Global research trends related to coronavirus disease 2019 and the aged: a bibliometric analysis

ABSTRACT BACKGROUND: A bibliometric analysis covering only the production of original studies or considering world production until 2022 has yet to be conducted. The creation and advancement of vaccines have also influenced research priorities, demonstrating the need for a new approach to this subject. OBJECTIVES: To analyze worldwide scientific production related to coronavirus disease 2019 (COVID-19) and the aged and to describe what has already been produced. DESIGN AND SETTING: Bibliometric analysis with a quantitative approach. METHOD: The search terms "COVID-19," "SARS-CoV-2," "Aged," and "Elderly" were used to retrieve articles from the Web of Science database. A total of 684 articles were included in the analysis. Data were imported into RStudio Desktop Software and linked to R Software. The Bibliometrix R package and VOSviewer software were used for analysis. RESULTS: Most articles were published in 2020. These were produced by 4,937 authors and published in 379 journals. The keyword most used by the authors was "COVID-19." Publications from 77 countries were obtained. China had the highest article production ranking, and Spain collaborated the most. The articles addressed the implications of the pandemic on the aged, the relationship between vaccination in the aged, and the implications for the disease itself. CONCLUSION: Further research should be conducted, mainly concerning vaccines and vaccination of the aged, owing to the need for and importance of immunization in this risk group, including assessing the long-term effects of vaccines.

Prevalência dos componentes da sarcopenia e fatores socioeconômicos associados em idosos de uma população rural do estado do Ceará, Brasil / Prevalence of sarcopenia components and associated socioeconomic factors among older adults living in rural areas in the state of Ceará, Brazil

Resumo O objetivo é estimar prevalência de componentes da sarcopenia e associações com variáveis socioeconômicas em idosos de população rural do Ceará. Estudo transversal com 274 idosos. Massa muscular foi determinada por Índice de Massa Muscular (IMM) por bioimpedância elétrica e por circunferência da panturrilha; força muscular (FM) por teste de preensão palmar; e desempenho físico por testes da caminhada (VC) e Timed-up-and-go. Provável sarcopenia foi caracterizada por diminuição da FM, sarcopenia quando associada a diminuição do IMM, e sarcopenia grave quando estes dois foram acompanhados de baixa VC. Foram estimadas associações entre condições sociodemográficas, hábitos de vida e componentes da sarcopenia. Na regressão logística, foi observada frequência mais elevada: i) no sexo masculino, idade>69 anos, e nos que não trabalham, entre os idosos com FM diminuída; ii) com idade>69 anos, nos que não moram com o cônjuge, e nos que não praticam atividade física num nível adequado, entre os idosos com IMM diminuído; iii) com idade>69 anos, nos que residem na zona rural há menos que 30 anos, e nos que não trabalham, entre os idosos com VC diminuída.

Abstract The aim is to determine the prevalence of sarcopenia components and associations with socioeconomic variables in older persons living in rural areas in the state of Ceará, Brazil. We conducted a cross-sectional study with 274 older adults. Muscle mass was assessed using muscle mass index (MMI), measured by bioelectrical impedance analysis and calf circumference. Muscle strength (MS) was assessed using the handgrip test. Physical performance was measured using the walk test to calculate gait speed (GS) and the timed up-and-go test. Probable sarcopenia was defined as the presence of low MS, while confirmed sarcopenia was defined as the presence of low MS and low MMI. Severe sarcopenia was defined as the presence of the latter two criteria and slow GS. We tested for associations between sociodemographic characteristics and lifestyle habits and the components of sarcopenia. The logistic regression produced the following results: i) prevalence of low MS was higher among men, individuals aged >69 years, and in those not working at the time of the study; ii) the prevalence of low MMI was higher in individuals aged >69 years, those not living with a spouse, and those with an inadequate level of physical activity; iii) the prevalence of slow GS was higher in individuals aged >69 years, those who had lived in rural areas for less than 30 years, and those not working at the time of the study.

Prevalence of eczema among older persons: A population-based cross-sectional study

Background: There are very few population-based studies on the prevalence of eczema among older persons Aims: To estimate the prevalence and types of eczema in those aged 65 years or more in the community and to evaluate the effectiveness of community-based interventions for case finding. Methods: In the first stage of this cross-sectional survey, trained health workers of a non-governmental organization surveyed the eligible population and identified persons likely to have eczema. In the second stage, dermatologists examined such persons to ascertain the diagnosis. Statistical analysis was done using Epi Info software version 7. Prevalence of eczema was expressed in percentages. Chi-square test was used for comparing the difference in prevalence of eczema in various age groups and sex. Results: Health workers identified 98 persons as possible cases of eczema after interviewing 385 older persons in the community. Among them 95 persons were examined by dermatologists and 44 were confirmed to have eczema (diagnostic accuracy of health workers = 46.3%).Point prevalence of eczema was 11.4% (44/385). Prevalence was similar in males and females. It was greater (18.2 %) among persons aged 81 years or more. Asteatotic eczema, gravitational eczema and lichen simplex chronicus were the more common types of eczema. Limitations: Possible underestimation of the prevalence rates due to limited medical knowledge of health workers; limited facilities for examination and investigations at the medical camps and home visits. Conclusion: There appears to be a considerable burden of eczema among older persons in the community. A community-based approach involving non-governmental organizations has the potential to identify cases and offer care close to their homes

Association of socio-demographic factors and likelihood of depression with family function among community – dwelling elderly

Background and Objective@#A positive family functionality is a significant factor to a good quality of life in the elderly. This study sought to determine the factors that contribute to family dysfunction among community-dwelling older persons.@*Methods@#A cross-sectional study was done among community-dwelling elderly ages 60 years old and above through the outpatient department of a tertiary government hospital. A researcher-assisted interview was done to gather socio-demographic factors such as age, sex, family type, and, GDS-S score, and family APGAR. Multiple linear regression analysis was done to determine the association of the said socio-demographic factors and likelihood of depression through GDS-S with family function through family APGAR.@*Results@#Among the 309 respondents, the average age of respondents was 69 years(SD=6.53), with female predominance of 61.8%, and a higher frequency of older persons belonging to an extended family. The mean GDS-S score is 1.69(SD=1.83), with a frequency of 13.9%. A very minimal percentage of 8.06% (25, N=309) showed to exhibit family dysfunction. Regression studies revealed association of advancing age, and female sex with family dysfunction. The type of family, and GDS-S are not significantly associated with family dysfunction.@*Conclusion@#Advancing age and female sex are associated with family dysfunction. There is no specific family type that is significantly associated with family dysfunction. Likelihood of depression does not necessarily imply family dysfunction in an elderly.

Prevalence of Depression Among Community Dwelling Older Persons in Thailand and the Associated Factors: A Systematic Review

@#Aim: Depression symptoms in older persons are overlooked and untreated because they coincide with other conditions that older persons face. This review aimed to determine the prevalence and factors associated with depression among community dwelling older persons in Thailand according to the Social Cognitive Theory constructs. Design: Systematic review. Data sources: Four electronic databases: PubMed, PsychINFO, ScienceDirect and Scopus, with only articles published between January 2000 and December 2021 were included. Methods: The Preferred Reporting Systems for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct this systematic review. All included articles were appraised using the Crowe Critical Appraisal Tool (CCAT), with all 13 studies were assessed to be of high quality, with score of more than 75. Results: A total of 13 full-texts articles were included in this review, of which 12 were cross-sectional study design, and only one was a cohort study. The prevalence of depression among older persons in Thailand were between 5.7% to 68%, with the most commonly reported factors that significantly associated with depression were gender, social support, marital status, employment status or income, and education level. Conclusion: Depression among older persons is a mental Health challenging issue in Thailand. Studying the factors that contribute to depression in older persons is more important in order to have a better understanding of the underlying causes as well as for early detection and effective management of depression among older persons in Thailand.

Effectiveness of Lumbar Stabilization Exercise on Pain, Disability and Functional Performance among Older People with Low Back Pain: A Systematic Review

@#Introduction: Lumbar stabilization exercises may improve core stability and reduce low back pain among older persons. However, the evidence is scarce. The objective of this study was to update evidence on the effectiveness of lumbar stabilization exercises on pain, disability, and functional performance among older persons with low back pain. Methods: This systematic review retrieved articles from PubMed, MEDLINE (via EBSCO), PEDro, Google Scholar, and ScienceDirect published from 2005 to 2020. The selected articles were scored using the McMaster Critical Review Form for Quantitative Studies for quality assessment. The data was extracted based on the study design, sample size, inclusion criteria, intervention, outcome, and conclusion. Results: A total of 2349 articles were found but only two articles met the inclusion criteria with both showing excellent scores on the McMaster Critical Review Form for Quantitative Studies. The findings showed lumbar stabilization exercises alone or combined with other interventions were effective in reducing pain intensity, and improving disability, and gait functional performance among older persons with low back pain. Conclusion: The current study suggests lumbar stabilization exercise is effective for pain, disability, and functional performance among older persons. However, further investigation is needed to gain more conclusive evidence for clinical practice.

Development and Feasibility Assessment of a Nutrition Screening Guideline in Older Patients for Use by Healthcare Staff in Health Clinic Setting: An Action Research Study

@#Introduction: Older persons are more susceptible to malnutrition. However, malnutrition identification through nutrition screening is not routinely performed in Malaysia’s health clinics due to no specific nutrition screening guideline and validated tool in this setting. This study aimed to develop a nutrition screening guideline for older patients and assess its feasibility for use by healthcare staff in health clinic setting. Methods: This study was conducted in three phases. In Phase I, needs assessment was conducted amongst healthcare staff. Development of nutrition screening guideline in Phase II involved scoping review and validation amongst six experts and twelve healthcare staff. In Phase III, twenty-two healthcare staff participated in feasibility assessment using in-depth interviews after completing nutrition screening in older patients. Interview data was analysed thematically using NVivo Software 12.0. Results: A Malay language version of nutrition screening guideline in A4-sized with 31 pages was developed and validated. Items with a content validity index ≥0.83 from experts review were retained, while <0.83 were revised accordingly. Validation amongst healthcare staff showed positive responses. The guideline was then assessed for feasibility, where 110 older patients (mean age= 68.7±6.1 years) were screened by healthcare staff using the newly developed nutrition screening guideline. Four themes emerged from in-depth interviews: 1) Ease of use; 2) Identification and management of malnutrition; 3) Acceptability; and 4) Implementation of nutrition screening. Conclusion: The newly developed and validated nutrition screening guideline is well-accepted and feasible for healthcare staff to screen older patients in health clinic setting for timely malnutrition identification and management.

Prevalence of Metabolic Syndrome and specific cardiovascular risk factors among older persons in the Philippines: Results from the 8th Philippine National Nutrition Survey

Background@#Cardiovascular diseases are the leading causes of deaths among adults in the Philippines, and this is true also among older persons aged 60 years and above. Identification of risk factors and diseases that lead to cardiovascular mortality among the elderly is important to have an impact on longevity.@*Objective@#This study aimed to determine the prevalence of metabolic syndrome and specific cardiovascular risk factors among older persons in the Philippines.@*Methods@#A cross sectional design was used, with data taken from the results of the 8th Philippine National Nutrition Survey (NNS) Clinical and Health Survey done in 2013. Although there is a more recent survey, only the 2013 data is complete and available for secondary analyses.@*Results@#There were 1,835 older persons who were participants in the 8th Philippine NNS who had complete clinical data. The prevalence of Metabolic Syndrome was 52.6% in this population with the distribution of the components as follows: 33.5% have elevated waist circumference; 59.25 had elevated BP >130/85 mm Hg; 30.1% had fasting blood glucose ≥100 mg/dL (includes prediabetes and diabetes); 63% have low HDL, and 39% have elevated triglycerides ≥150 mg/dL. The results for other cardiovascular diseases and risk factors are as follows: 44% had hypertension using the criterion of the JNC VII report (BP ≥140/90 mm Hg); 85% had LDL cholesterol ≥100 mg/dL; 31% are current alcohol drinkers; 22% are current smokers; 53.7% have low physical activity; and 82% have an unhealthy diet.@*Conclusions@#Fifty-two percent (52%) of older Filipinos have metabolic syndrome and have a high prevalence of cardiovascular risk factors, foremost of which are elevated LDL-cholesterol at 85%, hypertension at 44% based on JNC VII, approximately 10% with diabetes mellitus, but with a double burden of overweight/obesity and undernutrition. This data can help plan for public health approaches to improve quality of life and increase longevity of Filipinos.

Risco nutricional e cardiovascular em idosos quilombolas / Nutritional and cardiovascular disease risk in older persons living in Quilombola communities

Resumo O objetivo deste artigo é avaliar o risco nutricional e cardiovascular segundo medidas antropométricas em idosos quilombolas do estado do Maranhão. Trata-se de estudo transversal realizado em 11 comunidades remanescentes de quilombolas do município de Bequimão, Maranhão, Brasil. Realizou-se censo da população idosa que representou 205 pessoas. Foram estimados os riscos nutricional e cardiovascular por meio dos indicadores antropométricos segundo sexo e idade. Realizou-se Testes de Qui-quadrado de Pearson ou Exacto de Fisher e análises de variância. Diferenças foram consideradas estatisticamente significantes quando p<0,05. Idosos quilombolas vivem em precárias condições de moradia e de infraestrutura sanitária, com elevado risco nutricional e cardiovascular, mas com diferenças entre sexo e idade. O excesso de peso foi mais prevalente em mulheres e idosos mais jovens, enquanto os homens e idosos com 80 ou mais anos apresentaram-se mais desnutridos e com maior perda de massa corporal. O risco cardiovascular foi maior entre as mulheres e em todas as faixas etárias. Idosos quilombolas vivem em vulnerabilidade socioeconômica e apresentaram alta prevalência de baixo peso, perda de massa muscular e alto risco cardiovascular, sendo maior risco entre mulheres e idosos do grupo de maior idade.

Abstract This article aims to assess nutritional and cardiovascular disease (CVD) risk based on anthropometric measures among older persons living in Quilombola communities in the state of Maranhão, Brazil. We conducted a cross-sectional study with 205 older persons living in 11 Quilombola communities in Bequimão, Maranhão. Nutritional and CVD risk were estimated according to sex and age group based on anthropometric indicators using Pearson's chi-square or Fisher's exact tests and analysis of variance, adopting a significance level of p<0.05. The study participants suffer precarious housing, basic sanitation and social conditions. Prevalence of nutritional and CDV risk was high across the sample, showing differences between sexes and age groups. Prevalence of excess weight was higher in women and the youngest age group, while prevalence of malnourishment and loss of muscle mass was higher in men and individuals aged 80 years and over. Prevalence of CVD risk was high across all age groups and higher in women than men. The older persons living in the Quilombola communities investigated by this study are socially vulnerable and showed high prevalence of low weight, loss of muscle mass and CDV risk. The prevalence of CVD risk was higher among women and the oldest age group.

Cenário nacional da promoção da saúde e prevenção de riscos e doenças para a pessoa idosa na saúde suplementar / National panorama of health promotion and risk and disease prevention for older persons in the private health sector / Escenario nacional de la promoción de la salud y prevención de riesgos y enfermedades para los ancianos en la salud suplementaria

O cenário nacional dos programas de promoção da saúde e prevenção de riscos e doenças para a pessoa idosa na saúde suplementar é descrito em pesquisa com dados secundários de 1999 a 2019, fornecidos pela Agência Nacional de Saúde Suplementar. Para análise qualitativa, utilizou-se a técnica de análise de conteúdo com apoio do software IRaMuTeQ® e, para a quantitativa, do software RStudio. Encontraram-se 87 programas exclusivos para a pessoa idosa. As motivações apresentadas foram: aumento da população-alvo no Brasil; aumento do número de beneficiários da população-alvo; mudanças nos padrões de morbimortalidade; e necessidades de adoção de um novo modelo assistencial. As principais atividades foram: rede multidisciplinar de atenção; ações multidisciplinares; e desenvolvimento de um plano de cuidado individualizado. O número de programas mostra-se insuficiente em relação à demanda. Esperam-se atitudes mais rígidas na regulamentação do setor e mudanças no modelo assistencial vigente.(AU)

This article provides a national panorama of health promotion and risk and disease prevention programs for older persons in the private health sector using secondary data from 1999 to 2019 provided by the Supplemental Health Agency. Content analysis was performed using the software IRaMuTeQ® and a quantitative analysis was conducted using RStudio. We found 87 programs targeting older persons. The reasons found were: an increase in the target audience; an increase in the number of beneficiaries among the target audience; changes in patterns of morbidity and mortality; and the need to adopt a new care model. The main activities were: multidisciplinary care network; multidisciplinary actions; and development of individualized care plans. The number of programs is insufficient to meet demand. A more stringent approach is expected in the regulation of the sector and changes need to be made to the current care model.(AU)

Se describe el escenario nacional de los programas de promoción de la salud y prevención de riesgos y enfermedades para los ancianos en la salud suplementaria, en investigación con datos secundarios de 1999 a 2019, suministrados por la Agencia Nacional de Salud Suplementaria. Para el análisis cualitativo se utilizó la técnica de análisis de contenido con apoyo del software IRaMuTeQ® y para el cuantitativo el software RStudio. Se encontraron 87 programas exclusivos para los ancianos. Las motivaciones encontradas fueron: aumento de la población-objetivo, cambios en los estándares de morbimortalidad y necesidades de adopción de un nuevo modelo asistencial. Las principales actividades fueron: red multidisciplinaria de atención, acciones multidisciplinarias, desarrollo de un plan de cuidado individualizado. El número de programas se muestra insuficiente con relación a la demanda. Se esperan actitudes más rígidas en la reglamentación del sector y cambios en el modelo asistencial vigente.(AU)

Prevalence of Diabetes among community-living older persons in the Philippines: The FITforFrail study / Journal of the ASEAN Federation of Endocrine Societies

Objective@#To estimate the prevalence of diabetes among Filipino older persons living in the community.@*Methodology@#A cross-sectional analysis was done on a random sample of persons 60 years and older from the Focused Interventions for Frail Older Adults Research and Development Program (2018-2019). A diagnosis of diabetes was established by self-reported physician’s diagnosis or if the person was on any antihyperglycemic drugs.@*Results@#The prevalence of self-reported diabetes was 20.5%, with no difference in age, sex, education, or body mass index between older persons with and without diabetes. The presence of 2 or more comorbidities was significantly more common among older persons with diabetes (p<0.001). Visual impairment (p<0.01), hypertension (p<0.001) and hyperlipidemia (p<0.001) were more frequent among those with diabetes.@*Conclusion@#Diabetes is prevalent among community-living older Filipinos. Therefore, effective public health measures for diabetes prevention and management are needed for the ever-growing older population, who are at the highest risk for morbidity and mortality.

Análise do estado funcional e força muscular de adultos e idosos em Unidade de Terapia Intensiva: Coorte prospectiva / Analysis of functional status and muscle strength in adults and older adults in an intensive care unit: a prospective cohort study

Resumo Avaliar e correlacionar o estado funcional (EF) e a força muscular (FM) em adultos jovens, adultos e idosos em Unidade de Terapia Intensiva (UTI). Coorte prospectiva com 48 pacientes avaliando EF por meio do Functional Status Score for the Intensive Care Unit (FSS-ICU) e FM pelo Medical Research Council Sum-Score (MRC-SS) e força de preensão palmar (FPP), no despertar e na alta da UTI. Dados analisados pelos testes Kruskall-Wallis, Qui-quadrado, Wilcoxon e Correlação de Sperman. Na comparação do despertar em relação à alta, o EF e o MRC-SS foram maiores na alta em todos os grupos, com menor ganho nos idosos. A FPP aumentou bilateralmente na alta, exceto no grupo de adultos, pois apresentavam valores maiores no despertar. Na comparação dos grupos, o FSS-ICU foi maior nos adultos no despertar e alta, e a FPP-D menor nos idosos. O EF apresentou forte associação com a FM em adultos jovens e adultos, pois ambos apresentam progressiva melhora durante a permanência na UTI. Os idosos apresentam menor ganho do estado funcional, além de apresentarem menor força muscular desde o despertar. Estas variáveis apresentam importante associação apenas nos adultos jovens e adultos, considerando a natureza multifatorial do processo de adoecimento e incapacidade nos idosos.

Abstract The aim of this study was to analyze and assess the association between functional status (FS) and muscle strength (MS) in young adults, adults and older adults in an intensive care unit (ICU). We conducted a prospective cohort study with 48 patients. FS was assessed using the Functional Status Score for the Intensive Care Unit (FSS-ICU) and MS was measured using the Medical Research Council Sum-Score (MRC-SS) and by testing handgrip strength (HS). The assessments were performed on awakening and ICU discharge. The data were analyzed using the Kruskall-Wallis, chi-squared, Wilcoxon and Spearman's correlation tests. FS and MRC-SS scores were higher on ICU discharge in all groups. Gains were lowest in the older adult group. HS was greater in both hands on ICU discharge in all groups except the adults. FSS-ICU on both awakening and ICU discharge was highest in the adults; HS-R was lowest in the older adults. There was a strong association between FS and MS in the young adults and adults. FS and MS showed progressive improvement during ICU stay. Gains in FS and MS on awakening and ICU discharge were lowest among the older adults. Important associations were found between these variables in all groups except the older adults. This can be explained by the multifactorial nature of illness and incapacity in this group.

El ejercicio del derecho a la salud en personas mayores en Argentina y Colombia: una aproximación a partir del análisis de la mortalidad por causas sensibles a la atención de la salud en el siglo XXI / O exercício do direito à saúde em pessoas idosas na Argentina e na Colômbia: uma abordagem baseada na análise da mortalidade por causas sensíveis aos cuidados de saúde no século XXI / The exercise of the right to health in older persons in Argentina and Colombia: an approach based on the analysis of mortality due to causes sensitive to health care in the XXI century

A partir de que Argentina y Colombia reconocen la salud como un derecho esencial y se comprometen, entre otras cuestiones, a brindar prestaciones sanitarias para garantizar su ejercicio sin discriminación, se propone indagar, comparativamente, acerca de los desafíos que estos países enfrentan para cumplir con este compromiso en las personas de sesenta años y más. Para ello, se calculan y analizan, para los trienios 2000-2002 y 2013-2015, tasas de mortalidad por causas consideradas sensibles a la atención de la salud según país, sexo y edad, con base en información de la Organización de las Naciones Unidas, y se calculan proporciones específicas sobre encuestas oficiales de cada país. Los resultados evidencian, en ambos países y para el conjunto de causas referidas, una mayor mortalidad en hombres, que crece con la edad hasta los 74 años y con tendencia al descenso, principalmente en Colombia. Un análisis más detallado por causas revela una situación similar en este último caso, a diferencia de Argentina, donde aumenta la mortalidad asociada a enfermedades respiratorias. Independientemente de estas diferencias, las tasas obtenidas al final del período investigado acusan, en los dos países, la necesidad de redoblar los esfuerzos para continuar su reducción (o revertir su incremento), con especial foco en las personas mayores que menos recursos tienen y su valor en tanto ciudadanos con iguales derechos al resto de la población.

Tendo em vista que a Argentina e a Colômbia reconhecem a saúde enquanto um direito essencial e comprometem-se, entre outras questões, a fornecer benefícios à saúde para garantir seu exercício sem discriminação, propõe-se investigar, comparativamente, os desafios enfrentados para o cumprimento desse compromisso para pessoas com 60 anos ou mais. Para esse fim, as taxas de mortalidade por causas consideradas sensíveis aos cuidados de saúde de acordo com país, sexo e idade, com base em informações da Organização das Nações Unidas, são calculadas e analisadas para os períodos 2000-2002 e 2013-2015, sendo que proporções específicas são calculadas em pesquisas oficiais de cada país. Os resultados mostram, nos dois países e por todas as causas referidas, uma maior mortalidade em homens, aumentando com a idade de 74 anos e com tendência a declinar, principalmente na Colômbia. Uma análise mais detalhada por causas revela uma situação semelhante no último caso, ao contrário da Argentina, onde a mortalidade por doenças respiratórias aumenta. Independentemente dessas diferenças, as taxas obtidas no final do período investigado acusam, em ambos os países, a necessidade de redobrar esforços para continuar a redução da mortalidade (ou reverter seu aumento), com foco especial nos idosos que têm menos recursos e em seu valor enquanto cidadãos com direitos iguais ao resto da população.

Since Argentina and Colombia recognize health as a fundamental right, and undertake, among other issues, to provide healthcare services to guarantee its exercise without discrimination, our aim is to inquire, comparatively, about the challenges these countries face in fulfilling this commitment for population aged 60 and older. Thus, mortality rates from causes considered sensitive to health care by country, sex and age are calculated and analysed for trienniums 2000-2002 and 2013-2015, based on information from the United Nations. Besides, specific proportions are calculated based on each country's official surveys. Results show, in both countries and for all groups of causes considered, a higher mortality in men, increasing with age up to 74 years and with a tendency to decline, mainly in Colombia. A more detailed analysis by causes reveals a similar situation in the latter case, unlike Argentina where mortality from respiratory diseases increases. Regardless of these differences, the rates associated to period 2013-2015 reveal, in both countries, the need to increase efforts to continue their reduction (or reverse their increase), with a special focus on those who have fewer resources and on their value as citizens with the same rights as the rest of the population.

Anti-diabetic medication burden amongst older persons with diabetes and associated quality of life

@#Background: Older persons with diabetes are the major demographic of diabetic patients followed up in primary health clinics. Despite their increasing age and morbidities, they are still being managed strictly towards good sugar control in order to achieve the ideal HbA1c level without taking their quality of life into consideration. This study aimed to determine the prevalence in the use of antidiabetic drugs among older persons with diabetes and its association with their quality of life. Methodology: A cross-sectional study was conducted among 269 older persons with diabetes in all government health clinics in Kuantan using Diabetes Quality of Life questionnaire. SPSS version 23 was used for the statistical analysis. Results: Majority of the respondents were females (61%), Malays (84.8%), pensioners (54.3%) with education up to primary school (52%) and are staying with family members (93.7%). Most of the patients were on two antidiabetic agents (48%) followed by a single antidiabetic agent (32%). Despite the risk of hypoglycaemia, 0.4% of them are on glibenclamide. The use of insulin is still common among 21% of them that are on intermediate-acting insulin, 15.6% on premixed insulin and 7.8% on short-acting insulin. Those taking a higher number of antidiabetic agents were found to be associated with poorer quality of life (p=0.001) compared to those taking one or two antidiabetic medications. Those on insulin also have significantly poorer quality of life score (p=0.012). Conclusion: Despite aiming for controlled diabetes, older persons suffer poor quality of life with further intensification of their antidiabetic medications according to the guidelines. This includes the complexity of insulin usage and polypharmacy, which contribute to the low quality of life score.

Filipino elderlies' perception on abuse: Their safety status and treatment of social networks

Background and Objectives@#Elderly Filipinos have four important concerns: security in old age, health status, impact of aging, and elder abuse. Elder abuse committed in their homes or in their community is alarming. How their social networks (their family, friends, relatives, and significant others) treat them plays a crucial role in their well-being. The aim of this study was to explore the perceptions on elder abuse and the safety status of Filipino older persons along with the treatment afforded to them by their social networks. The study also determined such perception to be able to devise a cost effective, community-based interventions to address elder abuse. @*Methodology@#The study used mixed methods design and the Experience of Abuse Suspicion Index (EASI) tool, a questionnaire along with the demographic profile of the participants. The results were tallied and analyzed using descriptive statistics. How social networks treat them and their safety status were explored using researcher-made open-ended questions analyzed using the qualitative approach. @*Results and Conclusion@#Findings revealed the perceptions of Filipino older persons on elder abuse, with participants from the 60-69 age group, predominantly female, with no work, and have low monthly income. The major themes generated from the qualitative findings were relationship issues with the self, environment, coping, abuses, and values. Several sub-themes were also discovered and were related to the findings. An awareness campaign on the issue of elder abuse in Philippine society was recommended. Educating social networks about the perils of abuse is crucial in maintaining the safety of older persons. A monitoring system must be developed at the barangay level and policies must be put in place to address the concerns of elder abuse.

Prevalence of metabolic syndrome and specific cardiovascular risk factors among older persons in the Philippines: Results from the 8th Philippine National Nutrition Survey

Background@#Cardiovascular diseases are the leading causes of deaths among adults in the Philippines, and this is true also among older persons aged 60 years and above. Identification of risk factors and diseases that lead to cardiovascular mortality among the elderly is important to have an impact on longevity. @*Objective@#This study aimed to determine the prevalence of metabolic syndrome and specific cardiovascular risk factors among older persons in the Philippines. @*Methods@#A cross sectional design was used, with data taken from the results of the 8th Philippine National Nutrition Survey (NNS) Clinical and Health Survey done in 2013. Although there is a more recent survey, only the 2013 data is complete and available for secondary analyses. @*Results@#There were 1,835 older persons who were participants in the 8th Philippine NNS who had complete clinical data. The prevalence of Metabolic Syndrome was 52.6% in this population with the distribution of the components as follows: 33.5% have elevated waist circumference; 59.25 had elevated BP >130/85 mm Hg; 30.1% had fasting blood glucose ≥100 mg/dL (includes prediabetes and diabetes); 63% have low HDL, and 39% have elevated triglycerides ≥150 mg/dL. The results for other cardiovascular diseases and risk factors are as follows: 44% had hypertension using the criterion of the JNC VII report (BP ≥140/90 mm Hg); 85% had LDL cholesterol ≥100 mg/dL; 31% are current alcohol drinkers; 22% are current smokers; 53.7% have low physical activity; and 82% have an unhealthy diet. @*Conclusions@#Fifty-two percent (52%) of older Filipinos have metabolic syndrome and have a high prevalence of cardiovascular risk factors, foremost of which are elevated LDL-cholesterol at 85%, hypertension at 44% based on JNC VII, approximately 10% with diabetes mellitus, but with a double burden of overweight/obesity and undernutrition. This data can help plan for public health approaches to improve quality of life and increase longevity of Filipinos.

Association of Sleep Duration and Depression with Periodontitis in Older People Aged 65 Years and Older / 치위생과학회지

BACKGROUND: Sleep disorder is a precursor to depression, which is one of the psychological factors associated with periodontal disease that, in turn, affects general and periodontal health. This study aimed to investigate the relationship between sleep duration, depression, and periodontitis in older people aged over 65 years. METHODS: A total of 2,002 older adults aged 65 years or older were included in the study. Their general and health aspects, including smoking, drinking, diabetes, hypertension, and depression, were investigated. Periodontitis was examined using the Community Periodontal Index (CPI). Data were analyzed through a complex sampling design method. Frequency and crossover analyses were conducted to investigate the relationship between depression and periodontitis. To investigate the effect of depression on periodontitis, a logistic regression analysis was performed. RESULTS: Regarding depression and participants' general characteristics, statistically significant differences were found in sex, economic activity, smoking habit, and CPI (p<0.05). In the presence of depression, the odds ratio for periodontitis was 1.84, and the adjusted odds ratio for age, sex, economic activity, residence type, household income, education level, smoking habit, drinking, hypertension, and diabetes was 1.72, representing a significant difference (p<0.05). CONCLUSION: This study examined the relationship between depression and periodontitis in older persons and confirmed a significant correlation. As the population of older adults increases, we should pay attention to their mental and oral health as well as systemic diseases. Various programs for the health promotion of older persons need to be implemented to improve the quality of life of older people.

Sexuality in Later Life: Sexual Desire and Satisfaction among Malay Older Persons in Malaysia

Abstract@#Introduction: Malaysia is known for its shy and prudent community that indirectly causing the stigma and taboos related to later life sexuality. This study aimed to explore the sexual desire and satisfaction in later life among the Malay ethnic elderly in Malaysia who were living in the urban area, where discussions about sexual issues are perceived less sensitive and stigmatized. Methods: A total of 234 eligible elderly were approached but only 160 older people completed the questionnaire, sampled using multistage cluster sampling method. Face-to-face interviews were conducted using questionnaires consisted of sociodemographic characteristics, cognitive function, perceived health status, presence of chronic illnesses, smoking history, disability, perceived sexual problems, sexual desire and satisfaction. Multiple logistic regression was conducted to determine the associated factors for sexual desire and satisfaction, respectively. All tests significant level was set at 0.05. Results: Majority of the respondents were having sexual desire (53.8%) and not satisfied with their sexual life (51.3%), with elderly women (55.7%) experienced more sexual problems compared to men. The results showed male, being married, good perceived health and absence of arthritis were the significant contributing factors of better sexual desire. Having good health perception, being married and absence of sexual problems were significantly predicting better sexual satisfaction. Conclusion: The study emphasized the multifactorial aspects contributed towards the sexual dissatisfaction among the respondents despite having desire for sexual activity. Focus should be given to elderly women who tend to have multiple chronic diseases and more likely a widow due to their longer life expectancy.

Quedas recorrentes e fatores de risco em idosos institucionalizados / Recurrent falls and risk factors among institutionalized older people

Resumo Queda recorrente representa alto risco de morbidade e mortalidade em idosos, principalmente institucionalizados, dado ao seu quadro de fragilidade e declínio funcional evidentes. O objetivo deste estudo é determinar a incidência e os fatores de risco relacionados a quedas recorrentes em idosos institucionalizados. Estudo longitudinal tipo coorte no período de um ano. Foram avaliados indivíduos com 60 anos ou mais residentes em 10 Instituições de Longa Permanência para Idosos, que deambulassem e possuíssem capacidade cognitiva preservada. Foi questionada a ocorrência de quedas nos últimos doze meses, considerando recorrentes a ocorrência de dois ou mais episódios neste período. Foram ainda coletadas variáveis referentes à instituição, condições sócio demográficas e de saúde do idoso através de questionários. Do total de 364 idosos, 130 foram incluídos. A incidência de quedas recorrentes foi de 26.9% (IC 95% = 22.4 - 31.5). A partir do Qui-quadrado e Regressão Logística, considerando o nível de significância de 5%, foi encontrada fadiga como fator de risco (p = 0.001; RR = 2.9) e uso de betabloqueadores como fator de proteção (p = 0.010; RR = 0.1). Conclui-se que queda recorrente é comum nas Instituições de Longa Permanência para Idosos e a fadiga representa fator de risco.

Abstract Recurrent falls constitute a high risk for morbidity and mortality among older people, especially institutionalized individuals, due to greater frailty and functional decline in this group. The aim of this study was to identify risk factors associated with recurrent falls among institutionalized older persons. A longitudinal cohort study was conducted over a one-year period with a study sample consisting of individuals aged 60 years and over living in 10 Nursing homes (NH) who were able to walk and had preserved cognitive ability. The older persons and carers were asked about the occurrence of falls over the last twelve months. The older persons were considered recurrent fallers if they had had two or more falls during this period. Institutional, sociodemographic and health data was also collected using questionnaires and the residents' medical records. One hundred and thirty individuals were included in the sample out of a total of 364 older people living in the NH. The incidence of recurrent falls was 26.9% (CI95% = 22.4 - 31.5). The results of the chi-square test and logistic regression adopting a significance level of 0.05 showed that fatigue was a risk factor for recurrent falls(p = 0.001; RR = 2.9) and that the use of beta blockers was a protective factor (p = 0.010; RR = 0.1). It was concluded that recurrent falls are common in NH and that fatigue constitutes an important risk factor.

The Factors Associated With Older Adults Receiving Care in Jamaica / Factores Asociados con los Adultos Mayores que Reciben Cuidados en Jamaica

ABSTRACT Objective: To ascertain the level of care and the predisposing, enabling and need factors associated with care received by older adults using Andersen's framework. Methods: The 2012 Jamaica Survey of Living Conditions was used to conduct descriptive, bivariate and binary logistic analyses for the receipt of care among older adults defined by activities of daily living (ADL) and the instrumental activities of daily living (IADL) measures. The ADL sample comprised 3152 older adults and the IADL sample comprised 3141 older adults. Results: Approximately 16% of older adults received ADL care and significant binary logistic associations with age, area of residence, living arrangements, source of financial support, disability, and perceived health status were found. Approximately 69% received IADL care and significant binary logistic associations with gender, age, employed, living arrangements, wealth status, source of financial support, satisfaction with life accomplishments, disability and perceived health status were found for those receiving IADL care. Conclusion: Predisposing, enabling and need factors of the Andersen framework predict ADL and IADL care. Therefore, plans for care of older adults must address those 70 years or older who live alone, have a disability, a chronic illness and rate their health poorly.

RESUMEN Objetivo: Determinar el nivel de cuidados y los factores predisponentes, capacitantes y de necesidad asociados con el cuidado recibido por los adultos mayores, usando el modelo de Andersen. Métodos: La Encuesta de Condiciones de Vida en Jamaica 2012 fue utilizada para realizar análisis descriptivos, bivariantes y logísticos binarios en relación con el recibimiento de cuidados entre los adultos mayores, definidos por las medidas de las actividades de la vida diaria (AVD) y las actividades instrumentales de la vida diaria (AIVD). La muestra de AVD abarcó 3152 adultos mayores y la muestra de AIVD abarcó 3141 adultos mayores. Resultados: Aproximadamente el 16% de los adultos mayores recibieron cuidados de AVD, y en su análisis se hallaron asociaciones logísticas binarias significativas con la edad, el área de residencia, la situación de vivienda, la fuente de apoyo financiero, la discapacidad y el estado de salud percibido. Aproximadamente el 69% recibió cuidados de AIVD, y en su análisis se hallaron asociaciones logísticas binarias con el género, la edad, los empleados, la situación de vivienda, la situación económica, la fuente de apoyo financiero, la satisfacción con los logros de vida, la discapacidad, y el estado de salud percibido. Conclusión: Los factores predisponentes, capacitantes y de necesidad del modelo de Andersen predicen los cuidados de AVD y AIVD. Por lo tanto, los planes para el cuidado de adultos mayores tienen que abarcar a aquellas personas de 70 años o más que viven solas, tienen una discapacidad, una enfermedad crónica, y valoran su salud como pobre.