scholarly journals Urban-rural disparity in the utilization of national community-based hypertension monitoring service—results from the China Health and Retirement Longitudinal Study, 2015

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7842
Author(s):  
Hongxun Song ◽  
Da Feng ◽  
Ruoxi Wang ◽  
Shangfeng Tang ◽  
Bishwajit Ghose ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Antihypertensive Agents ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Middle Aged ◽  
Community Based ◽  
Hypertensive Patients ◽  
Urban Rural ◽  
Monitoring Service

Background Since 2009, community-based hypertension monitoring service (CBHMS) has been provided free of charge by the Chinese government as part of the national Essential Public Health Services (EPHS) policy. This study aimed to examine the disparity in the utilization of CBHMS between urban and rural community-dwelling middle-aged and older adults with hypertension. Methods Subjects were 3,479 community-residing hypertensive patients, identified from the China Health and Retirement Longitudinal Study (CHARLS), 2015, a nationally representative survey of Chinese residents aged 45 years and older. The utilization of CBHMS was defined as having one’s blood pressure (BP) examined at least once a season by community or village doctors. Rates of CBHMS use of urban and rural residents with hypertension were compared by using chi-square test. Multiple logistic regression analyses were conducted to examine factors associated with the utilization of CBHMS of hypertensive patients. Results CBHMS was significantly more likely to be used by rural than urban middle-aged and older residents with hypertension (38.6% vs. 25.1%, P < 0.001). Results from multiple logistic regression analyses showed that urban patients who were living in central (OR = 0.37) and western (OR = 0.48) regions (vs. eastern region), had an educational attainment of middle school (OR = 0.33) and college and above (OR = 0.48) (vs. illiterate), and were not taking antihypertensive agents (OR = 0.26) were less likely to use CBHMS, while rural patients who had no medical insurance (OR = 0.56), and were not taking antihypertensive agents (OR = 0.31) were less likely to use CBHMS. Conclusions The national CBHMS is more likely to be used by rural middle-aged and older adults with hypertension in China. The urban-rural difference in the utilization of CBHMS may be resulted from the different demographics of urban and rural middle-aged and older residents and uneven distributions of health services resources between urban and rural areas. Urban-rural disparities in characteristics of CBHMS use should be taken into consideration when promoting the utilization of CBHMS in China.

scholarly journals Factors Influencing the Stages of Frailty among Korean Older Adults Focusing on Objective and Subjective Social Isolation

2021 ◽  
Author(s):  
Song Yi Han ◽  
Hye Young Jang ◽  
Young Ko
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Social Isolation ◽  
Social Relationships ◽  
Regular Exercise ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Health Related

Abstract Background: Although many studies have investigated the factors influencing frailty, studies on factors affecting transition between frailty stages are insufficient. This study was conducted to identify factors influencing the stages of frailty in Korean older adults, focusing on objective and subjective social isolation. Methods: This study analyzed the data of 10,041 older adults from the 2017 National Survey of Older Koreans. Two multiple logistic regression analyses were performed to identify the factors influencing the frailty stages.Results: Among Korean older adults, 6% were in a frail stage, and 42.5% were in the pre-frail stage. The progression to the pre-frail stage was influenced by sociodemographic and health-related characteristics and by objective and subjective social isolation. Contrastingly, the transition from the pre-frail to frail stage was influenced by factors including objective social isolation, declining hearing, and lack of regular exercise.Conclusions: In the development of future interventions, researchers should consider differences in factors that influence the stages of frailty among Korean older adults. Interventions that help older people maintain existing social relationships or connect to new social networks can delay the transition from the pre-frail to frail stages.

scholarly journals Growth Mindset and Older Adults’ Well-Being During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 94-94
Author(s):  
Yena Kyeong ◽  
Pamela Sheffler ◽  
Esra Kürüm ◽  
Leah Ferguson ◽  
Elizabeth Davis ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Self Regulation ◽  
Well Being ◽  
Growth Mindset ◽  
Regression Analyses ◽  
Middle Aged ◽  
Older Adulthood ◽  
Gender Education ◽  
Middle Aged Adults

Abstract Growth mindset, the belief that abilities and attributes are improvable, may help buffer against older adults’ feelings of social isolation during the COVID-19 pandemic, as it may foster effective self-regulation and resilience. This study examined the effects of growth mindset on older adults’ well-being and adjustment, compared to younger and middle-aged adults. Participants self-reported on their growth mindset, depression, well-being, and daily habits amid the pandemic. For older adults (N = 178, 82% female, M age = 70.42, SD age = 6.50, range 60-90), regression analyses (controlling for gender, education, income, and age) revealed that growth mindset was associated with decreased depression (β = -.29, p = .001) and increased well-being (β = .38, p &lt; .001). In addition, a logistic regression showed that older adults with a higher growth mindset were more likely to adjust their daily tasks during the pandemic (e.g., using technology to remotely socialize; OR = 1.77, p = .012). The same set of analyses in samples of younger (N = 235, 72% female, M age = 29.84, SD age = 5.89, range 18-39) and middle-aged adults (N = 188, 74% female, M age = 50.02, SD age = 6.10, range 40-59) revealed that growth mindset was associated with decreased depression and increased well-being. However, in these groups, growth mindset did not predict the likelihood of adjusting daily tasks. Findings suggest that while growth mindset is linked to enhanced well-being during the pandemic, its effect on adjusting to new circumstances might be salient in older adulthood.

scholarly journals Prediction of 11-year incidence of psychophysically dependent status or death among community-dwelling younger elderlies: from an age-specified community-based cohort study (the NISSIN project)

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Satoe Okabayashi ◽  
Takashi Kawamura ◽  
Hisashi Noma ◽  
Kenji Wakai ◽  
Masahiko Ando ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cohort Study ◽  
Prediction Model ◽  
Nursing Care ◽  
Family Members ◽  
Limited Resource ◽  
Community Dwelling ◽  
Older Individuals ◽  
Regression Analyses

Abstract Background Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. Methods We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2005 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. Results Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714–0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699–0.771). Conclusions We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.

Abstract 395: State-Level CPR Education Legislation Associated With Higher Survival After Out-Of-Hospital Cardiac Arrest in Older Adults

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
David G Buckler ◽  
Megan Barnes ◽  
Tyler D Alexander ◽  
Marissa Lang ◽  
Alexis M Zebrowski ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cardiac Arrest ◽  
State Level ◽  
Categorical Variables ◽  
Multiple Logistic Regression ◽  
Education Legislation ◽  
Chi Squared ◽  
Patient State ◽  
Hospital Cardiac Arrest

Introduction: State-level legislation requiring CPR education prior to high school graduation (CPR Legislation) is associated with an increased likelihood of community-level CPR training. CPR Legislation has also been shown to be associated with increased bystander CPR. We hypothesized that states with recent CPR Legislation would be associated with higher survival in older adults following out-of-hospital cardiac arrest (OHCA). Methods: Utilizing 2014 Medicare Claims data for emergency department (ED) visits and inpatient stays, we identified OHCA via ICD-9-CM code. CPR Legislation data was collected through online statute review. Exposure to CPR Legislation was assessed using the patient state of residence reported on the first claim. Patient dispositions were coded as home, SNF, death/hospice, rehab or other. All categories were considered survival to discharge except for death/hospice. Associations between categorical variables were assessed by chi-squared test. Multiple logistic regression was used to calculate the odds ratio associated with OHCA survival and CPR Legislation, controlling for patient age and sex. Results: In 2014, 256,277 OHCAs were identified. Mean age was 79 ±8 y, 48% were female, 23% were non-white, and survival to discharge was 22%. Prior to 2013, 4 states had passed CPR Legislation and 6 others passed legislation in 2013. These states account for 12% of OCHA for the study year. States that passed CPR Legislation in 2013 had the highest survival compared to states with earlier passage or no CPR Legislation (22.2% vs 20.6% vs. 21.8%, respectively, p < 0.001). Among those who survived to discharge, more patients were discharged home from states with 2013 CPR Legislation, than earlier or no legislation (50.8% vs. 41.3% vs. 42.8%, p <0.001). Results of the multiple logistic regression showed CPR Legislation passed in 2013 was associated with a 12% increase in the odds of survival to discharge compared to states with CPR Legislation prior to 2013 (OR: 1.12, p <0.001). Conclusion: States with CPR Legislation passed in 2013 were associated with higher survival to discharge and discharge to home, compared to earlier adopters and states with no legislation. Further work is needed to assess the mechanisms underlying this relationship.

Asthma and Suicidal Ideation Among Youth in the Community

Crisis ◽  
2004 ◽  
Vol 25 (3) ◽  
pp. 99-102 ◽  
Author(s):  
Renee D. Goodwin ◽  
Andrej Marušič
Keyword(s):  
Mental Health ◽  
United States ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Community Based ◽  
Comorbid Mental Disorders

Summary: Objective: To determine the association between asthma and suicidal ideation among youth in the community. Method: Data were drawn from the MECA (n = 1285), a community-based study of youth aged 9-17 in the United States. Multiple logistic regression analyses were used to determine the association between asthma and suicidal ideation, adjusting for differences in sociodemographic characteristics and mental disorders. Results: Asthma was associated with a significantly increased likelihood of suicidal ideation (OR = 3.25 ‘1.04, 10.1’), compared to youth without asthma. Conclusions: These data suggest that youth who are hospitalized for asthma may have higher than expected levels of suicidal ideation, compared with youth without asthma in the community. This association appears to persist after controlling for the effects of comorbid mental disorders. These findings are consistent with previous clinical reports of an association between physical illness and suicidal ideation, as well as with links between asthma and suicidal ideation among adults. More in-depth evaluation of the mental health of youth hospitalized for asthma may be indicated if these results are replicated.

scholarly journals Elevated triglyceride-to-HDL cholesterol ratio is an indicator for insulin resistance in middle-aged and elderly Taiwanese population: a cross-sectional study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Wei-Chung Yeh ◽  
Yu-Chung Tsao ◽  
Wen-Cheng Li ◽  
I-Shiang Tzeng ◽  
Liang-Sien Chen ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Logistic Regression ◽  
Correlation Coefficient ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Multiple Logistic Regression ◽  
Clinical Prediction ◽  
Middle Aged ◽  
Pearson’S Correlation Coefficient ◽  
Pearson's Correlation

Abstract Background Previous studies have reported that the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio could be a simple clinical indicator of insulin resistance (IR), but the results indicated that there were heterogeneities between different ethnicities. We aimed to investigate the association between TG/HDL-C and IR (as measured by homeostasis model assessment of IR [HOMA-IR]), and establish a clinical prediction rule for IR in middle-aged and elderly Taiwanese. Methods A total of 398 subjects were recruited, and each subject completed a questionnaire that included personal and medical history data, and underwent anthropometric measurement and blood sampling. IR was defined as HOMA-IR index value ≥2.0. Chi-squared test, independent two-sample t-test, Pearson’s correlation coefficient, and multiple logistic regression were used to evaluate the association between IR and TG/HDL-C ratio. A receiver operating characteristic (ROC) analysis was conducted to evaluate the ability of the developed clinical prediction rule to correctly discriminate between subjects of IR positive and IR negative groups. Results A significant association between IR and TG/HDL-C ratio was identified with a Pearson’s correlation coefficient of 0.35 (p-value< 0.001). In multiple logistic regression, high BMI (OR = 1.23; 95% C.I. = 1.13–1.33), hypertension (OR = 1.90; 95% C.I. = 1.12–3.21), diabetes mellitus (OR = 5.44; 95% C.I. = 2.93–10.08) and high TG/HDL ratio (OR = 1.45; 95% C.I. = 1.23–1.72) were significantly associated with the risk of elevated HOMA-IR. The area under ROC curves for TG/HDL-C ratio was 0.729 and the optimal threshold value was 2.197 where the corresponding of sensitivity and specificity were 72.4 and 65.1%. Conclusions Our findings showed that the elevated TG/HDL-C ratio was significantly associated with IR and could be used as an indicator of IR among the middle-aged and elderly population in Taiwan. It is clinically available, thus eliminating any additional costs. Future research is warranted to investigate the use of TG/HDL-C ratio combined with other risk factors for predicting IR under diverse ethnic backgrounds.

Sleep Disturbance in Older Adults With or Without Mild Cognitive Impairment and Its Associated Factors Residing in Rural Area, China

2020 ◽  
pp. 089198872096424
Author(s):  
Li Qin Xie ◽  
Bing Xiang Yang ◽  
Yang Hui Liao ◽  
Gui Xian Gao ◽  
Na Jiang ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Sleep Disturbance ◽  
Rural Areas ◽  
Associated Factors ◽  
Multiple Logistic Regression ◽  
Affect Balance ◽  
Drinking Habits ◽  
Factors Influencing

Aims: To evaluate the prevalence of sleep disturbance in older adults with or without mild cognitive impairment (MCI) and associated factors among residents in rural central China. Methods: A cross-sectional survey was conducted in adults in rural areas of the Hunan province aged≥60 years. Study participants (N = 1213) included 479 individuals meeting the criteria for MCI and 734 with normal cognitive abilities. The participants completed the Athens Insomnia Scale, Stress Resilience Quotient Scale, Affect Balance Scale and Activities of Daily Living (ADL) Scale. Chi-square test, Wilcoxon rank sum analyses and multiple logistic regression were used in this study. Results: A total of 60.33% of participants with MCI demonstrated sleep disturbance (60.33%, 95% CI: 0.559-0.649), which was significantly higher than in the non-MCI group (43.73%, 95% CI: 0.759-0.838). Multiple logistic regression conducted separately in the populations of older adults with or without MCI showed that age, drinking habits, affect balance and activities of daily life were correlates of self-reported sleep disturbance in rural older adults with MCI ( B = −5.469), whereas age, ADL, living arrangement and resilience were the main influencing factors in older adults without MCI ( B = 2.991). Conclusion: Sleep disturbance is more common in older adults with MCI than without MCI in rural areas of China. The factors influencing sleep disturbances vary between older adults with or without MCI, with age and ADL representing common factors influencing sleep disturbance in both groups. Interventions focusing on the age, drinking habits, affect balance and ADL may improve sleep quality in MCI older adults.

scholarly journals Relationship between obesity indices and hypertension among middle-aged and elderly populations in Taiwan: a community-based, cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031660 ◽  
Author(s):  
Yen-An Lin ◽  
Ying-Jen Chen ◽  
Yu-Chung Tsao ◽  
Wei-Chung Yeh ◽  
Wen-Cheng Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Cross Sectional Study ◽  
Multiple Logistic Regression ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Elderly Populations ◽  
Obesity Indices ◽  
Northern Taiwan

ObjectiveObesity and hypertension (HTN) have become increasingly prevalent in Taiwan. People with obesity are more likely to have HTN. In this study, we evaluated several anthropometric measurements for the prediction of HTN in middle-aged and elderly populations in Taiwan.DesignCross-sectional observational study.SettingCommunity-based investigation in Guishan Township of northern Taiwan.ParticipantsA total of 396 people were recruited from a northern Taiwan community for a cross-sectional study. Anthropometrics and blood pressure were measured at the annual health exam. The obesity indices included body mass index (BMI), body fat (BF) percentage and waist circumference (WC).Outcome measuresStatistical analyses, including Pearson’s correlation, multiple logistic regression and the area under ROC curves (AUCs) between HTN and anthropometric measurements, were used in this study.ResultsOf the 396 people recruited, 200 had HTN. The age-adjusted Pearson’s coefficients of BMI, BF percentage and WC were 0.23 (p<0.001), 0.14 (p=0.01) and 0.26 (p<0.001), respectively. Multiple logistic regression of the HTN-related obesity indices showed that the ORs of BMI, BF percentage and WC were 1.15 (95% CI 1.08 to 1.23, p<0.001), 1.07 (95% CI 1.03 to 1.11, p<0.001) and 1.06 (95% CI 1.03 to 1.08, p<0.001), respectively. The AUCs of BMI, BF percentage and WC were 0.626 (95% CI 0.572 to 0.681, p<0.001), 0.556 (95% CI 0.500 to 0.613, p=0.052) and 0.640 (95% CI 0.586 to 0.694, p<0.001), respectively.ConclusionsWC is a more reliable predictor of HTN than BMI or BF percentage. The effect of abdominal fat distribution on blood pressure is greater than that of total BF amount.

scholarly journals Analysis of the Relationship between Asthma and Coffee/Green Tea/Soda Intake

2020 ◽  
Vol 17 (20) ◽  
pp. 7471
Author(s):  
Jee Hye Wee ◽  
Dae Myoung Yoo ◽  
Soo Hwan Byun ◽  
Chang Myeon Song ◽  
Hyo-Jeong Lee ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Confidence Intervals ◽  
Green Tea ◽  
Coffee Consumption ◽  
Protective Effects ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Epidemiology Study ◽  
Soda Consumption ◽  
The Relationship

This study aimed to evaluate the association between asthma and the intake of coffee/green tea/soda. We used Health Examinee data from the Korean Genome and Epidemiology Study (2004–2016). The participants (n = 3146 with asthma; n = 158,902 non-asthma) were asked about the frequency and amount of their coffee/green tea/soda intake. Multiple logistic regression analyses were used to calculate the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for asthma according to the frequency and amount of coffee/green tea/soda intake. Compared to the group consuming no coffee, the aORs for asthma were 0.82 (95% CI = 0.73–0.93, p = 0.002) in the group consuming coffee 1–2 times/day and 0.87 (95% CI = 0.78–0.97, p = 0.011) in the group consuming coffee in quantities of 1 cup, respectively. However, the frequency and amount of green tea and soda consumption were not significantly associated with asthma after adjusting for coffee consumption (all p > 0.05). These findings were consistent in the female subgroup (1–2 times/day: aOR = 0.76, 95% CI = 0.66–0.87, p < 0.001, and 1 cup each time: aOR = 0.79, 95% CI = 0.70–0.90, p < 0.001) but not in the male subgroup. Drinking 1 cup of coffee each time and 1–2 times per day may have protective effects against asthma in a Korean population. However, the associations between asthma and green tea/soda cannot be clearly established.

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