Quality Of Life In Older Persons Research Articles

Relationship between urinary incontinence and quality of life of older persons in Malaysia.

As the Malaysian population is aging rapidly, there is an urgent need for an effective management plan for healthy aging, to extend life expectancy and to improve quality of life (QoL). Urinary incontinence (UI), which is common in older persons, is often linked to reduced QoL. This study aimed to determine the effects of UI on QoL among older persons in Malaysia. This study was based on data obtained from 3716 Malaysians aged ≥60 years as part of the National Health and Morbidity Survey (NHMS) 2018. QoL was measured using the Control, Autonomy, Self-realization and Pleasure 19-item (CASP-19) questionnaire. UI was measured using the Questionnaire Urinary Incontinence Diagnosis (QUID) score. Association between UI and QoL were examined using linear regression analysis, after controlling socio-demographic variables and comorbidities. Overall, the prevalence of UI was 5.2%. By subtypes, the prevalence of stress UI and urge UI were both 2.0%, while that of mixed UI was 1.3%. The UI group rated their lives more negatively in all four domains of QoL compared with non-UI group. Those who were incontinent had lower standardized scores on control and autonomy domains of CASP-19 as well as total score. Results from linear regression analysis indicated that UI had a significantly negative impact on control and autonomy domains of QoL after controlling for socio-demographic factors and comorbidities. UI contributes to a significant reduction on QoL of older persons. Healthcare providers need to be sensitive in evaluating and discussing UI, particularly with their older patients. Geriatr Gerontol Int 2020; 20: 38-42.

Methods of Measuring Quality of Life: Theoretical Aspects and Empirical Evidence from Older Persons at Rajshahi City in Bangladesh

Bangladesh has become an ageing society and is going to increase her older persons. Health condition, quality of life (QOL) and physical functioning are worsen as people age. Due to increasing life expectancies, enhancement of medical and health facilities, modernization, Bangladesh, recently, experiencing the rapid change in demographic transition, as well as the most common challenge, population ageing. This paper presents an organizing framework that assists researchers in the design and validation of formative and reflective measurement models for assessing QOL of older persons. The framework draws from the extant literature, includes both theoretical and empirical considerations, and is illustrated through empirical example for measuring QOL of older persons using data from a project entitled “Quality of Life and Active Ageing of Older persons at Rajshahi City in Bangladesh” conducted at the Department of Population Science and Human Resource Development, University of Rajshahi. This example concern constructs that is fundamental to theory-building in this discipline, and most of the scholars used formative model. In contrast, application of the framework to this example suggests that a reflective measurement model may be more appropriate. These results reinforce the need to justify, both theoretically and empirically, the choice of measurement model for measuring subjective QOL.

Consensus document on the detection and diagnosis of urinary incontinence in older people

Urinary incontinence (UI), one of the Geriatric Giants, is a very common problem in the older person. It especially affects those with comorbidities, polypharmacy and functional impairment, physical as well cognitive, in whom the prevalence could be as high as 70–80%. Despite its very negative effects on quality of life (QOL), UI is still largely undetected and undertreated, due to many different reasons. UI produces numerous negative effects on QOL in older persons. Patients’ perception of the impact of UI on their lifestyle is very important, and even mild UI could have a significant impact on QOL. Unfortunately, both detection and index consultation for UI are low, as is the percentage of older persons that receive effective treatment (about 30–50%), in spite of the valid management options available. Also, older persons are less likely than younger age groups to discuss incontinence with their physician and only about half of those with incontinence seek help for their symptoms. Geriatricians should be in the frontline of the detection and diagnosis of UI, which can be considered as the ‘Frequently Forgotten Geriatric Giant’. To this effect a multidisciplinary European group of professionals developed this scientific document in order to present the current “state of the art” on the management of Urinary Incontinence in the older population. The aim of this Consensus Document is to increase awareness, as well as knowledge of this under-recognized Geriatric Syndrome, and to facilitate and improve the clinical management of older people with UI.

Consensus document on the management of urinary incontinence in older people

Urinary incontinence (UI), one of the geriatric giants, is a very common problem in the older person. It especially affects those with comorbidities, polypharmacy and functional impairment, physical as well cognitive, in whom the prevalence could be as high as 70–80%. Despite its very negative effects on quality of life (QOL), UI is still largely undetected and undertreated, due to different, but incomprehensible reasons. UI produces numerous negative effects on QOL in older persons. Patients’ perception of the impact of UI on their lifestyle is very important, and even mild UI could have a significant impact on QOL. Unfortunately, both detection and index consultation for UI are low, as is the percentage of older persons that receive effective treatment (about 30–50%), in spite of the valid management options available. Also, older persons are less likely than younger age groups to discuss incontinence with their physician and only about half of those with incontinence seek help for their symptoms. Geriatricians should be in the frontline of the detection and diagnosis of UI, which can be considered as the ‘Frequently Forgotten Geriatric Giant’. To this effect, a multidisciplinary European group of professionals developed this scientific document in order to present the current “state of the art” on the management of urinary incontinence in the older population. The aim of this consensus document is to increase awareness, as well as knowledge of this under-recognized geriatric syndrome, and to facilitate and improve the clinical management of older people with UI.

Improving Function in Age-related Macular Degeneration: A Randomized Clinical Trial

To compare the efficacy of problem-solving therapy (PST) with supportive therapy (ST) to improve targeted vision function (TVF) in age-related macular degeneration (AMD).Single-masked, attention-controlled, randomized clinical trial with outcome assessments at 3 months (main trial endpoint) and 6 months (maintenance effects).Patients with AMD (n = 241) attending retina practices.Whereas PST uses a structured problem-solving approach to reduce vision-related task difficulty, ST is a standardized attention-control treatment.We assessed TVF, the 25-item National Eye Institute Vision Function Questionnaire plus Supplement (NEI VFQ), the Activities Inventory (AI), and vision-related quality of life (QoL).There were no between-group differences in TVF scores at 3 (P = 0.47) or 6 (P = 0.62) months. For PST subjects, mean ± standard deviation TVF scores improved from 2.71±0.52 at baseline to 2.18±0.88 at 3 months (P = 0.001) and were 2.18±0.95 at 6 months (change from 3 to 6 months, P = 0.74). For ST subjects, TVF scores improved from 2.73±0.52 at baseline to 2.14±0.96 at 3 months (P = 0.001) and were 2.15±0.96 at 6 months (change from 3 to 6 months, P = 0.85). Similar proportions of PST and ST subjects had less difficulty performing a TVF goal at 3 months (77.4% vs 78.6%, respectively; P = 0.83) and 6 months (76.2% vs 79.1%, respectively; P = 0.61). There were no changes in the NEI VFQ or AI. Vision-related QoL improved for PST relative to ST subjects at 3 months (F(4, 192) = 2.46; P = 0.05) and at 6 months (F(4, 178) = 2.55; P = 0.05). The PST subjects also developed more adaptive coping strategies than ST subjects.We found that PST was not superior to ST at improving vision function in patients with AMD, but that PST improved their vision-related QoL. Despite the benefits of anti-vascular endothelial growth factor treatments, AMD remains associated with disability, depression, and diminished QoL. This clinical reality necessitates new rehabilitative interventions to improve the vision function and QoL of older persons with AMD.The authors have no proprietary or commercial interest in any of the materials discussed in this article.