Factors associated with self‐reported use of oral health services among older Melbournians

Objectives: This paper discusses the utilisation of oral health‐care services by older adults in Melbourne, Australia, and factors associated with their use. Methods: The study involved 993 older adults who participated in the Melbourne Longitudinal Studies on Healthy Ageing baseline data collection. Results: Nearly 38% of respondents had used oral health services in the previous year. Another 4% had not visited a dentist for more than 5 years. Recent use of dental services was associated with five predictors: higher level of education, non‐pension sources of income, lower age, more social support and higher levels of depression. Conclusion: This study provides important information about dental utilisation by older Melbournians. Lack of information on dentition status, and type of dental visits limits the interpretation of the data, highlighting the need to collect relevant information that would inform the design of longitudinal studies aimed at determining predictors of use of oral health services by older Australians.     

Medicines and disease information needs of older Arabic‐speaking Australians

Aim: To explore access, satisfaction, awareness and needs for medicines and disease information (MADI) sources for older Arabic‐speaking Australians. Method: Five focus groups were conducted (in Arabic) with 29 participants with a chronic disease, aged over 65 years, and unable to speak or read English fluently. Discussions were audiotape recorded, simultaneously interpreted into English, transcribed verbatim and content analysed. Results: Arabic‐speaking general practitioners were identified as the main source of MADI, despite dissatisfaction with their counselling. Written Arabic MADI was not accessed by participants, who revealed low English and Arabic literacy levels and a reliance on family members to act as interpreters. Male participants were more concerned and active about their health and medicine information than female participants. Conclusions: This study highlighted limited availability and access to Arabic MADI for older Arabic‐speaking Australians, with reliance on Arabic‐speaking health‐care professionals for information and family members as interpreters. An accessible and sustainable system for MADI is required.     

Effects of health literacy to self‐efficacy and preventive care utilization among older adults

Aim: This study examined the relationships between health literacy, self‐efficacy and preventive care utilization among older adults in Taiwan. Methods: The data were from a longitudinal survey, “Taiwan Longitudinal Study in Aging” in 2003 and 2007. A total of 3479 participants who completed both two waves were included for analysis. Health literacy first was constructed through education, cognitive function and disease knowledge through structural equation modeling (SEM); then, the associations of health literacy to later self‐efficacy and preventive care were examined. Results: The model fit of SEM was good, indicating that the construct of health literacy was appropriate. Healthy literacy showed a moderate positive effect on self‐efficacy and a small positive effect on preventive care utilization. Conclusions: Health literacy increases self‐efficacy and utilization of preventive care. Promoting people's health knowledge and health literacy is suggested. Geriatr Gerontol Int 2013; 13: 70–76 .     

Linguistic disparities in health care access and health status among older adults

BACKGROUND: English proficiency may be important in explaining disparities in health and health care access among older adults. SUBJECTS: Population-based representative sample (N=18,659) of adults age 55 and older from the 2001 California Health Interview Survey. METHODS: We examined whether health care access and health status vary among older adults who have limited English proficiency (LEP), who are proficient in English but also speak another language at home (EP), and who speak English only (EO). Weighted bivariate and multivariate survey logit analyses were conducted to examine the role of language ability on 2 aspects of access to care (not having a usual source of care, delays in getting care) and 2 indicators of health status (self-rated general health and emotional health). RESULTS: Limited-English proficient adults were significantly worse off (1.68 to 2.49 times higher risk) than EO older adults in 3 of our 4 measures of access to care and health status. Limited-English proficient older adults had significantly worse access to care and health status than EP older adults except delays in care. English proficient adults had 52% increased risk of reporting poorer emotional health compared with EO speakers. CONCLUSIONS: Provision of language assistance services to patients and training of providers in cultural competence are 2 means by which health care systems could reduce linguistic barriers, improve access to care, and ultimately improve health status for these vulnerable populations.     

The association between demographic and oral health‐related quality of life factors and dental care attendance among underprivileged older people

Aim: In order to identify whether demographic and oral health‐related quality of life factors are associated with dental care attendance among an underprivileged older population, a comparison was performed between people who have and have not attended dental care. Methods: A cross‐sectional purposive sample of 344 older underprivileged people comprised the study population. The dependent variable was dental care attendance. The 14‐item version of the Oral Health Impact Profile index (OHIP‐14) was used as the independent variable, together with other social and general variables, using a structured interview. Results: The variables that were significantly associated with dental care attendance were family status (not married, the highest attendance), dwelling location (living at home, the highest attendance), caregiver (family member, the highest attendance), place of birth (Western countries, the highest attendance) and income (pension, the highest attendance). Sex, welfare support, functional ability, education, age and OHIP‐14 were not associated with dental care attendance. Conclusions: Attending dental care was not associated with oral health‐related quality of life measured by OHIP‐14. Several socioeconomic variables were strongly associated.     

Oral health beliefs and practices among Greek and Italian older Australians: A focus group approach

Introduction: The oral health of older Australians is a major public health challenge in the twenty‐first century. However, little is known about the oral health status and needs of older migrants. Aims: This paper uses a qualitative methodology to obtain a better understanding of the oral health meanings and experiences of Greek and Italian older migrants. Methods: Seventeen focus group discussions were conducted, made up of 172 participants, recruited from eight Italian and nine Greek elderly clubs in Melbourne. Results: Participants were aware of the major oral diseases and treatments available. The data suggests that, although they knew of the need for periodic dental check‐ups, there were barrier, which interfered with seeking check‐ups. Participants also held a number of false beliefs, and strong negative attitudes towards dentistry. Conclusion: If programs are to increase the use of oral health services, specific barriers, myths, false beliefs and negative attitudes must be addressed.     

Self-rated health (SRH) and socioeconomic position (SEP) among urban home-dwelling older adults

The main purpose of this study was to examine the association of education and adequacy of income with self-rated health (SRH) among home-dwelling older people aged 75 and over living in the urban area. A cross-sectional survey from 2008 was used to study 1395 older adults aged 75 and over living in one of the central areas of the city center of Helsinki, the capital of Finland. Associations of SRH with, education and adequacy of income were tested using ordinal regression model. Those with a lower level of education had higher level of poor health. Self-assessed adequacy of income had also a strong association with SRH. For the oldest respondents this association was even stronger than the association between education and SRH. Subjective evaluation of financial situation should be used as a key indicator of socioeconomic position (SEP) in studies examining inequalities in health especially among older adults.     

Concepts of dementia prevention in the health promotion among older adults: A narrative review

The number of older adults with dementia is predicted to markedly increase in the coming decades. A person suffers from dementia every 3 seconds globally, and one out of every 7 people suffers from dementia in Taiwan. The purpose of this narrative review is to integrate existing concepts of dementia prevention into health promotion and improve older adults’ quality of life. This narrative review was performed using the PubMed database by searching for basic research and systematic reviews on dementia prevention and health promotion among older adults. We established a framework for dementia prevention and health promotion with regard to the physical, mental, spiritual, and social health aspects. We identified the following strategies related to older adults towards dementia prevention and health promotion in follows: Physical health promotion: cognitive activities, physical activities, body mass index, balanced diet, rainbow diet, Mediterranean diet, dietary approaches to stop hypertension diet, mind diet, no smoking and drinking, avoiding the “three highs” (i.e., hyperglycemia, hyperlipidemia, and hypertension), and head trauma; Mental health promotion: Positive thinking, Brief Symptom Rating Scale (BSRS-5), depression scale, and ascertained dementia 8 questionnaire (AD8) screening; Spiritual health promotion: religious beliefs, spiritual music, meditative activities, mindfulness, yoga, Qi-gong, Tai-chi, and Baduanjin; and Social health promotion: A supportive family system, socialization, social support, social networks, social interaction, and social participation. The conclusion of this narrative review was to integrate the concepts of dementia prevention and health promotion among older adults.     

Individual's perspective of local community environment and health indicators in older adults

Aim: This study evaluated the relationship between individual's perspective of local community environment and health in older people. Methods: A survey about quality of life in older adults in Spain was applied to a representative sample of 1106 community‐dwelling people (mean age ± SD = 72.07 ± 7.83 years, 43.67% males). Local community (Community Wellbeing Index, neighborhood problems, time in the neighborhood), psychosocial and sociodemographic measures were considered. Four health outcomes (self‐perceived health status, functional independence, depression and number of chronic medical conditions) were studied. Multivariate logistic analyses were carried out. Results: At least two local community measures were independently associated with each health outcome. Satisfaction with community services significantly contributed to all models; it was positively related with self‐rated health and functional independence, and negatively associated with depression and chronic medical conditions. Conclusion: The individual's perspective of the local community environment was associated with health outcomes in older adults. This can be useful in the development of policies committed to promoting social integration and active aging in the community. Geriatr Gerontol Int 2013; 13: 130–138 .