Iranian Older People Research Articles

Sleep duration and quality are associated with health-related quality of life in adults aged 60years and older.

The current study aimed to determine the association between sleep duration and quality with health-related quality of life (HRQoL) among the Iranian older persons. This study was conducted on a representative sample of 3452 Iranian older people (≥ 60years) who participated in the Iranian Longitudinal Study on Ageing (IRLSA) launched in Neyshabur (Razavi Khorasan province, northeastern Iran). The Persian versions of 12-Item Short Form Survey (SF-12) and Pittsburgh Sleep Quality Index (PSQI) were utilized to measure the level of HRQoL and the level of sleep duration and quality, respectively. Multiple linear regression model was performed to analyze the data and clarify the independent association of sleep duration and quality with HRQoL. More than half of the study population (52.4%) suffered from poor sleep quality. 57.3% and 3.9% of individuals were short sleepers (< 7h) and long sleepers (equal or more than 9h), respectively. The total score of HRQoL was achieved 65.87 ± 20.55. After adjusting the covariates, the results indicated that short sleep duration was negatively associated with HRQoL (P < 0.05), whereas no significant associations were found between long sleep duration and HRQoL (P > 0.05). Interestingly, the results of multiple linear regression model revealed a significant negative association between poor sleep quality and HRQoL (P < 0.001). The current study confirmed that short sleep duration and poor sleep quality were independently associated with lower HRQoL in the older persons. Therefore, interventional courses should be planned to enrich sleep-related healthcare and general HRQoL in the older persons.

The evaluation of clinical factors affecting oral health impacts on the quality of life of Iranian elderly patients visiting dental clinics: A cross-sectional study.

Iran will soon have an aging population. Healthcare providers must consider factors affecting the quality of life for those 60 and older. Understanding oral health as one of these factors can improve the elderly's quality of life. Oral health-related quality of life (OHRQoL) is a crucial reflection of individuals' general well-being and their overall quality of life linked to health. This study aimed to evaluate the OHRQoL among elderly Iranians referring to Azad University of Medical Sciences in Tehran. In this cross-sectional study, 171 individuals over 65 (93 men and 78 women) were evaluated using OHIP-14 and GOHAI-12 questionnaires to analyze their quality of life. Gender, age, systemic diseases, using medications and dentures, the number of remaining teeth, and oral lesions were recorded. Salivary flow and xerostomia were analyzed with the spitting method and xerostomia index questionnaire, respectively. Also, four main flavor solutions were used to evaluate the taste perception. Data were analyzed using PASS11 and p value<.05 was the significance level. Based on OHIP-14 and GOHAI-12, Iranian older people's quality of life can be affected by cardiovascular diseases, hypertension, xerostomia, and the number of remaining teeth (p<.05). The results also showed a significant correlation between the OHIP-14 and GOHAI-12 scores (p<.001). Both indexes revealed that the number of remaining teeth, xerostomia, salivary flow, and taste perception greatly influenced participants' quality of life. More remaining teeth, improved salivary flow, and better perception of sweetness and sourness were all linked to a higher quality of life, while increased xerostomia, reduced salivary flow, and bitter taste perception were linked to a decline in overall well-being. Cardiovascular diseases, hypertension, and medication use were also found to significantly impact quality of life. This study's results indicate that cardiovascular diseases, hypertension, dry mouth, and tooth loss can negatively impact the elderly's quality of life. So, improving both systemic and oral health is vital for enhancing life quality in this age group.

Role of family factors in provision and perception of social support for older people in Iran: a cross-sectional survey

BackgroundIran has experienced a very fast fertility transition. The process of demographic transition, coupled with modernization, has had considerable consequences for the structure and function of families. There is rising concern in Iran about a potential decline in family care and support for older people as a result of these changes. The main aim of this study was to provide a benchmark by examining current associations between family factors and older people’s social support, both perceived and received.MethodsA cross-sectional survey of a random sample of 644 people aged 60 + years resident in Tehran was conducted using stratified cluster random sampling method in 2015. Outcome variables were perceived social support, as measured by Social Provision Scale, and received instrumental social support. Multilevel mixed-effects models were used to examine the hypotheses.ResultsThe analyses showed that most of the family factors measured, including family size (p = 0.01), living arrangements (p = 0.05), and amount of contact with family members (p = 0.001) were associated with older people’s receipt of instrumental social support. Living arrangements and quality of relationships with family members were associated with older people’s perceptions of social support (p < 0.001). Also, a significant gender interaction was found in associations between family size and SPS (p = 0.03). Having a large size family was positively associated with higher SPS for women (Coef. = 3.9, p = 0.009) but not for men (Coef. = -0.4, p = 0.7).Conclusionfindings of this study support the premise that most of family factors play an important role in provision and perception of social support for Iranian older people. Further policies should mostly be selective of those at higher risk of low support such as widowed, childless, those living alone, having poor relationship with their relatives and those with worse health status. The results of this study may be utilized to target older populations who are at higher risk of low support with innovative programs that focus on building social networks and enhancing social support.

Prevalence of osteosarcopenic obesity and related factors among Iranian older people: Bushehr Elderly Health (BEH) program.

Osteosarcopenic obesity syndrome (OSO) is a condition that involves osteopenia/osteoporosis, sarcopenia, and obesity. It leads to a reduction in the quality of life of the elderly and an increase in hospitalization which has attracted the attention of physicians. This study aimed to determine the prevalence and risk factors of osteosarcopenic obesity in people over 60years of age in Bushehr. We used data from the Bushehr study, which included 2426 participants aged ≥ 60years. We assessed osteoporosis/osteopenia based on T-score; sarcopenia based on hand grip strength, skeletal muscle mass index (SMI), and walking speed; and obesity based on fat mass and BMI for diagnosing OSO. We first examined the factors related to OSO in the univariable analysis and then fitted the multiple logistic regression model, separately for women and men. The result was summarized as adjusted odds ratios with a 95% confidence interval. In total, 2339 elderly were examined in our study, of which 464 elderly were suffering from osteosarcopenic obesity. The standardized prevalence of OSO was 23.66% (95% CI: 21.15-26.16) in women and 18.53% (95% CI 16.35-20.87) in men. Age was positively linked to osteosarcopenic obesity in both genders and so was diabetes in men. However, education, physical activity, and protein intake were negatively linked to osteosarcopenic obesity in both genders, as well as hypertriglyceridemia and hypertension in women. The prevalence of OSO among men and women of Bushehr city is high and is related to increasing age, low levels of education, physical activity, and protein intake among women and men.

Is poor sleep quality associated with lipid profile in elderly population? Finding from Iranian Longitudinal Study on Ageing.

Abnormal lipid profile as one of reversible cardiovascular disease risk factors might be affected by poor sleep quality. This study aimed to assess the association between poor sleep quality and serum concentration of lipid profile in Iranian elderly population. The study was performed on a representative sample of 3452 Iranian older people (≥60 years) who contributed in the Iranian Longitudinal Study on Ageing (IRLSA). Sleep quality was measured through the validated Persian version of Pittsburgh Sleep Quality Index (PSQI). Fasting blood samples were collected from the participants to measure plasma levels lipid profile. We used multiple linear regression model to evaluate the independent association of poor sleep quality with lipid profile. The mean age of participants was 68.0±6.7 years and 52.5% of them were male. In total, 52.4% of study population reported poor sleep quality (PSQI>5). Mean serum concentration of triglycerides (TG), total cholesterol(TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was 143.2±74.2 mg/dl, 195.6±43.2 mg/dl, 112.9±31.0 mg/dl, and 57.3±12.4 mg/dl, respectively. Poor sleep quality was significantly associated with serum levels of TG (β=17.85;P=0.006), LDL-C (β=5.45; P=0.039) and HDL-C (β=-2.13; P=0.039) after adjusting for studied covariates. Our study illustrates that poor sleep quality is a risk factor for poorer lipid profile. Therefore, early behavioral or pharmacological interventions that improve sleep quality are necessary to modify lipid profile in elderly population.

Psychometric Properties of the Persian Version of the Care Transitions Measure (CTM-15) in Iranian Older People

Objectives The care transitions measure (CTM-15) is a reliable and valid tool to evaluate the transition of care. This study aims to assess the psychometric properties of the Persian version of CTM-15 in Iranian older people. Methods &amp; Materials This is a psychometrics study. The questionnaire was first translated into Persian based on the international quality of life assessment protocol. Then, it was completed by 200 older people who were selected using a convenience sampling method based on the inclusion criteria. After completion, face validity, content validity, construct validity (using confirmatory factor analysis and exploratory factor analysis) and convergent validity were investigated. The reliability of the questionnaire was evaluated in terms of internal consistency (using Cronbach’s α) and test-retest reliability. Statistical analyses were done in SPSS software, version 26 and AMOS software, version 24. Results The content validity index (CVI) for the whole questionnaire was obtained as S-CVI=0.966. Following CFA, the 4-factor solution was not confirmed and did not show a good fit (P&lt;0.001, RMSEA=0.093, GFI=0.851, NFI=0.644, CFI=0.731). After performing EFA, three factors were found and named as “patient and caregiver preferences”, “self-management and follow-up” and “medication management”. Convergence validity of the Persian CTM-15 with GSE-10 was assessed using Pearson’s correlation test which obtained as r=0.468. The internal consistency using Cronbach’s α coefficient was 0.76 and intraclass correlation coefficient was 0.85. Conclusion The Persian version of CTM-15 did not support the 4-factor model of the original version. The Persian version with 3 subscales, due to having acceptable validity and reliability, can be used as an efficient tool to evaluate the transition of care for the elderly in Iran. The benefits of measuring the transition of care and its impact on the promotion of discharge programs and continuity of care in various settings justify the need to pay attention to this tool.

Exploring the Lived Experiences of Older Adults in Iran During the COVID-19 Pandemic: A Phenomenological Study

Objectives Since older people make up a great percent of the population is Iran, and they experienced higher mental, physical, and emotional pressures due to quarantine and lockdown during the COVID-19 pandemic, the present study aims to investigate the lived experiences of older adults during the COVID-19 pandemic in Iran. Methods &amp; Materials This qualitative phenomenological study was conducted in Fars, Kermanshah, and Tehran provinces of Iran from October 1, 2021 to January 30, 2022. The data were collected through interviewing 16 older adults. Data analysis was done by Smith’s interpretative phenomenology analysis. Results Of 16 older adults, 9 were male and 7 were female, with a mean age of 73 years. Their lived experiences were classified into three main categories: Psychological tensions, resilience (healing) measures, and economic tensions. Conclusion Iranian older people experienced various types of tensions during the COVID-19 pandemic. Social distancing and quarantine increased the concerns about their mental health. Therefore, it is very important to identify and analyze the psychological concepts and protective factors along with preparing practical guidelines to protect their mental health during the COVID-19 pandemic.

Psychometric Properties of the Falls Efficacy Scale-International, Cut-off Points, and Validating its Short Version Among Iranian Older People.

Older people have a fear of falling, which is far more difficult than falling itself. We measured the extent of this feeling using a short and valid Falls Efficacy Scale-International (FES-I) 7-item questionnaire for the aging community in Iran. The present psychometric work deals with outlining the validation and translation of FES-I (short version) among 9117 Persian-speaking elderly people with a mean age of 70.2±8.3 years (54.1% female and 45.9% male) in July 2021. Investigations were performed on confirmatory factor analysis, exploratory factor analysis, internal consistency, and construct validity along with test-retest reliability, receiver operating characteristic analysis, inter-rater, and convergent validity. 72.4% of the subjects were living alone, 92.9% required support in activities of daily living, and 93.0% experienced falling in the past two years. A one-factor solution was assigned by exploratory factor analysis for FES-I. Thus, this model was proved by the confirmatory factor analysis with valid fit indices. Based on Cronbach's alpha, intra-cluster correlation coefficient, and McDonald's omega (≥ 0.80), internal consistency was confirmed. The exact cut-off value was represented by the receiver operating characteristic analysis for male/female and between with/without fear of falling among older samples with higher measures of specificity and sensitivity. Moreover, a significant effect of age, aging in place, loneliness, hospitalization rate, frailty, and sense of anxiety (effect size ≥ 0.80, p ≤ 0.05) on fear of falls was detected using analysis of variance. The psychometric properties of the original scale were preserved by the Persian version of FES-I seven items as a self-reported measure of fear of falling. It could be assuredly a measure in both community and clinical settings. The possible uses and limitations of the Iranian FES-I were also discussed.

Conspiracy Illusion, Superstitions, and Death Anxiety of Older Adults Who Refused Covid-19 Vaccination in Iran: A Cross-Sectional Study on Their Beliefs.

The study was aimed to assess mental health of the older adults who did not participate in the three stages of national vaccination program. As a descriptive-analytical study, about 285 Iranian older people were interviewed in 2022. Data collection tools included demographic characteristics, conspiracy scale, superstitious beliefs instrument, and Templer death anxiety. The convenience sampling method was used and data were analyzed using BIM-SPSS version 28. Death anxiety statistically effect on conspiratory and superstitions with scores 0.190 and 0.320 using adjusted Eta squared, respectively and superstitious beliefs effected 81% of conspiracy as well (p = 0.001). Using ROC analysis, the cutoff points for conspiracy of men and women and final SEM model were extracted too. Interaction of conspiracy illusion, superstitions with death anxiety during the pandemic time among vulnerable groups i.e ageing community can shape a decision line in health policy making.

Gender Interaction in Association of Perceived Social Support and Health-Related Quality of Life Among Iranian Older People: A Cross-sectional Survey.

Background: The purpose of this study was to examine the relationship between perceived social support (PSS) and dimensions of health-related quality of life (HRQoL) and to examine possible gender interaction in the mentioned associations. Methods: A community-based cross-sectional study conducted among 644 participants over the age of 60 years old in Tehran. The data were collected through face-to-face interviews conducted in their own homes, by using a structured multi-sectional questionnaire. The version 1 of the SF-12 scale was used to measure the HRQoL, consisting of two summary measures; PCS (Physical Component Score) and MCS (Mental Component Score). The Persian version of the Social Provisions Scale (SPS) was used to measure PSS. Four multilevel mixed-effects logistic regression models were used to examine the associations. Results: Older people with poor SPS score were 1.8 times more likely to be in the worst quartile of the MCS distribution (CI=1.11-2.93, P =0.021), and twice as likely to be in the worst quartile of the PCS distribution (CI=1.18-3.54, P =0.011). We found strong evidence to support the hypothesis of gender interaction in the association between economic status and PCS [Men: OR 0.28, CI (0.11-0.71); Women: OR 1.00, CI (0.53-1.88); P of Interaction 0.021], and a borderline evidence for gender interaction in the association between physical activity and PCS [Men: OR 5.32, CI (2.14-13.20); Women: OR 1.80, CI (0.82-3.93); P of Interaction 0.051]. Conclusions: Social support could be regarded as one of the main social determinants affecting HRQoL among older people. Men with poor economic status and poor physical activity, compared to women, are more likely to suffer from poor quality of life, thus men should be prioritized in financial support and life style and physical activity interventions.

Cultural Adaption and Psychometric Analysis of Family APGAR Scale in Iranian Older People.

BackgroundFamily function is a necessary factor that influences older people’s health. The Family APGAR has been widely used to study family functions. However, there has been no Persian version of this instrument to assess family function in older people. The aim of this study was to determine the psychometric properties of the Persian version of the Family APGAR Scale to evaluate the perception of family functions.MethodsThe “forward-backward” procedure was applied to translate the scale from English into Persian. The translated version was checked in terms of validity and reliability, with a sample of 281 older people selected from retirement centers. The factor structure of the scale was also tested using a confirmatory factor analysis. To test reliability, internal consistency and test–retest analyses were performed.ResultsThe results of the confirmatory factor analysis indicated a good structural model. Criterion-related validity was strongly supported by the pattern of association between the APGAR Scale and the social support survey. Cronbach’s α of the scale was 0.88 and test–retest reliability ranged from 0.96 to 0.98, indicating a good range of reliability.ConclusionThe findings of this study suggest that the Iranian version of the Family APGAR is a valid and reliable scale to evaluate family functions in health intervention programs.

Prevalence and determinants of depression, anxiety and stress among the Iranian older people with type 2 diabetes

Introduction: Mental disorders (depression, anxiety and stress) cause disability and aggravate various diseases, including diabetes mellitus and its common complication such as diabetic nephropathy. Objectives: The current study aimed to investigate the prevalence of mental health disorders (depression, anxiety and stress) and their associated factors among the Iranian older people with type 2 diabetes mellitus (T2DM). Patients and Methods: In this cross-sectional study, 501 subjects with T2DM and 551 subjects without T2DM were selected by a multistage stratified sampling method from Yazd Greater Area, Iran. Delphi method and experts panel were used for selection of priorities of effective factors. The obtained data were analyzed using the chi-square test and Stata software version 14. A P value of ≤0.05 was considered statistically significant. Results: The prevalence of moderate to severe depression and anxiety was 51.9% and 61.9%, among diabetic, 22% and 33.4% among non-diabetic groups, respectively. According to multiple logistic regression analysis results in diabetics group specified female gender (OR=1.97, 95% CI=1.03-3.75), poor sleep quality (OR=1.08, 95% CI=1.02-1.15), decreased social support (OR=0.89, 95% CI=0.54-1.68), and body mass index (BMI) ≥30 kg/m² (OR=1.6, 95% CI=1.2-5.63) for depression, as well as female gender (OR=2.97, 95% CI=1.5- 5.87), BMI ≥30 kg/m² (OR=2.69, 95% CI=1.22-5.96), and decreased social support (OR=0.87, 95% CI=0.78-0.98) for anxiety as the predicting characteristics. Conclusion: The present research findings revealed a significantly higher prevalence of depression and anxiety in older people with T2DM rather than older people without T2DM. Therefore, appropriate interventions such as screenings and psychiatric evaluations are necessary to diagnose and treat depression and anxiety in this population, especially the females to avoid diabetic complications like diabetic kidney disease.

A perspective on the sense of loneliness and its determinants in Iranian older people.

The sense of loneliness is one of the common problems of older people and their quality of life, and is affected by many factors such as personal resources, gender, health condition, and age. This study investigates the determinants of the sense of loneliness between older men and women in Birjand. This study was a part of the community-based prospective cohort study of the Birjand Longitudinal Aging Study (BLAS). Individuals over 60 years of age and their families (selected by random cluster sampling) were assessed through structured interviews with questionnaires such as Patient Health Questionnaire, Short-Form-12, Longitudinal Aging Study Amsterdam Physical Activity Questionnaire, loneliness, and social support questions. The mean age of the participants in the study was 68.59 ± 6.72, and 53.2% were women. Based on the findings of pathway analysis, the most critical determinants of loneliness in older men and women were the number of children (total effect=-0.112, P=0.006) and mood, respectively (total effect=0.142, P < 0.001). According to results, older people with fewer children feel lonelier. Compared with men, emotional loneliness is more common in older women. Older women, who lost their husbands, suffer from loneliness, mental health disorders, and low quality of life.

Comparing Psychometric Properties of GLFS-5 With GLFS-25 for Screening Locomotive Syndrome in Community-dwelling Iranian Older People

Objectives: Locomotive syndrome refers to reduced mobility due to impairment of locomotive organs. Because of the importance of screening locomotive syndrome among older people, this article is focused on psychometric characteristics of Geriatric Locomotive Function Scale (GLFS)-5 and comparing it with GLFS-25 in Iranian older adults Methods: This research was conducted on 320 older Iranian people. Validity and reliability of the GLFS-5 were examined and confirmed using Content Validity Index (CVI), factor analysis, correlation coefficient with the European Quality of Life Scale-5 Dimension (EQ-5D) questionnaire, the Cronbach α value for internal consistency, and intraclass correlation and Receiver Operating Characteristic (ROC) technique to determine the cutoff score for the locomotive syndrome. Results: In phase 1 of the study, 250 Iranian older people ≥60 years were analyzed. The factor analysis showed that the GLFS-25 is a multi-dimensional scale (Activities of Daily Livings [ADLs] and Quality of Life [QoL], pain, social relationship, and psychological status), and GLFS-5 is a one-dimensional scale (the ability to perform daily activities). The Cronbach α values for GLFS-25 and GLFS-5 were 0.93 and 0.84, respectively. As for association between the GLFS-25 and GLFS-5 with EQ-5D and Visual Analogue Scale (VAS) (health self-perceived), the Pearson correlation coefficients were 0.85 and -0.72 for GLFS-25 (P=0.01) and 0.82 and -0.67 for GLFS-5 (P=0.01), respectively. The cutoff scores to identify locomotive syndrome for the GLFS-25 and GLFS-5 were 16 and 4, respectively. Discussion: Considering the good validity and reliability properties of the GLFS-5 compared to GLFS-25 and the more convenient use of this short version of the GLFS, its application is highly recommended for community-based screening of locomotive syndrome in Iranian older people.

Association between biomarkers of bone health and osteosarcopenia among Iranian older people: The Bushehr Elderly Health (BEH) program

BackgroundOsteosarcopenia is referred to as co-incidence of osteoporosis/osteopenia and sarcopenia which is defined as a geriatric syndrome with a significant prevalence that increases morbidity and mortality. There are some relevant factors that can show an increased risk of incidence of osteosarcopenia.AimWe aimed to consider the association of bone turnover markers such as Osteocalcin (OC), C-terminal cross-linked telopeptide (CTX), Tartrate Resistant acid Phosphatase (TRAP), Bone Alkaline Phosphatase (BALP) and also other factors like vitamin D, calcium, phosphorous, and ALP with osteosarcopenia in elderly.Methods We carried out a cross-sectional study on a random sample including 400 elder participants of Bushehr Elderly Health (BEH) study, in Iran. Osteopenia/ osteoporosis was defined as a T-score ≤ -1.0 standard deviation below the mean values of a young healthy adult. We defined sarcopenia as low muscle strength (handgrip strength<26 kg for men and <18 kg for women) with reduced skeletal muscle mass [Skeletal muscle index (SMI) < 7.0 kg/m2 for male and <5.4 kg/m2 for female]. Osteosarcopenia was considered as the presence of both osteopenia/osteoporosis and sarcopenia. We estimated the age-standardized prevalence of osteosarcopenia for men and women, separately. We used multivariable logistic regression to address the factors associated with osteosarcopenia.ResultsThe results showed that there was a statistically significant difference in OC), CTX, TRAP were between the osteosarcopenia (-) and osteosarcopenia (+) groups. No statistically significant difference was observed in BALP, vitamin D, calcium, phosphorous, and ALP between the compared groups.In the multivariable logistic regression model, OC and CTX were associated with increased likelihood of osteosarcopenia [adjusted OR= 1.023(1.002-1.045 for OC, 4.363(1.389-15.474 for CTX)]. Furthermore, TRAP increases the odds of osteosarcopenia in crude model [OR= 1.333 (1.070- 1.660)].ConclusionsWe observed the association between bone turnover markers particularly OC, CTX and osteosarcopenia. Given the rapid growth of the aging population, we should focus on geriatric diseases such as musculoskeletal disorders. Bone turnover markers maybe improve the early diagnosis, screening and assess the response to therapies in people with osteosarcopenia.

Comparing Fear of COVID-19 and Preventive COVID-19 Infection Behaviors Between Iranian and Taiwanese Older People: Early Reaction May Be a Key.

This study assessed fear of the novel coronavirus-2019 (COVID-19), preventive COVID-19 infection behaviors, and the association between fear of COVID-19 and preventive COVID-19 infection behaviors among older people in Iran and Taiwan. Older people aged over 60 years (n = 144 for Iranians and 139 for Taiwanese) completed the Fear of COVID-19 Scale (FCV-19S) and two items on preventive COVID-19 infection behaviors (i.e., hand washing and mouth covering when sneezing). Iranian older people had a significantly higher level of fear of COVID-19 than did Taiwanese older people. Moreover, Iranian older people had significantly lower frequencies of preventive COVID-19 infection behaviors than did Taiwanese older people. Different timings in implementing COVID-19 infection control policies in Iran and Taiwan may explain why Iranian older people had greater fear of COVID-19 and lower preventive COVID-19 infection behaviors than did Taiwanese older people.

Comparison of anthro-metabolic indicators for predicting the risk of metabolic syndrome in the elderly population: Bushehr Elderly Health (BEH) program.

Metabolic syndrome (MetS) is a cluster metabolic disorder that includes central obesity, insulin resistance, hypertension, and dyslipidemia, and is highly associated with an increased risk of developing non-communicable diseases (NCDs). This study aimed to compare the reliability of anthro-metabolic indices [visceral adiposity index (VAI), body roundness index (BRI), and a body shape index (BSI), body adiposity index (BAI), lipid accumulation product (LAP), waist to hip ratio, and waist to height ratio] in predicting MetS in Iranian older people. This cross-sectional study was conducted based on the data of 2426 adults aged ≥60years that participated in the second stage of the Bushehr Elderly Health (BEH) program, a population-based prospective cohort study being conducted in Bushehr, Iran. MetS was defined based on the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. The receiver operating characteristic (ROC) curve analysis was used to assess predictive performance of anthro-metabolic indices and determine optimal cutoff values. Logistic regression analysis was applied to determine the associations between MetS and indices. 2426 subjects (48.1% men) with mean ± SD age of 69.34 ± 6.40years were included in the study. According to ATP III criteria, 34.8% of men and 65.2% of women had MetS (P < 0.001). Of the seven examined indices, the AUCs of VAI and LAP in both genders were higher than AUCs of other anthro-metabolic indices. Also, in general population, VAI and LAP had the greatest predictive power for MetS with AUC 0.87(0.86-0.89) and 0.87(0.85-0.88), respectively. The lowest AUC in total population belonged to BSI with the area under the curve of 0.60(0.58-0.62). After adjusting for potential confounders (e.g. age, sex, education, physical activity, current smoking) in the logistic regression model, the highest OR in the total population was observed for VAI and LAP, which was 16.63 (13.31-20.79) and 12.56 (10.23-15.43) respectively. The lowest OR for MetS was 1.93(1.61-2.30) for BSI. This study indicated that both VAI and LAP are the most valuable indices among the anthro-metabolic indices to identify MetS among the elderly in both genders. So, they could be used as proper assessment tools for MetS in clinical practice. However, the cost-benefit of these indices compared to the ATP III criteria need further studies.

Psychometric properties of the Short Form-8 Health Survey (SF-8) among diabetes and non-diabetes Iranian older people.

Background: The current study aimed to evaluate the psychometric properties of the Persian version of the 8-item Short-Form Health Survey (SF-8). For this purpose, we examined a large sample of the older adult in two different groups with and without diabetes using the YazdHealth Study (YaHS) data.Methods: Using a two-stage cluster random sampling method, 1901 older adults were recruited, according to the World Health Organization (WHO) STEPwise approach to surveillance(STEPS) guidelines. To test the scale’s reliability, the internal consistency and test-retest methods were applied. The convergent validity of the entire questionnaire was evaluated by the average variance extracted (AVE) and composite reliability (CR) for each subscale. An independent samples t-test was used to assess the demographic differences between the study groups. Results: The Cronbach’s alpha coefficient for the subscales of SF-8 were measured to range between 0.85 and 0.79 (physical & mental health). The test-retest reliability coefficient of the physical component summary (PCS) and (0.97) and mental component summary (MCS) (0.98)indicated the appropriate reliability of the SF-8. The CFA-concerned results indicated that the the2‐factor model presented a good fit to the data for the explored diabetes and non-diabetes groups, as well as the total research participants [goodness of fit index (GFI)=0.99, comparative fit index (CFI)=0.992, normed fit index (NFI)=0.99, incremental fit index (IFI)=0.992, root mean square error of approximation (RMSEA)=0.056]. Values >0.5 and >0.7 for AVE and CR indicated the evidence of the convergent validity of the SF-8.Conclusion: The present study was the first attempt to confirm the traditional 2-factor structure of SF-8 among a large sample of Iranian older individuals. The obtained results suggested that the Persian version of the SF-8 is a reliable and valid tool for measuring health-related quality of life (HRQoL) among Iranian older adults (including the older adult with & without diabetes).

Typology of Family Support in Home Care for Iranian Older People: A Qualitative Study.

The world population is rapidly aging. In older people, age-related biological decline in most body systems causes functional decline, an increase in dependence, and an increased need for support, especially by their family members. The aim of this study was to explore the main aspects of family support for older parents in home care. This qualitative study was conducted using a deductive qualitative content analysis approach. Participants were 21 older parents living in their own homes, as well as four family members of some participants. Data were collected using semi-structured interviews and then were analyzed using the primary matrix developed based on the existing literature. The main aspects of family support for older parents were grouped into five predetermined categories and one new category: “instrumental support”, “financial support”, “psycho-emotional support”, “healthcare-related support”, “informational-technological support”, and “social preference support “. Family support for older people in home care is a multi-dimensional phenomenon. Family members can identify the needs of their older parents and provide them with appropriate support in collaboration with healthcare professionals to enhance their quality of life, autonomy, and satisfaction with life.

Relationship Between Sarcopenia and Electrocardiographic Abnormalities in Older People: The Bushehr Elderly Health Program.

Background: Sarcopenia is characterized by low skeletal muscle mass and function, which is associated with cardiovascular risk factors and may even be related to adverse cardiovascular events and mortality. This study aimed to evaluate whether sarcopenia is related to electrocardiographic (ECG) abnormalities in a large sample of older adults.Methods: We performed a cross-sectional study based on the data collected during the Bushehr Elderly Health (BEH) cohort study. Body composition was measured by dual X-ray absorptiometry (DXA) and muscle strength was measured using a digital dynamometer for each hand of every participant. A person who had low muscle strength, as well as low muscle mass was identified as having sarcopenia. The subjects were classified into three groups according to the Minnesota Code (MC) as major, minor ECG abnormalities and participants with no abnormalities ECG.Results: Of the 2,426 participants, 354 (14.6%) had major ECG abnormalities and 193 (8%) had minor ECG abnormalities. Sarcopenia was associated with an increased risk of major ECG abnormality in all models. After adjustment for confounders of CHD in full model, the OR for major ECG abnormality was 1.47 (95% CI 1.11–1.95) in those with sarcopenia. Low muscle strength and low muscle performance were both with an increased risk of major ECG abnormality in all models. Sarcopenia and low muscle strength increased 28% and 62% risk of any ECG abnormality in the full models [sarcopenia: 1.28(1.01–1.63), low muscle strength: 1.62(1.30–2.03)], respectively.Conclusions: This study showed that sarcopenia and its components are associated with ECG abnormalities in Iranian older people. Although some older adults have higher cardiovascular risk factors, these data showed that further factors such as sarcopenia may be identified as a particular risk factor for future cardiovascular events. Therefore, sarcopenia could be added to the screening of the older population to reduce the risk of cardiovascular events.