Clinical Status, Nutritional Behavior, and Lifestyle, and Determinants of Community Well-Being of Patients from the Perspective of Physicians: A Cross-Sectional Study of Young Older Adults, Nonagenarians, and Centenarians in Salerno and Province, Italy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Sampling
2.2. Data Collection Procedure
2.3. Data Collection Instrument
2.4. Statistical Analysis
3. Results
3.1. Sociodemographic Data of Physicians Who Participated in the Survey
3.2. Physician’s Assessment of the Clinical Status of the Young Older Adults and the Nonagenarians/Centenarians
3.3. Physician’s Assessment of Behavioral, Lifestyle, and Nutritional Factors of the Young Older Adults and the Nonagenarians/Centenarians
3.4. Physician’s Assessment of the Social and Community Determinants of the Young Older Adults and the Nonagenarians/Centenarians
3.5. Physician’s Assessment of the Organization of the Health Care System
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Model 1 | Younger Older Adults (Outcome) Log Likelihood= −8822.6, x2 = 2873.08 (15 df), p < 0.001 | Nonagenarians/Centenarians (Outcome) Log Likelihood= −7728.0, x2 = 3632.16 (16 df), p < 0.001 | ||||
Clinical Status Variables * | IRR | 95% CI | p | IRR | 95% CI | p |
Completely healthy | 1.28 | 1.24–1.31 | <0.001 | 0.90 | 0.84–0.97 | 0.009 |
Little limited ability | 0.98 | 0.96–0.99 | 0.024 | 1.31 | 1.25–1.37 | <0.001 |
Clearly marked by diseases | 0.96 | 0.94–0.98 | <0.001 | 1.22 | 1.17–1.27 | <0.001 |
Suffer a lot | 1.11 | 1.08–1.14 | <0.001 | 1.42 | 1.36–1.48 | <0.001 |
Cardiovascular diseases | 1.04 | 1.02–1.06 | <0.001 | 0.82 | 0.77–0.86 | <0.001 |
Respiratory diseases | 1.11 | 1.09–1.13 | <0.001 | 1.24 | 1.19–1.29 | <0.001 |
Blood diseases | 0.99 | 0.97–1.01 | 0.634 | 1.40 | 1.34–1.45 | <0.001 |
Rheumatic diseases | 1.06 | 1.05 - 1.08 | <0.001 | 1.20 | 1.15–1.25 | <0.001 |
Metabolic diseases | 0.93 | 0.91–0.95 | <0.001 | 1.15 | 1.10–1.19 | <0.001 |
Gastrointestinal diseases | 1.14 | 1.12–1.16 | <0.001 | 1.23 | 1.18–1.29 | <0.001 |
Neurological diseases | 1.11 | 1.09–1.13 | <0.001 | 1.87 | 1.77–1.98 | <0.001 |
Biliary diseases | 0.89 | 0.87 - 0.92 | <0.001 | 0.44 | 0.41–0.48 | <0.001 |
Oncological diseases | 1.01 | 0.99–1.02 | 0.136 | 1.09 | 1.03–1.14 | 0.001 |
Other diseases | 1.20 | 1.17–1.23 | <0.001 | 1.76 | 1.67–1.86 | <0.001 |
Comorbidities | 1.00 | 1.00–1.00 | <0.001 | 1.00 | 1.00–1.00 | <0.001 |
Model 2 | Log Likelihood = −3212.6, x2 = 611.68 (5 df), p < 0.001 | Log Likelihood = −2212.1, x2 = 396.84 (6 df), p < 0.001 | ||||
Asymptomatic | 1.00 | 1.00–1.00 | <0.001 | 0.99 | 0.99–1.00 | 0.286 |
Paucisymptomatic | 0.99 | 0.99–0.99 | <0.001 | 1.00 | 1.00–1.00 | <0.001 |
Symptomatic | 1.00 | 1.00–1.00 | 0.015 | 0.99 | 0.99–0.99 | <0.001 |
Symptomatic with severe disease | 0.99 | 0.99–0.99 | <0.001 | 1.01 | 1.01–1.02 | <0.001 |
Deaths | 1.01 | 1.01–1.01 | <0.001 | 0.99 | 0.98–0.99 | 0.009 |
Model 3 | Younger Older Adults (Outcome) Log Likelihood= −10343.7, x2 = 590.11 (7 df), p < 0.001 | Nonagenarians/Centenarians (Outcome) Log Likelihood= −7480.3, x2 = 2687.25 (11 df), p < 0.001 | ||||
Behavioral and Mental Health Variables * | IRR | 95% CI | p | IRR | 95% CI | p |
Use of drugs | 1.00 | 0.99–1.00 | 0.070 | 1.00 | 0.99–1.00 | 0.127 |
Tobacco | 1.00 | 1.00–1.00 | <0.001 | 0.99 | 0.99–1.00 | <0.001 |
Alcohol | 0.99 | 0.99–1.00 | 0.212 | 1.00 | 1.00–1.00 | 0.001 |
Alcohol addition | 1.00 | 1.00–1.00 | <0.001 | 1.06 | 1.05–1.07 | <0.001 |
Smoking addition | 1.00 | 1.00–1.00 | 0.780 | 0.99 | 0.99–0.99 | <0.001 |
Psychosomatic problems | 1.00 | 1.00–1.00 | <0.001 | 0.99 | 0.99–0.99 | <0.001 |
Depression | 0.99 | 0.99–1.00 | 0.458 | 1.01 | 1.01–1.01 | <0.001 |
Nonagenarians/centenarians grateful for a long life | ||||||
- Undecided | 1 a | 1 a | 1 a | |||
- No | 1.66 | 1.58–1.75 | <0.001 | |||
- Yes | 0.97 | 0.91–1.04 | 0.468 | |||
Nonagenarians/centenarians suffered the burden of not dying | ||||||
- Undecided | - | - | - | 1 a | 1 a | 1 a |
- No | 1.06 | 1.01–1.11 | 0.006 | |||
- Yes | 0.57 | 0.53–0.61 | <0.001 | |||
Model 4 | Importance of Nutrition in YOA (Outcome) Log Likelihood= −8822.6, x2 =2873.08 (15 df), p < 0.001 | Importance of Nutrition in N/C (Outcome) Log Likelihood= −7728.0, x2 =3632.16 (16 df), p < 0.001 | ||||
Nutritional Variables * | OR | 95% CI | p | OR | 95% CI | p |
Variety and freshness of foods | 0.08 | 0.06–0.12 | <0.001 | 0.37 | 0.27–0.50 | <0.001 |
Consumptions of ready to eat meals | 3.06 | 2.18–4.28 | <0.001 | 0.94 | 0.70–1.28 | 0.72 |
Bottled water | 1.67 | 1.15–2.41 | 0.006 | 6.63 | 4.27–10.30 | <0.001 |
Tap water | 1.42 | 0.97–2.07 | 0.06 | 0.40 | 0.27–0.62 | <0.001 |
Meat consumption | 1.79 | 1.19 -2.68 | 0.004 | 0.94 | 0.63–1.38 | 0.75 |
Fish consumption | 0.09 | 0.04–0.17 | <0.001 | 1.44 | 0.90–2.31 | 0.12 |
Specific diets | 0.62 | 0.31–1.21 | 0.16 | 1.00 | 1.00–1.01 | 0.03 |
Overweight | 1.01 | 1.01–1.02 | <0.001 | 1.01 | 1.00–1.02 | 0.008 |
Model 5 | Young Older Adults (Outcome) Log Likelihood= −6680.1, x2 =1059.75 (12 df), p < 0.001 | Nonagenarians/Centenarians (Outcome) Log Likelihood= −6778.0, x2 =756.26 (11 df), p < 0.001 | ||||
---|---|---|---|---|---|---|
Social and Community Gradient Variables * | IRR | 95% CI | p | IRR | 95% CI | p |
Living with family member | 1.00 | 0.99–1.00 | 0.610 | 0.99 | 0.99–0.99 | <0.001 |
Living alone with family support | 0.99 | 0.99–0.99 | <0.001 | 1.00 | 0.99–1.00 | 0.160 |
Living alone with third-party support (neighbors, caregivers) | 1.00 | 1.00–1.00 | <0.001 | 0.99 | 0.99–0.99 | <0.001 |
Living in nursing homes or shared apartments | 1.00 | 0.99–1.00 | 0.971 | 1.00 | 1.00–1.00 | <0.001 |
Continuing in professional positions | 0.93 | 0.87–0.99 | 0.042 | 0.59 | 0.51–0.68 | <0.001 |
Honorary achievement | 0.93 | 0.91–0.95 | <0.001 | 0.75 | 0.71–0.79 | <0.001 |
Physical activities (gardening, yoga, sports, etc.) | 1.48 | 1.42–1.54 | <0.001 | 0.69 | 0.60–0.78 | <0.001 |
Cultural activities | 0.66 | 0.59–0.72 | <0.001 | 0.59 | 0.53–0.66 | <0.001 |
Social life | 1.21 | 1.11–1.31 | <0.001 | 0.32 | 0.27–0.40 | <0.001 |
Parish activities | 0.82 | 0.79–0.84 | <0.001 | 1.28 | 1.20–1.36 | <0.001 |
Bar meetings | 1.04 | 1.02–1.07 | <0.001 | 1.40 | 1.32–1.50 | <0.001 |
Association activities | 0.92 | 0.87–0.96 | 0.001 | 1.14 | 1.03–1.27 | 0.009 |
Model 6 | Male and Female Physicians (Outcome) | ||
---|---|---|---|
Structural Variables of Health * | OR | 95% CI | p |
Hospital equipment | |||
good | 1 a | ||
so-so | 1.63 | 1.09–2.43 | 0.015 |
poor | 2.49 | 1.50–4.14 | <0.001 |
Cooperations between institutions | |||
good | 1 a | ||
so-so | 0.25 | 0.13–0.47 | <0.001 |
poor | 0.05 | 0.02—0.11 | <0.001 |
Public health information | |||
good | 1 a | ||
so-so | 1.09 | 0.69–1.71 | 0.701 |
poor | 1.04 | 0.60–1.79 | 0.888 |
Cooperation between clinics and primary care physicians | |||
good | 1 a | ||
so-so | 5.45 | 2.93–10.16 | <0.001 |
poor | 25.76 | 12.32–53.84 | <0.001 |
Cooperations between clinics and rehabilitation facilities | |||
good | 1 a | ||
so-so | 0.58 | 0.34–0.97 | 0.041 |
poor | 0.37 | 0.19–0.72 | 0.004 |
Cooperations between hospitals and specialty clinics | |||
good | 1 a | ||
so-so | 0.44 | 0.25–0.77 | 0.004 |
poor | 0.58 | 0.29–1.15 | 0.124 |
Self-help group | |||
good | 1 a | ||
so-so | 1.21 | 0.64–2.26 | 0.544 |
poor | 0.90 | 0.46–1.76 | 0.773 |
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Aliberti, S.M.; Funk, R.H.W.; Schiavo, L.; Giudice, A.; Ciaglia, E.; Puca, A.A.; Gonnella, J.; Capunzo, M. Clinical Status, Nutritional Behavior, and Lifestyle, and Determinants of Community Well-Being of Patients from the Perspective of Physicians: A Cross-Sectional Study of Young Older Adults, Nonagenarians, and Centenarians in Salerno and Province, Italy. Nutrients 2022, 14, 3665. https://doi.org/10.3390/nu14173665
Aliberti SM, Funk RHW, Schiavo L, Giudice A, Ciaglia E, Puca AA, Gonnella J, Capunzo M. Clinical Status, Nutritional Behavior, and Lifestyle, and Determinants of Community Well-Being of Patients from the Perspective of Physicians: A Cross-Sectional Study of Young Older Adults, Nonagenarians, and Centenarians in Salerno and Province, Italy. Nutrients. 2022; 14(17):3665. https://doi.org/10.3390/nu14173665
Chicago/Turabian StyleAliberti, Silvana Mirella, Richard H. W. Funk, Luigi Schiavo, Aldo Giudice, Elena Ciaglia, Annibale Alessandro Puca, Joseph Gonnella, and Mario Capunzo. 2022. "Clinical Status, Nutritional Behavior, and Lifestyle, and Determinants of Community Well-Being of Patients from the Perspective of Physicians: A Cross-Sectional Study of Young Older Adults, Nonagenarians, and Centenarians in Salerno and Province, Italy" Nutrients 14, no. 17: 3665. https://doi.org/10.3390/nu14173665
APA StyleAliberti, S. M., Funk, R. H. W., Schiavo, L., Giudice, A., Ciaglia, E., Puca, A. A., Gonnella, J., & Capunzo, M. (2022). Clinical Status, Nutritional Behavior, and Lifestyle, and Determinants of Community Well-Being of Patients from the Perspective of Physicians: A Cross-Sectional Study of Young Older Adults, Nonagenarians, and Centenarians in Salerno and Province, Italy. Nutrients, 14(17), 3665. https://doi.org/10.3390/nu14173665