Seasonal pattern of single falls and recurrent falls amongst community-dwelling older adults first applying for long-term care services in Hong Kong.

BACKGROUND: few studies had investigated seasonal pattern of recurrent falls. OBJECTIVE: to examine seasonal pattern of both single and recurrent falls amongst community-dwelling older adults first applying for long-term care (LTC) services. METHODS: a cohort of 89,100 community-dwelling Hong Kong older adults aged 65 and over first applying for LTC services from 2005 to 2014 was obtained. Logistic regression models were used to examine seasonal pattern in single and recurrent falls, whilst controlling for gender, age and year. RESULTS: amongst 89,100 older adults, about 32% fell in past 90 days. Amongst the fallers, 34% fell recurrently. In 2014, the incidences of all fall, single fall and recurrent fall were 1.95, 0.80 and 1.15 per person-years, respectively. For single falls, the 90-day fall risk was highest during November to February with an odds ratio (OR) of 1.29 (95% confidence interval [CI] 1.19-1.41), compared with the lowest one during July to October. For recurrent falls, the highest OR for 90-day risk was highest during November to February (1.46, 95% CI 1.31-1.64) as well. CONCLUSIONS: single and recurrent falls both peaked during winter months. Interventions, such as implementing educational publicity and sending reminder to older adults in fall season, may be considered.

Physical Activity Intensity and Biopsychosocial Correlates in Chinese Middle-Aged and Older Adults With Chronic Kidney Disease.

BACKGROUND: The study aims to characterize physical activity (PA) participation by intensity and examine the biopsychosocial correlates among middle-aged and older adults with CKD in China. METHOD: Data are examined from the 2011 China Health and Retirement Longitudinal Study. RESULTS: The percentages of participation in vigorous, moderate, and light activity among participants with CKD were 22.7%, 42.1%, and 76.3%, respectively. Participants were less likely to engage in vigorous and moderate PA if they were 70 years of age or older, not married/partnered, unemployed, lived in urban areas, had advanced disease stage, had heart disease, and/or experienced mobility limitations. The magnitude of associations between biophysical factors and PA participation was small for light PA. CONCLUSION: The higher the intensity of regular PA, the less likely older adults with CKD were to participate; Practitioners could consider the psychosocial characteristics of the older adults with CKD and facilitate their participation in PA.

Physical activity and posttraumatic growth in patients receiving maintenance hemodialysis: A prospective study.

This study used a prospective design to examine the association between self-reported physical activity and posttraumatic growth (PTG) over a 1-year period among 150 patients receiving maintenance hemodialysis. Transport-related, household, and leisure-time physical activity were positively associated with PTG at baseline and follow-up. Total physical activity could predict higher levels of PTG at follow-up, after controlling for baseline PTG and other covariates. The findings indicate that daily physical activity could be a modifiable behavioral factor associated with PTG among patients receiving maintenance hemodialysis. Further study is needed using a randomized controlled design and objective measures of physical activity.

Continued social participation protects against depressive symptoms across the retirement transition: Longitudinal evidence from three waves of the China Health and Retirement Longitudinal Survey.

AIM: Social participation is an important social resource over retirement, but little is known about how changing social participation might affect mental health over retirement. This study examined the impact of retirement status, changes in social participation and their interactions on subsequent depressive symptoms over a 4-year period. METHODS: Data were obtained from the first three waves of the China Health and Retirement Longitudinal Survey. The analytical sample included 2364 individuals with different retirement statuses (remained retired, transitioned to retirement, remained working). Generalized estimating equations were used to examine the impact of retirement status, changes in social participation and their interactions on depressive symptoms. RESULTS: Compared with those who remained working, individuals who remained retired reported reduced depressive symptoms (ß = -0.64, 95% CI -1.23 to -0.05); individuals who transitioned to retirement reported elevated depressive symptoms (ß = 0.74, 95% CI 0.07 to 1.41). Relative to those who reported no participation over the study, individuals who maintained or increased social participation reported reduced depressive symptoms (ß = -1.12, 95% CI -1.67 to -0.56; ß = -1.03, 95% CI -1.90 to -0.17); individuals who decreased social participation reported elevated depressive symptoms (ß = 0.70, 95% CI 0.13-1.28). Individuals with decreased social participation were more influenced by the negative impact of transition to retirement on depressive symptoms (ß = 1.93, 95% CI 0.12-3.74). CONCLUSION: These results highlighted the time-varying effects of retirement on mental health, and continued social participation acting as an adaptive strategy to protect against depressive symptoms over time. Geriatr Gerontol Int 2019; 19: 972-976.

Prevalence and correlates of abuse screening items among community-dwelling Hong Kong Chinese older adults.

AIM: The present study aims to describe the prevalence of potential elder abuse, and to examine correlates of abuse screening items among Chinese community-dwelling older adults. METHODS: We analyzed the data of 3435 older persons aged ≥60 years who had first applied for the long-term care services in Hong Kong and completed the screening tool (Minimum Data Set-Home Care) in 2006. For each of the five abuse screening items ("fearful of a family member/caregiver," "unexplained injuries/broken bones/burns," "physically restrained," "unusually poor hygiene" and "neglected/abused/mistreated"), we examined its relationship with four types of factors: older person, perpetrator, relationship and environment. RESULTS: The rates of individual abuse screening items ranged from 3.9% for physically restrained to 0.03% for unexplained injures/broken bones/burns. Physically restrained was positively associated with activities of daily living impairments, instrumental activities of daily living impairments, perceived poor health, physically abusive behavior and caregiver mental health. Unusually poor hygiene was positively associated with socially inappropriate behavior and actively resisted care. "Fearful of a family member/caregiver" was positively associated with perceived poor health, conflicting relationship and mental health, and negatively with care activities. Neglected/abused/mistreated was positively associated with age and informal care, and negatively with care activities. CONCLUSIONS: We identified a number of associated factors of different abuse screening items among older adults. Our findings could inform healthcare practitioners in identifying those older persons who might be at higher risk of abuse, and provide a knowledge base on which to develop effective preventive measures in the Chinese population. Geriatr Gerontol Int 2017; 17: 150-160.