Health Status Of Older People Research Articles

Association of Living in Evacuation Areas With Long-Term Care Need After the Fukushima Accident.

A previous report indicated that evacuation owing to the government order after the Fukushima disaster impacted the health status of older people; however, the association between living in evacuation areas and independence in their daily lives was unclear. This study examined the hypothesis that people who were forced to evacuate their homes were more likely to need long-term care (LTC). Historical cohort study. Older individuals (n= 13,934) in Minamisoma, Fukushima Prefecture, Japan, part of which was designated as an evacuation area. Background and certification data from April 2012 to December 2016 were extracted. Logistic regression analysis with sex stratification was performed to examine the association between certification of care levels 1-5 and living in evacuation areas. In total, 18,178 Minamisoma residents aged ≥65years who had not received LTC certification as of March 11, 2011, were eligible for follow-up. Of these, 4244 residents without a certificate of residence by June 1, 2016, were excluded. Of 13,934 residents followed up, 1553 (11.1%) were newly certified as care levels 1-5. Certification of care levels 1-5 was associated with living in evacuation areas [odds ratio (OR) 1.61, 95% confidence interval (CI) 1.20-2.18] and living alone at the time of the disaster (OR 2.58, 95% CI 1.92-3.47) in men and living alone at the time of the disaster (OR 1.35, 95% CI 1.15-1.59) in women. Living in evacuation areas and living alone were associated with LTC certification. In evacuation areas, individuals with family members were more likely to be certified compared with those in nonevacuation areas. Among residents in evacuation areas, several individuals with family members experiencing family structure changes might need LTC. Preventive measures (including group relocation) may be beneficial for those being evacuated following a disaster.

The Impact of Living Arrangements and Intergenerational Support on the Health Status of Older People in China

Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people’s living arrangements and intergenerational support provision/ receipt on their physical and psychological wellbeing, focusing on rural/ urban differences. The results show that receiving economic support from one’s adult children was a stronger predictor for higher life satisfaction among older rural residents compared to those in urban areas, while grandchild care provision was an important determinant for poor life satisfaction only for older urban residents. Receiving informal care from one’s adult children was associated with a poor (I)ADL functional status and with depressive symptoms among older rural people. Meanwhile, having weekly in-person and distant contact reduced the risk of depression among older people in both rural and urban areas. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological well-being of urban older residents, such as with the early diagnosis of depression.

Multimorbidity, activity limitation and self-reported health all predict mortality risk, but better measures were required

Background and ObjectiveWith an ageing population, morbidity and multiple health conditions are an increasing public health concern. This study aimed to investigate how morbidity as measured by the Charlson comorbidity index and two morbidity measures; activity limitation and self-reported health, individually and collectively explain the increased risk of mortality with age. MethodsWe used the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) wave one, dataset, a national representative sample of people over 50 years of age, with follow-up until May 31, 2020. Cox proportional hazard regression models were used to assess the associations between a modified Charlson comorbidity index (m-Charlson), self-reported health, activity limitation, and mortality in the Northern Irish cohort. Resultsm-Charlson showed a steeper relationship with age, the proportion of participants with a Charlson of two or more increase from 15.2% (aged 50–59) to 32.0% (aged 80+). All measures of morbidity exhibited a strong relationship with socio-economic status, though the gradients were more marked for self-reported health than for activity limitation or Charlson index. All three morbidity measures were independently related to mortality risk though the associations attenuated with age. However, even in models with all three measures of morbidity, most of the age-related increase in mortality risk remained unexplained. ConclusionAll three morbidity measures carry separate and independent information about the health status of older people and therefore about mortality risk; it is apparent that it is still worth asking patients how they feel and how their health is affecting their activity. Further research should aim to dissect health trajectories in dynamic prediction models in addition to other measures of health status.

Factors associated with self-rated health status of older people with multimorbidity in Colombia: A cross-sectional study

Background and objectiveIn Colombia, older adults (60 years and older) are expected to represent 15.5% of the overall population by 2025. Consequently, the demand for social and healthcare services will increase, especially because of the numerous medical conditions associated with aging. The purpose of the present study was to determine the patient's self-rated health status of older adults with multimorbidity and its determining factors based on gender in an insurance company of the Colombian health system. MethodologyA cross-sectional study was performed to analyze the sociodemographic and clinical characteristics of 438 patients older than 75 years as well as their self-rated health status (EQ-5D-3L questionnaire) during the first geriatric consultation of a comprehensive healthcare program. A multivariate linear regression analysis was performed to identify factors determining their self-rated health status. ResultsWomen had a worse self-rated health status than men [mean (standard deviation) EQ-5D index score: 0.77 (0.20) vs. 0.65 (0.18); p<0.001]. In all sample, factors independently associated with self-rated health status were self-perception of weakness and dependency. In men, additional factors related to EQ-5D index were low levels of physical activity, recurrent falls, fecal incontinence, and auditory and visual disorders. In women, other health-determining factors were decrease in walking speed, and a medical history of depression/anxiety. ConclusionsFactors associated with the self-rated health status of older adults who were part of a comprehensive healthcare program in Colombia varied according to gender. This study will help in approaching health interventions in healthcare programs for older adults in a differentiated manner.

Direct and Indirect Effects of COVID-19 in Frail Elderly: Interventions and Recommendations.

Frailty is a state of vulnerability to stressors because of a decreased physiological reserve, resulting in poor health outcomes. This state is related to chronic conditions, many of which are risk factors for outcomes in elderly patients having SARS-COV-2. This review aims to describe frailty as a physiological vulnerability agent during the COVID-19 pandemic in elderly patients, summarizing the direct and indirect effects caused by the SARS-COV-2 infection and its prognosis in frail individuals, as well as the interventions and recommendations to reduce their effects. Cohort studies have shown that patients with a Clinical Frailty Scale higher than five have a higher risk of mortality and use of mechanical ventilation after COVID-19; nonetheless, other scales have also associated frailty with longer hospital stays and more severe forms of the disease. Additionally, the indirect effects caused by the pandemic have a negative impact on the health status of older people. Due to the above, a holistic intervention is proposed based on a comprehensive geriatric assessment for frail patients (preventive or post-infection) with emphasis on physical activity and nutritional recommendations, which could be a potential preventive intervention in viral infections by COVID-19.

Risk factors, quality of life and health of the elderly age persons

Introduction. Elderly people are among the most important social groups in Russian society, remaining the least protected, socially and biologically vulnerable part of the population. The objective of the study is to rank and assess the risk factors and health status of older people. Materials and Methods. 40 elderly persons aged 60 to 87 years were examined. The average age was 71.2 ± 7.4 years. Clinical, audiometric, stabilometric, psychological examination, biochemical blood test, osteodensitometry, ultrasound examination were carried out. An assessment of the health-related quality of life and diet is given. Statistica software was used for statistical processing. V.10 Results. On average, 5.3 diseases were found to be detected per one older person. This indicates the polymorbidity of the pathology. At the same time, more than half of the examined persons were found to have combined vascular lesions (52.5%) with lesions of the vessels of the brain and heart, accompanied by impaired cholesterol metabolism. The analysis of the indicators of the quality of life scales in the elderly population made it possible to establish pronounced problems associated with physical and emotional health and the deficit in the intake of B vitamins and protein in the diet. Conclusion. The older persons differ due to polymorbidity pathology. The analysis of the indicators of the quality of life scales in the elderly allowed establishing the presence of pronounced problems associated with physical and emotional health. It demonstrates the presence of increased depletion of mental activity and fatigue, and the lack of activation processes, which may further affect the limitation of daily activities and reduce the health-related life quality.

Instrument development and validation of the comprehensive ability of older people assessment scale.

AimThe study is aimed to develop and psychometrically test the Comprehensive Ability of Older People Assessment scale and classify the ability grades.DesignA cross‐sectional design was used for instrument development.MethodThe Comprehensive Ability of Older People Assessment scale was developed by a sample of 971 older people from 4 long‐term care institutions in China. The data were collected between April 2018 and March 2020. One‐way analysis of variance and multiple regression analysis was used to screen scale items, while focus group interviews were used to integrate the subjective and objective items. Confirmative factor analysis and expert judgment were applied to explore construct validity. Reliability was explored through internal consistency estimation using Cronbach's alpha and homogeneity evaluation using corrected item‐total correlations. Cluster analysis and discriminant analysis were used to segment the comprehensive ability assessment scores and discriminant function was established to determine the boundary value of each segment, using correlation analysis to perform reverse verification.ResultsFactor analysis yielded 40 items with six dimensions, including “mentation and cognitive,” “perception and communication,” “emotional problems,” “mental and behavioural problems,” “daily life and social participation,” and “skin and oral status.” The Cronbach's α was 0.951, while the dimensions showed Cronbach's α values ranging from 0.760–0.946. The rationality and scientificity of this scale were proved by the correlation analysis of reverse validation.ConclusionThe 4‐grade Comprehensive Ability of Older People Assessment scale is proved to be with good validity and reliability and should be considered for institutional assessors.ImpactAssessors can accurately evaluate older people's health status and nursing needs through this scale in long‐term care institutions, communities and hospitals, so as to provide accurate and high‐quality nursing services. It will become a scientific basis for the government to offer accurate pension subsidies, purchase pension services scientifically for older people and establish third‐party objective evaluation and supervision.

Oral Health of Older Patients in Dental Practice: An Exploratory Study

BackgroundSome older people stop visiting the dentist when they get older. This study aims to identify the characteristics and oral health status of older people who do visit community dental practices. MethodsIn this exploratory cross-sectional study, the oral health of Dutch community-dwelling older people was assessed. A random sample of general dental practitioners and older people who visit the dental practice was drawn. The dentists were asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to complete a questionnaire. Data were described for 3 distinct groups of older people. Statistical measures for distribution and dispersion were used to describe the oral health of community-dwelling older patients in relation to the age. ResultsA total of 373 (40.4%) dentist registration forms and 372 (40.3%) patient questionnaires were returned. Data were available for 364 (39.4%) dentist–patient couples. Amongst the patients, 52.8% were female and most had a high socioeconomic status. About 65.7% had one or more problems related to general health, and 75.2% used medication. Regarding the overall oral health status, the average number of teeth was 20, 3.5% were edentulous. Oral health problems were more common in the older patient group (aged 75+), in whom frailty was also most common. ConclusionsOlder people who visit community dental practices are still relatively healthy, non-frail, and highly educated. Even in this group, there is a turning point in both general and oral health from the age of 75.

Abstract 2531: Function-related indicator and outcomes of screening mammography in older women from the BCSC-Medicare Cohort

Abstract Background: Although there is evidence pointing to the role of comorbidity and age in screening mammography outcomes among older women, the impact of functional decline on mortality in this population is unknown. Methods: We used data from 238,849 women in the Breast Cancer Surveillance Consortium-Medicare (BCSC) linked database from 1999-2015 who had at least one screening mammogram at ages 66-94 years. We estimated the 10-year cumulative incidence of breast cancer, breast cancer death, and non-breast cancer death by function-related indicator (FRI) which incorporated 16 claims-based items reflecting functional or health status in older people. In the analysis, FRI score was categorized as an ordinal variable (0, 1, and 2+) and a higher score indicated a higher burden of functional limitations. Fine and Gray proportional sub-distribution hazards models were applied with incident breast cancer and death treated as competing events. Risk estimates by FRI scores (0, 1, and 2+) were adjusted by age and NCI comorbidity index separately and stratified by these factors. Results: During a median follow-up of 101 months, 9,252 women were diagnosed with breast cancer. During follow-up, 406 women died of breast cancer and 41,640 died from non-breast cancer causes. The 10-year age-adjusted cumulative incidence of invasive breast cancer slightly decreased with increasing FRI score (FRI=0: 4.0%, 95% CI=3.8%-4.1%; FRI=1: 3.9%, 95% CI=3.7%-4.2%; FRI=2+: 3.5%, 95% CI=3.1%-3.9%). Risk of death from non-breast cancer causes increased with FRI score (FRI=0: 18.8%, 95% CI=18.5%-19.1%; FRI=1: 24.4%, 95% CI=23.9%-25.0%; FRI=2+: 39.8%, 95% CI=38.8%-40.9%). Risk of breast cancer death was low with minimal risk differences across FRI scores (FRI=0: 0.24%, 95%CI=0.20%-0.28%; FRI=1: 0.20%, 95%CI=0.14%-0.26%; FRI=2+: 0.30%, 95% CI=0.18%-0.42%). Risk estimates in NCI comorbidity index-adjusted models were largely similar to outcomes in age-adjusted models. Stratified analyses suggested similar patterns of risk estimates by FRI. Conclusion: Cumulative risk of death from non-breast cancer causes substantially increases with FRI score, suggesting that the potential of screening mammography to benefit older women is low among those with a high burden of functional limitation. Citation Format: Dongyu Zhang, Linn Abraham, Joshua Demb, Diana L. Miglioretti, Shailesh Advani, Brian L. Sprague, Louise M. Henderson, Tracy Onega, Karen Wernli, Louise C. Walter, Karla Kerlikowske, John T. Schousboe, Ellen S. O'Meara, Dejana Braithwaite. Function-related indicator and outcomes of screening mammography in older women from the BCSC-Medicare Cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2531.

The impact of living arrangements and intergenerational support on the health status of older people in China: are rural residents disadvantaged compared to urban residents?

AbstractResearch to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people's living arrangements and intergenerational support provision/receipt on their physical and psychological wellbeing, focusing on rural–urban differences. The results show that receiving economic support from one's adult children was a stronger predictor for higher life satisfaction among rural residents compared to urban residents, while grandchild care provision was an important determinant for poor life satisfaction only for urban residents. Having weekly in-person and distant contact with one's adult children reduced the risk of depression in both rural and urban residents. Older women were more likely than men to receive support and to have contact with adult children, but also to report poor functional status and depression. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological wellbeing of urban older residents, such as with the early diagnosis of depression.

ABORDAJE DE ENFERMERÍA SOBRE EL MIEDO Y ANSIEDAD ANTE LA MUERTE EN PERSONAS ADULTAS MAYORES

Ante los marcados cambios poblacionales que indican una elevación en la concentración de personas adultas mayores, es relevante visualizar un panorama de atención en salud integral tomando en cuenta las preocupaciones y emociones que se pueden presentar en la etapa de la vejez por lo cual es necesario tomar en cuenta el abordar temáticas como el fin de la existencia o la muerte que es una parte natural de la condición humana. Aunque los aspectos sociales, religiosos, culturales, psicológicos, ambientales, políticos y económicos direccionan la mayoría de las veces la percepción o idea que tenga el sujeto acerca de la muerte, las emociones que regularmente se encuentran asociadas ante tal hecho inminente son el miedo y ansiedad los cuales repercuten en el estado de salud de las personas mayores disminuyendo su bienestar físico y emocional y a la vez le impide concientizar o reflexionar acerca de los logros personales alcanzados, nuevas metas de vida y reconocimiento de su esencia y valor humano. Es por ello que el reflexionar acerca de las intervenciones clave de enfermería que pueden mitigar o disminuir este tipo de temores o respuestas ante la muerte marcará el camino para emprender acción y brindar atención de calidad.

Validation of Walking Speed Estimation from Trunk Mounted Accelerometers for a Range of Walking Speeds.

Walking speed is a strong indicator of the health status of older people and patients. Using algorithms, the walking speed can be estimated from wearable accelerometers, which enables minimally obtrusive (longitudinal) monitoring. We evaluated the performance of two algorithms, the inverted pendulum (IP) algorithm, and a novel adaptation correcting for lateral step movement, which aimed to improve accuracy during slow walking. To evaluate robustness, we gathered data from different groups (healthy adults, elderly, and elderly patients) of volunteers (n = 159) walking under various conditions (over ground, treadmill, using walking aids) at a broad range of speeds (0.11–1.93 m/s). Both of the algorithms showed good agreement with the reference values and similar root-mean-square errors (RMSEs) for walking speeds ≥0.5 m/s, which ranged from 0.09–0.16 m/s for the different positions, in line with the results from others. However, for slower walking, RMSEs were significantly better for the new method (0.06–0.09 m/s versus 0.15–0.19 m/s). Pearson correlation improved for speeds <0.5 m/s (from 0.67–0.72 to 0.73–0.82) as well as higher speeds (0.87–0.97 to 0.90–0.98) with the new method. Overall, we found that IP(-based) walking speed estimation proved to be applicable for a variety of wearing positions, conditions and speeds, indicating its potential value for health assessment applications.

Oral Health Status in Older People with Dementia: A Case-Control Study.

Dementia is characterized by a range of cognitive defects with impaired activities of daily living that have implications for patient oral health. Objectives. A case-control study was made of the impact of dementia upon oral health. A total of 152 patients were included: 69 with dementia and 83 controls from the region of Murcia (Spain). The Global Deterioration Scale (GDS) was used to classify the patients and an oral exploration was carried out. Odds ratios (ORs) and confidence intervals (CIs) were estimated using regression models. The patients with more severe disease were significantly more likely to have fewer natural teeth (OR 11.00, 95%CI 1.28–23.22; p = 0.001), a higher plaque index (p = 0.001), and a greater bleeding index (p = 0.001) than the control group. These findings suggest that older adults with dementia have deficient oral health. A higher bleeding index increases the risk of deterioration of cognitive function. The oral hygiene and health of older people with dementia need to be improved.

Factors related to ikigai among older residents participating in hillside residential community-based activities in Nagasaki City, Japan.

Objective: The present study aims to investigate the factors related to self-rated ikigai (purpose in life) among older residents participating in hillside residential community-based activities in Nagasaki City.Methods: A self-administered anonymous questionnaire survey was carried out with older residents participating in two hillside residential community-based activities in Nagasaki City, Japan. The questionnaire included questions on sociodemographic information (age, sex, family structure, education, and self-rated economic satisfaction), self-rated health, mental health status measured using Geriatric Depression Scale-15 (GDS-15), and self-rated ikigai score that was estimated using a visual analog scale.Results: A total of 32 older residents (7 males, 25 females) participated in the questionnaire survey. Although self-rated ikigai score was not associated with sociodemographic factors, there were associations between the score, self-rated health (P=0.001), and mental health (GDS-15) (P=0.015). Statistically significant correlations between self-rated ikigai score and social participation (ρ=0.426, P=0.017), self-rated health (ρ=−0.485, P=0.007), and mental health (GDS-15) (ρ=−0.523, P=0.007) were observed.Conclusion: Increasing social participation may increase individual ikigai, preventing poor self-rated health and low mental health status in older people. Maintaining their social participation in the community might be effective for the health promotion of older residents in hillside residential areas of Nagasaki City.

Assessing the health status and mortality of older people over 65 with HIV.

BackgroundNearly half of people with HIV in the United States are 50 years or older, and this proportion is growing. Between 2012 and 2016, the largest percent increase in the prevalence rate of HIV was among people aged 65 and older, the eligibility age for Medicare coverage for individuals without a disability or other qualifying condition. Previous work suggests that older people with HIV may have higher rates of chronic conditions and develop them more rapidly than older people who do not have HIV. This study compared the health status of older people with HIV with the older US population not living with HIV by comparing: (1) mortality; (2) prevalence of certain conditions, and (3) incidence of these conditions with increasing age.Methods and findingsWe used a sample of Medicare beneficiaries aged 65 and older from the Medicare Master Beneficiary Summary File for the years 2011 to 2016, including 100% of individuals with HIV (N = 43,708), as well as a random 1% sample of individuals without diagnosed HIV (N = 1,029,518). We conducted a survival analysis using a Cox proportional hazards model to assess mortality and to determine the need to adjust for differential mortality in our analyses of the incidence of certain chronic conditions. These results showed that Medicare beneficiaries living with HIV have a significantly higher hazard of mortality compared to older people without diagnosed HIV (3.6 times the hazard). We examined the prevalence of these conditions using logistic regression analysis and found that people with HIV have a statistically significant higher odds of depression, chronic kidney disease, chronic obstructive pulmonary disease (COPD), osteoporosis, hypertension, ischemic heart disease, diabetes, chronic hepatitis, end-stage liver disease, lung cancer, and colorectal cancer. To look at the rate at which older people are diagnosed with conditions as they age, we used a Fine-Gray competing risk model and showed that for individuals without diagnosis of a given condition at age 65, the future incidence of that condition over the remaining study period was higher for people with HIV even after adjusting for differential hazard of mortality and for other demographic characteristics. Many of these results also varied by personal characteristics including Medicaid dual enrollment, sex, and race and ethnicity, as well as by condition.ConclusionsIncreasing access to care and improving health outcomes for people with HIV is a critical goal of the National HIV/AIDS Strategy 2020. It is important for clinicians and policymakers to be aware that despite significant advances in the treatment and care of people with HIV, older people with HIV have a higher odds of having multiple chronic conditions at any point in time, a higher incidence of new diagnoses of these conditions over time, and a higher hazard of mortality than Medicare beneficiaries without HIV.

Estado de salud dental y Calidad de Vida Relacionada a Salud Bucal en personas mayores, de Puerto Montt, Chile

Abstract: Introduction: Older people tend to have poor oral health, which can affect their quality of life. This study aimed to explore the relationship of the Oral Health-Related Quality of Life (OHRQoL) with sociodemographic variables and the dental health status of older people who belong to Elderly Clubs in the district of Puerto Montt, Chile. Material and methods: A cross-sectional study was carried out in 140 elderly people from Elderly Clubs in the district of Puerto Montt, Chile. Sociodemographic and dental variables were studied using a questionnaire and clinical examination. The GOHAI instrument validated in Chile was applied to measure the OHRQoL. Results: The mean of the total GOHAI was 50.8±8.6 points, and the median was 53. Of the 140 elderly people, 87.9% were females, the means of age and years of education were 73.2±6.2 and 7.5±4.4 years, respectively. 30% were edentulous, the number of remaining teeth was 7.8±8.1, the OHI-S was 1.3±1.0. 85.7% wore dentures, and the time of denture wearing was 8.8±9.4 years. Significant associations were found between the total GOHAI and non-belonging to an indigenous people (p=0.024), being edentulous (p=0.006), and the presence of healthy teeth (p=0.039). Conclusion: The GOHAI showed a significant relationship with not-belonging to an indigenous ethnicity, being edentulous, and the number of healthy teeth. The OHRQoL was higher in males, with formal education, edentulous, dentated without teeth mobility, with complete dentures, and moderate denture hygiene.

The Relationship between Social Media Usage and General Health in the Older People of Shiraz City in Iran

Older people today have the fastest growth among demographic groups with increased life expectancy. Contemporary advances in the Internet, especially social media, have changed the pattern of health-based communication. Novel technologies in the form of using the Internet are affecting the healthcare environment. Online interactions can help the people pay more attention to their health and well-being. Patients frequently use the Internet, both as a source of information and for psychological support. The purpose of this study was to investigate the impact of social media use on the general health of older people. In this cross-sectional study, the general health survey for older people aged between 60 and 85 years of Shiraz was completed. The four health criteria also examined those using social media and those who did not. Data were analyzed using non-parametric statistical methods such as Mann-Whitney, ANOVA, t-test, and chi-square. The study revealed that the general health of the elderly was better for people using social media than for those not using the Internet. It was also found that using social media for more than an hour a day reduced the level of health in older people. No correlation was found between age and health status in older people. It was also found that the effect of using the Internet on increasing the women’s health was more pronounced. Using the Internet to interact with others can significantly improve the social functioning of older people. Given the positive impact of using social media on the health of older people, planning to encourage and adequately train the use of the Internet and social media in the elderly group is of particular importance.

Physical Activity, Ability to Walk, Weight Status, and Multimorbidity Levels in Older Spanish People: The National Health Survey (2009-2017).

Background. Many studies have shown a relationship between physical functioning and health status in older people. Aim. The purpose of this study was to analyze the temporal trends of physical activity (PA), ability to walk, weight status, self-perceived health, and disease or chronic health problems in people over 65 years from 2009 to 2017, using the European Health Survey in Spain and the National Health Survey in Spain. Methods. This study included 13,049 older people: 6026 (2330 men and 3696 women; age (mean, SD (Standard Deviation)) = 75.61 ± 7.11 years old) in 2009 and 7023 (2850 men and 4173 women; age (mean, SD) = 76.01 ± 7.57 years old) in 2017. Results. In 2017, older people exhibited lower values of moderate PA (p < 0.001), a lower number of hours of walking per week (p < 0.001), and worse self-perceived health status (p < 0.001) compared to 2009. These differences are maintained when comparing the sexes. Compliance with PA recommendations was 27.9% and 6.1% (chi-squared = 352.991, p < 0.001) in 2009 and 2017, respectively. There were no significant differences in weight status between older people in 2009 and 2017. In 2017, older people had significantly high percentages of disease or chronic health problems (p < 0.05), number of diseases (p < 0.001), severe difficulty walking 500 m without assistance (p < 0.05), and severe difficulty going up or down 12 stairs. Conclusions. From 2009 to 2017, Spanish older people worsened their PA levels and perception of their health status, and they increased their disease levels, which could be associated with the worsening of ability to walk in 2017.

A Literature Review of the Quality of Life, Health Status and Prosthesis Satisfaction in Older Patients With A Trans-tibial Amputation.

Several reviews have been published regarding quality of life (QoL) and Health Status (HS) in persons with lower limb amputation (LLA). However, little has been discussed in the literature with respect to older populations (i.e. age>60 years) with trans-tibial amputation. Furthermore, the perceived satisfaction with prosthesis is another important aspect for consideration in the amputees' life. The purpose of this review was to evaluate the impact of trans-tibial amputation on the QoL, HS and prosthesis satisfaction, in order to determine the appropriate intervention to improve these aspects in older population of trans-tibial amputees (TTA). Research articles, published between January 2000 to March 2019, were found using Scopus, PubMed and Google Scholar databases. The methodological quality of the selected articles was assessed using the Critical Review Form-Quantitative Studies checklist. Ten articles that met the inclusion criteria were selected. In these papers, we can summarize that people with trans-tibial amputation have a better QoL compared to those with above knee amputation. Moreover, physical functioning and mobility are the most influencing factors for QoL and HS in older people with lower limb amputation. Finally, the prosthesis weight reduction may improve satisfaction with the prosthetic limb. Efforts have to be made in order to improve mobility in older population with transtibial amputation for better QoL and HS. This can be accomplished by means of adequate rehabilitation, pain management and an accurate choice of appropriate prosthetic components. We observed that the quality of evidence in the literature available is inadequate and future research would benefit from more prospective observational cohort studies with appropriate inclusion criteria and larger sample sizes to better understand the QoL and HS in this population.

Spatial Variability of Health Inequalities of Older People in China and Related Health Factors.

China is facing serious population aging issues because of many unintended consequences of the economic reforms that began in the 1980s and with social policies such as the “one child” policy. Understanding the spatial distribution of the health status of older people has attracted more and more attention in many countries, including China. By employing descriptive analysis, this study uses data from the Chinese Population Censusand Statistical Year Bookto explore the health inequalities of older people at the national level. Based on the Getis-Ord Gi*, this study finds that the uneven spatial distribution of socio-economic status results in health inequalities for older people at the national level. The geographic distribution of life expectancy was correlated with a number of important demographic, socio-economic, and environmental variables. For further research, investigations should be conducted among individuals at micro-geographic scales.