Logistic regression was performed to evaluate the association between the risk of malnutrition and Zn deficiency. Municipality of Tromsø, Norway. Random sample of 743 men and 778 women aged 65-87 years. Zn deficiency was found in 10.1% of the participants, including 13.1% of the men and 7.3% of the women. Among the men and women at risk of malnutrition, 31.0% and 12.7%, respectively, had Zn deficiency. In a model adjusted for age, gender, serum albumin and smoking status, Zn deficiency was positively associated with the risk of malnutrition (OR=2.2; 95% CI 1.3, 3.6). Overall, Zn deficiency was found in one out of ten community-living elderly people and was associated with the risk of malnutrition. Our results encourage the assessment of Zn status in elderly people at risk of malnutrition, with a special emphasis on elderly men.

Psychiatric symptoms are not an independent mortality risk factor in community-living elderly people

Mortality risk factors have attracted great research interest in recent years. Physical illness is strongly associated with mortality risk in elderly people. Furthermore, a relationship between mortality risk and psychiatric disease in the elderly has gained research interest. This is a prospective longitudinal multicenter study. A sample of 324 participants was selected as a representative sample of community members aged 65 years and older and living in Huesca (Spain). The following information was collected: affiliation data, severity of physical illness, psychosocial, and psychiatric factors. Statistical analyses were completed with a multivariate analysis in order to control possible confounding variables related to mortality. Of the initially selected sample, 293 participants were assessed. Sixty-four participants died (21.8%, 95% CI [16.9%, 26.7%]), 5.3% annual rate, and 46.1% showed symptomatology of mental disorders. Older people have eight times greater risk of mortality. The risk increased 53 times in patients affected by several physical illness. No relationship between cognitive dysfunction and depressive symptomatology was observed. In fact, physical condition was associated with depression, and the percentage of participants with depressive symptoms increased according to the severity of physical illness. Severity of physical illness and age are independently and directly associated with mortality in the elderly people. Therefore, severity of physical illness seems to be a crucial factor in the bi-directional association between mortality and depression, acting as a risk factor independently for both. So the relationship between depression and mortality can be affected by the severity of physical illness.

Impact of spinal imbalance and back muscle strength on locomotive syndrome in community-living elderly people

BackgroundThe Japanese Orthopaedic Association has proposed the term locomotive syndrome (“locomo”) to designate a condition of individuals in high-risk groups with musculoskeletal disease who are highly likely to require nursing care. The specific characteristics of “locomo” must still be determined. The spinal column is a major and important component affected by “locomo,” but no literature has examined the relationship between spinal factors and “locomo.” The current study investigates the influence of spinal factors on “locomo” in the elderly. MethodsA total of 135 subjects >70years old were enrolled in the study (Yakumo study). Those answering yes to least one of the seven categories in the self-assessment checklist for “locomo” were defined as having “locomo.” We evaluated lateral lumbar radiographs, sagittal parameters, sagittal balance using the spinal inclination angle (SIA) as an index, spinal mobility as determined with SpinalMouse®, back muscle strength (BMS), and body mass index (BMI). ResultsAge, BMS, and SIA showed significant correlations with “locomo” and five of the seven self-assessment categories. Multivariate logistic regression analysis indicated that a decrease in BMS (OR 0.971, p < 0.001) and an increase in SIA (OR 1.144, p < 0.05) were significantly associated with “locomo.” BMS had significant negative correlations with age (r = −0.363), SIA (r = −0.294), and lumbar kyphosis (r = −0.254), and positive correlations with sacral slope angle (r = 0.194). SIA had significant negative correlations with BMS (r = −0.294), lumbar spinal range of motion (ROM) (r = −0.186) and total spinal ROM (r = −0.180), and positive correlations with age (r = 0.403) and lumbar kyphosis (r = 0.593). ConclusionsA decrease in BMS and an increase in SIA may be the most important risk factors for “locomo.” Lumbar kyphosis is an important factor related to BMS and SIA. Back muscle strengthening and lumbar spinal ROM exercises could be useful for improving the status of an individual suffering from “locomo.”

Falls Among the Community-living Elderly People in Hong Kong: A Retrospective Study

Purpose To examine the base rate of falls for a group of community-living elderly people in Hong Kong. Methods This was a retrospective cross-sectional study of 554 elderly people aged 65 years or above living in various geographical regions of Hong Kong, who had completed assessments at a community centre over a period of 4 months. Participants were recruited by convenience sampling and stratified by age range according to the distribution in Hong Kong population. They were asked to report on their fall history for a period of the 12 months before joining the study. Results Of all the participants, 111 reported having fallen during the preceding 12 months. The fall rate was 29%, and the 1-year prevalence of falls was 20%, dropping to 6.3% for two or more falls. Of all the falls, 47.7% occurred indoors whereas 52.3% occurred outdoors. Results showed female gender, Timed Up & Go Test, self-reported history of upper limb fracture, an intake of four or more types of medication, receiving rehabilitation services, and living with a couple only were independent predictors for fallers with at least one fall. There were no significant differences between the number of near-miss experienced by fallers and nonfallers in the past 12 months. Conclusion We determined the base rate of falls for a group of community-living elderly people of Hong Kong. Retrospective methods, which ask elderly people living in a community to recall their falls, may be used to identify risks preceding falls and to facilitate early intervention.

Number of teeth and selected cardiovascular risk factors among elderly people

To produce evidence on an association between the number of teeth and selected cardiovascular risk factors among an elderly population. The study population comprised of 523 community-living elderly people who participated in the population-based Kuopio 75+ study. The data for each subject were collected using a structured clinical health examination, an interview and laboratory tests. Linear regression models were used to estimate adjusted mean values and confidence limits. Edentulous persons and persons with a small number of teeth had lower serum HDL cholesterol and higher triglyceride, leucocyte and blood glucose levels and a higher body mass index (BMI) compared with subjects to a large number of teeth. The study showed that, in the Finnish home-dwelling population aged 75 years or older, those with a large number of teeth were less likely to have cardiovascular risk factors such as a low serum HDL cholesterol level, a high triglyceride level and a high BMI than did subjects with a small number of teeth or who were edentulous.

The break remains – Elderly people's experiences of a hip fracture 1 year after discharge

Purpose. To explore experienced long-term consequences of a hip fracture and conceptions of what influences hip fracture recovery among community-living elderly people 1 year after discharge.Method. Fifteen subjects (13 females and 2 males), aged 66–94, were interviewed. The phenomenographic method was used for analysis.Results. Experiences of insecurity and restricted life dominated the interviews. The descriptive categories within experienced consequences of a hip fracture were: (1) isolated life with more restricted activity and fewer social contacts, with the two sub-categories (a) more insecure and afraid and (b) more limited ability to move, (2) disappointed and sad that identity and life have changed and (3) satisfied with the situation or feeling even better than before the fracture. The categories within conceptions of what influences hip fracture recovery were: (4) own mind and actions influence recovery, (5) treatment and actions from others influence recovery and (6) you cannot influence recovery.Conclusion. The findings accentuate that the negative consequences of a hip fracture are substantial and long-lasting. As it strikes mostly elderly people, who may have experienced earlier losses and growing disabilities, a hip fracture could add to the risk of losing important life values. Furthermore, the findings indicate that all health care professionals who meet the patients need to consider the patients’ own experiences and possible fear and not merely focus on the physical injury and disabilities.

Number of teeth and myocardial infarction and stroke among elderly never smokers

BackgroundIn most previous studies the association between number of teeth and cardiovascular diseases has been found to be stronger among younger age groups than in older age groups, which indicates that age may modify the association between number of teeth and cardiovascular diseases.We investigated the association between tooth loss and atherosclerotic vascular diseases such as myocardial infarction and stroke in a homogeneous elderly population.The study population was comprised of a subpopulation of 392 community-living elderly people who participated in the population-based Kuopio 75+ study. The data were collected through an interview, a structured clinical health examination and from patient records. The main outcome measures were a history of diagnosed myocardial infarction and diagnosed ischemic stroke. Prevalence proportion ratios (PPR) were estimated using generalised linear models.ResultsEdentate subjects had a weakly, statistically non-significantly increased likelihood of a history of myocardial infarction and ischemic stroke compared with dentate subjects. Those with a large number of teeth had a slightly, but not statistically significantly increased likelihood of a history of myocardial infarction and ischemic stroke compared with those with a small number of teeth.ConclusionThese data did not show evidence that total or partial tooth loss would be associated with atherosclerotic vascular diseases such as myocardial infarction and ischemic stroke among an elderly population aged 75 years or older.

Incidência de depressão e fatores associados em idosos residentes na comunidade: revisão de literatura

Resumo Depressão geriátrica ocorre com frequência, mesmo na população residente na comunidade. Vários fatores de risco associados estão descritos na literatura. O objetivo deste estudo é realizar uma revisão da literatura sobre a incidência de depressão geriátrica e os fatores de risco associados em idosos residentes na comunidade. Para este fim, realizou-se revisão bibliográfica da literatura sobre o tema, sendo efetuada consulta às bases de dados MEDLINE, PUBMED, LILACS e SCIELO, utilizando-se das palavras chaves "idoso", "fator de risco", "depressão" e "incidência". A incidência de depressão na população idosa residente na comunidade é de 13,23%, em média. Os preditores de depressão identificados foram: sexo feminino, idade avançada, condição marital, baixa escolaridade, condição socioeconômica desfavorável, condições de moradia, baixo suporte social, eventos estressores, depressão prévia, co-morbidades psiquiátricas, características de personalidade, distúrbios do sono, déficits cognitivos, condições de saúde adversas, limitação funcional e dor. Depressão ocorre com frequência na população idosa e constitui problema grave. A identificação dos fatores de risco associados com sua incidência pode ajudar os profissionais que atuam na área a diagnosticar e propor intervenções mais precoces e adequadas.