Physical Health Data Research Articles

Sleep complaints in older blacks: do demographic and health indices explain poor sleep quality and duration?

To examine the relationship between measures of sleep quality and the presence of commonly encountered comorbid and sociodemographic conditions in elderly Black subjects. Analyses included participants from the Baltimore Study of Black Aging (BSBA; n = 450; mean age 71.43 years; SD 9.21). Pittsburgh Sleep Quality Index (PSQI) measured overall sleep pattern and quality. Self-reported and objective measures of physical and mental health data and demographic information were collected for all participants. Sociodemographic and comorbid health factors were significantly associated with sleep quality. Results from regression analyses revealed that older age, current financial strain, interpersonal problems, and stress were unique predictors of worse sleep quality. Sleep duration was significantly correlated with age, depressive affect, interpersonal problems, and stress; only age was a unique significant predictor. While participants 62 years or younger had worse sleep quality with increasing levels of stress, there was no significant relationship between sleep quality and stress for participants 81 years and older. Several potential mechanisms may explain poor sleep in urban, community dwelling Blacks. Perceived stressors, including current financial hardship or hardship experienced for an extended time period throughout the lifespan, may influence sleep later in life.

Investigation on Influencing Environmental Factors on Health Status of Korean Septuagenarians Dwelling in Longevity Region in Jeonla Province

Objectives: To evaluate the critical environmental factors on healthy-aging of Korean people, we investigated the significant factors influencing health status of septuagenarians living in rural area of Jeonla province, known to be one of the representative longevity regions in Korea. Methods: We divided subjects into healthy group (36M/25F) or poor-health group (26M/73F) based on self-reported health status, body mass index, a number of prescription, and blood test data. General characteristics, physical measurements, lifestyle, dietary behavior and nutrient intake, physical health and mental health data were statistically compared between the two groups. Results: Average age was not different between healthy group and poor-health group in men and women, respectively. In men, significantly favorable factors to health were observed to be higher education, regular exercise, higher grip strength and walking function, body mass index (≥ 18.5 kg/m ), moderate frequency of drinking and eating-out, non-smoking, normal red blood cell (RBC) count, higher serum dehydroepiandrosteronesulfate (DHEAS) level, good digestive function and appetite, normal hearing function, regular meals, adequate vegetable and fruit intake, diverse food intake, adequate energy and nutrients (protein, vitamin B , B , C and E, folate, niacin, P, Zn and K) intake, higher mininutrient status assessment (MNA) score and low level of depression. On the other hand, in women, those were literacy, living arrangement, moderate frequency of drinking, healthy teeth, higher grip strength and walking function, bone mineral density, normal RBC and white blood cell (WBC) count, higher DHEAS concentration, higher MNA score, normal cognition and memory function, having snack and adequate fruit intake. Conclusions: These results could be useful to plan effective strategies to increase health-life expectancy of Korean old people living in rural areas. Korean J Community Nutr 19(2): 142~162, 2014

Contours of usual care: meeting the medical needs of diverse people with serious mental illness.

To examine practices, barriers, and recommendations for addressing the physical health of racially and ethnically diverse people with serious mental illness (SMI). Semi-structured interviews and participant observations were conducted with 21 administrators and 25 clinicians representing six mental health care organizations. Data were analyzed using constant comparative methods. Practices included intermittently collecting consumers' physical health data, connecting consumers with primary care, and providing on-site, culturally-tailored health promotion programs. Barriers included limited care coordination infrastructure, financial and professional boundaries, unhealthy local environments and culturally-specific dietary habits. Recommendations included: strengthening dialogue with medical providers and developing staff training programs. Meeting the physical health needs of diverse consumers with SMI is impeded by organizational, environmental, and consumer-level barriers. Establishing better care coordination networks, increasing mental health provider education on medical issues, and culturally-tailoring health promotion programming provide plausible strategies for improving the physical health of this vulnerable population.

Perfil do apoio social de idosos no município de Natal, Estado do Rio Grande do Norte, Brasil, 2010-2011

Objective: to describe social support for elderly residents in a community in the city of Natal, state of Rio Grande do Norte. Methods: a descriptive study conducted between November/2010 and July/2011 with a convenience sample of 300 elderly people. We used a structured questionnaire to obtain sociodemographic, economic and physical health data. The ‘Health, Welfare and Aging’ survey questionnaire and the ‘Minimum Map of Elderly Connections’ were used to assess social support. The data underwent descriptive statistical analysis. Results: 26.3% of the elderly were found to have low frequency of aid received and 25.7% had low frequency of aid provided. Family members were seen to be the principal aid providers. Conclusion: the elderly support network is completed through expressive ties with family, friends and community members. The absence of aid provided by health services stood out.

Apoio social e síndrome da fragilidade em idosos residentes na comunidade

Frailty among the elderly is a result of the complex interplay between social and clinical factors involved in its genesis. However, it is still unclear whether the fraailty syndrome can be aggravated due to lack of social support. The scope of this study was to analyze the association between social support and the frailty syndrome among elderly residents in the community. It is an analytical observational cross-sectional study, with a sample of 300 elderly people. Socio-demographic, economic and physical health, frailty and social support data were collected. For statistical analysis, the Pearson chi-square, the Student t and the binary logistic regression were performed, adopting a significance level of 5%. No associations were observed between frailty and the social support variables, except for the housekeeping aspect (p = 0.04). In logistic regression frailty with age (OR = 1.19), physical activity (OR = 2.56) and self-perceived health (OR = 3.33) remained associated. It is considered that more studies need to be conducted to characterize social vulnerability and health services also need to recognize the importance of social support as an integral part of care for the elderly.

Apoio social e síndrome da fragilidade em idosos residentes na comunidade

A fragilidade em idosos resulta da complexa interação entre fatores clínicos e sociais envolvidos na sua gênese. Porém, ainda não se sabe, de forma clara, se esta síndrome pode ser agravada devido à ausência do apoio social. Assim, o objetivo do presente estudo foi analisar a associação entre este e a síndrome da fragilidade em idosos residentes na comunidade. Trata-se de estudo observacional analítico de caráter transversal, com uma amostra de 300 idosos. Foram coletadas informações sobre os dados sociodemográficos e econômicos e de saúde física, fragilidade e apoio social. Para análise estatística, foram realizados o teste qui-quadrado de Pearson, o teste t de student e a regressão logística binária, adotando-se um nível de significância de 5%. Não foram observadas associações da fragilidade com as variáveis do apoio social, com exceção da modalidade tarefas domésticas (p = 0,04). Na regressão logística, permaneceram associadas a fragilidade à idade (OR = 1,19), à atividade física (OR = 2,56) e à saúde percebida (OR = 3,33). Acredita-se que mais estudos precisam ser desenvolvidos para uma caracterização da vulnerabilidade social, como também os serviços de saúde necessitam reconhecer a importância do apoio social como parte integrante da prestação de cuidados aos idosos.

Journal Digest

Journal Digest

The Impact of Housing Stressors on the Mental Health of a Low-Income African-American Population

Health and disease reflect broad social conditions including economic, environmental, and cultural components. The impact of challenging housing conditions experienced by low-income African American households on their mental health is an example of this principle. Do physical housing conditions, the presence of roaches and rodents, plumbing defects, and heating/cooling problems contribute to mental health dysfunction such as being depressed, feeling worried, feeling sad, feeling helpless, and feeling emotionally upset? To address this research question, a sample of 128 households that originally lived in public housing in Washington, D.C. were surveyed. These households had been relocated to other low-income housing during the demolition and reconstruction phase of a HOPE VI project, some to alternative public housing developments and others to private units based on vouchers. The survey included self-reports by heads of household on their housing conditions and mental health status using Likert scales. The survey also asked participants for demographic, socio-economic, and physical health data and for information on neighborhood characteristics. Correlation and regression analyses were used to estimate the impact of building structure, building systems, neighborhood characteristics, physical health, and socio-economic/demographic variables on mental health stresses. Specific housing issues included the number of bedrooms, plumbing, heating, cooling, rodents, roaches, and building security (the independent variables). Mental health stresses (the dependent variables) included feeling depressed, nervous, anxious, sad, helpless, and having trouble concentrating. Several alternative specifications and models were used and estimated. They generally demonstrated strong overall explanatory value. The findings from these models suggested that challenging housing conditions significantly contributed to many mental health disorders. For example, in the 2SLS model of “problem being depressed”, the condition of the apartment (β =0.278, t=2.022) and plumbing (β = 0.182, t=2.145) were significant and the model's explanatory power was reasonable with an adjusted R2=0.221. Many non-housing control variables were also significantly associated with mental health challenges.

Análise multifatorial do perfil de idosos ativos com história de quedas

OBJETIVO: Explorar o relacionamento entre variáveis sociodemográficas, clínicas, funcionais e psico-cognitivas em idosos participantes de grupo de convivência, residentes na comunidade, e identificar a associação entre a interação dessas variáveis e quedas e quedas recorrentes. MÉTODO: Estudo transversal, exploratório com 150 idosos, de ambos os sexos, participantes de um grupo de terceira idade no município de Itu, São Paulo. Utilizou-se uma entrevista semiestruturada contendo características sociodemográficas, de saúde física, físico-funcionais (Brazilian OARS Multidimensional Functional Assessment Questionnaire - BOMFAQ e Timed up and go test - TUG), de saúde mental (Geriatric Depression Scale - GDS-15 e Mini Mental State Examination - MMSE). O nível de atividade física foi determinado por questões sobre frequência e duração das atividades físicas. A variável desfecho utilizada foi o número de quedas no último ano. Foi conduzida uma análise de cluster para se identificar perfis de grupos formados pela distribuição da variabilidade dos dados em cada bloco de variáveis: sociodemográficas, desempenho físico-funcional, saúde física e mental. Procedeu-se a análise de regressão uni e multivariada com quedas únicas e quedas recorrentes. RESULTADOS: A idade média dos participantes foi de 71,9 (±5,6) anos. A prevalência de quedas foi de 38,7%. A análise univariada revelou uma associação independente entre o cluster saúde mental (sem sintomas depressivos e com declínio cognitivo) e quedas recorrentes (OR=2,73 IC 95% 1,04-7,22 p=0,042), porém esta associação não foi significativa na análise multivariada (p=0,082). CONCLUSÃO: Não foi possível identificar um perfil de caidores e caidores recorrentes em idosos ativos. Mas nossos achados sugerem que, em idosos ativos com história de quedas, uma avaliação geriátrica abrangente com ênfase na função cognitiva seja considerada.

Relationship between lower-limb muscle strength and frailty among elderly people.

Sarcopenia is the main factor involved in the development of frailty syndrome. The aims here were to investigate relationships between lower-limb muscle strength and the variables of sex, age and frailty criteria; compare lower-limb muscle strength with each frailty criterion; and assess the power of each criterion for estimating the risk of frailty among elderly outpatients. Cross-sectional study at the Geriatrics Outpatient Clinic of a university hospital in Campinas. A non-probabilistic convenience sample of 150 elderly people of both sexes who were followed up as outpatients was assessed. Sociodemographic data (sex and age) and physical health data (frailty criteria and the five-times sit-to-stand test) were gathered. Descriptive, comparative and multivariate logistic regression analyses were performed. The majority of the elderly people (77.3%) were 70 years of age or over, with predominance of females (64.2%) and had a low score for the five-times sit-to-stand test (81.4% scored 0 or 1); 55.3% of the elderly people presented three or more frailty criteria. A significant association was found between lower-limb muscle strength and the variables of age and number of frailty criteria. Lower levels of lower-limb muscle strength were associated with advanced age and greater presence of signs of frailty. Moreover, lower-limb muscle strength was also associated with the criteria of reduced walking speed criteria and hand-grip strength.

Built Environment and Its Influences on Walking among Older Women: Use of Standardized Geographic Units to Define Urban Forms

Consensus is lacking on specific and policy-relevant measures of neighborhood attributes that may affect health outcomes. To address this limitation, we created small standardized geographic units measuring the transit, commercial, and park area access, intersection, and population density for the Portland, Oregon metropolitan area. Cluster analysis was used to identify six unique urban forms: central city, city periphery, suburb, urban fringe with poor commercial access, urban fringe with pool park access, and satellite city. The urban form information was linkable to the detailed physical activity, health, and socio-demographic data of 2,005 older women without the use of administrative boundaries. Evaluation of the relationship between urban forms and walking behavior indicates that older women residing in city center were more likely to walk than those living in city periphery, suburb communities, and urban fringe with poor commercial access; however, these women were not significantly more likely to walk compared to those residing in urban fringe with poor park access or satellite city. Utility of small standardized geographic units and clusters to measure and define built environment support research investigating the impact of built environment and health. The findings may inform environmental/policy interventions that shape communities and promote active living.

Risk Profiles of Subtypes of Mild Cognitive Impairment: The Sydney Memory and Ageing Study

To compare the risk profiles of mild cognitive impairment (MCI) subtypes in a population-based elderly sample. Cross-sectional study. The population-based Sydney Memory and Ageing Study. Seven hundred fifty-seven English-speaking, community-dwelling individuals without dementia aged 70 to 90. Comprehensive neuropsychological assessments were used to diagnose MCI and its subtypes, categorized as amnestic (aMCI) or nonamnestic (naMCI) and as single- (sdMCI) or multiple- (mdMCI) domain. Risk profiles were derived from sociodemographic; lifestyle; and cardiac, physical, mental, and general health data. Whole-sample and sex-specific comparisons between aMCI and naMCI and between mdMCI and sdMCI were made using age- (and sex-) adjusted multiple regressions comprising initially significant univariate factors. Risk factors for MCI were presence of the apolipoprotein E (APOE) ε4 allele, heart disease, high homocysteine, poor odor identification ability, low visual acuity, and lower mental activity. The odds of having naMCI rather than aMCI were lower with greater levels of social activity and greater if taking antihypertensives, the latter particularly in men. The odds of naMCI were greater in men taking antidepressants or with a longer 6-meter walk time and in women with hypertension. The odds of having mdMCI rather than sdMCI were greater in participants with a history of depression or having the APOE ε4 allele. Greater odds of mdMCI were also associated with lower mental activity, particularly for women. For men, the odds of mdMCI were greater with the APOE ε4 allele and lower if diagnosed with high cholesterol. MCI subtypes exhibit distinctive, sex-dependent risk profiles. This is consistent with MCI subtypes having different etiologies and outcomes and supports the idea that subtyping MCI may offer predictive validity and clinical application.

Integrating Comparative Effectiveness Research Programs Into Predictive Health: A Unique Role for Academic Health Centers

The growing burden of chronic disease, an aging population, and rising health care costs threaten the sustainability of our current model for health care delivery. At the same time, innovations in predictive health offer a pathway to reduce disease burden by preventing and mitigating the development of disease. Academic health centers are uniquely positioned to evaluate the comparative effectiveness of predictive and personalized health interventions, given institutional core competencies in innovative knowledge development. The authors describe Emory University's commitment to integrating comparative effectiveness research (CER) into predictive health programs through the creation and concurrent evaluation of its Center for Health Discovery and Well Being (hereafter, "the Center"). Established in 2008, the Center is a clinical laboratory for testing the validity and utility of a health-focused rather than disease-focused care setting. The Center provides preventive health services based on the current evidence base, evaluates the effectiveness of its care delivery model, involves trainees in both the delivery and evaluation of its services, and collects structured physical, social, and emotional health data on all participants over time. Concurrent evaluation allows the prospective exploration of the complex interactions among health determinants as well as the comparative effectiveness of novel biomarkers in predicting health. Central to the Center is a cohort study of randomly selected university employees. The authors describe how the Center has fostered a foundation for CER through the structured recruitment of study cohorts, standardized interventions, and scheduled data collection strategies that support pilot studies by faculty and trainees.

Feeling Healthy? A Survey of Physical and Psychological Wellbeing of Students from Seven Universities in the UK

University students’ physical and psychological health and wellbeing are important and comprise many variables. This study assessed perceived health status in addition to a range of physical and psychological wellbeing indicators of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these variables across males and females, and across the participating universities. The data was collected in 2007–2008. A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), self-reported physical and psychological health data, as well as questions on health awareness, health service use, social support, burdens and stressors and university study related questions. While females generally reported more health problems and psychological burdens, male students felt that they received/had fewer persons to depend on for social support. The comparisons of health and wellbeing variables across the different universities suggested some evidence of ‘clustering’ of the variables under study, whereby favourable situations would be exhibited by a cluster of the variables that is encountered at some universities; and conversely, the clustering of less favourable variables as exhibited at other universities. We conclude that the level of health complaints and psychological problems/burdens is relatively high and calls for increased awareness of university administrators, leaders and policy makers to the health and well-being needs of their students. The observed clustering effects also indicated the need for local (university-specific) health and wellbeing profiles as basis and guidance for relevant health promotion programmes at universities.

Examination of General Health Following Typhoon Xangsane: A Pre–Postanalysis

An individual's health status immediately following a disaster may predict long-term morbidity and mortality. However, relative to the growing literature on postdisaster mental health, less is known about physical health outcomes, particularly in developing countries. Unlike most studies, the current investigation obtained physical health data both before and after Typhoon Xangsane, which struck the Da Nang province of Vietnam in 2006, and related these predisaster data to postdisaster health functioning, among other factors. Specifically, a sample of 795 randomly selected adults was interviewed both prior to, and after the typhoon. Results indicated that participants with symptoms of major depressive disorder and panic disorder, older participants, and participants who reported high distress during the actual typhoon were most at-risk for lower self-rated health postdisaster compared to those without these risk factors. Given that Vietnam is still designated a developing country, the present study enhances the literature on postdisaster physical health correlates in developing nations.

Adolescents who are frequent attenders to primary care: contribution of psychosocial factors

Frequent attendance to primary care services has shown an association with psychosocial factors in adult and child populations. Little is known about the psychosocial correlates of attendance in adolescents. To study the contribution of psychosocial factors to frequent primary care attendance in a community sample of young British people. The method used was a cross-sectional survey of 1,251 secondary school pupils, using self-report questionnaires for socio-demographic, physical and psychological health data. A total of 1,116 pupils [mean age 13.51 years (SD 1.5), 52% female] completed questionnaires and provided information about contact with their general practitioner (GP) in the previous year; 30% were frequent attenders (≥4 appointments). Frequent attenders were significantly younger; they were more likely to come from lower socioeconomic backgrounds, report significantly more past and current physical problems, have more hospital visits in the previous year, have more recent intense somatic symptoms made worse by stress and causing impairment, and have more days off school. Frequent attendance was also significantly associated with the presence of emotional symptoms and a history of mental health consultations. Logistic regression analysis identified seeing a hospital doctor, current illness, having days off school, a history of mental health consultations and younger age as independent predictors of frequent attendance. In addition to physical health problems, social factors and psychiatric difficulty are linked to and require attention in young people who are frequent attenders at primary care health services.

Exploring the relationship between physical health, depressive symptoms, and depression diagnoses in Hispanic dementia caregivers

Objectives: The present study examined the relationship between self-reported physical health, depressive symptoms, and the occurrence of depression diagnosis in Hispanic female dementia caregivers. Participants: Participants were 89 Hispanic female dementia caregivers. Design: This study used a cross-sectional design. Baseline depression and physical health data were collected from participants enrolled in the ‘Reducing Stress in Hispanic Anglo Dementia Caregivers’ study sponsored by the National Institute on Aging. Measurements: Physical health was assessed using the Medical Outcome Study Short Form-36 (SF-36), a one-item self-report health rating, body mass index, and the presence or history of self-reported physical illness. Depressive symptoms were assessed using the Center for Epidemiologic Studies–Depression Scale (CES-D). The occurrence of depression diagnosis was assessed using the Clinical Interview for DSM-IV Axis I Disorders (SCID). Analysis: Multiple linear and logistic regression analysis was used to examine the extent to which indices of physical health and depressive symptoms accounted for variance in participants’ depressive symptoms and depressive diagnoses. Results. Self-reported indices of health (e.g., SF-36) accounted for a significant portion of variance in both CES-D scores and SCID diagnoses. Caregivers who reported worsened health tended to report increased symptoms of depression on the CES-D and increased likelihood of an SCID diagnosis of a depressive disorder. Conclusion. Self-reported health indices are helpful in identifying Hispanic dementia caregivers at risk for clinical levels of depression.

Morbidity severity classifying routine consultations from English and Dutch general practice indicated physical health status

Objective To investigate the construct validity of morbidity severity scales based on routine consultation data by studying their associations with sociodemographic factors and physical health. Study Design and Setting Study participants were 11,232 English adults aged 50 years and over and 9,664 Dutch adults aged 18 years and over, and their consulting morbidity data in a 12-month period were linked to their physical health data. Consulters with any of 115 morbidities classified on four ordinal scales of severity (“chronicity,” “time course,” “health care use,” and “patient impact”) were compared to all other consulters. Results As hypothesized, in both countries, morbidity severity was associated with older age, female gender, more deprivation (all comparisons P ≤ 0.05), and poor physical health (all trends P < 0.001). The estimated strengths of association of poor physical health with the highest severity category expressed as odds ratios, for each of the four scales, were 5.4 for life-threatening on the “chronicity” scale, 1.8 for time course, 2.8 for high health care use, and 3.7 for high patient impact. Conclusions Four scales of morbidity severity have been validated in English and Dutch settings, and they offer the potential to use simple routine consultation data as an indicator of physical health status in populations from general practice.

School adjustment and health in Russian adolescents

Associations between common physical and mental diseases and school adjustment, on one hand, and personal and social resources, on the other, were analyzed in 446 Russian adolescents, aged 12 to 16 years. Physical health data were obtained from the school medical documents. Children's psychological health was assessed using a translated short form of the Child Behaviour Checklist and the Rutter Teacher Questionnaire. School adjustment was measured by grade point average and the School Adjustment Scale. Personality was measured by a short form of the Eysenck Personality Questionnaire and the Gray-Wilson Personality Questionnaire. School adjustment was negatively related to behavioural problems and was associated with some physical conditions. Five physical health variables were related to academic attainment: Postural disturbances, myopia, thyroid enlargement, autonomic vascular dysfunction and cerebral asthenia. They were also positively related to neuroticizm and GWPQ Behavioural Inhibition scores and were negatively related to psychoticizm and Behavioural Activation scores.

A longitudinal study of the development of low back pain in an industrial population.

This is a longitudinal study in which industrial workers without chronic low back pain (LBP) were initially assessed with a comprehensive test battery and surveyed every 6 months thereafter for 2 years. To determine factors that may predispose industrial workers who lift over 5000 kg per shift to LBP. Prospective studies are small in number and often limited in breadth or depth of the test battery, methodologic issues, or investigator expertise. There are no prospective studies that focus on a homogeneous work sample of industrial employees. Production workers (n = 149) who volunteered for the 2-year study were assessed using physical measures (e.g., muscular strength, endurance, and flexibility), lifting kinematics (a sagittal plane box lift), and health, lifestyle, and work environment data (paper questionnaires). Follow-up questionnaires were distributed every 6 months for 2 years. Using self-report of LBP as the main outcome measure, eight variables predicted LBP in this sample with a 75% correct prediction rate. Predictor variables included age, thoracic acceleration during the trunk velocity test, median frequency intercept of electromyography of the right L3 erector spinae, quadriceps strength, quadriceps endurance, self-assessment of fitness, having a confidante, and number of medications currently taken. Results confirmed the multifactorial nature of low back pain and suggest that personal fitness is an important defense against low back pain, even in manual handling lifting tasks.