Socio-demographics,spirituality, and quality of life among community-dwelling and institutionalized older adults: A structural equation model

PurposeThe increasing life expectancy of the population prompts an array of health conditions that impair an older adults’ quality of life (QoL). Although demographics and spirituality have been associated with QoL, limited literature elucidated the exact mechanisms of their interactions, especially in a culturally-diverse country like Philippines. Hence, this study determined the relationship among socio-demographics, spirituality, and QoL of Filipino older adults in a community and institutional setting.Materials and methodsA predictive-correlational study among 200 randomly-selected community-dwelling and institutionalized older adults was conducted, with a 99% power and a medium effect size. Data were collected using a three-part questionnaire from September to November 2015. The questionnaire was composed of the robotfoto, Spirituality Assessment Scale, and modified Older People’s Quality of Life which assessed socio-demographics, spirituality, and QoL.ResultsAnalysis showed that institutionalization in a nursing home positively and negatively affected spirituality and QoL, generating an acceptable model (χ²/df = 2.12, RMSEA = 0.08, and CFI = 0.95). The negative direct effect of institutionalization on social relationship, leisure, & social activities QoL (β=–0.42, p < 0.01) also initiates a cascade of indirect negative effects on both spirituality and QoL dimensions.ConclusionsThe development of a structural model illustrating the interrelationship of socio-demographics, spirituality, and QoL helps healthcare professionals in predicting facets of spirituality and QoL that can be compromised by living in a nursing home. This understanding provides impetus in evaluating and refining geriatric healthcare programs, policies, and protocols to render individualized, holistic care in a socially-cohesive environment among older adults.     

Late-career unemployment and all-cause mortality,functional disability and depression among the older adults in Taiwan: A 12-year population-based cohort study

ObjectiveTo evaluate whether late-career unemployment is associated with increased all-cause mortality, functional disability, and depression among older adults in Taiwan.MethodIn this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was conducted from 1996 to 2007. The complete data from 716 men and 327 women aged 50–64 years were retrieved. Participants were categorized as normally employed or unemployed depending on their employment status in 1996. The cumulative number of unemployment after age 50 was also calculated. Logistic regression analysis was used to examine the effect of the association between late-career unemployment and cumulative number of late-career unemployment on all-cause mortality, functional disability, and depression in 2007.ResultsThe average age of the participants in 1996 was 56.3 years [interquartile range (IQR) = 7.0]. A total of 871 participants were in the normally employed group, and 172 participants were in the unemployed group. After adjustment of gender, age, level of education, income, self-rated health and major comorbidities, late-career unemployment was associated with increased all-cause mortality [Odds ratio (OR) = 2.79; 95% confidence interval (CI) = 1.74–4.47] and functional disability [OR = 2.33; 95% CI = 1.54–3.55]. The cumulative number of late-career unemployment was also associated with increased all-cause mortality [OR = 1.91; 95% CI = 1.35–2.70] and functional disability [OR = 2.35; 95% CI = 1.55–3.55].ConclusionLate-career unemployment and cumulative number of late-career unemployment are associated with increased all-cause mortality and functional disability. Older adults should be encouraged to maintain normal employment during the later stage of their career before retirement. Employers should routinely examine the fitness for work of older employees to prevent future unemployment.     

Symptoms of anxiety and depression are independently associated with inflammatory bowel disease-related disability

BackgroundInflammatory bowel disease (IBD) frequently results in disability. The relevance of psychological effects in causing disability, and whether disability occurs similarly in non-Western cohorts is as yet unknown.AimWe assessed the relationship between symptoms of anxiety and depression, quality of life and disability in a Singaporean IBD cohort and their predictors.MethodsCross-sectional study. We assessed consecutive IBD subjects’ IBD-Disability Index (IBD-DI), Hospital Anxiety and Depression Scale (HADS), and IBD questionnaire (IBDQ). Clinical and demographic variables were collected. Non-parametric statistical analyses were performed. Independent predictors of disability were identified through multivariate logistic regression.Results200 consecutive subjects were recruited (males: 69%; median age: 43.8 (±15.4) years; 95 had Crohn’s disease (CD), 105 had ulcerative colitis (UC); median IBD duration: 10.8 (±9.0) years.) 27% of the cohort had anxiety and/or depression, which worsened disability (IBD-DI: −9 (±14) with anxiety vs 6 (±13) without anxiety, P < 0.001; −12 (±16) with depression vs 5 (±13) without depression, P < 0.001). Age at diagnosis, use of prednisolone, stricturing CD and active IBD were significant predictors of disability. IBDQ strongly correlated with IBD-DI(r_s = 0.82, P < 0.01).ConclusionSymptoms of anxiety and depression were common in this Asian cohort of IBD and were strongly associated with IBD-related disability. Recognizing psychological issues contributing to disability in IBD is important to ensure holistic care and appropriate treatment.     

Predictors of functional disability with focus on activities of daily living: A community based follow-up study in older adults in India

BackgroundDisability in activities of daily living is a growing concern among older populations all over the world. India has one of the rapidly ageing populations and predicted burden of functional disability is higher for Indian older adults as compared to other ageing Asian countries.MethodsTotal 1140 aged 60 years and over participated in a baseline study. 560 of them participated in the prospective cohort study conducted in the city of Pune, India. An interview and functional assessment using a questionnaire and Pune-FAAT tool was carried out in 2013–14. Binary logistic regression was used to obtain the factors that increased the odds of having ADL disability at follow-up.ResultsThe mean age of the study population was 69.73 ± 5.48 years. Squatting, walking and climbing functions were affected significantly. Total 376 participants (67.1%) reported difficulties and/or disability in performing activities of daily living (ADL) at follow-up. Hospitalization (OR = 3.6; 95% CI: 1.9–6.7), being female (OR = 2.3; 95% CI: 1.5–3.5), presence of two or more chronic diseases (OR = 1.7; 95% CI: 1.1–2.7), experience of memory loss (OR = 1.9; 95% CI: 1.2–3.0) and feeling of loneliness (OR = 2.3; 95% CI: 1.0–5.3) increased the odds of being in the “With disability” group at follow-up. Apart from this, self-rated health and self-reported depression were associated with limitations in ADL.ConclusionHospitalization and being female appeared to be the most significant risk factors for disability in urban older adults in India. Rehabilitation services after hospitalization, physical exercise, effective control on chronic illness, and social participation to reduce loneliness is recommended.     

Personalized citizen assistance for social participation (APIC): A promising intervention for increasing mobility,accomplishment of social activities and frequency of leisure activities in older adults having disabilities

BackgroundSocial participation, a determinant of health in older adults, requires innovative interventions. The personalised citizen assistance for social participation (APIC) involves weekly three-hour personalised stimulation sessions targeting significant social and leisure activities difficult to accomplish. Recently adapted for older adults, the APIC’s impact on this population is unknown.ObjectiveThis study explored the impact of APIC on older adults with disabilities.MethodsA mixed-method design including a pre-experimental component was used with 16 participants (11 women) aged 66–91 (79.4 ± 8.7) with disabilities, living at home. They completed functional autonomy, social participation, leisure and quality of life questionnaires, and semi-structured interviews.ResultsAPIC increased older adults’ functional autonomy (p = 0.02), accomplishment (p < 0.01) and satisfaction (p = 0.02) with social participation, and frequency of leisure practice (p < 0.01). Post-intervention, participants wished to modify the practice (p < 0.01) and frequency (p < 0.01) of leisure activities, and difficulties in their social environment diminished (p = 0.03). Their attitude toward leisure (p = 0.04) as well as their health (p < 0.01) and psychological (p = 0.03) quality of life improved. Older adults thought APIC helped them resume, maintain, explore and experiment with significant social activities. It also increased their psychological and physical well-being, feeling of control, connectedness, self-esteem and motivation to accomplish activities. Finally, APIC can compensate for an unavailable and crumbling social network.ConclusionAPIC is a promising intervention that leads to new opportunities for older adults to increase community integration and enhance the social component of their lives. It can also optimise how the needs of older adults are met, including utilisation of personal and environmental resources.     

Prevalence,characteristics, and acute care utilization of disabled older adults with an absence of help for activities of daily living: Findings from a nationally representative survey

ObjectiveThe aim of this study was to investigate the prevalence, characteristics, and acute care utilization of community dwelling disabled older adults with an absence of help for activities of daily living (ADL).MethodsWe analyzed cross-sectional data from a nationally representative sample of people aged 65 years and over (n = 2904) participating in the 2009 National Health Interview Survey in Taiwan. Disability was defined as self-reporting a lot of difficulty or complete inability to carry out one or more ADL tasks. Participants with disability were asked whether they received help in the form of personal assistance or assistive devices to complete ADL tasks, with a yes response indicating the presence of help and a no response indicating the absence of help. Hospitalization and emergency department visits was assessed as a dichotomous variable (any or none), respectively.ResultsAn absence of available help for ADL disability was reported in 16.6% of disabled older adults. Disabled older adults reporting an absence of help were more likely to be female. After adjustment for other factors, compared to older adults without disability, older adults with disability not receiving help for ADL tasks were highly related to hospitalization (OR = 4.57; 95%CI = [1.51–13.82]) and emergency department visits (OR = 3.52; 95%CI = [1.15–10.76]) during the past year, respectively.ConclusionsWe found that there is high prevalence of absence of help to perform ADL tasks in older adults with disability, and that this absence of help for ADL disability is associated with a greater burden of acute care utilization than those without disability.     

The latent factors of depression from the short forms of the CES-D are consistent,reliable and valid in community-living older adults

BackgroundDepression is an important public health outcome in the older adult population. It is associated with declining physical and psychological well-being and increasing healthcare utilisation. The Center for Epidemiological Studies Depression Scale (CES-D) although widely accepted as a screening tool for depressive symptoms in older adults, can be long and exhaustive as part of a comprehensive geriatric assessment.AimWe investigated the consistency, reliability and validity of the original and three short formats of the CES-D.MethodsSix thousand six hundred and thirty-seven community-living adults, aged ≥ 50 years from The Irish Longitudinal Study on Ageing (TILDA), completed the 20-item CES-D. Confirmatory factor analysis determined the factor structures of the 20-, 10- and two 8-item formats of the CES-D. Latent factors from each format were validated against disability and perceived stress, particularly the Positive Affect factor. Analysis was also performed in a subset aged 65+ years.ResultsAll formats of the CES-D displayed good internally consistency (0.87–0.72) and good model fit for the expected four- and three-factor structures of the CES-D. Latent factors from all formats were representative of each other and the Positive Affect factor was negatively correlated with disability and perceived stress on all CES-D formats.ConclusionShort forms of the CES-D are consistent, reliable and valid for use in the older adult population (50+ or 65+ years), where avoiding long assessments and response fatigue is warranted. These formats may be used to measure Positive Affect, an important construct related to physical health, resilience and psychological well-being in later life.     

The psychological impact of permanent cardiac pacemakers on pediatric patients and their parents: A case control study

BackgroundThis study assessed anxiety and depression in children with permanent pacemakers (PPM) and quality of life of their parents.MethodsNinety children (63.3% males and 36.6% females) and their parents were included in the study and were divided into three groups. The control group (Group 1) included 30 normal healthy children (57% males and 43% females), the PPM group (Group 2) included 30 age-matched children (70% males and 30% females) with PPM and structurally normal heart, while the Group 3 included 30 children (63% males and 37% females) with PPM and congenital heart disease (PPM + CHD). Psychological assessment of children and their parents was carried out using an interview-based questionnaires.ResultsPsychiatric disorders were more prevalent in PPM + CHD group including depression (P = 0.04), anxiety (P = 0.02) and lower parents’ QoL (P = 0.01). The PPM group had higher depression and lower parents’ QoL than the control group. Family income was independent factor for depression (r2 = −6.3, with P < 0.05). Sex of the child and CCU admission were independent factors for anxiety (r2 = −9.5, P < 0.05 & r2 = 10.5, P = 0.001) in PPM group.ConclusionChildren with pacemakers have higher psychiatric disorders and their parents have lower QoL.     

Cough affects Quality of Life in asthmatic children aged 8-14 more than other asthma symptoms

BackgroundAsthma may influence children's health-related quality of life (QoL) differently by various symptoms, at different severity. The primary aim of this study was to evaluate the QoL in children with asthma and describe the impact of each asthma symptom on the child's well-being at different severity levels.Material and MethodsTwo hundred randomly selected children and one of their parents who consulted an outpatient asthma clinic, participated in the study. Qol was assessed with DISABKIDS-Smiley measure for children aged 4-7 years and with DISABKIDS DCGM-37 and Asthma Module for children 8-14 year old.ResultsMost of the children suffered from mild or moderate persistent asthma. Children with uncontrolled asthma stated lower QoL compared to partly controlled or controlled in both age groups (p < 0.05 in all domains). Cough appeared to affect QoL of 8-14 year olds more than other symptoms, especially in girls. In younger children, sex (boys, p = 0.039), age (p = 0.045), proxy sex (father, p = 0.048), frequency of doctor visits (4-6 months, p = 0.001), use of beta-2 agonists (p = 0.007) and father's smoking habits (p = 0.015) were associated with the QoL of coughing children but no correlation between cough and QoL was detected. In the 8-14 year age group coughers reported lower QoL compared to their counterparts; moreover, cough was found to affect QoL more than other symptoms (p < 0.05 in all domains).ConclusionsCough has a direct effect on asthmatic children's QoL but there is still an obvious need for research to reveal all the determinats of this effect.     

Risk factors for depression in the elderly inflammatory bowel disease population

Background and aimsLittle is known about depression in elderly individuals with inflammatory bowel diseases (IBD). We assessed the point prevalence of depression and determined associations with disease activity, quality of life, and medication adherence in elderly patients with IBD.MethodsWe identified elderly (≥ 65 years) individuals within Crohn's and Colitis Foundation of America Partners, an online IBD cohort. Individuals completed the short geriatric depression scale (GDS). We used bivariate statistics to determine whether demographic or disease-related factors, disease activity, quality of life or medication adherence was associated with depression. We used logistic regression to estimate independent effects of depression on medication adherence.ResultsA total of 359 elderly individuals with IBD completed the GDS. The mean age was 70.2 years (SD 4.7); mean disease duration was 25.6 years (SD 17.6), and 62.6% had Crohn's disease (CD). The point prevalence of depression was 22.6%. Lower education levels (p = 0.001), higher corticosteroid use (< 0.01) and lower exercise levels (< 0.001) were associated with depression. For both CD and ulcerative colitis (UC), those with depression had increased disease activity (short Crohn's disease activity index 52.5 versus 29, p = 0.005, and simple clinical colitis activity index 5 versus 2, p = 0.003). Depressed patients had lower quality of life (short IBD questionnaire 4.6 versus 5.7, p < 0.001). Depressed individuals had reduced medication adherence (adjusted OR 2.18; 95% CI 1.04–4.57).ConclusionsDepression is common in this geriatric IBD cohort. Depression is independently associated with reduced medication adherence. Recognition and treatment of depression in elderly patients with IBD could improve outcomes.     

Quality of life,mood and sleep quality in patients with primary hyperparathyroidism. Impact of socio-personal and clinical profile

IntroductionQuality of life (QoL) in patients with primary hyperparathyroidism (PHPT) can be negatively affected by the disease, and it is important to identify risk factors. The objectives of the present study were to analyze QoL, mood and quality of sleep in patients with PHPT and to determine the impact of socio-personal and clinical variables.Patients and methodThe study group included patients diagnosed with PHPT, and the control group was taken from general population, paired by age and gender. QoL was analyzed using the SF-36 and the PHPQoL questionnaires. The Beck-II and Pittsburg questionnaires were used to assess depression and sleep quality. Socio-personal and clinical variables were analyzed. Statistical analysis on SPSS software v.28 used the Student t-test, ANOVA, Pearson's rank correlation, Mann-Whitney test, Kruskal-Wallis test and Spearman's rank correlation. A multiple linear regression model of the QoL was constructed.ResultsSixty-five patients with PHPT were analyzed. A greater negative effect on QoL, mood and sleep quality were observed in patients with PHPT than in controls (P < 0.05), with a good correlation between the various questionnaires. Several socio-personal variables had an effect on QoL and mood (P < 0.05). QoL in patients with PHPT was affected by educational level, having offspring, and psychological symptoms (P < 0.05).ConclusionsPatients with PHPT had poorer QoL and greater neurocognitive disorder than the general population. Socio-personal profile should be taken into account in the clinical assessment of these patients, together with psychological symptoms.     

Prevalence and associative factors of orthostatic hypotension in older adults: Results from the Well-being of the Singapore Elderly (WiSE) study

BackgroundOrthostatic hypotension (OH) is commonly reported among older adults and is associated with an increased risk of mortality. This study aimed to describe the prevalence and investigate the possible associations between OH with sociodemographic variables, chronic medical conditions, health service utilisation, dementia and cognitive status among older adults residing in Singapore.MethodsData was collected from 2266 participants aged 60 years and older who participated in the Well-being of the Singapore Elderly (WiSE) study in 2013. Face-to-face interviews were conducted and data collected includes sociodemographic information, blood pressure measurements, medical history, health services utilisation, and cognitive status.ResultsThe prevalence of OH among older adults in Singapore was 7.8%. OH was highest in participants aged 85 years and above (OR: 2.33; 1.26–4.30; p = 0.007) compared to those aged 75–84 years (OR: 1.76; 1.08-2.85; p = 0.023). Participants with hypertension were more likely to have OH (OR: 3.03; 1.56–5.88, p = 0.001) than those without hypertension. Those with dementia were also more likely to have OH than those with normal cognitive status (p = 0.007).ConclusionsOlder age, hypertension, and dementia were independently associated with OH in the older adult population in Singapore. Interventions such as home safety assessment and preventive measures should be implemented to improve older adult’s functional capacity and quality of life to prevent injury.     

Prevalence of mental disorder and impact on quality of life in inflammatory bowel disease

IntroductionDifferent studies have described psychiatric comorbidities in inflammatory bowel disease (IBD) patients, but most of them focus mainly on depression and anxiety. Even though major mental disorders are considered one of the main factors that decrease quality of life (QoL), its role in IBD patients remains unclear. We sought to identify the prevalence of different mental disorders as well as its relationship with QoL.Patients and methodsSubjects were recruited from the IBD Clinic. IBD Questionnaire 32 and structured clinical interview (SCID) for DMS-IV Text Revision were applied. Demographic and clinical data were collected via self-report questionnaires and medical records. The correlation between mental disorders and QoL (IBDQ-32 score) was evaluated using the Spearman correlation test.ResultsIn all, 104 patients were recruited, 12 with Crohn's disease, and 92 with ulcerative colitis. The prevalence of any major mental disorder was 56.7%: anxiety (44.2%), mood (27.9%), substance use (12.2%), and other psychiatric diagnoses (17.3%), and 29.8% of the patients presented three or more comorbid diagnoses. Mental Disorder (p = 0.005), mood disorder (p = 0.004), anxiety disorder (p = 0.009), were found to be significantly associated with lower QoL. Substance use disorder was associated with lower Digestive QoL (p = 0.01). Major depressive disorder (p = 0.004), social phobia (p = 0.03), PTSD (p = 0.02), and Generalized Anxiety Disorder (p < 0.001), were found to be significantly associated with lower QoL.ConclusionsIBD patients had important psychiatric comorbidity that significantly affects their QoL. These results warrant a systematic evaluation of psychiatric conditions in IBD patients.     

Associations of sleep duration and sleep quality with life satisfaction in elderly Chinese: The mediating role of depression

This study investigated whether sleep duration and quality were related to life satisfaction (LS) among older Chinese adults and whether depression mediated those relationships. Cross-sectional data from the aging arm of the Rugao Longevity and Aging Study were used. Sleep duration, sleep quality, depression, LS and covariates were analyzed using logistic regressions. To assess the potential mediation of depression on the association between sleep duration and quality and LS, Aroian tests were used. Of 1756 older Chinese adults aged 70–84 years, 90.7% of the men and 83.3% of the women reported being satisfied with their lives. After adjusting for covariates, older adults who slept ≤6 h per night were more likely to suffer from life dissatisfaction compared with those who slept 7–8 h (OR = 2.67, 95% CI 1.86–3.79), and individuals who slept poorly were almost 2 times (OR = 2.91, 95% CI 2.16–3.91) more likely to have life dissatisfaction. The Aroian tests confirmed that these relationships were partially mediated by depression (p < 0.001). Between short sleep and LS, the mediating effect of depression accounted for 13.9% of the total effects. Moreover, the mediating effect of depression on the association between sleep quality and LS was 13.3%. Short sleep duration and poor sleep quality were inversely associated with LS, and the relationships were partially mediated by depression. Our study suggests that both sleep and depression status are important factors for LS among the elderly.     

Hyperphagie boulimique et obésité : aspects épidémiologiques,cliniques et psychopathologiques. étude d’une population d’obèses à Sfax (Tunisie)

ObjectivesTo evaluate the prevalence of binge eating disorder (BED) in a population of obese patients, to appreciate the impact of obesity on BED through a comparison between the obese group and a control group, and to assess anxiety, depression and quality of life in obese patients with BED.Patients and methodsA cross-sectional study including 60 obese patients and 60 controls. BED was diagnosed using the Binge Eating Scale. Quality of life was assessed by the Quality Of Life, Obesity and Dietetics Scale, and depression and anxiety symptoms by the Hospital Anxiety and Depression Scale.ResultsThe obese group had a higher prevalence of BED than the control group (40% versus 8.3%; p < 0.001; OR = 3.5). The average score of BES was also higher (p < 0.001). Obese patients with BED were younger (p = 0.034). BED was correlated with an early onset of obesity (p = 0.01; OR = 1.12), depression (p = 0.002), anxiety (p = 0.008) and a poorer quality of life.ConclusionThis study confirms the relationship between obesity and BED, which is correlated with a high prevalence of anxiety and depression and with a poorer quality of life.     

Quality of life assessment in Egyptian rheumatoid arthritis patients: Relation to clinical features and disease activity

Aim of workTo assess the impact of rheumatoid arthritis (RA) on the health related quality of life (QoL) of patients, using the 36-item short form (SF-36) and to study the influence of different disease variables.Patients and methodsEighty-six RA patients were recruited from the Rheumatology and Rehabilitation outpatient of Assiut University Hospital. Forty-three, age and sex matched subjects were included as controls. The QoL was measured in all subjects using the SF-36 health survey. Disease activity was assessed in RA patients by the disease activity score (DAS28).ResultsAll domains of the SF36 were significantly lower in the patients (p < 0.0001). Patients with a lower educational level and those unemployed had significantly lower SF36 components. Those with a disease duration >5 years, positive rheumatoid factor and higher disease activity had a significantly lower SF36 physical component. Patients receiving hydroxychloroquine or prednisolone had significantly lower mental component. Significant negative correlation of the SF36 physical and mental components was found with both disease duration (p = 0.01 and p < 00001 respectively) and DAS28 (p < 0.0001 for both). Rheumatoid factor negatively correlated with the physical component (p < 0.0001). Regression analysis showed that disease duration was the most profound predictor of both SF36 components (p < 0.0001).ConclusionThe quality of life is impaired in Egyptian RA patients and disease duration was the most significant predictor. Routine assessment of the health-related QoL in those patients is recommended to detect and monitor the impact of the disease and medications used on different aspects of their quality of life.     

Depression and pain in patients with rheumatoid arthritis: Mediating role of illness perception

Aim of the workIllness perception is considered to be an important contributor in the relationship between physical and psychological factors in rheumatoid arthritis (RA). This study examined the mediational role of illness perceptions in the relationship between depression and pain in RA.Patients and methodsIllness perception, depression and pain were assessed in 100 adults with RA (72 females and 28 males). Patients were asked to complete 4 questionnaires including socio-demographic data form, depression subscale of Hospital Anxiety and Depression Scale (HADS), Brief Illness Perception Questionnaire (Brief-IPQ) and Rheumatoid Arthritis Pain Scale (RAPS). Using the Baron and Kenny approach and Sobel tests, the mediation of illness perceptions in the relationship between depression and pain symptoms was examined.ResultsSixty-six RA patients (66%) endorsed a clinically significant level of depression (HADS 12.94 ± 5.39). The mean RAPS was 41.97 ± 23.45 (range = 4–91.93). Depression symptoms were significantly associated with perceived pain (r = −0.57, p < 0.001). Three illness perceptions significantly mediated the relationship between depression and pain; consequences (z = 1.39, p < 0.05); personal control (z = 1.47, p < 0.05) and emotional response (z = 1.51, p < 0.05). Gender and education showed no significant effect on the presented results.ConclusionsGreater depression symptoms were associated with perceptions that pain negatively affected one’s life and emotions and was difficult to control. These negative illness perceptions were, in turn, related to greater pain symptoms. Illness perceptions helped explain the depression-pain link in RA patients. Results suggest that targeting illness perceptions in adults with RA and depression may help reduce pain symptoms.     

Factors associated with happiness in the elderly persons living in the community

ObjectiveThe aim of the present study was to evaluate factors associated with happiness in a sample of Brazilian older adults.MethodsA study was conducted with 263 elderly people in the area of coverage of a family health unit located in the state of São Paulo, Brazil. The Subjective Happiness Scale was used to measure happiness, the final score of which determined one of three outcomes: not happy, intermediate, and happy. Disability, sociodemographic characteristics, and psychological, cognitive, and physical factors were considered for the multinomial logistic regression analysis.ResultsStatistically significant differences were found among the three groups regarding satisfaction with life, disability, social phobia, anxiety, depression, and frailty (p ≤ 0.05). In the multinomial regression analysis, being “not happy” was significantly associated with satisfaction with life (RRR: 0.53), depression (RRR: 1.46), social phobia (RRR: 1.24), and age (RRR: 1.06).ConclusionThe present findings indicate that psychological factors and age influence the levels of happiness in older adults living in the community. Furthermore, better screening, diagnosis, and treatment of mental health disorders could increase the feeling of happiness among older adults.     

Quality of life after Roux-en-Y gastric bypass and changes in body mass index and obesity-related comorbidities

AimDynamics of improvement in health-related quality of life (QoL) after bariatric surgery have never been fully assessed, and neither has the potential influence of body mass index (BMI) and comorbidity modification. The objective of this study was to investigate early and medium-term changes in QoL following Roux-en-Y gastric bypass (RYGB), and their relationship to BMI and comorbidity variations.MethodsA total of 71 obese subjects (80% women, mean age 42.1 ± 11.2 years, mean baseline BMI 47.6 ± 6.2 kg/m²) undergoing RYGB filled in QoL questionnaires (SF-36) before and 3, 6 and 12 months after surgery. QoL was assessed using repeated-measures Anova, with associations between its changes and changes in BMI and comorbidities (diabetes, hypertension, dyslipidaemia, sleep apnoea, knee pain) assessed by mixed-effects models.ResultsPhysical QoL scales (physical component summary, PCS) significantly increased over time (from 38.9 ± 9.3 to 52.6 ± 7.9; P < 0.001) as did other physical SF-36 scales (all P < 0.001), whereas mental QoL summary scale did not vary significantly (from 45.7 ± 9.5 to 48.6 ± 11.5; P = 0.072). Major changes in QoL occurred at 3 months after surgical intervention to reach values comparable to those in the general population. PCS was mostly associated with changes in either BMI or comorbidity status except for diabetes, dyslipidaemia and sleep apnoea.ConclusionResults show that improvements in physical QoL after RYGB are observed as early as 3 months after intervention, and are independently associated with weight loss and improvements in comorbidities.     

Anxiety,personality traits and quality of life in functional dyspepsia‐suffering patients

BackgroundPsychosocial stressors either acute or more sustained frequently precede the onset and exacerbation of the symptoms of the functional dyspepsia (FD). Depressive mood and quality of life have been already reported for interference in functional dyspepsia suffering patients.MethodsThe examination were performed on 60 FD patients (30 females and 30 males), aged 20–79 years, 60 peptic ulcer subjects and 60 healthy volunteers in which we have investigate levels of anxiety and depression, personality traits and quality of life.ResultAccording to the Hamilton Depression and Anxiety Rating Scales, the population with FD had the average score which classified them into the group of patients with the moderate depression (20.57 ± 4.45). Personality traits estimation based on data obtained by the Eysenck personality questionnaire revealed higher neuroticism scores in the group with functional dyspepsia. Both parameters, level of the neuroticism and anxiety level, expressed highly significant level of mutual concordance. Patients with functional dyspepsia reported a greater adverse impact of symptoms of emotional distress and food and drink problems.ConclusionResults are indicating that the depression and anxiety level is the highest in patients with functional dyspepsia and that anxiety level corroborates with the neuroticism level from the Eysenck scale. Psychological disturbances are influencing the quality of life mostly in patients with dyspepsia in the form of emotional distress and the problem with the food and beverage intake.