scholarly journals Pathways to Pain and Disability: the Impact of Early Social Deprivation and Educational Attainment in Newly Diagnosed Osteoarthritis Patients

2021 ◽  
Author(s):  
Afroditi Kouraki ◽  
Tobias Bast ◽  
Eamonn Ferguson ◽  
Ana M. Valdes
Keyword(s):  
Cognitive Function ◽  
Educational Attainment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Social Deprivation ◽  
Dynamic Relationship ◽  
Negative Effect ◽  
Disease Stages ◽  
The Impact ◽  
First Time

Abstract BackgroundLinks between pain and cognitive function on one hand and pain and anxiety on the other have already been shown in other studies and there is biological evidence linking osteoarthritis to educational attainment. However, the inter-play of these factors and the role of key social (social deprivation) factors at the early disease stages are not understood. Therefore, we tested how social deprivation, education and anxiety, before diagnosis, affects the cognition, pain and independence (activities of daily living) relationship longitudinally after diagnosis of osteoarthritis. MethodsUsing data from waves 4, 5, 6 and 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 1,240), we examined the impact of social deprivation, education and anxiety on the dynamic relationship between cognitive function, pain and instrumental activities of daily living (IADL) in a subsample of respondents reporting a diagnosis of osteoarthritis at wave 6, with cross-lagged panel models.ResultsSocial deprivation before diagnosis predicted poorer cognitive function and higher pain levels after diagnosis, and further predicted impairments in IALD at wave 7 through its negative effect on cognitive function at wave 6. Education before diagnosis was protective against impairments in daily living after diagnosis via better cognitive function and lower anxiety at wave 5.ConclusionWe show for the first time that social deprivation, before osteoarthritis diagnosis, predicts functional impairment in daily living, after diagnosis with this effect partly mediated by impaired cognitive function. We also show for the first time that, education before diagnosis was protective against impairments in daily living after diagnosis via better cognitive function and lower anxiety before diagnosis. Therefore, improving cognitive function and managing anxiety may dampen the impact of social deprivation and low educational attainment on poor health and help to promote independence in patients with osteoarthritis.

scholarly journals Pathways To Pain And Disability: The Impact of Early Social Deprivation And Educational Attainment In Newly Diagnosed Osteoarthritis Patients

2021 ◽  
Author(s):  
Afroditi Kouraki ◽  
Tobias Bast ◽  
Eamonn Ferguson ◽  
Ana Valdes
Keyword(s):  
Cognitive Function ◽  
Educational Attainment ◽  
Daily Living ◽  
Independent Living ◽  
Social Deprivation ◽  
Negative Impact ◽  
Using Data ◽  
Disease Stages ◽  
The Impact

Abstract Previous research established links between pain and cognitive function on one hand and pain and anxiety on the other, and there is some evidence linking osteoarthritis to lower educational attainment. However, the inter-play of these factors and the role of key social factors (social deprivation) at the early disease stages are not understood. Using data from waves 4, 5, 6 and 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 1,240), we tested how social deprivation, education and anxiety, before diagnosis, affects the relationship between cognitive function, pain and independence (activities of daily living) in a subsample of respondents reporting a diagnosis of osteoarthritis at wave 6, with cross-lagged panel models. We show that social deprivation, before osteoarthritis diagnosis, predicts functional impairment in daily living after diagnosis, with this effect partly mediated by impaired cognitive function, and that education before diagnosis is protective against impairments in daily living after diagnosis via better cognitive function and lower anxiety at wave 5. Therefore, improving cognitive function and managing anxiety may mitigate the negative impact of social deprivation and low educational attainment on independent living and help to promote independence in patients with osteoarthritis.

scholarly journals Multimorbidity, Disadvantage, and Trends in Disability-Free Life Expectancy: The CFAS Studies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 641-641
Author(s):  
Andrew Kingston ◽  
Holly Bennett ◽  
Louise Robinson ◽  
Lynne Corner ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Life Expectancy ◽  
Longitudinal Data ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Health Conditions ◽  
Disadvantaged Groups ◽  
Disability Free Life Expectancy ◽  
Reported Health

Abstract The combined contribution of multi-morbidity and socio-economic position (SEP) to trends in disability free life expectancy (DFLE) is unknown. We use longitudinal data from the Cognitive Function and Ageing Studies (CFAS I: 1991; CFAS II: 2011), with two year follow up. Disability was defined as difficulty in activities of daily living, and SEP as area-level deprivation. Multi-morbidity was constructed from nine self-reported health conditions and categorised as 0-1, 2-3, 4+ diseases. In 1991 and 2011, shorter total and disability-free years were associated with greater multi-morbidity. Between 1991 and 2011, gains in life expectancy and DFLE were observed at all levels of multi-morbidity, the greatest gain in DFLE being 4 years for men with 0-1 diseases. As multi-morbidity is more prevalent in more disadvantaged groups, further analyses will investigate whether SEP differences remain at all levels of multi-morbidity.

scholarly journals Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044416
Author(s):  
Tan Van Nguyen ◽  
Huyen Thanh Dang ◽  
Mason Jenner Burns ◽  
Hiep HH Dao ◽  
Tu Ngoc Nguyen
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Tertiary Hospital ◽  
Logistic Regression Models ◽  
Hospitalised Patients ◽  
Patients With Heart Failure ◽  
The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

Effect of education on migration decisions in Ghana: a rural-urban perspective

2016 ◽  
Vol 43 (2) ◽  
pp. 336-356 ◽  
Author(s):  
Franklin Amuakwa-Mensah ◽  
Louis Boakye-Yiadom ◽  
William Baah-Boateng
Keyword(s):  
Educational Attainment ◽  
Rural Areas ◽  
Migration Decision ◽  
Skilled Workers ◽  
Mixed Effect ◽  
Content Type ◽  
Rural And Urban ◽  
Migration Decisions ◽  
Negative Effect ◽  
The Impact

Purpose – The purpose of this paper is to investigate the effect of education on migration decisions focusing on rural and urban in-migrants by comparing the 2005/2006 and 2012/2013 rounds of the Ghana Living Standards Survey (GLSS5 and GLSS6). After correcting for selectivity bias, the authors observed that anticipated welfare gain and socio-economic variables such as sector of employment, sex, experience, age, educational level and marital status significantly affect an individual’s migration decision. Design/methodology/approach – The authors made use of Sjaastad’s (1962) human capital framework as a basis for examining the impact of education on migration. The migration decision equation was based on the Heckman two stage procedure. Findings – While educational attainment is observed to have a positive effect on migration decision in the period 2005/2006, the authors find a negative effect of educational attainment on migration decision in the period 2012/2013. The effect of educational attainment on migration decision in 2005/2006 for urban in-migrant is higher than the effect for rural in-migrant, with its significance varying for the different stages of educational attainment. In absolute terms, whereas the effect of secondary educational attainment on migration decisions for urban in-migrant is higher than that of rural in-migrant, the reverse holds for higher educational attainment during the period 2012/2013. Social implications – Based on the mixed effect of education on migration decision as evident from the study, policies to enhance the educational system in Ghana should be complemented with job creations in the entire country. Moreover, special attention should be given to the rural sector in such a way that the jobs to be created in the sector do not require skilled workers. With quality education and job creation, the welfare of individuals living in urban and rural areas will be enhanced. Originality/value – In spite of the importance of education in migration decisions, there is scanty literature on the rural-urban dimension. To the best of the author’s knowledge there is no literature in the Ghanaian context which examines the rural and urban perspective of the impact of education on migration with a much recent data. Further, the author consider how the determinants of migration decision have changed over time focusing on rural and urban perspectives.

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