Investigating Risk Factors for Falls among Community-Dwelling Older Adults According to WHO's Risk Factor Model for Falls.

OBJECTIVES: The World Health Organization developed the Risk Factor Model for Falls to describe fall risks in a comprehensive manner. However, there was a lack of study adopting such framework in quantifying falls risk from different factors in a single model. Therefore, this study examined the risk factors from four domains in the Risk Factor Model for Falls among older adults. DESIGN: Secondary data analysis of 10-year assessment records of the Minimum Data Set-Home Care instrument. SETTING: Hong Kong. PARTICIPANTS: 89,100 community-dwelling adults aged 65 and over who first applied for publicly funded long-term care services from 2005 to 2014. MEASUREMENTS: The Minimum Data Set-Home Care instrument was used to ascertain older adults' care needs and match them with appropriate services. Additionally, meteorological records from the same period were extracted from the Hong Kong Observatory. The logistic regression model was used to examine risk factors and their associations with falls. RESULTS: In total 70 factors were included in the analysis, of which 37 were significantly associated with falls. Behavioral risk factors generally had greater odds ratios of falling, as compared with biological, socioeconomic, and environmental factors. Out of all significant factors, functional status, alcohol drinking, and locomotion outdoors had the largest odds ratios of falling. CONCLUSION: Behavioral risk factors for falls are of remarkable influence yet are modifiable among older adults. Hence, falls prevention programs may need to prioritize addressing these factors.

A comparison of the acceptance of immunochemical faecal occult blood test and colonoscopy in colorectal cancer screening: a prospective study among Chinese.

BACKGROUND: Preferences to choose immunochemical faecal occult blood test (FIT) and colonoscopy as colorectal cancer (CRC) screening modalities among asymptomatic Chinese subjects remain unknown. AIM: To evaluate the preference of choosing colonoscopy vs. FIT among CRC screening participants. METHODS: From a community-based CRC screening programme for asymptomatic Hong Kong Chinese aged 50-70 years, participants attended standardized educational sessions and chose the options of annual FIT for 5 years or direct colonoscopy once. Factors associated with choosing colonoscopy were evaluated by multivariate regression analysis. RESULTS: Among 3430 participants [mean age 56.8 years (s.d. 5.0); female 55.1%, male 44.9%], 51.3% chose colonoscopy and 48.7% chose FIT. Older participants (65-70 years) were less likely to choose colonoscopy [adjusted odds ratio (aOR) 0.731, P = 0.041]. Subjects who chose colonoscopy were those disagreed screening would lead to discomfort (aOR 1.356, P < 0.001), had relatives or friends who had CRC (first degree relatives aOR 1.679, P < 0.001; second degree relatives aOR 1.304, P = 0.019; friends or others aOR 1.252, P = 0.026) and those who self-perceived their health as poor (aOR 1.529, P = 0.025). CONCLUSIONS: Faecal occult blood test and direct colonoscopy were equally preferable to Chinese. Colonoscopy was preferred among the younger subjects, those with positive family history of CRC and self-perceived poor health status.

Relationship between adherence to tradition and depression in Chinese elders in China.

This study examined the relationship between adherence to tradition and depression in a large sample (N = 1502) of Chinese elders living in the People's Republic of China. In Chinese traditional culture, an elder's purpose, meaning and self-worth are derived, in large, from their social roles within the family and community. As the traditional culture declines so do these familiar roles, supports, and ways of coping. This constitutes a major loss which can have a variety of psychosocial consequences, one of which could be depression. The elders in our study responded to a nine-item measure of traditional mutual aid and intergenerational exchange. Depression was measured by the Center for Epidemiological Studies Depression Scale. Regression analysis found a significant and negative relationship between tradition and depression which suggests that adherence to tradition may have protective benefits. These findings have application with elders in China as well as with those who are immigrants to other societies.