Multimorbidity patterns in old adults and their associated multi-layered factors: a cross-sectional study

Abstract Background Influenced by various factors such as socio-demographic characteristics, behavioral lifestyles and socio-cultural environment, the multimorbidity patterns in old adults remain complex. This study aims to identify their characteristics and associated multi-layered factors based on health ecological model. Methods In 2019, we surveyed a total of 7480 participants aged 60+ by using a multi-stage random cluster sampling method in Shanxi province, China. Latent class analysis was used to discriminate the multimorbidity patterns in old adults, and hierarchical regression was performed to determine the multi-layered factors associated with their various multimorbidity patterns. Results The prevalence of multimorbidity was 34.70% among the old patients with chronic disease. Over half (60.59%) of the patients with multimorbidity had two co-existing chronic diseases. “Degenerative/digestive diseases”, “metabolic diseases” and “cardiovascular diseases” were three specific multimorbidity patterns. Behavioral lifestyles-layered factors had the most explanatory power for the three patterns, whose proportions of explanatory power were 54.00, 43.90 and 48.15% individually. But the contributions of other multi-layered factors were different in different patterns; balanced diet, medication adherence, the size of family and friendship network, and different types of basic medical insurance might have the opposite effect on the three multimorbidity patterns (p < 0.05). Conclusions In management of old patients with multimorbidity, we should prioritize both the “lifestyle change”-centered systematic management strategy and group-customized intervention programs.

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Predictors of Polypharmacy Among Elderly Patients in China: The Role of Decision Involvement, Depression, and Taking Chinese Medicine Behavior

Frontiers in Pharmacology ◽

10.3389/fphar.2021.745688 ◽

2021 ◽

Vol 12 ◽

Author(s):

Chaoyi Chen ◽

Zhanchun Feng ◽

Qian Fu ◽

Jia Wang ◽

Zehao Zheng ◽

...

Keyword(s):

Logistic Regression ◽

Chinese Medicine ◽

Chronic Diseases ◽

Inappropriate Prescribing ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Prescription Data ◽

Cross Sectional ◽

Old Patients ◽

Important Challenge

Introduction: The prevalence of polypharmacy is gradually increasing in geriatrics, which may contribute to adverse effects, such as potential drug–drug and drug–disease interactions. These side effects remain an important challenge in patient safety, which has a significant impact on mortality and incidence rate.Aims: Therefore, this study aims to understand the epidemiology of polypharmacy and identify factors that have an impact on the management of potentially inappropriate prescribing.Methods: This study is a cross-sectional study, analyzing the prescription data from 720 hospitalized patients aged 50+ with a random cluster sampling method. We used inverse probability treatment weighting (IPTW) method to group and match polypharmacy and non-polypharmacy patients, and logistic regression was conducted to explore the factors associated with polypharmacy.Results: The prevalence of polypharmacy accounted for 50.14% among the old patients in this study. Female patients (67.34%) have more polypharmacy than male patients, and key predictors associated with polypharmacy in the logistic regression model included the following: domicile (AOR = 0.63, 95% CI 0.42–0.95), annual income (AOR = 0.38, 95% CI 0.20–0.70), the number of chronic diseases (AOR = 3.68, 95% CI 2.69–5.06), taking Chinese medicine (AOR = 1.70, 95% CI 1.22–2.36), decision involvement (AOR = 1.49 95% CI 1.10–2.03), and depression (AOR = 1.42, 95% CI 1.03–1.96).Conclusion: Polypharmacy is common among the participants with chronic diseases in Hubei province, China. The study emphasizes that gerontology practitioners should be prudent in applying clinical guidelines to provide personalized, comprehensive assessment of decision making of prescriptions, especially in socioeconomically deprived areas.

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The associations of physical activity and the risk of CVD among Chinese population: a cross-sectional study

10.21203/rs.3.rs-100857/v1 ◽

2020 ◽

Author(s):

Chong Chen ◽

Shurong Lu ◽

Ganling Ding ◽

Jiaqi Wang ◽

Yu Qin ◽

...

Keyword(s):

Physical Activity ◽

Leisure Time ◽

Latent Class ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Latent Classes ◽

Chinese Adults ◽

Cross Sectional ◽

Framingham Risk ◽

The Relationship

Abstract Background: Previous studies in Western suggest the association between physical activity (PA) and cardiovascular diseases (CVD). However, limited evidence is available among Chinese adults. Objective: To evaluate the relationship between PA and the risk of CVD among Chinese adults.Methods: A total of 3568 adults were recruited from seven counties and districts in Jiangsu Province of China using a stratified multistage cluster sampling method. Information of PA, anthropometric measurements and laboratory indices were collected according to standard protocols. Three latent classes of PA were identified using the latent class analysis (LCA) method, and the risk of CVD in the next 10-year was calculated by the Framingham risk score (FRS).Results: Three latent classes of PA were identified: CLASS1 represented participants with high occupational and low sedentary PA (32.1% of male, 26.5% of female), ClASS2 consistently engaged in low occupational and high leisure-time PA (27.0% of male, 14.2% of female). CLASS3 had low leisure-time and high sedentary PA (40.9% of male, 59.3% of female). The FRS in male were higher than that in female across three Latent Classes. CLASS1 (OR=0.694, 95%CI: 0.553-0.869) and CLASS2 (OR=0.748, 95%CI: 0.573 -0.976) were both the protective factors for CVD in males, however, such association was not observed among females.Conclusion: Higher occupational or leisure-time PA were associated with decreased risk of CVD, whilst more sedentary behaviour may increase the risk of CVD among Chinese adults.

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The Effect of Foetal And Early Childhood Growth on Metabolic Derangements of Sri Lankan Children

10.21203/rs.3.rs-42415/v1 ◽

2020 ◽

Author(s):

Vithanage Pujitha Wickramasinghe ◽

C. Arambepola

Keyword(s):

Early Childhood ◽

Metabolic Diseases ◽

Sampling Technique ◽

Postnatal Growth ◽

Cross Sectional Study ◽

Metabolic Parameters ◽

Cluster Sampling ◽

Cross Sectional ◽

Prenatal Growth ◽

Age Category

Abstract Background Studies have shown that accelerated postnatal growth plays a significant role on the onset of adult metabolic diseases. The aim of this study was to identify the effects of intrauterine and later growth on metabolic derangements among children in Colombo, Sri Lanka Materials: A school-based cross-sectional study was conducted among 5–15 year old children selected using a two-stage probability-proportionate-to-size cluster sampling technique. Birthweight (BW) was extracted from records to denote prenatal growth; and body mass index (BMI) and fat mass (FM) measured to denote the current growth of children. As metabolic parameters, fasting and random blood glucose, lipid profile and blood pressure (BP) were measured. The sample was stratified by age (5–10 years and 11–15 years); and each age group further categorized into tertiles of BW and BMI. Based on these two parameters, metabolic parameters were evaluated within each age category. Results The sample comprised 833 (494 boys). Metabolic parameters did not significantly differ by sex or across BW tertiles of each BMI tertile. However, significant increases were noted in all except FBS across the BMI tertiles of each BW tertile. Children belonging to the lowest BW and highest BMI tertiles had worst metabolic profiles, while those in the lowest BW as well as BMI tertile were protected. Changes were more significant in the older age category. Irrespective of BW, fat deposition rather than nutritional growth seemed to move children to higher BMI tertiles. Conclusion Poor prenatal growth is not the sole risk factor for abnormal metabolic profile found in childhood. Those who gain weight during early childhood are at higher risk than those who remain small. This favours the accelerated postnatal growth hypothesis.

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Faculty Opinions recommendation of Identification of three hidradenitis suppurativa phenotypes: latent class analysis of a cross-sectional study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725107476.793501401 ◽

2014 ◽

Author(s):

Iltefat Hamzavi ◽

Melissa Williams

Keyword(s):

Latent Class Analysis ◽

Hidradenitis Suppurativa ◽

Latent Class ◽

Cross Sectional Study ◽

Class Analysis ◽

Sectional Study ◽

Cross Sectional

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Non-compliance to Mass Drug Administration Associated with the Low Perception of the Community Members About their Susceptibility to Lymphatic Filariasis in Ankobra, Ghana

Infectious Disorders - Drug Targets ◽

10.2174/1871526519666190206210808 ◽

2020 ◽

Vol 20 (2) ◽

pp. 167-174

Author(s):

Ilo Dicko ◽

Yaya Ibrahim Coulibaly ◽

Modibo Sangaré ◽

Bismark Sarfo ◽

Priscillia Awo Nortey

Keyword(s):

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Health Workers ◽

Compliance Rate ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Cross Sectional ◽

Improve Compliance ◽

Degree Of Association

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.

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Portuguese Patient Dignity Question: A cross-sectional study of palliative patients cared for in primary care

Palliative & Supportive Care ◽

10.1017/s1478951520000164 ◽

2020 ◽

Vol 18 (6) ◽

pp. 658-661

Author(s):

Mafalda Lemos Caldas ◽

Miguel Julião ◽

Ana João Santos ◽

Harvey Max Chochinov

Keyword(s):

Primary Care ◽

Health Care Providers ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Clinical Tool ◽

Cross Sectional ◽

Old Patients ◽

Promising Tool ◽

Palliative Patients

AbstractIntroductionThe Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness.ObjectiveTo study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC).MethodA cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed.ResultsTwenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary.Significance of resultsThe PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.

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Association of Health Literacy with the Implementation of Exercise during the Declaration of COVID-19 State of Emergency among Japanese Community-Dwelling Old-Old Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042100 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2100

Author(s):

Daijo Shiratsuchi ◽

Hyuma Makizako ◽

Yuki Nakai ◽

Yoshiaki Taniguchi ◽

Tomomi Akanuma ◽

...

Keyword(s):

Health Literacy ◽

Mail Survey ◽

Good Health ◽

Cross Sectional Study ◽

Exercise Group ◽

Community Dwelling ◽

Multivariate Logistic Regression Model ◽

Cross Sectional ◽

State Of Emergency ◽

Old Adults

Health literacy is important for promoting and maintaining good health in old-old adults. It may influence the implementation of exercise in the coronavirus disease epidemic. The present cross-sectional study investigated the association of each dimension of health literacy with the implementation of exercise during the declaration of a state of emergency due to coronavirus disease in community-dwelling old-old adults. We collected data from 483 community-dwelling old-old adults (52.8% women) aged between 77 and 99 years who participated in a mail survey. Participants were divided into exercise or nonexercise groups based on the implementation of exercise during the declaration of a state of emergency. Health literacy was assessed using a 14-item health literacy scale. There were 327 (67.7%) participants in the exercise group and 156 (32.3%) in the nonexercise group. A significantly higher score of health literacy was observed in the exercise group than in the nonexercise group (communicative health literacy score = 14.0 ± 3.6 vs. 12.7 ± 3.8, p = 0.001). In a multivariate logistic regression model adjusted for potential confounders, high communicative health literacy scores were significantly associated with the implementation of exercise during the declaration of a state of emergency (odds ratio = 1.88, 95% confidence interval = 1.20–2.93). Approximately two-thirds of community-dwelling old-old adults implement exercise during the declaration of a state of emergency. High communicative health literacy was associated with the implementation of exercise during this period.

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Falls among the elderly: risk factors in a population-based study

Revista Brasileira de Epidemiologia ◽

10.1590/1809-4503201400030011 ◽

2014 ◽

Vol 17 (3) ◽

pp. 705-718 ◽

Cited By ~ 9

Author(s):

Iara Guimarães Rodrigues ◽

Gustavo Pereira Fraga ◽

Marilisa Berti de Azevedo Barros

Keyword(s):

The Elderly ◽

Population Based ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Elderly Adults ◽

Cross Sectional ◽

Population Based Study ◽

Factors Associated ◽

Gender And Age ◽

Policies And Programs

Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008). Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR) were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI) 1.47 - 3.87), elderly adults (80 years old and older) (PR = 2.50; 95%CI 1.61 - 3.88), widowed (PR = 1.74; 95%CI 1.04 - 2.89) and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48), osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49), asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74), headache (PR = 1.59; 95%CI 1.07 - 2.38), mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64), dizziness (PR = 2.82; 95%CI 1.98 - 4.02), insomnia (PR = 1.75; 95%CI 1.16 - 2.65), use of multiple medications (five or more) (PR = 2.50; 95%CI 1.12 - 5.56) and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93). Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

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Nutritional Status and Anthropometric Indices in High School Girls in Ilam, West Iran

Scientifica ◽

10.1155/2016/4275148 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Fatemeh Jamalikandazi ◽

Elham Ranjbar ◽

Eskandar Gholami-Parizad ◽

Zeinab Ghazanfari ◽

Seyed-Ali Mostafavi

Keyword(s):

High School ◽

Nutritional Status ◽

Human Growth ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Anthropometric Indices ◽

Cross Sectional ◽

Dietary Recall ◽

High School Girls ◽

School Girls

Background. Adolescence is one of the most challenging periods for human growth and nutritional status. The aim of this study was to assess the nutritional status and anthropometric indices in high school girls in Ilam.Methods. This cross-sectional study was performed on 360 domestic high school girl students chosen randomly by cluster sampling. Data were gathered through interviews performed by a dietitian to fill 24-hour dietary recall and food frequency and demographic questionnaires. Then we performed the anthropometric measurements and we compared the results with CDC2000 standards. We analyzed our data by N4 food analyzer and SPSS16 software.Results. The prevalence of obesity and overweight was 5% and 10.8%, respectively. Simultaneously, the prevalence of underweight was 20.2%. The prevalence of stunting was 5.8%. We also showed that 50% of high school girls in Ilam suffered from severe food insecurity, 14.7% suffered from mild insecurity, and 4.7% get extra energy from foods. Food analysis showed that micronutrients such as zinc, iron, calcium, folate, fiber, magnesium, and vitamin B12 were less than what is recommended by the RDA.Conclusion. Undernutrition and overnutrition are completely prevalent among girls studied in Ilam. This needs further acts and investigations in the field and more nutritional and health educations.

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Knowledge and attitude about tobacco use among school personnel in Bangalore South-a Cross Sectional Study.

RGUHS Journal of Dental Sciences ◽

10.26715/rjds.11_1_5 ◽

2019 ◽

Vol 11 (1) ◽

pp. 14-20

Author(s):

Dr. Padma K Bhat ◽

Dr. Sushma S G ◽

Dr. Jayachandra M Y

Keyword(s):

Tobacco Use ◽

School Personnel ◽

Cross Sectional Study ◽

Second Hand Smoke ◽

Cluster Sampling ◽

Sectional Study ◽

Cross Sectional ◽

Significance Level ◽

Knowledge And Attitude ◽

The Government

Background: Tobacco use is so addictive among youth and is one of the global epidemics which require constant monitoring and timely appropriate action to prevent usage. School personnel play one of the main roles in taking appropriate action. Aim: To assess knowledge and attitude of tobacco use pattern among school personnel in Bangalore city. Material and Methods: A cross sectional study was carried out for a period of six months from May to October 2017. Stratified cluster sampling was done to include the government and English medium schools in Bangalore south. All the school personnel in the selected schools were eligible to participate. The data collection tool was GSPS questionnaire (WHO FCTC Tobacco Control). Chi-square test and Fisher’s Exact Test was used to demonstrate cross tabulation with confidence intervals. Significance level of 0.05 was considered for statistical analyses Results : Majority of both Kannada and English medium school personnel did not use any forms of tobacco. Both the English and Kannada medium school personnel were aware of the addictive effect of tobacco, but majority of the Kannada medium personnel said second hand smoke is not harmful as compared to their counterparts. Conclusion: Tobacco use among school personnel was low. Most of the school personnel were informed about the addictive nature of tobacco.

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