Search Results (142)

In this paper, the authors survey and summarize the widely researched morbidities and their life expectancy results. A constant impaired mortality adjustment for each morbidity is defined so that life expectancy is consistent with current medical research. Impaired mortality factors are derived and used to evaluate morbidity’s impact on retirement benefits. A morbidity-based pension benefit evaluation algorithm is proposed. Popular pension payment options, such as single life payment and joint life, are evaluated. The authors found that the optimal decision is highly sensitive to health status: lump sums are preferred when health is impaired, whereas annuities dominate for healthier individuals. Full article

Background/Objectives: Financial toxicity (FT) refers to the financial burden directly or indirectly caused by a patient’s medical care. Patients with head and neck cancer (HNC) are particularly vulnerable to FT due to lower rates of return to work and higher out-of-pocket payments (OOPP). In this cross-sectional study, we assessed the amount and types of OOPP, as well as the prevalence of FT, in HNC patients who had completed curative radiotherapy. Methods: We included HNC patients who underwent curative-intent radiotherapy at four private clinics in Romania, within 12 months of completing treatment. Participants completed a 25-item questionnaire capturing sociodemographic information, insurance status, income, and OOPP. To assess subjective FT, we used the validated nine-item Financial Index of Toxicity (FIT), which measures three FT domains: financial stress, financial strain, and lost productivity. Each domain and the total score range from 0 to 100, with higher scores indicating greater financial toxicity. Descriptive statistics were used to summarize patient characteristics. Pearson’s chi-square, t-tests, and one-way ANOVA were used to assess statistical associations, with a significance threshold of p < 0.05. Results: Among 113 patients (mean age: 59), the majority were male (74.3%) and married (74.3%), with 40% having completed university or higher education. The most frequent tumor sites were the oropharynx (29 cases), larynx (22), and oral cavity (21). Concurrent chemoradiation was the most common treatment modality (47%). The mean total FT score was 18.8. Overall, 39.8% of patients experienced financial toxicity, and 29.2% scored above the mean in financial stress. Moderate financial strain (score > 21) was reported by 39.8% of participants, and approximately one-third reported loss of productivity. Transportation and nutritional supplements were the most common OOPP categories. Notably, 42% of patients spent at least 400 euros—equivalent to Romania’s monthly minimum income—on transportation during radiotherapy. FT was significantly associated with employment and marital status, but not with tumor site or treatment type. Conclusions: Among Romanian HNC patients treated with curative radiotherapy, we found substantial OOPP, particularly for transportation and nutritional supplements. While overall FT levels were moderate, divorced patients and those retired due to other chronic conditions were the most vulnerable to financial distress. Financial toxicity can directly affect treatment adherence, survival, and quality of life. By integrating financial counseling, social support, and broader coverage of treatment-related expenses, healthcare systems can mitigate FT for these patients. Full article

Taking the “Broadband China” policy (BCP) as a quasi-natural experiment, this paper utilizes nationwide tracking data from the China Health and Retirement Longitudinal Survey (CHARLS) for 2011, 2013, 2015, and 2018 and employs a Difference-in-Differences (DID) model to evaluate whether and how urban information infrastructure development affects resident health. We identify a clear and significant improvement in health outcomes attributable to BCP. After the implementation of BCP, physical health and mental health increase by 2.5% and 1.7%, respectively. Furthermore, mechanism analysis confirms that BCP enhances resident health primarily by improving information and communication technology (ICT) levels and by promoting local economic development. The positive health effect of BCP is more pronounced in regions with a better medical environment, suggesting the presence of complementary public-service capacity. At the individual level, heterogeneity tests reveal that BCP exerts a stronger positive influence on the physical health of male and rural respondents, while the benefits for older respondents are relatively smaller. At the city level, the health-promoting effect of BCP is stronger in economically less developed regions, and cities with higher administrative status exhibit more substantial health improvements. Full article

Background: Cognitive impairment is a major health problem, so several studies worldwide have studied its aggravating and protective factors. However, few studies have looked into the prediction of better or worsening cognitive status based on the presence of the most relevant biopsychosocial factors. Thus, the aim of this study is to predict cognitive status classification, specifically into normal cognitive status, mild cognitive impairment, and severe cognitive impairment, based on the most studied risk and protective factors in the context of the Survey of Health, Ageing and Retirement in Europe and Harmonized Cognitive Assessment Protocol association (SHARE-HCAP) project. Methods: Participants were from five European countries, and measures included their cognitive status classification from SHARE-HCAP and several associated factors previously measured in the eighth wave of SHARE. Results: A multinomial logistic regression was performed, with normal cognition as the reference category. Most individuals were correctly classified. Conclusions: Frequent participation in social activities and good cognitive task performance were associated with a lower likelihood of mild cognitive impairment compared to normal cognitive status. In turn, higher scores in depression and social network were associated with an increased likelihood of being classified as MCI in contrast to normal cognition. Additionally, being a woman and having worse cognitive performance were predictors of severe cognitive impairment classification over normal cognition status. Depression also contributed to a higher likelihood of being classified as mild and severe cognitive impairment, in contrast to a normal cognitive status. These findings highlight the importance of preventive medical check-ups and interventions before the onset of the first cognitive decline symptoms. Full article

As the Buddhist monastic community in Korea has entered an era marked by aging demographics, the issues surrounding the welfare of the order’s monastics in their retirement years have become increasingly pressing. In response, in 2011, the Jogye Order enacted the Monastic Welfare Act and established the Monastic Welfare Society with the aim of enabling monks to fully devote themselves to their religious duties by assuming institutional responsibility for their healthcare, pension, residential welfare, and end-of-life needs. Over a decade since the system’s implementation, the Jogye Order has achieved notable progress towards achieving the Monastic Welfare Act’s aims. However, while the order has stabilized medical coverage for its clergy, there remain considerable gaps in its provisions for income and housing for elderly monastics. This article surveys the Jogye Order’s efforts to establish systemic care for its elderly monastics, with a particular focus on the Jogye Order’s 2011 Monastic Welfare Act and subsequent activities of the Monastic Welfare Society. It then critically examines the current state of eldercare within the order, along with its strengths and weakness, before engaging in a comparative discussion regarding the clerical eldercare and welfare systems provided by both the Korean Catholic Church and the Thai Buddhist community. Full article

Background: Direct clinical training on real patients is essential in dental education. However, the declining patient inflow increasingly challenges this objective. This cross-sectional study aimed to assess patients’ experiences and preferences to derive recommendations for improving patient recruitment. Material and Methods: Over a period of one year, patients treated by students in the courses and final examinations at the dental school of conservative dentistry were questioned using a specially designed questionnaire and reviewed using their medical records. They were asked about their complete treatment process, and patient files were used to record socio-demographic as well as economic and appointment-specific data. Results: We analysed 297 patients (142 women, 47.8%; 155 men, 52.2%) treated by undergraduates across two semesters (four courses) and two final examinations. Median age was 57.0 years (IQR 46–67; mean 55.2, SD 15.2; range 14–85) with no sex-based difference (p > 0.05). Arrival was predominantly by car (72.7%, n = 216); median one-way distance was 20.5 km (IQR 11.2–32.1); and 58.4% were employed, while 41.6% were not employed (33.7% retired, 7.9% unemployed). The leading reason for course attendance was “satisfaction with previous treatments” (65.32%). Information sources were reported by 290/297 (98%); the most common was already being a course patient (143, 48.1%). Most patients attended one appointment (109, 36.7%). Median travel cost per appointment (including parking) was €17.0 (typically €10.0–€23.5). Of 285 respondents, 93.68% answered “Yes” to satisfaction with student treatment. Conclusions: Important steps include enhancing parking facilities, optimizing recall systems and appointment accessibility, and strengthening relationships with regular patients to encourage word-of-mouth referrals. The main focus is to maintain high clinical quality, ensure affordability, and further reduce patient copayments where possible. Full article

Background/Objectives: For most adults receiving a cochlear implant (CI), the primary goal is to enhance their oral communication with others. The aim of this study was to investigate the total CI usage time per day among retired CI users and to characterize in which auditory environments they were using their CI. One additional aim was to analyze whether usage time, auditory environment, or social factors influenced CI speech perception. Methods: Participants completed a questionnaire addressing retirement status, whether they lived with another adult, educational level, and participation in social activities. Speech perception scores were obtained from medical records, and CI datalogging was extracted from the CI programming software. Results: Seventy-three CI users aged >65 years were included. The average usage was 12.9 h/day. No statistically significant correlations were found between total usage time or time spent listening to speech and CI speech perception. CI users who regularly met with family or friends had statistically significantly higher CI speech perception than those who did not (p = 0.003). Conclusions: Social interaction may play a crucial role in supporting speech perception among elderly CI users. Opportunities for communication and participation in social life appear to be important for maximizing benefit. Full article

Background: The continuous expansion of the National Reimbursement Drug List has led to an increasing cost disparity among alternative drugs for the same indications. Under the current proportional reimbursement mechanism, choosing higher-cost treatments often results in higher compensation. Given the lack of empirical evidence on whether income affects the medication choices of insured individuals in the Chinese context, this study aims to evaluate the impact of income levels on drug selection, providing a basis for optimizing the medical insurance reimbursement policy. Methods: This study extracts data from hospitalized patients enrolled in basic medical insurance from the China Health and Retirement Longitudinal Study (CHARLS) database and preprocesses it in Excel. Subsequently, SPSS is used to conduct descriptive statistics, difference analysis, correlation analysis, and regression analysis on the processed data to explore the impact of income levels on drug selection. Results: After controlling for length of hospitalization and hospitalization costs, the regression coefficient for urban employee basic medical insurance participants is β = 0.505 (p < 0.01), and the regression coefficient for new rural cooperative medical insurance participants is β = 0.195 (p < 0.01). This means that, regardless of whether participants are enrolled in urban employee basic medical insurance or new rural cooperative medical insurance, an increase in income will lead to higher hospitalization drug costs. Conclusions: Compared to low-income insured individuals, high-income participants in the basic medical insurance are more likely to choose higher-cost drugs among alternatives, which leads to unfair reimbursement under the current proportional reimbursement system. Full article

Annuity insurance is a crucial financial tool for mitigating risks associated with aging, yet it has not gained significant traction in China’s insurance market, especially amid the challenges posed by an aging population. This study develops a discrete-time multi-period life-cycle model to analyze optimal annuity purchases for China’s middle-aged population under disability risk and explores in depth the impact and underlying mechanisms of disability risk on their annuity insurance purchase decisions. Disability is endogenized via two channels: financial-constraint effects (medical costs and pre-retirement income loss) and stochastic health state transitions with recovery and mortality. Using data from China Health and Retirement Longitudinal Study (2018–2020) to estimate age- and gender-specific transition matrices and data from China Household Finance Survey (2019) to link income with initial assets, we solve the model by the endogenous grid method and simulate actuarially fair annuities. The findings reveal substantial under-demand for annuities among China’s middle-aged population. Under inflation, the modest yield premium of annuities over inflation significantly depresses purchases by middle- and low-wealth households, while high-wealth individuals are jointly constrained by rapidly rising health expenditures and inadequate annuity returns. Notably, behavioral patterns could shift fundamentally under a hypothetical zero-inflation scenario. Full article

Background and Objectives: Inflammatory bowel diseases (IBDs) are chronic conditions of the digestive tract, often requiring life-long treatments in order to achieve and maintain remission. However, treatment adherence among patients with IBD can frequently be suboptimal, which can compromise disease control and long-term outcomes. The aim of this study was to analyze the adherence rate and to identify factors that significantly influence treatment adherence in patients with IBD. Materials and Methods: The study employed a cross-sectional design and was conducted at the Fundeni Clinical Institute, a tertiary medical center in Bucharest, Romania. The treatment adherence was assessed using the Medication Adherence Report Scale-5 (MARS-5), with patients scoring greater than 23 considered adherent. Anxiety, depression and perceived stress were assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS), and coping strategies were assessed using the Brief Coping Orientation to Problems Experienced Inventory (Brief COPE Inventory). Results: A total of 188 patients were included in the final analysis. Of these, 99 patients (52.7%) were male and 109 (58.0%) had a diagnosis of Crohn’s disease. The majority of patients (81.9%) were receiving treatment with advanced therapies, including biologics or small molecules. Forty patients were receiving their therapy through more than one route of administration. Optimal adherence was noted in 160 patients (85.1%). Patients treated with advanced therapies (biologics and small molecules) had significantly higher odds of optimal adherence (OR 10.52, 95% CI: 4.3–25.74, p < 0.001), with a rate of adherence of 92.2%. Significantly lower odds of adherence were found for the oral (OR 0.35, 95% CI: 0.14–0.83, p = 0.01) and rectal (OR 0.09, 95% CI: 0.03–0.29, p < 0.001) routes of administration, while the intravenous administration had higher odds of adherence (OR 4.85, 95% CI: 1.02–22.9, p = 0.04) compared to the subcutaneous route. Other factors associated with an improved adherence were being retired (OR 3.5, 95% CI: 1.13–10.8, p = 0.029) and using positive reframing (p = 0.04), planning (p = 0.01) and venting (p = 0.02) as coping strategies; active smoking (OR 0.26, 95% CI: 0.11–0.6, p = 0.002), active disease (OR 0.36, 95% CI: 0.16–0.81, p = 0.014) and behavioral disengagement (p = 0.04) were associated with impaired treatment adherence. No significant differences in adherence were observed between disease phenotypes. Conclusions: The route of administration, smoking status and psychosocial factors, such as perceived stress of social support and coping strategies, may play an important role in influencing treatment adherence in patients with IBD. While the disease phenotype was not associated with differences in adherence, patients with active disease had significantly lower odds of optimal adherence. Full article

Background/Objectives: The COVID-19 pandemic has had a profound impact on the mental health of the general population, particularly older adults. This study aimed to explore the association between loneliness and mental health disorders in this demographic during the pandemic. Methods: A cross-sectional survey was conducted in Portugal using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) database between June and August 2020, during the COVID-19 pandemic (Wave 8 COVID-19 Survey), using computer-assisted telephone interviews. Results: The final sample included 836 participants, with 387 (46.4%) men and a mean age of 74.5 years (SD = 6.7). Mental health indicators revealed that 441 (52.1%) reported feelings of nervousness, 384 (45.3%) experienced sadness or depression, 349 (41.2%) encountered sleeping difficulties, and 280 (33.1%) reported experiencing loneliness often or some of the time. Increased feelings of loneliness were notably associated with women in poorer health, those with heightened fear of falling, dizziness, fatigue, anxiety, depression, and concurrent health and sleep issues. Age and medication use did not significantly impact feelings of loneliness. Conclusions: The findings highlight a potential association between adverse mental health outcomes among older adults during the initial phase of the pandemic. Future research, employing longitudinal research designs, is warranted to explore these relationships more rigorously, in a post-pandemic context, and to inform effective intervention development and strategies to prevent mental health problems within this vulnerable population. Full article

Background: The present study seeks to examine how social disparities relate to the prevalence of poor glycemic control (HbA1c ≥ 7%), comorbidities such as hypertension and dyslipidemia, and diabetes-related complications (microvascular or macrovascular) among Saudi patients diagnosed with type 2 diabetes. Methods: A cross-sectional study was conducted among 574 patients with type 2 diabetes mellitus (T2DM) attending family medicine clinics at King Saud University Medical City in Riyadh. Participants were selected using a simple random sampling technique and interviewed via phone using a validated questionnaire. Data collected included demographic and clinical variables. Descriptive statistics and multivariate logistic regression analyses were performed to assess the association between socioeconomic status (SES) and cardiovascular complications, including stroke, dyslipidemia, hypertension, and acute coronary syndrome. Result: The analysis revealed that certain socioeconomic factors significantly increased the odds of cardiovascular complications among patients with T2DM. Being female was associated with higher odds of hypertension (OR = 2.29, p = 0.014), dyslipidemia (OR = 2.59, p = 0.012), acute coronary syndrome (ACS) (OR = 2.35, p = 0.001), and stroke (OR = 2.17, p = 0.003). Divorced or widowed participants had significantly increased odds of ACS (OR = 2.91, p = 0.001) and stroke (OR = 2.83, p = 0.002). A lower educational level (secondary school or less) was significantly associated with increased odds of hypertension (OR = 2.64, p = 0.031), dyslipidemia (OR = 2.22, p = 0.005), and stroke (OR = 2.88, p = 0.042). Monthly income between 3001 and 6000 SAR was significantly associated with higher odds of ACS (OR = 2.61, p = 0.003) and stroke (OR = 2.64, p = 0.012). Participants with diabetes duration >15 years had higher odds of dyslipidemia (OR = 2.86, p = 0.004) and stroke (OR = 2.89, p = 0.005). Being retired or not working increased the odds of all four cardiovascular outcomes, with stroke showing the highest risk (OR = 3.18, p < 0.001). Living outside the Riyadh region was also associated with elevated risk across outcomes, notably stroke (OR = 1.52, p = 0.046). Conclusions: The study concluded that notable social disparities exist among diabetic individuals affected by cardiovascular conditions, such as stroke and acute coronary syndrome (ACS), as well as risk factors for cardiovascular disease like dyslipidemia (DLD). These findings can inform targeted cardiovascular risk reduction strategies and address health inequities among diabetic populations in Saudi Arabia. Full article

This observational pilot study investigated neurocardiovascular responses to an active stand test using continuous physiological monitoring and functional data analysis (FDA) in older women. A sample of 25 community-dwelling female adults aged 59–78 years (mean age: 70.3 years) participated. Participants were dichotomized into comparison groups based on five factors: age (<70 vs. ≥70 years); the presence of initial orthostatic hypotension (IOH, yes/no); body mass index (BMI < 25 vs. ≥25 kg/m²); antihypertensive medication use (yes/no); and physical frailty status assessed by the Survey of Health, Ageing and Retirement in Europe—Frailty Instrument (SHARE-FI score < −0.5 vs. ≥−0.5). Each participant completed an active stand test during which six physiological signals were continuously recorded: systolic (sBP) and diastolic (dBP) blood pressure and heart rate (HR) via digital artery photoplethysmography and left frontal oxygenated hemoglobin (O₂Hb), deoxygenated hemoglobin (HHb), and tissue saturation index (TSI) via near-infrared spectroscopy (NIRS). The signal analysis focused on a standardized 200 s window spanning 50 s before to 150 s after the stand, with all signals resampled and synchronized at 5 Hz. FDA was used to statistically compare the full time series between groups for each signal. Group-level differences revealed that younger participants (<70 years) exhibited significantly higher HR in multiple periods following the stand (~10 s, ~30 s, ~90 s, and ~140 s post-stand) compared to their older counterparts. Participants with IOH demonstrated significantly lower sBP at ~10 s, ~80 s, and ~130 s post-stand and lower dBP at ~10 s post-stand. Among participants classified as overweight/obese (BMI ≥ 25 kg/m²), significantly lower levels of HHb were observed at ~10 s, ~30–50 s, and ~60 s post-stand, while O₂Hb levels were reduced at ~50 s, ~60 s, ~70–110 s, ~130 s, and ~140 s post-stand. No statistically significant group-level differences were observed based on antihypertensive medication use or frailty status. These findings demonstrate the utility of FDA in detecting subtle, time-dependent physiological variations during orthostatic challenge and underscore the value of continuous neurocardiovascular monitoring in assessing orthostatic tolerance in aging populations. Full article

Background: Chronic kidney disease (CKD) significantly affects health-related quality of life (HRQoL), impacting physical and mental well-being. This study aimed to identify the key determinants influencing HRQoL among patients with CKD. Methods: A cross-sectional observational study was conducted from July 2022 to March 2023 at the Rajiv Gandhi Cooperative Multi-Specialty Hospital, Palakkad, Kerala, South India, including 154 patients diagnosed with CKD stages 3 to 5. Eligible participants were required to be at least 18 years of age and have a confirmed diagnosis of CKD, specifically stages 3 to 5, with prior treatment. CKD stages were defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines, based on estimated glomerular filtration rate (eGFR) thresholds as follows: Stage 3 (eGFR 30–59 mL/min/1.73 m²), Stage 4 (eGFR 15–29 mL/min/1.73 m²), and Stage 5 (eGFR < 15 mL/min/1.73 m²). Participants were classified into stages based on their most recent stable eGFR value at the time of recruitment. HRQoL was assessed using the European Quality of Life-5 Dimensions-3 Levels (EQ-5D-3L) questionnaire. Chi-square, ANOVA, and multivariate regression were used to analyze associations with EQ-5D-3L domains. Results: Out of 154 participants, 68.8% were male, 91.6% were aged over 50 years, and 63.6% were from rural areas. Most had primary education (55.2%) and were unemployed, retired, or housewives (66.2%). As CKD progressed, comorbidities, particularly diabetes mellitus and coronary artery disease (CAD), increased, with Stage 5 showing the highest prevalence. Clinical markers showed significant declines in the glomerular filtration rate (GFR) (Stage 3: 49.16 ± 7.59, Stage 4: 22.37 ± 3.88, Stage 5: 8.79 ± 1.68) and hemoglobin (Stage 3: 10.45 ± 0.84, Stage 4: 8.88 ± 0.60, Stage 5: 7.12 ± 0.53) and an increase in serum creatinine (Stage 3: 1.72 ± 0.40, Stage 4: 3.21 ± 0.44, Stage 5: 7.05 ± 1.46). HRQoL assessments showed significant declines in mobility, self-care, usual activities, pain, and anxiety/depression with advancing CKD. Mobility issues increased from 61.2% in Stage 3 to 62.0% in Stage 5, with greater difficulties in self-care and usual activities at Stage 5. Pain and anxiety/depression worsened across stages. Multivariate analysis identified female gender, older age (≥50 years), lower education, unemployment, multiple comorbidities, smoking, lack of social support, and advanced CKD stages as significant factors linked to impaired HRQoL. CKD stage 5 (GFR < 29 mL/min/1.73 m²) and high serum creatinine (>1.2 mg/dL) were associated with significantly higher odds of impairment in all HRQoL domains. Conclusions: This study highlights that factors such as female gender, older age, lower education, unemployment, multiple comorbidities, smoking, advanced CKD stages, and high serum creatinine levels are associated with reduced quality of life in CKD patients. Conversely, social support acts as a protective factor. The findings emphasize the need for targeted interventions that address both medical care and psychosocial aspects, including lifestyle changes, patient education, mental health support, and community involvement, to improve CKD patients’ well-being. Full article

Background: Rare diseases are defined as clinical conditions that affect only a small number of persons in a population, considered fewer than 1 per 2000 in the European Union or fewer than 1 per 1600 in the United States They are serious, often chronic and progressive conditions, characterized by a pronounced clinical polymorphism that crosses all medical specialties. Multiple areas of life beyond just physical health are affected with significant impact on patients, families, and healthcare systems. Objective: To analyze the socio-demographic, medical, and vocational characteristics that correlate with functional status and work disability as a measure of quality of life in rare diseases. Methods: An observational retrospective study of adults with rare diseases evaluated for eligibility for social insurance rights in the National Institute of Medical Assessment and Work Capacity Rehabilitation Bucharest (INEMRCM, the Romanian abbreviation) over a 5-year period was made. Descriptive analysis was used to present sample characteristics. Means and standard deviations (SD) were calculated to describe numerical variables, frequencies were used to describe categorical variables, and logistic regression analysis was conducted to evaluate potential predictors of work capacity. All statistical analyses were performed by PSPP.3 software. p < 0.05 was the cut-off for statistical significance with a 95% confidence interval. Results: 90 consecutive persons were included in the survey. The mean age of the group was 44.5 years ± SD 10.61 years, with a female/male ratio of 48/42 persons. The mean disease duration was 10.61 years ± SD 9.76 years. Men had more severe disease (73.81%); p = 0.018 and significantly younger retirement age, M/F = 39.10 ± 12.26/43.06 ± 9.32; p = 0.037. Less disabling diseases were predominant autoimmune conditions (85.71% of cases); genetic conditions had a more severe functional impact in 63.75% of cases; p = 0.037. People with multisystem diseases but with specific or targeted treatment can work more frequently (76.19%); those with visual impairment have more severe impairments (73.77%); p < 0.001. All individuals who received specific therapy had a better functional status, unlike only 37.21% of those who received symptomatic treatment or treatment for complications; p = 0.023. Logistic regression analysis indicated that the type of impairment and the availability of specific treatments could serve as predictors of a reduced likelihood of employment in rare disease cases. Education level and occupation were not correlated with functional impairment and work disability (NS). Conclusions: Several factors, including some that are modifiable, were associated with better outcomes, such as reduced disability and an increased potential for work participation. Sex, disease etiology, type of impairment, and treatment were all significantly linked to functional capacity. Among these, the type of impairment and the availability of specific treatments might be predictors of employment. Addressing these parameters requires a multidisciplinary team, involving specialized care and comprehensive support services to improve the overall quality of life of individuals affected by rare diseases. Full article