scholarly journals Age, gender, and residence differences in prevalence and patterns of multimorbidity among older Chinese: Evidence from Chinese Longitudinal Healthy Longevity Survey

2022 ◽  
Author(s):  
Siyue Han ◽  
Guangju Mo ◽  
Tianjing Gao ◽  
Qing Sun ◽  
Huaqing Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Functional Decline ◽  
Self Report ◽  
Care Utilization ◽  
Rule Mining ◽  
Demographic Differences ◽  
Healthy Longevity ◽  
Older Chinese ◽  
Multimorbid Patients

Abstract Background With the dramatic acceleration of ageing in China, multimorbidity among the older adults has become increasingly common，which are associated with more functional decline and higher health care utilization and mortality. Understanding demographic differences of patterns of multimorbidity is in favor of making targeted intervention strategies. The purpose of this study was to reveal age- specific, gender- specific, and residence- specific prevalence and patterns of multimorbidity among older adults in China. Methods The present analysis is based on the 2018 wave of Chinese Longitudinal Health Longevity Survey (CLHLS). We selected 13 chronic diseases from the CLHLS survey, and information was collected based on self-report. Multimorbidity was defined as the coexistence of two or more chronic diseases from 13 chronic diseases in the same individual. Descriptive statistical analysis was used to examine multimorbidity according to age, sex, and residence. Patterns and trends of chronic disease pairs and multimorbidity were explored using association rule mining. Results 9,660 individuals aged 65-117 years in the CLHLS were analyzed in this study. Overall, 74.4% of all participants had one or more morbidities, and 42.4% were multimorbid. The prevalence of individual chronic diseases ranged from 1.5% for cancer to 41.8% for hypertension, and each disease was often accompanied by one or more other chronic diseases. The prevalence of multimorbidity does not always increase with age. The subgroups with the highest prevalence of multimorbidity was 80-89 years old (48.2%), female (45.0%) and urban (47.2%) group. Prevalence of the hypertension- diabetes pattern decreases with age and is higher in women than in men. The prevalence of hypertension- depression pattern was at the highest among the 90-117 years and rural older adults, while the other groups were hypertension-heart disease. Moreover, it was noteworthy that the multimorbidity rate of dyslipidemia is the highest at 95.5% among the 13 chronic diseases. Conclusions The prevalence of multimorbidity among older Chinese was substantial, and patterns of multimorbidity differed in age, sex, and residence. Future efforts are needed to identify possible prevention strategies and guidelines targeted demographic differences of multimorbid patients to promote health in older adults.

scholarly journals Life-space assessment and associated clinical factors: SABE Colombia

2021 ◽  
Vol 15 ◽  
Author(s):  
Elly Morros-González ◽  
Isabel Márquez ◽  
José Pablo Prada ◽  
Daniela Patino-Hernandez ◽  
Diego Chavarro-Carvaja ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Mental Disease ◽  
Secondary Analysis ◽  
Self Report ◽  
Noncommunicable Diseases ◽  
Therapeutic Approaches ◽  
Life Space ◽  
Limited Life ◽  
Logistic Regressions

OBJECTIVES: Our aim was to assess whether an association exists between chronic diseases or multimorbidity and limited life space in older adults. METHODS: This is a secondary analysis of the SABE (Salud, Bienestar y Envejecimiento) Colombia Study. We assessed chronic diseases through self-report, and a limited life space was defined as any score ≤ 60 in the Life-Space Assessment scale. Multimorbidity was defined as having two or more coexisting diseases. We performed bivariate analyses and multivariate logistic regressions aiming to obtain odds ratios with 95% confidence intervals. RESULTS: The prevalence of limited life space was 2.95% with a mean score of 76.27 ± 19.34. Statistically significant associations were found between limited life space and mental disease (OR 1.45; 95%CI 1.15 – 1.82) and between limited life space and multimorbidity (OR 1.32; 95%CI 1.06 – 1.63). CONCLUSIONS: Mental disease and multimorbidity are associated with limited life space in older adults. Therefore, preventing, diagnosing, and treating mental illness should be sought in addition to the existing preventive and therapeutic approaches available for noncommunicable diseases.

scholarly journals Chronic diseases, multimorbidity, and handgrip strength among older adults from Southern Brazil

2016 ◽  
Vol 29 (1) ◽  
pp. 43-52 ◽  
Author(s):  
Júlia PESSINI ◽  
Aline Rodrigues BARBOSA ◽  
Erasmo Benício Santos de Moraes TRINDADE
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Handgrip Strength ◽  
Living Arrangement ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Self Report ◽  
Southern Brazil ◽  
Cross Sectional ◽  
Comorbid Chronic Diseases

ABSTRACT Objective: To investigate the association between various chronic diseases, multimorbidity, and handgrip strength in community dwelling older adults in Southern Brazil. Methods: A cross-sectional study carried out with 477 older adults (60 years and older) who resided in Antônio Carlos, Santa Catarina state. Subjects aged 60-79 years were selected by probability sampling (n=343) and all subjects aged 80 years or older (n=134) were evaluated. Chronic diseases were identified by self-report. A mechanical dynamometer verified handgrip strength (i.e., the outcome). Adjustments variables were age, literacy, living arrangement, smoking, body mass index, cognitive function, and comorbid chronic diseases. Sex-stratified analyses were conducted with simple and multiple linear regression. Results: A total of 270 women (73.2±8.8 years) and 207 men (73.3±9.0 years) were assessed. In the adjustment analysis, cancer (β=-3.69; 95%CI=-6.97 to -0.41) and depression (β=-1.65; 95%CI=-3.20 to -0.10) were associated with lower handgrip strength in women. For men, diabetes (β=-5.30; 95%CI=-9.64 to -0.95), chronic lung disease (β=-4.74; 95%CI=-7.98 to -1.50), and coronary heart disease (β=-3.07; 95%CI=-5.98 to -0.16) were associated with lower handgrip strength values. There was an inverse trend between number of diseases and handgrip strength for men only. Conclusion: The results showed an independent association between chronic diseases and handgrip strength. As such, handgrip strength is a valid measure to use for prevention or intervention in chronic disease and multimorbidity.

scholarly journals Disability incidence and functional decline among older adults with major chronic diseases

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joelle H. Fong
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Chronic Care ◽  
Comparison Group ◽  
Oldest Old ◽  
Functional Decline ◽  
Chronically Ill ◽  
Noncommunicable Diseases ◽  
Functional Loss ◽  
Early Loss

Abstract Background More than 80% of elderly Americans have at least one chronic disease. While past studies have shown that hierarchical patterns of functional loss may differ by gender and institutional settings, little is known about whether such patterns differ in relation to chronic health condition. The aim of this study is to investigate the pattern of functional loss among older adults with major chronic illnesses, and to compare their onset and ordering of incident ADL disability with those of persons without such conditions. Methods We use a nationally representative sample of persons aged 80+ from the 1998–2014 Asset and Health Dynamics of the Oldest Old survey. The group with major noncommunicable diseases (including cardiovascular disease, cancer, chronic respiratory disease, and diabetes) comprises 3,514,052 subjects, while the comparison group comprises 1,073,263 subjects. Self-reports of having difficulty with six distinct ADLs are used to estimate disability incidence rate. Nonparametric statistical methods are used to derive median onset ages and ADL loss sequence separately for each group. Results Older adults with major chronic diseases have higher rates of incident disability across all ADL items. Estimated median onset ages of ADL disabilities for the full sample range from 91.5 to 95.6. Disability occurs earlier for chronically ill persons (onset ages 91.1–95.0) than for those in the comparison group (onset ages 93.5–98.1). Among those with major chronic diseases, the ADL loss sequence ordered by median ages of disability onset is bathing, walking, dressing, toileting, transferring and eating. The activities are also distinctly separated into an early-loss cluster and a late-loss cluster. Although the loss sequence derived for the comparison group is largely similar, disability progression for those with major chronic diseases is compressed within a shorter timeframe and the timing gaps between adjacent disabilities are smaller. Conclusions Older Americans with major noncommunicable diseases face an earlier and steeper slope of functional decline. Chronic care delivery programs should adapt to dynamic changes in older patients’ functional status. Health interventions to help patients delay disability onset and optimize functional autonomy within emerging models of chronic care should especially target early-loss activities such as bathing, dressing, and walking.

scholarly journals PERCEIVED MENTAL FATIGABILITY: NOVEL INSIGHTS INTO SOCIOBEHAVIORAL CORRELATES AND HERITABILITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S232-S232
Author(s):  
Nancy W Glynn ◽  
Eleanor M Simonsick
Keyword(s):  
Older Adults ◽  
Coping Styles ◽  
Functional Decline ◽  
Patient Reported Outcome ◽  
Self Report ◽  
Future Directions ◽  
Brain Volumes ◽  
Diurnal Patterns ◽  
Patient Reported ◽  
And Coping

Abstract Fatigue, a common patient-reported outcome, is a unique risk factor associated with both cognitive and physical function. Perceived mental fatigability, a self-report measure of cognitive fatigue anchored to activities of fixed intensity and duration, eliminates self-pacing bias, and therefore is a more sensitive measure of the degree to which cognitive tiredness limits activity. Higher perceived mental fatigability has been associated with functional decline and lower grey matter brain volumes in older adults. We developed the Pittsburgh Fatigability Scale (PFS), a self-administered, 10-item tool to assess perceived physical and mental fatigability across a range of activities, which is widely used internationally. We previously validated the PFS physical subscale. Using a large multicenter international cohort, the Long Life Family Study, we will present the validation of the PFS mental subscale, examine its epidemiology, and explore genetic and socio-behavioral factors associated with perceived mental fatigability in older adults. Specifically, Ms. Renner will share the results of the validation of the PFS mental subscale; Ms. Meinhardt will present heritability and prevalence of higher perceived mental fatigability across age strata and sex; and Ms. Gmelin will consider the link between stress and coping styles on perceived mental fatigability. Further, using a smaller methodological study, the Developmental Epidemiologic Cohort Study, Ms. Graves will explore whether diurnal patterns of physical activity using accelerometry differ in older adults with higher versus lower perceived mental fatigability. Dr. Simonisick, our Discussant, will critically review the presentations and share future directions to inform potential interventions aimed at lowering perceived mental fatigability.

scholarly journals Factors Associated with Health Status and Health Care Utilization among Korean Older Adults

2017 ◽  
Vol 1 (1) ◽  
pp. 10
Author(s):  
Ju Moon Park
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Status ◽  
Health Care Utilization ◽  
Chronic Diseases ◽  
Predictive Power ◽  
Individual Characteristics ◽  
Poor Health ◽  
Care Utilization ◽  
Poor Health Status

<p><em>This study described the individual characteristics of physician and inpatient service users that affected health status and health care utilization and examined the factors that are associated with health status and health services utilization among Korean older adults. Based on the 2010 Korea National Health and Nutrition Examination Survey which was conducted by the Korea Centers for Disease Control and Prevention, descriptive and logistic regression analysis was performed. The sample for this study was 1,478 individuals who indicated older than 65 years and older. Self-rated health status was ranked lower among lower-income families, married persons, and those with chronic diseases. The presence of chronic diseases was significant in predicting the likelihood of poor health status, with socio-economic and health-related need factors having predictive power of the use of inpatient hospital services. The study findings show that elderly Koreans who were in poor health status were married, poorer, and had chronic diseases. The implications of these results are discussed in terms of more effectively targeting interventions to older Koreans in poor health and the factors having predictive power of physician and inpatient utilization.</em><em></em></p>

scholarly journals Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

2020 ◽  
pp. 1-12
Author(s):  
Gemma Stringer ◽  
Iracema Leroi ◽  
Sietske A. M. Sikkes ◽  
Daniela Montaldi ◽  
Laura J. E. Brown
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Convergent Validity ◽  
Functional Decline ◽  
Weighted Average ◽  
Self Report ◽  
Average Score ◽  
Subjective Cognitive Decline ◽  
Functional Measures ◽  
The Uk

ABSTRACT Objective: Commonly used measures of instrumental activities of daily living (IADL) do not capture activities for a technologically advancing society. This study aimed to adapt the proxy/informant-based Amsterdam IADL Questionnaire (A-IADL-Q) for use in the UK and develop a self-report version. Design: An iterative mixed method cross-cultural adaptation of the A-IADL-Q and the development of a self-report version involving a three-step design: (1) interviews and focus groups with lay and professional stakeholders to assess face and content validity; (2) a questionnaire to measure item relevance to older adults in the U.K.; (3) a pilot of the adapted questionnaire in people with cognitive impairment. Setting: Community settings in the UK. Participants: One hundred and forty-eight participants took part across the three steps: (1) 14 dementia professionals; 8 people with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia due to Alzheimer’s disease; and 6 relatives of people with MCI or dementia; (2) 92 older adults without cognitive impairment; and (3) 28 people with SCD or MCI. Measurements: The cultural relevance and applicability of the A-IADL-Q scale items were assessed using a 6-point Likert scale. Cognitive and functional performance was measured using a battery of cognitive and functional measures. Results: Iterative modifications to the scale resulted in a 55-item adapted version appropriate for UK use (A-IADL-Q-UK). Pilot data revealed that the new and revised items performed well. Four new items correlated with the weighted average score (Kendall’s Tau −.388, −.445, −.497, −.569). An exploratory analysis of convergent validity found correlations in the expected direction with cognitive and functional measures. Conclusion: The A-IADL-Q-UK provides a measurement of functional decline for use in the UK that captures culturally relevant activities. A new self-report version has been developed and is ready for testing. Further evaluation of the A-IADL-Q-UK for construct validity is now needed.

scholarly journals Association between exercise and the risk of dementia: results from a nationwide longitudinal study in China

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017497 ◽  
Author(s):  
Zi Zhou ◽  
Jian Fu ◽  
Y. Alicia Hong ◽  
Ping Wang ◽  
Ya Fang
Keyword(s):  
Estimating Equation ◽  
Population Based ◽  
Self Report ◽  
Regular Exercise ◽  
Causal Association ◽  
Logistic Regression Models ◽  
Healthy Longevity ◽  
Time Lagged ◽  
Older Chinese

ObjectiveThis study was conducted to examine the causal association between exercise and the risk of dementia among older Chinese adults.DesignLongitudinal population-based study with a follow-up duration of 9 years.SettingData for the Chinese Longitudinal Healthy Longevity Survey waves occurring from 2002 to 2011–2012 were extracted from the survey database.ParticipantsIn total, 7501 dementia-free subjects who were older than 65 years were included at baseline. Dementia was defined as a self-reported or proxy-reported physician’s diagnosis of the disease.Outcome measures and methodsRegular exercise and potential confounding variables were obtained via a self-report questionnaire. We generated longitudinal logistic regression models based on time-lagged generalised estimating equation to examine the causal association between exercise and dementia risk.ResultsOf the 7501 older Chinese people included in this study, 338 developed dementia during the 9-year follow-up period after excluding those who were lost to follow-up or deceased. People who regularly exercised had lower odds of developing dementia (OR=0.53, 95% CI 0.33 to 0.85) than those who did not exercise regularly.ConclusionRegular exercise was associated with decreased risk of dementia. Policy-makers should develop effective public health programmes and build exercise-friendly environments for the general public.

scholarly journals DISPARITIES OF DENTAL CARE AND CONSEQUENCE OF POOR ORAL HEALTH AMONG OLDER ADULTS IN THE U.S.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S606-S606
Author(s):  
Yanyan Wu ◽  
Wei Zhang ◽  
Bei Wu
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Chronic Diseases ◽  
Dental Care ◽  
Care Utilization ◽  
Negative Effects ◽  
Dental Care Utilization ◽  
Racial Ethnic ◽  
The U.S

Abstract Oral health is an essential part of staying healthy. Neglect of dental care may lead to tooth decay/ loss, poor nutrition, and affects individuals’ quality of life. Over the past decades, dental care utilization has risen considerably, however, racial/ethnic and socioeconomic disparities still persist in the U.S. Additionally, poor oral health is a contributing factor to, and a consequence of chronic diseases such as cognitive impairment, diabetes and cardiovascular disease. Faced with the complex and intertwined health and social challenges, it’s imperative to understand the disparities of dental care utilization and the relationships among oral health and chronic diseases so that effective policies and preventions can be implemented to improve quality of care. In this symposium, we present findings for older adults from diverse racial/ethnic populations in the U.S. We begin with results from two national-wide trend analyses: a 15-year review of dental care utilization and the evaluation of dental care performance over a 16-year period in nursing homes. The next study presents the barriers of dental care utilization in Hawaii. Finally, we present results of the negative effects of diabetes and poor oral health on cognitive function. Our studies address the disparities of dental care utilization among minority and under-represented ethnic groups as well as the connections between oral health and chronic conditions. Our results are helpful in educating policy makers and health practitioners about how to improve dental care and how dental care can be effectively integrated into chronic disease prevention and health promotion activities.

scholarly journals Association between depressive symptoms and medical care utilization in South Korean older adults with chronic diseases: A cross-sectional study

2021 ◽  
Author(s):  
Yoon Sik Park ◽  
Eun-Cheol Park
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Medical Care ◽  
Chronic Diseases ◽  
National Sample ◽  
Care Utilization ◽  
Cross Sectional ◽  
South Korean ◽  
Medical Care Utilization ◽  
Outpatient Visits

Abstract BackgroundThis study examined the effects of depressive symptoms on medical care utilization among South Korean older adults with chronic diseases.MethodsA national sample of 3,921 elders with chronic diseases participated in the Korean Longitudinal Study of Aging. Using multiple logistic regression, odds ratios (ORs) were calculated for the effects of depressive symptoms on medical care utilization.ResultsOlder adults with depressive symptoms had fewer outpatient visits (OR = 0.81, 95% confidence interval [CI] = 0.67–0.98) and more inpatient hospitalizations (OR = 1.49, 95% CI = 1.13–1.97) than those who did not suffer depressive symptoms. Participants with depressive symptoms visited outpatient clinics less often (OR = 0.69, 95% CI = 0.48–0.97) and were hospitalized more frequently (OR = 1.81, 95% CI = 1.04–3.16) than were men without depressive symptoms. Patients with depressive symptoms with hypertension and diabetes were hospitalized more often (OR = 2.77, 95% CI = 1.45–5.30).ConclusionsDepressive symptoms and chronic diseases are common among elders in South Korea, often resulting in decreased outpatient visits and increased inpatient hospitalization. These findings suggest the necessity for management of chronic disease in elders with depressive symptoms.

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