1
|
Kovacs N, Piko P, Juhasz A, Nagy C, Oroszi B, Ungvari Z, Adany R. Comparative analysis of health status and health service utilization patterns among rural and urban elderly populations in Hungary: a study on the challenges of unhealthy aging. GeroScience 2024; 46:2017-2031. [PMID: 37798385 PMCID: PMC10828334 DOI: 10.1007/s11357-023-00926-y] [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] [Received: 07/19/2023] [Accepted: 08/27/2023] [Indexed: 10/07/2023] Open
Abstract
The demographic transition poses a significant challenge for health systems, especially in Central and Eastern European (CEE) countries, where the healthcare needs of aging populations are on the rise. This study aimed to describe and compare the health status and utilization of health services among the elderly residing in urban and rural areas of the most deprived region in Hungary. A comprehensive health survey was conducted in 2022, involving a randomly selected sample of 443 older adults (≥ 65 years) in Northeast Hungary. Multivariable logistic regression models adjusting for age, sex, education, financial status, chronic diseases, and activity limitations were used to investigate the association between type of residence and health service use. Among the study participants, 62.3% were female, 38.3% attained primary education, 12.5% reported a bad or very bad financial situation and 52.6% lived in urban areas. Overall, 24% of the elderly rated their health as very good or good (27.8% in urban and 19.7% in rural areas), while 57.8% (52.6% and 63.5% in urban and rural areas) reported limitations in daily activities. Compared to urban residents, rural residents reported lower rates of dentist visits (p = 0.006), specialist visits (p = 0.028), faecal occult blood testing (p < 0.001), colorectal cancer screening with colonoscopy (p = 0.014), and breast cancer screening (p = 0.035), and a higher rate of blood pressure measurement (p = 0.042). Multivariable models indicated that urban residence was positively associated with faecal occult blood testing (OR = 2.32, p = 0.014), but negatively associated with blood pressure (OR = 0.42, p = 0.017) and blood glucose measurements (OR = 0.48, p = 0.009). These findings highlight the influence of residence on health service utilization among older adults in Hungary. Further comprehensive studies are needed to better understand the health needs of the elderly population and to develop policies aimed at promoting healthy aging in CEE countries.
Collapse
Affiliation(s)
- Nora Kovacs
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Peter Piko
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary
| | - Attila Juhasz
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary
| | - Csilla Nagy
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary
| | - Beatrix Oroszi
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Departments of Public Health and Translational Medicine, Semmelweis University, Budapest, Hungary
- The Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Roza Adany
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary.
- Department of Public Health, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
2
|
Choi YA, Kim YH. Self-Reported Reasons for Activity Limitations According to Age and Sex in Community-Dwelling Stroke Survivors. Healthcare (Basel) 2023; 11:healthcare11101420. [PMID: 37239705 DOI: 10.3390/healthcare11101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
We examined self-reported reasons for activity limitations among Korean community-dwelling stroke survivors, focusing on age and sex differences. Data from 1547 stroke survivors who participated in the Korean National Health and Nutrition Examination Survey were analysed. The study outcomes were the self-reported reasons for activity limitations, encompassing general medical factors and stroke-related problems. These reasons were compared by age (<65 vs. ≥65 years) and sex using a complex-sample chi-square test. Stroke survivors reported different musculoskeletal, medical, and neurological problems as reasons for activity limitations, which differed by age and sex. Older stroke survivors reported more problems related to dementia, memory loss, auditory problems, back or neck problems, arthritis, or leg pain than younger survivors. Women reported more psychiatric problems, headaches or dizziness, back or neck problems, arthritis, gastrointestinal problems, and dental or oral problems than men. Older and female stroke survivors reported a higher mean number of reasons for activity limitations compared to younger and male survivors. Thus, a tailored approach considering age and sex is necessary to help stroke survivors with activity limitations in the Korean community. This study highlights the importance of considering demographic factors when designing interventions to improve their quality of life.
Collapse
Affiliation(s)
- Young-Ah Choi
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yeo Hyung Kim
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| |
Collapse
|
4
|
Maruta M, Makizako H, Ikeda Y, Miyata H, Nakamura A, Han G, Shimokihara S, Tokuda K, Kubozono T, Ohishi M, Tomori K, Tabira T. Associations between Depressive Symptoms and Satisfaction with Meaningful Activities in Community-Dwelling Japanese Older Adults. J Clin Med 2020; 9:E795. [PMID: 32183284 PMCID: PMC7141267 DOI: 10.3390/jcm9030795] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 12/15/2022] Open
Abstract
The aim of this cross-sectional study was to investigate relationships between individuals' ratings of satisfaction and performance of activities that they found meaningful and depressive symptoms. Data was obtained from 806 older adults (mean age 74.9 ± 6.3 years, women = 63.0%) who participated in a community-based health check survey (Tarumizu Study 2018). Participants selected meaningful activities from 95 activities using the Aid for Decision-Making in Occupation Choice and evaluated their satisfaction and performance. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15) and defined by a GDS-15 score of ≥5. Non-linear logistic regression analyses were used separately by gender to examine the association between satisfaction and performance of meaningful activities and depressive symptoms. The prevalence of depressive symptoms was 15.8%. We found no significant difference between meaningful activity choice between older adults with depressive symptoms and those without, in both men and women. After adjusting for potential covariates, satisfaction was associated with depressive symptoms in both men (OR 0.52, 95% CI 0.35-0.77) and women (OR 0.67, 95% CI 0.49-0.91), but performance was limited in women (OR 0.87, 95% CI 0.77-0.99). Our findings suggest that depressive symptoms are associated with satisfaction in meaningful activities regardless of activity categories.
Collapse
Affiliation(s)
- Michio Maruta
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, 3-95, Masagohonmachi, Kagoshima 890-0067, Japan
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Yuriko Ikeda
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hironori Miyata
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
- Faculty of Health Science, Department of Rehabilitation, Division of Occupational Therapy, Kumamoto Health Science University, 325, Izumimachi, Kita-ku, Kumamoto 861-5598, Japan
| | - Atsushi Nakamura
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
- National Institute for Minamata Disease, Ministry of the Environment, 4058-18 Hama, Minamata, Kumamoto 867-0008, Japan
| | - Gwanghee Han
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan, 1-1-1 Honjo Chuo-ku, Kumamoto 860-8556, Japan
| | - Suguru Shimokihara
- Master's Program of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Keiichiro Tokuda
- Master's Program of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan
| | - Kounosuke Tomori
- Department of Occupational Therapy, School of Health Science, Tokyo University of Technology, 5-23-22, Nishikamata, Ota-Ku, Tokyo 144-8535, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| |
Collapse
|