Community-Living Elderly Research Articles

Determinants of Oral Health Problems among Community-Living Elderly Persons in Greece - The Role of Diet and Chronic Diseases in Oral Health

Several studies have examined the relationship between oral health, diet and chronic diseases. The aim of the present study was to investigate the determinants of oral health problems, and more particularly to examine the association of diet and chronic diseases with oral health among community living elderly persons in Greece.

Living Arrangement of Older People: A Study of Community Living Elderly from Nepal

Background: Aging has caused changes in the structure of families that raises reflections on the sustainability of the traditional models of family care for older adults. The aim of this article is to analyze the situation of living arrangements of Nepalese older people. Methods: This study is a secondary analysis of structured interview data collected by the Central Department of Population Studies at Tribhuvan University (TU) via a cross-sectional survey of community-dwelling persons aged 60+ in the Pharping area of Kathmandu. For this study, there were 1326 valid responses. Results: Findings show over four-fifths of respondents (81.3%) were living with family members, far more than with a spouse only (11.6%), alone (6.2%), and others (0.9%). The proportion of Populace residing alone tends to increase with the increase in age of respondents; more widowers tend to live alone compared to those in marital unions; more elderly males without living children tend to live alone compared to those who have at least one living child. The sex of the respondents, marital status, ethnicity, income situation, and feeling of insecurity have significant differences in the living arrangement of older people in this study. Conclusion: Traditionally, Nepalese older adults are contented to live with their family members. The government of Nepal should promote the traditional living arrangements of older people through some incentives providing for family members taking care of their senior citizens.

Diagnostic Accuracy of Handgrip Strength as a Screening Tool of Nutritional Status in Community-Living Elderly

Diagnostic Accuracy of Handgrip Strength as a Screening Tool of Nutritional Status in Community-Living Elderly

Heart Failure and Frailty in the Community-Living Elderly Population: What the UFO Study Will Tell Us.

Heart failure and frailty are clinical syndromes that present with overlapping phenotypic characteristics. Importantly, their co-presence is associated with increased mortality and morbidity. While mechanical and electrical device therapies for heart failure are vital for select patients with advanced stage disease, the majority of patients and especially those with undiagnosed heart failure would benefit from early disease detection and prompt initiation of guideline-directed medical therapies. In this article, we review the problematic interactions between heart failure and frailty, introduce a focused cardiac screening program for community-living elderly initiated by a mobile communication device app leading to the Undiagnosed heart Failure in frail Older individuals (UFO) study, and discuss how the knowledge of pre-frailty and frailty status could be exploited for the detection of previously undiagnosed heart failure or advanced cardiac disease. The widespread use of mobile devices coupled with increasing availability of novel, effective medical and minimally invasive therapies have incentivized new approaches to heart failure case finding and disease management.

Letter to the editor: Long-Term Tea Consumption and Depressive and Anxiety Symptoms in Elderly.

To the editor, the publication on “Associations of Long-Term Tea Consumption with Depressive and Anxiety Symptoms in Community-Living Elderly” is very interesting (1). Chan et al. concluded that “There was evidence suggesting that long-term tea consumption was associated with reduced depressive and anxiety symptoms among community-living elderly (1).” In fact, tea drinking is a rooted behavior among Chinese Asian population. The health usefulness of tea is approved. Neuroprotective system due to tea drinking is believed to due to the active ingredients including to flavonoids (2). In a recent report, the green tea was found to have more neuroprotective activity than red and black tea (3). It is no doubt that the long-term tea consumption can result in neuroprotective effect as reported by Chan et al (1). However, as noted by Chan, further investigation is needed. The main concern for the present report is confounding effect that is not controllable. The studied elderly might have other foods, beverages or activities that can help protect against depressive and anxiety symptoms. Finally, tea contain caffeine, an extremely high dose drinking might result in problem, induction of anxiety instead of prevention of anxiety (4).

A Cross-Sectional Study on Relationship between Backward Falls and Fall Risk Evaluation in Community-Living Elderly

A Cross-Sectional Study on Relationship between Backward Falls and Fall Risk Evaluation in Community-Living Elderly

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

Classification of Isolated Deaths among Community-living Elderly Documented by Community Comprehensive Support Centers

Classification of Isolated Deaths among Community-living Elderly Documented by Community Comprehensive Support Centers

Association of Metabolic Syndrome with Serum Adipokines in Community-Living Elderly Japanese Women: Independent Association with Plasminogen Activator-Inhibitor-1.

Associations between metabolic syndrome (MetS) with serum adipokines and basal lipoprotein lipase mass (serum LPL) have not been extensively studied in elderly Asians, who in general have lower body mass index than European populations. A cross-sectional analysis was conducted including 159 community-living elderly Japanese women whose age averaged 77 years. MetS was defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria, but using a body mass index ≥25 kg/m(2) instead of waist circumference. Serum LPL, leptin, adiponectin, plasminogen activator inhibitor 1 (PAI-1), interleukin-6, tumor necrosis factor-alpha, and high-sensitivity C-reactive protein were measured. Both the presence of MetS and the number of MetS components were associated with higher homeostasis assessment of insulin resistance, serum levels of leptin, PAI-1, and tumor necrosis factor-alpha and with lower serum levels of LPL and adiponectin (all P < 0.05), but not with high-sensitivity C-reactive protein and interleukin-6. Among six biomarkers of MetS, PAI-1 remained associated with MetS independent of fat mass index and insulin resistance. Although proinflammatory, prothrombotic, and anti-inflammatory states were associated with MetS, higher PAI-1 was associated with MetS independent of fat mass index and insulin resistance in elderly Japanese women, in whom obesity is rare.

A Longitudinal Study of Dietary Supplement Use in Community-living Middle Age and Elderly Japanese.

A Longitudinal Study of Dietary Supplement Use in Community-living Middle Age and Elderly Japanese.

Development and Validation Study of Self-Neglect Scale for Older Adults : Focusing on Community-living Elderly Adults

Development and Validation Study of Self-Neglect Scale for Older Adults : Focusing on Community-living Elderly Adults

The Risk of Malnutrition in Community-Living Elderly on Admission to Hospital for Major Surgery

Background: With prevalence rates varying from 10 to 60%, malnutrition in acute hospitals has been acknowledged as a persistent problem in older adults worldwide. This publication is to describe the nutritional condition and associated risk factors of malnutrition in free living elderly on admission to the hospital for major elective surgery. Methods : A cross sectional, multi-center study in eight surgical wards in three Belgian hospitals. A total of 204 free living elderly, aged 74.8 ± 6.6 years (Mean ± SD), on admission to the hospital for major elective surgery and requiring at least 3 days of hospitalization, were consecutively recruited to the study. The nutritional status was assessed on admission and before surgery using the recommended NRS-2002. Data on possible associated factors were collected during post-operative stay using a structured questionnaire.Results : A total of 107 patients (51.4%) were at high risk of malnutrition. In patients older than 70 years (n 150) the risk of malnutrition increased up to 66%. None of the included patients reported preoperative referral to a dietician or nutritional advice nor any prescribed preoperative nutritional supplement. In a multivariate regression analysis it appeared that none of the possible associated factors were significantly associated with malnutrition.Conclusions : This study confirms the high risk of malnutrition in community living elderly on admission to hospital for elective surgery. According to the NRS-2002 these patients might benefit from nutritional support. However, it appears that nutritional support is not yet commonly implemented in preoperative care for this population at risk.

PP047-MON: Influence of Supplemental Drinks on Body Composition among the Community-Living Healthy Elderly in Japan

PP047-MON: Influence of Supplemental Drinks on Body Composition among the Community-Living Healthy Elderly in Japan

Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant

Background: The Clinical Dementia Rating (CDR) scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI) and evaluated its reliability and validity for assessing mild cognitive impairment (MCI) and dementia among community-dwelling elderly subjects. Method: At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE) <26 and/or Montreal Cognitive Assessment (MOCA) <26] and without informants according to a protocol. CDR domains and global scores were assigned after the second visit based upon corroborative information from the subjects' responses to questions, role-play, and observed performance in specifically assigned tasks at home and within the community. Results: The CDR-NI scores (0, 0.5, 1) showed good internal consistency (Crohnbach's a 0.83-0.84), inter-rater reliability (κ 0.77-1.00 for six domains and 0.95 for global rating) and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating), good agreement (κ 0.79) with the clinical assessment status of MCI (n = 37) and dementia (n = 4) and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p < 0.001). Conclusion: Owing to the protocol of the interviews, assessments and structured observations gathered during the two visits, CDR-NI provides valid and reliable assessment of MCI and dementia in community-living elderly subjects without an informant.

Association of Low Serum Iron Levels with Low-grade Inflammation and Hyperadiponectinemia in Community-living Elderly Women

There have been inconsistent reports regarding the relationship between the iron status and coronary vascular diseases (CVD). Recently, low serum iron levels have been shown to be associated with mortality from CVD in women. The relationships between the serum iron levels and traditional and nontraditional risk factors for CVD were examined in 202 community-living elderly Japanese women. The women in the lowest iron tertile had higher high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor-α (TNF-α) levels than the women in the top iron tertile (p<0.01 or less for both). In addition, the women in the lowest tertile had higher serum levels of adiponectin and copper and ratios of serum copper to zinc and lower serum levels of albumin, hemoglobin and hematocrit. Furthermore, the women in the lowest tertile had higher creatinine levels and lower eGFR values, although there were no significant differences in the prevalence of chronic kidney disease between the three tertile groups. In a multiple regression analysis including the levels of hsCRP, TNF-α, adiponectin and serum creatinine and the ratio of serum copper to zinc as independent variables, the levels of hsCRP, TNF-α and adiponectin emerged as independent determinants of the serum iron level (R(2)= 0.106). In the model to which the hemoglobin level was added as an independent variable, the levels of hemoglobin, hsCRP and TNF-α emerged as independent determinants of the serum iron level (R(2)= 0.192). The present study demonstrated that community-living elderly Japanese women with low serum iron levels have nontraditional risk factors for CVD, including low-grade inflammation and higher levels of serum adiponectin.

Association Between Depressive and Anxiety Disorders and Adherence to Antihypertensive Medication in Community‐Living Elderly Adults

To identify the determinants of antihypertensive medication adherence in community-living elderly adults. Longitudinal observational study. Population-based health survey in the province of Quebec, Canada. Data from a representative sample (N = 2,811) of community-dwelling adults in Quebec aged 65 and older participating in the Étude sur la Santé des Aînés study. The final study sample analyzed consisted of 926 participants taking antihypertensive drugs during the 2 years of the study. Adherence to antihypertensive medication was measured using days of supply obtained during a specified time period. Depression and anxiety disorders were assessed using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, and physical health status was measured using the Charlson Comorbidity Index. Other factors considered were age, education, marital status, annual family income, and number of antihypertensive drugs that participants used. Mean antihypertensive proportion (percentage) of days supplied in was 92.5% in Year 1 and 59.4% in Year 2. The presence of depression and anxiety disorders and the number of antihypertensive medications significantly predicted medication adherence. The sex by depression and anxiety disorders interaction term was significant. Adherence to antihypertensive medication was significantly associated with depression and anxiety disorders in men but not women. The treatment of depression and anxiety disorders in individuals with hypertension may be helpful in improving medication adherence rates and healthcare outcomes.

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.

Markers of Mineral Metabolism Are Not Associated With Aortic Pulse Wave Velocity in Community-Living Elderly Persons: The Health Aging and Body Composition Study

Disorders in mineral metabolism are associated with risk for cardiovascular disease (CVD) events in patients with kidney disease as well as in the general population. This risk is thought to be mediated, in part, through the mechanism of stiffening of the arteries. The objective of this study was to evaluate the relationships between serum calcium, phosphorus, intact parathyroid hormone (iPTH), and 25-hydroxyvitamin D levels and arterial pulse wave velocity (aPWV) among 2,229 community-dwelling elderly persons participating in the Health Aging and Body Composition (Health ABC) study. The mean age of the participants was 72 years; 52% were woman, 39% were black, and 17% had chronic kidney disease (CKD) (estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2)). In parallel unadjusted analyses, the following associations were observed: 2.86% greater aPWV per 12 ng/ml (s.d.) lower 25-hydroxyvitamin D (95% confidence interval -4.38%, -1.31%), 3.04% greater aPWV per 28 pg/ml (s.d.) higher iPTH (95% confidence interval 1.42-4.68%), and 2.37% lower aPWV per 0.5 mg/dl (s.d.) higher phosphorus (95% confidence interval -3.90% to - 0.81%). Except for phosphorus, these associations were attenuated and rendered no longer statistically significant after adjustment for demographic risk factors, clinical site, season, medications and other CVD risk factors. The results were similar in men and women and were not dependent on the presence of CKD. Among well-functioning community-dwelling elderly persons, only serum phosphorus was associated with aPWV; and this association was in the opposite direction of the one hypothesized. Factors other than vascular stiffening may mediate the relationship between disordered mineral metabolism and CVD events in community-living elders.

Socioeconomic and Other Characteristics Affecting Dietary Adequacy in Community-Living Elderly Chinese in South Florida

Socioeconomic and Other Characteristics Affecting Dietary Adequacy in Community-Living Elderly Chinese in South Florida