福州市老年公寓人群分类初探

目的 为发展多种模式的老年公寓提供参考依据。方法 对福州市5区4所老年公寓的112名老年人进行分类调查。结果 依据老人的文化程度、职业、收入和家庭成员等因素，福州市老年公寓可分为福利型、康复型和开放型。结论 根据各类型老年人特点，应努力纠正现存老年公寓缺陷，完善养老制度，发展多种模式的老年公寓，满足不同层次老年人的需求。     

老年人养老模式选择的影响因素研究

目的 了解老年人对家庭养老和机构(养老院等)养老两种养老模式的选择意愿及其影响因素，探索适合中国国情的养老模式，为政府对老年设施的投资提供参考依据。方法 采用目的抽样的方法，分别调查家庭、社区老人的个人特征、养老状况、养老的意愿及其可能的影响因素、健康状况、生命质量等，用t检验、χ2检验、方差分析和逐步回归方法进行统计分析。结果 自愿选择家庭养老的老人占54．9％，多于选择机构养老的老人(占44．9％)；无论单因素分析还是多因素分析，年龄，性别，婚姻状况，月基本生活费用，生命质量中的躯体活动功能、疼痛、社会功能、心理功能都是影响老人养老模式选择的主要因素。结论 发展以家庭养老为主的综合性社区养老服务体系，提高老人的经济收入，是实现“健康老龄化”的保证。     

农村老年人群对养老方式的态度及养老模式探析

目的：了解农村老年人群对养老方式的态度，为寻求适宜的农村养老服务模式提供参考。方法：采取问卷法，随机抽取60岁以上的农村老年人600例进行调查。结果：有91．3％的老年人选择家庭养老，0．5％的老年人选择社区养老，8．2％的老年人选择机构养老。养老方式的选择受年龄、文化程度、职业、医疗保障形式、家庭人均月收入、健康状况多种因素的影响。结论：从家庭养老向社会化养老过渡将成为我国未来养老模式发展的必然趋势。应逐步建立以居家养老为基础、社区服务为依托、机构养老为补充的农村养老保障体系。     

上海市某养老院老年人生活质量的影响因素分析

目的了解上海市某养老院老年人的生活质量及其影响因素,为行业管理部门制定养老服务的相关政策提供依据。方法2011年12月应用简明健康状况调查表（SF-36）、社会支持评定量表、老年抑郁量表（GDS）和孤独量表（UCLA—LS）对养老院内160名老年人进行调查,分析影响养老院老年人生活质量的因素以及生活质量与社会支持、抑郁、孤独的相关性。结果总调查人数160名,占该养老院老人总数的76．2％,年龄分布范围为60—98岁,平均年龄（82．0±8．8）岁。逐步多元线性回归分析显示,养老院老人生活质量中与生理功能明显相关的影响因素有3个,分别是有无子女、参加体育活动频率、自我健康状况评价;与生理职能、社会功能、活力及情感职能明显相关的影响因素有3个,分别是有年龄、参加体育活动频率、自我健康状况评价;与躯体疼痛明显相关的影响因素有2个,分别是性别、自我健康状况评价;与总体健康明显相关的影响因素有4个,分别是年龄、参加体育活动频率、慢性病数目、自我健康状况评价;与精神健康明显相关的影响因素有4个,分别是年龄、居住状况、参加体育活动频率、自我健康状况评价。Spearman秩相关分析显示,养老院老人客观支持与生活质量量表中情感职能、精神健康呈正相关,其主观支持、对社会支持利用度、社会支持总分与生活质量量表各维度均呈正相关;养老院老人其抑郁分值、孤独分值与生活质量量表各维度均呈负相关。结论影响养老院内老年人生活质量的因素众多,社会及家庭应予以关注。     

某远郊地区养老院老年人营养状况调查分析

目的探讨养老院内老年人的营养状况及相关影响因素,为改善老年人的营养状况提供依据。方法2013年4月采用整群随机抽样法,随机抽取上海市某远郊地区2个养老院进行调查,以养老院中年龄≥60岁的老年人为调查对象,采用简易营养评价精法（MNA．SF）量表调查研究对象的营养状况及相关影响因素,并以单因素f检验、Logistic多因素回归模型分析营养状况的影响因素。结果105例老年人中,营养不良者有33例（占31．4％）。不同饮食方式（X^2=4．131,P〈0．05）、有无疾病（3（2=3．919,P〈0．05）、不同医疗费支付情况（X^2=4．242,P〈0．05）的老年人营养状况比较,差异具有统计学意义。Logistic多因素回归分析结果显示,年龄和医疗费支付情况是养老院老年人营养不良发生的重要影响因素妒〈0．05）。结论远郊地区养老院老年人的营养状况不容乐观,应引起社会的重视。养老院应根据老年人的饮食习惯和特点合理调整膳食结构,同时还应加强心理健康宣教。     

老了，你会去养老院养老吗

儿女孝顺,子孙满堂,这对于老年人来说,应该算是最大的幸福了。如今,越来越多的老人面临着谁来养老的问题。不久前。重庆市老龄委对3900位重庆老人进行了调查,其中42％的人表示,愿意在养老院或老年公寓中度过晚年。这与发达国家老人的养老观念非常接近。     

养老院与老年公寓

目前社会上的养老机构从服务层次上分,大体上可分为养老院(敬老院、老年福利院、老人院等等)和老年公寓两种。在性质上它们并没有太大的区别,只不过老年公寓比养老院的条件更好,服务更高级些,因而收费更多罢了。下面我们分别予以介绍。过去计划经济体制下的养老院是用来收养无经济来源的孤寡老人和低收入家庭送养的老人,属于国家或集体创办的社会福利事业。随着社会生活的变化和社会经济的转轨变型,那种养老院大部分已经不存在了,现在的养老院多是由集体或个人经营的有偿服务养老机构。现在一般的养老院把入住者的情况分为三种:一种是生活完…     

养老院老年人生活现状调查

据预测到21世纪中期左右,我国养老事业将面临一个史无前例的巨大挑战。由于我国实施独生子女的生育政策,导致四个老人、两名中年、一个孩子的"421"家庭数量日益增多。老年人不能自己解决养老问题,将给家庭带来巨大的压力,因而社会养老的关注度日益提高。相较于其他的养老方式,养老院养老更加专业、更容易满足老年人对于生活照料、健康护理和精神关怀等多方面的需求。故越来越多的老年人选择进入养老院进行养老。深入了解养老院老年人的生活现状,为进一步提高养老院的养老质量提供理论依据。     

上海市某养老机构老年人社会支持的影响因素分析

目的了解上海市某养老机构老年人的社会支持状况及其影响因素,为政府有关部门完善相关政策提供依据。方法应用社会支持评定量表、老年抑郁量表和孤独量表等测量工具对养老机构内160名老年人社会支持状况进行分析研究。结果经单因素分析,年龄大的老年人所获得的客观支持高（P〈0.05）;有配偶老年人获得的主观支持、客观支持及社会支持总分均高于无配偶者（P〈0.01）;与家人居住老年人获得的主观支持、客观支持及社会支持总分均高于与其他老年人居住者（P〈0.01）;有子女老年人获得的社会支持均高于无子女老年人（P〈0.01）;不同性别、文化程度和家庭经济收入的老年人在各方面的社会支持在统计学上无差异（P〉0.05）。经逐步多元线性回归分析,影响养老机构内老年人社会支持总分的主要因素有性别、有无配偶、居住状况、体育活动频率、养老院居住时间和自我健康状况评价。相关性分析发现,养老院老年人抑郁分值、孤独分值与客观支持、主观支持、对社会支持利用度和社会支持总分呈负相关（P〈0.01）。结论影响养老机构内老年人社会支持的因素众多,社会及家庭应予以关注,共同为老年人营造幸福安康的生活环境,以提高其生命质量。     

天津养老机构为老年人维权

老年人是社会弱势群体，由于年老体衰，与社会接触面日渐减少，住进养老院老年公寓的老年人由于环境局限，这种情况尤为突出。因此一旦出现这样那样的问题与纠纷，常常手足无措无法应对。针对这种情况，天津的养老机构成为老年的维权代言人。     

Usage of community services and domestic helpers predicted institutionalization of elders having functional or cognitive impairments: a 12-month longitudinal study in Hong Kong

ObjectivesTo estimate the 12-month institutionalization rate and to identify the associated predictors among functionally impaired elders with or without cognitive impairment.MethodsA cohort of Hong Kong community-dwelling elders aged 65 or older with functional and/or cognitive impairments was recruited and interviewed from 2007 to 2008. Twelve months after the baseline interview, the family caregivers or elders were interviewed to update the residence status of the elders. Logistic regressions were used to examine the association between institutionalization and the baseline variables.ResultsEighty elders (of 749 respondents) had been institutionalized within 12 months from baseline. The institutionalization rates were 6.2% (95% confidence interval (CI): 4.0%–8.5%) for elders with functional impairment only and 17.3% (95% CI: 13.0%–21.6%) for elders with both functional and cognitive impairments. Stepwise multiple logistic regressions found that more usage of community services was the single predictor to institutionalization in 1 year for the elders with functional impairment only. The risk was doubled (odd ratio = 2.166, 95% CI: 1.286–3.647) for usage in 1 more community service. For elders with both functional and cognitive impairments, the institutionalization risk was reduced by about 70% with employment of a domestic helper (odd ratio = 0.268, 95% CI: 0.120–0.598), despite increased risk being associated with advancing age of caregiver, caregiver being male, and deteriorating functional status of the elder.ConclusionAmong the functionally impaired elders, more usage of community services predicted increased institutionalization, whereas among the functionally and cognitively impaired elders, employment of a domestic helper predicted reduced institutionalization. Innovative services and care models are needed to prevent unnecessary institutionalization and to postpone premature institutionalization. Further research needs to be conducted to investigate the long term care needs of the elders from the perspective of both the elders and their caregivers.     

福州市鼓山镇4237名老年人日常生活能力及影响因素调查

目的探讨福州市鼓山镇老年人日常生活能力状况及影响因素。方法在自愿原则的基础上，采用横断面调查法对该镇≥60周岁老年人进行普查。结果4237名老年人中日常生活能力下降者占17．3％；自然属性、社会经济结构特征、生活习惯、抑郁症状、精神活动、患病种数是影响老年人日常生活能力的主要因素。结论福州市鼓山镇大部分老年人生活基本能够自理，其日常生活能力受多方面因素的影响。采取综合性的措施，改善其日常生活功能，有助于实现健康老龄化。     

Cognitive Decline After Entering a Nursing Home: A 22-Year Follow-Up Study of Institutionalized and Noninstitutionalized Elderly People

ObjectiveThe objective of this study is to compare cognitive decline of elderly people after entering an institution with that of elders living in the community with similar clinical conditions.DesignThe Personnes Agées QUID (PAQUID) cohort is a prospective population-based study which included, at baseline, 3777 community-dwelling people aged 65 years and older. Participants were followed-up for 22 years. Among those who were nondemented and living at home at baseline, 2 groups were compared: participants who entered a nursing home during study follow-up (n = 558) and those who remained living at home (n = 3117). Cognitive decline was assessed with Mini-Mental State Examination (MMSE), Benton visual retention test, and verbal fluency Isaacs Set Test.ResultsAfter controlling for numerous potential confounders, including baseline MMSE and instrumental activities of daily living scores, incident dementia, depressive symptoms, and chronic diseases, nursing home placement was significantly associated with a lower score on MMSE between the last visit before and after institutionalization (difference of 2.8 points, P < .0001) and greater further cognitive decline after institutionalization (difference of 0.7 point per year, P < .0001). Similar results were found for the Benton memory test. In a second series of analysis in which the persons who became demented over the study follow-up were excluded, the results remained unchanged.ConclusionsThe present study suggests that institutionalized elderly people present a greater cognitive decline than persons remaining in the community. The reasons of that decline remain unclear and may be related to physical and psychological effects of institutionalization in elderly people.     

Dynamics of institutionalization of older adults in Belo Horizonte, Brazil

INTRODUCTION: Epidemiological and social changes related to population aging in Brazil will probably increase the need for nursing homes (NH). The study analyses the dynamics of institutionalization in Belo Horizonte, a 3 million inhabitant city of whom 8.0% are aged 60 or more. METHODS: Age and length of stay of 1,128 NH residents (92.5% of the estimated population) was registered and occupancy and institutionalization rates were determined. RESULTS: Among women aged 65+ in Belo Horizonte, 0.88% were living in NH; among men, 0.26%. Occupancy rates were 92%. Women (81%) were older than men (76.4 x 70.4 years; two-tailed t test = 6. 4; p=0.00) and lived there for a longer period (5.6 x 4.5 years; two-tailed t test = 2.6; p=0.01). Almost 1/3 of the men were aged < 65. CONCLUSIONS: High occupancy rates, long waiting lists and hard criteria for admission (half reject demented or dependent individuals) insinuates that these low institutionalization rates are related to scarcity of beds. The preponderance of women reflects the proportion of those widowed or separated in the community (66% of those aged 65-+, versus 76% of married man). The high frequency of institutionalized men aged <65 suggests lower capacity of maintaining themselves after widowhood. High death rates (24% during a 20 month follow-up of a 263 random sample) determines the small median length of stay (3 years). These data unveil the anachronism of a system which is not directed towards the maintenance of the Brazilian older people among their families and homes.     

Why older people living with a spouse are less likely to be institutionalized: the role of socioeconomic factors and health characteristics

AIMS: To examine whether the lower risk of institutionalization among older adults living with a spouse as compared with those living alone or with other persons could be explained by socioeconomic factors, housing, and chronic medical conditions. METHODS: We used population-based follow-up data on Finnish adults aged 65 years and over (N=280,722), covering the period from January 1998 to September 2003, to analyse the risk of entering into long-term institutional care by living arrangements. Kaplan-Meier estimates and Cox regression models were applied. RESULTS: Among men, those living alone had a 70% higher risk and those living with other persons a 56% higher risk of being institutionalized than those living with a spouse, independently of age, region, and urbanicity. The corresponding figures for women were 29% and 21%. Among men, the lower risk of institutionalization among those living with a spouse than among those living alone was partly explained by higher educational level, occupation-based social class, household income, home ownership, house type, better housing conditions, and lower likelihood of having depressive symptoms. Almost the same factors helped to explain the lower risk among women, except that those living with a spouse were not advantaged in terms of education or having fewer chronic diseases. CONCLUSIONS: As controlling for socioeconomic factors, housing and health characteristics explained only 35-43% of the lower risk of institutionalization among those living with a spouse as compared to those living alone, having a spouse seems to have a major independent role in preventing and delaying institutionalization among older men and women.     

Who are those most likely to be institutionalized,the elderly who receive comprehensive home care services or those who do not?

Three samples of clients aged 65 and over from three different home care and homemaker programs are compared to elderly persons with a risk of institutionalization chosen from three random samples of people aged 65 and over living in the catchment areas of the three programs. The most important differences between the clienteles and the populations with a risk of institutionalization appear when examining the availability of help. The populations at risk generally have access to a source of help living with the elderly person while the clienteles of comprehensive home care programs depend on outside help. Home care and homemaker programs therefore replace in-home services with out-of-home services. These services will be effective insofar as they succeed in reproducing some of the essential characteristics of in-home care.     

Prevalence and Factors Associated with Tinnitus: A Community-Based Study of Japanese Elders

Background

The prevalence of tinnitus is reported to be high in older Western populations, and several risk factors have been suggested. However, community-based evidence on prevalence is limited and, to our knowledge, there is no such information from older non-Western populations. The purpose of this study was to determine the prevalence and factors associated with tinnitus in community-dwelling Japanese elders.

Methods

In this community-based cross-sectional study, 1320 residents of Kurabuchi Town aged 65 years or older (584 men and 736 women; participation proportion = 98.7%) were interviewed at home in 2006, and information on tinnitus and factors associated with tinnitus was collected. We estimated the prevalence of tinnitus by age group and sex and used a logistic regression model to investigate associated factors.

Results

The prevalence of tinnitus was 18.6% (men: 18.0%; women: 19.0%); there were no statistically significant differences by age group or sex. Hearing difficulty, depressive mood, prescribed medication, past/current history of coronary heart disease, and knee joint pain requiring medical consultation were associated with tinnitus.

Conclusions

These findings suggest that tinnitus is common in Japanese aged over 65 years. Because the factors associated with tinnitus in this cross-sectional study are potentially modifiable, they should be thoroughly investigated in a longitudinal study.Key words: tinnitus, prevalence, risk factors, aged     

唐山市老人院老年人抑郁现状及影响因素调查

[目的]调查唐山市老人院老年人抑郁现状及其影响因素,从而获取相应的干预方法。[方法]按整群随机抽样法,应用一般人口资料量表,老年抑郁量表(GDS),社会支持量表和日常生活能力量表(ADL)对唐山市老人院60岁及以上老年人进行调查。[结果]唐山市老人院老年抑郁情绪的发生率为27.85%,其中文化程度低,社会支持水平低,经济支持水平低,健康状况和睡眠状况差,日常生活能力有障碍,不经常读书看报和进行体育锻炼的老年人抑郁发生率高,差异有统计学意义(P﹤0.05或P﹤0.01)。[结论]唐山市老人院老年人抑郁症发生率较高,与多种因素相关。     

福州市老年人慢性病现状调查

目的了解福州市社区老年人的慢性病患病情况及其相关因素为开展社区老年人的预防保健工作提供依据.方法制定专门调查表于2002年4月～5月对福州市1767老年人慢性病患病现状进行问卷调查.结果老年人的总患病率为89.41%,其中患1种慢性病的占55.16%,同时患2种慢性病的占23.57%,患3种及以上慢性病的占21.27%.患病率随着年龄的增加而升高(P＜0.05).其中慢性支气管炎、脑血管意外男性明显高于女性,骨关节病女性明显高于男性(P＜0.05).结论福州市老年人慢性病患病率与年龄组呈线性上升趋势,其中主要以心血管疾病和肌肉骨骼系统性疾病为主,积极开展社区医疗保健服务及以高血压为主的老年人慢性病的综合防治是当务之急.     

Institutionalized and the non-institutionalized elderly

A survey covering all the elderly over 65 years of age at home and in institutions was made in a rural town of Japan in order to reveal the physical and socio-psychological factors which were related to their current placement status. The proportion of those over 65 in this town is 13%, of which 53% are living either alone or with spouse only, which anticipates the future national trend. Of the 3039 enumerated, 6.0% were hospitalized, 1.5% in the Home for the aged and only one in a Nursing home. As the level of disability became more serious, the proportion institutionalized increased; however, even at the severe level only half were in institutions. This situation could only be understood when the family caring capacity was taken into consideration. Those at home had a greater possibility of having a healthy, not employed caring person. Economic factors were relevant only for the Home for the aged subjects. At the same disability level, the family of the institutionalized expressed a greater subjective burden in caring compared with those at home. A tentative criteria for evaluating institutional care need based on the level of disability and family caring capacity is proposed.