Feeling Younger, Rehabilitating Better: Reciprocal and Mediating Effects between Subjective Age and Functional Independence in Osteoporotic Fracture and Stroke Patients

The Role of Subjective Age in Predicting Post-Hospitalization Outcomes of Older Adults

INTRODUCTION

Studies of community-dwelling older adults find subjective age affects health and functional outcomes. This study explored whether younger subjective age serves as a protective factor against hospital-associated physical, cognitive, and emotional decline, well-known consequences of hospitalization among the elderly.

METHODS

This study is a secondary data analysis of a subsample (N = 262; age: 77.5 ± 6.6 years) from the Hospitalization Process Effects on Mobility Outcomes and Recovery (HoPE-MOR) study. Psychological and physical subjective age, measured as participants' reports on the degree to which they felt older or younger than their chronological age, was assessed at the time of hospital admission. Independence in activities of daily living, life-space mobility, cognitive function, and depressive symptoms were assessed at hospital admission and 1 month post-discharge.

RESULTS

The odds of decline in cognitive status, functional status, and community mobility and the exacerbation of depressive symptoms were significantly lower in those reporting younger vs. older psychological subjective age (odds ratio [OR] = 0.68, 95% CI = 0.46-0.98; OR = 0.59, 95% CI = 0.36-0.98; OR = 0.64, 95% CI = 0.44-0.93; OR = 0.64, 95% CI = 0.43-0.96, respectively). Findings were significant after controlling for demographic, functional, cognitive, emotional, chronic, and acute health predictors. Physical subjective age was not significantly related to post-hospitalization outcomes.

CONCLUSION

Psychological subjective age can identify older adults at risk for poor hospitalization outcomes and should be considered for preventive interventions.

Effect of individualized narrative nursing mode on recovery of elderly patients with fracture complicated with cerebrovascular accident

Fractures often occur in elderly patients. Osteoporosis caused by massive loss of calcium ions in the bones of elderly patients can easily lead to femoral fractures after suffering a low- and medium-energy injury. With the gradual entry of the aging society in China, the incidence of senile fracture is also gradually increasing. However, there is no report on the application of personalized narrative nursing to the mental health, cognitive function, and limb function recovery of elderly patients with fracture complicated with cerebrovascular accident, in order to enhance the cognitive level of elderly patients with fracture complicated with cerebrovascular accident. This study was specially conducted with a positive attitude toward the disease and improving the life quality. During July 2018 to July 2021, 80 elderly patients with fracture complicated with cerebrovascular accident cured were selected in our hospital. The patients were arbitrarily classified into an assigned control group (n = 40) and a study group (n = 40). The former received routine nursing, and the latter received personalized narrative nursing mode. The nursing satisfaction, functional independence scale (FIM), self-rating anxiety scale (SAS), self-rating depression scale (SDS), cognitive function, fracture healing time, length of hospital stays, and hospitalization expenses were compared. The study group had a satisfaction rate of 100.00%, while the control group had 87.50%. The nursing satisfaction of the study group was higher (P < .05). After 3 months of nursing, the FIM scores augmented. The FIM scores of upper and lower limbs in the study group were remarkably higher (P < .05). A decrease in SAS and SDS scores was observed. The SAS and SDS scores of the study group were lower (P < .05). Three months after discharge, the cognitive function score augmented. At 3 months after discharge, the study group had a higher cognitive function score (P < .05). The fracture healing time, length of stay, and cost of hospitalization in the study group were lower (P < .05). Personalized narrative nursing model can successfully enhance the mental health and cognitive function of elderly patients with fracture complicated with cerebrovascular accident, enhance the recovery of limb function, promote patients' nursing satisfaction, and alleviate the economic burden.

The cognitive tenacity of self-directed ageism

Ageism refers to prejudice or discrimination based on a person's age. When ageism is directed at older people, it is unique in two ways: it is socially condoned in a manner that other types of prejudice are not, and the animus is eventually self-directed. Of central interest here is why ageism becomes self-directed in late adulthood, despite its potentially harmful personal costs. We present a cognitive model in which negative ageist beliefs become increasingly accessible and difficult to eliminate owing to broader developmental shifts in mentation. Given that these effects are contingent on our social environment, systemic changes in societal conceptions of age and aging are needed if we are to reduce vulnerability to self-directed ageism.