Low-income Elderly People Research Articles

Unmet Dental Care Needs of The Low-Income Elderly in South Korea: Applying the Andersen behavioural model.

Retirement reduces income and increases dental care needs for the elderly, but there are few studies on unmet dental care needs among the low-income elderly. This study aimed to identify actors associated with unmet dental care needs of low-income elderly people in South Korea. Secondary analysis of 2020 KNHANES data relating to 1,016 elderly individuals (65+) below median income. Unmet dental care needs were higher for women at 28.9% (p ⟨0.001), those with a middle school education at 28.5% (p ⟨ 0.05), individuals who rated their health as "poor" at 31.3%, those reporting feelings of depression at 44.8% (p ⟨ 0.001), individuals who rated their oral health as "poor" at 36.2% (p ⟨ 0.001), and those who experienced toothache at 37.2% (p ⟨ 0.001). In regression analysis women (Risk Ratio = 1.59, 95% CI 1.09-2.32), people with depression (RR = 2.29, 95% CI 1.01-5.15), those who perceived their oral health as "poor" (3.20, 95% CI 1.90-5.32) and those toothache (1.88, 95% CI 1.27-2.76) had higher unmet dental needs. Substantial unmet dental care needs exist among the low-income retired elderly. Comprehensive public oral health policies and community programs are needed for this population group.

Recommendations for acceptance of digital public services by low-income seniors in smart cities by human-centered design

Background: In Brazil, the federal government has developed a digital platform for public health services, with state and municipal governments connecting their solutions to unify citizen registration. Objective: To understand the phenomena involved, in order to provide recommendations for the acceptance of digital technologies by low-income elderly people in the context of smart cities. Method: The theory of the consolidated meta-analytic approach (TCMA) was used for a systematic bibliographic review (SBR) and case studies presented in a Design Postgraduate class, carried out in collaboration between two Brazilian Federal Universities. Results: Creation of recommendations in three categories within the framework of human-centered design. Conclusions: This study identifies opportunities for the development of products, services and public policies for the digital inclusion of low-income older people in the context of smart cities.

A study on care management practices for supporting low-income elderly people in Japan

A study on care management practices for supporting low-income elderly people in Japan

Tracking the Influence of Misinformation on Elderly People’s Perceptions and Intention to Accept COVID-19 Vaccines

ABSTRACT In this study, we surveyed low-income elderly people in Hong Kong and their family or friends to test a dual-path model with which we identified how misinformation in the media reached elderly people and how the elderly people’s perception and acceptance of coronavirus disease 2019 (COVID-19) vaccines were influenced. The findings suggest that elderly people’s own exposure to erroneous information regarding vaccines and COVID-19 in the media was positively associated with their misperceptions. In addition, their family or friends, who also received misinformation from the media, were found to relay the misleading or erroneous information to the elderly people, indicating a two-step flow of media influence. While previous studies have predominantly focused on the direct influence of misinformation in the media, our study suggests that social influence can also mediate the influence of misinformation in the media and negatively impacts elderly people’s perceptions of COVID-19 vaccines.

FLEXIBILIZAÇÃO DO CRITÉRIO DE HIPOSSUFICIENCIA NA CONCESSÃO DO BENEFÍCIO DE PRESTAÇÃO CONTINUADA (BPC-LOAS)

A Constituição Federal de 1988, no intuito de proporcionar uma melhor condição de vida para as pessoas portadoras de deficiência e idosos de baixa renda, assegurou o direito ao recebimento de um salário mínimo mensal, oriundo do Benefício de Prestação Continuada (BPC), também conhecido pelo nome da lei que o regulamenta, LOAS. Diante disso, o presente trabalho tem como objetivo analisar o BPC e seus critérios de concessão, dando um especial enfoque na possibilidade de flexibilização do critério de hipossuficiência que tem gerado grande repercussão devido a discordâncias da doutrina e jurisprudência com o requisito objetivo previsto no art. 20, §3 da Lei 8.742/93. A abordagem foi realizada utilizando o método dedutivo e pesquisa bibliográfica com caráter descritivo qualitativo e demonstrou-se, através da apresentação de argumentos, o contexto histórico da assistência social, o benefício de prestação continuada e suas espécies e as quatro teses que defendem a flexibilização do critério de hipossuficiência econômica.

Associação entre comportamento sedentário e diabetes em idosos de baixa renda na cidade de Ibicuí-BA: pesquisa populacional brasileira

O objetivo deste estudo foi estimar um ponto de corte do tempo gasto em comportamento sedentário como discriminador da presença de diabetes mellitus na população idosa. Métodos: estudo transversal, de base populacional, com dados de 310 idosos de baixa renda de Ibicuí-BA, Brasil, selecionados aleatoriamente. O comportamento sedentário foi avaliado pelo tempo gasto na semana e no fim de semana, e o diabetes foi avaliado por autorrelato. Os dados foram analisados pela estatística descritiva, Curva ROC e regressão de Poisson (p ≤ 0,05). O tempo médio gasto em atividades sedentárias foi de 272,63 ± 163,71 min / dia. A prevalência geral de diabetes foi de 13,5%. As características sociodemográficas, hábitos de vida e presença de diabetes não demonstraram associação estatisticamente significante (p> 0,05). A área sob a curva ROC foi de 0,60, IC 95% (0,54-0,65) ep = 0,003 e o ponto de corte foi> 325 min / dia que melhor discriminou a presença de diabetes mellitus entre os idosos. A análise bruta e ajustada para a associação entre comportamento sedentário e diabetes não revelou associação entre as variáveis. Identificou-se que o tempo despendido no comportamento sedentário possui boa capacidade discriminatória para a presença de diabetes mellitus. Por outro lado, não houve associação entre o primeiro e a presença de diabetes, após ajuste pelas variáveis intervenientes.

Income inequality and functional capacity of the elderly in a city in Southeastern Brazil.

Estimate the magnitude of the income inequality in the prevalence of functional dependency for basic and instrumental activities of daily life (BADLs, IADLs) and the abandonment of advanced activities (AADLs). This was a cross-sectional, population-based study, developed using sample data of 986 elderly people from a health survey carried out in the municipality of Campinas, São Paulo, in 2014/15. The prevalence of functional dependency in BADLs and IADLs and of abandonment of the AADLs was estimated according to monthly family income per capita. A multiple regression Poisson analysis was developed to estimate the prevalence ratio (PR) adjusted by gender and age. There was no significant association between income and functional dependency for BADLs. Of the seven IADLs analyzed, five presented a higher prevalence of dependency in the lower-income stratum, with special highlight to using the phone (PR = 3.50), controlling medication usage (PR = 2.44), and use of transportation (PR = 2.35). The abandonment of AADLs was higher among low-income elderly people in all activities analyzed, with the greatest inequalities observed in making contact by letter, phone and e-mail (PR = 3.76), using the Internet (PR = 3.34), driving vehicles (PR = 2.85) and visiting family (PR = 2.77). The broad inequality detected among income stratum regarding the functional capability for the IADLs and abandonment of the AADLs emphasize the importance of fully implementing and maintaining the policies and programs directed toward the social protection of elderly adults. The focus should be on the most socially vulnerable segments, with the aim of achieving a population that is more equal, active, independent, and involved in participatory ageing.

Decision Tree Algorithm for Precision Marketing via Network Channel

With the development of e-commerce, more and more enterprises attach importance to precision marketing for network channels. This study adopted the decision tree algorithm in data mining to achieve precision marketing. Firstly, precision marketing and C4.5 decision tree algorithm were briefly introduced. Then e-commerce enterprise A was taken as an example. The data from January to June 2018 were collected. Four attributes including age, income, occupation and educational background were selected for calculation and decision tree was established to extract classification rules.The results showed that the consumers of the products of the company were high-income young and middle-aged people, middle-income young people, middle-income middle-aged and elderly people with a college degree or above, low-income middle-aged people with a college degree or above and low-income elderly people with a state-owned enterprise. After precision marketing to these customers, it was found that the monthly sales volume of the enterprise increased by 22.82% and the marketing cost decreased by 28.21%, which verified the effectiveness and application value of precision marketing and showed that the decision tree algorithm could provide enterprises with decision support in precision marketing.

Dependency in Activities of Daily Living Is Associated with Household Food Insecurity Among Mexican Older Adults (P04-070-19)

ObjectivesTo analyze the association between dependency in activities of daily living (DADL) among Mexican older adults and the presence of household food insecurity. MethodsData on 6674 Mexican adults aged ≥60 years and their households were drawn from the 2012 Mexican National Health and Nutrition Survey (ENSANUT). DADL dependency, measured under the Katz Index (1983), was determined when respondents indicated needing assistance from another person in order to perform at least one DADL. Food insecurity (FI) was measured according to the Latinoamerican and Caribbean Food Security Scale (ELCSA). We used Path Analysis to examine the structure of the association of FI with DADL and other socio-demographic variables. Results22.6% of older adults analyzed were ADL-dependent, and 72.9% lived in households marked by a FI category. We found that DADL (P = 0.001) exerted a significant impact on moderate and severe FI in households not benefiting from a food aid program (P = 0.000) or retirement pension plan (P = 0.000). ConclusionsFew studies have explored this issue. DADL are intimately linked to household FI in that they affect the productivity of working adults and their caregivers. The findings from this study support the creation of nutritional policies and programs which address the unique needs of low income elderly people who have functional limitations. Funding SourcesN/A.

저소득층 노인 대상 영양교육 프로그램 개발 및 적용

The aim of this study was to develop a nutrition education program ‘Nutritional Management for Healthy Aging’ for elderly. The program was developed and implemented for low-income elderly people using welfare facility located in Daejeon for 18 weeks. Various experiential activities were included to enhance the effectiveness of the education. After, the interest and performance level of the participants was investigated. The media material showed the highest interest, and the game materials drew the highest performance level among the materials.

저소득 독거노인의 삶의 만족에 관한 연구

The degree of difficulty in low-income elderly people who living alone' life satisfaction is increased. The aim of this study is to find factors affecting the low-income elderly people who living alone' life satisfaction by examining the comparative influence of loneliness, family support, social support. For achieving this purpose, this study analyzed data of 300 low-income elderly people who living alone in Gyeonggi province. Findings of the study identified that the factors affecting the life satisfaction were health status, loneliness, family support, social support. Further, family support and social support had a significant influence on the low-income elderly people who living alone' life satisfaction even after controlling the influences of other factors. On the basis of the results, practical suggestions to increase the life satisfaction of low-income elderly people who living alone were discussed.

A Study on Depression of Low-income Elderly People Who Live Alone - Focusing on the Moderating Effect of Social Support -

A Study on Depression of Low-income Elderly People Who Live Alone - Focusing on the Moderating Effect of Social Support -

Educação Financeira com Idosos em um Contexto Popular

Este artigo discute o consumo entre idosos de classes populares no contexto brasileiro e a importância de pensarmos intervenções educativas destinadas a esta população. A discussão deriva de uma pesquisa de caráter participante, desenvolvida por meio de uma ação pedagógica realizada com mulheres idosas, fundamentada em princípios da educação popular e da abordagem histórico-cultural. Os resultados sinalizaram que as participantes produziram coletivamente estratégias de controle financeiro e novas construções conceituais dos mecanismos do crédito consignado. Por fim, propõem-se alguns princípios para a criação de práticas de educação para o empoderamento e protagonismo do consumidor idoso.

저소득층 노인의 의치만족도에 영향을 미치는 요인

Objectives: The purpose of this study was to investigate the factors influencing on the denture satisfaction in the low income elderly people. Methods: The subjects were 143 elderly people from 60 to 75 years old wearing dentures and receiving consistent follow-up in the public health center in Busan. A self-reported questionnaire was filled out by the elderly people from February 1 to March 1, 2013. The questionnaire consisted of denture satisfaction, social variables, and psychological variables. Data were analyzed by ANOVA and multiple regression analysis using SPSS 18.0. The sociodemographic characteristics included gender, age, and chronic diseases. The recognition of oral health included pronunciation, denture maintenance, mastication ability, and education for denture care. The questionnaire was measured by Likert 5 scale. Results: Gender, chronic disease, denture care instructions, and the self-preception of the oral health after denture treatment were closely correlated with denture satisfaction(p<0.001). Age and the number of repairs were very important factor to denture satisfaction(p<0.05). Elderly women were more satisfied with denture than men and those who had no chronic diseases tended to be more satisfied with denture. Those who received oral care instructions were more satisfied with the denture than those who did not. The younger age group and no repairing prosthetic group tended to be more satisfied with the denture. Conclusions: It is important to provide the denture management services to the low income elderly when they demand the services. The national dental health policy must be focused on connection of the elderly people denture services with the public health center.

Reliability of screening tests for health-related problems among low-income elderly.

Screening tests for health problems can identify elderly people who should undergo the Comprehensive Geriatric Assessment, enabling the planning of actions to prevent disability. The aim of this study was to analyze the inter-rater reliability (IRR) of self-assessment questions (SAQ) and performance tests (PT) recommended in Brazil, in a sample of low-income elderly people, through an exploratory study performed with 165 elderly assessed by two professionals on different days. IRR was evaluated using the intraclass correlation coefficient (ICC) for continuous variables and the kappa statistic for categorical ones. The IRR for the PT (muscle strength, mobility body mass index, vision) was excellent and presented ICC values greater than 0.75. By contrast, the IRR for SAQ (urinary incontinence, self-perceived health and hearing impairment) was intermediate. Only the fall-related item presented a good IRR. In this study single SAQ had poor reliability when compared to PT, suggesting the necessity of revision of subjective self-assessment items with low reproducibility before implementation.

A tool for assessing the feasibility of comparative effectiveness research

Background: Comparative effectiveness research (CER) provides actionable information for health care decision-making. Randomized clinical trials cannot provide the patients, time horizons, or practice settings needed for all required CER. The need for comparative assessments and the infeasibility of conducting randomized clinical trials in all relevant areas is leading researchers and policy makers to non-randomized, retrospective CER. Such studies are possible when rich data exist on large populations receiving alternative therapies that are used as-if interchangeably in clinical practice. This setting we call “empirical equipoise.” Objectives: This study sought to provide a method for the systematic identification of settings it in which it is empirical equipoise that offers promised non-randomized CER. Methods: We used a standardizing transformation of the propensity score called “preference” to assess pairs of common treatments for uncomplicated community-acquired pneumonia and new-onset heart failure in a population of low-income elderly people in Pennsylvania, for whom we had access to de-identified insurance records. Treatment pairs were considered suitable for CER if at least half of the dispensings of each treatment-pair member fell within a preference range of 30% to 70%. Results: Among 3889 community-acquired pneumonia patients, insurance claims histories were sufficiently similar in seven drug pairs to suggest that observational CER might be effective. Relapse appears to have been less common in levofloxacin recipients than in similar patients given other products. In 6035 heart failure patients, metoprolol, carvedilol, and atenolol were employed in patients with similar claims histories, and thus might be suitable for observational CER. The long-acting succinate formulation of metoprolol had lower failure rates in head-to-head comparisons with all other beta-blockers. Both findings are candidates for further investigation. Confounding by unmeasured factors operating in the same manner as the measured covariates would not have produced the apparent superiority of levofloxacin, which was given to people in poorer respiratory health. The baseline covariate distributions of persons starting beta-blockers suggest only that carvedilol recipients were healthier than others. Conclusion: A straightforward algorithm can identify empirical equipoise, in which prescribers as a group seem evenly divided on the merits of alternative therapies. This is the setting in which CER may be most necessary and is likely to be most accurate. The imbalances identified by propensity models can identify situations in which the results of screening analyses may be biased in the direction of the observed effect.

Subclinical hyperthyroidism and dementia: the Sao Paulo Ageing & Health Study (SPAH).

BackgroundSeveral epidemiologic studies have shown a possible association between thyroid function and cognitive decline. Our aim was to evaluate the association of subclinical hyperthyroidism and dementia in a population sample of older peopleMethodsA cross-sectional study - São Paulo Ageing & Health Study (SPAH) - in a population sample of low-income elderly people ≥ 65 years-old to evaluate presence of subclinical thyroid disease as a risk factor for dementia. Thyroid function was assessed using thyrotropic hormone and free-thyroxine as well as routine use of thyroid hormones or antithyroid medications. Cases of dementia were assessed using a harmonized one-phase dementia diagnostic procedure by the "10/66 Dementia Research Group" including Alzheimer's disease and vascular dementia. Logistic regression models were used to test a possible association between subclinical hyperthyroidism and dementia.Results and discussionPrevalence of dementia and of subclinical hyperthyroidism were respectively of 4.4% and 3.0%. After age adjustment, we found an association of subclinical hyperthyroidism and any type of dementia and vascular dementia (Odds Ratio, 4.1, 95% Confidence Interval [95% CI] 1.3-13.1, and 5.3 95% CI, 1.1-26.4; respectively). Analyzing data by gender, we found an association of subclinical hyperthyroidism with dementia and Alzheimer's disease only for men (OR, 8.0; 95% CI, 1.5-43.4; OR, 12.4; 95% CI, 1.2-128.4; respectively). No women with subclinical hypothyroidism presented Alzheimer's disease in the sample.ConclusionThe results suggest a consistent association among people with subclinical hyperthyroidism and dementia.

Fall Risk in Low-Income Elderly People in One Urban Area

The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas. The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14. Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbidity of diabetes with visual deficits, and with depression. Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.

Successful ageing among low-income older people in South Korea

ABSTRACTThe aim of this study was to investigate ‘successful ageing’ among low income elderly people in the Republic of Korea (South Korea). A sample of men and women aged 65 or more years who received welfare benefits and social welfare services from senior welfare centres and who had good cognition were identified and recruited by the staff of eight such centres in Seoul, the capital city of the country. Face-to-face interviews were conducted with a structured questionnaire using measures and instruments that were selected following a literature review and previous studies of low-income older people. The survey instrument was pre-tested with seven subjects to ensure the comprehensibility of the items, and 220 main interviews were conducted in the respondents' homes and at senior welfare centres during October and November 2006. Factor analysis identified three factors in successful ageing: ‘a positive attitude towards life’, ‘success of adult children’, and ‘relationships with others’. Men reported higher scores on successful ageing than women. It was concluded that the concept of ‘successful ageing’ does apply to low-income elderly people in Korean, although its components have little to do with material or social success as conceived by previous studies of the general elderly population in either western or Asian countries.

Next Steps in Choice-based Letting in the Dutch Social Housing Sector

Abstract In the Dutch social housing sector, after almost 20 years of allocating dwellings with choice-based letting (CBL), there is a growing need to adapt the allocation systems currently in use. The policy debate on improvements in housing allocation centres around three main themes. First, many policymakers are torn between the egalitarian idea of freedom of choice for all customers in the social housing market and the desire of housing associations to provide preferential treatment to certain categories of customers, such as low income groups, large households, elderly people, local residents, occupational groups, or residents from redeveloping neighbourhoods. Second, housing associations would rather do away with long waiting lists and find the right balance between doing justice to those customers needing urgent housing and those seeking a dwelling in the longer term to better suit their needs, thus improving the efficiency of housing allocation. Third, both housing associations and local governmen...