Evolution of Geriatric Medicine: Midcareer Faculty Continuing the Dialogue

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137692/1/jgs14842_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137692/2/jgs14842.pd

Constructing and identifying predictors of frailty among homeless adults—A latent variable structural equations model approach

Homeless urbanites are a heterogeneous population with unique health and social service needs. The study examined situational, behavioral, health-related and resource indicators in terms of their direct impact on frailty, hypothesized as a latent variable. Using structural equation modeling (SEM), a model was tested with 150 homeless men and women, ages 40–73, from three homeless day center drop-in sites on Skid Row and one residential drug treatment (RDT) facility that works with homeless parolees and probationers. In bivariate analyses with the latent construct frailty, months homeless (p < 0.01), female gender (p < 0.05), education (p < 0.05), comorbid conditions (p < 0.001), nutrition (p < 0.001), resilience (p < 0.001), health care utilization (p < 0.01), and falls (p < 0.001) were significantly associated with frailty. In the final path model, significant predictors of frailty included educational attainment (p < 0.01), comorbid conditions (p < 0.001), nutrition (p < 0.001), resilience (p < 0.001), and falls (p < 0.01). These findings will serve as a foundation for future nurse-led, community-based initiatives that focus on key predictors of frailty among the homeless and the development of interventions

Gender Differences in the Relationship Between Diabetes-Specific Quality of Life and Depressive Symptoms in Middle-Aged and Older Korean Immigrants

This study examined age and gender differences in the relationship between diabetes specific quality of life (DQOL) and depressive symptoms among Korean immigrants with type 2 diabetes (DM). In this cross-sectional study, 160 Korean immigrants with DM aged between 40 and 80 years were assessed for depressive symptoms, DQOL, and related demographic, clinical, and psychosocial factors. The relationship between DQOL and depressive symptoms was stronger for men than women. Whereas there were no main effects of age or gender in predicting depressive symptoms, there was a significant three-way interaction between gender, age (middle-aged or older), and DQOL on depressive symptoms, with older men demonstrating the strongest positive association between DQOL and depression. Age and gender differences should be considered for DQOL and depressive symptoms in diabetic Korean immigrants. Efforts to address DQOL may be likely to have the greatest impact on decreasing depressive symptoms when targeting older male Korean immigrants