Evaluation on the Nutrition Quotient Scores of Elderly People Living Alone in Korea.

As the Korean society is aging rapidly, the issues on physical, social, economic, and mental disabilities of single-person households aged 65 years or older has also increased. This study aimed to investigate the nutrition-related dietary conditions of elderly people living alone and determine their dietary behavior by calculating the nutrition quotient for elderly (NQ-E). One hundred and three elderly people living alone who were basic living recipients were recruited from six senior welfare centers in Seoul, and the data were collected using a questionnaire from 19 July 2016 to 17 August 2016, with a 1:1 in-depth interview using the modified version of the NQ-E questionnaire. The data were analyzed using SPSS 27.0 for Mac (IBM Corp., Armonk, NY, USA); a p value of <0.05 was considered significant. The nutrition-related dietary conditions of the elderly living alone were limited, and many of them received support from the government, which helped improve their diet. The nutrition quotient score of the elderly living alone was 50.14, which was lower than the NQ-E mean score (57.6) of the Korean elderly and the NQ-E (62 points), which is the top 25% of the national survey subjects according to the criteria value presented by the Korean Nutrition Society. Elderly people living alone often have poor dietary habits and nutritional status. The NQ-E presented in this study can be used to evaluate the dietary conditions of the elderly and is expected to be used as an indicator for developing community programs for health promotion and evaluating their effectiveness.

Perspectives of the Elderly with Mild Cognitive Impairment Living Alone on Participating in a Dementia Prevention Program: A Q Methodology Study.

This study aimed to identify and describe the various patterns of perspectives among older adults with mild cognitive impairment (MCI) living alone on participating in a dementia prevention program. Q methodology was applied to investigate the perspectives of 30 community-dwelling elderly people with MCI living alone from March to August 2018. As Q methodology applies a forced distribution through the Q-sorting technique, it could capture participants' perspective patterns. Thirty-two Q-statements were constructed to explore the participants' attitudes regarding their participation in a dementia prevention program. The participants performed Q-sorting to rank the 32 statements into a Q-sort grid. Principal component analysis was conducted using the PQ Method 2.35 software to identify patterns in participants' perspectives. Four patterns of shared perspectives, accounting for 54.65% of the total variance, were identified: (a) awareness of health benefits and readiness to take preventive actions; (b) emphasis on cost consideration, and not ready to participate; (c) concern about family's attitude and needing family support; (d) emphasis on medical care and needing providers' recommendation. The exploration of clusters of the elderly with MCI could assist health professionals in acknowledging elderly people's attitudes and responses towards participating in a dementia prevention program.

Calidad de la asistencia social en ancianos solos con atención domiciliaria / Quality of the social care in old men living alone under home care

Introducción: La calidad de la atención geriátrica en Cuba constituye una realidad impostergable. Objetivo: Evaluar la calidad de la asistencia social de salud en ancianos solos con atención domiciliaria. Método: Se realizó una investigación cualitativa, que incluyó a 4 838 ancianos, controlados por los departamentos de Trabajo Social del municipio de Santiago de Cuba, desde enero hasta diciembre del 2015, para lo cual se efectuó un muestreo por conglomerados bietápico, constituido por 387 gerontes. Se utilizó la metodología de la Escuela Nacional de Salud Pública de Cuba para evaluar las dimensiones: estructura, proceso y resultados. Resultados: Se encontró inadecuado el indicador recursos humanos y materiales. En el proceso resultaron adecuados la confección de la historia social y los registros administrativos. Conclusiones: La calidad de la asistencia social en ancianos solos con atención domiciliaria resultó inadecuada en los componentes estructura, proceso y resultados.

Introduction: The quality of geriatric care in Cuba constitutes an inevitable reality. Objective: To evaluate the quality of health social care in geriatric patients living under home care. Method: A qualitative investigation that included 4 838 old men, controlled by the departments of Social Work of Santiago de Cuba municipality was carried out from January to December, 2015, for which a sample through two-stage conglomerate constituted by 387 aged persons was made. The Cuban National School of Public Health methodology was used to evaluate the dimensions: structure, procedure and results. Results: The indicator human resources and materials resulted inadequate. Making the social history and the administrative registrations were appropriate. Conclusions: The quality of the social care in elderly living alone under home care was inadequate in the components structure, procedure and results.

[The influence of types of living alone on 2-year health changes according to elderly adults' marital status: Based on the Comprehensive Regional Studies for Preventing Isolation of the Elderly Who Live in Metropolitan Area (CAPITAL Study)].

Objectives　The aim of this research is to classify elderly adults who live alone by their marital status type and to clarify how those types affect their higher-level functional capacity and mental health with a 2-year follow-up survey.Methods　This research is based on the results from a survey in 2013. The base-line scores were from 757 participants who completed a survey by mail, carried out in B area of A ward, Tokyo, within the jurisdiction of community general support centers, with people who were not at nursing care levels 4 or 5 and who were not residents of welfare facilities. This study analyzed data for 517 of 527 participants, who answered all questions in the 2015 survey and indicated their marital status. This research categorized the respondents into 4 types of marital status: separation, divorce, bereavement, and unmarried groups. This study adopted the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) as the index of higher-level functional capacity, and the WHO-Five Well-Being Index (WHO-5-J) as the mental health index. In the analysis of the causes of 2-year variations in TMIG-IC total scores and WHO-5-J scores, the dependent variable was each variation. This study used an analysis of covariance in which the fixed factors were types of living alone, sex, annual income, and having children who lived separately in the 2013 survey, and the covariance comprised the base-line scores for the dependent variables, age, and chronic diseases in the 2013 survey.Results　With regards to the variation in TMIG-IC total scores, main effects of the types of living alone were observed. The adjusted variation of covariance decreased most in the separation group (-0.95). For the variation in WHO-5-J scores, main effects of the types of living alone were indicated. In the divorce group, the adjusted variation of covariance was significantly higher than for the unmarried group (2.33 vs. -0.55).Conclusion　The results revealed that the types of marital status: separated, divorced, bereaved, and unmarried, affect changes in the higher-level functional capacity and mental health status of elderly adults living alone, 2 years later. Thus, although previously regarded as a single category, types of marital status should be considered in the analysis of elderly adults who live alone.

The Median Effect of Social Support on the Loneliness of Resilience in the Healthy Elderly Living Alone

Will teenagers today live with and care for their aged parents tomorrow?

AIMS: Older adults who live alone are vulnerable physically, emotionally and socially. However, there is a trend towards children not living with their parents. We studied the willingness of teenagers today to live with and care for their aged parents tomorrow, and the reasons for their decision. METHODS: A convenient sample of 1405 teenage students (M age = 14.9 ± 1.30) in the north region of Singapore completed a purpose-designed questionnaire. Structural equation modeling was used to explore the relationships between teenagers' closeness to grandparents, challenges faced living with grandparents, positive and negative perceptions towards aging, and willingness to stay with aged parents in the future, stratified by sex. Thematic analysis was used to understand the reasons for their choice. RESULTS: The majority (85.6%) chose to live with their parents, and the significant predictors were "closeness to grandparents" (P = 0.034) and "positive perceptions towards aging" (P < 0.01), but not "challenges in living with grandparents" (P = 0.391) or "negative perceptions" (P = 0.302). Among teenagers with positive perceptions, boys were more likely to live with their parents (P < 0.01). Conversely, among teenagers with negative perceptions, girls were more likely to do so (P = 0.026). Primary reasons for willingness included: "desire to care," "expression of love," "sense of responsibility" and "prompted by moral values." CONCLUSIONS: Efforts should be undertaken to strengthen teenagers' relationships with grandparents, and promote positive perceptions towards aging to better sustain the family as a social safety net for aging and frail older adults. Geriatr Gerontol Int 2018; 18: 957-964.

Medication adherence and beliefs about medication in elderly patients living alone with chronic diseases.

PURPOSE: The aim of this study was to assess medication adherence and its related factors among elderly people living alone with chronic diseases using a conceptual framework with the Belief about Medicines Questionnaire and the Adherence to Refills and Medication Scale-Korean version. PARTICIPANTS AND METHODS: This was a cross-sectional study conducted in 3,326 elderly people living alone, who were enrolled in Seongnam Center for Home Health Care in South Korea. They completed validated questionnaires assessing their adherence and beliefs about medication in general. RESULTS: In attitudinal analysis using Belief about Medicines Questionnaire, 37.0% of patients were accepting of medication (high necessity with low concerns), 49.7% were ambivalent (high necessity with high concerns), 1.9% were skeptical (low necessity with high concerns), and 11.4% were indifferent (low necessity and low concerns). In multivariable analysis, we found that adherence was related to patients' beliefs about medication; compared with patients who were accepting of medication, those in the other three attitudinal groups had significantly lower adherence (indifferent, p=0.003; skeptical, p=0.001; ambivalent, p<0.001). Also, low adherence was associated with heavy burden of drug costs (ß=0.109; 95% CI 0.03, 0.19), presence of drug side effects (ß=0.431; 95% CI 0.11, 0.75), dissatisfaction with medication (ß=-0.626; 95% CI -0.77, -0.48), perceiving health status as poor (ß=-0.151; 95% CI -0.27, -0.03), and receiving medical aid (ß=0.655; 95% CI 0.42, 0.89). Gender, age group, and number of prescribed medication were not associated with medication adherence. CONCLUSION: To improve medication adherence of elderly living alone, it is essential to identify barriers to adherence, including their concerns and attitudes toward medications. These factors associated with adherence should be considered in further intervention studies.

A Study on Factors Affecting Suicidal Tendency of the Elderly Living Alone on Care Services

OBJECTIVES: The high suicide rate has risen as a main concern in South Korea. Given the complexity of the mechanism resulting in complete suicide, studies targeting various populations are needed for broader understanding of its risk factors. This study aims to analyze the factors affecting the suicidal tendency in the population of the elderly living alone in Seoul depending on basic elderly-care services. METHODS: A total number of 415 people participated in the study. Home-visit interviews were administered by trained interviewers. Suicidal tendency was measured by the Korean version of mini international neuropsychiatric interview (K-MINI). Health-related quality of life was measured by a brief version of the World Health Organization Quality-of-life Scale (WHOQOL-BREF). Alcohol problem was assessed by the Korean version of the alcohol use disorders identification test (AUDIT-K). Among total subjects of 415 interviewees, the actual responses of 408 people were used for the final analysis. RESULTS: The result showed that the suicide risk was high in persons isolated from social support [odds ratio (OR) = 4.49], having depression (OR = 14.85), and having low quality of life (OR = 4.39). CONCLUSIONS: We found that social support, depression and health-related quality of life are associated with suicidal tendency in the elderly living alone on basic services. Our evidence will contribute to suicide prevention policy for the elderly living alone on care services.

Factors Associated with the Use of Over-the-Counter Medications in the Elderly Living Alone / 정신신체의학

OBJECTIVES: This study aimed to describe the use of over-the-counter (OTC) drugs and to identify predictors for their use in the elderly living alone. METHODS: This is a cross-sectional study that enrolled 1,099 subjects. Data regarding socio-demographic status, medical condition, cognition, mood disorder and use of OTC drugs were collected using self-administered questionnaire and from a specific semi-structured interview by a trained nurse. Data regarding use of OTC drugs were analyzed using descriptive statistics. Logistic regression analysis was applied to examine factors associated with the use of OTC drugs. RESULTS: The use of OTC drugs were reported by 35.4% of the subjects. Analgesics (13.6%) was the most frequent drugs. Depression (OR=1.10, 95% CI=1.10–1.87) and comorbidities measured by cumulative illness rating scale (CIRS) (OR=1.08, 95% CI=1.03–1.12) were significantly associated with the use of OTC drugs in the elderly living alone. CONCLUSIONS: Depression and severity of underlying medical conditions could be a predictor of the use of OTC drugs in the elderly living alone. The clinicians should be vigilant regarding the potential use of nonprescription medications in the elderly.

Analysis of health-related quality of life of elderly people living alone in Shanghai / 第二军医大学学报

Objective To analyze the health-related quality of life of elderly people living alone in Shanghai according to the survey data. Methods The data were extracted from the fifth national health services survey of Shanghai, and the data of 11 103 elderly people from 17 districts were analyzed. The elderly people living alone and those not living alone were matched using propensity score matching method, and the health-related quality of life of elderly people was measured by the European quality of life 5-dimensions (EQ-5D). The health-related quality-of-life indicators between the elderly people living alone and not living alone, including selection of EQ-5D dimensions, EQ-5D scores and EQ-VAS scores, were compared by Chi-square test and Mann-Whitney U test. Results The baselines of the elderly people living alone and not living alone matched well by propensity score matching, and there were no significant differences in selection of each dimension of the health-related quality of life, EQ-5D index scores or EQ-VAS scores between the two groups. Conclusion There is no difference in health-related quality of life between elderly people living alone and not living alone in Shanghai.

Activities of daily living (ADL) of single elderly individuals using social assistive programs in a rural community.

Objectives　The proportion of elderly individuals living alone is increasing in Japan. Matsumoto city office provides social assistive programs such as home help, lunch delivery, life advice, and safety check telephone calls. The purpose of this study was to compare the level of ADL between the elderly using social assistive programs (the use group) and those who did not (the non-use group).Methods　We conducted a cross-sectional study at Shiga district of Matsumoto city in September 2014. A total of 128 elderly individuals participated in this study. Health volunteers asked these subjects to complete a questionnaire without assistance. Measurement items included lifestyle variables and social support networks. With respect to the frequency of use, we used questions that inquired about the use of the social assistive program. We included a set of instruments commonly used in the health assessment of elderly populations: functional capacity (Instrumental ADL, Intellectual Activity, Social Role), social support, nutrition (Mini Nutrition Assessment [MNA]) and depressive symptoms (Geriatric Depression Scale [GDS]).Results　The use group consisted of 24 elderly individuals participating in the social support program. The non-use group consisted of 89 elderly individuals living alone without programs. The mean age of those who completed the survey was 83.9±4.2 years for the use group and 82.3±4.3 years for the non-use group. Comparisons between the two groups did not show significant difference in terms of their intellectual activity, social role, emotional social support, and MNA or GDS scores. The use group was more likely to use the public transfer service and receive instrumental social support from children and relatives.Conclusions　By means of utilizing the public transfer service, and receiving family support, the elderly living alone who used social assistive programs could live independently. These findings suggest a need for improvement in the public transfer service and social network.

The Influencing Factors on the Ego Integrity of Elderly Living Alone / 한국간호교육학회지

PURPOSE: This study was conducted in order to determine the extent of ego integrity and to confirm the association between the sense of ego integrity and integrated loneliness, social support, and social activities. METHODS: For this study, 146 elderly people participated. The data was analyzed with SPSS/WIN 21.0, using descriptive statistics, t-test, ANOVA, correlation analysis, and hierarchical regression analysis. RESULTS: In regards to differences between ego integrity according to general characteristics of subjects, there was a statistically significant difference in education (F=4.13, p=.007). In elderly living alone, ego integrity was significantly positive correlated with social support and social activities, but negative correlated with loneliness. These variables explained 43.2% of the sense of ego integrity. CONCLUSION: The study suggested that nursing programs and social activity programs designed to aid the elderly living alone must focus on reducing loneliness, as well as increasing social support and social activities, while taking education into consideration. Also, these programs should strive to build social support systems.

Factors Associated with Suicidal Ideation in Korean Elderly Living Alone ; Sociodemographic and Clinical Characteristics

OBJECTIVE: The purpose of this study was to examine the relationship between suicidal ideation and the associated with sociodemographic and clinical factors in community dwelling, elderly living alone in Korea. METHODS: A total of the 329 community-dwelling elderly aged 65 years or older who lived alone were recruited and they underwent the questionnaire including their sociodemographic data, Activities of Daily Living/Instrumental Activities of Daily Living scale (ADL/IADL) and the Korean version of the Short Geriatric Depression Scale (SGDS-K). Suicidal ideation was evaluated by using the "suicidal thought" item of the Beck Depression Inventory (BDI). RESULTS: According to the result of our sample of elderly living alone, 22.8% of the subjects reported their suicidal ideation. ADL/IADL score (p<0.01), subjective economic status (p<0.05), and subjective health status (p<0.05) had a negative correlation with suicidal ideation. SGDS-K score (p<0.05) had positive correlations with suicidal ideation. Multiple regression analysis revealed that suicidal ideation correlates to ADL/IADL score (p=0.025). CONCLUSION: This study exhibit that ADL/IADL is significantly associated with suicidal ideation.

Depressive status and influencing factors of elderly living alone in a community of Shanghai: A survey / 第二军医大学学报

Objective To investigate the depression status among the elderly living alone in a community of Shanghai and to analyze the influencing factors.

A novel sensor-assisted RFID-based indoor tracking system for the elderly living alone.

The population of elderly people is increasing rapidly in many developed nations. Providing safe and comfortable care to aging people is an important social goal. Moreover, obtaining correct activity and location information for an elderly person is an important research goal. This work proposes a novel intelligent RFID-based indoor tracking system for elderly people living alone. The proposed system uses environment information for inhabitants and received signal strength of an RFID reader to estimate the probable location of an inhabitant. The proposed system then coordinates with the wireless sensor node of a three-axis accelerometer and uses a genetic algorithm to compute the location of the inhabitant. The proposed system also uses context and gait information to improve inhabitant-tracking accuracy. Experiment results show that the accuracy of the proposed system is better than that of existing RFID-based systems.

A Study on the Nutrient Intake, Health Risk Factors, Blood Health Status in Elderly Korean Women Living Alone / 대한지역사회영양학회지

This purpose of this study was to investigate the nutrient intake, the health status as determined self-assessment checklist, biochemical indicators of elderly Korean women. We interviewed and 55 female subjects living alone in the Urban aged over 65 years. Information on their dietary intake was collected by 24-hour Recall method. Their health status was determined by a NSI checklist. Biochemical indicators were performed in whole blood and plasma of subjects. Except for protein, Fe, all of the elderly subjects belonged to over moderate nutritional risk. The average daily nutrient intake of the elderly was below the level of the recommended dietary allowances (RDA) for Koreans. A relationship between their health risk score and nutrient intake was observed negatively (not significantly). They had a risk of anemia as hemoglobin and hematocrit of subjects were under the normal value. Therefore, the reason that health risk score and health status badly was thought for lower nutrient intake.

Anthropometric and Biochemical Indicators and Related Factors for the Community Dwelling Elderly Living Alone / 대한지역사회영양학회지

In this study, anthropometric and biochemical indicators and related factors for community dwelling elderly living alone (ELA). as well as for elderly not living alone (ENLA) were explored. The subjects were 140 elderly females (70 living alone, 70 not living alone) residing in Bucheon. Anthropometric measurements revealed significant differences between the two groups (ELA/ENLA) for height, weight, BMI, triceps skinfold thickness, suprailiac skinfold thickness, subscapular skinfold thickness, and body fat percentage. The ELA showed significantly lower data for most of the anthropometric indices, except PIBW. Biochemical indicators of iron status (hemoglobin, serum iron, transferrin saturation) were significantly lower for the ELA, whereas the total serum cholesterol, LDL-C, LDL-C/HDL-C, for the ELA were significantly higher. The prevalence of hypercholesterolemia (240 mg%) was 30%. The latter three are not in accordance with general malnutrition among the ELA. The hemoglobin of the ELA was positively correlated with energy, fat, iron and cholesterol intake, but negatively correlated with height. The serum cholesterol of the ELA was positively associated with most of their nutrient intake.

The Dietary Behaviors, Depression Rates and Nutrient Intakes of the Elderly Females Living Alone / 대한지역사회영양학회지

In this study, the dietary behaviors, depression rates and nutrient intakes were assessed for elderly females living alone (ELA) and elderly females not living alone (ENLA). The subjects were 140 elderly females (living alone 70; not living alone 70) residing in Bucheon city. Dietary data were obtained using the 24-hr recall method. There were more subjects with low monthly incomes (less than 500,000 won) in the ELA group. The proportion of the ELA group which skipped at least one meal per day was 38.5% and the main reasons given were low appetite and depression. Fewer of the ELA group were observed to have smoking and drinking habits. However, the majority of the ELA smokers smoked more than 6 cigarettes per smoking. The drinking score of the ELA group was also higher than that of the ENLA group. The total score of depression for the ELA group was higher than that of the ENLA group. The total score of nutrition risk index (NRI) of the ELA group (8.09) was also higher than that of the ENLA group (2.31). The dietary assessment using the 24 hr-recall method showed that the ELA group had lower nutrients intakes, and significant differences were shown in the intakes of energy (1137 kcal vs 1275 kcal), animal protein, animal fat, carbohydrates, animal Ca, and animal Fe. There was a positive correlation between the NRI and the depression scores. However a higher NRI was associated with lower intakes for most of the nutrients in the ELA group.