فصلنامه سالمند
پیاپی 70 (تابستان 1402)

Since older people make up a great percent of the population is Iran, and they experienced higher mental, physical, and emotional pressures due to quarantine and lockdown during the COVID-19 pandemic, the present study aims to investigate the lived experiences of older adults during the COVID-19 pandemic in Iran. 

This qualitative phenomenological study was conducted in Fars, Kermanshah, and Tehran provinces of Iran from October 1, 2021 to January 30, 2022. The data were collected through interviewing 16 older adults. Data analysis was done by Smith’s interpretative phenomenology analysis.

Of 16 older adults, 9 were male and 7 were female, with a mean age of 73 years. Their lived experiences were classified into three main categories: Psychological tensions, resilience (healing) measures, and economic tensions.

Iranian older people experienced various types of tensions during the COVID-19 pandemic. Social distancing and quarantine increased the concerns about their mental health. Therefore, it is very important to identify and analyze the psychological concepts and protective factors along with preparing practical guidelines to protect their mental health during the COVID-19 pandemic.

This study aims to assess the effect of music therapy (MT) and sleep hygiene (SH) education on sleep disorders of the elderly in Urmia, Iran.

This is a randomized controlled clinical trial. Participants were 150 older adults referred to health centers in Urmia, Iran. They were divided into three groups of SH+MT, SH, and control using the block randomization method. To measure their sleep quality, the standard Pittsburgh sleep quality index (PSQI) was used. The intervention was conducted for two months. Data analysis was conducted in SPSS software, version 21. To know the baseline difference in the qualitative variables among the three groups, chi-square test was used. Kolmogorov Smirnov test was used to check the normality of data distribution and then one-way ANOVA test was used to compare the seven dimensions of PSQI among the three groups.

The comparison of seven PSQI dimensions showed that subjective sleep quality (F=14.34, P=0.0001), sleep latency (F=10.05, P=0.0001), sleep duration (F=21.91, P=0.0001), habitual sleep efficiency (F=24.98, P=0.0001), sleep disturbances (F=15.37, P=0.0001), use of sleep medication (F=1.840, P=0.04) and daytime drowsiness (F=1.181, P=0.02) were significantly different among the three groups. The combination of SH education and MT improved the sleep quality of participants more than the SH education alone.

It seems that sleep disorders of the elderly can be reduced by teaching sleep hygiene and listening to favorite music before going to sleep.

Due to the increase in life expectancy in different countries and, thus, the increase in the number of aged people and the prevalence of physical problems related to old age, it is important to find low-risk methods that can lead to the improvement of the physical fitness and activities of daily living (ADLs) in the elderly. Hence, this study aims to assess the effects of a technology-based exercise program on physical fitness and ADLs of the elderly people with balance impairment residing in nursing homes.

This is a clinical trial that was conducted on 60 older adults with balance impairment living in nursing homes in Shiraz, Iran. They were randomly divided into two groups of intervention (n=30) and control (n=30). The intervention group received technology-based exercises using the Xbox Kinect sensor at two sessions of 30-45 minutes per week for six weeks. The control group received the routine programs of nursing homes including walking and playing table tennis. After six weeks, their physical fitness and ADLs were measured using the senior fitness test (SFT) and the ADL questionnaire in both groups.

After the intervention, the mean score of ADL significantly increased (from 87.1±10.4 to 92.6±9.1) compared to the control group (from 86.5±11.3 to 85.1±1.2) (P=0.00). In addition, the intervention led to an increase in the SFT tests of chair stand test (P<0.001), arm curl test (P<0.001), chair sit and reach test (P=0.001), back scratch test (P=0.007) and 8-foot up & go test (P=0.001). These changes were not observed in the control group.

The technology-based exercise program is effective in increasing the physical fitness and ADLs of the elderly people with balance impairment residing in nursing homes, and can be replaced with team sports.

It is necessary to implement educational programs to maintain the nutritional knowledge of the elderly. This study aims to compare the effects of three educational methods (lecture, question and answer, pamphlet presentation) on nutrition status and sustainability of nutritional knowledge in the elderly in Bandar Abbas, Iran.

In this quasi-experimental study, the study population consists of all older people aged ≥60 years in Bandar Abbas city. Of these, 120 people (30 people in the control group and 30 in each of three intervention groups) were selected by a two-stage sampling method. Educational intervention were done by presenting pamphlets, lecturing, and questions & answers (Q&A) sessions. Data collection tools were a 20-item questionnaire on sustainable nutrition knowledge of the Ministry of Health and a 35-item questionnaire on nutritional behavior of the elderly. Data were analyzed in SPSS software, version 23 using one-way analysis of variance and repeated measures analysis of variance.

The age range of the elderly was 60-79 years. The majority were male (53.3%). The results showed that the effect of Q&A method was effective in improving nutrition status (F=4.397, P=0.031) and sustainability of nutritional knowledge (F=10.108, P=0.002). Education by presentation of pamphlets and lecture had no significant effect on nutrition status and sustainability of knowledge.

By the Q&A method, the nutritional knowledge can be maintained and the nutrition status can be improved in the elderly compared to lectures and pamphlet presentation methods. It helps formulate appropriate educational programs for the elderly.

Fear of falling affects the daily performance of older adults, exacerbates the frailty syndrome, and ultimately reduces their independence. This study aims to investigate the relationship between fear of falling and frailty in older adults in Bushehr, Iran. 

This descriptive-analytical study with a cross-sectional design was conducted on 215 older adults aged ≥60 years referred to urban comprehensive health centers in Bushehr, Iran in 2021 who were selected by a cluster sampling method. A demographic/clinical form, falls efficacy scale international (FES-I), and Fried’s frailty scale were used for collecting data. Data were analyzed using chi-square test, and logistic regression analysis in SPSS software, version 24.

The mean age of the participants was 68.81±8.31 years. They included 56.7% female (n=122) and 43.3% male (n=93). The chance of developing frailty syndrome in people with high level of fear of falling was 6 times that of people with low fear of falling (OR=6.37, 95% CI, 1.44%-28.08%). The fear of falling was significantly higher in those with younger age, low education level, low income, those who were widower/widow, housekeeper or retired, and those with a history of falling in the last year, and frailty (P<0.001).

Fear of falling can cause frailty and thus increase the dependence of older adults; therefore, timely screening and intervention are recommended to reduce its negative effects

Rehabilitation is one of the basic services for the elderly and people with disabilities and provides the possibility of equal opportunities and participation in the society. In fact, it is one of the main pillars of the health; however, less attention has been paid to this issue in Iran, and it does not have a specific place in the health system. The present study aims to find barriers and facilitators regarding rehabilitation programs for the elderly and people with disabilities in Iran.

This is a qualitative study using content analysis method. Participants were 13 experts in different fields of rehabilitation who were selected using a purposive sampling method which continued until the data saturation. The data were collected using a semi-structured in-depth interview from February 2021 to February 2022. The interviews were transcribed verbatim, and then were analyzed by using conventional content analysis method and using constant comparative analysis.

Two main categories of barriers and facilitators, each with 4 sub-categories were identified. The barriers were: High number of rehabilitation trustees, lack of awareness of officials and people, lack of attention to the role of the municipality in rehabilitation, and poor rehabilitation management. Facilitators were: Building culture in the field of rehabilitation and disability, improving the insight of officials, the role of rehabilitation specialists, benefiting from the experiences of other countries.

The identified barriers and facilitators can help officials and policymakers in Iran to improve the status of rehabilitation and provide better services to people with disabilities.

The rapid growth of the elderly population requires the design of age-friendly healthcare systems to respond to the complex needs of the elderly. This study aims to assess the hospitals in Isfahan, Iran based on the age-friendly primary health care centers criteria and identify challenges. 

This cross-sequential study was conducted in two phases in 2020-2021. First, using the checklist of Ahmadi et al.’ study, the teaching hospitals in Isfahan were assessed based on the age-friendly primary health care centers criteria. The checklists were completed by observation and based on the opinions of the experts. Data analysis was done in SPSS software, version 26 using descriptive statistics and Pearson correlation test. Qualitative data were collected through a semi-structured interview and were analyzed using Conventional content analysis method.

Most of the hospitals were in good conditions in terms of physical environment, sanitary facilities, and signboards. The lowest scores were related to the areas of admission and payment, appointments, accessibility, and inpatient services. The mean age-friendly score of hospitals was 51.7 out of 100. There was no significant relationship between the characteristics of hospitals (type of ownership, type of activity, specialty, number of beds, bed occupancy rate, degree of accreditation, and manager’s study field) and their age-friendly scores. We identified 9 themes and 27 sub-themes related to challenges of being age-friendly in the hospitals. 

The hospitals in Isfahan have many shortcomings in being age-friendly. Promoting the expertise of geriatric medicine and geriatric nursing, designing a special queuing system for the elderly, considering a special administrator for the elderly in different departments, reducing the costs of treatment for the elderly, promoting consultation/examination/treatment/follow-up programs for the elderly with an emphasis on upstream documents and cooperation between different departments, empowering employees, upgrading physical infrastructure can help solve existing challenges.

The care transitions measure (CTM-15) is a reliable and valid tool to evaluate the transition of care. This study aims to assess the psychometric properties of the Persian version of CTM-15 in Iranian older people.

This is a psychometrics study. The questionnaire was first translated into Persian based on the international quality of life assessment protocol. Then, it was completed by 200 older people who were selected using a convenience sampling method based on the inclusion criteria. After completion, face validity, content validity, construct validity (using confirmatory factor analysis and exploratory factor analysis) and convergent validity were investigated. The reliability of the questionnaire was evaluated in terms of internal consistency (using Cronbach’s α) and test-retest reliability. Statistical analyses were done in SPSS software, version 26 and AMOS software, version 24.

The content validity index (CVI) for the whole questionnaire was obtained as S-CVI=0.966. Following CFA, the 4-factor solution was not confirmed and did not show a good fit (P<0.001, RMSEA=0.093, GFI=0.851, NFI=0.644, CFI=0.731). After performing EFA, three factors were found and named as “patient and caregiver preferences”, “self-management and follow-up” and “medication management”. Convergence validity of the Persian CTM-15 with GSE-10 was assessed using Pearson’s correlation test which obtained as r=0.468. The internal consistency using Cronbach’s α coefficient was 0.76 and intraclass correlation coefficient was 0.85.

The Persian version of CTM-15 did not support the 4-factor model of the original version. The Persian version with 3 subscales, due to having acceptable validity and reliability, can be used as an efficient tool to evaluate the transition of care for the elderly in Iran. The benefits of measuring the transition of care and its impact on the promotion of discharge programs and continuity of care in various settings justify the need to pay attention to this tool.

Older diabetic patients with myocardial infarction (MI) are vulnerable group. This study aims to compare the prevalence of risk factors, type of reperfusion therapy, and mortality in diabetic and non-diabetic elderly with MI.

This is a cohort study. The statistical population consists of all older adults (age ≥60 years), whose information was available in the ST-segment elevation myocardial infarction (STEMI) registry system of Imam Ali hospital in Kermanshah, Iran from July 2016 to January 2020. Of these, 1460 participants with STEMI were selected based on the inclusion criteria and divided into two diabetic and non-diabetic groups. Their information was recorded by trained nurses using a checklist surveying demographic information, medical records, cardiovascular disease risk factors, clinical and diagnostic tests, type of treatment, and death at the time of admission, hospitalization and discharge. Data analysis was performed using descriptive statistics, independent t-test, Mann-Whitney and chi-square test in Stata software, version 14. P<0.05 was considered as significant level.

The number of diabetic women (47.11%) was significantly higher than the number of those without diabetes (25.60%) (P<0.001). The mean LDL and cholesterol levels in non-diabetics was significantly higher than diabetics (P<0.001). The mean HDL was not significantly different between the two groups (P=0.777). The number of patients with BMI≥30, history of myocardial infarction, blood lipid, hypertension, triglyceride level, and glomerular filtration rate <60 were significantly higher in the diabetic group than in the non-diabetic group. There were no significant differences between the two groups regarding the variables of place of residence, literacy level, smoking, history of stroke, coronary angioplasty and coronary artery bypass surgery. In addition, there was no significant difference in mortality rate and type of reperfusion treatment between the two groups.

Some of risk factors for MI are different between diabetic and non-diabetic elderly with MI. The results of this study can provide useful information to experts in this field to develop lifestyle modification programs by making drug prescription more purposeful and providing awareness for this group of patients.

Most studies have investigated the effect of pathological aging brain on information recall and recognition memory of patients by using yes-no procedures. For this reason, they provide an incomplete picture of memory defect, and other factors related to recognition memory such as recognition discriminability (RD) and response bias (RB) are not taken into consideration. In this regard, present study aims to examine the effect of amnestic mild cognitive impairment (MCI) and Alzheimer’s disease on RD and RB using the Shiraz verbal learning test (SVLT) compared to healthy peers.

This descriptive cross-sectional study was conducted on 190 eligible older people aged 60-89 years with amnestic MCI, Alzheimer’s disease, and normal memory in Shiraz, Iran, in 2021. The data collection tools were SVLT and mini-mental status examination. Data analysis was done in SPSS software, version 19 using descriptive statistics (No., Mean±SD) and analytical tests (ANOVA and Scheffe’s test). The significance level was set at 0.05.

The patients with amnestic MCI and Alzheimer’s disease had significantly lower scores than the healthy older people in recognition memory performance (P<0.001). They also had lower scores and more false-positive errors in RD domains (global, semantic, source, and new) (P<0.001). in RB, the patients with Alzheimer’s disease had significantly higher scores than older people with amnestic MCI and normal memory (P<0.001).   

The study of recognition memory performance (RB and RD) in patients with amnestic MCI can provide useful information to predict Alzheimer’s disease in the prodromal stage.