The Impact of Physiotherapy Interventions on the Elderly Population with Mental Health Conditions at Chainama Hills College Hospital in Zambia. A Pre-Post Single Sample Study Design

Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.

Research on the Establishment of a Long-Term Care System for the Elderly with Alzheimer’s Disease Under the Background of Long-Term Care Insurance: A Literature Review

With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.

Do Child Characteristics Matter to Mitigate the Widowhood Effect on the Elderly’s Mental Health? Evidence from China

This study empirically examines whether child characteristics mitigate the negative impact of widowhood on the elderly’s mental health using follow-up survey data from the China Health and Retirement Longitudinal Study(CHARLS).A total of 5,326 older adults aged 60 years and older are selected from three waves of panel data(2013,2015,and 2018).Thefindings suggest that respondents who experienced widowhood exhibit an increase in depressive symptoms.However,the higher income of children and frequent face-to-face emotional interactions improve the mental health of the widowed elderly.Moreover,heterogeneity analyses show that the buffering effect of higher child income is more significant among men and the Midwestern widowed elderly,and frequent face-to-face emotional interactions are more effective in improving the psychological status of women and the Midwes-tern widowed elderly.In the special social and cultural background of China,family members remain the main support for the elderly,and the current social pension system is still imperfect.Therefore,children should strengthen emotional communication with their parents while increasing their economic income.In that way,widowhood can achieve both material and spiritual prosperity.The government should identify the vulnerable groups among the elderly widows and introduce policies aimed at improving their mental health and reducing the disparity in mental health status.

A Preliminary Study of Medical Books on Health Care for the Elderly and Prolonging Life in the Early 20th Century

The present research of Chinese medical history lack detailed discussions on Chinese medicine philology of the elderly and the various sorting of related literature of physiology and diseases both at home and abroad.Based on previous literature,the article aims to introduce the publishing trend of medical books on health cultivation and prolonging life on since modern times,generally describe its significance,and initially analyze the contents related to health cultivation for the elderly.The article finds out that after the scientific concepts were imported into China in large quantities from the beginning of the 20th century,the past superstitions rose again.The sciences of nutrition,bacteriology,and physiology in such books had all verified that the road to immortality was possible.The concept of longevity at the time emphasized a concept that could be controlled by science.With the advancement of scientific research and health concepts,people believed that they could eventually achieve immortality.It was obvious that people were filled with optimism about science at that time,thus gradually subverting the definition of the elderly.

Developed Fall Detection of Elderly Patients in Internet of Healthcare Things

Falling is among the most harmful events older adults may encounter.With the continuous growth of the aging population in many societies,developing effective fall detection mechanisms empowered by machine learning technologies and easily integrable with existing healthcare systems becomes essential.This paper presents a new healthcare Internet of Health Things(IoHT)architecture built around an ensemble machine learning-based fall detection system(FDS)for older people.Compared to deep neural networks,the ensemble multi-stage random forest model allows the extraction of an optimal subset of fall detection features with minimal hyperparameters.The number of cascaded random forest stages is automatically optimized.This study uses a public dataset of fall detection samples called SmartFall to validate the developed fall detection system.The SmartFall dataset is collected based on the acquired measurements of the three-axis accelerometer in a smartwatch.Each scenario in this dataset is classified and labeled as a fall or a non-fall.In comparison to the three machine learning models—K-nearest neighbors(KNN),decision tree(DT),and standard random forest(SRF),the proposed ensemble classifier outperformed the other models and achieved 98.4%accuracy.The developed healthcare IoHT framework can be realized for detecting fall accidents of older people by taking security and privacy concerns into account in future work.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Health risk assessment of trace metal(loid)s in agricultural soils based on Monte Carlo simulation coupled with positive matrix factorization model in Chongqing, southwest China

This study aimed to investigate the pollution characteristics, source apportionment, and health risks associated with trace metal(loid)s(TMs) in the major agricultural producing areas in Chongqing, China. We analyzed the source apportionment and assessed the health risk of TMs in agricultural soils by using positive matrix factorization(PMF) model and health risk assessment(HRA) model based on Monte Carlo simulation. Meanwhile, we combined PMF and HRA models to explore the health risks of TMs in agricultural soils by different pollution sources to determine the priority control factors. Results showed that the average contents of cadmium(Cd), arsenic (As), lead(Pb), chromium(Cr), copper(Cu), nickel(Ni), and zinc(Zn) in the soil were found to be 0.26, 5.93, 27.14, 61.32, 23.81, 32.45, and 78.65 mg/kg, respectively. Spatial analysis and source apportionment analysis revealed that urban and industrial sources, agricultural sources, and natural sources accounted for 33.0%, 27.7%, and 39.3% of TM accumulation in the soil, respectively. In the HRA model based on Monte Carlo simulation, noncarcinogenic risks were deemed negligible(hazard index <1), the carcinogenic risks were at acceptable level(10^(-6)<total carcinogenic risk ≤ 10^(-4)), with higher risks observed for children compared to adults. The relationship between TMs, their sources, and health risks indicated that urban and industrial sources were primarily associated with As, contributing to 75.1% of carcinogenic risks and 55.7% of non-carcinogenic risks, making them the primary control factors. Meanwhile, agricultural sources were primarily linked to Cd and Pb, contributing to 13.1% of carcinogenic risks and 21.8% of non-carcinogenic risks, designating them as secondary control factors.

Health Effect of Forest Bathing Trip on Elderly Patients with Chronic Obstructive Pulmonary Disease

Forest bathing trip is a short, leisurely visit to forest. In this study we determined the health effects of forest bathing trip on elderly patients with chronic obstructive pulmonary disease （COPD）. The patients were randomly divided into two groups. One group was sent to forest, and the other was sent to an urban area as control. Flow cytometry, ELISA, and profile of mood states （POMS） evaluation were performed. In the forest group,

Effect of self-management program on health status of elderly patients with heart failure: a single-blind, randomized clinical trial

Objective:To determine the effect of self-management program on the health status of elderly patients with heart failure.Methods:The present study was a single-blind,randomized clinical trial,and conducted on 90 patients with heart failure of stages Ⅱ-Ⅲ at one teaching hospital in eastern Iran in 2017.The participants were randomly assigned into two groups:the intervention group and the control groups,with 45 patients in each group.Self-management programs including awareness and recognition,problem-solving process,diet,exercise,and stress management were carried out.The participants were trained for six weeks and were followed for two months.Data of the health status were collected before,after and eight weeks after intervention by Kansas City Cardiomyopathy Questionnaire.Data analysis by chi-square,independent t-test,Fisher,ANOVA with repeated measures was conducted.Results:Patients in both groups were matched in terms of demographic characteristics before the intervention.There was no significant difference in the mean scores of health status between the two groups (P=0.1) before the intervention.However,the second measurement after intervention showed a significant difference in the mean scores between the two groups (P=0.001).Conclusions:Self-management program can improve the different dimensions of health (except in the subscale of sign and symptoms).Therefore,this supportive method can be used to improve the health of patients and manage problems caused by heart failure.

Associations between obesity and metabolic health with nonalcoholic fatty liver disease in elderly Chinese

Background:Nonalcoholic fatty liver disease(NAFLD)is closely associated with obesity.However,this association could be influenced by the coexisting metabolic abnormalities.This study aimed to investigate the role of obesity and metabolic abnormalities in NAFLD among elderly Chinese.Methods:A cross-sectional study was performed among elderly residents who took their annual health checkups during 2016 in Keqiao District,Shaoxing,China.Results:A total of 3359 elderly adults were retrospectively included in this study.The overall prevalence of NAFLD was 28.7%.The prevalence of NAFLD were 7.14%,27.92%,34.80%,and 61.02%in participants with metabolically healthy normal weight(MHNW),metabolically abnormal normal weight(MANW),metabolically healthy obese(MHO),and metabolically abnormal obese(MAO),respectively.NAFLD patients in MHO group had more unfavorable metabolic profiles than those in MHNW group.Logistic regression analysis showed that sex,body mass index(BMI),fasting blood glucose,and serum uric acid were the risk factors of NAFLD.Conclusions:Both obesity and metabolic health were significantly associated with NAFLD in elderly Chinese.Screening for obesity and other metabolic abnormalities should be routinely performed for early risk stratification of NAFLD.

Effects of social capital on the health quality of the rural elderly in Xihaigu,China: a hierarchical linear model analysis

Based on the analysis and measurement of the social capital and the health quality and structure of the elderly people,this paper examined the effects of social capital on the health quality of the elderly as well as its composition.The examination was conducted by applying a hierarchical linear model (HLM) and using survey data obtained in the Xihaigu area of Ningxia Province in 2017.The empirical results showed that individual social capital had a significant influence on the health of the rural elderly,but the impacts were different on its composition.Village social capital should improve both the physical and mental health quality of the elderly through building mutual trust and promoting stability,unity and a harmonious living environment.In addition,factors such as mode of habitation,diet,medical approaches,intergenerational interactions,and village geographical location also affect the health quality of the elderly.

The Study on Community Health Education of Empty Nest Elderly

Objective:To study the demands of community health education on the empty nest elderly and analyse the related factors. Methods:The 36-Item Short-Form Health Survey(SF-36), activities of daily living (ADL) and the community health services satisfaction scale were used to investigate the community health service demand and supply of 358 empty nesters. Results:The results showed that the ability of self-care was worse and needed more nursing or caring from others in the empty nest elderly;the empty nest elderly, in comparison with the non-empty-nest elderly, had lower physical and mental scores. With the age changing, the requirements of community health services were different in empty nest elderly and the satisfaction of community health service was low in the empty nest (39.1%). Conclusions: Empty nest elderly generally needed the different degree of community health education demands. The utilization rates of community health education were low.

Causal relationships between physical, mental and social health-related factors among the Japanese elderly: A chronological study

The World Health Organization defines health as a state of physical, mental and social well being. This study was conducted to explore chronological relationships between physical, mental and social factors. Among urban-dwelling elderly aged 65 years and over, data were collected via a self-report questionnaire in 2001 and 2004. The three health-related latent factors were identified with nine measurement variables by an exploratory factor analysis. A structural equation modeling method was used to analyze underlying relationships among the three factors with a cross-lagged model and a synchronous model. A total of 7,683 individuals aged between 65 and 84 years were analyzed. The three-year prior and current physical health significantly affected social health as well as mental health, and this effect appeared to be stronger in males compared to females. Maintenance of physical health may be crucial to support mental and social health among elderly individuals.

Health and widowhood: Meanings and experience of elderly women in Chile

Aging and widowhood signal a real and symbolic landmark of change toward new vital experiences of elderly people. In the aging experience of women, there are three social age markers that participate directly in the construction of their identity as women during old age: menopause, work and widowhood. The present paper reports the results of a research on widowhood in old age and the experience of aging in elderly women in Chile. Through a qualitative methodological strategy, in depth biographic interviews were held with elderly people who were widowed after reaching 60 years of age, centering the analysis on its meanings on the body, health and death in old age, highlighting sociocultural aspects of the aging and widowing processes. Approaching widowhood in old age shows us not only a person who has lost a husband, but also what it means to be an elderly woman in a life experience continuum that also brings about key changes to understand the aging process of people, because marital relations can get to be determining factors for the construction of the identity of women and their experience of the aging process.

Mental health promotion for elderly populations in World Health Organization South-East Asia Region:Needs and resource gaps

The accelerated population growth of the elderly(individuals aged 60 years or more)across the globe has many indications,including changes in demography,health,the psycho-social milieu,and economic security.This transition has given rise to varied challenges;significant changes have been observed in regard to developing strategies for health care systems across the globe.The World Health Organization(WHO)is also engaging in initiatives and mediating processes.Furthermore,advocacy is being conducted regarding a shift toward the salutogenic model from the pathogenic model.The concept behind this move was to shift from disablement to enablement and from illness to wellness,with the notion of mental health promotion(MHP)being promoted.This article attempts to discuss the MHP of elderly individuals,with special reference to the need to disseminate knowledge and awareness in the community by utilizing the resources of the health sector available in the WHO South-East Asia Region countries.We have tried to present the current knowledge gap by exploring the existing infrastructure,human resources,and financial resources.There is much to do to promote the mental health of the elderly,but inadequate facilities are available.Based on available resources,a roadmap for MHP in elderly individuals is discussed.

Significant Differences in Elderly Health between Urban and Rural Communities: A Literature Review

This study aimed to examine measures pertaining to elderly health in urban versus rural settings, and to identify differences in the health of elderly people living in urban and rural communities through a literature review. An electronic literature search was performed using PubMed for English articles published in peer-reviewed journals up to August 2018, with the following search terms: “urban”, “rural”, “comparison of community”, “elderly health”, and “comparison of community health”. A total of 35 articles were extracted for a critical full-text review, and six articles that met the inclusion criteria were subjected to analysis. Measures related to elderly health in urban and rural communities were classified into the following three categories: functional abilities, health, and health perception. Five of the six articles described functional abilities (e.g., social function) and health (e.g., mental health, depression) as categories with significant differences in elderly health between urban and rural communities. The results suggest that elderly health measures related to social function and mental health or depression are more important outcome measures of effective person-centered integrated community care systems from the perspective of community characteristics. As there were only a few articles reporting on elderly health according to differences in environment between urban and rural communities, further investigation is globally warranted.

Investigation and Countermeasures on the Health-Promoting Lifestyle of the Disabled Elderly in a Rural Area

Objective： To investigate the level of health-promoting lifestyle in the disabled elderly in a rural area and to provide useful countermeasures for health care workers and the government to improve the elderly＇ s lifestyle behaviors. Methods： A total of 446 disabled elderly people were recruited and examined using the General Questionnaire and Health-Promoting Lifestyle Profile II. Results： The mean score of the health-promoting lifestyle was 109.73（ SD = 16.80）, in which 90.6 percent of the disabled elderly demonstrated unhealthy lifestyle behaviors. The average score for each of the subscales includedthe following： interpersonal relations, stress management, nutrition, self-actualization, health responsibility, and sports activity. Conclusions： The health-promoting lifestyle of the disabled elderly needs to be improved; health care workers and the government should pay more attention to the countermeasures that can improve the lifestyle behaviors and promote the health of the disabled elderly.

Potential Legal Issues and Care Implications during Care-Prevention Gymnastic Exercises for the Elderly Using Pepper in Long Term Health Care Facilities

In Japan, the shortage of personnel is a problem in long-term care nursing and rehabilitative care prevention. Nevertheless, Japan has taken measures to compensate for these shortages by promoting medical and nursing care activities using robotic technologies, and employing human resources from overseas. The purpose of this study was to determine potential legal issues and subsequent implications for care during prevention gymnastic exercises for the elderly using Pepper in long-term health facilities. The application program of Care-Prevention Gymnastics Exercises for Pepper (Pepper with CPGE) was made by the Xing Company Japan. Currently, care workers become intermediaries for the safe use of Pepper with CPGE. However, it was realized that some legal issues may arise if Pepper with CPGE alone will carry out these preventive care programs for the elderly without the presence of care workers as intermediaries. In this situation, using Pepper with CPGE alone to conduct care prevention gymnastics will require safety measures to prevent these possible practice issues and anticipate implications for care. In this regard, determining detailed target levels of rehabilitation exercise demands and environmental setting safety become essential factors. The use of humanoid robots in healthcare is expected to influence more practice protocols in contemporary and futurist rehabilitative human care. The identification of possible safety issues in performance and environmental situations, and implications for care are critical to ensure safe and valuable rehabilitative health care practices for the elderly population.

Limited Focus on the Use of Health Care by Elderly Migrants——A Literature Review

Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found;few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.

Relationship between the Self-Efficacy and Mental Health of Elderly Patients with Coronary Heart Disease in Rural Hebei Province

Objective:To investigate the self-efficacy and mental health of elderly patients with coronary heart disease(CHD)in rural Hebei Province as well as to analyze the relationship between them.Methods:From June 2021 to December 2021,480 elderly patients with CHD from rural areas,who had been discharged by the Department of Cardiology from three tertiary hospitals in three cities with different economic levels in Hebei Province for more than a year,were selected as the research subjects.The general self-efficacy scale(GSES)and symptom self-rating scale(SCL-90)were used to investigate the self-efficacy and mental health of these patients.SPSS 25.0 was used for data analysis.Results:The total mean self-efficacy score of elderly patients with CHD in rural Hebei Province was 17.18±4.68,which is lower than the international norm(t=-32.067,P=0.000)and the national norm(t=-28.783,P=0.000);the total average SCL-90 score was 148.64±55.13,which is higher than the national norm for adults and the reference norm for ordinary elderly people;except for hostility and psychosis,the other dimensions were significantly higher than the national norm for adults(P<0.05);except for psychosis,the other dimensions were significantly higher than the reference norm for ordinary elderly people(P<0.05);the self-efficacy score was found to be negatively correlated with the total SCL-90 score and the score for each dimension(P<0.05).Conclusion:Elderly CHD patients with higher self-efficacy in rural Hebei Province have higher mental health level.It is suggested that the mental health of elderly patients with CHD in rural areas can be improved by improving their self-efficacy.