Association between community environment and dependency among the elderly people from a service provision perspective.

BACKGROUND: The incidence of dependency is high among the elderly people worldwide and increases with increasing life expectancy. The purpose of this study was to establish from the perspective of resource demand the association between community environmental resources and dependency among the elderly people. METHODS: This study is a cross-sectional design based on community from 22 locations in China. A multistage sampling method was used to select the study objects. The questionnaires were used to collect the survey data by face-to-face interviews. A total of 950 individuals completed the survey, and 913 individuals were available for this analysis. Dependency and community environment were measured using the standard instruments. Logistic regression analysis was performed to identify the community environment factors associated with dependency. Cluster analysis was used and demonstrated that dependency was mainly associated with community primary preventive care service resources. RESULTS: In the group aged under 70 years, the utilization of electronic health records and the need for health assessments, and rehabilitation equipment rentals were significantly associated with the levels of dependency scores: the OR was 2.81, 2.25 and 2.13 (P < 0.05), respectively. In the group aged 70 years and over, a short-term care home was strongly associated with levels of dependency: the OR was 4.01 (P = 0.002). The daycare and nursing service, transportation service, and regular lectures on health knowledge were associated with levels of dependency: the OR was 2.41, 1.86 and 1.93 (P < 0.05). In the group with low social support, an emergency call or monitoring system, transportation services, the need for health assessment, and regular lectures on health knowledge were significantly associated with levels of dependency: the OR was 2.42, 2.19, 1.89 and 1.98 (P < 0.05), respectively. CONCLUSIONS: Community environment resources were significantly associated with dependency. These results suggest that the dependent on local environment resources may consider as the resource needs among elderly people.

Use of the Dementia Assessment Sheet for Community-based Integrated Care System 21 items among Chinese community-dwelling older adults.

AIM: The objective of this study was to verify the reliability and validity of the Dementia Assessment Sheet for Community-based Integrated Care System 21 items (DASC-21) among Chinese community-dwelling older adults, and to explore the related factors for dementia screening. METHODS: The study adopted a cross-sectional design, and a total of 1152 participants aged ≥60 years were recruited from 26 locations in China. All data were collected using questionnaires through face-to-face interviews. The logistic regression model was used to evaluate the effect factors of DASC-21 for dementia screening. The receiver operating characteristic curves were used to determine the optimal cut-off points and the accuracy of the DASC-21 for dementia and mild cognitive impairment screening. RESULTS: For test-retest reliability, the Pearson correlation coefficient was 0.873 (P < 0.001). In the criterion-related validity, the DASC-21 scores were significantly and negatively correlated with the Mini-Mental State Examination (r = -0.663, P < 0.001) and the Montreal Cognitive Assessment (r = -0.565, P < 0.001) scores. The results of the receiver operating characteristic analysis showed that there were different optimal cut-off values for different age groups. The areas under the receiver operating characteristic curves were 95.6% and 90.3% for dementia and mild cognitive impairment screening using DASC-21 after considering related effect factors. CONCLUSIONS: The DASC-21 was confirmed to be a valid and reliable instrument for dementia screening among Chinese community-dwelling older adults. Our results suggested that the age, education level and 2-week prevalence were important effect factors for dementia screening using the DASC-21. Geriatr Gerontol Int 2021; 21: 705-711.

Important Dependency-Associated Community Resources among Elderly Individuals with a Low Level of Social Support in China.

Background: The prevalence of dependency personality disorder is high among elderly individuals with a low level of social support. The objective of this study was to explore the dependency associated with important community resources among elderly individuals with a low level of social support from the perspective of resource demand. Methods: The population-based cross-sectional study was conducted in 22 locations in China. A total of 950 participants aged ≥60 years were selected using a complex multistage sampling design. All the data were collected using questionnaires via face-to-face interviews. The dependency was assessed using the standardized Chinese version of the Minnesota Multiphasic Personality Inventory-II. Community resources were assessed using 43 items. Logistic regression analysis was used to evaluate the association between dependency and important community resources. Results: Bivariate analysis showed that the level of social support was negatively associated with levels of income (p < 0.001) and education (p = 0.008) and was positively associated with social communication and interactions (p < 0.001). The logistic regression analysis showed that the emergency call or survival monitoring system (ECSMS) was the most important community resource that was significantly associated with the levels of dependency; the odds ratio was 2.64 (95% CI, 1.07-3.91; p = 0.031) among elderly individuals with a low level of social support. Conclusions: The levels of dependency were most significantly associated with the ECSMS among elderly individuals with a low level of social support. Our results suggest that improving the ECSMS can be the main problem in the development of community resources.

The role of social support in the association between dependency and important risk factors among the elderly.

BACKGROUND: This study aimed to assess the association between social resources and dependency, and explored the effect of social support in modifying important risk factors for dependency among the elderly. METHODS: This was a population-based cross-sectional study. A total of 950 participants aged ≥60 years were selected using a complex multistage sampling design from 22 locations in China. All data were collected using questionnaires by face-to-face interviews. Dependency was assessed using the Minnesota Multiphasic Personality Inventory-II, and social resource status with the Chinese version of the Older American Resources and Services (OARS) questionnaire. Logistic regression analysis was used to evaluate the association between dependency and social resources. Analysis of covariance was performed to evaluate the effect of social support on modifications of important risk factors for dependency. RESULTS: A total of 913 participants were included in the analysis, and 10.3% of the males and 14.4% of the females were identified as in dependency. The results of logistic regression analysis showed a significant negative association between the levels of social resources and dependency. The odds ratio was 0.78 (95% confidence interval, 0.73-0.84) after adjusting for important confounding factors. The results of analysis of covariance showed differences in the mean dependency scores between different groups defined by chronic disease status and social support level. CONCLUSIONS: Levels of social resources were negatively associated with dependency. Our results suggest that social support has both a direct effect on dependency and an indirect effect through modifying chronic disease status and individual income.