International Journal of Environmental Research and Public Health

Research

18 pages, 1296 KiB

Open AccessArticle

Comparison of Machine Learning Techniques for Mortality Prediction in a Prospective Cohort of Older Adults

by Salvatore Tedesco, Martina Andrulli, Markus Åkerlund Larsson, Daniel Kelly, Antti Alamäki, Suzanne Timmons, John Barton, Joan Condell, Brendan O’Flynn and Anna Nordström

Int. J. Environ. Res. Public Health 2021, 18(23), 12806; https://doi.org/10.3390/ijerph182312806 - 4 Dec 2021

Cited by 8 | Viewed by 2795

Abstract

As global demographics change, ageing is a global phenomenon which is increasingly of interest in our modern and rapidly changing society. Thus, the application of proper prognostic indices in clinical decisions regarding mortality prediction has assumed a significant importance for personalized risk management [...] Read more.

As global demographics change, ageing is a global phenomenon which is increasingly of interest in our modern and rapidly changing society. Thus, the application of proper prognostic indices in clinical decisions regarding mortality prediction has assumed a significant importance for personalized risk management (i.e., identifying patients who are at high or low risk of death) and to help ensure effective healthcare services to patients. Consequently, prognostic modelling expressed as all-cause mortality prediction is an important step for effective patient management. Machine learning has the potential to transform prognostic modelling. In this paper, results on the development of machine learning models for all-cause mortality prediction in a cohort of healthy older adults are reported. The models are based on features covering anthropometric variables, physical and lab examinations, questionnaires, and lifestyles, as well as wearable data collected in free-living settings, obtained for the “Healthy Ageing Initiative” study conducted on 2291 recruited participants. Several machine learning techniques including feature engineering, feature selection, data augmentation and resampling were investigated for this purpose. A detailed empirical comparison of the impact of the different techniques is presented and discussed. The achieved performances were also compared with a standard epidemiological model. This investigation showed that, for the dataset under consideration, the best results were achieved with Random UnderSampling in conjunction with Random Forest (either with or without probability calibration). However, while including probability calibration slightly reduced the average performance, it increased the model robustness, as indicated by the lower 95% confidence intervals. The analysis showed that machine learning models could provide comparable results to standard epidemiological models while being completely data-driven and disease-agnostic, thus demonstrating the opportunity for building machine learning models on health records data for research and clinical practice. However, further testing is required to significantly improve the model performance and its robustness. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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17 pages, 561 KiB

Open AccessArticle

Can the Development of Religious and Cultural Tourism Build a Sustainable and Friendly Life and Leisure Environment for the Elderly and Promote Physical and Mental Health?

by Hsiao-Hsien Lin, Ko-Hsin Chang, Chih-Hung Tseng, Yueh-Shiu Lee and Chih-Hsiang Hung

Int. J. Environ. Res. Public Health 2021, 18(22), 11989; https://doi.org/10.3390/ijerph182211989 - 15 Nov 2021

Cited by 18 | Viewed by 3149

Abstract

From the perspective of satisfaction, physical and mental health, and re-travel, this study explored whether the development of religious and cultural tourism could construct a sustainable and friendly life and leisure environment for the elderly to promote physical and mental health. This research [...] Read more.

From the perspective of satisfaction, physical and mental health, and re-travel, this study explored whether the development of religious and cultural tourism could construct a sustainable and friendly life and leisure environment for the elderly to promote physical and mental health. This research adopted a mixed method, collected 700 questionnaires, used SPSS 22.0 statistical software, and analyzed basic statistics, t-test, and PPMCC test. Then, the researchers conducted semi-structured interviews, collected the opinions of six interviewees, and finally analyzed with multiple checks Law discussion. The results found that people of different genders and stakeholders had different opinions about DIY activities on leisure satisfaction, featured itineraries, relaxation areas, signs and instructions, community association and service center services, historical landmarks, and public transportation. They found people’s life satisfaction in physical and mental health was increased, their headaches or pressures on the top of their heads were relieved, backache problems were reduced, and they were no longer anxious and lost tempers. They had a greater willingness to revisit some places and share experiences. This study found significant differences among these topics (p < 0.01). Women, residents, and tourists had different opinions. In addition, although the natural environment landscape and feelings have the greatest influence, the better the physical and mental health was improved, the better the willingness to travel. However, the more perfect the local construction and development, the less favorable to attract people to engage in leisure activities or tourism consumption. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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13 pages, 339 KiB

Open AccessArticle

Pneumonia Risk Associated with the Use of Individual Benzodiazepines and Benzodiazepine Related Drugs among the Elderly with Parkinson’s Disease

by Kuang-Hua Huang, Chih-Jaan Tai, Yu-Hsiang Kuan, Yu-Chia Chang, Tung-Han Tsai and Chien-Ying Lee

Int. J. Environ. Res. Public Health 2021, 18(17), 9410; https://doi.org/10.3390/ijerph18179410 - 6 Sep 2021

Cited by 7 | Viewed by 3412

Abstract

Most patients with Parkinson’s disease (PD) gradually develop oropharyngeal dysphagia which is often associated with pneumonia risk. The possible association of benzodiazepine (BZD) and benzodiazepine related drugs (BZRD) use with pneumonia risk has received increasing attention but remains controversial. We investigated pneumonia risk [...] Read more.

Most patients with Parkinson’s disease (PD) gradually develop oropharyngeal dysphagia which is often associated with pneumonia risk. The possible association of benzodiazepine (BZD) and benzodiazepine related drugs (BZRD) use with pneumonia risk has received increasing attention but remains controversial. We investigated pneumonia risk associated with the use of BZDs and BZRDs in older adult patients with PD. This case-control study analyzed data of 551,975 older adult patients with PD between 2001 and 2018 in Taiwan. To minimize potential confounding, we used 1:4 propensity score matching to include older adult patients without pneumonia as controls. Incident pneumonia risk was significantly higher in current (adjusted odds ratio (aOR) = 1.25, 95% CI = 1.23–1.27) and past (aOR = 1.13, 95% CI = 1.11–1.15) users of BZDs. Regarding BZRDs, recent (aOR = 1.08, 95% CI = 1.06–1.11) and past (aOR = 0.89, 95% CI = 0.88–0.91) users had higher and lower risks of incident pneumonia, respectively. Pneumonia risk varied based on their use of BZDs and BZRDs. In these individuals, incident pneumonia risk was high in users of BZDs, such as midazolam, lorazepam, flunitrazepam, estazolam, and clonazepam. Regarding the use of BZRDs, zopiclone increased incident pneumonia risk. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

9 pages, 353 KiB

Open AccessArticle

Acceptance of Pharmaceutical Services by Home-Dwelling Older Patients: A Case Study in a Portuguese Community Pharmacy

by Ana Rita Paiva, Ana Isabel Plácido, Isabel Curto, Manuel Morgado, Maria Teresa Herdeiro and Fátima Roque

Int. J. Environ. Res. Public Health 2021, 18(14), 7401; https://doi.org/10.3390/ijerph18147401 - 11 Jul 2021

Cited by 4 | Viewed by 2551

Abstract

Background: Aging-related comorbidities predispose older adults to polypharmacy and consequently an increased risk of adverse drug reactions and poor compliance. Pharmacists’ interventions can have a beneficial impact on the improvement of clinical outcomes. Thus, this work aimed to assess the acceptance of Portuguese [...] Read more.

Background: Aging-related comorbidities predispose older adults to polypharmacy and consequently an increased risk of adverse drug reactions and poor compliance. Pharmacists’ interventions can have a beneficial impact on the improvement of clinical outcomes. Thus, this work aimed to assess the acceptance of Portuguese home-dwelling older adults regarding a pharmaceutical service paid by patients for medication management and pharmacotherapy follow-up. We also intended to analyze medication, characterize the medication consumption profile, and identify the main difficulties of our sample during their daily medication management. Methods: A questionnaire on adherence and medication therapy management was applied to polymedicated patients ≥65 years old, in a community pharmacy. Results: Of the 88 participants, 92.2% would be willing to pay for a pharmacotherapy management service, and 75.6% answered that they would be willing to pay for an individual medication preparation service. In addition, 45.7% of the participants were categorized as lower adherents to a medication therapeutic regimen. Our sample reported that during their daily lives, they felt difficulty: to remember to take their pills (17%), to manage so many medicines (15.9%), and to swallow the pills (9.1%). Conclusions: Polymedicated older adults are willing to pay for a service to improve the management of their medicines, suggesting that they recognize the role of pharmacists in medication management. This study provides useful information for the conceptualization of a pharmacotherapy management service that includes medication review and a pharmacotherapy follow-up. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

15 pages, 716 KiB

Open AccessArticle

Computer Education and Third Age Universities: A Systematic Review

by Sónia Rolland Sobral and Margarida Sobral

Int. J. Environ. Res. Public Health 2021, 18(14), 7390; https://doi.org/10.3390/ijerph18147390 - 10 Jul 2021

Cited by 6 | Viewed by 3871

Abstract

An aging population and a digital society are realities. There is a need to equip older people with knowledge and computer skills so that they can participate in society, without feeling excluded or being marginalized. Third age universities are organizations around the world [...] Read more.

An aging population and a digital society are realities. There is a need to equip older people with knowledge and computer skills so that they can participate in society, without feeling excluded or being marginalized. Third age universities are organizations around the world that specialize in teaching and learning for senior students in a more informal and more integrated way than other educational institutions. The objective of this study was to identify the existing quality publications that deal with the subject of computer education at senior universities. The SCOPUS and Web of Science databases were used, and 18 records were found according to the adopted criteria. It was found that these articles, depending on their focus, can be divided into four groups: educators, organizations/directors, students, and conceptual/review papers. Through these articles, it was possible to draw a picture of what older people’s computer learning is like, what barriers exist for students to not be able to attend these classes, as well as tips on how courses should be organized and the pedagogical methodologies that must be adopted. It is intended that this article is used as a good tool for people who work in teaching information technology to the elderly, and especially for course directors who intend to create or reformulate courses of this type for this specific age group. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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10 pages, 352 KiB

Open AccessArticle

Physical Activity and the Improvement of Autonomy, Functional Ability, Subjective Health, and Social Relationships in Women over the Age of 60

by María Antonia Parra-Rizo and Gema Sanchís-Soler

Int. J. Environ. Res. Public Health 2021, 18(13), 6926; https://doi.org/10.3390/ijerph18136926 - 28 Jun 2021

Cited by 18 | Viewed by 3223

Abstract

Regarding functional ability, autonomy, promotion of social relationships and health, little scientific evidence has been found of physical practice in active women over 60 years of age. Hence, the goal of this study was to assess the functional abilities and autonomy, social relationships [...] Read more.

Regarding functional ability, autonomy, promotion of social relationships and health, little scientific evidence has been found of physical practice in active women over 60 years of age. Hence, the goal of this study was to assess the functional abilities and autonomy, social relationships and subjective health of physically active older women according to the level of activity practiced. The IPAQ and CUBRECAVI scales were applied to a sample of 257 women between 61 and 93 years old (M = 69.44, SD = 4.61). Statistically significant outcomes were obtained in functional ability and autonomy according to their level of physical activity (p = 0.001): greater satisfaction and frequency of social relationships with a mild level of physical activity (p = 0.011), and statistically significant differences in the degree of satisfaction with their health according to the level of physical activity they practice (p < 0.001). The results showed that those with high physical activity obtained better levels of functional abilities and autonomy. Additionally, dissatisfaction with one’s own health is associated with low levels of physical activity. In conclusion, it could be said that the practice of mild physical exercise in older women encourages greater autonomy and functional ability for activities of daily living, which results in independence in everyday life in addition to fostering social links as well as gaining a better satisfaction with their own health, with the socio-emotional benefits that this can bring. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

18 pages, 8444 KiB

Open AccessArticle

Where and How Extensive Are the Living Areas of the Elderly? An Empirical Study on ‘Ageing in Place’ in Three Small and Medium-Sized Japanese Cities

by Tatsuya Nishino

Int. J. Environ. Res. Public Health 2021, 18(11), 5960; https://doi.org/10.3390/ijerph18115960 - 2 Jun 2021

Cited by 4 | Viewed by 2869

Abstract

The policies regarding the elderly in advanced countries are based on the notion of ‘ageing in place’. The question arises, where and how extensive can the ‘place’ be? Is there a method of estimating a senior’s living area? The purpose of this study [...] Read more.

The policies regarding the elderly in advanced countries are based on the notion of ‘ageing in place’. The question arises, where and how extensive can the ‘place’ be? Is there a method of estimating a senior’s living area? The purpose of this study was to determine the common characteristics of the living areas of seniors in three small and medium-sized Japanese cities. The basic methodology involved a comparative analysis involving these cities. We used case studies to cross tabulate interviews regarding the daily outings of participants, some of whom needed long-term care while others did not. The data covered a total of 727 participants, 307 of whom needed long-term care and 420 requiring none. Comparative analysis revealed the common characteristics of living areas for seniors in these cities, i.e., two-layered living areas of healthy seniors; fewer outings on foot due to frailty; the average moving time via transportation is approximately 12 min; and living areas overlap districts where hospitals and stores are located. The results indicate that we can roughly estimate the living areas of seniors in any neighborhood to investigate accessibility to nearby hospitals and stores. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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13 pages, 840 KiB

Open AccessArticle

Influence of Active and Healthy Ageing on Quality of Life Changes: Insights from the Comparison of Three European Countries

by Alba Ayala, Carmen Rodríguez-Blázquez, Amaia Calderón-Larrañaga, Giorgi Beridze, Laetitia Teixeira, Lia Araújo, Fermina Rojo-Pérez, Gloria Fernández-Mayoralas, Vicente Rodríguez-Rodríguez, Víctor Quirós-González, Vanessa Zorrilla-Muñoz, María Silveria Agulló-Tomás, Oscar Ribeiro and Maria João Forjaz

Int. J. Environ. Res. Public Health 2021, 18(8), 4152; https://doi.org/10.3390/ijerph18084152 - 14 Apr 2021

Cited by 9 | Viewed by 4265

Abstract

This study aimed to analyze the determinants of quality of life (QoL) in older people in three European countries (Portugal, Spain and Sweden). A sample of 7589 participants in waves 4 (2011) and 6 (2015) of the Survey on Health, Aging, and Retirement [...] Read more.

This study aimed to analyze the determinants of quality of life (QoL) in older people in three European countries (Portugal, Spain and Sweden). A sample of 7589 participants in waves 4 (2011) and 6 (2015) of the Survey on Health, Aging, and Retirement in Europe (SHARE) project, aged 50 and over and living in Portugal, Spain and Sweden, was included. The CASP-12 scale was used to measure QoL. A principal component analysis was performed to group preselected variables related to active and healthy ageing into the dimensions of health, social participation, and lifelong learning. A linear regression model was built using the change in CASP-12 scores over the 4-year follow-up as the dependent variable, including the interactions between country and each independent variable in the model. After four years, the average QoL increased in Portugal (difference = 0.8, p < 0.001), decreased in Spain (−0.8, p < 0.001), and remained constant in Sweden (0.1, p = 0.408). A significant country-participation component interaction (p = 0.039) was found. In Spain, a higher participation (β = 0.031, p = 0.002) was related to a higher QoL improvement at 4 years, but not in Sweden or Portugal. Physical health and emotional components (β = 0.099, p < 0.001), functional ability (β = 0.044, p = 0.023), and cognitive and sensory ability (β = 0.021, p = 0.026) were associated with QoL changes over time in all countries. The country-specific associations between health, social participation and QoL should be taken into account when developing public health policies to promote QoL among European older people. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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12 pages, 898 KiB

Open AccessArticle

Thai Older People’s Willingness (Intention) to Participate in a Care Prevention, Community Group Exercise Program: An Assessment before Implementing an Intervention Trial in Chiang Mai, Northern Thailand

by Thin Nyein Nyein Aung, Myo Nyein Aung, Saiyud Moolphate, Yuka Koyanagi, Nadila Mulati, Siripen Supakankunti and Motoyuki Yuasa

Int. J. Environ. Res. Public Health 2021, 18(8), 4044; https://doi.org/10.3390/ijerph18084044 - 12 Apr 2021

Cited by 5 | Viewed by 3794

Abstract

Background: Sustainability of a current family-based long-term care model in Thailand has been challenged by demographic aging, and the rising burden of non-communicable diseases and age-related morbidities. In order to overcome these challenges, a community-integrated intermediary care (CIIC) service model, including functional training [...] Read more.

Background: Sustainability of a current family-based long-term care model in Thailand has been challenged by demographic aging, and the rising burden of non-communicable diseases and age-related morbidities. In order to overcome these challenges, a community-integrated intermediary care (CIIC) service model, including functional training as one of the interventions, was introduced. To increase program uptake and adherence, it is vital to understand the facilitators and barriers for joining this group exercise. Therefore, we aimed to explore the determinants of older adults’ willingness to participate in it. Methods: A total of 1509 participants from an intervention arm of a cluster randomized trial were interviewed with a structured questionnaire. A descriptive analysis and binary logistic regression were applied. Results: More than half of participants (51.4%) were willing to join community-based care prevention, functional training exercise program. Significant associated motivators were being of younger age, female, married, working seniors, original community residents, having (regular and irregular) exercise habits, history of a fall in the last six months, needs for walking aids and secondary caregivers. Conclusion: Our findings highlighted both personal and social factors motivated old people to access health promotion activities. It might help design or implement effective programs to promote healthy aging among community-dwelling seniors in Thailand. This research is analysis of baseline results from a Community Integrated Intermediary Care project. TCTR20190412004. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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13 pages, 2207 KiB

Open AccessArticle

Frailty Status and Polypharmacy Predict All-Cause Mortality in Community Dwelling Older Adults in Europe

by Luís Midão, Pedro Brochado, Marta Almada, Mafalda Duarte, Constança Paúl and Elísio Costa

Int. J. Environ. Res. Public Health 2021, 18(7), 3580; https://doi.org/10.3390/ijerph18073580 - 30 Mar 2021

Cited by 25 | Viewed by 3368

Abstract

European population ageing is associated with frailty, a complex geriatric syndrome, and polypharmacy, both resulting in adverse health outcomes. In this study we aimed to evaluate the impact of frailty and polypharmacy, on mortality rates, within 30 months, using a cohort of SHARE [...] Read more.

European population ageing is associated with frailty, a complex geriatric syndrome, and polypharmacy, both resulting in adverse health outcomes. In this study we aimed to evaluate the impact of frailty and polypharmacy, on mortality rates, within 30 months, using a cohort of SHARE participants aged 65 years old or more. Frailty was assessed using a version of Fried’s phenotype criteria operationalized to SHARE while polypharmacy was defined as taking five or more drugs per day. We found a prevalence of 40.4% non-frail, 47.3% pre-frail and 12.3% frail participants. Moreover, a prevalence of polypharmacy of 31.3% was observed, being 3 three times more prevalent in frail individuals and two times in pre-frail individuals, when compared with non-frail. Individuals with both conditions had shown higher mortality rates. Comparing with non-polymedicated non-frail individuals all the other conditions are more prone to die within 30 months. Polymedicated older and male participants exhibited also higher mortality rates. This work shows polypharmacy and frailty to be associated with a higher risk of all-cause of mortality and highlights the need to decrease ‘unnecessary’ polypharmacy to reduce drug-related issues and also the need to assess frailty early to prevent avoidable adverse outcomes. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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16 pages, 1467 KiB

Open AccessArticle

Dose-Response Association of Tai Chi and Cognition among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

by Mei-Lan Chen, Stephanie B. Wotiz, Starr M. Banks, Sabine A. Connors and Yuyin Shi

Int. J. Environ. Res. Public Health 2021, 18(6), 3179; https://doi.org/10.3390/ijerph18063179 - 19 Mar 2021

Cited by 14 | Viewed by 3820

Abstract

Previous studies indicated that Tai Chi might be an effective way to improve or prevent cognitive impairments in older populations. However, existing research does not provide clear recommendations about the optimal dose of Tai Chi practice, which is the most effective in improving [...] Read more.

Previous studies indicated that Tai Chi might be an effective way to improve or prevent cognitive impairments in older populations. However, existing research does not provide clear recommendations about the optimal dose of Tai Chi practice, which is the most effective in improving cognitive function in older adults. The purpose of this systematic review and meta-analysis was to investigate the dose–response relationship between Tai Chi and cognition in community-dwelling older adults. A total of 16 studies with 1121 subjects were included in this study. Meta-regression analyses of Tai Chi duration (Tai Chi session duration, Tai Chi practice duration per week, study duration, and Tai Chi practice duration for the entire study) on the study effect size (ES) were performed to examine the dose–response association of Tai Chi and cognition. The results showed that there was a positive effect of Tai Chi on cognitive function, but there were no statistically significant dose duration effects on cognition. The findings suggest that Tai Chi has beneficial effects on cognitive function, but a longer duration was not associated with larger effects. In order to establish evidence-based clinical interventions using Tai Chi, future research should clearly demonstrate intervention protocol, particularly the style and intensity of Tai Chi. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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12 pages, 1178 KiB

Open AccessArticle

The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

by Marta Estrela, Maria Teresa Herdeiro, Pedro Lopes Ferreira and Fátima Roque

Int. J. Environ. Res. Public Health 2020, 17(22), 8612; https://doi.org/10.3390/ijerph17228612 - 19 Nov 2020

Cited by 33 | Viewed by 5514

Abstract

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. [...] Read more.

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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24 pages, 2990 KiB

Open AccessArticle

Health Care Needs and Services for Elder and Disabled Population: Findings from a Barcelona Study

by Jessica Rodriguez-Pereira, Jesica de Armas, Lorenzo Garbujo and Helena Ramalhinho

Int. J. Environ. Res. Public Health 2020, 17(21), 8071; https://doi.org/10.3390/ijerph17218071 - 2 Nov 2020

Cited by 7 | Viewed by 2865

Abstract

Health care is a pillar of modern society. This study focuses on the use of descriptive analytics to provide demographic and territorial insights that will be of strategic importance in planning subsequent projects meant to improve health care services. We especially focus on [...] Read more.

Health care is a pillar of modern society. This study focuses on the use of descriptive analytics to provide demographic and territorial insights that will be of strategic importance in planning subsequent projects meant to improve health care services. We especially focus on the assessment of the elder and disabled population health care needs in Barcelona, and evaluate to what extent the current health care infrastructure is successful in covering the demand of these fragile population segment. This work is developed around three main assessments in the municipality of Barcelona: the elder and disabled health care demand, the available health care services, and the relationship between demand and services, showing that territorial and demographic aspects are relevant in assessing the health needs of the population. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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19 pages, 1778 KiB

Open AccessArticle

Multidimensional Geriatric Assessment with MAGIC Questionnaire and Quality of Life in Elderly Primary Care Patients

by Fátima Dios-Quiroga, Susana Soliño-Lourido, Carmen Pallas-Queijo, Clara González-Formoso, Aurelia Constenla-Castro, Soledad Conde-Freire and Ana Clavería

Int. J. Environ. Res. Public Health 2020, 17(19), 7089; https://doi.org/10.3390/ijerph17197089 - 28 Sep 2020

Cited by 4 | Viewed by 3277

Abstract

The Manageable Geriatric Assessment (MAGIC) questionnaire, recently developed by a group of European family doctors for multidimensional geriatric assessment in primary care, has not yet been evaluated in clinical practice. The objectives of this study were to translate and adapt it to Spanish [...] Read more.

The Manageable Geriatric Assessment (MAGIC) questionnaire, recently developed by a group of European family doctors for multidimensional geriatric assessment in primary care, has not yet been evaluated in clinical practice. The objectives of this study were to translate and adapt it to Spanish and to check the association between the limitations of older adults identified by this questionnaire and their perceived health status assessed by the five-level version of the EuroQol-5D (EQ-5D-5L). First, questionnaire translation, back translation and cognitive test were applied. Then, a cross-sectional observational study was performed in two Spanish health centers Galicia, Spain. Participants were 170 people aged over 75, recruited opportunistically by consecutive case sampling. Anonymous surveys were used to collect data. The MAGIC questionnaire, the EQ-5D-5L scale, age and sex were employed. The visual analog scale of EQ-5D-5L (EQ VAS) was used as the outcome variable. Descriptive and bivariate analyses by sex and outcome variable are presented. The linear regression analysis showed an association with quality of life for daily activities, recognizing people and stress incontinence. As this is associated with quality of life, the MAGIC questionnaire may be useful in primary care and a study to investigate the impact on health with a clinical trial would be worth considering. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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10 pages, 349 KiB

Open AccessArticle

Voices of Polymedicated Older Patients: A Focus Group Approach

by Ana Isabel Plácido, Maria Teresa Herdeiro, João Lindo Simões, Odete Amaral, Adolfo Figueiras and Fátima Roque

Int. J. Environ. Res. Public Health 2020, 17(18), 6443; https://doi.org/10.3390/ijerph17186443 - 4 Sep 2020

Cited by 15 | Viewed by 2554

Abstract

Polypharmacy in older adults is frequently associated with incorrect management of medicines, which causes drug-related problems and, subsequently, poor health outcomes. Understanding why older adults incorrectly manage their medicines is fundamental to health outcomes, however, it is an issue that remains poorly explored. [...] Read more.

Polypharmacy in older adults is frequently associated with incorrect management of medicines, which causes drug-related problems and, subsequently, poor health outcomes. Understanding why older adults incorrectly manage their medicines is fundamental to health outcomes, however, it is an issue that remains poorly explored. The aim of this study is to examine older people’s perceptions, attitudes, beliefs, and concerns in the central region of Portugal. Thirteen focus groups with sixty-one older adults taking five or more prescription medicines were conducted to explore older patients’ perceptions and beliefs about and management of their medication. Sampling was conducted until theme saturation had been achieved. Transcripts were coded and data were obtained using the NVivo qualitative data-analysis software programme. Older adults recognise the importance of medicines for ensuring healthy ageing. Owing to a lack of literacy, however, they frequently commit medication mistakes and compromise their health outcomes. Promoting the literacy and empowerment of older patients, as well as strengthening the relationship between health professionals and patients, is crucial when it comes to addressing drug-related problems and improving health outcomes. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

18 pages, 1018 KiB

Open AccessArticle

Psychosocial Resources for Hedonic Balance, Life Satisfaction and Happiness in the Elderly: A Path Analysis

by Raquel Lara, Mᵃ Luisa Vázquez, Adelaida Ogallar and Débora Godoy-Izquierdo

Int. J. Environ. Res. Public Health 2020, 17(16), 5684; https://doi.org/10.3390/ijerph17165684 - 6 Aug 2020

Cited by 22 | Viewed by 5302

Abstract

We explored possible paths from physical and mental health-related quality of life, self-efficacy, optimism, and social support to happiness in older adults, considering hedonic balance and life satisfaction as mediators. A total of 154 Spanish male and female (50%) older adults (65–96 years [...] Read more.

We explored possible paths from physical and mental health-related quality of life, self-efficacy, optimism, and social support to happiness in older adults, considering hedonic balance and life satisfaction as mediators. A total of 154 Spanish male and female (50%) older adults (65–96 years old, M = 77.44, SD = 8.03; 64% noninstitutionalized elderly) voluntarily participated in this correlational, cross-sectional study. The participants completed self-reports on their perceived health status, self-efficacy, social support, optimism, and global subjective well-being (SWB) as well as its dimensions. Path analysis was used to examine direct and indirect relationships. The final model had an excellent fit with the data (χ2(10) = 11.837, p = 0.296, χ2/df = 1.184; SRMR = 0.050, CFI = 0.994, RMSEA = 0.035), revealing the unique causal effects of all the included predictors on happiness. With the exception of self-efficacy, the psychosocial resources predicted older adults’ current happiness, and this relationship was fully mediated by hedonic balance and life satisfaction, which were found to be putative intermediary factors for SWB. Self-efficacy in turn predicted the remaining psychosocial resources. Our findings extend the existing evidence on the influences of health-related quality of life, self-efficacy, optimism, and social support on SWB. Furthermore, they support the proposal of hedonic balance and life satisfaction as dimensions of SWB, thus supporting the tripartite hierarchical model of happiness. These results may inform future interventions seeking to improve happiness in late adulthood. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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9 pages, 337 KiB

Open AccessArticle

Associations of Lifestyle Intervention Effect with Blood Pressure and Physical Activity among Community-Dwelling Older Americans with Hypertension in Southern California

by Mei-Lan Chen, Jie Hu, Thomas P. McCoy, Susan Letvak and Luba Ivanov

Int. J. Environ. Res. Public Health 2020, 17(16), 5673; https://doi.org/10.3390/ijerph17165673 - 5 Aug 2020

Cited by 4 | Viewed by 3974

Abstract

A healthy lifestyle and regular physical activity are highly recommended for older adults. However, there has been limited research into testing lifestyle intervention effects on physical activity in older adults with hypertension. The purpose of this study was to assess the association of [...] Read more.

A healthy lifestyle and regular physical activity are highly recommended for older adults. However, there has been limited research into testing lifestyle intervention effects on physical activity in older adults with hypertension. The purpose of this study was to assess the association of lifestyle intervention effects with physical activity and blood pressure in older adults with hypertension, accounting for social support and perceived stress as control variables. This study performed a secondary analysis of a two-arm randomized controlled trial. A total of 196 participants were randomly assigned to a six-month lifestyle intervention group or a control group. Hierarchical multiple regression analyses demonstrated that lifestyle intervention effects were not significantly associated with improvements in physical activity and blood pressure, but the final regression models were statistically significant (all p < 0.001). The result revealed that only physical activity frequency at baseline was significantly related to improvement in physical activity. Systolic blood pressure (SBP) at baseline and monthly income were significantly associated with change in SBP, while age and diastolic blood pressure (DBP) at baseline were significantly related to change in DBP. The findings provide empirical evidence for developing and optimizing lifestyle interventions for future research and clinical practice in this population. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

13 pages, 1752 KiB

Open AccessArticle

Effects of Types of Horticultural Activity on the Physical and Mental State of Elderly Individuals

by Pei-Chun Tu, Wen-Chen Cheng, Ping-Cheng Hou and Yu-Sen Chang

Int. J. Environ. Res. Public Health 2020, 17(14), 5225; https://doi.org/10.3390/ijerph17145225 - 20 Jul 2020

Cited by 20 | Viewed by 4637

Abstract

This study aimed to evaluate the effect of types of horticultural activities among elderly individuals in a senior citizen learning camp. We arranged four horticultural activities: Grass Doll, Kokedama, Rocky Leaf Prints, and Herb Tasting and Smelling. Twenty-seven senior citizens (60 to 76 [...] Read more.

This study aimed to evaluate the effect of types of horticultural activities among elderly individuals in a senior citizen learning camp. We arranged four horticultural activities: Grass Doll, Kokedama, Rocky Leaf Prints, and Herb Tasting and Smelling. Twenty-seven senior citizens (60 to 76 years) were recruited to participate. We assessed their physiological and mental state before and after the activities by measuring heart rate variability (HRV), pulse rate, blood pressure, salivary amylase activity (SAA), and Profile of Mood States (POMS). Results showed that SAA was significantly lower after the Rocky Leaf Prints, Herb Tasting and Smelling, and Kokedama. Pulse rate had a downward trend after the four horticultural activities. The ratio of low frequency (LF) over high frequency (HF) results showed that the Rocky Leaf Prints had a larger downward trend, followed by Herb Tasting and Smelling. POMS scores indicated significant improvement for Rocky Leaf Prints and Herb Tasting and Smelling. The types including artistic creation and food tasting were promising methods for psychological relaxation, stress reduction, and vigor enhancement for elderly persons. Findings showed that the impact of activities involving contact with plants was more significant in short-term activities. We hope this study can help plan the horticultural activities of the elderly in the future. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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13 pages, 702 KiB

Open AccessArticle

Unplanned Readmission within 28 Days of Hospital Discharge in a Longitudinal Population-Based Cohort of Older Australian Women

by Dinberu S. Shebeshi, Xenia Dolja-Gore and Julie Byles

Int. J. Environ. Res. Public Health 2020, 17(9), 3136; https://doi.org/10.3390/ijerph17093136 - 30 Apr 2020

Cited by 15 | Viewed by 3623

Abstract

This study aimed to estimate the incidence of 28-day unplanned readmission among older women, and associated factors. Data were used from the 1921–1926 birth cohort of the Australian Longitudinal Study on Women’s Health. Linkage of self-reported survey data with the Admitted Patient Data [...] Read more.

This study aimed to estimate the incidence of 28-day unplanned readmission among older women, and associated factors. Data were used from the 1921–1926 birth cohort of the Australian Longitudinal Study on Women’s Health. Linkage of self-reported survey data with the Admitted Patient Data Collection allowed the identification of hospital admissions for each woman and the corresponding baseline characteristics. The Cox proportional-hazards model was used to identify factors associated with time to unplanned readmission, using SAS software V 9.4. (SAS Institute, Cary, NC, USA). Of 2056 women with index unplanned admission, 363 (17.5%) were readmitted within 28 days of discharge, and of these 229 (11.14%) had unplanned readmission. Among women with unplanned readmission, 24% were for the same condition as for the index hospitalisation. Cardiovascular diseases were the main diagnoses for the index admission and readmission. Unplanned readmission risk was higher if not partnered (hazard ratio (HR) = 1.43, 95% confidence interval (CI): 1.05–1.95), of non-English speaking background (HR = 1.62%, 95% CI: 1.07–2.47), more than three days length of stay on index admission (HR = 1.41%, 95% CI: 1.04–1.90) and one or two of the assessed chronic diseases (HR = 1.68, 95% CI: 1.19–2.36). At least one in ten women had unplanned readmission at some time between ages 75–95 years. Women who are not partnered, not of English-speaking background, with longer hospital stay and those with multi-morbidity, may need further efforts during their stay and on discharge to mitigate unplanned readmission. Full article

(This article belongs to the Special Issue Health and Wellbeing on Aging)

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