Letter: Social work and clinical synergy—Optimising health interventions for elderly DGBI populations

Abstract

We were interested in the recent study by Sperber et al.¹ This explored the prevalence and clinical significance of disorders of gut–brain interaction (DGBI) in the elderly population. It found that despite a lower prevalence than in younger populations, elderly patients still face a significant health burden, particularly with regard to faecal incontinence. Although the study provided valuable insights, we believe that there are still areas for improvement.

First, despite the authors' efforts to minimise missing data, it remains an unavoidable issue that could impact the accuracy and reliability of the results. This concern is particularly relevant in older populations, where reporting biases such as recall bias and social desirability bias may be more pronounced. We recommend the use of multiple imputation and sensitivity analyses to mitigate these biases and strengthen the robustness of the findings.²

Second, although the study effectively adjusted for key variables such as age, gender, geographic region and symptom severity through univariate and multivariate logistic regression analyses, we suggest incorporating additional relevant factors. These include socio-economic status,³ lifestyle factors⁴ and chronic comorbidities⁵ to better tailor intervention strategies.

Given the significant differences in healthcare policies, resource allocation, socio-economic conditions and patient education across different countries, conducting subgroup analyses by country or centre is particularly important.⁶ This approach would allow for a more precise assessment of regional disparities and provide a stronger basis for developing targeted interventions. For instance, in regions with limited healthcare resources, interventions may need to focus more on community-level support and education.

Moreover, as populations age, effective collaboration between social workers and clinicians is essential for providing comprehensive care to elderly patients, especially in managing complex health issues such as DGBI. Individually, social workers can conduct mental health assessments to identify anxiety and depression in elderly patients with DGBIs and collaborate with clinicians to develop treatment plans that include psychological interventions. At the community level, social workers and clinicians should jointly deliver health education, raise awareness of DGBI, and connect patients with community resources such as support groups and counselling services to ensure continuous social support and psychological care. At the policy level, social workers can work with policymakers and healthcare providers to advocate for more comprehensive public health strategies, including increased focus and resources for DGBIs in the elderly population.

In summary, Sperber et al have provided valuable insights into the impact of DGBIs across different age groups. By further optimising data handling, incorporating more confounding factors, conducting subgroup analyses, and enhancing multidisciplinary collaboration, future research and practice can more effectively address the challenges posed by DGBIs, ultimately improving the quality of life for the elderly population.

Rui Zhang: Methodology; formal analysis; writing – original draft. Hua Wei: Methodology; writing – original draft. Ming Liu: Conceptualization; methodology; supervision; writing – review and editing.

No fundings were received for this research.

The authors declare no conflicts of interest that pertain to this work.

This article is linked to Sperber et al papers. To view these articles, visit https://doi.org/10.1111/apt.18103 and https://doi.org/10.1111/apt.18252