Factors In Older Adults Research Articles

Chronic Kidney Disease and Accelerated Decline of Renal Function in Older Adults with HIV in Northern Thailand.

Kidney disease remains prevalent in people living with HIV even in the antiretroviral treatment era. We determine the frequency of chronic kidney disease (CKD), rate of renal function decline, and associated factors in older adults with HIV (OAHIV) aged ≥50 years in northern Thailand. We used data from the medical records and calculated the estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration equation. Of the 269 participants (58% women, 61.8 years median age), 7.1% had CKD (eGFR <60 mL/min per 1.73 m2). There were 21 OAHIV (7.8%) with >25% decline in eGFR in the past year, 90 (33%) with accelerated (>5 mL/min per 1.73 m2 per year), and 44 (16%) with rapid (>10 mL/min per 1.73 m2 per year) declining eGFR. Female gender was the only factor associated with an accelerated decline in eGFR (odds ratio, 2.307; 95% confidence interval, 1.331-3.998; p = .003). Continuous monitoring of renal function is recommended for OAHIV to guide treatment modification and intervention.

Influence of the Built Environment on Older Adults’ Travel Time: Evidence from the Nanjing Metropolitan Area, China

The built environment is among the critical factors in older adults’ travel behavior, and a favorable built environment can encourage them to travel and engage in various activities. Existing studies have mostly focused on exploring the correlation between the built environment and travel behavior, ignoring the heterogeneity between the two at different times of the day. In this study, we conducted structured, face-to-face interviews in the Nanjing (China) metropolitan area to investigate the time consumed per trip by older adults using various travel modes and used the structural equation and random forest models to explore the relationship between the built environment and older adults’ travel time. The results demonstrated that older adults had different perspectives on travel during different time periods. Different environments and the convenience of destinations affected their overall satisfaction during travel. We found a nonlinear relationship between the built environment and travel time. Metropolitan street connectivity initially had a positive effect on travel time until a certain threshold or peak, whereafter a gradual decline ensued. This nonlinear relationship also existed between the proportion of green space and the distance to subway stations. These results can guide the retrofitting and construction of age-friendly metropolitan infrastructure facilities that promote older adults’ mobility.

Prevalence of frailty and pre-frailty and related factors in older adults with cardio-cerebral vascular disease in China: a national cross-sectional study.

Frailty increases adverse clinical outcomes in older patients with cardio-cerebral vascular disease (CCVD). The aim of this study was to investigate the prevalence of frailty and pre-frailty in older adults with CCVD in China and the factors associated with it. In this cross-sectional study, we used data from the fourth Sample Survey of Aged Population in Urban and Rural China. We used the frailty index for frailty and pre-frailty assessment, and the diagnosis of CCVD in older adults was self-reported. A total of 53,668 older patients with CCVD were enrolled in the study. The age-standardized prevalence of frailty and pre-frailty in older patients with CCVD was 22.6% (95% CI 22.3-23.0%) and 60.1% (95% CI 59.7-60.5%). Multinomial logistic regression analyses showed that being female, increasing age, rural residence, illiteracy, widowhood, ethnic minority, living alone, no health screening during the last year, hospitalization during the last year, difficult financial status, comorbid chronic conditions, and disability in activities of daily living were associated with frailty and pre-frailty in older patients with CCVD. CCVD is strongly associated with frailty and pre-frailty in older Chinese people, and assessment of frailty should become routine in the management of older CCVD patients. Appropriate public health prevention strategies should be developed based on identified risk factors for frailty in older CCVD patients, which can help prevent, ameliorate or reverse the development of frailty in CCVD in the older population.

Global Prevalence of Obstructive Sleep Apnea in the Elderly and Related Factors: A Systematic Review and Meta-Analysis Study

PurposeThe aims of current meta-analysis was to combine data and statistics on the global prevalence of OSA and related factors in older adults. DesignA systematic review and meta-analysis. MethodsTo find related studies, various databases were searched including Embase, PubMed, Scopus, Web of Science (WoS), MagIran, and SID (two local databases) using appropriate keywords, MeSH and controlled vocabulary, with no time limitation up to June, 2021. Heterogeneity of studies was evaluated using I2, and Egger's regression intercept was used to detect publication bias. Findings39 studies with a total sample size of 33,353 people were included. The pooled prevalence of OSA in older adults was 35.9% (95% confidence interval: 28.7%-43.8%; I2 = 98.81%). Considering the high heterogeneity of included studies, subgroup analysis was conducted and yielded the most prevalent in Asia continent with 37.0% (95% CI: 22.4%-54.5%; I2 = 97.32%). However, heterogeneity was remained at high level. In the majority of studies, OSA was significantly and positively related to obesity, increased BMI, age, cardiovascular diseases, diabetes, and daytime sleepiness. ConclusionsResults of this study showed that global prevalence of OSA in older adults is high and is significantly related to obesity, increased BMI, age, cardiovascular diseases, diabetes, and daytime sleepiness. These findings can be used by experts working on the diagnosis and management of OSA in the geriatric population. These findings can be used by experts on the diagnosis and treatment of OSA in the older adults. Due to high heterogeneity, findings should be interpreted with great caution.

COGNITIVE IMPAIRMENT AND CARDIOVASCULAR RISK FACTORS: FINDINGS FROM THE PURE-COLOMBIA COHORT

Objective: To estimate the prevalence of cognitive impairment and its association with cardiovascular risk factors in the cohort population of the Prospective Urban and Rural Epidemiological Study (PURE) for the fifteenth year of follow-up in some departments of Colombia. Design and method: Cross-sectional study nested in the PURE cohort in participants with Mini-Cog test for cognitive screening, with a cut-off point of &lt; = 2 points to screen cognitive impairment. We evaluate behavioral cardiovascular factors such as smoking, pathological history such as arterial hypertension, and measurements of blood pressure, weight, height, waist/hip ratio, glucose, triglycerides, cholesterol, hdl, ldl, and creatinine. We stimate The prevalence ratios for cognitive impairment using a generalized linear model with binomial family and link log. Results: In 707 participants whose mean age is 64.9 (SD 9.2) years, 66.8% are women, we found that 26.8% with indicators of cognitive impairment, with complete difficulty for the clock sub-test in 24.5% and 3.9% on the memory subtest. A higher prevalence of cognitive impairment was found among hypertensives compared to non-hypertensives (63.7% vs. 41.8%, Prevalence Ratio = 1.51, 95% CI 1.17; 1.93, p = &lt;0.001). In addition, systolic blood pressure was 9 mmHg, higher in participants with cognitive impairment (median 138mmHg vs 129mmHg, p = 0.0001) Also, the proportion of people with deterioration was higher in those who had a cholesterol greater than 200mg/dL (PR = 1.38 95% CI = 1.11;1.72 p = 0.004) and with an increase in the waist-hip ratio (PR = 3.27 95% CI = 1.21; 8.8 p = 0.019) the above adjusted for age, sex and educational level. Conclusions: More than a quarter of the participants in the PURE cohort presented indicators of cognitive impairment, its prevalence was significantly higher in hypertensive patients, in people with high cholesterol and with a significantly higher waist/hip ratio, which indicates the importance of preventing and controlling the Cardiovascular risk factors in older adults with cognitive alterations.

Poor oral health predicts cognitive impairment in elders

AbstractBackgroundTooth loss, periodontal disease, dementia, and Alzheimer’s disease share several risk factors in older adults. Several previous studies have reported positive associations between these dental problems and global cognitive defects. However, limited is known about the relationships among multiple dental/periodontal statuses and different cognitive domains.MethodThis six‐year (2011‐2017) cohort study includes 515 older adults (65+). Global cognition was assessed by Montreal cognitive assessment‐Taiwan version (MoCA‐T). For cognitive domains, we used logical memory tests (immediate and delayed theme and free recall) in Wechsler Memory Scale‐Third Edition (WMS‐III) to assess memory. Trail Making Test A and B was used to assess attention and executive function, respectively. Digit span‐forward and backward was used to evaluate attention and working memory/short‐term memory, respectively. Verbal fluency tests were used to assess category/semantic fluency. A Z‐score was calculated for each cognitive domain‐specific test according to baseline mean and standard deviation. Oral health status includes tooth defect (dental caries, tooth wear, cervical abrasion, retained root or crown fracture), periodontal health (disease severity from healthy periodontal status, gingivitis to periodontitis), and arch integrity (no tooth loss nor retained root or crown fracture). Generalized linear mixed models were used to assess the associations above adjust important covariates.ResultAt baseline, periodontitis was associated with poor performance in executive function [Trail Making Test A: b = ‐0.14, 95% confidence interval (CI) = ‐0.27 to ‐0.01]. The association between baseline severity of tooth defect and poor memory decreased (logical memory‐immediate theme recall: b = ‐0.05, 95% CI = ‐0.10 to ‐0.01); similarly finding was found for attention domain (digit span‐forward: b = ‐0.04, 95% CI = ‐0.07 to ‐0.001). At baseline, loss of arch integrity was associated with a better working memory/short‐term memory (digit span‐backward: β = 0.18, 95% CI = 0.01 to 0.36); as follow‐up time increased, this association decreased over six years (β = ‐0.04, 95% CI = ‐0.07 to ‐0.003).ConclusionPeriodontitis, tooth defects, or arch integrity was associated with poor performance of cognitive domains (memory, attention, and executive function) over time. A oral health evaluation may serve as predictors of the preclinical phase of dementia in its upcoming years.

The effects of a magic-based intervention on self-esteem, depressive symptoms, and quality of life among community-dwelling older adults: a randomised controlled trial.

Magic-based programs have been utilised to enhance well-being across various health aspects. However, there is a lack of studies on whether performing magic tricks can provide mental health benefits for older adults living in the community. Therefore, this study aims to investigate the effects of a magic-based intervention program on self-esteem, depressive symptoms, and quality of life (QOL), and to examine the relationship between these factors in older adults. Thirty-eight participants, aged 60-90 years, were randomly assigned to either a magic intervention group or a control group. The magic intervention program, tailored for older adults, was conducted for 90 min, twice weekly, over 6 weeks. The Rosenberg Self-Esteem Scale (RSE), the 15-item Geriatric Depression Scale (GDS-15), and the World Health Organization Quality of Life-BREF scores were measured and analyzed in both groups before and after the intervention. The magic-based intervention significantly increased self-esteem and reduced depressive symptoms in older adults, with large effect sizes. However, no significant impact on QOL was observed. Additionally, no significant correlation was found between the improvement in self-esteem and the reduction in depressive levels. Despite this, a moderate but significant negative correlation was detected between the post-intervention scores of RSE and GDS-15 in the magic intervention group. The study demonstrated that the magic intervention program was beneficial in promoting mental health in community-dwelling older adults. Implementing magic programs in communities appears to be an effective approach to enhance self-esteem and alleviate depressive symptoms in the older population.

ADL/IADL limitations and related factors in older adults in 3 Northern provinces Vietnam

This cross-sectional study aimed to identify the prevalence and factors related to the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) among elderly people in Ha Noi, Ninh Binh, and Quang Binh in 2018. In total, 2448 participants were interviewed and measured using an adapted short version of Katz ADL Index and Lawton IADL Scale. The study showed a high prevalence of ADL and IADL disability (29.1% and 33.1%, respectively) in older adults. The risks of ADL and IADL limitations increased with age, gender ( higher in females), individuals withlower incomes, who had a history of chronic diseases, who self-rated poor health status, reported a moderate or severe somatic pain and who had weak grip strength. People who were still employed and regularly performed heavy physical activities had a lower chance of ADL and/or IADL limitations. We suggest that ADL/IADL limitations should be taken in account for any potential health care strategies and interventions for elderly population.

NREM sleep as a novel protective cognitive reserve factor in the face of Alzheimer's disease pathology

BackgroundAlzheimer’s disease (AD) pathology impairs cognitive function. Yet some individuals with high amounts of AD pathology suffer marked memory impairment, while others with the same degree of pathology burden show little impairment. Why is this? One proposed explanation is cognitive reserve i.e., factors that confer resilience against, or compensation for the effects of AD pathology. Deep NREM slow wave sleep (SWS) is recognized to enhance functions of learning and memory in healthy older adults. However, that the quality of NREM SWS (NREM slow wave activity, SWA) represents a novel cognitive reserve factor in older adults with AD pathology, thereby providing compensation against memory dysfunction otherwise caused by high AD pathology burden, remains unknown.MethodsHere, we tested this hypothesis in cognitively normal older adults (N = 62) by combining 11C-PiB (Pittsburgh compound B) positron emission tomography (PET) scanning for the quantification of β-amyloid (Aβ) with sleep electroencephalography (EEG) recordings to quantify NREM SWA and a hippocampal-dependent face-name learning task.ResultsWe demonstrated that NREM SWA significantly moderates the effect of Aβ status on memory function. Specifically, NREM SWA selectively supported superior memory function in individuals suffering high Aβ burden, i.e., those most in need of cognitive reserve (B = 2.694, p = 0.019). In contrast, those without significant Aβ pathological burden, and thus without the same need for cognitive reserve, did not similarly benefit from the presence of NREM SWA (B = -0.115, p = 0.876). This interaction between NREM SWA and Aβ status predicting memory function was significant after correcting for age, sex, Body Mass Index, gray matter atrophy, and previously identified cognitive reserve factors, such as education and physical activity (p = 0.042).ConclusionsThese findings indicate that NREM SWA is a novel cognitive reserve factor providing resilience against the memory impairment otherwise caused by high AD pathology burden. Furthermore, this cognitive reserve function of NREM SWA remained significant when accounting both for covariates, and factors previously linked to resilience, suggesting that sleep might be an independent cognitive reserve resource. Beyond such mechanistic insights are potential therapeutic implications. Unlike many other cognitive reserve factors (e.g., years of education, prior job complexity), sleep is a modifiable factor. As such, it represents an intervention possibility that may aid the preservation of cognitive function in the face of AD pathology, both present moment and longitudinally.

An analysis of nutritional risk factors in older adults with gastrointestinal tumours

IntroductionThe aim of this study was to investigate risk factors for nutritional risk in older adults with gastrointestinal tumours. Materials and MethodsA total of 170 eligible hospitalised older adults with gastrointestinal tumours were included. Their clinical characteristics were collected, their nutritional risk was screened by NRS 2002, and then patients were divided into a nutritional risk group and a non-nutritional risk group. The observation indicators included body mass index (BMI), muscle mass, muscle strength, and calf circumference. The third lumbar skeletal muscle index (L3 SMI) was calculated using abdominal computed tomography (CT) scan results, and grip strength/muscle strength, 6-m walking speed and calf circumference were measured. Sarcopenia was diagnosed according to the criteria of the Asian Sarcopenia Working Group (AWGS). Finally, we analysed the relationship between nutritional risk and sarcopenia and other related factors (BMI, calf circumference, L3 SMI, grip strength/muscle strength, 6-m walking speed) in older adults with gastrointestinal tumours by multivariate logistic regression analysis. ResultsOlder adults with gastrointestinal tumours who were at nutritional risk accounted for 51.8% of patients in this study. The differences between sex, tumour stage, age, BMI, calf circumference, L3 SMI, grip strength/muscle strength, 6-m walking speed, and prevalence of sarcopenia were statistically significant in two groups (all P < 0.05). Multivariate logistic regression analysis showed that age, BMI, grip strength/muscle strength, and sarcopenia were risk factors of nutritional risk in older adults with gastrointestinal tumours (all P < 0.05). DiscussionOlder adults with gastrointestinal cancer had a higher proportion of nutritional risk, and L3 SMI, grip strength/muscle strength were independent risk factors for nutritional risk. In clinical practice, attention to nutritional risk screening and sarcopenia development in older adults with gastrointestinal cancer is warranted.

Analysis of the current status of rehabilitation motivation and its influencing factors in older adults with stroke: a cross-sectional study.

Among stroke patients, exercise adherence is an important factor in reducing the rate of physical disability and mortality. Rehabilitation exercise after stroke is a safe and effective measure to restore normal body functions, but the analysis of factors influencing patients' motivation for rehabilitation is not well established. Therefore, this study will explore the influencing factors of rehabilitation motivation in older adults with stroke so as to reduce the disability rate of stroke. A convenience sampling method was used to study 350 patients in a stroke ward of a tertiary care hospital in Jinzhou, Liaoning Province. Patients' general demographic data, Multidimensional Scale of Perceived Social Support (PSSS), Questionnaire of Exercise Adherence (EAQ), Tampa scale of kinesiophobia (TSK-11), and Motivation in stroke patients for rehabilitation scale (MORE) were assessed. ANOVA or t-test analysis, correlation analysis, and linear regression analysis were used to explore the factors influencing the motivation for rehabilitation in older adults with stroke. The results showed that stroke patients' motivation for rehabilitation was at a moderate level. Perceived social support, exercise adherence, and stroke motivation were positively correlated (r = 0.619, p < 0.01; r = 0.569, p < 0.01), and kinesiophobia was negatively correlated with stroke motivation (r = -0.677, p < 0.01). Time of stroke, location of the lesion, perceived social support, exercise adherence, and kinesiophobia are influential factors affecting patients' motivation to recover. In the rehabilitation program for older adult patients with stroke, healthcare providers should specify targeted rehabilitation measures according to the different degrees of the patient's condition, so as to improve the effectiveness of rehabilitation medical implementation.

Caregivers’ fear of older care recipients falling: A systematic review of qualitative studies

ObjectiveThis qualitative systematic review aimed to describe informal caregivers’ and health personnel's experiences of the FOF (fear of falling) of older adults under their care. MethodsA systematic search of databases included not only the PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Cochrane Library but also the Chinese databases of CNKI, WanFang, and Vip. The Critical Appraisal Skills Programme (CASP) tool was used to assess the quality of the included studies. ResultsIn total, 17 studies were included in the systematic evaluation. Four themes were identified, and an evidence model was developed that includes multiple attributions of FOF, management strategies for fall prevention, dynamic challenges and adaptation, and external support and unmet needs. ConclusionsThe fear of falling felt by informal caregivers and health personnel is mainly affected by internal factors in older adults, and harms the health of older adults through overprotective behavior. Thus, there is an urgent need of external support to improve the quality of life and promote the healthy aging of older adults.

Older Adults' Advance Aging and Life Satisfaction Levels: Effects of Lifestyles and Health Capabilities.

Many studies in the literature have examined older adults' past and current lifestyles in either positive or negative association with their life satisfaction levels. Health capabilities naturally decline with aging and can consequently be related to older adults' life satisfaction levels. Thus, the present study sought to examine the effects of age difference, lifestyles, and health capabilities on older adults' life satisfaction levels. A total of 290 older adults from three clinical research centers in the United States completed a self-administered questionnaire on their lifestyles and life satisfaction levels, and their health capability assessments were evaluated. There was a significant effect of advancing age on life satisfaction levels among older adults. Additionally, engagement in exercise or physical activity significantly influenced life satisfaction levels. However, there were no statistical effects of vital signs and functional assessments of health capabilities on life satisfaction among older adults. The findings suggest that advancing age itself is the strongest factor in older adults' life satisfaction. Additionally, engagement in exercise and physical activity can enhance life satisfaction levels as a supplemental factor among older adults. These findings can be beneficial to optimize life satisfaction levels through appropriate programs to encourage positive lifestyles among older adults.

Predominant Objective Cognitive Function Groups and their Association with Risk Factors in Older Adults: Cross-Sectional Study

Background: The epidemiological characterization of the predominant population groups by cognitive function allows supporting health policies to prevent dementia in Older Adults (OA). Objective: To analyze if there are association among predominant cognitive function groups and lifestyle factors, comorbidity and motor function in OA. Materials and Methods: Cross-sectional study with a probabilistic sample of insured OA, &gt;60 years old of either sex. Sociodemographic, habits, comorbidities and motor function data were the risk factors. Data for hierarchical cluster analysis were subjective and objective cognitive function, sex and academic level. Cognitive function from population groups defined according to DSM-5, and their association with risk factors. Results: A sample of 350 OA, 65 ± 7.4 years old. Cluster analysis grouped four groups: i) without Neurocognitive Disorder (NCD), ii) with major NCD, iii and iv) with minor NCD in OA ≥70 years and &lt;70 years. The factors associated with major NCD were unqualified work, Living Alone (LA), Diabetes Mellitus (DM), Hypertension (HT), reduced March Speed (MS), frailty and alteration of Activities of Daily Life (ADL). The minor NCD &gt;70 years: unqualified work, LA, DM, frailty and alterations in ADL; and finally, minor NCD &lt;70 were unqualified work, LA, DM, HT, dyslipidemia, obesity, cardiac diseases and hypothyroidism. Physical activity was a protector for the three groups. The likelihood value for major NCD had lower values than the model soft heminor NCD groups. Conclusions: There are association among lifestyle factors, comorbidity, and motor function for protection and risk for the predominant cognitive function groups.

Combined training prescriptions for improving cardiorespiratory fitness, physical fitness, body composition, and cardiometabolic risk factors in older adults: Systematic review and meta-analysis of controlled trials

Improved physical fitness is important for preventing COVID-19-related mortality. So, combined training can effectively increase peak oxygen consumption, physical fitness, body composition, blood pressure, and the healthrelated characteristics of adults; however, its impact in the elderly remains unclear. This systematic review and meta-analysis aimed to evaluate the effects of combined training on older adults. Four electronic databases (PubMed, Scopus, Medline, and Web of Science) were searched (until April 2021) for randomized trials comparing the effect of combined training on cardiorespiratory fitness, physical fitness, body composition, blood pressure, and cardiometabolic risk factors in older adults. Combined training significantly improved peak oxygen consumption compared to no exercise (WMD=3.10, 95% CI: 2.83 to 3.37). Combined resistance and aerobic training induced favorable changes in physical fitness (timed up-and-go=-1.06, 30-s chair stand=3.85, sit and reach=4.43, 6-minute walking test=39.22, arm curl=4.60, grip strength=3.65, 10-m walk=-0.47, maximum walking speed=0.15, one-leg balance=2.71), body composition (fat mass=-2.91, body fat%=-2.31, body mass index=-0.87, waist circumference=-2.91), blood pressure (systolic blood pressure=-8.11, diastolic blood pressure=-4.55), and cardiometabolic risk factors (glucose=-0.53, HOMA-IR=-0.14, high-density lipoprotein=2.32, total cholesterol=-5.32) in older individuals. Finally, the optimal exercise prescription was≥30min/session×50-80% VO2peak,≥3 times/week for≥12weeks and resistance intensity 70-75% one-repetition maximum, 8-12 repetitions×3 sets. Combined training improved VO2peak and some cardiometabolic risk factors in older populations. The dose-effect relationship varied between different parameters. Exercise prescriptions must be formulated considering individual needs during exercise.

Functional disability and associated factors in older adults seen at a primary health care unit

Objectives: To assess functional disability and associated factors in older patients cared for at a large Brazilian urban area. Methods: This is a cross-sectional study performed at a primary health care unit in the city of São Paulo, Brazil. Participants were selected via probabilistic sampling of 400 older individuals. We used a sociodemographic and health questionnaire along with instruments for assessing fear of falling (FES-I), cognitive function (MMSE), and depression symptoms (GDS-15). For dependent variables, we used instruments for assessing basic activities (BADL; Katz) and instrumental activities of daily living (IADL; Lawton). Factors associated with functional disability were analyzed via logistic regression models. Results: The mean age of participants was 75.23 (SD = 8.53); 63.20% were female, 27.00% were dependent in BADL and 39.25%, in IADL. Older individuals with better cognitive function and who had not been hospitalized in the previous year were less prone to functional disabilities. Factors such as older age, more depression symptoms, and greater fear of falling were more linked to disabilities in BADL. Factors such as older age, female sex, and greater fear of falling were more linked to disabilities in IADL. Conclusions: The prevalence of disability in BADL and IADL in the studied sample was high. Modifiable and non-modifiable factors were associated with functional disability. These results may help primary health care professionals understand the risk factors for functional disability in the older population.

Incidence of depression and associated factors in older adults in Bagé, Rio Grande do Sul State, Brazil

To evaluate the cumulative incidence of depression and its associated factors in the older population living in the urban area of the municipality of Bagé, Rio Grande do Sul State, Brazil, a prospective cohort study was conducted from 2008 to 2016/2017. The analysis was restricted to 615 older adults with complete information on the Geriatric Depression Scale (GDS-15), both at baseline and at follow-up, and who did not present depression in 2008. To calculate crude and adjusted incidence ratios and 95% confidence interval, Poisson regression with robust variance adjustment was used, including the baseline variables. A hierarchical model of four levels of determination was used. The variables were controlled for those of the same or of higher levels, and the p-value ≤ 0.20 was established to remain in the analysis model. In 2008, 523 older people did not have depression and 92 had been screened with the disease. In 2016/2017, of the 523 individuals without depression in the baseline measure, 10.3% tested positive at screening (incident cases), whereas 89.7% of the older adults remained free of the condition. Of the 92 older adults with depression in 2008, 32.6% continued to present depressive symptoms at follow-up and 67.3% had remission of symptoms. Leaving home once or never and being incapable of doing functional and instrumental activities of daily living were associated with a higher risk of positive screening for depression. The results reinforce the multidimensional and dynamic character of depression, which alternates short and long episodes, and may become recurrent and chronic.

Kırsalda Yaşayan Yaşlılarda Polifarmasi Yaygınlığı: Kesitsel Bir Çalışma

Objective: This study aimed to determine the prevalence of polypharmacy and its associated factors in older adults living in rural areas. Material and Methods: This cross-sectional study included a total of 585 older adults aged ≥65 years living in a town in western Türkiye. Data were collected through face-to-face interviews at family health centers using a questionnaire prepared by the authors in line with the literature. The data collected for the research were analyzed using the SPSS for Windows 25.0. Descriptive statistical methods were used to evaluate data. In addition, a logistic regression analysis was performed to identify the influential factors in the presence of polypharmacy. The results were evaluated at a significance level of p<0.05. Results: The prevalence of polypharmacy was 24.1%. In addition, 51.6%, 52.1%, and 12.1% older adults used at least one over-thecounter drug, herbal medicines along with prescribed medications, and alternative treatment methods, respectively. However, older patients with four or more chronic diseases were exposed to polypharmacy approximately nine times (95% confidence interval 3.02-26.75) more than those with 1-3 chronic diseases. Conclusion: Approximately one-quarter of the older adults had polypharmacy, which was affected by multiple variables. The older adults should be evaluated for prescription and non-prescription drug use, and the rational drug use education should be provided.

Uso de medicamentos potencialmente inapropriados em pessoas idosas na Atenção Primária à Saúde: estudo transversal

Abstract Objective To verify the prevalence of potentially inappropriate medications (PIM) in use and possible associated factors in older adults and the agreement between two assessment tool in Primary Health Care (PHC) contex Methods Cross-sectional study. The prevalence of older adults in use of PIM and associated factors were estimated. First of all was calculated the frequency of drugs, among those used, considered PIM. Classification as PIM was based on the 2019 Beers Criteria and the 2016 Brazilian Consensus on Potentially Inappropriate Medications 2016 (BCPIM) for the older adults. The agreement between the two classifications was also evaluated. Multivariate logistic regression models were estimated. Association was evaluated by Odds Ratio (OR). Kappa was calculated for agreement between both classifications. Results The prevalence of older adults using MPI was 32.9%, according to Beers Criteria and 27.6% according to the BCPIM. The reports of diabetes (OR=1.96), depression (OR=2.25) and polypharmacy (OR=4.11) were associated (p&lt;0.001) with the use of inappropriate medication, according to the Beers Criteria. Older adults who were very satisfied with their own health were less likely to use inappropriate medication both according to the Beers Criteria (OR=0.02) and the BCPIM (OR=0.09). Agreement between classifications was considered good (k=0.75, p&lt;0.001). Conclusion Reports of diabetes and depression, polypharmacy and negative self-rated health and satisfaction were associated with PIM’s use. The associations were similar between the two classifications, indicating that both are relevant in identifying PIM use in older adults in the context of PHC.

Prevalence of Delirium and its Related Factors in the Elderly Admitted to Selected Hospitals in Tehran, Iran

Objectives: Delirium is an acute and fluctuating change in the patient’s mental state associated with decreased alertness and impaired attention. This study aims to investigate the prevalence of delirium and its related factors in older adults hospitalized in selected hospitals in Tehran, Iran. Methods &amp; Materials: This is a cross-sectional study. The study population consists of all the elderly hospitalized in the emergency and internal departments of Firoozabadi and Rasoul Akram hospitals in Tehran, Iran. Using a simple random sampling method, 300 eligible patients were selected for the study. To collect the required information, a demographic and medical history questionnaire and the 4AT test were used. Related blood biomarkers were also examined. After collection, the data were analyzed in SPSS software, version 24 using descriptive statistics (Mean±SD) and inferential statistics (Pearson correlation test). The significance level was set at 0.05. Results: The Mean age of patients was 70.91±8.77 years; 53% were male and 62% were married. Thirty-one percent were exposed to delirium and 43% had delirium. The patients’ delirium status had a significant relationship with the history of polypharmacy (r=0.503, P&lt;0.001), independence in performing activities of daily living at home (r=0.404, P&lt;0.001), history of hospitalization in the past month (r=0.390, P&lt;0.001), hearing loss (r=0.362, P=0.001), vision loss (r=0.382, P=0.006), history of cognitive impairment (r=0.350, P=0.002), Parkinson’s disease (r=0.301, P=0.004), history of specialized treatment for depression (r=0.218, P=0.012), and chronic pain (r=0.251, P=0.043). Conclusion: Early diagnosis of delirium can prevent its adverse effects. It is necessary to identify the risk factors of this syndrome and provide appropriate and comprehensive interventions for the hospitalized elderly with delirium.