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

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.

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

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.

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

2021 ◽  
Author(s):  
Jaya Singh Kshatri ◽  
Trilochan Bhoi ◽  
Shakti Ranjan Barik ◽  
Subrata Ku 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

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.

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

2020 ◽  
Vol 28 (3) ◽  
pp. 333-342 ◽  
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.

Depression in the Developing World

2017 ◽  
Author(s):  
Harry Minas
Keyword(s):  
Mental Health ◽  
International Development ◽  
Social Services ◽  
Development Programs ◽  
Middle Income ◽  
Health And Social Services ◽  
Middle Income Countries ◽  
Culturally Informed ◽  
Global Understanding

This chapter provides an overview of what is known about prevalence, social determinants, treatment, and course and impact of depression in developing, or low- and middle-income, countries. The importance of culture in depression and in the construction and application of diagnostic classifications and in health and social services is highlighted, with a particular focus on the applicability of ‘Western’ diagnostic constructs and service systems in developing country settings. The role of international organizations, such as WHO, and international development programs, such as the SDGs, in improving our understanding of depression and in developing effective and culturally appropriate responses is briefly examined. There is both a need and increasing opportunities in developing countries for greater commitment to mental health of populations, increased investment in mental health and social services, and culturally informed research that will contribute to improved global understanding of mental disorders in general and depression in particular.

Health research capacity in Nepal: Analysis of the trend and the role of local researchers

2021 ◽  
pp. 004947552098277
Author(s):  
Madhu Kharel ◽  
Alpha Pokharel ◽  
Krishna P Sapkota ◽  
Prasant V Shahi ◽  
Pratisha Shakya ◽  
...  
Keyword(s):  
Health Research ◽  
Fold Increase ◽  
Research Capacity ◽  
Rapid Review ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Evidence Based Decision Making

Evidence-based decision-making is less common in low- and middle-income countries where the research capacity remains low. Nepal, a lower-middle-income country in Asia, is not an exception. We conducted a rapid review to identify the trend of health research in Nepal and found more than seven-fold increase in the number of published health-related articles between 2000 and 2018. The proportion of articles with Nepalese researchers as the first authors has also risen over the years, though they are still only in two-thirds of the articles in 2018.

scholarly journals Peripheral Inotropes in Critically Ill Children: Is It Safe?

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110222
Author(s):  
Ravi K. Mooli ◽  
Kalaimaran Sadasivam
Keyword(s):  
Central Venous Access ◽  
Pediatric Intensive Care ◽  
Venous Access ◽  
Critically Ill Children ◽  
Middle Income ◽  
Central Lines ◽  
Middle Income Countries ◽  
Peripheral Venous Access ◽  
Vasoactive Medications

Many children needing pediatric intensive care units care require inotropes, which are started peripherally prior to securing a central venous access. However, many hospitals in low- and middle-income countries (LMIC) may not have access to central lines and the vasoactive medications are frequently given through a peripheral venous access. Aim: The aim of our study was to describe the role of peripheral vasoactive inotropes in children. Methods: Children requiring peripheral vasoactive medications were included in this study. We retrospectively collected data at 2 time points on use and complications of peripheral vasoactive medications. Results: Eighty-four children (51 pre-COVID era and 33 COVID pandemic) received peripheral vasoactive medications. Only 3% of children (3/84) developed extravasation injury, all of whom recovered completely. Conclusions: Results from our study suggest that extravasation injury due to peripheral inotrope infusion is very low (3%) and it may be safely administered in children at a diluted concentration.

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

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

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

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.

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

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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