Fear of Falling: Exploring Associated Factors among Elderly Residents in the Rural Communities of Vietnam.

This research aimed to explore factors associated with the fear of falling (FOF) among community-dwelling older adults in Vietnam. A cross-sectional study was conducted in five communes in Soc Son, Hanoi, Vietnam, from March to June 2017. We recruited a total of 487 participants, which provided sufficient data for analysis. The outcome variable was fear of falling. Several covariates, including demographics, medical history, general health status, geriatric syndromes, eye diseases, assessment of fall risk environment, timed up-and-go test, and number of standing up in 30 s, were collected. A multivariable logistic regression model was performed to determine predictors associated with FOF. The results showed that 54.6% of the participants had FOF. Furthermore, the logistic multivariable regression model revealed several factors associated with FOF among participants in the research sites, including polypharmacy status (OR: 1.79; 95%CI 1.07-2.99), higher scores in quality of life according to the EQ-5D-5L index (OR:6.27; 95%CI: 2.77-14.17), and having fallen during the past 12 months (OR:4.4; 95%CI: 2.39-8.11). These findings contribute to a comprehensive understanding of the intricate relationship between FOF and several associated factors, notably polypharmacy status, quality of life, and having a fall during the past 12 months.

The efficacy and tolerability of proteoglycan F in the treatment of knee osteoarthritis: A prospective, randomized, double-blind controlled trial.

Objective: To identify the efficacy and tolerability of Proteoglycan F in patients with primary knee OA.Design: A 24-week randomized, placebo-controlled, double-blind clinical trial with two arms: (1) Proteoglycan F (received 10 â€‹mg proteoglycan daily, for 24 weeks) and (2) control group (received placebo). Knee symptoms and joint cartilage status (evaluated by ultrasound and MRI of knee joints), quality of life, serum cytokine levels (IL-1ß and TNF-α), and safety evaluation were measured before, during, and after the treatment. Results: After 24-week treatment, pain reduction (in the KOOS pain score) of at least 20% and at least 50% (NRS scale) compared to baseline in the PGF group was significantly higher than those in the control group. The PGF group had greater reductions in the total scores of subchondral bone marrow edema, and bone cocoon under cartilage on knee MRI (classification according to WORMs), which were -2.27 (-4.0; -0.51) and -1.77 (-3.08; -0.46), respectively (p â€‹< â€‹0.05). The two groups had no statistically significant difference in knee ultrasound characteristics. After 4 weeks, 12, and 24 weeks compared to baseline, there was no statistically significant difference in levels of urea, creatinine, aspartate aminotransferase, and alanine aminotransferase within the group and between the two study groups. Conclusions: Salmon cartilage PG with 10 â€‹mg per day has potential to improve pain symptoms and subchondral bone marrow edema and bone cocoon under cartilage lesions in primary knee OA. However, the efficacy of PGF should be viewed with caution, and future studies are needed for more specific evaluation.

Effectiveness of Non-Pharmacological Interventions for Dementia among the Elderly: A Randomized Controlled Trial.

(1) Background: Up until now, there is still no medicine that can cure dementia, but there are some that can only help slow down the progression of the disease and reduce some symptoms. Pharmacological interventions for dementia have many side effects and are expensive, so non-pharmacological treatments for dementia become more urgent. This study aimed to evaluate the effectiveness of multifactorial non-pharmacological interventions in dementia patients; (2) Methods: This is a randomized controlled trial conducted in Hai Duong from July 2021 to December 2022. Selected subjects included 88 patients diagnosed with very mild, mild, and moderate dementia, of whom 44 patients were assigned to the intervention group and 44 patients to the control group; (3) Results: For the effectiveness of the non-pharmacological multifactorial intervention on depression severity: in the intervention group, the GDS 15 depression score decreased from 4.8 to 2.9, while, in the control group, the GDS 15 depression score increased by 1.3 points after six months of no intervention. For the effect of the non-pharmacological multifactorial intervention on the level of sleep disturbance, in the intervention group, the PSQI sleep disturbance score decreased by nearly half (from 10.2 to 5.6), while, in the control group, this trend was not clear. For the effect of the non-pharmacological multifactorial intervention on daily functioning: in the intervention group, the ADL and IADL scores improved (1.02 ± 1.32 and 1.23 ± 1.75), while, in the control group, the ADL and IADL scores decreased (0.93 ± 1.2 and 0.98 ± 2.19). For the effect of the non-pharmacological multifactorial intervention on quality of life: in the intervention group, the EQ-5D-5L scores improved (0.17 ± 0.19), while, in the control group, the EQ-5D-5L scores decreased (0.20 ± 0.30); (4) Conclusions: Non-pharmacological multifactorial interventions, including physical activity, cognitive training, listening to educational lectures, and organizing miniature social models, have been shown to improve mental health, self-control, and quality of life.

A national program to advance dementia research in Vietnam.

BACKGROUND: As Vietnam and other low- and middle-income countries (LMIC) experience a rapid increase in the number of people living with dementia, an acute need exists to strengthen research capacity to inform policy, improve care and support, and develop national dementia plans. We describe the development and early outcomes of an National Institutes of Health (NIH)/National Institute on Aging (NIA)-funded national dementia research capacity building program in Vietnam. METHODS: The research capacity building program commenced in 2019 and has three components: (1) Vietnam Alzheimer's and other dementias research Network (VAN), (2) a mentored pilot grant program, and (3) research training, networking, and dissemination activities. The pilot grant program funds Vietnamese researchers for one to two years to conduct research focusing on Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD). Grants are reviewed and scored using NIH criteria, and priority is given to pilot grants with policy relevance and potential for future funding. An international pool of high-income country (e.g., United States, Australia, and United Kingdom) mentors has been engaged and mentors paired with each funded project. Training and networking activities include workshops on AD/ADRD research topics and regular meetings in conjunction with Vietnam's annual national dementia/geriatric conferences. Dissemination is facilitated through targeted outreach and the creation of a national network of institutions. RESULTS: Over four years (2019-2023), we received 62 applications, reviewed 58 applications, and funded 21 projects (4-5 per year). Funded investigators were from diverse disciplines and institutions across Vietnam with projects on a range of topics, including biomarkers, prevention, diagnosis, neuropsychological assessment, family caregiver support, dementia education, and clinical trials. A network of 12 leading academic and research institutions nationwide has been created to facilitate dissemination. Six research training workshops have been organized and included presentations from international speakers. Grantees have published or presented their studies at both national and international levels. The mentoring program has helped grantees to build their research skills and expand their research network. CONCLUSION: This research capacity building program is the first of its kind in Vietnam and may serve as a useful model for other LMIC.

Health-Related Quality of Life among Older Adults with Dementia Living in Vietnamese Nursing Homes.

Better understanding of the quality of life among nursing home residents with dementia is important for developing interventions. The objectives of this cross-sectional study were to examine factors associated with poor health-related quality of life in older people with dementia living in nursing homes in Hanoi, Vietnam. In-person interviews were conducted with 140 adults who were 60 years and older with dementia, and information about their quality of life was obtained using the Quality of Life in Alzheimer's Disease (QOL-AD) scale. The sociodemographic and clinical factors associated with poor health-related quality of life (lowest quartile) were assessed through the results of physical tests, interviews with nursing home staff, and review of medical records. The average age of the study sample was 78.3 years, 65% were women, and their average QOL-AD total score was 27.3 (SD = 4.4). Malnutrition, total dependence in activities of daily living, and urinary incontinence were associated with poor quality of life after controlling for multiple potentially confounding factors. Our findings show that Vietnamese nursing home residents with dementia have a moderate total quality of life score, and interventions based on comprehensive geriatric assessment remain needed to modify risk factors related to poor health-related quality of life.

Care needs assessment of older adults with dementia in a semi-rural district in Vietnam: A community-based cross-sectional study.

BACKGROUND: The increasing needs of people living with dementia (PLWD) in Vietnam present an enormous public health challenge. Vietnam is an understudied country, and little is known regarding the overall unmet needs of caregivers or the demographic risk factors associated with unmet caregiving needs. This study aimed to determine the burden of unmet care needs of community-dwelling PLWD and identify sociodemographic risks associated with unmet care needs. METHODS: A cross-sectional study in a rural area facing urbanisation in Hanoi, Vietnam recruited PWLD-caregiver dyads with multistage sampling. We utilised the Camberwell Assessment of Need for the Elderly (CANE) instrument to evaluate care needs across four domains. Caregivers rated PLWD needs, with higher scores indicating greater unmet needs. The Mann-Whitney test was employed for comparing two groups, while the Kruskal-Wallis test was used for comparisons involving more than two groups in the analysis, and a P-value of less than 0.05 was considered statistically significant. RESULTS: Among 90 PLWD participating in the study, the overall mean care needs score was 11.6 ± 4.3, with only 16.2% of PLWD having their care needs met. Environmental and physical needs were more frequently met than psychological or social needs. Only 48.0% and 43.9% of environmental and physical needs were met respectively, and a meagre 20.9% and 23.6% for psychological and social needs. Unmet care needs were more frequent for PWLD who were female, single or divorced, had lower monthly household income, or who were in more advanced stages of dementia, as indicated by Clinical Dementia Rating scores ≥1. CONCLUSIONS: Unmet needs for PWLD are common. Increased caregiver education, resources, and services in Vietnam are urgently required to improve the quality of life for this population.

Factors associated with frailty in geriatric patients with and without sarcopenia in Vietnam.

OBJECTIVES: This study aimed to investigate the relationship between sarcopenia and frailty and examine factors associated with frailty among older patients with and without sarcopenia. METHODS: This cross-sectional study was conducted on older inpatients and outpatients in Vietnam. Participants aged 60 years or older were consecutively enrolled in the study. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Fried's frailty phenotype was applied to define frailty. Logistic regression models with frailty as the dependent variable were applied. RESULTS: A total of 835 patients (mean age: 71.3 years, SD 8.4) were recruited. The overall prevalence of frailty was 17%. Among participants with and without frailty, 92% and 47% had sarcopenia, respectively. In unadjusted analysis, sarcopenia was significantly associated with increased frailty (OR 12.3, 95% CI 6.7-22.6) and remained significant after adjustment for sociodemographic factors (OR 6.3, 95% CI: 3.0-12.6) and for both sociodemographic and clinical factors (OR 5.4, 95% CI: 2.4-12.2). Among participants with sarcopenia, older age, inpatient status, having a high risk for falls, malnutrition and a history of hospitalisation in the last year were significantly associated with frailty. Among participants without sarcopenia, the factors associated with frailty were older age, inpatient status, low educational level, high risk of falls and malnutrition. CONCLUSIONS: Our study results highlighted that sarcopenia and frailty are two related but distinct geriatric syndromes.

Salt Stress-Induced Modulation of Porphyrin Biosynthesis, Photoprotection, and Antioxidant Properties in Rice Plants (Oryza sativa).

Salt stress disrupts cellular ion homeostasis and adversely impacts plant growth and productivity. We examined the regulatory mechanisms of porphyrin biosynthesis, photoprotection, and antioxidant properties in salt-stressed rice seedlings. In response to 150 mM NaCl, the rice seedlings exhibited dehydration, reduced relative water content, and increased levels of conductivity, malondialdehyde, and H2O2. The expression levels of the salt-stress-responsive genes NHX1, SOS1, and MYB drastically increased after NaCl treatment. The seedlings grown under NaCl stress displayed declines in Fv/Fm, ΦPSII, rETRmax, and photochemical quenching but increases in nonphotochemical quenching (NPQ) and the expression of genes involved in zeaxanthin formation, BCH, and VDE. Under salt stress conditions, levels of chlorophyll precursors significantly decreased compared to controls, matching the downregulation of CHLD, CHLH, CHLI, and PORB. By contrast, NaCl treatment led to increased heme content at 24 h of treatment and significant upregulations of FC2, HO1, and HO2 compared to controls. Salt-stressed seedlings also increased their expression of CATs (catalases) and APXs (ascorbate peroxidases) as well as the activities of superoxide dismutase, CAT, APX, and peroxidase. Our results indicate that chlorophyll and heme biosynthesis involve the protective strategies for salt stress alleviation through photoprotection by the scavenging of chlorophyll precursors and NPQ as well as activating antioxidant enzymes.

The Frail Scale - A Risk Stratification in Older Patients with Acute Coronary Syndrome.

Purpose: The aim of this study was to explore the impact of frailty on in-hospital adverse outcomes and net adverse clinical events (NACE) in older patients with acute coronary syndrome. Patients and Methods: This observational study included elderly patients (≥60 years old), diagnosed with acute coronary syndrome (ACS) at admission from February 2021 to August 2021. The primary outcome was net adverse clinical events (NACE) defined as a composite of all-cause mortality, stroke, and major bleeding. Secondary outcome was in-hospital adverse outcomes including arrhythmia, acquired pneumonia, stroke, major bleeding, and all-cause mortality. Frailty was assessed using the Frail scale (FS). Data about socio-demographics, comorbidities, body mass index, ACS type, coronary angiography, left ventricular ejection fraction, and length of hospital stay were also collected. Univariate and multivariate logistic regressions were employed to identify the potential association between frailty and outcomes. Results: Of the 116 ACS patients, 38 patients were frail (32.76%). Frail subjects were more often female (50%) and older (p < 0.01) and had higher rates of in-hospital adverse outcomes (OR = 2.37, p = 0.05) and NACE (OR = 7.12; p < 0.01). In univariate analysis, the increased frail score was significantly associated with increased odds of NACE (unadjusted OR = 1.98, 95% CI 1.17-3.35 for each score increase in Frail Score). In multivariable logistic regression, models controlling for age, gender, PCI, LVEF, and coronary angiography (adjusted OR 2.19, 95% CI 1.12-4.29 for each score increase in Frail Score). Conclusion: This study revealed the reference data of frailty assessment in older patients with ACS in Vietnam. Our result indicated that over 30% of ACS older patients presented with frailty which was associated with an increased risk of in-hospital adverse outcomes and NACE. This study also provided promising information about the simple FRAIL scale's potential role in the risk stratification of older patients with ACS.

Symptom Burden among Hospitalised Older Patients with Heart Failure in Hanoi, Vietnam.

This study aimed to assess the symptom burden among older patients hospitalised for heart failure. This hospital-based, cross-sectional study was conducted at the National Geriatric Hospital, Hanoi, Vietnam, from June 2019 to August 2020. Face-to-face interviews were performed to gather the following information: socio-demographic characteristics, heart failure classification, and clinical characteristics (comorbidities, polypharmacy, pro-B-type natriuretic peptide, left ventricular ejection fraction (LVEF), symptom burden, and depression). Symptom burden was assessed using the Edmonton Symptom Assessment Scale (ESAS), and depression was measured using the Patient Health Questionnaire. A total of 314 patients participated in the study. The mean participant age was 72.67 (SD = 9.42) years. The most frequently reported symptoms on the ESAS were shortness of breath (95.5%), fatigue (94.8%), and anxiety (81.2%). In univariate analyses, depression was significantly associated with heart failure class (p < 0.05). Multivariate linear regression revealed that major depression was significantly associated with total symptom burden score (Beta: 11.74; 95% CI: 9.24-14.23) and LVEF (Beta: -0.09; 95% CI: -0.17-(-0.007)). Patients hospitalised for heart failure experienced a high burden of symptoms. Further studies addressing adverse outcomes and expanding to community-dwelling older people are essential. Palliative care approaches that target symptom reduction should be considered in patients with heart failure.

Walking Speed Assessed by 4-Meter Walk Test in the Community-Dwelling Oldest Old Population in Vietnam.

This study aims to provide data on usual walking speed in individuals aged 80 years or older and determine the association between walking speed and related factors in community-dwelling older adults. A cross-sectional study design was conducted to measure walking speed on community-dwelling elders aged 80 years or older in Soc Son district, Vietnam. Walking speed was assessed by a 4-Meter Walk Test with a usual-pace walking mode. Health-related characteristics of participants including risk of falls (The Timed Up and Go test, activities of daily living (ADL), instrumental activities of daily living (IADLs), cognitive impairment (Mini-Cog test) and frailty syndrome (The Reported Edmonton Frail Scale (REFS)). Multiple logistic regression was used to analyze the association between a slow walking speed and selected factors. A total of 364 older people were recruited, and the majority were female (65.4%). The overall average walking speed was 0.83 ± 0.27 m/s. The proportion of participants with a slow walking speed (<0.8 m/s) was 40.4%. Multiple logistic regression analyses showed that age, female, high fall risk (assessed by TUG test), ADL/IADL dependence and frailty syndrome had a negative effect on slow walking speed in this population. The results could provide useful reference data for further investigations and measures in clinical practice.

Comprehensive Geriatric Assessment in Older Patients with Diabetes Mellitus in Hanoi, Vietnam.

INTRODUCTION: Comprehensive geriatric assessment (CGA) of older diabetic patients is thought to be of value, but there have been limited studies on the prevalence of impairments in the components of a CGA as well as the relationship between CGA and diabetic control in this group. OBJECTIVE: This study aimed to evaluate the prevalence of components of CGA in older patients with diabetes in National Geriatric Hospital, Hanoi, Vietnam, and determine the association among domains of CGA with measures of diabetic control. METHODS: A cross-sectional study of diabetic outpatients aged ≥60 years at National Geriatric Hospital in Hanoi, Vietnam, recruited over 3 months. The CGA questionnaire includes different assessments consisting of cognitive impairment (using Mini-Cog test), depression (using the 15-item Geriatric Depression Scale), urinary incontinence (using the 3-Incontinence questions), Activities of Daily Living (ADL) dependence, Instrumental Activities of Daily Living (IADL) dependence, high fall risk (using Hendrich II Fall Risk Model), hearing loss (using Whisper test), low visual acuity (using Snellen test), polypharmacy, malnutrition (using the Mini-Nutritional Assessment Short Form), and multiple geriatric conditions (patients had 2 or more geriatric conditions). Multiple logistic regression was used to analyze the association between demographic factors and CGA components with measures of diabetes control. RESULTS: A total of 412 patients were recruited (56.6% female, mean age 71.9 [7.6] years). Prevalence of impairment in components of the CGA was high and highest for vision impairment (94.2%) and multiple geriatric conditions (89.3%). Age <75 years, cognitive impairment, depressive symptom, IADL impairment, and high fall risk were significantly associated with both poor fasting plasma glucose control (>130 mg/dL) and poor HbA1c control (≥7%). CONCLUSIONS: This study highlights that geriatric syndromes are common in older diabetic patients and associated with poorer diabetic control. It suggests CGA may be important to conduct in this group by establishing an interdisciplinary Geriatric health care team.

Chronic Pain and Associated Factors Related to Depression among Older Patients in Hanoi, Vietnam.

The interaction of chronic pain and depression among older people has been studied for many years. This study aimed to investigate the frequency of chronic pain and depression among older patients and correlated factors. A cross-sectional study was conducted in 921 older patients at the National Geriatric Hospital from November 2019 to March 2020. We used the Charlson Comorbidity Index (CCI) to assess the comorbid condition, a numerical rating scale (NRS) to examine pain severity, and Geriatric Depression Scale-15 items (GDS-15) to measure depression among participants. A chi-square test and Tobit regression were used to analyze the relationships. A total of 921 older patients participated in the study. The proportion of depression accounted for 55.8%. The mean Charlson score and number of diseases were 1.2 and 4.7, respectively. A positive correlation was found between comorbidity and chronic pain and depression. Moreover, socio-demographic variables such as occupation, education, and income were associated with pain and depressive symptoms. This study highlights the issue of mental health in older people with chronic pain. The results indicate the necessity of frequent depression screening, pain management, and social activity programs for older people to enhance their health.

Association of Frailty Status and Functional Disability among Community-Dwelling People Aged 80 and Older in Vietnam.

OBJECTIVES: This study investigated associations between frailty and functional disability in elder suburban Vietnamese. METHOD: Cross-sectional analysis was carried out on 251 participants aged 80 and over in Soc Son district. We used the Instrumental Activities of Daily Living (IADL) scale including 8 items, and functional disability was defined as ≥3 IADL impairment. We defined frail as ≥3 out of 5 frailty components including weight loss > 5%, weak grip, exhaustion, low walking speed, and low physical activity. RESULTS: Of 251 participants with a mean age of 84.6, 11.2% was classified as frail and 64.5% had ≥3 IADLs. Among the frailty components, low walking speed and low physical activity were significantly associated with increased odds of having ≥3 IADLs: ORs (95% CI) were 4.2 (2.3-7.9) and 3.7 (1.7-8.2). CONCLUSION: Frailty is associated with the higher likelihood of having functional disability. Further longitudinal studies are needed to examine the causal this relationship.

A Description of Handgrip Strength in the Very Older Adult People Living in Rural Vietnam and Its Association with Daily Functions.

OBJECTIVE: To describe handgrip strength (HGS) and identify associated factors in community-dwelling older adults in rural Vietnam. METHODS: A cross-sectional study was conducted in community-dwelling older adults 80 years and over in five rural communities in Hanoi, Vietnam. Age-gender-BMI stratified HGS values were reported as means and standard deviations. Demographic characteristics, malnutrition, risk of fall, basic activities of daily living (ADL), and instrumental activities of daily living (IADL) were investigated. Multivariate linear regression explored the association between HGS and these factors. RESULTS: In 308 participants, mean age was 85.4 ± 4.2 years. Mean HGS was 21.6 ± 6.1 kg for males and 15.3 ± 4.3 kg for females. HGS in our sample was generally lower than that in other European countries and Asian threshold. Low HGS was correlated with older age (ß = -0.196, p < 0.001), female (ß = -0.443, p < 0.001), low education (ß = -0.130, p < 0.05), risk of falls (ß = -0.114, p < 0.05), and lower IADL (ß = 0.153, p = 0.001). CONCLUSIONS: The age-gender-BMI stratified HGS values of 80 years and over community-dwellers in rural Vietnam were described. HGS decreased with advanced age, female, low education, high risk of falls, and impaired IADLs. The results could provide useful reference data for further investigations and measures in clinical practice.

Assessing Knowledge and Attitudes Regarding Pain Management Among Nurses Working in a Geriatric Hospital in Vietnam.

BACKGROUND: Nurses play a pivotal role in pain management. Knowing more about nurses' knowledge and attitudes regarding pain is important as we develop multidisciplinary pain services. Therefore, this study aimed to assess knowledge and attitudes regarding pain management among nurses in a geriatric hospital and its associated factors. SUBJECTS AND METHODS: A survey was conducted of nurses worked at the National Geriatric Hospital over a 3-month period. The Knowledge and Attitudes Survey Regarding Pain (KASRP) was utilized to assess nurses' knowledge and attitudes toward pain management. Four domains were defined based on KASRP, included cancer-related pain, pain assessment, pharmacology and substance abuse and physical dependence. Knowledge and attitudes regarding pain were classified as poor, fair, or good (≤50%, 50% - 75%, or ≥75% of the KASRP score). Multivariate Tobit regression models were applied to identify factors associated with the knowledge and attitudes regarding pain management. RESULTS: Of 154 participants completed the survey, 72.2% (111 participants) had poor knowledge and attitudes regarding pain management. The participants had a correct mean score of 45.2% (SD = 2.2). Nurses' knowledge of pain assessment was poor, with the proportion of correct answers to nine questions ranging from 2.6% to 50%. 44.8% of nurses reported never or rarely using pain assessment tools. Nurses who had previous training regarding pain at medical universities had significantly higher scores of knowledge and attitudes compared to those without training. Nurses who often use pain assessment tools had a significantly higher level of knowledge and attitudes than those who never or rarely use them. CONCLUSION: This study highlights significant deficits of knowledge and negative attitudes regarding pain management among nurses. The subject of pain management should be applied and enhanced in the nursing undergraduate curriculum. Nurses' active participation in pain management should be encouraged by healthcare providers for older patients.

Prevalence and Factors Associated with Falls among Older Outpatients.

Falls in older people are a major public health issue, as they are associated with increased risks of morbidity and mortality. This study aims to investigate the prevalence and factors associated with falls among older outpatients. A cross-sectional study was conducted in 539 outpatients aged 60 and over at the National Geriatric Hospital, Hanoi, Vietnam. Falls and their associated factors were analyzed by multivariable logistic regression. The prevalence of falls was 23.7% (single fall 17.9%, recurrent falls 5.8%). The majority of falls occurred at home (69.6%) and were caused by a slippery floor (51.6%). After falling, most patients sustained physical injuries (65.6%); notably, women suffered more severe injuries than men. Alcohol consumption, using psychotropic medications, having three or more comorbidities, hypertension, COPD, urinary incontinence, frailty, fear of falling, ADL/IADL limitation, slow walking speed and mobility impairment were significantly associated with falls. Overall, the data indicated that falls were prevalent among older outpatients. Behavior factors, comorbidities, geriatric syndromes and physical function were substantially associated with falls, suggesting that most falls are preventable. Further longitudinal studies of longer periods are needed to comprehensively investigate the risk factors for falls.

Older Patient Satisfaction with Chronic Pain Management in the National Geriatric Hospital in Vietnam.

PURPOSE: The high prevalence of chronic pain and difficulties in pain management in older people are challenging for healthcare providers globally. Patient satisfaction regarding pain management is one of the measures to assess efficacy of pain control as well as healthcare services. Thus, our study aimed to evaluate the older patients' satisfaction with pain management and its associated factors in Vietnam. PATIENTS AND METHODS: A cross-sectional study was conducted at National Geriatric Hospital, Hanoi, Vietnam from May to October 2018. Face-to-face interviews were conducted on 495 older patients with chronic pain by using a structured questionnaire. The Pain Treatment Satisfaction Scale (PTSS) was used to assess the level of satisfaction with pain management. A Tobit regression model was used to estimate factors associated with satisfaction toward pain management. RESULTS: The mean total satisfaction score was 1.77 (SD= 0.22). Older patients were most satisfied with the aspect of side effects of pain relief medication (mean=0.66, SD=0.56). On the contrary, they were most dissatisfied with information provided about pain and its treatment and efficacy of pain relief medication. Outpatients were less satisfied with information provided, the impact of current medication and pain management in general compared to inpatients. The regression model showed that patients with severe pain tended to be more dissatisfied with pain management than those with no pain. CONCLUSION: This study indicated that the general satisfaction with chronic pain management in older patients was quite good especially in the aspect of pain medication's side effects. However, dissatisfactory factors remained, including information provided about pain and efficacy of current pain medication. Intensive training regarding pain in geriatric care, health education communication for older people, and improved quality of medical services should be performed to ensure the quality of pain management, especially in the older population.

Knowledge, Attitude and Practice of Elderly Outpatients with Type 2 Diabetes Mellitus in National Geriatric Hospital, Vietnam.

BACKGROUND: Diabetes-related complications have become increasingly prevalent and complicated to manage, especially among frail older adults with co-morbidities, poor physical function, and impaired cognition. Thus, knowledge, attitude, and practice (KAP) of elderly diabetic patients play an essential role in controlling the disease and its complications. PATIENTS AND METHODS: A cross-sectional study was conducted on 176 diabetic patients at the outpatient clinics, National Geriatric Hospital, Hanoi, Vietnam from August to November 2015. Patients' knowledge, attitude, and practice regarding diabetes mellitus were assessed using a structured questionnaire. Exploratory factor analysis and multivariate Tobit regression model were used to identify factors associated with knowledge, attitude, practice about diabetes mellitus. RESULTS: Of 176 diabetic patients, patients' knowledge was divided into two main groups: "Diabetes definition and management" (mean score = 57.7 ± 25.6) and "Targets for diabetic control" (mean score = 66.1 ± 30.4). Patients scored high points of attitudes toward diabetes severity and its complications (mean score = 95.8 ± 13.0); however, knowledge and practice scores were only moderate (mean score = 68.1 ± 16.8). There were only 8.5% of people having daily self-blood glucose monitoring. Advanced age, low educational level, rural area, and duration of diabetes less than 5 years were negative associated with knowledge, attitude, and practice regarding diabetes mellitus. This study also shows that frailty and co-morbidities/diabetic complications could impair patients' knowledge. CONCLUSION: Older patients with diabetes had high levels of perceived severity attitudes on diabetes mellitus. However, the knowledge and practice levels were still inadequate. Pragmatic diabetic health literacy, counseling and education programs, as well as home-based treatments are viable options to improve health outcomes.