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Geriatrics refers to the study of health and care of older population. It is a branch of medicine or social sciences dealing with special care to older people by preventing and/or treating their diseases and managing their disabilities, so that they would be able to live a good life. However, there is no standard rule for considering someone to be in geriatric population. A physician, who specializes in geriatrics, is known as geriatrician. Several studies have been done to improve the quality of life of older people having different diseases or disabilities. One of the most commonly used methods of research in knowing about the older people is “cross-sectional study.” In a cross-sectional study, observational data is collected from a population that can help in describing some important features of the population.
In 2010, a study was published in the journal Health and Quality of Life Outcomes in which researchers worked on the relationship between two closely-linked variables, i.e. frailty and quality of life in older adults in Italy. Researchers performed a cross-sectional survey. In the survey, they considered 239 community-dwelling patients having more than 65 years of age. Those patients were selected from a geriatric medicine clinic in Italy between the months from June to November, 2009. Researchers comprehensively assessed the frailty status and quality of life of patients after dividing the patients in different groups, which were “robust”, “pre-frail”, and “frail”. Frailty status was checked by the Study of Osteoporotic Fractures criteria, and quality of life was checked by utilizing the Older People's QOL questionnaire. Statistical analysis including one-way analysis of variance as well as chi-squared tests were performed to find correlating factors of frailty including dimensions of quality of life such as health, home and neighborhood, independence, activities, emotional and psychological well-being, religion, social relationships, and financial circumstances. Multiple linear regression analyses were done to find correlates of quality of life in the entire sample as well as among “robust” and “frail” participants. Reduced energy level, depression, bathing abilities, dependence in transferring, and money management were considered as independent correlates. Researchers found a negative trend in almost all dimensions of quality of life except social relationships and financial issues. In frail patients, significant associations were found between depression and age, and in robust patients associations were found with lower body mass index. Researchers concluded that most of the dimensions of quality of life are negatively affected because of frailty in older people (Bilotta et al., 2010).
In a study, published in The American Journal of Geriatric Psychiatry, researchers reported the work on the patients of Alzheimer’s disease (AD). Researchers assessed whether the symptoms of Alzheimer’s disease as well as caregiver factors tell about the quality of life of patients. Researchers worked with 412 family caregivers of community-living patients from fifteen dementia as well as geriatric clinics in Canada. In the study, researchers took caregiver ratings of patient quality of life with the help of Disease-Specific Quality of Life Measure, Generic Health Utility Indexes, Global Quality of Life Rating Scale, and Generic Health Profile Measure. Researchers assessed the cognition of patients with the help of AD Assessment Scale-Cognitive Subscale as well as Mini-Mental State Examination; function with the help of the Disability Assessment for Dementia, and behavioral as well as psychological symptoms with the help of Neuropsychiatric Inventory and the Geriatric Depression Scale. Researchers assessed the caregiver burden with the help of Zarit Burden Interview and caregiver depression with the help of Center for Epidemiologic Studies-Depression scale. Researchers also performed statistical analysis including one way ANOVA and multiple linear regressions to find the relationship between the symptoms of patient dementia and caregiver variables with quality of life ratings. Researchers concluded that caregiver ratings of patient function as well as depression are consistent independent predictors of quality of life, and caregiver ratings can be considered as an important source of information in assessing the quality of life of patients with Alzheimer’s disease (Naglie et al., 2011).
In an article published in IOSR Journal of Pharmacy researchers worked on the factors behind quality of life of geriatric patients having HIV/AIDS. They reported that the number of aging population with HIV infection is increasing, and this is due to the increased effectiveness of highly active antiretroviral therapy. This number would increase with time. Therefore, it is important to study the factors that can help in successful aging of the growing population with HIV infection. Researchers performed a cross-sectional study in 320 patients of AIDS having more than 60 years of age in Mysore, India. They used WHO-QOL-Bref, a shortened quality of life questionnaire to check the quality of life of patients. They also used pre-structured and predesigned questionnaire to determine different factors influencing quality of life patients. Statistical analysis including t-test and multiple linear regressions were also used in the study. Researchers found that social relationships have maximum affect on the quality of life of older patients. Moreover, certain other factors such as marital status, employment, higher education, lower stage of disease, and elevated CD4 count were also significantly related to better quality of life. Researchers concluded that health care providers as well as policy makers have to consider the long-term effects of disease management especially in the older population, because many epidemiologic and clinical differences can be present between younger and older patients of HIV (Sudhir, Deepa, Ashok, Murali Dhar, 2013).
All of these researches were based on cross-sectional study. Cross-sectional studies are often without any hypothesis, and are usually performed to determine the prevalence of an outcome of interest for a given population; so in our studies, quality of life was studied in geriatric population. These studies can help in public health planning. Researchers performed a survey by using questionnaire designed after thorough research and made a conclusion based on that survey. As the studies are based on questionnaire, they can help in knowing about the individual data. These studies also involved a definite period of time in which the data was collected. Researchers use statistical analyses to reach a conclusion.
In the selected studies, researchers checked the quality of life of geriatric population in different conditions such as in frailty, in Alzheimer’s disease, and in HIV infection. In one study, researchers considered sex, residence, marital status, and education of the study population (Sudhir et al., 2013). Similarly, Bilotta et al., considered the sex, education, and participants of the target population, but they did not mention the demographic data in a separate table (2010). Naglie et al., worked on caregiver ratings, so they have enlisted not only patient characteristics but also caregiver characteristics. Among the patient characteristics were age, gender, education, language, marital status, and living alone or with someone (2011). Caregiver characteristics also included almost same points (Naglie et al., 2011).
In one study, researchers found that caregivers’ rating of the quality of life of patients could be an important predictor. They found that caregivers could help in knowing about patient functions and depression. Overall, the study can help in knowing about the life of patients. However, the study was related to most of the dementia patients, as patients with behavioral disturbances were not able to take part in the study. Therefore, the outcomes of the study may have some limitations (Naglie et al., 2011). In the other study, researchers found that almost all aspects of quality of life including health, independence, and activities were affected by frailty in older ages. They also reported that therapeutic interventions for older community must not only target health-related quality of life but also target other dimensions of quality of life. However, the study had some limitations such as the number of patients, i.e. researchers worked on a small number of population including frail and robust people; therefore, the outcomes of the study may not be extended to a larger population (Bilotta et al., 2010). In the third study, researchers concluded that sometimes both health care providers as well as policy makers do not consider the long-term effects of disease management. They found that in patients of HIV, better quality of life is related to sex, marital status, higher education, employment, lower stage of disease, and increased CD4 count (Sudhir et al., 2013).
All of these studies utilized cross-sectional method, so they may be considered to be of equal effectiveness. However, some studies have used more instruments (questionnaires) and statistically analyses as compared to others, so they may be considered as slightly more authentic. For example, Naglie et al., have used more instruments in knowing about the caregiver ratings for the quality of life of older people, so their study can be considered as more authentic (2011).
These studies can be redesigned by considering the important aspects of quality of life in all the three different states, i.e. Alzheimer’s disease, frailty, and HIV infection in older adults. Moreover, caregiver ratings in all three conditions can also help in enhancing the quality of results. These studies can help in performing empirical studies on geriatric population. They can also help healthcare policy makers in improving their policies related to older patients of a community.
References
Bilotta, C., Bowling, A., Case, A., Nicolini, P., Mauri, S., Castelli, M., & Vergani, C. (2010). Dimensions and correlates of quality of life according to frailty status: a cross-sectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy. Health Qual Life Outcomes, 8, 56. doi: 10.1186/1477-7525-8-56
Naglie, G., Hogan, D. B., Krahn, M., Black, S. E., Beattie, B. L., Patterson, C., . . . Tomlinson, G. (2011). Predictors of family caregiver ratings of patient quality of life in Alzheimer disease: cross-sectional results from the Canadian Alzheimer's Disease Quality of Life Study. Am J Geriatr Psychiatry, 19(10), 891-901. doi: 10.1097/JGP.0b013e3182006a7f
Sudhir, Deepa, K., Ashok, N.C., Murali Dhar, M. (2013). Factors Determining Quality Of Life of Geriatric Patients With HIV/AIDS: A Cross Sectional Study In South India. IOSR Journal Of Pharmacy, 3(9), 63-67.
