Prevalence and Associated Factors of Falls among Older Adults between Urban and Rural Areas of Shantou City, China

Background: To investigate the prevalence of falls and associated factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions. Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical status, falls, home environment, and balance ability among 649 older adult participants. Univariate and multivariate logistic regression were used to examine the associated factors of falls. Results: The incidence of falls among older adults in Shantou City was 20.65%. Among them, the incidence was 27.27% in urban areas and 16.99% in rural areas. The rate of injury from falls among older adults was 14.48%, with18.61% in urban area and 12.20% in rural area. Multivariate analysis showed that the associated factors of falls among older adults in Shantou City included a high school or below education level (OR = 2.387, 95% CI: 1.305–4.366); non-farming as the previous occupation (OR = 2.574, 95% CI: 1.613–4.109); incontinence(OR = 2.881, 95% CI: 1.517–5.470); lack of fall prevention education (OR = 1.856, 95% CI: 1.041–3.311); and reduced balance ability (OR = 3.917, 95% CI: 2.532–6.058). Discussion: Older adults have a higher rate of falling in Shantou City, compared to the average rate in China. There are similarities and differences in the associated factors of falls among older adults between urban and rural areas of Shantou City. Targeted interventions for older adults in different regions may be more effective in reducing the risk of falls.

Download Full-text

Comparison of The Risk Factors For Falls Among Older Adults Between Urban and Rural Areas of Shantou City, China

10.21203/rs.3.rs-72830/v1 ◽

2020 ◽

Author(s):

Xiaodong Chen ◽

Zeting Lin ◽

Ran Gao ◽

Yijian Yang ◽

Liping Li

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Prevention ◽

Rural Areas ◽

Urban Areas ◽

Multivariable Analysis ◽

Living Environment ◽

Balance Function ◽

Urban And Rural Areas ◽

Risk Factors For Falls

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.

Download Full-text

Decomposing Urban-rural Differences in Multimorbidity Among Older Adults in India: A Study Based on Lasi Data

10.21203/rs.3.rs-701569/v1 ◽

2021 ◽

Author(s):

Shekhar Chauhan ◽

Shobhit Srivast ◽

Pradeep Kumar ◽

Ratna Patel

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Decomposition Analysis ◽

The Public ◽

Analysis Techniques ◽

Ageing Study ◽

Urban Rural ◽

The Difference ◽

Urban And Rural Areas

Abstract Background: Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity, however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity.Methods: The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release of the Longitudinal Ageing Study in India (LASI) wave 1 data. Descriptive, bivariate, and multivariate decomposition analysis techniques were used.Results: Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p<0.001). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively.Conclusion: There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.

Download Full-text

Association Between Happiness and Objective/Subjective Economic Status Among Older Adults in Myanmar

10.21203/rs.3.rs-122513/v1 ◽

2020 ◽

Author(s):

Yuri Sasaki ◽

Yugo Shobugawa ◽

Ikuma Nozaki ◽

Daisuke Takagi ◽

Yuiko Nagamine ◽

...

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Wealth Index ◽

Economic Indicator ◽

Sampling Procedure ◽

Household Asset ◽

Face To Face ◽

Urban And Rural Areas

Abstract BackgroundFew studies have examined whether objective or subjective economic status (ES) has a greater effect on the happiness of older adults in developing countries with ageing populations. This study examined whether objective/subjective economic status (ES) is associated with happiness in older adults in Myanmar.MethodA multistage, random sampling procedure and face-to-face interviews were conducted in urban and rural areas in Myanmar. The happiness of 1,200 participants aged 60+ was evaluated using a single happiness score of 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective economic indicator, was calculated from household asset items. Subjective economic status was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” The possible responses ranged from (1) very difficult to (5) very comfortable. ResultsThe mean happiness score was lower among participants with low objective and subjective ES than among those with medium or high objective ES (6.24 versus 6.80 points, p < 0.001) and average or higher subjective ES (5.62 versus 6.83 points, p < 0.001), respectively. Both low objective and subjective ES were negatively associated with happiness after adjusting for confounding variables (B: -0.41, 95% confidence interval [CI]: -0.69, -0.13 and B: -0.71, 95% CI: -1.00, -0.42, respectively) and stratification by region (low objective ES, urban: B: -0.52, 95% CI: -1.03, -0.02; low subjective ES, urban: B: -0.50, 95% CI: -0.96, -0.03; low objective ES, rural: B: -0.37, 95% CI: -0.73, -0.02; and low subjective ES, rural: B: -0.80, 95% CI: -1.18, -0.41). ConclusionsIn Myanmar, both objective and subjective ES might influence happiness among older adults. Although they had a similar impact on happiness in urban areas, subjective ES had a stronger impact in rural areas. Interventions for promoting happiness in older adults should consider differences in how objective/subjective ES impacts happiness in different regions, and focus should be placed not only on improving objective ES but also subjective ES in society.

Download Full-text

PREDICTION OF THE NUMBER OF AND CARE COSTS FOR DISABLED OLDER ADULTS FROM 2020 TO 2050 IN URBAN AND RURAL AREAS IN CHINA

Innovation in Aging ◽

10.1093/geroni/igz038.3117 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S847-S847

Author(s):

liangwen zhang ◽

Ya Fang

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Census Data ◽

The Elderly ◽

Severe Disabilities ◽

Term Care ◽

Total Care ◽

Urban And Rural Areas ◽

Care Costs

Abstract Disability for the elderly has become a crucial policy concerns in rapidly aging Asia counties, especially in China. This study aimed to predict the trend of the number of and care costs for disabled older adults from 2020 to 2050 in urban and rural areas in China. Population Administration Decision Information System was used to predict the population of China by urban and rural areas and age group from 2020 to 2050. Monte Carlo simulation and Policy Simulation Model were used to estimate the number and care costs of disabled elderly between urban and rural areas, based on the Chinese latest census data, statistical yearbook, and national survey database. The total disabled population rises rapidly from 43.75 million in 2020 to 91.4 million in 2050, of which 69.7% were urban adults. Compared with the values in 2020, the growth rates of the adults with mild, moderate and severe disabilities were 108%, 104% and 120% in 2050, respectively. The value were 167% and 39% in urban and rural areas, respectively. By 2050, the total care costs increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan, of which 80.2% occurs in urban areas. The predicted results indicate that the numbers and care costs for disabled older adults increase sharply from 2020 to 2050, especially in urban areas of China. It provided a series of evidence for the establishment of the long-term care insurance system in China.

Download Full-text

Fall Characteristics Among Elderly Populations in Urban and Rural Areas in Korea

10.21203/rs.3.rs-19363/v1 ◽

2020 ◽

Author(s):

Myeongkyu Kim ◽

Misoo Chang ◽

Eunwoo Nam ◽

Seul Gi Kim ◽

Sung-il Cho ◽

...

Keyword(s):

Fall Prevention ◽

Rural Areas ◽

Urban Areas ◽

Common Ground ◽

Prevention Education ◽

Significant Difference ◽

Elderly Populations ◽

External Conditions ◽

Urban And Rural Areas ◽

Recent Falls

Abstract BackgroundFalling is one of the leading causes of injury among elderly populations. As the population over 65 years old increases, medical costs due to falling will also increase. Urban and rural areas have different fall characteristics, and research into these differences is lacking.MethodsA survey was conducted on 2,012 people over 60 years old between September 1, 2015 to October 12, 2015. Guro-gu (Seoul), Yeongdeungpo-gu (Seoul), and Jung-gu (Daegu) were classified as urban areas and included 1,205 of the study participants. Dalseong-gun (Daegu) and Yangpyeong-gun (Gyeonggi-do) were categorized as rural areas and included 807 participants. Several region characteristics, including population density, were considered to distinguish between urban and rural areas. The survey included questions about fall history, cause, season and time of recent falls, and external conditions associated with recent falls, like floor or ground material and shoe types.ResultsRural respondents were older than urban respondents (p<0.001) but did not differ significantly in gender proportion (p=0.082). Fall history over the past year was not different between the two regions (p=0.693), but lifetime fall history was greater among rural respondents (p<0.001). Only 5.1% of all respondents had undergone fall-prevention education. A slippery floor was the most common cause of falls in both regions, but there was a significant difference in pattern of fall causes (p<0.001). Falls were more frequent in the summer, spring, and the afternoon in urban areas, and in the summer, autumn, and the morning in rural areas. Cement and asphalt were the most common ground materials at the time of falls in both regions, but rural respondents had higher fall rates when walking on soil and when wearing slippers.ConclusionsA fall-prevention program that reflects the characteristics and differences of falls in urban and rural areas should be developed and used to effectively prevent falling among elderly people.

Download Full-text

Ageing in a changing place: a qualitative study of neighbourhood exclusion

Ageing and Society ◽

10.1017/s0144686x1900045x ◽

2019 ◽

Vol 40 (10) ◽

pp. 2238-2256 ◽

Cited By ~ 3

Author(s):

Lena Dahlberg

Keyword(s):

Older Adults ◽

Social Exclusion ◽

Rural Areas ◽

Urban Areas ◽

Mining Industry ◽

Political Agency ◽

Active Involvement ◽

Neighbourhood Change ◽

Urban And Rural Areas ◽

High Level

AbstractAn inclusive neighbourhood is a key facilitator enabling older adults to age in place. Neighbourhoods have been identified as a dimension of social exclusion important to older adults, and it has been argued that older adults are particularly vulnerable to neighbourhood change. The aim of this study was to explore older adults’ experiences of neighbourhood exclusion within the context of neighbourhood change. Focus groups were undertaken in the urban and rural areas of a metropolitan borough in England involving a total of 41 older adults, with data analysed via thematic analysis. Urban areas in the borough studied have transformed following the closure of the mining industry, with a high level of deprivation in many areas, while some rural areas have undergone gentrification. Within the context of structural neighbourhood change, four themes were identified: community cohesion, political agency, feelings of safety and the physical environment. The themes were interlinked, which calls for collaboration across traditional lines of professional responsibility, and for research that encompasses different aspects of neighbourhood exclusion. This study contributes with knowledge on older adults’ experiences of exclusion, including novel findings on the importance of political agency and collective memory, and identifies actions to combat exclusion. An active involvement of older adults in the development of initiatives to tackle social exclusion is recommended.

Download Full-text

FALL PREVENTION IN RURAL COMMUNITIES OF NORTH DAKOTA

Innovation in Aging ◽

10.1093/geroni/igz038.3550 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S980-S980

Author(s):

Melissa L OConnor ◽

Jane Strommen ◽

Philip Estepp ◽

Megan Hay ◽

Heather Fuller ◽

...

Keyword(s):

Older Adults ◽

Rural Communities ◽

North Dakota ◽

Fall Prevention ◽

Rural Areas ◽

Repeated Measures ◽

Safety Issues ◽

Post Test ◽

Risk Of Falls ◽

Risk Factors For Falls

Abstract Fall-related injuries are common sources of morbidity and mortality for adults aged 65 and older. Thus, interventions for preventing falls can have substantial public health benefits. One promising fall prevention program is the Stepping On program, which involves seven community-based workshops. In these workshops, older adults learn about risk factors for falls, as well as safety-conscious behaviors. Stepping On has been offered in several states, and outcomes have been positive. However, research in rural areas has been lacking. To address this issue, the current study examined 508 older adults who participated in the Stepping On program across 53 rural communities in North Dakota through May of 2019. Most participants were female (82%), with an average age of 79 years (range 65-98). Participants completed baseline and post-test assessments of their knowledge regarding health, mobility, and safety issues. At baseline, 46% of participants reported falling at least once during the previous year. Repeated-measures ANOVAs showed that participants had improved significantly in the following areas at post-test: understanding how vision influences safety; knowledge of balance and strength exercises; recognizing hazards in the home; choosing safe footwear; confidence in mobility; understanding how medications affect fall risk; and the importance of bone health (p<0.001 for all). Just 14% of participants reported falling during the year following the workshops, and 62% felt that the program reduced their risk of falls “to a big extent.” These findings suggest that the Stepping On program is feasible to administer in rural areas and benefits older adults in such communities.

Download Full-text

Do Where The Elderly Live Matter? Factors Associated with Diet Quality among Korean Elderly Population Living in Urban Versus Rural Areas

Nutrients ◽

10.3390/nu12051314 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1314

Author(s):

Sohyun Park ◽

Hyun Ja Kim ◽

Kirang Kim

Keyword(s):

Older Adults ◽

Diet Quality ◽

Rural Areas ◽

Urban Areas ◽

Elderly Population ◽

Healthy Eating Index ◽

Personal Factors ◽

Cross Sectional ◽

Urban And Rural Areas ◽

Korean Elderly

This study aimed to examine whether there is an area difference on diet quality among the Korean elderly population. The effect of personal factors on diet quality is also estimated and compared between rural and urban areas. A cross-sectional data from the 2013–2015 Korea National Health and Nutrition Examination Survey (KNHANES) was used for this study. The participants were older adults aged ≥ 65 years (n = 3207) who participated in the KNHANES. Urban and rural areas classified the region and the Korean Healthy Eating Index (KHEI) assessed the diet quality. Personal factors that were related to diet quality included socio-demographic factors, health behaviors, and health conditions. This study found that the diet quality was different between urban and rural areas in the Korean elderly population, showing a higher mean of KHEI scores in urban areas than rural areas (67.3 for urban seniors, 63.6 for rural seniors, p < 0.001), and the regional difference was still significant, even after adjusting for the personal factors (p < 0.001). Different sets of personal factors were found to be significant that explain the diet quality of participants between areas, such as economic resources, walking exercise, and perceived oral health status in urban areas, and age and food insecurity in rural areas. In conclusions, this study found that there was a regional disparity in diet quality and some personal factors affecting diet quality were dependent on areas, which implied that regional environment with diverse contexts could influence diet quality. These findings emphasize the need to provide targeted intervention programs that take into account both the characteristics of individuals and local food environments in order to improve the overall diet quality in older adults.

Download Full-text

Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062818 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2818

Author(s):

Yuri Sasaki ◽

Yugo Shobugawa ◽

Ikuma Nozaki ◽

Daisuke Takagi ◽

Yuiko Nagamine ◽

...

Keyword(s):

Older Adults ◽

Middle School ◽

Depressive Symptoms ◽

Rural Areas ◽

Urban Areas ◽

Depression Scale ◽

Wealth Index ◽

School Level ◽

Cross Sectional ◽

Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

Download Full-text

Patterns of Alcohol Consumption in the PURE Poland Cohort Study and Their Relationship with Health Problems

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084185 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4185

Author(s):

Katarzyna Zatońska ◽

Piotr Psikus ◽

Alicja Basiak-Rasała ◽

Zuzanna Stępnicka ◽

Maria Wołyniec ◽

...

Keyword(s):

Cohort Study ◽

Alcohol Consumption ◽

Rural Areas ◽

Urban Areas ◽

Level Of Education ◽

Adult Participants ◽

Frequent Consumption ◽

Urban And Rural Areas ◽

Socio Demographic Factors ◽

High Level

(1) Background: Alcohol is a leading risk factor of premature morbidity and mortality. The objective of this study was to investigate the patterns of alcohol consumption in the PURE Poland cohort study baseline. (2) Methods: A Polish cohort was enrolled in the baseline study in 2007–2010. The study group consisted of 2021 adult participants of urban and rural areas from the Lower Silesia voivodeship in Poland (747 men and 1274 women). (3) Results: In the overall study population, 67.3% were current drinkers, 10.3% were former drinkers, and 22.4% were abstainers. Current use of alcohol products was more prevalent in men (77.2%), people living in urban areas (73.0%), and people with a higher level of education (78.0%). The percentage of current drinkers decreased with increasing age (from 73.4% in 30- to 44-year-olds to 48.8% in participants aged 64 and more). The majority of participants (89.2%) declared a low level of alcohol intake. The chance of high level of intake of alcohol was four times higher in men than in women (OR 4.17; CI 1.64–10.6). The majority of participants (54.6%) declared most frequent consumption of low-alcohol drinks (beer, wine) and 21% declared most frequent consumption of spirits. Current drinkers had almost 1.5-fold higher odds of diabetes and cardiovascular diseases (CVD) than never drinkers (OR 1.49, CI 1.03–2.17; OR 1.66, CI 1.27–2.18, respectively). Former drinkers had higher odds for hypertension and CVD than never drinkers (1.73, CI 1.05–2.85; OR 1.76, CI 1.22–2.53, respectively). (4) Conclusions: In our cohort study, we observed several socio-demographic factors differentiating the patterns of alcohol consumption. The preventive programs should focus predominantly on men, people aged <45 years, and those with a higher level of education.

Download Full-text