Elderly Health Journal

Fear of Falling and Quality of Life in Older Hemodialysis Patients in Tehran Hospitals

Mohammad Dehesh — 2024-06-29

Introduction: Several factors influence the quality of life (QoL) of older adults, particularly those on hemodialysis. Fear of falling and its resulting limitations are significant contributors. This study investigated the association between fear of falling and QoL in older hemodialysis patients in Tehran hospitals .

Methods: A descriptive-correlational design was used with 197 older hemodialysis patients in Tehran hospitals (2021) recruited through convenience sampling. Data were collected using a demographic questionnaire, the Falls Efficacy Scale-International , and the Leiden International Psychogeriatric Assessment of Life Functions scale to assess QoL. Spearman's rank correlation was performed using SPSS-21 software.

Results: The mean QoL score (54.68 ± 16.09) indicated a moderate level. The mean fear of falling score (35.29 ± 13.54) reflected a high level. A significant negative correlation (R = -0.63, p = 0.001) was found between fear of falling and QoL.

Conclusion: Our findings suggest that increased fear of falling is associated with a decrease in QoL among older hemodialysis patients. Further research is warranted to explore interventions aimed at managing fear of falling, preventing falls, and ultimately improving QoL in this population.

Longitudinal Health Consequences of Insomnia Symptoms among Middle-Aged and Older Adults in Thailand

Supa Pengpid — 2024-06-29

Introduction: Insomnia symptoms may impact on various health outcomes. It is unclear how insomnia symptoms impact on health in Thailand. In a longitudinal study of ageing adults in Thailand, the goal of the research was to evaluate the relationships between insomnia symptoms and 20 health indicators.

Methods: Prospective cohort data from the Health, Aging and Retirement in Thailand study, which included participants 45 years of age and older (N = 2863) from three successive waves in 2015, 2017, and 2020 were analyzed. Insomnia symptoms and health indicators were assessed by self-report. Generalized Estimating Equations analysis and logistic regression analysis were used to evaluate the longitudinal relationships between measures of insomnia symptoms and 20 health indicators.

Results: In 2020, 11.7% of people reported having insomnia symptoms, compared to 15.6% in 2015 and 14.6% in 2017. Insomnia symptoms were positively correlated with three poor mental health indicators (depressive symptoms, quality of life and self-rated mental health), eight poor physical health indicators (hypertension, self-rated physical health status, cardiovascular disease, diabetes, osteoporosis, chronic lung disease, kidney disease, and physical injury), and two lifestyle indicators (physical inactivity and meal skipping) in logistic regression models.

Conclusion: The study found that a number of indicators of physical and mental illness as well as lifestyle choices were linked to symptoms of insomnia. Improved detection and management of insomnia symptoms could lower indicators of physical and mental illness in Thailand.

Neglect in Nursing Homes: Prevalence and Risk Factors

Zahra Khalili — 2024-06-29

Introduction: Neglect refers to the failure to meet the needs and well-being of elderly individuals. This can include inadequate care by responsible caregivers or a lack of essential necessities such as food, water, shelter, personal hygiene, medication, comfort, and safety. Despite the prevalence of neglect, no studies have specifically investigated its occurrence and related factors among elderly residents in nursing homes in Iran. In this study, we aimed to address this gap by examining neglect among older adults covered by state welfare centers in Ardabil city (Iran) in 2020.

Methods: We conducted a cross-sectional analytical study involving 130 older people in Ardabil, located in northwestern Iran. Our data collection tool consisted of a two-part questionnaire: one section focused on demographic information and the Elder Neglect Checklist. Participants were selected through a census from older adults residing in nursing homes. Data analysis was performed using SPSS software (version 22).

Results: Among the 130 participants, 56 (43.08%) were male, and 74 (56.92%) were female. The overall prevalence of neglect was 39.2%. Dental problems were the most common type of neglect (36.2%), followed by neglect related to providing a healthy environment (24.6%). Additionally, our findings revealed significant associations between neglect and marital status (p = 0.001), previous occupation (p = 0.002), and a history of illness (p = 0.046).

Conclusion: The study highlights a concerning rate of neglect among elderly individuals, posing serious risks to their health and security. To address this issue, health and welfare officials, along with nursing homes, should implement necessary measures to improve the well-being of older adults and align with international standards.

Social Support, Body Image, and Death Anxiety in Later Life: A Cross-Sectional Study in Yazd City, Iran

Mohammad Ali Morowatisharifabad — 2024-06-29

Introduction: Social support is a crucial factor in how well older adults adjust to the aging process and related challenges, such as anxiety about death. Body image in older adults is a complex and important concept, yet it has been under-researched. This study examined the correlations between social support, death anxiety, and body image in older adults residing in Yazd City, Iran.

Methods: This cross-sectional study involved older adults from Yazd City, Iran, who visited comprehensive urban health centers in 2022. A convenience sample of 200 participants was selected. They completed questionnaires on demographics, social support perception, body image concerns, and death anxiety.

Results: The total social support score (p < 0.01) as well as the score of family support (p < 0.05) and others' support (p < 0.01) showed a significant negative correlation with death anxiety. However, no significant association was found between death anxiety and body image, nor between social support and body image. Regression analysis revealed that only "support from others" was a significant predictor of death anxiety (p < 0.01). Men reported receiving more friends' social support than women (p < 0.05). Participants with higher socioeconomic status were more likely to receive greater family’s social support (p < 0.01) and experience less death anxiety (p < 0.05).

Conclusion: Social support positively impacts the mental well-being and morale of older adults. It can, therefore, be considered a readily available resource and a form of social capital to reduce death anxiety, enhance their sense of purpose, and improve their quality of life.

Emotion Regulation Mediates the Associations of Loneliness and Empathy with Death Anxiety in the Elderly

Roya Ahmadimajd — 2024-06-29

Introduction: In old age, diseases and frailty can be minimized through proper care and understanding, paving the way for healthy and normative aging. The present study aimed to investigate the mediating role of emotion regulation in the relationship between loneliness and empathy with death anxiety in the elderly.

Methods: This study utilized structural equation modeling. The statistical population included all elderly residents of Ahvaz, Iran, in 2023. Convenient sampling was employed to select 108 elderly individuals. The research instruments included the Death Anxiety Scale, UCLA Loneliness Scale, Interpersonal Reactivity Index, and Cognitive Emotion Regulation Questionnaire. Pearson correlation coefficient and structural equation modeling were adopted for data analysis.

Results: There was a direct relationship between loneliness and adaptive emotion regulation and maladaptive emotion regulation in the elderly. Additionally, there was a direct relationship between empathy and death anxiety, adaptive emotion regulation, and maladaptive emotion regulation. Moreover, a positive relationship was observed between maladaptive emotion regulation and death anxiety, while a negative relationship existed between adaptive emotion regulation and death anxiety in the elderly (p < 0.001). The results revealed an indirect relationship between loneliness and death anxiety mediated by emotion regulation. There was also an indirect relationship between empathy and death anxiety mediated by emotion regulation (p < 0.001).

Conclusion: The proposed model exhibited a good fit. Therefore, raising awareness and implementing measures to empower the elderly in emotion regulation concerning the relationship between loneliness and empathy can play a key role in reducing their death anxiety.

The Effect of Eight-Week Kegel Exercise on Quality of Life in Postmenopausal Females with Urinary Incontinence

Elham Afshari — 2024-06-29

Introduction: Urinary incontinence (UI) is the leakage of urine which is often uncontrollable and can negatively impact on the quality of life (QoL). The aim of this study was to determine the effects of an eight-week of Kegel exercise as a complementary therapy on QoL in postmenopausal females with UI.

Methods: The study design was a quasi-experimental pre-test post-test with a control group trial. The participants were Iranian women aged between 60 to 95 years with UI problems referring to medical centers in Najafabad city in Isfahan Province, Iran. Twenty four female UI patients were recruited and randomly divided into Kegel exercise (n = 12) and control group (n = 12). The Kegel group received exercise three times a week for eight-week, and the control group continued their routine life. The Questionnaire for Urinary Incontinence Diagnosis and the World Health Organization Quality of Life questionnaire were used for data collection. The variables were measured before and after the Kegel protocol in both groups. Descriptive statistics and analysis of covariance were used to assess variable differences between groups (p < 0.05).

Results: The mean age of UI patients was 70.83 ± 7.61 years old. Analysis of variance demonstrated a significant decrease in stress urinary incontinence symptoms (F = 61.88, p = 0.01), urge urinary incontinence symptoms (F = 111.56, p = 0.01), and UI symptoms (F = 88.20, p = 0.01), and significant increase in physical health (F = 28.93, p = 0.01), psychological health (F = 15.35, p = 0.01), social relationships (F = 18.83, p = 0.01), environment health (F = 155.51, p = 0.01), QoL (F = 132.07, p = 0.01) in Kegel exercise group.

Conclusion: Kegel exercise can be an effective complementary therapy for improving QoL in postmenopausal female suffering from UI. Healthcare providers should consider recommending Kegel exercise as part of comprehensive treatment approach for postmenopausal female with UI to help alleviate symptoms and enhance their overall QoL.

Comparison of the Effects of Mobile Learning and Traditional Self-care Education on Loneliness and Social Isolation in Community-dwelling Older Adults: Study Protocol of a Three-Arm Randomized Controlled Trial

Nasrin Nikpeyma — 2024-06-29

Introduction: Loneliness and social isolation are common problems in older adults, which has negative effects on health. Increasing self-care ability seems to help. Therefore, the present study will be conducted with the aim of comparing the effects of mobile learning and traditional self-care education on loneliness and social isolation in community-dwelling older adults.

Methods: This three-arm randomized controlled trial will be conducted in Tehran-Iran 2024. The qualified older adults from health centers in Tehran city will be consecutively selected and randomly allocated into three groups: mobile learning (n = 40), traditional education (n = 40), and control (n = 40). The loneliness inventory for older adults, Lubben social network scale, and demographic characteristics will be used to collect information, and completed before, immediately, and 12 weeks after the intervention. The data will be analyzed using descriptive and inferential statistics by SPSS software version 16 at a significance level of p < 0.05.

Conclusion: This clinical trial will determine the most successful and cost-effective approach in reducing loneliness and social isolation in older adults. The results are expected to improve the self-care skills of the older adults, thereby reducing the negative consequences of loneliness and social isolation, including various health issues and mortality rates, in the long run.

Comparison of Mindfulness-Based Cognitive Therapy and Integrated Transdiagnostic Psychotherapy for Emotion Regulation and Distress Tolerance

Masoumeh Bigonah Roodmajani — 2024-06-29

Introduction: Cardiac disease significantly impacts global health, causing substantial disability and mortality. This study compared the effectiveness of mindfulness-based cognitive therapy (MBCT) and integrated transdiagnostic psychotherapy (ITP) on emotion regulation and distress tolerance in patients with type D personality, characterized by social inhibition and negative affectivity.

Methods: A semi-experimental design randomly assigned 60 cardiac patients with type D personality from Simorgh Heart Clinic, Mashhad, Iran, in 2022, to MBCT group (n = 20), ITP group (n = 20) and control group (n = 20). The MBCT and ITP groups received respective interventions, while the control group received no intervention. Emotion regulation and distress tolerance were assessed using validated scales before and after the interventions.

Results: MBCT demonstrated significantly greater improvement in both emotion regulation and distress tolerance compared to ITP and the control group.

Conclusion: This study suggests that MBCT may be a more effective intervention than ITP in improving emotion regulation and distress tolerance in cardiac patients with type D personality. Mindfulness-based approaches could offer valuable tools for managing emotional challenges in this population.

Awareness: the Golden Key to Understanding Healthcare Seeking Behavior among Elderly Hypertensive Patients in Taft, Iran

Mandana Pirouz — 2024-06-29

Introduction: Healthcare seeking behavior is crucial for early detection and proper management of hypertension in the elderly. This study investigated the factors influencing healthcare seeking behavior among elderly hypertensive patients residing in Taft, Iran.

Methods: This cross-sectional study recruited 230 hypertensive individuals aged 60 and above residing in Taft, Yazd Province, Iran. Participants were randomly selected and completed a questionnaire through face-to-face interviews. The questionnaire assessed their healthcare seeking behaviors and potential influencing factors. Data analysis was performed using SPSS software. Correlation tests and linear regression analysis were employed to identify significant relationships (p < 0.05).

Results: A significant majority (70%) of participants reported always paying attention to symptoms of high blood pressure. When experiencing symptoms, over half (53.9%) of the participants indicated a preference for visiting health centers, general practitioners' offices, or emergency departments. Among the factors studied, awareness (B = 0.228) emerged as the most significant positive predictor of healthcare seeking behavior (p < 0.05). Other positive influences included decision-making autonomy (B = 0.177), prior experience with healthcare services (B = 0.131), and social support (B = 0.131) – all statistically significant at p < 0.05. Conversely, barriers to healthcare seeking had a negative and significant impact (B = - 0.064, p < 0.05). Collectively, the investigated factors explained 23% of the variation observed in healthcare seeking behavior among the elderly participants (R² = 0.23).

Conclusion: This study identified awareness of hypertension as the strongest predictor of healthcare seeking behavior in elderly patients. Additionally, providing accessible and supportive healthcare services can further encourage elderly hypertensive patients to seek necessary care.

Depression, Perfectionism, and Hypertension in the Elderly: A Path Analysis Examining Worry, Ambiguity Tolerance, and Problem-Solving

Masood Ghorbanalipour — 2024-06-29

Introduction: Hypertension is a prevalent condition among the elderly, significantly contributing to the burden of cardiovascular disease and related complications. This study examined how depression and perfectionism influence hypertension in older adults. It also explored how worry, tolerance for ambiguity, and problem-solving skills might influence this relationship.

Methods: Researchers recruited 192 participants with hypertension from a health center in Khoy city, Urmia, Iran. Participants completed questionnaires that assessed depression, perfectionism, worry, ambiguity tolerance, and problem-solving skills. Statistical methods were used to analyze the data and identify relationships between these factors and hypertension.

Results: Depression, perfectionism, worry, and ambiguity tolerance were all significantly associated with hypertension. Interestingly, problem-solving skills were not linked to blood pressure. Further analysis revealed that worry played a reinforcing role in the link between depression/perfectionism and hypertension, while ambiguity tolerance had a protective effect. In other words, higher worry levels strengthened the association between depression/perfectionism and high blood pressure, while greater tolerance for ambiguity lessened this association.

Conclusion: These findings suggest that emotional factors like worry and intolerance for ambiguity can significantly impact blood pressure in older adults. Therefore, managing these emotions alongside depression and perfectionistic tendencies may be crucial for controlling hypertension.