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Sequential multiple mediating effect of loneliness and family health on physical frailty and willingness to age at home in older adults: a national survey in China. 孤独和家庭健康对老年人身体虚弱和居家养老意愿的连续多重中介效应:中国的一项全国性调查。
IF 4.3 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-07 DOI: 10.1186/s12877-024-05520-1
Xuan Wang, Yifan Jiang, Zhiyong Xu, Lin Qi, Yibo Wu, Min Zhang

Background: With the rapid ageing of the global population, the number of older adults with physical frailty has been gradually increasing, making ageing at home a key strategy for coping with this demographic change. The opinions of older adults regarding their willingness to age at home deserve to be considered respectfully. As a result, this study aimed to investigate willingness to age at home and any associated underlying mechanisms involving physical frailty among older Chinese adults.

Methods: This study was a national cross-sectional survey. Stratified random and quota sampling were used before and after the individual level respectively. Willingness to age at home was compared between older adults with different characteristics using the Mann-Whitney U test and Kruskal-Wallis H test. A Spearman rank test was conducted to explore the correlations among physical frailty, loneliness, family health, and willingness to age at home. The path hypothesis that loneliness and family health influence the relationship between physical frailty and willingness to age at home among older adults was further tested through sequential multiple mediation analysis.

Results: A total of 3,837 older adults were included in this study. They returned a median score of 78 in terms of willingness to age at home. Physical frailty (β = - 0.044, P < 0.01) and loneliness (β = - 0.070, P < 0.001) were negatively associated, and family health (β = 0.275, P < 0.001) was positively associated with a willingness to age at home among older Chinese adults. Loneliness and family health played sequential multiple mediating role (β = - 0.018, Boot SE = 0.002, 95% CI = [-0.022, - 0.014]) between physical frailty and willingness to age at home.

Conclusions: Reducing physical frailty in older adults, reducing their sense of loneliness, and enhancing their family health is essential, as it can increase their levels of confidence with regard to ageing at home.

背景:随着全球人口迅速老龄化,身体虚弱的老年人逐渐增多,居家养老成为应对这一人口变化的关键策略。老年人对在家养老意愿的看法值得尊重。因此,本研究旨在调查中国老年人居家养老的意愿以及与身体虚弱相关的潜在机制:本研究是一项全国性横断面调查。方法:本研究是一项全国性横断面调查,在个人层面前后分别采用了分层随机抽样和配额抽样。采用 Mann-Whitney U 检验和 Kruskal-Wallis H 检验比较了不同特征的老年人在家养老的意愿。斯皮尔曼秩检验探讨了身体虚弱、孤独、家庭健康和居家养老意愿之间的相关性。通过序列多重中介分析,进一步检验了孤独感和家庭健康影响老年人身体虚弱与在家养老意愿之间关系的路径假设:本研究共纳入了 3837 名老年人。结果:本研究共纳入 3837 名老年人,他们在家养老意愿的中位数为 78 分。身体虚弱(β = - 0.044,P 结论:减轻老年人的身体虚弱,可以提高他们的生活质量:减轻老年人的身体虚弱程度、减少他们的孤独感以及增强他们的家庭健康至关重要,因为这可以提高他们在家养老的信心水平。
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引用次数: 0
Factors associated with the occupational balance in caregivers of people with dementia: A cross-sectional study from the ATENEA project. 与痴呆症患者照顾者职业平衡相关的因素:ATENEA 项目的横断面研究。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-06 DOI: 10.1186/s12877-024-05518-9
Daniel Prieto-Botella, Paula Fernández-Pires, Paula Peral-Gómez, Cristina Espinosa-Sempere, Verónica Company-Devesa, José-Ángel Pastor-Zaplana, Loreto González-Román, Jessica Garrido-Pedrosa, Inmaculada Zango-Martín, Petra Wagman, Alicia Sánchez-Pérez

Background: Occupational balance (OB) has been associated with health indicators in informal caregivers (CGs) such as well-being and subjective health. Consequently, maintaining an adequate OB could be crucial to providing adequate care without becoming overwhelmed, converting the condition of caregivers into an important aspect of public health as the ageing population increases. However, little is known about the factors influencing OB in CGs. Thus, this study aimed to explore the associated factors with the OB in CGs of persons with dementia.

Methods: We cross-sectionally analysed data from 134 CGs and the individuals with dementia. We assessed CGs' OB using the Occupational Balance Questionnaire (OBQ). Simultaneously, several sociodemographic, clinical, and caregiving-related variables including CGs' burden and psychological distress were assessed. The association between the CGs' OB and those factors was explored through robust multiple linear regression.

Results: Firstly, CGs that presented secondary education exhibited a decrement of 5.41 (CI95% = -10.62, -0.41; p-value = 0.03) OB points. Moreover, CGs with higher education experienced a more pronounced OB reduction (β = -7.74; 95%CI = -12.19, -3.29; p-value = < 0.001). Secondly, those CGs that were retired showed an OB increment of 5.52 (CI95% = 1.14, 9.38; p-value = 0.01). Thirdly, receiving assistance with household chores was associated with an OB increase of 5.80 (CI95% = 2.21, 9.38; p-value = 0.001). Fourthly, and regarding clinical measures, CGs experiencing overload or psychological distress were associated with an OB points decrement of 7.87 (CI95% = -12.51, -3.23; p-value = 0.001) and 9.17 (CI95% =-13.51, -4.84; p-value < 0.001), respectively. Finally, 1% increment in the Disability Assessment for Dementia obtained from the individuals with dementia was associated with an increment of 0.11 (CI95% = 0.04, 0.18; p-value = 0.002) OB points.

Conclusions: This study identified several associated factors with the OB of CGs of persons with dementia. Specifically, we remarked that the CGs' education, employment status, household chores assistance, overload presence, psychological distress symptoms and the functional level of the person with dementia who cared for were important variables that should be considered when evaluating OB or creating OB-related interventions in CGs.

背景:职业平衡(OB)与非正规护理人员(CGs)的健康指标(如幸福感和主观健康)有关。因此,随着老龄化人口的增加,保持适当的职业平衡对于提供充分的护理而不至于不堪重负至关重要,这也使护理人员的状况成为公共卫生的一个重要方面。然而,人们对影响 CGs OB 的因素知之甚少。因此,本研究旨在探讨与痴呆症患者社区活动中心的活动量相关的因素:我们横向分析了 134 家老年痴呆症患者团体和老年痴呆症患者的数据。我们使用职业平衡问卷(OBQ)对老年痴呆症患者的职业平衡进行了评估。同时,我们还评估了与社会人口学、临床和护理相关的几个变量,包括CGs的负担和心理困扰。通过稳健的多元线性回归,探讨了 CGs 的职业平衡与这些因素之间的关联:首先,受过中等教育的 CGs 的 OB 下降了 5.41(CI95% = -10.62, -0.41;P 值 = 0.03)分。此外,受过高等教育的 CGs 的 OB 下降更为明显(β = -7.74; 95%CI = -12.19, -3.29;p 值 = 结论:本研究发现了几个与痴呆症患者脑电图转播相关的因素。具体而言,我们注意到,老年痴呆症社区工作者的教育程度、就业状况、家务协助、是否超负荷工作、心理困扰症状以及所照顾的老年痴呆症患者的功能水平是评估老年痴呆症社区工作者转播或制定与转播相关的干预措施时应考虑的重要变量。
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引用次数: 0
Sociodemographic and health disparities in self-care difficulties among older individuals: Evidence from South Africa. 老年人自我护理困难的社会人口和健康差异:南非的证据。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-06 DOI: 10.1186/s12877-024-05416-0
Ghose Bishwajit, Sanni Yaya

Background: As South Africa's population rapidly ages, the burden of non-communicable diseases and the challenges of performing daily care activities among older individuals are increasing. This study investigates trends in self-reported difficulties with daily care activities among older adults in South Africa and examines the association between these difficulties, sociodemographic factors, and chronic conditions.

Methods: The study used cross-sectional data from ten rounds of South Africa General Household Survey (2012-2021). Sample population included 26,362 men and 42,400 women aged 60 years and above. The outcome measure was assessed by self-reported difficulty in performing basic care activities such as washing or dressing.

Results: Between 2012 and 2021, the percentage of participants reporting "A lot of difficulty" increased by 79.75%, "Some difficulty" increased by 112.11%, while "Unable to do" decreased by 8.97%. The risk of self-care difficulties was higher for men (RR = 1.11, 95% CI = 1.02, 1.20) and increased with age: RR = 1.24 (95% CI = 1.08, 1.42) for ages 65-69; RR = 2.27 (95% CI = 2.00, 2.58) for ages 70-74; and RR = 5.65 (95% CI = 5.08, 6.28) for ages 75+. Not being currently married (RR = 1.65, 95% CI = 1.51, 1.79), being of African/Black (RR = 1.21, 95% CI = 1.06, 1.38) or Coloured race (RR = 1.41, 95% CI = 1.21, 1.65), and having diabetes (RR = 1.44, 95% CI = 1.34, 1.55), hypertension (RR = 1.35, 95% CI = 1.26, 1.45), or asthma (RR = 1.30, 95% CI = 1.14, 1.48) were also associated with a higher risk of self-care difficulties.

Conclusion: There was a notable increase in the proportion of participants reporting significant difficulty and some difficulty in performing self-care tasks, while a decrease was observed in the category of participants unable to do such tasks. Health policies should prioritize the specific needs of vulnerable sociodemographic and health groups, considering their increased risk of self-care difficulties.

背景:随着南非人口迅速老龄化,非传染性疾病给老年人带来的负担以及他们在进行日常护理活动时所面临的挑战与日俱增。本研究调查了南非老年人自我报告的日常护理活动困难的趋势,并研究了这些困难、社会人口因素和慢性病之间的关联:研究使用了十轮南非住户总体调查(2012-2021 年)的横截面数据。样本人群包括 26,362 名男性和 42,400 名女性,年龄均在 60 岁及以上。结果通过自我报告在进行基本护理活动(如洗漱或穿衣)时遇到的困难进行评估:2012年至2021年期间,报告 "非常困难 "的参与者比例增加了79.75%,"有些困难 "的参与者比例增加了112.11%,而 "无法完成 "的参与者比例减少了8.97%。男性出现自我护理困难的风险较高(RR = 1.11,95% CI = 1.02,1.20),并且随着年龄的增长而增加:65-69岁的RR=1.24(95% CI=1.08,1.42);70-74岁的RR=2.27(95% CI=2.00,2.58);75岁以上的RR=5.65(95% CI=5.08,6.28)。目前未结婚(RR = 1.65,95% CI = 1.51,1.79)、非洲/黑人(RR = 1.21,95% CI = 1.06,1.38)或有色人种(RR = 1.41,95% CI = 1.21,1.65)以及患有糖尿病(RR = 1.44, 95% CI = 1.34, 1.55)、高血压(RR = 1.35, 95% CI = 1.26, 1.45)或哮喘(RR = 1.30, 95% CI = 1.14, 1.48)也与较高的自我护理困难风险有关:结论:报告在完成自我护理任务时遇到重大困难和一定困难的参与者比例明显增加,而无法完成此类任务的参与者比例则有所下降。考虑到弱势社会人口和健康群体自我护理困难的风险增加,卫生政策应优先考虑他们的特殊需求。
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引用次数: 0
Mazor X robot-assisted upper and lower cervical pedicle screw fixation: a case report and literature review. Mazor X机器人辅助上下颈椎椎弓根螺钉固定术:病例报告和文献综述。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-06 DOI: 10.1186/s12877-024-05447-7
Zilin Gao, Xiaobo Zhang, Zhengwei Xu, Chao Jiang, Wei Hu, Haiping Zhang, Dingjun Hao

Background: Manual placement of cervical pedicle screws is risky, and robot-assisted placement of atlantoaxial pedicle screws has not been reported.

Case report: We describe a 74-year-old female patient with atlantoaxial fracture and dislocation combined with spinal cord injury caused by a car accident. The left lower limb muscle strength was grade 0, the right upper limb muscle strength was grade 1, and the right lower limb muscle strength was grade 2. Loss of sensation below the clavicle level, decreased superficial sensation in the extremities, loss of deep sensation in the left lower extremity, and incontinence were observed. We successfully placed atlas pedicle screws with the assistance of the Mazor X robot. One week after the operation, radiological imaging revealed that the reduction effect was good, the placement of the pedicle screws was satisfactory, the left upper limb and left lower limb muscle strength was level 2, the right upper limb and the muscle strength of the right lower limb were grade 3, and the sensory function was partially restored. No complications related to screw placement were found at the 3-month postoperative follow-up.

Conclusions: Mazor X robot-assisted descending pedicle screw fixation of the atlas is feasible and safe.

背景:手动放置颈椎椎弓根螺钉有一定风险,而机器人辅助放置寰枢椎椎弓根螺钉尚未见报道:我们描述了一名因车祸导致寰枢椎骨折和脱位合并脊髓损伤的 74 岁女性患者。左下肢肌力为 0 级,右上肢肌力为 1 级,右下肢肌力为 2 级。患者锁骨水平以下感觉缺失,四肢浅层感觉减退,左下肢深层感觉缺失,大小便失禁。在 Mazor X 机器人的协助下,我们成功地植入了寰椎椎弓根螺钉。术后一周,放射影像学检查显示,缩窄效果良好,椎弓根螺钉置入满意,左上肢和左下肢肌力为二级,右上肢和右下肢肌力为三级,感觉功能部分恢复。术后3个月随访未发现与螺钉置入相关的并发症:结论:Mazor X机器人辅助下椎弓根螺钉固定寰椎是可行且安全的。
{"title":"Mazor X robot-assisted upper and lower cervical pedicle screw fixation: a case report and literature review.","authors":"Zilin Gao, Xiaobo Zhang, Zhengwei Xu, Chao Jiang, Wei Hu, Haiping Zhang, Dingjun Hao","doi":"10.1186/s12877-024-05447-7","DOIUrl":"10.1186/s12877-024-05447-7","url":null,"abstract":"<p><strong>Background: </strong>Manual placement of cervical pedicle screws is risky, and robot-assisted placement of atlantoaxial pedicle screws has not been reported.</p><p><strong>Case report: </strong>We describe a 74-year-old female patient with atlantoaxial fracture and dislocation combined with spinal cord injury caused by a car accident. The left lower limb muscle strength was grade 0, the right upper limb muscle strength was grade 1, and the right lower limb muscle strength was grade 2. Loss of sensation below the clavicle level, decreased superficial sensation in the extremities, loss of deep sensation in the left lower extremity, and incontinence were observed. We successfully placed atlas pedicle screws with the assistance of the Mazor X robot. One week after the operation, radiological imaging revealed that the reduction effect was good, the placement of the pedicle screws was satisfactory, the left upper limb and left lower limb muscle strength was level 2, the right upper limb and the muscle strength of the right lower limb were grade 3, and the sensory function was partially restored. No complications related to screw placement were found at the 3-month postoperative follow-up.</p><p><strong>Conclusions: </strong>Mazor X robot-assisted descending pedicle screw fixation of the atlas is feasible and safe.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"916"},"PeriodicalIF":3.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utilization of home-based care and its buffering effects between dementia caregiving intensity and caregiver burden in China. 中国居家护理的利用及其在痴呆症护理强度和护理负担之间的缓冲作用。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-05 DOI: 10.1186/s12877-024-05501-4
Yang Zhou, Wallace Chi-Ho Chan

Background: Home-based care (HBC) services have gained global attention for their potential to reduce caregiver burden among informal caregivers of persons with dementia (PwDs), who experience high caregiving intensity. However, research on HBC and its effects on dementia caregiving in China remains limited.

Methods: Data were collected from primary caregivers of PwDs in Jiangsu Province, China. Caregiving intensity and HBC utilization were measured using self-developed instruments. Caregiver burden was assessed by The Burden Scale for Family Caregivers-short. Factor analysis was employed to decompose HBC services. Hierarchical multiple regression analysed the moderating effects of HBC on the relationship between caregiving intensity and burden.

Results: A community sample of 318 caregiver and PwDs dyads was included. Caregivers averagely aged 62.16 years, with 61% being female, 84% not employed, and 66.2% having low income. PwDs aged 77.45 years averagely, with 52.8% being female and an average behavioural problems score of 42.27. Caregivers averaged 15.19 on response measures. The number and time spent on ADL-based tasks were positively associated with caregiver burden (β = 0.26, p < .001; β = 0.16, p < .01). However, attendance and time of supervision tasks were not significant predictors of burden. HBC services in China comprised four dimensions: Referral service, Household care, Skilled care, and Mental health service. While these did not directly predict caregiver burden, they moderated the associations between ADL-based tasks and caregiver burden (β=-0.25, p < .001; β=-0.24, p < .001; β=-0.23, p < .001; β=-0.20, p < .001), between time of ADL-based tasks and caregiver burden (β=-0.17, p < .001; β=-0.18, p < .001; β=-0.17, p < .001; β=-0.15, p < .01), and between the attendance at supervision tasks and caregiver burden (β=-0.11, p < .05; β=-0.20, p < .001; β=-0.17, p < .001; β=-0.17, p < .001). Only Referral service buffered the relationship between supervision time and caregiver burden (β = -0.13, p < .01).

Conclusion: Informal caregivers of PwDs face high caregiving intensity and burden. HBC services may moderate this relationship, with different services playing varying roles. Further research is essential to explore the impact of supervision levels and develop effective strategies to enhance HBC services for dementia caregiving in China.

背景:居家照护(HBC)服务因其可减轻高照护强度的痴呆症患者非正式照护者的照护负担而受到全球关注。然而,在中国,有关居家照护及其对痴呆症照护影响的研究仍然有限:方法:从中国江苏省痴呆症患者的主要照顾者那里收集数据。方法:数据收集自中国江苏省的残疾人主要照护者,照护强度和HBC使用情况通过自主开发的工具进行测量。照顾者负担采用家庭照顾者负担量表(短)进行评估。采用因子分析法对居家养老服务进行分解。层次多元回归分析了家庭护理中心对护理强度和负担之间关系的调节作用:结果:研究纳入了 318 个照顾者和残疾人的社区样本。照顾者的平均年龄为 62.16 岁,61% 为女性,84% 没有工作,66.2% 为低收入。残疾人的平均年龄为 77.45 岁,52.8% 为女性,行为问题的平均得分为 42.27 分。照护者的平均回答指数为 15.19。用于日常活动的次数和时间与照顾者的负担呈正相关(β = 0.26,p 结论:照顾者的负担与日常活动的次数和时间呈正相关(β = 0.26,p 结论:照顾者的负担与日常活动的次数和时间呈正相关):残疾人的非正规照顾者面临着很高的照顾强度和负担。居家社区服务可能会缓和这种关系,不同的服务会发挥不同的作用。进一步的研究对于探索督导水平的影响和制定有效策略以加强中国痴呆症照护者的居家社区服务至关重要。
{"title":"Utilization of home-based care and its buffering effects between dementia caregiving intensity and caregiver burden in China.","authors":"Yang Zhou, Wallace Chi-Ho Chan","doi":"10.1186/s12877-024-05501-4","DOIUrl":"10.1186/s12877-024-05501-4","url":null,"abstract":"<p><strong>Background: </strong>Home-based care (HBC) services have gained global attention for their potential to reduce caregiver burden among informal caregivers of persons with dementia (PwDs), who experience high caregiving intensity. However, research on HBC and its effects on dementia caregiving in China remains limited.</p><p><strong>Methods: </strong>Data were collected from primary caregivers of PwDs in Jiangsu Province, China. Caregiving intensity and HBC utilization were measured using self-developed instruments. Caregiver burden was assessed by The Burden Scale for Family Caregivers-short. Factor analysis was employed to decompose HBC services. Hierarchical multiple regression analysed the moderating effects of HBC on the relationship between caregiving intensity and burden.</p><p><strong>Results: </strong>A community sample of 318 caregiver and PwDs dyads was included. Caregivers averagely aged 62.16 years, with 61% being female, 84% not employed, and 66.2% having low income. PwDs aged 77.45 years averagely, with 52.8% being female and an average behavioural problems score of 42.27. Caregivers averaged 15.19 on response measures. The number and time spent on ADL-based tasks were positively associated with caregiver burden (β = 0.26, p < .001; β = 0.16, p < .01). However, attendance and time of supervision tasks were not significant predictors of burden. HBC services in China comprised four dimensions: Referral service, Household care, Skilled care, and Mental health service. While these did not directly predict caregiver burden, they moderated the associations between ADL-based tasks and caregiver burden (β=-0.25, p < .001; β=-0.24, p < .001; β=-0.23, p < .001; β=-0.20, p < .001), between time of ADL-based tasks and caregiver burden (β=-0.17, p < .001; β=-0.18, p < .001; β=-0.17, p < .001; β=-0.15, p < .01), and between the attendance at supervision tasks and caregiver burden (β=-0.11, p < .05; β=-0.20, p < .001; β=-0.17, p < .001; β=-0.17, p < .001). Only Referral service buffered the relationship between supervision time and caregiver burden (β = -0.13, p < .01).</p><p><strong>Conclusion: </strong>Informal caregivers of PwDs face high caregiving intensity and burden. HBC services may moderate this relationship, with different services playing varying roles. Further research is essential to explore the impact of supervision levels and develop effective strategies to enhance HBC services for dementia caregiving in China.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"913"},"PeriodicalIF":3.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of low socioeconomic status with cognitive decline among older persons in underdeveloped areas in China - a data analysis of the Gansu aging study. 低社会经济地位与中国欠发达地区老年人认知能力下降的关系--甘肃老龄化研究的数据分析。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-05 DOI: 10.1186/s12877-024-05496-y
Juxia Zhang, Yuping Feng, Xiaoli Zhang, Jing Wang, Hu Cheng, Yunhua Wang, Jiancheng Wang

Background: Individuals with low socioeconomic status (SES) bear a disproportionate share of the cognitive impairment (CI) burden, there are growing evidence focusing on socioeconomic inequalities in CI among older persons. However, data in the underdeveloped regions is limited. This study aims to measure socioeconomic inequalities in CI among individuals aged 65 years or older in Gansu, China, and determine the contributions of socioeconomic factors to the inequalities.

Methods: Data from the Gansu Aging Study in 2022 including 3241 participants. Participates' SES was assessed by using education, income, and occupation. Multivariate logistic regression was conducted to identify the associated between SES and CI, and decomposition analysis was further applied to decompose the contribution of each determinant to the observed inequalities in CI. The SES inequalities in CI were illustrated and quantified by the concentration curve index.

Results: Overall, 24.2% of participants suffered from CI in the study. The likelihood of CI was lower among those with a medium SES (OR = 0.04, 95% CI:0.03, 0.07), good SES (OR = 0.06, 95% CI: 0.04, 0.09) compared to those with lower levels of SES. Older adults with mild depression (OR = 3.66, 95% CI:2.70,4.95), moderate-severe (OR = 2.82, 95% CI:2.05,3.88) were more likely to have CI in comparison to those with no depression and regular social activities were protective factors for CI (OR = 0.28, 95% CI:0.11,0.75). The concentration index indicated that CI was more concentrated in households with poor SES. Subsequently, SES explained 34.65% of socioeconomic inequality in CI.

Conclusion: This study suggested that, approximately one-quarter of older persons suffered from CI in Gansu, China. Low SES was substantially associated with risk of CI. Although interventions to modify traditional risk factors may decrease the risk of CI, disparities by SES may remain without addressing SES itself.

背景:社会经济地位(SES)低下的人承担着过重的认知障碍(CI)负担,越来越多的证据表明,老年人的认知障碍与社会经济地位不平等有关。然而,欠发达地区的数据十分有限。本研究旨在测量中国甘肃省 65 岁及以上老年人认知障碍的社会经济不平等现象,并确定社会经济因素对不平等现象的影响:数据来自 2022 年甘肃老龄化研究,包括 3241 名参与者。通过教育、收入和职业评估参与者的社会经济地位。进行多元逻辑回归以确定 SES 与 CI 之间的相关性,并进一步应用分解分析来分解各决定因素对观察到的 CI 不平等的贡献。SES 与 CI 的不平等通过浓度曲线指数进行了说明和量化:结果:总体而言,24.2% 的参与者在研究中患有 CI。与社会经济地位较低的人相比,社会经济地位中等(OR = 0.04,95% CI:0.03,0.07)和社会经济地位较高(OR = 0.06,95% CI:0.04,0.09)的人患 CI 的可能性较低。与没有抑郁症的老年人相比,患有轻度抑郁症(OR = 3.66,95% CI:2.70,4.95)和中度-重度抑郁症(OR = 2.82,95% CI:2.05,3.88)的老年人更有可能患有 CI,而经常参加社交活动是 CI 的保护因素(OR = 0.28,95% CI:0.11,0.75)。集中指数表明,CI 更集中于社会经济条件较差的家庭。因此,社会经济条件解释了 CI 中 34.65% 的社会经济不平等:本研究表明,中国甘肃省约有四分之一的老年人患有 CI。低社会经济地位与 CI 风险密切相关。尽管通过干预措施改变传统的风险因素可以降低 CI 风险,但如果不解决社会经济地位本身的问题,社会经济地位的差异可能会继续存在。
{"title":"Association of low socioeconomic status with cognitive decline among older persons in underdeveloped areas in China - a data analysis of the Gansu aging study.","authors":"Juxia Zhang, Yuping Feng, Xiaoli Zhang, Jing Wang, Hu Cheng, Yunhua Wang, Jiancheng Wang","doi":"10.1186/s12877-024-05496-y","DOIUrl":"10.1186/s12877-024-05496-y","url":null,"abstract":"<p><strong>Background: </strong>Individuals with low socioeconomic status (SES) bear a disproportionate share of the cognitive impairment (CI) burden, there are growing evidence focusing on socioeconomic inequalities in CI among older persons. However, data in the underdeveloped regions is limited. This study aims to measure socioeconomic inequalities in CI among individuals aged 65 years or older in Gansu, China, and determine the contributions of socioeconomic factors to the inequalities.</p><p><strong>Methods: </strong>Data from the Gansu Aging Study in 2022 including 3241 participants. Participates' SES was assessed by using education, income, and occupation. Multivariate logistic regression was conducted to identify the associated between SES and CI, and decomposition analysis was further applied to decompose the contribution of each determinant to the observed inequalities in CI. The SES inequalities in CI were illustrated and quantified by the concentration curve index.</p><p><strong>Results: </strong>Overall, 24.2% of participants suffered from CI in the study. The likelihood of CI was lower among those with a medium SES (OR = 0.04, 95% CI:0.03, 0.07), good SES (OR = 0.06, 95% CI: 0.04, 0.09) compared to those with lower levels of SES. Older adults with mild depression (OR = 3.66, 95% CI:2.70,4.95), moderate-severe (OR = 2.82, 95% CI:2.05,3.88) were more likely to have CI in comparison to those with no depression and regular social activities were protective factors for CI (OR = 0.28, 95% CI:0.11,0.75). The concentration index indicated that CI was more concentrated in households with poor SES. Subsequently, SES explained 34.65% of socioeconomic inequality in CI.</p><p><strong>Conclusion: </strong>This study suggested that, approximately one-quarter of older persons suffered from CI in Gansu, China. Low SES was substantially associated with risk of CI. Although interventions to modify traditional risk factors may decrease the risk of CI, disparities by SES may remain without addressing SES itself.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"908"},"PeriodicalIF":3.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of cognitive performance with overall, dosage, intensity, and domain physical activity in aging: NHANES 2011-2014. 老年认知能力与总体、剂量、强度和领域体育活动的关系:Nhanes 2011-2014。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-05 DOI: 10.1186/s12877-024-05503-2
Si-Jia Li, Hao-Ming Ma, Ao-Qi Wang, Runyuan Pei, Xing-Yi Tang, Guang-Nan Liu, You Zhou, Mei-Hua Piao

Background: The specific relationship between PA in detailed types and cognition is still unclear due to limited evidence. Our study aimed to investigate the relationship between cognitive performance and various aspects of physical activity, including overall activity, dosage, intensity levels [moderate physical activity (MPA), vigorous PA], and different domains of activity [occupational PA (OPA), transportation PA (TPA), and leisure-time PA (LTPA)] in older adults using data from the NHANES database.

Methods: This cross-sectional analysis used data from 2 cycles of NHANES (2011-2014). PA was determined through participants' self-reports using the Global Physical Activity Questionnaire (GPAQ). Cognitive performance was evaluated by the presence of psychometric mild cognitive impairment (p-MCI), identified based on a composite measure derived from three cognitive tests including the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency test, and the Digit Symbol Substitution test (DSST). Logistic regression models were used to evaluate the association.

Results: A total of 2588 participants aged 60 years or older were included, with an average age of 69.4 years and 48% being male. In the fully adjusted model, compared to no PA, performing 300 min of PA, and MPA were associated with 44%, and 33% reductions in the prevalence of p-MCI, respectively. Additionally, engaging in 1-149 min/week [OR 0.56, 95% CI (0.33-0.92)] and ≥ 300 min/week [OR 0.66, 95% CI (0.44-0.96)] of OPA, as well as ≥ 300 min/week [OR 0.56, 95% CI (0.36-0.86)] of LTPA, were also associated with a lower prevalence of p-MCI. Additionally, engaging in a diverse range of PA had better outcomes.

Conclusions: Our results suggested a positive association between higher levels of PA and enhanced cognitive performance. Different intensities and domains of PA have varying impacts on cognition. Future exploration, such as objectively measured PA and longitudinal studies were needed to validate our conclusion.

背景:由于证据有限,详细类型的体育锻炼与认知能力之间的具体关系仍不清楚。我们的研究旨在利用 NHANES 数据库中的数据,调查老年人的认知能力与体育锻炼各个方面的关系,包括总体活动量、活动量、强度水平(适度体育锻炼(MPA)、剧烈体育锻炼)以及不同活动领域(职业体育锻炼(OPA)、交通体育锻炼(TPA)和业余体育锻炼(LTPA)):这项横断面分析使用了两个周期(2011-2014 年)的 NHANES 数据。运动量通过参与者使用全球身体活动问卷(GPAQ)进行自我报告来确定。认知表现通过是否存在心理轻度认知障碍(p-MCI)进行评估,该认知障碍是根据建立阿尔茨海默病登记联盟(CERAD)、动物流畅性测试和数字符号替换测试(DSST)等三项认知测试得出的综合测量结果确定的。研究采用逻辑回归模型来评估两者之间的关联:共纳入了 2588 名 60 岁或以上的参与者,平均年龄为 69.4 岁,男性占 48%。在完全调整模型中,与不参加体育锻炼相比,参加 300 分钟体育锻炼和参加 MPA 分别可使 p-MCI 患病率降低 44% 和 33%。此外,从事 1-149 分钟/周[OR 0.56,95% CI (0.33-0.92)]和≥ 300 分钟/周[OR 0.66,95% CI (0.44-0.96)]的 OPA,以及≥ 300 分钟/周[OR 0.56,95% CI (0.36-0.86)]的 LTPA,也与 p-MCI 患病率降低有关。此外,从事各种活动的人的结果也更好:我们的研究结果表明,较高水平的业余爱好与认知能力的提高之间存在正相关。不同强度和领域的业余爱好对认知能力的影响各不相同。未来的探索,如客观测量PA和纵向研究,需要验证我们的结论。
{"title":"Association of cognitive performance with overall, dosage, intensity, and domain physical activity in aging: NHANES 2011-2014.","authors":"Si-Jia Li, Hao-Ming Ma, Ao-Qi Wang, Runyuan Pei, Xing-Yi Tang, Guang-Nan Liu, You Zhou, Mei-Hua Piao","doi":"10.1186/s12877-024-05503-2","DOIUrl":"10.1186/s12877-024-05503-2","url":null,"abstract":"<p><strong>Background: </strong>The specific relationship between PA in detailed types and cognition is still unclear due to limited evidence. Our study aimed to investigate the relationship between cognitive performance and various aspects of physical activity, including overall activity, dosage, intensity levels [moderate physical activity (MPA), vigorous PA], and different domains of activity [occupational PA (OPA), transportation PA (TPA), and leisure-time PA (LTPA)] in older adults using data from the NHANES database.</p><p><strong>Methods: </strong>This cross-sectional analysis used data from 2 cycles of NHANES (2011-2014). PA was determined through participants' self-reports using the Global Physical Activity Questionnaire (GPAQ). Cognitive performance was evaluated by the presence of psychometric mild cognitive impairment (p-MCI), identified based on a composite measure derived from three cognitive tests including the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency test, and the Digit Symbol Substitution test (DSST). Logistic regression models were used to evaluate the association.</p><p><strong>Results: </strong>A total of 2588 participants aged 60 years or older were included, with an average age of 69.4 years and 48% being male. In the fully adjusted model, compared to no PA, performing 300 min of PA, and MPA were associated with 44%, and 33% reductions in the prevalence of p-MCI, respectively. Additionally, engaging in 1-149 min/week [OR 0.56, 95% CI (0.33-0.92)] and ≥ 300 min/week [OR 0.66, 95% CI (0.44-0.96)] of OPA, as well as ≥ 300 min/week [OR 0.56, 95% CI (0.36-0.86)] of LTPA, were also associated with a lower prevalence of p-MCI. Additionally, engaging in a diverse range of PA had better outcomes.</p><p><strong>Conclusions: </strong>Our results suggested a positive association between higher levels of PA and enhanced cognitive performance. Different intensities and domains of PA have varying impacts on cognition. Future exploration, such as objectively measured PA and longitudinal studies were needed to validate our conclusion.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"910"},"PeriodicalIF":3.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of improvement and worsening of depressive symptoms with arthritis. 抑郁症状的改善和恶化与关节炎的关系。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-05 DOI: 10.1186/s12877-024-05498-w
Ruxi Liu, Yinuo Xin, Yining Shao, Bo Wu, Yan Liu

Purpose: The longitudinal association between changes in depressive symptoms (improvement/worsening) and arthritis is unclear.

Methods: Study data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2018. The 10-item Center for Epidemiological Studies Depression Scale (CES-D-10) was used to examine participant depressive symptoms and data on self-reported history of arthritis were collected. Depressive symptoms improving is defined as depression at baseline and no depression at follow-up. Similarly, depressive symptoms worsening is defined as no depression at baseline and depression at follow-up. Cox proportional hazards models were used to evaluate the effects of improvement or deterioration in depressive symptoms on arthritis. Participants with missing data on depression and arthritis, having arthritis in 2011 CHARLS and lost to follow-up was excluded.

Results: A total of 8556 participants free of arthritis were included from 2011 to 2018. After adjustment for confounders, depressive symptoms were associated with a 54% increased risk of developing arthritis. Each 1-point increase in CES-D-10 score was associated with a 4% higher risk of arthritis. Participants with depressive symptoms at baseline but improved symptoms (without depressive symptoms) at follow-up had a 25% lower rate of arthritis, and a 1-point reduction in CES-D-10 score during 8 years of follow-up was associated with a 5% lower risk of developing arthritis. Participants with no depressive symptoms at baseline but depression at follow-up had a 66% higher rate of arthritis, and a 1-point increase in CES-D-10 score during 8 years of follow-up was associated with a 5% higher risk of arthritis.

Conclusions: Improvement in depressive symptoms was associated with lower risk of arthritis and worsening of depression was associated with higher risk of arthritis. These findings suggest that the relationship between depression and arthritis is complex.

目的:抑郁症状变化(改善/恶化)与关节炎之间的纵向关系尚不明确:研究数据来自2011-2018年中国健康与退休纵向研究(CHARLS)。采用流行病学研究中心抑郁量表(CES-D-10)的10个项目来检测参与者的抑郁症状,并收集自我报告的关节炎病史数据。抑郁症状好转是指基线时有抑郁,随访时无抑郁。同样,抑郁症状恶化也被定义为基线时无抑郁,随访时有抑郁。Cox比例危险模型用于评估抑郁症状改善或恶化对关节炎的影响。排除了抑郁症和关节炎数据缺失、在2011年CHARLS中患有关节炎和失去随访的参与者:从2011年到2018年,共纳入了8556名无关节炎的参与者。在对混杂因素进行调整后,抑郁症状与关节炎发病风险增加 54% 相关。CES-D-10得分每增加1分,患关节炎的风险就会增加4%。基线时有抑郁症状但随访时症状有所改善(无抑郁症状)的参与者患关节炎的风险降低了 25%,随访 8 年期间 CES-D-10 评分每降低 1 分,患关节炎的风险降低 5%。基线时无抑郁症状但随访时有抑郁症状的参与者患关节炎的比例高出66%,随访8年期间CES-D-10得分每增加1分,患关节炎的风险就增加5%:结论:抑郁症状的改善与关节炎风险的降低有关,而抑郁症状的恶化与关节炎风险的升高有关。这些研究结果表明,抑郁症与关节炎之间的关系非常复杂。
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引用次数: 0
The mobile seniors' clinic - an innovative transition of care for frail older adults. 流动老年人诊所--为体弱老年人提供创新的过渡护理。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-05 DOI: 10.1186/s12877-024-05490-4
Valérie Boucher, Eva-Marie Jouhair, Marie-Josée Sirois, Luc Tailleur, Philippe Voyer, Éric Mercier, Anik Giguère, Clermont E Dionne, France Légaré, Clémence Dallaire, Stéphane Bergeron, Pierre-Hugues Carmichael, Marcel Emond

Background: This study aims to evaluate the impact of Quebec's first hospital-at-home-inspired mobile Seniors' Clinic, the "Clinique des Ainés (CDA)", on frail older adults' returns to the Emergency Department (ED), mortality, and hospital Length Of Stay (LOS) and rehospitalizations.

Methods: Design: Quasi-experimental pre-post implementation cohort study.

Population: Patients aged ≥ 75 years admitted to the short-term geriatric unit after an ED consultation (control) or included by the CDA (intervention).

Outcomes: return to ED (RtoED), mortality, ED & hospital LOS, and rehospitalizations.

Statistical analyses: Multivariable regression modelling.

Results: Overall, 891 patients were included. At the intervention site (CDA) (n = 437), RtoED were similar at 30 (17.5% & 19.5%, p = 0.58), 90 (34.4% & 37.3%, p = 0.46) and 180 days (47.2% & 54.0%, p = 0.07) in the pre and post-implementation phases. No mortality differences were found. The hospitalization LOS was significantly shorter (28.26 and 14.22 days, p < 0.01). At 90 days, rehospitalization LOS was decreased by 8.51 days (p = 0.02) and by 6.48 days at 180 days (p = 0.03). Compared to the control site (n = 454) in the post-implementation phase, RtoED was 54% at the intervention site compared to 44.1% (p = 0.02) at 180 days. The CDA had a lower adjusted probability of mortality at 90 days compared to the control site (4.8% VS 11.7%, p = 0.03). No rehospitalization LOS differences were noted.

Conclusions: The Clinique des Ainés showed effectiveness in caring for frail older patients in their homes by decreasing their hospital LOS by half and 90 days mortality risk. It was a safe care trajectory without a clinically significant increase in ED returns or mortality.

研究背景本研究旨在评估魁北克首个受医院启发的流动老年人诊所 "Clinique des Ainés (CDA) "对体弱老年人重返急诊科(ED)、死亡率、住院时间(LOS)和再次住院的影响:方法:设计:方法:设计:实施前-实施后的准实验性队列研究:结果:返回急诊室(RtoED)、死亡率、急诊室和住院时间以及再次住院:统计分析:多变量回归模型:结果:共纳入 891 名患者。在干预地点(CDA)(n = 437),在实施前和实施后阶段,30 天(17.5% 和 19.5%,p = 0.58)、90 天(34.4% 和 37.3%,p = 0.46)和 180 天(47.2% 和 54.0%,p = 0.07)的 RtoED 相似。未发现死亡率差异。住院时间明显缩短(分别为 28.26 天和 14.22 天,P=0.05):Ainés 诊所显示了在家中照顾年老体弱病人的有效性,将他们的住院时间缩短了一半,并降低了 90 天的死亡风险。这是一种安全的护理方式,不会增加急诊室就诊率或死亡率。
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引用次数: 0
Relative-to-resident abuse in Norwegian nursing homes: a cross-sectional exploratory study. 挪威养老院中相对于住院者的虐待行为:一项横断面探索性研究。
IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-11-05 DOI: 10.1186/s12877-024-05513-0
Anja Botngård, Arne Henning Eide, Laura Mosqueda, Lene Blekken, Wenche Malmedal

Background: In community settings, relatives often provide care to their older family members, which is sometimes perceived as a high burden, overwhelming and stressful, contributing to an increased risk of elder abuse. In most countries, relatives have no legal obligation to provide care when family members are admitted to nursing homes; nevertheless, studies have shown that relatives continue to provide emotional, instrumental, and personal care after admission, often related to the understaffing and high workload of nursing staff. Despite the growing interest in elder abuse in nursing homes, most studies have concentrated on the abuse perpetrated by nursing staff or co-residents, but few studies have explored the abuse that relatives may perpetrate.

Methods: This study was a cross-sectional survey of 3,693 nursing staff members recruited from 100 nursing homes in Norway, to examine the extent of relative-to-resident abuse in Norwegian nursing homes, as observed by nursing staff.

Results: The findings indicate that 45.6% of the nursing staff had observed one or more episodes of relative-to-resident abuse during the past year. Among the subtypes of abuse, 44.8% of the nursing staff had observed psychological abuse, 8.4% had observed physical abuse, 2.7% had observed financial/material abuse, and 0.7% had observed sexual abuse at least once during the past year.

Conclusions: This is the first large study exploring the extent of relative-to-resident abuse in nursing homes, which is a phenomenon that is significantly less addressed than abuse committed by staff and co-residents. The findings in our study illustrate that abuse committed by relatives needs more awareness and attention to improve the well-being of nursing home residents. Further research is recommended to enhance our understanding of such abuse and should include other approaches measuring the proportion of relative-to-resident abuse, as relying solely on staff observations is insufficient for determining the prevalence in this case. Future studies should also examine the cumulative impact of victimization in nursing homes and should include an analysis of how cases of abuse are reported and handled.

背景:在社区环境中,亲属经常为年长的家庭成员提供护理,这有时被认为是一种沉重的负担,让人难以承受,压力很大,导致虐待老人的风险增加。在大多数国家,当家庭成员住进养老院时,亲属没有提供护理的法律义务;然而,研究表明,亲属在入院后继续提供情感、工具和个人护理,这往往与护理人员人手不足和工作量大有关。尽管人们越来越关注养老院中的虐老问题,但大多数研究都集中在护理人员或共同住户实施的虐待行为上,很少有研究探讨亲属可能实施的虐待行为:本研究对挪威100家养老院的3693名护理人员进行了横断面调查,以了解护理人员观察到的挪威养老院中亲属对住院老人的虐待程度:结果表明,45.6%的护理人员在过去一年中观察到过一次或多次亲属对住院患者的虐待行为。在虐待的子类型中,44.8%的护理人员在过去一年中至少观察到一次心理虐待,8.4%观察到一次身体虐待,2.7%观察到一次经济/物质虐待,0.7%观察到一次性虐待:这是第一项探讨养老院中亲属对住客虐待程度的大型研究,与员工和共同住客的虐待行为相比,亲属对住客的虐待行为受到的关注要少得多。我们的研究结果表明,需要提高对亲属虐待行为的认识和关注,以改善疗养院住客的福祉。建议开展进一步研究,以加深我们对此类虐待行为的了解,并应采用其他方法来衡量亲属对住客的虐待比例,因为仅靠工作人员的观察不足以确定这种情况的普遍程度。今后的研究还应考察养老院中受害情况的累积影响,并应包括对如何报告和处理虐待案件的分析。
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