1
|
Gabrys L, Schaller A, Peters S, Barzel A, Berrisch-Rahmel S, Dreinhöfer KE, Eckert K, Göhner W, Geidl W, Krupp S, Lange M, Nebel R, Pfeifer K, Reusch A, Schmidt-Ohlemann M, Sewerin P, Steindorf K, Ströhle A, Sudeck G, Wäsche H, Wolf S, Wollesen B, Thiel C. [DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research]. DAS GESUNDHEITSWESEN 2024. [PMID: 39047784 DOI: 10.1055/a-2340-1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
The DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research summarizes, for the first time, the highly interdisciplinary and interprofessional field of physical activity-based health care in the German healthcare system. In addition to providing a conceptual framework and definition of key measures and concepts in physical activity-related health care research, existing research gaps and needs are identified, and methods for advancing this relatively young field of research are described. A particular focus of this study is the relevant outcome parameters and their standardized assessment using established and valid measurement tools. The memorandum aims to establish a general understanding of the complex subject of promoting physical activity and sports therapy in the context of healthcare, to give an impulse to new research initiatives, and to integrate the currently available strong evidence on the effectiveness of physical activity and exercise into healthcare.
Collapse
Affiliation(s)
- Lars Gabrys
- ESAB Fachhochschule für Sport und Management Potsdam, Gesundheitssport und Prävention, Potsdam, Germany
| | - Andrea Schaller
- Universität der Bundeswehr München, Institut für Sportwissenschaft, Arbeitsbereich Gesundheit, Betriebliche Gesundheitsförderung und Prävention, München, Germany
| | - Stefan Peters
- Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Hürth-Efferen, Germany
- Universität der Bundeswehr, Institut für Sportwissenschaft, Arbeitsbereich Gesundheit, Betriebliche Gesundheitsförderung und Prävention, München, Germany
| | - Anne Barzel
- Universitätsklinikum Ulm, Institut für Allgemeinmedizin, Ulm, Germany
| | - Susanne Berrisch-Rahmel
- Projektgruppe PG 05 Prävention der Deutschen Gesellschaft für Kardiologie, Herz- und Kreislaufforschung e.V., Sprecherin der AG Sport und Prävention des Bundesverband niedergelassener Kardiologen e.V., Düsseldorf, Germany
| | - Karsten E Dreinhöfer
- Medical Park AG, Orthopädie und Unfallchirurgie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Katharina Eckert
- IST-Hochschule für Management GmbH, Gesundheitsmanagement & Public Health, Düsseldorf, Germany
| | - Wiebke Göhner
- Katholische Hochschule Freiburg, Bereich Gesundheitspsychologie, Freiburg, Germany
| | - Wolfgang Geidl
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Sportwissenschaft und Sport, Lehrstuhl Bewegung und Gesundheit, Erlangen, Germany
| | - Sonja Krupp
- Forschungsgruppe Geriatrie Lübeck, Krankenhaus Rotes Kreuz Lübeck - Geriatriezentrum, Lübeck, Germany
| | - Martin Lange
- IST-Hochschule für Management GmbH, Fachbereich Fitness & Gesundheit, Düsseldorf, Germany
| | - Roland Nebel
- Deutsche Gesellschaft zur Prävention und Rehabilitation von Herz-Kreislauferkrankungen e.V. (DGPR), Klinik Roderbirken der Deutschen Rentenversicherung Rheinland, Leichlingen, Germany
| | - Klaus Pfeifer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Sportwissenschaft und Sport, Lehrstuhl Bewegung und Gesundheit, Erlangen, Germany
| | - Andrea Reusch
- Zentrum Patientenschulung und Gesundheitsförderung, (ZePG e.V.), Würzburg, Germany
| | | | - Philipp Sewerin
- Ruhr-Universität Bochum, Rheumazentrum Ruhrgebiet, Bochum, Germany
| | - Karen Steindorf
- Nationales Centrum für Tumorerkrankungen (NCT) Heidelberg, DKFZ, Abteilung für Bewegung, Präventionsforschung und Krebs, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - Andreas Ströhle
- Charite Universitatsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie Campus Charité Mitte, Berlin, Germany
| | - Gorden Sudeck
- Eberhard Karls Universität Tübingen, Arbeitsbereich Bildungs- und Gesundheitsforschung im Sport, Institut für Sportwissenschaft, Tübingen, Germany
- Eberhard Karls Universität Tübingen, Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Tübingen, Germany
| | - Hagen Wäsche
- Universität Koblenz-Landau Fachbereich 3 Mathematik/Naturwissenschaften, Institut für Sportwissenschaft, Koblenz, Germany
| | - Sebastian Wolf
- Eberhard Karls Universität Tübingen, Arbeitsbereich Bildungs- und Gesundheitsforschung im Sport, Institut für Sportwissenschaft, Tübingen, Germany
| | - Bettina Wollesen
- Universität Hamburg, Arbeitsbereich Bewegungs- und Trainingswissenschaft, Fakultät für Psychologie und Bewegungswissenschaft, Hamburg, Germany
| | - Christian Thiel
- Hochschule für Gesundheit Bochum, Studienbereich Physiotherapie, Department für Angewandte Gesundheitswissenschaften, Bochum, Germany
- Ruhr-Universität Bochum, und Forschungsbereich Trainingswissenschaft, Fakultät für Sportwissenschaft, Bochum, Germany
| |
Collapse
|
2
|
Laininger L, Dietzel N, Graessel E, Prokosch HU, Kolominsky-Rabas PL. Impact of social network composition on cognitive decline: Digital Dementia Registry Bavaria (digiDEM Bayern). PLoS One 2024; 19:e0306447. [PMID: 38995919 PMCID: PMC11244788 DOI: 10.1371/journal.pone.0306447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/17/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Currently, there is no curative treatment for dementia. The implementation of preventive measures is of great importance. Therefore, it is necessary to identify and address individual and modifiable risk factors. Social isolation, defined through social networks, is a factor that may influence the onset and progression of the disease. The networks of older people are mostly composed of either family or friends. The aim of this study is to examine the influence of social isolation and network composition on cognition over the course of 12 months in people with cognitive impairment. METHODS Data basis is the multicentre, prospective, longitudinal register study 'Digital Dementia Registery Bavaria-digiDEM Bayern'. The degree of social isolation was assessed using the Lubben Social Network Scale- Revised (LSNS-R) and the degree of cognitive impairment using the Mini Mental State Examination (MMSE), conducted at baseline and after 12 months. Data were analysed using pre-post ANCOVA, adjusted for baseline MMSE, age, gender, education, living situation and Barthel-Index. RESULTS 106 subjects (78.9 ± 8.2 years; 66% female) were included in the analysis. The mean MMSE score at baseline was 24.3 (SD = 3.6). Within the friendship subscore, risk for social isolation was highly prevalent (42.5%). Though, there was no difference between individuals with higher/ lower risk of social isolation within the friendship-network after adjusting for common risk factors in cognitive decline over time, F (1,98) = .046, p = .831, partial η2 = .000. CONCLUSION The results of this study showed that the risk of social isolation from friends is very high among people with cognitive impairment. However, social isolation does not appear to have a bearing influence on the course of cognition. Nevertheless, it is important for people with cognitive impairment to promote and maintain close social contacts with friends.
Collapse
Affiliation(s)
- Lisa Laininger
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nikolas Dietzel
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Elmar Graessel
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hans-Ulrich Prokosch
- Chair of Medical Informatics, Department of Medical Informatics, Biometrics and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter L. Kolominsky-Rabas
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
3
|
Axmon A, Mattisson K, Lethin C, Fänge AM, Carlsson G, Stroh E. Access to urban green spaces and use of social services and institutional long-term care among older people in Malmö, Sweden: a longitudinal register study. BMC Geriatr 2024; 24:489. [PMID: 38834961 PMCID: PMC11151513 DOI: 10.1186/s12877-024-05112-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Finding ways to prolong independence in daily life among older people would be beneficial for both individuals and society. Urban green spaces have been found to improve health, but only a few studies have evaluated the association between urban green spaces and independence in daily life. The aim of this study was to assess the long-term effect of urban green spaces on independence in daily life, using social services and support, mobility aids, and relocation to institutional long-term care as proxies, among community dwelling people 65 + years. METHODS We identified 40 357 people 65 + years living in the city of Malmö, Sweden in 2010. Using geographical information systems (GIS), we determined the amount of urban green spaces (total, public, and quiet) within 300 m of each person's residence. All three measures were categorized based on their respective percentiles, so that the first quartile represented the 25% with the least access and the fourth quartile the 25% with the most access. In 2015 and 2019, we assessed the outcomes minor assistance (non-personal support), major assistance (personal support), and relocation into institutional long-term care. These three outcome measures were used as proxies for independence in daily life. The effect of amount of urban green spaces in 2010 on the three outcomes in 2015 and 2019, respectively, was assessed by pairwise comparing the three highest quartiles to the lowest. RESULTS Compared to the lowest quartile, those in the highest quartile of quiet green spaces in 2010 were less likely to receive minor assistance in both 2015 and 2019. Besides this, there were no indications that any of the measures of urban green space affected independence in daily life at the five- and nine-year follow-up, respectively. CONCLUSION Although urban green spaces are known to have positive impact on health, physical activity, and social cohesion among older people, we found no effect of total, public, or quiet green spaces on independence in daily life. This could possibly be a result of the choice of measures of urban green spaces, including spatial and temporal aspects, an inability to capture important qualitative aspects of the green spaces, or the proxy measures used to assess independence in daily life.
Collapse
Affiliation(s)
- Anna Axmon
- EPI@LUND (Epidemiology, population research, and infrastructures), Department of Laboratory Medicine, Lund University, Biskopsgatan 9, Lund, SE-223 62, Sweden.
| | - Kristoffer Mattisson
- Planetary Health, Department of Laboratory Medicine, Lund University, Biskopsgatan 9, Lund, SE- 223 62, Sweden
| | - Connie Lethin
- Department of Health Sciences, Lund University, P.O. Box 117, Lund, SE-22362, Sweden
| | - Agneta Malmgren Fänge
- Department of Health Sciences, Lund University, P.O. Box 117, Lund, SE-22362, Sweden
| | - Gunilla Carlsson
- Department of Health Sciences, Lund University, P.O. Box 117, Lund, SE-22362, Sweden
| | - Emilie Stroh
- EPI@LUND (Epidemiology, population research, and infrastructures), Department of Laboratory Medicine, Lund University, Biskopsgatan 9, Lund, SE-223 62, Sweden
| |
Collapse
|
4
|
Zilbershlag Y. From Hospital to Home: Validating a Cognitive-Functional Evaluation of Elders (COFEE-HD). Can J Occup Ther 2024:84174241240226. [PMID: 38783783 DOI: 10.1177/00084174241240226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Background. Increase in hospitalizations of older adults emphasizes the need for efficient hospital discharge planning to enable optimal reentry upon returning home. Yet few assessments offer an extensive picture of the older adult's functional-cognitive state. A comprehensive assessment for discharge planning together with a written summary can be beneficial to the older adult and family. Purpose. This quantitative study compared a modified version of a previously validated tool COFEE (cognitive OT functional evaluation of elders), for use in the hospital, HD (hospital discharge) with standard hospitals assessments. Methods. Of the 77 participants recruited in hospital, home assessments were conducted 4 months later on 64 participants. Findings. The COFEE-HD scores (physical functioning, personal and environmental safety and meta cognitive functioning) were significantly correlated with standard hospital measures and with the home assessment. Implications. The COFEE-HD was found to have a high level of validity in a hospital setting, and the resulting evaluation can provide important insights into function, safety and cognitive function for post-discharge behaviors.
Collapse
|
5
|
Sait MI, Christie RA, Cox C, Board M, Thomas S, O'Sullivan C, Davies C, Walker DM, Vassallo M, Sadler EA, Allen-Pick M, Moore P, Bradbury K, Murphy J. DIALOR (DIgitAL cOaching for fRailty): protocol for a single-arm mixed-methods feasibility study of a digital health coaching intervention for older people with frailty in primary care. BMJ Open 2024; 14:e080480. [PMID: 38760042 PMCID: PMC11103224 DOI: 10.1136/bmjopen-2023-080480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/15/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Multidomain interventions in older adults offer the best opportunity to prevent, delay or reverse existing symptoms in the earlier stages of frailty and improve independence but can be costly, and difficult to deliver at scale. However, digital health interventions enable personalised care and empowerment through self-management of long-term conditions, used at any time and when combined with health coaching offer the potential to enhance well-being and facilitate the achievement of health-related goals. We aim to evaluate the feasibility and acceptability of a digital health platform for long-term disease management combined with health coaching for people living with mild-moderate frailty, targeting self-identified goals-activity, nutrition, mood, enhancing social engagement and well-being. METHODS AND ANALYSIS This is a non-randomised feasibility, single-group, pretest/post-test study, using qualitative and quantitative methods. The digital health coaching intervention (DIALOR-DIgitAL cOaching for fRailty) has been developed for implementation to older adults, aged 65 years or older with mild to moderate frailty and diagnosis of one or more long-term health conditions in the community. Participants will receive 12 weeks of health coaching and have access to a mobile health platform for 6 months. The primary outcome measure is the acceptability and feasibility of DIALOR along with a range of secondary outcome measures (including frailty, functioning measures, quality of life, social engagement, diet quality and self-reported indicators) collected at baseline and at 6 months. The findings will inform whether a wider effectiveness trial is feasible and if so, how it should be designed. ETHICS AND DISSEMINATION Ethical approval has been granted by the Southeast Scotland Research Ethics Committee 02 (reference: 22/SS/0064). Research findings will be disseminated in a range of different ways to engage different audiences, including publishing in open-access peer-reviewed journals, conference presentations, social media, dissemination workshop with patients, carers, and healthcare professionals and on institution websites.
Collapse
Affiliation(s)
- Matthew I Sait
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Rachel A Christie
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Chantel Cox
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Michele Board
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Sarah Thomas
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | | | - Cheryl Davies
- Wessex Academic Health Science Network, Chilworth, UK
| | - Dawn-Marie Walker
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Michael Vassallo
- Older Person Medicine, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
| | - E A Sadler
- Faculty of Environmental and Life Sciences, School of Health Sciences, University of Southampton, Southampton, UK
| | - Mark Allen-Pick
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | | | | | - Jane Murphy
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| |
Collapse
|
6
|
Kelbling E, Ferreira Prescott D, Shearer M, Quinn TJ. An assessment of the content and properties of extended and instrumental activities of daily living scales: a systematic review. Disabil Rehabil 2024; 46:1990-1999. [PMID: 37415395 DOI: 10.1080/09638288.2023.2224082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/27/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE We performed a systematic review to assess the psychometric properties of extended Activities of Daily Living (eADL) scales. MATERIALS AND METHODS Articles assessing eADL scales' properties were retrieved by searching multidisciplinary databases, and reference screening. Data on the following properties were extracted: validity, reliability, responsiveness, and internal consistency. The COSMIN (Consensus-based Standards for the selection of health status Measurement Instruments) risk of bias checklists are used to assess the quality of included articles. All aspects were performed by two independent researchers. RESULTS Of 245 titles, 26 articles were eligible, comprising 15 different eADL scales. The Lawton scale had the most papers describing properties, while the Performance-based Instrumental Activities of Daily Living received the highest COSMIN rating. Properties most often assessed were convergent validity and reliability, no articles assessed all COSMIN properties. The COSMIN assessment rated 43% of the properties as 'positive', 31% 'doubtful' and 26% 'inadequate'. Only Lawton was assessed in more than one paper, available data suggest that this scale has excellent reliability, construct validity, internal consistency, and medium criterion validity. CONCLUSION Despite their common use, there are limited data on the properties of eADL scales. Where data are available there are potential methodological issues in the studies.
Collapse
Affiliation(s)
- Eline Kelbling
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | - Mary Shearer
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
7
|
Pomiersky R, Matting L, Haigis D, Eschweiler GW, Frahsa A, Niess A, Thiel A, Sudeck G. Physical Activity, Sedentary Behavior, and Their Predictors Among Nursing Home Residents-Cross-Sectional Results of the BaSAlt Study. J Aging Phys Act 2024:1-10. [PMID: 38589013 DOI: 10.1123/japa.2023-0088] [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: 03/27/2023] [Revised: 12/04/2023] [Accepted: 02/23/2024] [Indexed: 04/10/2024]
Abstract
Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = -0.27, p = .008), body mass index (β = -0.29, p = .002), Barthel Index (β = 0.24, p = .040), and hand grip strength (β = 0.30, p = .048). SB was significantly predicted by body mass index (β = 0.27, p = .008) and Barthel Index (β = -0.30, p = .012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB.
Collapse
Affiliation(s)
- Rebekka Pomiersky
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Leon Matting
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Daniel Haigis
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Gerhard W Eschweiler
- Center for Geriatric Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Andreas Niess
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Gordon Sudeck
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| |
Collapse
|
8
|
de Rooij AM, Maier AB, Trompet S, Meskers CGM. Pre-stroke activities of daily living do not predict functional decline after stroke in a cohort of community dwelling older subjects at risk for vascular disease. Arch Gerontol Geriatr 2024; 117:105174. [PMID: 37677863 DOI: 10.1016/j.archger.2023.105174] [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] [Received: 07/04/2023] [Revised: 08/10/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND & PURPOSE Pre-stroke impairment of activities of daily living (ADL) is considered a major determinant for functional outcome after stroke. However, findings are based on studies in stroke patients in which pre-stroke information is gathered retrospectively, with inherent risks of selection and recall bias. The objective of this study was to verify the predictive value of pre-stroke ADL with respect to ADL decline in a large prospective cohort of community dwelling older subjects with known vascular risk factors or vascular disease, thereby minimizing selection and recall bias. METHODS Within the four-year study follow-up of a cohort including 5,804 community dwelling older subjects from three countries at risk for vascular disease, incident stroke survivors were identified. Incident myocardial infarction (MI) survivors and the remaining study survivors without incident vascular events served as comparison groups. Multivariate logistic regression analyses for each of the aforementioned groups were performed to assess associations between pre-stroke ADL by the Barthel Index (BI) and Instrumental Activities of Daily Living (IADL) scale and risk for ADL decline. RESULTS In stroke survivors, neither pre-event BI (n = 230, OR 1.00 (95% CI 0.83-1.23)) nor IADL (OR 1.07 (95% CI 0.94 - 1.20)) predicted risk of post-stroke ADL decline in contrast to ADL decline after MI (n = 443, OR 0.83 (95% CI 0.70-0.98) and 0.87 (95% CI 0.78-0.97) respectively) and the group without vascular events (n = 4336, OR 0.85 (95% CI 0.78-0.92) and 0.87 (95% CI 0.83-0.92) respectively). CONCLUSIONS In the present prospective cohort of community dwelling older subjects with known vascular risk factors, pre-stroke ADL measured by BI and IADL scale did not predict post-stroke ADL decline.
Collapse
Affiliation(s)
- Annetje M de Rooij
- Department of Rehabilitation Medicine, Maasstad Hospital, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore
| | - Stella Trompet
- Department of Internal Medicine, section of Gerontology and Geriatrics, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.
| |
Collapse
|
9
|
Narayan A, Goncharova M, Goncharov M, Gostine A, Shah NR, Kaplan RM. Continuous monitoring of eating and sleeping behaviors in the home environments of older adults: a case study demonstration. Front Public Health 2024; 11:1277714. [PMID: 38283288 PMCID: PMC10811267 DOI: 10.3389/fpubh.2023.1277714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/01/2023] [Indexed: 01/30/2024] Open
Abstract
Accurate observation of patient functioning is necessary for rigorous clinical research and for improving the quality of patient care. However, clinic or laboratory environments systematically differ from the contexts of everyday life. Further, assessments that are completed in a single institutional session may not be generalizable. Here, we describe a computer vision methodology that measures human functioning continuously in the environments where patients live, sleep, and eat.
Collapse
Affiliation(s)
- Aditya Narayan
- Stanford University School of Medicine, Palo Alto, CA, United States
| | | | | | - Andrew Gostine
- Artisight, Chicago, IL, United States
- Northwestern Medicine, Chicago, IL, United States
| | - Nirav R. Shah
- Department of Medicine, Clinical Excellence Research Center, Stanford University, Palo Alto, CA, United States
| | - Robert M. Kaplan
- Department of Medicine, Clinical Excellence Research Center, Stanford University, Palo Alto, CA, United States
| |
Collapse
|
10
|
Bjerregaard P, Ottendahl CB, Jensen T, Nørtoft K, Jørgensen ME, Larsen CVL. Muscular strength, mobility in daily life and mental wellbeing among older adult Inuit in Greenland. The Greenland population health survey 2018. Int J Circumpolar Health 2023; 82:2184751. [PMID: 36880125 PMCID: PMC10013347 DOI: 10.1080/22423982.2023.2184751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
The purpose was to analyse the association of muscular strength, muscle pain and reduced mobility in daily life with mental wellbeing among older Inuit men and women in Greenland. Data (N = 846) was collected as part of a countrywide cross-sectional health survey in 2018. Hand grip strength and 30-seconds chair stand test were measured according to established protocols. Mobility in daily life was assessed by five questions about the ability to perform specific activities of daily living. Mental wellbeing was assessed by questions about self-rated health, life satisfaction and Goldberg's General Health Questionnaire. In binary multivariate logistic regression models adjusted for age and social position, muscular strength (OR 0.87-0.94) and muscle pain (OR 1.53-1.79) were associated with reduced mobility. In fully adjusted models, muscle pain (OR 0.68-0.83) and reduced mobility (OR 0.51-0.55) but were associated with mental wellbeing. Chair stand score was associated with life satisfaction (OR 1.05). With an increasingly sedentary lifestyle, increasing prevalence of obesity and increasing life expectancy the health consequences of musculoskeletal dysfunction are expected to grow. Prevention and clinical handling of poor mental health among older adults need to consider reduced muscle strength, muscle pain and reduced mobility as important determinants.
Collapse
Affiliation(s)
- Peter Bjerregaard
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Denmark
| | | | - Tenna Jensen
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Denmark.,Institute of Nursing and Health Science, University of Greenland, Greenland
| | - Kamilla Nørtoft
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Denmark
| | - Marit Eika Jørgensen
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Denmark.,Institute of Nursing and Health Science, University of Greenland, Greenland.,Steno Diabetes Center Greenland, Nuuk, Greenland.,Steno Diabetes Center Copenhagen, Denmark
| | - Christina Viskum Lytken Larsen
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Denmark.,Institute of Nursing and Health Science, University of Greenland, Greenland
| |
Collapse
|
11
|
Williams T, Geffen L, Kalula S, Stein DJ, Amuthavalli Thiyagarajan J, Mikton C, Diaz T. A systematic review of measures of ability to meet basic needs in older persons. Age Ageing 2023; 52:iv112-iv117. [PMID: 37902519 PMCID: PMC10615038 DOI: 10.1093/ageing/afad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND The ability of older persons to meet their basic needs (i.e. personal, financial and housing security), as well as to perform Activities of Daily Living (ADL), is crucial. It is unclear, however, whether such measures exist. This systematic review aimed to review English-language measures of the ability of older persons to meet their basic needs, and to critically review the comprehensiveness of these measures and their psychometric properties. METHODS Fifteen electronic databases including PubMed, EBSCOhost and CINAHL were systematically searched for studies of measures that assessed the ability of older persons to meet their basic needs, as defined by the World Health Organization. Two review authors independently assessed the studies for inclusion in the review and evaluated their comprehensiveness and psychometrics. RESULTS We found seven instruments from 62 studies that assessed multi-domain function including ADL and some elements of basic needs. The instruments varied in breadth and in reporting of key psychometric criteria. Further, no single instrument provided a comprehensive assessment of the ability of older persons to meet their basic needs. CONCLUSION No single instrument that measures the ability to meet basic needs was identified by this review. Further research is needed to develop an instrument that assesses the ability of older persons to meet their basic needs. This measure should include an evaluation of ADL.
Collapse
Affiliation(s)
- Taryn Williams
- The Samson Institute for Ageing Research, Cape Town, South Africa
- SAMRC Unit on Risk & Resilience for Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Leon Geffen
- The Samson Institute for Ageing Research, Cape Town, South Africa
- The Albertina and Walter Sisulu Institute of Ageing in Africa, Department of Medicine, University of Cape Town/Groote Schuur Hospital, International Longevity Centre, Cape Town, South Africa
| | - Sebastiana Kalula
- The Albertina and Walter Sisulu Institute of Ageing in Africa, Department of Medicine, University of Cape Town/Groote Schuur Hospital, International Longevity Centre, Cape Town, South Africa
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience for Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | | | - Christopher Mikton
- Demographic Change and Healthy Ageing Unit, Department of Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Theresa Diaz
- Epidemiology, Monitoring and Evaluation Unit, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| |
Collapse
|
12
|
Banadinović M, Vočanec D, Lukačević Lovrenčić I, Lončarek K, Džakula A. Role and perspectives of informal care: a qualitative study of informal caregivers in the Republic of Croatia. BMJ Open 2023; 13:e074454. [PMID: 37827736 PMCID: PMC10582946 DOI: 10.1136/bmjopen-2023-074454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVES Population ageing and the prevalence of multimorbidity represent major challenges for healthcare systems. People who need long-term care have complex conditions requiring both health and social services. Informal caregivers are emerging as an important part of the long-term care ecosystem. This paper aims to explore the position and capacities of informal caregivers in Croatia. DESIGN Health and social care legislative documents were analysed using a structured set of keywords. In addition, focus groups were conducted with informal caregivers who cared for a family member. The qualitative method of thematic analysis was used. SETTING AND PARTICIPANTS Two focus groups were conducted with 15 caregivers (13 women and 2 men). Geographically, participants came from all four NUTS2 Croatian regions. All participants cared for a close family member. The length of care provision ranged from 3 to 35 years. Focus groups were conducted using the Zoom platform. RESULTS The analysis of the documents indicates the fragmentation of national policy into health and social policy. Long-term care as a term is recognised only in health policy. However, some components related to long-term care are part of social policy. Caregivers are recognised in social policy, although not in healthcare. In focus groups, three main themes were identified as follows: (1) position and role of the caregivers in the system and society; (2) types of care based on the recipient's need and (3) support for the caregivers. CONCLUSION The research showed that the process of exercising certain rights and services for caregivers is not sufficiently clear and feasible in practice. There is a lack of a clearly defined role of caregivers and relationships towards professional care providers in the system. The key to improving long-term care is connecting community services, including health and social services, both formal and informal, with the process of providing care.
Collapse
Affiliation(s)
- Maja Banadinović
- Firefly - Association for Helping Children and Families Facing Malignant Diseases, Zagreb, Croatia
| | - Dorja Vočanec
- Department of Social Medicine and Organization of Health Care, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Iva Lukačević Lovrenčić
- Department of Social Medicine and Organization of Health Care, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Karmen Lončarek
- Department of Integrated and Palliative Care, Rijeka University Hospital Center, Rijeka, Croatia
| | - Aleksandar Džakula
- Department of Social Medicine and Organization of Health Care, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| |
Collapse
|
13
|
Nakatake J, Arakawa H, Shogo M, Totoribe K, Chosa E. Effect of age on upper limb, neck, and trunk kinematics during activities of daily living. Heliyon 2023; 9:e20535. [PMID: 37829804 PMCID: PMC10565693 DOI: 10.1016/j.heliyon.2023.e20535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023] Open
Abstract
Motion analysis during activities of daily living has been conducted in numerous studies. However, information is lacking regarding age-related differences that affect clinical assessment and treatment goals. This study aimed to examine the effect of age on kinematics during activities of daily living. Three-dimensional motions of the shoulder, elbow, neck, and trunk of 12 younger adults (age, 29.8 ± 5.4 years; 7 men and 5 women) and 10 older adults (age, 69.5 ± 4.9 years; 6 men and 4 women) were measured during the acts of reaching for a table, bringing a glass to the mouth for drinking, wiping the buttocks, tying shoelaces, washing hair, washing the axilla, reaching for a high shelf, and reaching for the floor. The ranges of motion and sequential joint angles were compared between age groups by using discrete analysis and statistical parametric mapping, respectively. The ranges of motion of all joint angles in older and younger adults were comparable in the drinking, washing hair, washing the axilla, and reaching for the floor tasks. Statistical parametric mapping indicated that older adults had significantly poorer neck extension than did younger adults during the drinking (67-92% cycle time) and tying shoelaces (64-95% cycle time) tasks. Kinematics were mostly maintained in healthy older adults during activities of daily living. However, reduced motions were confirmed later during some tasks. The results indicated that existing knowledge combined with the current findings, which take age into account, could be used in clinical settings to assess the kinematics of activities of daily living and set treatment goals.
Collapse
Affiliation(s)
- Jun Nakatake
- Rehabilitation Unit, University of Miyazaki Hospital, Kiyotake-cho Kihara 5200, Miyazaki, 889-1692, Japan
| | - Hideki Arakawa
- Rehabilitation Unit, University of Miyazaki Hospital, Kiyotake-cho Kihara 5200, Miyazaki, 889-1692, Japan
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Kiyotake-cho Kihara 5200, Miyazaki, 889-1692, Japan
| | - Maeda Shogo
- Rehabilitation Unit, University of Miyazaki Hospital, Kiyotake-cho Kihara 5200, Miyazaki, 889-1692, Japan
| | - Koji Totoribe
- Department of Rehabilitation, Miyazaki City Tano Hospital, Tano-cho Minamibaru 1-6-2, Miyazaki, 889-1704, Japan
| | - Etsuo Chosa
- Rehabilitation Unit, University of Miyazaki Hospital, Kiyotake-cho Kihara 5200, Miyazaki, 889-1692, Japan
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Kiyotake-cho Kihara 5200, Miyazaki, 889-1692, Japan
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Pan Y, Xu M, Mei Y, Wang Y, Zhang Q. Activities of daily living predict periprocedural myocardial infarction and injury following percutaneous coronary intervention: a cross-sectional study. BMC Cardiovasc Disord 2023; 23:427. [PMID: 37644419 PMCID: PMC10466711 DOI: 10.1186/s12872-023-03468-5] [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] [Received: 06/07/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND In recent years, there has been growing interest in exploring the relationship between activities of daily living (ADL) and cardiovascular diseases. This retrospective cross-sectional study aimed to investigate the association of ADL measured by Barthel index (BI) with periprocedural myocardial infarction (PMI) and injury following percutaneous coronary intervention (PCI). METHODS Enrolled patients were stratified into impaired and unimpaired ADL groups according to their BI scores. Logistic regressions were conducted to explore the association of ADL on admission with periprocedural myocardial injury and infarction. Restricted cubic spline (RCS) curve and subgroup analysis were also performed. RESULTS Totally, 16.4% of patients suffered from PMI; the mean age was 65.8 ± 10.4 years old. RCS analysis showed that the morbidity of periprocedural myocardial infarction and injury showed a downward tendency with increasing BI scores. Multivariable logistic regression analysis demonstrated that impaired ADL was an independent risk factor for periprocedural myocardial infarction (OR = 1.190, 95% CI [1.041, 1.360], P = 0.011) and injury (OR = 1.131, 95% CI [1.017, 1.257], P = 0.023). Subgroup analysis showed that the association between ADL and PMI was founded in several subgroups, while the association between ADL and periprocedural myocardial injury was founded only in BMI ≥ 24 kg/m2 subgroup. CONCLUSION Impaired ADL at hospital admission was an independent risk factor for periprocedural myocardial infarction and injury among patients following PCI.
Collapse
Affiliation(s)
- Yifan Pan
- Department of Cardiology, Yongkang People's Hospital, Yongkang, Zhejiang, 321300, China
| | - Min Xu
- Department of Cardiology, Yongkang People's Hospital, Yongkang, Zhejiang, 321300, China
| | - Yaosheng Mei
- Department of Cardiology, Yongkang People's Hospital, Yongkang, Zhejiang, 321300, China
| | - Yunxiang Wang
- Department of Cardiology, Yongkang People's Hospital, Yongkang, Zhejiang, 321300, China
| | - Qiongli Zhang
- Department of Cardiology, Yongkang Hospital, Yongkang, Zhejiang, 321300, China.
| |
Collapse
|
16
|
Vargas Matamala M, Tapia C, Salvador Sagüez F, Guerrero-Henriquez J. Postural performance assessment in aging people with diabetes and diabetic peripheral neuropathy using a Wii balance board. Disabil Rehabil 2023; 45:1202-1207. [PMID: 35369833 DOI: 10.1080/09638288.2022.2055168] [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: 11/03/2022]
Abstract
PURPOSE To determine the effect of sensory perturbations on static postural control in older people with type 2 diabetes mellitus by comparing postural outcomes of people with and without diabetic neuropathy using a Wii Balance Board (WBB). MATERIALS AND METHODS Static postural balance assessments were performed in 31 participants: nine with type 2 diabetes mellitus; 12 with diabetic neuropathy; and 10 non-diabetic controls. Participants stood on the WBB under sensory perturbations (visual and proprioceptive). Body balance was analysed using centre of pressure ellipse area, mean velocity, and sample entropy. The effects of within-participant factors, sensory perturbations and the between-participants factor 'group' on outcomes were analysed using a multivariate analysis of variance model. RESULTS Type 2 diabetes mellitus participants with and without neuropathy showed altered postural performance under sensory perturbations compared to non-diabetic participants. Moreover, participants with diabetic neuropathy showed impaired postural performance when one perceptual system was disturbed. Finally, participants with type 2 diabetes mellitus without neuropathy decreased their postural performance when both sensory disturbances were present. CONCLUSIONS The Wii Balance Board can be a useful alternative for balance impairment screening related to diabetic neuropathy and contribute as an affordable source of insight in early interventions in integral diabetes care.Implications to rehabilitationOlder people with diabetic peripheral neuropathy depend on visual and somatosensory cues to keep their static postural balance.Static balance assessment using the Wii Balance Board allows the identification of alterations in postural performance in participants with diabetes.This low-cost method used can be considered as a complement to integral diabetes care.
Collapse
Affiliation(s)
- Martin Vargas Matamala
- Department of Rehabilitation Sciences and Human Movement, University of Antofagasta, Antofagasta, Chile
| | - Claudio Tapia
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Juan Guerrero-Henriquez
- Department of Rehabilitation Sciences and Human Movement, University of Antofagasta, Antofagasta, Chile
| |
Collapse
|
17
|
Meredith SJ, Roberts H, Grocott MPW, Jack S, Murphy J, Varkonyi-Sepp J, Bates A, Lim SER. Frail2Fit study protocol: a feasibility and acceptability study of a virtual multimodal intervention delivered by volunteers to improve functional outcomes in older adults with frailty after discharge from hospital. BMJ Open 2023; 13:e069533. [PMID: 36927597 PMCID: PMC10030662 DOI: 10.1136/bmjopen-2022-069533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Physical activity (PA) and replete nutritional status are key to maintaining independence and improving frailty status among frail older adults. In response to the COVID-19 pandemic, healthcare has increasingly turned to virtual modes of delivery and there is interest in the use of trained volunteers to deliver PA and nutrition interventions. We aim to evaluate the feasibility and acceptability of training hospital volunteers to deliver an online intervention, comprising exercise, behaviour change and nutrition support, to older people with frailty after discharge from hospital. METHODS We will use a quasi-experimental mixed methods approach. Hospital volunteers (n=6) will be trained to deliver an online, 3-month, multimodal intervention to frail (Clinical Frailty Scale ≥5) adults ≥65 years (n=30) after discharge from hospital. Feasibility will be assessed by determining the number of volunteers recruited, trained and retained at the end of the study; the proportion of intervention sessions delivered; participant recruitment, retention and adherence to the intervention. To determine the acceptability of the intervention, interviews will be conducted among a purposive sample of older adults, and volunteers. Secondary outcomes will include physical function, appetite, well-being, quality of life, anxiety and depression, self-efficacy for managing chronic disease and PA. Outcomes will be measured at baseline, 3 months and 6 months. ANALYSIS Descriptive statistics will be used to describe feasibility and adherence to the intervention. Secondary outcomes at baseline will be compared at 3 and 6 months. Interviews will be transcribed verbatim and analysed using thematic analysis. ETHICS AND DISSEMINATION Health Research Authority ethical approval was obtained on 30 May 2022 (reference: 22/WA/0155). Results will be disseminated through peer-reviewed journal articles, volunteer organisations, National Health Service communication systems and social media platforms. A toolkit will be developed to facilitate roll out of volunteer training. TRIAL REGISTRATION NUMBER NCT05384730.
Collapse
Affiliation(s)
- Samantha Jane Meredith
- Academic Geriatric Medicine, University of Southampton Faculty of Medicine, Southampton, Hampshire, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
| | - Helen Roberts
- Academic Geriatric Medicine, University of Southampton Faculty of Medicine, Southampton, Hampshire, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
| | - Michael P W Grocott
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
- Clinical and Experimental Science, University of Southampton, Southampton, UK
| | - Sandy Jack
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
- Clinical and Experimental Science, University of Southampton, Southampton, UK
| | - Jane Murphy
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Judit Varkonyi-Sepp
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
- Clinical and Experimental Science, University of Southampton, Southampton, UK
- Clinical Health Psychology Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andrew Bates
- Clinical and Experimental Science, University of Southampton, Southampton, UK
- Nursing, Midwifery, and Health, University of Southampton, Southampton, UK
| | - Stephen Eu Ruen Lim
- Academic Geriatric Medicine, University of Southampton Faculty of Medicine, Southampton, Hampshire, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
| |
Collapse
|
18
|
Eating Difficulties and Relationship With Nutritional Status Among Patients With Dementia. THE JOURNAL OF NURSING RESEARCH : JNR 2023; 31:e260. [PMID: 36602459 DOI: 10.1097/jnr.0000000000000538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND One of the most common behavioral problems in patients with dementia is eating problems, which are known to increase the risk of malnutrition. However, few studies have been conducted in this patient group regarding the relationship between eating difficulties and nutritional status. PURPOSE This study was designed to determine the eating difficulties faced by patients with dementia and to evaluate the relationship in this population between eating difficulties and malnutrition. METHODS This study was carried out in a dementia outpatient clinic of a university hospital in Istanbul, Turkey. This cross-sectional, case-control study included 50 patients and 50 healthy controls as participants. Participants were assessed for eating difficulties and for nutritional, cognitive, and functional statuses. RESULTS The patients with dementia had more difficulties in terms of self-feeding skills. Although problems related to manipulating food on the plate and the use of utensils were not seen in the control group, these problems were found in 30% of the participants in the dementia group ( p < .001). Moreover, 30% of the patients in the dementia group were unable to eat without assistance ( p < .001). Associations were found between eating difficulties and age, duration of illness, and cognitive and functional (basic and instrumental activities of daily living) statuses. In addition, self-feeding skills were found to be associated with nutritional status. Rate of malnutrition or risk of malnutrition was higher in patients with dementia than in those in the control group. CONCLUSIONS In this study, compared with the control group, patients with dementia had more problems in self-feeding skills such as manipulation of food on a plate, use of utensils, need for assistive tools, ability to eat without assistance, and negative eating behaviors (refusal to eat). An association was found between eating difficulties and nutritional status. Evaluating eating difficulties is recommended in patients with dementia to prevent nutritional deterioration.
Collapse
|
19
|
Billeret A, Rousseau C, Thirion R, Baillard-Cosme B, Charras K, Somme D, Thibault R. Assessment of Food Intake Assisted by Photography in Older People Living in a Nursing Home: Maintenance over Time and Performance for Diagnosis of Malnutrition. Nutrients 2023; 15:nu15030646. [PMID: 36771353 PMCID: PMC9920108 DOI: 10.3390/nu15030646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023] Open
Abstract
Malnutrition is related to poor outcomes. Food intake semi-quantitative assessment is helpful for malnutrition screening. Aims: to assess maintenance over one month of one-day semi-quantitative assessment of food intake (primary aim) and its performance in diagnosing malnutrition (secondary aim) in older people living in a nursing home. Food portions consumed at lunch and dinner were measured during 20 days by the Simple Evaluation of Food Intake (SEFI)® assisted by photography (SEFI®-AP) in 70 residents. Nutritional status was assessed in each patient during the first week of food intake monitoring according to Global Leadership Initiative on Malnutrition criteria. Food intake was decreased, i.e., SEFI®-AP < 7, in 39% (n = 27/73) of patients. According to the methods, 36 to 48% (n = 25 to 33/73) of patients had malnutrition, and 6 to 37% (n = 4 to 25/73) sarcopenia. According to a generalized linear model on ranks with repeated measures, the SEFI®-AP medians of lunch (p = 0.11) and means of lunch and dinner (p = 0.15) did not vary over time. Day 3 SEFI®-AP anticipated decreased food intake from days 4 to 20, with a sensitivity of 78% (95% confidence interval (CI), 62-94), a specificity of 30% [95%CI, 17-44] and positive and negative predictive values of 41% [95%CI, 28-55] and 68% [95%CI, 48-89]. The performance of SEFI®-AP for diagnosis of malnutrition using calf circumference <31 cm as a phenotypic criterion was correct: area under the curve = 0.71 [95%CI, 0.59-0.83]. SEFI®-AP sensitivity was better if ≤9.5 than <7, and inversely for specificity. The food intake of older people living in nursing homes is stable over one month. One-day SEFI®-AP correctly anticipates food intake during the following month and predicts diagnosis of malnutrition. Any decrease in food intake should lead to suspect malnutrition.
Collapse
Affiliation(s)
- Anne Billeret
- CHU Rennes, Service d’Endocrinologie-Diabétologie-Nutrition, Centre labellisé de Nutrition Parentérale au Domicile, INRAE, INSERM, Univ Rennes, NuMeCan, Nutrition Metabolisms Cancer, F-35000 Rennes, France
| | | | - Rémy Thirion
- CHU Rennes, Service de Gériatrie, F-35000 Rennes, France
| | | | - Kevin Charras
- CHU Rennes, Living Lab Vieillissement et Vulnérabilités, F-35000 Rennes, France
| | - Dominique Somme
- CHU Rennes, Living Lab Vieillissement et Vulnérabilités, F-35000 Rennes, France
- CHU Rennes, Service de Gériatrie, CNRS, Arènes—UMR 6051, Inserm, RSMS—U 1309, Living Lab Vieillissement et Vulnérabilités, Univ Rennes, F-35000 Rennes, France
| | - Ronan Thibault
- CHU Rennes, Service d’Endocrinologie-Diabétologie-Nutrition, Centre labellisé de Nutrition Parentérale au Domicile, INRAE, INSERM, Univ Rennes, NuMeCan, Nutrition Metabolisms Cancer, F-35000 Rennes, France
- Correspondence:
| |
Collapse
|
20
|
Liao MC, Yen CC, Lin YT, Huang FD, Chang YT. Sarcopenia is associated with mortality in non-critical elderly patients visiting the emergency department. Front Med (Lausanne) 2023; 9:1027503. [PMID: 36714126 PMCID: PMC9874113 DOI: 10.3389/fmed.2022.1027503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/14/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Geriatric syndrome (GS) increases risk of disability and mortality in older adults. Sarcopenia is a predominant illness of GS and accelerate its progression. This study aimed to investigate associations between mortality, emergency department (ED) re-visits and GS-related illnesses among older adults who visited the ED. Method This retrospective observational study enrolled elderly patients who visited the ED in our hospital between January 2018 and October 2020. Patients were evaluated for potential sarcopenia, which was defined by both low handgrip strength and calf circumference. Follow-up was at least 6 months. Data of age, gender, mortality, ED re-visits, and GS-related illnesses were collected and analyzed for associations. Results A total of 273 older adults aged 74 years or older were included, of whom 194 were diagnosed with possible sarcopenia. Older adults with possible sarcopenia also had significantly lower body mass index (BMI); a higher proportion needed assistance with daily activities; more had malnutrition, frailty, and history of falls (all p < 0.001) and acute decline in activities of daily living (p = 0.027). Multivariate analysis showed that possible sarcopenia [adjusted hazard ratio, aHR): 9.89, 95% confidence interval (CI): 1.17-83.81, p = 0.036], living in residential institutions (aHR: 2.85, 95% CI: 1.08-7.50, p = 0.034), and frailty (aHR: 7.30, 95% CI: 1.20-44.62, p = 0.031) were associated with mortality. Aged over 85 years (adjusted odds ratio: 2.44, 95% CI: 1.25-4.80, p = 0.02) was associated with ED re-visits. Conclusion Sarcopenia is associated with mortality among older adults who visit ED. Initial screening for sarcopenia and relevant risk factors among older adults in the ED may help with early intervention for those at high-risk and may improve their prognosis.
Collapse
Affiliation(s)
- Mei-Chen Liao
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Cheng-Chang Yen
- Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Yuh-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Fong-Dee Huang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Yun-Te Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan,School of Medicine, National Yang-Ming University, Taipei City, Taiwan,Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, Taiwan,Department of Emergency & Critical Care Medicine, Pingtung Veterans General Hospital, Pingtung City, Taiwan,*Correspondence: Yun-Te Chang, ,
| |
Collapse
|
21
|
Sadacharan CM. Research study on the effects of multi-component exercise on older adults with chronic conditions. J Sports Med Phys Fitness 2023; 63:144-154. [PMID: 35333032 DOI: 10.23736/s0022-4707.22.13697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Multicomponent exercises involving eccentric contraction (ECC) exercise, chair yoga (CY) and tai chi (TC) are practiced extensively to treat older adults with chronic conditions. The study investigated the effect of CY and TC performance after various intensity of ECC exercise induced muscle pain, delayed onset of muscle sores (DOMS), and strength in sedentary older adults. METHODS Nine sedentary older adults with chronic condition(s) aged between 60 and 90 performed CY and TC after ECC exercise protocol for 9 weeks. The medical preprotocol, ECC exercise, CY, and TC performance, subjective (health activities of daily living [ADL] difficulty scale; Visual Analog Scale [VAS], and DOMS), objective (pressure pain threshold [PPT]), and medical postprotocol assessments were carried out and compared the physical status before and after the protocol. RESULTS Our results show that functional limitations, DOMS, VAS, and PPT levels were improved in the CY and TC performed weeks 3, 4, 7, and 8 compared to ECC exercise weeks 2 and 6. The manual muscle testing (MMT), active range of motion (AROM), and maximal voluntary isometric contraction (MVIC) were improved and showed significant differences on the weak muscle groups. The mean Tinetti balance and gait score, and general endurance showed significant difference. CONCLUSIONS Our findings have important implications for clinical exercise prescription as low perceived CY and TC, and ECC exercise might suit well for older adults with chronic conditions. Performing multicomponent exercises can help to reduce the risk of injury from falls and prevent age-related mobility, balance, and physical function decline in older adults.
Collapse
Affiliation(s)
- Chakravarthy M Sadacharan
- Department of Biomedical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA -
| |
Collapse
|
22
|
Alhalal E, Alkhair Z, Alghazal F, Halabi R, Muhaimeed F. Psychological elder abuse among older Saudi adults: A cross-sectional study. J Elder Abuse Negl 2022; 34:349-368. [PMID: 36597203 DOI: 10.1080/08946566.2023.2164880] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The research examining elder abuse in diverse cultural contexts, such as in Saudi Arabia, remains limited. This study examined the extent of psychological elder abuse among older Saudi adults and investigated the characteristics of the victims that increase the risk of such abuse and its impact on older adults' self-rated health. Between December 2021 and April 2022, a sample of 444 older adults were recruited from 25 primary health care centers in Saudi Arabia and completed a structured interview. Of those surveyed, 88.3% reported at least one symptom or suspected symptom of psychological elder abuse. Age, gender, income, living arrangements, functioning, and social networking predicted vulnerability psychological elder abuse. Self-rated health was negatively impacted by psychological elder abuse, and this relationship is not moderated by social networking. These findings can provide insights about psychological elder abuse in Saudi Arabia and increase awareness of its impact.
Collapse
Affiliation(s)
- Eman Alhalal
- Community and Mental Health Nursing Department, Nursing College, King Saud University, Riyadh, Saudi Arabia
| | - Zainab Alkhair
- Qatif Health Centers Administration, Qatif Health Network, Eastern Region, Saudi Arabia
| | | | - Rehab Halabi
- The Administration of School Health Affairs in Makkah Health Care Cluster, Makkah, Saudi Arabia
| | - Fatema Muhaimeed
- Hematology/ Oncology unit, King Saud Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
23
|
Tchalla A, Laubarie-Mouret C, Cardinaud N, Gayot C, Rebiere M, Dumoitier N, Rudelle K, Druet-Cabanac M, Laroche ML, Boyer S. Risk factors of frailty and functional disability in community-dwelling older adults: a cross-sectional analysis of the FREEDOM-LNA cohort study. BMC Geriatr 2022; 22:762. [PMID: 36123606 PMCID: PMC9484156 DOI: 10.1186/s12877-022-03447-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Frailty is a geriatric syndrome associated with disability and negative health outcome. To determine the factors associated with frailty and functional disability in older participants living in community in France. We included 753 community-dwelling old participants with available frailty data at baseline. RESULTS Overall, 31.9% were frail, 58.3% were prefrail, and 9.8% were robust. The SMAF (French acronym for Functional Autonomy Measurement System) score was significantly lower (mean ± standard deviation: -25.8 ± 11.2) in frail participants compared to prefrail (-14.3 ± 9.7) or robust participants (-8.1 ± 7.0); 82% of frail older participants had limitation in at least one ADL and 97.5% in at least one IADL compared to 54.2 and 76.8%, respectively of pre-frail and 29.7 and 47.3% of robust participants. Age, depression, impaired cognition and diabetes were significantly associated with higher odds of frailty. These variables were also strongly associated with functional disability. Female gender, polypharmacy, and smoking were additional variables significantly associated with degraded SMAF and/or ADL/IADL. CONCLUSIONS This study showed that functional disability increased proportionally to frailty, and depression, cognitive decline and diabetes are modifiable risk factors significantly associated with frailty and functional disability.
Collapse
Affiliation(s)
- Achille Tchalla
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut OMEGA HEALTH, Université de Limoges, 87000, Limoges, France. .,CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France. .,Unité de Recherche Clinique Et d'Innovation (URCI) en Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France. .,Department of Clinical Geriatric, University Hospital Centre, 2 Avenue Martin Luther King, 87042, Limoges, France.
| | - Cécile Laubarie-Mouret
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut OMEGA HEALTH, Université de Limoges, 87000, Limoges, France.,CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France
| | - Noëlle Cardinaud
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut OMEGA HEALTH, Université de Limoges, 87000, Limoges, France.,CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France
| | - Caroline Gayot
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut OMEGA HEALTH, Université de Limoges, 87000, Limoges, France.,CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France.,Unité de Recherche Clinique Et d'Innovation (URCI) en Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
| | - Marion Rebiere
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut OMEGA HEALTH, Université de Limoges, 87000, Limoges, France.,CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France
| | - Nathalie Dumoitier
- CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France.,Département de Médecine Générale, Faculté de Médecine de Limoges, Limoges, France
| | - Karen Rudelle
- CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France.,Département de Médecine Générale, Faculté de Médecine de Limoges, Limoges, France
| | - Michel Druet-Cabanac
- CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France
| | - Marie-Laure Laroche
- CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France.,Centre de Pharmacovigilance Et de Pharmaco-Épidémiologie, CHU de Limoges, Limoges, France
| | - Sophie Boyer
- Laboratoire VieSanté - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), Institut OMEGA HEALTH, Université de Limoges, 87000, Limoges, France.,CHU de Limoges, Pôle HU Gérontologie Clinique, 2 Avenue Martin-Luther King, 87042, Limoges, France.,Unité de Recherche Clinique Et d'Innovation (URCI) en Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
| |
Collapse
|
24
|
Casanova-Muñoz V, Hernández-Ruiz Á, Durantez-Fernández C, López-Mongil R, Niño-Martín V. Descripción y aplicación clínica de las escalas de valoración geriátrica integral: una revisión sistemática rápida de revisiones. Rev Clin Esp 2022. [DOI: 10.1016/j.rce.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
25
|
Casanova-Muñoz V, Hernández-Ruiz Á, Durantez-Fernández C, López-Mongil R, Niño-Martín V. Description and clinical application of comprehensive geriatric assessment scales: A rapid systematic review of reviews. Rev Clin Esp 2022; 222:417-431. [PMID: 35504782 DOI: 10.1016/j.rceng.2022.01.002] [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] [Received: 12/22/2021] [Accepted: 01/26/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This work aims to describe the main scales used in comprehensive geriatric assessment through a narrative analysis detailing their clinical application in relation to their advantages and disadvantages in terms of their psychometric properties (mental assessment) and biases in their application. The scales selected were: Barthel Index, Katz Index, Lawton and Brody Scale, Mini-Mental State Examination, Clock Test, Geriatric Depression Scale, and the Social Resources Scale. METHODS We conducted a rapid systematic review of reviews in MEDLINE (PubMed) up to January 2021, reporting findings using PRISMA, 2020. MeSH language, keywords, and the Boolean operators AND and OR were used to construct the reproducible search strategy. RESULTS Thirty-one works were selected that met the eligibility criteria: 18 systematic reviews, 12 literature reviews, and one scoping review. Multiple versions were found for some of the scales and biases in their interpretation were observed. Short, easy-to-administer questionnaires are recommended and cut-off points should be defined by formal education. CONCLUSION Comprehensive geriatric assessment scales are inexpensive, effective, and useful instruments for identifying problems and potential problems in the elderly. They should be easy to apply, not extensive, valid for multiple cultures and different levels of formal education, and applicable to individuals with different degrees of disability. It is recommended that health professionals be instructed in their use to avoid biases in the interpretation of the results.
Collapse
Affiliation(s)
- V Casanova-Muñoz
- Departamento de Enfermería, Universidad de Valladolid, Valladolid, Spain; Unidad de Onco-Hematología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Á Hernández-Ruiz
- Área de Desarrollo de proyectos científicos, Fundación Iberoamericana de Nutrición (FINUT), Granada, Spain.
| | - C Durantez-Fernández
- Facultad de Ciencias de la Salud, Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | | | - V Niño-Martín
- Departamento de Enfermería, Universidad de Valladolid, Valladolid, Spain; Grupo de investigación en Cuidados de Enfermería (GICE), Facultad de Enfermería, Universidad de Valladolid, Valladolid, Spain; Gerencia de Atención Primaria Valladolid Este (SACYL), Valladolid, Spain
| |
Collapse
|
26
|
Garg D, Gupta A, Agarwal A, Mishra B, Srivastava MVP, Basheer A, Vishnu VY. Latest Trends in Outcome Measures in Dementia and Mild Cognitive Impairment Trials. Brain Sci 2022; 12:922. [PMID: 35884729 PMCID: PMC9313078 DOI: 10.3390/brainsci12070922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 11/20/2022] Open
Abstract
Disease modification trials in dementia and mild cognitive impairment (MCI) have not met with success. One potential criticism of these trials is the lack of sensitive outcome measures. A large number of outcome measures have been employed in dementia and MCI trials. This review aims to describe and analyze the utility of cognitive/clinical outcome measures in Alzheimer's disease (AD) and MCI trials. Methods: A PubMed search was conducted using relevant MeSH terms and exploded keywords. The search was confined to English language publications of human studies from the last five years which describe the latest trends in the use of outcome measures. Results: Despite broad use, the outcome measures employed are heterogeneous, with little data on correlations between scales. Another problem is that most studies are over-reliant on clinician/researcher assessment and cognitive outcomes, and there is a definite lack of stakeholder input. Finetuning of the paradigm is also required for people with early-stage disease, mild to moderate disease, and advanced dementia, as the outcome measures in these subgroups have varying relevance. Disease modification/prevention is an appropriate goal in early disease, whereas palliation and freedom from discomfort are paramount in later stages. The outcome measures selected must be suitable for and sensitive to these particular care goals. Although there is a shift to enrich MCI cohorts using a biomarker-based approach, the clinical relevance of such outcome measures remains uncertain. Conclusions: Outcome measures in dementia/MCI trials remain inhomogeneous and diverse, despite extensive use. Outcome measures fall within several paradigms, including cognitive, functional, quality-of-life, biomarker-based, and patient-reported outcome measures. The success of future disease-modifying trials is reliant to a large extent on the selection of outcome measures which combine all outcomes of clinical relevance as well as clinical meaning. Outcome measures should be tied to the type and stage of dementia and to the specific interventions employed.
Collapse
Affiliation(s)
- Divyani Garg
- Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India;
| | - Anu Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India; (A.G.); (A.A.); (B.M.); (M.V.P.S.)
| | - Ayush Agarwal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India; (A.G.); (A.A.); (B.M.); (M.V.P.S.)
| | - Biswamohan Mishra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India; (A.G.); (A.A.); (B.M.); (M.V.P.S.)
| | | | - Aneesh Basheer
- Department of Medicine, DM Wayanad Institute of Medical Sciences (DM WIMS), Wayanad 673577, India;
| | - Venugopalan Y. Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India; (A.G.); (A.A.); (B.M.); (M.V.P.S.)
| |
Collapse
|
27
|
Verstraeten HMF, Ziylan C, Gerritsen DL, Huijsman R, Nakanishi M, Smalbrugge M, van der Steen JT, Zuidema SU, Achterberg WP, Bakker TJEM. Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study. JMIR Res Protoc 2022; 11:e34550. [PMID: 35731558 PMCID: PMC9260522 DOI: 10.2196/34550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Neuropsychiatric symptoms occur frequently in many nursing home residents with dementia. Despite the availability of multidisciplinary guidelines, neuropsychiatric symptoms are often inadequately managed. Three proven effective methods for managing neuropsychiatric symptoms were integrated into a single intervention method: the STIP-Method, a personalized integrated stepped-care method to prevent and treat neuropsychiatric symptoms. The STIP-Method comprises 5 phases of clinical reasoning to neuropsychiatric symptoms and 4 stepped-care interventions and is supported with a web application. Objective This study aims to identify the facilitators and barriers in the implementation of the STIP-Method in nursing homes. Methods A mixed methods design within a participatory action research was used to implement the STIP-Method in 4 facilities of 2 Dutch nursing home organizations. In total, we aimed at participation of 160-200 persons with dementia and expected an intervention fidelity of 50% or more, based on earlier studies regarding implementation of effective psychosocial interventions to manage neuropsychiatric symptoms. All involved managers and professionals were trained in the principles of the STIP-Method and in using the web application. An advisory board of professionals, managers, and informal caregivers in each facility supported the implementation during 21 months, including an intermission of 6 months due to the COVID-19 pandemic. In these 6-weekly advisory board meetings, 2 researchers stimulated the members to reflect on progress of the implementation by making use of available data from patient records and the web application. Additionally, the 2 researchers invited the members to suggest how to improve the implementation. Data analysis will involve (1) analysis of facilitators and barriers to the implementation derived from verbatim text reports of advisory board meetings to better understand the implementation process; (2) analysis of patient records in accordance with multidisciplinary guidelines to neuropsychiatric symptoms: personalized, interdisciplinary, and proactive management of neuropsychiatric symptoms; (3) evaluation of the web application in terms of usability scores; (4) pre- and postimplementation analysis of patient records and the web application to evaluate the impact of the STIP-Method, such as changes in neuropsychiatric symptoms and informal caregiver burden. Results We enrolled 328 persons with dementia. Data collection started in July 2019 and ended in December 2021. The first version of this manuscript was submitted in October 2021. The first results of data analysis are expected to be published in December 2022 and final results in June 2023. Conclusions Our study may increase understanding of facilitators and barriers to the prevention and treatment of neuropsychiatric symptoms in nursing home residents with dementia by implementing the integrated STIP-Method. The need for well-designed implementation studies is of importance to provide nursing homes with optimal tools to prevent and treat neuropsychiatric symptoms. International Registered Report Identifier (IRRID) DERR1-10.2196/34550
Collapse
Affiliation(s)
- Helma M F Verstraeten
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Canan Ziylan
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Robbert Huijsman
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands
| | - Miharu Nakanishi
- Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai-shi, Japan
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands
| | - Sytse U Zuidema
- Department of Primary Care and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Ton J E M Bakker
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Stichting Wetenschap Balans, Rotterdam, The Netherlands
| |
Collapse
|
28
|
Martínez-Hernández BM, Rosas-Carrasco O, López-Teros M, González-Rocha A, Muñoz-Aguirre P, Palazuelos-González R, Ortíz-Rodríguez A, Luna-López A, Denova-Gutiérrez E. Association between physical activity and physical and functional performance in non-institutionalized Mexican older adults: a cohort study. BMC Geriatr 2022; 22:388. [PMID: 35505279 PMCID: PMC9066903 DOI: 10.1186/s12877-022-03083-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/22/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Aging is an independent risk factor for deterioration in functional capacity. Some studies have reported that physical activity (PA) improves functional capacity and physical performance among older adults (OA). Thus the objective of the present study was to assess the longitudinal association between PA and functional and physical performance in non-institutionalized OA. METHODS A longitudinal analysis using data from the Frailty, Dynapenia and Sarcopenia in Mexican adults (FRADYSMEX, by its Spanish acronym) cohort study was conducted. PA was assessed through the Community Healthy Activities Model Program for Seniors (CHAMPS) instrument. Functionality was measured with the Barthel index and the Lawton and Brody scale, while physical performance was measured with the Short Physical Performance Battery (SPPB). To evaluate the association between the level of PA and physical and functional performance as a continuous variable, a linear regression of mixed effects was performed. To assess PA and dependence in basic activities of the daily life (BADL), instrumental activities of the daily life (IADL), and low physical performance (PP), generalized estimation equation models [to compute odds ratios (OR) and 95% confidence intervals (95%CI)] were computed. RESULTS Older people who performed moderate to vigorous-intensity PA had a lower risk of dependence in IADL (OR = 0.17; 95%CI: 0.10, 0.80) and lower risk of low PP (OR = 0.18; 95%CI: 0.11, 0.58) compared to those in lower categories of PA. CONCLUSIONS Older adults living in the community who perform PA of moderate to vigorous intensity have a lower risk of dependence in BADL and IADL and have a lower risk of low PP.
Collapse
Affiliation(s)
| | | | - Miriam López-Teros
- Departamento de Salud, Universidad Iberoamericana, Ciudad de Mexico, México
| | - Alejandra González-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Paloma Muñoz-Aguirre
- CONACYT-Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Rosa Palazuelos-González
- Center for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México.
| |
Collapse
|
29
|
Gomez G, Botero-Rodríguez F, Misas JD, Garcia-Cifuentes E, Sulo S, Brunton C, Venegas-Sanabria LC, Gracia DA, Cano Gutierrez CA. A Nutritionally Focused Program for Community-living Older Adults Resulted in Improved Health and Well-being. Clin Nutr 2022; 41:1549-1556. [DOI: 10.1016/j.clnu.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 11/03/2022]
|
30
|
Chiu SC, Livneh H, Chen JC, Chang CM, Hsu H, Chiang TI, Tsai TY. Parecoxib Reduced Postsurgical Pain and Facilitated Movement More Than Patient Controlled Analgesia. Front Surg 2022; 9:799795. [PMID: 35465430 PMCID: PMC9019031 DOI: 10.3389/fsurg.2022.799795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Postoperative pain management is an imperative issue for patients undergoing lumbar spinal fusion surgery. Delayed pain relief is associated with poor clinical outcomes. This study compared the effects of intravenously administered patient-controlled analgesia (PCA) with intravenous parecoxib, both commonly used methods for analgesic pain control after surgery. Methods A non-randomized study was used to recruit 68 patients who were scheduled to receive lumbar spinal fusion surgery at a hospital in Taiwan from April through December of 2020. The group treated with parecoxib received an initial perioperative dose of parecoxib 40 mg during a 30-min period and then postoperative intravenous parecoxib at 40 mg per 12-h period, for 72 h. Those with PCA received morphine (0.4 mg/ml), droperidol (0.02 mg/ml), diphenhydramine (0.48 mg/ml), midazolam (0.02 mg/ml) and saline solution during the 3-day study course. Major outcomes, including visual scale pain score and Barthel index of activities of daily living, were collected via review of medical records at 4 times: 12, 24, 48 and 72 h after surgery. Comparative effects between two groups were assessed by the generalized estimating equations. Results After adjusting for potential confounders, the administration of parecoxib was associated with a significant decrease in pain scores and an increase in the Barthel Index, when compared with the PCA group (all p < 0.05). Notably, both effects would maintain for 72 h after surgery. Discussion This is the first trial of which the authors are aware, that supports intravenous parecoxib as significantly enhancing patient mobility, in addition to having pain control efficacy, when compared with PCA. This study could be used as a reference when instituting interventions to improve the adaptation process and clinical prognoses after lumbar spinal fusion surgery.
Collapse
Affiliation(s)
- Szu-Ching Chiu
- Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Portland, OR, United States
| | - Jin-Cheng Chen
- Department of Neurosurgery, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chia-Ming Chang
- Department of Anesthesiology, Taichung Tzu Chi Hospital, The Buddhist Tzuchi Medical Foundation, Taichung, Taiwan
- *Correspondence: Chia-Ming Chang
| | - Honda Hsu
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Plastic Surgery, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Tsay-I Chiang
- Department of Nursing, Hungkuang University, Taichung, Taiwan
- Tsay-I Chiang
| | - Tzung-Yi Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
- Tzung-Yi Tsai
| |
Collapse
|
31
|
Caffò AO, Spano G, Tinella L, Lopez A, Ricciardi E, Stasolla F, Bosco A. The Prevalence of Amnestic and Non-Amnestic Mild Cognitive Impairment and Its Association with Different Lifestyle Factors in a South Italian Elderly Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3097. [PMID: 35270789 PMCID: PMC8910691 DOI: 10.3390/ijerph19053097] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 11/26/2022]
Abstract
Mild Cognitive Impairment (MCI) is a transition stage between normal aging and dementia and can be useful to monitor the cognitive status of people at risk of dementias. Our aims were to investigate the prevalence of amnestic and non-amnestic MCI in a South Italian elderly population, and to identify socio-demographic, clinical and lifestyle factors associated with MCI. A cross-sectional retrospective population study on 839 community-dwelling participants over 60 years of age was carried out. Elderly people were administered a brief neuropsychological screening to identify their cognitive and functional status, and a questionnaire to investigate several socio-demographic, clinical, and lifestyle factors. Prevalence estimate for MCI was 12.0% (95% CI: 10.0-14.5%), for amnestic MCI was 7.4% (95% CI: 5.8-9.4%), and for non-amnestic MCI was 4.6% (95% CI: 3.4-6.4%), for people older than 60 years of age. Logistic regression models, corrected for age, sex, and education, revealed a significant association of MCI with the following factors: age, education, intellectual activities, and topographical disorientation. On the other hand, education, clinical factors (e.g., depression level and perceived physical pain), lifestyle factors (e.g., smoking, alcohol, and leisure/productive activities), dietary habits, quality of life, and self-reported topographical disorientation were non-significantly associated with MCI. Prevalence estimates and the association of MCI and its subtypes with risk and protective factors were discussed in comparison with the most recent systematic reviews and meta-analyses.
Collapse
Affiliation(s)
- Alessandro Oronzo Caffò
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (G.S.); (L.T.); (A.L.); (E.R.); (A.B.)
| | - Giuseppina Spano
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (G.S.); (L.T.); (A.L.); (E.R.); (A.B.)
| | - Luigi Tinella
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (G.S.); (L.T.); (A.L.); (E.R.); (A.B.)
| | - Antonella Lopez
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (G.S.); (L.T.); (A.L.); (E.R.); (A.B.)
| | - Elisabetta Ricciardi
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (G.S.); (L.T.); (A.L.); (E.R.); (A.B.)
| | - Fabrizio Stasolla
- Law Department, “Giustino Fortunato” University of Benevento, 82100 Benevento, Italy;
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, 70122 Bari, Italy; (G.S.); (L.T.); (A.L.); (E.R.); (A.B.)
| |
Collapse
|
32
|
Morton H, Basu T, Bose C, Reddy PH. Impact of Chronic Conditions and Dementia in Rural West Texas: A Healthy Aging Study. J Alzheimers Dis 2022; 87:33-49. [PMID: 35275552 DOI: 10.3233/jad-220084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer's disease (AD) is a devastating illness in elderly individuals, that currently has no known cure. Causal genetic factors only account for 1-2% of AD patients. However, other causal factors are still unknown for a majority of AD patients. Currently, multiple factors are implicated in late-onset AD, including unhealthy diet, physical inactivity, traumatic brain injury, chronic conditions, epigenetic factors, and environmental exposures. Although clinical symptoms of dementia are common to all races and ethnic groups, conditions that lead to dementia are different in terms of lifestyle, genetic profile, and socio-economic conditions. Increasing evidence also suggests that some elderly individuals age without cognitive impairments in their 60-90s as seen in rural West Texas, while some individuals progress with chronic conditions and cognitive impairments into their 60s. To understand these discriminations, we assessed current literature on demographic features of health in rural West Texas. This paper also outlines our initiated clinical study with a purpose of understanding the factors that allow some individuals to live without cognitive impairments at the age of 60-90 years, whereas others develop deficits in cognitive function around or above 60 years. Our ongoing study hopes to determine the factors that delay aging in some individuals by investigating various aspects including genetics, epigenetics, ethnicity, biology, culture, and lifestyle. This will be achieved by gathering information about participants' ethnographic profiles, cognitive assessments, blood-profiles, brain scans, and blood-based genomic analyses in relation to lifestyle. The outcomes of our study will provide insights into healthy aging in rural West Texas.
Collapse
Affiliation(s)
- Hallie Morton
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Tanisha Basu
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Chhanda Bose
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Neuroscience & Pharmacology, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Public Health Department of Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| |
Collapse
|
33
|
Experiences of Performing Daily Activities in Middle-Aged and Older Autistic Adults: A Qualitative Study. J Autism Dev Disord 2022; 53:2037-2049. [PMID: 35217945 PMCID: PMC10123035 DOI: 10.1007/s10803-022-05473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
This is the first study to investigate instrumental activities of daily living in older autistic adults. We conducted interviews with fifteen adults (mean age = 60.1, SD = 7.4, range = 50-73) from Australia with no intellectual disability. Analysis included both deductive and inductive steps, to categorise responses using the Occupational Performance Model Australia and identify themes across participants' experiences. Strengths and challenges were unique to the individual, as were the methods they had developed to manage tasks. Challenges occurred mostly at the interaction between aspects of the environment (sensory, cognitive, social and cultural) and personal factors such as health conditions and sensory sensitivities. Enhanced person-environment fit is needed, as is a shift in wider sociocultural attitudes to enable comfort and autonomy in later life.
Collapse
|
34
|
Homan PA, Brown TH. Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity. Health Aff (Millwood) 2022; 41:219-227. [PMID: 35130073 DOI: 10.1377/hlthaff.2021.01414] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Theoretical research suggests that racialized felony disenfranchisement-a form of structural racism-is likely to undermine the health of Black people, yet empirical studies on the topic are scant. We used administrative data on disproportionate felony disenfranchisement of Black residents across US states, linked to geocoded individual-level health data from the 2016 Health and Retirement Study, to estimate race-specific regression models describing the relationship between racialized disenfranchisement and health among middle-aged and older adults, adjusting for other individual- and state-level factors. Results show that living in states with higher levels of racialized disenfranchisement is associated with more depressive symptoms, more functional limitations, more difficulty performing instrumental activities of daily living, and more difficulty performing activities of daily living among Black people. However, there are no statistically significant relationships between racialized disenfranchisement and health among White people. These findings suggest that policies aiming to mitigate disproportionate Black felony disenfranchisement not only are essential for political inclusion but also may be valuable tools for improving population health equity.
Collapse
Affiliation(s)
- Patricia A Homan
- Patricia A. Homan, Florida State University, Tallahassee, Florida
| | - Tyson H Brown
- Tyson H. Brown , Duke University, Durham, North Carolina
| |
Collapse
|
35
|
Lim SER, Meredith S, Agnew S, Clift E, Ibrahim K, Roberts H. Evaluating the feasibility and acceptability of virtual group exercise for older adults delivered by trained volunteers: the ImPACt study protocol. BMJ Open 2022; 12:e052631. [PMID: 35105576 PMCID: PMC8808406 DOI: 10.1136/bmjopen-2021-052631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Physical activity is important for healthy ageing. Despite strong evidence on the benefits of physical activity for health and well-being, physical inactivity remains a significant problem among older adults. This study aims to determine the feasibility and acceptability of implementing an online volunteer-led group exercise for older adults. METHODS A quasi-experimental mixed-methods approach will be used in this study. A training programme will be developed to train volunteers to deliver online group exercises to older adults aged >65 years (n=30). The primary outcome is the feasibility of implementing the intervention. This will be assessed by the number of volunteers recruited, trained, and retained at the end of the study, and the number of exercise sessions delivered and completed by participants. Secondary outcomes include physical activity levels measured using the Community Health Model Activities Programme for Seniors questionnaire, Barthel Index, EQ-5D-5L as a measure of health-related quality of life, SARC-F to determine sarcopenia status, and PRIMSA-7 to determine frailty status. Outcomes will be measured at baseline and at 6 months.Qualitative interviews will be conducted with volunteers(n=5), older adults (n=10) and family members (n=5) to explore their views on the intervention. ANALYSIS Simple descriptive statistics will be used to describe participant characteristics, the feasibility of the study and the impact of the intervention on health outcomes. Parametric(t-test) or non-parametric(Mann-Whitney U test) statistics will be used to analyse continuous variables. χ2 test will be used for categorical variables. Qualitative data will be analysed using an inductive thematic analysis approach. ETHICS AND DISSEMINATION This study received ethical approval from the University of Southampton Faculty of Medicine Ethics Committee and Research Integrity and Governance committee (ID: 52 967 .A1). Study findings will be made available to service users, voluntary organisations and other researchers who may be interested in implementing the intervention. TRIAL REGISTRATION NUMBER NCT04672200.
Collapse
Affiliation(s)
- Stephen Eu Ruen Lim
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Samantha Meredith
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | | | - Esther Clift
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Kinda Ibrahim
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Helen Roberts
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| |
Collapse
|
36
|
Zilbershlag Y, Ravitz-Ron K, Engel-Yeger B. The Role of Altered Sensory Processing and Its Association with Participation in Daily Activities and Quality of Life among Older Adults in the Community. Occup Ther Health Care 2022; 37:230-247. [PMID: 35034550 DOI: 10.1080/07380577.2022.2025552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To identify variables that contribute to fall risk in older adults, this study examined the relationship between fall risk, sensory processing, participation in daily activities, and quality of life (QoL). Of the 123 participants, those at high-risk were significantly less able to register sensory input and had increased sensory sensitivity, restricted participation and overall lower QoL. Altered sensory processing was related with risk of falling. Additionally, both sensory process and fall risk were subsequently related with lower daily participation and, together, were related with lower QoL. Thus, sensory processing, participation and QoL assessments need to be included in occupational therapy evaluations and interventions for fall risk among older adults.
Collapse
Affiliation(s)
- Yael Zilbershlag
- Department of Occupational Therapy, Faculty of Health Allied Professions, Ono Academic College, Kiryat Ono, Israel
| | - Keren Ravitz-Ron
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| |
Collapse
|
37
|
Naughton C, Cummins H, de Foubert M, Barry F, McCullagh R, Wills T, Skelton DA, Dahly D, Palmer B, Murphy A, McHugh S, O'Mahony D, Tedesco S, O Sullivan B. Implementation of the Frailty Care Bundle (FCB) to promote mobilisation, nutrition and cognitive engagement in older people in acute care settings: protocol for an implementation science study. HRB Open Res 2022. [DOI: 10.12688/hrbopenres.13473.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Older people are among the most vulnerable patients in acute care hospitals. The hospitalisation process can result in newly acquired functional or cognitive deficits termed hospital associated decline (HAD). Prioritising fundamental care including mobilisation, nutrition, and cognitive engagement can reduce HAD risk. Aim: The Frailty Care Bundle (FCB) intervention aims to implement and evaluate evidence-based principles on early mobilisation, enhanced nutrition and increased cognitive engagement to prevent functional decline and HAD in older patients. Methods: A hybrid implementation science study will use a pragmatic prospective cohort design with a pre-post mixed methods evaluation to test the effect of the FCB on patient, staff, and health service outcomes. The evaluation will include a description of the implementation process, intervention adaptations, and economic costs analysis. The protocol follows the Standards for Reporting Implementation Studies (StaRI). The intervention design and implementation strategy will utilise the behaviour change theory COM-B (capability, motivation, opportunity) and the Promoting Action on Research Implementation in Health Services (i-PARIHS). A clinical facilitator will use a co-production approach with staff. All patients will receive care as normal, the intervention is delivered at ward level and focuses on nurses and health care assistants (HCA) normative clinical practices. The intervention will be delivered in three hospitals on six wards including rehabilitation, acute trauma, medical and older adult wards. Evaluation: The evaluation will recruit a volunteer sample of 180 patients aged 65 years or older (pre 90; post 90 patients). The primary outcomes are measures of functional status (modified Barthel Index (MBI)) and mobilisation measured as average daily step count using accelerometers. Process data will include ward activity mapping, staff surveys and interviews and an economic cost-impact analysis. Conclusions: This is a complex intervention that involves ward and system level changes and has the potential to improve outcomes for older patients.
Collapse
|
38
|
Alhalal E, Alkhair Z, Alghazal F, Muhaimeed F, Halabi R. Fear of contamination among older adults in the post-COVID-19 era. Geriatr Nurs 2022; 48:1-7. [PMID: 36095886 PMCID: PMC9424512 DOI: 10.1016/j.gerinurse.2022.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 12/14/2022]
Abstract
This study assesses older adults' fear of contamination in the post-coronavirus disease 2019 (COVID-19) era, examining the factors associated with this fear and investigating its effects on their well-being and use of primary healthcare, considering the moderating effects of activities of daily living (ADL) and multimorbidity in these two relationships. A cross-sectional study was conducted in primary healthcare centers in three regions in Saudi Arabia with a convenience sample of 444 older adults diagnosed with chronic diseases. The results indicated that 77.9% of older adults had high contamination fear, predicted by their age, education level, gender, ADL, and previous COVID-19 infection experience. Subjective well-being and the number of primary healthcare visits in the post-COVID-19 era were negatively affected by contamination fear and both ADL and multimorbidity moderated these relationships. In conclusion, the study confirmed the need to focus on older adults' contamination fear to mitigate its negative effects on well-being and critical primary healthcare visits.
Collapse
Affiliation(s)
- Eman Alhalal
- Community and Mental Health Nursing Department, Nursing College, King Saud University, Saudi Arabia,Corresponding author
| | - Zainab Alkhair
- Qatif Health Centers Administration, Qatif Health Network, Saudi Arabia
| | | | | | - Rehab Halabi
- The Administration of School Health Affairs, Makkah Health Care Cluster, Saudi Arabia
| |
Collapse
|
39
|
Idaiani S, Indrawati L. Functional status in relation to depression among elderly individuals in Indonesia: a cross-sectional analysis of the Indonesian National Health Survey 2018 among elderly individuals. BMC Public Health 2021; 21:2332. [PMID: 34969381 PMCID: PMC8719407 DOI: 10.1186/s12889-021-12260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Depression among elderly individuals is related to physical illness, functional status, prolonged treatment and other factors. Depression is not effectively treated with medication but can be alleviated by treating the physical illness and improving functional status. Therefore, this study aims to determine the relationship between functional status and depression in elderly individuals in Indonesia. METHODS The data used were obtained from a national survey dataset, namely, the Basic Health Research and Socio-Economic Survey in 2018, which was carried out in 34 provinces and 514 districts or cities. The total number of respondents was 93,829, aged ≥60 years. Functional status and depression were assessed using the Barthel index and MINI (Mini International Neuropsychiatric Interview), respectively. Furthermore, data processing was carried out with the Statistical Package for Social Sciences (SPSS) version 26 program and analyzed using the chi-square test and multiple logistic regression with the complex sample method. RESULTS Elderly individuals with severe dependence were at the greatest risk of becoming depressed compared to those without functional impairment or with independence after considering sociodemographic factors and disease history have 5.730 (95% CI = 4.302-7.632) the adj odds. Furthermore, this figure was higher than that of individuals with total dependence have 4.147 (95% CI = 3.231-5.231) the adj odds. The physical illness experienced also played a role in the risk for depression, which was higher among elderly individuals with stroke and a history of injury. The sociodemographic factors involved include low education and economic levels. In contrast, the area of residence and marital status had no statistically significant effect on the relationship between functional disorders and depression. CONCLUSIONS Elderly individuals with decreased functional status are prone to depression. The highest probability for depression was observed among those with severe dependence compared to those with total dependence. Consequently, interventions that involve various sectors, including social and family support, are needed.
Collapse
Affiliation(s)
- Sri Idaiani
- National Institute of Health Research and Development, Ministry of Health of Republic of Indonesia, Jalan Percetakan Negara. 29, Jakarta, 10560 Indonesia
| | - Lely Indrawati
- National Institute of Health Research and Development, Ministry of Health of Republic of Indonesia, Jalan Percetakan Negara. 29, Jakarta, 10560 Indonesia
| |
Collapse
|
40
|
Ģiga L, Pētersone A, Čakstiņa S, Bērziņa G. Comparison of content and psychometric properties for assessment tools used for brain tumor patients: a scoping review. Health Qual Life Outcomes 2021; 19:234. [PMID: 34625062 PMCID: PMC8501604 DOI: 10.1186/s12955-021-01863-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/15/2021] [Indexed: 01/28/2023] Open
Abstract
AIMS To determine the most frequently utilized functional status assessment instruments for patients with brain tumors, compare their contents, using the International Classification of Functioning, Disability and Health (ICF), and their psychometric properties. METHODS A scoping review was conducted to explore possible assessment instruments and summarize the evidence. A systematic literature search was performed for identification of the frequently used functional assessment tool in clinical trials in PubMed, ScienceDirect, and ProQuest databases. The content of most used instruments was linked to the ICF categories. The psychometric qualities of these assessment tools were systematically searched and analyzed. RESULTS Nine most used assessment tools in clinical trials were identified. The most frequently used assessment instrument is the Karnofsky Performance Scale, which is developed for a general assessment of oncological patients. Out of four self-assessment tools, two were disease-specific (EORTC QLQ-BN20 and FACT-Br), EORTC QLQ-C30 has been shown good psychometric properties in patients with brain tumors as well as in patients with various oncological diseases, similar to the SF-36, it is used in patients with brain tumors as well as in patients with various diseases. The Functional Independence Measure and the Barthel Index were two objective assessment tools that described functioning, but two were neuropsychological tests (MMSE and Trial Making Test). Two hundred eighty-three meaningful concepts were identified and linked to 102 most relevant second-level categories covering all components of the ICF. Forty-nine studies reporting psychometric properties of those nine assessment tools were identified, indicating good reliability and validity for all the instruments. CONCLUSION Nine most frequently utilized functional status assessment instruments for patients with brain tumors represent all components of the ICF and have good psychometric properties. However, the choice of the tool depends on the clinical question posed and the aim of its use.
Collapse
Affiliation(s)
| | - Anete Pētersone
- Riga Stradiņš University, Riga, Latvia.,Riga East University Hospital, Riga, Latvia
| | | | - Guna Bērziņa
- Riga Stradiņš University, Riga, Latvia. .,Riga East University Hospital, Riga, Latvia. .,Department of Rehabilitation, Riga Stradiņš University, Anniņmuižas Boulevard 26a, Riga, 1067, Latvia.
| |
Collapse
|
41
|
Carter L, O'Neill S, Austin PC, Keogh F, Pierce M, O'Shea E. Admission to long-stay residential care and mortality among people with and without dementia living at home but on the boundary of residential care: a competing risks survival analysis. Aging Ment Health 2021; 25:1869-1876. [PMID: 33317328 DOI: 10.1080/13607863.2020.1857698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Health policy in many countries is underpinned by a commitment to support dependent older people to remain in their own home for as long as possible and practicable. This study explores factors affecting both admission to long-stay residential care (LSRC) and mortality among people with and without dementia who are currently living at home with intensive formal care support. METHODS This is a cross-sectional study based on administrative data collected on 429 dependent older people in Ireland, 269 of whom were people with dementia. A cause-specific hazard model was used to investigate the hazard of admission to LSRC, while accounting for mortality as a competing risk and vice versa. RESULTS Admission to LSRC was higher for people with dementia relative to people without and for those receiving lower amounts of informal care. The hazard of mortality was significantly higher for older people aged 85+, whereas it was lower for individuals with a medium level of dependency relative to those with high levels of dependency. The hazard of mortality was also influenced by the amount of informal care provision. CONCLUSION People with dementia are more likely to be admitted to LSRC than people without. Care for people with dementia needs to be more specialised and personal, and intensity of provision should not be equated to the number of care hours on offer. Informal care provision may help to prevent admission to LSRC. Advanced age, physical dependency and informal care provision affect mortality, raising interesting issues in relation to resource allocation.
Collapse
Affiliation(s)
- L Carter
- Centre for Economic and Social Research on Dementia, Institute for Lifecourse and Society, National University of Ireland, Galway, Ireland
| | - S O'Neill
- J.E. Cairnes School of Business and Economics, Upper Newcastle, National University of Ireland, Galway, Ireland
| | - Peter C Austin
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. Institute of Health Management, Policy and Evaluation, University of Toronto, Toronto, Canada
| | - F Keogh
- Centre for Economic and Social Research on Dementia, Institute for Lifecourse and Society, National University of Ireland, Galway, Ireland
| | - M Pierce
- Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | - E O'Shea
- Centre for Economic and Social Research on Dementia, Institute for Lifecourse and Society, National University of Ireland, Galway, Ireland
| |
Collapse
|
42
|
Zidrou C, Kleisiaris C, Adamakidou T. Associations between Disability in Activities of Daily Living and Social Capital aspects among older adults: a scoping review. J Frailty Sarcopenia Falls 2021; 6:119-130. [PMID: 34557611 PMCID: PMC8419853 DOI: 10.22540/jfsf-06-119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 11/29/2022] Open
Abstract
Social capital aspects are playing an important role in activities of daily living (ADL) performance, thus on independent living. This paper was aimed to present an overview of the associations and adverse effects between social capital aspects and disability in ADL and health-related quality of life (HRQoL) in an older population aged 65 years old and over. Α scoping review was designed following the guidelines of PRISMA Extension for Scoping Reviews (PRISMA-ScR) and the review was conducted by 3 authors. A total of 185 primary studies were extracted and, finally, 40 studies did meet the inclusion criteria and critically appraised in two main categories; Category 1(29 studies) ‘social capital and disability in ADL’ deducing that as greater a social capital as better ADL performance and Category 2 (11 studies) ‘Social capital and HRQoL’ concluding that people 65 years old and over with lower social capital were presented with a poor HRQoL. Study synthesis highlights the impact of social capital suggesting that nurses caring for older people must focus on their engagement in terms of social diversity and trust in the community.
Collapse
Affiliation(s)
- Christiana Zidrou
- 2 Orthopaedic Department, G. Papageorgiou General Hospital, Thessaloniki, Greece
| | - Christos Kleisiaris
- Hellenic Mediterranean University, Department of Nursing, Iraklion Crete, Greece
| | | |
Collapse
|
43
|
Nielsen LM, Oestergaard LG, Kirkegaard H, Maribo T. Construct Validity and Clinical Utility of World Health Organization Disability Assessment Schedule 2.0 in Older Patients Discharged From Emergency Departments. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:710137. [PMID: 36188825 PMCID: PMC9397984 DOI: 10.3389/fresc.2021.710137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022]
Abstract
Introduction: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is designed to measure functioning and disability in six domains. It is included in the International Classification of Diseases 11th revision (ICD-11). The objective of the study was to examine the construct validity of WHODAS 2.0 and describe its clinical utility for the assessment of functioning and disability among older patients discharged from emergency departments (EDs). Material and Methods: This cross-sectional study is based on data from 129 older patients. Patients completed the 36-item version of WHODAS 2.0 together with the Barthel-20, the Assessment of Motor and Process Skills (AMPS), Timed Up and Go (TUG), and the 30-Second Chair Stand Test (30 s-CST). Construct validity was examined through hypothesis testing by correlating the WHODAS with the other instruments and specifically the mobility domain in WHODAS 2.0 with the TUG and 30 s-CST tests. The clinical utility of WHODAS 2.0 was explored through floor/ceiling effect and missing item responses. Results: WHODAS 2.0 correlated fair with Barthel-20 (r = -0.49), AMPS process skills (r = -0.26) and TUG (r=0.30) and correlated moderate with AMPS motor skills (r = -0.58) and 30s-CST (r = -0.52). The WHODAS 2.0 mobility domain correlated fair with TUG (r = 0.33) and moderate with 30s-CST (r = -0.60). Four domains demonstrated floor effect: D1 "Cognition," D3 "Self-care," D4 "Getting along," and D5 "Household." Ceiling effect was not identified. The highest proportion of missing item responses were present for Item 3.4 (Staying by yourself for a few days), Item 4.4 (Making new friends), and Item 4.5 (Sexual activities). Conclusion: WHODAS 2.0 had fair-to-moderate correlations with Barthel-20, AMPS, TUG, and 30s-CST and provides additional aspects of disability compared with commonly used instruments. However, the clinical utility of WHODAS 2.0 applied to older patients discharged from EDs poses some challenges due to floor effect and missing item responses. Accordingly, patient and health professional perspectives need further investigation.
Collapse
Affiliation(s)
- Louise Moeldrup Nielsen
- Department of Occupational Therapy, Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
| | - Hans Kirkegaard
- Research Centre for Emergency Medicine, Emergency Department, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
| |
Collapse
|
44
|
Population with Long-Term Care Needs in Six Latin American Countries: Estimation of Older Adults Who Need Help Performing ADLs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157935. [PMID: 34360226 PMCID: PMC8345476 DOI: 10.3390/ijerph18157935] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/17/2022]
Abstract
The population in Latin America is ageing, and there is an inevitable demand for long-term care services. However, there are no comparative analyses between Latin American countries of the dependency situation of older adults. This study aims to calculate and compare percentages of older adults who need help performing the activities of daily living in six Latin American nations. The study is observational, transversal, and cross-national and uses microdata drawn from national surveys conducted in Argentina (n = 3291), Brazil (n = 3903), Chile (n = 31,667), Colombia (n = 17,134), Mexico (n = 7909), and Uruguay (n = 4042). Comparable indicators of the need for help in performing the basic and instrumental activities of daily living were calculated. The percentages of older adults in need of help for basic activities of daily living ranged from 5.8% in Argentina to 11% in Brazil; for instrumental activities of daily living, from 13.8% in Mexico to 35.7% in Brazil; and combined, from 18.1% in Argentina to 37.1% in Brazil. Brazil thus has the highest indicators, followed by Colombia. The results warn of the frail physical condition of older people and the high potential demand for long-term care services. The information provided could be useful for further research on and planning for long-term care needs in Latin American and middle-income countries.
Collapse
|
45
|
Echeverría A, Cauas R, Díaz B, Sáez C, Cárcamo M. Herramientas de evaluación de actividades de la vida diaria instrumentales en población adulta: revisión sistemática. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
46
|
Flikweert ER, Wendt KW, Diercks RL, Izaks GJ, Stewart R, Stevens M, Reininga IHF. A comprehensive multidisciplinary care pathway for hip fractures better outcome than usual care? Injury 2021; 52:1819-1825. [PMID: 33947587 DOI: 10.1016/j.injury.2021.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Hip fracture surgery is among the most performed surgical procedures in elderly patients. Mortality rates are high, however, and patients often fail to live independently following a hip fracture. To improve outcome, multidisciplinary care pathways have been initiated, but longer-term results are lacking. Aim of this study was to compare functional outcome and living situation six months after hip fracture treatment with and without a care pathway. PATIENTS AND METHODS A multicentre prospective controlled trial was conducted with three hospitals: in one hospital patients were treated with a care pathway, in the other hospitals patients received usual care. All patients aged ≥ 60 years with a hip fracture were asked to participate. Besides basic characteristics, health-related quality of life (EQ-5D) and performance scores of activities of daily living (Katz Index and Lawton IADL) were assessed. Differences in scores were analysed using linear regression. Propensity score adjustment was used to correct for differences between the care pathway and the usual care group. Missing data were imputed. RESULTS No differences in rate of return to prefracture ADL level were found between patients in the care pathway group and the usual care group. The percentage of participants in the same situation as before the fracture was the same in both treatment groups (81%). There were no significant differences in quality of life, activities of daily living or mortality (15% vs 10%, p = 0.17), but hospital stay in the care pathway group was significantly shorter (median 7 vs 10 days). DISCUSSION Treatment of elderly patients with a hip fracture is commonly organised in care pathways. Although short-term advantages are reported, positive effects on longer-term functional results could not be proven in our study. This study confirmed a shorter hospital stay in the care pathway group, which potentially may lead to a reduction in costs. CONCLUSIONS Functional outcome and living situation six months after a hip fracture is the same for patients treated with or without a care pathway.
Collapse
Affiliation(s)
- Elvira R Flikweert
- Department of Surgery-Traumatology University of Groningen, University Medical Center Groningen, P.O. Box 300019700 RB Groningen, The Netherlands.
| | - Klaus W Wendt
- Department of Surgery-Traumatology University of Groningen, University Medical Center Groningen, P.O. Box 300019700 RB Groningen, The Netherlands
| | - Ronald L Diercks
- Department of Orthopedic Surgery University of Groningen, University Medical Center Groningen, P.O. Box 300019700 RB Groningen, The Netherlands
| | - Gerbrand J Izaks
- University Center for Geriatric Medicine University of Groningen, University Medical Center Groningen, P.O. Box 300019700 RB Groningen, The Netherlands
| | - Roy Stewart
- Department of Health Sciences, Community and Occupational Medicine University of Groningen, University Medical Center Groningen, P.O. Box 300019700 RB Groningen, The Netherlands
| | - Martin Stevens
- Department of Orthopedic Surgery University of Groningen, University Medical Center Groningen, P.O. Box 300019700 RB Groningen, The Netherlands
| | - Inge H F Reininga
- Department of Surgery-Traumatology University of Groningen, University Medical Center Groningen, P.O. Box 300019700 RB Groningen, The Netherlands
| |
Collapse
|
47
|
Liu CJ, Chang PS, Griffith CF, Hanley SI, Lu Y. The Nexus of Sensory Loss, Cognitive Impairment, and Functional Decline in Older Adults: A Scoping Review. THE GERONTOLOGIST 2021; 62:e457-e467. [PMID: 34131697 DOI: 10.1093/geront/gnab082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The prevalence of cognitive impairment and sensory loss in hearing or vision increases with age. Based on the Information Processing Model, cognitive impairment coupled with sensory loss may exacerbate disability in late life. Yet this issue has not been systematically studied. The purpose of this scoping review was to examine the literature that studied the relationship between cognitive impairment, sensory loss, and activities of daily living in older adults. RESEARCH DESIGN AND METHODS Two reviewers independently screened 1,410 studies identified from five electronic databases (Medline, EMBASE, PsycINFO, CINHAL, and the Web of Science). The search was completed in June 2020. A study was eligible if it included measurements of cognitive function, vision or hearing, and activities of daily living. Additionally, the data analyses must address how cognitive impairment and sensory loss are related to the performance of activities of daily living. RESULTS The final review included 15 studies. Findings show an additive effect of cognitive impairment and sensory loss on the activities of daily living. Cognitive impairment or vision loss independently relates to the decline in activities of daily living. Hearing loss relates to the decline only when the loss is severe, or if the daily task is hearing specific. DISCUSSION AND IMPLICATIONS Older adults with coexisting sensory loss and cognitive impairment have the highest risk or prevalence of disability, comparing to cognitive impairment or sensory loss alone. This finding highlights the importance of developing interventions to reduce the risk of disability for older adults experiencing multiple impairments.
Collapse
Affiliation(s)
- Chiung-Ju Liu
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Pei-Shiun Chang
- Department of Community and Health Systems, Indiana University School of Nursing, Bloomington, Indiana, USA
| | - Cheryl F Griffith
- Academic Affairs, Office of Clinical Education, Indiana University Health, Indianapolis, Indiana, USA
| | - Stephanie I Hanley
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Yvonne Lu
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| |
Collapse
|
48
|
Zhao J, Liu X, Wan L, Gao Y, Huang M, Zha F, Long J, Li D, Nie G, Wang Y. A novel Longshi Scale measured activity of daily living disability in elderly patients affected by neurological diseases: a multi-center cross-sectional study in China. BMC Geriatr 2021; 21:348. [PMID: 34090363 PMCID: PMC8180129 DOI: 10.1186/s12877-021-02296-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/24/2021] [Indexed: 11/22/2022] Open
Abstract
Background Ability in the activities of daily life is often impaired in the older adults with a neurological disease. The Barthel Index is an instrument used worldwide to assess such ability. The Longshi Scale is a picture-based alternative, but its effectiveness has not been evaluated with older adult subjects. This study was to determine whether the Longshi Scale can effectively quantify the ability of older adults in the activities of daily living by comparing its ratings with those using the Barthel Index. Methods A multi-center cross-sectional study was conducted among patients over 65 years. A total of 2438 patients were divided into three groups, including bedridden, domestic, or community group based on their ability to go out of bed, move outdoors, and return indoors. Their ability in the activities of daily living among three groups was evaluated using both the Longshi Scale and the Barthel Index, and the results were compared. Results There was a significant difference in the average Barthel Index scores of three groups classified using the Longshi Scale. The average Longshi Scale scores also showed significant differences between the four groups classified using the Barthel Index. Spearman correlation coefficients showed strong correlation(>0.83) between the Longshi Scale and Barthel Index scores. Conclusions The Longshi Scale can efficiently distinguish the ability in the activities of daily living of people with a neurological disease. Its rating correlate well with those using the Barthel Index.
Collapse
Affiliation(s)
- Jingpu Zhao
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xiangxiang Liu
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Li Wan
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yan Gao
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Meiling Huang
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Fubing Zha
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jianjun Long
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Dongxia Li
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Guohui Nie
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
| | - Yulong Wang
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
| |
Collapse
|
49
|
Gao S, Hou Y, Ma R, Kaudimba KK, Jin L, Wang H, Wang R. A Novel Management Platform Based on Personalized Home Care Pathways for Medicine Management and Rehabilitation of Persons With Parkinson's Disease-Requirements and Implementation Plan of the Care-PD Program. Front Neurol 2021; 12:672208. [PMID: 34113314 PMCID: PMC8186830 DOI: 10.3389/fneur.2021.672208] [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] [Received: 02/25/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
As the percentage of the aging population increases, the incidence of Parkinson's disease (PD) in China is increasing year by year. PD is both a public health and social problem facing the government and society as a whole. Persons with PD need reasonable medication management and rehabilitation strategies after a clear diagnosis. A proper home care plan can effectively slow the progression of PD. However, people with PD lack an effective way to manage their illnesses and cannot achieve the recommended clinical path in a family environment. Medication management, condition monitoring, and rehabilitation training are important components of the home care plan for PD. Persons with PD require strategies that delay the development of the disease and to adhere to treatment, which would contribute to improving their quality of life. Thus, we developed a small program called Care-PD to build a medicine management and service platform for PD. The development of Care-PD is a multi-dimensional model designed for PD, which is funded by the National Key R&D Program of China (No. 2018YFC1314700), and includes services such as medication management, symptom monitoring, professional counseling, home life, and community communication. Care-PD can become a key technology that increases the compliance of persons with PD with home care plans and improve measures to control the disease. In this article, we describe the medication management and services for PD based on the Care-PD program and its structure. The small program will improve the adverse conditions faced by persons with PD by combining the latest technology and clinical approaches. Meanwhile, we describe a verification strategy to evaluate the effectiveness of the Care-PD program as a comprehensive management strategy for PD.
Collapse
Affiliation(s)
- Song Gao
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yuning Hou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Renyan Ma
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | | | - Lingjing Jin
- Department of Neurology, Tongji Hospital, Tongji University, Shanghai, China
| | - Han Wang
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Ru Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
50
|
Sanz B, Arrieta H, Rezola-Pardo C, Fernández-Atutxa A, Garin-Balerdi J, Arizaga N, Rodriguez-Larrad A, Irazusta J. Low serum klotho concentration is associated with worse cognition, psychological components of frailty, dependence, and falls in nursing home residents. Sci Rep 2021; 11:9098. [PMID: 33907242 PMCID: PMC8079365 DOI: 10.1038/s41598-021-88455-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/13/2021] [Indexed: 01/13/2023] Open
Abstract
Serum alpha-klotho (s-klotho) protein has been linked with lifespan, and low concentrations of s-klotho have been associated with worse physical and cognitive outcomes. Although its significance in aging remains unclear, s-klotho has been proposed as a molecular biomarker of frailty and dependence. This study is a secondary analysis of data from a clinical trial performed in a population of 103 older individuals living in 10 nursing homes in Gipuzkoa (Spain). We aimed to elucidate associations between s-klotho (as measured by enzyme-linked immunosorbent assay) and body composition, physical fitness, and cognition, as well as frailty and dependence (determined using validated tests and scales). In addition, we investigated the association of s-klotho concentration with falls in the six months following the initial assessment. Low s-klotho levels were associated with a lower score in the psychological component of the Tilburg Frailty Indicator, a worse score in the Coding Wechsler Adult Intelligence Scale, and a greater dependence in activities of daily living. Moreover, participants with lower s-klotho concentrations suffered more falls during the 6 months after the assessment. Future translational research should aim to validate klotho's putative role as a biomarker that could identify the risk of aging-related adverse events in clinical practice.
Collapse
Affiliation(s)
- Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain.
| | - Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 20014, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Education, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
| | - Ainhoa Fernández-Atutxa
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
| | - Jon Garin-Balerdi
- Caser Residencial Anaka, Fundación Caser, 20301, Irun, Gipuzkoa, Spain
| | - Nagore Arizaga
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
- Intensive Care Unit, Donostia University Hospital, 20014, Donostia, Spain
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
| |
Collapse
|