scholarly journals Simple scoring algorithm to identify community-dwelling older adults with limited health literacy: a cross-sectional study in Taiwan

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e045411
Author(s):  
Wen-Hsuan Hou ◽  
Ken N Kuo ◽  
Mu-Jean Chen ◽  
Yao-Mao Chang ◽  
Han-Wei Tsai ◽  
...  

ObjectiveHealth literacy (HL) is the degree of individuals’ capacity to access, understand, appraise and apply health information and services required to make appropriate health decisions. This study aimed to establish a predictive algorithm for identifying community-dwelling older adults with a high risk of limited HL.DesignA cross-sectional study.SettingFour communities in northern, central and southern Taiwan.ParticipantsA total of 648 older adults were included. Moreover, 85% of the core data set was used to generate the prediction model for the scoring algorithm, and 15% was used to test the fitness of the model.Primary and secondary outcome measuresPearson’s χ2 test and multiple logistic regression were used to identify the significant factors associated with the HL level. An optimal cut-off point for the scoring algorithm was identified on the basis of the maximum sensitivity and specificity.ResultsA total of 350 (54.6%) patients were classified as having limited HL. We identified 24 variables that could significantly differentiate between sufficient and limited HL. Eight factors that could significantly predict limited HL were identified as follows: a socioenvironmental determinant (ie, dominant spoken dialect), a health service use factor (ie, having family doctors), a health cost factor (ie, self-paid vaccination), a heath behaviour factor (ie, searching online health information), two health outcomes (ie, difficulty in performing activities of daily living and requiring assistance while visiting doctors), a participation factor (ie, attending health classes) and an empowerment factor (ie, self-management during illness). The scoring algorithm yielded an area under the curve of 0.71, and an optimal cut-off value of 5 represented moderate sensitivity (62.0%) and satisfactory specificity (76.2%).ConclusionThis simple scoring algorithm can efficiently and effectively identify community-dwelling older adults with a high risk of limited HL.

Author(s):  
Takafumi Abe ◽  
Kenta Okuyama ◽  
Tsuyoshi Hamano ◽  
Miwako Takeda ◽  
Masayuki Yamasaki ◽  
...  

Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01–1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Resshaya Roobini Murukesu ◽  
Devinder Kaur Ajit Singh ◽  
Noor Izyani Mokhtar ◽  
Janet Bong May Ing ◽  
Ponnusamy Subramaniam ◽  
...  

Abstract Introduction The presence of either frailty or cognitive impairment have been determined as precursors of falls among older adults. However, the association between falls and cognitive frailty has yet to be established. Objective To investigate the association between falls and cognitive frailty among community dwelling older adults. Methods A total of 246 Malaysian community dwelling older adults aged 60 years and above residing in the state of Selangor participated in this cross-sectional study. Sociodemographic details and clinical characteristics including the history of falls were obtained via interview. The presence of cognitive frailty was identified using the Clinical Dementia Rating Scale and Fried Frailty Index. Data analysis was carried out via binary logistic regression. Results The prevalence of falls and cognitive frailty in this study were 21.2% and 21.9% respectively among community dwelling older adults (mean age 72.39±5.40). No significant relationship between falls and cognitive frailty [OR:1.187, 95% C.I: 0.493-2.856, p=0.702] was demonstrated. However, older women [OR:2.663, 95% C.I, 1.136-6.239, p=0.024] and the presence of multi-morbidities [OR: 1.431, 95% C.I, 1.026-1.997, p=0.035] were significantly associated with falls which corroborates with existing literature. Conclusion Cognitive frailty was not a significant risk factor of falls among community dwelling older adults in this study. Further research is required in prospective, longitudinal, population-based studies to confirm this result.


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