Prevalence of sarcopenia and its associated factors in patients attending geriatric clinics in Vietnam: a cross-sectional study.

OBJECTIVES: This study aims to investigate the prevalence of sarcopenia and its associated factors in patients attending geriatric clinics in Vietnam. DESIGN AND SETTING: A cross-sectional study was conducted in consecutive patients aged ≥60 visiting outpatient clinics of the National Geriatric Hospital in Hanoi, Vietnam, from January 2018 to October 2018. Handgrip strength was measured with a hand dynamometer. Whole-body dual-energy X-ray absorptiometry was applied to measure the appendicular skeletal muscle mass. Sarcopenia was defined by the criteria proposed by the Asian Working Group for Sarcopenia (AWGS 2019) and by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. RESULTS: There were 600 participants, mean age 70.0±8.0, 60.8% female. The prevalence of sarcopenia was 54.7% according to AWGS 2019 criteria and 40.5% according to FNIH. In multivariate logistic regression, age (adjusted OR 1.08, 95% CI 1.05 to 1.11), male (adjusted OR 2.03, 95% CI 1.29 to 3.21), underweight (adjusted OR 2.32, 95% CI 1.22 to 4.41), being malnourished (adjusted OR 3.77, 95% CI 1.19 to 11.91), chronic lung diseases (adjusted OR 3.48, 95% CI 2.10 to 5.77) and lower physical activity were significantly associated with sarcopenia defined by AWGS 2019 criteria. With FNIH definition, the significantly associated factors were age (adjusted OR 1.07, 95% CI 1.04 to 1.11), male (adjusted OR 6.78, 95% CI 4.12 to 11.17), low education (adjusted OR 2.15, 95% CI 1.27 to 3.63), being malnourished (adjusted OR 3.35, 95% CI 1.28 to 8.76), chronic lung diseases (adjusted OR 2.58, 95% CI 1.56 to 4.28) and lower physical activity level. CONCLUSION: The prevalence of sarcopenia in patients attending geriatric clinics was high. Further studies are needed to examine the impact of sarcopenia on adverse outcomes in this population.

Assessment of nutritional status in older diabetic outpatients and related factors in Hanoi, Vietnam.

Purpose: Nutritional status is an important element for the wellness among older diabetic outpatients. This study aimed to assess the nutritional status of the older diabetic outpatient by using the Mini-Nutrition Assessment Short Form (MNA-SF) tool, and describe the relationship among related factors in older diabetic outpatients in the National Geriatric Hospital, Hanoi, Vietnam. Patients and methods: A cross-sectional study was conducted from June to September 2015 in the National Geriatric Hospital. A total of 158 diabetic patients aged ≥60 years at the Outpatient Department were included in this study. Patients were interviewed face-to-face to evaluate their nutritional status by using the MNA-SF. Socio-demographic, diabetic treatment information, frailty, exhaustion, cognitive function, hand grip strength and 4 m walk test were collected. Multivariate regression was used to determine factors associated with nutritional status. Results: The mean age was 69.52 (SD=6.758) with 31% patients malnourished and at risk of malnutrition. A significant association was found between the nutritional status and exhaustion, cognitive impairment, and frailty. In multiple logistic regression, the study found that risk of malnutrition was associated with frailty (OR=8.45; 95%CI=1.91-37.39) and cognitive impairment (OR=2.21; 95%CI=1.01-4.84). Conclusion: The results suggest that frailty was significantly associated with risk of malnutrition in older diabetic outpatients. Thus, early screening by nutritional assessment, and other interventions might improve the nutritional status of older outpatients with diabetes to prevent this complication and its effects.

Determining Risk for Depression among Older People Residing in Vietnamese Rural Settings.

(1) Background: Major causes of the burden of disease in older persons include mental disorders and neurological diseases, such as depression. This study aims to explore the prevalence of older people at risk for depression and identify the factors associated with this risk in rural Vietnam. (2) Methods: A cross-sectional study was conducted in Soc Son, Hanoi with 523 community dwelling elders aged 60 and over. Face-to-face interviews were performed to collect data about socioeconomic status, risk for depression, health status, and health utilization. The Geriatric Depression Scale-4 items (GDS-4) was used to assess the risk for depression occurrence. Multivariable logistic regression was employed for determining the factors associated with the risk for depression. (3) Results: Among 523 participants, there were 26.4% of participants at risk for depression. The proportion of females at risk for depression (29.0%) was significantly higher than males (20.4%). Differences were found in economic status (near poor group had higher risk for depression compared to the poor group) (p < 0.01). Older adults living with spouse/partner, living in near-poor household, and suffering pain/discomfort were all more likely to be at risk for depression. (4) Conclusions: Being female, living in a near poor household, being in pain or experiencing discomfort are all factors strongly correlated to high risk for depression. These findings highlight the urgent need for additional research among Vietnamese community-dwelling older people.

Sex Differences in Quality of Life and Health Services Utilization among Elderly People in Rural Vietnam.

In Vietnam, as in much of the world, the elderly population is growing rapidly. Two-thirds of Vietnam's elderly live in rural areas, where there may be unique health profiles and needs. Furthermore, the sex ratio in the elderly population is highly skewed. The relationship between sex, health-seeking behavior, and health outcomes in elderly individuals residing in rural areas has not been well-characterized, and needs to be elucidated in order to better serve this population. This study sought to explore the associations of sex with health and health-seeking behavior among the elderly in Soc Son, a rural district of Hanoi. A cross-sectional design was employed; elderly women and men were surveyed across the domains of socioeconomic information, health status, and healthcare service utilization. We found differences between women and men in sociodemographic characteristics, quality of life, health outcomes, and patterns of health services utilization. Overall, women had poorer health and quality of life, but no difference was found between sexes regarding level of health services utilization. Future research should expand upon these findings and, moreover, characterize their underlying systemic, sociocultural, and psychological mechanisms, in order to help bring solutions to improve the health of elderly persons in rural parts of Vietnam.

Adherence to methadone maintenance treatment and associated factors among patients in Vietnamese mountainside areas.

BACKGROUND: Medication adherence is essential to achieve successful methadone maintenance treatment (MMT). However, treatment adherence among MMT patients in the mountainous setting in Vietnam has not been yet investigated. This study aimed to explore the medication adherence and associated factors in MMT patients in Tuyen Quang, a mountainous province. METHODS: A cross-sectional survey was conducted in two MMT clinics namely Tuyen Quang and Son Duong. Convenience sampling method was used to recruit patients. Adherence to MMT was assessed by using three questions: 1) number of days that they missed doses in the last 4 days; 2) whether they missed doses during the last weekend and 3) when they missed a dose within the last 3 months. Adherence was considered optimal if patients reported 'no' to three questions. Socioeconomic status, health status (measured by EuroQol-5 Dimensions - 5 Levels - EQ5D5L and Visual analogue scale - VAS), substance use and abuse and methods to support adherence were also collected. RESULTS: Among 241 patients, 34.4% reported optimal adherence. Self-help was the most popular (89.2%) method used to support adherence. Risk factors of missing doses and suboptimal adherence included higher education and economic status; being a worker/farmer; longer duration of treatment; and suffering pain/discomfort and anxiety/depression. Protective factors were older age, having problems in usual activities/self-care, higher EQ-VAS and EQ-5D index; and reminded by mobile phone and family members. CONCLUSIONS: This study found a high sub-optimal adherence rate among MMT patients in a mountainous setting in Vietnam. Measuring adherence by using several simple items could be used periodically to monitor the treatment adherence in the clinical setting. Family and mobile phone support would have a potential role in supporting patients to adhere treatment.