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Goodarzi F, Khoshravesh S, Ayubi E, Bashirian S, Barati M. Psychosocial determinants of functional independence among older adults: A systematic review and meta-analysis. Health Promot Perspect 2024; 14:32-43. [PMID: 38623346 PMCID: PMC11016145 DOI: 10.34172/hpp.42354] [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: 07/01/2023] [Accepted: 11/11/2023] [Indexed: 04/17/2024] Open
Abstract
Background In current years, the increase in older population has led to creating one of the main public health challenges, worldwide. Because of the special characteristics of older adults, this age group is exposed to possible problems, such as mental and physical disorders, that usually affect their functional independence. The study aimed to determine the psychosocial determinants (e.g., depression, social support, and self-efficacy) affecting functional independence among older population. Methods Our search was conducted on three international databases (Web of Sciences, PubMed/Medline, and Scopus) for all the observational studies (cross-sectional, cohort or longitudinal designs) on the social and psychological determinants of functional independence among older adults. Papers published in English without limitation of time were reviewed from inception to 26 August 2023. The quality assessment tool was the Newcastle-Ottawa Scale (NOS). The I2 index was used to quantify the degree of heterogeneity among the studies. In the case of heterogeneity higher than 50%, the random effects model has been used for overall estimation of the effects; otherwise, the fixed effects model was used. The pooled associations were expressed as odds ratio (OR) and 95% confidence intervals (CIs). Stata version 14 software (StataCorp LP) was used for data analysis. The significance level was considered at 0.05. Results In the initial search, 6978 articles were retrieved, and finally, considering the inclusion criteria, 46 articles were examined. Finally, 18 articles were eligible for meta-analysis. The findings indicated that among all the determinants affecting functional independence among older adults, depression could lead to a 76% increase in functional dependence. Conclusion The findings provide a statistically significant relationship between psychosocial factors and functional independence. Depression was the strongest determinant of functional dependence among older adults.
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Affiliation(s)
- Fataneh Goodarzi
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khoshravesh
- Department of Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Ayubi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Moreira JS, Melo A, Santos R, Sousa ASP. Indicators and Instruments to Assess Components of Disability in Community-Dwelling Older Adults: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:8270. [PMID: 36365968 PMCID: PMC9653663 DOI: 10.3390/s22218270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The epidemiological demands of aging point to the need for characterizing older adults regarding health and disability. This systematic review aims to summarize the indicators (instruments) identifying different components of disability as a result of aging exposition in community-dwelling older adults, considering the International Classification of Functioning, Disability, and Health framework. Taking the PRISMA 2020 recommendations as a reference, studies with community-dwelling older adults, reporting the development and/or age disability modifications were included. Two reviewers analyzed the observational studies searched in the MEDLINE, CINAHL, Web of Science, Scopus, and Embase databases. Of the 137 potentially eligible studies, 49 were included in this review. Several indicators (instruments) demonstrated older adults' disabilities according to the different domains of the ICF. Objective measures assessed Body Structures, Body Functions, and Environmental Factors and included handgrip strength (dynamometry, n = 8), cognitive function (Mini-Mental State examination, n = 7), gait speed (walk test, n = 6), and endurance (Chair stand-test, n = 4). Self-reported measures assessed Activities and Participation, but not the Body Structures, and included the basic and instrumental activities of daily living (ADL) (the Katz Index of ADL, n = 4 studies, the Lawton and Brody Instrumental ADL, n = 4 studies). The summary of the measures gathered can guide researchers and health professionals to select indicators (instruments) to assess and monitor older adults' disabilities resulting from aging exposition, to support the development of new wearables, and to provide improvements to the existing ones, allowing the tailored assessment of different health and disability dimensions.
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Affiliation(s)
- Juliana Santos Moreira
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
| | - Ana Melo
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
| | - Rubim Santos
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physics, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Andreia S. P. Sousa
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
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Yang S, Wang S, Tai P, Jia W, Han K, Liu M, He Y. Central and Peripheral Adiposity Had Different Effect on Disability in Centenarians. Front Endocrinol (Lausanne) 2021; 12:635205. [PMID: 33796073 PMCID: PMC8008817 DOI: 10.3389/fendo.2021.635205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the correlations between waist circumference, body mass index, calf circumference (CC), and waist-calf circumference ratio (WCR) and activities of daily living (ADLs) and instrumental activities of daily living (IADLs) in Hainan centenarians. Patients and Methods A total of 1,002 Hainan centenarians were selected by full sample household survey. ADLs and IADLs were used to investigate the ability of activity and instrumental activity in daily living. The possible non-linear associations were further analyzed using restricted cubic spline. Results After adjusting for demographic characteristics (gender, age, ethnicity, marital status, educational level, and type of residence) and lifestyle (smoking, drinking, and exercise), the odds ratio (OR) of CC (continuous variable) on ADL disability in centenarians was 0.90 (95% CI: 0.85-0.96), while high WCR (continuous variable) was related with high risk of ADL disability (OR=1.73; 95% confidence interval[CI], 1.07-2.80). The ORs of CC and WCR for IADL severe disability were 0.86 (95% CI, 0.82-0.91) and 2.23 (95% CI, 1.52-3.28), respectively. Conclusion Central (WCR) and peripheral (CC) adiposity had different effects on disability (ADL and IADL) in centenarians. Even in centenarians, maintaining muscle mass (with higher calf circumference) and avoiding central obesity are of positive significance for the prevention of ADL/IADL disability.
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Affiliation(s)
- Shanshan Yang
- Department of Disease Control and Prevention, The Medical Center, Chinese PLA General Hospital, Beijing, China
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Penggang Tai
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Wangping Jia
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Ke Han
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Miao Liu
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Yao He
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
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Ikegami ÉM, Souza LA, Tavares DMDS, Rodrigues LR. Functional capacity and physical performance of community-dwelling elderly: a longitudinal study. CIENCIA & SAUDE COLETIVA 2020; 25:1083-1090. [PMID: 32159676 DOI: 10.1590/1413-81232020253.18512018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/23/2018] [Indexed: 11/22/2022] Open
Abstract
This study aimed to verify the occurrence of changes in the functional capacity and physical performance of community-dwelling elderly and its determining factors over a two-year period. This is a quantitative, observational and longitudinal household survey conducted in 2014 and 2016, with the participation of 380 elderly from Uberaba, Minas Gerais. The following instruments were used: The Mini-Mental State Examination and questionnaires with sociodemographic/economic, clinical and life habits data. The functional capacity was evaluated through the Katz Index and Lawton-Brody's scale. Physical performance was verified through the Short Physical Performance Battery. A descriptive, bivariate and linear multiple regression analysis was conducted, with a significance level of α < 0.05. The results showed reduced functional capacity for the instrumental activities of daily living and physical performance in a two-year period. The determining factors for both outcomes were age group, occupational activity, and physical activity. Schooling was a specific factor only for the instrumental activities of daily living, and gender and the number of medicines used, for physical performance.
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Affiliation(s)
- Érica Midori Ikegami
- Centro de Graduação em Enfermagem, Universidade Federal do Triângulo Mineiro. Praça Manoel Terra 330, Centro. 38015-050, Uberaba, MG, Brasil.
| | - Lara Andrade Souza
- Centro de Graduação em Enfermagem, Universidade Federal do Triângulo Mineiro. Praça Manoel Terra 330, Centro. 38015-050, Uberaba, MG, Brasil.
| | - Darlene Mara Dos Santos Tavares
- Centro de Graduação em Enfermagem, Universidade Federal do Triângulo Mineiro. Praça Manoel Terra 330, Centro. 38015-050, Uberaba, MG, Brasil.
| | - Leiner Resende Rodrigues
- Centro de Graduação em Enfermagem, Universidade Federal do Triângulo Mineiro. Praça Manoel Terra 330, Centro. 38015-050, Uberaba, MG, Brasil.
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Lino VTS, Rodrigues NCP, Andrade MKDN, Reis INDC, Lopes LAE, Atie S. Association between visual problems, insufficient emotional support and urinary incontinence with disability in elderly people living in a poor district in Rio de Janeiro, Brazil: A six-year follow-up study. PLoS One 2019; 14:e0217456. [PMID: 31150450 PMCID: PMC6544343 DOI: 10.1371/journal.pone.0217456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 05/13/2019] [Indexed: 11/27/2022] Open
Abstract
Introduction Disability follows the rapid rate of population ageing, imposing a huge burden on society. Functional assessment in older people can identify predictors of disability. Objective Analyze the incidence and the risk factors for disability in activities of daily living (ADL) and instrumental activities of daily living (IADL) in older adults over six years. Methods Six year-follow up study initiated in 2010. The baseline non-probabilistic sample consisted of 180 independent community dwelling individuals aged 60 and over. The procedures comprised an interview with sociodemographic data, questions about falls, urinary incontinence, self-rated health, and assessment of ADL, IADL, mobility, depression, vision, hearing, cognition, nutrition, grip strength and social support. The second research was carried out by telephone and assessed ADL and IADL. Logistic regression models calculated the odds of disability in ADL and IADL according to the age, sex and all other variables. Results At six-year follow-up, 118 participants were still alive (65.6%), 31 died (17%) and other 31 were missed (17%). The incidence of disability to performADL and IADL were 25.4% and 32.3%, respectively. The regression logistic models revealed thaturinary incontinence (OR = 3.2; P = 0.03) and insufficient emotional support (OR = 3.8; P = 0.04) were associated with ADL disability, while visual problems (OR: 2.9; P = 0.03) and insufficient emotional support (OR: 5.6; P = 0.01) were associated with IADL disability. Conclusion The current study has identified that insufficient emotional support, visual problems and urinary incontinence are associated with disability in older adults. The routine assessment of these problems in the primary care clinics enable the implementation of strategies aimed at reducing or postponing disability. Educating patients and families will also enable better choices to reduce the risk of functional decline.
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Affiliation(s)
| | | | | | | | | | - Soraya Atie
- National Public Health School/ Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Vagetti GC, Oliveira VD, Silva MP, Pacífico AB, Costa TRA, Campos WD. Association of body mass index with the functional fitness of elderly women attending a physical activity program. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2017. [DOI: 10.1590/1981-22562017020.160160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to investigate the association between body mass index (BMI) and functional fitness levels linked to the Elderly in Movement Program of the city of Curitiba, in the state of Paraná, Brazil. Methods: The study is characterized as correlational and cross-sectional. The sample consisted of 1,806 elderly female participants of the Elderly in Movement Program. The short version of the IPAQ was used to evaluate participation in physical activities; body weight (kg) and height (m) were measured to calculate BMI (kg/m²), while the motor tests proposed in the Senior Fitness Test were used to evaluate the functional fitness of the elderly women. Descriptive statistics, the chi-squared test and binary logistic regression were used for data analysis. Results: The results showed that 24.0% of the sample exhibited eutrophic nutritional status, 42.9% were overweight and 33.1% were obese. The elderly women classified as overweight and obese had lower functional fitness scores, based on the rating of Rikli and Jones, while the elderly women classified as eutrophic exhibited levels within the normal range. Obese elderly women were more likely to have low scores in the following functional fitness tests: Walk for 6 minutes, Chair Stand, Chair Sit and Reach, Back Scratch and 8-Foot Up and Go. Conclusion: The study indicated an association between, BMI and functional fitness in the elderly women participating in the program, where the majority of elderly women classified as obese exhibited low fitness in all tests.
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