Successful aging defined by health-related quality of life and its determinants in community-dwelling elders.

BACKGROUND: Successful aging in old age is important. However, the determinants of successful aging vary across populations due to cultural differences, and only a limited number of studies have addressed these determinants in Taiwan population. This study aimed to evaluate successful aging via better physical and mental functions as well as to explore associated determinants in an elderly Taiwan population that had no impaired cognitive function. METHODS: A community-based cross-sectional survey was conducted in January 2009 in Taichung, Taiwan. A total of 903 elderly persons (≥65 years) without impaired cognitive function were enrolled. Those with physical and mental component scores in the top tertile of the Short-Form 36 were considered to be aging successfully. All participants completed a structured questionnaire and the comprehensive geriatric assessment measurements of the five components of frailty defined by Fried et al. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the relationship between associated factors and successful aging using logistic regression analysis. RESULTS: The prevalence of successful aging was 10.4% in elders. A higher proportion of successful aging was found in non-frail (16.9%) and pre-frail elders (7.2%) than in frail elders (0.9%). Multivariate logistic regression showed pre-frail elders to be associated with lower prevalence of successful aging relative to non-frail elders (OR: 0.45; 95% CI: 0.24-0.84). Relative to those aged ≤70 years, elders aged 71-75 years were associated with a lower prevalence of successful aging (OR: 0.27; 95% CI: 0.13-0.58). Successful aging was also more likely among those able to visit relatives and friends (OR: 3.86, 95% CI: 1.09-13.61) and among those without a history of falling (OR: 4.95; 95% CI: 1.79-13.74), pain (OR: 4.04; 95% CI: 2.18-7.50), or sleep disorders (OR: 2.36; 95% CI: 1.30-4.27). CONCLUSION: Successful aging was associated with age, frail status, chronic health-related problems and psychosocial support. However, whether or not these associations are causal requires further exploration.

Metabolic syndrome is associated with change in subclinical arterial stiffness: a community-based Taichung community health study.

BACKGROUND: The aim of this study was to evaluate the effect of MetS on arterial stiffness in a longitudinal study. METHODS: Brachial-ankle pulse wave velocity (baPWV), a measurement interpreted as arterial stiffness, was measured in 1518 community-dwelling persons at baseline and re-examined within a mean follow-up period of 3 years. Multivariate linear regression with generalized estimating equations (GEE) were used to examine the longitudinal relationship between MetS and its individual components and baPWV, while multivariate logistic regression with GEE was used to examine the longitudinal relationship between MetS and its individual components and the high risk group with arterial stiffness. RESULTS: Subjects with MetS showed significantly greater baPWV at the end point than those without MetS, after adjusting for age, gender, education, hypertension medication and mean arterial pressure (MAP). MetS was associated with the top quartile of baPWV (the high-risk group of arterial stiffness, adjusted odds ratio [95% confidence interval] 1.52 [1.21-1.90]), and a significant linear trend of risk for the number of components of MetS was found (p for trend < 0.05). In further considering the individual MetS component, elevated blood pressure and fasting glucose significantly predicted a high risk of arterial stiffness (adjusted OR [95% CI] 3.72 [2.81-4.93] and 1.35 [1.08-1.68], respectively). CONCLUSIONS: MetS affects the subject's progression to arterial stiffness. Arterial stiffness increased as the number of MetS components increased. Management of MetS is important for preventing the progression to advanced arterial stiffness.

The psychological well-being and associated factors of caregivers of outpatients with schizophrenia in Taiwan.

The purpose of this study attempted to understand the psychological well-being of caregivers of individuals with schizophrenia and factors affecting the caregivers' psychological well-being. More specifically, quality of life and psychiatric morbidity were used to represent the psychological well-being. Personal interviews using questionnaires were administrated to 57 caregivers. Data regarding knowledge of schizophrenia, perceived causes of schizophrenia, quality of life and psychiatric morbidity was collected. Psychiatrists assessed the symptoms severity of the schizophrenic patients. Compared with the controls, the psychological well-being of caregivers of patients with schizophrenia was poorer. There was a significant association between the positive symptoms score and the psychological well-being of caregivers. Life quality and psychiatric morbidity were affected by caregivers' knowledge of schizophrenia and beliefs about the cause of schizophrenia. Health care providers should consider the patients and their caregivers as a whole and provide psychoeducaiton to reduce the negative psychological impact of caregivers.