Factors Associated with Nonattendance to a Geriatric Clinic among Mexican Older Adults

Introduction: Outpatient appointment nonattendance (NA) represents a public health problem, increasing the risk of unfavorable health-related outcomes. Although NA is significant among older adults, little is known regarding its correlates. This study aimed to identify the correlates (including several domains from the geriatric assessment) of single and repeated NA episodes in a geriatric medicine outpatient clinic, in general and in the context of specific comorbidities. Methods: This is a cross-sectional study including data from 3,034 older adults aged ≥60 years with ≥1 scheduled appointments between January 1, 2016, and December 31, 2016. Appointment characteristics as well as sociodemographic, geographical, and environmental information were obtained. Univariate and multivariate multinomial regression analyses were carried out. Results: The mean age was 81.8 years (SD 7.19). Over a third (37.4%) of participants missed one scheduled appointment, and 14.4% missed ≥2. Participants with a history of stroke (OR 1.336, p = 0.041) and those with a greater number of scheduled appointments during the study time frame (OR 1.182, p < 0.001) were more likely to miss one appointment, while those with Parkinson’s disease (OR 0.346, p < 0.001), other pulmonary diseases (OR 0.686, p = 0.008), and better functioning for activities of daily living (ADL) (OR 0.883, p < 0.001) were less likely to do so. High socioeconomic level (OR 2.235, p < 0.001), not having a partner (OR 1.410, p = 0.006), a history of fractures (OR 1.492, p = 0.031), and a greater number of scheduled appointments (OR 1.668, p < 0.001) increased the risk of repeated NA, while osteoarthritis (OR 0.599, p = 0.001) and hypertension (OR 0.680, p = 0.002) decreased it. In specific comorbidity populations (hypertension, type 2 diabetes mellitus, and cancer), better ADL functioning protected from a single NA, while better mobility functioning protected from repeated NA in older patients with hypertension and cancer. Discussion/Conclusion: Identifying geriatric factors linked to an increased probability of NA may allow one to anticipate its likelihood and lead to the design and implementation of preventive strategies and to an optimization of the use of available health resources. The impact of these factors on adherence to clinical visits requires further investigation.

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Sex differences in impact of sarcopenia on falls in community-dwelling Korean older adults

BMC Geriatrics ◽

10.1186/s12877-021-02688-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yunsoo Soh ◽

Chang Won Won

Keyword(s):

Older Adults ◽

Sex Differences ◽

Diagnostic Algorithm ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

Adjusted Model ◽

The Impact

Abstract Background Falls are one of the most serious health problems among older adults. Sarcopenia is characterized by a decrease in muscle mass, strength, and physical function. Due to potentially age-related conditions, both falls and sarcopenia have common risk factors. However, the association between sarcopenia and falls is controversial. Moreover, the sex differences in the impact of sarcopenia on falls is not yet clear. This study aimed to investigate the sex differences in the impact of sarcopenia, defined by the Asian Working Group for Sarcopenia (AWGS), on falls in Korean older adults. Methods In this cross-sectional study, we used data from the Korean Frailty and Aging Cohort Study; 2323 community-dwelling older adults (1111 males and 1212 females) aged 70–84 years were recruited in this cross-sectional study. To evaluate sarcopenia, the AWGS diagnostic algorithm was used. We compared the faller and non-faller groups. We performed unadjusted and fully adjusted logistic regression analyses to evaluate the relationship between sarcopenia, falls, and fall-related fractures. Results A total of 239 (24.1%) females in the faller group had a history of falls in the past year, which was statistically higher than that in males (176, 15.8%). In the fully adjusted model, handgrip strength (odds ratio [OR] = 1.508, 95% confidence interval [CI] = 1.028–2.211), and short physical performance battery (OR = 2.068, 95% CI = 1.308–3.271) were significantly lower in the male faller group. However, in the fully adjusted model, the female faller group only showed a significantly low appendicular skeletal muscle mass index (OR = 1.419, 95% CI = 1.058–1.903). Conclusions This large cohort study aimed to identify the sex differences in the incidence of sarcopenia in the older Korean population, using the AWGS diagnostic algorithm, and its correlation with falls and fall-related fractures. The incidence of falls did not increase in the sarcopenia group. Among the sarcopenia components, sex differences affect the history of falls. Therefore, when studying the risk of falls in old age, sex differences should be considered.

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Impact of COVID-19 Home Confinement in Children’s Refractive Errors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105347 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5347

Author(s):

Cristina Alvarez-Peregrina ◽

Clara Martinez-Perez ◽

Cesar Villa-Collar ◽

Cristina Andreu-Vázquez ◽

Alicia Ruiz-Pomeda ◽

...

Keyword(s):

Public Health Problem ◽

Cross Sectional Study ◽

World Population ◽

Sectional Study ◽

Cross Sectional ◽

School Aged Children ◽

Digital Devices ◽

Visual Screening ◽

Near Work ◽

The Impact

Background: Myopia is a public health problem, with estimations that 50% of the world population will be myopic by 2050. Some environmental factors, such as time spent outdoors, doing near work, and using digital devices, influence the development of myopia in children. Home confinement in Spain has increased these risk factors, so this study aims to investigate the impact of home confinement during the COVID-19 outbreak in the vision of school-aged children; Methods: A cross-sectional study in children between 5 and 7 years old that completed a visual screening and a questionnaire about their lifestyles at opticians in Spain in September and October of 2019 and 2020. Statistical analysis to compare lifestyles pre and post confinement, and vision in 2020 versus a similar cohort examined at the same opticians in 2019, was conducted; Results: Spanish children spent less time outdoors and more time doing near work in 2020 than in 2019 (p ≤ 0.001). There was a significant decrease of the spherical equivalent (mean ± standard deviation; 0.66 ± 2.03 D in 2019 vs. 0.48 ± 1.81 D in 2020; p ≤ 0.001); Conclusions: Lifestyles of Spanish children changed during the home confinement at the beginning of 2020. Together with changes in their lifestyles, spherical equivalents have decreased, which implies higher figures of myopia for children aged between 5 and 7.

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Assessing the Impact of a Hilly Environment on Depressive Symptoms among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094520 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4520

Author(s):

Takafumi Abe ◽

Kenta Okuyama ◽

Tsuyoshi Hamano ◽

Miwako Takeda ◽

Masayuki Yamasaki ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Depression Scale ◽

Cross Sectional Study ◽

Community Dwelling ◽

Rural Setting ◽

Sectional Study ◽

Cross Sectional ◽

The Impact ◽

Community Dwelling Older Adults

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.

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Reliability of HOME FAST BRAZIL—Self-Reported Version for Community-Dwelling Older Adults

Frontiers in Public Health ◽

10.3389/fpubh.2021.713202 ◽

2021 ◽

Vol 9 ◽

Author(s):

Karina Stella Aoki Ferreira ◽

Tamires Terezinha Gallo da Silva ◽

Jarbas Melo Filho ◽

Natacha Verônica Bazanella ◽

Audrin Said Vojciechowski ◽

...

Keyword(s):

Older Adults ◽

Cross Sectional Study ◽

Environmental Risks ◽

Community Dwelling ◽

Cross Sectional ◽

Rater Reliability ◽

Risk Of Falls ◽

History Of ◽

Spearman Test ◽

Community Dwelling Older Adults

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL—Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults.Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL—Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC > 0.70 as adequate. To test the correlations, the Spearman test was used.Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL—Self-reported version was ICC 0.83 (IC95%, 0.70–0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74–0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls.Conclusions: The HOME FAST BRAZIL—Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.

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Factors influencing Fear of Falling in Community-Dwelling Older Adults in Singapore: A Cross-Sectional Study

10.21203/rs.3.rs-963330/v1 ◽

2021 ◽

Author(s):

Jacqueline Giovanna De Roza ◽

David Wei Liang Ng ◽

Blessy Koottappal Mathew ◽

Teena Jose ◽

Ling Jia Goh ◽

...

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Cross Sectional Study ◽

Community Dwelling ◽

Clinical Factors ◽

Cross Sectional ◽

Frail Older Adults ◽

History Of ◽

The Mean ◽

Community Dwelling Older Adults

Abstract BackgroundFalls in older adults is a common problem worldwide. Fear of falling (FoF) is a consequence of falls which has far-reaching implications including activity restriction, functional decline and reduced quality of life. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. MethodsThis descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors and clinical factors including history of falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine predictors of high FoF.ResultsOut of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had three or more chronic conditions. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77 – 19.13), use of walking aids (OR = 3.67, 95% CI = 1.54 – 8.77) and increasing frailty were significant predictors for high FoF. The odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66 – 17.37), mildly frail older adults (OR =18.58, 95% CI = 4.88 – 70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86 – 1512.60).ConclusionsFoF is a prevalent and compelling issue in community-dwelling older adults, particularly those with frailty. The demographic and clinical factors identified in this study will be helpful to develop targeted and tailored interventions for FoF.

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Attitudes about Care at the End of Life among Clinicians: A Quick, Reliable, and Valid Assessment Instrument

Journal of Palliative Care ◽

10.1177/082585970001600103 ◽

2000 ◽

Vol 16 (1) ◽

pp. 6-14 ◽

Cited By ~ 33

Author(s):

Elizabeth H. Bradley ◽

Domenic V. Cicchetti ◽

Terri R. Fried ◽

David M. Rousseau ◽

Rosemary Johnson-Hurzeler ◽

...

Keyword(s):

End Of Life ◽

Geriatric Medicine ◽

Reliability And Validity ◽

General Medicine ◽

Cross Sectional Study ◽

Assessment Instrument ◽

Cross Sectional ◽

Valid Assessment ◽

Test Retest Reliability ◽

The Impact

Several initiatives to improve care at the end of life involve educational programs to influence clinicians’ attitudes about care for patients with terminal illnesses. The objective of this research was to develop and test a short and easily administered instrument for measuring physicians’ and nurses’ attitudes towards care at the end of life. The instrument was tested using a cross-sectional study of 50 clinicians (25 physicians and 25 nurses) from general medicine, cardiology, oncology, and geriatric medicine. Both reliability and validity were assessed, and the instrument was found to have acceptable test-retest reliability and construct validity. Such an assessment instrument may be useful in evaluating the impact of initiatives to modify attitudes towards terminal care and in improving the quality of care at the end of life.

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Hypertension is the underlying cause of death assessed at the autopsy of individuals

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2018006103457 ◽

2019 ◽

Vol 53 ◽

Author(s):

Juliana Chaves Coelho ◽

Renata Eloah de Lucena Ferretti-Rebustini ◽

Claudia Kimie Suemoto ◽

Renata Elaine Paraizo Leite ◽

Wilson Jacob-Filho ◽

...

Keyword(s):

Cause Of Death ◽

Public Health Problem ◽

Female Gender ◽

Cross Sectional Study ◽

Aging Brain ◽

Cross Sectional ◽

History Of ◽

Underlying Cause Of Death ◽

Definition Of ◽

Brain Study

ABSTRACT Objective: To analyze hypertension and its relationship with the causes of death identified by the autopsy. Method: Cross-sectional study analyzed 356 participants belonging to the Brazilian Aging Brain Study Group, over 50 years of age, autopsied at the Sao Paulo Autopsy Service between 2004 to 2014. A clinical interview was conducted with the informant of the deceased. Hypertension was defined by reporting the disease and/or use of antihypertensive medication, by the informant of the deceased. Descriptive analyzes and bivariate and multivariable associations were performed. Results: The prevalence of hypertension was 66.2% and it was the second leading cause of death (25.6%) identified by autopsy, preceded by atherosclerosis (37.8%). The variables associated with hypertension were: female gender (OR=2.30 (1.34-3.90)); living with partner [OR=0.55 (0.32-0.92)]; Body Mass Index [OR=1.14 (1.08-1.22)] and history of diabetes [OR=2.39 (1.34-4.27)]. Conclusion: The prevalence of hypertension was high, and it was the second most common underlying cause of death. The gold standard for the definition of cause of death, the autopsy, shows important results, which confirmed the relevance of hypertension as a public health problem.

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Understanding Driving as an Everyday Activity: International Perspectives

Innovation in Aging ◽

10.1093/geroni/igaa057.2592 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 730-730

Author(s):

Anne Dickerson ◽

Isabelle Gelinas ◽

Moon Choi

Keyword(s):

Older Adults ◽

Cross Sectional Study ◽

Crash Risk ◽

Sectional Study ◽

Fitness To Drive ◽

Cross Sectional ◽

Everyday Activity ◽

Older Adulthood ◽

International Perspectives ◽

The Impact

Abstract This international symposium brings together leading occupational therapy researchers from around the world with a shared focus is on evaluating and improving the driving performance of older adults to decrease their crash risk and facilitate their community participation. In this session, five groups of international scholars will share their collective and individual research outcomes for driving as a means of community mobility. The first presentation will outline their collective international, cross-sectional study of 247 older adults from seven countries where the impact of driving on out-of-home mobility was compared. Each presentation that follows will then present results from innovative studies of ways in which to assess and address fitness to drive in older adulthood. Our discussant will summarize the potential expansion of the current work and engage the audience through interactive questions. Transportation and Aging Interest Group Sponsored Symposium.

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A novel model to quantify balance alterations in older adults based on the center of pressure (CoP) measurements with a cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0256129 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256129

Author(s):

Ángel Gabriel Estévez-Pedraza ◽

Lorena Parra-Rodríguez ◽

Rigoberto Martínez-Méndez ◽

Otniel Portillo-Rodríguez ◽

Zoraida Ronzón-Hernández

Keyword(s):

Older Adults ◽

Fall Risk ◽

Center Of Pressure ◽

Low Cost ◽

Area Under The Curve ◽

Public Health Problem ◽

Cross Sectional Study ◽

Community Dwelling ◽

Mean Velocity ◽

Cross Sectional

Background The timely detection of fall risk or balance impairment in older adults is transcendental because, based on a reliable diagnosis, clinical actions can be taken to prevent accidents. This study presents a statistical model to estimate the fall risk from the center of pressure (CoP) data. Methods This study is a cross-sectional analysis from a cohort of community-dwelling older adults aged 60 and over living in Mexico City. CoP balance assessments were conducted in 414 older adults (72.2% females) with a mean age of 70.23 ± 6.68, using a modified and previously validated Wii Balance Board (MWBB) platform. From this information, 78 CoP indexes were calculated and analyzed. Multiple logistic regression models were fitted in order to estimate the relationship between balance alteration and the CoP indexes and other covariables. Results The CoP velocity index in the Antero-Posterior direction with open eyes (MVELAPOE) had the best value of area under the curve (AUC) to identify a balance alteration (0.714), and in the adjusted model, AUC was increased to 0.827. Older adults with their mean velocity higher than 14.24 mm/s had more risk of presenting a balance alteration than those below this value (OR (Odd Ratio) = 2.94, p<0.001, 95% C.I.(Confidence Interval) 1.68–5.15). Individuals with increased age and BMI were more likely to present a balance alteration (OR 1.17, p<0.001, 95% C.I. 1.12–1.23; OR 1.17, p<0.001, 95% C.I. 1.10–1.25). Contrary to what is reported in the literature, sex was not associated with presenting a balance alteration (p = 0.441, 95% C.I. 0.70–2.27). Significance The proposed model had a discriminatory capacity higher than those estimated by similar means and resources to this research and was implemented in an embedded standalone system which is low-cost, portable, and easy-to-use, ideal for non-laboratory environments. The authors recommend using this technology to support and complement the clinical tools to attend to the serious public health problem represented by falls in older adults.

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Mass Drug Distribution Strategy Efficacy for Schistosomiasis Control in Mali (West Africa)

10.21203/rs.3.rs-480049/v1 ◽

2021 ◽

Author(s):

Abdoulaye Dabo ◽

Mouctar Diallo ◽

Privat Koba Agniwo ◽

Salim Danté ◽

Assitan Traoré ◽

...

Keyword(s):

Schistosoma Haematobium ◽

Drug Distribution ◽

Public Health Problem ◽

Cross Sectional Study ◽

Major Public Health Problem ◽

Cross Sectional ◽

Transmission Cycle ◽

Heavy Infection ◽

Girls School ◽

The Impact

Abstract Background - Schistosomiasis is a water-based parasitic disease caused by blood flukes of the genus Schistosoma. Mass Drug Distribution (MDD) with Praziquantel is periodically recommended in schistosomiasis-endemic countries to prevent morbidity. In Mali, schistosomiasis still remains endemic, especially in Senegal and Niger rivers basin, although the strategy has been adopted since 2005. Our study aimed to assess the impact of annual school-based MDD. Materials and methods – The study was conducted at twelve sentinel sites across Kayes and Koulikoro regions. A cross-sectional study design was performed in April 2018 after four-or five-years post treatment with praziquantel (PZQ) depending on the statute of sites. At baseline (2014-2015) and for the control year (2018), 734 (386 boys and 347 girls) and 1708 (844 boys and 864 girls) school children of 7-14 years of age, were successfully examined respectively. Infections with Schistosoma haematobium and S. mansoni were diagnosed with the urine filtration and the Kato-Katz method respectively. Results – From eight schools treated in 2014, the four annual rounds of MDD with PZQ were associated with a significant decrease in S. haematobium prevalence in five sites (p<0,001) and a significant increase in one site (p<0,001). Of them, the prevalence of high-intensity (≥50 eggs/10mL of urine) significantly decreased in four previous sites but not in Diakalele where it increased ((p<0.001). In all the four sites treated in 2015, S. haematobium prevalence increased significantly in Kokoun and Samaya (P<0.05). The heavy infection increased slightly in Dougourakoro and Samaya (P>0.05). The prevalence of S. mansoni significantly decreased in three sites (p<0.001), increased in three and remains zero in the six others sites. Conclusion – Our findings show that five of the twelve sentinel sites have achieved the criterion of elimination of schistosomiasis due to Schistosoma haematobium as a major public health problem (Prevalence of heavy infection <1%); three have achieved the criterion of morbidity control (Prevalence of heavy infection <5%), whereas two sites remain confined below the control criterion. These results call for a strong improvement in the therapeutic coverage associating, education and provision of safe water, sanitation and hygiene to interrupt the transmission cycle of the schistosome.

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