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Wollesen B, Schott N, Klotzbier T, Bischoff LL, Cordes T, Rudisch J, Otto AK, Zwingmann K, Hildebrand C, Joellenbeck T, Vogt L, Schoene D, Weigelt M, Voelcker-Rehage C. Cognitive, physical and emotional determinants of activities of daily living in nursing home residents-a cross-sectional study within the PROCARE-project. Eur Rev Aging Phys Act 2023; 20:17. [PMID: 37697252 PMCID: PMC10494417 DOI: 10.1186/s11556-023-00327-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/31/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Interdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents. METHODS The study included n = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05). RESULTS Indices showed (Chi2(148) = 217, PCMIN/DF = 1.47; p < .001; Comparative Fit Index = .940; Tucker Lewes Index = .902, RMSEA = .033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p < .01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance. DISCUSSION AND CONCLUSION Objective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance. TRIAL REGISTRATION Trial registration number: DRKS00014957.
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Affiliation(s)
- Bettina Wollesen
- Department of Human Movement Science, University of Hamburg, Turmweg 2, 20148, Hamburg, Germany.
| | - Nadja Schott
- Department of Sports and Movement Science, University of Stuttgart, Stuttgart, Germany
| | - Thomas Klotzbier
- Department of Sports and Movement Science, University of Stuttgart, Stuttgart, Germany
| | - Laura Luise Bischoff
- Department of Human Movement Science, University of Hamburg, Turmweg 2, 20148, Hamburg, Germany
| | - Thomas Cordes
- Department of Human Movement Science, University of Vechta, Vechta, Germany
| | - Julian Rudisch
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Ann-Kathrin Otto
- Department of Human Movement Science, University of Hamburg, Turmweg 2, 20148, Hamburg, Germany
| | - Katharina Zwingmann
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Claudia Hildebrand
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Thomas Joellenbeck
- Department of Sport & Health Sciences, University of Paderborn, Paderborn, Germany
| | - Lutz Vogt
- Institute of Sports Sciences, Goethe-University Frankfurt, Frankfurt, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Weigelt
- Department of Sport & Health Sciences, University of Paderborn, Paderborn, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
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