Sensory Loss in China: Prevalence, Use of Aids, and Impacts on Social Participation

The number of older adults with vision and/or hearing loss is growing world-wide, including in China, whose population is aging rapidly. Sensory loss impacts on older people's ability to participate in their communities and their quality of life. This study investigates the prevalence of vision loss, hearing loss, and dual sensory loss (combined vision and hearing loss) in an older adult Chinese population and describes the relationships between these sensory losses and demographic factors, use of glasses and hearing aids, unmet needs, and impacts on social participation. The China Health and Retirement Longitudinal Study is a population-based longitudinal survey conducted since 2011. The 2013 dataset for people aged 60 and over was used in this study. Items analyzed included demographic data (age, gender, education, rurality, and SES), self-reported ratings of vision (including legally blind, excellent-poor long, and short distance vision and the use and frequency of wearing glasses), hearing (excellent-poor hearing and the use of hearing aids), dual sensory loss (both poor/fair vision and hearing), and social participation. Of the sample, 80.2% reported poor/fair vision, 64.9% reported poor/fair hearing, and 57.2% had poor/fair vision and hearing. Few respondents (10%) wore glasses regularly and 20.1% wore glasses from time to time. Only 0.8% of respondents wore hearing aids although the proportion with hearing loss was high (64.9%). The proportion of unmet needs for glasses and hearing aids was 54.9 and 63.9%, respectively. Low socio-economic status (SES), poor education, and rurality were significantly associated with the prevalence of poor/fair vision and hearing, the use of glasses and hearing aids and the unmet needs of glasses/hearing aids. Poor/fair vision and/or hearing, and the unmet needs for glasses/hearing aids were significantly and negatively associated with social participation. Sensory loss is a significant health issue for older Chinese people that impacts on their social participation. Training primary care health professionals in identification and rehabilitation approaches is needed as well as increasing the numbers of vision and hearing specialists working in the field. Providing information on sensory loss and the use of aids to older adults will also help improve older adult's quality of life.This study has been funded by an Australian Research Council (ARC) Discovery Project (Number: DP160103023)

Dual Sensory Loss, Mental Health, and Wellbeing of Older Adults Living in China

Introduction: Deterioration in vision and hearing commonly occurs as adults age. Existing literature shows that Dual Sensory Loss (DSL) is a prevalent condition amongst older adults. In China, it has been estimated that 57.2% of the population experience DSL. Based on a small number of research papers, it has been identified that DSL influences mental health and wellbeing. The aims of this study were to explore the relationship between DSL and mental health and wellbeing in a sample of older adults residing in China; and investigate whether the comorbidities of functional dependency [Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL)] and chronic diseases influence the impacts of DSL on mental health and wellbeing.This study has been funded by an Australian Research Council (ARC) Discovery Project (Number: DP160103023)

Dual Sensory Loss, Mental Health, and Wellbeing of Older Adults Living in China

Introduction: Deterioration in vision and hearing commonly occurs as adults age. Existing literature shows that Dual Sensory Loss (DSL) is a prevalent condition amongst older adults. In China, it has been estimated that 57.2% of the population experience DSL. Based on a small number of research papers, it has been identified that DSL influences mental health and wellbeing. The aims of this study were to explore the relationship between DSL and mental health and wellbeing in a sample of older adults residing in China; and investigate whether the comorbidities of functional dependency [Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL)] and chronic diseases influence the impacts of DSL on mental health and wellbeing.Method: The China Health and Retirement Longitudinal Study Wave 2, 2013 data collection of a sample of people aged 60 years and over (n = 8,268) was used in this study. The sensory loss variables selected for analysis included a combined variable of self-reported vision and hearing loss (DSL). Mental health was measured by depression, and general wellbeing was measured by life satisfaction. In addition, chronic diseases, and limitations in IADL and ADL were used to test how their comorbidities with DSL influence mental health and wellbeing. Results were analyzed descriptively and using regression and modeling techniques.Results and Discussion: DSL was significantly and positively associated with advanced age, having difficulty in any ADL or IADL and experiencing depression and less life satisfaction. The observed negative associations between DSL and mental health or wellbeing, are indirect and could be partially explained by its comorbidity with chronic diseases and relationship to functional limitations. It is recommended that health services in China screen for DSL in older people and develop integrated services to assist with appropriate management and rehabilitation of older people with DSL focusing on both functional and mental health issues

Interventions to promote physical activity in older with type 2 diabetes mellitus: a systematic review

INTRODUCTION: Type 2 diabetes mellitus (T2DM) among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with T2DM. METHODS: A literature search was conducted using Ovid MEDLINE, PubMed, EMBASE, SPORTDiscus, and CINAHL databases to retrieve articles published between January 2000 and December 2012. Randomized controlled trials and quasi-experimental designs comparing different strategies to increase physical activity level in persons aged 65 years and older with T2DM were included. The methodological quality of studies was assessed. RESULTS: Twenty-one eligible studies were reviewed, only six studies were rated as good quality and only one study specifically targeted persons aged 65 years and older. Personalized coaching, goal setting, peer support groups, use of technology, and physical activity monitors were proven to increase the level of physical activity. Incorporation of health behavior theories and follow-up supports also were successful strategies. However, the methodological quality and type of interventions promoting physical activity of the included studies in this review varied widely across the eligible studies. CONCLUSION: Strategies that increased level of physical activity in persons with T2DM are evident but most studies focused on middle-aged persons and there was a lack of well-designed trials. Hence, more studies of satisfactory methodological quality with interventions promoting physical activity in older people are required

‘Being treated like an actual person’: attitudinal accessibility on the bus

Whilst the essential nature of built environment accessibility has been well established in transport research, attitudinal, behavioural, and communication barriers experienced by transport users remain largely overlooked. Subtle and insidious, repetitive negative attitudes, behaviour, and communication can force disabled passengers out of the most affordable transport option available. Applying the Disability Justice Framework and a Mobility Justice approach, this study investigated disabled passengers’ reported experience of bus driver attitudes, behaviours, and communication methods, and the impact of these encounters. A mixed methods cross-sectional survey and focus groups with disabled adults and support persons were conducted. An Advisory Working Group of transport accessibility advocates, all with lived experience, were engaged to oversee the study design. Participants reported that some bus drivers demonstrated ableist attitudes, discriminatory behaviour, and communication methods. Many passengers had reduced or stopped catching buses altogether due to these negative encounters, restricting their community mobility, which further impacted their quality of life. Participants’ recommendations for drivers, operators, and transport authorities were thematically integrated into one statement, reinforcing the power of attitudinal access—‘treat me like the person I am, who is valid; with a right to time, space and safety; listen to me, and prove you care’

Sensory Loss in China: Prevalence, Use of Aids, and Impacts on Social Participation

The number of older adults with vision and/or hearing loss is growing world-wide, including in China, whose population is aging rapidly. Sensory loss impacts on older people's ability to participate in their communities and their quality of life. This study investigates the prevalence of vision loss, hearing loss, and dual sensory loss (combined vision and hearing loss) in an older adult Chinese population and describes the relationships between these sensory losses and demographic factors, use of glasses and hearing aids, unmet needs, and impacts on social participation. The China Health and Retirement Longitudinal Study is a population-based longitudinal survey conducted since 2011. The 2013 dataset for people aged 60 and over was used in this study. Items analyzed included demographic data (age, gender, education, rurality, and SES), self-reported ratings of vision (including legally blind, excellent-poor long, and short distance vision and the use and frequency of wearing glasses), hearing (excellent-poor hearing and the use of hearing aids), dual sensory loss (both poor/fair vision and hearing), and social participation. Of the sample, 80.2% reported poor/fair vision, 64.9% reported poor/fair hearing, and 57.2% had poor/fair vision and hearing. Few respondents (10%) wore glasses regularly and 20.1% wore glasses from time to time. Only 0.8% of respondents wore hearing aids although the proportion with hearing loss was high (64.9%). The proportion of unmet needs for glasses and hearing aids was 54.9 and 63.9%, respectively. Low socio-economic status (SES), poor education, and rurality were significantly associated with the prevalence of poor/fair vision and hearing, the use of glasses and hearing aids and the unmet needs of glasses/hearing aids. Poor/fair vision and/or hearing, and the unmet needs for glasses/hearing aids were significantly and negatively associated with social participation. Sensory loss is a significant health issue for older Chinese people that impacts on their social participation. Training primary care health professionals in identification and rehabilitation approaches is needed as well as increasing the numbers of vision and hearing specialists working in the field. Providing information on sensory loss and the use of aids to older adults will also help improve older adult's quality of life

The inter-relationship of diversity principles for the enhanced participation of older people in their care : a qualitative study

Background: The health and aged care workforce must understand and support the diverse needs of older people to enhance their care experience. We previously identified five principles of diversity training for this workforce: awareness of unconscious bias and prejudice; promotion of inclusion; access and equity; appropriate engagement; and intersectionality. This study aims to explore how these principles are considered from the perspectives of older Australians. Methods: Older people (≥65 years) receiving home care and nursing services based in Victoria, Australia were invited to participate in a home-based semi-structured interview about their experience of, or with, diversity. Interviews were thematically analysed using a priori categories based on our previous work on principles of diversity training, and themes were interpreted and expanded upon based on the participants' experiences and understanding of diversity concepts and their care needs. Results: Fifteen older people (seven female, eight male), mean age 76 years (range 71-85 years), were interviewed. Five themes were drawn from the data. It was found that human connection through building (1) trust and rapport was highly valued as an approach by older people, crucial as a first step to understanding what is important to the older person. Identifying with (2) intersectionality, that is, the different intersecting aspects of who they are and their experiences was understood by the participants as an important framework to meet their needs. The participants were aware of (3) unconscious bias and prejudice by health professionals and its impact on their care. Participants also noted that (4) promotion of inclusion through language was important to for a positive relationship with the healthcare worker. The participants understood that to facilitate human connection, these four principles of human interaction were critical, underpinned by (5) access and equity of the system. A model articulating these relationships was developed. Conclusion: Health and aged care training should incorporate the five diversity principles to support older people to participate in their own care. © 2020 The Author(s)

Bridging the gap in ageing: Translating policies into practice in Malaysian Primary Care

Population ageing is poised to become a major challenge to the health system as Malaysia progresses to becoming a developed nation by 2020. This article aims to review the various ageing policy frameworks available globally; compare aged care policies and health services in Malaysia with Australia; and discuss various issues and challenges in translating these policies into practice in the Malaysian primary care system. Fundamental solutions identified to bridge the gap include restructuring of the health care system, development of comprehensive benefit packages for older people under the national health financing scheme, training of the primary care workforce, effective use of electronic medical records and clinical guidelines; and empowering older people and their caregivers with knowledge, skills and positive attitudes to ageing and self care. Ultimately, family medicine specialists must become the agents for change to lead multidisciplinary teams and work with various agencies to ensure that better coordination, continuity and quality of care are eventually delivered to older patients across time and settings