scholarly journals Reduced Risk of Hospitalization With Stronger Community Belonging Among Aging Canadians Living With Diabetes: Findings From Linked Survey and Administrative Data

2021 ◽  
Vol 9 ◽  
Author(s):  
Neeru Gupta ◽  
Zihao Sheng

Background: Social isolation has been identified as a substantial health concern in aging populations, associated with adverse chronic disease outcomes and health inequalities; however, little is known about the interconnections between social capital, diabetes management, and hospital burdens. This study aimed to assess the role of community belonging with the risk of potentially avoidable hospitalization among aging adults living with diabetes in Canada.Methods: The study leveraged a novel resource available through Statistics Canada's Social Data Linkage Environment: the Canadian Community Health Survey linked to administrative health records from the hospital Discharge Abstract Database. A population-representative sample of 13,580 community-dwelling adults aged 45 and over with diabetes was identified. Multiple logistic regression was used to assess the association of individuals' sense of community belonging with the risk of diabetes-related hospitalization over the period 2006–2012.Results: Most (69.9%) adults with diabetes reported a strong sense of belonging to their local community. Those who reported weak community belonging were significantly more likely to have been hospitalized for diabetes (χ2 = 13.82; p < 0.05). The association between weak community attachment and increased risk of diabetes hospitalization remained significant [adjusted OR: 1.80 (95%CI: 1.12–2.90)] after controlling for age, education, and other sociodemographic and behavioral factors.Conclusion: The COVID-19 pandemic has resurfaced attention to the need to better address social capital and diabetes care in public health strategies. While the causal pathways are unclear, this national study highlighted that deficits in social attachments may place adults with diabetes at greater risk of acute complications leading to hospitalization.

2019 ◽  
Vol 73 (5) ◽  
pp. 451-454 ◽  
Author(s):  
Sarianna Ilmaniemi ◽  
Heidi Taipale ◽  
Antti Tanskanen ◽  
Jari Tiihonen ◽  
Sirpa Hartikainen ◽  
...  

BackgroundInjuries caused by falling are a major health concern among older population. For older people, falls are the leading cause of head injuries; especially, persons with cognitive disorders have an increased risk of falling.ObjectiveTo compare the incidence of head injury and traumatic brain injury (TBI) among persons with Alzheimer’s disease (AD) with persons without AD.MethodsThis register-based study was conducted on a nationwide cohort, which includes all community-dwelling persons diagnosed with AD in Finland in 2005–2011. Persons with previous head injuries were excluded, leaving 67 172 persons with AD. For each person with AD, a matching person without AD and previous head injury were identified with respect to age, sex and university hospital district. The Cox proportional hazard model and competing risk analyses were used to estimate HR for head injury and TBI.ResultsPersons with AD had 1.34-fold (95% CI 1.29 to 1.40) risk of head injuries and 1.49-fold (95% CI 1.40 to 1.59) risk of TBIs after accounting for competing risks of death and full adjustment by socioeconomic status, drug use and comorbidities.ConclusionPersons with AD are more likely to have a head injury or TBI incident than persons without AD.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252208
Author(s):  
Liqun Wang ◽  
Jiangping Li ◽  
Zhizhong Wang ◽  
Yong Du ◽  
Ting Sun ◽  
...  

Background Studies have found that social capital (SC) is associated with the risk of cognitive decline; however, the mechanism explaining how SC leads to cognitive decline is unclear. The current study examines the mediation effect of sleep duration on the relationship between SC and cognitive decline in Chinese older adults. Methods A cross-sectional study of 955 community-dwelling aged 60 or over was conducted. The mini-mental state examination (MMSE), self-report sleep duration questionnaire, and social capital scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model. Results After controlling for covariates, both social cohesion and social interaction were positively correlated with the MMSE score (p<0.001), and social cohesion was negatively correlated with sleep duration (p = 0.009); On the contrary, sleep duration was negatively correlated with MMSE score (p<0.001). Linear regression analysis showed social cohesion was positively associated with the MMSE score (β = 0.16, p = 0.005), while sleep duration was associated with an increased risk of cognitive decline (β = -0.72, p<0.001). Sleep duration has mediated the relationship between social cohesion and cognitive decline (explaining 21.7% of the total variance). Conclusions Social capital negatively associated with the risk of cognitive decline in this Chinese population, and sleep duration may partly explain this relationship. It may be a suggestive clue to identify those at a higher risk of progressing to cognitive impairment. Further prospective study in need to confirm this finding due to the cross-sectional design.


2020 ◽  
Vol 20 (S1) ◽  
Author(s):  
Sabine Britting ◽  
◽  
Rada Artzi-Medvedik ◽  
Paolo Fabbietti ◽  
Lisanne Tap ◽  
...  

Abstract Background Reduced kidney function has become a major public health concern, especially among older people, as Chronic Kidney Disease (CKD) is associated with increased risk of end stage renal disease and mortality. Falls are a serious negative health outcome in older persons with one third of people aged 65 years experiencing a fall per year and increasing fall rates with increasing age. The impact of CKD on falls in older community-dwelling persons is not well investigated. Additionally, lower urinary tract symptoms (LUTS) may also increase the risk of falls. Therefore, our aim was to investigate the impact of CKD and LUTS on falls as well as on injurious falls. Methods The SCOPE study is an observational, multinational, multicenter, prospective cohort study involving community-dwelling older persons aged 75 years and more recruited from August 2016 to March 2018 in seven European countries. The main outcomes of the present study were any falls and any injurious falls during the 12 months before enrolment. The cross-sectional association of estimated glomerular filtration rate (eGFR) and LUTS with study outcomes was investigated by logistic regression analysis adjusted for baseline characteristics of enrolled subjects. Results Our series consisted of 2256 SCOPE participants (median age = 79.5 years, 55.7% female). Of them, 746 participants experienced a fall and 484 reported an injurious fall in the 12 months prior to baseline assessment. CKD was not significantly associated with falls (OR = 0.95, 95%CI = 0.79–1.14 for eGFR< 60; OR = 1.02, 95%CI = 0.81–1.28 for eGFR< 45; OR = 1.08, 95%CI = 0.74–1.57 for eGFR< 30) or injurious falls (OR = 0.91, 95%CI = 0.67–1.24 for eGFR< 60; OR = 0.93, 95%CI = 0.63–1.37 for eGFR< 45; OR = 1.19, 95%CI = 0.62–2.29 for eGFR< 30). LUTS were found significantly associated with both falls (OR = 1.56, 95%CI = 1.29–1.89) and injurious falls (OR = 1.58, 95%CI = 1.14–2.19), and such associations were confirmed in all multivariable models. Conclusions Cross-sectional data suggest that CKD may not be associated with history of falls or injurious falls, whereas LUTS is significantly associated with the outcomes. Trial registration This study was registered on 25th February 2016 at clinicaltrials.gov (NCT02691546).


2021 ◽  
Vol 2 ◽  
Author(s):  
Andrea Marjorie Stennett ◽  
Lorraine H. De Souza ◽  
Meriel Norris

People with multiple sclerosis (MS) report lower physical activity levels and are at a risk of becoming sedentary. As such, they are at an increased risk of developing secondary health conditions associated with inactivity. This is of major public health concern. Attempts to improve the physical activity levels in people with MS remain a challenge for health professionals. One key reason might be the lack of understanding about the meanings people with MS ascribe to exercise and physical activity. This paper draws on the key findings of a three-phased interconnected mixed methods sequential explanatory study to examine the meanings of exercise and physical activity from the perspectives of people with MS and health professionals. Phase 1 used a four-round Delphi questionnaire to scope and determine the consensus of priorities for exercise and physical activity and the reasons why people with MS (N = 101) engaged in these activities. Phase 2 used face-to-face semistructured interviews of people with MS (N = 16) to explore the meanings ascribed to exercise and physical activity. Phase 3 explored the perceptions of physiotherapists (N = 14) about exercise and physical activity using three focus groups. Using the International Classification of Functioning, Disability, and Health as a theoretical framework to underpin this study, the authors discuss the key factors, for example, emphasis on the contextual factors, that drive decision making around exercise and physical activity participation in people with MS and explore the clinical implications to health professionals.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 453-454
Author(s):  
Anna Robertson ◽  
Katherine Johanson ◽  
Allison Walden ◽  
Rebecca Ingram ◽  
Lauren Schneider ◽  
...  

Abstract Type 2 diabetes mellitus (T2DM) is a major public health concern requiring engagement with specific self-care activities for improvement. Due to the increased risk for neuropathy, foot ulcers, and infections, engagement with certain footcare practices (e.g., inspecting feet and inside shoes, washing and drying between toes) is an important part of overall diabetes self-care. However, interventions targeting blood glucose monitoring, medication management, nutrition, and/or physical activity often precede footcare interventions. Question-Behavior Effects (QBEs), which describe the effects of behavior questioning on future engagement in that behavior, provide a unique framework for studying diabetes self-care. Although clinicians may not administer footcare interventions for people with T2DM, footcare behaviors are often still assessed (e.g., through questionnaires) in session and, consistent with QBEs, may improve through the repetition of questioning. The present study evaluated footcare QBEs (specifically, the number of days of foot inspection and cleaning in the past week) across 7 sessions of an at-home diabetes management program without intentional footcare intervention. Paired-samples t-tests (N = 78, ages 40-88 years) revealed significant improvements in the number of days of foot inspection and cleaning from intake to session 1 and intake to session 5. However, from intake to session 7, only significant improvements in foot inspection were detected. These findings reflect the potency of footcare QBEs in the absence of specific footcare interventions. They also reveal differential engagement in foot inspection and cleaning after an extended period of questioning, suggesting certain diabetes self-care behaviors may taper without the intentional introduction of intervention.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S760-S760
Author(s):  
XinQi Dong ◽  
Melissa Simon

Abstract Elder mistreatment (EM) is increasingly recognized as a global health concern. Among U.S. minority and immigrant populations, the social contexts and psychological consequences associated with EM remain poorly understood. Further population-based epidemiological studies using standard EM measures are required to advance the field. To address this gap and to challenge prior assumptions regarding Asian populations, this purpose of this symposium is to improve our understanding of EM epidemiology in an older minority population. Data were drawn from the Population-based Study of Chinese Elderly in Chicago (PINE), a longitudinal, representative, population-based study of 3,157 community-dwelling Chinese older adults in the greater Chicago area. Session 1 will examine the transmission between child mistreatment, intimate partner violence, and EM. Session 2 will take a typology approach to capture the multifaceted family relationships, and will further examine which family typologies were associated with greater likelihood of EM, while which typologies were protective against EM. Session 3 will explore the positive and negative aspects of social support from spouse, family, and friends in relationship to EM subtypes, including psychological, physical, financial and sexual mistreatment, and caregiver neglect. Session 4 will examine the relationship between broad, moderate, and strict definitions of EM and likelihood of experiencing anxiety. Last, Session 5 will explore the differential relationships between EM subtypes and depressive symptoms. In summation, this symposium challenges popular conceptions of the “model minority myth” and aims to increase the practical and clinical relevance of EM epidemiology in community, research, healthcare, and policy settings.


Author(s):  
Kazuya Nogi ◽  
Haruhiko Imamura ◽  
Keiko Asakura ◽  
Yuji Nishiwaki

Previous studies have shown both positive and non-positive associations between social capital and health. However, longitudinal evidence examining its comprehensive effects on well-being is still limited. This study examined whether structural social capital in the local community was related to the later well-being of Japanese people aged 40 or above. A 3.6-year longitudinal study was conducted in a rural Japanese town. “Well-being” was measured using three indicators (happiness, self-rated health, and depressive symptoms), and those who were high in well-being in the baseline 2015 survey and responded to the follow-up 2018 survey were analyzed (n = 1032 for happiness, 938 for self-rated health, and 471 for depressive symptoms). Multilevel Poisson regression analysis adjusted for covariates showed that having contact with fewer neighbors was associated with a decline in happiness at both the community level (adjusted relative risk = 1.64, 95% confidence interval = 1.20–1.63) and the individual level (adjusted relative risk = 1.51, 95% confidence interval = 1.05–2.17), but participation in local community activities was not. The results suggest that dense personal networks might be more important in areas with thriving local community activities, not only for individuals but also for all community members.


2021 ◽  
pp. 155982762110024
Author(s):  
Alyssa M. Vela ◽  
Brooke Palmer ◽  
Virginia Gil-Rivas ◽  
Fary Cachelin

Rates of type 2 diabetes mellitus continue to rise around the world, largely due to lifestyle factors such as poor diet, overeating, and lack of physical activity. Diet and eating is often the most challenging aspect of management and, when disordered, has been associated with increased risk for diabetes-related complications. Thus, there is a clear need for accessible and evidence-based interventions that address the complex lifestyle behaviors that influence diabetes management. The current study sought to assess the efficacy and acceptability of a pilot lifestyle intervention for women with type 2 diabetes and disordered eating. The intervention followed a cognitive behavioral therapy guided-self-help (CBTgsh) model and included several pillars of lifestyle medicine, including: diet, exercise, stress, and relationships. Ten women completed the 12-week intervention that provided social support, encouraged physical activity, and addressed eating behaviors and cognitions. Results indicate the lifestyle intervention was a feasible treatment for disordered eating behaviors among women with type 2 diabetes and was also associated with improved diabetes-related quality of life. The intervention was also acceptable to participants who reported satisfaction with the program. The current CBTgsh lifestyle intervention is a promising treatment option to reduce disordered eating and improve diabetes management.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura Leuenberger ◽  
Erik Lehman ◽  
Jennifer McCall-Hosenfeld

Abstract Background Almost one-half of U.S. women will experience intimate partner violence (IPV), defined as physical, sexual, or psychological harm by a current or former partner. IPV is associated with an increased risk of homicide, with firearms as the most commonly used weapon. We designed this study to better understand the correlation of interpersonal trauma exposures and demographic factors on firearm perceptions among a cohort of IPV-exposed women. Methods Two hundred sixty-seven women in central Pennsylvania with exposure to IPV were surveyed about perceptions of gun access, safety, and gun presence in the home. Trauma variables included IPV type, IPV recency, unwanted sexual exposure, and adverse childhood experiences (ACEs). Multivariable analyses examined three questions examining firearm perceptions controlling for trauma exposures and demographics. Results Ease of firearm acquisition: Women who were older (mean 44.92 years +/− SD 12.05), compared to women who were younger (40.91 +/− SD 11.81 years) were more likely to describe it as easy or very easy to acquire a gun (aOR 1.05, 95%CI 1.004, 1.10). Perceived safety in the proximity of a gun: Women with the highest ACE score were less likely to feel safe with a gun nearby (aOR 0.31, 95%CI 0.14, 0.67). Odds of guns in the home: Women who were divorced or separated (aOR 0.22, 95%CI 0.09, 0.54), women were widowed or single (aOR0.23, 95%CI 0.08, 0.67), and women who were partnered (aOR 0.45 95%CI 0.20, 0.97) had lower odds of having a gun in the home, compared to married women. There was no significant effect of the trauma variables on the odds of having a gun at home. Conclusions Women with more severe childhood trauma felt less safe around firearms, but trauma exposures did not predict the perception of gun prevalence in the local community or gun ownership. Instead, demographic factors of marriage predicted presence of a gun in the home.


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