Urban Elderly Population Research Articles

Subfoveal choroidal thickness in a general elderly population; Tehran geriatric eye study

PurposeTo determine the distribution of subfoveal choroidal thickness (SFCT) and its associated demographic, ocular, and systemic factors in an elderly population.MethodsThis report is part of the Tehran Geriatric Eye Study (TGES); a population-based cross-sectional study that was conducted on the urban elderly population of Tehran, aged 60 years and above using multi-stage stratified random cluster sampling. Choroidal imaging was performed using Spectralis SD-OCT with enhanced depth imaging mode.ResultsThe average SFCT was 265.3 ± 25.9 μm (95% CI: 262.8-267.7) in the whole sample. According to the multiple generalized estimating equation (GEE) model, pseudophakia had a statistically significant direct relationship with SFCT (coefficient = 5.69), and history of cerebrovascular accident (CVA) was significantly inversely related to SFCT (coefficient=-4.77). Moreover, there was a significant interaction between age and sex in the average SFCT so that with increasing age, the SFCT increased in men and decreased in women.ConclusionThe normal values of SFCT in the present study can be used as a reference database for clinical and research purposes. Age-sex interaction, pseudophakia, and history of CVA were significantly associated with SFCT in the elderly population. It is recommended that these factors be taken into account when interpreting SFCT data.

泸州市城镇老年群体健康适能现状调查与分析

泸州市城镇老年群体健康适能现状调查与分析

The correlation between periodontitis and uncontrolled hypertension is mediated by inflammatory markers: results from a cross-sectional study of urban elderly population in southeast China

BackgroundPeriodontal diseases is considered the most important global oral health burden according to the world health organization (WHO) (Oral health. https://www.who.int/news-room/fact-sheets/detail/oral-health#Overviewth (who.int). Accessed 21 Sep 2023). It is a common local inflammatory disease associated with hypertension, this study aims to explore the relationship between periodontitis and uncontrolled hypertension and whether inflammation indication such as white blood cell (WBC) count or neutrophil count is a mediator of this relationship.MethodsOne thousand four hundred eighty-eight elders attending annual physical and oral examinations in Zhejiang province were included in this study. The staging of Periodontitis was classified as none, mild-moderate and severe. Participants are categorized into two groups based on blood pressure: hypertensive( positive high blood pressure( HBP) history or underwent HBP medication or blood pressure( BP) ≥ 140/90 mmHg) and uncontrolled hypertensive (systolic blood pressure( SBP) ≥ 140 mmHg or distolic blood pressure( DBP) ≥ 90 mmHg). Peripheral blood samples were collected, information on hypertension history and potential confounders (age, sex, smoking, alcohol consumption, exercise frequency, diabetes) was collected in questionnaires. The correlation between periodontitis and hypertension was investigated using logistics regression analyses, mediation analysis was assessed for the effect of inflammation on hypertension.ResultsThe study population includes 1,488 participants aged 55–90 years. Odds of uncontrolled hypertension increased significantly along with periodontitis in the regression models both in unadjusted model (odds ratio( OR): 1.407, 95% confidence intervals( CI): 1.037 ~ 1.910) and fully adjusted model (OR: 1.950, 95% CI: 1.127 ~ 3.373). Mediation analysis confirmed that WBC and neutrophic count function as a full mediator of the association between periodontitis and uncontrolled hypertension either in the unadjusted or the adjusted model.ConclusionsIn a study of urban elderly population in southeast China, periodontitis is found to be significantly associated with uncontrolled hypertension, such relation is mediated by WBC and neutrophil count. Periodontitis can increase the difficulty of controlling hypertension. Promotion of periodontal health strategies in the dental setting could help reduce the burden of hypertension and its complications.

Comparative analysis of health status and health service utilization patterns among rural and urban elderly populations in Hungary: a study on the challenges of unhealthy aging

The demographic transition poses a significant challenge for health systems, especially in Central and Eastern European (CEE) countries, where the healthcare needs of aging populations are on the rise. This study aimed to describe and compare the health status and utilization of health services among the elderly residing in urban and rural areas of the most deprived region in Hungary. A comprehensive health survey was conducted in 2022, involving a randomly selected sample of 443 older adults (≥ 65 years) in Northeast Hungary. Multivariable logistic regression models adjusting for age, sex, education, financial status, chronic diseases, and activity limitations were used to investigate the association between type of residence and health service use. Among the study participants, 62.3% were female, 38.3% attained primary education, 12.5% reported a bad or very bad financial situation and 52.6% lived in urban areas. Overall, 24% of the elderly rated their health as very good or good (27.8% in urban and 19.7% in rural areas), while 57.8% (52.6% and 63.5% in urban and rural areas) reported limitations in daily activities. Compared to urban residents, rural residents reported lower rates of dentist visits (p = 0.006), specialist visits (p = 0.028), faecal occult blood testing (p < 0.001), colorectal cancer screening with colonoscopy (p = 0.014), and breast cancer screening (p = 0.035), and a higher rate of blood pressure measurement (p = 0.042). Multivariable models indicated that urban residence was positively associated with faecal occult blood testing (OR = 2.32, p = 0.014), but negatively associated with blood pressure (OR = 0.42, p = 0.017) and blood glucose measurements (OR = 0.48, p = 0.009). These findings highlight the influence of residence on health service utilization among older adults in Hungary. Further comprehensive studies are needed to better understand the health needs of the elderly population and to develop policies aimed at promoting healthy aging in CEE countries.

Factors influencing the risks of depression among urban elderly people in Phitsanulok Province, Thailand

Depression poses a significant and widespread issue in numerous countries and is capable of inflicting severe hardships if left untreated. However, there remains limited understanding regarding the influential factors contributing to the risk of depression among elderly individuals residing in urban areas of Thailand. Thus, this study employed a cross-sectional descriptive research approach. The research involved 735 elderly participants residing in urban regions of Phitsanulok Province, Thailand, selected through stratified sampling. Data collection included interviews, with subsequent analysis incorporating percentage calculations, means, standard deviation, and binary logistic regression analysis. Findings revealed several risk factors associated with depression among urban elderly individuals, encompassing single status, dietary inadequacy, a close relative with the history of depression, low self-esteem, and low social support. Collectively, these factors predict a 57.90% risk of depression among urban elderly individuals, with a predictive accuracy rate of 97.40%. The study outcomes provide relevant agencies with valuable insights for monitoring and safeguarding urban elderly populations against the risk of depression, with potential applications in other contexts as deemed appropriate.

Association Between Socioeconomic Status, Productive Aging, and Frailty Index in Urban Elderly Population in China

To explore the impact of socioeconomic status and productive aging on the frailty index of urban elderly population in China, and to provide reference for improving their health level. We obtained data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) and included 1890 urban elderly people aged 60 and over in the study. Multiple linear regression model was used to analyze the influencing factors of the productive aging and the frailty index of the urban elderly population in China. A structural equation model was constructed to explore the relationship between socioeconomic status, productive aging, and frailty index. Elderly people with high socioeconomic status ( β=0.082, P<0.001) had higher level of productive aging. Elderly people with high socioeconomic status ( β=－0.091, P<0.001) and high level of productive aging ( β=－0.330, P<0.001) had lower frailty index. Productive aging played an intermediary role ( β=－0.259, 95% CI: －0.380--0.181) between socioeconomic status and frailty index. The socioeconomic status and productive aging of the elderly people are important predictors of their frailty index. The government should exert its leadership functions to encourage the elderly, especially those with low education and income levels, to actively learn knowledge and skills, and to provide support for the elderly to participate in productive activities.

Edge-Assisted IoMT-Based Smart-Home Monitoring System for the Elderly With Chronic Diseases

The World Health Organization predicted that by 2050, the proportion of Chinese people over 60 years old will exceed 400 million. The most common health problem in the elderly is chronic diseases that require long-term treatment and substantial medical costs. Meanwhile, 30% of the urban population possesses 70% of health resources, whereas the proportion of the urban elderly population is lower than that in towns. This mismatch leads to difficulties in hospital examination and comprehensive treatment for the elderly. To reduce the number of hospital visits and improve the diagnosis efficiency of chronic diseases in the elderly, this letter proposes an edge-assisted Internet of Medical Things (IoMT)-based smart-home monitoring system for the elderly with chronic disease. The system aims to achieve rapid access to medical data and local disease diagnosis for the elderly through continuous monitoring of smart-home medical data. The system is evaluated to show several advantages.

Urban-Rural Disparity in Mortality Patterns of Respiratory Diseases Among Older Adults - China, 1987-2021.

Respiratory diseases (RDs) are the primary cause of death in older adults in China. However, there is limited evidence regarding the disparity in mortality rates of RDs between urban and rural areas among the elderly population. The age-standardized mortality rate (ASMR) due to RDs in the elderly population in both urban and rural areas of China has shown a consistent decrease. This trend is observed in both males and females. However, there was no significant change in the average annual percentage of ASMR for pneumonia among the urban elderly population and rural elderly men throughout the study period. Efforts should be made in China to reduce mortality from chronic lower respiratory disease and pneumonia among the elderly, particularly in urban populations.

Using A Study of the Social Challenges of Urbanization in the Next 30 Years based on Age Transition and Comprehensive Plans for Iranian Cities: The Case of Hamedan City

An examination of population growth in Iran during the past three decades shows that the sharp increase in the rate of birth in the 1980s significantly expanded the base of the age pyramid of the Iranian population in that decade. Throughout time, this expanded surface has gradually transitioned to the higher levels of the pyramid and has now reached the age group of 25-29 and will soon reach the age group of 20-24, two age groups that form 1/4 of Iran’s population. Considering this and the expansion of urbanization in recent years, elderly citizens will constitute a large part of Iran’s urban population in the next 30 years. An urban elderly population has special needs and requires special social spaces. But a closer look at the comprehensive plans proposed for Iranian cities, which often have been prepared with the next 20 years in mind, shows that most of the government’s policies and plans in cities involve the needs of the younger generation. In other words, the current status of Iranian cities and the proposed plans will not meet the needs of the elderly in the coming decades. Using documentary research and analysis of the contemporary structural maps of Hamedan City, this study examined the urbanization challenges resulting from age transition in 2041 to meet the World Health Organization (WHO) efficient requirements in quality-of-life. The findings indicate that Hamedan’s current form and its urban development plans have fundamental flaws because of inattention to the phenomenon of age transition based on United Nations (UN) policies in the determination of land uses and accessibility to public spaces for elderly citizens and this creates social challenges in the city.

Metabolic Disorder Enhances Oxidative Stress after Exposure to Aromatic Components of Fine Particulate Matter

Metabolic disorder can exacerbate oxidative damage following exposure to fine particulate matter (PM2.5), but the role of chemical composition in this process remains unclear. This study comprehensively assessed the oxidative stress effect from the synergy of metabolic disorder and the organic components in PM2.5 as well as their molecular features. We high-throughput characterized 942 PM2.5 chemicals from an elderly urban population exposure and found the association between oxidative stress markers of exhaled nitric oxide (eNO) and urinary malondialdehyde (MDA) and 330 and 32 compounds, respectively, was enhanced by metabolic disorder. Most of these compounds were aromatics, including PAHs and their functionalized and oxidized products. The integrated explanatory random forest approach incorporating source tracers showed that primary aromatics arising from combustion with a high unsaturation degree, high logKOW, and low volatility were responsible for the increased eNO levels in participants with metabolic disorder, while compounds formed through atmospheric oxidation reactions with high numbers of carbonyl groups and oxygen atoms and relatively low logKOW were associated with elevated MDA in disordered individuals. This study provides the first evidence that metabolic disorder exacerbates oxidative stress after exposure to specific PM2.5 components, which could in turn exacerbate chronic diseases in the elderly population.

Challenges for Technology Adoption Towards Primary Geriatrics Services

Background: The telemedicine-based approach facilitates remote health and social care for maintaining autonomy, thereby improving quality of life for geriatric patients with associated morbidities. Thus, the present study focusses on various challenges encountered during the use of technology-based model for geriatric care in urban as well as rural settings. Materials and Methods: The present operational research-based study was conducted on 2531 elderly individuals from rural and urban settings. The HUB and spoke model have been developed using cloud-based teleconsulting as well as mobile-based teleconsulting approaches which were setup up in rural and urban areas in India and Sweden for teleconsulting of elderly population. The rural and urban elderly population were screened using the telemedicine-based model. Feedbacks were taken from elderly subjects in both rural and urban settings to assess various challenges encountered during the use of technology-based model for geriatric care Results: Of 2531 elderly individuals, 701 (27.7%) individuals belonged to the urban population, while 1830 (72.3%) individuals belonged to the rural population who were examined with the help of model developed using telemedicine technology. Majority of persons screened were in the age group of 60–69 years with mean age 69.7 ± 7.90 years. Some of the challenges faced implementation of this tele-geriatrics model includes non-availability of accurate patient history, limitations over clinical examination, etc. have been highlighted working upon which would further improve this model. Conclusion: This teleconsultation-based model developed through this study provides practical evidence for its use in treating elderly population and associated challenges thereby improving their quality of life.

Comparing the functional status among rural and urban elderly population: A pilot study

Comparing the functional status among rural and urban elderly population: A pilot study

Decomposition and Comparative Analysis of the Prevalence of and Factors Associated With Smoking Between the Rural and Urban Elderly Population in China: A National Cross-Sectional Study.

This study aimed to compare and analyse the differences in smoking prevalence, and knowledge, attitudes, and factors associated with smoking between the rural and urban elderly population in China. In total, 6,966 participants aged 60 and above were included in this study, which assessed their smoking-related knowledge, attitudes, and perceptions toward tobacco control. The Chi-square test and logistic regression model were used for statistical analysis, and the Fairlie model was used for decomposition analysis. The overall prevalence of smoking was 25.6%; the rate was much higher in men than in women (overall: OR = 26.234; urban: OR = 31.260; rural: OR = 23.889). The rate of correct responses to all questions on smoking problems was significantly higher among the urban elderly than the rural elderly. Further, 64.18% of the participants supported printing photos of the health hazards of smoking on the cover of cigarette packs, and the rural elderly were more supportive of this. Moreover, only 36.52% of the participants supported increasing taxation and retail price of cigarettes; the urban elderly showed more support for this. Rules about smoking at home also played an important role, especially for families where smoking was not allowed at home, but with exceptions to the rule; however, this factor was only meaningful in urban families (urban: OR = 0.117). Through the Fairlie decomposition analysis, gender (-1.62%), age (-2.03%), region (13.68%), knowing about e-cigarettes (5.17%), rules about smoking at home (3.95%), and smoking-related knowledge scores (42.85%) were found to be associated with rural-urban disparities. This study focused on the differences in smoking between urban and rural areas in China. Smoking among the urban elderly was significantly less prevalent compared with the rural population. Factors including education, region, and smoking-related knowledge need to be addressed to reduce the gap between urban and rural health hazards in China.

A Research on the Different Financing Models of Long-term Care Insurance in China

Establishing a long-term care insurance (LTCI) system covering the whole people and balancing urban and rural areas is an important strategic plan for China to deal with the aging and disability of the population. Since the establishment of the LTCI system at the national level in 2016, China has 49 pilot areas for LTCI by 2020. Each pilot area is seriously fragmented, and the financing model of LTCI has not yet been finalized. So what is the financing model of LTCI that suits China’s national conditions? In addition, different financing models have their own advantages and disadvantages. The optimal financing model may depend on economic, social and demographic factors. Since the fund funded system does not have the function of mutual assistance in social insurance, this paper limits the financing model of LTCI between the pay-as-you-go system and the mixed system. Which one is optimal for the long-term sustainable development of China’s LTCI? Starting from the evolutionary law of the health status of elderly individuals, this paper explores the operation of China’s LTCI system under different financing models.This paper uses multi-period micro-tracking survey data, through the continuous time homogeneous Markov process and the generalized linear model, to describe the movement law of the health status transition of the elderly in China, and combines the seven census data and the age shift algorithm to calculate the size and structure of the disabled elderly population from 2020 to 2040. Further, based on the social insurance actuarial balance theory, a dynamic actuarial model under the pay-as-you-go system and three mixed systems is constructed to simulate the equilibrium premium rate and payment amount of LTCI for urban employees and urban and rural residents in the next 20 years. The study finds that, in terms of the size of disabled population, the female elderly are the main body of disabled population; the scale of disabled population in urban areas is significantly higher than that in rural areas. The main reason is that rural-urban migration has made urban elderly population larger, and the urban disability rate is higher than that in rural areas. In addition, in terms of funding pressure, the study shows that at any time and under any financing model, the relative payment pressure of LTCI for urban employees is significantly lower than that of urban and rural residents, but the absolute payment pressure is slightly higher than that of urban and rural residents. Finally, in terms of the selection of financing models, this paper believes that LTCI for urban employees should adopt a mixed system, and LTCI for urban and rural residents should adopt a pay-as-you-go system.The contribution of this paper is mainly reflected in two aspects: First, at the level of empirical research, it combines macro and micro data to describe the evolution of the health status of the elderly from the micro level, predicts the size of disabled population in China from the macro level, and finally establishes a LTCI system that covers the entire population. This not only deepens the research on individual health, but also enriches the research results in the social insurance actuarial field. Second, at the policy level, based on the results of the research, it provides an optimal financing model for LTCI for urban employees and LTCI for urban and rural residents. This optimal model can alleviate the payment burden of financing entities and enhance the stability of the LTCI system. It has important practical significance for the work focus and further promotion of China’s LTCI system.

Screening of Depression in Elderly Population Using a Geriatric Depression Scale in the Field Practice Area of Urban Health Training Centre Attached to SMS Medical College, Jaipur.

Background and objective: Depression is one of the most common illnesses worldwide, with more than 264 million people affected. Various studies in the elderly population have estimated the prevalence of depression across India, with results ranging from 6% to 62%. The objectives of this study were to estimate the prevalence of depression among the elderly population using a Geriatric Depression Scale (GDS) and to find out the association between various sociodemographic parameters and depression among elderly people.Materials and methods: This cross-sectional study was conducted in the field practice area of Urban Health Training Centre (UHTC), attached to Sawai Man Singh (SMS) Medical College, Jaipur from September 2019 to July 2020 among elderly people. Some 250 participants were interviewed.Results: Depression was present in 41.6% of the study participants. Age group, gender, marital status, educational qualification, type of family, financial dependence, socioeconomic status, and presence of morbidity were significantly associated with the presence of depression among study participants (p<0.05).Conclusion: The prevalence of depression in the urban elderly population was high (41.6%). By identifying risk factors for depression among the elderly population and screening them on time, we can reduce the severity and burden of the disease to a greater extent.

Hair Se Is a Sensitive Biomarker to Monitor the Effects of Se Supplementation in Elderly.

It is rapidly increasing to have selenium (Se) supplementation for urban elderly population in China since they are facing a widespread deficiency daily Se intake. However, until now, there is no low-cost, non-invasive, rapid, and reliable method to monitor the health improvement or risk for elderly Se-supplemented population in China. The present cross-sectional study (229 participants with older than 55 years old) performed in Beijing, China, revealed that the Se concentrations of non-supplementer users (n = 27) were 55 ± 23 μg/L in urine, 139.9 ± 102.3 μg/L in serum, and 487.6 ± 158.7 μg/kg in hair. But a significant increase on hair Se concentrations (615.4 ± 238.8 μg/kg) was observed for Se supplementer users (n = 202) (p < 0.05); there were no significant statistical differences in serum and urine between the Se-supplemented (n = 202) and Se non-supplemented groups (n = 27). This indicated the hair Se levels could be a more sensitive biomarker for Se-supplemented elderly population. Participants who consumed Se supplements for 7-12 months had the highest Se status based on hair and serum Se concentrations (p < 0.05). The present study also revealed that most elderly adults in Beijing just need to supplement 50 μg Se per day to achieve Se plateau status. Furthermore, hair Se levels were positively related with triglycerides/TG levels (p < 0.05) but not body mass index/BMI, total cholesterol/TC, and low-density lipoprotein cholesterol/LDL, implicating Se supplementation for Se sufficiency baseline in elderly population in Beijing likely posed health risk, especially on TG because of excessive Se oxidation stress. An ongoing monitoring of Se status via hair is still warranted to prevent future Se deficiency or excess in China.

HEALTH OF THE ELDERLY PEOPLE AS THE BASIS FOR FORMATION OF MEDICAL AND SOCIAL NEEDS

The aim: The identification and determination of needs that the population of older age groups have in medical and social services on the basis of health data and the results of a survey. Material and methods: Because of bibliographic, epidemiological, medical-statistical, analytical methods the research has investigated the problems of healthy aging, tendencies in population health of the population of Ukraine of senior age groups during 2000-2017, features and tendencies of health of a sample contingent of urban population of elderly age according to appeals in health care facilities during 2009-2019. The use of the sociological method, the self-evaluation of elderly people of their own health, characteristics of lifestyle and medical activity are determined, the needs of older people in medical and social services were assessed. Results: Negative tendencies to increase during 2000-2017 the prevalence of pathology among the population older than working age by 22.8%, including blood diseases in 2 times, endocrine system - in 1.8 times, urogenital system - by 1.5 times, digestive organs - by 1.4 times, tumors and nervous system - by 1.3 times. Among the urban elderly population, the prevalence of sensory diseases, including ear and eye diseases, endocrine disorders, injuries and poisonings, has increased, and mental health indicators have deteriorated. The sociological survey found a low level of self-esteem (31.5±3.5 per 100 had health problems, 10.1±2.3 are significant). Self-medication was practiced by 76.4±3.2 per 100 respondents, 74.2±3.3 were not followed or they violated the doctor's recommendations. 56.2 ±3.7 per 100 respondents had physical examinations in the non-right time 29.7±3.4 had not it.There was a significant prevalence of risk factors, including hypodynamics (21.9±3.1 per 100), tobacco use (29.8±3.4), malnutrition (37.1±3.6), overweight (obesity) (32, 6±3.5), arterial hypertension (37.6±3.6), hypercholesterolemia (28.7±3.4), glucosemia 16.3±2.8). The research has discovered the needs of older people in health care and social services, inter alia in preventive counseling (65.2±3.6 per 100), the introduction of electronic technologies in health care (68.5±3.5), information educational services on health issues (67.4±3.5), provision of services in hospitals at home (66.3±3.5), in increasing the availability of rehabilitation (43.8±3.7), specialized counseling (34.3±3.6) and emergency medical care (16.2±2.8), improvement of socio-economic determinants (78.0±3.1), introduction of activities (48.3±3.7), joint training programs for older people (42.1±3.7), the development of certain skills, the use of technical means, assistive devices (67.4±3.5), the formation of a conducive to better health environment (58, 4±3.7). Conclusions: The low level of the elderly people's health, the tendency to increase the burden of disease, the prevalence of risk factors for disease and low medical activity lead tosignificant needs for medical and social services of preventive, treatment-diagnostic, rehabilitation, improving socio-economic determinants, measures to reduce social isolation.

General Health Status and Functional Independence of Rural and Urban Elderly Population of Sub-Himalayas Region, India

Introduction: Preserving independence in tasks and continuing an active life are the most significant features in improving elderly's health care. The aim of the present study was to identify and compare elderly general health status and functional independence among rural and urban areas of the Sub-Himalayas region, India. Materials and Methods: The study was nonexperimental comparative design, in which multistage sampling techniques were used. 200 elderly participants were selected, i.e., 100 elderly from rural and urban areas, respectively. Results: Majority elderly of rural and urban areas belong to 61–70 years, male, Hindu, married, living with their children, receiving government pension, taking three times meals/day and have a previous history of medical illness. The general health status of the rural elderly is good (P = 0.000 [3.45, 5.16]) as compared to the urban elderly. Rural elderly were functional independent (P = 0.009 [0.37, 1.38]) than urban elderly. Conclusions: It is important to monitor the general health status and functional independence of the elderly. The status of daily living activity always has a great impact on the level of happiness, well-being, and quality of life of the elderly.

Health-Related Quality of Life among Elderly Population of Bangladesh

Introduction: Elderly population in Bangladesh is one of the largest in the world in term of absolute number and ageing is an emerging problem. Elderly are at risk from non-communicable diseases as well as mental problems and health-related quality of life (HRQoL) affects in urban and rural elderly.&#x0D; Objective: To find out and compare HRQoL in urban and rural elderly population of Bangladesh.&#x0D; Materials and Methods:A comparative cross-sectional study was carried out to compare HRQoL in urban and rural elderly. This was a two samples study; 130 each from urban and rural. Total 260 elderly were selected conveniently. Data were collected through face to face interview using a pre-tested semi structured questionnaire of SF-36 v2 HRQoL survey. This study was carried in urban elderly residing in Ward number 3, Race Course, Cumilla City Corporation and in rural elderly residing in Noapuskuni Village of Babutipara Union, Muradnager Upazila, Cumilla. This one-year study was conducted from 15 July 2017 to 14 June 2018.&#x0D; Results: Majority of the elderly were Muslim (91.5%), female (53.5%), married (59.6%) and from joint family (91%). The mean ± SD age of elderly was 69.26±6.337 years and mean ± SD monthly family income was Tk. 16561.54±9192.076. SF- 36 v2 HRQoL scale; a licensed software-based survey tool was used measure the health-related quality of life of elderly. Most of the elderly were found with average physical component summary (PCS) (53.1%) and mental component summary (MCS) (50.8%) of HRQoL. Age had significant negative correlation with PCS (p&lt;0.001) and MCS (p&lt;0.001) in urban and rural elderly. Education level of urban and rural elderly had significant positive correlation with PCS (p&lt;0.01) and MCS (p&lt;0.01). Marital status of urban and rural elderly had significant negative correlation with PCS (p&lt;0.001) and MCS (p&lt;0.001) of HRQoL. Among the rural respondents, the mean ± SD of PCS of male was 43.79±5.766 and female was 41.14±6.860. The difference was statistically significant (p&lt;0.05). Mean score of PCS of urban and rural respondents were 45.68±6.366 and 42.43±6.467 respectively. This difference was statistically significant (p&lt;0.001). Mean scores of MCS of urban and rural respondents were 43.96±4.921 and 42.56±7.028 respectively. This difference was not statistically significant (p&gt;0.05).&#x0D; Conclusion: Most of the elderly had average level of health-related quality life. Rural female elderly had significantly lower physical health of HRQoL than that of rural male elderly. Physical dimension of HRQoL of rural elderly was significantly lower than that of urban elderly.&#x0D; JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 161-164

Role of white matter hyperintensities, hemoglobin and vitamin B‐12 on cognitive decline: Two‐year follow‐up data from the Tata Longitudinal Study of Ageing (TLSA)

AbstractBackgroundThe presence of white matter hyperintensities is commonly seen in elderly individuals and many studies have identified its relation to cognitive decline, however the effect size of this relationship has been seen to be relatively small. Evidence also suggests that among older individuals, low levels of hemoglobin and Vitamin B‐12 are indicators of cognitive decline. This study seeks to identify the role of white matter hyperintensities, hemoglobin and Vitamin B‐12 on cognitive change among an urban elderly population in Bangalore, India.MethodA subset of 87 individuals (49 Males and 38 Females, mean age=65.9 years) from TLSA Cohort above the age of 45 participated in the TATA longitudinal Study of Ageing, conducted in Bangalore, India. All participants underwent the Addenbrooke’s Cognitive Examination III (ACE‐III), blood investigations and Magnetic Resonance Imaging (MRI) scans as per the Alzheimer's Disease Neuroimaging Initiative (ADNI‐II) protocol at baseline. Brain images were acquired with a 3T Siemens Skyra MR Scanner. MRI scans were then visually rated on Fazeka’s scale for white matter lesions. Cognitive assessments were repeated two years later, on all participants. Change in cognition was calculated by subtracting followup scores from baseline scores. Regression analysis was conducted in order to examine the relation between White matter hyperintensities, vitamin b‐12 and hemoglobin at baseline with change in cognitive scores over time.ResultThe results indicate that Fazeka’s deep white matter scores, hemoglobin and vitamin B‐12 are significant predictors of changes in ACE‐III Memory scores at a 2 year follow up. A significant regression equation was found (F(3,38)=6.73, p&lt;0.001), with an R2 of 0.347.ConclusionThe findings of the study suggest that an individual’s deep white matter hyperintensity, along with hemoglobin levels and Vitamin B12 at baseline are potential indicator of cognitive change during follow up. Future longitudinal studies with larger sample size are required to examine whether this model is a significant predictor of cognitive decline and dementia.