Singaporeans' perceptions of and attitudes toward long-term care services.

Use of long-term care (LTC) services among older adults in Asia has emerged as an important issue in light of rapidly aging countries and changing family structures. Simply building more LTC facilities will not result in higher usage rates, and more insight is needed on the usage of existing services. Few studies have been conducted among Asian populations outside Western settings on this topic. The multi-ethnic population in Singapore is useful for understanding the factors influencing the use of long-term care services in Asia. We present our qualitative findings on long-term care service usage in the older population (50+ years) over time. We highlight caregivers' needs as an important determinant of LTC use. Although preferences of the care recipients were considered, caregiver needs, the availability of formal and informal care support, attitudes, perceived control, and social norms surrounding family caregiving governed the use of formal LTC services in Singapore.

Living arrangements, social networks and onset or progression of pain among older adults in Singapore.

AIMS: We aimed to evaluate the relationship between living arrangements, and strength of social network with onset and progression of chronic pain over 2 years in elderly Singaporeans. METHODS: We used data from the Social Isolation Health and Lifestyles Survey, a nationally representative survey of community-dwelling older Singaporeans aged >60 years (n = 4990) in 2009 and follow up in 2011. We used binomial logistic regression models to examine factors associated with self-reported onset and progression of chronic pain over time. RESULTS: A total of 3103 participants (53.8% women) completed both surveys (weighted response rate 63.7%). The mean age (SD) was 69.4 (0.5) years. The prevalence of mild and moderate-extreme chronic pain at baseline were 27.7% and 12.8%. A total of 20.1% and 3.9% of the participants reported having chronic pain onset and progression over 2 years, respectively. In the binomial regression models, lower education level, living alone and poorer self-rated health were predictors for onset of chronic pain in women. Weak social networks and disability were associated with progression of chronic pain in women. CONCLUSIONS: Chronic pain is common in Singaporean older adults. Living alone and weak social network were sociopsychological factors associated with the onset or progression of chronic pain. Geriatr Gerontol Int 2015; ●●: ●●-●●.

Self-Care for Older People (SCOPE): a cluster randomized controlled trial of self-care training and health outcomes in low-income elderly in Singapore.

UNLABELLED: Population aging is associated with a higher prevalence of chronic health conditions. Previous studies have shown that older persons, specifically those with chronic conditions, often lack sufficient knowledge about their condition and thus frequently have poor self-care skills. Efforts to increase general health screenings and improve access to chronic condition management resources are hampered by a lack of disease and health awareness. Self-Care for Older People (SCOPE) study, a cluster randomized controlled trial in Singapore, was designed to evaluate the impact of a self-care program for chronic disease awareness and management of specific health measures and quality of life of older people over eighteen months. SCOPE provided self-care education targeted at older people with low income and low education in order to improve health-related knowledge. A total of 378 low-income older people with no or minimal disability, defined as having difficulty in one or more activities of daily living (ADL), were recruited from senior activity centers. The measurements taken included self-reported health conditions, health and disease knowledge questions, and biomarkers (HbA1c, blood pressure, peak expiratory flow, lipid panel, albumin, and creatinine). SCOPE was also designed to provide information for policy makers on chronic disease burden and healthcare facility utilization among community-dwelling older adults. TRIAL REGISTRATION NUMBER: NCT01672177.

Prevalence and Risk Factors of Atrial Fibrillation in Chinese Elderly: Results from the Chinese Longitudinal Healthy Longevity Survey.

BACKGROUND: Prevalence of atrial fibrillation (AF) is increasing as the world ages. AF is associated with higher risk of mortality and disease, including stroke, hypertension, heart failure, and dementia. Prevalence of AF differs with each population studied, and research on non-Western populations and the oldest old is scarce. METHODS: We used data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey, a community-based study in eight longevity areas in China, to estimate AF prevalence in an elderly Chinese population (n = 1418, mean age = 85.6 years) and to identify risk factors. We determined the presence of AF in our participants using single-lead electrocardiograms. The weighted prevalence of AF was estimated in subjects stratified according to age groups (65-74, 75-84, 85-94, 95 years and above) and gender. We used logistic regressions to determine the potential risk factors of AF. RESULTS: The overall prevalence of AF was 3.5%; 2.4% of men and 4.5% of women had AF (P < 0.05). AF was associated with weight extremes of being underweight or overweight/obese. Finally, advanced age (85-94 years), history of stroke or heart disease, low high-density lipoprotein levels, low triglyceride levels, and lack of regular physical activity were associated with AF. CONCLUSIONS: In urban elderly, AF prevalence increased with age (P < 0.05), and in rural elderly, women had higher AF prevalence (P < 0.05). Further exploration of population-specific risk factors is needed to address the AF epidemic.

Vitamin D levels and cognition in elderly adults in China.

OBJECTIVES: To evaluate the association between vitamin D level and cognitive impairment in individuals aged 60 and older. DESIGN: Cross-sectional cohort study. SETTING: Chinese Longitudinal Healthy Longevity Survey, a community-based cohort study in areas in China where the density of centenarians is exceptionally high. PARTICIPANTS: Individuals with mean age of 84.9 ± 12.7 (N = 2,004). MEASUREMENTS: Participants' cognitive state was evaluated using the Mini-Mental State Examination (MMSE). Vitamin D was measured in plasma using an enzyme-linked immunoassay. RESULTS: The cross-sectional association between quartiles of plasma vitamin D level and cognitive impairment (MMSE score <18) was modeled using logistic regressions. Plasma vitamin D levels were lower in individuals with cognitive impairment (31.9 ± 15.3 nmol/L) than in those without (45.6 ± 19.6 nmol/L). There was a reverse association between plasma vitamin D and cognitive impairment. After adjusting for age, sex, chronic conditions, smoking and drinking habits, outdoor activities, depression, and activity of daily living limitations, the association remained significant. The multivariable-adjusted odds ratio for lowest versus highest vitamin D levels was 2.15 (95% confidence interval (CI) = 1.05-4.41) for cognitive impairment, and the multivariable odds ratio associated with a 1-standard deviation decrement in plasma vitamin D was 1.32 (95% CI = 1.00-1.74) for cognitive impairment. CONCLUSION: Low plasma vitamin D levels were associated with greater odds of cognitive impairment. Further prospective studies in Asian populations are needed to examine the causal direction of this association.