Topical Collection "Health Care and Services for Elderly Population"

A topical collection in Healthcare (ISSN 2227-9032). This collection belongs to the section "Nursing".

Editor

Dr. Hideki Nakano
E-Mail Website
Collection Editor
Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
Interests: neurorehabilitation; neural plasticity; electroencephalography; neuromodulation; neurofeedback; motor learning; motor control; stroke; aging
Special Issues, Collections and Topics in MDPI journals

Topical Collection Information

Dear Colleagues,

Extension of healthy life expectancy of the elderly is an important issue worldwide. According to the World Health Organization, healthy life expectancy is defined as the average number of years that a person can expect to live in “full health”, while also considering the years they may live in less than full health due to disease and/or injury. The difference between healthy life expectancy and average life expectancy is the interval during which an individual experiences an unhealthy state that limits daily life; increasing this difference will increase the period of required spending on medical expenses and care costs. Therefore, if the difference between the average life expectancy and healthy life expectancy can be lessened by disease prevention, health promotion, and preventative care for the elderly, it is expected that the quality of life of the elderly will be improved and the social security burden will be reduced. This Special Issue features a wide range of research papers on care and services for extending the healthy life expectancy of the elderly.

Dr. Hideki Nakano
Collection Editor

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Keywords

  • Elderly
  • Health care and services
  • Healthy life expectancy
  • Aging brain care

Published Papers (46 papers)

2021

Jump to: 2020

Article
The Association between Social Support and Cognitive Impairment among the Urban Elderly in Jinan, China
by , and
Healthcare 2021, 9(11), 1443; https://doi.org/10.3390/healthcare9111443 - 26 Oct 2021
Viewed by 106
Abstract
China is currently facing a severe challenge of population ageing. However, no study has specifically explored the association between social support and cognitive impairment in Chinese urban elderly aged 60 and older. We explored the prevalence of cognitive impairment and its relationship with [...] Read more.
China is currently facing a severe challenge of population ageing. However, no study has specifically explored the association between social support and cognitive impairment in Chinese urban elderly aged 60 and older. We explored the prevalence of cognitive impairment and its relationship with social support among the urban elderly aged above 60 years in Jinan, China. A total of 522 urban elderly individuals were recruited using multi-stage cluster random sampling, of which 35.55% were males and 64.45% were females. The average age of all participants was 69.66 ± 8.91 years old. Social support was assessed using the Social Support Rating Scale. Cognitive status was assessed using the Mini-Mental State Examination. Data were collected through face-to-face interviews using structured questionnaires. Descriptive analysis, chi-square tests, and logistic regression analyses were conducted. After analysing the data from 512 participants, 154 (30.1%), 352 (68.8%), and 6 (1.2%) participants had high, moderate, and low levels of social support, respectively. In addition, 125 participants (24.4%) had a cognitive impairment, while the other 387 participants (75.6%) had a normal cognitive status. Binary logistic regression analyses showed that age, educational level, occupation or pre-retirement occupation, and social support were statistically associated with cognitive impairment. A significant association between social support and cognitive impairment was found among the urban elderly in Jinan, China, which provided useful information for the intervention of cognitive impairment. More attention should be paid to the social support of the urban elderly to effectively reduce the occurrence of cognitive impairment. Full article
Article
The Effects of Social Support and Morbidities on Self-Rated Health among Migrant Elderly Following Children to Jinan, China
Healthcare 2021, 9(6), 686; https://doi.org/10.3390/healthcare9060686 - 07 Jun 2021
Viewed by 575
Abstract
Social support has been demonstrated to be associated with the health status of old adults, but no study has clarified the relationship between social support, morbidities and self-rated health among the migrant elderly following children (MEFC) to new cities. This study aimed to [...] Read more.
Social support has been demonstrated to be associated with the health status of old adults, but no study has clarified the relationship between social support, morbidities and self-rated health among the migrant elderly following children (MEFC) to new cities. This study aimed to explore the effect of social support and morbidities on self-rated health among MEFC to Jinan, China. A total of 656 MEFC were included in this study by using multi-stage cluster random sampling. Social support was measured by the Social Support Rating Scale. Correlation analysis and multivariable logistic regression analysis were employed to clarify the association between social support, morbidities and self-rated health among the MEFC. Approximately 75.9% of the MEFC rated their health as good. Logistic regression analysis showed that MEFC who lived with family were more likely to have a higher level of self-rated health. In addition to social support, body mass index (BMI), monthly income, one-year living style, the presence of an elevator, heart disease, stroke, duration of chronic disease, and outpatient service attendance were also associated with the self-rated health of MEFC. Social support and morbidities were significantly associated with self-rated health among MEFC. Targeted policies should be made to improve social support status and lower the morbidities in MEFC. Full article
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Article
Impact of Selected Geriatric Syndromes on the Quality of Life in the Population Aged 60 and Older
Healthcare 2021, 9(6), 657; https://doi.org/10.3390/healthcare9060657 - 31 May 2021
Cited by 1 | Viewed by 596
Abstract
Background: Geriatric syndromes represent a critical domain in the population more than 60 years old. Basic syndromes include frailty, sarcopenia, loss of body mass, and a mild cognitive disorder. These are significant problems which can affect the quality of life. In our study, [...] Read more.
Background: Geriatric syndromes represent a critical domain in the population more than 60 years old. Basic syndromes include frailty, sarcopenia, loss of body mass, and a mild cognitive disorder. These are significant problems which can affect the quality of life. In our study, the Rapid Geriatric Assessment (RGA) tool was used to assess the geriatric syndromes, and the WHOQOL-BREF was used to assess the quality of life to survey 498 respondents from a population aged 60 and older. In all the assessments, the distribution of variables was tested, a nonnormal distribution of variables was identified, and subsequently, nonparametric tests were performed to identify the differences between groups. The study showed that the domain of physical health and the psychological domain were most affected. The results have shown that individual geriatric syndromes affect certain domains of the quality of life of the population above 60 with various intensity. Full article
Article
The Reciprocal Relationship between Frailty and Depressive Symptoms among Older Adults in Rural China: A Cross-Lag Analysis
Healthcare 2021, 9(5), 593; https://doi.org/10.3390/healthcare9050593 - 17 May 2021
Cited by 1 | Viewed by 454
Abstract
(1) Objective: This study aimed to investigate the reciprocal relationship between frailty and depressive symptoms using longitudinal data among older adults in China. (2) Methods: Data derived from 2014 and 2017 waves of a longitudinal study of 1367 older adults aged 70–84 years, [...] Read more.
(1) Objective: This study aimed to investigate the reciprocal relationship between frailty and depressive symptoms using longitudinal data among older adults in China. (2) Methods: Data derived from 2014 and 2017 waves of a longitudinal study of 1367 older adults aged 70–84 years, living in rural areas of Jiangsu Province, China. Cross-lagged panel model and a multiple group model were used to examine the temporal effect of frailty on depressive symptoms and vice versa. (3) Results: Frailty was associated with subsequent increase in depressive symptoms, such that participants with higher levels of frailty increase the risks of depressive symptoms (b = 0.090, p < 0.01). Depressive symptoms were significant predictors of increased frailty (b = −0.262, p <0.001). However, older men and older women had no significant differences in the reciprocal relationship between frailty and depressive symptoms. (4) Conclusions: In conclusion, we find a significant bi-directional relationship between frailty and depressive symptoms. This finding confirms the dyadic model of frailty and depression. Implications for interventions and policy to help frail and depressive older adults are discussed. Full article
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Article
Development of the Active Ageing Awareness Questionnaire in Malaysia
Healthcare 2021, 9(5), 499; https://doi.org/10.3390/healthcare9050499 - 22 Apr 2021
Viewed by 609
Abstract
The world’s ageing population is associated with increased morbidity, disability, and social and financial insecurity, which may affect quality of life (QoL). Therefore, the World Health Organization (WHO) endorsed the Active Ageing Framework (AAF) in 2002 to enhance QoL as people age. However, [...] Read more.
The world’s ageing population is associated with increased morbidity, disability, and social and financial insecurity, which may affect quality of life (QoL). Therefore, the World Health Organization (WHO) endorsed the Active Ageing Framework (AAF) in 2002 to enhance QoL as people age. However, little is known about the status of awareness of active ageing among the population, and there is no appropriate tool for assessment. Hence, the Awareness of Active Ageing Questionnaire (AAAQ) was developed. The content, linguistic and face validations together with test-retest reliability were conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test the structural validity of the AAAQ. A total of 110 participants (mean ± SD = 50.19 ± 5.52) were selected for the pilot, 81 participants (mean ± SD = 49.40 ± 5.70) for the test-retest, and 404 participants (mean ± SD = 49.90 ± 5.80) for CFA and EFA tests. The 16-item AAAQ Malay version showed satisfactory reliability and validity. The Cronbach’s alpha was more than 0.7 and showed good fit: Cmin/df = 2.771, GFI = 0.903, TLI = 0.951, RMSEA = 0.08. The AAAQ is suitable for measuring the awareness of active ageing among the middle-aged population in Malaysia. Full article
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Article
Low Grip Strength and Muscle Mass Increase the Prevalence of Osteopenia and Osteoporosis in Elderly Women
Healthcare 2021, 9(4), 476; https://doi.org/10.3390/healthcare9040476 - 16 Apr 2021
Cited by 2 | Viewed by 605
Abstract
The risk of developing low muscle strength and muscle mass is affected by aging, osteopenia, and osteoporosis and increases with age. The purpose of this study was to investigate the prevalence and cutoff values for osteoporosis and osteopenia according to the level of [...] Read more.
The risk of developing low muscle strength and muscle mass is affected by aging, osteopenia, and osteoporosis and increases with age. The purpose of this study was to investigate the prevalence and cutoff values for osteoporosis and osteopenia according to the level of grip strength and muscle mass associated with sarcopenia. A cross-sectional study was conducted, and data from 734 women aged from 60 to 79 years old who visited the healthcare center from 2016 to 2019 were analyzed. Bone mineral density was measured on the lumbar spine from 1–4 using dual X-ray absorptiometry. Osteopenia and osteoporosis were classified on the basis of a T-score ranging from −1.0 to −2.4 and under −2.5, respectively. The diagnostic criteria for sarcopenia were a grip strength of <18 kg and muscle mass of <5.7 kg/m2 according to the Asian Working Group of Sarcopenia. Logistic regression analysis was used to determine the odds ratio, and the receiver operating characteristic curve was applied for the cutoff values. There were 351 (47.8%) patients with osteopenia and 152 (20.7%) patients with osteoporosis. The prevalence of osteopenia increased 1.593 times in the lowest grip strength group and 1.810 times in the lowest muscle mass group (p < 0.05). For osteoporosis, the lowest grip strength increased 2.512 times and the lowest muscle mass increased 2.875 times, compared to the highest grip strength group. In the sarcopenia group, osteopenia increased 2.451 times and osteoporosis increased 3.137 times, compared to the non-sarcopenia group (p < 0.05). In conclusion, the prevalence of osteoporosis and osteopenia was increased in elderly women with low grip strength and muscle mass. Full article
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Article
Factors Associated with Frailty According to Gender of Older Adults Living Alone
Healthcare 2021, 9(4), 475; https://doi.org/10.3390/healthcare9040475 - 16 Apr 2021
Viewed by 624
Abstract
This study was conducted to identify the factors associated with frailty according to gender of older adults living alone in Korea. Data from the National Survey of the Living Conditions of Korean Elderly in 2017 were used. Participants were 2340 older adults who [...] Read more.
This study was conducted to identify the factors associated with frailty according to gender of older adults living alone in Korea. Data from the National Survey of the Living Conditions of Korean Elderly in 2017 were used. Participants were 2340 older adults who live alone. Frailty was determined based on the frailty criteria developed by van Kan et al. that consist of fatigue, resistance, ambulation, and illness. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, Jonckheere–Terpstra test and multinomial logistic regression. Among the older men living alone, 47.7% were in the pre-frail and 5.1% were in the frail. On the other hand, 51.8% were in the pre-frail and 12.2% were in the frail among the older women living alone. The factors associated with frailty according to gender are as follows. In males, depressive symptoms, limitation in IADL, and number of medications in pre-frail; BMI, limitation in IADL, and number of chronic diseases in frail. In females, depressive symptoms, number of chronic diseases, age, and nutritional status in pre-frail; limitation in IADL, depressive symptoms, age, number of chronic diseases, number of medications, nutritional status in frail. Based on the findings of this study, it is considered necessary to approach frailty management considering gender as well as the classification of frailty. Full article
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Article
The Implementation of a Clinical Ladder in Rural Japanese Nursing Education: Effectiveness and Challenges
Healthcare 2021, 9(4), 469; https://doi.org/10.3390/healthcare9040469 - 15 Apr 2021
Viewed by 549
Abstract
The clinical ladder is an essential tool for nursing education, enabling nurses to ascend from novice to expert. The learning content for nurses can depend on their clinical situations. The aging of societies has changed the demand for nurses at community hospitals because [...] Read more.
The clinical ladder is an essential tool for nursing education, enabling nurses to ascend from novice to expert. The learning content for nurses can depend on their clinical situations. The aging of societies has changed the demand for nurses at community hospitals because of the multimorbidity of older patients. At the same time, the gap in nursing education between urban and rural hospitals is wide, as rural hospitals often lack the application of the clinical ladder. This study investigates the effectiveness of using the clinical ladder in a rural Japanese community hospital using the clinical ladder scale and interviews. Through its application, we found that both novice nurses and nursing educators came to recognize the effectiveness and importance of the ladder. However, unfamiliarity with assessments, working conditions, and Japanese culture inhibited the smooth application of the ladder. For the effective application of the clinical ladder, continual training on assessments and the ladder’s effectiveness in clinical situations, along with consideration of educational background, should be enhanced through the monitoring of the clinical ladder. Full article
Article
The Beneficial Effects of Cognitive Walking Program on Improving Cognitive Function and Physical Fitness in Older Adults
Healthcare 2021, 9(4), 419; https://doi.org/10.3390/healthcare9040419 - 05 Apr 2021
Viewed by 681
Abstract
Exercise and cognitive training can improve the brain-related health of the elderly. We investigated the effects of a cognitive walking program (CWP) involving simultaneous performance of indoor walking and cognitive training on cognitive function and physical fitness compared to normal walking (NW) outdoors. [...] Read more.
Exercise and cognitive training can improve the brain-related health of the elderly. We investigated the effects of a cognitive walking program (CWP) involving simultaneous performance of indoor walking and cognitive training on cognitive function and physical fitness compared to normal walking (NW) outdoors. Participants were grouped according to whether they performed regular exercise for at least 3 months prior to the participation in this study. Active participants were assigned to the CWP-active group (CWPAG). Sedentary participants were randomly assigned to the CWP (CWPSG) or NW group (NWSG). CWP and NW were performed for 60 min, 3 times a week, for 6 months. Cognitive function (attention, visuospatial function, memory, and frontal/executive function) and physical fitness (cardiorespiratory fitness, lower extremity muscular strength, and active balance ability) were measured at baseline, 3 months, and 6 months after the program onset. Cognitive function showed improvements over time in all three groups, especially in CWPAG. No clear difference was observed between CWPSG and NWSG. Improvements in all fitness measures were also observed in all three groups. These findings collectively indicate the beneficial effects of CWP, as well as NW, on improving cognitive function and physical fitness in older adults, especially those who are physically active. Full article
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Article
Nurses Working in Nursing Homes: A Mediation Model for Work Engagement Based on Job Demands-Resources Theory
Healthcare 2021, 9(3), 316; https://doi.org/10.3390/healthcare9030316 - 12 Mar 2021
Cited by 1 | Viewed by 765
Abstract
This study examined the impact that the attractiveness of working in nursing homes and autonomous clinical judgment have on affective occupational commitment, and whether work engagement mediates these relationships. This analysis was based on the job demands-resources theory. The study setting was 1200 [...] Read more.
This study examined the impact that the attractiveness of working in nursing homes and autonomous clinical judgment have on affective occupational commitment, and whether work engagement mediates these relationships. This analysis was based on the job demands-resources theory. The study setting was 1200 nursing homes (including long-term care welfare facilities and long-term care health facilities) in eastern Japan. An anonymous, self-report questionnaire survey was administered to two nurses from each facility, resulting in a prospective sample of 2400 participants. Overall, 552 questionnaires were analyzed, in which structural equation modeling and mediation analysis using the bootstrap method were performed. The results showed that the attractiveness of working in nursing homes does not directly affect affective occupational commitment; work engagement fully mediates the impact of attractiveness of working in nursing homes on affective occupational commitment. Additionally, autonomous clinical judgment showed a direct impact on both work engagement and affective occupational commitment, indicating that work engagement partially mediates the impact on affective occupational commitment. To increase the affective occupational commitment of nurses working in nursing homes, managers should help nurses recognize the attractiveness of working in nursing homes, and then provide appropriate support to help such nurses work in a motivated manner. Full article
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Article
Design of Occupational Therapy Interventions for Middle-Aged and Elderly Family Caregivers
Healthcare 2021, 9(3), 275; https://doi.org/10.3390/healthcare9030275 - 03 Mar 2021
Viewed by 483
Abstract
This study aimed to develop an interactive app for occupational therapy interventions for middle-aged and elderly family caregivers by integrating life review and narrative therapy. The results indicated that the interventions improved the mood of individuals, but the improvement in the quality of [...] Read more.
This study aimed to develop an interactive app for occupational therapy interventions for middle-aged and elderly family caregivers by integrating life review and narrative therapy. The results indicated that the interventions improved the mood of individuals, but the improvement in the quality of life was less significant due to the multiple facets of life. The interface design of the interactive app had good operating characteristics and was above average in terms of learnability and usability. Overall, the intervention program positively improved participants’ psychological aspect, which was in line with the purpose of the life review. Thus, a focus group put forward specific suggestions on the contextual construction of life review, the intelligent development of guiding questions, scenario simulation, and the introduction of creative collaboration functions, which could be used as a reference for subsequent content adjustment and interface design. Full article
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Article
Health, Psycho-Social Factors, and Ageism in Older Adults in Spain during the COVID-19 Pandemic
Healthcare 2021, 9(3), 256; https://doi.org/10.3390/healthcare9030256 - 01 Mar 2021
Viewed by 682
Abstract
Older adults are a population at risk for COVID-19. This study has two independent objectives: (1) to report the impact of COVID-19, as well as psycho-social responses during lockdown, in a sample of older adults in Spain, and (2) to explore through the [...] Read more.
Older adults are a population at risk for COVID-19. This study has two independent objectives: (1) to report the impact of COVID-19, as well as psycho-social responses during lockdown, in a sample of older adults in Spain, and (2) to explore through the review of published surveys what extent ageism has increased at the population level. The first objective was to search through an online questionnaire collecting information about self-reported health, lifestyles, psycho-social conditions, and a diversity of concerns. This questionnaire was administered to a volunteer sample of 315 older Spanish men and women (301 COVID-19-free and 14 diagnosed with COVID-19). All individuals reported that they had information about the COVID-19 pandemic. Their self-perception of health was also quite good, most maintaining healthy lifestyles and few reporting unhealthy behaviors. They reported few changes in family and interpersonal relations during lockdown. Those diagnosed with COVID-19 reported higher levels of anxiety, irritation, and fear, in comparison with the COVID-19-free group. Interestingly, instead of being concerned about health, the greatest concern in both groups (COVID-free and those diagnosed with COVID) were politics and the future. Our second objective, to explore ageism during the first wave of the COVID-19 pandemic, was examined across various surveys conducted in several populations by several authors. Results showed an increase in ageism in Spain. Although some new information about health perception, psychosocial responses, and concerns during this unknown stressful situation was obtained, much more research with representative samples is required in order to arrive at more accurate conclusions. Full article
Article
Relationship between Active Aging and Quality of Life in Middle-Aged and Older Koreans: Analysis of the 2013–2018 KNHANES
Healthcare 2021, 9(2), 240; https://doi.org/10.3390/healthcare9020240 - 23 Feb 2021
Cited by 1 | Viewed by 705
Abstract
With the increase in the aging population worldwide, social interest in having a vibrant and valuable old age has been increasing with changes in the perspectives on old age. This study aimed to determine the relationship between active aging and health-related quality of [...] Read more.
With the increase in the aging population worldwide, social interest in having a vibrant and valuable old age has been increasing with changes in the perspectives on old age. This study aimed to determine the relationship between active aging and health-related quality of life (HRQOL) in middle-aged and older Korean using national data. The subjects were 14,117 adults aged ≥55 years. HRQOL was evaluated using the EuroQol–5 Dimension (EQ-5D) questionnaire, and active aging was defined based on the health factors, participation factors, and security factors. The average EQ-5D score was 91.04 ± 0.143. Hierarchical multiple regression analysis sequentially inputting the health, participation, and security factors showed that health factors had the strongest influence on HRQOL (F = 216.656, p < 0.001). In the final model, which included all variables, activity limit (B = −10.477, p < 0.001) and subjective health status (B = −7.282, p < 0.001) were closely related to the HRQOL. In addition, economic activity, income level, home ownership, private health insurance, and unmet healthcare needs were associated with HRQOL. The R2 of the model was 38.2%. To improve the HRQOL of middle-aged and older people, it is necessary to consider active aging factors. Furthermore, follow-up studies using various indicators reflecting active aging should be conducted. Full article
Article
Impact of Economic Accessibility on Realized Utilization of Home-Based Healthcare Services for the Older Adults in China
Healthcare 2021, 9(2), 218; https://doi.org/10.3390/healthcare9020218 - 17 Feb 2021
Viewed by 610
Abstract
Home-based healthcare service has gradually become the most important model to cope with aging in China. However, the contradiction between oversupply and insufficient demand of healthcare services is becoming increasingly serious. How to effectively improve the realized utilization of healthcare resources has become [...] Read more.
Home-based healthcare service has gradually become the most important model to cope with aging in China. However, the contradiction between oversupply and insufficient demand of healthcare services is becoming increasingly serious. How to effectively improve the realized utilization of healthcare resources has become a key issue in the development of healthcare services. Based on the social background of “getting old before getting rich”, this article explores the relationship between economic accessibility and realized utilization, and finds that the impact of economic accessibility on realized utilization is inverted U-shaped, not a linear positive effect. In addition, considering the moderating role of family support, it is found that family support can strengthen the inverted U-shaped effect of economic accessibility on realized utilization. Therefore, exerting the role of family and improving economic accessibility can effectively solve the dilemma of low utilization of healthcare services. Full article
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Article
Stereoscopic Depth Perception and Visuospatial Dysfunction in Alzheimer’s Disease
Healthcare 2021, 9(2), 157; https://doi.org/10.3390/healthcare9020157 - 03 Feb 2021
Cited by 1 | Viewed by 700
Abstract
With visuospatial dysfunction emerging as a potential marker that can detect Alzheimer’s disease (AD) even in its earliest stages and with disturbance in stereopsis suspected to be the prime contributor to visuospatial deficits in AD, we assessed stereoscopic abilities of patients with AD [...] Read more.
With visuospatial dysfunction emerging as a potential marker that can detect Alzheimer’s disease (AD) even in its earliest stages and with disturbance in stereopsis suspected to be the prime contributor to visuospatial deficits in AD, we assessed stereoscopic abilities of patients with AD and mild cognitive impairment (MCI). Whereas previous research assessing patients’ stereoacuity has yielded mixed results, we assessed patients’ capacity to process coarse disparities that can convey adequate depth information about objects in the environment. We produced two virtual cubes at two different distances from the observer by manipulating disparity type (absolute vs. relative), disparity direction (crossed vs. uncrossed) and disparity magnitude, then had participants judge the object that appeared closer to them. Two patient groups performed as well as, or even better than elderly controls, suggesting that AD patients’ coarse disparity processing capacity is capable of supporting common tasks involving reaching, grasping, driving, and navigation. Results may help researchers narrow down the exact cause(s) of visuospatial deficits in AD and develop and validate measures to assess visuospatial dysfunction in clinical trials and disease diagnosis. Full article
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Article
Age-Related Changes in the Response of Finger Skin Blood Flow during a Braille Character Discrimination Task
Healthcare 2021, 9(2), 143; https://doi.org/10.3390/healthcare9020143 - 01 Feb 2021
Viewed by 672
Abstract
We hypothesized that age-related changes in sensory function might be reflected by a modulation of the blood flow response associated with tactile sensation. The aim of the present study was to clarify how the blood flow response of the fingers during concentrated finger [...] Read more.
We hypothesized that age-related changes in sensory function might be reflected by a modulation of the blood flow response associated with tactile sensation. The aim of the present study was to clarify how the blood flow response of the fingers during concentrated finger perception is affected by aging. We measured the tactile-pressure threshold of the distal palmar pad of the index finger and skin blood flow in the finger (SBF) during Braille reading performed under blind conditions in young (n = 27) and older (n = 37) subjects. As a result, the tactile-pressure threshold was higher in older subjects (2.99 ± 0.37 log10 0.1 mg) than in young subjects (2.76 ± 0.24 log10 0.1 mg) (p < 0.01). On the other hand, the SBF response was markedly smaller in older subjects (−4.9 ± 7.0%) than in young subjects (−25.8 ± 15.4%) (p < 0.01). Moreover, the peak response arrival times to Braille reading in older and young subjects were 12.5 ± 3.1 s and 8.8 ± 3.6 s, respectively (p < 0.01). A decline in tactile sensitivity occurs with aging. Blood flow responses associated with tactile sensation are also affected by aging, as represented by a decrease in blood flow and a delay in the reaction time. Full article
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Article
Work, Leisure Time Activities, and Mental Health among Family Caregivers of the Elder People in Japan
Healthcare 2021, 9(2), 129; https://doi.org/10.3390/healthcare9020129 - 28 Jan 2021
Viewed by 558
Abstract
In Japan, there is a high incidence of family members caring for their elderly. To facilitate this, caregivers often quit their jobs, work reduced hours, and forfeit leisure activities. This study examined the relationship between the mental health of the caregivers and the [...] Read more.
In Japan, there is a high incidence of family members caring for their elderly. To facilitate this, caregivers often quit their jobs, work reduced hours, and forfeit leisure activities. This study examined the relationship between the mental health of the caregivers and the sacrifices and adjustments they make to care for the elderly. A cross-sectional survey was conducted with responses from 171 caregivers. Referencing Pearlin’s stress process model, the relationship among five types of work change, four types of leisure activity quitting, caregivers’ subjective care burden, and depression were analyzed using t-test and multiple regression analysis. Caregivers who quit their work or other home activities had significantly more daily living care responsibilities than those who did not. Moreover, caregivers who gave up leisure activities had a greater sense of subjective care burden than those who did not. The experience of giving up peer activities and taking leave of absence from work was significantly associated with increased depressive symptoms. Being a part-timer or financially prosperous was associated with good mental health. To support family caregivers, it is essential to reduce the burden of long-term care and provide financial help and an environment where they interact with their peers, and their moods can be enhanced. Full article
Article
Hand-to-Environment Contact during Indoor Activities in Senior Welfare Centers among Korean Older Adults: A Pilot Study
Healthcare 2021, 9(2), 105; https://doi.org/10.3390/healthcare9020105 - 20 Jan 2021
Viewed by 518
Abstract
(1) Background: This study aimed to describe the characteristics of hand-to-environment contact (HEC) and identify the influencing factors of HEC behavior during the indoor daily life of Korean older adults in senior welfare centers. (2) Methods: A cross-sectional observational study was used with [...] Read more.
(1) Background: This study aimed to describe the characteristics of hand-to-environment contact (HEC) and identify the influencing factors of HEC behavior during the indoor daily life of Korean older adults in senior welfare centers. (2) Methods: A cross-sectional observational study was used with 30 participants over 65 years of age attending programs in senior welfare centers. Video recordings of the 30 participants were collected for two hours a day for participants selected from 20 November to 4 December 2018. Contact frequency, density, and duration were measured. (3) Results: Video recordings of 3,930 HEC cases were analyzed. Furniture surface (25.0%), tableware and cooking utensils (5.4%), phones (5.3%), and door handles (0.1%) were found to be the items with the most frequent contact, in this order. The average contact frequency and contact density (frequency-duration/min/person) of HEC for two hours were highest for the Category I equipment (personally used, accounting for 70.4%), and the average contact duration of HEC was highest in the Category III equipment (commonly used, 47.7 s/contact/person). Contact density was as high as 266.5 (frequency-duration/min/person). Participants above 75 years of age and the unemployed showed high HEC with Category III. (4) Conclusions: Older adults need to be educated to avoid unnecessary hand contact with items in Category III. In particular, hand hygiene and sanitization through the regular and thorough disinfection of furniture surfaces and shared equipment are very important to prevent the spread of pathogens. Full article
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Systematic Review
Age-Friendly Health Care: A Systematic Review
Healthcare 2021, 9(1), 83; https://doi.org/10.3390/healthcare9010083 - 16 Jan 2021
Cited by 1 | Viewed by 867
Abstract
Background: Health care provided to older adults must take into account the characteristics of chronic diseases and the comorbidities resulting from ageing. However, health services are still too oriented towards acute situations. To overcome this problem, the World Health Organization (WHO) proposed a [...] Read more.
Background: Health care provided to older adults must take into account the characteristics of chronic diseases and the comorbidities resulting from ageing. However, health services are still too oriented towards acute situations. To overcome this problem, the World Health Organization (WHO) proposed a set of Age-Friendly Principles that seek to optimize the provision of health care for this population. This article aims to understand how such Principles are considered in the implementation of age-friendly health care worldwide. Methods: A systematic review was conducted to synthesize the literature on age-friendly health care in accordance with the PRISMA recommendations in the PubMed, Web of Science, and Scopus databases. Results: The research identified 34 articles, with only seven recognizing the WHO Principles and only four using the implementation toolkit. In addition, in the context of primary care, three studies recognize the WHO Principles, but only two use the toolkit. Conclusions: The WHO Principles are being implemented in health care, but in a smaller scale than desired, which reveals possible flaws in their dissemination and standardization. Thus, a greater scientific investment in age-friendly health care should be considered, which represents a greater operationalization of the Principles and an evaluation of their effectiveness and impacts. Full article
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2020

Jump to: 2021

Concept Paper
Designing a Randomized Trial with an Age Simulation Suit—Representing People with Health Impairments
Healthcare 2021, 9(1), 27; https://doi.org/10.3390/healthcare9010027 - 30 Dec 2020
Viewed by 678
Abstract
Due to demographic change, there is an increasing demand for professional care services, whereby this demand cannot be met by available caregivers. To enable adequate care by relieving informal and formal care, the independence of people with chronic diseases has to be preserved [...] Read more.
Due to demographic change, there is an increasing demand for professional care services, whereby this demand cannot be met by available caregivers. To enable adequate care by relieving informal and formal care, the independence of people with chronic diseases has to be preserved for as long as possible. Assistance approaches can be used that support promoting physical activity, which is a main predictor of independence. One challenge is to design and test such approaches without affecting the people in focus. In this paper, we propose a design for a randomized trial to enable the use of an age simulation suit to generate reference data of people with health impairments with young and healthy participants. Therefore, we focus on situations of increased physical activity. Full article
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Article
Data Analysis Model Design of Health Service Monitoring System for China’s Elderly Population: The Proposal of the F-W Model Based on the Collaborative Governance Theory of Healthy Aging
Healthcare 2021, 9(1), 9; https://doi.org/10.3390/healthcare9010009 - 23 Dec 2020
Cited by 1 | Viewed by 933
Abstract
In the era of artificial intelligence, big data and 5G, health care for elderly people is facing an important digital transformation. The objective of this study is to design the data analysis module of the elderly health service monitoring system (HSMS) and attempt [...] Read more.
In the era of artificial intelligence, big data and 5G, health care for elderly people is facing an important digital transformation. The objective of this study is to design the data analysis module of the elderly health service monitoring system (HSMS) and attempt to put forward a new healthy aging (HA) model that is applicable not only to the individual HA, but also to the regional HA system. Based on the HA theory of collaborative governance, we divided the elderly HSMS into four modules, including physical health, mental health, ability of daily activity, and social participation. Then, factors that influence HA were assessed by stepwise logistic regression to build the analysis model, using the public micro-panel data of the China Health and Retirement Longitudinal Survey (CHARLS). Age (odds ratio (OR) = 1.55 (95% confidence interval (CI): 1.06–2.27)), living in urban areas (OR = 1.57 (95% CI: 1.03–2.39)), being literate (OR = 1.51 (95% CI: 1.01–2.23)), expecting to get long-term health care in the future from their grown children (OR = 1.69 (95% CI: 1.10–2.61)) and having literate grown children (OR = 2.01 (95% CI: 0.26–0.97)) had a significant positive impact on HA of elderly people. Therefore, the F-W (factors and weighs, also family and welfare) model is proposed in this paper. The outcomes can contribute with designing HSMS for different provinces and several different regions in China and leave a door open to improve the model and algorithm application for HSMS in the future studies. Full article
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Article
The Relationship between Subjective Cognitive Decline and Health Literacy in Healthy Community-Dwelling Older Adults
Healthcare 2020, 8(4), 567; https://doi.org/10.3390/healthcare8040567 - 16 Dec 2020
Viewed by 885
Abstract
Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a [...] Read more.
Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a population of healthy community-dwelling older adults. SCD status was assessed using the Cognitive Function domain of the Kihon Checklist (KCL-CF). Health literacy, in turn, was evaluated using the Communicative and Critical Health Literacy (CCHL) scale. Global cognitive function and depressive symptoms were evaluated using the Mini-Mental State Examination (MMSE) and a five-item version of the Geriatric Depression Scale (GDS-5), respectively. Participants who were suspected of having SCD were significantly older than their non-SCD peers, and scored significantly worse on the CCHL, MMSE, and GDS-5. In addition, SCD status was found to be associated with CCHL and GDS-5 scores, as well as age, according to a logistic regression analysis. These findings suggest that low health literacy is linked to SCD morbidity in healthy community-dwelling older adults and should prove useful in the planning of dementia prevention and intervention programs for this population. Full article
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Article
Television Viewing and Cognitive Dysfunction of Korean Older Adults
Healthcare 2020, 8(4), 547; https://doi.org/10.3390/healthcare8040547 - 10 Dec 2020
Viewed by 467
Abstract
This study examined the association between television (TV) viewing and cognitive dysfunction in elderly Koreans. Among participants of the 2014 National Survey of Older Koreans, 9644 were considered in this study. To better identify the association between two factors, propensity score (PS) matching [...] Read more.
This study examined the association between television (TV) viewing and cognitive dysfunction in elderly Koreans. Among participants of the 2014 National Survey of Older Koreans, 9644 were considered in this study. To better identify the association between two factors, propensity score (PS) matching with exact method was used. Finally, 168 viewers and non-viewers each were selected based on estimated PS on key variables and eliminating double matches. Multivariate logistic regression analysis was performed when controlling for possible covariates. Viewers were more likely to have cognitive dysfunction than non-viewers, with significant differences in most covariates. After correcting confounding effects of these covariates with PS matching, TV viewing was found to be a significant risk factor of cognitive dysfunction, along with absence of diagnosed hypertension and non-participation in physical leisure activities. TV viewing might be associated with increased risk of cognitive dysfunction in later life. Appropriate education and strategies to minimize TV viewing among older adults should be established to contribute to attenuating cognitive aging. More interventional studies can help older adults, caregivers, and healthcare professionals explore the cognitively beneficial alternatives to TV use considering the impact of socioeconomic factors of selecting TV viewing as a preferred leisure activity. Full article
Article
The Meaning of Work and Self-Management Experiences among Elderly Workers with Multiple Chronic Diseases: A Qualitative Study
Healthcare 2020, 8(4), 471; https://doi.org/10.3390/healthcare8040471 - 09 Nov 2020
Viewed by 630
Abstract
With population aging, increasingly many elderly individuals are expected to participate in economic activities. Elderly workers have a higher prevalence of multiple chronic diseases, making it necessary to examine elderly workers’ experiences of health-related self-management in work environments. This qualitative study investigated the [...] Read more.
With population aging, increasingly many elderly individuals are expected to participate in economic activities. Elderly workers have a higher prevalence of multiple chronic diseases, making it necessary to examine elderly workers’ experiences of health-related self-management in work environments. This qualitative study investigated the meaning of work and health-related self-management experiences among elderly workers with multiple chronic diseases. The study participants were elderly workers residing in South Korea (65 years old or older) with at least two chronic diseases. Twelve participated in individual interviews, which were audio-recorded and transcribed. Qualitative content analysis was conducted with the transcribed data. Six themes, 21 sub-themes, and 40 codes were derived. The themes were “benefit of work on health and life”, “adaptation to a new work environment”, “endurance”, “continuous efforts to maintain health”, “difficulties in self-management”, and “requirements for health promotion”. The participants experienced difficulties in health-related self-management due to time constraints, poor work environment, and financial burdens. However, participants expressed their desire to invest effort into managing their physical and psychological health and to work as long as possible. Programs that consider the aging and health-related characteristics of elderly workers and their work environments should be developed and implemented. Full article
Article
Differences in the Potential Accessibility of Home-Based Healthcare Services among Different Groups of Older Adults: A Case from Shaanxi Province, China
Healthcare 2020, 8(4), 452; https://doi.org/10.3390/healthcare8040452 - 01 Nov 2020
Viewed by 811
Abstract
With the increase of the aging population and the lack of family care, home-based healthcare services have gradually become the main model to cope with aging, so local governments have invested heavily in the construction of home-based healthcare services. However, healthcare services still [...] Read more.
With the increase of the aging population and the lack of family care, home-based healthcare services have gradually become the main model to cope with aging, so local governments have invested heavily in the construction of home-based healthcare services. However, healthcare services still have problems such as low resource utilization and imbalanced development. The reason is that the supply and demand of healthcare services are not matched and the potential accessibility is low. Therefore, based on the supply and demand of healthcare services, this article pulls out the spatial and social factors that affect the potential accessibility, and tests the influence of individual factors on the potential accessibility among different groups of older adults. It is found that the perceived vulnerability of the older adults will reduce the potential accessibility of healthcare services. The psychosocial status, income and education level with the willingness to use healthcare services of the older adults are directly proportional, while residence has a negative impact on the potential accessibility. Finally, based on this finding, this article puts forward feasible suggestions from the perspective of policy content, publicity, and implementation. Full article
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Article
Perception of COVID-19 Restrictions on Daily Life among Japanese Older Adults: A Qualitative Focus Group Study
Healthcare 2020, 8(4), 450; https://doi.org/10.3390/healthcare8040450 - 01 Nov 2020
Cited by 12 | Viewed by 1706
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has exposed older adults to health and social risks. This study examined the perceptions of community-dwelling older adults regarding how COVID-19 restricted their daily lives. Six focus-group interviews were conducted with 24 participants (mean age, 78.2 ± [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic has exposed older adults to health and social risks. This study examined the perceptions of community-dwelling older adults regarding how COVID-19 restricted their daily lives. Six focus-group interviews were conducted with 24 participants (mean age, 78.2 ± 5.5 years) living in urban and rural areas in Japan. Then, a qualitative inductive content analysis was performed. Six themes were generated: “fear of infection and public, watchful eyes,” “consistency in daily personal life,” “pain from reducing my social life,” “readiness to endure a restricted life,” “awareness of positive changes in myself,” and “concern for a languishing society.” There was no change that would make their lives untenable, and they continued their daily personal lives at a minimum level. However, their social lives were reduced, which over the long term can lead to a lost sense of purpose in life. This was reported as an adverse factor in the development of other diseases and functional decline in previous studies. While there is no doubt that infection prevention is important, supporting older adults in engaging in activities that provide a sense of purpose in life could contribute to their present and future overall health including mental health. Full article
Article
The Association between Health Literacy and Gait Speed in Community-Dwelling Older Adults
Healthcare 2020, 8(4), 369; https://doi.org/10.3390/healthcare8040369 - 28 Sep 2020
Viewed by 1118
Abstract
The association between gait speed, a vital health outcome in older adults, and health literacy, an important health promotion aspect, is unclear. This study examined the relationship of gait speed with health literacy, physical function, and cognitive function in community-dwelling older adults. The [...] Read more.
The association between gait speed, a vital health outcome in older adults, and health literacy, an important health promotion aspect, is unclear. This study examined the relationship of gait speed with health literacy, physical function, and cognitive function in community-dwelling older adults. The subjects were 240 older adults (52 men, mean age 73.8 ± 6.0 years). Gender, age, and education were self-reported, while height and weight were measured directly. Health literacy was evaluated using Communicative and Critical Health Literacy (CCHL). Grip strength, knee extension strength, toe-grip strength, sit-up test, sit-and-reach test, one-leg stance test time, 30-s chair-stand test (CS-30), and normal gait speed were measured. Subjects were divided into two groups based on normal gait speed—fast (speed ≥ 1.3 m/s) and slow (<1.3 m/s). In the logistic regression analysis, the dependent variable was normal gait speed (fast/slow). Four logistic regression models were utilized to determine whether health literacy affects gait speed. Height and CCHL were found to independently affect gait speed. That health literacy influences gait speed is a new discovery. Full article
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Article
Measurement Development for Japanese Clients’ Experiences during Adult Day Care Service Use (The J-AdaCa Tool)
Healthcare 2020, 8(4), 363; https://doi.org/10.3390/healthcare8040363 - 24 Sep 2020
Cited by 1 | Viewed by 1012
Abstract
Adult day care (ADC) is among the most common services in the Japanese long-term care context, but information on how such care is offered remains scarce. This study aimed to develop a measurement tool to assess the richness of clients’ experiences regarding their [...] Read more.
Adult day care (ADC) is among the most common services in the Japanese long-term care context, but information on how such care is offered remains scarce. This study aimed to develop a measurement tool to assess the richness of clients’ experiences regarding their ADC service use. Through a collaboration with ADC administrators and staff, semi-structured interviews were conducted with three ADC clients (in one ADC agency), and a questionnaire survey (17 items about clients’ and their families’ experiences within ADC) was applied to 360 ADC clients (in 11 ADC agencies). Principle component analysis showed four factors regarding experience of ADC use: “Social participation”, “Hygiene and health”, “Exercise and eating habits”, and “Family support”. These positive experiences might be effectively provided if stakeholders refer to clients’ needs during ADC experiences, and their effective provision may relate to better care outcomes. Full article
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Article
Subjective and Objective Mental and Physical Functions Affect Subjective Cognitive Decline in Community-Dwelling Elderly Japanese People
Healthcare 2020, 8(3), 347; https://doi.org/10.3390/healthcare8030347 - 18 Sep 2020
Cited by 1 | Viewed by 1044
Abstract
Subjective cognitive decline (SCD) is complex and not well understood, especially among Japanese people. In the present study, we aimed to elucidate the relationships of subjective and objective mental and physical function with SCD among older community-dwelling Japanese adults. SCD was evaluated using [...] Read more.
Subjective cognitive decline (SCD) is complex and not well understood, especially among Japanese people. In the present study, we aimed to elucidate the relationships of subjective and objective mental and physical function with SCD among older community-dwelling Japanese adults. SCD was evaluated using the Kihon Checklist: Cognitive Function. Other parameters were evaluated using the Mini-Mental State Examination (MMSE) and the five-item version of the Geriatric Depression Scale (GDS-5), for an objective mental function other than SCD. A timed up-and-go test (TUG) and knee extension strength were used to test objective physical function, and the Mental Component Summary (MCS) and Physical Component Summary (PCS) in the Health-Related Quality of Life survey eight-item short form (SF-8) were used for subjective mental and physical functions. The results of the MMSE, GDS-5, TUG, knee extension strength, and MCS were significantly worse in the SCD group. In addition, logistic regression analysis showed that GDS-5 and MCS were associated with SCD onset. Depressive symptoms and decreased subjective mental function contribute to SCD among community-dwelling Japanese adults. These findings will be useful for planning dementia prevention and intervention programs for older Japanese adults. Full article
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Article
Association of Low Bone Mass with Decreased Skeletal Muscle Mass: A Cross-Sectional Study of Community-Dwelling Older Women
Healthcare 2020, 8(3), 343; https://doi.org/10.3390/healthcare8030343 - 16 Sep 2020
Viewed by 974
Abstract
This study aimed to investigate the characteristics of skeletal muscle mass, muscle strength, and physical performance among community-dwelling older women. Data were collected from 306 older adults, and the data of 214 older women were included in the final analysis. Participants’ calcaneus bone [...] Read more.
This study aimed to investigate the characteristics of skeletal muscle mass, muscle strength, and physical performance among community-dwelling older women. Data were collected from 306 older adults, and the data of 214 older women were included in the final analysis. Participants’ calcaneus bone mass was measured using ultrasonography. Based on their T-scores, participants were divided into the following three groups: normal (T-score > −1), low (−2.5 < T-score ≤ −1), and very low (T-score ≤ −2.5) bone mass. Further, participants’ skeletal muscle mass, muscle strength (grip and knee extension strength), and physical performance [gait speed and timed up and go (TUG)] were measured. Arm skeletal muscle index (SMI, skeletal muscle mass/height2), leg SMI, and appendicular SMI in the very low bone mass group were low compared to those of the low bone mass group (p = 0.034, p = 0.011, and p = 0.009, respectively). Grip and knee extension strength, gait speed, and TUG were not significantly different between the groups. These findings suggest that older women with low bone density had decreased skeletal muscle mass. Therefore, maintaining or improving skeletal muscle mass may prevent low bone mass. Full article
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Protocol
Prevalence Of, and Factors Associated with, Obesity among the Oldest Old. A Study Protocol for a Systematic Review
Healthcare 2020, 8(3), 319; https://doi.org/10.3390/healthcare8030319 - 04 Sep 2020
Viewed by 874
Abstract
Some empirical studies have identified the prevalence of, and factors associated with, obesity among the oldest old. However, there is a lack of a systematic review synthesizing the existing evidence. Therefore, the purpose of our upcoming systematic review is to provide an overview [...] Read more.
Some empirical studies have identified the prevalence of, and factors associated with, obesity among the oldest old. However, there is a lack of a systematic review synthesizing the existing evidence. Therefore, the purpose of our upcoming systematic review is to provide an overview of the evidence provided by observational studies. The current paper presents the protocol for this systematic review. We will search four electronic databases (Medline, PsycINFO, CINAHL, and Cochrane Library). Furthermore, we will perform a manual search (searching reference lists of included studies). Cross-sectional and longitudinal observational studies identifying the prevalence and preferably the factors associated with obesity among the oldest old (80 years and over) will be included. Data extraction will concentrate on study design, assessment of obesity and its associated factors, statistical analysis, sample characteristics, and key findings. We will evaluate the quality of the included studies. Two individuals will perform study selection, data extraction, and evaluation of study quality. We will present the results in figures, summary tables and narrative summaries. If data permits, a meta-analysis will be conducted. Full article
Article
Factors Associated with Healthy Ageing, Healthy Status and Community Nursing Needs among the Rural Elderly in an Empty Nest Family: Results from the China Health and Retirement Longitudinal Study
Healthcare 2020, 8(3), 317; https://doi.org/10.3390/healthcare8030317 - 03 Sep 2020
Cited by 1 | Viewed by 1191
Abstract
Health care for the rural elderly in and empty nest family is a major problem in such an ageing society such as China. Based on previous studies, China’s rural health care services only focus on the physical health of the elderly, while public [...] Read more.
Health care for the rural elderly in and empty nest family is a major problem in such an ageing society such as China. Based on previous studies, China’s rural health care services only focus on the physical health of the elderly, while public health care services only provide primary services such as blood pressure and blood glucose measurement. This leads to the question of whether physical health is the most important issue for the Chinese rural empty nest elderly (CREE). It is necessary to find out their health status, nursing needs and influencing factors associated with healthy ageing (HA). Using the method of logistic regression, four dimensions of HA (adding psychological health, social participation and daily activities to physical health) among 618 respondents in total were analyzed based on public panel data from the national survey of the China Health and Retirement Longitudinal Study (CHARLS). Interesting results have been found; for example, the most important factor restricting the HA of the CREE is not physical health but social participation. The independence, health, good employment and economic conditions of their adult children play an important role in protecting the HA of the CREE. Full article
Article
Place of Residence and Marital Status as Variables Differentiating a Sense of Self-Efficacy in the Elderly—A Descriptive Cross-Sectional Survey
Healthcare 2020, 8(3), 300; https://doi.org/10.3390/healthcare8030300 - 26 Aug 2020
Viewed by 983
Abstract
Background: Studies on the self-efficacy of the elderly are still being conducted to a very limited extent. Nevertheless, they can provide relevant information for specialists to use in many disciplines of science, as well as for practitioners, especially gerontologists, geriatricians, psychologists and other [...] Read more.
Background: Studies on the self-efficacy of the elderly are still being conducted to a very limited extent. Nevertheless, they can provide relevant information for specialists to use in many disciplines of science, as well as for practitioners, especially gerontologists, geriatricians, psychologists and other people associated with prophylaxis and health promotion. The aim of the study is to assess the impact of the place of residence and marital status on the self-efficacy in the elderly. Methods: A diagnostic survey method was used for the study and within the method, the authors’ sociodemographic data questionnaire and the generalized self-efficacy scale (GSES) were applied. The study was carried out in a group of 171 females and 130 males under nursing care in the home environment or in nursing-home care in Poland. Results: The average level of generalized sense of self-efficacy in the research cohort was M = 26.69, SD = 8.49. A relatively high percentage of the group (48.9%) showed a sense of self-efficacy at a high level. The level of a sense of self-efficacy was low in 38.2% of the cohort, while its average intensity in the remaining ones constituted 12.9% of the total. A statistically significant impact of a place of residence (Z = −2.940; p = 0.003) and marital status (H = 12.000; p = 0.007) on the sense of efficacy in the research cohort was proven in favor of those from the rural environment and the respondents having spouses. Conclusions: On the scale of the studied group, the results of a sense of self-efficacy are optimistic, as older people with high levels predominated. However, the results of the cohort whose self-efficacy is insufficient to cope with their old age should be considered carefully, especially in the case of lonely people living in the urban environment and NHC (nursing-home care) residents. Full article
Article
Type of Care and Living Situation Are Associated with Nutritional Care but Not Nutritional Status of Older Persons Receiving Home Care
Healthcare 2020, 8(3), 296; https://doi.org/10.3390/healthcare8030296 - 25 Aug 2020
Viewed by 978
Abstract
Nutritional care and nutritional status may differ in older persons receiving informal (IC) or professional (PC) home care and further depend on the living situation, but little is known in this regard. In this analysis of a cross-sectional multicenter study, type of care, [...] Read more.
Nutritional care and nutritional status may differ in older persons receiving informal (IC) or professional (PC) home care and further depend on the living situation, but little is known in this regard. In this analysis of a cross-sectional multicenter study, type of care, living situation, and nutritional care were enquired in 353 older adults (≥65) receiving IC or PC, living either with partner (LP), with others (LO) or alone (LA), and the nutritional status was determined by BMI and MNA®. For IC receivers, food shopping (IC-LP 94%, IC-LO 96%, IC-LA 92%) and warm meals (IC-LP 89%, IC-LO 90%, IC-LA 71%) were mainly provided by relatives, whereas 47% of PC-LA prepared warm meals by themselves and 22% received meals on wheels. Thirteen percent were underweight, 13% malnourished, and 57% at risk of malnutrition without differences between the groups. Adjusted odds ratios (OR) of being malnourished were also not different (IC-LP 2.2 [95% CI 0.5–9.7], IC-LO 1.4 [0.3–6.6], IC-LA 1.4 [0.3–6.6]) compared to PC-LA. In conclusion, provision of nutritional care obviously differed according to the type of care and living situation, whereas nutritional status does not seem to be affected by these aspects. More research is clearly needed in this field. Full article
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Article
Effect of an EMG–FES Interface on Ankle Joint Training Combined with Real-Time Feedback on Balance and Gait in Patients with Stroke Hemiparesis
Healthcare 2020, 8(3), 292; https://doi.org/10.3390/healthcare8030292 - 24 Aug 2020
Cited by 1 | Viewed by 1133
Abstract
This study evaluated the effects of an electromyography–functional electrical stimulation interface (EMG–FES interface) combined with real-time balance and gait feedback on ankle joint training in patients with stroke hemiplegia. Twenty-six stroke patients participated in this study. All subjects were randomly assigned to either [...] Read more.
This study evaluated the effects of an electromyography–functional electrical stimulation interface (EMG–FES interface) combined with real-time balance and gait feedback on ankle joint training in patients with stroke hemiplegia. Twenty-six stroke patients participated in this study. All subjects were randomly assigned to either the EMG–FES interface combined with real-time feedback on ankle joint training (RFEF) group (n = 13) or the EMG–FES interface on ankle joint training (EF) group (n = 13). Subjects in both groups were trained for 20 min a day, 5 times a week, for 4 weeks. Similarly, all participants underwent a standard rehabilitation physical therapy for 60 min a day, 5 times a week, for 4 weeks. The RFEF group showed significant increases in weight-bearing lunge test (WBLT), Tardieu Scale (TS), Timed Up and Go Test (TUG), Berg Balance Scale (BBS), velocity, cadence, step length, stride length, stance per, and swing per (p < 0.05). Likewise, the EF group showed significant increases in WBLT, TUG, BBS, velocity, and cadence (p < 0.05). Moreover, the RFEF group showed significantly greater improvements than the EF group in terms of WBLT, Tardieu Scale, TUG, BBS, velocity, step length, stride length, stance per, and swing per (p < 0.05). Ankle joint training using an EMG–FES interface combined with real-time feedback improved ankle range of motion (ROM), muscle tone, balance, and gait in stroke patients. These results suggest that an EMG–FES interface combined with real-time feedback is feasible and suitable for ankle joint training in individuals with stroke. Full article
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Article
Palliative and End-of-Life Care Conversations with Older People with Chronic Obstructive Pulmonary Disease in Croatia—A Pilot Study
Healthcare 2020, 8(3), 282; https://doi.org/10.3390/healthcare8030282 - 20 Aug 2020
Viewed by 1110
Abstract
Despite the progressive nature of chronic obstructive pulmonary disease (COPD), its association of high morbidity and mortality with severe COPD, and the view that discussions between patients and clinicians about palliative care plans should be grounded in patients’ preferences, many older patients do [...] Read more.
Despite the progressive nature of chronic obstructive pulmonary disease (COPD), its association of high morbidity and mortality with severe COPD, and the view that discussions between patients and clinicians about palliative care plans should be grounded in patients’ preferences, many older patients do not receive timely end-of-life care (EOLC) discussions with healthcare professionals (HPs), potentially risking inadequate care at the advanced stages of the disease. The aim of this pilot study was to evaluate EOLC discussions and resuscitation issues as a representative and illustrative part within EOLC in older patients with COPD in the University Hospital Center Osijek, Slavonia (Eastern Region), Croatia, as such data have not yet been explored. The study was designed as cross-sectional research. Two groups of participants, namely, patients at least 65 years old with COPD and healthcare professionals, were interviewed anonymously. In total, 83 participants (22 HPs and 61 patients with COPD) were included in the study. According to the results, 77% of patients reported that they had not had EOLC discussions with HPs, 64% expressed the opinion that they would like such conversations, and the best timing for such discussion would be during frequent hospital admissions. Furthermore, 77% of HPs thought that EOLC communication is important, but only 14% actually discussed such issues with their patients because most of them felt uncomfortable starting such a topic. The majority of older patients with COPD did not discuss advanced care planning with their HPs, even though the majority of them would like to have such a discussion. EOLC between HPs and older patients with COPD should be encouraged in line with patients’ wishes, with the aim to improve their quality of care by anticipating patients’ likely future needs in a timely manner and thereby providing proactive support in accordance with patients’ preferences. Full article
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Article
Effect of an Integrated Healthcare Program for Korean Rural Older Adults: A Quasi-Experimental Study
Healthcare 2020, 8(3), 244; https://doi.org/10.3390/healthcare8030244 - 30 Jul 2020
Viewed by 1102
Abstract
Studies have been conducted on the development of healthcare programs for older adults in rural areas, not only in Asia but also in Europe and the United States. However, these reports have been limited by largely non-comprehensive results, lack of demand surveys, or [...] Read more.
Studies have been conducted on the development of healthcare programs for older adults in rural areas, not only in Asia but also in Europe and the United States. However, these reports have been limited by largely non-comprehensive results, lack of demand surveys, or programs with no systematic development. The purpose of this study was to develop an integrated healthcare program for rural older adults and investigate the effects of the program. A nonequivalent control group pretest–posttest design was used. Subjects were aged over 65 and lived in the rural community. The integrated healthcare program involved 12 three-hour sessions over 12 weeks. Compared with the control group, the experimental group demonstrated significant differences in both upper extremities strengths (t = 2.74, p = 0.008; t = 2.03, p = 0.047), static balance (z = −2.38, p = 0.017), dynamic balance (t = −4.82, p < 0.001), loneliness (t = −3.02, p = 0.003), and role self-efficacy (t = 2.39, p = 0.020), but no differences for ego integration (t = 1.51, p = 0.137). To improve physical, mental, and social health of the rural older adults, we developed an integrated healthcare program. The program improved physical functions, loneliness, and role self-efficiency of the rural older adults. Therefore, it is recommended that healthcare professionals actively apply this program in primary healthcare institutes and elsewhere. Full article
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Review
Satisfaction with Health Care Interventions among Community Dwelling People with Cognitive Disorders and Their Informal Caregivers—A Systematic Review
Healthcare 2020, 8(3), 240; https://doi.org/10.3390/healthcare8030240 - 29 Jul 2020
Viewed by 972
Abstract
Informal caregivers have a leading role when implementing health care services for people with cognitive disorders living at home. This study aims to examine the current evidence for interventions with dual satisfaction with health care services for people with cognitive disorders and their [...] Read more.
Informal caregivers have a leading role when implementing health care services for people with cognitive disorders living at home. This study aims to examine the current evidence for interventions with dual satisfaction with health care services for people with cognitive disorders and their caregivers. Original papers with quantitative and mixed method designs were extracted from two databases, covering years 2009–2018. Thirty-five original papers reported on satisfaction with health care services. The International Classification of Health Interventions (ICHI) was used to classify the interventions. Most interventions had a home-based approach (80%). Reduction in caregiver depression was the outcome measure with the highest level of satisfaction. Interventions to reduce depression or increase cognitive performance in persons with cognitive disorders gave the least satisfaction. Satisfaction of both caregivers and persons with cognitive disorders increased their use of services. In the ICHI, nearly 50% of the interventions were classified as activities and participation. A limited number of interventions have a positive effect on satisfaction of both the persons with cognitive disorders and the caregiver. It is important to focus on interventions that will benefit both simultaneously. More research is needed with a clear definition of satisfaction and the use of the ICHI guidelines. Full article
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Article
The Correlation between Social Support and Quality of Life of Seniors without Cognitive Disorders from an Institutional Environment—A Descriptive Cross-Sectional Survey
Healthcare 2020, 8(3), 212; https://doi.org/10.3390/healthcare8030212 - 14 Jul 2020
Cited by 1 | Viewed by 1061
Abstract
The aim of this study was to confirm the correlation between social support and the quality of life of seniors who live without cognitive disorders, but are living in an institutional environment. The measurement of variables was based on a cross-sectional survey method. [...] Read more.
The aim of this study was to confirm the correlation between social support and the quality of life of seniors who live without cognitive disorders, but are living in an institutional environment. The measurement of variables was based on a cross-sectional survey method. A representative sample of 957 seniors participated in the survey. The study covered public nursing homes (NHs) and residential care homes (RCHs) selected for the study by stratified sampling. The results confirmed a linear correlation between social support and the quality of life of seniors (p < 0.001). It was also confirmed that there were differences in the range of studied variables depending on the type of institution (NH versus RCH; p < 0.001). Social support is a significant component, and at the same time, a modifier of the perception of the quality of life for older people. Its variable level determines the subjective assessment of functioning in particular domains of quality of life. RCH as an institution of a social nature satisfies the needs for support at a higher level than NH, which translates into a better perception of older people’s quality of life. Full article
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Article
Quality of Life in Older Adults with Benign Prostatic Hyperplasia
Healthcare 2020, 8(2), 158; https://doi.org/10.3390/healthcare8020158 - 04 Jun 2020
Cited by 1 | Viewed by 1470
Abstract
The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote [...] Read more.
The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote the treatment of BPH in older patients. The 2015 Korea Health Panel Survey data were used in this study. A total of 422 BPH patients aged 65 or older were included. Logistic regression analysis was conducted to identify factors affecting the HRQOL of older patients with BPH. General characteristics of factors affecting older patients with BPH included income level and type of insurance. In addition, among medical-related characteristics and health behavior factors, subjective health status, unmet medical care needs, moderate physical activity, sitting time, and drinking influenced the HRQOL. Therefore, in order to improve the HRQOL of adult patients with BPH, it is necessary to improve medical accessibility by strengthening primary care. In addition, it is necessary to increase the amount of activity in daily life through healthcare medical devices. Full article
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Article
Temporal Patterns in Performance of the 30 s Chair-Stand Test Evince Differences in Physical and Mental Characteristics among Community-Dwelling Older Adults in Japan
Healthcare 2020, 8(2), 146; https://doi.org/10.3390/healthcare8020146 - 28 May 2020
Viewed by 1553
Abstract
Studies involving the 30 s chair-stand test (CS-30) have shown that subjects’ movements can vary during the test, and that these variations may follow several patterns. The present study aimed to define these different patterns and their respective incidences among a population of [...] Read more.
Studies involving the 30 s chair-stand test (CS-30) have shown that subjects’ movements can vary during the test, and that these variations may follow several patterns. The present study aimed to define these different patterns and their respective incidences among a population of community-dwelling older adults in Japan. We also investigated, among the patterns identified, potential associations with physical and mental characteristics. The study population comprised 202 community-dwelling older adults. Subjects were classified into four groups based on how their CS-30 performance (defined through sit–stand–sit cycle count) changed over three successive 10 s segments: “steady-goers,” “fluctuators,” “decelerators,” and “accelerators.” Several other measures were also evaluated, including sit-up count, knee-extension strength, toe-grip strength, and Mini-Mental State Examination score. We found that steady-goers and decelerators comprised 70% of the sample. Fluctuators and steady-goers showed comparable physical function. Decelerators exhibited significant correlations between CS-30 score (total cycles) and tasks involving persistence and repetitive actions (p < 0.05). In addition, accelerators showed significantly stronger knee extension than steady-goers (p < 0.01). Differences in temporal patterns of CS-30 performance corresponded to differences in certain dimensions of physical and mental function. Our findings may be useful for planning and evaluating intervention programs aimed at long-term-care prevention among community-dwelling older adults. Full article
Article
Relationship Between Lumbar Motor Control Ability and Spinal Curvature in Elderly Individuals
Healthcare 2020, 8(2), 130; https://doi.org/10.3390/healthcare8020130 - 09 May 2020
Viewed by 1290
Abstract
This study aimed to clarify the relationship between spine curvature and the movement pattern/motor control ability of the lumbar and hip joints during prone hip extension in elderly individuals. The participants were 14 elderly people who attended a community health class. We measured [...] Read more.
This study aimed to clarify the relationship between spine curvature and the movement pattern/motor control ability of the lumbar and hip joints during prone hip extension in elderly individuals. The participants were 14 elderly people who attended a community health class. We measured the motion angle, motion ratio (movement pattern), and motor control ability of the lumbar and hip joints during prone hip extension. In addition, the lumbar lordosis angle and thoracic kyphosis angle were measured in the standing position. There was no correlation between the spinal curvature in the standing position and the lumbar/hip joint movement pattern and motor control ability during prone hip extension. When evaluating the lumbar spine, it is necessary to perform a comprehensive evaluation by interpreting static evaluations such as spinal alignment or dynamic evaluations such as movement patterns and motor control abilities. Full article
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Review
Comparison of the Measurement of Long-Term Care Costs between China and Other Countries: A Systematic Review of the Last Decade
Healthcare 2020, 8(2), 117; https://doi.org/10.3390/healthcare8020117 - 29 Apr 2020
Cited by 5 | Viewed by 1822
Abstract
Background: The rapid aging of populations in some countries has led to a growing number of the disabled elderly, creating a huge need for Long-Term Care (LTC) and meeting its costs, which is a heavy economic burden on the families of the disabled [...] Read more.
Background: The rapid aging of populations in some countries has led to a growing number of the disabled elderly, creating a huge need for Long-Term Care (LTC) and meeting its costs, which is a heavy economic burden on the families of the disabled elderly and governments. Therefore, the measurement of Long-Term Care (LTC) costs has become an important basis for the government to formulate Long-Term Care (LTC) policies, and academic research on Long-Term Care (LTC) costs is also in the process of continuous development and deepening. Methods: This is a systematic review that aims to examine the evidence published in the last decade (2010–2019) regarding the comparison of the measurement of Long-Term Care (LTC) costs between China and other countries. Results: Eighteen Chinese studies and 17 other countries’ studies were included in this review. Most Chinese scholars estimated long-term care costs based on the degree of disability among the disabled elderly. However, the studies of European and American countries are more and more in-depth and comprehensive, and more detailed regarding the post-care cost of specific diseases, such as Parkinson’s disease, Alzheimer’s disease, and epilepsy. Conclusion: In future academic research, we should fully consider the human value of long-term care providers and further study the differences in the long-term care costs of different chronic diseases. In China’s future policymaking, according to the experience of Germany, Sweden, and other countries, it may be an effective way to develop private long-term care insurance and realize the effective complementarity between private long-term care insurance and public long-term care insurance (LTCI). Full article
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Review
Designing Socially Assistive Robots for Alzheimer’s Disease and Related Dementia Patients and Their Caregivers: Where We Are and Where We Are Headed
Healthcare 2020, 8(2), 73; https://doi.org/10.3390/healthcare8020073 - 26 Mar 2020
Cited by 5 | Viewed by 2368
Abstract
Over the past few years there has been a large rise in the field of robotics. Robots are being in used in many industries, but there has not been a large surge of robots in the medical field, especially the robots for healthcare [...] Read more.
Over the past few years there has been a large rise in the field of robotics. Robots are being in used in many industries, but there has not been a large surge of robots in the medical field, especially the robots for healthcare use. However, as the aging population keeps growing, current medical staff and healthcare providers are increasingly burdened by caring for the ever-growing number of senior patients, especially those with cognitive impairment of Alzheimer’s disease (AD) and Alzheimer’s disease-related dementia (ADRD) patients. As a result, we can expect to see a large increase in the field of medical robotics, especially in forms of socially assistive robots (SARs) for senior patients and healthcare providers. In fact, SARs can alleviate AD and ADRD patients and their caregivers’ unmet medical needs. Herein, we propose a design outline for such a SAR, based on a review of the current literature. We believe the next generation of SARs will enhance health and well-being, reduce illness and disability, and improve quality of life for AD and ADRD patients and their caregivers. Full article
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Article
Psychometric Testing of the Korean Version of the Attitudes toward the Advance Directives in Low-Income Chronically Ill Older Adults
Healthcare 2020, 8(1), 62; https://doi.org/10.3390/healthcare8010062 - 18 Mar 2020
Cited by 4 | Viewed by 1655
Abstract
The purpose of this study was to examine the psychometric properties of the Advance Directive Attitude Survey in Korean (K-ADAS), a measure of attitudes toward advance directives (ADs). A total of 118 low-income, community-dwelling older adults (mean age, 75.09 years) participated. An exploratory [...] Read more.
The purpose of this study was to examine the psychometric properties of the Advance Directive Attitude Survey in Korean (K-ADAS), a measure of attitudes toward advance directives (ADs). A total of 118 low-income, community-dwelling older adults (mean age, 75.09 years) participated. An exploratory factor analysis (EFA) was conducted to determine the factor structure of the K-ADAS. Validity was further assessed by known associations of the K-ADAS with perceived susceptibility and severity using part of the Advance Care Planning surveys. Its reliability was examined by calculating alpha coefficients. EFA determined a three-factor structure model with good model fit. Validity was further supported with significant correlations between the K-ADAS and susceptibility and severity. Reliability was supported by adequate level of Cronbach’s alpha. The K-ADAS was a valid and reliable measure for assessment of AD attitudes with a sound model fit. Thus, the K-ADAS can be used to assess AD attitudes among community-dwelling elders. Full article
Protocol
Cost-Effectiveness and Effects of a Home-Based Exercise Intervention for Female Caregivers of Relatives with Dementia: Study Protocol for a Randomized Controlled Trial
Healthcare 2020, 8(1), 54; https://doi.org/10.3390/healthcare8010054 - 06 Mar 2020
Cited by 3 | Viewed by 2084
Abstract
Previous research has proposed a range of support interventions to mitigate the adverse impact of caregiving on the daily life of caregivers of relatives with dementia. However, the effectiveness of these interventions shows a high variability. Informal caregivers usually lack the time and/or [...] Read more.
Previous research has proposed a range of support interventions to mitigate the adverse impact of caregiving on the daily life of caregivers of relatives with dementia. However, the effectiveness of these interventions shows a high variability. Informal caregivers usually lack the time and/or live too far from conventional facilities to do physical exercise, especially those who live in rural areas. Thus, home-based interventions may be more efficacious due to their greater convenience for this population. The present work proposes and describes a study protocol for a randomized control trial that will analyze the efficacy and cost-effectiveness of a home-based, structured individual physical exercise intervention to improve the health-related quality of life and the mental health of female informal caregivers of relatives with dementia. The nine-month-long intervention will comprise participation in two supervised physical exercise sessions per week at the caregiver’s home. The proposed study outcomes will be: (1) feasibility of and adherence to the home-based provision of the intervention; (2) improvement in physical fitness and quality of life; and (3) reduction in subjective burden, psychological symptomatology and depression. Analyses will also be performed to determine the cost-effectiveness after the intervention. In conclusion, this intervention might thus represent a tailored and feasible strategy to help caregivers cope with the physical and psychological stress resulting from caregiving-related responsibilities, and it could represent a novel cost-effective support home-based intervention for caregivers. Full article
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