Aging and health research最新文献

Background

Sleep problems in the older adults are often linked to their self-perceived health status, significantly affecting their overall well-being. Investigating this relationship is essential to understand how sleep impacts health perception in older adults and to develop targeted strategies to improve their quality of life and health outcomes. The objective was to verifying the association between sleep problems and negative self-perception of health in community-dwelling older adults.

Methods

Cross-sectional study, with data from 43,554 older adults participants of the National Health Survey (PNS-2019). The exposure variable was self-report of sleep problems in the last 15 days (difficulty in falling asleep, waking up frequently at night, or sleeping more than usual) and the study endpoints were self-perception of health (positive/negative). Associations were checked using multivariable logistic regression.

Results

Older adults with sleep problems were 1.92 (95 %CI 1.77; 2.08) more likely to have a negative self-perception of health when compared to older adults without sleep problems.

Conclusions

These findings reinforce the need for programs aimed at reducing sleep problems in older adults, since these are associated with negative self-perceptions of health. A better understanding of these associations may help health care professionals to better control sleep disturbances as well as their outcomes.

Background

: Qualitative research shows barriers in access to healthcare for persons with a migration background, possibly leading to healthcare inequalities. We aimed to compare healthcare use between older community-dwelling persons with a migration background and native Dutch persons with dementia.

Methods

: Observational cohort study using electronic health records of NIVEL Primary Care Database (2013–2014) linked to nationwide administrative registries managed by Statistics Netherlands. We included all community-dwelling persons with dementia in the Netherlands aged 65 years and older. Negative binomial and logistic regression analyses were conducted to assess differences in healthcare use outcomes. The largest migrant groups (persons born in Surinam, Turkey and Morocco) were studied separately.

Results

: 138,864 persons with dementia were included in the study, whereof 3,991 persons with a migration background and 132,477 native Dutch persons. Moroccan-born persons showed 1.46 higher odds of having an unplanned hospital admission compared to native Dutch persons (95 % Confidence Interval [CI] 1.22–1.74). Persons with a migration background used less professional home care (Odds Ratio [OR] 0.55, 95 %CI 0.51–0.59), and received less home visits from their general practitioner (OR 0.50, 95 %CI 0.43–0.57) than native Dutch persons. Moroccan-born persons had more often an out-of-hours general practitioner consultation compared to native Dutch persons (Incidence Rate Ratio 1.36, 95 %CI 1.18–1.57).

Conclusions

: We found significant quantitative differences in healthcare use between persons with a migration background and native Dutch persons with dementia. Further research is needed to gain insight into the reasons of these differences, with consideration of specific migration background.

This review aims to assess the impact of oral health care interventions on the overall health enhancement and prevention of disease among older adults residing in nursing homes. A systematic search was conducted for reviews published between January 2012 and December 2022, focusing on oral health in nursing home settings. Seventeen reviews met the inclusion criteria, encompassing studies involving older adults, their families, and nursing home staff. Various databases, including PubMed, CINAHL Complete, Scopus, and others, were searched, and quality assessments were performed using established guidelines.

Findings suggest a correlation between oral health and nutritional status, with potential implications for pneumonia prevention through professional oral health care. However, recommendations for interventions remain elusive due to insufficient evidence, particularly regarding the effectiveness of oral health education for caregivers. Despite a documented low oral health-related quality of life among older nursing home residents, oral health promotion programs show promise in addressing this issue.

In conclusion, there is a pressing need to enhance oral health among older adults in nursing homes. While certain interventions demonstrate potential effectiveness, the current evidence lacks consistency and comprehensiveness. Future research efforts should prioritize collaborative approaches between practice and research to explore diverse outcomes and ensure optimal practice.

Heat waves are increasingly becoming a serious threat to human health, especially for children, adults above 65 years and vulnerable populations. Older adults are already burdened with several chronic illnesses with cardiovascular diseases being the most prevalent and among the leading causes of death in that population. In this review, we explore evidence of the impact of heat stress on cardiovascular health outcomes of older adults. We further attempt to simplify the mechanisms by which aging compromises thermoregulation of individuals above the age of 65 thereby exacerbating cardiovascular diseases. Articles used in this mini review were retrieved from PubMed, Google scholar, Scopus and other academic internet databases relevant to the field of study. The keywords used in the search were ‘heat stress’, ‘cardiovascular diseases in older adults’ ‘heat stress and cardiovascular diseases’ as well as ‘heat stress and aging’. The publications included in this mini review have been carefully chosen based on their relevance, reliability, and contribution to advancing our understanding of the topic. This review reveals that heat stress in older adults may lead to increased hospitalization and death in some cases. There is a dearth of studies focusing on this area in developing countries. Therefore, this review can stimulate research interest for under studied regions or countries on the subject area considering that heat stress is a growing concern as a risk factor for cardiovascular diseases. Understanding the role of heat stress in cardiovascular diseases can help health care workers and policy makers to plan for mitigation strategies to avoid the risk of hospitalization and/or death during heat waves among older adults.

Accounting for approximately 70 % of dementia cases and rising globally, Alzheimer's Disease Dementia (ADD) is a formidable challenge to patients, carers and healthcare professionals worldwide. ADD has a significant impact on patient's and carers’ quality of life, as well as substantial economical and societal costs. Therefore, understanding the pathogenesis of ADD to identify potential treatment targets is becoming an important research priority. For several decades, the amyloid cascade hypothesis has dominated ADD research, however recent critiques have called this into question. Research suggests there may be a significant vascular component, which may occur earlier, potentiate, and drive further amyloid pathology in the brain. One potential area for further exploration is the role of vascular dysregulation in the pathogenesis of ADD. In this review, we examine the current literature regarding vascular dysregulation, and its role in the development of ADD. We further explore the complexity involved in the intersection between vascular insults and the amyloid-cascade hypothesis, and call for further research in the use of cerebral blood flow for a diagnostic and therapeutic target for ADD.

Rehabilitation is increasingly being integrated into dementia care. To provide person-centred rehabilitation interventions, a systematic assessment of rehabilitation needs is essential. This scoping review was conducted to identify and map the characteristics of tools and procedures used by health professionals to assess the rehabilitation needs of people living at home with early-stage dementia. A comprehensive literature search was conducted in 2018, 2020, 2021 and 2023 of PubMed, Embase, PsycInfo, CINAHL and Prospero. Identified tools were classified according to the World Health Organization's ICF classification and subjective perspectives. Procedures were classified according to place, time and the people involved in the needs assessment. Eleven papers were included. The population considered was predominantly people diagnosed with Alzheimer's dementia. The identified tools mainly assessed problems with functioning, predominantly focusing on activity and less frequently on participation. One tool had a focus on the environment. None of the tools focused on personal factors. Subjective perspectives were mainly assessed in terms of goal setting. Procedures were poorly described. While several needs assessment tools were identified, procedures for needs assessment were sparsely described in the included papers. This scoping review indicates that a strengthened focus on needs assessment is needed in future research and practice.

Background

Vitality is a relatively unresearched concept and defined in existing literature either on the premise of one's functioning, or in terms of feeling alive. There is, however, little known about the significance of a sense of connectedness to life for vitality, especially from the perspective of older adults. This research aims to explore the association between the concept of connectedness and the perspective of vitality as a sense of aliveness, in order to formulate a theoretical understanding grounded in the subjective perceptions that older adults themselves hold of vitality.

Methods

Following a constructivist grounded theory approach and theoretical sampling, constant comparative analysis was performed on the transcripts of 15 semi-structured interviews, conducted in the Netherlands with older adults (mean age 73 years, eight females and seven males), regarding their vitality. Concurrently, empirical and theoretical findings were translated into a theoretical conceptualisation.

Results

According to the older participants, connecting to life itself enhanced their sense of vitality. This connection was achieved through internal connectedness (connecting to one's own life, intrinsic stimuli and intrinsic goals in an independent manner) and external connectedness (social connectedness, environmental connectedness, engagement with the external world). Furthermore, our findings revealed distinct interactions between internal and external connectedness and facilitating tools, such as freedom from physical constraints, financial freedom and adaptation.

Conclusions

Our findings provide a holistic concept of vitality and connectedness and consolidate existing perspectives on vitality into an overarching framework, which can contribute to the development of effective care policy, healthcare interventions and welfare services.

Background

This study aims to investigate the clinical characteristics and the short-term consequences of COVID-19 in older people with epilepsy.

Methods

From January 28 to March 6,2023,a telephone follow-up survey was conducted to a group of older people with epilepsy after COVID-19 outbreak in Shanghai. Data on infection symptoms,duration,COVID-19 vaccination, and clinical characteristics and management of epilepsy were collected.

Results

Eighty-two participants aged ≥50 years with SARS-CoV-2 infection were recruited. Common symptoms included fever (72.0%) and cough (63.4%).Overall, anti-seizure medication(ASM) accessibility was sufficient (95.1%),and medication adherence was good (93.9%).Three participants (3.7%)reported 1–3 seizures after virus infection. No statistically significant differences were observed in terms of clinical characteristics and consequences of COVID-19 in subgroups with participants aged <63 and ≥63years,with and without fever, antipyretic drugs users and non-users, and with ≥4 and <4 seizures/year before COVID-19.

Conclusion

Our study found few cases of seizure onset and good ASM adherence after SARS-CoV-2 infection in older people with epilepsy. Further prospective studies are needed to understand the long-term consequences of COVID-19.

Growing evidence shows a relationship between social infrastructure (SI) – the physical places where people gather outside of home and work – and health. However, existing data sources for rigorously investigating this relationship are limited, especially for rural areas. Therefore, we conducted an environmental scan of existing data for furthering research on this topic, with a focus on the rural United States (U.S.). A total of 10 datasets met inclusion criteria. Key information was collated from websites and reviewed by data administrators. We summarize key features of these datasets, including available measures of geography/rurality, SI availability and utilization, and physical, mental and social health. We describe analytic strengths and weaknesses of the available data, which is essential for researchers to be able to assess their data options. While the scan focuses on U.S.-based data, the key points will be applicable more broadly, including a need for more data on availability and use of social infrastructure combined with geographic indicators.

Background

Evidence for the time trend of mortality with dementia from low- and middle-income countries is scarce.

Objective

To explore the secular trend of dementia mortality in a Chinese community over 2 decades.

Methods

The Shanghai Epidemiological Survey of Dementia and Alzheimer's Disease (SESD) and the Shanghai Aging Study (SAS) are community-based studies established in the same resident district in 1987 and 2010. We examined changes in 5-year mortality of dementia (i.e. Alzheimer's disease [AD], vascular dementia [VD], and all dementia) by analyzing survival data of participants aged≥65 years from the prospective stages of SESD (1987–1992) and SAS (2010–2015). Mortality rate (MR), case fatality rate (CFR), and standardized mortality ratio (SMR) in SAS were adjusted by the sex, age, and education-structured population data in SESD.

Result

The adjusted 5-year MRs of AD (0.76% vs. 2.24 %; OR, 95 %CI 0.34, 0.20–0.57), VD (0.37% vs. 1.16 %; OR 0.33,0.16–0.68), and all dementia (1.23% vs. 3.74 %; OR 0.32, 0.22–0.48) in SAS were lower than that in SESD. The same trend of the 5-year CFRs was also observed in AD (23.3% vs. 62.2 %; OR 0.19, 0.10–0.35), VD (48.7% vs. 77.4 %; OR 0.29, 0.10–0.90), and all dementia (61.0% vs. 70.6 %; OR 0.21, 0.12–0.35). The 2-year SMR in individuals with VD increased significantly (3.18 vs. 15.31), but the 5-year SMR increased gently (3.81 vs. 5.32) during the 2 decades.

Conclusion

We observed a decreasing trend of dementia mortality, and VD still induced a higher threat to life loss over 20 years in this older Chinese population.