Determinants of Health-Related Quality of Life Among Community-Dwelling Thai Older Adults in Chiang Mai, Northern Thailand

Validation of the Thai World Health Organization Quality of Life-OLD (WHOQOL-OLD) among Thai older adults: Rasch analysis

Rasch analysis was employed to investigate the psychometric properties of the Thai version of the World Health Organization Quality of Life-OLD (WHOQOL-OLD) instrument among the Thai older adults. The analysis was conducted on a subset of 300 individuals randomly selected from a group of 800 older adults. The results revealed that the WHOQOL-OLD showed an acceptable fit to the Rasch model (χ2[9] = 7.39, p = 0.60), confirming unidimensionality, local independence, and satisfactory reliability (person separation index [PSI] = 0.75) when the domains were merged into three superitems: 1) autonomy, past-present-future activities, and death and dying; 2) social participation and intimacy; and 3) sensory ability. These three-domain superitems showed significant differential item functioning (DIF) related to education level (p < 0.05), which was resolved by splitting the items based on education level. Each WHOQOL-OLD domain also met the expectations, which included item-trait interaction fit, unidimensionality, local independence, lack of significant DIF, and satisfactory reliability. Ordinal-to-interval conversion tables were generated for the three-domain superitems by education level and for each WHOQOL-OLD domain. Therefore, the Thai WHOQOL-OLD and its domain are valid and reliable for the assessment of health-related quality of life (HRQoL) in between-group analyses among the Thai older population.

Socio-demographic disparities in health-related quality of life in hypertensive patients in Bangladesh: a comprehensive survey analysis

PURPOSE

Hypertension is a major health concern in Bangladesh. Assessing the health-related quality of life (HRQoL) among hypertensive patients in Bangladesh can highlight the broad impacts of the condition on morbidity and mortality. Such insights are essential for developing targeted healthcare and prevention strategies to reduce complications, including heart disease, stroke, and kidney failure.

METHODS

In this cross-sectional study, 5,086 hypertensive patients aged between 18 and 80 were recruited from 75 pharmacies in Bangladesh. We assessed the participants' health using the EQ-5D-5 L descriptive system and the EQ-VAS. Utility scores were calculated using the Indian EQ-5D-5 L value set. Regression models were employed to identify factors associated with overall HRQoL and individual health dimensions.

RESULTS

Study participants were mean aged 52 years old, with average systolic and diastolic blood pressures of 140.79 mmHg and 85.98 mmHg, respectively. The average EQ-index and EQ-VAS score were 0.83 and 67.47, respectively. 39% reported difficulties with self-care, 43.5% had mobility problems, 80.6% had pain, and 61.2% had anxiety. HRQoL scores decreased significantly with age, according to the multilevel model. Higher education levels, however, were associated with better HRQoL scores. Male respondents reported fewer problems with mobility, self-care, activity, pain, and anxiety. A decrease in HRQoL scores was observed among older individuals, those without formal education, those in lower quintiles, those unemployed, and those with poor blood pressure control, obesity, or fasting glucose.

CONCLUSION

Study findings indicate disparities in HRQoL based on age, gender, education, and socioeconomic status, highlighting the need for targeted policy interventions.

Substantial Impact of Later-Life Depression Among Community Older Adults on the Family Caregivers' Burden in the Home Care Setting of Chiang Mai, Northern Thailand

Background and Objectives: Depression is a common geriatric problem globally. It is particularly burdensome in low- and middle-income countries, where care for older people mainly relies on the family in the absence of long-term care facilities. This study aimed to assess the level of caregivers' burden among family caregivers who are taking care of older persons with depression in the home care setting within the communities of Chiang Mai, Northern Thailand. Materials and Methods: This cross-sectional study investigated 867 pairs of community-dwelling older adults and their family caregivers in Chiang Mai, Thailand. The depression of older people was screened using the 15-item Geriatric Depression Scale. The family caregivers' burden and quality of life were measured using the Caregiver Burden Inventory (CBI) and the European Quality of Life (EQ) Five Dimension Five Level scales. The analysis applied was multivariable regression. Results: Two-thirds of the family caregivers were female. The mean age was 55.3 ± 13.8 years. The family caregivers caring for older persons with depression experienced significantly higher levels of burden in terms of the CBI total score (Coefficient: 10.60, 95% CI: 8.60, 12.60) and lower quality of life in terms of the EQ visual analogue scale (Coefficient: -5.52, 95% CI: -8.41, -2.62). They were more likely to take sick leave from their jobs (adj. OR 4.00, 95% CI: 1.73, 9.24) and more often to get sick (adjusted OR 7.26, 95% CI: 2.68, 19.64) than the caregivers of older adults without depression. Conclusions: Urgent interventions to prevent depression among older adults and systematic support to relieve family caregiver burden are necessary. The measures to relieve family caregiver burden include care capacity building, psychological support, respite care service, financial support, and other health promotion activities.

Identifying the Relationship Between Residential Type and Health Outcomes of the Community-Dwelling Thai Older Adults in the Baseline Analysis of a Cluster-Randomized Controlled Trial

BACKGROUND/OBJECTIVES

As people age, their environment plays a critical role in shaping their health. With Thailand's rapidly aging population, it is crucial to understand how different living environments affect the well-being of older adults. This study examines differences in biopsychosocial health indicators between older adults living in village communities and private housing estates in Chiang Mai, Thailand.

METHODS

A cross-sectional study was conducted using baseline data from the Community-Integrated Intermediary Care (CIIC) Service Model, a Cluster Randomized Controlled Trial in Thailand (TCTR20190412004). The study included 2788 older adults (aged 60+). Of these, 89.49% resided in village communities, and 10.51% in private housing estates. Validated instruments were used to assess health indicators. Descriptive statistics, multivariate analysis of variance, and multiple logistic regression analyses were performed.

RESULTS

Older adults in private housing estates had significantly lower odds of experiencing pain or discomfort (Adj OR: 0.64, 95% CI: 0.49-0.84) and were 1.36 times more likely to report positive perceived health. However, they had lower odds of perceiving themselves as physically and socially active (Adj OR: 0.74, 95% CI: 0.57-0.97) and were 0.30 times less likely to rate their quality of life higher (Adj OR: 0.30, 95% CI: 0.22-0.40) compared to their village community counterparts.

CONCLUSIONS

The residential environment significantly influences older adults' health and well-being. Tailored health promotion interventions should leverage the unique strengths of both village communities and private housing estates to enhance social connections, physical activity, and quality of life, promoting healthy, active aging across diverse settings.

Prevalence of sarcopenia and depressive symptoms among older adults: a scoping review

Sarcopenia causes a loss of skeletal muscle mass and decreases muscle strength and function. Depressive symptoms are a common cause of distress among geriatrics, significantly affecting the quality of life of older adults. Recently, studies have shown that a correlation exists between sarcopenia and depression. To determine the prevalence of sarcopenia and depressive symptoms and identify the factors associated with sarcopenia, we systematically searched the SCOPUS, Science Direct, and PubMed databases for papers on sarcopenia and depressive symptoms published from 2012 to 2022. We reviewed the literature on sarcopenia, depressive symptom prevalence, the prevalence of subjects with both sarcopenia and depressive symptoms, and the factors associated with sarcopenia. Only cross-sectional studies were included. Nineteen articles met the inclusion criteria for review, with overall sarcopenia prevalence ranging from 3.9% to 41.7%. The prevalence of depressive symptoms was reported in seven studies, ranging from 8.09% to 40%. The most commonly used tools to diagnose sarcopenia and depressive symptoms were the European Working Group on Sarcopenia in Older People consensus and the Geriatric Depression Scale, respectively. Being aged, malnourished, obese, having comorbidities (hypertension and diabetes), having impaired cognitive function, and having polypharmacy were found to be the factors associated with sarcopenia. Sarcopenia and depressive symptoms have been found to cause adverse health outcomes among older people. Appropriate nutritional assessments and interventions should be taken to manage these two geriatric conditions. Further studies should be planned, considering multidomain intervention strategies to improve sarcopenia and older people's mental health.

Factors related to quality of life in community-dwelling adults in Sleman Regency, Special Region of Yogyakarta, Indonesia: Results from a cross-sectional study

BACKGROUND

Quality of life studies in low- and middle-income countries have demonstrated the influence of socioeconomic factors on the quality of life (QoL). However, further studies are required to confirm this association in developing countries with rapidly ageing populations. Using Ferrans et al.'s QoL model, this study aimed to identify the factors associated with the QoL of community-dwelling adults in Indonesia.

METHODS

A cross-sectional study among 546 community-dwelling adults aged 50+ years was conducted in Yogyakarta, Indonesia, in 2018. QoL was measured using the Short Form 12 questionnaire, which consists of a summary of physical and mental health. We performed stepwise logistic regression analyses to determine odds ratios (ORs) with 95% confidence intervals (CIs) and examined the association between the QoL (physical and mental health) and demographic characteristics, socioeconomic status, financial management behaviour, multimorbidity status, nutritional status, cognitive impairment status, depression status, and independence. Statistical significance was set at p<0.05.

RESULTS

Among the respondents, 15% reported poor physical health, and 9.2% reported poor mental health. Good physical health was significantly associated with the absence of chronic disease (OR 2.39; 95% CI: 1.07-5.33), independence in activities of daily living (OR 3.90; 95% CI 1.57-9.67) and instrumental activities of daily living (OR 4.34; 95% CI 2.28-8.26). Absence of depression was significantly associated with good mental health (OR 2.80; 95% CI 1.3-5.96).

CONCLUSION

The QoL of community-dwelling adults in Indonesia is associated with activities of daily living and instrumental activities of daily living, as well as the absence of chronic disease and depression. Efforts should be made to prevent chronic disease and delay functional decline through healthy lifestyles and routine physical and mental health screenings.

A comparison of the disease occurrence of cerebrovascular diseases, diabetes mellitus, hypertensive diseases, and ischaemic heart diseases among hospitalized older adults in Thailand

This observational research analyzed public hospital data from the Thailand Ministry of Public Health website to investigate gender differences in four categories of non-communicable diseases (NCDs) affecting hospitalized senior Thai populations for 12 years. This study aimed to determine the cumulative effects and analyze the odds ratio (OR) according to ICD-10 cause categories for the data from 2010 to 2021, accounting for 1,327,093 cases in 2010 and 2,275,936 cases in 2021. The findings revealed statistically significant gender differences in four categories of NCDs. Men were found to be more likely than women to have two types of NCDs, as measured by the OR (95%CI): cerebrovascular diseases (OR 1.34-1.47, 95%CI 1.32-1.48), and ischaemic heart disease (OR 1.24-1.63, 95%CI 1.23-1.64). Conversely, diabetes mellitus (OR 0.64-0.84, 95%CI 0.63-0.85) and hypertensive disorders (OR 0.82-0.95, 95%CI 0.81-0.97) were discovered to have a lower likelihood of ratios related in men compared to women. However, the trend of all four NCDs in men has significantly increased every year: cerebrovascular diseases = 0.0093 year(s) + 1.3391, (R2 0.82, p-value 0.001); diabetes mellitus = 0.0171 year(s) + 0.6143, (R2 0.97, p-value 0.001); hypertension = 0.0125 year(s) + 0.8091, (R2 0.96, p-value 0.001); and ischaemic heart disease = 0.0345 year(s) + 1.1884, (R2 0.99, p-value 0.001).Gender, a crucial biological factor, contributes to variations in the prevalence of illness. As such, it is essential to prioritize the disease risk occurrence and preventive care for men and women separately, with a focus on implementing more detailed screening and detection strategies, as well as tailored interventions.

Physical Activity, Functional Status, and Quality of Life Among Older Adults in India

Introduction

Physical activity and social engagement protect older adults against functional decline and improve their quality of life. Physical inactivity poses an increased risk for noncommunicable diseases. Globally, one in four adults is physically inactive. Enhancing the physical activity of older adults is crucial not only for increasing their life expectancy but also for improving their functional status and quality of life.

Objective

This study aimed to evaluate the physical activity, functional status, and quality of life of older adults attending the medical outpatient department of a tertiary care hospital in Chennai, Tamil Nadu, India.

Methods

The study adopted a descriptive cross-sectional research design. A total of 100 female and male patients above 65 years of age with comorbid conditions attending the medical outpatient department participated in the study. The sociodemographic and clinical characteristics of these patients were assessed. In addition, the Rapid Assessment of Physical Activity, Katz Index of Independence in Activities of Daily Living, Lawton Instrumental Activities of Daily Living Scale, and Older People Quality of Life Questionnaire were used to measure the physical activity, functional status, and quality of life of patients. The data were analyzed using descriptive and inferential statistics.

Results

Among the participants, only 17% were active, and 35% were underactive for regular light activities. Approximately 81% did not perform any activity to improve their muscle strength or flexibility. In 56% of the participants, disability was present. The majority mentioned that they experienced difficulties in preparing food and shopping. Regarding the quality of life of the participants, the mean ± standard deviation score was 77.38 ± 9.03. Significant results were found in the domains of independence, control over life, and freedom. The overall quality of life was not related to leisure and activities, financial circumstances, the Instrumental Activities of Daily Living Scale score, the Rapid Assessment of Physical Activity 2 score, and the Rapid Assessment of Physical Activity 1 score. The quality of life was weakly related to emotional and psychological well-being, control over life, home and neighborhood, freedom, independence, and social relationships.

Conclusion

Limited physical activity and poor functional status impact the quality of life of older adults. Therefore, educational and physical interventions should be implemented at the hospital and community levels to improve the physical activity, functional status, and quality of life of older adults.

Promoting the Integration of Elderly Healthcare and Elderly Nursing: Evidence from the Chinese Government

The increase of the aging population in China and the rise of the concept of healthy aging have accelerated the transformation and upgrading of the traditional elderly nursing pattern. Nevertheless, there is a critical limitation existing in the current situation of China's elderly care, i.e., the medical institutions do not support elderly nursing and the elderly nursing institutions do not facilitate access to medical care. To eliminate the adverse impact of this issue, twelve ministries and commissions of the Chinese government have jointly issued a document, i.e., the Several Opinions on Further Promoting the Development of Combining the Healthcare with the Elderly care (SOFPDCHE), to provide guidance from the government level for further promoting the integration of elderly healthcare and elderly nursing. Under this background, this paper constructs a healthcare-nursing information collaboration network (HnICN) based on the SOFPDCHE, proposing three novel strategies to explore the different roles and collaboration relationships of relevant government departments and public organizations in this integration process, i.e., the node identification strategy (NIS), the local adjacency subgroup strategy (LASS), and the information collaboration effect measurement strategy (ICEMS). Furthermore, this paper retrieves 484 valid policy documents related to "the integration of elderly healthcare and elderly nursing" as data samples on the official websites of 12 sponsored ministries and commissions, and finally confirms 22 government departments and public organizations as the network nodes based on these obtained documents, such as the National Health Commission of the People's Republic of China (NHC), the Ministry of Industry and Information Technology of the People's Republic of China (MIIT), and the National Working Commission on Aging (NWCA). In terms of the collaboration effect, the results of all node-pairs in the HnICN are significantly different, where the collaboration effect between the NHC and MIIT is best and that between the NATCM and MIIT is second best, which are 84.572% and 20.275%, respectively. This study provides the quantifiable results of the information collaboration degree between different government agencies and forms the optimization scheme for the current collaboration status based on these results, which play a positive role in integrating elderly healthcare and elderly nursing and eventually achieving healthy aging.

Tooth Loss, Cognitive Impairment and Fall Risk: A Cross-Sectional Study of Older Adults in Rural Thailand

Tooth loss is associated with both cognitive impairment and fall risk. However, the relationships between these variables are complex and bidirectional. Observed associations have been reported in separate studies but data on rural-dwelling older adults remain sparse. This cross-sectional study investigated socioeconomic and dental factors affecting cognitive functions, and the association between tooth loss, cognitive functioning, and fall risk. Two hundred and thirty-one rural-dwelling older adults (60−74 years old) were recruited from a single Dental Service Unit. Cognitive function and fall risk were assessed with the Mini-Mental State Examination and the Morse Fall Scale, respectively. Oral examinations were performed by a dentist using the Community Periodontal Index of Treatment Needs form. 38.1%, had >16 tooth loss. Socioeconomic data and health status were obtained from a questionnaire and interviews. Age, Activities of Daily Living (ADL) score, and the number of teeth lost was significantly associated with impaired cognitive function. Chi-square analysis showed that cognitive function was also associated with fall risk. Past research suggests that much cognitive impairment and fall risk is induced by tooth loss. Service planners need to be aware of the complex bidirectional relationships between these variables and give higher priority to dental services that can improve the general health status and social functioning of older rural adults.