DESIGN: Descriptive, cross-sectional survey.
METHODS: The research method employed in this study is characterized as a methodological study. Self-reported survey data were collected among community-dwelling older adults with chronic diseases residing in suburban counties in China. Including the following psychometric characteristics, item analysis was performed using the decision value method and Pearson's correlation analysis. Content validity was assessed through expert panel evaluation. The internal consistency of the questionnaire was determined by calculating Cronbach's alpha coefficient and corrected item-total correlation. Additionally, confirmatory factor analysis (CFA) was utilized to assess the construct validity of the ACPRS-C.
RESULTS: A total of 228 older adults participated in this psychometric study from August to October 2023. The item content validity index ranged from 0.80 to 1.00, while the scale content validity index was 0.945. The scale demonstrated excellent internal consistency (Cronbach's alpha = 0.931), and the correlation between items and total score was satisfactory. The structural validity was deemed robust (CFA model fit: chi-square/df = 1.121, comparative fit index = 0.992).
CONCLUSION: The ACPRS-C is a scale with strong psychometric properties to assess the ACP readiness within the context of community-dwelling older adults with chronic diseases residing in suburban counties in China. Its reliability and validity hold considerable significance for both research and clinical practice.
METHODS: RCTs comparing the early complication rates following LVSG and LRYGB between 2000 and 2015 were selected from PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane database. The outcome variables analyzed included 30-day mortality, major and minor complications and interventions required for their management, length of hospital stay, readmission rates, operating time, and conversions from laparoscopic to open procedures.
RESULTS: Six RCTs involving a total of 695 patients (LVSG n = 347, LRYGB n = 348) reported on early major complications. A statistically significant reduction in relative odds of early major complications favoring the LVSG procedure was noted (p = 0.05). Five RCTs representing 633 patients (LVSG n = 317, LRYGB n = 316) reported early minor complications. A non-statically significant reduction in relative odds of 29 % favoring the LVSG procedure was observed for early minor complications (p = 0.4). However, other outcomes directly related to complications which included reoperation rates, readmission rate, and 30-day mortality rate showed comparable effect size for both surgical procedures.
CONCLUSIONS: This meta-analysis and systematic review of RCTs suggests that fewer early major and minor complications are associated with LVSG compared with LRYGB procedure. However, this does not translate into higher readmission rate, reoperation rate, or 30-day mortality for either procedure.
STUDY DESIGN AND OUTCOME VARIABLES: This study used data from four waves of the Chinese Longitudinal Health and Longevity Survey (CLHLS) conducted in 2002, 2005, 2008 and 2011. The sample comprised 2137 older adults who were interviewed in 2002 and re-interviewed in the following waves. Cross-tabulations were run to show the rise in chronic disease and disability with age. Ordinal logistic regression was run to examine the debilitating effects of these diseases in terms of the ability of the oldest old to perform activities of daily living.
RESULTS: The prevalence of chronic diseases rose sharply with age. The prevalence rate of six major diseases increased between 38% (respiratory diseases) and 533% (neurological disorder) among respondents who were re-interviewed nine years later. Cardiovascular diseases were the most common. Neurological disorder and cancer were less common, but had the most debilitating effects on patients. Overall, 10.0%, 3.1% and 3.1% of the respondents were disabled by cardiovascular, musculoskeletal and sensorial diseases, respectively. Ordinal logistic regression showed that neurological disorder had the strongest debilitating effects, followed by musculoskeletal and cardiovascular diseases among 2137 older persons who had survived and were followed up from the base year (2002) through 2011.
CONCLUSION: The rapid rise in chronic diseases has resulted in an increased burden of disability among the oldest old in China. There is a need to improve health care systems for the prevention and management of chronic diseases.
METHOD: In this cross-sectional study, 9432 community-dwelling elderly people aged 60 years and older living in rural or urban areas in Haikou were investigated. The interviews collected self-reported information on the presence of four major chronic diseases, as well as socio-demographic characteristics, lifestyle factors and self-reported height and weight.
FINDINGS: Overall, 31.7% (2961/9344) reported at least one of the four chronic diseases. The prevalence of hypertension, diabetes mellitus, COPD, and stroke was 26.0% (2449/9407), 8.0% (749/9371), 1.0% (95/9360), and 1.9% (175/9382), respectively. Common correlates of the four major chronic diseases were older age, being engaged in intellectual work, currently being a smoker and obesity. Gender, locality of residence, and alcohol consumptions were also found to be associated to some of the chronic conditions.
CONCLUSION: This finding indicates that multiple chronic conditions among elderly people in Haikou are prevalent and warrant special attention to reduce diseases burden and align health care services to cater the holistic elderly patients' need.
METHODS: Secondary analysis was carried out of data from the Malaysian national survey that involved 2322 community residents aged 60 years or older in Peninsular Malaysia. Cognition was measured by the digit symbol substitution test. Metabolic syndrome was assessed by five biomarkers: triglyceride, fasting blood sugar, systolic blood pressure, cholesterol ratio and body mass index. Chronic conditions were assessed by self-reported medical history. The structural equation modeling technique was used to analyze the mediation and moderation tests.
RESULTS: The number of chronic conditions partially mediated the association between metabolic syndrome and cognition. Men and women did not differ in the relationship between metabolic syndrome and cognition; however, the number of chronic conditions was found to be negatively associated with cognition in older women, but not in men.
CONCLUSIONS: Metabolic syndrome might increase the likelihood of older adults to suffer from more chronic conditions; these responses might reduce their cognition. To prevent cognitive decline in old age, specific intervention to minimize the number of chronic conditions by reducing their vascular risk factors is warranted, especially among older women. Geriatr Gerontol Int 2017; 17: 1914-1920.