Prevalence of self-care disability among older adults in China

Guo, Yu; Ge, Tingshuai; Jiang, Quanbao

doi:10.1186/s12877-022-03412-w

Cited by 13 publications

(8 citation statements)

References 14 publications

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“…The second hypothesis believes that individuals with sensory dysfunction may have reduced auditory and spatial awareness of their immediate surroundings, rendering them more vulnerable to accidents and accidental injuries, in an already cognitively compromised population (Jiam et al 2016;Lubetzky 2020). The third theory is based on the effect of multisensory integration, proposing that individuals with hearing loss develop substitution strategies that make them more dependent on visual, vestibular, or somatosensory information to maintain balance (Lubetzky 2020;Zhang et al 2020;Wang et al 2022). HI, in the presence of cognitive impairment, may serve as an indicator for frailty (e.g., sensory, cognitive, and physical frailty) (Yamada et al 2016;Wang et al 2020), which is a powerful predictor of falling.…”

Section: Discussionmentioning

confidence: 99%

“…China’s 2020 population census revealed that the prevalence of self-care disability increases with age. The prevalence of self-care disability was 2.34% in adults aged 60 years and above, was higher than 5% in those aged 80 and above, and higher than 15% in those over 90 years (Guo et al 2022).…”

Section: Introductionmentioning

confidence: 99%

“…The oldest old (those aged 80 years) represents a population that is more likely to suffer from impairment of vestibular, sensory, cognitive function, and self-care ability than their younger old counterparts (people aged 65 to 80) (Xie et al 2008; Brumback-Peltz et al 2011; Jeng et al 2020; Guo et al 2022). Histopathological studies showed that degeneration of the peripheral vestibular system is associated with advanced age (Furman et al 2001; Jeng et al 2020).…”

Section: Introductionmentioning

confidence: 99%

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Association of Hearing Status and Cognition With Fall Among the Oldest-Old Chinese: A Nationally Representative Cohort Study

et al. 2023

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Objectives: The oldest-old (aged ≥80 years) are the most rapidly growing population and age is related to hearing impairment (HI) and cognitive decline. We aimed to estimate the association between HI and fall, and the effect of different cognitive states on this association among the oldest-old Chinese population. Design: A total of 6931 Chinese oldest-old were included in the 2018 cross-cohort from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The presence of HI was identified by using a dichotomized metric of self-reported hearing status. Cognitive function was evaluated by using the modified Mini-Mental State Examination (MMSE). Cognitive impairment was defined as the MMSE score below 24 points. Data on fall history were collected by questionnaires survey from the participants or their relatives. We studied the association of hearing status and cognitive function with fall by using multivariable logistic regressions, upon adjustment of sociodemographic characteristics, lifestyles, and health conditions. Results: Our participants were aged 92 (range 80 to 117) on average, with 60.1% being women. In total, 39.1% of the participants had reported HI, 50.1% had cognitive impairment, and 26.2% had a history of falling. Participants with HI had a higher incidence of cognitive impairment (79.4%), as compared with their counterparts without HI (31.3%). Compared with those without HI, HI patients had a higher risk of falling after full adjustment for potential confounders (OR = 1.16 [95% confidence interval, CI, 1.01, 1.32], p = 0.031). In comparison with HI participants without cognitive impairment, HI patients with cognitive impairment had a higher fall risk (OR = 1.45 [95% CI = 1.23, 1.72], p < 0.001). Conclusions: Association of hearing status and cognition with fall was, for the first time, examined on the basis of a nationally-representative oldest-old Chinese population. Poor cognitive performance was common in individuals with HI, and those with HI and cognitive impairment further increased the risk of falling.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of Hearing Status and Cognition With Fall Among the Oldest-Old Chinese: A Nationally Representative Cohort Study

et al. 2023

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“…One potential explanation is that some Chinese older adults still hold the social norm that children should take care of them when they are sick and old. However, given the decades‐long decline in fertility rates, family sizes in China have become smaller, and family functions have weakened (Guo et al., 2022). Chinese older adults tend to recognise that totally relying on their children is not realistic because of the mobility of their children, the decrease of family sizes and the responsibilities younger generations have in modern society.…”

Section: Discussionmentioning

confidence: 99%

Self‐identified culturally related stressors that influence self‐care in older adults with multiple chronic conditions: A qualitative study

Jin,

Bowers,

Cotton

et al. 2023

Journal of Clinical Nursing

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AimTo identify culturally related stressors that influence self‐care in Chinese older adults with multiple chronic conditions.BackgroundEffective self‐care can improve health outcomes for chronic conditions, but implementing self‐care is challenging. Individuals with multiple chronic conditions face even more self‐care complexity than those with single chronic conditions, generating additional stressors. Although stressors have been found to negatively influence self‐care in multiple chronic conditions, the role of culture in generating stressors has been neglected.DesignThis paper reports on the qualitative component of a larger mixed‐methods study. Two free‐response items in a survey were used to identify culturally related stressors that influence self‐care. This report adhered to the SRQR guideline checklist.MethodsData were collected between January and April 2022. One hundred and thirty‐eight free text responses asking participants to identify stressors that influenced their self‐care effectiveness were analysed sequentially using deductive content analysis and thematic analysis.ResultsFindings from deductive content analysis largely confirmed published work in Western literature on stressors complicating self‐care, including symptom burdens, financial strains, social disconnection, caregiving responsibilities and major life events. Findings from reflexive thematic analysis extended current literature by identifying three culturally relevant stressors: intergenerational obligations and commitments, ambivalence about receiving care and worries about potential problems.ConclusionChinese older adults with multiple chronic conditions identified a wide range of stressors that impacted their day‐to‐day self‐care. This study provided valuable insights into culturally related stressors in older adults with multiple chronic conditions. Findings deepened our knowledge of cultural influences on the success of self‐care in older adults with multiple chronic conditions, suggesting the potential for reaching populations across different cultures and regions.Implications for the profession and/or patient careStressors that might influence self‐care ability are important for nurses to assess in people with multiple chronic conditions. The design of self‐care interventions should take a culturally tailored intergenerational family‐centred approach to help mitigate the impact of stressors and ultimately improve patient outcomes.Impact What problem did the study address?Stressors documented in older adults with MCCs have all been generated from research with Western populations. China is now home to the largest population of older people in the world. Understanding the influence of culturally relevant stressors on self‐care in Chinese older adults with MCCs is lacking. What were the main findings?Findings from deductive content analysis largely confirmed published work in Western literature on stressors that complicated self‐care, including symptom burdens, financial strains, social disconnection, caregiving responsibilities and major life events. Findings from reflexive thematic analysis extended current literature by identifying three culturally relevant stressors in older adults with MCCs in China: intergenerational obligations and commitments, ambivalence about receiving care and worries about potential problems. Where and on whom will the research have an impact?The research will have an impact on guiding nurses' assessment of culturally relevant stressors' impact on self‐care for older adults with MCCs. In addition, findings could inform research and policy development to aim at mitigating the impact of culturally based stressors on self‐care. Reporting MethodThis study adhered to the Standards for Reporting Qualitative Research (SRQR) guideline checklist.Patient or Public ContributionDuring the member‐checking process, the validation of findings for accuracy was carried out by 10 participants, who also found resonance between these findings and their own experiences.

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“…With Chinese life expectancy at 78.2 years in 2022, and the prevalence of disabilities among the elderly at 26.2% (95% CI: 23.7-28.6%) [ 1 ], Chinese parents have long life expectancies but require assistance. While 2.34% of Chinese aged over 60 years require assistance from a caregiver for daily behaviors [ 2 ], elderly depend heavily on their children for care due to a lack of care infrastructure such as nursing homes and geriatric services. Finally, the rapidity of the growth and sheer size of China’s graying population creates unique challenges.…”

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confidence: 99%