Prevalence and Factors Associated with Psychological Distress among Older Adults Admitted to Hospitals After Fall Injuries in Vietnam

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Abstract

Although psychological distress is one of the major health issues among aging populations, little is known about how this challenge affects older patients after falls. A cross-sectional study was conducted in Thai Binh province, Vietnam, to explore the prevalence of psychological distress and associated factors among 405 older patients after falls. The 6-item Kessler Psychological Distress Scale (K6) was used to measure psychological distress. Socio-demographic and clinical characteristics were collected using a structured questionnaire. Multivariate Tobit and Logistic regressions were used to determine factors associated with psychological distress. The prevalence of psychological distress among participants was 26.2%. Patients who were alone or older had a higher likelihood of psychological distress. Patients with a history of falls in the past 12 months were more likely to suffer from psychological distress (OR = 2.87, 95%CI = 1.74; 4.72). Having two and three comorbidities was significantly associated with greater K6 scores and a higher risk of psychological distress. This study underlined a significantly high prevalence of psychological distress among older patients after falls. Providing frequent mental health monitoring, screening, treatment, and facilitating social engagements are important implications to improve the mental health of this population.

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Most cited references 24

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Consequences of major and minor depression in later life: a study of disability, well-being and service utilization.

A Beekman, Dirk Smit, Arjan Braam … (1997)

The consequences of major depression for disability, impaired well-being and service utilization have been studied primarily in younger adults. In all age groups the consequences of minor depression are virtually unknown. In later life, the increased co-morbidity with physical illness may modify the consequences of depression, warranting special study of the elderly. With rising numbers of elderly people, excess service utilization by depressed elderly represents an increasingly important issue. Based on a large, random community-based sample of older inhabitants of the Netherlands (55-85 years), the associations of major and minor depression with various indicators of disability, well-being and service utilization were assessed, controlling for potential confounding factors. Depression was diagnosed using a two-stage screening design. Diagnosis took place in all subjects with high depressive symptom levels and a random sample of those with low depressive symptom levels. The study sample consists of all participants to diagnostic interviews (N = 646). As in younger adults, associations of both major and minor depression with disability and well-being remained significant after controlling for chronic disease and functional limitations. Adequate treatment is often not administered, even in subjects with major depression. As the vast majority of those depressed were recently seen by their general practitioners, treatment could have been provided in most cases. Bivariate analyses show that major and minor depression are associated with an excess use of non-mental health services, underscoring the importance of recognition. In multivariate analyses the evidence of excess service utilization was less compelling. Both major and minor depression are consequential for well-being and disability, supporting efforts to improve the recognition and treatment in primary care. However, controlled trials are necessary to assess the impact this may have on service utilization.

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The association of depression and mortality in elderly persons: a case for multiple, independent pathways.

D. Blazer, Claus C Pieper, C Hybels (2001)

The evidence for an association between depression and mortality among community-dwelling elderly persons remains inconclusive, although it is well established for younger individuals. Extant studies suggest that this association weakens when adjusted for potential confounding factors, especially functional impairment. A cohort of elderly subjects followed for 3 years was analyzed to determine the association of depression and 3-year mortality, controlling for the major known risk factors for mortality in the elderly population. Information on depression (CES-D scores), mortality, demographics, body mass index, chronic disease, smoking history, cognitive impairment, functional impairment, self-rated health, and social support was obtained from a stratified probability-based sample of community-dwelling elderly persons, with equal distribution between African Americans and whites in the Piedmont of North Carolina. Descriptive statistics were calculated, and logistic regression was used for a series of models with progressively more control variables. The unadjusted relative odds of mortality among depressed subjects at baseline was 1.98 over 3 years of follow-up. Inclusion of age, gender, and race into the model did not reduce the relative odds. When chronic disease and health habits, cognitive impairment, functional impairment, and social support were added to the model, the odds ratios for mortality with depression were 1.74, 1.69, 1.29, and 1.21, respectively. This decrease in odds ratios was not observed for other variables in the model when additional variables were added. The estimated odds of dying if depressed moved toward unity as other risk factors for mortality were controlled. Unlike other known risk factors for mortality in the elderly population, depression appears to be associated with mortality through a number of independent mechanisms, perhaps through complex feedback loops.

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Associations between living arrangements and health-related quality of life of urban elderly people: a study from China.

Xiaojie Sun, Yaoguang Zhang, Henry Lucas … (2011)

This study aimed to compare health-related quality of life (HRQOL) for elderly men and women in three mutually exclusive living arrangements: living alone, living only with spouse, and non-empty-nesters. It also examined whether such living arrangements and other factors relating to social interaction have an independent influence on HRQOL after controlling for other variables. The data were drawn from China's 4th National Household Health Survey (NHHS) conducted in 2008. The final sample included 9,711 urban elderly people of 60 years and above. The EQ-5D inventory was used to measure health-related quality of life. The proportions of non-empty-nested men and women both changed following a 'U'-shaped curve with the increasing age. Controlling for other variables not including social interaction indicators, "living alone" was a significant predictor of reporting problems on Mobility, Pain/Discomfort and Anxiety/Depression. After introducing social interaction indicators, urban older adults 'having close contact with neighbors every week' had lower odds of problems on all five EQ-5D indicators, those 'having close contact with friends and relatives' had lower odds of problems on Mobility, Pain/Discomfort and Anxiety/Depression, and those 'taking part in social activities every week' had lower odds of problems on all dimensions but Anxiety/Depression. In addition, after introducing social interaction indicators, the odds of reported problems on the three dimensions increased obviously. This study suggests that the most vulnerable urban older adults are those who live entirely on their own. Frequent social interaction may buffer the negative effect of living alone on HRQOL of older adults. Policies that attempt to build harmonious neighborhoods, extend older adults' social network and encourage them to take part in social activities should be considered by the policy-makers in the future.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 15 November 2019

Publication date (Print): November 2019

Volume: 16

Issue: 22

Electronic Location Identifier: 4518

Affiliations

[1 ]Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; longnh.ph@ 123456gmail.com (L.H.N.); pcmrhcm@ 123456nus.edu.sg (R.C.M.H.)

[2 ]Department of Trauma and Orthopaedic, Thai Binh Medical University Hospital, Thai Binh 410000, Vietnam; vuminhhai.ythaibinh@ 123456gmail.com

[3 ]Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; giang.coentt@ 123456gmail.com

[4 ]Institute of Orthopaedic and Trauma Surgery, Vietnam–Germany Hospital, Hanoi 100000, Vietnam; tranhoangtung.vd@ 123456gmail.com

[5 ]Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; phamhuytuankiet_vkt@ 123456fpt.vn (K.T.H.P.); bach.ipmph@ 123456gmail.com (B.X.T.)

[6 ]Department of Psychiatry, Thai Binh University of Medicine and Pharmacy, Thai Binh 410000, Vietnam; nguyenthanhbinhdhytb@ 123456yahoo.com

[7 ]Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam

[8 ]Centre of Excellence in Artificial Intelligence in Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; ngochieu.coentt@ 123456gmail.com

[9 ]Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; carl.latkin@ 123456jhu.edu

[10 ]Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore; cyrushosh@ 123456gmail.com

[11 ]Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore

[12 ]Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore

Author notes

[* ]Correspondence: haipt.ighi@ 123456gmail.com ; Tel.: +84-333998764

Author information

Bach Xuan Tran https://orcid.org/0000-0001-7827-8449

Carl A. Latkin https://orcid.org/0000-0002-7931-2116

Roger C. M. Ho https://orcid.org/0000-0001-9629-4493

Article

Publisher ID: ijerph-16-04518

DOI: 10.3390/ijerph16224518

PMC ID: 6888520

PubMed ID: 31731721

SO-VID: 29efca11-f9ac-4773-8dec-dddfcdeb34ac

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Prevalence and Factors Associated with Psychological Distress among Older Adults Admitted to Hospitals After Fall Injuries in Vietnam

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Most cited references 24

Consequences of major and minor depression in later life: a study of disability, well-being and service utilization.

The association of depression and mortality in elderly persons: a case for multiple, independent pathways.

Associations between living arrangements and health-related quality of life of urban elderly people: a study from China.

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