Is multimorbidity associated with risk of elder abuse? Findings from the AHSETS study

AbstractIntroductionCommensurate with demographic and lifestyle transition, increasing magnitude of multimorbidity is common among older adults in low- and middle-income countries (LMIC). At the same time the rising prevalence of elder abuse is concurrently observed in these populations. However, little is known about the elder abuse in the context of multimorbidity with no reports on their interplay from LMIC settings. This study examined the association of multimorbidity with the risk of elder abuse and its correlates in a rural elderly population of Odisha, India.MethodsThe data was collected as a part of our ASHETS study encompassing 725 older adults residing in rural Odisha, India. Multimorbidity was assessed by previously validated MAQ PC tool. Hwalek-Sengstock elder abuse screening test (HS-EAST) was used to assess the risk of elder abuse. Care dependence was measured by Katz index questionnaire. We performed ordinal logistic regression models to identify the correlates of elder abuse.ResultsAround 48.8% (95% CI:45.13-52.53%) older adults had multimorbidity while 33.8% (95% CI:30.35-37.35%) had some form of care dependence. Out of 725, 56.6% (CI 52.85 – 60.19%) were found to be at low-risk elder abuse and 15.9% (CI 13.27 – 18.72%) being at high-risk. The risk of elder abuse was significantly associated with multimorbidity (AOR=1.88; 95%CI: 1.54-2.21), economic dependence (AOR=1.62; 95%CI: 1.25-1.99) and functional dependence (AOR=1.86; 95%CI: 1.42-2.29). Staying alone (AOR= 1.75; 95%CI: 1.13-2.38) and lower socio-economic status (AOR=2.96; 95%CI: 2.09-3.84) were two other significant correlates.ConclusionsOlder adults with multimorbidity are at 1.88 times higher risk of elder abuse compared to their non-multimorbid counterparts. Both economic and functional dependence are associated with an increase in elder abuse. This suggests the mediating role of care dependence in the pathway to elder abuse in multimorbidity. Future geriatric multimorbidity assessment studies should consider screening for care dependence as well as elder abuse while designing integrated care models.

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Is multimorbidity associated with risk of elder abuse? Findings from the AHSETS study

10.21203/rs.3.rs-236011/v1 ◽

2021 ◽

Author(s):

Jaya Singh Kshatri ◽

Trilochan Bhoi ◽

Shakti Ranjan Barik ◽

Subrata Kumar Palo ◽

Sanghamitra Pati

Keyword(s):

Older Adults ◽

Elder Abuse ◽

Functional Dependence ◽

Economic Status ◽

Middle Income ◽

Logistic Regression Models ◽

Mediating Role ◽

Middle Income Countries ◽

Katz Index ◽

Care Models

Abstract Introduction: Commensurate with demographic and lifestyle transition, increasing magnitude of multimorbidity is common among older adults in low- and middle-income countries (LMIC). At the same time the rising prevalence of elder abuse is concurrently observed in these populations. However, little is known about the elder abuse in the context of multimorbidity with no reports on their interplay from LMIC settings. This study examined the association of multimorbidity with the risk of elder abuse and its correlates in a rural elderly population of Odisha, India. Methods: The data was collected as a part of our ASHETS study encompassing 725 older adults residing in rural Odisha, India. Multimorbidity was assessed by previously validated MAQ PC tool. Hwalek-Sengstock elder abuse screening test (HS-EAST) was used to assess the risk of elder abuse. Care dependence was measured by Katz index questionnaire. We performed ordinal logistic regression models to identify the correlates of elder abuse. Results: Around 48.8% (95% CI:45.13-52.53%) older adults had multimorbidity while 33.8% (95% CI:30.35-37.35%) had some form of care dependence. Out of 725, 56.6% (CI 52.85 – 60.19%) were found to be at low-risk elder abuse and 15.9% (CI 13.27 – 18.72%) being at high-risk . The risk of elder abuse was significantly associated with multimorbidity (AOR=1.88; 95%CI: 1.54-2.21), economic dependence (AOR=1.62; 95%CI: 1.25-1.99) and functional dependence (AOR=1.86; 95%CI: 1.42-2.29). Staying alone (AOR= 1.75; 95%CI: 1.13-2.38) and lower socio-economic status (AOR=2.96; 95%CI: 2.09-3.84) were two other significant correlates. Conclusions: Older adults with multimorbidity are at 1.88 times higher risk of elder abuse compared to their non-multimorbid counterparts. Both economic and functional dependence are associated with an increase in elder abuse. This suggests the mediating role of care dependence in the pathway to elder abuse in multimorbidity. Future geriatric multimorbidity assessment studies should consider screening for care dependence as well as elder abuse while designing integrated care models.

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Is multimorbidity associated with risk of elder abuse? Findings from the AHSETS study

BMC Geriatrics ◽

10.1186/s12877-021-02347-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jaya Singh Kshatri ◽

Trilochan Bhoi ◽

Shakti Ranjan Barik ◽

Subrata Kumar Palo ◽

Sanghamitra Pati

Keyword(s):

Older Adults ◽

Elderly Population ◽

Elder Abuse ◽

Functional Dependence ◽

Rural Elderly ◽

Middle Income ◽

Logistic Regression Models ◽

Middle Income Countries ◽

Multimorbid Patients

Abstract Background With an increasing number of older adults in low- and middle-income countries (LMIC), the burden of multimorbidity and functional dependence is on the rise. At the same time, a higher prevalence of elder abuse is observed in these populations. There is scarce evidence on the interplay between elder abuse and multimorbidity with no reports from LMIC settings yet. Present study examined the association of multimorbidity with the risk of elder abuse and its correlates in a rural elderly population of Odisha, India. Methods The data for this study was collected as a part of our AHSETS study comprising of 725 older adults residing in rural Odisha, India. Multimorbidity was assessed by the MAQ PC tool while Hwalek-Sengstock elder abuse screening test (HS-EAST) was used to assess the risk of elder abuse. Functional dependence was measured by the Lawton IADL questionnaire. We used ordinal logistic regression models to identify the correlates of elder abuse and test for mediation by functional dependence. Results Around 48.8 % (95 % CI:45.13–52.53 %) older adults had multimorbidity while 33.8 % (95 % CI:30.35–37.35 %) had some form of dependence. Out of 725, 56.6 % (CI 52.85–60.19 %) were found to be at low-risk elder abuse and 15.9 % (CI 13.27–18.72 %) being at high-risk. The prevalence of higher risk of elder abuse was greater among females, non-literates, widowed persons, those not currently working and those belonging to lower socio-economic strata. The risk of elder abuse was significantly associated with multimorbidity (AOR = 1.68; 95 %CI: 1.11–2.57) and functional dependence (AOR = 2.08; 95 %CI: 1.41–3.06). Additionally, we found a partial mediation mechanism of functional dependency between the pathway of multimorbidity and elder abuse. Conclusions Elder abuse and multimorbidity are emerging as issues of significant concern among rural elderly in Odisha, India. Multimorbidity and functional dependence are associated with significantly higher odds of elder abuse among rural older adults. Further, we report the role of functional dependence as a partial mediator between multimorbidity and elder abuse. Therefore, potential interventions on reducing the economic, physical and care dependence among multimorbid patients may reduce the risk of elder abuse.

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Socio-economic disparity in the occurrence of disability among older adults in six low and middle income countries

International Journal of Human Rights in Healthcare ◽

10.1108/ijhrh-05-2018-0034 ◽

2019 ◽

Vol 12 (1) ◽

pp. 60-75 ◽

Cited By ~ 1

Author(s):

Mohammad Hifz Ur Rahman ◽

Ashish Singh

Keyword(s):

South Africa ◽

Older Adults ◽

Economic Status ◽

Bivariate Analysis ◽

Partial Credit Model ◽

Adult Health ◽

Middle Income ◽

Content Type ◽

Middle Income Countries ◽

The World

PurposeNearly 200m people in the world experience considerable functioning difficulties. Also, more than three-fourth of the population aged 50 years and over is suffering from some kind of disability in India, China, Ghana, Russia, Mexico and South Africa. Despite the compelling nature of this issue, evidence on socioeconomic disparity in the occurrence of disability is lacking throughout the world and particularly in the aforementioned countries. The purpose of this paper is twofold – first, to examine the socioeconomic inequalities in the prevalence of disability in the selected countries; and second, to investigate the cross-country differentials in the prevalence of disability by socioeconomic characteristics.Design/methodology/approachThe authors use data from the Study on Global Ageing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia and South Africa during 2007–2010. Disability scores have been constructed using Item Response Theory Partial Credit Model based on eight health and functioning domains. Bivariate analysis, concentration curves, concentration indices and multivariate regressions have been used in the analysis presented in this paper.FindingsThe authors find that the prevalence of disability varied considerably across sociodemographic groups. Moreover, this variation is not uniform across all countries. Also, age, Sex, work status, years of schooling and economic status emerged out as significant predictors of disability among the studied countries.Originality/valueThis is perhaps the first study which examines the socioeconomic inequality in disability conceptualized in a comprehensive manner among older adults spread across low to upper middle income countries. The alarming level of prevalence of disability among sociodemographic disadvantage groups calls for immediate attention in terms of detailed study of risk factors, effective policy and timely intervention.

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Meeting Physical Activity Guidelines by Walking in Older Adults From Three Middle-Income Countries: A Cross-Sectional Analysis From the International Mobility in Aging Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2018-0463 ◽

2020 ◽

Vol 28 (3) ◽

pp. 333-342 ◽

Cited By ~ 2

Author(s):

Chevelle M.A. Davis ◽

Tetine L. Sentell ◽

Juliana Fernandes de Souza Barbosa ◽

Alban Ylli ◽

Carmen-Lucia Curcio ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Ecological Model ◽

Study Data ◽

International Mobility ◽

Cross Sectional ◽

Middle Income ◽

Logistic Regression Models ◽

Middle Income Countries ◽

Aging Study

Physical activity (PA) among older adults is understudied in middle-income countries. The authors examined the associations of factors across levels of the social ecological model (individual, interpersonal, organizational, and community) with older adults meeting guidelines of 150 min of moderate- to vigorous-intensity PA per week through walking in three middle-income countries: Albania (n = 387), Colombia (n = 404), and Brazil (n = 402). Using 2012 International Mobility in Aging Study data, multivariate logistic regression models identified the following significant associations with meeting PA guidelines through walking (a) individual level: depression (odds ratio [OR] = 0.62, 95% confidence interval, CI [0.45, 0.86]), being female (OR = 0.74, 95% CI [0.56, 0.998]), and high relative education (OR = 1.79, 95% CI [1.33, 2.41]) and (b) interpersonal level: high life partner (OR = 1.38, 95% CI [1.04, 1.83]) and friend social ties (OR = 1.39, 95% CI [1.05, 1.83]). While individual and interpersonal variables were associated with meeting PA guidelines, community-level social and environmental variables were not.

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Association of objective and subjective far vision impairment with perceived stress among older adults in six low- and middle-income countries

Eye ◽

10.1038/s41433-021-01634-7 ◽

2021 ◽

Author(s):

Louis Jacob ◽

Karel Kostev ◽

Lee Smith ◽

Guillermo F. López-Sánchez ◽

Shahina Pardhan ◽

...

Keyword(s):

Older Adults ◽

Perceived Stress ◽

Vision Impairment ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Sarcopenia and fall-related injury among older adults in five low- and middle-income countries

Experimental Gerontology ◽

10.1016/j.exger.2021.111262 ◽

2021 ◽

Vol 147 ◽

pp. 111262

Author(s):

Nicola Veronese ◽

Lee Smith ◽

Mario Barbagallo ◽

Lin Yang ◽

Liye Zou ◽

...

Keyword(s):

Older Adults ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Nutrients ◽

10.3390/nu13031038 ◽

2021 ◽

Vol 13 (3) ◽

pp. 1038

Author(s):

Ana Carolina B. Leme ◽

Sophia Hou ◽

Regina Mara Fisberg ◽

Mauro Fisberg ◽

Jess Haines

Keyword(s):

English Language ◽

Economic Status ◽

High Income ◽

Dietary Guidelines ◽

Systemic Review ◽

Healthy Children ◽

Future Health ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

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Childlessness, Individual Socioeconomic Resources, and Health: Exploring Variation in 20 Countries

Innovation in Aging ◽

10.1093/geroni/igaa057.1664 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 515-516

Author(s):

Nekehia Quashie ◽

Christine Mair ◽

Radoslaw Antczak ◽

Bruno Arpino

Keyword(s):

Older Adults ◽

Health Outcomes ◽

Health Indicators ◽

Data Repository ◽

Middle Income ◽

Individual Level ◽

Socioeconomic Resources ◽

Middle Income Countries ◽

Using Data ◽

The Impact

Abstract Childless older adults may be at risk for poorer health cross-nationally, yet most studies on this topic analyze only a small number of countries and only 1 or 2 health outcomes. To our knowledge, two papers exist that explore associations between childlessness and multiple indicators of health using data from a large number of regionally diverse countries (e.g., 20 countries from North America, Asia, and Europe), but neither study includes an examination of socioeconomic resources. The level of health risk faced by childless older adults is likely to be distinctly shaped by older adults’ socioeconomic resources (e.g., education, income, wealth). Associations between childlessness, socioeconomic resources, and health may also differ by country context. Using harmonized, cross-national data for adults aged 50 and older across 20 high- and middle-income countries (United States (HRS), European Union (SHARE), Mexico (MHAS), and China (CHARLS) from the Gateway to Global Aging data repository), we explore if and how individual-level socioeconomic resources (income, education, wealth) moderate associations between childlessness and five health indicators (self-rated health, ADL limitations, IADL limitations, chronic conditions, and depression). Results suggest that associations between childlessness and health outcomes vary by individual socioeconomic resources in some country contexts, but not in others. We discuss these findings in light of the impact of individual-level socioeconomic resources on older adults’ support options and health outcomes cross-nationally.

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Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126271 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6271

Author(s):

Yee Mang Chan ◽

Norhafizah Sahril ◽

Ying Ying Chan ◽

Nor’ Ain Ab Wahab ◽

Norliza Shamsuddin ◽

...

Keyword(s):

Older Adults ◽

Gender Differences ◽

Activities Of Daily Living ◽

Hearing Impairment ◽

Daily Living ◽

Hearing Impairments ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Adl Disability

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults’ level of independence.

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