General Health Measures Research Articles

Hand grip strength in older and very old people: Results of the study Gesundheit 65+

Abstract Background Functional capacity decreases with increasing age. Hand grip strength (HGS) is considered as an objective general measure of health and a parameter of muscle strength, a component of functional capacity and is part of the evaluation of frailty. HGS is important for many everyday functions, such as holding heavy objects or supporting oneself to prevent a fall. Low HGS is associated with a higher mortality risk. In our study we describe HGS in people aged 66 to 101 years in Germany and identify groups with low HGS. Methods Gesundheit 65+ is a longitudinal epidemiologic study of the health status of persons 65 years and older in Germany by the Robert Koch Institute. In 2022/23, one year after baseline, isometric HGS was measured during the examination part of the study using a hand-held dynamometer (Smedley, Scandidact, Denmark, 100 kg). Two values were recorded for each hand. Maximum HGS from all attempts was used for analyses. Weighted prevalence estimates and 95% confidence interval (CI) for grip strength are reported by sex, age-group, height, self-rated health, chronic conditions, and difficulties in activities of daily living (ADL). Results HGS was measured in 1,457 persons aged 66 to 101 (48% women). Mean maximum HGS was 28.8 kg (CI 28.4-29.3). HGS was significantly related to sex (men: 35.4 kg, CI 34.8-36.0, women 21.8 kg, CI 21.4-22.2) and age (66-79: 31.0 kg, CI 30.1-31.9, 80+: 23.9 kg, CI 23.0-24.7). In both sexes, shorter persons and persons with bad self-rated health, chronic conditions or difficulties in ADL showed lower HGS than their reference group. Conclusions HGS was reduced in very old people, people with support needs, and people with poor health or chronic diseases, identifying these people as important risk groups for preventive measures. These should aim to improve not only endurance but also strength in older and very old people. In the long term, this could also maintain independence and reduce serious injuries from falls. Key messages • We found sex and age-related differences in hand grip strength in older people in Germany. • Based on the results, planning of prevention and intervention could be enhanced.

Exploring Older Adults' Subjective Views on Aging Positively: Development and Validation of the Positive Aging Scale.

Historically, aging research has focused primarily on health deterioration and negative aspects associated with aging. This has limited the scope of our understanding of the experience of aging and the relationships between aging and well-being from an integrative biopsychosocial perspective. In the same vein, there is a lack of reliable and valid assessments of aging that capture the positive aspects that characterize and improve the subjective experience of this period of life, particularly one that focuses on psychosocial well-being, including meaningful experiences and activities, group memberships, and general abilities. This study presents the development and validation of the Positive Aging Scale (PAS), a novel self-report assessment. This was an online cross-sectional study conducted on 501 UK residents aged ≥60 years. A number of self-reported items and measures of positive aging, general health, well-being, and cognitive functioning were administered to the sample. We used exploratory and confirmatory factor analyses and assessed the dimensionality, reliability, and concurrent criterion-related validity of the PAS. The results suggested that a unidimensional solution represents the data well, with the positive aging factor adequately loading on 8 items, and the solution showing factorial invariance between young-old and old participants (i.e., ≥75 years). Total PAS scores positively correlate with general health, well-being, and cognitive functioning. The PAS demonstrated strong psychometric properties and the findings highlight correlations between the PAS and key outcomes of positive aging, including general health. Implications for research and interventions are discussed.

Development of a brief core set for knee dysfunction based on the International Classification of Functioning, Disability and Health: assessing construct validity and measurement potential

BackgroundThe comprehensive core set for knee dysfunction was developed to classify the functioning of people with any knee dysfunction. To be used as a clinical instrument to measure the functioning of people with knee dysfunction, the construct validity of the core set still needs to be assessed. The purpose of this study was to analyze the construct validity of the comprehensive core set for knee dysfunction as an instrument to measure functioning.MethodsA cross-sectional study with 200 participants with knee dysfunction with or without clinical diagnosis of knee pathology, with or without complaint of pain, with or without instability, and/or with or without knee movement restriction of any type. Participants were assessed using the comprehensive core set for knee dysfunction with 25 categories, the subjective form from the International Knee Documentation Committee scale, and measures of self-perceived general health and functioning. The construct validity of the core set was assessed by Rasch analysis, and the external construct validity was assessed by correlation between the score of the brief core set for knee dysfunction with the subjective form from the International Knee Documentation Committee scale, and scores of self-perception of health and functioning.ResultsTwelve categories were consistent with a unidimensional construct, with no difference in the response pattern for age, sex, educational level, and time of complaint. These categories were included in the brief core set for knee dysfunction. The mean score of the brief core set was 37 ± 21 points, a value classified as moderate impairment regarding functioning. Correlations with the subjective form from the International Knee Documentation Committee scale and scores of self-perception were adequate (p < 0.01; r > 0.5).ConclusionThe brief core set for knee dysfunction, a set with 12 categories, can be used as a clinical instrument to measure and score the functioning of people with knee dysfunction, aged between 18 and 89 years, with adequate construct validity.

Test de Autoevaluación de Meditación Transcendental: a psychometric study of Peruvian school children and adolescents

The specific, as well as holistic, effects of practicing the Transcendental Meditation technique have been thoroughly documented. Findings associated with the practice have included a range of physiological, psychological and sociological benefits, but have also encompassed measures of general health, well-being and human development. However, few if any indigenous test instruments have been used to gather these data. In Perú, a test instrument called Test de Autoevaluación de Meditación Transcendental (i.e., Self-Assessment Test of Transcendental Meditation) designed to measure benefits of Transcendental Meditation in school children and adolescents has been deployed with some degree of success. The test was designed about 25 years ago to measure physical health, cognitive health, emotional health, and school performance, and has been completed by about 50,000 primary and secondary school students since its introduction. Recently published studies have documented the results. But the test has never been psychometrically evaluated. The purpose of the present study therefore was to rigorously assess the reliability and construct validity of the instrument using exploratory factor analysis and confirmatory factor analysis. Results of these analyses revealed a five latent factors—more alertness and energy, improved physical and mental health, enhanced cognitive performance, enhanced emotional and behavioural self-regulation, and more fulfilling interpersonal relationships—which reliably predicted an overall scale of health in students. Application of a revised Test de Autoevaluación de Meditación Transcendental is now ready for further use in Perú and, with translation, other school settings.

Is anchoring at 'dead' a theoretical requirement for health state valuation?

Values that accompany generic health measures are typically anchored at 1=full health and 0=dead. Some health states may then be considered 'worse than dead' (WTD) and assigned negative values, which causes fundamental measurement problems. In this paper, we challenge the assumption that anchoring values at 'dead=0' is necessary for quality-adjusted life year (QALY) estimation. We summarise the role of 'dead' in health state valuation and consider three critical questions: (i) whether the measurement properties of health state values require 'dead'; (ii) whether 'dead' needs to be valued relative to health states; and (iii) whether values for states WTD are meaningful or useful. We conclude that anchoring 0 at dead is not a requirement of health status measurement or cost-effectiveness analysis. This results from reframing QALYs as the relevant unit of measurement and reframing values as being derived from QALYs rather than the reverse.

Evidence of quality of life for hospitalised patients with COVID-19: a scoping review.

Information on the quality of life of people hospitalised with COVID-19 is important, both in assessing the burden of disease and the cost-effectiveness of treatments. However, there were potential barriers to collecting such evidence. To review the existing evidence on quality of life for people hospitalised with COVID-19, with a focus on the amount of evidence available and methods used. A scoping review with systematic searches. A total of 35 papers were selected for data extraction. The most common study type was economic evaluation (N = 13), followed by cross-sectional (N = 10). All economic evaluations used published utility values for other conditions to represent COVID-19 inpatients' quality of life. The most popular quality-of-life survey measure was the Pittsburgh Sleep Quality Index (N = 8). There were 12 studies that used a mental health-related survey and 12 that used a sleep-related survey. Five studies used EQ-5D, but only one collected responses from people in the acute phase of COVID-19. Studies reported a negative impact on quality of life for people hospitalised with COVID-19, although many studies did not include a formal comparison group. Although it used systematic searches, this was not a full systematic review. Quality-of-life data were collected from people hospitalised with COVID-19 from relatively early in the pandemic. However, there was a lack of consensus as to what survey measures to use, and few studies used generic health measures. Economic evaluations for COVID-19 treatments did not use utilities collected from people with COVID-19. In future health crises, researchers should be vigilant for opportunities to collect quality-of-life data from hospitalised patients but should try to co-ordinate as well as ensuring generic health measures are used more. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132254.

Staunch the Age Related Decline into Dementia, Cancer, Autoimmunity (Long Covid), Obesity, and Other Diseases with a Prebiotic, Probiotic, Postbiotic Triple Play

“All diseases originate in the gut.” Hippocrates (400 BC) A healthy gut microbiome via the gut-brain-axis elevates heart rate variability (HRV), a general measure of health and well-being. A dysbiotic gut microbiome, low in biodiversity and butyrate producers, can alter tryptophan metabolism (ATM) and increase the kynurenine to tryptophan ratio (KTR) with release of proinflammatory cytokines, predominantly TNF-α, IL-6, and IL-1β. These also characterize chronic inflammation, oxidative stress, and a multitude of diseases. Also proposed is the gut-lung dysbiosis concept and consequent degradation of ACE2 (richest in lungs and gut). Leaky gut (and lung) induced autoantibodies (AAs) related to G-protein coupled receptors (GPCRs) in combination with increased Ang II further potentiate oxidative stress. The underappreciated pathogenic role of these receptors on invading Candida hyphae is explored. The efficacy of fecal microbiome transplantation (FMT) in treating dementia, cancer, and autoimmunity supports the plausibility of success with “FMT-lite”. This triple play of prebiotic (d-mannose), probiotic (bifidobacteria and lactobacilli), and postbiotic (butyrate) might improve intestinal barrier integrity, oppose entry of GPCR antigens (epitopes), suppress the inflammatory cytokine triad, balance IFN-γ and TGF-β, suppress oxidative stress, depress KTR, elevate HRV, and extend lifespan and its quality.

Staunch the Age Related Decline into Dementia, Cancer, Autoimmunity (Long Covid), Obesity, and Other Diseases with a Prebiotic, Probiotic, Postbiotic Triple Play

“All diseases originate in the gut.” Hippocrates (400 BC) A healthy gut microbiome via the gut-brain-axis elevates heart rate variability (HRV), a general measure of health and well-being. A dysbiotic gut microbiome, low in biodiversity and butyrate producers, can alter tryptophan metabolism (ATM) and increase the kynurenine to tryptophan ratio (KTR) with release of proinflammatory cytokines, predominantly TNF-α, IL-6, and IL-1β. These also characterize chronic inflammation, oxidative stress, and a multitude of diseases. Also proposed is the gut-lung dysbiosis concept and consequent degradation of ACE2 (richest in lungs and gut). Leaky gut (and lung) induced autoantibodies (AAs) related to G-protein coupled receptors (GPCRs) in combination with increased Ang II further potentiate oxidative stress. The underappreciated pathogenic role of Candida is explored. The efficacy of fecal microbiome transplantation (FMT) in treating dementia, cancer, and autoimmunity supports the plausibility of success with “FMT-lite”. This triple play of prebiotic (d-mannose), probiotic (bifidobacteria and lactobacilli), and postbiotic (butyrate) might improve intestinal barrier integrity, oppose entry of GPCR antigens, suppress the inflammatory cytokine triad, balance IFN-γ and TGF-β, suppress oxidative stress, depress KTR, elevate HRV, and extend lifespan and its quality.

Staunch the Age Related Decline into Dementia, Cancer, Autoimmunity (Long Covid), Obesity, and Other Diseases with a Prebiotic, Probiotic, Postbiotic Triple Play

“All diseases originate in the gut.” Hippocrates (400 BC) A healthy gut microbiome via the gut-brain-axis elevates heart rate variability (HRV), a general measure of health and well-being. A dysbiotic gut microbiome, low in biodiversity and butyrate producers, can alter tryptophan metabolism (ATM) and increase the kynurenine to tryptophan ratio (KTR) with release of proinflammatory cytokines, predominantly TNF-α, IL-6, and IL-1β. These also characterize chronic inflammation, oxidative stress, and a multitude of diseases. Also proposed is the gut-lung dysbiosis concept and consequent degradation of ACE2 (richest in lungs and gut). Leaky gut (and lung) induced autoantibodies (AAs) related to G-protein coupled receptors (GPCRs) in combination with increased Ang II further potentiate oxidative stress. The underappreciated pathogenic role of Candida is explored. The efficacy of fecal microbiome transplantation (FMT) in treating dementia, cancer, and autoimmunity supports the plausibility of success with “FMT-lite”. This triple play of prebiotic (d-mannose), probiotic (bifidobacteria and lactobacilli), and postbiotic (butyrate) might improve intestinal barrier integrity, oppose entry of GPCR antigens, suppress the inflammatory cytokine triad, balance IFN-γ and TGF-β, suppress oxidative stress, depress KTR, elevate HRV, and extend lifespan and its quality.

Epigenetic scores of blood-based proteins as biomarkers of general cognitive function and brain health

BackgroundEpigenetic Scores (EpiScores) for blood protein levels have been associated with disease outcomes and measures of brain health, highlighting their potential usefulness as clinical biomarkers. They are typically derived via penalised regression, whereby a linear weighted sum of DNA methylation (DNAm) levels at CpG sites are predictive of protein levels. Here, we examine 84 previously published protein EpiScores as possible biomarkers of cross-sectional and longitudinal measures of general cognitive function and brain health, and incident dementia across three independent cohorts.ResultsUsing 84 protein EpiScores as candidate biomarkers, associations with general cognitive function (both cross-sectionally and longitudinally) were tested in three independent cohorts: Generation Scotland (GS), and the Lothian Birth Cohorts of 1921 and 1936 (LBC1921 and LBC1936, respectively). A meta-analysis of general cognitive functioning results in all three cohorts identified 18 EpiScore associations (absolute meta-analytic standardised estimates ranged from 0.03 to 0.14, median of 0.04, PFDR < 0.05). Several associations were also observed between EpiScores and global brain volumetric measures in the LBC1936. An EpiScore for the S100A9 protein (a known Alzheimer disease biomarker) was associated with general cognitive functioning (meta-analytic standardised beta: − 0.06, P = 1.3 × 10−9), and with time-to-dementia in GS (Hazard ratio 1.24, 95% confidence interval 1.08–1.44, P = 0.003), but not in LBC1936 (Hazard ratio 1.11, P = 0.32).ConclusionsEpiScores might make a contribution to the risk profile of poor general cognitive function and global brain health, and risk of dementia, however these scores require replication in further studies.

The Impact of COVID-19 on Health Behavior Engagement and Psychological and Physical Health Among Active Duty Military Enrolled in a Weight Management Intervention: An Exploratory Study.

The COVID-19 pandemic profoundly affected the health and well-being of people globally. Some studies suggest individuals with overweight or obesity may have been more adversely impacted by pandemic restrictions. Additionally, military personnel may have been more vulnerable to stress during the pandemic because of job demands (e.g., work in close quarters). Our research group was conducting a randomized clinical trial of a weight management intervention in active duty military personnel with overweight or obesity when the COVID-19 pandemic struck. Thus, we collected additional pandemic-related data from participants enrolled during the COVID-19 pandemic and conducted exploratory analyses to understand how the pandemic affected their stress levels and perceived abilities to engage in health behaviors like exercise and healthy eating. The aims of this exploratory study were to: (1) assess associations between pandemic-related stress and health behaviors with body fat percentage (BF%) and psychological and physical health, and (2) explore how pandemic-related stress and health behaviors affected BF% during and after the intervention. A total of 29 active duty Navy personnel (55% female, 69% White) were enrolled after the onset of pandemic restrictions and completed measures assessing pandemic-related stress and health behaviors as well as measures of general psychological and physical health before the intervention. BF% was collected at 5 timepoints, including baseline, during, and following the intervention. Bivariate correlations assessed associations at baseline. Linearmixed-effects longitudinal models explored how pandemic-related stress and health behaviors affected BF%. Post-hoc analyses evaluated the effects of pandemic factors on BF% at each timepoint. Most participants perceived of the pandemic as increasing stress and detracting from their abilities to engage in health behaviors (i.e., exercise and healthy eating). Higher pandemic stress was significantly associated with reporting exercise and healthy eating as more difficult, worse overall health, and more anxiety and general stress. Reporting exercise as harder during the pandemic also was associated with more psychological distress at baseline. A linearmixed- effects model controlling for age, sex, and number of intervention sessions attended revealed endorsing "exercise as harder" was associated with higher BF%. Post-hoc regression analyses revealed rating "exercise as harder" significantly predicted higher BF% 3 months post-intervention (B = 0.65, P = .01), whereas pandemic stress was not significantly associated with higher BF% at 3 month (B =0.14, P = .08) or 6 month (B = 0.21, P = .09) follow-up. As expected, most participants perceived of the pandemic as heightening stress and interfering with engagement in health behaviors. It is possible that pandemic-related stress may have exacerbated weight gain-promoting behaviors and/or interfered with achievement of desired weight management outcomes. Outside the context of the pandemic, it may be beneficial for healthcare providers to screen individuals for stress and perceptions of ease of engagement in health behaviors before enrollment in a weight management intervention. Further, tailoring interventions to mitigate stress and promote perceptions of ease in engaging in health behaviors may promote better weight management outcomes.

The Measurement Properties of the EQ-HWB and the EQ-HWB-S in Italian Population: A Comparative Study With EQ-5D-5L

ObjectivesThe EQ Health and Well-being, EQ-HWB (25-item) and the EQ-HWB-S (9-item), are new generic measures of health and well-being. The purpose of this study was to examine the measurement properties of the EQ-HWB and EQ-HWB-S measures in relation to the EQ-5D-5L among the Italian general population. MethodsA cross-sectional survey was conducted from October 2020 to February 2021, followed by secondary analysis of collected data from Italian adults. This analysis included response pattern distributions, correlation strength, and known-group comparison. Known-group comparison was assessed using effect sizes (ES) across health conditions, caregiver status, and social care usage. The EQ-HWB-S index-based score was based on the UK pilot value set, whereas the Italian value set was used for scoring the EQ-5D-5L index. ResultsOut of the 1182 participants, 461 reported having a chronic condition, 185 identified as caregivers, and 42 were social care users. EQ-HWB items (7.5%) showed fewer ceiling effects than EQ-5D-5L items (34.7%). Strong correlations (rs > 0.5) were found between overlapping EQ-HWB and EQ-5D-5L items. EQ-HWB-S and EQ-5D-5L index scores demonstrated similar discrimination based on symptomatic chronic conditions (ES d = 0.68 vs d = 0.71), but EQ-HWB-S had slightly higher ES for social care users (ES d = 0.84 vs d = 0.74). ConclusionsInitial evidence supports the validity of EQ-HWB/EQ-HWB-S because outcome measures in the Italian population. EQ-HWB-S performed comparably to EQ-5D-5L among patients and was better in differentiating social care users. A slight decrease in discriminative properties for caregivers was observed when transitioning from EQ-HWB to EQ-HWB-S.

Measuring EQ-5D-5L utility values in parents who have experienced perinatal death

BackgroundPolicymakers use clinical and cost-effectiveness evidence to support decisions about health service commissioning. In England, the National Institute for Health and Care Excellence (NICE) recommend that in cost-effectiveness analyses “effectiveness” is measured as quality-adjusted life years (QALYs), derived from health utility values. The impact of perinatal death (stillbirth/neonatal death) on parents’ health utility is currently unknown. This knowledge would improve the robustness of cost-effectiveness evidence for policymakers.ObjectiveThis study aimed to estimate the impact of perinatal death on parents’ health utility.MethodsAn online survey conducted with mothers and fathers in England who experienced a perinatal death. Participants reported how long ago their baby died and whether they/their partner subsequently became pregnant again. They were asked to rate their health on the EQ-5D-5L instrument (generic health measure). EQ-5D-5L responses were used to calculate health utility values. These were compared with age-matched values for the general population to estimate a utility shortfall (i.e. health loss) associated with perinatal death.ResultsThere were 256 survey respondents with a median age of 40 years (IQR 26–40). Median time since death was 27 months (IQR 8–71). The mean utility value of the sample was 0.774 (95% CI 0.752–0.796). Utility values in the sample were 13% lower than general population values (p < 0.05). Over 10 years, this equated to a loss of 1.1 QALYs. This reduction in health utility was driven by anxiety and depression.ConclusionsPerinatal death has important and long-lasting health impacts on parents. Mental health support following perinatal bereavement is especially important.

Effect of Cucurbita ficifolia Bouché on glutathione level and glycosylated hemoglobin percentage in a Mexican rural population with type 2 diabetes

Ethnopharmacological importanceCucurbita ficifolia Bouché fruit is widely used in Mexican traditional medicine to treat type 2 diabetes (T2D) because it has been attributed with antioxidant and hypoglycemic properties in different experimental models and T2D patients. An imbalance in physiological glutathione (GSH) concentrations increases the susceptibility to developing complications associated with oxidative stress in T2D patients. Aim of the studyTo investigate the effect of C. ficifolia on the antioxidant properties of GSH, general health measurements, and biochemical parameters in a Mexican rural population, and to evaluate the changes in socio-affective scores of patients due to improvement in T2D. Materials and methodsTwenty-seven women diagnosed with T2D with poor glycemic control volunteered and were divided into two groups: C. ficifolia (0.5 g/kg of fresh pulp weight) with hypoglycemic pharmacotherapy, and another group with only hypoglycemic pharmacotherapy, for 12 weeks. We evaluated the effect of the fresh pulp of C. ficifolia on body mass index, blood pressure, glucose, glycosylated hemoglobin, cholesterol, triglycerides, and GSH. Expanding the study, we evaluated the quality of life, anxiety, and depression scores before and after the intervention. ResultsTreatment with the fresh pulp of C. ficifolia for 12 weeks reduced glycosylated hemoglobin, similar to the hypoglycemic pharmacotherapy group, and significantly increased GSH concentrations. The patients' moods did not change despite increased GSH concentrations and improved T2D control. ConclusionsThe increased GSH concentrations due to the consumption of fresh pulp of C. ficifolia could help to protect against oxidative stress and extend therapeutic benefits in addition to the usual hypoglycemic drugs in patients with T2D.

DOES SURGERY FOR IBD DELIVER ON ITS “PROMIS”ES? IMPACT OF SURGERY ON SHORT-TERM PATIENT REPORTED OUTCOMES FROM THE CROHN’S &amp; COLITIS FOUNDATION’S SURGICAL INNOVATIONS, RESEARCH, &amp; QUALITY COLLABORATIVE

Abstract BACKGROUND As part of the Crohn’s &amp; Colitis Foundation’s IBD Plexus, a novel prospective, longitudinal multicenter surgical inception cohort was implemented. In this first report from the first 100 patients enrolled, we aimed to assess patient reported outcomes before and after IBD surgery. We hypothesized surgery is associated with improved patient reported outcomes. METHODS Beginning in Aug. 2022 patients were prospectively enrolled into a multicenter IRB-approved observational longitudinal cohort at 6 centers with 17 enrolling surgeons. Inclusion criteria: adults undergoing major abdominopelvic surgery for a known diagnosis of IBD. Baseline demographics, intra-operative details, 30-day outcomes, and patient reported outcomes were recorded at baseline and 30-days postoperatively. Overall health status was assess using the PROMIS General Health measures, symptom specific measures: PROMIS Pain Interference, Fatigue, and Sleep scales, and disease-specific measures: the Crohn’s &amp; Ulcerative Colitis Questionnaire items. Figures represent frequency (proportion), median (range). P-values represent Wilcoxon rank-sum test or chi-squared test or Fisher’s exact test. RESULTS A total of 103 patients were enrolled to date; median age 43 (20 – 74), 49% female, diagnoses: Crohns (64%), ulcerative colitis (35%), and IBDu (1%). A total of 69 (67%) patients completed surveys, and 58 (56%) patients completed the post-operative survey. In terms of overall health status within 7 days, improved overall median pain scores (3 vs. 2, p=0.04), overall health (p=0.04), physical health (p=0.03), and less fatigue (p=0.05) were observed after surgery compared to baseline (Table 1), while overall quality of life, mental health, social measures, and emotional problems were similar. Patients reported more difficulties with activities of daily living after surgery (p=0.01). In terms of symptoms within 7 days, less fatigue (p&amp;lt;0.05), but no difference in pain interference or sleep disturbance was observed after surgery (p&amp;gt;0.05). In terms of disease-specific outcomes within 2 weeks, fewer days feeling unwell (5 vs. 3, p=0.02), bloated (5 vs 2, p=0.04), or needing to rush to the toilet (5 vs 1, p=0.007), and no difference in feeling tired, upset, abdominal pain, or nocturnal bowel movements was observed after surgery. CONCLUSIONS In a prospective longitudinal cohort, surgery was associated with improved pain and physical health scores, with fewer days feeling unwell, fatigued, bloating, and fecal urgency. On the other hand, mental, social, and emotional health did not change 30-days after surgery. Our data suggest patients are still recovering 30-days after surgery, and longer follow-up may reveal further improvements. Targeted psychosocial interventions and support at home early in the acute post-operative period may improve the quality of recovery after surgery for patients with IBD. Table 1 Table 2

Exploring factors associated with self-rated health in individuals with diabetes and its impact on quality of life: Evidence from the Survey of Health, Ageing, and Retirement in Europe.

Self-rated health (SRH), a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = -1.261 (Wald chi-square test, χ2 = 22.097, df = 1, p < .05). As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL.

SOCIAL ENGAGEMENT AMONG COMMUNITY-DWELLING OLDER ADULTS: A QUALITY-OF-LIFE ANALYSIS

Abstract Older adults are living longer without sufficient efforts from health and social service systems to improve their quality of life (QoL). QoL is a nuanced, dynamic aspect to analyze. Literature shows that higher levels of social engagement provide a range of benefits to physical, mental, and cognitive health, all broad indicators of overall QoL. Social engagement comprises the person’s subjective experience of the richness of their relationships. The purpose of this study was to examine empirically the connection among this richness of relationships — specifically social engagement and perceived quality of relationships — and overall QoL among older adults. The study used a large sample (N=746) of non-institutionalized adults, ages 65 and older, from the nationally representative, AARP Social Engagement and Brain Health Survey. Two primary independent variables (IVs) were quantifiable measures of social engagement and perceived quality of social relationships; covariance controlled for several demographic factors (e.g., sex, ethnicity, income) and general health measures of physical, mental, and emotional health. The outcome variable was a composite score from a popular QoL measure. Analyses involved bivariate regression for the primary IVs, then multivariate OLS regression with each IV to predict quality of life. Results showed that QoL significantly regressed with predictors of social engagement (positively); each health variable (positively); unmarried status; ethnicity of Black/African American or Asian; and male gender. These results enhance our understanding of the relationship between social engagement, relationship quality, and QoL in older adults, particularly those who identify within the aforesaid demographic brackets. Implications are discussed.

Frailty and mild behavioral impairment: A longitudinal study of pre‐dementia markers

AbstractBackgroundFrailty and mild behavioral impairment (MBI) are non‐cognitive markers of dementia and have been associated with one another cross‐sectionally. Better understanding the association between frailty, MBI, and dementia is necessary to determine whether dementia prognostication could be improved by assessing for both frailty and MBI. This study investigated the longitudinal associations between frailty, MBI, and incident dementia.MethodWe analyzed data from 20,010 dementia‐free older adults from the National Alzheimer’s Coordinating Center. Frailty was operationalized using a previously published 44‐item frailty index (FI). MBI was derived from the Neuropsychiatric Inventory Questionnaire using a published algorithm; participants were classified as MBI+ if MBI symptoms were present for ≥2 consecutive visits. We used Cox proportional hazards regression to model the association between: (1) baseline FI and incident MBI; (2) baseline MBI and the incident severe frailty (FI≥0.20). We also examined whether MBI+ older adults with higher FI were more likely to develop dementia than those with lower FI. All models were adjusted for age, sex, education, and cognitive status (cognitively normal or mild cognitive impairment).ResultParticipant characteristics are described in Table 1. The hazard of developing MBI rose by 45% for every 0.1 increase in FI (adjusted hazard ratio; aHR = 1.45, 95%CI: 1.36‐1.55, p&lt;.001) [Table 2]. Likewise, the hazard of developing severe frailty (FI≥0.20) was 97% greater in MBI+ participants compared to MBI‐ participants (aHR = 1.97, 95%CI: 1.85‐2.10, p&lt;.001). Finally, although MBI alone was associated with incident dementia (aHR = 2.02, 95%CI:1.89‐2.17, p&lt;.001), the hazard developing dementia further rose by 1.17 (95%CI: 1.08‐1.26, p &lt;.001) for every 0.1 increase in FI within a sample of MBI+ participants.ConclusionIn dementia‐free older adults, frailty is associated with the development of MBI. Further, MBI is associated with the development of severe frailty. Understanding these relationships identifies the potential to use frailty screening as an indicator of individuals who could develop MBI, and MBI screening as an indicator of individuals at risk of accumulating more health deficits. Although, MBI alone predicts incident dementia, our findings suggest that including general health measures, i.e., frailty, in modeling may improve dementia prognostication.

COVID-19 and mental health in the UK: Depression, anxiety and insomnia and their associations with persistent physical symptoms and risk and vulnerability factors.

Mental health problems and persistent COVID-19 symptoms were prevalent in the context of COVID-19. However, despite the long-observed association between physical symptoms and mental health problems, such association has not been adequately examined in the context of COVID-19. Our understanding of wider patterns of risk and vulnerability factors for mental health also remains limited. This study investigated the associations between general mental health, and persistent physical symptoms, and additional risk and vulnerability factors in the context of COVID-19. Two hundred fourteen adults, living in the UK, recruited via social media, completed the online survey and were included in the analyses. Correlation and regression analyses were conducted to examine the associations of persistent physical symptoms and risk and vulnerability factors with measures of general mental health including depressive symptoms, anxiety and insomnia. 78.5% of the participants reported between 1 and 26 persistent symptoms, and about 28%-92% of them associated these symptoms with COVID-19 infection. Persistent physical symptoms were uniquely associated with all measures of mental health, β = .19-.32. Mental health history and worries were the most prominent risk factors, |β| = .12-.43. People who experience more persistent physical symptoms post-COVID-19 have poorer mental health. It may be important to consider and discuss the recovery from COVID-19 beyond a negative COVID-19 test. Multidisciplinary interventions that address the complex impact of COVID-19 for people with long COVID are needed.

Self-perceived problems of Afghan asylum seekers and refugees and their experiences with a short psychological intervention

BackgroundThe present study examined Afghan asylum seekers’ and refugees’ self-perceived problems, and their experiences of treatment with an adapted version of the brief transdiagnostic psychological intervention “Problem Management Plus” (aPM+). Specifically, the study explored which problems trouble them most and how these problems influence their daily functioning. Further, it examined how various standardized outcome measures correlate with these subjectively perceived problems.MethodThis study is part of a larger RCT study (PIAAS study) in which 88 Afghan asylum seekers and refugees were randomly allocated either to aPM + in addition to treatment as usual (aPM+/TAU) or TAU alone. The presented study uses a multi-method approach consisting of two parts: First, we investigated participants’ self-identified problems and subjective functional impairment using quantitative and qualitative assessment in both the aPM+/TAU and TAU group (n = 88). Second, we conducted in-depth qualitative interviews with a subsample of the aPM+/TAU group (n = 24) to gain a deeper understanding of participants’ personal experiences with aPM + and to obtain suggestions for improvement. Spearman correlations were applied for quantitative data, and deductive and inductive approaches of thematic analysis were used for qualitative data.ResultsWe identified six main themes of self-perceived problems (primary post-migration living difficulties, general mental health problems, interpersonal stressors, secondary post-migration living difficulties, mental health problems specifically associated with stress, and somatic problems) and their consequences, as well as subjective functional impairment. Standardized measures of general mental health, posttraumatic psychopathology, and quality of life did not correlate with the intensity of self-perceived problems. aPM + was mostly perceived positively, and few participants had recommendations for its improvement.ConclusionThe study aimed at giving a voice to Afghan trauma survivors to inform service providers and policy makers about their needs. Based on their expertise, future interventions can be tailored to their actual needs and optimized in terms of practical use. aPM + proved to be a positively perceived intervention that reduces subjective symptom burden and facilitates daily functioning. Culture-sensitive treatments within (mental) health services should increase service utilization and improve (mental) health in the long term.