Differences according to gender and health status in CD4:CD8 ratio in a sample of community-dwelling oldest old. The OCTABAIX immune study

2011 ◽  
Vol 23 (4) ◽  
pp. 268-272 ◽  
Author(s):  
Francesc Formiga ◽  
Assumpta Ferrer ◽  
Gloria Padros ◽  
Alfons Lopez Soto ◽  
Marta Sarro ◽  
...  
Keyword(s):  
Health Status ◽  
Oldest Old ◽  
Community Dwelling ◽  
Gender And Health ◽  
Immune Study

Prioritization and management of calls from older people to GP out-of-hours services

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Suzanne Smith ◽  
Lucia Carragher
Keyword(s):  
Older People ◽  
Service Provision ◽  
Emergency Services ◽  
Oldest Old ◽  
Community Dwelling ◽  
Third Party ◽  
Older Person ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Community Dwelling Older People

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

scholarly journals Polypharmacy in a Belgian cohort of community-dwelling oldest old: baseline observations and associated risk factors

2015 ◽  
Vol 37 (8) ◽  
pp. e8 ◽  
Author(s):  
Maarten Wauters ◽  
Monique Elseviers ◽  
Bert Vaes ◽  
Jan Degryse ◽  
Olivia Dalleur ◽  
...  
Keyword(s):  
Risk Factors ◽  
Oldest Old ◽  
Community Dwelling ◽  
Associated Risk Factors

scholarly journals Eating alone at each meal and associated health status by cohabitation situation among Japanese community-dwelling elderly: a cross-sectional analysis of the KAGUYA study

2020 ◽  
Author(s):  
Osamu Kushida ◽  
Jong-Seong Moon ◽  
Daisuke Matsumoto ◽  
Naomi Yamasaki ◽  
Katsuhiko Takatori
Keyword(s):  
Health Status ◽  
Functional Capacity ◽  
Health Status Indicators ◽  
Subjective Health ◽  
Community Dwelling ◽  
Care Needs ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
History Of ◽  
Sectional Analysis

Abstract Background: This study investigated the association between eating alone at each meal and health status including functional capacity according to cohabitation situation among Japanese community-dwelling elderly.Methods: This was a cross-sectional analysis of baseline data from the Keeping Active across Generations Uniting the Youth and the Aged (KAGUYA) study in Japan. A self-administered questionnaire was mailed to all 8004 residents aged 65 or older residing in the same Japanese town the participants in March 2016. Eating alone was assessed by first asking whether participants ate three separate meals each day (i.e., breakfast, lunch, and dinner), and those who answered affirmatively were then asked how many people were usually present at each meal. Health status was assessed in terms of subjective health, medical history, care needs, body mass index, depression, and functional capacity.Results: Data from 3057 respondents were analyzed. Among those living with others, those who reported not being in good subjective health and a history of hypertension were significantly more likely to eat alone at breakfast (odds ratio 1.27; 95% confidence interval 1.01–1.61, and 1.26; 1.06–1.49). Depressive symptoms and many subscales of functional capacity were also significantly associated with eating alone at breakfast, lunch, and dinner (P < 0.05). Among those living alone, those eating alone at breakfast had lower scores for indicators of functional capacity including information practice (P = 0.010) and total scores (P = 0.049).Conclusions: For both cohabitation situations, many health status indicators were related to eating alone at each meal, especially breakfast.

Medication adherence in community-dwelling older people exposed to chronic polypharmacy

2021 ◽  
pp. jech-2020-214238
Author(s):  
Carlotta Franchi ◽  
Ilaria Ardoino ◽  
Monica Ludergnani ◽  
Gjiliola Cukay ◽  
Luca Merlino ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Older People ◽  
Oldest Old ◽  
Medication Possession Ratio ◽  
Community Dwelling ◽  
Administrative Database ◽  
Lombardy Region ◽  
Drug Classes ◽  
Community Dwelling Older People ◽  
Lower Adherence

BackgroundTo evaluate medication adherence and associated factors of seven of the most common drug classes prescribed to community-dwelling older people.MethodsThis is a retrospective cohort study on medication adherence in community-dwelling older people (65–94 years old) on chronic polypharmacy and recorded from 2013 to 2015 in the administrative database of the Lombardy region (Northern Italy). Adherence was assessed for diabetic drugs, antithrombotic agents, drugs acting on the renin–angiotensin system, statins, bisphosphonates, antidepressants and drugs for obstructive airway diseases by calculating the medication possession ratio (MPR). Patients were then divided in fully (MPR ≥80%), partially (40%≤MPR<80%) and poorly adherent (10%<MPR<40%).ResultsAmong 140 537 patients included in the study, only 19.3% was fully adherent to all the therapies considered. Almost 40% of them were poorly adherent to at least one drug class, becoming 50% when patients exposed to four or more drug classes were considered. In adjusted regression model, being women (OR=1.14, 95% CI 1.13 to 1.16) and aged ≥80 years old (OR=1.22, 95% CI 1.20 to 1.24) were associated with an overall lower adherence. Instead, the participation to an experimental healthcare programme was associated with higher adherence (OR=0.92, 95% CI 0.87 to 0.96). Furthermore, being coprescribed with ≥10 drugs was associated with lower adherence to all the drug classes, with different effects (ORs from 0.42 to 0.73).ConclusionThis study overall shows a low medication adherence in community-dwelling older people on chronic polypharmacy, especially in women and oldest old. The implementation and promotion of healthcare programmes for these patients could help improve overall adherence to chronic drug therapies.

A Profile of Older Adults With a History of Stroke Receiving Home Care in Ontario, Canada

2019 ◽  
Vol 31 (3) ◽  
pp. 162-171
Author(s):  
Michael J. Zoratti ◽  
Kathryn Fisher ◽  
Dawn Guthrie ◽  
Lauren E. Griffith
Keyword(s):  
Sex Differences ◽  
Health Status ◽  
Home Care ◽  
Population Level ◽  
Home Care Services ◽  
Community Dwelling ◽  
Assessment Instrument ◽  
Cross Sectional ◽  
Stroke Diagnosis ◽  
History Of

The demand for home care services is increasing, yet the literature describing the clinical characteristics of community-dwelling individuals with a history of stroke who receive home care is limited. In this retrospective, cross-sectional, population-level study, data were sourced from home care recipients aged 65+ who had a routine assessment using the Resident Assessment Instrument for Home Care (RAI-HC) in Ontario between January 2007 and December 2011. The RAI-HC contains several health status indicators and validated health index scales. The association of a history of stroke on health status was assessed through a series of logistic regression models, adjusted for age, sex, and number of comorbidities. Sex differences were also explored. A change in odds of ≥25% was considered to indicate a clinically important finding. From the home care data ( N = 319,694), 56,909 individuals had a stroke diagnosis, with approximately 86% diagnosed with ≥3 chronic conditions. A stroke diagnosis was associated with a higher risk of limitations or impairments with communication, locomotion, continence, activities of daily living, and cognitive performance. A clinically meaningful difference was not observed for symptoms of depression. Few sex differences were observed. In an effort to support the development of effective home and community-based care programs, research is needed to understand differences in community-dwelling versus institutional populations. Community-dwelling individuals with a history of stroke show higher levels of impairment and limitations compared with those without, suggesting areas where home care resources could be improved to help manage the chronic effects of stroke.

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