Wen-Chun Liao

Healthy Behaviors and Onset of Functional Disability in Older Adults:: Results of a National Longitudinal Study

OBJECTIVES: To examine the combined effect of healthy behaviors on the development of functional disability in an elderly cohort.

Cigarette smoking and cognitive impairment: A 10-year cohort study in Taiwan

The relationship between cigarette smoking and cognitive impairment is not a simple one. Some studies have demonstrated that cigarette smoking is a risk factor for cognitive impairment in the elderly, whereas other studies have shown cigarette smoking to be protective against dementia. This study aims to explore the relationship between cigarette smoking and cognitive impairment in elderly persons without dementia, during a 10-year period. Data were derived from a population-based cohort study of 1436 elderly Taiwanese. Cognitive function was measured by the SPMSQ both in 1993 and in 2003. A total of 1436 participants free of cognitive impairment at baseline (SPMSQ> or =6 in 1993) were included in these analyses. Subsequently, participants were divided into three groups: never, past, and current smokers. The effect of cigarette smoking on cognitive function was assessed using logistic regression. In the logistic regression model adjusted for age, education, hypertension, diabetes, heart disease, and stroke at baseline, persons who had quit smoking (Odds ratio=OR=0.31; 95% CI=0.18-0.53; p<0.001) and those who continued to smoke (OR=0.37; 95% CI=0.20-0.70; p<0.001) were about one-third as likely to develop cognitive impairment as were those who never smoked. However, no dose-response relationship was observed between pack-years and cognitive impairment. Past and current smokers were less likely to develop cognitive impairment during a 10-year follow-up than were those who had never smoked. The present study suggests that smoking may be protective for cognitive function.

Social support and mortality among the aged people with major diseases or ADL disabilities in Taiwan: A national study

OBJECTIVE To determine the effects of social support on mortality among the aged people with major diseases or ADL disabilities. METHOD In this prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging from 1996 to 2007. Data for 1297 males and 1666 females aged ≥65 years were collected. The participants were divided into having major diseases or ADL disability or none. Subjects received financial, instrumental, and emotional support, and they actively provided instrumental and emotional support to others. The effect of the association between providing and receiving social support on mortality was examined using Cox regression analysis after adjusting several covariates. RESULTS Results showed a significant finding that providing instrumental support can lower mortality rates in the aged people [Hazard ratio (HR)=0.77; 95% confidence interval (CI)=0.66-0.90; p=0.0009] and those with major diseases or impairment of activities of daily living [Hazard ratio (HR)=0.62; 95% confidence interval (CI)=0.50-0.78; p≤0.0001] after adjusting for several covariates. Providing instrumental social support to others may prolong life expectancy in the aged people and even those with major diseases or those facing difficulties performing ADL. CONCLUSION Based on the finding, we should encourage older adults who have major diseases or ADL disabilities to be supporting providers especially in providing instrumental social support.

Evaluating outcomes of Taiwan's first gerontology certification program

The elderly population will approach 20% within the next 20 years. This enhances the need for skilled and experienced health care providers. There is a critical need to strengthen gerontology curricula to prepare health-related professionals for a graying population. The purpose of this article is to investigate student satisfaction with the first National Project for Excellence in Gerontological Care Education (NPEGCE) in Taiwan. A cross-sectional design was used. A sample of 151 medical, nursing, and physical therapy students, who had enrolled in the NPEGCE and had taken at least one core course, completed a satisfaction questionnaire. To ensure content validity, a multidisciplinary, institutional committee of gerontology and geriatric faculty designed the content. Overall satisfaction scores varied between satisfied (4-points) and very satisfied (5-points). Medical students gave higher ratings than others. Two factors (Curriculum and Teaching) were extracted. A strong correlation was found between the subscales and overall satisfaction scores. Internal scale consistency reliability scores ranged from 0.92 to 0.96. Overall, this study demonstrates a moderate level of satisfaction with the NPEGCE. However, these results are from a single institution; they are not generalizable. This is also the first student satisfaction report from Taiwan. There are no similar programs or evaluation results to compare them with. Since the NPEGCE was well received by students and seemed to encourage a more nurturing attitude towards the elderly; it can be regarded as a catalyst for better elderly care in the future.