BMC Geriatrics最新文献

Background: Arthritis is a prevalent condition among older adults, potentially influenced by environmental exposures. However, evidence on the relationship between household mold exposure and arthritis in aging populations remains limited.

Methods: This study utilized data from the 2014 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Logistic regression models estimated the association between mold exposure and arthritis, adjusting for demographic, lifestyle, and health-related covariates. Subgroup and interaction analyses explored potential effect modifiers. In the first sensitivity analysis, 1:2 propensity score matching (PSM) was applied to improve covariate balance, while the second (2018 wave) additionally adjusted for indoor ventilation, vitamin supplementation, and analgesic use.

Results: The prevalence of arthritis was 13.2%. Among older Chinese adults, participants with arthritis were more likely to be younger, female, reside in city, engage in physical activity, have higher BMI, and report mold exposure. Mold exposure was associated with higher odds of arthritis (Model 1: OR = 1.32, 95% CI: 1.05-1.65; Model 2: OR = 1.36, 95% CI: 1.08-1.71), and the association persisted after PSM (Model 1: OR = 1.33, 95% CI: 1.03-1.71; Model 2: OR = 1.34, 95% CI: 1.03-1.73). Drinking status significantly modified this relationship (P for interaction < 0.05). Sensitivity analyses confirmed robustness of the association between mold exposure and arthritis, and analgesic use was additionally found to be associated with arthritis.

Conclusions: Our findings indicate that both mold exposure and analgesic use are associated with an increased likelihood of arthritis in older adults, underscoring the need to improve damp and deteriorating housing conditions and to promote the rational use of analgesics to support healthy aging.

Background: Chronic pain in older adults represents a major public health concern, with non-pharmacological interventions gaining importance as a key strategy for pain management. Social support, positive and negative affect, and pain catastrophizing are known to be associated with pain intensity in older adults. This study aimed to investigate the effect of social support on pain intensity in older adults with chronic pain and to explore the mediating roles of positive affect, negative affect, and pain catastrophizing.

Methods: This cross-sectional study involved 363 older adults with chronic pain who completed the Social Support Rating Scale (SSRS), Positive and Negative Affect Scale (PANAS), Pain Catastrophizing Scale (PCS), and Numeric Rating Scale (NRS). Serial mediation analysis was conducted to test whether positive and negative affect and pain catastrophizing act sequentially as mediators between social support and pain intensity. Structural equation modeling (SEM) was conducted using Mplus 8.3 to examine whether positive and negative affect and pain catastrophizing serially mediate the association between social support and pain intensity.

Results: Social support was negatively associated with pain intensity, both directly and indirectly, through the separate mediating effects of positive affect (β = -0.129, 95% CI: -0.176, -0.082) and pain catastrophizing (β = -0.199, 95% CI: -0.262, -0.136). The sum of these indirect effects accounted for 49.84% of the total effect. Furthermore, social support was indirectly associated with reduced pain intensity via the serial mediation of negative affect and pain catastrophizing (β = -0.088, 95% CI: -0.131, -0.059) and the serial mediation of positive affect and pain catastrophizing (β = -0.066, 95% CI: -0.099, -0.043). These pathways collectively accounted for 23.40% of the total effect.

Conclusion: Healthcare providers (e.g., nurses, physicians, and therapists) should enhance chronic pain management by assessing patients' social support levels and implementing interventions focused on emotional regulation and cognitive restructuring. An interdisciplinary approach is recommended to effectively reduce pain intensity in older adults.

Trial registration: Not applicable.

Background: There is limited evidence on the prevalence of frailty and its impact on health outcomes in older adults with atrial fibrillation (AF) in Vietnam. This study aimed to (1) Compare the agreement of the physical frailty phenotype (Fried's criteria) and the Clinical Frailty Scale (CFS) in identifying frailty in older adults with AF, and (2) Compare the associations of these frailty definitions with hospitalisation.

Methods: Adults aged 65 or older with AF attending the outpatient clinics of a hospital in Vietnam. Frailty was defined as having ≥ 3/5 of Fried's criteria or a CFS ≥ 4. All participants were followed up for 9 months, recording hospitalisations. The kappa statistic was used to quantify the agreement between frailty defined by the modified physical frailty phenotype and the CFS. Logistic regression was applied to examine the association between frailty and hospitalisation.

Results: There were 305 participants. They had a mean age of 76.7 (SD 7.8), 40% were female. The prevalence of frailty was 34% according to the modified physical frailty phenotype criteria, and 88% according to the CFS (kappa coefficient 0.14, 95%CI 0.09-0.19). The hospitalisation rate during follow up was 28.8%, higher in frail participants compared to the non-frail. Frailty defined as CFS ≥ 4 was significantly associated with increased hospitalisation (adjusted OR 3.72, 95%CI 1.23-11.31, p = 0.020). A non-significant association was observed with frailty defined by the modified physical frailty phenotype (adjusted OR 1.64, 95%CI 0.95-2.84, p = 0.077). Similar results were obtained when frailty was analysed as a continuous score: adjusted ORs 1.39 (95%CI 1.05-1.83, p = 0.022) for each higher category of the CFS, and 1.24 (95%CI 1.00-1.53, p = 0.051) for each unit higher of of the physical frailty score.

Conclusion: Frailty was highly prevalent among older patients with AF. There was a poor agreement between the two frailty criteria when identifying frail and non-frail participants in the cohort using the cut-offs. The CFS had a stronger association with hospitalisations than the modified physical frailty phenotype criteria. Further studies are needed to compare the predictive values of these two frailty definitions in older adults in Vietnam.