BMC Geriatrics最新文献

{"title":"Association between intrinsic capacities limitations and annual healthcare costs in Nursing Home residents.","authors":"N Costa, E Gombault, C Marcélo, A Pagès, L Molinier, P de Souto Barreto, Y Rolland","doi":"10.1186/s12877-025-05914-9","DOIUrl":"https://doi.org/10.1186/s12877-025-05914-9","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to analyse the associations of annual Intrinsic Capacities (IC) impairment evolution with the annual cost of care in Nursing Home (NH) residents. This was a prospective, longitudinal and multicenter study. NH residents in the Occitanie region (south of France), 60 years and older with moderate level of dependency were included in the study and were followed during 12 months.</p><p><strong>Methods: </strong>IC was assessed for four of the six IC domains (Cognitive, locomotion, vitality and psychological). Longitudinal IC impairment trajectories of residents were built using the K-means Longitudinal method. Costs were assessed from the healthcare payer's perspective and include direct medical and non-medical costs. Descriptive analyses of costs and characteristics as well as general linear models were carried out.</p><p><strong>Results: </strong>Three hundred forty-five residents (86 years old on average and mostly women) were included. Mild, moderate and severe impairment profiles were clustered. For the cognitive domain, we observe a total cost decrease of 1552€ between the most severe impairment profile and the less severe profile, led by medication costs. For the locomotion, psychological and vitality domains we observed a total cost increase of 1,672€, 3,869 € and 1,709€ for the most severe impairment profile in comparison with the less severe profile, respectively. This cost increase was driven by hospitalisation for the psychological and the vitality domains and by physiotherapist costs for the locomotion domain. Medication costs decrease with the severity of impairment whatever the IC domain considered.</p><p><strong>Conclusions: </strong>Our study is the first aiming to estimate the association between impairment on IC domains and healthcare costs in NH. The implementation of clusterization highlight resident's profiles using data driven process, which may facilitate the implementation of personalized health strategies.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"301"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease trajectories and medical expenditures of older adults with disabilities: insights from China's long-term care insurance program.","authors":"Lijun Zeng, Huaicheng Tan, Shujuan Yang, Lisha Hou, Jinhui Wu, Birong Dong, Adam Gordon, Qingyu Dou","doi":"10.1186/s12877-025-05985-8","DOIUrl":"https://doi.org/10.1186/s12877-025-05985-8","url":null,"abstract":"<p><strong>Background: </strong>In China, long-term care (LTC) system has been implemented in recent years to improve the quality of care for older adults. To address healthcare needs of older adults with disabilities, this study investigated the disease trajectory and medical expenditures.</p><p><strong>Methods: </strong>This study included older adults aged 65 and above with disabilities, using data from China's Long-Term Care Insurance (LTCI) program since July 2017. The participants were followed until June 2021. Diagnoses and hospitalization costs were extracted from electronic medical records and the medical insurance system. Disease trajectory networks were constructed by identifying and linking disease pairs with overlapping conditions. Medical expenditures associated with specific diseases were then calculated.</p><p><strong>Results: </strong>The study included 30,003 participants with a mean age of 79.6 ± 11.1 years, 57.0% of whom were female. After a mean follow-up of 21 ± 16 months, 17,428 (58.1%) deaths occurred. The diseases with the highest hazard ratios (HRs) included septic shock (HR 3.59, 95% CI, 3.36-3.84), respiratory failure (HR 3.19, 95% CI, 3.05-3.34), sepsis (HR 2.98, 95% CI, 2.80-3.18), malnutrition (HR 2.38, 95% CI, 2.27-2.48), and decubitus ulcer (HR 2.27, 95% CI, 2.14-2.41). Disease trajectories indicated that mortality was closely associated with malnutrition related diseases (anemia, hypoproteinemia, and malnutrition), pneumonia, and organ failure (respiratory failure and heart failure). Among the top 30 diseases leading to frequent hospitalization, intracerebral hemorrhage (47,882.4 CNY), sepsis (37,978.2 CNY), and respiratory failure (25,921.1 CNY) accounted for the highest total medical costs.</p><p><strong>Conclusions: </strong>The study revealed that malnutrition and infection-related diseases contributed significantly to mortality among older adults with disabilities, with the latter also driving higher medical costs. These findings could inform updates to LTCI policies by emphasizing adequate nutritional support and strengthened infection prevention measures.</p><p><strong>Trial registration: </strong>chictr.org.cn, ChiCTR2100049973, retrospectively registered.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"302"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric-led transitional care for older adults discharged from the emergency department: impact on hospital readmissions and disability. Protocol for the controlled prospective quasi-experimental study LASUITE.","authors":"Manuel Sanchez, Philippine Eloy, Virginie Godard, Marina Coutauchaud, Christine Lenouvel, Mathilde Charpigny, Pauline Manchon, Thi Hong Lien Han, Agathe Raynaud-Simon, Claire Patry","doi":"10.1186/s12877-025-05929-2","DOIUrl":"https://doi.org/10.1186/s12877-025-05929-2","url":null,"abstract":"<p><strong>Background: </strong>Even when older people are discharged directly home after an emergency department (ED) visit, the risk of deterioration of health status and loss of independence persists. We hypothesize that among older adults discharged from the ED, hospital-community transition care provided by geriatric mobile teams (GMTs) may reduce the early readmission rate and level of disability. Such approaches have rarely been evaluated and cannot be generalized yet. Providing evidence of the positive impact of these strategies may influence public health policies.</p><p><strong>Methods: </strong>We will conduct a national, multicentre, prospective, controlled, quasi-experimental study. All participating centres have an ED and a GMT, some of which provide transitional care. Participants recruited from hospitals where GMT provide transitional care form the \"intervention group\", whereas participants recruited from hospitals where GMT provide standard in-hospital management are the \"control group\". Inclusion criteria are age ≥ 75 years, returning to personal home after the ED visit (exclusion of nursing home residents) and having a significant risk for early readmission and/or loss of independence after discharge according to a Triage Risk Screening Tool score ≥ 2. The primary objective of this study is to compare hospital ED readmission rates within 30 days. Among secondary objectives, disability scores at 3 and 6 months will be compared between groups. We estimated that 1322 participants, i.e., 661 per group, is required for the main analysis.</p><p><strong>Discussion: </strong>By conducting this study, we aim to provide more evidence of the effectiveness of transitional care on reducing ED readmissions for older adults, and particularly highlight determinants and effects of hospital-community GMT-led interventions. These strategies can be cost-effective while preserving independence and quality of life. We expect that the results will provide a basis to generalize effective strategies to address the challenges of demographic ageing for healthcare systems.</p><p><strong>Trial registration: </strong>The study protocol was registered on ClinicalTrial.org (ID NCT05814328 Date 20230414).</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"299"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential drug-drug interactions among geriatric oncology patients: a retrospective study in Saudi Arabia.","authors":"Munirah A Alkathiri, Reem F Bamogaddam, Hanaa Ali Alhabshi, Mohammed Nasser AlAjmi, Abdulmalik Alasmar Alashgaai, Ghadah A Assiri, Majed S Al Yami, Omar A Almohammed","doi":"10.1186/s12877-025-05965-y","DOIUrl":"https://doi.org/10.1186/s12877-025-05965-y","url":null,"abstract":"<p><strong>Background: </strong>Drug-drug interactions (DDIs) are significant causes of adverse drug reactions among patients with cancer. We aimed to identify the prevalence, severity, and predictors of potential DDIs among geriatric oncology patients.</p><p><strong>Methods: </strong>A cross-sectional, retrospective study was conducted at two tertiary medical centers. Geriatric patients (≥ 65 years) who were diagnosed with solid tumors and received outpatient prescriptions with a minimum of two drugs between January 2018 and December 2022 were included in the study. Patients' medications were screened for DDIs using Lexi-Interact. Univariate and multivariable logistic regression models were used to explore factors associated with DDIs.</p><p><strong>Results: </strong>The study included 247 geriatric patients with a mean age of 74.0 ± 7.3 years, and 48.6% of the patients were female. The most common type of cancer was gastrointestinal cancer (35.6%), followed by genitourinary cancer (20.6%), and 50.6% of the patients had metastasized tumors. Approximately one-half of the patients (49.0%) received anticancer therapy, and hormonal therapy (21.9%) or chemotherapy (16.6%) was the most common therapy. The mean number of medications used per patient was 6.9 ± 3.5. The majority of patients (79.4%) had at least one DDI, with a mean of 5.6 ± 5.3 DDIs per patient. Most of the interactions were classified as moderate (58.9%), and only 19.3% were classified as major. Multiple logistic regression revealed that females were more vulnerable to DDIs than their male counterparts were (adjusted odds ratio (AOR) = 37.4; 95% CI 4.13-338.3). The number of medications used was significantly associated with the risk of DDIs (AOR = 4.07; 95% CI 2.53-6.54). Compared with patients with gastrointestinal cancers, patients with breast or gynecologic cancers had lower odds of experiencing DDI (AOR = 0.02; 95% CI < 0.01-0.24 and AOR = 0.04; 95% CI < 0.01-0.29, respectively).</p><p><strong>Conclusion: </strong>This study revealed a high prevalence of DDIs among geriatric oncology patients, with most interactions classified as moderate. Female patients and patients taking multiple medications had a greater risk of experiencing DDIs. Routine screening for potential DDIs is essential for this vulnerable population, and the factors identified in this study should be carefully considered.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"300"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-space mobility trajectory patterns and associated characteristics in older cancer survivors: a secondary data analysis.","authors":"Richard A Taylor, Marie Bakitas, Rachel Wells, J Nicholas Odom, Richard Kennedy, Grant R Williams, Jennifer Frank, Peng Li","doi":"10.1186/s12877-025-05940-7","DOIUrl":"https://doi.org/10.1186/s12877-025-05940-7","url":null,"abstract":"<p><strong>Background: </strong>Life-space mobility (LSM) measures the size of the real-world geographic area an individual purposely transverses in their daily life. While older cancer survivors often have declines in LSM that negatively affects their quality of life, independence, and social engagement the factors that predispose to adverse outcomes are unknown. Understanding different patterns of LSM and its decline can help identify those needing support. The purpose of this study was to identify: (1) LSM trajectory patterns and (2) factors associated with those patterns in older cancer survivors.</p><p><strong>Methods: </strong>This paper reports a secondary data analysis of 153 participants with cancer ≥ 65 years from the University of Alabama Study of Aging. LSM was assessed using the UAB Life-Space Assessment-Composite score (LSA-C) at study entry and every 6 months for 96 months (LSA-C < 60 = restricted LSM). LSM trajectory patterns based on the LSA-C were determined using group-based trajectory analysis. A classification tree analysis revealed factors that predicted the trajectory patterns.</p><p><strong>Results: </strong>Participants (n = 153) were a mean age of 76.1 (SD 6.33), mostly male (58%), White (58%), married (55%) or widowed (37%), and had a diagnosis of prostate (37.3%), breast (20.3%), or colon (11.8%) cancer. Three LSM trajectory patterns were identified: (1) high start and stable (37.3%) with unrestricted LSM (LSA-C = 81.2) at study entry, which remained stable over time, (2) high start progressive decline (27.5%) with unrestricted LSM (LSA-C = 78.0) at study entry that progressively declined, and (3) low start progressive decline (35.3%) with restricted LSM level (LSA-C = 42.0) at study entry, which progressively declined. Each pattern was associated with a unique set of demographic and clinical characteristics. Baseline physical performance score was the most important predictor of the LSM trajectory patterns.</p><p><strong>Conclusions: </strong>Three distinct LSM trajectory patterns, each with unique demographic and clinical characteristics, were identified. Because older cancer survivors have distinct LSM patterns, interventions should be tailored to address specific characteristics and clinical needs. LSM measurement can contribute to assessment of older adults generally and should become part of standard assessment in older cancer survivors.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"297"},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing students' knowledge, attitudes, and behaviors toward aging and ageism in Palestine.","authors":"Bahaaeddin M Hammad, Basma Salameh, Faeda A Eqtait, Kassabry Maysa, Imad H Fashafsheh, Ahmad J Ayed, Mohamed E H Elzeky, Rasmieh Anabtawi, Mohammed F Hayek","doi":"10.1186/s12877-025-05946-1","DOIUrl":"https://doi.org/10.1186/s12877-025-05946-1","url":null,"abstract":"<p><strong>Background: </strong>Nursing students, as future healthcare professionals, hold a crucial role in delivering high-quality care to older adults. Their ability to provide effective geriatric care depends significantly on comprehensive knowledge and the cultivation of positive attitudes, and behaviors. Recognizing this critical responsibility, this study aimed to assess nursing students' attitudes, behaviors, and knowledge regarding aging and ageism.</p><p><strong>Methods: </strong>A cross sectional study was conducted with a convenience sample from 334 nursing students during Spring 2024. Data were collected using a self-administered questionnaire, including the Facts on Aging Quiz (knowledge assessment), the Relating to Older People Evaluation (ageist behaviors), and Kogan's Attitudes toward Older People Scale.</p><p><strong>Results: </strong>Results revealed significant knowledge gaps, with only a small percentage achieving an acceptable knowledge level. Ageist attitudes were prevalent, though positive attitudes outweighed negative ones. Students generally held somewhat positive views of aging, but negative behaviors persisted, particularly among female students. Work experience with older adults and a family history of caregiving were positively associated with higher knowledge scores. Additionally, satisfaction with nursing education and Confidence in caring for older adults were strongly associated with positive behaviors, attitudes, and knowledge regarding older adults. Correlation analysis showed positive relationships between knowledge, attitudes, and behaviors, with attitudes significantly predicting behaviors in regression analysis.</p><p><strong>Conclusion: </strong>Nursing students demonstrated insufficient knowledge about older adults, with positive attitudes and behaviors prevailing despite persistent negative behaviors. Female students exhibited higher negative behaviors, while work experience and caregiving history correlated with better knowledge but did not influence attitudes or behaviors. Satisfaction with nursing education and confidence in geriatric caring were strongly linked to positive outcomes. Enhancing nursing curricula with practical, relevant content and opportunities for meaningful interaction with older adults is essential to improve students' preparedness and foster quality care.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"296"},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of sarcopenia on postoperative recovery in elderly patients after cardiac surgery with cardiopulmonary bypass.","authors":"Xiaoqian Wang, Zhen Wang, Yongqing Cheng, Xiaotian Chen","doi":"10.1186/s12877-025-05966-x","DOIUrl":"https://doi.org/10.1186/s12877-025-05966-x","url":null,"abstract":"<p><strong>Background: </strong>Few studies have assessed sarcopenia identified by erector spinae muscle (ESM) using thoracic computed tomography (CT) before cardiac surgery. We aimed to explore the relationship between sarcopenia evaluated via ESM and poor outcomes following cardiac surgery with cardiopulmonary bypass (CPB) in elderly patients.</p><p><strong>Methods: </strong>268 patients older than 65 years who underwent cardiac surgery with CPB at our institution in 2020 were included in the retrospective, single center, cohort study. Preoperative chest CT scans were used to measure the cross-sectional areas of the ESM (ESM_CSA), which were then adjusted for body surface area (BSA) to determine the muscle mass index. Patients were categorized into sarcopenia and non-sarcopenia groups based on ESM_CSA/BSA scores, and their short- and long-term clinical outcomes were compared.</p><p><strong>Results: </strong>The ESM_CSA/BSA detected sarcopenia in 51.1% of patients. Patients with sarcopenia had significantly extended durations of stay in both the intensive care unit and the hospital compared to those without sarcopenia. Furthermore, the incidence of major adverse events was significantly higher in the sarcopenia group compared to the non-sarcopenia group (15.3% vs. 32.1%, P < 0.001). Furthermore, multivariate logistic regression analysis demonstrated that sarcopenia (OR 2.457, 95% CI 1.178-5.126, P = 0.017) independently predicted the risk of postoperative complications after adjusting for gender, preoperative nutritional status, serum albumin, estimated glomerular filtration rate, creatinine, white blood cell count, lymphocytes, type of surgery, surgical time, and aortic cross-clamp time. Kaplan-Meier survival analysis revealed a statistically significant difference in overall mortality between groups (log-rank P = 0.011). The Cox proportional hazards model identified preoperative sarcopenia as an independent risk factor for long-term mortality (HR, 2.132; 95% CI 1.144-3.972, P = 0.017).</p><p><strong>Conclusion: </strong>Our study identified preoperative sarcopenia, assessed via ESM muscle mass on chest CT, as an independent predictor of postoperative complications and long-term overall mortality in elderly cardiac surgery patients with CPB.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"295"},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizing life with both hands: longitudinal analyses of grip strength among informal caregivers in Europe (SHARE).","authors":"Larissa Zwar, Hans-Helmut König, André Hajek","doi":"10.1186/s12877-025-05949-y","DOIUrl":"https://doi.org/10.1186/s12877-025-05949-y","url":null,"abstract":"<p><strong>Background: </strong>This longitudinal study analyzed the association between informal caregiving inside and caregiving outside the household with changes in grip strength, and whether these associations varied based on caregivers' gender and age among adults in Europe.</p><p><strong>Methods: </strong>Data from the longitudinal Survey of Health, Ageing and Retirement in Europe (SHARE) was used, including participants aged ≥ 40 years from 10 European countries (pooled over five waves; 2004-2015). Grip strength was measured as maximum grip strength of both hands, informal caregiving as transitions in status as caregiver inside or outside the household. Fixed Effects regression analysis was used, adjusted for health, body mass index and sociodemographic background and additional analyses were conducted with age and gender as moderators.</p><p><strong>Results: </strong>Higher grip strength was found among those who transitioned into caregiving outside the household. With higher age, the association between caregiving outside the household and grip strength was stronger, and more pronounced among men. The transition into caregiving inside the household was associated with lower grip strength at older age.</p><p><strong>Conclusions: </strong>The location of caregiving, and caregiver's age and gender play an important role for changes in grip strength. The findings suggest that caregiving outside the household might be helpful for grip strength, in particular for older and male adults. Older caregivers inside the household, however, seem to need more support to prevent further decline in grip strength.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"298"},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Path analysis of the influence of digital health literacy on self-management behaviour among elderly patients with chronic diseases in rural China.","authors":"Xuefang Liu, Xiaomin Gan, Guangqin Ren, Zhongrui Mao, Jiuying Hu, Chengcheng Sha, Juan Wu","doi":"10.1186/s12877-025-05952-3","DOIUrl":"https://doi.org/10.1186/s12877-025-05952-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic disease self-management is very important for the progression and treatment of diseases worldwide. The management of chronic diseases among elderly individuals in rural areas is an urgent public health concern in China. The purpose of this study was to investigate the relationship between digital health literacy and chronic disease self-management behaviour in elderly Chinese patients with chronic diseases in rural areas, as well as the chain mediating effects of social support and depression. The objective was to provide a scientific basis for improving the active health behaviour of rural elderly patients with chronic diseases in China and worldwide.</p><p><strong>Methods: </strong>Using convenience sampling, the survey subjects were elderly patients with chronic diseases in rural areas of Anhui Province, China. A self-designed questionnaire was used to collect general survey data, digital health literacy scale scores, social support scale scores, depression scale scores, and chronic disease self-management behaviour scale scores. Common method bias tests, descriptive statistics and correlation analyses were performed via SPSS 29.0. The structural equation model was constructed and tested via AMOS 27.0. Differences for which p < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>In all, 202 elderly patients with chronic diseases who resided in rural areas were enrolled. The digital health literacy score was 39.25 ± 9.00, and the chronic disease self-management behaviour score was 27.82 ± 9.56. The self-management behaviours of rural elderly patients with chronic diseases were positively correlated with digital health literacy and social support and were negatively correlated with depression (p < 0.01). After the mediating effect test, the total indirect effect value of social support and depression was 0.167, which accounted for 36.07% of the total effect. Among them, social support and depression were partial mediators of digital health literacy and chronic disease self-management behaviour, with effect values of 0.055 (95% CI: 0.012, 0.127) and 0.094 (95% CI: 0.024, 0.201), which accounted for 11.88% and 20.3% of the total effect, respectively. Social support and depression were chain mediators of digital health literacy and chronic disease self-management behaviour, with an effect value of 0.018 (95% CI: 0.004, 0.055) and an effect share of 3.89%.</p><p><strong>Conclusion: </strong>The self-management level of elderly patients with chronic diseases in rural China is low. Digital health literacy not only directly affects the chronic disease self-management behaviour of elderly individuals but also indirectly predicts chronic disease self-management behaviour through the mediating effects of social support and depression.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"293"},"PeriodicalIF":3.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and influencing factors of self-management in patients with chronic heart failure: a longitudinal study.","authors":"Wen Ding, Jingyu Lu, Fei Wang, Ling Bai, Juan Liu, Ru Wang","doi":"10.1186/s12877-025-05959-w","DOIUrl":"https://doi.org/10.1186/s12877-025-05959-w","url":null,"abstract":"<p><strong>Background: </strong>Good self-management behaviors can improve the physical function and quality of life of patients with heart failure and reduce hospitalization, mortality, and medical expenses. While the overall self-management level among patients with chronic heart failure (CHF) in China is low, previous studies have often used a cross-sectional design, and few have followed up on patients' self-management beyond 6 months after discharge. This study aimed to explore the factors influencing and the changes in the self-management level of patients with CHF and provide a basis for the timing and choice of interventions within 1 year after discharge.</p><p><strong>Methods: </strong>A longitudinal study was conducted from December 2021 to June 2022, including patients with CHF who met all the inclusion criteria. Data on demographics, disease-related details, social support, self-efficacy, and other information were collected during hospitalization (T0) and reevaluated at 1 month (T1), 3 months (T2), 6 months (T3), and 12 months (T4) after discharge.</p><p><strong>Results: </strong>A total of 213 patients were enrolled at T0, with 206, 201, 189, and 173 patients completing follow-up at T1, T2, T3, and T4, respectively. The self-management score was lowest at T0, highest at T1, began to decline at T2, and stabilized at T3; however, T3 remained higher than T0. Social support, self-efficacy, disease course, medication type, education level, and personal monthly income were identified as factors influencing self-management.</p><p><strong>Conclusions: </strong>The study findings indicate that self-management is a dynamic process of change. The level of self-management was at a high level 3 months after the patients were discharged from the hospital, but showed a decreasing trend from 6 months, which was related to numerous factors. This study helps to provide a theoretical basis for the timing and content of self-management intervention for patients with CHF by clinical healthcare professionals.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"294"},"PeriodicalIF":3.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}