Too late to quit? Effect of smoking and smoking cessation on morbidity and mortality among the elderly in a longitudinal study.

This prospective study of the elderly population estimated the risks of smoking for morbidity and mortality and identified whether cessation of smoking reduced the risk of disease. Data came from face-to-face interviews that used a population-based probability sample of those aged 60 years or over in Taiwan, provided by the Population and Health Research Center, Bureau of Health Promotion. In total, 4,049 subjects were included at the baseline year of 1989 and followed up in 1993 and 1996. Smoking-related variables included current smoking status, smoking history, daily consumption, and years since the cessation of smoking. Cox regression models were used to analyze the relative risks for morbidity and mortality, controlling for demographics, physical function, and comorbidities. The sample was made up of 50.2% nonsmokers, 15.2% ex-smokers, and 34.6% current smokers in the baseline year. Current smokers were more likely to have lower respiratory tract diseases throughout the study. Current smokers had a higher risk of stroke from 1989 to 1993. No dose-response relationship for smoking exposure or impact of years since smoking cessation was found. Whether cessation of smoking is protective should be investigated for middle-aged adults followed to old age. An effective strategy for smoking cessation in the elderly is suggested, and people should be encouraged to quit smoking at any time

What makes you good and happy: Effects of internal and external resources to adaptation and psychological well-being for the disabled elderly in Taiwan

[[abstract]]"Aim: This study explored the effect of internal adaptation and external resources to psychological well-being for the disabled elderly. Methods: Data were collected by face-to-face interviews with physically disabled elderly people, including the institutional and community-based long-term care service users in middle Taiwan. The number of persons interviewed was 563, of whom 505 completed the survey and met the disability criteria. Path analysis was applied. Internal resources (coping strategies and self-management of health) and external resources (social support and environmental support) were hypothesized to be related to difficulty in adapting to disability, and had a further impact on depressive symptoms and life satisfaction. Results: Acceptance–action coping strategies were beneficial in the adaptation process and in psychological well-being, and self-management of health was positively related to successful adaptation. Social support and environmental support were beneficial to adaptation and psychological well-being, although the effects were modest. In general, the effect of internal resources was larger than the external resources to adaptation and psychological well-being. Conclusion: Positive coping and self-management as well as the use of external resources are positive indicators of successful adaptation to disability. The disabled elderly should be encouraged to take a positive attitude toward disability, and external resources should also be built up to support them.

Physical function trajectories, depressive symptoms, and life satisfaction among the elderly in Taiwan

[[abstract]]Objective: The purpose of this study was to examine the effect of physical function trajectories on emotional health and subjective well-being among the elderly in Taiwan. Methods: Data was from a 6-year nation-representative panel for analysis. Physical function trajectories were categorized as independent, declined, disabled, improved, fluctuating, died well and died disabled. The effects of physical function trajectories on depressive symptoms and life satisfaction were examined by controlling for demographics, chronic disease, cognitive function and social support. Mixed linear modeling was used for analysis. Results: Among the physical trajectory groups, differences were shown between depressive symptoms and life satisfaction. An increase in the difficulty of physical function also increases depressive symptoms and reduces life satisfaction. The died-well group showed a difference from the independent group in depressive symptoms and life satisfaction, but these who died without disability did have better emotional health and subjective well-being than the disabled survivors. Conclusion: Coping strategies and supporting resources to help the disabled elderly to improve their successful aging is suggested in future research and health policies

Too late to quit? Effect of smoking and smoking cessation on morbidity and mortality among the elderly in a longitudinal study

[[abstract]]This prospective study of the elderly population estimated the risks of smoking for morbidity and mortality and identified whether cessation of smoking reduced the risk of disease. Data came from face-to-face interviews that used a population-based probability sample of those aged 60 years or over in Taiwan, provided by the Population and Health Research Center, Bureau of Health Promotion. In total, 4,049 subjects were included at the baseline year of 1989 and followed up in 1993 and 1996. Smoking-related variables included current smoking status, smoking history, daily consumption, and years since the cessation of smoking. Cox regression models were used to analyze the relative risks for morbidity and mortality, controlling for demographics, physical function, and comorbidities. The sample was made up of 50.2% nonsmokers, 15.2% ex-smokers, and 34.6% current smokers in the baseline year. Current smokers were more likely to have lower respiratory tract diseases throughout the study. Current smokers had a higher risk of stroke from 1989 to 1993. No dose-response relationship for smoking exposure or impact of years since smoking cessation was found. Whether cessation of smoking is protective should be investigated for middle-aged adults followed to old age. An effective strategy for smoking cessation in the elderly is suggested, and people should be encouraged to quit smoking at any time

Gender differences in health-related quality of life among the elderly in Taiwan

[[abstract]]"Purpose: This study examines the gender disparity in the elderly’s health-related quality of life in Taiwan. Method: Data came from the National Health Interview Survey, a series of nation-representative face-to-face interviews held in Taiwan in 2001. The samples were chosen from those aged 65 or over, including populations drawn from the Taiwan area (with a number n=1845), remote mountain areas (n=169), and offshore islands (n=179). Health-related quality of life (HQOL) was measured by SF-36, including the dimensions of physical functioning, role limitation due to physical problems, bodily pain, general health, vitality, social functioning, role limitation due to emotional problems, and mental health. Two-stage linear regression models were used for analysis. Results: Elderly women showed lower HQOL in almost every dimension in the Taiwan area and offshore islands. After controlling for age, education, marital status, activities of daily living, and numbers of chronic diseases, women elderly showed a lower score in HQOL than men, and the difference was the most prominent in bodily pain which had a 23.6% lower score. The elderly in offshore islands and mountain areas had a lower HQOL than that in the Taiwan area. Other effects were greater than gender for the elderly in remote mountain areas. Discussion: Gender difference appeared across different dimensions of health-related quality of life. More effort to improve equal gender opportunities for health-related quality of life is necessary.

Does social participation by the elderly reduce mortality and cognitive impairment?

[[abstract]]Purpose: This longitudinal study examines the effect of social participation on mortality and cognitive impairment for the elderly in Taiwan. Methods: Data were from an elderly population panel in Taiwan 'The Survey of Health and Living Status of the Elderly' 1993-1999. Social participation was defined as paid/unpaid job and participating in volunteer and social groups. Logistic regression analysis was used for predicting the influence of social participation to 6-year mortality and cognitive function impairment, by controlling of socioeconomic status and health-related variables. Results: The elderly with continuous paid work were more likely to participate in social groups. Having paid or unpaid work at the baseline year could lower the risk of mortality six years later, especially for men. Having unpaid work was associated with a higher risk of impaired cognitive function compared to that of non-workers. Participating in a religious group reduced the risk of mortality for women and participating in political groups reduced the risk of impaired cognitive function for men. Discussion: Participating in some types of social activities may reduce mortality or cognitive function impairment in the elderly. However, different activities, gender roles and uneven opportunities for work and social group participation may affect the risk of these endpoints

Risk factors of falling among the elderly in Taiwan: a longitudinal study

[[abstract]]This study aimed to analyze the prevalence of falls and repeated falls of national elderly samples and to explore the risk factors of falls. Methods: Data were obtained from the "Survey of Health and Living Status of the Elderly in Taiwan" conducted in 1996 (n=2,669) and 1999 (n=2,310). The related risk factors of falls included demographic variables, chronic diseases, disability and changes in physical function, depressive symptoms, exercise behavior, and use of assistive devices (walker/sticks or glasses). Logistic regression was used for analysis. Results: The prevalence of falls was 19.5%, with 12.3% single fall and 7.2% repeated falls. The risk factors of falls included being female, having disability, reduced ADL function, with depressive symptoms, using stick/walker but walking well, and not wearing glasses but not seeing clearly. Among the fallers, 73.8% reported fear of falls, and 45.1% attributed their falls to environmental causes. Conclusion: Physical and psychological factors as well as environmental factors may cause falls and injuries for elderly. Physicians in the fields of geriatrics or family medicine should pay more and closer attention to the possible risks of their senior patients; home safety and appropriateness of assistive devices for the elderly should be regularly evaluated and carefully maintained

Physical function trajectories, depressive symptoms, and life satisafction among the elderly in Taiwan

[[abstract]]"Objective: The purpose of this study was to examine the effect of physical function trajectories on emotional health and subjective well-being among the elderly in Taiwan. Methods: Data was from a 6-year nation-representative panel for analysis. Physical function trajectories were categorized as independent, declined, disabled, improved, fluctuating, died well and died disabled. The effects of physical function trajectories on depressive symptoms and life satisfaction were examined by controlling for demographics, chronic disease, cognitive function and social support. Mixed linear modeling was used for analysis. Results: Among the physical trajectory groups, differences were shown between depressive symptoms and life satisfaction. An increase in the difficulty of physical function also increases depressive symptoms and reduces life satisfaction. The died-well group showed a difference from the independent group in depressive symptoms and life satisfaction, but these who died without disability did have better emotional health and subjective well-being than the disabled survivors. Conclusion: Coping strategies and supporting resources to help the disabled elderly to improve their successful aging is suggested in future research and health policies.[ABSTRACT FROM AUTHOR] Copyright of Aging & Mental Health is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.Copyright applies to all Abstracts.

Implicit exchanges in family caregiving for frail elders in Taiwan

[[abstract]]"In this study, the authors use in-depth interviews with inductive analysis to develop a conceptual framework for exploring social exchanges and their implicit calculations for caregivers in Taiwan. They interviewed 12 caregivers, based on theory-based sampling and maximum variation. They found some components of implicit exchanges of the caregivers, and drew a framework to describe it. At the beginning of care, motivations were mostly from obligation accompanied by reciprocity or repaying motives. In the process of caregiving, some unique, implicit cultural implicit exchanges were found, such as karma, a demonstrative behavior to investment, equitable share of responsibility, and the pressure or rewards from public opinion. These implicit exchanges might be intermediary factors in helping caregivers cope with their burden or even in influencing their continuation of care. The findings are implicated to help family caregivers continue their care and not damage their quality of care.