scholarly journals Social isolation and health outcomes among older people in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yun Zhang ◽  
Wen Hu ◽  
Zhixin Feng
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Older People ◽  
Health Outcomes ◽  
Activities Of Daily Living ◽  
Social Isolation ◽  
Daily Living ◽  
Functional Health ◽  
Social Contacts ◽  
Living Children

Abstract Background Social isolation is a serious public health issue affecting a significant number of older adults worldwide. However, associations between different dimensions of social isolation and functional health are unclear. We assessed the varied effects of social isolation on health among a nationwide sample of older adults from China. Methods We assessed social isolation among 5,419 people aged 65 and older who took part in both the 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Social isolation includes objective social isolation (kinlessness and lack of social contacts) and subjective social isolation. Four functional health outcomes were examined: self-rated health (SRH), activities of daily living (ADLs), instrumental activities of daily living (IADLs), and cognitive function measured by the Mini-Mental State Examination (MMSE). We used multivariable regression analyses to examine the associations between social isolation and health outcomes. Results Older people who never married or who had recently lost a spouse were more likely to report poor SRH (OR=2.44) and difficulty with IADLs (ORs=1.46) than those who were married and lived with a spouse. Older people who never gave birth were less likely to report cognitive impairment (OR=0.53) than those who had living children, while older people who had recently lost a child were more likely to report poor SRH than those who had living children (OR=1.32). Older people who had no children visiting were more likely to report difficulty with IADLs than those who had children visiting (OR=1.25). In terms of subjective social isolation, older people who felt lonely were more likely to report poor SRH, cognitive impairment, and difficulty with ADLs and IADLs (ORs=1.19, 1.27, 1.28 and 1.21, respectively), and older people who had no one to talk to were more likely to report poor SRH, cognitive decline, and difficulty with ADLs and IADLs (ORs=2.08, 5.32, 2.06 and 1.98, respectively). Conclusions Kinlessness, lack of social contacts and subjective social isolation may impact various dimensions of health in older people. Due to the varied health consequences of social isolation, targeted health interventions should be developed to address relevant situations of social isolation.

scholarly journals Short-Term and Long-Term Effects of Social Isolation on Health Outcomes among Older People in China

2021 ◽  
Author(s):  
Yun Zhang ◽  
Zhixin Feng
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Health Outcomes ◽  
Activities Of Daily Living ◽  
Health Effects ◽  
Social Isolation ◽  
Daily Living ◽  
Long Term Effects ◽  
Short Term

Abstract Background Social isolation and loneliness are serious public health risks affecting a significant number of older adults globally. However, it is uncertain whether their health effects are short-term or long-term, which impedes the developing of more effective and precising interventions. We therefore assessed the varied health effects of short-term and long-term exposure of social isolation and loneliness among a nationwide sample of older adults from China. Methods We assessed social isolation and loneliness in 6,066 men and women aged 65 and older who took part in both 2011 and 2014 waves of Chinese Longitudinal Healthy Longevity Survey. Social isolation was assessed in terms of absence of key family members, including spouse, children or siblings, and a deficiency in participating in social activities. Loneliness was administered by using a questionnaire. Four health outcomes were investigated: self-rated health, activities of daily living (ADLs), Instrumental activities of daily living (IADLs), and cognitive function measured by Mini-Mental State Examination (MMSE). We used different tests and multivariate regression analyses to examine the short-term (< 3 years) and long-term (>= 3 years) effects of social isolation and loneliness on health outcomes.Results After controlling for covariates of demographic, socioeconomic, lifestyle, and baseline health factors, in the short-term effects, there are significant associations found between absence of children and poor SRH and cognitive impairment (ORs=1.53 and 9.87); absence of siblings and poor SRH, cognitive impairment, and difficulty with ADLs and IADLs (ORs=1.29, 1.35, 1.26 and 1.22 respectively); loneliness and poor SRH and difficulties with IADLs (ORs=1.92 and 1.55). While, in the long-term effects, absence of siblings is marginally significantly associated with cognitive impairment (OR=1.21), but significant associations are found between deficiency in participating in social activities and poor SRH, difficulty with ADLs and IADLs (ORs=1.33, 1.55 and 1.69, respectively); loneliness and poor SRH, difficulty with IADLs and less difficulties in ADLs (ORs=2.96, 2.45 and 0.32, respectively).Conclusions The results of this study show that social isolation at family level mainly have short-term effects, while social isolation at societal level have mainly have long-term, and loneliness has both short-term and long-term effects on older people’s health outcomes.

scholarly journals Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Psychological Health ◽  
Daily Living ◽  
Basic Needs ◽  
Well Being ◽  
Asset Ownership ◽  
Increased Risk

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.

scholarly journals Activities of Daily Living and Categorization Skills of Elderly with Cognitive Deficit: A Preliminary Study

2021 ◽  
Vol 11 (2) ◽  
pp. 213
Author(s):  
Dulce Romero-Ayuso ◽  
Cristian Cuerda ◽  
Carmen Morales ◽  
Ricardo Tesoriero ◽  
José Matías Triviño-Juárez ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Deductive Reasoning ◽  
Personal Autonomy ◽  
Assessment Process ◽  
Digital Version ◽  
Routine Tasks

Cognitive dysfunction affects the performance of Activities of Daily Living (ADL) and the quality of life of people with these deficits and their caregivers. To the knowledge of the authors, to date, there are few studies that focus on knowing the relationship between personal autonomy and deductive reasoning and/or categorization skills, which are necessary for the performance of the ADL. The aim of this study was to explore the relationships between ADL and categorization skills in older people. The study included 51 participants: 31 patients with cognitive impairment and 20 without cognitive impairment. Two tests were administered to assess cognitive functions: (1) the Montreal Cognitive Assessment (MoCA); and (2) the digital version of Riska Object Classification test (ROC-d). In addition, the Routine Tasks Inventory-2 (RTI-2) was applied to determine the level of independence in activities of daily living. People with cognitive impairment performed poorly in categorization tasks with unstructured information (p = 0.006). Also, the results found a high correlation between cognitive functioning and the performance of ADLs (Physical ADL: r = 0.798; p < 0.001; Instrumental ADL: r = 0.740; p < 0.001), a moderate correlation between Physical ADLs and categorization skills (unstructured ROC-d: r = 0.547; p < 0.001; structured ROC-d: r = 0.586; p < 0.001) and Instrumental ADLs and categorization skills in older people (unstructured ROC-d: r = 0.510; p < 0.001; structured ROC-d: r = 0.463; p < 0.001). The ROC-d allows the assessment of categorization skills to be quick and easy, facilitating the assessment process by OT, as well as the accuracy of the data obtained.

scholarly journals Tracking personalized functional health in older adults using geriatric assessments

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anup K. Mishra ◽  
Marjorie Skubic ◽  
Mihail Popescu ◽  
Kari Lane ◽  
Marilyn Rantz ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Case Studies ◽  
Daily Living ◽  
Short Form ◽  
Depression Scale ◽  
Functional Health ◽  
Adverse Health ◽  
Health Trajectories ◽  
Model Predictions

Abstract Background Higher levels of functional health in older adults leads to higher quality of life and improves the ability to age-in-place. Tracking functional health objectively could help clinicians to make decisions for interventions in case of health deterioration. Even though several geriatric assessments capture several aspects of functional health, there is limited research in longitudinally tracking personalized functional health of older adults using a combination of these assessments. Methods We used geriatric assessment data collected from 150 older adults to develop and validate a functional health prediction model based on risks associated with falls, hospitalizations, emergency visits, and death. We used mixed effects logistic regression to construct the model. The geriatric assessments included were Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Short Form 12 (SF12). Construct validators such as fall risks associated with model predictions, and case studies with functional health trajectories were used to validate the model. Results The model is shown to separate samples with and without adverse health event outcomes with an area under the receiver operating characteristic curve (AUC) of > 0.85. The model could predict emergency visit or hospitalization with an AUC of 0.72 (95% CI 0.65–0.79), fall with an AUC of 0.86 (95% CI 0.83–0.89), fall with hospitalization with an AUC of 0.89 (95% CI 0.85–0.92), and mortality with an AUC of 0.93 (95% CI 0.88–0.97). Multiple comparisons of means using Turkey HSD test show that model prediction means for samples with no adverse health events versus samples with fall, hospitalization, and death were statistically significant (p < 0.001). Case studies for individual residents using predicted functional health trajectories show that changes in model predictions over time correspond to critical health changes in older adults. Conclusions The personalized functional health tracking may provide clinicians with a longitudinal view of overall functional health in older adults to help address the early detection of deterioration trends and decide appropriate interventions. It can also help older adults and family members take proactive steps to improve functional health.

scholarly journals Neuropsychological and Functional Impact of COVID-19 on Mild Cognitive Impairment

2020 ◽  
Vol 35 ◽  
pp. 153331752096087
Author(s):  
Kalpana P. Padala ◽  
Christopher M. Parkes ◽  
Prasad R. Padala
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Case Report ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Older Adult ◽  
Daily Living ◽  
Functional Decline ◽  
Depression And Anxiety ◽  
Physically Active

We present a case report to showcase that behavioral, cognitive, and functional decline may be associated with COVID-19 stay-home guidance among older adults with pre-existent cognitive impairment. In a functionally independent and physically active older adult with Mild Cognitive Impairment, there was worsening in depression and anxiety symptoms associated with the restrictions of COVID-19. Functional decline was also noted as assessed by Instrumental Activities of Daily Living. We discuss solutions to mitigate the effects of COVID-19 restrictions in this vulnerable population.

scholarly journals Two-year course of cognitive function and instrumental activities of daily living in older adults with bipolar disorder: evidence for neuroprogression?

2012 ◽  
Vol 43 (4) ◽  
pp. 801-811 ◽  
Author(s):  
A. G. Gildengers ◽  
D. Chisholm ◽  
M. A. Butters ◽  
S. J. Anderson ◽  
A. Begley ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Activities Of Daily Living ◽  
Cognitive Aging ◽  
Repeated Measures ◽  
Daily Living ◽  
Time Points ◽  
Instrumental Activities

BackgroundWhile bipolar disorder (BD) is a leading cause of disability, and an important contributor to disability in BD is cognitive impairment, there is little systematic research on the longitudinal course of cognitive function and instrumental activities of daily living (IADLs) in late-life. In this report, we characterize the 2-year course of cognitive function and IADLs in older adults with BD.MethodWe recruited non-demented individuals 50 years and older with BD I or BD II (n = 47) from out-patient clinics or treatment studies at the University of Pittsburgh. Comparator subjects (‘controls’) were 22 individuals of comparable age and education with no psychiatric or neurologic history, but similar levels of cardiovascular disease. We assessed cognitive function and IADLs at baseline, 1- and 2-year time-points. The neuropsychological evaluation comprised 21 well-established and validated tests assessing multiple cognitive domains. We assessed IADLs using a criterion-referenced, performance-based instrument. We employed repeated-measures mixed-effects linear models to examine trajectory of cognitive function. We employed non-parametric tests for analysis of IADLs.ResultsThe BD group displayed worse cognitive function in all domains and worse IADL performance than the comparator group at baseline and over follow-up. Global cognitive function and IADLs were correlated at all time-points. The BD group did not exhibit accelerated cognitive decline over 2 years.ConclusionsOver 2 years, cognitive impairment and associated functional disability of older adults with BD appear to be due to long-standing neuroprogressive processes compounded by normal cognitive aging rather than accelerated cognitive loss in old age.

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