Prediction of Risk of Frailty Among Institutionalized Older Adults in India.

BACKGROUND: Frailty is a state of age-related physiological vulnerability resulting from impaired homeostatic reserve and a reduced capacity of the individual to withstand stress and an independent predictor of deleterious health outcomes among the aged. Early identification of people who are at risk for frailty is vital in preventing and minimizing its socio-economic consequences in low-resource countries like India. However, risk factors for frailty among Indian institutionalized older adults have been seldom explored. OBJECTIVE: The objective of this study is to develop a prediction model for the risk of frailty among institutionalized older adults. METHODS: This study adopted a case-control design, wherein institutionalized adults were categorized into frail and non-frail, using Fried's criteria. Individuals above 55 years of age who could follow instructions without severe motor and cognitive impairment and terminal illness were recruited from nine conveniently selected institutions. Socio-demographic, lifestyle, behavioral, and physical performance factors were evaluated by including hundred participants. RESULTS: Among the fourteen independent variables, age, cognition, income, functional mobility, polypharmacy and presence of more than 3 comorbidities were significant in univariate analysis. But adjusted odds ratio showed a statistical significance for low educational status, low income, poor functional mobility, and presence of more than 3 co-morbidities only, hence they were used for developing the prediction model. CONCLUSION: Low education status, low income, poor functional mobility, and presence of more than 3 comorbidities were found to have a significant association with the risk of frailty. A model has been developed to predict the risk and early identification of frailty among institutionalized older adults.

Promoting healthy lifestyles using information technology during the COVID-19 pandemic.

In this pandemic era there exist a relationship between a sedentary lifestyle during lockdown with periods of anxiety and stress among the population. Moreover, the population with chronic disease will be vulnerable to the ill effects of a physically inactive lifestyle. Besides, social media platforms and technological advances also appear to be another potential tool for promoting health and wellbeing, however, the capability of these interventions during the pandemic era is largely unknown. To explore the possible role of technological advances and social media platforms as an alternate tool in promoting a healthy living style during the COVID-19 era. The studies with the predefined criteria were used to synthesize information regarding the opportunities and challenges. Studies delivering lifestyle intervention using social media platforms, technologies for health promotion were considered for the review. The studies included to synthesize evidence were randomized controlled trials, systematic reviews and meta-analysis. Database like Medline, Scopus, and Science Direct were searched independently by two reviewers. A total of 17 studies were included in the review, Internet and lifestyle modification n = 2, mHealth and lifestyle modification n = 3, Social media and lifestyle modifications n = 3, technology adoption for lifestyle modification n = 4, and hazards = 5. Technology and social media-based interventions appear to be a promising technique for promoting health and wellbeing and it is the only effective method for delivering an intervention during a pandemic situation. However, there also appears a need for the development of guidelines for social media usage to prevent probable hazards.

Barriers Encountered by Accredited Social Health Activists (ASHA) in Arthritis Rehabilitation: A Qualitative Study.

INTRODUCTION: Healthy behaviour through education of individuals with arthritis is the mainstay of long term management. Time and access constraints restrict medical professionals from active involvement in arthritis education in the community. Reaching the community through the Accredited Social Health Activists (ASHAs) is the plan of action operational in India. Hence, the factors encountered by ASHAs while delivering arthritis education programs need to be studied. AIM: The aim of the study was to explore the experiences of ASHAs while delivering arthritis education program. MATERIALS AND METHODS: Qualitative exploratory design employing semi-structured interviews was adapted for the study. The interviews were conducted using focus groups of ASHAs from two geographically similar villages. Inductive analysis of focus group discussions was undertaken to determine themes, categories and codes. RESULTS: Three broad themes were identified from the interviews which influenced the performance of ASHAs. Categories identified show the influence of training, characteristics of ASHAs, geographical features, family characteristics and community attitude. Few problems reported were means of transport, time constraints, multiple tasks, type of incentive and frequency of on-field demonstrations. CONCLUSION: Providing motivation for altruistic services has always been a challenge to governing bodies. The issues identified in this study can be addressed prior to integrating ASHAs for rehabilitation services.