Factors related to successful aging among community-dwelling elderly in Wenzhou,China

Objectives:To examine the level of successful aging and the relationship between successful aging and activities of daily living(ADL),life satisfaction,social support,income,and self-efficacy among community-dwelling elderly in Wenzhou,China.Methods:A descriptive correlational design was applied.Subjects were community-dwelling elderly in 4 districts of Wenzhou,China.Simple random sampling was used to recruit 83 participants.All participants were screened using the Mini-Cog tool.Data were collected using 6 questionnaires such as a demographic questionnaire,the Successful Aging Inventory(SAI),the Barthel Index for ADL,the Satisfaction With Life Scale(SWLS),the Social Support Rating Scale(SSRS),and the General Self-Efficacy Scale(GSES).Data were analyzed using descriptive statistics and Pearson correlation analysis.Results:The results showed that 53%of the participants had a higher level of successful aging and 43.4%had a moderate level of successful aging with a mean score of 56.76(standard deviation[SD]=12.31).Factors such as elderly income(r=0.73,P<0.001)and self-efficacy(r=0.72,P<0.001)had high correlations with successful aging,whereas ADL(r=0.67,P<0.001),life satisfaction(r=0.63,P<0.001),and social support(r=0.36,P<0.001)had moderate correlations with successful aging.Conclusions:There was a significant positive correlation between successful aging and ADL,life satisfaction,social support,income,and self-efficacy among community-dwelling elderly in Wenzhou,China.The findings may guide the formulation of more effective health education and intervention measures to improve successful aging among the elderly.

Metabolic syndrome and its association with components of sarcopenia in older community-dwelling Chinese

Aging and obesity contribute to muscle dysfunction. This study aimed to determine the cross-sectional associations between components of metabolic syndrome (MetS) and sarcopenia in 251 older community- dwelling Chinese. The total fat-free mass was measured by dual-energy X-ray absorptiometry, muscle strength (handgrip strength) by a handheld dynamometer, physical performance by 4-meter walk, 5-time chair stand test, and the short physical performance battery (SPPB). MetS was defined using the International Diabetes Federation (IDF) criteria. The participants with MetS had a higher appendicular skeletal muscle mass (ASM) and relative ASM (RASM). The males with MetS had higher handgrip strength, and the females with MetS had higher SPPB scores. After adjusting for age and body mass index, the participants with an increased waist circumference had a higher ASM, and those with increased diastolic blood pressure (DBP) also had higher handgrip strength. The males with elevated fasting blood glucose (FBG) levels had a lower gait speed. Components of MetS, such as DPB and FBG, were associated with muscle strength and physical performance in older adults. These results suggest that muscle strength and function should be considered in treating older adults with MetS.

Nicotine dependence in community-dwelling Chinese patients with schizophrenia

Background Smoking is a serious public health problem. Patients with schizophrenia usually have a higher prevalence of smoking than the general population, but the level of nicotine dependence is seldom studied, especially for patients living in the communities. Aims This study aimed to examine the level of nicotine dependence in Chinese community-dwelling patients with schizophrenia and explored its associated sociodemographic and clinical factors. Methods A total of 621 patients with schizophrenia treated in the primary care centres of Guangzhou were consecutively recruited. The level of nicotine dependence was assessed with the Chinese version of the Fagerstrom Test for Nicotine Dependence (FTND). Results 148 patients with schizophrenia were current smokers, and the mean (SD) score of FTND was 5.06 (2.55) for all the current smokers. The prevalence of nicotine addiction was 48.0%(95% Cl: 40.0%-56.0%) in patients with current smoking. The patients with schizophrenia had a significantly higher level of nicotine dependence than the Chinese general population. Multiple linear regression analysis revealed that male gender, being unemployed, having a family history of psychiatric disorders, having major medical conditions, first illness episode and less severe positive symptoms were significantly associated with a higher level of nicotine dependence. Conclusion Community-dwelling patients with schizophrenia in China, especially male patients, had a higher level of nicotine dependence than the general population.

The level and influencing factors of gerotranscendence in community-dwelling older adults

Purpose:To study the level and influencing factors of gerotranscendence in communitydwelling older adults.Methods:We investigated 772 community-dwelling older adults in Hengyang in the Hunan Province of the People's Republic of China using a translated Gerotranscendence Scale and demographic information.Results:The community-dwelling older adults had an overall intermediate level of gerotranscendence.One-way analysis of variance and multiple linear regression analysis showed that sex,living arrangements,regular activities,and religious affiliation influenced the gerotranscendence perspective of the community-dwelling older adults(p<0.05),but that living arrangement and gerotranscendence perspective were not significantly correlated.The covariates clarified about 38.8%of the variation in gerotranscendence perspective.Conclusions:Our findings suggest that sex,regular activities,religious affiliation,and living arrangement influence gerotranscendence.These findings can guide the planning and implementation of better practices in elderly care by nurses and other healthcare professionals.

Care Prevention Needs in Community-Dwelling Older Adults in Japan

Care prevention comprises an integral part of long-term care in Japan and is provided across the following populations: those without problems when screened by the Basic Check List (BCL, Type 1), those having problems when screened by the BCL (Type 2), and those certified in the “support need levels” by the long-term care insurance eligibility assessment (Type 3). We aimed to clarify the care prevention needs across these three populations by using the interRAI Check-Up, an internationally developed instrument. We conducted cross-sectional surveys to assess care prevention needs for convenience samples of community-dwelling older adults in two cities in western Japan from October 2016 to December 2017, and we integrated the secondary data of older adults’ assessment from September 2014 to June 2018. Prevalence rates of nine domains of care prevention needs were calculated. Among the 125 participants, 20 were Type 1, 23 were Type 2, and 82 were Type 3. All three types had the following needs that had not been assessed in the BCL: pains, risk of hospital-emergency room visits, driving reviews, and instrumental activities of daily living capacity. The results showed that interventions for a wide range of care prevention needs should be considered in the long-term care prevention project.

Determination of a Cut-Off Point of a Scale for Achievement Motive in Geriatrics That Predicts the Frequency of Undertaking Instrumental Activities of Daily Living in Community-Dwelling Elderly People

Background: Among elderly people, rehabilitation is important for reducing the risk of falls and hospitalization and to maintain an independent life for longer. Motivation is a factor for elderly people to lead an active daily life and leave home more frequently. Purpose: The purposes of this study were to determine the optimal cut-off point in the Scale for Achievement Motive in Geriatrics (SAMG) that could identify individuals as inactive or active, based on the Frenchay Activities Index (FAI), and to compare characteristics between active and inactive groups classified by the cut-off point. Methods: A cross-sectional study of 285 community-dwelling elderly people measured SAMG and FAI and physical function. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) that was the optimal cut-off point for the SAMG total score, with the associated sensitivity and 1-specificity when compared with the FAI results. Demographic parameters and physical function were compared between two groups defined by cut-off point. Results: The AUC was 0.78, the optimal cut-off for SAMG total score for indicating inactivity was ≤48, the sensitivity was 77.98% and the 1-specificity was 75.00%. The group with SAMG score >48 was characterized by a significantly higher proportion of women, fewer people sharing a house, and participation in more hobbies. Discussion: A cut-off point of 48 in the SAMG could be a predictive index of motivation toward goals for individuals with inactive daily activities. The group with score higher than the cut-off was characterized by more women, fewer people living together, and more hobbies than the group with lower scores.

Sensitivity and Specificity of a Short Questionnaire to Screen Frailty in the Community-Dwelling Older Population

Introduction. Frailty represents a major risk factor for death and Use of Hospital Services (UHS) among older adults. A simple tool to detect frailty might permit stratification of the community-dwelling older population according to the risk of negative outcomes. The present study aims at determining the sensitivity and specificity in predicting mortality and UHS of the Short Functional Geriatric Evaluation (SFGE), a short questionnaire to screen for frailty in community-dwelling older citizens. Methods. The study is a secondary analysis of all the data collected through an observational longitudinal cohort study carried out in Lazio region (Italy). The SFGE is compared with the Functional Geriatric Evaluation (FGE) questionnaire to define sensitivity and specificity for mortality and for UHS during the first year following its administration. Results. The SFGE classifies 36.3% of the respondents as frail and shows a sensitivity of 90.4% and a specificity of 78.3% compared to the FGE (area under the ROC: 0.928;CL95%: 0.910 - 0.947;p-value Conclusion. The SFGE identifies as frail a larger portion of the enrolled population than the FGE. Those people so identified show a high rate of UHS. Because of its easy and quick administration, it can be considered a useful primary screening tool but it must be followed up with a more extensive assessment of those identified as frail. The small time needed to fill in the tool and the possibility of administering it by telephone makes the SFGE a useful tool to screen for frailty and to plan the provision of care services at both individual and population level.

Association of Oral Diadochokinesis, Physical Function and Swallowing Function in Community-Dwelling Elderly People

Objective: Oral diadochokinesis (ODK) has been shown to be associated with oral frailty. In this study, we investigate the relationship between physical function, swallowing function, nutritional evaluation, and each syllable of ODK. Methods: The subjects are 26 elderly people living in an area where they can walk. ODK, tongue pressure, modified water swallowing test, EAT-10, grip strength, MNA-SF, skeletal muscle index, height, weight, and BMI were evaluated. For statistical analysis based on ODK values, the subjects were divided into two groups on the basis of the number of times the syllables /pa/, /ta/, and /ka/ were repeated: 1) The first group with >6 repetitions exceeded six; 2) the second group with ≤5 repetitions. Both groups were compared using the Mann-Whitney U test (Model 1). In addition, the syllables /pa/, /ta/, and /ka/ were also divided among the groups and a comparison was performed (Model 2). Results: In Model 1, the tongue pressure value was significantly higher in the good group (p < 0.01). In Model 2, the good group showed significantly higher values for the syllables /pa/ (p < 0.01) and /ta/ (p < 0.05). There was no significant difference in the values for the syllable /ka/. Conclusion: In community-dwelling elderly people, tongue pressure was positively associated with ODK values for the syllables /pa/ and /ta/, suggesting that tongue pressure may be associated with strength of the lip and tongue tip muscles. Furthermore, it was suggested that the ODK values may even be lower than normal values in the elderly who maintain skeletal muscle mass and thus have adequate tongue pressure;therefore, these indicators may be used as a guideline to assess oral frailty.

Prevalence of osteoporotic vertebral fracture among community-dwelling elderly in Shanghai

To the Editor:Osteoporosis is becoming a common,serious,and costly health problem,which causes over nine million fractures annually worldwide.[1] Currently,osteoporotic fractures are a considerable burden to public health services and have fairly high morbidity and mortality.[2] Vertebral fractures are the most common osteoporotic fracture and may lead to a high risk of further fracture and could be prevalent in both females and males.[3] Ling et al[4] and Ms.OS studies[5] evaluated the prevalence of vertebral fractures in Beijing and Hong Kong,respectively.However,our knowledge of the descriptive epidemiology and risk factors for vertebral fracture in China still remains poor.

Combined effects of knee extension strength, visual acuity, and knee-joint pain on older women’s gait

The purpose of this study was to examine the combined effects of knee extension strength (KES), visual acuity (VA), and knee joint pain (KP) on gait in 212 older women. Including, walking speed, cadence, were selected as gait parameters. Knee extension strength was measured by isometric knee extension strength, while knee joint pain and decreased visual acuity were evaluated by subjective judgment. The combine effect of KP and KES factors was examined. Stance time was significantly longer in persons with both-KP than in persons with no KP. In addition, people with superior KES had significantly greater values in walking speed, cadence, and step length, and lower values in stance time and walking angle than those with inferior KES. Furthermore, double support time showed that persons with both-KP have significantly greater values than persons with no or one-KP in the inferior KES group. Also, persons with the inferior KES had significantly greater values in persons with both-KP. The combine effect of KES and VA factors was examined. There are significant differences between the superior and the inferior KES groups. In conclusion, the elderly with both the factors of decreasing KES and both-KP, as compared to the elderly with just one of those factors, have markedly different gait properties.

Factors Associated with Tobacco Use among Community Dwelling Older Adults in Jos South, Nigeria

Background: Tobacco use poses an enormous threat to public health worldwide. Its use is associated with an epidemic of cancer, heart disease, stroke, chronic lung disease and other non-communicable diseases especially with increases in age leading to increase morbidity and mortality. The aim of the study was to determine prevalence and associated factors with tobacco use among elderly members of a community in Jos South LGA, Plateau State, Nigeria. Methods: Data was collected from 17th to 31st August, 2018. The study employed a cross sectional design. Out of 422 elderly members (≥60 years) of the community identified, only 400 were interviewed with a composite questionnaire that includes the following: socio-demography, Alcohol Smoking and Substance Involvement Screening Test (ASSIST), Mini International Neuropsychiatric Interview (MINI) as well as the 12-item General Health Questionnaire (GHQ-12). Results: Results show the lifetime prevalence of tobacco use to be 17.5% and current prevalence to be 15.8%. Tobacco use disorders were not significantly associated with gender (X2 = 0.10, p<0.75), or living status (p = 0.22). Participants who used tobacco were more likely to report cardiovascular (X2 = 0.03, p = 0.96), respiratory (X2 = 0.21, p = 0.65), digestive (X2 = 3.86, p = 0.05), difficulty ambulating (X2 = 0.34, 0.56), probable psychiatric co-morbidity (X2 = 0.12, p = 0.72) and chronic pain conditions (X2 = 0.74, p = 0.39), and had more hospital visits (X2 = 1.18, p = 0.40), and admissions (X2 = 0.03, p = 0.96) but the relationships did not attain statistical significance. Conclusion: We conclude that tobacco use is highly prevalent among older adults living in the community. There is need to step up efforts on programs of intervention especially smoking cessation programs and as a result reduce the burden of tobacco related diseases and disorders.

Life Space Assessment in Older Women Undergoing Non-Surgical Treatment for Urinary Incontinence

Objective: Urinary incontinence (UI) impacts all aspects of life activities. This study aims to characterize change in mobility within the community utilizing the Life Space Assessment (LSA) questionnaire in women undergoing non-surgical UI treatment. Methods: This prospective cohort study, performed from July 2007 to March 2009, followed women seeking non-surgical UI treatment from an outpatient tertiary-care clinic and assessed their mobility and symptoms using LSA, Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7) at baseline and 2, 6, and 12 months post-treatment. Estimated Percent Improvement (EPI) and Patient Satisfaction Question (PSQ) were obtained post-treatment. The women were treated with multi-component behavioral and/or pharmacologic therapies, and we hypothesized that LSA would improve with treatment. Repeated measures analysis with Tukey’s HSD and backwards selection linear regression model were performed. Results: 70 ambulatory, community-dwelling women, aged 65 years or older, seeking non-surgical care for UI were recruited. LSA score decreased from baseline to 2 months (mean ± SD;63 ± 29 to 56 ± 28, p < 0.001) and was sustained at 6 and 12 months (54 ± 28, 54 ± 28). UDI scores improved from 36 ± 23 to 25 ± 24, p < 0.001, at 2 months, and improvement persisted at 6 and 12 months (22 ± 22, 21 ± 24). Improvements in UDI and patient perceived improvement in UI were not associated with LSA change. Age, race, and depression impacted LSA, which decreased 1-point for each additional year of age (p = 0.004), 6-points for each point higher on the Geriatric Depression Scale (GDS) (p = 0.002), and 6-point for African American race (p = 0.048). Conclusion: Decreased mobility represented by LSA was related to age, depression, and race, but not UI symptom improvement.