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Nikolic D, Mujovic N, Santric-Milicevic M, Mitrovic S, Krstic N, Radic A, Radovic D, Nurbakyt A, Sukenova D, Kostadinovic M. Gender Differences in Predictors of Physical Functioning Limitations Among the Elderly Population in Serbia: A Population-Based Modeling Study. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:508. [PMID: 40142319 PMCID: PMC11943745 DOI: 10.3390/medicina61030508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2025] [Revised: 03/11/2025] [Accepted: 03/14/2025] [Indexed: 03/28/2025]
Abstract
Background and Objective: Active aging is influenced by various factors, including chronic diseases, multimorbidity, functional limitations, and disabilities. The presence of these factors might lead to greater dependence on caregivers and could present potential barriers to community engagement. Physical functioning might be considered as one of the vital components for healthier aging experience promotion and support in elderly people. This study aimed to assess self-perceived general health and related health characteristics among the elderly population in Serbia, with a focus on varying degrees of functional limitations, as well as to analyze the predictors of physical functioning limitations in relation to gender. Materials and Methods: This population-based modeling study included a representative sample of 3540 elderly individuals aged above 65 years from Serbia. We employed a dual approach to model the four distinct difficulty levels related to the two groups of limitations of physical functioning (PF1 and PF2) for both genders. The PF1 focused on walking half a kilometer on level ground without the assistance of any mobility aids, and the PF2 navigated a set of 12 steps of ascent and descent: Model 1: inability to execute PF1, Model 2: some/a lot of difficulty in PF1, Model 3: inability to execute PF2, and Model 4: some/a lot of difficulty in PF2. Further variables were evaluated: self-perceived general health, long-lasting health problems, and chronic diseases/chronic conditions. Logistic regression analysis was performed to assess predictors of physical functioning. The models' performance was presented. Results: Significant predictors were as follows: self-perceived general health (Model 1 (male OR: 8.639; female OR: 3.569); Model 2 (male OR: 2.759; female OR: 2.277); Model 3 (male OR: 24.290; female OR: 5.090); Model 4 (male OR: 3.256; female OR: 2.152)); long-lasting general health (Model 1 (female OR: 2.867); Model 3 (female OR: 3.602)); pulmonary diseases (Model 2 (male OR: 2.036); Model 4 (male OR: 1.976; female OR: 1.756)); musculoskeletal diseases (Model 1 (female OR: 1.537); Model 2 (male OR: 1.397; female OR: 1.410); Model 3 (male OR: 1.954; female OR: 1.739); Model 4 (male OR: 1.531; female OR: 1.483)); and other chronic diseases (Model 3 (male OR: 2.215)). Conclusions: Bad self-perceived general health and pulmonary and musculoskeletal diseases were predictors of functional disability in both genders of elderly individuals, while long-lasting health problems were predictors of functional disability in females and other chronic diseases were predictors in elderly males.
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Affiliation(s)
- Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (S.M.); (N.K.)
- Department of Physical Medicine and Rehabilitation, University Children’s Hospital, 11000 Belgrade, Serbia
| | - Natasa Mujovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (S.M.); (N.K.)
- University Clinical Center of Serbia, 11000 Belgrade, Serbia;
| | | | - Sindi Mitrovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (S.M.); (N.K.)
- Clinic for Rehabilitation “Dr Miroslav Zotovic”, 11000 Belgrade, Serbia;
| | - Nevena Krstic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.M.); (S.M.); (N.K.)
- University Clinical Center of Serbia, 11000 Belgrade, Serbia;
| | - Ana Radic
- Clinic for Rehabilitation “Dr Miroslav Zotovic”, 11000 Belgrade, Serbia;
| | - Diana Radovic
- Institute of Rehabilitation, 11000 Belgrade, Serbia;
| | - Ardak Nurbakyt
- Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan; (A.N.); (D.S.)
| | - Dinara Sukenova
- Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan; (A.N.); (D.S.)
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Denche-Zamorano A, Perez-Gomez J, Barrios-Fernandez S, Oliveira R, Adsuar JC, Brito JP. Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2857. [PMID: 36833555 PMCID: PMC9958756 DOI: 10.3390/ijerph20042857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.
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Affiliation(s)
- Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Perez-Gomez
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Jose C. Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
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Zhang M, Rong J, Liu S, Zhang B, Zhao Y, Wang H, Ding H. Factors related to self-rated health of older adults in rural China: A study based on decision tree and logistic regression model. Front Public Health 2022; 10:952714. [PMID: 36530664 PMCID: PMC9748102 DOI: 10.3389/fpubh.2022.952714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/08/2022] [Indexed: 12/05/2022] Open
Abstract
Objective This study aimed to explore the related factors of self-rated health (SRH) by using decision tree and logistic regression models among older adults in rural China. Methods Convenience sampling was employed with 1,223 enrolled respondents who met the inclusion criteria from 10 randomly selected villages in M County in China. The content of the questionnaire covered demographic characteristics, physical and mental health, sleep status, and risk of falling. The Pittsburgh Sleep Quality Index (PSQI) and the Morse Falls Risk Scale (MFS) were used to evaluate sleep status and risk of falling, respectively. The decision tree and logistic regression models were employed to analyze the related factors of SRH. Results Notably, 817 (68.7%) subjects had good SRH. The logistic regression model showed that living standard, alcohol consumption, sleep quality, labor, hospitalization, discomfort, the number of chronic diseases, and mental health were associated with SRH (P-value < 0.05), while the decision tree model showed that the number of chronic diseases, sleep quality, mental health, hospitalization, gender, and drinking were associated with SRH. The sensitivity and specificity of the logistic regression model were 67.7 and 75.5%, respectively, and the area under the ROC curve was 0.789 (0.763, 0.816); the sensitivity and specificity of the decision tree model were 71.5, and 61.4% respectively, and the area under the ROC curve was 0.733 (0.703, 0.763). Conclusion Decision tree and logistic regression models complement each other and can describe the factors related to the SRH of the elderly in rural China from different aspects. Our findings indicated that mental health, hospitalization, drinking, and sleep quality were the important associated factors.
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Affiliation(s)
- Min Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Jian Rong
- Department of Scientific Research, The Second Hospital of Anhui Medical University, Anhui, China
| | - Song Liu
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Beibei Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Yaodong Zhao
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Haibo Wang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Hong Ding
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China,*Correspondence: Hong Ding
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Denche-Zamorano Á, Mendoza-Muñoz M, Carlos-Vivas J, Muñoz-Bermejo L, Rojo-Ramos J, Pastor-Cisneros R, Giakoni-Ramírez F, Godoy-Cumillaf A, Barrios-Fernandez S. A Cross-Sectional Study on Self-Perceived Health and Physical Activity Level in the Spanish Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5656. [PMID: 35565051 PMCID: PMC9104406 DOI: 10.3390/ijerph19095656] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/29/2022] [Accepted: 05/04/2022] [Indexed: 12/21/2022]
Abstract
One-third of the Spanish population over 15 years of age did not achieve a reasonable amount of physical activity (PA) before the COVID-19 pandemic. We aim to analyse the associations between the PA level (PAL) and self-perceived health (SPH) in the Spanish population aged 15−69 years during the pre-pandemic period. A cross-sectional study was conducted using the Spanish National Health Survey 2017 (ENSE 2017) data, with 17,777 participants. We carried out a descriptive analysis, analysed intergroup differences with non-parametric statistical tests, and calculated the Odds Ratio (OR) and Relative Risk (RR) of having a negative SPH according to PAL. In addition, correlations between PAL and SPH were studied, finding associations between them (p < 0.001). Thus, performing moderate and intense PA was related to better SPH than just walking or inactive. Weak and moderate correlations were found between PAL and SPH (p < 0.001). We also found high ORs and RRs of negative SPH as PAL decreased. Moderate and intense PA were related to positive SPH, while the risk of negative perception in inactive people was higher.
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Affiliation(s)
- Ángel Denche-Zamorano
- Health Economy Motricity and Education (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain;
| | - María Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain;
| | - Laura Muñoz-Bermejo
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain; (L.M.-B.); (J.R.-R.); (S.B.-F.)
| | - Jorge Rojo-Ramos
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain; (L.M.-B.); (J.R.-R.); (S.B.-F.)
| | - Raquel Pastor-Cisneros
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain;
| | - Frano Giakoni-Ramírez
- Faculty of Education and Social Sciences, Universidad Andres Bello, Las Condes, Santiago 7550000, Chile;
| | - Andrés Godoy-Cumillaf
- Grupo de Investigación en Educación Física, Salud y Calidad de Vida, Facultad de Educación, Universidad Autónoma de Chile, Temuco 4780000, Chile;
| | - Sabina Barrios-Fernandez
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain; (L.M.-B.); (J.R.-R.); (S.B.-F.)
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Denche-Zamorano Á, Muñoz-Bermejo L, Carlos-Vivas J, Mendoza-Muñoz M, Franco-García JM, Rojo-Ramos J, Vega-Muñoz A, Contreras-Barraza N, Barrios-Fernandez S. A Cross-Sectional Study about the Associations between Physical Activity Level, Self-Perceived Health Perception and Mental Health in Informal Caregivers of Elderly or People with Chronic Conditions in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5320. [PMID: 35564725 PMCID: PMC9101566 DOI: 10.3390/ijerph19095320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 12/25/2022]
Abstract
Providing informal care for older people, or people with chronic conditions, is associated with poorer physical and mental health and reduced quality of life. This task, in many cases, often relies on the women in the immediate family. Physical activity (PA) is a tool to enhance caregivers' physical and mental health and their quality of life. Thus, this study aimed to analyse the associations between the physical activity level (PAL), self-perceived health (SPH) and mental health (SM) and its factors (positive coping, self-esteem, and stress) by conducting a cross-sectional study by using data from in the National Health Survey 2017 (ENSE 2017), the last one before the COVID-19 pandemic. The sample included 2225 caregivers (866 men and 1361 women). Descriptive analysis and non-parametric statistical tests, including chi-square, the Kruskal-Wallis test, the Mann-Whitney U test, and the Spearman's rho correlation coefficient, were used. Dependence relationships were found between PAL and SPH and MH and their factors. The population groups that performed moderate or vigorous PA showed better results in both SPH and MH. Women scored worse than men in all the variables analysed. Hence, intense, or moderate PA practice may improve SPH and MH in Spanish informal caregivers, requiring the implementation of policies and programs considering the differences found between men and women in PAL, SPH, and MH.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain; (Á.D.-Z.); (J.C.-V.)
| | - Laura Muñoz-Bermejo
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain; (J.R.-R.); (S.B.-F.)
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain; (Á.D.-Z.); (J.C.-V.)
| | - María Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain;
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - Juan Manuel Franco-García
- Health Economy Motricity and Education (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Jorge Rojo-Ramos
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain; (J.R.-R.); (S.B.-F.)
| | - Alejandro Vega-Muñoz
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile;
| | | | - Sabina Barrios-Fernandez
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain; (J.R.-R.); (S.B.-F.)
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