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Kekäläinen T, Koivunen K, Pynnönen K, Portegijs E, Taina Rantanen. Cohort Differences in Depressive Symptoms and Life Satisfaction in 75- and 80-Year-Olds: A Comparison of Two Cohorts 28 Years Apart. J Aging Health 2024; 36:3-13. [PMID: 36947727 PMCID: PMC10693740 DOI: 10.1177/08982643231164739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Objectives: To examine birth cohort differences in depressive symptoms and life satisfaction in older men and women and the mechanisms underpinning the possible cohort differences. Methods: Two independent cohorts of Finnish men and women aged 75 and 80 were assessed in 1989-1990 (n = 617) and 2017-2018 (n = 794). They reported their depressive symptoms (CES-D), current life satisfaction, and evaluation of life until now. Results: The later-born cohort reported fewer depressive symptoms (8.6 ± 7.1 vs. 13.9 ± 8.3) and the differences were similar for the subdomains of depressive symptoms. The later-born cohort was more often mostly satisfied with life until now (90 vs. 70%) but not with the current life than the earlier-born cohort. Better self-rated health and education of the later-born cohort partly explain the cohort differences. Discussion: Older people in Finland report fewer depressive symptoms and they are more satisfied with their past life compared to their counterparts assessed 28 years ago.
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Affiliation(s)
- Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisa Koivunen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Pynnönen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Erja Portegijs
- Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Taina Rantanen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Hajek A, Volkmar A, König HH. Prevalence and correlates of loneliness and social isolation in the oldest old: a systematic review, meta-analysis and meta-regression. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02602-0. [PMID: 38102477 DOI: 10.1007/s00127-023-02602-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Conducting a systematic review, meta-analysis and meta-regression regarding the prevalence and correlates of loneliness and social isolation amongst the community-dwelling and institutionalised oldest old (80 years and over). METHODS Three electronic databases (PsycINFO, CINAHL and Medline) were searched, including studies from inception to January 5, 2023. An additional hand search was conducted by checking included studies' references, and studies that cited included studies. We included observational studies describing the prevalence and (ideally) the correlates of loneliness, or social isolation, amongst individuals aged 80 years and over. Study design, operationalization of loneliness and social isolation, statistical analysis, characteristics of the sample and key findings were extracted. A random-effects meta-analysis was conducted. RESULTS We included 22 studies. The estimated prevalence of severe loneliness was 27.1% (95% CI: 23.7-30.4%). The estimated prevalence of moderate loneliness equalled 32.1% (95% CI: 15.8-48.4%). Moreover, the estimated prevalence of social isolation was 33.6% (95% CI: 28.9-38.2%). There was heterogeneity between the studies. Egger tests suggest the absence of potential publication bias. Meta-regressions showed that the heterogeneity could neither be attributed to the assessment of loneliness nor to the continent where the study was conducted. CONCLUSION Loneliness and social isolation are important problems in the oldest old. In this age group, studies are required, in particular from regions outside Europe. Additionally, longitudinal studies are required to investigate the determinants of loneliness and social isolation amongst individuals aged 80 years and over. Studies using more sophisticated tools to quantify loneliness and social isolation are required.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - Alina Volkmar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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3
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Aunsmo RH, Langballe EM, Hansen T, Selbæk G, Strand BH. Time trends in loneliness from 1984 to 2019 among 27,032 older adults in Norway: A HUNT study. Prev Med 2023; 175:107659. [PMID: 37567367 DOI: 10.1016/j.ypmed.2023.107659] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
The aging population and increasing evidence of the detrimental health impacts of loneliness emphasize the importance of studying and predicting changes in loneliness prevalence among older adults. To understand and project changes in loneliness over time, we examined 35-year trends in adults aged 70 and older, considering factors such as sex, age, and living situation. Cross-sectional data from 27,032 home-dwelling adults aged 70 years and older who participated in at least one of the four Norwegian HUNT surveys from 1984 to 2019, and Norwegian population data from Statistics Norway were used for the analyses. Loneliness was self-reported, and the prevalence of loneliness was standardized to the Norwegian population at the survey year by age and sex. The results showed that the prevalence of loneliness significantly decreased between each survey. The higher categories of loneliness (a good amount, very much) decreased, from 11.4% (1995-97), 6.7% (2006-08), and 5.8% (2017-19). Across surveys, loneliness was significantly more common among women, the oldest, and those living alone. The prevalence of loneliness among the oldest adults living alone increased from 2006 to 2019. The gradual decline in loneliness observed from 1995 to 2019 coincided with notable societal changes in Norway. We estimated that the number of older adults experiencing loneliness in Norway could rise from 184,000 in 2020 to 286,000 in 2035, and potentially reach 380,000 in 2050.
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Affiliation(s)
- Ragnhild Holmberg Aunsmo
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Verdal municipality, Norway.
| | - Ellen Melbye Langballe
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
| | - Thomas Hansen
- Norwegian Institute of Public Health, Oslo, Norway; Oslo Metropolitan University, Oslo, Norway; Promenta Research Center, University of Oslo, Oslo, Norway.
| | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Bjørn Heine Strand
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; Norwegian Institute of Public Health, Oslo, Norway.
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D'Oliveira A, Dominski FH, De Souza LC, Branco JHL, Matte DL, da Cruz WM, Andrade A. Impact of air pollution on the health of the older adults during physical activity and sedentary behavior: A systematic review. ENVIRONMENTAL RESEARCH 2023; 234:116519. [PMID: 37392827 DOI: 10.1016/j.envres.2023.116519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Air pollution, in addition to presenting health risks, can impact the practice of physical activity (PA) and sedentary behavior (SB) in older adults. This study analyzed the impact of air pollution on the health of older adults during PA and SB, through a systematic review. METHODS A keyword and reference search was performed in PubMed, SCOPUS, SPORTDiscus, and Web of Science. Predetermined selection criteria included study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies and case-control studies; population: older adults aged 60 years or older; exposures: specific air pollutants (particulate matter (PM), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), sulfur dioxide (SO2), black carbon (CN), ultrafine particles (PU), nitrogen oxides (NOx) and biomass fuels) indoors and outdoors; and outcomes: physical activity and/or sedentary behavior. RESULTS The beneficial effects of PA were attenuated or harmed in 11 studies, showing negative impacts on the health of the older adults, mainly by PM2.5 pollutants. On the other hand, in 10 studies the effects of PA were greater than the negative effects of air pollutants, with a greater frequency in relation to PM2.5. In general, even the articles presenting controversial results suggest that practicing PA in polluted environments is more favorable to the health of older adults than remaining in SB. DISCUSSION AND CONCLUSIONS On the one hand, air pollution negatively impacted the health of the older adults during PA practices, while on the other hand, PA can mitigate the negative effects of pollutants on the health of older adults during the practices. Evidence shows that practicing PA in environments with low concentrations of pollutants can provide gains and reduce health risks. Remaining in SB in environments with high levels of air pollution worsens the health of older adults.
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Affiliation(s)
- Anderson D'Oliveira
- Health and Sports Science Center, Department of Physical Education, Santa Catarina State University, Florianópolis, 88035-901, Brazil.
| | - Fábio Hech Dominski
- Health and Sports Science Center, Department of Physical Education, Santa Catarina State University, Florianópolis, 88035-901, Brazil.
| | - Loiane Cristina De Souza
- Health and Sports Science Center, Department of Physical Education, Santa Catarina State University, Florianópolis, 88035-901, Brazil.
| | | | - Darlan Lauricio Matte
- Physical Therapy Graduate Program, Santa Catarina State University, 88080-350, Florianópolis, SC, Brazil.
| | - Whyllerton Mayron da Cruz
- Health and Sports Science Center, Department of Physical Education, Santa Catarina State University, Florianópolis, 88035-901, Brazil.
| | - Alexandro Andrade
- Health and Sports Science Center, Department of Physical Education, Santa Catarina State University, Florianópolis, 88035-901, Brazil.
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5
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Timmermans EJ, Leeuwis AE, Bots ML, van Alphen JL, Biessels GJ, Brunner-La Rocca HP, Kappelle LJ, van Rossum AC, van Osch MJP, Vaartjes I. Neighbourhood walkability in relation to cognitive functioning in patients with disorders along the heart-brain axis. Health Place 2023; 79:102956. [PMID: 36525834 DOI: 10.1016/j.healthplace.2022.102956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
This study examined associations of neighbourhood walkability with cognitive functioning (i.e., global cognition, memory, language, attention-psychomotor speed, and executive functioning) in participants without or with either heart failure, carotid occlusive disease, or vascular cognitive impairment. Neighbourhood walkability at baseline was positively associated with global cognition and attention-psychomotor speed. These associations were stronger in patients with vascular cognitive impairment. Individuals who live in residential areas with higher walkability levels were less likely to have impairments in language and executive functioning at two-year follow-up. These findings highlight the importance of the built environment for cognitive functioning in healthy and vulnerable groups.
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Affiliation(s)
- Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Anna E Leeuwis
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Juliette L van Alphen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - L Jaap Kappelle
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Matthias J P van Osch
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Klokgieters SS, Picavet HSJ, Huisman M, Monique Verschuren WM, Uiters EAH, Kok AA. Differences in the Mediating Role of HL in Socioeconomic Inequalities in Health Across Age Groups: Results from the Dutch Doetinchem Cohort Study. Health Lit Res Pract 2023; 7:e26-e38. [PMID: 36779930 PMCID: PMC9918305 DOI: 10.3928/24748307-20230124-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Although it is known that health literacy (HL) plays an explanatory role in educational inequalities in health, it is unknown whether this role varies across age groups. OBJECTIVE The purpose of this study was to investigate whether the mediating role of HL in educational inequalities in four health outcomes varies across age groups: age 46 to 58 years, age 59 to 71 years, and age 72 to 84 years. METHODS We used data from the Dutch Doetinchem Cohort Study, which included 3,448 participants. We included years of education as predictor, chronic illness prevalence and incidence, mental and self-perceived health as outcomes, and HL, based on self-report, as mediator. We used multiple-group mediation models to compare indirect effects across age groups. KEY RESULTS In the complete sample without age stratification, HL partly mediated the effect of education on all health outcomes except for incidence of chronic diseases. These indirect effect estimates were larger for subjective (self-perceived health, proportion mediated [PM] = 37%, and mental health, PM = 37%) than for objective health outcomes (prevalence of chronic disease, PM = 17%). For the prevalence of chronic disease, the indirect effect estimate was significantly larger among individuals age 46 to 58 years compared to individuals age 59 to 71 years and for incidence of chronic disease also compared to individuals age 72 to 84 years. All other indirect effect estimates did not differ significantly between age groups. Using an alternative cut-off point for HL or adjusting for cognitive functioning did not meaningfully change the results. CONCLUSIONS Overall, we found that the explanatory role of HL in educational inequalities in mental and subjective health was stable but that it varied across age groups for chronic diseases, where it was largest among individuals age 46 to 58 years. Future studies may investigate the benefits of starting to intervene on HL from a younger age but means to improve HL may also benefit the subjective health of older adults with lower education. [HLRP: HL Research and Practice. 2023;7(1):e26-e38.] Plain Language Summary: This study examined age-group differences in the mediating role of HL in the relationship between education and health. Overall, we found that the explanatory role of HL in educational inequalities in mental and subjective health was stable but that it varied across age groups for chronic diseases, where it was largest among individuals age 46 to 58 years compared to individuals age 59 to 71 years and individuals age 72 to 84 years.
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Affiliation(s)
- Silvia S. Klokgieters
- Address correspondence Silvia S. Klokgieters, PhD, Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, Amsterdam Public Health, de Boelelaan 1117, Amsterdam, Netherlands;
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7
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Camargo Pereira C, Pagotto V, de Oliveira C, Silveira EA. Low muscle mass and mortality risk later in life: A 10-year follow-up study. PLoS One 2022; 17:e0271579. [PMID: 35901119 PMCID: PMC9333286 DOI: 10.1371/journal.pone.0271579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 07/05/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Little is known about the impact of low muscle mass (MM) assessed by calf circumference (CC), arm circumference (AC), arm muscle circumference (AMC), and corrected arm muscle circumference (CAMC)—on mortality risk later in life. We aimed to investigate the impact of low MM assessed by CC, AC, AMC and, CAMC on all-cause, cardiovascular, and cancer mortality risk. Methods Data came from 418 older adults who participated in a 10-year follow-up prospective cohort study. Low MM was defined as a CC < 33 cm for women and < 34 cm for men and by the lowest tertile of AC, AMC, and CAMC stratified by sex. The log rank test, Kaplan-Meier curves, and Cox regression were used. Results There were 147 deaths: 49 related to CVD and 22 to cancer. A small CC (HR = 1.57, 95% CI, 1.12–2.20), AMC (HR = 1.61, 95% CI, 1.13–2.30) and CAMC (HR = 1.45, 95% CI, 1.03–2.04) were associated with all-cause mortality. A small CAMC was a protective factor for CVD mortality (HR = 0.46, 95% CI, 0.22–0.98). In the Kaplan-Meier analysis, older adults with LMM presented low all-cause mortality survival, with AC (p < 0.05), AMC (p < 0.005), CAMC (p < 0.002), and CC (p < 0.001). Cancer mortality was associated with low CAMC (p < 0.020). Conclusions Low MM assessed by anthropometric measures (AC, AMC, CAMC and CC) increased the all-cause mortality risk. A small CAMC decreased the CVD mortality.
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Affiliation(s)
- Cristina Camargo Pereira
- Postgraduate Program in Health Sciences, Medical School, Federal University of Goiás (UFG), Goiania, Brazil
| | - Valéria Pagotto
- Faculty of Nursing, Postgraduate Program in Nursing, Federal University of Goiás (UFG), Goiania, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, United Kingdom
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Medical School, Federal University of Goiás (UFG), Goiania, Brazil
- Department of Epidemiology & Public Health, University College London, London, United Kingdom
- * E-mail:
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Klokgieters SS, Kok AAL, Visser M, van Groenou MIB, Huisman M. Changes in the role of explanatory factors for socioeconomic inequalities in physical performance: a comparative study of three birth cohorts. Int J Equity Health 2021; 20:252. [PMID: 34895239 PMCID: PMC8665629 DOI: 10.1186/s12939-021-01592-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to societal changes and changes in the availability of health promoting factors, explanatory factors of socioeconomic inequalities in health (SIH) may change with time. We investigate differences in the relative importance of behavioural, social and psychological factors for explaining inequalities in physical performance between three birth cohorts. METHODS Data came from N = 988, N = 1002, and N = 1023 adults aged 55-64 years, collected in 1992, 2002 and 2012 as part of the Longitudinal Aging Study Amsterdam. Physical performance was measured by three performance tests. We included lifestyle factors (physical activity, smoking, alcohol use and Body Mass Index (BMI)); social factors (network size, network complexity, divorce, social support); and psychological factors (mastery, self-efficacy and neuroticism). In multi-group mediation models, we tested whether the strength of indirect effects from socioeconomic position (SEP) via the explanatory factors to health differed between birth cohorts. Stronger indirect effects indicate an increase in the importance; weaker indirect effects indicate a decrease in importance. RESULTS Absolute SIH were present and similar across cohorts. The strength of indirect effects of SEP on physical performance through smoking, binge alcohol use, emotional support and mastery increased across cohorts. The indirect effects of BMI, network size, self-efficacy and neuroticism were similar across cohorts. CONCLUSIONS Inequalities in smoking, binge alcohol use, emotional support and mastery may have become more important for explaining SIH in recent cohorts of middle-aged adults. Policies that aim to reduce socioeconomic inequalities may need to adapt their targets of intervention to changing mechanisms in order to reduce SIH.
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Affiliation(s)
- Silvia S Klokgieters
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Uniersiteit Amsterdam, Amsterdam Public Health, de Boelelaan 1117, Amsterdam, Netherlands.
| | - Almar A L Kok
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Uniersiteit Amsterdam, Amsterdam Public Health, de Boelelaan 1117, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Martijn Huisman
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Uniersiteit Amsterdam, Amsterdam Public Health, de Boelelaan 1117, Amsterdam, Netherlands
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit, Amsterdam, The Netherlands
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Timmermans EJ, Visser M, Wagtendonk AJ, Noordzij JM, Lakerveld J. Associations of changes in neighbourhood walkability with changes in walking activity in older adults: a fixed effects analysis. BMC Public Health 2021; 21:1323. [PMID: 34225681 PMCID: PMC8259368 DOI: 10.1186/s12889-021-11368-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Supporting older adults to engage in physically active lifestyles requires supporting environments. Walkable environments may increase walking activity in older adults, but evidence for this subgroup is scarce, and longitudinal studies are lacking. This study therefore examined whether changes in neighbourhood walkability were associated with changes in walking activity in older adults, and whether this association differed by individual-level characteristics and by contextual conditions beyond the built environment. Methods Data from 668 participants (57.8–93.4 years at baseline) across three waves (2005/06, 2008/09 and 2011/12) of the Longitudinal Aging Study Amsterdam (LASA) were used. These individuals did not relocate during follow-up. Self-reported outdoor walking activity in minutes per week was assessed using the LASA Physical Activity Questionnaire. Composite exposure measures of neighbourhood walkability (range: 0 (low)-100 (high)) within 500-m Euclidean buffer zones around each participant’s residential address were constructed by combining objectively measured high-resolution Geographic Information System data on population density, retail and service destination density, land use mix, street connectivity, green space density, and sidewalk density. Fixed effects linear regression analyses were applied, adjusted for relevant time-varying confounders. Results Changes in neighbourhood walkability were not statistically significantly associated with changes in walking activity in older adults (β500m = − 0.99, 95% CI = -6.17–4.20). The association of changes in neighbourhood walkability with changes in walking activity did not differ by any of the individual-level characteristics (i.e., age, sex, educational level, cognitive impairment, mobility disability, and season) and area-level characteristics (i.e., road traffic noise, air pollution, and socioeconomic status). Conclusions This study did not show evidence for an association between changes in neighbourhood walkability and changes in walking activity in older adults. If neighbourhood walkability and walking activity are causally linked, then changes in neighbourhood walkability between 2005/06 and 2011/12 might have been not substantial enough to produce meaningful changes in walking activity in older adults.
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Affiliation(s)
- Erik J Timmermans
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Alfred J Wagtendonk
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J Mark Noordzij
- Mulier Institute, Herculesplein 269, Utrecht, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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10
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Hoogendijk EO, Stolz E, Oude Voshaar RC, Deeg DJH, Huisman M, Jeuring HW. Trends in Frailty and Its Association With Mortality: Results From the Longitudinal Aging Study Amsterdam, 1995-2016. Am J Epidemiol 2021; 190:1316-1323. [PMID: 33534876 PMCID: PMC8245891 DOI: 10.1093/aje/kwab018] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to investigate trends in frailty and its relationship with mortality among older adults aged 64–84 years across a period of 21 years. We used data from 1995 to 2016 from the Longitudinal Aging Study Amsterdam. A total of 7,742 observations of 2,874 respondents in the same age range (64–84 years) across 6 measurement waves were included. Frailty was measured with a 32-item frailty index, with a cutpoint of ≥0.25 to indicate frailty. The outcome measure was 4-year mortality. Generalized estimating equation analyses showed that among older adults aged 64–84 years the 4-year mortality rate declined between 1995 and 2016, while the prevalence of frailty increased. Across all measurement waves, frailty was associated with 4-year mortality (odds ratio = 2.79, 95% confidence interval: 2.39, 3.26). There was no statistically significant interaction effect between frailty and time on 4-year mortality, indicating a stable association between frailty and mortality. In more recent generations of older adults, frailty prevalence rates were higher, while excess mortality rates of frailty remained the same. This is important information for health policy-makers and clinical practitioners, showing that continued efforts are needed to reduce frailty and its negative health consequences.
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Affiliation(s)
- Emiel O Hoogendijk
- Correspondence to Dr. Emiel O. Hoogendijk, Department of Epidemiology & Data Science, Amsterdam UMC, VU University Medical Center, P.O. Box 7057, 1007MB Amsterdam, the Netherlands (e-mail: )
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Timmermans E, Motoc I, Noordzij JM, Beenackers MA, Wissa R, Sarr A, Gurer A, Fabre G, Ruiz M, Doiron D, Oude Groeniger J, Deeg D, Van Lenthe FJ, Huisman M. Social and physical neighbourhood characteristics and loneliness among older adults: results from the MINDMAP project. J Epidemiol Community Health 2021; 75:464-469. [PMID: 33154148 PMCID: PMC8053323 DOI: 10.1136/jech-2020-214217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/23/2020] [Accepted: 10/13/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Loneliness is associated with several adverse mental and physical health outcomes in older adults. Previous studies have shown that a variety of individual-level and perceived area-level characteristics are associated with loneliness. This study examined the associations of objectively measured social and physical neighbourhood characteristics with loneliness. METHODS We used cross-sectional data from 1959 older adults (63-98 years) who participated in the Longitudinal Ageing Study Amsterdam (LASA; wave 2011/12) and the Health and Living Conditions of the Population of Eindhoven and Surroundings study (GLOBE; wave 2014) in the Netherlands. Study-specific loneliness scores were harmonised across both cohort studies and divided into tertiles denoting low, medium and high levels of loneliness. Objectively measured neighbourhood characteristics, including area-level percentages of low educated residents, social security beneficiaries and unoccupied dwellings, average income, crime levels and land use mix, were linked to individual-level data. Multinomial logistic regression analyses were conducted to examine the associations of interest. RESULTS There was no statistical evidence for an association of the included neighbourhood characteristics with loneliness. Although not statistically significant, the observed associations suggested that participants living in neighbourhoods with more heterogeneous land use mix were less likely to have a medium and high level of loneliness than those living in more homogeneous neighbourhoods in terms of land use mix (ORmedium=0.54, 95% CI=0.18-1.67; ORhigh=0.67, 95% CI=0.21-2.11). CONCLUSION The results indicate that the included objectively measured social and physical neighbourhood characteristics are not associated with loneliness in old age.
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Affiliation(s)
- Erik Timmermans
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands
| | - Irina Motoc
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands
| | - J Mark Noordzij
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marielle A Beenackers
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Rita Wissa
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Aliou Sarr
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Asli Gurer
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Guillaume Fabre
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Milagros Ruiz
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Dany Doiron
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Public Administration and Sociology, Erasmus University, Rotterdam, The Netherlands
| | - Dorly Deeg
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands
| | - Frank J Van Lenthe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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12
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Kudesia P, Salimarouny B, Stanley M, Fortin M, Stewart M, Terry A, Ryan BL. The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2021; 11:26335565211032880. [PMID: 34350127 PMCID: PMC8287424 DOI: 10.1177/26335565211032880] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 12/17/2022]
Abstract
Multimorbidity, the presence of 1+ chronic condition in an individual, remains one of the greatest challenges to health on a global scale. Although the prevalence of multimorbidity has been well-established, its incidence is not fully understood. This systematic review determined the incidence of multimorbidity across the lifespan; the order in which chronic conditions accumulate to result in multimorbidity; and cataloged methods used to determine and report accumulation of chronic conditions resulting in multimorbidity. Studies were identified by searching MEDLINE, Embase, CINAHL, and Cochrane electronic databases. Two independent reviewers evaluated studies for inclusion and performed quality assessments. Of 36 included studies, there was high heterogeneity in study design and operational definitions of multimorbidity. Studies reporting incidence (n = 32) reported a median incidence rate of 30.7 per 1,000 person-years (IQR 39.5 per 1,000 person-years) and a median cumulative incidence of 2.8% (IQR 28.7%). Incidence was notably higher for persons with older age and 1+ chronic conditions at baseline. Studies reporting patterns in accumulation of chronic conditions (n = 5) reported hypertensive and heart diseases, and diabetes, as among the common starting conditions resulting in later multimorbidity. Methods used to discern patterns were highly heterogenous, ranging from the use of latent growth trajectories to divisive cluster analyses, and presentation using alluvial plots to cluster trajectories. Studies reporting the incidence of multimorbidity and patterns in accumulation of chronic conditions vary greatly in study designs and definitions used. To allow for more accurate estimations and comparison, studies must be transparent and consistent in operational definitions of multimorbidity applied.
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Affiliation(s)
- Prtha Kudesia
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
| | - Banafsheh Salimarouny
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
| | - Meagan Stanley
- Allyn & Betty Taylor Library, University of Western
Ontario, London, Ontario, Canada
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Moira Stewart
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| | - Amanda Terry
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| | - Bridget L Ryan
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
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13
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Pruchno R, Wilson-Genderson M, Heid AR, Cartwright FP. Type of Disaster Exposure Affects Functional Limitations of Older People 6 Years Later. J Gerontol A Biol Sci Med Sci 2020; 75:2139-2146. [PMID: 31678995 PMCID: PMC7566386 DOI: 10.1093/gerona/glz258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Natural disasters, including earthquakes, tsunamis, tornadoes, and hurricanes, are traumatic events that simultaneously affect the lives of many people. Although much is known about the effects that natural disasters have on mental health, little is known about how natural disasters affect physical health. These analyses add to the literature by examining the ways in which four types of disaster exposure (geographic, peri-traumatic stress, personal and property loss, and poststorm hardship) experienced by older people during and after Hurricane Sandy affected functional limitations. METHODS We analyzed five waves of data from the ORANJ BOWL panel ("Ongoing Research on Aging in New Jersey: Bettering Opportunities for Wellness in Life") using multilevel mixed-effects models. RESULTS We found that although peri-traumatic stress and poststorm hardship each had independent effects on functional limitations, the effects of peri-traumatic stress dominated and were evident 6 years after the hurricane. Geographic exposure and personal/property loss were not associated with functional limitations. CONCLUSIONS These findings add important information to what is known about older people who experience a natural disaster and suggest opportunities for intervention. Finding that an individual's emotional response during the disaster plays an important role in the development of functional limitations suggests that reduction of exposure to traumatic stress during a storm (ie, evacuation from a storm area) may be important for older people. Likewise, interventions immediately after a disaster that target older people who experience high levels of peri-traumatic distress may be needed in order to alleviate functional limitations before they develop.
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Affiliation(s)
- Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
| | | | - Allison R Heid
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
| | - Francine P Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
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14
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Speksnijder CM, Lankhorst PJM, de Bree R, de Haan AFJ, Koole R, Merkx MAW. Depression and related factors after oral oncological treatment: a 5-year prospective cohort study. Support Care Cancer 2020; 29:2907-2916. [PMID: 33001267 PMCID: PMC8062368 DOI: 10.1007/s00520-020-05795-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
PURPOSES Being diagnosed with oral cancer is a life-threatening life event. It often induces social, emotional and psychological consequences and may cause depressive disorders. The primary aim of this study was to identify and quantify the personal and clinical characteristics involved in depression for patients who have been treated for oral cavity malignancies, with a 5-year follow-up period after treatment. The secondary aim of this study was to identify the clinical factors that increase a patient's risk of experiencing depression 5 years after treatment. METHODS Patients with primary oral cancer were assessed for up to 5 years after primary treatment. A mixed-model analysis was performed, with depression measured by the Center for Epidemiologic Studies Depression Scale as outcome measure. RESULTS A total of 141 patients were included in the study. Factors associated with depression were gender, tumour location and having an emotion-oriented coping style. The occurrence of depression within 5 years after treatment could be reliably predicted by a patient's gender, the location of their tumour and the extent to which they had an emotion-oriented coping style. CONCLUSIONS This study revealed that being female, having a maxillary tumour and having an emotion-oriented coping style are associated with higher levels of depressive symptoms in patients treated for oral cancer up to 5 years post-treatment. A substantial proportion of the patients with oral cancer experienced high levels of depression both before and after their treatment, suggesting that adequate diagnostics and care are needed to try to prevent severe depression in these patients.
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Affiliation(s)
- Caroline M Speksnijder
- Cancer Center, Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. .,Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. .,Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, P.O. Box 85.500, 3508, GA, Utrecht, The Netherlands.
| | - Petra J M Lankhorst
- Department of Medical Oncology, Deventer Hospital, Deventer, The Netherlands
| | - Remco de Bree
- Cancer Center, Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anton F J de Haan
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ron Koole
- Department of Medical Oncology, Deventer Hospital, Deventer, The Netherlands
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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15
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Timmermans EJ, Reinhard E, Ruijsbroek A, Huisman M, Avendano M. Regeneration of deprived neighbourhoods and indicators of functioning in older adults: A quasi-experimental evaluation of the Dutch District Approach. Health Place 2020; 64:102359. [PMID: 32838884 DOI: 10.1016/j.healthplace.2020.102359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/07/2020] [Accepted: 05/20/2020] [Indexed: 12/21/2022]
Abstract
This study examines the impact of the Dutch District Approach, a major urban regeneration programme that was started in 2008 in the Netherlands, on social, physical and mental functioning of older adults. Data from 1092 participants (58-93 years at baseline) across two waves (2005/06 and 2011/12) of the Longitudinal Aging Study Amsterdam were linked to detailed data on exposure to the programme. Using a difference-in-difference approach, we assessed differences from pre-intervention to the intervention period between the target and control districts in loneliness, social engagement, social isolation, physical activity, and anxiety and depressive symptoms. Regardless of programme intensity, the results indicate that the Dutch District Approach did not benefit or harm these aspects of functioning in older adults.
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Affiliation(s)
- Erik J Timmermans
- Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Erica Reinhard
- Department of Global Health and Social Medicine, King's College London, London, United Kingdom; Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Annemarie Ruijsbroek
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and Environment, Bilthoven, the Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mauricio Avendano
- Department of Global Health and Social Medicine, King's College London, London, United Kingdom; Department of Social Behavioral Sciences, Harvard T. H. Chan School of Public Health, Cambridge, MA, USA
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16
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Nieboer AP, Hajema K, Cramm JM. Relationships of self-management abilities to loneliness among older people: a cross-sectional study. BMC Geriatr 2020; 20:184. [PMID: 32460707 PMCID: PMC7254755 DOI: 10.1186/s12877-020-01584-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/19/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND We investigated relationships of broader self-management abilities (self-efficacy, positive frame of mind, investment behavior, taking initiatives, multifunctionality of resources, variety of resources) to social and emotional loneliness among community-dwelling older people while controlling for background characteristics. METHODS This cross-sectional study employed a representative sample of 41,327 community-dwelling people aged ≥55 years in Limburg, the Netherlands, identified using the population register (weighted per district, complex sampling design). In total, 20,327 (50%) people responded to the questionnaire. RESULTS All self-management abilities were associated negatively with emotional loneliness. Taking initiatives, multifunctionality, self-efficacy, and a positive frame of mind were associated negatively with social loneliness. Self-efficacy had the strongest relationships with social and emotional loneliness. CONCLUSIONS In combatting loneliness among older people, investment in their ability to self-manage their social lives and activities, such as increasing opportunities for positive social interaction and social support and reducing maladaptive cognition, seems to be crucial.
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Affiliation(s)
- Anna Petra Nieboer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
| | - KlaasJan Hajema
- Public Health Service Zuid Limburg, Academic Collaborative Centre for Public Health Limburg, Heerlen, The Netherlands
| | - Jane Murray Cramm
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
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17
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Gontijo Guerra S, Berbiche D, Vasiliadis HM. Changes in instrumental activities of daily living functioning associated with concurrent common mental disorders and physical multimorbidity in older adults. Disabil Rehabil 2020; 43:3663-3671. [PMID: 32255362 DOI: 10.1080/09638288.2020.1745303] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction: Instrumental activities of daily living (IADL) are key indicators of general functional status that are frequently used to assess the autonomy of older adults living in the community.Aims: To evaluate the changes in IADL in community-living older adults and the role of common mental disorders and physical multimorbidity in predicting these changes.Method: A secondary analysis including participants from the Longitudinal Survey on Senior's Health and Health Services. Self-reported sociodemographic and clinical information on chronic conditions were obtained at baseline interview (n = 1615). Measures of IADL were obtained at two time points, 3 years apart. Administrative data on physician diagnoses of chronic diseases were linked to self-reported information. Logistic and multinomial regression models were used to study the outcomes of interest.Results: More than one-third of participants reported disability. Significant increase in global and specific IADL tasks disability were observed over time. Concurrent mental and physical chronic conditions predicted persistent and future incidence of disability.Conclusions: We draw attention to the synergistic effect of mental and physical co-morbidities on IADL functioning and to the importance of the simultaneous management of these conditions in order to prevent disability, future decline and the associated health and societal burden.Implications for RehabilitationBy establishing the prevalence of global and specific IADL disability, we can better recognize the needs of older adults and inform health and social care planning.Influenced by the morbidity profile, older adults may experience decline, improvement or maintenance of autonomy in IADL over time.The presence of synergistic effect of physical and mental chronic conditions on functioning suggests that their simultaneous management is crucial in delaying or preventing disability.Reports of significant impairment in tasks such as taking medication calls attention to the need for increased accessibility to programs on medication management.The progressive loss of ability to take medication among multimorbid patients emphasize the need for therapeutic plans that circumvent polypharmacy.
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Affiliation(s)
- Samantha Gontijo Guerra
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, QC, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Campus Longueuil, Longueuil, QC, Canada
| | - Djamal Berbiche
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, QC, Canada.,Faculty of Medicine and Health Sciences, Department of Community Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
| | - Helen-Maria Vasiliadis
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, QC, Canada.,Faculty of Medicine and Health Sciences, Department of Community Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
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18
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Subramaniam M, Zhang Y, Lau JH, Vaingankar JA, Abdin E, Chong SA, Lee ES. Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population. BMC Public Health 2019; 19:1612. [PMID: 31791301 PMCID: PMC6889682 DOI: 10.1186/s12889-019-7941-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/12/2019] [Indexed: 12/18/2022] Open
Abstract
Background The co-occurrence of two or more chronic medical conditions in an individual is defined as multimorbidity. Lifestyle factors, including poor dietary patterns, physical inactivity, tobacco use, and excessive alcohol consumption are key modifiable risk factors that play a role in the development of chronic medical conditions and potentially multimorbidity. The current study aimed to examine the level of physical activity among those with multimorbidity and its association with socio-demographic factors, clinical parameters, and health-related quality of life (HRQoL) among community-dwelling adults attending a primary care clinic in Singapore. Methods This cross-sectional study was conducted among patients with multimorbidity between August 2014 and June 2016. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) Short Form. HRQoL was measured using the EuroQol-5 Dimension (EQ-5D-3 L). Data on clinical parameters including hemoglobin A1c (HbA1C), low-density lipoprotein cholesterol (LDL-C), and blood pressure were collected from patient records. Multivariable logistic regression analysis and linear regression were performed to determine the association between IPAQ and clinical health outcomes, as well as HRQoL measures, respectively. Results In all, 932 respondents with multimorbidity were recruited for the study. Of these, 500 (53.8%) had low physical activity, 325 (35.0%) had moderate physical activity, while 104 (11.2%) had high physical activity. Respondents who were insufficiently active had significantly higher odds of being overweight/ obese (OR: 1.5, 95% confidence interval [CI]: 1.1–1.9, p = 0.01) as compared to those who were sufficiently physically active. The multiple linear regression model revealed that insufficient activity level was negatively associated with EQ-5D index score (β = − 0.05, p < 0.001) and the visual analogue scale (β = − 4.4, p < 0.001) measuring HRQoL as compared to sufficient activity levels in respondents with multimorbidity. Conclusions The low levels of physical activity among patients with multimorbidity, and its association with overweight status and poorer HRQoL emphasizes the importance of increasing physical activity in this population. Family physicians treating patients with chronic diseases need to continue encouraging and helping individuals to initiate and maintain appropriate physical activity levels.
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Affiliation(s)
- Mythily Subramaniam
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Yunjue Zhang
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Jue Hua Lau
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Eng Sing Lee
- National Healthcare Group Polyclinics, Singapore, Singapore
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19
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The Longitudinal Aging Study Amsterdam: cohort update 2019 and additional data collections. Eur J Epidemiol 2019; 35:61-74. [PMID: 31346890 PMCID: PMC7058575 DOI: 10.1007/s10654-019-00541-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/20/2019] [Indexed: 10/27/2022]
Abstract
The Longitudinal Aging Study Amsterdam (LASA) is a prospective cohort study of older adults in the Netherlands, initially based on a nationally representative sample of people aged 55-84 years. The study has been ongoing since 1992, and focuses on the determinants, trajectories and consequences of physical, cognitive, emotional and social functioning. Strengths of the LASA study include its multidisciplinary character, the availability of over 25 years of follow-up, and the cohort-sequential design that allows investigations of longitudinal changes, cohort differences and time trends in functioning. The findings from LASA have been reported in over 600 publications so far (see www.lasa-vu.nl). This article provides an update of the design of the LASA study and its methods, on the basis of recent developments. We describe additional data collections, such as additional nine-monthly measurements in-between the regular three-yearly waves that have been conducted among the oldest old during 2016-2019, and the inclusion of a cohort of older Turkish and Moroccan migrants.
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20
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Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies. JOURNAL OF COMORBIDITY 2019; 9:2235042X19870934. [PMID: 31489279 PMCID: PMC6710708 DOI: 10.1177/2235042x19870934] [Citation(s) in RCA: 260] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 07/30/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND With ageing world populations, multimorbidity (presence of two or more chronic diseases in the same individual) becomes a major concern in public health. Although multimorbidity is associated with age, its prevalence varies. This systematic review aimed to summarise and meta-analyse the prevalence of multimorbidity in high, low- and middle-income countries (HICs and LMICs). METHODS Studies were identified by searching electronic databases (Medline, Embase, PsycINFO, Global Health, Web of Science and Cochrane Library). The term 'multimorbidity' and its various spellings were used, alongside 'prevalence' or 'epidemiology'. Quality assessment employed the Newcastle-Ottawa scale. Overall and stratified analyses according to multimorbidity operational definitions, HICs/LMICs status, gender and age were performed. A random-effects model for meta-analysis was used. RESULTS Seventy community-based studies (conducted in 18 HICs and 31 LMICs) were included in the final sample. Sample sizes ranged from 264 to 162,464. The overall pooled prevalence of multimorbidity was 33.1% (95% confidence interval (CI): 30.0-36.3%). There was a considerable difference in the pooled estimates between HICs and LMICs, with prevalence being 37.9% (95% CI: 32.5-43.4%) and 29.7% (26.4-33.0%), respectively. Heterogeneity across studies was high for both overall and stratified analyses (I 2 > 99%). A sensitivity analysis showed that none of the reviewed studies skewed the overall pooled estimates. CONCLUSION A large proportion of the global population, especially those aged 65+, is affected by multimorbidity. To allow accurate estimations of disease burden, and effective disease management and resources distribution, a standardised operationalisation of multimorbidity is needed.
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Affiliation(s)
- Hai Nguyen
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, King’s College London, London, UK
| | - Gergana Manolova
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, King’s College London, London, UK
| | - Christina Daskalopoulou
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, King’s College London, London, UK
| | - Silia Vitoratou
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, King’s College London, London, UK
| | - Martin Prince
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, King’s College London, London, UK
| | - A Matthew Prina
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, King’s College London, London, UK
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