Risk factors associated with residential aged care, respite and transitional aged care admission for older people following an injury-related hospitalisation

IntroductionMusculoskeletal problems, including conditions such as back pain, neck pain, rheumatoid arthritis, gout and osteoarthritis are common in the population and significant contributors to global disease burden. Age is one of the most common risk factors for musculoskeletal conditions and over 40% of older people accessing residential aged care have a musculoskeletal condition. It is not known whether individuals living in the community with musculoskeletal conditions have similar needs to those in permanent care and this is important to know in order to provide appropriate care. Objectives and ApproachThe objective of this study was to profile individuals with musculoskeletal conditions in different aged care service settings (i.e. permanent care, community care only, transition/ respite care, or no services). Specifically, we examined the concurrent chronic conditions, health risk factors and functional limitations of individuals by service setting. A cross-sectional evaluation of individuals in the National Historical Cohort of the Registry of Senior Australians (ROSA) between 2004 and 2014 was conducted. Multivariable logistic regression models estimated the factors associated with being in different aged care settings. Odds ratios (OR) and 95% confidence intervals (CI) were determined. Results401,026 (42.5%) individuals with musculoskeletal conditions were assessed for aged care service eligibility during the study period. Of these 197,181 (49.2%) accessed permanent care, 37,003 (9.2%) accessed home care, 54,826 (13.7%) transition/respite, and 112,016 (27.9%) - no care. Individuals accessing community care compared to residential care were more likely to be female, have pain and have difficulty maintaining their home, as were individuals accessing no services compared to residential care. Conclusion / ImplicationsCompared to those in residential care, individuals with musculoskeletal conditions in the community with or without assistance had few differences related to other chronic conditions and functional limitations. But the reasons why some had support, while others did not, are unclear.

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Prevalence of Mild Cognitive Impairment in Rural Thai Older People, Associated Risk Factors and their Cognitive Characteristics

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000506279 ◽

2020 ◽

Vol 10 (1) ◽

pp. 38-45 ◽

Cited By ~ 2

Author(s):

Jiranan Griffiths ◽

Lakkana Thaikruea ◽

Nahathai Wongpakaran ◽

Peeraya Munkhetvit

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Older People ◽

Significant Risk ◽

Depression Scale ◽

Cross Sectional ◽

Factors Associated ◽

Low Education ◽

Rural Thailand

Introduction: Mild cognitive impairment (MCI) is a transitional stage between normal cognition and dementia. A review showed that 10–15% of those with MCI annually progressed to Alzheimer’s disease. Objective: This study aimed to investigate the prevalence and risk factors associated with MCI as well as the characteristics of cognitive deficits among older people in rural Thailand. Methods: A cross-sectional study in 482 people who were 60 years old and over was conducted in northern Thailand. The assessments were administered by trained occupational therapists using demographic and health characteristics, Mental Status Examination Thai 10, Activities of Daily Living – Thai Assessment Scale, 15-item Geriatric Depression Scale and the Montreal Cognitive Assessment-Basic (MoCA-B, Thai version). Results: The mean age of MCI was 68.3 ± 6.82 years, and most had an education ≤4 years. The prevalence of MCI in older people was 71.4% (344 out of 482), and it increased with age. Low education and diabetes mellitus (DM) were the significant risk factors associated with cognitive decline. Older people with MCI were more likely to have an education ≤4 years (RR 1.74, 95% CI 1.21–2.51) and DM (RR 1.19, 95% CI 1.04–1.36) than those who did not. The 3 most common cognitive impairments according to MoCA-B were executive function (86%), alternating attention (33.1%) and delayed recall (31.1%). Conclusion: The prevalence of MCI in older Thai people in a rural area is high compared with that in other countries. The explanation might be due to low education and underlying disease associated with MCI. A suitable program that can reduce the prospects of MCI in rural Thailand is needed.

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