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Zhao D, Luo Y, Kemper KA, Zhang L, Pan X. Household Environments and Functional Decline Among Middle-Aged and Older Adults in China: Variations by Gender, Age, and Residence. Res Aging 2024; 46:451-467. [PMID: 38605601 DOI: 10.1177/01640275241246051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
This study examined the associations between household social, economic, and physical environments and the trajectory of functional limitations over time among middle-aged and older adults in China, and how this relationship differs by gender, age, and residence. Linear growth curve models were applied to a sample of 13,564 respondents aged 45 years and older from four waves of the China Health and Retirement Longitudinal Study (CHARLS 2011-2018). Living alone, particularly for rural, female, and older respondents, was associated with a faster functional decline when compared to living with a spouse and without children. Improved housing quality was associated with a slower functional decline. Living with young descendants and without adult children for urban residents and a lower expenditure per capita for younger respondents were associated with a faster functional decline. These findings suggest that policies aimed at enhancing living conditions have the potential to improve physical functioning of older adults.
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Affiliation(s)
- Dandan Zhao
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Ye Luo
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Karen A Kemper
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Lingling Zhang
- Department of Nursing, University of Massachusetts Boston, Boston, MA, USA
| | - Xi Pan
- Department of Sociology, Texas State University, San Marcos, TX, USA
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2
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Gobbens RJ, Santiago LM, Uchmanowicz I, van der Ploeg T. Predicting Disability Using a Nomogram of the Tilburg Frailty Indicator (TFI). Healthcare (Basel) 2023; 11:healthcare11081150. [PMID: 37107984 PMCID: PMC10137888 DOI: 10.3390/healthcare11081150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/02/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Disability is associated with lower quality of life and premature death in older people. Therefore, prevention and intervention targeting older people living with a disability is important. Frailty can be considered a major predictor of disability. In this study, we aimed to develop nomograms with items of the Tilburg Frailty Indicator (TFI) as predictors by using cross-sectional and longitudinal data (follow-up of five and nine years), focusing on the prediction of total disability, disability in activities of daily living (ADL), and disability in instrumental activities of daily living (IADL). At baseline, 479 Dutch community-dwelling people aged ≥75 years participated. They completed a questionnaire that included the TFI and the Groningen Activity Restriction Scale to assess the three disability variables. We showed that the TFI items scored different points, especially over time. Therefore, not every item was equally important in predicting disability. 'Difficulty in walking' and 'unexplained weight loss' appeared to be important predictors of disability. Healthcare professionals need to focus on these two items to prevent disability. We also conclude that the points given to frailty items differed between total, ADL, and IADL disability and also differed regarding years of follow-up. Creating one monogram that does justice to this seems impossible.
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Affiliation(s)
- Robbert J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands
- Zonnehuisgroep Amstelland, 1186 AA Amstelveen, The Netherlands
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
- Department of Tranzo Academic Centre for Transformation in Care and Welfare, Faculty of Behavioural and Social Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands
| | - Livia M Santiago
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-912, Brazil
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
| | - Tjeerd van der Ploeg
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands
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3
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St John PD, Swift AU, Tate RB. Patterns of Functional Impairment over Time Amongst Older Men-the Manitoba Follow-up Study. Can Geriatr J 2021; 24:144-150. [PMID: 34079608 PMCID: PMC8137456 DOI: 10.5770/cgj.24.453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background To determine the incidence and prevalence patterns of activity of daily living (ADL) impairments in ageing men. Methods 3,983 men were enrolled in the Manitoba Follow-up Study (MFUS) cohort study in 1948. From 1996 onwards, functional status was measured. We classified basic (BADL) and instrumental (IADL) into mutually exclusive categories as a time dependant factor after the second survey wave as: First survey response; no limitation; incident (first episode of disability); persistent (limitation which was seen on all questionnaires after the incident episode); resilient (noted in previous surveys but not present); and recurrent (noted in present survey, and limitations noted as present and absent in previous surveys). Results There were 1,745 participants in 1996 at a mean age of 76 years. Incident BADL limitations increased substantially with age: from 1% at age 75 to 15% at age 95. Similarly, persistent limitations increased with age: from 0.4% at age 75 to 18% at age 95. However, BADL function was fluid, with many individuals grouped within the resilient and recurrent patterns. Similar age effects and variability were noted in IADLs. Conclusion New and persistent disabilities are highly associated with age. However, there is considerable change in functional status over time.
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Affiliation(s)
- Philip D St John
- Section of Geriatrics, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB.,Centre on Aging, University of Manitoba, Winnipeg, MB
| | - Audrey U Swift
- Dept of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
| | - Robert B Tate
- Centre on Aging, University of Manitoba, Winnipeg, MB.,Dept of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
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Gracia-García P, López-Antón R, Santabárbara J, Quintanilla MÁ, De la Cámara C, Marcos G, Lobo E, Lobo A. Cognition and daily activities in a general population sample aged +55. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:270-283. [PMID: 32249666 DOI: 10.1080/13825585.2020.1745140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: We tested the association of individual cognitive domains measured with the Mini-Mental State Examination (MMSE) and disability. Method: Cross-sectional study in a population-based cohort aged ≥55 years (n = 4,803). Sample was divided into two groups: individuals with cognition within the normal range (CNR) (n = 4,057) and those with cognitive impairment (CI) (n = 746). Main outcome measures: The MMSE, the Katz Index (Basic Activities of Daily Living, bADL), the Lawton and Brody Scale (Instrumental Activities of Daily Living, iADL), and the Geriatric Mental State (GMS-AGECAT). Results: MMSE-orientation was associated with disability in bADL, iADL and a decrease in social participation, regardless of cognitive status. MMSE-attention was associated with disability in iADL, but only in CNR. MMSE-language was associated with disability in bADL, iADL and with reduced social participation, but only in CI. Conclusions: The associations observed between disability and orientation may have clinical and public health implications.
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Affiliation(s)
- Patricia Gracia-García
- Psychiatry Service, Hospital Universitario Miguel Servet , Zaragoza, Spain.,Department of Medicine and Psychiatry, Universidad de Zaragoza , Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain
| | - Raúl López-Antón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Department of Psychology and Sociology, Universidad de Zaragoza , Zaragoza, Spain
| | - Javier Santabárbara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Department of Preventive Medicine and Public Health, Universidad de Zaragoza , Zaragoza, Spain
| | - Miguel Ángel Quintanilla
- Department of Medicine and Psychiatry, Universidad de Zaragoza , Zaragoza, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Psychiatry Service, Hospital Clínico Universitario , Zaragoza, Spain
| | - Concepción De la Cámara
- Department of Medicine and Psychiatry, Universidad de Zaragoza , Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Psychiatry Service, Hospital Clínico Universitario , Zaragoza, Spain
| | - Guillermo Marcos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Department of Preventive Medicine and Public Health, Universidad de Zaragoza , Zaragoza, Spain
| | - Elena Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Department of Preventive Medicine and Public Health, Universidad de Zaragoza , Zaragoza, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza , Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain
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Karadag Caman O, Karahan S, Ünal F, Bilir N, Saka E, Barışkın E, Ayhan Y. Adaptation of the Modified Mini-Mental State Examination (3MS) and Determination of Its Normative Values in Turkey. Dement Geriatr Cogn Disord 2020; 47:315-322. [PMID: 31390625 DOI: 10.1159/000500939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 05/13/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS This study aimed to adapt the Modified Mini-Mental State Examination (3MS) and determine its normative values in Turkey. METHODS After translation and cultural adaptation processes, a population-based study was conducted between February and June 2016 in Ankara with individuals over the age of 55 years. Subjects with a previous diagnosis of dementia along with neuropsychiatric disorders that might affect cognition were excluded. Data analyses were performed to assess the association of sociodemographic variables with 3MS scores. RESULTS Two versions of the Turkish 3MS (for educated and minimally educated individuals) were developed. A total of 2,235 participants were included in the field study. After exclusion, the data on the final sample of 1,909 individuals were analyzed, where age, gender, and education accounted for variance in 3MS scores. Younger age and higher educational attainment were associated with better 3MS performance. CONCLUSIONS A widely applicable dementia screening test was adapted to Turkish and its normative values were determined. The test will make it possible to evaluate the cognitive performance of both educated and minimally educated elderly individuals based on their age, gender, and educational level.
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Affiliation(s)
| | - Sevilay Karahan
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ferhat Ünal
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nazmi Bilir
- Institute of Public Health, Hacettepe University, Ankara, Turkey
| | - Esen Saka
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elif Barışkın
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yavuz Ayhan
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Evans IEM, Llewellyn DJ, Matthews FE, Woods RT, Brayne C, Clare L. Social isolation, cognitive reserve, and cognition in older people with depression and anxiety. Aging Ment Health 2019; 23:1691-1700. [PMID: 30518250 DOI: 10.1080/13607863.2018.1506742] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Poor social connections may be associated with poor cognition in older people who are not experiencing mental health problems, and the trajectory of this association may be moderated by cognitive reserve. However, it is unclear whether this relationship is the same for older people with symptoms of depression and anxiety. This paper aims to explore social relationships and cognitive function in older people with depression and anxiety. Method: Baseline and two-year follow-up data were analysed from the Cognitive Function and Ageing Study-Wales (CFAS-Wales). We compared levels of social isolation, loneliness, social contact, cognitive function, and cognitive reserve at baseline amongst older people with and without depression or anxiety. Linear regression was used to assess the relationship between isolation and cognition at baseline and two-year follow-up in a subgroup of older people meeting pre-defined criteria for depression or anxiety. A moderation analysis tested for the moderating effect of cognitive reserve. Results: Older people with depression or anxiety perceived themselves as more isolated and lonely than those without depression or anxiety, despite having an equivalent level of social contact with friends and family. In people with depression or anxiety, social isolation was associated with poor cognitive function at baseline, but not with cognitive change at two-year follow-up. Cognitive reserve did not moderate this association. Conclusion: Social isolation was associated with poor cognitive function at baseline, but not two-year follow-up. This may be attributed to a reduction in mood-related symptoms at follow-up, linked to improved cognitive function.
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Affiliation(s)
- Isobel E M Evans
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter , Exeter , United Kingdom
| | - David J Llewellyn
- Mental Health Research Group, Institute of Health Research, University of Exeter Medical School , Exeter , United Kingdom
| | - Fiona E Matthews
- Faculty of Medicine, Institute of Health and Society, Newcastle University , Newcastle , United Kingdom.,MRC Biostatistics Unit, Institute of Public Health, University of Cambridge , Cambridge , United Kingdom
| | - Robert T Woods
- Dementia Services Development Centre Wales, School of Healthcare Sciences, Bangor University , Bangor , United Kingdom
| | - Carol Brayne
- Institute of Public Health, University of Cambridge , Cambridge , United Kingdom
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter , Exeter , United Kingdom.,PenCLAHRC, Institute of Health Research, University of Exeter Medical School , Exeter , United Kingdom.,Centre for Research Excellence in Promoting Cognitive Health, Australian National University , Canberra , Australia
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7
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Opdebeeck C, Matthews FE, Wu YT, Woods RT, Brayne C, Clare L. Cognitive reserve as a moderator of the negative association between mood and cognition: evidence from a population-representative cohort. Psychol Med 2018; 48:61-71. [PMID: 28521844 DOI: 10.1017/s003329171700126x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive reserve (CR) has been associated with better cognitive function and lower risk of depression in older people, yet it remains unclear whether CR moderates the association between mood and cognition. This study aimed to investigate whether a comprehensive indicator of CR, including education, occupation and engagement in cognitive and social activities, acts as a moderator of this association. METHODS This was a cross-sectional study utilising baseline data from the Cognitive Function and Ageing Study II (CFAS II), a large population-based cohort of people aged 65+ in England. Complete data on the measures of CR, mood and cognition were available for 6565 dementia-free individuals. Linear regression models were used to investigate the potential modifying effect of CR on the association between cognition and mood with adjustment for age, sex and missing data. RESULTS Levels of CR did moderate the negative association between mood and cognition; the difference in cognition between those with and without a clinical level mood disorder was significantly smaller in the middle (-2.28; 95% confidence interval (CI) -3.65 to -0.90) and higher (-1.30; 95% CI -2.46 to -0.15) CR groups compared with the lower CR group (-4.01; 95% CI -5.53 to -2.49). The individual components of CR did not significantly moderate the negative association between mood and cognition. CONCLUSION These results demonstrate that CR, indexed by a composite score based on multiple indicators, can moderate the negative association between lowered mood and cognition, emphasising the importance of continuing to build CR across the lifespan in order to maintain cognitive health.
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Affiliation(s)
- C Opdebeeck
- Department of Psychology,Manchester Metropolitan University,Manchester,UK
| | - F E Matthews
- Institute for Health and Society,Newcastle University,Newcastle,UK
| | - Y-T Wu
- REACH: The Centre for Research in Ageing and Cognitive Health,School of Psychology,University of Exeter,Exeter,UK
| | - R T Woods
- DSDC Wales,Bangor University,Bangor,UK
| | - C Brayne
- Department of Public Health and Primary Care,Cambridge Institute of Public Health,School of Clinical Medicine,University of Cambridge,Cambridge,UK
| | - L Clare
- REACH: The Centre for Research in Ageing and Cognitive Health,School of Psychology,University of Exeter,Exeter,UK
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8
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Lin HR, Otsubo T, Imanaka Y. Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan. BMC Geriatr 2017; 17:182. [PMID: 28814271 PMCID: PMC5559793 DOI: 10.1186/s12877-017-0555-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 07/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Japan is known for its long life expectancy and rapidly aging society that there are various demands of older adults need to be fulfilled with, and one of them is long-term care needs. Therefore, Japan implemented the Long-Term Care Insurance in year 2000 for citizens who are above 65-year old and citizens who are above 40-year old in needs of long-term care services. This study was undertaken to longitudinally examine the influence of dementia and living alone on care needs increases among older long-term care insurance service users in Japan. METHODS Long-term care insurance claims data were used to identify enrollees who applied for long-term care services between October 2010 and September 2011, and subjects were tracked until March 2015. A Kaplan-Meier survival analysis was conducted to examine increases in care needs over time in months. Cox regression models were used to examine the effects of dementia and living alone on care needs increases. RESULTS The cumulative survival rates before care needs increased over the 4.5-year observation period were 17.6% in the dementia group and 31.9% in the non-dementia group. After adjusting for age, sex, care needs level, and status of living alone, the risk of care needs increases was found to be 1.5 times higher in the dementia group. Living alone was not a significant risk factor of care needs increases, but people with dementia who lived alone had a higher risk of care needs increases than those without dementia. CONCLUSION Dementia, older age, the female sex, and lower care needs levels were associated with a higher risk of care needs increases over the study period. Among these variables, dementia had the strongest impact on care needs increases, especially in persons who lived alone.
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Affiliation(s)
- Huei-Ru Lin
- The Japan Foundation for Aging and Health, 4F, 1-1 Aza Gengoyama, Oaza Morioka, Higashiura-cho, Chita-gun, Aichi, 470-2101, Japan.,Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Tetsuya Otsubo
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
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Woods EC, O'Conor R, Martynenko M, Wolf MS, Wisnivesky JP, Federman AD. Associations Between Asthma Control and Airway Obstruction and Performance of Activities of Daily Living in Older Adults with Asthma. J Am Geriatr Soc 2016; 64:1046-53. [PMID: 27160645 DOI: 10.1111/jgs.14108] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the effect of asthma on functional limitations of older adults in the United States. DESIGN Analyses were conducted with data from the Asthma Beliefs and Literacy in the Elderly study, a prospective cohort study of people aged 60 and older with asthma. SETTING Participants were recruited from urban primary care and pulmonary specialty practices in New York City and Chicago between 2010 and 2012. PARTICIPANTS Individuals aged 60 and older with asthma (380 women, 72 men, mean age 67.5 ± 6.8 (range 60-98), 40% Latino, 30% black). MEASUREMENTS Characteristics of participants with and without activity of daily living (ADL) limitations were compared using the chi-square test. Generalized estimating equations were used to model the relationships between poor asthma control (Asthma Control Questionnaire (ACQ) score >1.5) and severity of airway obstruction (forced expiratory volume in 1-second (FEV1 )) and number of ADL limitations. RESULTS Participants with one or more ADL limitations were more likely to be female (90% vs 81%, P = .02) and Latino (58% vs 32%, P < .001), have less than a high school education (53% vs 27%, P < .001) and an income of $1,350 per month or less (79% vs 46%, P < .001), and be unmarried (78% vs 64%, P = .003). In the adjusted analysis, poorer ACQ scores (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.0-2.4; P = .05) but not severity of airway obstruction (OR = 1.1, 95% CI = 0.6-1.9) was associated with greater ADL limitations. CONCLUSION Older adults reporting poor asthma control are more likely to have ADL limitations than those with controlled asthma, although one-time spirometry may not adequately identify those at risk of physical impairment from asthma.
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Affiliation(s)
- Eric C Woods
- Division of Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rachel O'Conor
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Michael S Wolf
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Juan P Wisnivesky
- Division of General Internal Medicine, New York, New York.,Division of Pulmonary, Critical Care and Sleep Medicine, New York, New York
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10
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Kamiya K, Adachi T, Sasou K, Suzuki T, Yamada S. Risk factors for disability progression among Japanese long-term care service users: A 3-year prospective cohort study. Geriatr Gerontol Int 2016; 17:568-574. [PMID: 27098728 DOI: 10.1111/ggi.12756] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/23/2015] [Accepted: 01/12/2016] [Indexed: 11/26/2022]
Abstract
AIM To examine the predictive ability of memory deterioration and grip strength for disability progression among those who utilized the home-help service. METHODS We prospectively followed a cohort of community-dwelling older people who were aged 65 years or older, certified support level 1-2 or care level 1-2 and home-help service users provided by Consumers' Cooperatives in Aichi and Kanagawa prefecture. Memory capability, grip strength, chronic conditions and other indices were surveyed at baseline. Disability progression was defined as being certified care level 3 or higher, or institutionalization during 3-year follow up. RESULTS We assessed 417 older adults, of which 386 were included (7.4% excluded). In multivariate Cox regression analyses, a higher eligibility level and memory deterioration were independently associated with a higher hazard ratio. When chronic conditions were entered in the model, cancer and low grip strength were additionally associated. CONCLUSIONS The findings of the present study show that memory deterioration is a risk factor for disability progression. Also, grip strength might be a risk factor with consideration of chronic conditions. The cause-effect relationship of those factors and disability progression would be a future challenging issue. Geriatr Gerontol Int 2017; 17: 568-574.
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Affiliation(s)
- Kuniyasu Kamiya
- Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuji Adachi
- Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Sasou
- Welfare Department, CO-OP AICHI Consumer Co-operative Society, Toyokawa, Japan
| | - Tadashi Suzuki
- Welfare Department, U CO-OP Consumer Co-operative Society, Yokohama, Japan
| | - Sumio Yamada
- Department of Rehabilitation Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
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11
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Olaya B, Moneta MV, Koyanagi A, Lara E, Miret M, Ayuso-Mateos JL, Chatterji S, Leonardi M, Koskinen S, Tobiasz-Adamczyk B, Lobo A, Haro JM. The joint association of depression and cognitive function with severe disability among community-dwelling older adults in Finland, Poland and Spain. Exp Gerontol 2016; 76:39-45. [PMID: 26805608 DOI: 10.1016/j.exger.2016.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 12/17/2015] [Accepted: 01/20/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. DESIGN Cross-sectional. SETTING Community-based. PARTICIPANTS Population-based sample of 7987 non-institutionalized adults aged 50 and older. MEASUREMENTS The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. RESULTS Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. CONCLUSION People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.
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Affiliation(s)
- Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Maria Victoria Moneta
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Ai Koyanagi
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Elvira Lara
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Marta Miret
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (ISS-IP), Madrid, Spain
| | - José Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (ISS-IP), Madrid, Spain
| | - Somnath Chatterji
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Seppo Koskinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Antonio Lobo
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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