Background: Maintaining social relationships has been defined as a core element of aging well. With a considerable amount of older adults living alone, social media provides the possibility to engage ...in meaningful social contact, e.g. by joining online social networks and online discussion forums. Objective: The review encompasses current knowledge of prerequisites in social media use of older adults such as functional capacity, information and communications technology-related knowledge, and favorable attitudes towards social media. Then, the potential of social media use for clinical practice and possible negative consequences are outlined. Method: Literature on social media use from a gerontological perspective was reviewed in July and August 2012. Results: Online communities are suitable for providing and receiving social support when confronted with a difficult life situation, regardless of geographical location or time. From a practitioner's perspective, social media can be used to advance health-related knowledge such as information on prevention, diagnosis, and treatment of specific conditions and disorders. Further positive consequences have been shown to be overcoming loneliness, relieving stress, and raising feelings of control and self-efficacy. Possible negative consequences could be misuse of personal data as well as the distribution and uncritical adoption of potentially harmful information via online communities. Discussion: The potential of social media in clinical practice is reflected in a wide range of intervention possibilities for older adults. However, with the rise of social media, new threats emerge for older adults as well.
We attempted to replicate findings that "most people are resilient" following three events: spousal loss, divorce, and unemployment. We applied growth mixture models to the same longitudinal data set ...that has previously been used to assert that resilience is ubiquitous. When using identical model specifications, as in prior studies, we found that resilient trajectories were most common, but the number of trajectories identified was different. When we relaxed two assumptions used in prior studies—that (a) all classes have similar variability in levels of postadversity adjustment and (b) there is no variability in changes within classes—we found that a resilience class was least common. Methodologically, our results show how findings on trajectories of change following major life stressors can vary substantially, depending on statistical model specifications. Conceptually, the results underscore the errors inherent in any categorical statements about "rates of resilience" among individuals confronted with major life stressors. Pragmatically, they underscore the dangers in recommending against prophylactic interventions (on the basis of one method of analyzing longitudinal data) for individuals who have experienced major life stressors.
The first-line management of behavioral and psychological symptoms of dementia (BPSD) is based on nonpharmacologic interventions such as the provision of guidance and medical support to caregivers. ...However, accessibility to specialized care and medical resources is often scarce. The ongoing COVID-19 pandemic has compromised the delivery of outpatient care (notably in order to minimize the risk of disease transmission), thus making it essential to provide other means of accessing care for these patient populations. The use of telemedicine (TM) may be a means of increasing access to specialist care for patients with disabilities and poor access to health services, such as those with BPSD. The aim of this study is to provide a review of the literature on the use of TM for treatment and follow-up of patients with BPSD and their caregivers. We searched the PUBMED, EMBASE and CINAHL for articles published between January 1st, 2000, and December 31st, 2020, on the applicability of TM support for people with BPSD and their caregivers. We included open-label studies, qualitative studies, and randomized controlled trials . We did not include studies on the use of TM during the COVID-19 pandemic. A total of 22 publications were included and reviewed. TM was found to 1) be acceptable and feasible for both patients and caregivers, 2) decrease the frequency and intensity of BPSD, and 3) improve the caregiver's perceived wellbeing and mental health. Videoconferencing was effective for patient-centered interventions in nursing homes. Telephone-based interventions were more relevant when they were targeted at caregivers. The published studies are lacking in scope and high-quality studies are now needed to confirm these findings and assess TM's cost-effectiveness and ability to improve the management of patients with BPSD. In view of the ongoing COVID-19 pandemic, remote solutions for assessing and monitoring individuals with BPSD are urgently needed - particularly those living in rural areas and so-called "medical deserts."
Background There is a growing concern that particulate matter (PM) such as PM.sub.2.5 and PM.sub.10 has contributed to exacerbating psychological disorders, particularly depression. However, little ...is known about the roles of these air pollutants on depression in elderly. Therefore, this study aimed to examine the association between PM.sub.2.5 and PM.sub.10, and depression in the elderly population in South Korea. Methods We used panel survey data, the Korean Longitudinal Study of Aging (KLoSA), administered by the Labor Institute during the study period of 2016, 2018, and 2020 covering 217 districts in South Korea (n = 7674). Annual district-specific PM.sub.2.5 and PM.sub.10 concentrations were calculated for the study period from the monthly prediction concentrations produced by a machine-learning-based ensemble model (cross-validated R.sup.2: 0.87), then linked to the people matching with year and their residential district. We constructed a generalized estimating equation (GEE) model with a logit link to identify the associations between each of the long-term PM.sub.2.5 and PM.sub.10 exposures and depression (CES-D 10) after adjusting for individual and regional factors as confounders. Results In single-pollutant models, we found that long-term 10 formula omitted increments in PM.sub.2.5 (OR 1.36, 95% CI 1.20-1.56) and PM.sub.10 (OR 1.19, 95% CI 1.10-1.29) were associated with an increased risk of depression in the elderly. Associations were consistent after adjusting for other air pollutants (NO.sub.2 and O.sub.3) in two-pollutant models. In addition, the impacts substantially differed by regions grouped by the tertile of the population density, for which the risks of particulate matters on depression were substantial in the middle- or high-population-density areas in contrast to the low-population-density areas. Conclusions Long-term exposure to PM.sub.2.5 and PM.sub.10 was associated with a higher risk of developing depression in elderly people. The impact was modified by the population density level of the region where they reside. Keywords: Air pollution, PM.sub.2.5, PM.sub.10, Older Korean adults, Depression
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objective: in the past decades, many studies have examined predictors of nursing home placement (NHP) in the elderly. This study provides a systematic review of predictors of NHP in the general ...population of developed countries. Design: relevant articles were identified by searching the databases MEDLINE, Web of Science, Cochrane Library and PSYNDEXplus. Studies based on population-based samples with prospective study design and identification of predictors by multivariate analyses were included. Quality of studies and evidence of predictors were determined. Results: thirty-six studies were identified; one-third of the studies were of high quality. Predictors with strong evidence were increased age, low self-rated health status, functional and cognitive impairment, dementia, prior NHP and a high number of prescriptions. Predictors with inconsistent results were male gender, low education status, low income, stroke, hypertension, incontinence, depression and prior hospital use. Conclusions: findings suggested that predictors of NHP are mainly based on underlying cognitive and/or functional impairment, and associated lack of support and assistance in daily living. However, the methodical quality of studies needs improvement. More theoretical embedding of risk models of NHP would help to establish more clarity in complex relationships in using nursing homes.
Zusammenfassung
In den nächsten zwei Jahrzehnten werden in Deutschland die Babyboomer aus dem Erwerbsleben ausscheiden. Erwerbsarbeit muss dann von der zahlenschwachen „Pillenknick“-Generation ...geleistet werden. Mehr ältere Personen in der Gesellschaft bedeuten trotz und teilweise wegen verbesserter medizinischer Möglichkeiten eine höhere Belastung durch Gesundheits- und Pflegeversorgung, die finanziert und personell getragen werden muss. Um mit weniger Erwerbstätigen mehr Bedürftige zu versorgen, muss das Gesundheitssystem umgebaut werden. Weil allerdings die Entwicklungen schleichend verlaufen, ist das Problembewusstsein vielerorts noch gering. Hier fokussieren wir auf den Bereich in unserem Gesundheitssystem, welcher mit am stärksten wächst und zusätzlich den größten Personalbedarf pro Betroffenem hat: die Versorgung schwerkranker und selbsthilfeeingeschränkter Menschen. Das Nebeneinander von Krankenhaus, Rehabilitationsklinik und Pflegeinstitution ist historisch bedingt und unzureichend koordiniert. Es fördert die Tendenz, selbsthilfeeingeschränkte Patient*innen in Pflegeeinrichtungen ohne Chance auf Wiederbefähigung zu entlassen, statt sie zu rehabilitieren. Mit dem weiteren demografischen Wandel droht sich diese Tendenz zu verstärken. Hier versuchen wir in einem ersten von zwei Teilen eine Beschreibung der aktuellen Situation.
Physical activity (PA), especially moderate-to-vigorous intensity, could protect older adults from cognitive impairment. However, most literature is based on self-reported PA which is limited by ...recall bias. Light PA is popular among older adults, but a paucity of objective longitudinal data has considered the relationship between light PA and cognitive ability. We examined if a higher level of objectively measured light PA, independent of moderate-to-vigorous physical activity (MVPA), was prospectively associated with better cognitive ability in older adults.
A longitudinal study over 22.12 (±1.46) months including 274 community-dwelling older adults across 14 regions in Taiwan was undertaken. Cognitive ability was obtained using a Chinese version of the Ascertain Dementia 8-item Questionnaire (AD8) and light PA and MVPA captured by 7days accelerometer positioned on waist. Multivariable negative binomial regression adjusted for confounders were undertaken.
274 participants (74.52years, 45.6% male) attended the follow-up (96.1%). Higher light PA, independent from MVPA, was associated with a reduced rate of decline in cognitive ability (rate ratio 0.75 0.60–0.92). MVPA, was also associated with a reduced decline in cognitive ability (rate ratio 0.85 0.75–0.95). Light PA was protective of cognitive ability in sensitivity analyses removing participants with activities of daily living difficulties, depressive symptoms and cognitive impairment at baseline.
Our data suggest that light PA may offer a protective influence of future cognitive ability in community dwelling older adults. The promotion of light PA may be a valuable means to maintain cognitive ability in older age.
•A paucity of studies have considered objective longitudinal PA and future cognitive ability decline in older adults.•Our data suggests that higher LPA, independent of MVPA, is associated with a reduced risk of future cognitive decline.•This is the first longitudinal paper to investigate light intensity PA and cognitive decline in older adults.•This extends the existing evidence for the benefits of PA for preventing cognitive deterioration in later life.
According to the cognitive reserve theory, intellectual stimuli acquired during life can prevent against developing cognitive impairment. The underlying cognitive reserve mechanisms were ...underexplored in low-educated individuals. Because episodic memory impairment due to hippocampal dysfunction is a key feature of Alzheimer's dementia (AD), we sought to look at a possible cognitive reserve mechanism by determining whether few years of education moderated the relationship between the hippocampal volumes and the episodic-memory scores. The sample was composed by 183 older adults, 40.1% male, with the median age of 7876,82 years and the median years of education of 42,10 who had undergone an episodic-memory test and a 3-Tesla MRI scan to access the hippocampal volumes. Overall, 112 were cognitively healthy, 26 had cognitive impairment-no dementia (CIND) and 45 had dementia. We used multiple linear regression to assess whether the interaction between years of education and each hippocampal volume significantly predicted the episodic-memory scores' variance, controlling for cognitive diagnosis and nuisance variables. The interaction term with the left hippocampus (ß = 0.2,
= 0.043, CI = 1.0, 1.4), but not with the right (ß = 0.1,
= 0.218, CI = 0.9, 1.2) significantly predicted the variation on memory scores. The mechanism by which the left hippocampus seems to play a more important role on memory processing in more educated individuals needs to be further investigated and might be associated with a better use of mnemonic strategies or higher hippocampal connectivity. Because the sample's median years of education was four, which corresponds to primary school, we may infer that this level might be sufficient to contribute for building cognitive reserve.
This study investigated the clinical characteristics and risk factors of coronavirus disease 2019 (COVID-19) in patients in designated hospitals (Port Hospital) in the Henan province. A total of 391 ...COVID-19 patients with complete case information from August 6, 2021 to February 26, 2022 were selected. Logistic regression was used to analyze the differences between the clinical types, ages, and sex of the patients. Multivariate regression analysis of the severe group indicated that underlying diseases odds ratio (OR):6.76, 95% confidence interval (CI):1.83-24.93, increased urea levels (OR: 1.41, 95% CI: 1.04-1.91), old age (OR: 1.05, 95% CI: 1.00-1.10), and increased lactic dehydrogenase (OR: 1.02, 95% CI: 1.01-1.03) levels and decreased hemoglobin (OR: 0.95, 95% CI: 0.91-1.00) levels were predictors of illness severity. Multivariate regression analysis for those > 50 years of age showed that underlying diseases (OR: 7.06, 95% CI: 2.79-17.89) and increased urea (OR: 1.91, 95% CI: 1.47-2.48), total bilirubin (OR: 1.14, 95% CI: 1.08-1.21), total protein (OR: 1.08, 95% CI: 1.00-1.17), and lactic dehydrogenase (OR: 1.01, 95% CI: 1.00-1.02) levels and decreased albumin (OR: 0.66, 95% CI: 0.58-0.76) levels were characteristics of COVID-19. Multivariate regression analysis stratified by sex showed that the characteristics of COVID-19 patients were increased white blood cell count in males (OR: 0.66, 95% CI: 0.55-0.78) as well as increased creatinine levels (OR: 0.89, 95% CI: 0.87-0.91). This retrospective analysis provides useful information to support the clinical management of patients with COVID-19.
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