Latent dependency classes according to the need for help: a population-based analysis for the older population.
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ABSTRACT: Background
Older adults living in the community may have daily needs for help to perform different types of activities. In developing countries, older adults face the additional challenge of lacking sufficient economic means to face their increasing needs with ageing, and health and social policies may be under pressure. The aim of this study was to assess dependency in the older population from a developing country using a latent class approach to identify heterogeneity in the type of activities in which dependent older adults require help.Methods
In this cross-sectional evaluation of dependency, we considered individuals aged 60 years and older from a nationally representative study (N = 5138) in Uruguay. We fitted latent class regressions to analyse dependency, measured by the need for help to perform Activities of Daily Living, adjusted by sociodemographic characteristics.Results
Four latent classes were identified, 86.4% of the individuals were identified as non-dependent, 7.4% with help requirements to perform instrumental activities while individuals in the other two classes need help to perform all types of activities with different degrees (4.3 and 1.9%). Less educated women are more likely to be in the group with needs in instrumental activities.Conclusions
The heterogeneous patterns of dependency have to be addressed with different services that meet the specific needs of dependent older adults.
SUBMITTER: Marroig A
PROVIDER: S-EPMC9317231 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The exploratory study presented here examines children's ability to recognize another person's need-of-help. This social perception process necessarily precedes the decision to actively help others. Fifty-eight children aged between 5 and 13 completed three experimental paradigms. They were asked to look at black-and-white drawings and to indicate which ones showed somebody in need of help. A control task requiring children to differentiate between pictures of humans and birds measured general categorization abilities. This experimental design enabled us to consider confounding effects of children's developmental status and motivation and to distinguish them from specific need-of-help recognition abilities. As gender and age have been shown to influence social perception as well as helping behavior, we explored whether these factors also have an impact on need-of-help recognition. Children's response accuracies and response times (RTs) were analyzed. We observed clearly higher accuracy rates for younger girls compared to younger boys specifically in the need-of-help recognition tasks. For boys, an age-related performance improvement was found. Younger girls performed at a similarly high level as older girls and boys. No gender differences were observed for children aged over nine. This report provides first evidence that the developmental trajectory of children's ability to recognize another person's need-of-help differs for girls and boys.
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Project description:BackgroundExisting studies have used ADL and IADL separately as measures of dependency. However, dependency is a heterogeneous and complex issue, and the dependency of each older adult is a synergistic combination of several functional activities. In this study, we assess the pattern of multidimensional dependency of older adults based on ADL, IADL, visual impairment, difficulty in climbing a flight of stairs, pushing or pulling objects, depressive symptoms, cognitive impairment, marital status, and economic distress. It is important to classify the dependency status of older adults because this will be key to evaluating the needs for care, and plan services that effectively cater for the needs of the older adults. The classification into different latent classes means that older adults within each class have the same needs of dependency but different needs between the latent classes. Our objective is to identify patterns of multidimensional dependency in older adults.MethodsData from the Longitudinal Ageing Study in India (LASI) Wave-1, was used, the analytical sample consisted of 32,827 individuals of age 45 years and above. LCA was used to identify the multidimensional dependency class. LCA was conducted in R statistical package, using the poLCA package. The optimal number of classes was selected based on the comparison of model fit statistics. Independent variables were incorporated to explore the association between these variables and the latent class.ResultsBased on nine indicator variables, three latent classes were identified: "Active Older adults", "Moderately independent" and "Psychological and physically impaired". The "Active older adults" profile is comprised of older adults who have a very low probability of needing help for any ADL, IADL and other activities. The "Moderately independent" class were characterized as those older adults who were visually impaired but less likely to need help for IADL activities. The "Psychological and physically impaired", the smallest of all classes, comprised of older adults with poor dependency status.ConclusionsIn this study, we found that the dependency status of older adults which is based on several domains of functional activity has been classified into three distinct classes. These three classes have distinct physical, psychological, economic, and socio-demographic characteristics in terms of activities in which help is required.
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Project description:Direct reciprocity, according to the decision rule 'help someone who has helped you before', reflects cooperation based on the principle of postponed benefits. A predominant factor influencing Homo sapiens' motivation to reciprocate is an individual's perceived benefit resulting from the value of received help. But hitherto it has been unclear whether other species also base their decision to cooperate on the quality of received help. Previous experiments have demonstrated that Norway rats, Rattus norvegicus, cooperate using direct reciprocity decision rules in a variant of the iterated Prisoner's Dilemma, where they preferentially help cooperators instead of defectors. But, as the quality of obtained benefits has not been varied, it is yet unclear whether rats use the value of received help as decision criterion to pay help back. Here, we tested whether rats distinguish between different cooperators depending purely on the quality of their help. Our data show that a rat's propensity to reciprocate help is, indeed, adjusted to the perceived quality of the partner's previous help. When cooperating with two conspecific partners expending the same effort, rats apparently rely on obtained benefit to adjust their level of returned help.
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Project description:Acute respiratory distress syndrome (ARDS) is a highly heterogeneous syndrome that can exhibit significant differences in the underlying causes, leading to different responses to treatment. It is required to identify subtypes of ARDS to guideline clinical treatment and trial design. The study aimed to identify subtypes of ARDS using latent class analysis (LCA). The study was a secondary analysis of the EDEN study, which was a randomized, controlled, multicenter trial conducted from January 2, 2008 to April 12, 2011. The primary study endpoint was death through 90-day follow up. LCA was performed incorporating variables on day 0 before randomization. The number of classes was chosen by a bootstrapped likelihood ratio test, Bayesian information criterion and the number of patients in each class. A total of 943 patients were enrolled in the study, including 219 (23.2%) non-survivors and 724 (76.8%) survivors. The LCA identified three classes of ARDS. Class 1 (hemodynamically unstable type) had significantly higher mortality rate (p = 0.003) than class 2 (intermediate type) and 3 (stable type) through 90 days follow up. There was significant interaction between cumulative fluid balance and the class (p = 0.02). While more fluid balance was beneficial for class 1, it was harmful for class 2 and 3. In conclusion, the study identified three classes of ARDS, which showed different clinical presentations, responses to fluid therapy and prognosis. The classification system used simple clinical variables and could help to design ARDS trials in the future.
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Project description:IntroductionWe classified individuals based on their baseline performance on cognitive measures and investigated the association between cognitive classifications and neuropathological findings ∼7 years later, as an external validator.MethodsBrain autopsies of 779 decedents were examined. Baseline latent class analysis on 10 neuropsychological measures was previously assigned: mixed-domains impairment (n = 39, 5%), memory-specific impairment (n = 210, 27%), frontal impairment (n = 113, 14.5%), average cognition (n = 360, 46.2%), and superior cognition (n = 57, 7.3%). Linear regressions and risks ratios were used to examine the relation of latent class assignment at enrollment with neuropathological indices.ResultsAmyloid β, tau, and transactive response DNA-binding protein 43 were associated with mixed-domains impairment and memory-specific impairment classes ∼7 years before death. Moderate arteriolosclerosis was associated with membership in the frontal impairment class.DiscussionOur findings support the use of latent class models that incorporate more comprehensive neuropsychological measures to classify cognitive impairment.
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