Relationships between Loneliness and Occupational Dysfunction in Community-Dwelling Older Adults: A Cross-Sectional Study
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SUBMITTER: Nakashima D
PROVIDER: S-EPMC10501838 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundWith the advancing age of the population, and increasing demands on healthcare services, community participation has become an important consideration for healthy ageing. Low levels of community participation have been linked to increased mortality and social isolation. The extent to which community participation has been measured objectively in older adults remains scarce. This study aims to describe where and how older adults participate in the community and determine the feasibility of measurement methods for community participation.MethodsThis observational cross-sectional study obtained data from 46 community dwelling older adults. A combination of Global Positioning Systems (GPS), accelerometry, and self-reported diaries were used over a 7-day monitoring period. Feasibility of methods were determined by calculating the loss of GPS data, questionnaires, and comparison of self-reported locations with GPS co-ordinates. Relationships between community participation, physical activity, social interactions, health related quality of life, sleep quality and loneliness were explored.ResultsOlder adults took a median (IQR) of 15 (9.25-18.75) trips out of home over the 7-day monitoring period, most frequently visiting commercial and recreational locations. In-home activities were mainly sedentary in nature, with out of home activities dependent on location type. Self-reported and GPS measures of trips out of home and the locations visited were significantly correlated (self-report 15.7 (5.6) GPS 14.4 (5.8) (r = 0.94)). Significant correlations between both the number of trips taken from home, with social interactions (r = 0.62) and the minutes of moderate to vigorous physical activity (MVPA) (r = 0.43) were observed. Daily MVPA was higher in participants who visited local walk/greenspaces (r = 0.48).ConclusionParticipants performed more activities with social interactions out of home and visited commercial locations most frequently. The combination of GPS, accelerometry and self-report methods provided a detailed picture of community participation for older adults. Further research is required with older adults of varying health status to generalise the relationships between community participation, location and physical activity.Trial registrationEthical approval was gained from the Flinders University Social and Behavioural Research Ethics Committee (protocol no. 8176).
| S-EPMC8008662 | biostudies-literature
Project description:ObjectiveThe aim of this study was to investigate the associations between each functional fitness (FF) domain and cognitive impairment (CI) in Chinese community-dwelling older adults.DesignA community-based, cross-sectional study was conducted.SettingParticipants were selected by multistage stratified random sampling in Wuhan City, Hubei Province, Central China, during December 2015-May 2016.ParticipantsA total of 2096 (1031 male and 1065 female) adults older than 65 years were included in our study. Exclusion criteria were age <65 years, losing self-living ability, previously diagnosed with dementia by a neurological physician, severe physical pain, congestive heart failure, dizziness and uncontrolled hypertension (exceeding 160/100 mm Hg).Primary and secondary outcome measuresThe Senior Fitness Test and the Mini-Mental State Examination were used to measure FF (including 30 s chair stand, 30 s arm curl, 2 min step, 8 foot up-and-go, chair sit-and-reach and back scratch) and screen CI, respectively. Activities of daily living and instrumental activities of daily living questionnaires were administered to evaluate functional status (FS).Results32.16% were classified as the CI group. The results showed that the CI group had significantly lower frequency of 30 s chair stand, 30 s arm curl and 2 min step, and longer time to complete the 8 foot up-and-go, shorter chair sit-and-reach and back scratch distance than the non-CI adults (p<0.05). Except for back scratch, older adults with moderate and high levels of FF were less likely to have CI than those with low levels, adjusted by sociodemographics, chronic disease, health condition, health behaviour and FS (p<0.05).ConclusionsThe relationship between FF and CI was independent of FS decline in Chinese community-dwelling older people.
| S-EPMC5961618 | biostudies-literature
Project description:BackgroundFalls among older adults is a common precipitating factor for unintentional injuries and represent a major health problem associated with increased morbidity, mortality, and health care cost in low-and-middle-income countries. The burden of fall in this population is well established in high-income countries and scant attention is given to this precipitating factor in low-and-middle-income countries, including Ethiopia. Therefore, this study aimed to estimate the prevalence and factors associated with fall among community-dwelling older adults in Ethiopia.MethodsA community-based cross-sectional study was conducted among community-dwelling older adults of Gondar. Multi-stage random sampling technique was used across administrative areas. Six hundred and five households were selected proportionally using systematic random sampling technique. Physical measurement and face to face interview method were employed using a structured questionnaire for data collection. Data were analyzed descriptively and through uni- and multivariate logistic regression model.ResultsOne hundred and seventy (n = 170, 28.4%; 95% CI 24.7-32.1) community-dwelling older adults reported having experienced fall in the past 12 months. Sex (OR = 1.91, 95% CI: 1.24-2.95), low educational status (OR = 2.37, 95% CI: 1.19-4.74), uncomfortable home environment (OR = 2.02, 95% CI: 1.34, 3.04), having diagnosed medical condition (OR = 4.659, 95% CI: 1.20-18.02), and use of medication (OR = 5.57, 95% CI: 1.19-26.21) were significantly associated risk factors of self-reported fall in the past 12 months. Most outdoor falls are associated with females and participants aged below 66 years.ConclusionIn conclusion, more than 1/4th of the community-dwelling older adults experienced at least one episode of fall and about 60% of them reported recurrent falls. Identifying risk group and risk factors that could be modified so as to prevent falls in older adults deserves attention. Outdoor falls are usually attributable to modifiable environmental aspects and improvements in outdoor environment needed.
| S-EPMC6736232 | biostudies-literature
Project description:ObjectiveDelay in seeking diagnosis of dementia is common in China. Misinformation and poor knowledge about dementia may contribute to it. The study was designed to explore the nationwide dementia literacy among older adults in urban China and to investigate the factors associated with overall dementia literacy.MethodsIn a cross-sectional study, a convenience sample of 3,439 community-dwelling old adults aged 60 and over was recruited from 34 cities in 20 provinces between June 20 and August 20, 2014. All participants were administered the face-to-face mental health literacy questionnaire, which included the prevalence, symptoms, intention, and options for treatment of dementia. Stepwise multivariate regression analysis was used to explore factors associated with overall dementia literacy.ResultsThe response rate was 87.4%. The overall dementia literacy was 55.5% (SD = 20.9%) among all respondents. The correct response rate was higher for questions on symptoms (58.7-89.6%), but lower for questions on the prevalence (22.2%) and choosing appropriate professional care personnel (22.2%). Being male [OR = 1.256, 95% CI (1.022-1.543)], having lower per capita annual income [OR = 1.314, 95% CI (1.064-1.623)], lower education [OR = 1.462, 95% CI (1.162-1.839)], and suspected depression [OR = 1.248, 95% CI (1.009-1.543)] were negatively associated with overall dementia literacy.ConclusionDementia literacy among community-dwelling older adults in urban China remains very low, in particular about the impact of dementia and appropriate treatment personnel. Community educational programs aiming to close this knowledge gap are encouraged to focus on those in the population at highest risk of low dementia literacy.
| S-EPMC5461251 | biostudies-literature
Project description:ObjectivesTo determine the prevalence of possible sarcopenia and its association with other conditions in older adults in Bengbu, China.Design, setting and participantsA cross-sectional study of 1082 community-dwelling Chinese people aged at least 60 years from March to June 2022.MethodsHandgrip strength and information regarding associated conditions were collected. Possible sarcopenia was estimated based on handgrip strength with cut-off values (<28 kg in men; <18 kg in women) recommended by the Asia Working Group for Sarcopenia in 2019. Mann-Whitney U tests, χ2 tests and binary logistic regression analyses were used to explore relationships between possible sarcopenia and associated conditions.ResultsPossible sarcopenia was more prevalent in men (52.79%, n=246, age 79.43±7.33 years among men with possible sarcopenia) than in women (44.48%, n=274, age 78.90±7.71 years among women with possible sarcopenia). In men, possible sarcopenia positively correlated with high age (OR 2.658, 95% CI 1.758 to 4.019), physical inactivity (OR 2.779, 95% CI 1.646 to 4.691) and diabetes (OR 4.269, 95% CI 2.397 to 7.602), and negatively with hypertension (OR 0.586, 95% CI 0.384 to 0.893). The risk of possible sarcopenia in men decreased by 12.6% for every 1 kg/m2 increase of body mass index (OR 0.874, 95% CI 0.817 to 0.935). In women, possible sarcopenia positively correlated with high age (OR 3.821, 95% CI 2.677 to 5.455), physical inactivity (OR 2.185, 95% CI 1.488 to 3.210) and arthritis (OR 2.076, 95% CI 1.411 to 3.056).ConclusionPossible sarcopenia is prevalent in older adults and the factors affecting possible sarcopenia are different in men and women. Health education about these target factors can be considered as a potential measure to prevent possible sarcopenia.
| S-EPMC9756196 | biostudies-literature
Project description:AimTo examine self-care behaviours among older adults with hypertension and identify related factors, including cognitive function, religious belief and comorbidities.DesignA cross-sectional study.MethodsSelf-care behaviours included diet and health. Participants completed a survey including items on demographics, disease-related characteristics and self-care behaviours and underwent cognitive function tests. Data were analysed using descriptive statistics, and multiple regression analysis was performed to analyse the factors affecting self-care.ResultsRegarding diet behaviour, older religious adults and those with higher scores on the Montreal Cognitive Assessment-Korean version had higher levels of self-care scores according to the HBP-SC. Regarding health behaviour, older adults with no comorbidities had higher levels of self-care scores according to the HBP-SC.ConclusionFactors affecting self-care diet behaviour include religion and Montreal Cognitive Assessment-Korean version scores and those affecting health behaviour include comorbidities among older adults with hypertension. Therefore, to improve their self-care behaviours, their religious practices and comorbidities should be considered, cognitive function should be assessed, and tailored education should be provided.Implications for the profession and/or patient careThis study investigated factors affecting self-care behaviours of hypertensive older adults in South Korea. The self-care was divided into diet and health behaviours. The factors influencing diet behaviour were religion and Montreal Cognitive Assessment-Korean version scores, and the factor influencing health behaviour was comorbidities. We also investigated self-care behaviour patterns. Older adults with hypertension were good at controlling alcohol consumption and did not forget to fill prescriptions. However, they were poor at reading nutrition labels to check on sodium content and checking blood pressure at home. Therefore, nurses could develop interventions considering these influencing factors and behavioural patterns to improve self-care behaviours and enhance health for older adults with hypertension.ImpactHypertension in older adults affects their health conditions and performance of self-care behaviours. Nurses could assess self-care based on diet and health behaviours. Additionally, further developing tailored programmes is recommended considering factors like religious belief, cognitive function and comorbidities.Reporting methodThis study followed the STROBE guidelines.Patient or public contributionThis study used a convenience sample of 105 participants aged ≥ 65 years recruited from a Korean hospital.
| S-EPMC10170949 | biostudies-literature
Project description:BackgroundLittle is known concerning the lifestyle habits and health conditions in community-dwelling elderly who do not get medical care. We investigated the cross-sectional association between medical expenses (ME) and intellectual activity (IA) in community-dwelling older Japanese.MethodsSelf-administered questionnaires were mailed to all residents born between 1945 and 1949 and covered by A City's medical insurance system (n = 19,354). Independent variables including health behaviors, oral health, social capital, neighborhood environment, and physical and mental functioning were included in the questionnaires. Medical fee receipts were used to evaluate ME for fiscal 2014, and respondents were classified into no, low, medium, and high ME groups. Higher-level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence, which is comprised of three subscales: instrumental activities of daily living, IA, and social role. Poisson regression models were used to examine the association of ME with IA, with the low ME group as reference.ResultsQuestionnaires were returned by 12,747 individuals (response rate 65.9%). The no ME group had the lowest response rate, the worst lifestyle behaviors, and the lowest social capital, but no problems with neighborhood environment. Higher-level functional capacity, especially IA, was reduced in both the high ME and no ME groups. After adjustments for age, gender, health insurance, accessibility to public facilities in their residential area, family size, body mass index, and physical and mental functioning, the prevalence ratio (PR) for impaired IA lost its significance in the high ME group (PR 0.97, 95% confidence interval 0.90-1.05), but remained significant in the no ME group (1.19, 1.08-1.31). After additional adjustments for health behaviors (i.e., health checks, smoking, fitness, and dietary variety), the PR of the no ME group was attenuated towards the null (1.08, 0.98-1.20).ConclusionsCommunity-dwelling elderly who did not seek medical treatment were indifferent to health surveys and health-promoting behaviors, and undesirable health behaviors were a possible determinant of their impaired IA. Further longitudinal research is needed to confirm the causal associations.
| S-EPMC5664812 | biostudies-literature
Project description:BackgroundWe examined the relationship between baseline olfactory performance and incident significant depressive symptoms and longitudinal depression trajectories in well-functioning older adults. Inflammation and cognitive status were examined as potential mediators.MethodsOlder adults (n = 2 125, 71-82 years, 51% female, 37% Black) completed an odor identification task at Year 3 (our study baseline) of the Health, Aging, and Body Composition study. Cognitive assessments, depressive symptoms, and inflammatory markers were ascertained across multiple visits over 8 years. Discrete-time complementary log-log models, group-based trajectory models, and multivariable-adjusted multinomial logistic regression were employed to assess the relationship between baseline olfaction and incident depression and longitudinal depression trajectories. Mediation analysis assessed the influence of cognitive status on these relationships.ResultsIndividuals with lower olfaction had an increased risk of developing significant depressive symptoms at follow-up (hazard ratio = 1.04, 95% confidence interval [CI]: 1.00, 1.08). Of the 3 patterns of longitudinal depression scores identified (stable low, stable moderate, and stable high), poorer olfaction was associated with a 6% higher risk of membership in the stable moderate (relative risk ratio [RRR] = 1.06, 95% CI: 1.02, 1.10)/stable high (RRR = 1.06, 95% CI: 1.00, 1.12) groups, compared to the stable low group. Poor cognitive status, but not inflammation, partially mediated the relationship between olfactory performance and incident depression symptom severity.ConclusionsSuboptimal olfaction could serve as a prognostic indicator of vulnerability for the development of late-life depression. These findings underscore the need for a greater understanding of olfaction in late-life depression and the demographic, cognitive, and biological factors that influence these relationships over time.
| S-EPMC10733184 | biostudies-literature
Project description:BackgroundSocial isolation has been recommended for reducing older adults' mortality and severe cases of COVID illness. That has resulted in unavoidable consequences of mental ill-health. This study aimed to examine the impact of the COVID-19 lockdown on the development of loneliness and depression and to analyse the factors associated with these conditions among community-dwelling older adults in Jordan.MethodsA cross-sectional survey was conducted with a random sample of 456 community older adults contacted by telephone three weeks after the first pandemic lockdown in April 2020. The study instrument included the screening three-item UCLA Loneliness Scale, the Geriatric Depression Scale, and relevant medical and functional history.ResultsThe mean age was 72.48 ± 6.84 years, and 50.2% were women. 41.4% were lonely, and of those 62% had a positive screen for depression. The mean UCLA score was significantly higher during the lockdown than before. Loneliness was significantly associated with being unmarried, having never worked previously, and being functionally dependent. Lonely participants were 1.65 times more likely to have depression. Likewise, a previous history of depression and cognitive impairment, multimorbidity, poor self-perceived health, and concern about contracting COVID infection were significant predictors of depression.ConclusionThe COVID-19 pandemic has had a heavy toll on older adults' mental health, particularly those with multimorbidity, baseline functional dependence, and those with a previous history of depression and cognitive impairment. Targeting these high-risk groups is important in order to minimize loneliness, depression, and subsequent increased morbidity. Using all-inclusive language might minimize ageism and the fear of catching an infection.
| S-EPMC9115360 | biostudies-literature
Project description:ObjectivePhysical distancing and stay-at-home measures implemented to slow transmission of novel coronavirus disease (COVID-19) may intensify feelings of loneliness in older adults, especially those living alone. Our aim was to characterise the extent of loneliness during the first wave in a sample of older adults living in the community and assess characteristics associated with loneliness.DesignOnline cross-sectional survey between 6 May and 19 May 2020.SettingOntario, Canada.ParticipantsConvenience sample of members of a national retired educators' organisation.Primary outcome measuresSelf-reported loneliness, including differences between women and men.Results4879 respondents (71.0% women; 67.4% 65-79 years) reported that in the preceding week, 43.1% felt lonely at least some of the time, including 8.3% who felt lonely always or often. Women had increased odds of loneliness compared with men, whether living alone (adjusted OR (aOR) 1.52, 95% CI 1.13 to 2.04) or with others (2.44, 95% CI 2.04 to 2.92). Increasing age group decreased the odds of loneliness (aOR 0.69 (95% CI 0.59 to 0.81) 65-79 years and 0.50 (95% CI 0.39 to 0.65) 80+ years compared with <65 years). Living alone was associated with loneliness, with a greater association in men (aOR 4.26, 95% CI 3.15 to 5.76) than women (aOR 2.65, 95% CI 2.26 to 3.11). Other factors associated with loneliness included: fair or poor health (aOR 1.93, 95% CI 1.54 to 2.41), being a caregiver (aOR 1.18, 95% CI 1.02 to 1.37), receiving care (aOR 1.47, 95% CI 1.19 to 1.81), high concern for the pandemic (aOR 1.55, 95% CI 1.31 to 1.84), not experiencing positive effects of pandemic distancing measures (aOR 1.94, 95% CI 1.62 to 2.32) and changes to daily routine (aOR 2.81, 95% CI 1.96 to 4.03).ConclusionsWhile many older adults reported feeling lonely during COVID-19, several characteristics-such as being female and living alone-increased the odds of loneliness. These characteristics may help identify priorities for targeting interventions to reduce loneliness.
| S-EPMC8023743 | biostudies-literature