Palliative care use in Taiwanese older adults
Related Articles
To bond or bridge: how do populist attitudes intensify the effect of online social capital on political engagement?
The latest 2024 Taiwan General Election proved to be yet another arena for populist politics, with candidates aligning their stances and aspirations with populism, uniting “the people” through different means. With an intensifying populist atmosphere not only in Taiwan but in various democracies across the globe, this timely study seeks to explore the impact of populism on individual behaviors. Specifically, given the wide body of existing literature on conventional politics, we aim to shift attention to the online context. By regarding populism as a moderator, we examine its effect on the association between both online bonding and bridging social capital, political efficacy, and online political engagement. Data from 450 young adults are analyzed with a moderated mediation model as well as a co-moderation model, the former with populism as the sole moderator, and the latter with populism and socioeconomic status as co-moderators. Upon confirming the association between online social capital and engagement along with the mediating effect of political efficacy, the highlight of our study lies in our finding that populism significantly moderates both online bonding and bridging social capital to political efficacy, but in opposing manners. Populism, furthermore, proves to be insignificant in directly moderating any paths to online engagement, while socioeconomic status moderates the association between online bonding social capital and online political engagement. In addition, the distinct party-led system and underlying political atmosphere in Taiwan will be addressed and discussed, in terms of their impact on our findings.
Longitudinal trends in schizophrenia among older adults: a 12-year analysis of prevalence and healthcare utilization in South Korea
As populations age worldwide, it is essential to explore the changing landscape of schizophrenia across different age groups. We analyzed cases of schizophrenia reported over a 12-year period (2010–2021) using the Health Insurance Review and Assessment (HIRA) database of South Korea. We explored changes in the prevalence of schizophrenia, physical comorbidity burden, and healthcare utilization by age. The annual disease prevalence and hospitalization patterns were analyzed using linear regression and linear mixed models. Of 420,203 patients diagnosed with schizophrenia, the number and proportion of older adults (aged ≥ 50 years) significantly increased from 82,556 (0.51%) in 2010 to 188,359 (0.89%) in 2021 (p < 0.001), more rapidly than did those of younger adults. The proportion of older adults increased from 37.0% to 54.7% during this period (p < 0.001); by 2021, 44.9% were medical aid beneficiaries. Lengths of psychiatric hospitalization for older adults increased from 230.2 days to 251.8 days (p = 0.023), significantly greater than for younger adults (p < 0.001), and the use of tertiary/general hospitals decreased over time from 15.2% to 9.5% (p < 0.001) while that of hospitals/nursing homes increased from 76.9% to 88.5% (p < 0.001). Older adults consistently showed significantly higher Charlson Comorbidity Index scores (p < 0.001) and longer lengths of non-psychiatric hospitalization (p < 0.001) than younger adults. These findings highlight the distinct healthcare needs and increasing physical health burden of older adults with schizophrenia.
Peripheral insulin resistance attenuates cerebral glucose metabolism and impairs working memory in healthy adults
People with insulin resistance are at increased risk for cognitive decline. Insulin resistance has previously been considered primarily a condition of ageing but it is increasingly seen in younger adults. It is possible that impaired insulin function in early adulthood has both proximal effects and moderates or even accelerates changes in cerebral metabolism in ageing. Thirty-six younger (mean 27.8 years) and 43 older (mean 75.5) participants completed a battery of tests, including blood sampling, cognitive assessment and a simultaneous PET/MR scan. Cortical thickness and cerebral metabolic rates of glucose were derived for 100 regions and 17 functional networks. Older adults had lower rates of regional cerebral glucose metabolism than younger adults across the brain even after adjusting for lower cortical thickness in older adults. Higher fasting blood glucose was also associated with lower regional cerebral glucose metabolism in older adults. In younger adults, higher insulin resistance was associated with lower rates of regional cerebral glucose metabolism but this was not seen in older adults. The largest effects of insulin resistance in younger adults were in prefrontal, parietal and temporal regions; and in the control, salience ventral attention, default and somatomotor networks. Higher rates of network glucose metabolism were associated with lower reaction time and psychomotor speed. Higher levels of insulin resistance were associated with lower working memory. Our results underscore the importance of insulin sensitivity and glycaemic control to brain health and cognitive function across the adult lifespan, even in early adulthood.
Foundation dentists’ attitudes and experiences in providing dental care for dependant older adults resident in care home settings
There is a continued increase of older dependant adults in England. Foundation Dentists (FDs) are often the dental workforce being tasked with providing dental care to dependant older adults resident in care home settings. This study explores whether FDs have the experience and confidence to deliver this.
Absence of care among community-dwelling older adults with dementia and functional limitations
Assistance with daily activities is crucial for persons living with dementia and functional limitations, yet many face substantial challenges in accessing adequate care and support. Using harmonized longitudinal survey data (2012–2018) from the United States, England, 18 European countries, Israel and China, we found that at least one-fifth of persons with dementia and functional limitations received no personal assistance for basic activities of daily living or instrumental activities of daily living, regardless of regional development level. Care gaps were widespread across both basic activities of daily living or instrumental activities of daily living limitations, as well as for informal and formal care. Disparities were evident, with less educated people more likely to lack formal care, whereas those living alone often lacked informal support, resulting in the absence of any care. Alarmingly, care availability showed no improvement over time. Our findings underscore the urgent need for policies to address inequities and ensure critical access to care services for this vulnerable population worldwide.
Responses