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BMC Geriatrics Nov 2022Quality of life (QOL) is a complex concept known for being influenced by socio-demographic characteristics, individual needs, perceptions and expectations. The study...
BACKGROUND
Quality of life (QOL) is a complex concept known for being influenced by socio-demographic characteristics, individual needs, perceptions and expectations. The study investigates influences of such heterogeneous variables and aims to identify and describe subgroups of older patients who share similar response patterns for the four domains (physical health, psychological health, social relationships and environment) of World Health Organization Quality of Life instrument, Short Form (WHOQOL-BREF).
METHODS
The sample used included older Romanian patients (N = 60; equal numbers of men and women; mean age was 71.95, SD = 5.98). Latent Profile Analysis (LPA) was conducted to explore quality of life profiles with the four WHOQOL-BREF domains as input variables. Differences between profiles were analysed by MANOVA and ANOVAs as a follow-up.
RESULTS
The LPA results showed that the three-profile model was the most suitable and supported the existence of three distinct QOL profiles: low and very low (28.3%), moderate (63.3%) and high (8.4%). The relative entropy value was high (0.86), results pointed to a good profile solution and the three profiles differed significantly from one another.
CONCLUSION
Our results reveal heterogeneity within the older adult sample and provide meaningful information to better tailor QOL improvement programs to the needs of older patient groups, especially those designed for patients of profiles related to poorer QOL in different domains.
Topics: Male; Humans; Female; Aged; Quality of Life; Surveys and Questionnaires; World Health Organization; Ethnicity
PubMed: 36368920
DOI: 10.1186/s12877-022-03518-1 -
Nutrients Oct 2019Increasing awareness of the impact of frailty on elderly people resulted in research focusing on factors that contribute to the development and persistence of frailty... (Review)
Review
Increasing awareness of the impact of frailty on elderly people resulted in research focusing on factors that contribute to the development and persistence of frailty including nutrition and physical activity. Most effort so far has been spent on understanding the association between protein intake and the physical domain of frailty. Far less is known for other domains of frailty: cognition, mood, social health and comorbidity. Therefore, in the present narrative review, we elaborate on the evidence currently known on the association between protein and exercise as well as the broader concept of frailty. Most, but not all, identified studies concluded that low protein intake is associated with a higher prevalence and incidence of physical frailty. Far less is known on the broader concept of frailty. The few studies that do look into this association find a clear beneficial effect of physical activity but no conclusions regarding protein intake can be made yet. Similar, for other important aspects of frailty including mood, cognition, and comorbidity, the number of studies are limited and results are inconclusive. Future studies need to focus on the relation between dietary protein and the broader concept of frailty and should also consider the protein source, amount and timing.
Topics: Affect; Aging; Cognition; Dietary Proteins; Exercise; Frailty; Health Status; Humans; Nutritional Requirements; Nutritional Status; Recommended Dietary Allowances
PubMed: 31597289
DOI: 10.3390/nu11102399 -
Journal of Animal Science Jun 2022Considering welfare through the "neonatal and nursery pig perspective" is an exciting approach and one that resonates with consumers. Overlaying this with the Five... (Review)
Review
Considering welfare through the "neonatal and nursery pig perspective" is an exciting approach and one that resonates with consumers. Overlaying this with the Five Domains Model, as we suggest in this review, points to practical on-farm improvements that provide each pig the opportunity to experience positive mental states. The Five Domains Model is broken into physical and functional states, which include Domain 1: Nutrition, Domain 2: Physical Environment, Domain 3: Health, and Domain 4: Behavioral Interaction, and Domain 5: Mental State. The Five Domains Model can build on the breadth and depth of swine welfare science to highlight opportunities to improve welfare on-farm. In Domain 1, management of increasingly large litters is considered, with examples of sow vs. artificial rearing, colostrum quality and quantity, and creep feed management strategies. Efforts can result in positive mental states such as feeling full and content and the ability to experience the pleasure of drinking and food tastes and smells. Domain 2 considers space complexity and access to key resources, along with thermal and physical amenities, to promote feelings of physical comfort. Domain 3 considers pig health in three broads, yet inter-linking categories 1) congenital and hereditary health, 2) environmental pathogen load, and 3) colostrum quality and quantity, and its effect on the microbiome. Improvements can result in a pig that displays vitality and feels healthy. Domain 4 provides the pig opportunities to express its rich behavioral repertoire, specifically positive social interactions, play, and exploration. These efforts can result in pigs feeling calm, safe, comfortable, having companionship, engaged, interested, and rewarded. In conclusion, using the Five Domains Model can highlight numerous opportunities to improve current and future housing and management through the "neonatal and nursery pig perspective" with a focus on inducing positive mental states that can result in improved quality of life and welfare state.
Topics: Animal Welfare; Animals; Colostrum; Farms; Female; Pregnancy; Quality of Life; Swine
PubMed: 35536191
DOI: 10.1093/jas/skac164 -
BMC Public Health Sep 2022This paper examines demographic differences in flourishing, defined as "complete well-being" and consisting of six domains: emotional health, physical health, purpose,...
This paper examines demographic differences in flourishing, defined as "complete well-being" and consisting of six domains: emotional health, physical health, purpose, character strengths, social connectedness, and financial security. Results are based on a random, cross-sectional sample of 2363 survey respondents drawn from employees of a large, national, self-insured employer based in the United States. We found that well-being across domains tends to increase with age, although there are some variations. Results are similar across most domains for men and women, although women score higher on character strengths, while men had higher scores on financial security. Racial and ethnic differences were striking. Black employees score higher than the reference group (White employees) on the emotional, purpose, and character strengths domains, but considerably lower on financial security. Hispanics also score lower on financial security (though not as low as Blacks), but higher than Whites on purpose, character strengths, and social connectedness. Asians reported higher well-being than Whites across all domains except purpose.
Topics: Asian People; Cross-Sectional Studies; Ethnicity; Female; Hispanic or Latino; Humans; Male; Racial Groups; United States
PubMed: 36068553
DOI: 10.1186/s12889-022-13769-7 -
Frontiers in Public Health 2023No study has comprehensively quantified the individual and collective contributions of various risk factors to the growing burden of diabetes in the United States.
INTRODUCTION
No study has comprehensively quantified the individual and collective contributions of various risk factors to the growing burden of diabetes in the United States.
METHODS
This study aimed to determine the extent to which an increase in the prevalence of diabetes was related to concurrent changes in the distribution of diabetes-related risk factors among US adults (aged 20 years or above and not pregnant). Seven cycles of series of cross-sectional National Health and Nutrition Examination Survey data between 2005-2006 and 2017-2018 were included. The exposures were survey cycles and seven domains of risk factors, including genetic, demographic, social determinants of health, lifestyle, obesity, biological, and psychosocial domains. Using Poisson regressions, percent reduction in the β coefficient (the logarithm used to calculate the prevalence ratio for prevalence of diabetes in 2017-2018 vs. 2005-2006) was computed to assess the individual and collective contribution of the 31 prespecified risk factors and seven domains to the growing burden of diabetes.
RESULTS
Of the 16,091 participants included, the unadjusted prevalence of diabetes increased from 12.2% in 2005-2006 to 17.1% in 2017-2018 [prevalence ratio: 1.40 (95% CI, 1.14-1.72)]. Individually, genetic domain [17.3% (95% CI, 5.4%-40.8%)], demographic domain [41.5% (95% CI, 24.4%-76.8%)], obesity domain [35.3% (95% CI, 15.8%-70.2%)], biological domain [46.2% (95% CI, 21.6%-79.1%)], and psychosocial domain [21.3% (95% CI, 9.5%-40.1%)] were significantly associated with a different percent reduction in β. After adjusting for all seven domains, the percent reduction in β was 97.3% (95% CI, 62.7%-164.8%).
CONCLUSION
The concurrently changing risk factors accounted for the increasing diabetes prevalence. However, the contribution of each risk factor domain varied. Findings may inform planning cost-effective and targeted public health programs for diabetes prevention.
Topics: Adult; Humans; Pregnancy; United States; Female; Nutrition Surveys; Prevalence; Cross-Sectional Studies; Diabetes Mellitus; Risk Factors; Obesity
PubMed: 37213641
DOI: 10.3389/fpubh.2023.1174632 -
Frontiers in Public Health 2023Population demography across the globe shows an increasing trend in the aging population due to better healthcare, improved nutrition, advanced health-related... (Review)
Review
INTRODUCTION
Population demography across the globe shows an increasing trend in the aging population due to better healthcare, improved nutrition, advanced health-related technology, and decreased fertility rate. Despite these advancements, there remains a knowledge gap in understanding the association between active aging determinants and quality of life (QoL) among older adults, particularly within diverse cultural contexts, which has not been adequately explored in previous research. Therefore, understanding the association between active aging determinants and QoL can help policymakers plan early interventions or programs to assist future older adults in both aging actively and optimizing their quality of life (QoL), as these two factors have a bidirectional relationship.
OBJECTIVE
This study aimed to review evidence regarding the association between active aging and quality of life (QoL) among older adults and to determine the most widely used study designs and measurement instruments in studies conducted between 2000 and 2020.
METHODS
Relevant studies were identified by a systematic search of four electronic databases and cross-reference lists. Original studies examining the association between active aging and QoL in individuals aged 60 years or older were considered. The quality of the included studies and the direction and consistency of the association between active aging and QoL were assessed.
RESULTS
A total of 26 studies met the inclusion criteria and were included in this systematic review. Most studies reported a positive association between active aging and QoL among older adults. Active aging had a consistent association with various QoL domains including physical environment, health and social services, social environment, economic, personal, and behavioral determinants.
CONCLUSION
Active aging had a positive and consistent association with several QoL domains among older adults, backing the notion that the better the active aging determinants, the better the QoL among older adults. Considering the broader literature, it is necessary to facilitate and encourage the active participation of older adults in physical, social, and economic activities for the maintenance and/or improvement of QoL. Identifying other possible determinants and enhancing the methods to improve those determinants may help improve the QoL among older adults.
Topics: Humans; Aged; Quality of Life; Aging; Birth Rate; Databases, Factual; Early Intervention, Educational
PubMed: 37435519
DOI: 10.3389/fpubh.2023.1193789 -
Journal of Cachexia, Sarcopenia and... Apr 2023How inflammation relates to intrinsic capacity (IC), the composite of physical and mental capacities, remains undefined. Our study aimed to investigate the...
BACKGROUND
How inflammation relates to intrinsic capacity (IC), the composite of physical and mental capacities, remains undefined. Our study aimed to investigate the cross-sectional and longitudinal associations between plasma inflammation-related biomarkers and IC in older adults.
METHODS
This secondary analysis of the Multidomain Alzheimer Preventive Trial (MAPT) included 1238 community-dwelling older individuals with IC assessments from 12 to 60 months. Plasma C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor receptor-1 (TNFR-1), monocyte chemoattractant protein-1 (MCP-1) and growth differentiation factor-15 (GDF-15) were measured at 12 months. IC was operationalized as a score ranging from 0 to 100, derived from four domains: cognition, Mini-Mental State Examination; locomotion, Short Physical Performance Battery; psychological, Geriatric Depression Scale; and vitality, handgrip strength. A five-domain IC score (plus sensory) was investigated in a subsample (n = 535) with a 1-year follow-up as an exploratory outcome.
RESULTS
The mean age of the 1238 participants was 76.2 years (SD = 4.3); 63.7% were female. Their initial four-domain IC scores averaged 78.9 points (SD = 9.3), with a yearly decline of 1.17 points (95% CI = -1.30 to -1.05; P < 0.001). We observed significant associations of lower baseline IC with higher CRP, IL-6, TNFR-1 and GDF-15, after controlling age, sex, MAPT group allocation and educational level [CRP: adjusted β (95% CI) = -1.56 (-2.64 to -0.48); P = 0.005; IL-6: adjusted β = -3.16 (-4.82 to -1.50); P < 0.001; TNFR-1: adjusted β = -6.86 (-10.25 to -3.47); P < 0.001; GDF-15: adjusted β = -7.07 (-10.02 to -4.12); P < 0.001]. Higher TNFR-1, MCP-1 and GDF-15 were associated with faster decline in four-domain IC over 4 years [TNFR-1: adjusted β (95% CI) = -1.28 (-2.29 to -0.27); P = 0.013; MCP-1: adjusted β = -1.33 (-2.24 to -0.42); P = 0.004; GDF-15: adjusted β = -1.42 (-2.26 to -0.58); P = 0.001]. None of the biomarkers was significantly associated with the five-domain IC decline.
CONCLUSIONS
Inflammation was associated with lower IC in older adults. Among all plasma biomarkers, TNFR-1 and GDF-15 were consistently associated with IC at the cross-sectional and longitudinal levels.
Topics: Humans; Female; Aged; Male; Independent Living; Growth Differentiation Factor 15; Hand Strength; Alzheimer Disease; Cross-Sectional Studies; Interleukin-6; Biomarkers; Inflammation
PubMed: 36660894
DOI: 10.1002/jcsm.13163 -
BMJ Open Apr 2022To evaluate the patterns and demographic correlates of domain-specific physical activities (PAs) and their associations with dyslipidaemia among ethnic minorities in...
OBJECTIVE
To evaluate the patterns and demographic correlates of domain-specific physical activities (PAs) and their associations with dyslipidaemia among ethnic minorities in China.
DESIGN
Cross-sectional.
PARTICIPANTS
In total, 17 081 individuals were included.
PRIMARY AND SECONDARY OUTCOME MEASURES
Domain-specific PAs were assessed using a questionnaire related to occupational, transportation, housework and leisure-time PAs. Dyslipidaemia was measured using an automatic biochemical instrument. Demographic variables were self-reported.
RESULTS
Housework accounted for most PAs in the study. Elderly people were more likely to participate in housework and leisure-time PA, whereas the mean level of PA in people with low education level and household income was high. With G3-G4 levels of occupational PA, Dong men (G4: OR=0.530, 95% CI 0.349 to 0.806), Miao women (G3: OR=0.698, 95% CI 0.524 to 0.931; G4: OR=0.611, 95% CI 0.439 to 0.850) and Bouyei women (G3: OR=0.745, 95% CI 0.566 to 0.981; G4: OR=0.615, 95% CI 0.440 to 0.860) tended to have a low risk of dyslipidaemia. With G2 levels of transportation, PA could reduce the risk of dyslipidaemia in Bouyei women (G2: OR=0.747, 95% CI 0.580 to 0.962). G2-G3 levels of leisure-time PA could reduce the risk of dyslipidaemia in Miao men (G2: OR=0.645, 95% CI 0.446 to 0.933; G3: OR=0.700, 95% CI 0.513 to 0.954). However, a high risk of dyslipidaemia was observed with G4 levels of leisure-time PA among Bouyei women (G4: OR=.353, 95% CI 1.001 to 1.905) and with transportation PA among Dong men (G4: OR=1.591, 95% CI 1.130 to 2.240).
CONCLUSION
The main PA of the ethnic minorities in Guizhou Province involved housework. Domain-specific PAs varied with demographic factors, and active domain-specific PAs were associated with a reduced risk of dyslipidaemia.
Topics: Aged; China; Cohort Studies; Cross-Sectional Studies; Demography; Dyslipidemias; Exercise; Female; Humans; Leisure Activities; Male
PubMed: 35418424
DOI: 10.1136/bmjopen-2021-052268 -
Clinical Nutrition (Edinburgh, Scotland) Nov 2023Both during and after hospitalization, nutritional care with daily intake of oral nutritional supplements (ONS) improves health outcomes and decreases risk of mortality... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND & AIMS
Both during and after hospitalization, nutritional care with daily intake of oral nutritional supplements (ONS) improves health outcomes and decreases risk of mortality in malnourished older adults. In a post-hoc analysis of data from hospitalized older adults with malnutrition risk, we sought to determine whether consuming a specialized ONS (S-ONS) containing high protein and beta-hydroxy-beta-methylbutyrate (HMB) can also improve Quality of Life (QoL).
METHODS
We analyzed data from the NOURISH trial-a randomized, placebo-controlled, multi-center, double-blind study conducted in patients with congestive heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease. Patients received standard care + S-ONS or placebo beverage (target 2 servings/day) during hospitalization and for 90 days post-discharge. SF-36 and EQ-5D QoL outcomes were assessed at 0-, 30-, 60-, and 90-days post-discharge. To account for the missing QoL observations (27.7%) due to patient dropout, we used multiple imputation. Data represent differences between least squares mean (LSM) values with 95% Confidence Intervals for groups receiving S-ONS or placebo treatments.
RESULTS
The study population consisted of 622 patients of mean age ±standard deviation: 77.9 ± 8.4 years and of whom 52.1% were females. Patients consuming placebo had lower (worse) QoL domain scores than did those consuming S-ONS. Specifically for the SF-36 health domain scores, group differences (placebo vs S-ONS) in LSM were significant for the mental component summary at day 90 (-4.23 [-7.75, -0.71]; p = 0.019), the domains of mental health at days 60 (-3.76 [-7.40, -0.12]; p = 0.043) and 90 (-4.88 [-8.41, -1.34]; p = 0.007), vitality at day 90 (-3.33 [-6.65, -0.01]; p = 0.049) and social functioning at day 90 (-4.02 [-7.48,-0.55]; p = 0.023). Compared to placebo, differences in LSM values for the SF-36 general health domain were significant with improvement in the S-ONS group at hospital discharge and beyond: day 0 (-2.72 [-5.33, -0.11]; p = 0.041), day 30 (-3.08 [-6.09, -0.08]; p = 0.044), day 60 (-3.95 [-7.13, -0.76]; p = 0.015), and day 90 (-4.56 [-7.74, -1.38]; p = 0.005).
CONCLUSIONS
In hospitalized older adults with cardiopulmonary diseases and evidence of poor nutritional status, daily intake of S-ONS compared to placebo improved post-discharge QoL scores for mental health/cognition, vitality, social functioning, and general health. These QoL benefits complement survival benefits found in the original NOURISH trial analysis.
CLINICAL TRIAL REGISTRATION
NCT01626742.
Topics: Female; Humans; Aged; Male; Quality of Life; Aftercare; Patient Discharge; Dietary Supplements; Hospitalization; Malnutrition; Nutritional Status
PubMed: 37757502
DOI: 10.1016/j.clnu.2023.09.004 -
BMC Medical Education Mar 2022Medical school curricular hours dedicated to ophthalmology are low and declining. Extracurricular ophthalmology activities, such as participation in community vision...
Demographics, clinical interests, and ophthalmology skills confidence of medical student volunteers and non-volunteers in an extracurricular community vision screening service-learning program.
BACKGROUND
Medical school curricular hours dedicated to ophthalmology are low and declining. Extracurricular ophthalmology activities, such as participation in community vision screenings, may serve an important adjunctive role in medical school curricula. The Johns Hopkins University (JHU) Vision Screening In Our Neighborhoods (ViSION) Program is an example of a voluntary medical student-directed community service-learning program.
METHODS
We used a mixed-methods cross-sectional approach, including an online survey and semi-structured interviews. JHU School of Medicine students enrolled in MD or MD/PhD programs during the 2019-2020 academic year were surveyed regarding demographics, career and service interests, involvement in ophthalmology-related activities, and confidence in their ophthalmology-related skills. Survey responses were compared between ViSION volunteers and non-volunteers using Fisher's exact chi-square tests. Semi-structured interviews were conducted via webconference with 8 prior or current ViSION volunteers and responses analyzed using inductive thematic analysis. Data were collected when ViSION volunteers were in variable stages of their medical education and involvement with the ViSION program.
RESULTS
A total of 118 medical students were included, representing an overall response rate of 24.6% of JHU medical students. ViSION volunteers reported greater involvement in ophthalmology-related research (42% vs. 4%, p < 0.001), intent to apply to ophthalmology residency programs (35% vs. 1%, p = 0.001), and confidence with multiple ophthalmology knowledge and clinical skill domains. In particular, ViSION volunteers were more likely to feel confident estimating cup-to-disc ratio using direct ophthalmoscopy (20% vs. 0%, p < 0.001). In open-ended survey and interview questions, most volunteers attributed at least some degree of their ophthalmology skill development and desire to pursue ophthalmology and public health careers to their ViSION experience.
CONCLUSIONS
Medical students who volunteered with a student-led community vision screening program were more likely to have a prior interest in ophthalmology than those who did not volunteer, but only 1/3 of volunteers planned to pursue a career in ophthalmology. Overall, volunteers reported higher confidence performing ophthalmology-related clinical skills, suggesting that student-led community vision screening programs may provide an important avenue for medical students to explore public health aspects of ophthalmology, while practicing ophthalmology exam skills and learning about common ophthalmic pathologies, regardless of their career intentions.
Topics: Career Choice; Demography; Humans; Ophthalmology; Social Welfare; Students, Medical; Surveys and Questionnaires; Vision Screening; Volunteers
PubMed: 35246114
DOI: 10.1186/s12909-022-03194-0