Health Status Of Older Persons Research Articles

Interplay of health literacy, healthcare access and health behaviors with oral health status among older persons.

This study contributes to the ongoing debate on social determinants of oral health of older persons. Specifically, it examines the direct and indirect effects of health literacy and access to healthcare on oral health status of older persons. The study also investigates whether general health status and health behavior (routine medical check-ups) explain the association of health literacy and healthcare access with oral health status. The gender dimensions of these relationships are also explored. Data were derived from 522 participants aged 50 years and older located in five regions in Ghana. Path analyses in structural equation modeling (SEM) were used to analyse the data. General health status (β = -0.049, p < 0.005), medical check-up (β = 0.124, p < 0.01), and health literacy (β = 0.133, p < 0.01) were positively associated with oral health status. General health status mediated the positive relationship between health literacy and oral health status (β = 0.048, p < 0.01). General health status (β = 0.016, p < 0.05) and medical check-ups (β = 0.025, p < 0.05) mediated the association between access to healthcare and oral health status. The mediational role of routine medical check-up in the association between access to healthcare and oral health status was significantly stronger (B = 0.063, p < 0.01) among men (β = 0.051, p < 0.01) than women (β = 0.003, p > 0.05). Analyses of oral health issues among older persons in Ghana and settings alike must recognize the complex interplay among critical social determinants to initiate pragmatic health and social policy interventions.

Nutrition of elderly persons during a new coronavirus infection

A new coronavirus infection (COVID-19) of a particularly severe course is more often observed in the elderly, this is largely due to age-related immunological and metabolic changes, as well as polymorbidity. In the literature, increasing evidence highlights how malnutrition negatively affects the immune system functionality, impairing protection from infections.Individual vitamins and trace elements play an important role in supporting both innate and acquired immune defenses. Many chronic diseases such as diabetes and cardiovascular diseases in the elderly are often associated with a high risk of malnutrition and a poorer prognosis. The main causes of malnutrition are limited mobility, catabolic changes in skeletal muscles, as well as a decrease in food intake, which can be further aggravated in the elderly. In this article the role of nutrition of elderly patients in the period of a new coronavirus infection pandemic is analyzed. Nutrition is a determinant of the health status of older persons. Inadequate nutrition contributes to the progression of many diseases, and also increases the risk of adverse outcomes, including coronavirus infection. Therefore, it is important to assess the nutritional status of patients infected with COVID‐19 at all stages of treatment. It is imperative to provide adequate nutrition, which will make up for the deficiency of micro- / macronutrients, primarily protein and energy necessary for the recovery of the body.According to modern recommendations, the management program for elderly patients with COVID-19 should include measures aimed at screening, preventing and treatment of malnutrition.

Physical and mental health of older people with disabilities in residential homes in Switzerland.

Objectives:People with disabilities are underserved in terms of health care and prevention, and special health conditions exist among older people with intellectual disabilities. The Swiss Health Survey only covers people over the age of 15 years living in private households. Therefore, this study aims to assess the health status of older persons living in residential facilities for adults with disabilities.Methods:A cross-sectional survey with written questionnaires was conducted in six cantons in Switzerland to capture context factors and the physical health status of persons aged between 50 and 65 years in residential homes in Switzerland. The survey collected data on physical and mental health from 241 persons aged 50–65 years living in residential homes for people with disabilities. This was compared with data from the 2012 Swiss Health Survey comprising a sample of 2261 persons of the same age with chronic morbidities living in their own apartments.Results:Regarding their health, 94.1% of the survey respondents rated it as being very good, good or moderate. Although higher limitations on activities of daily living, higher levels of psychological distress and lower energy and vitality were reported by all respondents, a lower level of health issues was assessed than in the sample of persons with chronic morbidities living in their own apartment.Conclusion:Low energy and vitality, high limitations on activities of daily living, high psychological distress, high obesity rates and the assessment of health issues and pain should be specifically addressed in residential homes for people with disabilities.

Health status and its socio-economic covariates in the older population in Poland - the assumptions and methods of the nationwide, cross-sectional PolSenior2 survey.

IntroductionPopulation ageing constitutes an increasing medical, social, and economic burden worldwide. Optimal senior policy should be based on well-assessed knowledge on the prevalence and control of age-related diseases, multimorbidity, disabilities, and their social determinants. The objective of this paper is to describe the assumptions, methods, and sampling procedures of the PolSenior2 survey, which was aimed at characterising the health status of old and very-old adults in Poland.Material and methodsThe project was conducted in the period 2018–2019 as a cross-sectional survey of a representative sample of people aged 60 years and over. Subjects were selected using three-stage stratified and proportional random sampling in seven equally sized (n = 850) age groups. The study protocol consisted of face-to-face interviews, specific geriatric scales and tests, and anthropometric and blood pressure measurements performed by well-trained nurses at participants homes as well as blood and urine sample laboratory tests.ResultsIn the Polsenior2 study a group of 5987 subjects underwent the questionnaire parts of the survey, and almost all (n = 5823) agreed to blood or urine sample collection.ConclusionsIn recent decades several studies focused on various aspects of elderly health and life conditions had been carried out in Poland and Central and Eastern Europe. However, none of them is so complex and has covered so many issues as PolSenior2, which is the largest study devoted to the health status of older persons in Poland and one of the largest and the most comprehensive in Europe. The results of the study will help to improve health policy targeted at the elderly population in Poland.

Cigarette Smoking, Alcohol Intake and Health Status of Older Persons in England: the Mediating Effects of Sociodemographic and Economic Factors

This study was conducted to determine whether there is an association between cigarette smoking, alcohol consumption and self-reported health status among older persons and how sociodemographic and socio-economic factors mediate the association between these lifestyle behaviours and health in old age. Data from wave 7 of the English Longitudinal Study of Ageing (ELSA) were analysed using bivariate and logistic regression method. Self-reported health status was assessed as a binary variable; cigarette smoking and alcohol consumption as independent variables; and age, sex, marital status, education, employment as well as financial status were assessed as covariates. Smoking had a significant inverse association with reported health status and the odds of reporting good health status versus bad health status was 59% and 38% times less for former and current smokers respectively compared with those that never smoked. However, mild alcohol consumption seemed to have a significant positive association with health status, while a negative association existed between heavy alcohol consumption and health. Sociodemographic and economic factors did not appear to mediate the effects of smoking and alcohol consumption on health status. This study provided evidence that it is important to consider interventions on smoking and heavy alcohol drinking behaviours on good health status of older adults.

Survey of the living conditions and health status of older persons living in Quilombola communities in Bequimão, Brazil: the IQUIBEQ Project

To analyze the socioeconomic conditions and health status of older persons living in 11 Quilombola communities (settlements originally created by escaped slaves) in the Baixada Maranhense region, Brazil. A cross-sectional household survey of the socioeconomic status, sanitary conditions, health behavior, and self-reported morbidities was conducted with 208 older persons. Fisher’s exact test and the chi-squared test were performed (α = 5%) to determine statistically significant gender and age differences in the prevalence of morbidities and multimorbidities (≥ 2 and ≥ 3 diseases). The respondents were categorized into three age ranges: 60 to 69 years, 70 to 79 years, and ≥ 80 years. The median age was 70. The majority of respondents had poor socioeconomic status and sanitary conditions and showed poor results across all dimensions of health (self-reported health status, limitations in performing activities of daily living, and leisure time physical activity). The most prevalent morbidities were high blood pressure, back problems, and glaucoma/cataracts. Statistically significant gender differences were only found for high cholesterol, asthma/bronchitis, and cancer (p < 0.05). The prevalence of multimorbidity was found to be high (52.9% for ≥ 2 diseases and 26.4% for ≥ 3 diseases; p < 0.001). The prevalence of both groups of multimorbidity was greater among women (p < 0.05) and in the 70 to 79-year age group. Statistically significant differences in prevalence rates across age groups were found among men for both multimorbidity groups (≥ 2 chronic diseases, p = 0.003, and ≥ 3 chronic diseases, p < 0.001). The findings show that older Quilombolas experience poor health and social conditions characterized by the lack of public investment to bring their health status in line with that of the general population.

The Role of a Health Protection Scheme in Health Services Utilization Among Community-Dwelling Older Persons in Ghana.

This study examines the relationships between National Health Insurance Scheme (NHIS) enrollment and the frequency and "timing" of health services utilization among community-dwelling older Ghanaians. It also investigates whether the NHIS policy has improved equity in access to health care in later life. Cross-sectional data were derived from an Ageing, Health, Psychological Wellbeing and Health-seeking Behavior Study collected between August 2016 and January 2017 (N = 1,200). Descriptive and bivariate analyses described the sample. Generalized Poisson and logit regression models, respectively estimated the predictors of frequency of health services utilization and time from onset of illness to health facility use and during last illness episode. Older persons with active NHIS membership frequently used health facilities (β = 0.237, standard error [SE] = 0.0957, p ˂ .005), but the association was largely a function of health-related factors. The NHIS enrollees were more likely to attend health facility earlier (β = 1.347, SE = 0.3437, p ˂ .001) compared with nonenrollees, after adjusting for theoretically relevant covariates. Moreover, given the NHIS enrollment, the rich (eβ = 2.149, SE = 0.240, p ˂ .005), social support recipients (eβ = 1.366, SE = 0.162, p ˂ .05) and those living with relevant others (eβ = 2.699, SE = 0.175, p ˂ .001) were more likely to consume health services. Ghana's NHIS policy generally increases health services utilization but at present lacks the capability to improve equitable access to health care, especially between poor and nonpoor older adults. This may hamper the progress toward universal health coverage (UHC), indicating the need for further refinements in the policy including ways to improve the health status of older persons.

Clinical Aspects of Foot Health in Individuals with Alzheimer's Disease.

Alzheimer’s disease (AD) shows a marked presence of physiologic changes and the start or aggravation of underlying diseases such as physical frailty in diverse anatomical regions. It is believed to have a particularly harmful effect on the health of the foot. We examined the foot health status in older persons with AD, with a specific focus on the extent to which people with AD may be using inadequate footwear in old age. Seventy-three community-dwelling people with probable, mild to moderate AD aged 65–95 years were recruited from a center of excellence for AD. A single trained physician evaluated health status and foot conditions. Current shoe and foot length and width measurements were taken using a calibrated Brannock device. The results indicate that sixty-five participants (89.04%) suffered from feet problems. Also, only twenty-two subjects (30.14%) used the correct shoes in width and size related with the morphology of their feet. Fifty-one participants (69.86%) were using incorrect shoes in length or width. The present study revealed that peoples with AD had a high presence of foot health problems. Also, the use of inappropriate shoes revealed measurable differences of association between shoe size and the morphology of the foot.

Oral health matters for the nutritional status of older persons-A population-based study.

To explore the association between oral health and nutritional status in the context of daily care for older people. Oral problems often increase with age and affect a person's ability to chew and swallow. They might also influence the ability to maintain a satisfactory nutritional status. Oral health awareness is therefore of great importance in nursing care for older people. A retrospective cross-sectional study. Data from the Swedish quality register, Senior Alert, were used, including structured assessments of both oral and nutritional status using the Revised Oral Assessment Guide-Jönköping and the Mini Nutritional Assessment. In total, 1,156 persons (mean age: 82.8±7.9) had both oral and nutritional assessments registered by the nursing staff in daily care. Approximately 29% of participants had moderate oral health problems. Another 12% had severe problems. Over 60% of the persons were considered at risk of malnutrition or were malnourished. There was a weak correlation between poor nutritional status and poor oral health, and approximately one-third of the persons who were at risk or malnourished had simultaneous oral problems. A multivariate logistic regression revealed that when problems involving voice and swallowing were present, there was also a greater possibility of being assessed as at risk of malnourishment or being malnourished. There is a relationship between oral health problems and nutritional status, indicating the importance of evaluating oral health status in older persons with nutritional problems. Nursing staff involved in care for older people should be aware of the importance of including regular oral health check-ups in their work. There is also a need for nursing staff members and oral health professionals to exchange knowledge.

COMMUNITY SERVICES FOR OLDER PERSONS PROVIDED BY FAMILIES AND THE YOUNG IN INDONESIA

AbstractBy 2050, the number of older people in Indonesia will approach 80 million. To enhance the health status of older persons, a referral program of networking hospitals and health clinics have been created. A survey of health centers in 33 provinces found them to be age-friendly. Our evaluation showed that the health status and daily life activity levels of older persons were maintained but depended on the number and dedication of young generations) providing services. Based on the programs reviewed, we conclude that there is national and community awareness of the issues surrounding the provision of care of older persons. However, it seemed that Indonesia is experiencing a decreasing number of the young supporting older persons. Suggestions are provided to reverse this trend to maintain community resilience and sustainability.

Exploring the health status of older persons in Sub-Saharan Africa.

Sub-Saharan Africa (SSA) has traditionally had a low life expectancy due to the onslaught of the HIV epidemic, high levels of chronic diseases, injuries, conflict and undernutrition. Therefore, research into public health concerns of older persons has largely been overlooked. With a growing population, the roll-out of antiretroviral treatment, and the effects of globalisation, SSA is experiencing an increase in the number of people over 50 years of age as well as an increase in the prevalence of non-communicable diseases (NCD). The aim of this review is to highlight available research on the health status of older persons in SSA, and to identify the current gaps that warrant further investigation. A literature search was conducted across multiple databases to identify studies in SSA on older persons (aged 50 years and older) related to health indicators including nutritional status, NCD and HIV burden. While it was concluded that older persons are at an increased risk of poor health, it was also determined that significant gaps exist in this particular area of research; namely nutrient deficiency prevalence. Resources should be directed towards identifying the health concerns of older persons and developing appropriate interventions.

Orofacial Pain and Mastication in Dementia.

Orofacial pain is a common condition in the general population. It is likely that this is also the case in older persons with a dementia. However, the assessment of (orofacial) pain in non-verbal individuals is hampered by the subjective nature of pain, and their limited communicative abilities. To overcome this drawback, several tools have been developed for the assessment of pain based on observations of pain-specific facial activities, body movements, and vocalizations. Unfortunately, none of the so far developed observational tools have been designed specifically for the assessment of orofacial pain. While the recent psychometric testing of the Orofacial MOBID Pain Scale did not yield reliable outcomes, the subsequently developed Orofacial Pain Scale for Non-Verbal Individuals (OPS-NVI) is currently being evaluated and shows good promise to be reliable and valid. Besides the assessment of orofacial pain, an important application of this instrument will be the investigation of the probable causal association between impaired chewing and cognitive decline, in which orofacial pain plays a mediating role by its negative influence on chewing ability. The identification of this negative influence will urge opinion leaders and policy makers to improve the oral health status in older persons with a dementia. Ultimately, pain-free oral functioning may lead to a higher quality of life and might help stabilizing or improving cognition in this frail and vulnerable patient population.

A subjective assessment of mental health of selected population of older persons in Delhi

A cross sectional survey was conducted among 60 subjects aged 60 years and above. The subjects in group was the geriatric population visiting Geriatric OPD, AIIMS, New Delhi. The convenient sampling technique was followed. General health questionnaire 12 administered to the subjects to detect those likely to have or be at risk of developing psychiatric disorders, domains of depression, anxiety, somatic symptoms, and social withdrawal. Study Result shows that 26.7% of elderly patients had evidence of psychological distress. It was found that the prevalence of psychological distress was 20% among elderly and illness and disability are related to psychological distress in old age with the feeling of loneliness is the single most important predictor of psychological distress. An immediate attention and remedial actions are to be taken for them so that they will be able to adapt healthy life style to improve the mental health status of older persons.

Limited Lung Function: Impact of Reduced Peak Expiratory Flow on Health Status, Health-Care Utilization, and Expected Survival in Older Adults

The authors examined whether peak expiratory flow (PEF) is a valid measure of health status in older adults. Survey and test data from the 2006 and 2008 cycles of the Health and Retirement Study, a longitudinal study of US adults over age 50 years (with biennial surveys initiated in 1992), were used to develop predicted PEF regression models and to examine relations between low PEF values and other clinical factors. Low PEF (<80% of predicted value) was prevalent among persons with chronic conditions, including frequent pain, obstructive lung disease, heart disease, diabetes, and psychological distress. Persons with higher physical disability scores had substantially higher adjusted odds of having low PEF, on par with those for conditions known to be associated with poor health (cancer, heart disease, and stroke). In a multivariate regression model for difficulty with mobility, PEF remained an independent factor (odds ratio (OR) = 1.69, 95% confidence interval (CI): 1.53, 1.86). Persons with low PEF in 2006 were more likely to be hospitalized (OR = 1.26, 95% CI: 1.10, 1.43) within the subsequent 2 years and to estimate their chances of surviving for 10 or more years at less than 50% (OR = 1.69, 95% CI: 1.24, 2.30). PEF is a valid measure of health status in older persons, and low PEF is an independent predictor of hospitalization and poor subjective mortality assessment.

Correlates of health and financial literacy in older adults without dementia

BackgroundRecent research has begun to recognize the important influence of literacy levels and how they affect health and wellbeing, especially in older adults. Our study focuses on health and financial literacy, two domains of literacy which previous research has suggested may be significantly related to health and wellbeing. Our study examines the relation of health and financial literacy with health promoting behaviors and health status among community-based older persons.MethodsWe conducted a cross-sectional study using data from the Rush Memory and Aging Project, a community-based cohort study of aging in northeastern Illinois. The study consisted of 556 older persons without dementia, each determined by a clinical evaluation. Health and financial literacy were measured using a series of questions designed to assess the ability to understand and process health and financial information, concepts, and numeracy; the two scores were averaged to yield a total literacy score. Health promoting behaviors, including engagement in cognitive, physical, and social activities, were assessed using self report measures. Indicators of heath status, including cognition (global cognition and five specific cognitive abilities), functional status (basic and instrumental activities of daily living, mobility disability), and mental health (depressive symptoms, loneliness) were assessed.ResultsIn a series of regression models adjusted for age, sex, and education, higher total literacy scores were associated with more frequent participation in health promoting behaviors, including cognitive, physical and social activities (all p values <0.05). Higher total literacy scores were associated with higher cognitive function, less disability, and better mental health (all p values < 0.05). Literacy remained associated with health promoting behaviors and health status in fully adjusted models that also controlled for income and the number of chronic medical conditions. Most of the findings were similar for health and financial literacy except that health literacy was more strongly associated with health promoting behaviors whereas financial literacy was more strongly associated with mental health.ConclusionsHealth and financial literacy are associated with more frequent engagement in health promoting behaviors and better health status in older persons without dementia.

Effects of dance on physical and psychological well-being in older persons

This study was aimed at determining the effects of dancing on the health status of older persons. A pool of 111 community-dwelling subjects were allocated to either an intervention group (IG), which included 23 sessions of dance over 12 weeks, or a control group (CG). All participants were assessed at baseline and 12 weeks. Physical outcome measures included the 6-min timed walking test (6MWT), trunk flexibility, body composition, lower limb endurance and strength, balance, the timed up-and-go test (TUG), resting heart rate and blood pressure. Quality of life was assessed by the Medical Outcomes Survey Short Form (SF-36) questionnaire. The IG’s views toward dancing were also evaluated at 12 weeks. Significant difference was observed between the groups in six outcome measures: mean change in resting heart rate, 6MWT, TUG, lower limb endurance and the ‘general health’ and ‘bodily pain’ domains of SF-36. The majority of the dance group felt the intervention improved their health status. These findings demonstrate that dancing has physical and psychological benefits, and should be promoted as a form of leisure activity for senior citizens.

Relationship Between Low Levels of Anabolic Hormones and 6-Year Mortality in Older Men&lt;subtitle&gt;The Aging in the Chianti Area (InCHIANTI) Study&lt;/subtitle&gt;

Aging in men is characterized by a progressive decline in levels of anabolic hormones, such as testosterone, insulinlike growth factor 1 (IGF-1), and dehydroepiandrosterone sulfate (DHEA-S). We hypothesized that in older men a parallel age-associated decline in bioavailable testosterone, IGF-1, and DHEA-S secretion is associated with higher mortality independent of potential confounders. Testosterone, IGF-1, DHEA-S, and demographic features were evaluated in a representative sample of 410 men 65 years and older enrolled in the Aging in the Chianti Area (InCHIANTI) study. A total of 126 men died during the 6-year follow-up. Thresholds for lowest-quartile definitions were 70 ng/dL (to convert to nanomoles per liter, multiply by 0.0347) for bioavailable testosterone, 63.9 ng/mL (to convert to nanomoles per liter, multiply by 0.131) for total IGF-1, and 50 microg/dL (to convert to micromoles per liter, multiply by 0.027) for DHEA-S. Men were divided into 4 groups: no hormone in the lowest quartile (reference) and 1, 2, and 3 hormones in the lowest quartiles. Kaplan-Meier survival and Cox proportional hazards models adjusted for confounders were used in the analysis. Compared with men with levels of all 3 hormones above the lowest quartiles, having 1, 2, and 3 dysregulated hormones was associated with hazard ratios for mortality of 1.47 (95% confidence interval [CI], 0.88-2.44), 1.85 (95% CI, 1.04-3.30), and 2.29 (95% CI, 1.12-4.68), respectively (test for trend, P <.001). In the fully adjusted analysis, only men with 3 anabolic hormone deficiencies had a significant increase in mortality (hazard ratio, 2.44; 95% CI, 1.09-5.46 (test for trend, P <.001). Age-associated decline in anabolic hormone levels is a strong independent predictor of mortality in older men. Having multiple hormonal deficiencies rather than a deficiency in a single anabolic hormone is a robust biomarker of health status in older persons.

Reporting peak expiratory flow in older persons.

Peak expiratory flow ("peak flow") predicts important outcomes in older persons. Nevertheless, its clinical application is uncertain because prior strategies for reporting peak flow may not be valid. We thus determined the frequency distribution of peak flow by the conventional strategy of percent predicted (%predicted) and by an alternative method termed standardized residual (SR) percentile, and evaluated how these two metrics relate to health status in older persons. Participants included 754 community-dwelling persons aged >/= 70 years. Data included chronic conditions, frailty indicators, and peak flow. Mean age was 78.4 years, with 63.7% reporting a smoking history, 17.4% chronic lung disease, and 77.1% having one or more frailty indicators. Peak flow >/= 80 %predicted was recorded in 67.5% of participants, whereas peak flow >/= 80th SR percentile was only noted in 15.9%. A graded relationship was observed between peak flow and health status, but %predicted yielded health risk at peak flows currently considered normal (80-100 %predicted), whereas SR percentile conferred health risk only at severely reduced peak flows (< 50th SR percentile). Peak flow expressed as SR percentile attains a frequency distribution more consistent with the characteristics of our elderly cohort, and establishes health risk at more appropriate levels of reduced peak flow. These findings establish the need for longitudinal studies based on SR percentile to further evaluate the use of peak flow as a risk assessment tool in older persons and to determine if pulmonary function, in general, is better reported in older persons as SR percentile, rather than as %predicted.

The Built Environment, Health, and Longevity

This paper reviews and integrates interdisciplinary literature that investigates the influence of the built environment on the subjective and objective health status of older persons that may improve their quality and quantity of remaining years of life. The development, expansion and synthesis of person-environment and ecological models provides the theoretical foundation. Central to this discussion is the identification and elaboration of salutogenic and pathogenic pathways (Antonovsky, 1979) through which the built environment may influence health, functioning and longevity. Research and knowledge drawn from literature on relocation, housing characteristics and well-being, the meaning of home, delay of institutionalization, technological devices, falls and other injuries, and healthy communities is used to demonstrate environmental pathways to health and longevity.

Organizational interventions to improve health outcomes of older persons.

With the reorganization of the financing of health care and creation of systems of care, it is possible to design and implement organizational interventions to improve the care of older persons beyond the services that can be provided by an individual provider. To review the effectiveness of organizational interventions for older persons, describe barriers to dissemination of success models into practice settings, and identify future directions for such interventions. Selective review of organizational interventions that have been aimed primarily at the geriatric population and have been formally evaluated using conventional research designs, usually randomized clinical trials. Organizational interventions can be classified into two groups: component models and systems changes. The former can be superimposed upon an intact system but do not fundamentally change the system of care whereas the latter modify the basic structure of primary care. A variety of organizational interventions have been implemented in diverse settings, but the evidence supporting the effectiveness of these interventions is inconsistent. Even when such interventions have been effective in research settings, these interventions rarely reduce health care costs. Moreover, there have been formidable barriers to implementation of successful interventions into practice. Organizational interventions are potentially powerful methods to influence health care and maintain health status of older persons. Nevertheless, gaps between knowledge and practice and unanswered questions about the effectiveness of organizational interventions currently limit the potential value of this approach to improving health care of older persons.