Back pain and treatment seeking among community-dwelling older adults: Findings from a population-based survey

2021 ◽  
Vol 42 (6) ◽  
pp. 1446-1453
Author(s):  
Muhammed Rashid ◽  
T. Muhammad ◽  
Shobhit Srivastava
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Population Based ◽  
Community Dwelling ◽  
Treatment Seeking ◽  
Community Dwelling Older Adults ◽  
Population Based Survey

scholarly journals LO13: Characteristics of emergency department visits by community-dwelling older adults who screened positive for elder abuse during home care assessments

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S11 ◽  
Author(s):  
E. Mercier ◽  
A. Jones ◽  
A. Brousseau ◽  
J. Hirdes ◽  
F. Mowbray ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Reporting System ◽  
Elder Abuse ◽  
Frailty Index ◽  
Population Based ◽  
Community Dwelling ◽  
Care Assessment ◽  
Ed Visits ◽  
Community Dwelling Older Adults

Introduction: Elder abuse is infrequently detected in the emergency department (ED) and less than 2% are reported to proper law authorities by ED physicians. This study aims to examine the characteristics of community-dwelling older adults who screened positive for elder abuse during home care assessments and the epidemiology of ED visits by these patients relative to other home care patients. Methods: This study utilized a population-based retrospective cohort study of home care patients in Canada between April 1, 2007 and March 31, 2015. Standardized, comprehensive home care assessments were extracted from the Home Care Reporting System. A positive screen for elder abuse was defined as at least one these criteria: fearful of a caregiver; unusually poor hygiene; unexplained injuries; or neglected, abused, or mistreated. Home care assessments were linked to the National Ambulatory Care Reporting System in the regions and time periods in which population-based estimates could be obtained to identify all ED visits within 6 months of the home care assessment. Results: A total of 30,413 from the 2,401,492 patients (1.3%) screened positive for elder abuse during a home care assessment. They were more likely to be male (40.5% versus 35.3%, p < 0.001), to have a cognitive impairment (82.9% versus 65.3%, p < 0.001), a higher frailty index (0.27 versus 0.22, p < 0.001) and to exhibit more depressive symptoms (depression rating scale 1 or more: 68.7% versus 42.7%, p < 0.001). Patient who screened positive for elder abuse were less likely to be independent in activities of daily living (41.9% versus 52.7%, p < 0.001) and reported having fallen more frequently (44.2% versus 35.5%, p < 0.001). Caregiver expressing distress was associated with elder abuse (35.3% versus 18.3%, p < 0.001) but not a higher number of hours caring for the patient. Victims of elder abuse were more likely to attend the ED for low acuity conditions (Canadian triage and acuity scale (CTAS) 4 or 5). Diagnosis at discharge from ED were similar with the exception of acute intoxication that was more frequent in patients who are victims of abuse. Conclusion: Elder abuse is infrequently detected during home care assessments in community-dwelling older adults. Higher frailty index, cognitive impairment, depressive symptoms were associated with elder abuse during homecare assessments. Patients who are victims of elder abuse are attending EDs more frequently for low acuity conditions but ED diagnosis at discharge, except for acute intoxication, are similar.

scholarly journals BODY MASS INDEX TRAJECTORY BEFORE DEATH IN COMMUNITY-DWELLING OLDER ADULTS. POPULATION-BASED COHORT STUDY

2021 ◽  
Author(s):  
Hari Venkatesh Pai ◽  
Martin C Gulliford
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
High Body Mass Index ◽  
Population Based ◽  
Community Dwelling ◽  
Housing Tenure ◽  
Age Related ◽  
Community Dwelling Older Adults

Background and objective: Both low and high body mass index (BMI) have been associated with greater mortality in older adults. This study evaluated the trajectory of BMI in the final years of life. Design: Population-based cohort study. Setting: Community-dwelling adults in the English Longitudinal Study of Ageing between 1998 and 2012. Measurements: Body mass index, years before death and all-cause mortality. Analyses were adjusted for age, gender, educational level, housing tenure and social class. Results: Data were analysed for 16,924 participants with 31,857 BMI records; mean age at study start, 61.6 (SD 10.9) years; mean BMI, 27.5 (4.7) Kg/m2. There were 3,686 participants (4,794 BMI records) who died and 13,238 participants (27,063 BMI records) who were alive at last follow-up. Mean BMI increased with age to 60-69 years but then declined, but the age-related decline was more rapid in decedents. At ages 80-89 years, mean BMI in decedents was 26.1 (4.7) compared with 27.1 (4.4) Kg/m2 in survivors. After adjusting for age and covariates, mean BMI declined in the five years before death. From 9 to 5 years before death or end of study, adjusted mean BMI was 0.51 (95% confidence interval 0.24 to 0.78) Kg/m2 lower for decedents than survivors; and from four to zero years before death, 1.55 (1.26 to 1.84) Kg/m2 lower in decedents. Conclusions: In community-dwelling older adults, mean body mass index enters an accelerating decline during five years before death. Reverse causation may account for the association of lower BMI with mortality.

scholarly journals Status of Constipation and Its Association with Sarcopenia in Older Adults: A Population-Based Cohort Study

2021 ◽  
Vol 18 (21) ◽  
pp. 11083
Author(s):  
Hyungchul Park ◽  
Jihye Lim ◽  
Ji Yeon Baek ◽  
Eunju Lee ◽  
Hee-Won Jung ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Population Based ◽  
Cross Sectional Study ◽  
Clinical Suspicion ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Iadl Disability ◽  
Community Dwelling Older Adults

(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV criteria were used to identify patients with clinically defined constipation, while sarcopenia was defined by the Asian Working Group for Sarcopenia consensus. The cohort was classified into three groups: no constipation, self-reported constipation only, and clinically defined constipation. (3) Results: The presence of constipation was associated with sarcopenia and slow gait speed (p < 0.001). After adjustment for possible covariates, the association with sarcopenia attenuated, while that for slow gait speed persisted. In terms of geriatric parameters, both groups with clinically defined and self-reported constipation had a higher burden of cognitive impairment, IADL disability, and lower QOL scores (p < 0.05) compared with those without constipation. (4) Conclusions: Sarcopenia and slow gait speed associated with constipation in community-dwelling older adults. Individuals with self-reported constipation symptoms alone showed comparable sarcopenic and geriatric burden to those with clinically defined constipation. Clinical suspicion for possible co-existing sarcopenia is warranted in older patients with constipation.

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