Developing a nomogram for predicting the depression of senior citizens living alone while focusing on perceived social support

BACKGROUND Although the number of senior citizens living alone is increasing,only a few studies have identified factors related to the depression characteristics of senior citizens living alone by using epidemiological survey data that can represent a population group.AIM To evaluate prediction performance by building models for predicting the depression of senior citizens living alone that included subjective social isolation and perceived social support as well as personal characteristics such as age and drinking.METHODS This study analyzed 1558 senior citizens(695 males and 863 females)who were 60 years or older and completed an epidemiological survey representing the South Korean population.Depression,an outcome variable,was measured using the short form of the Korean version CES-D(short form of CES-D).RESULTS The prevalence of depression among the senior citizens living alone was 7.7%.The results of multiple logistic regression analysis showed that the experience of suicidal urge over the past year,subjective satisfaction with help from neighbors,subjective loneliness,age,and self-esteem were significantly related to the depression of senior citizens living alone(P<0.05).The results of 10-fold cross validation showed that the area under the curve of the nomogram was 0.96,and the F1 score of it was 0.97.CONCLUSION It is necessary to strengthen the social network of senior citizens living alone with friends and neighbors based on the results of this study to protect them from depression.

Status of and Suggestions for Senior Citizens＇ Participation in Ethnic Tourism： A Case Study of Wolong National Nature Reserve in Sichuan

The participation of ethnic minority communities in the development of local tourism is usual y based on the family unit. Senior citizens can not only provide labor services within their reach, but inherit and defend local culture and landscape, playing an important social role. Their living conditions are tied to the rest of the family, and affect the sustainability of the entire community. Through field visits to ethnic minority communities in Wolong National Nature Reserve in Sichuan, authors of the paper summarized the status and problems of elderly people's participation in tourism development, and put forward specific suggestions.

Building a Community for the Senior Citizens Using the Idea of Vertical Farms

Global population growth and urbanization have posed increasing threats to the ecological environment. In an aging society, high-density living spaces have resulted in intensifying housing concerns for urban senior citizens. Among the rapid urban development, addressing the demands of senior citizens for suitable living environments and enabling senior city dwellers to engage in diversified social interactions are concerns that necessitate public attention. This study introduced the idea of the “vertical farm” to the living environments of senior citizens. By integrating vegetation appreciation and physical labor, vertical farming allows senior citizens to experience joy and a sense of accomplishment. In addition, these farms can change the monotonous and gloomy exteriors of concrete buildings. By conducting in-depth interviews with 12 senior citizens residing in the Happiness Community in Taipei City, by building vertical farms, senior citizens can experience joy and a sense of achievement at the psychological level and communicate with families, friends and neighbors in the community at a social level. At the environmental level, comprehensive ecological communities can be achieved. We explored how promoting vertical farms in a living environment can affect senior citizens at the psychological, social and environmental levels. The results can be used to build vertical farms that accommodate the needs of senior citizen living environments.

China Has Over 110 Million Senior Citizens

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Epidemiologic survey and analysis of mild cognitive impairment amongst community senior citizens of Changsha City

Objective:The purpose of the current study was to conduct a mild cognitive impairment(MCI)prevalence survey among the community senior citizens of Changsha City and analyze possible relevant factors so as to perform early screening and intervention for MCI patients,and delay or prevent MCI from developing into Alzheimer’s disease(AD).Methods:Between April and September 2012,a total of 1764 community senior citizens in Changsha City were selected through multi-stage and random cluster sampling as study subjects.The following tables were used during the investigation to perform preliminary MCI screening for the subjects of this study:a general information survey;Mini-Mental State examination(MMSe);Montreal Cognitive Assessment(MoCA);Beijing version;global Deteriorate Scale(gDS);Clinical Dementia Rating(CDR)scale;and Activities of Daily Living(ADL)scale.Then,neurology specialists made diagnoses according to the actual status of subjects,survey findings,and clinical MCI diagnostic standards.The prevalence of MCI was calculated and the rates concerning senior citizens with different demographic characteristics were compared.Logistic regression analysis was used to analyze relevant factors that led to MCI,and comparing findings with those of other cities was conducted.Results:The MCI prevalence among senior citizens in Changsha City was 16.27%(287/1764).The MCI prevalence increased with age[for the 60,70,and 80 age groups,the prevalence was 9.79%(84/858),20.14%(149/740),and 32.53%(54/166),respectively,P<0.05].The more education received,the less the likelihood of developing MCI[the prevalence of illiteracy,those who went to pri-mary school,junior high school,senior high school,or technical secondary school,college,and un-dergraduates and above was 32.10%(26/81),18.40%(90/489),13.97%(70/501),15.29%(61/399),14.39%(19/132),and 12.96%(21/162),respectively,P<0.05].Bluecollar workers’chances of developing MCI was higher than white-collar workers[19.12%(187/978)and 12.72%(100/786),respectively,P<0.05].Living alone increased the likelihood of developing MCI than not living alone[21.59%(65/301)and 15.17%(222/1463),P<0.05].The logistic regression analysis showed that age,educational background,and marital status were in the regression(P<0.05).The MCI prevalence of Changsha did not differ from that Portugal,Singapore,Beijing,and Urumchi(P>0.05),but lower than Shanghai[35.78%(161/450)]and higher than Chengdu[2.35%(92/3910)](P<0.05).Conclusion:The prevalence of MCI among the community senior citizens of Changsha City is highly related to factors like age,educational background,and marital status.Prevention against these highrisk factors shall be carried out to delay cognitive decline for senior citizens.

Higher intakes of lysine,threonine and valine are inversely associated with non-alcoholic fatty liver disease risk:a community-based case-control study in the Chinese elderly

The associations of individual amino acid with non-alcoholic fatty liver disease(NAFLD)risk remained unclear.The present study aimed to investigate the associations between the two in the Chinese elderly.Methods:A community-based health check-up program was conducted in Qingdao,China.NAFLD was diagnosed by ultrasonography accompanied by epidemiological investigation.The dietary intakes of amino acids were investigated with 3-day,24-h dietary records and calculated by Nutrition Calculator software.Restricted cubic spline model was used to evaluate a nonlinear relationship between amino acid intake and NAFLD risk.Results:400 NAFLD subjects were identified,and 400 participants were randomly selected as controls and matched by gender and age(±3 years)Dose-response analysis showed that 1000 mg increment of aromatic amino acids(AAAs)was associated with reduced 16%risk of NAFLD.Dietary increments of 750 mg/d threonine,950 mg/d valine,or 1700 mg/d lysine were associated with a 20%reduction in the NAFLD risk(all P for linearity<0.05).Conclusion:The present study demonstrated that the dietary increases in milk,eggs and deep-sea fish,which are rich in the amino acids,might contribute to protecting against NAFLD in the elderly.

Predictive value of systemic immunity index for sepsis in low-medium risk community-acquired pneumonia

Objective:To assess the predictive value of systemic immune inflammation index(SII)for sepsis in low-and medium-risk community-acquired pneumonia.Methods:A total of 589 elderly patients with low-and medium-risk community-acquired pneumonia admitted to the Emergency Department of the Second Affiliated Hospital of Hainan Medical University from January 2020 to January 2023 were included as the research subjects,and the general information and laboratory test results of the patients were collected,and the optimal cut-off value of continuous variables for predicting sepsis in elderly patients with low-and medium-risk community-acquired pneumonia was determined by plotting the receiver work characteristic(ROC)curve,which was converted into dichotomous variables and univariate and multivariate logistic Regression analysis of the influencing factors of sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.Based on this,a nomogram model is constructed to predict the risk of sepsis.The differentiation,consistency and accuracy of the model were verified by calibration curve and subject operating characteristic(ROC)curve,and the clinical utility of the model was determined by decision curve analysis.Results:A total of 589 elderly patients with low-and intermediate-risk community-acquired pneumonia were included in this study,of which 96(16.30%)developed sepsis.There were significant differences in age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,PCT,SII and other indexes between sepsis and non-sepsis groups(P<0.05).Logistics regression analysis showed that age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,and SII were independent risk factors for sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.The nomogram prediction model was used to verify the results,and the AUC was 0.826(95%CI:0.780-0.872),and the calibration curve tended to the ideal curve with good accuracy.The decision curve shows that when the threshold of the model is between 0.10~0.78,the model has the advantage of clinical benefit.Conclusion:The nomogram prediction model constructed based on SII to predict sepsis in elderly patients with low-and medium-risk community-acquired pneumonia has good accuracy,which can predict the occurrence of sepsis early,help early identification of high-risk groups and timely intervention,and thus improve the prognosis of patients.

A study on the health service demands and influence factors among elderly people based on a community survey in Western China

Objective:To investigate the health service demands and to analyze influencing factors among elderly people based on a community survey in Guilin,China.Methods:A random sampling was used to investigate 366 elderly people in a community using a Health-Care-Needs questionnaire,which was designed by The Western Nursing Alliance research team in China.This survey was used to understand the basic situation,financial condition,health condition,self-care abilities,pension plan,and care services demands of the elderly residing at home.Additionally,this article analyzed the influencing factors contributing to the obtained results.Results:The top 3 nursing needs were security needs(1.61±0.45 points),health education needs(1.54±0.57 points),and respect and self-development needs(1.13±0.64 points).Logistic multifactor regression analysis showed that gender,monthly income,lack of exercise,activities of daily living(ADL)scores,methods of medical payment,and pension plan were independent factors affecting elderly nursing needs.Conclusions:The home-based health services supply for elders did not meet their needs.Therefore,a comprehensive approach considering multifactors such as gender,income,exercise,self-care ability,medical expense payments,and supporting preferences should be considered to address the complex needs of health care.

Non-Intrusive Monitoring of Everyday Behavioral Activities in an Indoor Environment

A non-intrusive design for monitoring everyday activities of an elderly person is presented. The proposed system is intended to be used in the bedroom, allowing the elders to stay at home in a safe environment. The required hardware design is simple in structure and cost effective. The sensor design is implemented by using capacitive sensors and an Arduino microcontroller unit. And a real time graphical user interface is implemented to monitor the elderly person. The performance analysis shows that the sensor design is able to differentiate between a human body and a house pet.

A Study of Digital Disconnection Among Older Adults in the Internet Age

With internet and smartphone usage increasing every year,seniors are being exposed to digital media,either actively or passively.To better integrate into the information society for the elderly,efforts are also needed to clarify the causes of their digital disconnection and develop appropriate solutions.In this study,semi-structured interviews are utilized to investigate the self-adjustment and external intervention of the elderly in the age of digital media and to explore the ways,causes,and effects of digital disconnection of the elderly.The focus issue of this study is to clarify the subjective and objective factors of digital disconnection,especially cognitive problems,group influences,and technological access barriers in the elderly population concerning digital devices and the Internet.

Basic Study on Elderly Tele-nursing Model for Emote Nursing by Smart Device

This study was carried out to examine the development of an “elderly tele-nursing model” for care provided in-home by family members and through remote nursing systems in a super-aging society. This model studied the travel time, cost, and means of transportation of care providers. The pre-survey results regarding elderly tele-nursing show that a son/daughter can visit a parent more than once a week. In the results, the time required for elderly tele-nursing was influenced by whether or not the visitor uses the shinkansen （bullet train of Japan）. In the main survey, based on 40 questionnaires, clear differences were observed according to whether visits were “every two weeks” or “once per month”. Furthermore, this result was also indicated by t-tests.

Globalization and Transformation of Family Care

The effect of globalization on family care traditions has emerged as a significant issue of academic debate in recent years. Globalization and the growth of liberal market economy in local areas has rapidly transformed the traditional pattern of family structure, livelihood strategies of the family members, and care giving practices to the elderly in Nepal. Traditionally, the older people used to live in joint family comprised of their mamed son and their children. The reciprocal exchange of care between the parents and children was associated with the religious conception of virtue and vice. If the oft-springs would not take care for their parents, it was considered as a great sin. This tradition has been gradually eroding with the migration of youths to different destination in search of opportunities for their education and employment. This migratory process has weakened the traditional role of families as care giving institutions to old parents and disable member in the family. The old parents are now increasingly shelter to care homes for their caring. The children maintain their ties with their parents mainly by economic support for their maintenance. The old people have been unable to receive any moral care and support from other members of their family. This article examines the changes on the traditional responsibility of family as a care giving unit for the old people. It discusses the issues based on data gathered fllrough in-depfll interviews and case study of 37 senior citizens living in Siddhi Shaligram Senior Citizens Home （SSSCH） at Bhaktapur district. The secondary sources of information have also been used to shin-pen the conceptual issues related to this field